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Disability Youth Overview
Inclusion is a term used quite frequently in our society. It means
that as trainers and teachers, we will have students with
disabilities in our classrooms and fitness facilities, and we must
learn how to meet their unique needs in daily activities and
welcome them in our schools, churches, and recreation/gyms, while
striving to serve the general public as well. This is a daunting
task even for those people who specialize in special education. I
believe that this article is essential for anyone who works with
children with disabilities. This article is divided into four
categories addressing those students with physical, mental,
learning and emotional/behavioral disabilities. Please read each of
these sections since the persons you may be working with will have
a variety of disabilities and perhaps a combination of multiple
diagnoses.
Physical Disabilities
A physically disabled person will have various ranges of
coordination, mobility, balance, agility, strength, and endurance
challenges. It is important to remember when working with these
individuals that many of them have normal and gifted mental
abilities. Some disabilities have been a part of an individual’s
life since birth, others have developed over time, and still others
are the result of injuries that occurred after birth.
Arthritis and Rheumatism
Many people think that arthritis and rheumatism only occur in the
elderly, but this is not always the case. Arthritis is the
inflammation of the muscle joint line and pains in the body’s
muscles, tendons, and ligaments are rheumatism. Individuals with
arthritis and rheumatism may tire easy and activities such as
walking, climbing, going flights of stairs, rising and standing may
be challenging. It is recommended that physical exercise be mild
yet challenging and done at the same time of day for those with
these conditions. Many people with these conditions have reported
improved health with exercise.
Cerebral Palsy
Cerebral Palsy is caused by conditions that affect body movement
and muscle coordination. It ranges from mild to severe. Some people
with cerebral palsy are mobile and have hardly any physical
characteristics whereas others cannot move at all. Cerebral palsy
first appears during infancy. Some cases of cerebral palsy are
caused by a blood-type incompatibility or an infection that happens
before or just after birth. Cerebral palsy effects body movement
and muscle coordination. Some individuals with cerebral palsy have
either decreased muscle tone (hypotonic), increased muscle tone
(hypertonic), or stiff and rigid muscles. Faulty development and
damage to motor areas of the brain cause this disability. People
with cerebral palsy have average and above average mental abilities
and should be treated cognitively on that level. Physical abilities
should be tested under the direction of a physical and occupational
therapist. After assessment, assisted elastic tube body weight
training and weight machines are great to include in your strength
training program. Cardiovascular training will depend on the
individual’s physical stamina. Stationary cycling or swimming are
excellent options for someone with cerebral palsy. Modification of
equipment is also a great way to include the child in fitness
activities. Use balloons, beach balls, or soft balls for safe
tossing and catching. Modifying the rules of games, using large
scooters, or enlarging targets gives students success.
Tourette's Syndrome
Tourette's syndrome is a neurological or neuromechanical disorder
characterized by tics of involuntary, rapid movements and repeated
vocalization. This person frequently displays eye rolling,
blinking, twitches, sniffing, and throat clearing. Speech disorders
may include echolalia, the urge to repeat words spoken by someone
else; palatial, repeating one’s own words; lexilalia, the urge to
repeat read words, and coprolalia, using swear words or
inappropriate words uncontrollably during speaking. Teachers and
trainers can minimize embarrassment by educating the rest of the
class about this condition and having activities where the
individual’s strange behavior is ignored or minimized by
redirection or by allowing that child an opportunity to display
their behavior in a private space such as an extra classroom or gym.
Spinal Bifida
Spinal bifida is a birth defect that happens when the vertebral
canal fails to close normally around the spinal cord. Disabilities
with this disorder include paralysis or lack of feeling to the legs
and feet and lack of bladder and bowel control. Programs should be
conducted in conjunction with a physical or occupational therapist.
Visual Impairments
A visual impairment is more than someone who wears eyes glasses.
Their visual acuity is 20/70 or less, and they will struggle with
vision, even when using a corrective prescription. A trainer or
teacher may assist the student by using verbal directions and by
asking the student for how the student learns best. Because of
their limited vision, the student often has poor motor skills and
displays easy fatigue. Ask them how they would feel comfortable
being guided. Give students mental pictures and descriptive words.
Simplifying the game or skill is also effective.
Hearing Impairments
Those students who are hard of hearing and deaf may benefit from
the use of sign language, lip reading, or written directions. Face
the person when you are signing or talking with them, demonstrate,
increase hands-on experience of the activity, and ask them to
repeat anything that they did not understand. Reduce distractions
and background noises. When talking to the hearing-impaired, face
the person because they need to see your face to read your lips and
see your gestures.
Speech or Language Disability
Some children have a hard time understanding what other people are
saying. Students often do not hear greetings and mix up words and
sounds. They suffer from disorganization, trouble with rote
learning, noisy environments, and hav difficulty following
conversations. Some students struggle with expressive language and
others have difficulty with receptive language, despite the fact
that they are in a regular classroom. It is best with these
children to use sign language, if they use it, visual or written
directions, and a schedule. It is also perfectly acceptable to use
a chalkboard, dry erase board, or pad of paper to communicate. A
buddy is also effective, and most students enjoy taking a turn
being someone’s assistant.
