Sunday, January 20, 2013

Childhood Obesity

 (Third of a series of blogs related to this issue)
Some good news caught my attention lately.

First, this new season of “The Biggest Loser” (NBC) addresses childhood obesity; it includes three teenagers- a 16-year-old and two 13-year-old- to the cast. Kudos to NBC!
Second, a recent LA Times’ article about six big city school districts (LA, New York, Chicago, Dallas, Miami and Orlando, Fla.) uniting for healthier meals. We are talking about 2.5 million daily meals. The goal is to reduce fat, sugar and sodium. Less corn dogs, coffee cakes and chicken nuggets and more whole grains and fresh produce. “The alliance marks the biggest step yet to transform school meals,” said David Binkle, L.A. Unified’s food services director.
Are diabetes and obesity in children finally becoming a national concern? Will other school district join the crusade? Hopefully, yes.

I visit 11 LAUSD schools on a weekly basis. I still see field trips to the burger and donuts shops, and pizzas and cupcakes for celebrations. Why? Can field trips be planned a little more carefully?  Can they provide healthier options in the classrooms?
So, what’s being done is a good move in the right direction, but there is still plenty more to do. Although tough to confront, childhood obesity is an issue that has to be addressed by the professionals who work with children and adolescents (pediatricians, teachers, counselors, sport coaches, etc.), and even more so by parents.

In order to make a difference, serious behavioral changes need to be made at home surrounding the family’s eating habits and lifestyles. These kinds of changes can be difficult after years of bad habits have been created but here are some tips with steps you can start taking TODAY to slowly create new healthy habits.
-        Involving the whole family: Healthy eating should be part of the family culture. Sit down with your kids at a calm time and explain it to them in simple language they can understand. You can say something like “From now on we are going to eat healthy foods so we can feel better.” Involve your kids in planning weekly menus. They can search the Web for healthy and delicious foods. By educating them on the topic and involving them, they will make healthy eating their own goal.

-        Reducing the portions: Give your children smaller portions of food. When they ask for more, make some physical activity contingent to it (clean up the toys, take the trash out, do 10 push-ups, take a walk around the block, etc.)

-        Avoiding/Reducing junk food: Less pizza, sodas, candies, ice-cream, donuts, cheeseburgers, etc. You can replace them with healthy food, such as whole wheat vegetables pizzas, juices, low fat ice-cream, whole wheat pancakes, nuts, turkey burgers, etc. Add more vegetables and fruits to your kids’ diet. Make McDonald’s a just once-a-week family outing.

-        Keeping a meals schedule: No more eating throughout the day. Keep a schedule. Allow at least a couple of food-free hours between meals and snacks. 

-        Exercising: Take your kids to the park, if possible, every day. Make them ride their bikes more often. Park far away so they have to walk. Take stairs rather than elevators. Enroll them in sports activities: they will not only get good exercise, but also they will have the opportunity to socialize and learn important skills. Have them help with household chores.

-        Rewarding healthy habits: You can even use “some” junk food during weekends outings, for example, as a reward for good behaviors during the week. In order to chart progress use a visual starts board or put money in a glass jar towards those treats.

-        Educating yourself: Learn about healthy eating habits. Consult with a nutritionist. Search the Internet. There is lot of information out there, most of it for free.

Mom, dad, it is your turn.

*Important: Always consult with a doctor when implementing a weight management plan.

Daniel Adatto, MA, BCBA



Wednesday, January 9, 2013

I’m bored!

One of the most dreaded words from our kids’ mouth. And I don’t blame them. Nobody likes to be bored, right? Advertisers and video games and TV producers know this very well. Images change every few seconds and are full of visual and auditory stimulation. And viewers have the ultimate control tool- the remote control. If we don’t like it, we change it. Programs that do not produce instant and intense gratification are gone in a click (from “The ABA Program Companion”, by J. Tyler Fovel).

And this also applies, of course, to our kids and students. They “change the channel” by simply not paying attention, ignoring and exhibiting all kinds of disruptive behaviors. A lot of the challenging behaviors we deal with on a daily basis (not all, of course) are based on boredom. So, teachers and parents should pay special attention to the speed of instruction and activities and should have appropriate materials to keep children stimulated and engaged. It could drastically change the dynamic of the classroom and the household. Like hunger, if we wait until the child is bored is too late.    
Some proven effective strategies include:
-        Keep them busy: Plan ahead of time and structure the day in a consistently stimulating schedule of activities, including breaks and free time.

-        Choose very stimulating materials: The new technologies available (tablets, mini computers, smart phones, etc.) makes it much easier. Attention: Do no overload them with video games. Intersect arts & crafts and physical activities, including outings and outdoor playing.

-        Provide them with physical outlets and opportunities for social interactions in structure setting, such as sport/arts classes and community centers activities. Plan play-dates.

-        Eliminate the competition: make undesired items/activities unavailable as much as possible.

-        Set up the physical environment so that the opportunities for misbehaviors are reduced or eliminated.

-        Teach and encourage choice making: include in your daily schedule opportunities for your kids to make choices. Too many rules can create oppositional behaviors. If they feel they have no control, they will fight for it, I assure you.
-        And schedule times to play with them. See our previous blog “Special time” for more information.

Avoid boredom and you will be ahead of the game.

Daniel Adatto, BCBA