Tuesday, May 17, 2005

Teaching nutrition to an adult with special needs

In the process of teaching one of my clients about nutrition, I have been on a search for materials that were easily understandable rather than creating all of my own. This has taken me to nutrition sites, childrens sites, teacher's sites, and on the list is to look for children's coloring pictures as well. I must consider cognitive abilities as well as making the material interesting enough to actually follow.

Of course, all of this required me to think about the process of how we teach people what is good to eat and what constitutes balanced, healthy meals and menu planning (ultimately grocery list planning too). I remember some discussions with my mother, and some with my son, but honestly, the process seemed to work more by example. My mother was knowledgeable about a balanced healthy diet. I did my own additional research, first as a young adult and then as a young wife and again as an over thirty mother of an infant. My son (who will be twenty-one this week!!) has done his own research of healthy food and diets, being concerned with fitness and nutrition from a personal trainer aspect. He credits the food he grew up eating as giving him a head start in figuring out what might be best.

Teaching an independent adult with developmental disabilities, who has a growing understanding of the connection between eating and health, but not what constitutes healthy foods (except for staying away from McDonald's french fries) is a large task. To give an example, on the night which started my realization that we had to fit this sort of instruction into our time together, my client had Doritos and salsa for dinner. As you might imagine, the inner Mom was shocked but only suggested that we work on figuring out better and healthier meals.

In subsequent weeks with a routine checkup following blood-work, her doctor has suggested she eat high protein snacks halfway between meals because they are worried about her low blood sugar and gave her some high protein special drinks to use when there was nothing else available. My client thought perhaps to follow that advice, she could have Jello as her snack between meals or maybe fruit. She is on a saturated fat restricted diet because of cholesterol issues. She buys many things that she never eats, either because she doesn't know how to prepare them or because they are on sale. Another issue is not knowing how much of any food or staple she might need (a few weeks ago, unbeknownst to me, she bought 6 bottles of salad dressing because it was on sale- none opened as yet. Another example of her lack of grasp of how much of anything she might need are the six huge bottles of laundry detergent that she bought also because it was on sale; she does laundry for one). Clearly we have some work to do.

So the first thing was to present the Food Pyramid and the types of foods which needed to be eaten daily. We have talked about that a bit and she has an easy to read chart. Tonight I gave her some sheets with simple pictures of the types of foods in the various food groups. These are intended to be used as cards, to later mix and match to come up with balanced meals and snacks. That will come later. For now, we will take a food group per week (or longer if it seems needed) and learn the types of foods that fall into those categories, always going back to the Food Pyramid to see how many servings per day.

The last time I created "individualized lesson plans" was when I was tutoring Political Science four years ago. This is definitely a bigger challenge.

Some sites worth noting:
USDA: Food and Nutrition Center
USDA Food Guide Pyramid
Nutrition Explorations: Educators - a great little site with materials, suggestions, activities, games and handouts for educators, separated by the age groups to be taught.


clear_darkness said...

I just found this article and I'm trying to help a family friend that I've grown up with. He's quite the pain when trying to get him to eat healthy but I was wondering what kind of meal plans and ideas you were able to portray to your client successfully. As far as he's concerned food is all about corny dogs.
My friend has mild cerebral palsy and mild autism so he doesn't take well to some ideas like nutrition and being healthy. We're having a hard time getting him to get any blood work done of any kind as well.
I was just wondering if you had any resources or advice to offer up.

clear_darkness said...

In regards to someone with mild cerebral palsy and mild autism that thinks that corny dogs are an acceptable food for every meal...what were you able to convince your client to eat? He doesn't grasp certain ideas well and health is one of them. We aren't able to get him to allow blood work to be done because he doesn't understand why he should ever get shots if he's not sick.

I was wondering what your meal plans entailed and if you has any resources or advice to offer up.

Stormwind said...

Oh my goodness. I haven't thought about this in a while. I've moved from providing direct services to coordinating services (at the funding level). However, this continues to be an issue for many of the independent folks on my caseload. With this population, everything really must be individually crafted for their specific levels of cognition.

If he is able to read, or even if he is not, look at the government nutrition sites. There are things that can be downloaded, viewed on or offline, and/or printed. I would suggest that once you have talked about the categories of food (proteins, vegetables, fruits, etc,) you then start working with him to compile a list of foods that he likes that fit each category (even his corny dogs are in both protein and grain categories). Eventually you will have a list of foods/categories and servings and he can choose x number of foods from each category to compile a complete nutritious meal (It could be pictures instead of a list if needed). You could even turn it into a game, which has sometimes worked with different issues for some of the folks on my caseload.

An issue with some folks is their need for strict unvarying routines which often includes a limited variety of foods that they will eat. Coaxing them to try other things can be extremely difficult, but necessary. The longer the routine of eating only one food continues, the more difficult it is to change. For some with Autism, textures are as important as taste. Hopefully this helps some.

Here are some links to some information: Healthy Living or Main Nutrition Project, persons with developmental or intellectual disabilities