This role statement was developed by members of the Disability Interest Group.

It lists the knowledge and skills of an Accredited Practising Dietitian (APD) working in the disability area.

Knowledge

• Nutrition-specific evidence relating to a specific disability and implementation of evidence informed practice including regular review and reflection on outcomes.
• Impacts, interactions and side effects of medications, diet modifications, particular foods, fluids, nutritional supplements and thickeners that may be commonly used in the care of people with a disability.
• Popular diets and nutrition misinformation relating to specific disabilities.
• Policies, procedures and guidelines relating to health care in disability in line with the mandatory organisation/site specific, state and federal policy directives (for example, use of restricted or restrictive practice).^1-4
• Disability-related funding that may impact an individual’s access to health and dietetic care (for example, National Disability Insurance Scheme) and requirements of dietitians in relation to this including realistic implementation within community settings.⁵
• Awareness and utilisation of the International Classification of Functioning to inform nutrition assessment, care plans and decision making.⁶

Skills

• Consideration of accurate and relevant data, unique features of the client’s disability, and related nutrition impact symptoms, physical and cognitive limitations, and communication difficulties when conducting a nutrition assessment and developing a plan.^7,8
• Ability to determine health priorities for complex disability clients with multiple comorbidities using evidence base and clinical experience to inform practice.
• Ability to ethically work with clients with a disability who have intellectual/cognitive/memory impairments, behavioural disturbances and mental health co-morbidities. For example, working within scope of practice as part of an interdisciplinary team, delivering person-centred care using social justice principles, understanding informed consent and supported decision-making, and that behaviours are a form of communication.
• Assess the capacity and capability of people with a disability and/or their carers to follow dietetic recommendations and adjust interventions accordingly.
• Collaboration with clients, families, group homes, client support networks and interdisciplinary disability related health teams working within the person-centred practice paradigm, considering the individual’s needs, abilities, preferences, choices and aspirations.
• Confident identification of the most appropriate method to effectively communicate with clients, families and/or support workers with a range of cognitive abilities to deliver disability-specific nutrition recommendations using evidence-based reasoning.

Activities entry level APDs would conduct

• Nutrition assessment utilising the most appropriate methods, intervention and monitoring considering key disability-specific issues (For example, dysphagia, mealtime behavioural issues, menu choice, supports in day-to-day life, cognition, fluctuating health, level of intellectual impairment and client capacity to self-monitor, client access to services, communication or environmental stressors).
• Provide nutrition therapy for individuals with disabilities without complex comorbidities (For example, enteral feeding regimens, food fortification, healthy eating, food aversions, food allergies, mealtime management plans).
• Referral to and coordination with specialist/support services available for people with disabilities.
• Ability to work within scope as part of an interdisciplinary team, and appropriately identify when to refer on and/or be guided by more experienced clinicians (For example, inborn errors of metabolism or management of a ketogenic diet for epilepsy).
• Provide consultation and recommendations for meal planning in disability-related residential and respite facilities.

Activities APDs working at a higher level would conduct

• Provide nutrition therapy for individuals with disabilities who have complex comorbidities (For example, eating disorders, psychiatric illness with behaviours of concern, metabolic conditions including phenylketonuria (PKU)).
• Intuitively utilise advanced nutrition and dietetic skills acquired, and recognise other clinicians’ knowledge and skills to successfully problem solve and implement effective interventions.^7,8
• Facilitate a transdisciplinary approach when working with individuals with disabilities to implement holistic strategies that promote wellbeing.
• Design, develop and actively participate in research that informs policies and best practice for people with disabilities.
• Ability to confidently communicate at organisation and government levels to advocate for disability-specific nutrition priorities with evidence-based reasoning.
• Act as a nutrition resource to dietitians and members of the interdisciplinary team on application of disability related nutrition protocols and guidelines to an individual client or population. This includes the mentoring/supervision of students or less experienced dietitians as well as other health professionals.^7,8

Activities APDs working in this area of practice do not usually undertake

• Assessments of swallowing or making food texture and fluid thickness recommendations.
• Assessments of safety and functioning while cooking.
• Assessments of physical activity capacity.
• Assistance with feeding at mealtimes.

For more, download the full role statement. The full statement includes a list of document references.