Obesity In Children With Developmental Delays

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THE FITNESS PRIORITY BY KRISTIN MCNEALUS, PT, DPT

You get to influence your child’s health and set the pattern that, when your child grows, another caregiver will accommodate.

Does your child participate in physical education class at school? How much screen time does your child get every day? Does your child eat any vegetables?

The CDC (Centers for Disease Control & Prevention) finds that children with developmental disabilities have a higher prevalence of obesity than those without. It is estimated that  approximately 20% of children with intellectual disabilities are severely obese – that is 1 in 5 children! And that percentage goes up to 32% for children with ASD! This is compared to 13% of children without a disability (which is still higher than it should be.)

This is particularly concerning because this population is already at an increased risk for additional health complications, and childhood obesity tends to get worse as the child ages, rather than better. Adding the risk for diabetes, high blood pressure, and pain to the complications should be prevented.

Here is an interesting statistic: the rates of obesity in children with developmental disabilities is higher in the US than other countries. Does that surprise you? Probably not, since we have higher rates of obesity across most demographics. But what makes this interesting is that it shows that obesity is preventable – even with all of the challenges you may face with your child, you can have a positive impact on their health!

Remember that obesity arises when a greater amount of calories are consumed than expended. Many children, and commonly in those with intellectual disabilities, consume less than the recommended amount of fruits and vegetables. They consume more sweetened beverages, which are high in calories. And they consume too many high-calorie, low-nutrition snack foods. This leads to a significantly higher calorie intake than even a highly active child can expend! Your child may be a picky eater – you may even be reading this and think “my child is underweight and it is important that s/he just get calories!” But there are better options. Put limits on those sweetened beverages. Limit junk food. And insist your child eat fruits and vegetables, even if they resist.

Many children with developmental disabilities have aversions to particular foods; they may not eat certain textures, or colors. Your child may be sensitive to certain smells or temperatures. Children with ASD may also develop eating rituals or unusual feeding patterns. All of this could make finding nutritious foods that your child will eat difficult. But it is important, and it is worth the effort. You are developing lifelong eating habits now. You get to influence your child’s health and set the pattern that, when your child grows, another caregiver will accommodate.

Getting sufficient exercise may be difficult. Children with developmental delays may have impaired motor control or balance. But there are activities they can do safely. They may also have further difficulty if social skills or  communication are limited. One large contributor to sedentary behavior is increased screen time. Your child may be calmed and comforted by television or video games. But this is not exerting any calories. Screen time has also been correlated to snacking, which further increases the excessive caloric intake. Limit your child’s screen time.

Does your child take medications? Ask your pediatrician or pharmacist about the side effects of the medications. There are medications that could cause weight gain, or cause lethargy. Remember that medications cause systemic effects on top of the beneficial impact on any impairment they are addressing. You can always talk to your pediatrician about whether a lower dose is possible.

Again, obesity is more common in the US than other countries. Look for blogs that parents in other countries may have written where they talk about what has worked for them regarding nutrition and exercise. “It takes a village,” right? But we no longer live in small villages where many mothers can help raise a child. We have to reach out for advice from others.

There is an important role in the family for obesity prevention. Having family meal time has positive results by providing structure, as well as modeling healthy eating habits. Children can sense parental stress and a lack of cohesion, so more family time leads to improved behaviors and habits.

School should offer options for physical activity. But supplement that with active family time. Rather than watch a movie together, go to a park. Go for a walk. Do something that does not involve a screen. Additionally, look to your community for additional resources. There may be a local chapter of the Special Olympics. There may be exercise classes or sports designed specifically for children with intellectual disabilities. This will also introduce you to other parents where you can discuss the successes and challenges you face with your children. Look for a children’s  community gardening club. Learning how to grow fruits and vegetables will likely result in less of a challenge getting your child to eat them! And it is an activity that does not involve a screen.

Making these beneficial changes for your child will likely lead to a healthier lifestyle for yourself. And again, children model the behavior they observe, so it will be a healthy cycle for the whole family.•

THE FITNESS PRIORITY
Kristin McNealus, PT, DPT, ATP received her Masters in Physical Therapy from Boston University then went on to 1earn 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.