Motor Skills
Children with motor skills disabilities often have another
disability. They move slowly and have a hard time controlling their
muscles. Some children suffer from lack of ability with large motor
movements such as running, jumping, kicking and throwing, and
catching, and others with small motor movements such as using their
hands and fingers. Teachers and trainers must work together with an
adaptive physical educator to find simplified ways to teach fitness
skills. It is helpful to teach academic and physical skills by
breaking the tasks down into small parts. Fine motor skills that
should be integrated in academic and fitness activities include
kneading with dough, working with modeling clay, using whole
punchers, cutting with scissors, and writing in sand or shaving
cream. Painting with a bucket of water on a chalkboard or driveway
and writing words on a chalkboard or sidewalk are good activities
to include in fine motor coordination. An occupational and physical
therapist is helpful in the gym, classroom, and home.
Proprieties System and Sensory Integrative Disorders
In these disorders, the central nervous system does not respond
well to incoming stimuli and disorders of body position or space
awareness. They suffer from not understanding their receptors of
muscles, joints, and tendons. They may not give appropriate body
space and may make others feel uncomfortable. The central nervous
system does not respond well to incoming stimuli. Children often
have trouble interpreting emotions and may become easily frightened
or angered. They may avoid new things or fight with others
frequently. A teacher or trainer may find that it is essential to
see what sets that person off and to try to eliminate situations
that will upset the individual. It is important to give that person
space and not to allow others to get too close to that person if it
upsets him/her.
Tactile and Vestibular Disorders
These persons have difficulty determining appropriate senses of
touch and may overreact to light touches while other things that
could potentially harm them, such as a bee sting or hot stove, do
not affect them at all. They may be a picky eater, affected by
various textures of fabrics, react negatively to hygiene such as
washing hands and face, and be unwilling to try art projects that
are messy such as finger paints, glue, and clay. Autism and sensory
dysfunction also fall into this category. Vestibular is the system
of movement that begins in the inner ear and controls the movement
of the head, eyes, and body and causes balance. Students with this
disorder may have difficulty accomplishing bilateral tasks such as
cutting with scissors or riding a bike and may be developmentally
delayed.
Traumatic Brain Injury and Environmentally Induced Impairments
This is where the brain has been damaged through an accident or
abuse. There is generally a period of unconsciousness when injury
occurs and the person, as a result, loses part of their cognitive
abilities or physical functions. Lead poisoning, fetal alcohol
syndrome, pre-and post-natal complications, and drug use can be
environmentally induced impairments. In all of these disorders,
these children generally suffer from problems and seizures. They
may also sleep poorly and have irregular eating patterns. Often
these children are adopted or with foster families since many of
these cases occur as a result of parental abuse. Patience and
contact with support staff and home is essential when dealing with
students with these disorders.
Mental Disabilities
People with mental impairments develop at a slower rate
emotionally, developmentally, and physically. Genetic conditions,
problems with pregnancy, and early health problems may cause mental
retardation. Mental retardation is very common, affecting 3 out of
every 100 people. There are four basic levels of retardation. With
all mental disabilities, structure is key. Advice for working with
those students with mental retardation includes breaking down tasks
into simpler steps, using concise simple directions, providing
opportunities for repetition, repeating tasks and skills, and
striving for appropriate age-level behavior. A good teacher or
trainer will have more than one way to accomplish a goal if the
first way they teach the student does not work.
Educable Mentally Handicapped (EMH) is characterized as a mild
impairment. These individuals are typically mainstreamed in a
regular education classroom with additional help from aides and
special education support staff. Many EMH persons are able to lead
normal lives, live independently, and hold employment. Teachers
and trainers find that providing visual directions with pictures
and simple directions and pausing to give instructions at slower
rate work well with these children. Eighty-five percent of persons
with disabilities fall into this area. Poor motor coordination with
fine or gross motor skills or both is a part of mental retardation.
Down’s Syndrome
Most students will Down’s fall under the EMH category. They learn
at a slower rate, are often stubborn, but can also be very
affectionate. These students may suffer from physical defects such
as hearing or vision loss, heart defects, gastrointestinal
problems, and respiratory problems. Using a firm, fair, friendly,
fun, affirming, positive, and consistent environment will prove
effective with these students. When they have an opportunity to
spend time alone with a choice of teacher-directed activities, they
will perform well in the classroom or gym. They have infectious
personalities and easily make friends wherever they go.
