Nutrition screening for children with special health care needs

Children with special health care needs represent a population at increased risk for poor nutritional status and inadequate nutritional support. Although proper nutrition is critical for the growth and development of all children, these children require careful monitoring and early identification of nutrition problems that may result from physical or developmental disabilities, drug-nutrient interactions, or chronic medical conditions. This study was an evaluation of a statewide nutrition screening and referral effort designed to identify the nutrition needs of young children with disabilities. Analysis of 465 screening forms revealed the most frequently identified feeding concern as intake of less than 16 oz or more than 32 oz of milk or formula. The majority of anthropometric data indicated slowed or impaired growth; however, 17% of the screenings indicated no anthropometric data. Even though 734 feeding concerns were identified, 91% of the completed screening forms either did not make a referral to a nutritionist or had the section blank. Contingency tables and logistic regression, were used to examine the variables on the screening form. Interviews and focus groups, with professionals involved in the screening and referral process, identified several issues for children birth to 3 years of age with special health care needs, including lack of a uniform statewide system of nutrition screening and a lack of referral to appropriate community-based nutrition services for intervention. Results indicated a coordinated follow-up system is necessary to ensure that children identified at nutritional risk will receive nutrition intervention services.