RDNs in Intellectual and Developmental Disabilities
Patricia Novak MPH, RDN – IDD Resource Professional (3/2016)
Where services are provided
Individuals with intellectual and developmental disabilities (IDD) may independently in their own home, with their parents or family, in supportive semi-independent housing or in larger institutional housing. The RDN may be employed in the community directly by a family/client, part of the staff of a group home or community agency, a consultant to group homes or schools or part of a governmental agency or program. The hospital dietitian, regardless if she/he specializes in this area, will also care for individuals with IDD as they are frequently at greater risk for illness and chronic disease.
Typical populations served
The RDN specializing in this population requires an understanding of the etiology, treatment, prognosis and comorbidities associated with people of all ages and backgrounds with some of the following disorders (examples of):
- metabolic disorders (phenyketonuria PKU)
- genetic disorders (Down syndrome or Trisomy 21, Prader Willi Syndrome)
- neurodevelopmental disorders (Autism)
- neuromuscular disorders (cerebral palsy)
- traumatic brain injury
Comorbidities include those found in the general population, such as diabetes and obesity but also include concerns more specific to this population such as sensory or communication impairments. Common comorbidities also include celiac disease, sensory impairments (visual, tactile, processing, etc), motor impairments, dysphasia, communication disorders, mental health and behavioral concerns, seizure disorders, growth impairment and dementia.
Typical work and involvement with other professionals
In order to be successful, the RDN specializing in IDD has a deep toolbox of assessment tools, therapeutic strategies and resources. Effective nutrition intervention in IDD requires the RDN to be flexible. She/he responds not only to the nutrition imperatives of the disorder but also to the person’s cognitive level, social-emotional status, communication abilities, literacy/numeracy and daily living skills. The RDN assesses, treats and supports the individual while also assessing and supporting the caregivers involved with the person. Collaboration is an essential part of the RDN’s professional life. In addition to collaborating with the individual and his/her circle of support, the RDN works with the person’s education, employment and medical teams.
Recommended or required education and experience
Dietitians who specialize in working with individuals with IDD require a unique skill set. In contrast to other clinical specialty areas, IDD does not encompass a single disease state, or manifestations of a single disease state. Rather, IDD encompasses all diagnoses that may “cause significant limitations in both intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills.”
Specialized training is necessary for the dietitian choosing to work with this complex population. The Maternal Child Health training program has two nationally available programs that provide interdisciplinary training; The LEND Graduate Education program and the UCEDD-University Center of Excellence in Developmental Disabilities. (www.aucd.org). Continuing education for the practicing dietitian specializing in this population can be very diverse; it should include training in low literacy education, motivational interviewing, neuromuscular impairments including dysphasia, drug-nutrient interactions, and updates in all associated disorders.
Since there are a vast number of disorders associated with of IDD, what the RDN really needs are resources for locating up-to-date and evidenced based information regarding these diagnoses