Prader-Willi Syndrome
Prader-Willi Syndrome is another EMH condition usually present from
birth and characterized by obesity, decrease muscle tone, and
decreased mental ability. These individuals may have immature
physical development and short stature. This person has an
uncontrollable need to eat and will sneak and steal food. Food is
not properly digested so rapid weight gain occurs even when
portions are controlled. Behavioral characteristic include sudden
temper tantrums accompanied by violent outbursts, stubbornness,
resistance to change, and poor social relationship. Learning
disabilities, speech and language difficulties, and short-term
memory problems can also occur. A teacher or trainer can find
alternatives to food by providing activities that the individual
likes. Sport activities are limited because running and jumping can
cause joint injuries due to poor muscle strength and poor
coordination, possible bone fracture due to early osteoporosis, and
decreased muscle bulk. Walking, swimming, and stationary exercise
equipment are great alternatives. Training with weights or body
weight can be effective to preserve muscle tone, and daily exercise
at least 30 minutes can be helpful.
Moderate Mental Impairment
Trainable Mentally Handicapped (TMH) individuals have moderate or
severe disabilities. They are traditionally in self-contained
classrooms with mainstreamed opportunities during social times of
the day when they interact with students and special classes. They
may be self-sufficient if supervised during instruction, but it
very helpful to have physical occupational therapists and adaptive
specialists help modify activities when working with these
individuals.
Severe Mental Impairment
These students are often grouped by themselves in a non-traditional
school setting such as a cooperative or therapeutic school.
Activities must be basic with a lot of emphasis on improvement and
stabilization of fine and gross motor abilities. Some students may
talk but many are non-verbal. It is essential for teachers and
trainers to find an effective way to communicate with their
students through the use of sign language and pictures. Often these
students will have a secondary condition of a behavior disorder
because of their lack of ability to communicate.
Profound Mental Impairment
These individuals learn at an extremely slow rate. Often they can’t
talk and have limited self-help skills. They require supervised
care throughout life. Even these students enjoy group games using a
parachute, catching a ball, or taking a walk outside.
Rhett’s Syndrome
This disorder only occurs in girls with severe and profound mental
retardation. The individual is born normally and develops until
six to eighteen months of age. At that point, they lose mental and
development ability. Signs of Rhett’s include repetitive hand
movements, hand wringing, hand clapping, and hand mouthing.
Children with Rhett’s enjoy music, may benefit from working on
small and large motor movements, and enjoy long supervised walks.
Learning Disability
A learning disability is a disorder in which spoken or written
language, thinking, speaking, reading, writing, spelling, or
mathematical calculations is a struggle. That learner is typically
one or more grade levels below the average child, and for that
individual, learning is quite difficult. Milestones in motor skills
and memorization are inhibited. If a teacher or trainer can provide
activities using the learner’s strengths, increased visual and
verbal directions, and hand-on experiences, the learner can
experience success. Many people misunderstand students with
learning disabilities and mistakenly characterize them as lazy,
weird, and socially impaired. These persons learn differently, and
the attuned teacher or trainer must realize that learners should
work in their own ways.
Dyslexia
Students with dyslexia have difficulty reading and writing. They
often reverse letters and numbers in writing and read backwards.
The brain is confused by the ways letters and words are arranged.
The reader may also skip, repeat, or miss letters and numbers when
reading silently or aloud. This disorder is not corrected with
eyeglasses. A teacher or trainer might find that verbal directions
or pictures are better tools with these children. A tape recorder
with directions is also effective.
Behavioral Disorder
Students with a behavioral disorder generally have motor abilities
within acceptable limits of other children. They use seek attention
from adults by acting out, and use their disorder when they are
frustrated or cannot communicate their feelings. They may be
hyperactive, destructive, dangerous, impulsive, and at times
inattentive. An environment with consistent rules, environment, and
structure and fewer distractions and choices work best for this
student. Allow him/her to have their own personal space and realize
that they may not hear you if you force them to look at you while
you are speaking. Positive reinforcement is most effective with
this student, and a teacher/trainer must choose which behavior is
important to correct at times.
Attention Deficit Hyperactivity Disorder
Attention Deficit Hyperactivity Disorder (ADHD) is a behavioral and
developmental disorder. Individual has poor concentration,
hyperactivity, impulsiveness, figits and squirms, is aggressive,
defiant, disorganized, and can get very emotional. They often do
not sleep well at night and have high energy and activity levels.
Students can be helped with simplified directions, extended wait
period when answering questions, and activities that are broken up
into parts. It is important when working with an ADHD student to
eliminate distractions, organize the learning space, and minimize
background noise. Students could also benefit from a buddy and a
smaller group when doing activities, written and picture rules,
directions, and schedules. Changes in the schedule should be
minimized. Give directions both verbally and in writing. A
redirected word or counting down system is also effective. They
also enjoy helping the teacher and do well when given
responsibility.
Hyperactivity
These learners need a safe place to move and may use their bodies
or another object to manipulate energy. They do better with
individual sports such as track, gymnastics, and weightlifting.
They make excellent assistants and do well with structured time and
with using a timer to chart activities.
Social Skills Disability
These children or teens have difficulty with appropriate social
skills. They may have another diagnosis such as mental retardation.
They also suffer from ritualistic behavior. Obsessive Compulsive
Disorder (OCD) is one of these disabilities. A chemical imbalance
or genetic or neurological disorder can bring about OCD. These
individuals may have trouble with space and tone of voice and may
react at strange times. A stress or traumatic event can bring about
OCD. They can also obsess about harming others or themselves.
