obesity and swds prepared for paco iii prepared by: the honorable robert h. pasternack,ph.d. senior...
TRANSCRIPT
OBESITY AND SWDSPrepared for PACO III
Prepared by:
The Honorable Robert H. Pasternack,Ph.D.
Senior VP
Cambium Learning Group
INCIDENCE/PREVALENCE
According to the Centers for Disease Control and
Prevention (CDC):
SWDs are 38% more likely to be obese than their
non-disabled peers
DOWN SYNDROME
One study found that among teens with Down
syndrome, 86% were either overweight or obese.
Those figures are just as startling for children with
other disabilities
INCIDENCE/PREVALENCE
13% of U.S. families have a child with a disability.
Too often, children with special needs
have been left out of the obesity discussion
SWDS
While SWDs are children first, and disabled
second, they require an extra level of
thoughtfulness, advocacy and attention in order to
maintain a healthy weight.
SOLVING OBESITY
Solutions that work for typically-developing
children may NOT work for SWDs without
modification,
Those solutions that DO work may not be available
in their community
SWDS
SWDs do NOT exhibit the self-regulation of hunger
and fullness that non-disabled kids have
OBESITY
Obesity is defined using body mass index (BMI),
which is an estimate of the amount of body fat a
person has based on his or her height and weight
OVERWEIGHT OR OBESE?
A child is considered overweight if he or she has a
BMI at or above the 85th percentile and lower than
the 95th percentile for children of the same age and
sex.
OBESITY
A child is considered obese if he or she has a BMI
at or above the 95th percentile for children of the
same age and sex
GLOBAL ISSUES
Obesity is a global problem.
Overweight and obesity are the fifth leading risk
factors for global deaths and the problem is
increasing..
GLOBAL ISSUES
Worldwide, obesity has more than doubled since
1980
U.S.A.
In the U.S., more than one-third of all adults are
obese
SWDS
Research has demonstrated conclusively that both
PWDs and SWDs are significantly more likely than
their peers to be overweight or obese
OBESITY
Once people get very heavy, they tend
not to want to do physical activity.
It’s almost a self-fulfilling death sentence .
COSTS
The CDC estimates that health care costs of obesity
related to disability reach $44 billion each year
INCIDENCE/PREVALENCE
According to data from the National Health and
Nutrition Examination Survey (NHANES), 22.5% of
children with disabilities are obese compared to 16%
of
children without disabilities.
GENDER
The problem is more pronounced among girls than
boys
GENDER
Among girls with disabilities age 2-17, the
prevalence of obesity is 23%.
Among their peers without disabilities, the
prevalence is 14%.
GENDER
Among boys with disabilities age 2-17, the
prevalence of obesity is 21%.
Among their peers without disabilities, the
prevalence is 17%.
TWEENS
The problem is particularly acute among young
teens and “tweens.”
The CDC has found that while 18% of
children age 10-14 without disabilities are obese,
the rate for children in the same age group with
disabilities is 30%.
NHANES DATA
80.6% of children with functional limitations on
physical activity were either overweight or obese.
• 50.8% of children receiving special education
services were either overweight or obese.
• 44% of children with Attention Deficit Disorder
(ADD) were either overweight or obese.
ASD
67.1% of the teens with autism spectrum
disorder were either overweight or obese
ASD
• Children with autism are 40% more likely to be
obese than children without autism.
• Children with autism refused foods more than
twice as frequently as their typically developing peers.
• Children with autism consumed more sugar
sweetened beverages and snack foods than their
neuro-typical peers.
DOWN SYNDROME
86.2% of the teens with Down syndrome
were either overweight or obese
COGNITIVE & INTELLECTUAL DISABIL IT IES
39.6% of the teens with intellectual disability
were either overweight or obese
SWDS
SWDs already work harder than their counterparts
just to accomplish
everyday tasks.
Obesity adds an additional layer of difficulty for
both children and their caretakers.
