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McCants C, Vagadori J, Nadler EP, Mackey ER. Update on Outcomes After Laparoscopic Sleeve Gastrectomy in Youth with Special Health Care Needs. Obes Surg 2024; 34:2736-2738. [PMID: 38861122 DOI: 10.1007/s11695-024-07277-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 06/12/2024]
Affiliation(s)
- Cassianna McCants
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Jack Vagadori
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA
| | | | - Eleanor R Mackey
- Center for Translational Research, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA.
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
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Pitetti K, Bertapelli F, Miller RA, Loovis M, do Amaral-Junior WD, de Barros-Filho MM, Guerra-Junior G. Strength of relationship between body mass index and gross motor capacity in youth with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 38923135 DOI: 10.1111/jir.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/06/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Adequate skill levels of gross motor capacity affect activities of daily living, participation in recreational activities and general physical activity levels of youths (7-21 years). Most studies of typically developing youths have reported significant negative relationships between gross motor capacity and body mass index. The latter findings are especially of concern for youths with intellectual disabilities in that it has been estimated that 61% of children and 66% of adolescents were classified as overweight/obese. Therefore, the purpose of this study was to determine the strength of the relationship between body mass index and gross motor capacity among youths with mild to moderate intellectual disability (ID). METHODS Components of the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) were used for designated aspects of gross motor capacity: six items for upper limb coordination (ULC); seven items for balance (BAL); six items for bilateral coordination (BLC); and one item for agility (A-2). Participants consisted of 654 youths (438 men), ages 8-21 years with ID. Participants were divided into pre-puberty and post-puberty men (post ≥12 years) and women (post ≥10 years of age). Body mass index (BMI, kg/m2) was determined by height and weight measurements on the day of testing. A Kendall's tau correlation coefficient (τ) was used to determine the strength of the relationship between body mass index and gross motor capacity (BOT-2 test scores). RESULTS The τ values for both pre-puberty and post-puberty for all BAL, BLC, A-2 tests and for three of the six ULC tests were negligible to very weak (τ = 0 to ±0.19). Higher τ values were seen for pre-puberty youths in three of the ULC tests, but they fell within the weak range (τ < 0.24). When combining all pre-puberty and post-puberty participants, τ values were in the negligible to very weak range for all tests. CONCLUSION The strength of relationship between body mass index and gross motor capacity as measured by the BOT-2 subtest item scores used in this study is very weak and suggests that they are not clinically relevant.
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Affiliation(s)
- K Pitetti
- Department of Physical Therapy, College of Health Professions, Wichita State University, Wicxhita, KS, USA
| | - F Bertapelli
- School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - R A Miller
- Department of Biomedical Engineering, College of Engineering, Wichita State University, Wichita, KS, USA
| | - M Loovis
- Department of Health and Human Performance, College of Education and Human Services, Cleveland State University, Cleveland, OH, USA
| | | | | | - G Guerra-Junior
- School of Medical Sciences, University of Campinas, Campinas, Brazil
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Cuda S. Special considerations for the adolescent with obesity: An obesity medicine association (OMA) clinical practice statement (CPS) 2024. OBESITY PILLARS (ONLINE) 2024; 9:100096. [PMID: 38186667 PMCID: PMC10770754 DOI: 10.1016/j.obpill.2023.100096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details special considerations for the management of the adolescent with obesity. The information in this CPS is based on scientific evidence, supported by medical literature, and derived from the clinical experiences of members of the OMA. Methods The scientific information and clinical guidance in this CPS are based on scientific evidence, supported by the medical literature, and derived from the clinical perspectives of the authors. Results This OMA Clinical Practice Statement addresses special considerations in the management and treatment of adolescents with overweight and obesity. Conclusions This OMA Clinical Practice Statement on the adolescent with obesity is an overview of current recommendations. These recommendations provide a roadmap to the improvement of the health of adolescents with obesity, especially those with metabolic, physiological, and psychological complications. This CPS also addresses treatment recommendations and is designed to help the provider with clinical decision making.