Compulsions are the urges to perform certain behaviors in response
to the obsessions. These rituals seem to lesson the anxiety caused
the by the obsessions. Some things include excessive hand washing
or washing of other objects, repeating actions, a bad habit,
obsessive speech, or counting to a certain number. These
individuals have no control over the stopping and starting of
obsessions and compulsions. Redirection is effective and allows
the child to try new things. These learners benefit from working on
one skill at a time and, in that circumstance, have a high rate of
success.
Autism Spectrum
Some learning differences such as autism can have a range of mental
retardation to gifted status. Understanding these differences helps
the teacher and trainer better understand how to work with and
function with these disabilities.
Autism and Asperger’s Syndrome
In autism and Asperger’s, the developmental disability affects
verbal and nonverbal communication and is generally evident before
age three. One out of every 300 children is affected by autism. The
medical field has not narrowed down the cause of autism. Some
studies suggest genetics, others suggest chemicals in the child’s
environment or a vitamin deficiency, and others suggest the cause
lies in dairy and gluten allergies. Students are not able to
effectively communicate with one another; they are obsessed with
repetitive activities and do best with a consistent, predictable
daily routine. They also may have hyper- or hypo-sensitivity to
people, materials, and objects. Often they enjoy doing activities
by themselves. When working with these children, use pictures,
provide a less stimulating environment, seek to introduce
activities that will promote the student’s success, and offer two
choices for activities instead of telling the child the way it will
be done. Use literal speech and concrete examples. Make sure you
don’t use jokes, sarcasm, double meanings, or idioms. Autistic
individuals often display egocentric behavior and may become
obsessed or preoccupied with a particular topic or interest. An
instructor, at appropriate times, must try to integrate that
subject into the learning area.
When working with students with disabilities, be as
consistent as possible in your goals and expectations. Use clear
consistent, explicit communication and break tasks down into
smaller units to keep students from getting overwhelmed. Small
steps can keep you focused on goals and minimize distractions.
Repetition will benefit students. Be patient and celebrate the
small leaps. Use concrete directional words such a “first,” “next,”
and “finally,” and explain who, what, where, and why in directions.
Ask questions, and if possible, have the student repeat the
directions in their own words. Increase wait time in your
questioning and directions. Try to minimize unexpected surprises
and use white noise to block out distractions. Use a schedule with
minimum changes. When working with an individual with disabilities,
give those options with a basic plan of action in mind. These tips
will help you accomplish your goal while giving students ownership
over their learning. All students and adults with disabilities
respond well to positive reinforcement and genuine praise. Good
notes, phone calls home, token rewards, and extra privileges are
proven to be effective forms of reinforcement for those with
disabilities. Don’t expect perfection but…Be Positive! Be Creative!
Be Flexible!
References
Cummings, Rhoda and Fisher, Gary, (2003). The survival guide for
kids with LD. Minneapolis, MN: Free Spirit
General Accommodations for Students with Physical Impairments
http://www.glc.k12.ga.us/passwd/trc/ttools/attach/accomm/physimp.pdf
Tips for Teaching High Functioning People with
http://www.udel.edu/bkirby/asperger/moreno_tips_for_teaching.html
National Dissemination Center for Children with Disabilities
http://www.nichcy.org/index.html
South Suburban Special Recreation Association, (2005). SSSRA staff
and volunteer safety/orientation manual. Tinley Park, IL: SSSRA
Understanding the Student with Asperger's Syndrome: Guidelines for
Teachers
http://www.udel.edu/bkirby/asperger/karen_williams_guidelines.html
1)
Obesity in Special Education
The Problem of Obesity
Youth obesity is at an all-time high. Someone who is obese is
classified as someone who is in the 95th percentile of their Body
Measured Index or BMI (Patton, 2004). Current statistics show that
10.4% of 2- to 5-year-old children are obese, 11.5% of 6- to 11-
year-old children are obese, and 15.5% of 12- to 19-year-olds are
obese. (MacKinnis, & Rausser, 2005). Nine million adults—65% of
the population—are considered obese. (Anderson, 2005). Obesity has
tripled five times since 1970. Eighty percent of obese children
become obese adults (Best, 2003). Fewer than one in four youth get
the physical activity they need each day (Patton, 2004). Seventy-
five percent of all students eat out five days a week. Children
and youth 4-19 years old eat six pounds of fast food a year.
Caloric surplus plus the daily consumption of hot dogs and sausage
are common, particularly in metropolitan areas. Fresh fruit and
vegetables are not readily available in low income grocery stores (
Kaplan, Liverman, Kraak, 2005).
In 1977, the average caloric consumption was 3300 per day. In
2004, the caloric consumption is up by 500 calories to 3800
calories per day (Patton, 2004). Many toddlers—nine to eleven
months old—eat candy 60% everyday and salty snacks 16% everyday.
