Key areas of responsibility for the nutritionist may include participation in the IFSP process in which the nutritionist may collaborate in the following activities: conducting nutrition assessments (see Table 1 [not available]), developing nutrition care plans, monitoring the child’s nutritional status and reevaluating care plans as needed, initiating contact with other food and nutrition programs (e.g., WIC, primary care) to facilitate collaboration among services that are needed by the child, and providing direct nutrition counseling services as requested by families in the IFSP (Project Chance, 1995; Tluczek & Sondel, 1991).

The responsibilities of the nutrition services provider should be determined by the individual program’s service model. The staffing options for utilizing a nutritionist in an early intervention program depend on the size of the program, the availability of qualified nutrition services providers in an area, and the goals of the program. The model that an early intervention program selects will greatly influence staff responsibilities. For example, a nutritionist who works full time would be a full team member (versus a consultant) in many programs. This usually occurs in a transdisciplinary model. A transdisciplinary model is one in which all members of the team, including parents, come to a consensus on an integrated plan for child and family. The nutritionist’s responsibilities in the transdisciplinary model may include identifying and addressing a client’s needs in several areas (e.g., social, education, speech) in addition to the more traditional responsibilities (screening, assessment, and monitoring the nutritional status of the child). In the transdisciplinary model, the care provider then refers the client to other staff members for more intensive specialty interventions when appropriate. In a consultant or part-time role or in an interdisciplinary team model, the role of the nutritionist may be more focused on nutrition services (Cloud, 1993; Woodruff & Hanson, 1987).

To determine the job responsibilities of a nutritionist, the characteristics of the early intervention program (e.g., type of model, number of children enrolled, scope and depth of nutritional problems, clients’ diagnoses) should be assessed to determine the nutritionist’s role. The nutritionist’s job responsibilities should be flexible, as they may need to be modified as the program changes.

The nutritionist may also participate in the provision of education, training, and support services for parents and staff. This would involve identifying nutrition training needs; conducting parent support groups on feeding concerns for specific groups of children, such as those with Down syndrome, or on broad-scope nutrition issues (e.g., picky toddlers, healthful eating, breast-feeding); and conducting staff in-service sessions on growth, nutrition, and feeding. The nutritionist may also develop a system of referral and follow-up, which identifies community nutrition services providers; establishes communication with them; refers clients for follow-up; and provides to staff, parents, and community services providers education and training on nutritional needs of children who have special needs (Baer, Blyler, Cloud, & McCamman, 1991).

The nutritionist who works in early intervention must have the proper credentials, training, work experience, and educational skills. Part C specifies that nutrition services be provided by qualified staff. The nutrition services provider should be a registered dietitian (R.D.) of the American Dietetic Association (preferred) or a nutritionist who is not an R.D. but who has a master’s degree in public health or nutrition. In addition to the appropriate degree, the early intervention nutritionist should have training and/or work experience in pediatrics and in the following areas: developmental delays, working in community settings with families of young children (birth to 3), work experience as a member of a team, and training and experience in early intervention. Also, knowledge of the following areas would enhance the nutritionist’s effectiveness: early childhood development; preschool nutrition education; federal, state, and community food assistance programs; and consumer nutrition issues (Bayerl & Ries, 1995).


References

Baer, M.T., Blyler, E., Cloud, H., & McCamman, S. (1991). Providing early intervention services: Preparation of dietitians, nutritionists, and other team members. Infants and Young Children, 3(4), 56–66.

Bayerl, C.T., & Ries, J.D. (1995). EARLY START: Nutrition services in early intervention programs [Training manual]. Worcester, MA: Area Health Education Center.

Cloud, H. (1993). Feeding problems of the child with special health care needs. In S.W. Ekvall (Ed.), Pediatric nutrition in chronic diseases and developmental disorders: Prevention, assessment and treatment (pp. 203–217). New York: Oxford University Press.

Project CHANCE. (1995). A guide to feeding young children with special needs. Phoenix: Arizona Department of Health.

Tluczek, A., & Sondel, S. (Eds.). (1991). Project SPOON (Specialized Program of Oral Nutrition for Children with Special Needs). Madison: University of Wisconsin.

Woodruff, G., & Hanson, C. (1987). Project KAL. Brighton, MA: Project KAL.