EARLY IDENTIFICATION AND TREATMENT NECESSARY TO PREVENT MALNUTRITION IN CHILDREN AND ADOLESCENTS WITH SEVERE DISABILITIES

Children with severe developmental disabilities frequently have nutrit ion and growth problems that range from moderate to severe. Because of notable continuing medical concerns and lowered growth expectations, parents and physicians may fail to recognize gradual deterioration in nutritional status before severe medical complications occur. The two cases reported in this article illustrate the need for early identific ation and treatment to prevent the development of notable morbidity se condary to malnutrition. Children and adolescents who have growth para meters consistently below age norms require assessment and monitoring by a registered dietitian to detect feeding problems and intake change s and to provide early intervention to help prevent negative consequen ces (eg, dehydration, protein-energy malnutrition, decubitus ulcers, i ncreased rate and duration of infections, and altered bowel motility). An initial assessment should consist of measurement of length or heig ht, weight, triceps, and subscapular skinfolds; dietary and feeding hi story and a review of medical history; and biochemical testing as indi cated by the medical and dietary histories. Monitoring frequency, whic h is determined by age, severity of condition, and response to treatme nt, may vary from weekly to bimonthly.