The numbers increase to 27% everyday in kids 11-19 months old with
salty snacks. Toddlers are getting set up to eat comfort food that
is high in sugar and saturated fat and to learn how to use food to
console themselves. This is a flirtation with disaster since it
teaches kids bad habits at a young age. (Patton, 2004).
One out of every four teenagers becomes overweight. This is
certainly a problem since obesity contributes to 300, 000 deaths
annually (Patton, 2004). Obesity as a whole will claim more lives
than AIDS and tobacco this year (TLC, 2004).
The effects of childhood and teenage obesity are many and include
high blood pressure, heart disease, problems with weight bearing
joints, sleep apnea, gall bladder disease, stroke, respiratory
problems and some types of cancer (American Dietetic Association,
2001). Obesity may be a medical issue, but it can become a
psychological one that brings on self-hatred, depression, anxiety,
social isolation and alienation (Mintle, 2005). Other
psychological effects of youth obesity include a lower self-esteem,
inferior body image, poor relationships with peers, and more fights
with peers and those in authority (Patton, 2004 and Chapan, 2004).
Obesity is also expensive. Childhood obesity cost $35 million in
1979-81, and it quadrupled to $127 million between 1997-2000
(Zametkin, Zoon, Klein, & Munson, 2004). Youth obesity has
increased 197% in the last thirty years, gallbladder disease 228%,
and sleep apnea 438%. Obese kids are five and a half times more
likely to report an impaired quality of life than healthy normal
weight children. More days are taken off for illness—an average of
three more days than their average weight peers. School
performance suffers and severely obese children report a quality of
life as bad as that reported by children with cancer who have been
treated with chemotherapy (Patton, 2004).
Students who are obese are at risk for diabetes. Type II diabetes,
a disease that, in the past, used to strike older people has spread
to the younger generation and now afflicts children as young as
three (TLC, 2004). There has been a ten-fold rise in childhood
obesity in the last decade. Hospital costs have skyrocketed for
Type II, costing $35 million between 1979-81 and $127 million
between 1997-99 (Taking Action for Healthy Kids, 2004). One half
of all Hispanic and African American babies born in 2003 will
develop diabetes before they are 18 years old. One third of all
babies born in 2004 will develop diabetes before they are 18.
Children who suffer from Type II Diabetes are often on route to
heart disease, heart attacks, kidney failure, blindness,
amputation, miscarriages, and if their condition goes untreated,
they will see an early death.
Obesity affects all genders and races. This paper will focus on
three races I will discuss are Caucasian, African American, and
Hispanic. Twelve percent of Caucasian boys from ages 6-11 and
11.6% of Caucasian girls suffer from obesity. African American
children suffer from obesity in 17.1% of the boys and 22.6 % of
girls. Twenty-three percent of Hispanic boys are obese and 19.6 %
of Hispanic girls are obese (Ritter, 2004; Mainer & Alexander,
2005; Patton, 2004).
Obesity in teens climbs even higher. Twelve percent of Caucasian
boys suffer from obesity and 12.4% of girls. Twenty percent of
African American boys suffer from obesity and 26.6% of African
American girls are obese. Twenty-seven percent of Hispanic boys
are obese and nearly 20% of Hispanic girls are obese (Ritter, 2004;
Mainer & Alexander, 2005; Patton, 2004).
Children living in metropolitan areas like Chicago tend to be more
obese; that trend seems to be linked to the abundance of nearby
fast food restaurants. Chicago is the epicenter of the obesity
epidemic (Rado, 2005) Seventy-eight percent of Chicago schools have
at least one fast food chain within half a mile of the school.
Ninety-four percent have fast food restaurants within one mile.
There are, for example, twelve fast food establishments within one
half mile the Walter Payton Prep School (Rado, 2005) Students
prefer Whoppers to healthy food, and each hamburger contains at
least 1,000 calories or one-third of a typical student’s diet
(Ritter, 2004; Slide & Long ,2005; Mainer & DelRoy , 2004; Patton,
2004). The rate of youth obesity in North Lawndale is 68%, South
Lawndale 58%, Roseland 64%, and Humboldt 65%.
Special Needs Children and Obesity
Research is very limited in obesity for special needs students.
Unfortunately, studying obesity in special needs students is not
considered a lucrative business. Many health clubs feel that
disabled people are a risk for their businesses, so they don’t
encourage their use by their disabled public. Obesity is doubled
in special needs students when compared with the general public.
In a Chicago demographic study, 84% of people with special needs
were overweight, 62% were obese, and 22% were extremely obese. In
the Special Olympics, 64.5% of participants had a BMI <30 or more.
Sixty-eight students had dental carries. Obesity is a great problem
in the special needs population because people with disabilities
often have the bodies of their average counterparts, but 20 to 30
years older (America Academy of Orthopedic Surgeons, 2004).
