Teamwork is key to new project in South Dakota

Food and Nutrition, July, 1985 by Joanne Widner

Helping children with special needs often requires careful coordination between schools and parents. This is as true in the school lunchroom as it is in the classroom.

In a project now underway in South Dakota, a task force of parents, school lunch supervisors, and health professionals is working on a food service manual that encourages this kind of coordination.

The manual will address some of the specific nutritional needs of children with such problems as cerebral palsy, epilepsy, and autism, as well as overlapping dietary problems that may affect learning and behavior.

The manual is being edited by Dr. Cecilia Rokusek and Dr. Eberhard Heinrichs of the Center for the Developmentally Disabled, which is part of the South Dakota University School of Medicine. It is being produced under contract to the State Department of Education and Cultural Affairs, under the direction of Carol Davis Axtman, South Dakota's director of school food services.

Survey showed need for manual

Two years ago, Axtman and her staff did a survey of South Dakota school food supervisors to see if there was a need for training in this area. The survey showed that most supervisors felt little training had gone on to date, and most had many questions about the proper procedures to follow.

School food service staff were trying to cope the best they could, but with little actual knowledge of nutrition for the developmentally disabled. One institution had a full page of questions. A couple of schools said they were sending children home when they had problems.

Axtman, Rokusek, and Heinrichs feel it's crucial for parents and school food service staff to work closely together. According to Dr. Rokusek, schools see a lot of underweight and overweight extremes among handicapped children. While the lunch program alone isn't the entire solution, it is important.

"It should be a hand-to-hand cooperative effort," Rokusek says. Parents and school personnel must both know what they're doing in order to know when to call on medical prfessionals for further advice and help.

The information in the manual will include instructional guidelines for food service personnel, parents, and health professionals. It will consist of 18 chapters in an 8-1/2- by 11-inch three-ring format so that it can be adapted by other states to their own specific needs. For example, the final chapter will be a South Dakota resource listing that may be eliminated in favor of another state's resource list.

The manual will include information on dietary aids for specific disorders (or what to feed the child, listing several options), and feeding techniques for specific problems.

Some of the specific areas to be covered will be: slow-growing and underweight children, overweight children, special diets for special conditions (such as cerebral palsy, Down's Syndrome, and epilepsy), lack of appetite or excessive appetite, refusal to eat certain foods, abnormal mealtime behavior, and specific physiological difficulties that interfere with eating. Needs of both preschool and school-age children will be included.

"Every effort should be made," says Rokusek, "to understand the feeding abilities and food tolerances of the developmentally disabled person and to produce a widely varied diet within those parameters."

Physicians and nutritionists were recruited from around the state to contribute specific chapters dealing with their fields of expertise.

When editing is complete, the manual will be reviewed and approved by the South Dakota Medical Association's Research and Science Committee and by the Nutrition Education and Training Task Force of the South Dakota Division of Elementary and Secondary Education. Although it will undergo a thorough scientific review, it will be written in generally understood rather than scientific terminology.

Manual will be used widely

Upon publication, the manual will be made available to all of South Dakota's 195 public and 78 private schools, most of which participate in the National School Lunch Program.

It will also be available to other states upon request. The State of Minnesota has already expressed an interest and has initiated a training project for parents, school staff, and developmentally disabled students.

Axtman expects the manual to be used widely. "We're making it part of our certification training," she says, "and we will have a class incorporating the manual as part of the training program, so I would expect it to end up in virtually all of our schools."

For more information on the manual and its development, contact: Carol Axtman Division of Elementary and Secondary Education Richard F. Kneip Building 700 N. Illinois Pierre, South Dakota 57501 Telephone: (605) 773-3413