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 tendnot 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% ofchildren 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% ofchildren 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 syndromewere either overweight or obese

COGN ITIVE & IN TEL L ECTUAL DIS ABIL 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 accomplisheveryday 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 FACTO RS FO R O BESITY IN SWDS

Risk Factor 1:

A More Complex Relationship with FoodChildren 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

R ISK FACTOR 2 : BAR R IER S T O E X ER C ISE

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 Disabilitiesreport 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 moodstabilizers, 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

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