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Affiliation(s)
- Suzanne Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
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Öztürk Şahin Ö, Topan A, Aközlü Z, Kolukisa T. Evaluation of factors affecting body mass index of children with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:185-195. [PMID: 36046922 DOI: 10.1177/17446295221123866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study was conducted to evaluate the BMI of the children with intellectual disability and the factors affecting their BMI. This descriptive and cross-sectional study was carried out between March 2016 and April 2016 in Turkey and consisted of 135 children. Children's anthropometric measurements were and their BMI values were calculated. Categorization of children by BMI percentile according to AAP reference values was performed. There was a significant difference between the BMI categories of the children (p < 0.05) and the education level of children's father (x2 = 8.960; p = 0.028), the degree of intellectual disability (x2 = 16.113; p = 0.008), the presence of other disabilities (x2 = 22.013; p = 0.000), type of disability (x2 = 21.359; p = 0.001), the nutrient intake (x2 = 38.935; p = 0.000) and the presence of nutritional problems (x2 = 7.687; p = 0.042). Father's education level, children's degree of disability, child's having presence of other disabilities, child's being dependent in the view of nutrient intake, and child's having nutritional problems were determined as factors affecting BMI.
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Affiliation(s)
- Özlem Öztürk Şahin
- Karabük University, Faculty of Health Sciences Department of Pediatric Nursing, Karabük, Turkey
| | - Aysel Topan
- Zonguldak Bülent Ecevit University, Faculty of Health Sciences Department of Pediatric Nursing, Zonguldak, Turkey
| | - Zeynep Aközlü
- Maltepe University, School of Nursing, Ístanbul, Turkey
| | - Tuğçe Kolukisa
- Karabuk University, Safranbolu Şefik Yılmaz Dizdar Vocational School Department of Child Care and Youth Services Child Development Programme, Karabük, Turkey
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Bodde AE, White DA, Forseth B, Hastert M, Washburn R, Donnelly J, Sullivan D, Ptomey LT. Parent factors associated with BMI, diet, and physical activity of adolescents with intellectual and developmental disabilities. Disabil Health J 2023; 16:101507. [PMID: 37487764 DOI: 10.1016/j.dhjo.2023.101507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/27/2023] [Accepted: 07/03/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Adolescents with intellectual and developmental disabilities (IDD) experience overweight and obesity (OW/OB) up to 1.8 times the rate of their typically developing peers. Parents may influence adolescent weight management behaviors in this population, but the association between parent factors and adolescent weight management behaviors is unclear. OBJECTIVE To examine the associations between parent BMI and sociodemographic characteristics with adolescents' BMI, diet quality, daily energy intake, moderate to vigorous physical activity (MVPA), and sedentary behavior. METHODS This study analyzed baseline data from an 18-month randomized controlled weight loss trial for adolescents with IDD. We assessed parent BMI (kg/m2) and sociodemographic factors, and adolescent BMI z-score, MVPA, sedentary time, daily energy intake, and diet quality. Associations between parent and adolescent factors were assessed with Pearson, Spearman or Kendall Tau-b correlations; mean differences for categorical outcomes were assessed with independent samples t-tests/Mann-Whitney U tests or ANOVA/Kruskall-Wallis tests. RESULTS Ninety-five adolescent and parent dyads were included. Parent BMI was positively correlated with adolescent BMI z-score (n = 94: rs = 0.37, p < 0.01). Household income was inversely correlated with adolescent BMI z-score (n = 95: Tb = -0.18, p = 0.02). Parents with less than a bachelor's degree had adolescents with higher BMI z-scores than those with bachelor's or higher (2.1 ± 0.5 vs. 1.8 ± 0.5, p = 0.02) as well as higher sedentary behavior (n = 28, 515.2 ± 102.6 min/day vs. n = 40, 463.9 ± 148.1 min/day, p = 0.02). CONCLUSION We found parent BMI, income, and education associated with adolescent BMI z-score. These findings contribute to the sparse literature on parental factors associated with OW/OB in this population. CLINICAL TRIALS NUMBER NCT02561754.
