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How to Critique Michael Wilson's Assessment:

Now that you have done your own thorough evaluation of Jay Carter’s needs and risks, you are better prepared to critique Michael Wilson’s assessment of Jay.

Remember as you work on Task 1 with your teammates, you should allocate some time to working independently on the “On Your Own” tasks.

Get Organized

1. Meet with your team. Start by asking yourselves what exactly you have been asked to do. Re-read the email from Pat Niren and review the attached Assessment Critique Template, which you will walk you through all the elements of the analysis you need to critique. Note that you should provide the rationale for your critique, including scientific evidence.
   
   
2. Review the relevant support materials, including the Practitioner’s Assessment of Client Needs and Risks, from Pat’s earlier email in Task 1.1: Critiquing the Practitioner’s Interview.
   
   You may notice that the practitioner explained her rationale rather than cite specific sources when completing her assessment. As you complete your critique, however, you should provide specific sources to support your reasoning wherever possible.
   
   
3. Identify one person to be a team leader. Discuss with your team how you plan to tackle this work and make a concrete plan.

 

Conduct Your Critique

1. Compare your client evaluation to Michael Wilson’s and note the differences. The Assessment Critique Template will show you what you need to produce and submit when you have completed your analysis, but at this stage, you should conduct your critique and take notes on what you find. You may use the template to record your work, or you may wish to take notes in a separate document.
   
   
2. Review the steps for conducting a client assessment. To help you evaluate whether Wilson’s judgments and decisions were appropriate, refer to the steps (and corresponding questions) for conducting the assessment of a client’s needs and risks in the Step-by-Step Guide for Task 1.2: Assessing the Client’s Needs and Risks. These are questions that Michael Wilson should have answered in his assessment as well. As you complete each step of the critique, ask yourself:
   
   
   • In what ways did Wilson address (or not address) the questions?
     
     
   • Did Wilson overlook any information that Jay provided during the interview?
     
     
   • Or did Wilson fail to uncover any important information during the interview?
     
     
3. You may need to do additional research to make your decisions. Refer again to the Overview of Eating Disorders in Resources for helpful information as you complete this task.
   
   

Write your Report

1. Write your critique using the provided template. Once you have completed your critique work, convene your team and discuss your findings. Use the notes you took when conducting your critique above and work together to present your ideas in a carefully written report using the Assessment Critique Template.
   
   
2. Summarize your advice to Michael Wilson in a well-organized synopsis. The final section of the template asks you to summarize your findings. The goal is to offer advice to your colleague to improve his future analyses. Use as much space as is necessary to provide a thorough summary (i.e., do not limit yourself to the space on the template if you need more room).
   
   

Submit your Work

1. Review your work with your teammates and make sure everyone has signed-off on the report before the group leader submits it for review.
   
   
2. Submit your Assessment Critique Template to your mentor for review. Check the Submit your work section of this task to determine how to name and send your documents.

 

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Note: The Tips and Traps below are the same as those in Task 1.2: Assess Client's Needs and Risks. They are relevant here as well.

Height and Weight

• Remember that BMI is an indicator of body mass that leaves room for additional interpretation in the case of athletes. That is, an athlete who is very muscular and fit may appear to be overweight based on the BMI standards of what is normal body mass. A practitioner should consider whether a client falls into this category and make allowances when deciding whether or not his/her BMI falls within the normal range.

Weight Fluctuation

• A nutrition advisor should be aware of any dramatic shifts in the client’s weight and look for patterns that could indicate unhealthy behaviors such as severe dieting.

Eating Context and Outside Influences

• A practitioner might overlook the way family or friends may influence the client’s eating behaviors. Rather, s/he should consider the context in which the client eats (when, where, and how much) as well as the outside influences (peers, family, etc.) who may be shaping those habits.



• Sometimes social relationships can motivate a client in positive or negative ways that can affect his/her well-being. For example, people often make choices to follow their peers (teens are especially susceptible to this). Practitioners should consider any peer or familial relationships the client spoke of and the potential impact they may have in shaping the client’s behaviors and increasing his/her health risks.

Physical Activity

• Practitioners should be aware of extreme behaviors when it comes to exercise. A client who does not exercise at all faces different challenges than a client who over-exercises, but in both cases the level of activity could have a significant effect on the client’s overall well-being.

Caloric Needs

• When determining caloric needs, nutritional advisors should not forget to factor in the client’s exercise habits. Someone who exercises a lot needs more calories to maintain his or her current weight than someone of the same weight who leads a very sedentary lifestyle.
  
  
• Determining caloric intake is not an exact science. It’s best for a practitioner to use a preferred or recommended caloric formula.  In addition, s/he should follow the client’s eating habits, see how he/she is progressing toward their nutritional plan, and adjust the level of recommended calories appropriately over time.

Current Eating Habits

• Keep in mind, if a client is skipping meals or skipping snacks, it may or may not be a problem. To evaluate the situation, review Step 8 of the Client Assessment Template Questions in the Step-by-Step Guide.
  
  
• If the client’s diet does not reflect the suggested balance and variety offered by the Food Guide Pyramid, there may or may not be a problem. To evaluate the situation, review Step 8 of the Client Assessment Template Questions in the Step-by-Step Guide.
  
  
• A nutritional advisor should ask a client to track his/her diet history for several days, as opposed to just one day. It is recommended to get at least three days of history, including at least one weekday and one weekend day. This gives the practitioner more information to use when evaluating current eating habits and helps in identifying trends.

Client’s and Parent’s Goals and Concerns

• A practitioner should consider whether the client’s own personality traits or behaviors (e.g. overachiever, recluse, etc.) may be contributing to the risks he faces.



• Keep in mind that not all goals are healthy. Teens are sometimes influenced by peers to set unhealthy goals.



