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Why nutritional guidelines are needed for people with learning disabilitiesThere is considerable evidence that people with learning disabilities are more likely than those in the general population to have nutritionally-related ill health, and that this is less recognized by support staff and professionals than it is when it occurs in the general populationPeople with learning disabilities frequently live in more challenging circumstances, and may be socially excluded, all factors which may contribute to poorer eating patterns.There is a (2004 Scottish) study that suggests that people with a learning disability have a 58% higher chance of dying before they are 50 years old compared to the general population.Most of the causes are attributed to complications of their diagnoses, such as: respiratory diseases (such as pneumonia) exacerbated by swallowing difficulties, aspiration of food, posture, feeding difficulties and Reflux congenital heart disease, cerebral palsy, more limited mobilityresidence status in a hospital However researchers also found that poor nutritional status throughout life contributes to a reduced lifespan for this population. There is insufficient attention paid to the health needs of people with learning disabilities, a lack of basic health promotion, insufficient support to achieve a healthy lifestyle and under identification of particular health conditions all of which require specific action. __________++++++++++++_____________REFERENCES:5 NHS Health Scotland (2004) Health Needs Assessment Report: People with Learning Disabilities in Scotland. Glasgow: NHS HealthScotland6 Stewart L (2003) Development of the nutrition and swallowing checklist: a screening tool for nutrition risk and swallowing risk in people with intellectual disability. Journal of Intellectual and Developmental Disability; 28: 117-1877 Hollins S, Attard MT, Von Fraunhofer N et al (1998) Mortality in people with learning disability: risks, causes, and death certification findings in London. Developmental Medicine and Child Neurology; 40 (1): 50-56
For people with learning disabilities who may have sensorydisabilities, using cues to stimulate appetite may beparticularly important. The smell of food being prepared,the sound of food preparation and service, and the sight oflaid tables may help to orientate people to the mealtimeahead. Maintaining independence ineatingIt is generally agreed that help with eating, while sometimes essential, can lead to a loss of self-esteem and a sense of powerlessness and dependency.1Those who areable to eat independently, even if this is by hand only ,should be encouraged to do so to maximize independence and dignity. If independent eating skills are notencouraged, there may be a rapid decline to dependence.The use of finger foods can help people to maintain andrecover eating skills and has the advantage of boosting self esteem and independence as well as allowing people to eatat their own pace.1 BETTER STUFF HERE – HANDY TIPSSome very simple ideas which don’t cost a lot of time or money are the most helpful to making a kitchen and cooking more accessible. Before sitting down, gather all of the items that you need to cook on a wheeled cart. Store pull-out boards and other items in lower cabinets and areas that can easily be reached while sitting down.A lazy susan at the back of a counter or in a cabinet can be reached more easily.A rack can hold a cookbook for convenient reading. Use light, unbreakable dishes and kitchen utensils. Line the sink or a wheeled cart with a rubber matting to protect dishes and utensils from breaking when dropped.Sit down while you work. Select a comfortable chair that gives you back support. You may want arm rests to support your arms. A footstool or footrest can help not only ease stress on your legs but also serve as a more stable area on which to work. A chair may be lifted by leg extenders making it less stressful on hips and knees when you get up or down. When sitting, putting a large cutting board in the lap can give a solid work space that is easier to reach than a counter.Before you buy anything, consult with an occupational therapist. He or she can make suggestions about what types of devices might help you.Making eating easierSomething usually taken for granted - using a plate, mug or piece of silverware - can be especially hard for people with certain conditions. These include arthritis, tremors, limited range of motion, poor coordination and limited ability to grasp objects. But there are products that can take a lot of the aggravation out of sitting down to a meal. They include:Knives, forks and spoons that swivel. These help those with trouble moving their wrists, arms or fingers.Extension spoons for people with limited range of motion.Utensils that bend to the right or the left.Rocker knives for people who cannot use both hands.Automatic feeding devices for people who cannot hold utensils. These are controlled by chin, hand or foot switches.Utensils that can be attached to the palm of the hand and assist people with poor finger grip.Curved dishes that help guide food onto utensils.Non-slip dishes that help push food onto utensils.Cups with two handles for people who have trouble grasping objects.Regular pizza cutters that can be sharpened and used to cut food.Making cooking easierSomething as simple as taking a pot off the burner can be a real chore for people with special needs. These gadgets can help make cooking less complicated.Clip-on handles that help grip pots.Pizza-shop shovels for taking pans from the oven.Heat-proof wheelchair lapboards for transporting food from oven to table.Wire frames with suction cups that attach to the stove. These steady pots during stirring.Tipping platforms for teapots. These allow users to tilt the pot and fill a mug without picking up the teapot.Getting around the kitchenThe kitchen can be an uninviting place if you have a disability. But these tools can help make your kitchen less intimidating:Reachers. These devices have long handles with grips at the end that can help you grab out-of-reach items.Lazy susans or roll-out shelf trays. Installing these in cabinets permits easier access to stored items.Adjustable stools. These let the user remain seated while working in the kitchen.Wall racks. Pots, pans and other frequently-used objects can be placed on these racks for easy access.