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Affiliation(s)
- Amy E Bodde
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
| | - David A White
- Ward Family Heart Center, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA; School of Medicine, University of Missouri Kansas City, Kansas City, MO, USA
| | - Bethany Forseth
- Department of Physical Therapy and Rehabilitation Science, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Mary Hastert
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA; Department of Physical Therapy and Rehabilitation Science, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Richard Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Joseph Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Debra Sullivan
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Lauren T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Alghadir AH, Gabr SA, Iqbal A. Mineral elements and adiposity-related consequences in adolescents with intellectual disabilities. BMC Mol Cell Biol 2023; 24:29. [PMID: 37730529 PMCID: PMC10512604 DOI: 10.1186/s12860-023-00490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Patients with intellectual disabilities are shown to have a limited capacity for cooperation, communication,and other biological consequences, which significantly require a specialized interest in healthcare professionals worldwide. AIM In this respect, the present study was designed to evaluate the levels mineral elements, and their correlation with oxidative stress markers and adiposity markers; leptin (L), adiponectin (A), and L/A ratio in adolescents with intellectual disabilities. METHODS A total of 350 schoolchildren aged (12-18 years) were randomly invited to participate in this prospective, observational study. Only 300 participants agreed to participate in this study. According to Intelligence quotients scores (IQ) measured by WISC-III, the participants were classified into two groups; the healthy control group (no = 180; IQ = 90-114); and the moderate intellectual disability (MID) group (no = 120; IQ = 35-49). Adiposity markers; body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), physical activity scores, adipokines biomarkers; leptin, adiponectin, L/A ratio, oxidative stress, and plasma mineral elements were evaluated by prevalidated questionnaires, inductively coupled plasma-mass spectrometry (ICP-MS), colorimetric, and immunoassay techniques. RESULTS Intellectual disability of moderate type was reported in 40% of the studied populations most of them are men aged 12-18 years (66.6% for men vs. 33.3 for females). Obesity was shown to be associated with the degree of intellectual disability of the students. There was a significant (P = 0.001) increase in the BMI, WHR, and WHtR scores as obesity markers with poor physical activity (P = 0.01) in students with poor disability compared to healthy controls (HC). The levels of leptin (P = 0.001), adiponectin (P = 0.01), and L/A ratio (P = 0.01) as adiposity biomarkers were significantly increased in students with MID compared to healthy controls. Also, oxidative stress measured by malondialdehyde (MDA) (P = 0.01) and total antioxidant capacity (TAC) (P = 0.01) were significantly increased in students with MID compared to healthy control subjects. In addition, mineral elements were shown to be linked with intellectual disability. The data showed that the levels of Fe, Mn, Zn, Hg, Pb, Ca, Cr, Mg, and Ni significantly (P = 0.001) increased, and the levels of Al, Na, K, Cu, and Zn/Cu ratio significantly (P = 0.001) decreased in subjects with MID compared to healthy controls. Correlation analysis concluded that changes in mineral elements significantly correlated with adiposity markers, oxidative stress, and the scores of intellectual disability (WISC III-IQ score). CONCLUSION The intellectual disability of moderate type (MID) was associated with abnormal changes in the levels of essential mineral elements and adipokines and increased levels of cellular oxidative stress. Thus, evaluating plasma mineral elements and adipokines levels could be a potential diagnostic parameter for diagnosing MID.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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Jacob US, Pillay J, Johnson E, Omoya O(T, Adedokun AP. A systematic review of physical activity: benefits and needs for maintenance of quality of life among adults with intellectual disability. Front Sports Act Living 2023; 5:1184946. [PMID: 37361407 PMCID: PMC10285488 DOI: 10.3389/fspor.2023.1184946] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
The inactivity of people with intellectual disabilities (PwID) is a major contributor to ill health. Probably because people with intellectual disabilities are not adequately informed about physical activity and intervention programs required to enhance their fitness. This study critically reviewed physical activity: benefits and needs for maintenance of quality of life among adults with intellectual disability. An extensive search of bibliographic databases such as PubMed, PsycINFO, BioMed Central and Medline identified 735 academic papers. The research rigour was evaluated, and the validity of the findings was established. Based on the inclusion criteria, 15 studies were included in the review. Various forms of physical activity were studied as interventions. The results of a critical review indicate that physical activity has a moderate to strong positive impact on weight loss, sedentary behaviour, and disability-related quality of life. Adults with ID may benefit from physical activity as a non-pharmaceutical method of improving their health needs. However, this study's results may only apply to some adults with intellectual disabilities. The sample size needs to be increased in future studies in order to draw generalizable conclusions.
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Affiliation(s)
- Udeme Samuel Jacob
- South African Research Chair: Education and Care in Childhood, Faculty of Education, University of Johannesburg, Johannesburg, South Africa
| | - Jace Pillay
- South African Research Chair: Education and Care in Childhood, Faculty of Education, University of Johannesburg, Johannesburg, South Africa
| | - Ensa Johnson
- Department of Inclusive Education, College of Education, University of South Africa, Pretoria, South Africa
| | | | - Adewale Philip Adedokun
- Department of Special Education, Faculty of Education, University of Ibadan, Ibadan, Nigeria
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Gibson CA, Sullivan DK, Ptomey LT, Rice AM, Donnelly JE. Interviews with parents of adolescents with intellectual and developmental disabilities in a weight management study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:289-299. [PMID: 36453027 DOI: 10.1111/jar.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/05/2022] [Accepted: 11/12/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Adolescents and young adults with intellectual and developmental disabilities are at risk of obesity. Parents influence their diet and physical activity behaviours and therefore, can play important roles in weight management. The aims of this qualitative study were to explore parents' experiences assisting their son or daughter to participate in a weight management study. METHODS Interviews were completed at 6 months with 27 parents whose adolescent or young adult had completed the weight loss portion of an 18-month weight management study. Interviews were recorded, transcribed and thematic analysis performed. RESULTS Parents shared insights about how well program components worked with their family, and what strategies worked best to adopt healthier dietary choices and become more physically active. The importance of meeting regularly with someone outside the family to encourage healthier habits was stressed. CONCLUSIONS Future weight management studies should involve parents and their adolescents to help tailor strategies and adapt intervention approaches.
