Nutrition Services for Individuals with Intellectual and Developmental Disabilities and Special Health Care Needs

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Intellectual and developmental disability (IDD) affects about 1-3% of adults and children in the United States. Intellectual function and adaptive behavior will be limited which affects many aspects of daily life such as self-care, mobility, self-direction, and learning and language skills. Children and youth with special health care needs (CYSHCN) require special health service as a result of increase risk of emotional, behavioral, physical or developmental conditions. It was estimated that during the year of 2009-2010, there was 11.2 million children under this category.

Prevention and early treatment is essential in reducing the high cost of health care services that results from several chronic conditions that IDD and CYSHCN individuals may develop over their life span such as obesity, diabetes mellitus and hypertension. Many of these conditions are nutrition-related, therefore, the role of the RDN and the NDTR as part of the comprehensive care process is considered vital. 

The followings are nutrition-related issues that RDNs need to pay attention to when assessing individuals with IDD or CYSHCN:

  • ·      Oral health care: problems may include gingivitis, periodontitis, and caries. The type of diet/texture will be affected.
  • ·      Mealtime assistance: cooperation with the speech language pathologists and occupational therapists is important so that he RDN can estimate the best feeding plan (oral or enteral) for the patient according to the level of assistant he/she needs.
  • ·      Dysphagia: monitor signs and symptoms of dysphagia (food refusal, frequent vomiting, respiratory distress as a meal progresses, frequent gagging and/or coughing…), in addition to weight record/growth records for significant weight change.
  • ·      Enteral feedings: RDN will use enteral feeding when it is not possible to maintain optimum nutrition and hydration status through oral intake.


By working closely with the interdisciplinary team and the caregiver, the RDNs and the NDTRs will be able to assess the special needs of each of the IDD and CYSHCN individuals. Also, they will be able to provide individualized nutrition care plan. This will have impact on the development and growth of this population and will help to treat/reduce further complication of the nutrition-related health condition.


 A.K.B



Ptomey, L. T., & Wittenbrook, W. (2015). Position of the Academy of Nutrition and Dietetics: Nutrition Services for Individuals with Intellectual and Developmental Disabilities and Special Health Care Needs. Journal of the Academy of Nutrition and Dietetics, 115(4), 593-608.

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