Letter from Director Dr. James Rimmer
The epidemic of childhood obesity observed in non-disabled children seems to be a much greater health concern in children with disabilities. In research that our team has been conducting for the last six years on obesity prevalence and obesity-related secondary conditions in children with disabilities, we identified several possible reasons for this health disparity.
First, many parents who have a child with a disability do not have the resources or capability to find programs that meet the physical or programmatic needs of their child. While a few communities have an occasional special recreation or peer mentoring program for children with disabilities, even when these services are available their infrequency (e.g., offered once or twice per week at times that may not fit within the family member’s schedule) limits their utility as an effective method for managing their child’s weight.
Second, many if not most school-based programs do not provide the same level of opportunity to participate in recess and physical education. Class sizes are often too large and children with disabilities are not given the supports needed to achieve equivalent levels of physical activity time as their peers; physical education teachers often have little or no training in adapting programs for children with disabilities; and adaptive equipment is not available.
Third, the built environment is often inaccessible to children with physical and cognitive disabilities. In a report published last year by the Government Accountability Office (Government Accounting Office, 2010), youths with disabilities were found to have much lower rates of participation in physical education and sports compared to their peers, thus prompting the Office of Civil Rights to issue guidance on January 25, 2013, on the rights of students with disabilities to participate in after-school athletics.
An integrated model of primary care and public health approaches addressing policy, systems, and environmental supports for physical activity can improve risk factors for obesity in children with disabilities. This includes changes in factors such as improved parenting skills, reduced childhood obesity risk factors including higher levels of quality physical activity, improved sleep habits, higher consumption of fruits and vegetables, reduced television and screen time viewing, lower intake of energy dense foods and sweetened beverages, improved utilization of preventive services such as screening and counseling, and improved satisfaction with obesity preventative health care services provided by Federally qualified health centers and other primary care providers in the community.
There is a need for children with disabilities to be part of studies involving non-disabled children. Weight management strategies are the same for each group and have the potential to be tested in ‘real world’ settings with appropriate implementation guidelines and expertise that allow disability researchers to work with non-disability researchers in the same study (ie, similar to how NIH requires studies to include women, children and minorities unless there is a strong rationale for exclusion). Establishing an effective research network that can shape this research agenda is an important step in this process. Just this week we learned about another study where children who were more physically active adapted to stress better compared to inactive children. By the time we get around to funding a similar type of study involving children with disabilities, there will be a newer and more advanced type of research on non-disabled children. This will keep children with disabilities one step behind their peers on any new information related to the health benefits of physical activity.