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Affiliation(s)
- Cheryl A Gibson
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Lauren T Ptomey
- Department of Internal Medicine, Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Anna M Rice
- Department of Internal Medicine, Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Joseph E Donnelly
- Department of Internal Medicine, Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, Kansas, USA
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Ptomey LT, Washburn RA, Goetz JR, Sullivan DK, Gibson CA, Mayo MS, Krebill R, Gorczyca AM, Honas JJ, Rice AM, Helsel BC, Lee RH, Donnelly JE. A randomized trial comparing diet and delivery strategies for weight management in adolescents with intellectual disabilities. Pediatr Obes 2023; 18:e12972. [PMID: 36054481 PMCID: PMC9940267 DOI: 10.1111/ijpo.12972] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND The literature evaluating multi-component interventions for long-term weight loss in adolescents with intellectual disabilities (ID) is extremely limited. OBJECTIVES To compare the effectiveness of two delivery strategies, face-to-face (FTF) or remote delivery (RD), and two diets, enhanced Stop Light diet (eSLD) or conventional diet (CD) on weight change across 12 and 18 months. in response to an 18 months. weight management intervention (6 months Weight loss/12 months. Weight maintenance) in adolescents with ID. METHODS Adolescents with ID were randomized to one of three arms: FTF /CD, RD/CD, RD/eSLD and asked to attend individual education sessions with a health educator which were delivered during FTF home visits or remotely using video conferencing. The CD followed the US dietary guidelines. The eSLD utilized the Stop Light guide and was enhanced with portion-controlled meals. Participants were also asked to increase their physical activity (PA) and to self-monitor diet, PA and body weight across the 18-month. INTERVENTION RESULTS Weight was obtained from 92(84%) and 89(81%) randomized adolescents at 12 and 18 months, respectively. Weight change across 12 months. Differed significantly by diet (RD/eSLD: -7.0% vs. RD/CD: -1.1%, p = 0.002) but not by delivery strategy (FTF/CD: +1.1% vs. RD/CD: -1.1%, p = 0.21). Weight change across 18 months. Was minimal in all intervention arms and did not differ by diet (RD/eSLD: -2.6% vs. RD/CD: -0.5%; p = 0.28) or delivery strategy (FTF/CD: +1.6% vs. RD/CD: -0.5%; p = 0.47). CONCLUSIONS Additional research is required to identify effective strategies to improve long-term weight loss in adolescents with ID.
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Affiliation(s)
- Lauren T. Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Richard A. Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jeannine R. Goetz
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, Rainbow City, Kansas, USA
| | - Debra K. Sullivan
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, Rainbow City, Kansas, USA
| | - Cheryl A. Gibson
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Matthew S. Mayo
- Department of Biostatistics & Data Science, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Ron Krebill
- Department of Biostatistics & Data Science, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Anna M. Gorczyca
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jeffery J. Honas
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Anna M. Rice
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Brian C. Helsel
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Robert H. Lee
- Department of Population Health, The University of Kansas Medical Center, Rainbow City, Kansas, USA
| | - Joseph E. Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
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Meguid NA, Hemimi M, Ghozlan SAS, Kandeel WA, Hashish AF, Gouda AS, Nazim WS, Mohamed MF. Differential expression of cystathionine beta synthase in adolescents with Down syndrome: impact on adiposity. J Diabetes Metab Disord 2022; 21:1491-1497. [PMID: 36404855 PMCID: PMC9672282 DOI: 10.1007/s40200-022-01087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/05/2021] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
Purpose Obesity is more prevalent among people with Down Syndrome (DS) compared to general population. In this pilot study, we investigated the effect of cystathionine beta-synthase (CBS) overdosage on the regulation of transsulfuration pathway and the obesity phenotype in fifty adolescents (25 obese/overweight and 25 lean) with trisomy 21. Methods The transcriptional levels of CBS in leukocytes and its translational levels in plasma were quantified using real time polymerase chain reaction and enzyme-linked immunosorbent assay respectively. Meanwhile, ultra performance liquid chromatography tandem mass spectrometry was used to determine the plasma concentrations of methionine, homocysteine, cystathionine and cysteine. Fasting plasma lipid profiles were assessed by colorimetric assays. The anthropometric measurements and indices of all subjects were recorded. Results Both DS groups had comparable levels of CBS transcripts (p = 0.2734). The plasma levels of the enzyme were significantly higher in the lean DS cases (p = 0.0174) compared to the obese/overweight participants. Total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, methionine, homocysteine, cystathionine and cysteine showed similar plasma levels in both groups. However, the plasma cysteine levels exceeded the normal range in all DS cases. We reported a statistically significant inverse association between CBS enzyme levels and weight (r= - 0.3498, p = 0.0128), hip circumference (r= - 0.3584, p = 0.0106), body mass index (r= - 0.3719, p = 0.0078) and body adiposity index (r= - 0.3183, p = 0.0243). Conclusions Our data suggests that the high concentrations of CBS enzyme together with cysteine modulate the DS obesity presumably through increased hydrogen sulfide production which has recently showed anti-adiposity effects.
