Chapter 11 - Exam 2

Question 1

Who are Children with Special Health Care Needs?

Answer 1

> 40 dif. formal definitions of disability
est. 5-31% of children classified with disabiltiy
(90% of children with dis. have nutrition problem)

Question 2

Disability Services

Answer 2

toddlers and preschoolers with chronic conditions are eligible for same services as adults
Americans with Disabilities Act
Social Security Disability Program
Supplemental Social Security Insurance Program
additional services (nutritional services)

Question 3

Eligibility for Early Intervention

Answer 3

Services based on;

• developmental delays (cognitive, physical, language/speech, or psychological
• physical or mental condition with high prob. of delay (down syndrome)
• at risk medically or environ. for substantial delay
• specific diagnosis not required*

Question 4

Nutrition Needs of Toddlers/Preschoolers with Chronic Conditions

Answer 4

DRI’s apply as starting point for setting caloric needs (specific adjustments based on condition and customized for each child)
*important to distinguish between intake problems with conditions or just “growing up”

Question 5

Feeding Problems

Answer 5

special health care needs cause feeding problems that add on to typical feeding problems of average toddler/preschooler
ex; low interest in eating, long mealtimes, food refusal, excessive fluid intake

Question 6

Failure to Thrive (FTT)

Answer 6

inadequate wt/ht gain with growth
may result from; digestive problems, asthma/breathing problems, neurological porblems, pediatric AIDS, abuse/medical neglect

Question 7

Cystic Fibrosis

Answer 7

1 in 1,500-2,000 births
life threatening hereditary disorder affecting cells that produce mucus, sweat, saliva, and digestive enzymes
mucus is thick and sticky
symptoms; wheezing/coughing, bulky/greasy stools, bowel blockage, delayed growth
mutation on chromosome 7

Question 8

Cystic Fibrosis: Nutrition

Answer 8

Supplemental high cal nutrition
enteric-coated oral pancreatic
aerobic exercise

Question 9

Pulmonary Problems

Answer 9

ex’s; brochopulmonary dysplasia (damage of underdeveloped lungs), asthma
~80% of ELBW infants develop chronic lung problems

Question 10

Pulmonary Problems: Nutrition

Answer 10

increased nutrient needs due to extra energy expanded in breathing and lower interest in eating

Question 11

Autism Spectrum Disorders

Answer 11

brain development disorder (impaired social skills, restriced/repetitive behavior)
onset generally < 3 yo
~1/166 (~27,000/4 mil)

Question 12

Autism: Diet

Answer 12

no scientifically proven diet is recommended for prevention or treatment
gluten/casein-free diets have been recommended by non-scientific sources (not consistent with clinical trials)

Question 13

Rett Syndrome

Answer 13

1 in 10,000
development normal until 12-18 mo
loss of purposeful hand use, hand wringing, growth retardation, seizures, loss of speech, constipation

Question 14

Muscle Coordination/Cerebral Palsy

Answer 14

2-2.5/1,000 (~40-50% LBW-ELBW)

impaired muscle activity and coordinationduring voluntary movement, present at birth or developed during early childhood

Question 15

Cerebral Palsy: Nutrition

Answer 15

caloric needs may be higher or lower than expected (ex: higher in effort to walk, lower in wheelchair)

Question 16

Prader-Willi Syndrome

Answer 16

1 in 25,000
poor muscle tone and motor skills, short stature, hypogonadism, learning disabilities, behavioral problems (temper/sleep apnea), characteristic facial feature, overweight
failure to thrive in 1st year

Question 17

Prader-Willi Syndrome: Nutrition

Answer 17

heavy on veggies/fruits, breads/rice/pasta, little dairy, and little meats

Question 18

Chronic Conditions with High Energy Needs

Answer 18

cystic fibrosis, renal disease, ambulatory children with diplegia, pediatric AIDS

Question 19

Chronic Conditions with Low Energy Needs

Answer 19

down syndrome, spina bifida, non-ambulatory diplegia, prader-willi syndrome

Question 20

Toddler Diarrhea

Answer 20

“toddler diarrhea” typically caused by execss sucrose content of fruit juices (AAP rec limiting juice intake to 4-6 fl oz/day for 1-6 yo)

Question 21

Celiac Disease

Answer 21

sensitivity to gluten in wheat, rye, barley (oats often x-contaminated)
results in diarrhea

Question 22

Food Allergies

Answer 22

true food allergies seen in ~2-8% of children

common types; milk, eggs, wheat, peanuts, walnuts, soy, fish