[Molly: make sure the puff pastry is in the toaster oven]
Designed with a twist in the shaft that allows utensil to be easily hand bent to either side at any angle. For people with upper extremity weakness or reduced range of motion. These stainless steel utensils feature built-up handles for people with arthritis, weak grasps or other hand limitations. Their contoured shape makes them easier to hold and useT-shapedutensils:Innovative new handle design enables people with even the weakest grips to eat independently. Use an overhand or underhand grip, and then bend the utensil head left or right for a customized fit.Food Plate Bumper:Prevents spills and is easy to attach. Ideal for people who want to use conventional tableware, but have difficulty getting food onto utensils. Also practical for those who tend to push food off the plate because of a lack of coordination.Neater Eater
Also talk about all of the kitchen gadgets that can be modified for safety - The slicing guide is a functional cutting aid which simplifies kitchen work by standing firmly and holding in place whatever is to be cut. By turning the transverse lath, the thickness of the slices is easily changed. The knife fits in the guides, so users with tremor or impaired sight can cut straight – and safely.Practical aids to eating anddrinkingThere are a number of helpful aids to eating that somepeople with learning disabilities may find useful for feedingthemselves, or which family, friends and support staff canuse to help people to eat and drink more effectively.Occupational therapists can advise on suitable aids whichmight include the following.• Different shaped cups, with one or two handles, ofdifferent weights, materials, transparencies and designs.Cups should not shatter or break if they are bitten.• A transparent cup can be helpful when helping someoneto drink so the carer can see how much liquid is taken.• Cutlery of differing shapes, sizes, depths and materials.Cutlery should not shatter if it is bitten. Solid plastic cutleryor plastic-coated metal might be better for people whohave a bite reflex when cutlery is placed in their mouth.Shorter-handled cutlery is easier to manage and handgripsa utensil.• Plates and bowls which do not slip, have higher sides toprevent spillage, or which are angled to make access tofood easier.• Insulated crockery which keeps food hot if mealtimes arelengthy.• Non-slip mats which support crockery.• Straws which can help those with a weaker suck or whichhave different widths.• Automated eating systems such as Neater Eater whichallow people to feed themselves even when movement isvery limited.
Behavior Tracker Pro is an iPhone/Ipod Touch application that allows BCBAs, behavioral therapists, aides, teachers or parents to track behaviors and graph them. The application was specifically designed to support the behavioral treatment plans for children with Autism however it can be used to track behavior in any field.Proloquo2Go™ is a product from AssistiveWare that provides a communication solution for people who have difficulty speaking. It brings natural sounding text-to-speech voices, close to 8000 up-to-date symbols, powerful automatic conjugations, a large default vocabulary, full expandability and extreme ease of use to the iPhone, iPod touch and iPad.Sometimes, due to their sensory issues, getting a child with Aspergers to eat can make you want to pull your hair out. One day they will eat something, and the next day they scream when it comes near their mouth … not to mention your fears as a mother or father that your child is not getting adequate nutrition. One possible issue is the upset over food touching other food. This can be easily remedied by using divided plates that do not allow contact between areas and therefore, the food remains separated.Visual Scheduler from Able Link – mobile device and software application that can
Talking Tins Recordable Labels - These devices allow you to record your own message to identify container contents and any special instructions. Record a new message when you wish to identify a new container. Kit includes 3 magnetic devices which adhere to any canned products, plus 1 cloth fastener and 1 metal adapter to use with non-metal products, such as plastic bottles.Push Puller - This handy kitchen aid allows you to safely pull out your oven rack without getting your hands near the hot oven. Magnet on the back allows for easy storage on your fridge.One handed kitchen set - These specially selected products help anyone who functions with the use of only one hand. The kit includes a Rocker Knife,a Zim Jar and Bottle Opener (3086), a Hi-D Paring Board (3099), and an EZ Squeeze One-Handed Can Opener (9205-78). Latex free.Suction cup plateBowl Holder with Bowl.For the individual with use of only one hand. Plated metal frame holds a stainless-steel bowl while mixing. To pour, lift the bowl from the frame by its large sturdy handle and pour manually. For scraping, the bowl can be lowered into the slots in a pour position. Frame has rubber feet. Sorry, other bowls will not fit in frame. Three-quart capacity. Folding Pan Holder.Keeps the pan from turning when cooking on stove. One leg folds in for easy storage in the kitchen drawer. Sturdy plated steel with rubber suction cup feet. Holds 2 quart pan and is adjustable.
