Anthropometric nutritional assessment in children with severe neurological impairment and intellectual disability

This chapter discusses the current evidence and best practices of anthropometric measurements in children with severe neurological impairment and intellectual disability, who both have a severe motor impairment and moderate to profound intellectual disability due to congenital or acquired neurological damage. First the target population is described in detail, with regard to the etiology of the disorder, frequent concomitant medical problems and life expectancy. The necessity of regularly measuring the nutritional state is underlined in the light of these children's nutrition-related problems, such as dysphagia and gastro-esophageal reflux, which are potential causes of malnutrition. In contrast, a subgroup of these children is at risk of developing obesity due to tube feeding. An overview of the feasibility of commonly used anthropometric measurements in the target population, such as weight, height and skinfold measurements, is presented and where possible, alternative methods are described, such as the use of segmental measures when accurate measurement of standing height is not possible. Outcome of body composition measurement is interpreted by means of specific equations. An overview of frequently applied and, if available, group-specific norm values and equations for interpretation of the outcome is presented, followed by suggestions for future research needed for further improvement of the reliability and interpretation of anthropometric measurements in these children. Based on the current knowledge, practical recommendations are given for applying anthropometry in children with severe neurological impairment and ID.

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