Tammy Axt physically active, Special Education

Physical Health in students with Developmental Disabilities

If you have a student in your class this year with a Developmental Disability, I’d like to share some statistics today to help you make some decisions about their programming. Students with a DD have a different set of needs than the rest of the students that goes beyond academic programming.

Here are a few statistics taken from the Journal of Intellectual Disability Research:

Adolescents with autism and Down syndrome are two to three times more likely to be obese than adolescents in the general population.

Secondary health condition are higher in obese adolescents with IDD including high blood pressure, high blood cholesterol, diabetes, depression, fatigue and low self esteem.

Obesity presents a higher incidence of health problems including decreased social and physical functioning, reduced quality of life, difficulty forming peer relationships and increased likelihood of depression.

Clearly some of our students with Developmental Disabilities are more vulnerable to becoming overweight or obese. Much of the time they have so many things working against them like a disability that has obesity as a symptom, greater medication uses or altered eating habits related to their disability. However, that does not mean that as educators we cannot support students and families to manage their fitness levels.

As educators, we can:

  • Have an excellent relationship with the family of the student. You will NEED their help to ensure the wellness of their child.
  • Ensure that parents know how to access community programs that offer activities that include physical fitness. In addition, help connect parents with community supports that offer funding for these programs. (During Covid, many of these programs are not running as the requirements for physical distancing can’t be maintained with makes the next two points really important)
  • Talk about and model physical activity often. When we meet online, we speak almost every day about activities that we are doing at home.
  • Most importantly, include physical activity into the daily routine of your class. The government of Canada recommends 60 minutes of physical activity every day. During a pandemic, that is tough but encourage your student(s) with a Developmental Disability to move during class. You need to get their heartrate up and a good sweat going on!
  • When you go back to school, prioritize physical fitness for these students. Walking, running, biking, stairs, games, dancing. Put it ahead of many other programming goals to help get these students get back to daily activity.

Anecdotally, when some of my students returned to school in September their physical fitness had dropped significantly. As mentioned above, organized sports for these students did NOT open back up during the summer and my athletic group of students who used to run circles around me struggled to move for 5 minutes at a time. From September to December, I added a segmet of the daily routine that focused only on physical fitness and by December they were back to being very active for an hour at a time.

For many of us beginning any kind of physical program can be tough and motivation can be VERY low. Make sure you have a solid reward program based on anything the student likes (that hopefully is not food). For some of my students it was stickers, for others it was hot wheel cars and my other student was obsessed with Baby Shark colouring pages. Find whatever works and reward them for movement. Start with a couple of minutes at a time and keep increasing from there.  As our students begin to return to learning at school, this is going to need to be a priority for these students to protect their long-term physical health as well as their mental health.

As Hal Johnson and Joanne McLeod used to say “KEEP FIT AND HAVE FUN!”

Deb Weston Technology in school

Less Screen Time, More Play

 

24 hour movement guidelines

 

An April 2019, the World Health Organization (WHO) study highlighted the need for children to be more physically active and get more sleep. It particularly stressed the need for children under 5 to spend less time “sitting watching screens, or restrained in prams and seats, get better quality sleep and have more time for active play if they are to grow up healthy” WHO Director-General, Dr. Tedros Adhanom Ghebreyesus stated that “early childhood is a period of rapid development and a time when family lifestyle patterns can be adapted to boost health gains” (World Health Organization, ‎2019)‎.

The WHO developed new guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. The guidelines were developed based on the effects on young children of inadequate sleep and time spent sitting watching screens or restrained in chairs and/or strollers (World Health Organization, ‎2019)‎.

“Improving physical activity, reducing sedentary time and ensuring quality sleep in young children will improve their physical, mental health and wellbeing, and help prevent childhood obesity and associated diseases later in life,” stated Dr. Fiona Bull, WHO program manager for surveillance and population-based prevention of non-communicable diseases (World Health Organization, ‎2019)‎.

The WHO stressed the need to set healthy physical activity and sleep habits early in life as this helps shape healthy habits for the rest of peoples’ lives (World Health Organization, ‎2019)‎.

“What we really need to do is bring back play for children,” says Dr. Juana Willumsen, WHO focal point for childhood obesity and physical activity. “This is about making the shift from sedentary time to playtime, while protecting sleep” (World Health Organization, ‎2019)‎.

Recently, The American Academy of Pediatrics (Yogman, Garner, Hutchinson, Hirsh-Pasek, Golinkoff, & Committee on Psychosocial Aspects of Child and Family Health, 2018). released a policy statement characterizing exercise through play as critical to the developmental and neurological development of children. In addition, play encourages learning and “joyful discovery” (Yogman et. al., 2018). Play enhances social and emotional skills important to children’s development and mental wellness (Klass, 2019; Yogman et. al., 2018). Further, ” the importance of interacting with children, responding to their cues and questions, the value of the old-fashioned kind of face time, with parents and with peers, and the importance of helping kids find a variety of experiences that are not all about screens and screen time in a world that is increasingly virtual for both parents and children” (Klauss, 2019; Yogman et. al., 2018).