The biggest obstacles to designing anaccessible kitchen are access to sinks, cabinets, countertops and appliances which are usually not usable for people who are sitting or in a wheelchair.The Oxo container with zip ties as the “handle”, crock pots, electric griddles, rice cookers, the blender that heats to soup, smoothie blenders that blend right into the travel mug so no pouring needed. self-stirring pots that can sauté, sear, braise, boil or simmer while automatically stirring ingredients; motion-activated soap dispensers that dispense soap with a wave of the hand (Simple Human); motorized wall cabinets that lower to the front edge of the countertop (Granberg Interior AB); or a blender that cooks soup (Cuisinart).Here are some other solutions: One-Handed Rolling PinUsing a rolling pin one-handed is tricky at best. You can make your own one-handed rolling pins relatively easily.Using SteamersUse a "Marguerite" (steamer) to cook vegetables. Most steamers are easier to lift than the whole pot, especially if the pot is full of water.Measuring CupsUse exact sizes measuring cups instead of the multi-purpose measuring jugs.Pot HoldersIf your pot only has one handle, you can use a camping pot holder to lift pots with both the pot handle and the camping handle.Mirrors to See in PotsIf you are a wheelchair user, you can use a shaving mirror with goose neck angled above the stove in order to see in the pots on the stove.Multiple Cutting BoardsKeep several cutting boards. It may be easier to change cutting boards than clean one up while in the middle of cooking a meal.Tap ExtensionsInstall a hose attachment on your faucet to fill pots directly on the counter rather than to have to lift a full pot out of the sink.Pull-Out ShelvesIt can be difficult to reach the back of shelves. Installing pull-out shelves for your cupboards will make it easier for you to reach areas that may be otherwise difficult to reach. Plastic Cups for Stored IngredientsGet plastic measuring cups that you keep in your dry ingredients containers. Electric Can OpenersYou may find a hand held electric can opener easier to use than one that resides on the counter top. Pot StabiliserUse a pot stabilizer if you’re cooking on the stove. It will hold the handle steady so you don’t get the content of your pot in your lap when you stir.Rubber MatsYou can find non-skid rubber mats or double-sided suction cups to place under bowls or cutting boards to prevent them from sliding around when you use them.
Cook It Allergy Free- In this app, recipes are organized by allergy type, ranging from gluten free to nut, dairy to egg. Each dish offers tips to accommodate additional allergies. With its easily navigable layout, you'll be making egg- and gluten-free blueberry pancakes in no time.$6.99Substitutions for iPad - Substitutions is a very straightforward app. This is good because when we're halfway through a recipe and panicked about finding a sub for yogurt, the last thing we want to do is click through dozens of pages to find the information we're looking for.”$1.99How to Cook Everything - Not only are all 2,000 recipes of the original cookbook available, but the iPad app includes features such as a tutorial section, a notes tab, and voiceovers from Mark Bittman himself.The Photo Cookbook-iPad users love the simplicity, gorgeous photos, and comprehensive ingredient information contained in The Photo Cookbook, according to developer Michael Ditter. Since the app’s release, features have expanded to include the ability to make notes and mark favorite recipes, as well as new language versions for a wider audience. In fact, the wide popularity of The Photo Cookbook in the Apple store "influenced [many customers’] decision to buy an iPad," recounts Ditter.Paprika - Paprika is the go-to recipe manager for many, allowing cooks to search for recipes online and then organize them into customizable categories. Says Christina Meranda, co-creator of the app, "[With Paprika] you don't have to page through a binder to find what you want. You can organize more efficiently, search more fully; it's just a convenience factor, really." The app also seamlessly syncs the content between different devices, so that you can search for recipes on your Mac, shop for ingredients on your iPhone, and cook the recipes on your iPad.Read more: http://www.thedailymeal.com/10-best-ipad-cooking-apps-slideshow#ixzz1n5Cpz5yJEpicurious for the iPad contains more than 30,000 recipes, interactive shopping lists, and weekly updates from the editors and magazine partners at Gourmet and Bon Appétit.If you're the type of person who learns by doing (or if you're just a complete cooking novice) CookingCapsules is the next best thing to making the recipe yourself. Each recipe is accompanied by a how-to video that walks you through each step. Recipes come in collections. Your first collection is free, additional ones cost 99 cents each. Available on Android only. http://www.ablelinktech.com/index.php?id=35 Visual Assistant on windows based devices
