A Parent Supported Weight Reduction Program for Adolescents with Developmental/Intellectual Disabilities (funded by the Deborah Munroe Noonan Memorial Trust and John Alden Trust).

We have developed and are pilot-testing a parent-supported weight reduction (PSWR) program for adolescents with intellectual and developmental disabilities and their parents.  In a PSWR program, in addition to receiving sound educational content on nutrition and physical activity, participants are taught to apply supportive behavioral techniques, allowing them to make choices regarding a healthy diet and moderate physical activity, set goals, monitor performance and positively reinforce accomplishments. The proposed project includes a Curriculum Development phase and a Pilot-Testing phase.  We have designed a curriculum that includes 10 structured classes with specially designed materials and activities appropriate for adolescents with I/DD and their parents.  We will pilot test the educational component of the program alone with a group of overweight adolescents ages 13-18 with I/DD who meet criteria for mild to moderate mental retardation and their parents.  This pilot testing will commence in May 2006.  We will then conduct a second pilot test with the curriculum with the behavioral intervention component added in the fall of 2006.

To assess the feasibility and effectiveness of our program, we will collect and analyze the following data:  1) height and weight pre- and post-intervention; 2) pre- and post-test on nutrition and physical activity related knowledge; 3) documentation that participants were able to carry out the behavioral techniques; 4) participants’ acceptance and satisfaction with the program; 5) participants’ self-recorded pre- and post-intervention dietary intake; and 6) participants’ self-recorded pre- and post- intervention physical activity.  

For more information about the program, contact Carol Curtin , Principal Investigator at (781) 642-0256 or carol.curtin@umassmed.edu

Obesity, physical activity and fitness in children with Developmental Coordinatio n Disorders (funded by NICHD; 1-R21-HD051861)

Lack of adequate physical activity is a significant health problem in children in the

United States ; increasing participation in physical activity has been identified as a national health priority. While considerable efforts are underway to understand and address physical activity in the general population, there has been little research or focus on children with disabilities. We propose that children with  Developmental Coordination Disorder (DCD) are at particular risk for low activity, low levels of fitness, and obesity due to the nature of their disorder. DCD, also known as dyspraxia, is a neurologically-based developmental disorder characterized by impaired motor coordination that significantly interferes with academic achievement and activities of daily living. Because of their poor coordination, children with DCD often are excluded from or   are unable to participate in sports and physical activities with their peers. Descriptions of children with DCD indicate that they tend to be more sedentary and physical fitness may be compromised, either because of the nature of the disorder and/or their lack of activity.

The goal of this study is to examine physical activity levels, fitness and the prevalence of overweight in children with DCD compared to children with average motor coordination. We will use new methodology including accelerometry to measure activity level. Our aims are to determine whether children with DCD show significantly lower overall activity, spend less time in moderate-vigorous activity and more time in sedentary behavior, have significantly lower levels of physical fitness and significantly higher BMI z-scores, than children with average motor coordination. The relationship among measures will be examined to understand whether physical activity in children with DCD has the same effect on weight status and fitness as in children with adequte coordination.

Children with DCD represent a substantial number of children in the population who, due to their coordination disorders, may be at even higher risk for poor health outcomes. Identifying the barriers to these children's participation has the potential to inform current clinical practice and the development of future health promotion efforts in this group of children.

For more information, contact Sharon Cermak , Principal Investigator at (617) 353-7520  or sharon.cermak@umassmed.edu

Diet, Activity and Obesity in Children with Autism (funded by NICHD; R21-HD048989)

Obesity has become a significant health concern in children, given its high and increasing prevalence.  It is well accepted that obesity is the result of an energy imbalance, however, factors that are associated with obesity in children with autism may be different than those of their typically developing peers.  The implications of the persistence of obesity in this population are significant, as the demands of managing the associated medical consequences would likely limit individuals’ choices for independent living in the community.  Our preliminary studies suggest that children with developmental disabilities are at the same risk for obesity than typically developing (normal) children.  Children with autism appear to represent a unique group whose atypical eating patterns and   reduced opportunities for physical activity due to social or recreational limitations may be associated with the development of obesity.    

We are conducting an exploratory study to understand the risk factors associated with obesity in children with autism. The purpose of this study is to determine whether obesity in children with autism is associated with high levels of food selectivity and decreased levels of physical activity.   Our specific aims are to determine: (1) whether children with autism have a higher degree of food selectivity than typically developing children and whether these patterns are associated with increased risk for overweight (BMI greater than the 85^th%); (2) the nutrient adequacy of diets of children with autism; (3) whether children with autism engage in less structured physical activity;   (4) whether children with autism spend more time in sedentary behavior than typically developing children; and  (5) whether decreased levels of physical activity are associated with increased risk for obesity in children with autism.

We will enroll 60 children with autism and an equal number of typically developing children.  Body weight and height will be measured to determine body mass index (BMI).  We have defined food selectivity categorically as food aversion, restricted eating patterns, and single excess food intake and will determine whether food selectivity in children with autism is greater than that of typically developing children.  We will explore sensory factors and characteristics of food (e.g., temperature, color, texture, and smell) that may be associated with food selectivity.  We will also determine the types and amounts of physical activity that children with autism engage in and the time spent in sedentary behavior. 

This study will provide us with the necessary data to design a longitudinal study to determine the factors that lead to obesity in children with autism.   A better understanding of these factors has the potential to inform current clinical practice and future health promotion efforts in children with autism.

For more information, contact Linda Bandini , Principal Investigator, (781) 642-0280 or linda.bandini@umassmed.edu