The WHO stated that prolonged restrained or sedentary screen time  should be replaced with more active play and quality sedentary time spent in interactive non-screen-based activities with a caregiver, such as reading, storytelling, singing, and puzzles (World Health Organization, ‎2019)‎. The WHO stressed that this interactive time is very important for child development. The WHO further linked inadequate physical activity, too much sedentary behaviour, and inadequate sleep time to having an impact on the “physical and mental health and wellbeing” of children (World Health Organization, ‎2019)‎.

Recommendations at a glance (World Health Organization, ‎2019)‎:

Infants less than 1 year should (World Health Organization, ‎2019):

  • Be physically active several times a day in a variety of ways, particularly through interactive floor-based play; more is better. For those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake.
  • Not be restrained for more than 1 hour at a time(e.g. prams/strollers, high chairs, or strapped on a caregiver’s back). Screen time is not recommended. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
  • Have 14–17 hours (0–3 months of age) or 12–16 hours (4–11 months of age) of good quality sleep, including naps.

Children 1-2 years of age should (World Health Organization, ‎2019):

  • Spend at least 180 minutes in a variety of types of physical activities at any intensity, including moderate-to-vigorous-intensity physical activity, spread throughout the day; more is better.
  • Not be restrained for more than 1 hour at a time(e.g., prams/strollers, high chairs, or strapped on a caregiver’s back) or sit for extended periods of time. For 1-year-olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended. For those aged 2 years, sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
  • Have 11-14 hours of good quality sleep, including naps, with regular sleep and wake-up times.

Children 3-4 years of age should (World Health Organization, ‎2019):

  • Spend at least 180 minutes in a variety of types of physical activities at any intensity, of which at least 60 minutes is moderate to vigorous intensity physical activity, spread throughout the day; more is better.
  • Not be restrained for more than 1 hour at a time(e.g., prams/strollers) or sit for extended periods of time. Sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
  • Have 10–13 hour of good quality sleep, which may include a nap, with regular sleep and wake-up times.

A healthy 24 hours for children ages 5 to 18 years old (Canadian 24-Hour Movement Guidelines for Children and Youth  for ages 5-17 years) :

SWEAT: Moderate to Vigorous Physical Activity

  • An accumulation of at least 60 minutes per day of moderate to vigorous physical activity involving a variety of aerobic activities.
  • Vigorous physical activities, and muscle and bone strengthening activities should each be incorporated at least 3 days per week.

STEP: Light Physical Activity

  • Several hours of a variety of structured and unstructured light physical activities.

SLEEP: Uninterrupted sleep with consistent bed and wake up times

  • Ages 5-13 years old = 9 to 11 hours of sleep per night.
  • Ages 14-17 years old = 8 to 10 hours per night.

SIT: Sedentary Behaviour

  • No more than 2 hours per day of recreational screen time; Limited sitting for extended periods.
  • Preserving sufficient sleep, trading indoor time for outdoor time, and replacing sedentary behaviours and light physical activity with additional moderate to vigorous physical activity can provide greater health benefits.
  • Children 6 years and older should have established and consistent limits on the time spent using media, with parents ensuring that digital media doesn’t take the place of sleep, physical activity or real-life personal interactions.

One thing I gleaned out of this research is that adults should also follow this good advice for being more active. This includes (Canadian 24-Hour Movement Guidelines for Adults 18 to 64 years):

  • To achieve health benefits, adults aged 18-64 should accumulate at least 150 minutes of moderate to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes 
or more.
  • It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week.
  • More physical activity provides greater health benefits.

The bottom line is get moving, sleep enough at the same time every day, and get off your screens … the kids are watching you.

Collaboratively Yours,

Deb Weston, PhD

References

Klauss, P. (April 2019). Prescription for growth: Let your children play, New York Times, published in the Globe and Mail April 2019. Downloaded from https://www.nytimes.com/2018/08/20/well/family/let-kids-play.html

World Health Organization. (‎2019)‎. Grade Tables for Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age, World Health Organization. Downloaded from https://apps.who.int/iris/bitstream/handle/10665/311663/WHO-NMH-PND-19.2-eng.pdf?sequence=1&isAllowed=y

World Health Organization. (‎2019)‎. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age: web annex : evidence profiles. World Health Organization. Downloaded from http://www.who.int/iris/handle/10665/311663. License: CC BY-NC-SA 3.0 IGO

Yogman, M., Garner, A., Hutchinson, J., Hirsh-Pasek, K., Golinkoff, R. M., & Committee on Psychosocial Aspects of Child and Family Health. (2018). The power of play: A pediatric role in enhancing development in young children. Pediatrics, 142(3), e20182058. Downloaded from https://pediatrics.aappublications.org/content/142/3/e20182058?utm_source=STAT%20Newsletters&utm_campaign=053c00c518-MR_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-053c00c518-150867485