Catherine provides nutrition services for adults with intellectual and developmental disabilities (IDD) who live in group homes, host homes, residential care facilities, and with families or caregivers. Developmental disabilities may include mental retardation, autism spectrum disorders, cerebral palsy, Down’s syndrome, spinal bifida, epilepsy, fetal alcohol syndrome, and neurological impairment. Intellectual disabilities may also result from non-developmental causes such as traumatic brain injury or dementia which limits cognitive functioning.

Individuals with IDD are at an increased risk for nutrition-related problems due to functional limitations such as mobility, self-care, receptive and expressive language, learning, and self-direction. Many will not be able to live independently or be financially self-supporting. It is important that persons with IDD have a support system which is designed to improve their level of functioning throughout their lifetimes. Their support system may include a case manager, direct support staff, health care providers, social worker, and/or family members. A person-centered approach is vital putting emphasis on the person rather than the disability. This approach allows the individual to have some input into his care. It emphasizes what is important to the person and provides support to meet their desired goals. Because of this, both the caregivers and when appropriate, the person with IDD should receive nutrition education and instructions on how to manage their diet.

The Registered Dietitian Nutritionist (RDN) plays an important role in identifying nutrition-related problems for the individual with IDD. Eating problems may be the result of neuromuscular dysfunction such as the inability to chew or swallow, tongue thrust, or poor lip closure. Behavioral issues can also affect their nutritional status leading to aspiration, dehydration, and malnutrition. Stealing and pica are common conditions which can lead to toxicity and weight problems. Adults with IDD may also develop secondary conditions related to dietary intake such as overweight and obesity, bowel, and gastrointestinal dysfunction, cardiovascular disease, and nutritional deficiencies. Furthermore, individuals with IDD may be at an increased risk for drug and nutrient interactions precipitated by taking multiple medications to manage their medical conditions. Commonly used medications include anticonvulsants, antipsychotics, stimulants, and medications to treat esophageal reflux disease. The long term use of anticonvulsants can result in bone diseases such as osteopenia or osteoporosis while antipsychotic medications may cause anorexia or appetite stimulation resulting in weight problems.

Residents with IDD who live in group homes, host homes, or medical homes typically live with other residents but it is important to recognize that their nutritional needs may vary. Those who care for these individuals play a crucial role in making sure that each person’s nutritional needs are met based on their age, size, sex, activity level, and medical conditions. The RDN who has completed a nutrition assessment may recommend specific dietary interventions which may include following a special diet, providing assistance at meals, or preparing foods so that they can be swallowed safely. Diet instructions and training classes by the RDN provide opportunities to review dietary goals and answer questions. Research has proven that appropriate and cost effective nutrition interventions can improve the quality of life and produce positive health outcomes for individuals with IDD.

Conditions Common to IDD Population

• Aspiration
• Cardiovascular Disease
• Choking
• Constipation
• Dental Problems
• Depression
• Diabetes
• Diarrhea
• Dysphagia
• Eating Disorders
• Epilepsy
• Galactosemia
• Gastroesophageal Reflux Disease (GERD)
• Gastrointestinal Problems
• Hearing Problems
• Hypertension
• Osteoporosis
• Overweight and Obesity
• Pica
• Rumination
• Self Feeding Difficulty
• Underweight
• Vision Problems

Diets Common to IDD Population

• Anemia
• Calorie Controlled
• Cardiac Care
• Diabetes
• Dysphagia
• Eating Disorders
• Food Allergies
• Galactosemia
• Gastrointestinal Disease
• Heart-Healthy
• High Fiber
• High Calorie
• Lactose Free
• Low Sodium
• Low Fiber
• Osteoporosis
• Phenylketonuria
• Renal
• Weight Management