Dietitians (RD's) working with developmental disabilities (DD) in children commonly encounter nutritional disorders without national standards for management. Two different patterns of weight gain have been observed in children with DD. One group of children gains weight easily with energy intakes far below the RDA (Low Energy Needs or LEN). The other group (High Energy Needs or HEN) fails to gain weight with energy intakes well above the RDA. The Steering Committee of the state Pediatric Practice Group surveyed RD's at 14 pediatric long-term-care facilities to determine nutrition resources and assessment parameters. The survey included two case studies to differentiate nutritional management. Ten completed surveys (71.4%) were returned. Length was the most common parameter used to determine nutrient needs (6/10). No difference was noted between the two groups with regard to medical status or route of feeding. Estimated energy needs were low in the LEN group, ranging from 25% of the RDA for age to 75% of the RDA for height-age. In the HEN group the formula for catch-up growth was the most common (5/10) calculation used to determine energy needs. There was no difference in estimated requirements of protein, vitamins, or minerals between the two groups. The majority of RD's (7/10) responded that standards of care for nutritional management of DD need to be developed. In conclusion, RD's identify two distinct subpopulations within DD based on energy needs for weight gain. Nutritional management based primarily on energy needs for weight gain appear inconsistent with the RDA's and state regulations. Further research is needed to determine nutrient requirements in the DD population and to develop standards of care.