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Affiliation(s)
- Nagwa A. Meguid
- Department of Research on Children with Special Needs, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
- CONEM Egypt Child Brain Research Group, National Research Centre, Cairo, Egypt
| | - Maha Hemimi
- Department of Research on Children with Special Needs, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | - Said A. S. Ghozlan
- Department of Chemistry, Faculty of Science, Cairo University, Giza, Egypt
| | - Wafaa A. Kandeel
- Department of Biological Anthropology, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
- Theodor Bilharz Research Institute, Giza, Egypt
| | - Adel F. Hashish
- Department of Research on Children with Special Needs, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | - Amr S. Gouda
- Department of Biochemical Genetics, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Walaa S. Nazim
- Department of Biochemical Genetics, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Magda F. Mohamed
- Department of Chemistry (Biochemistry Branch), Faculty of Science, Cairo University, Giza, Egypt
- Department of Chemistry, College of Science and Arts at Khulais, University of Jeddah, Jeddah, Saudi Arabia
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Dreyer Gillette ML, Killian HJ, Fernandez C, Sweeney BR. Treating Obesity in Children and Adolescents with Special Healthcare Needs. Curr Obes Rep 2022; 11:227-235. [PMID: 36319822 DOI: 10.1007/s13679-022-00484-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE OF REVIEW This paper aims to summarize the literature regarding treatment of obesity in children with special healthcare needs and provide examples of implementation based on the available scientific evidence and the clinical experience of the authors. RECENT FINDINGS Due to the complexity of providing treatment for children with obesity and special healthcare needs, multidisciplinary teams are recommended to adapt care to meet the children's unique needs and ensure coordination of care across settings/caregivers. Medication management is often required to assist with the side effects of psychotropic medications. Children with special healthcare needs (SHCN) such as intellectual and developmental disabilities (IDD) should be considered for metabolic and bariatric surgery as they have similar outcomes to children without SHCN. Children with special healthcare needs can be successful in weight management treatment when they have access to comprehensive care including dietary, behavioral, pharmacological, and surgical interventions. Each child requires a tailored approach to ensure their special healthcare needs are addressed within the treatment plan.
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Affiliation(s)
- Meredith L Dreyer Gillette
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, USA.
- Divisions of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, USA.
- University of Missouri-Kansas City School of Medicine, Kansas City, USA.
- Division of Weight Management, Children's Mercy Kansas City, MO, Kansas, USA.
