Nutritional Disorders Telehealth Network Project
Strategies to increase calories (or other nutrition) are used to stabilize a child’s nutritional status (e.g., improved height to weight ratio) and promote catch up growth. Calories are added by selecting calorie rich food when menu planning and/or adding calories to foods already well accepted by the child (e.g., adding fat). Another strategy is to increase the typical volume of intake by the child at meals.
A primary area to consider for a child who eats too little is the risk of micro and macro nutrition imbalances and/or deficiencies. Our goal is to provide strategies which will correct and/or prevent imbalances through food selection changes or supplements.
Strategies to increase the variety of foods consumed by the child are used to stabilize a child’s nutritional status (e.g., improved micro & macro nutrition). Typically, foods are selected when menu planning for inclusion into the child’s diet. Strategies typically include exposure, appetite manipulation, differential reinforcement techniques, and shaping/chaining of foods (e.g., selection of new/non preferred foods which share characteristics of foods already accepted).
To advise family’s on appropriate dietary intake one must first consider the developmental age of a child and understand the “normal” fluctuations in dietary habits. Often, underweight children have not achieved developmental milestones for eating the full range of foods beyond a developmental age of two or older.
Tracking of dietary intake can offer additional nutrition details to the providers in their treatment of nutrition disorders.
Behavioral management procedures systematically apply positive and negative consequences contingent on specific child behaviors. Behavior management procedures consist of techniques based on learning principles that can be applied to problems to strengthen adaptive behaviors and to weaken maladaptive behaviors. Of particular interest in clinical feeding interventions are 1) aspects of the feeder’s responses that have an inadvertent affects on feeding patterns and 2) planned techniques for “unlearning” or modifying maladaptive feeding patterns by rearranging social and environmental consequences for feeding. Behavior management techniques have been particularly recommended for problems related to food selectivity, mealtime conduct problems, and delays in self-feeding, as opposed to problems with quantity of intake which may be more affected by appetitive variables.