Neurological Impairment in Children: Assessment and Nutritional Management

Denise is a children’s dietitian and jointly leads the paediatric team in First Community Health and Care. She has over 15 years of clinical dietetic experience and over 35 years of experience working in nutrition. In addition to regular outpatient clinics, she works with a large group of children and young people with complex needs, including genetic conditions, and physical and learning disabilities, many of whom require tube feeding. 

Denise has a strong interest in fighting for the nutritional needs of these children to be recognised and met, working together with families in a way that meets their wishes and needs whilst also meeting the requirements of the child. Denise has an interest in blended diets and was part of the British Dietetic Association working group on Blended Diets, and a member of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) working group for the position paper on Blended Diets published in January 2023. 

Denise is currently chair of DISC – Dietitians Interested in Special Children – an informal group of dietitians working with children with neurological impairment in the community.

Joanna is a senior children’s dietitian and jointly leads the paediatric team in First Community Health and Care. She has 24 years of clinical dietetic experience, 23 years of which have been in paediatric dietetics, mostly in community roles. She currently has a large caseload of children with complex needs, many of whom are tube fed. They have varied conditions including syndromes and genetic conditions, physical and intellectual disabilities, autistic spectrum conditions, and complex feeding disorders including ARFID. 

Joanna has an interest in ARFID and complex feeding and is involved with a local Autism charity to provide education sessions for families and professionals. She has also run educational sessions for the West Sussex Parent and Carers forum on ARFID and has been involved in discussions around re-designing local services to provide an ARFID care pathway. She is currently looking to create an ARFID pathway for her dietetic team. She is involved in a nursing-led Critical Appraisal Topic (CAT) Group on nasogastric tube feeding when pH > 5.5, developing a clinical paper and pathway for managing these patients safely and more effectively.