• A nutritional advisor should evaluate the client’s goals and parent’s goals independently of each other, but also take time to think about how the two may be interconnected. For example, the parent may have very high standards that could be driving the child’s behavior. The practitioner should consider the potential effect on the client’s well-being.



• When looking at the data have available to assess the client’s needs and risks, a practitioner may discover that information provided by the parent conflicts with information from the child. This does not mean that one is definitely right and the other is definitely wrong. A practitioner should consider both sides and entertain the possibility that they may both be right, but simply have different (but equally valid) perspectives.
  
  

Overall:

• In assessing the client’s needs and risks, a practitioner should consider whether s/he has enough information to develop a good nutritional plan. If not, s/he should identify the details that are lacking.

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Overview of Eating Disorders - This overview gives you information on how to identify, assess, and treat eating disorders. The content provided in the overview links to useful web sites that provide additional, relevant information on clinical findings, risk factors and treatment options.

TASK RESOURCES

Height and Weight

How to Assess Ideal Body Weight and Weight Fluctuations - This FAQ outlines helpful steps for assessing a client’s height and weight. It also includes tools and information on interpreting BMI and growth charts.

What is BMI and Why is it Useful? - This site gives you a detailed understanding of Body Mass Index (BMI) for children and teens.

Exercise

The Benefits of Exercise - This site offers insights into the benefits of exercise for adolescents, including how to start an exercise program, what kind of exercise is best, and how much exercise is enough.

Guidelines for Healthy Exercise - This FAQ addresses questions related to the recommended amount of daily exercise for teens and how much exercise is too much.

Diet and Nutrition

The Truth about Snacking - This FAQ addresses the misconceptions around snacking that exist in today's world.

Common Causes of Unhealthy Eating Habits - Unhealthy eating habits develop over time. This FAQ explains some of the common causes of unhealthy eating habits and provides questions that dietitians can ask clients to help uncover unhealthy eating habits.

Why Fiber is an Important Part of a Healthy Diet - This site explains why fiber is good for you and what foods contain fiber.

Dietary Calories from Proteins, Carbohydrates, and Fats - The U.S. Department of Agriculture’s Dietary Guidelines offer specific recommendations regarding the percentage of calories needed from key nutrients. See Chapter 5 for guidelines related to protein; Chapter 6 for fats; and Chapter 7 for carbohydrates.

Protein Content of Common Foods - This FAQ provides information on the amount of protein found in various common foods.

Assessing a Client’s Diet History - This FAQ explains what a practitioner looks for when evaluating a client’s diet history.

How Yo-Yo Dieting Affects the Immune System - This page talks about research regarding the long-term negative effects of yo-yo dieting on immune function.

Herbs and Foods Interacting with Drugs - This page features information about interactions between food, medications and dietary supplements.

Questions about Sports Nutrition - This site provides answers regarding the most common fitness and sports nutrition questions from teens.

Caloric Guidelines for Teens

Ask the Expert: How do you determine which caloric formula is the best to use?

Determining Caloric Needs - Trying to calculate how many calories a person needs is not an exact science. Most of the formulas available today are estimates of caloric needs. This FAQ explains how to determine a teen’s caloric needs.

General Calorie Requirements for Children and Teens
Guidelines vary somewhat as to appropriate caloric needs for children and teens. Click on the following links for caloric ranges that can serve as a general guideline. Each site has similar, equally valuable information. It’s best to use these guidelines in conjunction with the FAQ above to determine a client’s specific caloric needs.

• From Weight Loss Resources
  
  
• From Keep Kids Healthy

Scroll half-way down the page to view charts.

Calorie Calculator - A calorie calculator is a helpful tool for determining caloric consumption. Using the tool on the home page, you can plug in the foods and beverages contained in a client's diet history into the calculator and total them to arrive at an estimated number of calories per day.

Client and Parent Goals

Balancing Client and Parent Perspectives -This FAQ helps you understand the challenges of conducting an effective client interview when both a parent and child are present.

Athletes

Healthy Eating for Sports - This page provides a guide on how athletes can eat healthier to reach their peak performance level.

Young Athletes at Risk Over Weight-Control - This page talks about how young athletes are at risk of engaging in unhealthy efforts to lose or gain weight.

Making Weight for Wrestling - It is a common practice for wrestlers to restrict fluids and food to compete in weight classes below their normal weight. This page talks about the health risks involved as wrestlers try to make weight.

GENERAL NUTRITION RESOURCES

Nutrition Tools & Practices

The Diagnosis & Treatment Process Specific to Nutrition - This document describes a process that health care professionals, and dietitians and nutritionists in particular, typically use to assess what is wrong with their patients, and how they develop treatment plans to help them.

MyPlate - This site provides information on the MyPlate Program, which was designed by the U.S. Dept. of Agriculture to promote healthy nutrition in children over two years of age. It serves as a general guide to daily food choices.

Background Information

The American Dietetic Association - This is the site for the nation's largest organization of food and nutrition professionals.

The American Society for Nutrition - This is the site for The American Society for Nutrition, a premier research society dedicated to improving the quality of life through the science of nutrition.

U.S. Department of Agriculture: Food and Nutrition - Under the U.S. Department of Agriculture's web site, this page gives you general useful information on food and nutrition.

U.S. Department of Agriculture: Dietary Guidelines for Americans - Under the U.S. Department of Agriculture's web site, this page provides guidelines regarding how good dietary habits can promote health and reduce risk for major chronic diseases.

Nutritional Needs of Adolescents - This article provides a detailed account of facts and statistics regarding the nutritional needs of adolescents.

The Science of Biology, Eighth Edition, William K. Purves - This link requires a username and password. Your username is vista1, and your password is arginine. Using the menu at the top of the screen, select Chapter 50 (on nutrition) for the most relevant material.