Tobi Page, MS, RD June 3, 2013 University of Washington LEND Faculty Mentor: Sharon Feucht

Prevalence of Autism Spectrum Disorder Autism Spectrum Disorder Autism now affects about 1 in 88 children in the US (CDC, 2013) About 1 in 88 children has been identified with an autism spectrum disorder (ASD) according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network. ASDs are reported to occur in all racial, ethnic, and socioeconomic groups. ASDs are almost 5 times more common among boys (1 in 54) than among girls (1 in 252). (CDC, 2013)

Needs Assessment Parents and Behavior Therapists may have limited education on proper nutrition for children with special needs. Behavior Therapists do not receive any education on proper nutrition, they are trained to remediate behavior problems associated with eating and increase healthy behavior patterns Evidence-based Sources available Learner-centered, culturally competent This tutorial was made using learner-centered teaching methods Access prior knowledge Give new information Prompt into action

Sections of the Tutorial 1. Explore difficulties and problems around feeding and nutrition 2. Holistic View and Socio-ecological Model 3. Mealtime goals and behaviors (tips) 4. Nutrition (recommendations and concerns) 5. Independent Eating (steps) 6. Enhancing Nutrition (supplementation) 7. Special Diets (GFCF, Specific CHO, FODMAPs, Vegetarian) 8. ABA Therapy

(Adapted from Greis, 2010) A Holistic Approach to Specific Needs of ASD Consider your child s strengths in the diagram above, these are the areas that are used to teach new behaviors. Consider areas that cause your child difficulty, these are the areas to focus attention for development.

Communication Skills How does your child tell you what they want? Sign language is often used to help children communicate in a non-verbal way. Commonly used signs include: More (pictured) Please I m Done Teaching your child to point to things they want can help her communicate her choices.

Assessment #3 Mealtime Consider you family s mealtime routine. What can be adjusted to help your child enjoy mealtime more? Consider what stage your child is at with certain foods. He may be at several different stages with different foods at one time. What foods are a priority to progress with first? Consider what experiences your child has with food outside of mealtime as well as during mealtimes. Are there activities that may be enjoyable to your child while giving him another experience with a new food?

Nutrients of Concern ChooseMyPlate.gov Grains: fiber, iron(fortified) Protein: protein, iron Vegetables: insoluble fiber, vitamin A, vitamin C Fruit: soluble fiber, vitamin A, vitamin C Dairy: calcium, vitamin D If your child eats limited volume or variety, he may be at risk for nutrient deficiency. (Van Ripper, 2010)

Assessment #4 Nutrition Consider MyPlate and recommended amounts from each food group. Are all groups represented? Is volume or variety low in one or more food groups? What nutrients could be lacking in your child s diet? Consider your child s age and size. As the growth charts indicate, children grow at different rates throughout childhood. Around age two there is a considerable slowdown in growth, which may affect appetite and intake. Children who are smaller will eat less than children who are larger. Are the portions that are offered to your child appropriate?

Moving toward independent eating To promote oral motor development: Practice good oral hygiene; decreases sensitivity and problems with teeth and gums Work with a professional feeding therapist e.g., Speech Language Pathologist, Occupational Therapist, or Behavior Therapist Encourage jaw movements by modeling or by using a hand to gently move your child s jaw up and down, side to side Place a small piece of food on one side of your child s mouth and encourage him to move it to the other side Put a bit of nut butter in the corners of your child s mouth and let her lick it off Give your child ice cream on a cone or popsicles to lick

Format Person-centered Culturally competent Evidence-based User-friendly Allows participants to reflect on their prior knowledge of their child and their situation, then new information is given, then reflection questions are asked which prompt the viewer to action.

Structure Currently Microsoft PowerPoint, CD or Web-based??? Companion worksheet- assessment questions with space to write answers. Project limitations Literacy level is above 8 th grade English language Next Steps Pilot with parents with children with an ASD Pilot with ABA Therapists who work with these children

Thank you! Thank you to Building Bridges for welcoming me into their school, to the therapists and teachers who took their time to teach me about ABA therapy, and to the children who were so sweet to play with me. Thank you to the LEND program for giving me the opportunity to learn more about this special group of children and give some thing back to them that has the potential to have a positive lifetime impact.

Questions????