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- Disability Overview
- Fitness in Special Education
- The Problem of Obesity in Special Education
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Disability Overview
Disability Youth Overview
Christina Chapan
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 have 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
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Fitness in Special Education
Fitness Testing for Adaptive Fitness
Recently I had the opportunity to test my fitness students at my job to see
what their abilities were and what skills that they could work on. Here are
some of the tests that I utilized for this testing. Remember with testing
those with special needs to focus on growth and not necessarily norms.
Cardiovascular testing is very important to tests the student's ability to
effectively utilize oxygen. Here are some tests to see a student's progress.
Shuttle Run
Materials: two erasers and tape or parallel lines thirty feet apart
Have two parallel lines that are thirty feet apart and place two erasers
behind one of the lines. Students start at the opposite line. On the signal
to go the student runs to the blocks, picks one of them up, runs back to the
starting line, places the block behind the line, runs back and picks up the
second block and runs back to the finish line. Time is counted when the
student crosses the finish line.
Three Minute Step Test
Materials: Metronome, twelve inch step
Have the student walk up and down the step to the cadence of 96 beats per
minute. Tell them to walk up, up, then down, down. When they have finished
their three minutes have them sit down on the step or in the chair and take
their pulse.
I mile walk/run
The individual walks one mile as quickly as possible and has his heart rate
taken immediately at the end of the test. Try to have the area free from
distractions.
Strength is important for the activities of daily living. Here are some
tests that I used with my students to test their strength.
Curl Up
Materials: Tape and ruler
Have the student sit supine on the floor. Take two pieces of tape and put
them eight centimeters apart from each other. Tell them to put their hands
on the first tape and curl up the second piece of tape. Have them continue
the test until they are unable to perform more curl ups.
Sit-ups
Have the student do as many bent-knee sit-ups as possible within sixty
seconds. Make sure that the student's legs are anchored and hands are
clasped behind the head or neck. Elbows must travel to the knees for the
repetition to count. At the end of the sit up the back of the shoulders must
return to the floor.
Push-ups
Materials: Small Dixie cup
Have the students lie on the floor in the prone position with their hands
pointing forward and immediately under the shoulders. Start with the chin
touching the floor then have them push up into an up position with
straightening the arms. They go back down to the lying position and their
chin rests on the Dixie cup for the repetition to count. Males must push up
on their feet and women may sit on their knees. If you are testing with the
males doing the easier version or women using the advanced version please be
sure to note it on the testing when you reevaluate your client.
Flexibility Tests
Flexibility is important for the outcomes of daily living. Students often
have some muscles that are inflexible and prone to injury. Doing these tests
points out problems and helps the trainer to find ways to help their student.
Hamstring Stretch
Have the student lie on their back with both legs flat on the floor and then
lift one leg upward. See how straight the student can lift the leg in a
vertical position without bending either knee.
Trunk extension
Flexibility
Trunk Extension
Have the student lie prone with hands on the floor beneath the shoulders.
Attempt to push the upper body up while maintaining hip contact with floor.
Make sure that there is passing flexibility of the lumbar spine is with
elbows fully extended and hips on the floor.
Sit and Reach Test
Materials: Ruler and Tape
Mark a straight line two feet long on the floor as the baseline. Draw a
measuring line perpendicular to the midpoint of the baseline extending two
feet on each side and marked off in half-inches. The point where the
baseline and the measuring line intersect is the "0" point. Student removes
shoes and sits on floor with measuring line between legs and soles of feet
placed immediately behind baseline, heels 8-12" apart. Student clasps thumbs
so that hands are together, palms down and places them on measuring line.
With the legs held flat by a partner, student slowly reaches forward as far
as possible, keeping fingers on baseline and feet flexed. After three
practice tries, the student holds the fourth reach for three seconds while
that distance is recorded.
Shoulder Flexibility Test
Have the student reach his right arm and hand over his right shoulder and
down his spine, as if he was pulling up a zipper. Hold this position while
he reaches his left arm and hand behind his back and up the spine to try to
touch or overlap the fingers of his right hand. Hold whiles the teacher
checks. Have the student repeat reaching his left arm over his shoulder.
Children and youth with special needs are often in the low end of the
spectrum of fitness. It is more important to encourage growth instead of
norms. Youth who have positive experiences with exercises are more likely to
adopt them for a life-long healthy lifestyle.
References:
Best of Health
http://visitors.bestofhealth.com/get_fit/index.html
Brian Mac
http://www.brianmac.demon.co.uk/sitreach.htm
Brooks, Douglas (1999) Your Personal Trainer, Human Kinetics, Champaign: IL
Cotton, Richard ( 1997) Personal Trainer Manual, American Council on
Exercise, San Diego:CA
Exrt
http://www.exrx.net/
Galdwin, Laura ( 2002) Fitness Theory and Practice, Aerobics and Fitness
Association of America: Sherman Oaks: CA.
Hatfield, Fredrick C. (2004) Fitness the Complete Guide, International
Sports Science Association, Santa Barbara: CA
Health 24
http://www.health24.com/fitness/calcs/pushup.asp
How to be Fit
http://www.howtobefit.com/free-online-fitness-test.htm
President?s Challenge
http://www.presidentschallenge.org/e...huttlerun.aspx
Ron Wood?s Fitness Testing
http://www.topendsports.com/testing/...ulder-flex.htm
University at Austin Flexibility Testing
http://wwwhost.utexas.edu/cee/dec/sp...tnesstext.html
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The Problem of Obesity in Special Education
The Problem of Obesity
Youth t 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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