OBESITY
Obesity can make movement more difficult and
curtail a child’s ability to participate in activities,
Including :
P.E.; Playground; Recess; Athletics; Special
Olympics…
BULLYING
Obesity adds an added stigma for children who may
be already stigmatized because of their disability
Bullying occurs more frequently to SWDs than non-
disabled peers
COSTS
Obesity incurs additional health care costs for the
families of SWDs and our entire society
CAUSES OF OBESITY
• The higher price of healthy foods compared to
unhealthy foods
• Increased portion sizes
• Increased availability of processed foods
• Increased consumption of sugar-sweetened drinks
• Decreased physical activity
• Increased screen time
CAUSES OF OBESITY
Inadequate sleep that has been tied to weight gain.
• Increased exposure to endocrine-disrupting chemicals in
food and the environment, which may alter metabolism.
• Climate controlled environments that reduce the
calories burned by sweating and shivering.
• Women giving birth at older ages, which correlates with
heavier children.
RISK FACTORS FOR OBESITY IN SWDS
Risk Factor 1:
A More Complex Relationship with Food
Children with ASD may have an intense aversion to
certain textures, flavors or colors, leading them to eat
a very limited assortment of foods
PARENTS
Parents of children with special needs often are
reluctant to clash with their children over food
PEERS
Another element of Risk Factor1 is peer influence.
The desire to fit in is strong for any child,
particularly one with a disability
SWDs want to eat what their peers are eating
USING FOOD
Parents, therapists and TEACHERS may be in the
habit of using food for behavior modification,
Sometimes food is used to express affection or win
compliance
RI SK FACTOR 2 : BARR IERS TO EXERC I SE
Exercise is vital not just for maintaining a healthy
weight, but also for muscle tone, circulation and
mood
PHYSICAL DISABILITIES
39% of youth with Physical Disabilities
report never exercising at all, according to one study.
BARRIERS
The child’s own functional limitations,
The high cost of specialized programs and
equipment,
A lack of nearby facilities or programs.
RISK FACTOR 3: MEDICATIONS
75% of children with a special health care need take
at least one prescription drug.
Many medications, particularly certain
antipsychotics, antidepressants, anticonvulsants,
neuroleptics and mood
stabilizers, are associated with weight gain.
RISK FACTOR 4: FAMILY STRESS
Parents of SWDs often have schedules crowded with
medical and therapeutic appointments
FAMILY STRESS
With parents of SWDS having so much to do, high
calorie prepared or packaged food may seem like a
more viable option than cooking meals from scratch.
PARENTS
Healthy food, inclusive fitness classes or
professional consultation may simply be financially
out of reach for many parents of SWDs
RISK FACTOR 5 : GENET IC D ISORDERS
Certain genetic disorders that cause SWDs have
obesity as clinical features
RISK FACTOR 6: PERCEIVED RISK
Parents, TEACHERS,pediatricians and coaches may
feel that the activity will be too difficult, too
dangerous, or too disappointing for a child with a
physical, intellectual, or behavioral disability
PEDIATRICIANS
Pediatricians frequently underestimate the benefits
and overestimate the risks of physical recreation for
children with chronic health issues
RISK FACTOR 7: SOCIAL ISOLATION
Children with special health care needs may have fewer
friends than other children their age and thus may miss
out on the chance for free play in an outdoor setting.
SWDs may also be excluded from team sports because
others believe they won’t contribute to victory
RISK FACTOR 8: SCREEN TIME
Screen Time is strongly associated with obesity.
If a child is less engaged in physical activity than
they’re more engaged in sedentary behavior
SCREEN TIME
Childhood obesity is almost directly correlated with
the amount of time children spend in front of
computers and televisions
RECOMMENDATIONS
We need public policies that support physical
activity programs for PWDs.
We need more investment in programs both public
and private.
Private sports and fitness clubs must offer
choices for PWDs
RECOMMENDATIONS
Absence of curb cuts, crosswalks, sidewalks, or
working elevators are major impediments for PWDs
who may be trying to go for a fitness walk or reach a
swimming pool or inclusive exercise class.
Remove BARRIERS
RECOMMENDATIONS
P.E. as a core subject in schools
Increase amount of physical activity for SWDs in
schools
Build capacity of the learning community to focus
on Obesity Prevention