Nutrition Interventions for Children with Special Health Care Needs

CHAPTER 3
Section 1 - Determination of Nutrition Status
Physical Activity for Children with
Special Health Care Needs
Kathleen Washington, PT, PhD and Kay Kopp, OTR/L
Introduction
A 2005-06 survey conducted by the Centers for Disease Control and Preventions’
National Center for Health Statistics showed that 13.9 percent of US children have
special health care needs, and 21.8 percent of households with children include at
least one child with a special health care need (1). These children are at greater
risk than peers without disabilities to develop poor health, including obesity,
cardiovascular disease, and musculoskeletal limitations because they are not
appropriately physically active and fit.
The most frequently identified barriers to participation of these children in sports
and physical activities are the child’s functional limitations (18%), high costs
(15%), and lack of nearby facilities or programs (10%) (2). The child’s perceived
self-competence, time, social support from schools and communities, and family
and child preferences are additional factors influencing participation. Families who
engage in physical activities are more likely to encourage similar participation for
their children with special health care needs. Interestingly, environmental and family
factors seem to be more significant determinants of participation than characteristics
of the children themselves (2).
The primary goals for increasing physical activity in these children are to reverse
deconditioning secondary to impaired mobility, optimize performance of functional
activities, and enhance well-being. Regular physical activity is essential for the
maintenance of normal muscle strength, flexibility, and joint structure and function,
and may prevent, minimize, or slow the loss of function often associated with
disabling conditions. Other benefits of physical activity include improvements in
confidence and self-esteem (3).
Definitions and Types of Physical Activity
The term “physical activity” describes many forms of movement that involve the
large skeletal muscles and require significant energy expenditure. Physical activity is
Nutrition Interventions for Children With Special Health Care Needs 37