Nutrition Interventions for Children with Special Health Care Needs

Chapter 3 - Physical Activity for CSHCN
social). These contextual variables allow a more holistic view of disability on the
person’s functioning.
Note that the ICF framework is not a linear model. Within the ICF model, a child with
a health condition such as cerebral palsy may have impairments in body structures
(e.g. spasticity). However, this does not necessarily mean that the child will have
a participation restriction. While the child may not be able to play on the school
basketball team, he can participate in the sport of wheelchair basketball through
the local Special Olympics organization. Similarly, while he may not be able to walk,
his use of a manual wheelchair affords him mobility and access to his home and
community. Nutritionists and other health care professionals have an important role
in preventing or minimizing the degree of restrictions in activities and participation,
thus minimizing the degree of disability.
Benefits of Physical Activity for Children with
Special Health Care Needs
The benefits of physical activity for children with special health care needs have been
demonstrated in a growing body of scientific literature, as documented in the studies
cited below. Incorporating regular physical activity into their lifestyles will hopefully
increase the likelihood of improved health in adulthood for CSHCN, as well as reduce
secondary conditions such as cardiovascular disease and osteoporosis. Equally
important are the psychological benefits of physical activities including opportunities
to form friendships, express creativity, and develop self-esteem and confidence (3).
However, there are important health-related conditions, such as high blood sugar in
children with diabetes or cardiac defects in children with Down syndrome, that may
be affected by participation in physical activity. Thus, screening and assessment of
CSHCN, conducted by appropriate members of the individual’s health care team, is
recommended prior to participation in physical activity.
Benefits of Physical Activity for Children with Obesity
Currently, 11% of children and adolescents in the United States are affected
by obesity, as defined by a body mass index (BMI) at or greater than the 95th
percentile. There are many societal factors presumed to contribute to the increased
prevalence of childhood obesity, including less time playing outdoors and in
physical activities, increased “screen” time (computer, video games, TV), increased
consumption of high calorie fast foods, and the decline of family meals (9). In
addition to an increased risk of obesity in adulthood, there are a number of diseases
40 Nutrition Interventions for Children With Special Health Care Needs