Children and adults with severe disabilities may have nutritional problems due to the effects of the primary disability (including such syndromes as phenylketonuria, galactosemia, and Hurler's Disease), effects related to medications (including anticonvulsants, tranquilizers, and laxatives), effects of food preferences (restrictive food preferences or hypersensitive oral-facial structures), effects of pureed diets, and effects related to fluid intake. Eight suggestions to help reduce the nutritional and dietetic problems of most severely handicapped children include using a team approach involving nutritionists and dieticians; assessing the child's diet; checking for the nutritional effects of medication and compensating appropriately; working away from pureed foods if possible; ensuring adequate fluids; systematically programing for the child to accept more food, especially a more normal diet; providing good dental care; and promoting movement and activity. (CL)