Because clinical nutrition is who you are not just what you do.
The perfect opportunity to advance your credential has arrived:
CDR Advanced Practitioner Certification in Clinical Nutrition

The Commission on Dietetic Registration (CDR) is offering an advanced practitioner certification in clinical nutrition for registered dietitians with four or more years of clinical nutrition practice. Apply NOW for the April 2018 examination window!

Applications for April 2018 examination window are due March 2, 2018.

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Course Learning Objectives

After completing the self-study module, you will be able to:

  • Describe nutrition guidelines for healthy eating for children and adolescents recommended by professional and government agencies.
     
  • Identify the appropriate macro and micro nutrient requirements for healthy toddlers, children, and adolescents.
     
  • Describe age- and developmentally-appropriate activity patterns, feeding practices, eating behaviors for toddlers, children, and adolescents.
     
  • Describe the environmental, economic, psychosocial, and cultural factors that affect toddler, child, adolescent, and family food intake patterns.
     
  • Understand the regulations and functions of the School Lunch Program and their impact on the: physical facility, economic, nutritional and physical activity factors within the school environment.
     
  • Define body mass index (BMI), height for age, weight for age, and sexual maturity ratings and identify their indications for use in the anthropometric assessment of a toddler, child, and adolescent.
     
  • Assess and interpret a pediatric patient’s anthropometrics and growth pattern using standardized sex- and age-appropriate growth and BMI charts. 
     
  • Describe the epidemiological data demonstrating the increasing prevalence of pediatric overweight and obesity.
     
  • Identify co-morbidities associated with overweight and obesity in childhood, their potential for persistence into adulthood, and their potential relationship to adult chronic disease. 
     
  • Understand the current recommendations on how to screen, identify, and treat toddlers, children, and adolescents who are “at risk for overweight” and “overweight and obesity.”
     
  • Describe and contrast the techniques of motivational interviewing and cognitive behavioral therapy in health behavior change. 
     
  • List individual and community approaches for environmental change to prevent obesity among different ethnic and age groups of children and youth. 

 After completing the onsite workshop, participants will be able to:

Keynote on Fundamentals of Pediatric Overweight Epidemiology and Research

  • To describe the epidemiology and prevalence of overweight in the pediatric population for the participants to increase their understanding of the scope of the problem of pediatric overweight.

  • To relate chronic disease risk factors in a pediatric population to the presence of overweight in order to demonstrate to the participants the increased prevalence of risk factors in overweight pediatric patients.

  • To discuss the research supporting the persistence of chronic disease risk factors present in childhood and adolescence into adulthood to enable the participants to understand the future health consequences for the overweight child and adolescent.

  • To explain the metabolic pathways, both afferent and efferent, which regulate appetite, energy storage and energy production including the central and peripheral roles of such hormones as insulin, leptin, grelin, and PPY to increase the participant’s understanding of the pathophysiology of overweight.

  • To discuss the genetic component in the prevalence and development of pediatric overweight to help the participants understand gene-environment interactions of pediatric overweight.  

Prevention of Pediatric Overweight and Obesity

    • Recognize and incorporate evidence based parenting and family lifestyle interventions that may prevent the development of overweight in children and adolescents.

    • Take action to educate health care professionals on the importance of screening, anticipatory guidance and intervention for the prevention and early identification of obesity risk factors in the pediatric population.

    • Identify environmental, cultural, socio-economical, and family influences for the prevention of overweight in the pediatric population.

    • Identify population approaches, community programs, target sites for intervention (schools, ambulatory care centers, recreation centers) and areas of concern related to the prevention of and development of overweight.

    • Understand the impact of current local, state and federal policy and legislation on the prevention of pediatric overweight.

Behavioral Management: Assessment and Interventions

    • Identify appropriate screening and general assessment tools for depression, eating disorders and family dysfunction in a pediatric population for a RD to use in assessing a child, adolescent and family prior to initiating MNT.

    • Describe and differentiate between the major models of behavioral management and their application to pediatric weight management.

    • Assess child, adolescent and family's level of motivation and readiness to implement total lifestyle changes.

    • Incorporate counseling skills appropriate for the level of motivation and readiness to change conducive to establishing a therapeutic relationship with the child and family that promote healthy behaviors.

    • Describe behavioral strategies used to promote internal regulation of eating and satiety and use appropriate counseling skills for weight management in the overweight pediatric patient and family.

Medical and Nutrition Assessment and Management of Pediatric Overweight

    • Define the terms "overweight" and "at risk for overweight" using the criteria recommended by Barlow et al to describe the relative weight of children and adolescents.

    • Describe the limitations of BMI as a screening tool for overweight in a pediatric population.

    • Determine range of reasonable body weights using the assessment of family heights, tracking of BMI over time and rapid increases in weight or BMI.

    • Incorporate age and sex specific sexual maturity assessment and other appropriate body composition measurements in the evaluation of overweight in the pediatric population in various patient care settings.

    • Identify appropriate, reliable and valid dietary assessment tools for pediatric patients and their families.

    • Evaluate food intake and nutrient adequacy and excesses of pediatric patients' diets considering age, gender, puberty and special needs using generally accepted guidelines and recommendations.