The Cause of the Problem
Obesity is caused by a variety of genetic, biological,
psychological, and environmental factors (Kaplan, Liverman, &
Kraak, 2005). Some of the common causes include heredity, excess
consumption of calories, minimal exercise or no exercise at all and
poor nutrition (Patton, 2004; Mintle, 2005). Problems in the
family may increase the likelihood of obesity including divorce,
illness in the family or a way to be distracted from emotional pain
(Ritter 2004).
There are many factors to blame for obesity. First of which
is a lack of inactivity. In 1969, 80% of kids played sports. Now,
only 20% of all children play sports (Chapan, 2004). Mindless
snacking and passivity is another factor. Mindless eating and poor
habits lead kids to grab the soda or chips without thinking
(Patton, 2004). Children eat out of boredom, and they can not tell
the difference between hunger and appetite. Children have too
many toys, and they are lacking imagination ( LoGuerra, 2006).
There are more than 2,000 types of food condiments and 1,000 more
bakery items since the 1970s (Chapan, 2004). School lunches have
an average of 1,000 calories. Early elementary children should
consume about 1,500-1,700 calories per day and middle school
children about 2,300- 2,900 calories per day (Spurlock, 2004 and
2005). Students consume twice as much soda than the milk they
consumed twenty-five years ago (Kelly and Moag, 2002). Food
rewards are given such as Krispie Cream donuts for an A on a report
card, Book-its (reading) for pizza, and Chucky Cheese tokens for
good grades.
Fast food is also to blame. Many foods contain a multitude of
calories: Arby’s Beef and Cheddar has 490 calories, Burger King’s
Double Whopper has 884 calories, Wendy’s Taco Salad has 666
calories, and KFC’s Xtra Crispy Thigh has 406 calories. Children
eat forty percent of all their calories outside the home and twenty-
five percent of all the vegetables served are french fries
(Brownwell, 2004). A typical kid’s meal is 1,700 calories, one
entire day’s supply for early elementary students in a
cheeseburger, fries, soda, and sundae at Outback Steakhouse. In
conclusion, fast food is cheap, easy, and readily accessible
(Patton, 2004). But the future and permanent effects are life
threatening.
McDonald’s is the leader of these abuses. Eighty-three McDonald’s
are in Manhattan alone, and when I googled the restaurant, I found
four less than ten miles from my house. At my present place of
employment, they have a Mc Donald training kitchen and many of the
staff and students order from it everyday. The golden arches served
over four billion in 2002 (Nahhas & Hibbs, 2002). One hundred
percent of all children have visited a McDonald’s, 98% in Japan,
and 93% in the United Kingdom. Seventy-five percent of all
children visit McDonald’s every month. A Big Mac has 550 calories,
a McDonald’s fish sandwich has 370 calories, a large fry has 440
calories, an apple pie has 260 calories, and a Coke has 200
calories (Spurlock, 2004).
Advertising is another cause of obesity. Television in general
causes children to eat more high-calorie foods. Thirty billion was
spent on total advertising in 2003 (Brownwell, 2004). In the
area of advertising, thirteen billion was spent targeting
advertising on children alone. In 2003 in the area of advertising,
$1.4 billion was spent by McDonald’s, $1 billion by Pepsi, and $200
million by Hershey. The Five-a-Day Program spent a mere $2
million. In a typical TV programming morning on Nickelodeon, there
were over 52 commercials for food products. Kids are more likely
to identify Ronald McDonald than Jesus (Spurlock, 2004 and 2005).
A child sees 10,000 food commercials every year (Brownwell, 2004).
Television also causes obesity. If children are watching
television, they are idle. Those children who watch more than two
hours of day of television are more likely to be obese. Some
children watch it over four hours a day. Teenage girls of all
races watch the most television. The average American youth spends
20-30 hours a week watching television. Before the age of 18,
American kids spend three years of their waking lives in front of
the television. It is used a babysitter for latch key kids, and
unfortunately, television only burns 50 calories an hour compared
to walking moderately which burn 150 calories per hour. Seventeen
percent of all youth obesity is traced back to television viewing,
15% for raised cholesterol and 15% poor cardiovascular fitness
(Patton, 2004). We are trading safe kids for unsafe futures and
our current lifestyles.
Labor-saving devices and remote controls allow people to accomplish
more tasks in less time and cause less physical activity while
encouraging sedentary lifestyles. A drastic reduction in kids
walking or riding bikes to school also causes obesity. Obesity is
also caused by psychological factors. Food is used as a reward,
withheld as a punishment, and is used as an education tool in
behavioral modification programs.
The students are also to blame for their obesity. Our youth are
known as the sedentary generation. Less than half of US children
engage in activity sufficient for health benefits. Activity
declines as grade levels increase, especially in girls. Twenty-
five percent of young people 12-21 engage in no vigorous exercise,
and 14% report no recent light-to-moderate activity (Patton, 2004).
In the limited amount of information I found on special needs
obesity, I discovered that there are some medical causes for being
overweight. Sometimes an irregular hypothalamus is damaged or
quits functioning. Some of the disorders encountered in special
education that may predispose children to being overweight are
Prader-Willi, Bardet-Biedl, and Carpenter Syndrome. In these
disorders students do not have the mechanisms to have self-control
not to quit eating.
