Toddler and Preschool Interventions

Question 1

criteria for chronic condition or disability varies from ______

Answer 1

state to state

Question 2

it is estimated that ___ to ___% of children aged 0-5 years have special needs and ___% of children with disabilities have a nutrition problem

Answer 2

5-13.2%
90%

Question 3

____ are a starting point for setting
protein & micronutrient needs

Answer 3

DRIs

Question 4

conditions that have higher energy needs

Answer 4

cystic fibrosis
renal disease
ambulatory children with diplegia
pediatric AIDS
bronchopulmonary dysplasia (BPD)

Question 5

condition that have lower energy needs

Answer 5

down syndrome
spina bifida
non ambulatory children with diplegia
prader - willi syndrome
non ambulatory children with short stature

Question 6

Assessment of ________ should be
first step to determine if intensive nutrition
services are needed

Assessment answers the following:
◦ Is child’s growth on track?
◦ Is child’s nutrient intake adequate?
◦ Are feeding or eating skills appropriate for age?
◦ Does the diagnosis affect nutritional needs?

Answer 6

nutrition status

Question 7

Growth charts specific to some
conditions include:
◦ __________
- Gestation-adjusted age for prematurity
◦ ______________ chart

Answer 7

LBW or VLBW

Special head circumference

Question 8

Special health care needs cause ______
problems in young children combined with
_________ issues for that age

Examples include:
◦ Low interest in eating
◦ Long mealtimes (> 30 minutes)
◦ Preferring liquids over solids
◦ Food refusals
◦ Eating foods preferred by younger children

Answer 8

feeding

typical feeding

Question 9

Mealtime ________ problems & _________ are common in children with behavioral & attention disorders

Behavioral disorders:
◦ Autism Spectrum Disorders (ASD)
◦ Attention deficit hyperactivity disorder (ADHD)

May be suspected in ______ years but
primarily diagnosed in _____ years

Answer 9

behavioral
food refusals

preschool
school

Question 10

Excessive fluid intake
◦ Child would rather drink than eat solid
foods especially when not feeling well

Common in disabilities involving _______
control=>_______________

AAP recommends to limit juice intake to
___ oz./d for ages 1-6

Food safety=> Pureed foods and tubing or
devices for feeding may be ________

Answer 10

neuromuscular
- dysphagia
- chewing problems,
- hypotonia or hypertonia

4-6 oz/day
contaminated

Question 11

FTT is suspected when a child’s growth is the <___ percentile for age and declines more than ____growth percentiles placing him/her near or below the lowest percentile
in wt.-for-age, wt-for-length, &/or BMI-for-age

May result from:
◦ Digestive problems (e.g. celiac disease, GERD)
◦ Pulmonary disorders
◦ Neurological conditions
◦ Pediatric AIDS

Answer 11

<5th %ile
2

Question 12

Recovery from FTT can include catch-up growth which is an _______________

If energy is provided at a _______ than for a typical child of the same age, catch-up growth is likely

Length of time needed for catch-up growth varies but some weight gain should occur within ____

Answer 12

acceleration of growth rate for age
higher level
a few weeks

Question 13

“Toddler diarrhea”
◦ Healthy children with frequent diarrhea
◦ Often caused by ___________________

Other causes of diarrhea: _____________

Answer 13

sucrose & sorbitol content of fruit juices

lactose intolerance
DNI
celiac disease

Question 14

Group of developmental disorders characterized by deficits in communication, social interaction, & behavior

Answer 14

Autism Spectrum Disorders (ASD)

Question 15

ASD are Sensitive to ______ information resulting in rigid, self-restricted range of food choices

Answer 15

sensory

Question 16

Nutrition interventions for ASD may include

Answer 16

◦ Assessment of nutritional intake

◦ Introduction of one new food many times (15-20 times) over one-two month period

◦ MVI with minerals

Question 17

For ASD, No scientifically proven diet is
recommended for prevention or
treatment to improve behavior or GI
symptoms

___________________ diets have
been recommended via Internet and
support groups but not endorsed by
AAP

Answer 17

Gluten-free & casein-free

Question 18

Group of disorders characterized by
impaired muscle activity &
coordination due to damage to the
developing brain

Symptoms are present at _______________

Answer 18

cerebral palsy

birth or
develops during early childhood

Question 19

Severe Cerebral Palsy
◦ ____________: results in difficulty with voluntary muscle control of both the arms & legs

Answer 19

Spastic quadriplegia

Question 20

Nutrition Interventions of cerebral palsy

Answer 20

o Provide foods that are easy to chew with small portions
o Meal pattern to provide small, frequent meals, & snacks to prevent tiredness at meals
o Encouraging weight gain for children with low body fat stores
o Nutrition supplementation if needed

Question 21

Breathing problems can result in:

Answer 21

◦ Increased energy & protein needs
◦ May consume excessive fluid
◦ Weight loss due to frequent illness
◦ Lower interest in eating
◦ Slower growth

Question 22

Chronic respiratory disease that
occurs in premature infants who
received supplemental oxygen or
mechanical ventilation

Answer 22

bronchopulmonary Dysplasia (BPD)

Question 23

bronchopulmonary Dysplasia (BPD) characterized by _____________

Answer 23

◦ Pulmonary inflammation
◦ Impaired growth and development of
the alveoli

Question 24

bronchopulmonary Dysplasia (BPD) etiology (causes)

Answer 24

genetic component
ventilator trauma
vitamin A deficiency
- (needed for alveolar development, surfactant production, and respiratory epithelial cells)

Question 25

long term complications of BPD

Answer 25

more susceptible to infections decreased lung function decreased growth rate and muscle development developmental delays

Question 26

nutritional issues of Bronchopulmonary Dysplasia (BPD)

Answer 26

normal progression of eating skills is disrupted increased energy needs due to increased work of breathing and frequent respiratory infections decreased intake due to fatigue DNI

Question 27

nutrition interventions for BPD

Answer 27

small frequent meals with energy dense foods easy to eat foods for fatigue nutritional supplements id needed (ex: Pedisure)

Question 28

Condition in which partial deletion of chromosome ___ interferes with control of appetite, muscle development, and cognition ?

Answer 28

15 prader willi syndrome

Question 29

features of someone with prader willi syndrome

Answer 29

short stature hypotonia small hand and feet developmental delays and intellectual disabilities hypogonadism

Question 30

prader willi syndrome energy needs of _____ for weight loss, and _____ for weight gain. inpatient weight loss goals are around ____ kcal/day need fewer calories because of ________ increased risk of hyponatremia due to _____

Answer 30

1000 - 1400 600 low muscle tone excessive drinking

Question 31

interventions for prader willi syndrome

Answer 31

small cups and plates spread out food across the plate add low calorie items to plate to make it look fuller increase physical activity

Question 32

True food allergies seen in ___% of children Common food allergies include: ◦ Cow’s milk, peanuts, eggs, wheat, treenuts, soy, crustacean shellfish ◦ Most children eventually outgrow a ____ allergy

Answer 32

2-8 milk

Question 33

MNT for allergies is ____________ Provide education on: ◦ ___________________ ◦ ____________________

Answer 33

complete avoidance of the food ◦ hidden sources of food allergen ◦ substitutions for restricted foods of similar nutritional value

Question 34

early head start program is for _____ head start program is for _____

Answer 34

0-3 3-5

Question 35

Leadership Education in Neurodevelopmental & Related Disabilities (____) Train healthcare professionals, including RDNs, to provide interdisciplinary, family-centered care to children with neurodevelopmental disabilities

Answer 35

LEND