| | - Haley J Killian
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, USA
- Divisions of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, USA
| | - Cristina Fernandez
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, USA
- University of Missouri-Kansas City School of Medicine, Kansas City, USA
- Division of Weight Management, Children's Mercy Kansas City, MO, Kansas, USA
| | - Brooke R Sweeney
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, USA
- University of Missouri-Kansas City School of Medicine, Kansas City, USA
- Division of Weight Management, Children's Mercy Kansas City, MO, Kansas, USA
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12
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Motor Coordination and Global Development in Subjects with Down Syndrome: The Influence of Physical Activity. J Clin Med 2022; 11:jcm11175031. [PMID: 36078962 PMCID: PMC9457525 DOI: 10.3390/jcm11175031] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Many research studies have investigated motor impairments and delayed development in children with Down Syndrome (DS). However, very few studies detected these features in adults with DS. Hence, this study aimed to investigate the relationship between motor coordination and global development in subjects with DS, including adults. Furthermore, the second aim was to detect any differences in motor coordination and global development as a function of the practice of physical activity (PA) in this population. Methods: Twenty-five participants with DS (10 f, 15 m), with a chronological mean age of 27.24 years and development mean age of cognitive area of 4.93 years, were enrolled and divided into a physically active group (PA-G; n = 15) and a physically inactive group (PI-G; n = 10). All participants performed the Movement Assessment Battery for Children (M-ABC) to assess fine and gross motor skills, while the Developmental Profile 3 (DP-3) checklist was administered to the parents in order to screen strengths and weaknesses of five developmental areas of their relatives with DS. Results: Our results showed positive correlations between the following variables: global motor coordination and global development, global motor coordination and adaptive behavior development area, aiming and catching skills and global development, aiming and catching skills and adaptive behavior development area. As for the practice of PA, PA-G showed higher scores than PI-G in all the tasks of both the M-ABC and the DP-3, though significant differences were found only for the global motor coordination, for the aiming and catching skills, as well as for the physical development area. Conclusions: The findings of this study reinforce the need to implement and encourage the practice of PA in order to promote well-being and social inclusion in subjects with DS.
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13
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Akhtar TN, McGibbon E. Blindspot in the evidence base: A systematic review of psychological interventions for children and adolescents with intellectual disabilities and co-occurring obesity. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104240. [PMID: 35500443 DOI: 10.1016/j.ridd.2022.104240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/25/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Children and adolescents with intellectual disabilities (C&A-ID) face many disadvantages in healthcare research and service delivery. Intellectual disabilities have been found to precipitate weight-related problems, and together, they may be indicators of rare genetic diseases (RGDs). C&A-ID may require support for health problems exacerbated by primary diagnoses. While it is generally agreed that C&A-ID have more complex needs than typically developing individuals, psychological services to address these needs are under-explored. AIMS This systematic review aimed to identify psychological interventions for weight management in C&A-ID. METHOD MEDLINE, PsycINFO, CINAHL, The Cochrane Library and SCOPUS were systematically searched. Data extraction and quality appraisal were performed for all eligible studies RESULTS: The search strategy yielded seven studies published in English between 2010 and 2022. All interventions addressed obesity through multi-disciplinary programmes and resulted in weight reductions, with most interventions theoretically influenced by principles of behaviourism. Quality appraisal revealed methodological weaknesses in six of seven studies, such as heterogeneity in samples, interventions, and outcome measures, disallowing meta-analyses and weakening the generalisability of interventions to diverse contexts and groups CONCLUSIONS AND IMPLICATIONS: A genuine disconnect between empirical evidence and services for C&A with complex needs was observed. This emphasises an urgency for increased inclusion in clinical and behavioural research and for robust enquiries to test/adapt psychological interventions for weight management for C&A-ID. The findings of this review hold clinical utility for clinicians working with C&A-ID, and with RGDs such as Bardet-Biedl, Prader-Willi and Down syndromes. Recommendations and a conceptual framework are provided herein for enhanced efficacy of interventions.
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Affiliation(s)
- Tooba Nadeem Akhtar
- The Great Ormond Street Institute of Child Health, University College London, United Kingdom.
| | - Emma McGibbon
- Wolfson Neurodisability Service, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom.
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14
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Willems M, de Jong J, Overwijk A, Hilgenkamp TIM, van der Schans CP, Waninge A. Behaviour change techniques used in lifestyle support of adults with mild intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1327-1335. [PMID: 35734872 DOI: 10.1111/jar.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 03/27/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Professional caregivers are important in the daily support of lifestyle change for adults with mild intellectual disabilities; however, little is known about which behaviour change techniques (BCTs) are actually used. This study aims to gain insight in their use for lifestyle behaviour change using video observations. METHODS Professional caregivers (N = 14) were observed in daily work supporting adults with mild intellectual disabilities. Videos were analysed using the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy and BCTs utilised were coded. RESULTS Twenty one out of 40 BCTs were used by professional caregivers. The BCTs 'Information about others' approval', 'Identification as role model', 'Rewards on successful behaviour', 'Review behavioural goals' and 'Instructions on how to perform the behaviour' were most employed. CONCLUSION Professional caregivers used BCTs to support healthier lifestyle behaviour of adults with mild intellectual disabilities. However, most promising of them as defined previous by professionals were rarely used by professional caregivers.
