Nutrition
for Children with Special Health Care Needs
Nutrition
530
http://courses.washington.edu/nutr530/
Spring 2005
Room T-359
| Instructor: |
Assistant
Instructor: |
|
Betty Lucas, MPH, RD |
Joan Zerzan, MS, RD, CD |
|
Lecturer, Family and Child Nursing |
Clinical Associate, Pediatrics |
|
Nutritionist, CHDD |
Dietitian, NICU, UWMC |
|
685-1289 |
|
|
blucas@u.washington.edu |
siobhan@u.washington.edu |
Course Objectives:
By the end of the course, students will:
- Be
able to identify common nutritional problems of children with special
health care needs
- Identify
a framework for nutrition screening, assessment, and intervention
- Be
aware of major components of nutritional care for children with a variety
of special needs
- Access
literature to guide provision of nutritional care for children with
special health care needs that is evidence-based
- Be
able to identify medical and community resources for nutritional services
for children with special health care needs
- Prepare
two nutrition case studies for children with special health care needs,
and an evidence-based literature review
Course Requirements
and Grading:
|
1)
Class attendance and participation
|
20 points
|
|
2)
Completion of two in depth case studies with associated
readings and answers to study questions
3)
Presentation of final case study
|
50 points each
10 points
|
|
3)
Evidence based literature review and report
|
50 points
|
|
Total
|
180 points possible
|
Reserve Materials:
The following books
have been placed on reserve at the Health Sciences Library to be used in preparation
of the case studies:
American Academy of Pediatrics.
Pediatric Nutrition Handbook. 5th ed. American Academy of Pediatrics. 2004
Cox JH. Nutrition Manual for At-Risk Infants and Toddlers. Precept Press. 1997.
Groh-Wargo S, Thompson M, Cox JH.
Nutritional Care for High Risk Newborns.
Precept Press. 2000.
Guralnick MJ (ed). Interdisciplinary
Clinical Assessment of Young Children with Developmental Disabilities.
Brookes Publishing Co. 2000.
Kessler DB, Dawson P. Failure
to Thrive and Pediatric Undernutrition - A Transdisciplinary Approach.
Brookes Publishing Co. 1999.
Nardella M, Campo L, Ogata B (eds).
Nutrition Interventions for Children with Special Health Care Needs.
(2nd ed.) Washington State Department of Health. 2002.
Samour PQ, King K. Handbook of Pediatric Nutrition. Aspen Publishers, 1999.
Trahms CM, Pipes PL. Nutrition in Infancy and Childhood. WCB/McGraw-Hill, 1997.
Tsang RC, et al. (eds.).
Nutritional Needs of the Preterm Infant: Scientific Basics and Practical
Guidelines. Williams and Wilkins.
1993.
Walker WA, Watkins JB. Nutrition in Pediatrics: Basic Science and
Clinical Applications. 3rd ed. B.C. Decker. 2003.
Wolf L, Glass R.
Feeding and Swallowing Disorders in Infancy. Therapy Skill Builders, 1992.
A packet of Nutrition
Focus newsletter articles
and other materials for this course are also available on electronic reserves.
Students can access the Ereserves through the UW Libraries catalog.
Search the reserves either by "NUTR 530" or "Lucas."
From there, click on +LIST OF ELECTRONIC RESERVE MATERIALS FOR NUTR 530,"
then click on "Connect to this title online; UW restricted."
At the password screen, enter your UWNet ID. After accepting you will see
the list of folders.
Case Studies
There will be 2 case studies required for the course. All
are available on the Nutr 530 web site http://courses.washington.edu/nutr530/.
The first one is the mid-term and everyone will have the same case study.
The final case study can be chosen from several cases listed.
Students should avoid selecting the same case.
Students will hand in the written questions and answers for
each case study. There will be class discussion for the mid-term. Students
will also do a brief presentation of their second case study for the final.
Evidence Based
Practice Project
1. Review evidence-based practice elements at http://healthlinks.washington.edu/hsl/classes/evidence/ (includes a video and article by Sackett).
2. Develop
a well-built clinical question that could be related to nutritional care for
a hypothetical child with special health care needs. Some possible areas of interest include:
-
Does growth failure in infancy lead to
permanent cognitive impairment?
-
What kind of feedings would best meet the
specific nutritional concerns for the preterm infant after discharge, and
what feedings would not be recommended?
-
What are the effects of steroid medications
on nutritional status?
-
Do former preterm infants experience "catch-up"
growth?
-
How can we best support the mother who
is breastfeeding a child with special health care needs?
-
What is the optimal feeding method for
an infant with cleft lip and or palate?
-
What are the important nutrition-medication
interactions for any of the following conditions: epilepsy, cerebral palsy,
neural tube defects, cancer, HIV/AIDS?
-
What is the best method to wean children
from dependence on gastrostomy tube feedings once there is no longer a physiological
need for such feedings?
-
What affect does chronic illness have on
infant and childhood temperament and what affect does temperament have on
parent-child feeding interactions?
-
How does adolescence impact nutrition and
feeding issues for those who must maintain a special diet, for example Type
1 diabetes, Cystic Fibrosis, Phenylketoneuria?
-
What evidence is there to support vitamin/mineral/amino
acid supplements for children with Down syndrome or autism spectrum disorder?
-
What are the safety and/or efficacy of
herbal supplements for specific diseases or symptoms of children with special
health care needs?
-
What is optimal treatment of aspiration
and gastroesophageal reflux in children with severe neurological problems,
with and without gastrostomy tube placement?
-
What are the benefits and limitations of
specialty growth charts, i.e. Down syndrome, spastic quadriplegia, Turner
Syndrome?
-
What are the indications for use of the
Ketogenic diet for seizures? How effective is it?
-
Should low birth weight infants be fed
formula with long-chain omega-3 fatty acids?
3.
Develop an appropriate Medline (or other) search strategy to find related
articles.
4.
Select 5-8 current articles that address the question. Determine which levels of evidence are provided
by each article:
·
comparison of the advantages and disadvantages of different types of studies
·
levels of evidence - way of categorizing clinical usefulness of published
research in terms of making informed decisions
5.
Evaluate each of the articles using criteria presented from readings and in
class
6.
Prepare a paper with the following components:
·
Clearly stated question (5 points)
·
A brief background statement about why the question is of interest (5 points)
·
Studies: complete reference and short
summary of each article, include category of study design, strengths and weaknesses
of the study design and relevant findings.
Estimate the "level of evidence" provided by each study.
Use current guidelines for evaluation of medical literature and evidence
based practice. Additional useful
web sites are listed below: (15 points)
·
Discussion of your conclusions about the question and the current state of
the evidence about your question. Include evidence based medicine concepts.
(15 points)
7.
Prepare brief annotated bibliography for each student in the class
8.
Present your findings to the class in a 10 minute presentation.
Do not simply go over each study, but present relevant lines of theory
and research and the current state of understanding about each.
Use 2 or 3 concise overheads or up to 10 slides to summarize data or
lines of thinking. (10 points)
Other Evidence Based
Practice Web Sites:
http://www.cochrane.org/
The Cochrane Collaboration
http://www.guideline.gov
National Guideline Clearinghouse
http://www.eatright.org/Member/PolicyInitiatives/83_pgwrk02-03.cfm
ADA Evidence-based Practice Guides (also search for evidence-based practice
at www.eatright.org - members)