Schools are also part of the problem. The No Child Left Behind Act
has forced schools to put a strong emphasis on academics; physical
education and activity has suffered. Only one-third of elementary
and secondary schools offer daily physical education classes.
Illinois is the only state that requires daily physical education
and private schools are not required to fulfill this requirement.
High school enrollment in PE classes has declined from 42% to 25%.
Summer school physical education programs have replaced physical
education classes with a mere six weeks of physical activity. In
the Minneapolis Public School system, there are 52 physical
education teachers for 118 elementary schools and physical activity
is only offered once or less than once a week .
Despite the part schools play in physical fitness, families are the
most important influence in a student’s life. Parents who are
overweight have overweight kids. With two obese parents, there is
an 80% chance their children will be obese and a 50% chance if one
parent is obese. When both parents are average weight, their
children have only a 10% chance of being overweight. One half of
all parents never exercise vigorously (Patton, 2004). The over-
consumption of inexpensive, processed food further exacerbates the
problem. Children who do not eat with their families run a greater
risk of obesity and are also more prone to depression, suicide,
and risky sexual behavior (Mintle, 2005).
Nature or Nurture
Is obesity is a product of nature or nurture? Studies show that
obesity results from a combination of both. Thirty to fifty
percent of all obesity falls is hereditary but controllable with a
combination of diet and exercise . ( Patton, 2004) Infants born to
overweight mothers have been found to be less active and gain more
weight by three months than infants born to mother with normal
weight. Good habits are learned by example and start early. By
adolescence, the influence of the family decreases. Obese parents
may be reluctant to see that they and their children have a
problem. Unconditional love can be a blessing or an opportunity to
be self-indulgent. Exercise, coupled with the influence of more
active parents, makes a child six times less likely to become obese
(Patton, 2004)
Solutions
What can be done? Anyone who is involved in the life of a child
must focus on a balanced diet consisting of complex carbohydrates,
high quality lean proteins, lean meats, and skim milk. Fats should
not be restricted, but there should be a limitation on saturated
fats; they should not make up more than 10% of a child’s diet
(Patton, 2004). Children under 2 should have no restrictions on
the percentages of fat in their diets. Plenty of fiber, 5-10 grams
daily, must be a part of a child’s diet. There should be a greater
emphasis on eating more fruits and vegetables from the farmer’s
market and less of an emphasis on eating processed foods (Patton,
2004).
Weight loss should not be the primary focus in changing children’s
diets, but rather it is more important that they grow into their
weight as they mature. Only then will their BMI go down, and they
will eventually arrive at a normal body weight. It is estimated
that for every 20% in excess of a child’s ideal body weight, the
child will need 1 ½ years of weight maintenance to attain their
ideal body weight. Diets do not work, but healthy lifestyles do
(Patton, 2004).
To motivate the overweight child, parents, coaches, and teachers
should keep upbeat attitudes about healthy eating and exercise.
Physical activity should be more centered on cooperation than
competition and place more of a focus on teamwork and participation
than on winning and losing. More attention should be directed to
the duration of the activity than the workload, and the child
should be allowed to rest as needed. It is also important to find
out what activities the child enjoys and to focus on little
victories—stringing them together as they work toward accomplishing
the goals of a healthy lifestyle.
Children should also be taught to plan ahead for healthy eating.
Parents should ensure that healthy snacks are available and should
lead by example. Teachers, principals, parents, and coaches play a
very important role in encouraging the practice of healthy eating.
Those who interact with the child can even make a pact to encourage
consistency with other family members and peers, thus helping the
child develop a healthier lifestyle.
Schools play an important role in educating children. When a
school takes serious steps to make their cafeteria more
nutritionally friendly, provide more opportunities for activity,
and involve youth and parent nutrition education in their
curriculum, they can have an important impact on their students’
lives. When nutrition is improved in schools, there are
significant improvements in math and writing scores and less
disruptions stemming from classroom behavior. Healthier options
such as a salad bar and fresh fruits and vegetables help a student
do better in school (Patton, 2004).
Schools should select programs for healthy eating similar to the
project by Natural Foods in Appleton, Wisconsin. At Appleton
Alternative High School, they got rid of the fattening foods sold
in the vending machines and started serving healthy food. Their
menu consists of low sugar and fresh produce. The student’s
behavior has improved and teachers are telling the administration
that they are able to get done more work during the day. The cost
of the program was similar to an average lunch program. Another
solution is to have part of the schools’ food budget go to farmers
who bring in healthy, fresh produce (GAO, 2005).
Physical activity must be increased. It is estimated that only
three minutes of a typical gym class is spent in vigorous activity
(Wallis, 2004). School physical activities should focus on
structured and unstructured activity time. Recess should be
daily. Physical education programs should focus on muscle
endurance, flexibility, and cardiovascular fitness (Rimmer, 2006).