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Affiliation(s)
- Mariël Willems
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Johan de Jong
- School of Sports Studies, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Annelies Overwijk
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Physical Therapy Department, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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15
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Ptomey LT, Lee J, White DA, Helsel BC, Washburn RA, Donnelly JE. Changes in physical activity across a 6-month weight loss intervention in adolescents with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:545-557. [PMID: 34915594 PMCID: PMC9469505 DOI: 10.1111/jir.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/22/2021] [Accepted: 11/24/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Adolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate-to-vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6-month multi-component weight loss intervention. METHODS Adolescents and young adults with IDD and overweight or obesity (body mass index ≥ 85 percentile, n = 110, age ~16 years, 52.7% female) and a parent were randomised to one of three intervention groups: face-to-face delivery/conventional reduced energy diet (n = 36), remote delivery (RD)/conventional reduced energy diet (n = 39), or RD/reduced energy enhanced stop light diet (eSLD) (n = 35.) Participants were asked to engage in 60 min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self-monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face-to-face arm was delivered during home-visits and self-monitoring of MVPA and daily steps was completed by self-report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7 days at baseline and 6 months using a portable accelerometer (ActiGraph wGT3x-BT). RESULTS Mixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4-10 h days) at baseline (n = 68) and 6 months (n = 30) revealed no significant changes in light, moderate- MVPA, or sedentary time across the 6-month intervention (all P > 0.05). Participants obtained 15.2 ± 21.5 min/day of MVPA at baseline and 19.7 ± 19.7 min/day at 6 months (P = 0.119). Mixed modelling indicated no significant effects of group (P = 0.79), time (P = 0.10), or group-by-time interaction (P = 0.21) on changes in MVPA from baseline to 6 months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6 months (n = 24) revealed no significant associations between baseline sedentary time (r = 0.10, P = 0.40) and baseline MVPA (r = -0.22, P = 0.30) and change in MVPA across the 6-month intervention. Additionally, attendance at education/counselling sessions (r = 0.26, P = 0.22) and frequency of self-monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6 months (r = 0.26, P = 0.44). Baseline MVPA (r = 0.02, P = 0.92) and change in MVPA from baseline to 6 months (r = 0.13, P = 0.30) were not associated with changes in body weight across the 6-month intervention. CONCLUSION We observed a non-significant increase in MVPA (30%), which was not associated with the magnitude of weight loss in a sample of adolescents and young adults with IDD who participated in a 6-month multi-component weight loss intervention. Additional strategies to increase MVPA in adolescents and young adults with IDD participating in weight loss interventions need to be developed and evaluated.
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Affiliation(s)
- Lauren T. Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
| | - Jaehoon Lee
- Institute for Measurement, Methodology, Analysis and Policy, Texas Tech University, 2500 Broadway, Lubbock, TX, 79409 USA
| | - David A. White
- Ward Family Heart Center, Children’s Mercy Hospital Kansas City, Kansas City, MO USA
| | - Brian C. Helsel
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
| | - Richard A. Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
| | - Joseph E. Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
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16
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Yu S, Gao Y, Wang A, Sun Y, Wang J, Kwok HHM, Wu S, Lam CK, Tao ED, Jiao JJ, Fong SSM, Xie Y, Zhang D, Baker JS. Effectiveness of an adapted physical activity intervention for weight management in adolescents with intellectual disability: A randomized controlled trial. Pediatr Obes 2022; 17:e12882. [PMID: 35014215 DOI: 10.1111/ijpo.12882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/19/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a 9-month school-based adapted physical activity (APA) program for reducing weight among adolescents with intellectual disability (ID). METHODS In this randomized controlled trial, adolescents with ID, aged 12-18 years, who were overweight/or with obesity were randomly assigned into intervention and control groups. The APA intervention consisted of aerobic and resistance exercises with an overall moderate intensity and was delivered at a frequency of two sessions per week for 9 months. Changes in body mass index (BMI, primary outcome) and changes in BMIz, weight, percent body fat, waist circumference and waist-to-height ratio (secondary outcomes) were examined using general linear models. RESULTS In total 61 subjects (39 in the intervention and 22 in the control) completed the study and were included in the analyses. At 9 months, the intervention group exhibited a reduced BMI of -0.66 kg/m2 (95% CI -1.06 to -0.25 kg/m2 , p = 0.002), while a significant increase in BMI was observed in the control group. A significant post-intervention between-group difference in change in BMI (-1.31 kg/m2 [95% CI -1.99 to -0.63], p < 0.01) was found in favour of the intervention group. Similar results were also observed for all secondary outcomes. CONCLUSIONS This study provides evidence that a 9-month APA intervention induced clinically meaningful effects on weight loss in adolescents with ID.
