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Obesity and SWDs. Prepared 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):
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Obesity and SWDs Prepared 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 Disabilities • 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
Risk Factor 2: Barriers to Exercise • 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: Genetic Disorders • 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