If gym classes could extend by just 60 minutes a week, there would
be a decrease of 43% of obesity in girls and 60% of at-risk girls
in grades K-5. There is no significant impact on boys (Spurlock,
2005). Only 8% of all elementary students, 6.4% of middle school
students, and 5.8% of all high school students have physical
education everyday. This has to change.
Madison Junior High in Naperville, Illinois has a successful
physical education program that uses fitness machines, free weights
and bikes that power video games. This program was not started by
tax money but by fund raisers and parental financial support.
School programs should offer athletic programs such as
interscholastic sports and intramural clubs to encourage both the
athlete and the casual exerciser alike (Kaplan, Liverman, and
Kraak, 2005).
Children who work out improve their cardiovascular system and
improve their strength and endurance. This helps them build
healthy bones and muscles and control weight. They also learn to
reduce anxiety and stress and increase their self-esteem. They
lower their blood pressure and their cholesterol levels. Students
with ADHD or other problems with hyperactivity and focusing have
fewer symptoms after playing outdoors and performing physical
activity (Lawson, 2004). The goals of a successful physical
education program emphasize enjoyable participation in fitness in a
way that translates into lifelong enjoyment of physical activity.
The guidelines for heavy children include one hour or more of light
to moderate activities daily. Strength training is a great
complement and should include supervised light weights and body
weight-bearing exercises. Emphasize the total calories burned
rather than the intensity of the activities. Allow the child to
accumulate activity throughout the day. Reward and praise the
child for successful attempts and progress (Patton, 2004).
Insurance providers should provide fitness discounts to their
customers and no health club should charge an extra fee to disabled
individuals. Physical fitness facilities should hire staff and
provide accommodations for those with special needs. Education
should also be provided to personal trainers and group fitness
instructors to understand the unique needs of children and of those
with disabilities. Local government, private developers, and
community groups should work together to develop recreational
facilities and make safe bike and walking trails (Kaplan, Liverman,
and Kraak, 2005).
Fast food restaurants should have their nutrition information
posted at their establishments. Nutritional information should be
posted in both English and Spanish (GAO, 2005). Much of this
information is also found on the web. Patronize restaurants that
offer healthy options and let them know that is why you are there.
Television time must be limited to 1-2 hours per day. Children
under 2 should not watch television at all. Preschool children who
watch television are 6% more likely to be obese for every hour that
they watch television (Brownwell, 2004). Parents and teachers
should write, e-mail and call products to have healthy foods
advertised during children’s programming. In Canada, there are no
ads for children thirteen years of age allowed in their television
programming and in Belgium no ads are to be shown five minutes
before, during, and after a children’s television show. England may
soon follow suit. (Brownwell, 2004).
The family is the most important piece of the puzzle to combat
child and youth obesity. Families should identify opportunities
to exercise throughout the day. Walk to do errands, take the
stairs, and have children walk to school with their parents. Buy
toys and gifts that allow for creativity and promote activity.
Assign chores and make exercise one of the lists of tasks for an
allowance every week. Use moderation, but don’t restrict food.
Never take food away as a punishment.
Encourage teenagers to seek active jobs such as paper carrier, lawn
service or attendance runner at school. They should participate in
fund-raisers or events that promote activity instead of food.
Incorporate physical activity in celebrations and special
occasions. Add exercise to weekend plans such as swimming, flying
a kite, hiking and biking. Play one physical activity event each
week for the whole family such as walking, biking, hiking, and
playing tennis. Encourage the family to take up active pursuits.
Have kids walk/bike to their destination and park away from stores
and walk to the entrance. Plan snacks at set times and discourage
late night snacking (Rodriguez, 2004).
At mealtimes, cook only enough for everyone to have reasonable
portions. Don’t encourage a clean plate. Don’t buy junk food and
avoid allowing children to eat while they are reading, doing
homework, or watching television.
Avoid fast food, and if you must eat it, don’t buy super-sized
portions. Encourage good choices at fast food restaurants. Only
let kids buy lunch at the school once a week. Split meals at
restaurants or have them take a portion home, since serving sizes
in restaurants are often large. On car trips, take along a cooler
of healthy snacks. Avoid sodas and encourage children to drink
water. Make sure that kids eat breakfast and drink low-fat or skim
milk. Children over the age of 2 do not need whole milk.
Finally allow children the responsibility of helping cook and try
new things. Use smaller plates and give them opportunities to try
new fruits and vegetables. Make food fun with plates decorated for
kid-friendly eating and encourage your children to eat slower. Buy
bite-sized fruit to put into lunches.
Summary
Childhood obesity does not have to happen. Schools can provide a
learning environment with healthy food options and nutritional
education. They can also dedicate more time to physical education,
even if that means the academic school day is extended.
Advertisers can make the effort to provide healthier products, and
fast food establishments can make nutritious options available at
their restaurants. Parents are the most important influence in a
child’s life. They must work together as a family, eat
nutritiously balanced meals, and make exercise a family activity.
With positive encouragement, we can turn the tide and give our
youth a brighter future and tomorrow.
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