Interveners of weight management are recommended to
implement evidence-based practice (EBP) because EBP is more valid and reliable to
see the significantly positive outcomes of intended purposes. Hamilton and
other researchers (2007) have proposed clinical EBP for weight interventions of
individuals with ID, including the following components:
Behavioral
intervention
Teaching
self-control techniques such as self-monitoring of daily weigh and food intake.
Promoting
health behaviors such as eating habit and hygiene.
Health
promotion intervention
A group based learning for in-home preventative healthcare programmes such as diet and exercise.
An individual support from a healthy living coordinator, who regularly visits at-risk overweight/obese persons with ID.
Physical activity intervention
Combined exercise including aerobic and resistance training.
30 minute moderate physical activity intensity per day to limit health risks.
60-90 minute moderate exercise intensity to maintain weight loss per day.
Carer involvement
Family involvement integrated into weight control treatment.
(Walk Your Way to Fitness: Routines for people who have Intellectual Disabilities)
Reference
Hamilton, S., Hankey, C. R., Miller, S., Boyle, S., &
Melville, C. A. (2007). A review of weight loss interventions for adults with
intellectual disabilities. Obesity Reviews, 8(4), 339-345. doi:
10.1111/j.1467-789X.2006.00307.x
A healthy lifestyle encompasses multiple levels from the
perception of nutrition, attitude of health, and to practice of health habits.
Nutrition curriculum, such as diet selection, meal time planning and so
forth, is an important issue for a basic preparation level of leading to health
and wellness life. Use of proactive instructional strategies is considered
as an important means of teaching health eating behavior delivery
for students with cognitive or physical limitation. According to Simpson,
Swicegood, and Gaus, (2006), guideline principles taken into consideration
include the following:
* Modeling
and increased guidance.
"Thinking
aloud" may help students with intellectual disabilities (ID) to
appropriately choose good food and to avoid excessive intake. A guided
demonstration also facilitates more positive learning outcomes students with
ID.
*Scaffolded
experiences.
Explicit
guidance regarding clear feedback, multiple prompts based on students' present
level will foster learning step by step. To lead the discussion for students
definitely makes students with ID to clarify their confusion. This may develop
self-monitoring skills.
*Gradual
move from the concrete and familiar to the abstract and symbolic.
In an
early stage of nutrition classes, teachers focus more on concrete examples
(e.g., health eating habits) to link to learning of life experiences. When
achieved so, the abstract and symbolic learning such as "divergent and/or
convergent learning styles" may be blended into group discussion for
gaining more understanding of the reasons health eating habits are important
for themselves.
*Model
choice-making techniques
To provide
simple self-monitoring skill helps to make consequences of behaviors
appropriate. For example, the "STOP AND THINK" strategy as a self-question
approach is recommended in teaching NE.
*Set
clear, specific goals
The goal
must be attainable, manageable and reachable for students with ID. For example,
Roger will lose 20 pounds over an 8-week period, using aerobic and resistance
training 3 times per day, 60 mins per session.
*Design a
program for generalization.
Use of a field
trip (e.g., visit Wal-Mart) to practice the appropriate food choices may help
students in their real situation when grocery shopping with their parents.
Thus, a generalization of a nutrition program may be promoted to see how
students with ID to make their decision through the practical food options.
To conclude, we
propose some effective strategies in terms of modeling, scaffolding,
self-monitoring, and goal setting that are integrated into a nutrition
curriculum to expect a better quality of instructions to prevent obesity on
students with ID.
(Program keeps adults with disabilities on healthy track)
References
Simpson, C. G., Swicegood, P. R., & Gaus, M. D.
(2006). Nutrition and fitmess curriculum: Designing instructional interventions
for children with developmental disabilities. Teaching Exceptional Children,
38(6), 50-53.
Obesity is a public health concern in both general and ID
populations. The prevalence of obesity in adolescents with ID is approximately
36% higher than general populations in boys and girls (Stewart el a., 2009).
Another study byRimmer and his colleagues (2014) investigated the obesity and its
related secondary conditions among adolescents with intellectual/developmental disabilities, as follows.
²High blood pressure,
²High blood cholesterol,
²Diabetes,
²Depression,
²Fatigue,
²Liver or gallbladder problems,
²Low self-esteem,
²Preoccupation with weight,
²Early maturation
²Pressure sores.
Regarding the
obesity of health problems in children and adolescents in ID, Lin and his researchers
(2005) reported that the top five health concerns in this sample were neurological disorders (including epilepsy; 11%), others
(11%), Cardiovascular problems (7%), skin diseases (6%), gastrointestinal illness
(5%), and respiratory illness (5%). In addition, there were 26% of study sample
having regular medication history. With increase age, the weight status of obesity/overweight
conditions has been apparent in ID population. It draws an attention to the
fact that early interventions and strategies for the problem of obesity in children
and adolescents with ID are needed to ensure the quality of life.
(By TastyCakes [CC-BY-3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons)
References
Lin, J.-D., Yen,
C.-F., Li, C.-W., & Wu, J.-L. (2005). Patterns of obesity among children
and adolescents with intellectual disabilities in Taiwan. Journal of
Applied Research in Intellectual Disabilities, 18(2), 123-129. doi:
10.1111/j.1468-3148.2005.00241.x
Rimmer, J.
H., Yamaki, K., Lowry, B. M. D., Wang, E., & Vogel, L. C. (2010). Obesity
and obesity-related secondary conditions in adolescents with
intellectual/developmental disabilities. Journal of Intellectual Disability
Research, 54(Part 9), 787-794.
Stewart, L., Van
De Ven, L., Katsarou, V., Rentziou, E., Doran, M., Jackson, P., . . . Wilson,
D. (2009). High prevalence of obesity in ambulatory children and adolescents
with intellectual disability. Journal of Intellectual Disability Research,
53(10), 882-886. doi: 10.1111/j.1365-2788.2009.01200.x
