THE FITNESS PRIORITY BY KRISTIN MCNEALUS, PT, DPT
There are a number of factors contributing to unhealthy habits in children with special needs, namely behavioral issues, medications, and mobility limitations.
Childhood obesity is on the rise in our country, and the rate of obesity among children with special needs is even steeper than that of other children. There are a number of studies looking at these statistics, and although the exact numbers differ, here are some shocking findings among some specific groups:
• 67.1% of the teens with autism spectrum disorder were either overweight or obese.
• 86.2% of the teens with Down syndrome were either overweight or obese.
• 18.8% of the teens with cerebral palsy were either overweight or obese.
• 83.1% of the teens with spina bifida were either overweight or obese.
• 39.6% of the teens with intellectual disability were either overweight or obese.
Let those numbers sink in. But the good news is this can change. As exceptional parents, you can make healthier choices for your children!
Just to clarify the terms, “overweight” is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors; while “obesity” is defined as having excess body fat.
Why is this so concerning? Because according to the CDC, obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure, more likely to have pre-diabetes, and are at greater risk for bone and joint problems. Studies also show that children and adolescents who are obese are likely to be obese as adults. It is important to develop healthy habits in children to contribute to a lifelong healthy lifestyle.
There are a number of factors contributing to unhealthy habits in children with special needs, namely behavioral issues, medications, and mobility limitations. Acknowledging them is the first step to being able to make changes.
Let’s touch on the behavioral aspects of nutrition. As a parent, it may be challenging for you to guide your children to eat a healthier diet. If your child has difficulty chewing, or swallowing, or will not eat particular textures or flavors, you may be limited in the foods you can serve them. It may seem easier to grab some processed food, however the added sodium and sugar will contribute to increased weight. Understandably, as parents, you have many battles to fight throughout the day, and you may not want to take on another one by fighting over food. However, making changes now will help your children for the rest of their lives! And the whole family would benefit from following a healthier diet.
Another behavior to be aware is using food as a “reward.” Often junk food can be used as a treat for a desired behavior, or a prize for following directions. It’s easy to say “If you behave yourself, we go through the drive-thru on the way home!” Not only will this food contribute to added calories, but it will also associate junk food with achievement. Try to think of other (non-edible!) rewards that your child will appreciate.
The next factor contributing to obesity is medications. It is estimated that 75 percent of children in this demographic need take at least one prescription drug. Many medications, particularly certain antipsychotics, antidepressants, anticonvulsants, neuroleptics and mood stabilizers, are associated with weight gain. These medications may be unavoidable in your child’s care. It is good to be aware if this is a side effect of any of the medications your child needs and talk to the physician about modifying diet and exercise to counteract the potential pounds.
And the third factor is exercise. One study found that 39 percent of youth with physical disabilities report never exercising at all! Exercise is an important part to fight obesity. Physical activity can help maintain a healthy weight, increase muscle tone, and improve mood. When children exercise regularly, they are helping to control the progression of disease, and prevent functional decline while improving their overall health. Exercise has proven to have benefits for all the systems, including protecting the nervous system. It can also decrease pain!
There are many physical limitations that make getting enough activity difficult, but there are options. Don’t let fear keep you from getting your child involved with activities that may challenge them – it may bring them more feelings of accomplishment! Finding activities that they enjoy make take some time and effort, but again, could have lifelong benefits! Remember from August’s article, children will model after you. If you are active, they will want to be active. If you are excited about finding fun activities, they will be more interested in participating.
Focus on what your child CAN do. If your child fatigues quickly with activity due to respiratory or cardiac conditions, then pick low intensity activities that allow for frequent rest breaks. If your child has mobility limitations, look into local adaptive sports organizations. There may be sporting events that you can take your children to go watch to generate some excitement. You can find wheelchair team sports, which can also be an avenue for socialization for our child. You can find powered wheelchair soccer, wheelchair basketball, or sled hockey. Fencing and tennis may be an intermediate of individual sports that also have the team aspect. There are also individual sports if your child prefers to focus on the task and may not enjoy the team aspect. You may want to try track and field or martial arts.
If your child has an intellectual disability, look into the local chapter of the Special Olympics. They may hold clinics and fairs to see if any of the sports or activities interest your child, as well as introduce you to a social network. Again, you can find opportunities for your child whether they prefer to be social and participate in team sports, or if they choose to work individually. There are options if you look for them.
These days, children have access to many sedentary diversions like television, video games, computers, and mobile devices. These can provide hours of entertainment and distraction. It helps provide a break for parents and children. However, this can easily surpass a healthy amount of time. Did you know that screen time is strongly associated with obesity? Studies have found that television viewing lowers the rate of children’s metabolism more than resting does! The reason is not fully understood, but this is certainly alarming. There have also been plenty of studies about the exposure to advertisements for soda, snack foods, fast foods, and candy, and the affect on nutritional choices. Limiting the amount of screen time your child has on a daily basis could certainly be challenging, but again will contribute to healthy habits.
Financial burdens can make these suggested changes sound impossible. This is understandable. Having a child with special needs can put additional strain on any budget. However, with the way the health care system is changing, getting sick is going to cost more every year. The upfront costs of making healthy changes will save money later. This is difficult to see in a budget since the costs of illness are assumed. There are organizations and grants that can help with finding affordable local foods and with obtaining adaptive exercise equipment. And remember that making these healthy changes will benefit the whole family!
The other challenge is time. You are already spread thin between childcare, medical appointments, and everything else on your plate. Taking the time to prepare healthy meals may feel like squeezing water from a stone. Again, there are options like preparing in bulk and freezing meals for those hectic evenings, or keeping fresh fruits and vegetables in the home for snacks and not keeping chips and cookies.•
THE FITNESS PRIORITY
Kristin McNealus, PT, DPT, ATP received her Masters in Physical Therapy from Boston University then went on to earn her Doctorate in Physical Therapy from MGH Institute of Health Professions. She has been a staff physical therapist on inpatient rehabilitation for people with spinal cord injuries at a number of hospitals in Southern California, as well as Director of a community adaptive gym for people with neurological injuries. She is a member of the International Network Spinal Cord Injury Physiotherapists, and has contributed to the APTA Guidelines for Exercising with a SCI. She has completed 3 marathons, and 25 triathlons, including the Ironman! SCI Total Fitness is designed to promote health and wellness for people with physical disabilities.
Source Exceptional Parent Magazine