Recognizing Nutrition Needs of "Extra"ordinary Kids.


With the release of the movie “Wonder,” which is based on a book where the main character has Treacher Collins Syndrome, people are becoming aware of being inclusive of others no matter their ability or appearance. This is an issue that needs to be discussed in our society.  One of the things to keep in mind is that children with these “extra”ordinary needs have unique nutrition needs.  This is mentioned in the book “Wonder” as the main character has trouble chewing.  As a pediatric dietitian I have spent my career working with these “extra”ordinary children and their families and I wanted to write something that educates others on some of their specific nutrition needs.

Nutrition needs of “extra”ordinary children:                                                      

  • Some of these children may drink from a bottle or sippy cup much longer than other children their age. The reason for this is that their parents have likely worked with a medical team that includes a therapist to find the safest way for their child to receive hydration. Oral skills may be delayed and that is why their transition to other cups may not be the same as their peers.

  • Depending upon the child’s ability to chew or swallow some of these children may be dependent upon tube feedings. Tube feedings are provided to allow the child to receive adequate nutrition because either it is not safe for the child to swallow or the child may get tired when eating, making it difficult to take all the calories they need to grow.

  • Puree foods may be given longer than infancy if an “extra”ordinary child has trouble with their chewing skills. This can allow a child to still receive nutrition by mouth without having to chew if that is something that is difficult for the child. It does not mean that the child cannot chew it means that they may not be efficient enough to take in all of their calories with highly textured food.

  • Meals may take a longer since they may not be able to chew as quickly or efficiently as other children. This may mean that “extra”ordinary kids will be allowed to have more time to eat at school.

  • “Extra” ordinary children may also have sensory issues and these sensory issues may affect the types of foods that they accept and/or their meal time routine. If a child is overwhelmed by a lot of noise they may not be able to eat. If they have sensitivities to textures they may not be able to eat certain foods or overly prefer others. For example, they may prefer foods with crunchy textures because they like the sensory input it gives them.

  • Someone outside of the child’s life may think parents are feeding “extra”ordinary kids items that may not seem “healthy”. These items could include cheese puffs, veggie straws, or certain types of crackers. Sometimes these items are suggested to children that have difficulty chewing because a child can take a bite and then it can easily dissolve in their mouth, which allows them to get used to textures. This is likely something that parents may be giving for therapeutic reasons under direction of a feeding therapist.

I encourage all of you to either see the movie “Wonder” or read the book. Please remember these unique nutrition needs of “extra” ordinary children as we move to be a society that is more inclusive of all. If interested in receiving more information about the nutrition needs of children with special health care needs please sign up here.

*In the photograph there are two books other than "Wonder" pictured.  "Out of my mind" is by Sharon Draper and is about a girl who travels in a wheelchair and is unable to communicate until she gets a special communication device and then the world around her discovers how smart she really is.  "Ugly" is a memoir by Robert Hoge and it is his story of growing up with a face that looked different from others.  My 11-year-old has read all of these books and loved them.