    • Assess the pediatric patient's family, home, childcare, school and community environments for supports or barriers to healthy eating and weight management.

    • Apply current evidence-based or best practice recommendations for dietary treatment of weight status and associated medical comorbidities in the pediatric population.

    • Develop goals and an age, gender and developmentally appropriate family centered plan for medical nutrition therapy for weight management of the pediatric patient.

    • Recognize the importance of close monitoring of micro and macro nutrient intakes and anthropometrics during weight loss and maintenance.

    • Develop an appropriate nutritional care plan for the treatment, including long-term follow-up care, of pediatric overweight that targets both the child/adolescent and family.

    • Develop and implement protocols or critical pathways that document the monitoring of patient and family progress toward desired outcomes.

    • Appropriately advise pediatric patients and families regarding the role, indications and contraindications of popular diets, diet foods, and over the counter supplements for the growing child and adolescent.

    • Recognize the risk for development of unhealthy eating patterns following Medical Nutrition Therapy.

    • Recognize when referral for medical management of weight is warranted.

    • Recognize when referral for psychological/mental health counseling is appropriate.

    • Document and communicate care plan recommendations to appropriate healthcare and childcare providers.

    • Maintain and ensure confidentiality of patient and family information.

Weight Loss Surgery for Severely Obese Adolescents

    • Recognize evidence-based research demonstrating the outcomes and efficacy of weight loss surgery in promoting weight loss and weight maintenance for adolescents.

    • Recognize the established selection criteria for severely obese adolescents being considered for weight loss surgery.

    • Understand the nutrition and physical activity goals during the first year following weight loss surgery

    • Recognize the progression of food/drink and meal planning through the different dietary stages that takes into account the consistency, texture, volume and type of food and drink being consumed.

    • Understand the need for specific nutritional supplementation following weight loss surgery.

    • Understand the role of the dietetics professional in the pre-and post-operative management of obese adolescents undergoing weight loss surgery.

Developing a Clinical Program for Management of Childhood and Adolescent Obesity

    • Identify key stages and components when planning a new pediatric weight management program or revising an existing program using the development and future restructuring of the HealthWorks! behavioral weight management program prototype.

    • Review theories, components and efficacy of established pediatric weight management interventions with published outcome data.

    • Assess reimbursement potential for the MNT of pediatric overweight from third party payers to families and other health care providers and/or agencies, reflecting on the experience of the HealthWorks! behavioral weight management program.

Environmental Influences on Pediatric Overweight

    • Understand the impact of parental food choices and feeding practices on infant, toddler, childhood and adolescent eating behaviors and their possible relationship to the development of overweight.

    • Describe trends and current food consumption patterns of infants, toddlers, school-aged children and adolescents and their relationship to food choices and eating behaviors.

    • Understand the impact of socioeconomic factors, home and school environments on the prevention, promotion, and treatment of pediatric overweight patients.

    • Illustrate the influence of media, advertising and social marketing on children's and families' discretionary spending habits, leisure time activities and food choices.

    • Understand the societal, cultural, ethnic and community influences on body image, dietary intake, and meal patterns of children and adolescents.

Behavior Management: Client-Centered Counseling Techniques

    • Understand the basic principles of the client-centered counseling techniques of Motivational Interviewing.

    • Understand the role of client-centered counseling techniques in the prevention and treatment of pediatric overweight.

    • Practice client-centered counseling techniques in a supervised setting.

    • Incorporate client-centered counseling techniques such as reflective listening, open ended questions into nutritional counseling of children, adolescents and families.

Physical Activity as Treatment

    • Identify appropriate and reliable physical activity assessment tools for pediatric patients and their families.

    • Assess and evaluate the physical activity level of pediatric patients, based on generally accepted guidelines and recommendations, considering their age, gender, puberty, physical capacity and special needs.

    • Identify physiologic and metabolic factors that limit physical activity in overweight youth.

    • Identify biochemical, anthropometric, behavioral and fitness outcomes related to increased physical activity in the overweight pediatric patient.

    • Identify evidence-based recommendations and/or protocols for physical activity in the treatment of the overweight pediatric patient and apply these guidelines to develop treatment goals.

    • Implement an age, gender and developmentally appropriate physical activity plan for overweight pediatric patients tailored to their individual medical condition, family history and background.

    • Discuss motivational strategies to promote physical activity in youth with varied levels of overweight.

    • Recognize when a referral to an appropriate health professional of physical activity professional is warranted.

School Nutrition

  • Understand the positive influence the dietitian can have relative to the treatment and prevention of   childhood and adolescent overweight in a school setting.

  • Identify school nutrition healthy weight program success story strategies and develop models for replication.

  • Discuss emerging school nutrition strategies to promote healthy weight (i.e., grab and go healthy school meals, healthy vending machine options, classroom breakfast, second chance breakfast, healthy ethnic foods, healthy after school snacks. healthy classroom party foods).

  • Identify creative funding opportunities and resources to promote nutrition initiatives related to the treatment and/or the prevention of pediatric overweight in school settings (i.e. increase fresh fruits and vegetable consumption, improve eating areas, streamline meal service, utilize existing public domain resources).

  • Understand the current implementation of legislated changes in the school lunch programs in relation to the treatment and/or the prevention of pediatric overweight.

 

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