1. Position Paper 8: Providing Nutrition Services for Infants, Children, and Adults with Developmental Disabilities and Special Health Care Needs Group 8: Best of Times Hokies Ashley Holmes, Nikki Houck, Amy McMahon, Gabrielle Willis November 13, 2008

2. Objectives -ADA Position Statement -ADA Position Statement -Defining of population -Defining of population -Selected conditions -Selected conditions -Nutritional risk factors -Nutritional risk factors -Recommendations for -Recommendations for Dietitians Dietitians -Legislation -Legislation - Critique - Critique

3. Position of ADA “It is the position of the American Dietetic Association that nutrition services are essential components of comprehensive care for infants, children, and adults with development disabilities and special health care” Nutrition care should be continuous. Service should include a variety of methods. Special health complications and Risk Factors. Legislation is an evolutionary Process.

4. Population May or may not be associated with a diagnosed condition May or may not be associated with a diagnosed condition Includes people who require ongoing coordinated services/support Includes people who require ongoing coordinated services/support 3 to 4 million Americans in 2004 3 to 4 million Americans in 2004 Increased nutritional risk Increased nutritional risk www.flickr.com/photos

5. Selected Conditions Cerebral palsy Cerebral palsy Down syndrome Down syndrome Prader-Willi syndrome Prader-Willi syndrome Autism Autism Cystic Fibrosis Cystic Fibrosis Spina bifida Spina bifida http://www.blaenau-gwent.gov.uk/images/Images_Children/Children_With_Disabilities.jpg

6. Nutritional Risk Factors Overweight/obesity Overweight/obesity Prevalent in people with Down Syndrome Prevalent in people with Down Syndrome Medication-Nutrient Interaction Medication-Nutrient Interaction Anticonvulsants, psychotropics, Tricyclic antidepressants ect. Anticonvulsants, psychotropics, Tricyclic antidepressants ect. Energy Needs Energy Needs Differ depending on disability Differ depending on disability Oral Motor/ Feeding Issues Oral Motor/ Feeding Issues Self-feeding skills, swallowing function Self-feeding skills, swallowing function

7. Dietitian’s Role as an Agent of Change Support Attain ProvideImplement Address Advocate

8. Legislation: Transition from Institutions to Home and Community-based services Major Contributors: Major Contributors: -Developmental Disabilities Assistance Act (1963) -Individuals with Disabilities Education Act (1975) -Americans with Disabilities Act (1990) -Head Start (1965) -The Child Nutrition Act (1996) -Special Supplementation Nutrition Program for Women, Infants, and Children WIC (1972) for Women, Infants, and Children WIC (1972) -National School Lunch Program -Children’s Health Insurance Program (1997) As result of advocacy from parent and professional organizations

9. Critiques Pros Pros Cons Written for multiple healthcare professionals Written for multiple healthcare professionals Significant Legislative Information Significant Legislative Information Detailed Overview of Target Population Detailed Overview of Target Population Difficult to read Difficult to read The content did not correspond with the title or position of the paper The content did not correspond with the title or position of the paper Focus more on how nutrition services benefits the target population Focus more on how nutrition services benefits the target population