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Objective To evaluate whether the Community Support Services (CSS) Lunch Clinic can contribute to increased pleasure in eating and a reduction in challenging behavior during mealtimes by adjustments in environmental cues. Target audience Individuals with Intellectual and Developmental Disabilities (IDD) who are currently clients at CSS. Program Description This 8-week pilot program (30-minute session weekly) uses classical music to alter the eating environment for individuals with histories of rapid eating and disruptive mealtime behaviors. Behavioral changes during mealtimes are assessed via pre-/post test assessments from support staff. Use of Research or Theory Research suggests that music is an environmental factor that has direct influence on consumption patterns. Moreover, musical properties such as tempo and instrumentation can affect both the rate of eating as well as meal duration. The CSS Lunch Clinic incorporates these factors into a simple intervention involving the use of piano arrangements that are 45-120 beats per minute. Evaluation Methods In a pre-test format, support staff were interviewed about their clients’ current eating habits and mealtime behaviors; the same individuals participated in a post test activity where they provided information regarding changes in their client's behavior. Staff input included observations of both positive and negative nonverbal cues such as frowning or smiling. Results The observational data indicates that clients experienced the music as soothing and found the experience pleasurable. An assessment of reported nonverbal cues in the pre and post test interviews revealed a 50% increase in positive nonverbal cues (eg, smiling, swaying to music) and a 30% decrease in negative nonverbal cues (eg, frowning and restlessness) from the baseline. The staff additionally reported in the post test interviews that the clients responded positively to the Lunch Clinic, looked forward to the sessions, and seemed more relaxed during these mealtimes. Conclusion The CSS Lunch Clinic shows potential as a way to create a more enjoyable environment for the clients during mealtimes. Limitations included difficulty creating quantitative measurements to assess the eating pace and obtaining feedback from nonverbal clients. Future iterations of this program will continue to use staff observations as a primary research tool, a qualitative alternative to assess eating behavior.

During the progression of a pilot nutrition intervention designed to teach cooking skills to young adults with autism spectrum disorder (ASD), one participant—Paul—fell in the parking lot. Prior to the accident, Paul had been making significant gains in the program and had communicated in a number of ways his enthusiasm. After his accident, which resulted in broken and dislocated bones in his ankle, his demeanor was dramatically altered, program gains were lost, and staff noted the appearance of many new challenging behaviors. This article analyzes Paul’s behavior in reference to the pain response in autism. For some time, it was believed that many individuals with ASD did not experience pain based on anecdotal reports of how individuals responded to injury with seeming indifference. This view has given way of late to a more nuanced understanding of how atypical sensory processing and stimulus over-selectivity spill over into pain pathways and pain amplification mechanisms. The consequence is not a reduction in pain sensation, but a different expression of pain, determined by that individual’s particular communicative, cognitive, or physiological challenges. From this perspective, many of the disruptive and harmful behaviors that emerged after Paul’s accident can be seen as a delayed response to the incident. This article concludes by arguing that professionals across all domains of health care need to begin to see behavior as communicative for those with ASD. This is particularly true of changes in behavior, which can be significant indicators of health care problems rather than something to be dismissed as another manifestation of the condition.

Objective In order to promote dietary variety, “Tasting Tuesdays” were implemented at Community Support Services (CSS), a large community-based center for adults with autism. The goal of “Tasting Tuesdays” is to highlight new foods through an appeal to multiple sensory modalities (sight, smell, touch, taste) in an engaging format. Use of Theory or Research “Tasting Tuesdays” emphasize choice and individualization, basic principles of “Active Engagement,” a well-vetted approach to cooking that was first established at CSS and is now a manualized treatment option for individuals with autism. Target Audience Adults with autism are an at-risk and underserved population characterized by elevated rates of overweight/obesity. Individuals on the spectrum experience disordered eating at high prevalence and food selectivity is widespread. Program Description Each Tuesday a chosen food is offered in sample servings to the entire CSS community and all participants are asked to provide input through a visual graphing activity. Featured foods generally fall into one of several categories: unusual fruits/vegetables (dragon fruit, beet juice), specialty food products (broccoli tots, vegan chicken nuggets), unusual recipes (tofu scramble, watermelon salad) or seasonal specialties (latkes, eggnog). In the two years since inception, almost 100 different food samples have been included in the program. Evaluation Methods Tasters vote with a picture symbol containing a happy face (like) or a sad face (dislike). An “X” marker is used to track those individuals who decide not to taste the offered food. Outcomes are also reported in the biweekly nutrition newsletter distributed throughout the community. General participation rates are collected to assess the level of community involvement. Results Preference varies on a weekly basis due to personal choice. Program effectiveness, however, is assessed through participation rates which have increased by greater than 20% since inception, thus implying increased reach. Conclusions Making a range of new foods available, and offering community-based tasting as a form of engagement, appears to be an effective means of addressing dietary rigidity amongst individuals with autism. Funding None.

The relationship between diet and a number of chronic health conditions has been well established. One of the most widely utilized tools for mediating this relationship is carbohydrate counting and dietary exchange systems. At the same time, nutrition and dietetics professionals have begun to stress the importance of cultural competency by encouraging all professionals to develop a comfort level with the ethnic, religious and contextual background of their patients. This paper is intended to support that movement by introducing nutrition professionals to the most common Jamaican foods as interpreted through the exchange list system. Across the entire Caribbean, trends have demonstrated increasing rates of type 2 diabetes mellitus (T2DM) accompanied by elevated rates of obesity. At present in Jamaica, T2DM is the second most common non-communicable chronic disease. Rates among immigrants and individuals of Jamaican heritage in the United States are unknown but are believed to mirror these trends. Understanding the food choices of this population will be vital to providing appropriate and meaningful nutrition treatment options. This paper addresses an important need and serves as a model for how to introduce other cultural traditions in cuisine to professionals in the fields of nutrition and dietetics.

Journal of the Academy of Nutrition and Dietetics - In Press.Proof corrected by the author Available online since vendredi 12 aout 2016

Objective: Develop and test curricula for elementary teachers to use in the classroom to fulfill requirements of school wellness policies. Target Audience: Elementary school teachers. Theory, Prior Research, Rationale: Information Processing Model, Media Literacy Theory. Description: ‘‘Making Media for a Healthier U’’ is a compendium of resources and curriculum that supports the Common Core, which could be used to fulfill school wellness policy’s nutrition education requirement. The materials were based on MyPlate curriculum, media literacy theory, and Information Processing Models. Six lessons with supporting materials (e.g., student booklets, PowerPoint slides) were provided to third-grade teachers. A field experiment with a control and implementation group assessed the effectiveness of the Nutrition andMedia literacy lessons. Evaluation: Ten classes (intervention 1⁄46 classes, N1⁄4144; control1⁄44 classes, N1⁄486) in a high-poverty Chicago suburb participated in the field study. Pre and posttests measured knowledge of food groups and food attitudes and beliefs. Qualitative information was gathered from classroom observations and feedback from teachers for program improvement. Conclusions and Implications: The intervention group demonstrated a significant increase in knowledge of the food groups and the knowledge positively correlated with favorable food attitudes and beliefs. Children demonstrated media literacy through advertising analysis and production of advertising for carrots. Five of the intervention classes completed 6 hours of nutrition and media literacy in two weeks that engaged the children’s reading, math, art and language skills. Based on teacher feedback and classroom observation, teacher-training workshops are planned for curriculum expansion, refinement and testing. Funding: None.