Diagnosis of Malnutrition in Children and Adolescents with Identified Developmental Disabilities (IDD) Using Subjective Global Nutrition Assessment (SGNA)

Abstract

Background: Children with identified developmental disabilities (IDD) experience a higher risk of growth retardation. Anthropometric indicator is one common objective measurement used to determine malnutrition in those children. A comprehensive nutritional assessment tool should be introduced to offer a more robust approach in understanding their nutritional problems.

Objective: To determine the use of Subjective Global Nutrition Assessment (SGNA) as a nutrition assessment tool for children with IDD in comparison to the anthropometric indicators.

Methods: This cross-sectional study was conducted in local community settings. IDD included in this study were autism spectrum disorder (ASD), Down syndrome (DS) and cerebral palsy (CP). SGNA and anthropometry measurements including weight, height, mid-upper arm circumference and triceps skinfolds were performed on 93 children with IDD (40 ASD, 26 DS and 27 CP) aged 5-18 years. Cohen's Kappa, sensitivity, specificity and its 95% confidence interval were calculated between SGNA and anthropometric indicators for the agreement in determining malnutrition status of the children.

Results: SGNA identified a lower prevalence of malnutrition in children with IDD in comparison to the use of anthropometric indicators. SGNA obtained a moderate-to-fair agreement (above 80% agreement, except height-for-age parameter) and sensitivity (25.71-59.09%) against the use of a single anthropometric indicator in identifying the malnutrition status of the children.

Conclusions: The use of SGNA as an adjunct to body mass index-for-age as an anthropometric measurement for diagnosing malnutrition in children and adolescents with IDD is recommended.

Keywords: children; developmental disabilities; nutrition assessment.