Cooking With AT 2012
Cooking with AT Molly Ridout, AT Specialist firstname.lastname@example.org 907-563-2599 www.atlaak.org
Who is ATLA?Grant ActivitiesFederal Tech Act Project• Information & Awareness• Demonstrations• General AT Presentations (small or large group)• Short Term Loans• Reutilization of equipment
Feature Matching ATLA can assist by finding thebest AT solution to overcome barriers Try-Before-You-Buy short term loans trial software demonstration areas research and resources
What’s the next step? Servicing the state beyond the grant…
Who is ATLA?Nongrant ActivitiesFee Services• Device and software reseller• AT training on a variety of custom topics• AT assessments
Where is ATLA? Available throughout Alaska • Demonstration Centers • Virtual Help Desk SystemBasecamp • Webinars3330 Arctic Blvd., Suite 101Anchorage, AK 99503 • Resources
Who can ATLA help? Qualifying Criteria Be in Alaska Need assistive technology Be aliveCommunity Living Education Employment IT / Telecom
ATLA does not… Fix, maintain, or train general computer needs Provide funding Bill medicaid / medicare Therapeautic evaluationsoccupational, physical, speech Durable medical needs(wheelchairs, walkers, vehicle modifications, vents, etc..)
ATLA AT areas• Augmentative & Alternative Communication• Computer Access• Deaf & Hard of Hearing Aids• Environmental Controls• Learning & Cognitive Supports• Vision Impairment Aids
AT Assessment PrinciplesAssistive technology• is a process not a product Technology itself is not the goal…• is a team process The individual’s• is a system of devices and participation in services their chosen activities is the• requires new skills goal.• is a step towards independence
Cooking With AT Why present on cooking when we have so many other services to provide? HELLOOOOOO. Food is good. And it’s kind of a big deal.NutritionSocialEmotional
Impact of some disabilities on eating & drinking • Lack of understanding about then need for a balanced diet • Physical and dental health problems and difficulties with eating, chewing or swallowing • Lack of experienced skilled staff, specialized eating/drinking equipment or insufficient support at mealtimes • Digestive problems • Poor communication skills • Sensory impairments, the need for assistance with eating and loss of eating independence may reduce enjoyment • Abnormal eating behaviors or disorders • Poverty, poor housing and social isolation may mean that food choice is restricted and that affordable, good-quality food cannot be easily accessed • Some medicines may have side effects which play a part in abnormal eating behavior, appetite changes or eating disorders. There may also be interactions between particular drugs and nutrients.
Added ValueCooking is fun and whew, it’s almost the end of the week, right? DISCLAIMER: The pug in no way assisted in the preparation of any of today’s food. The pug simply provides inspiration.
A variety of challenges Cerebral palsy – difficulties with speech, hearing, balance, coordination, sight,swallowing, gastrointestinal difficulties, greater risk of heart disease, muscle rigidity
A variety of challenges Down’s Syndrome – difficulties with gastrointestinal tract, respiratory, thyroid disorders, congenital heart problems, prone to insulin-dependent diabetes, obesity, propensity toward chewing and jaw bone issuesDiabetes Buddy Lite Free diabetes e-magazine from iTunes
A variety of challenges Autism spectrum disorder (ASD) – difficulties with ability to form relationships,restrictive, obsessional or repetitive behavior which are often reflected in food and drink choices and around mealtimesBehavior Tracker Pro Proloquo2Go
A variety of challengesConditions such as arthritis, tremors, those with a limited range of motion, poor coordination and limited ability to grasp objects may have difficulty holding utensils or mugs
A variety of challengesMobility – ability to move in and around the kitchen, gross/fine motor skills
Cooking AppsSubstitutions Cook It Allergy Free Quick & Easy The Photo Cookbook Paprika Recipe Collector Epicurious
Links as promised!Therese Willkomm (McGyver of Assistive Technologyhttp://unh.edu/universityevents/speakersbureau/speakerdetails.cfm?sid=276Accessible Kitchen Designhttp://www.handicapped-accessible-kitchens.com/?gclid=CPz99NnXsK4CFa0FRQodBG2uQQVendorsLS&Shttp://www.lssproducts.com/category/daily-living-productsSammons Prestonhttp://www.pattersonmedical.com/