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Affiliation(s)
- Siyue Yu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Aiwei Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yan Sun
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Jingjing Wang
- Mass Sports Research Center, China Institute of Sport Science, Beijing, China
| | - Heather Hei Man Kwok
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Shing Wu
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Chi Kei Lam
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Emma Dan Tao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Jojo Jiao Jiao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Shirley Siu Ming Fong
- School of Public Health, University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China.,Department of Health and Physical Education, Education University of Hong Kong, Hong Kong, China
| | - Yaojie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Julien S Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
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17
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Sukal-Moulton T, Egan T, Johnson L, Lein C, Gaebler-Spira D. Use of Frame Running for Adolescent Athletes With Movement Challenges: Study of Feasibility to Support Health and Participation. Front Sports Act Living 2022; 4:830492. [PMID: 35356095 PMCID: PMC8959752 DOI: 10.3389/fspor.2022.830492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/28/2022] [Indexed: 12/18/2022] Open
Abstract
Children and adolescents with movement challenges have lower instances of physical activity and longer time spent in sedentary behaviors compared to children with typical development. The purpose of this study was to investigate the feasibility of a sport-based youth development running program modified for accessibility using a running frame and to evaluate initial evidence for its efficacy on endurance and functional strength. We completed four 8-week seasons (2–3 times per week) in a combination of 3 different formats by season: online remote (winter and spring), in person in a community park (winter, spring, and summer), and in person in an afterschool setting (autumn). Participants included 13 athletes (average age 14.46 years, range 8–18 years, 4 females), who collectively completed 22 season blocks. Diagnoses included cerebral palsy (n = 10), arthrogryposis (n = 1), Dandy-Walker malformation (n = 1), and transverse myelitis (n = 1). In all settings, participants engaged in activities of social emotional learning, cardiovascular endurance, and muscle strengthening in a progressive manner. We found that each season format was feasible to administer with high attendance rates (76–97%) and positive qualitative feedback from athletes. In addition, promising average improvements in motor performance across a season (6 min frame running test, 170 m; timed up and go test, 8.44 s; five times sit to stand, 14.1 s; and Goal Attainment Scale, t = 65.01) were identified in the pilot data of this non-randomized cohort. Training in any of the proposed settings with an overall goal of completing a community race in a running frame is feasible and warrants further study.
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Affiliation(s)
- Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- *Correspondence: Theresa Sukal-Moulton
| | - Tara Egan
- Office of Diverse Learner Supports and Services, Chicago Public Schools, Chicago, IL, United States
| | | | | | - Deborah Gaebler-Spira
- Shirley Ryan AbilityLab, Chicago, IL, United States
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Lurie Children's Hospital, Chicago, IL, United States
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18
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Choo TH, Xu Q, Budimirovic D, Lozano R, Esler AN, Frye RE, Andrews H, Velinov M. Height and BMI in fragile X syndrome: A longitudinal assessment. Obesity (Silver Spring) 2022; 30:743-750. [PMID: 35174658 PMCID: PMC11047757 DOI: 10.1002/oby.23368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Previously reported data regarding growth parameters in individuals with fragile X syndrome (FXS) are inconsistent. A longitudinal analysis of height and BMI in a large number of individuals with FXS was conducted. METHODS Age- and sex-specific z scores for height and BMI of 1,223 individuals with FXS were calculated based on published normative data. Mixed-effect linear regression models were fit separately for males and females, and z scores for height and weight were regressed against age and adjusted for intellectual disability (ID) and psychotropic medication use. RESULTS Mean height z score for both sexes decreased with age and was lower than normative data. Mean BMI z score was greater than normative data in both sexes, and this disparity increased with age. BMI z score in females was greater for those with moderate or severe ID than those with no or mild ID. Individuals taking antipsychotics had higher BMI z scores than those taking no or other medications; those taking anticonvulsants or stimulants had lower BMI z scores. CONCLUSIONS Individuals with FXS are at elevated risk for overweight and obesity. The risk is higher in individuals taking antipsychotics and among females with severe ID. These findings warrant increased attention to obesity prevention for all individuals with FXS.
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Affiliation(s)
- Tse-Hwei Choo
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Qing Xu
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Dejan Budimirovic
- Department of Psychiatry, Fragile X Clinic, Kennedy Krieger Institute/JHMI, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences-Child Psychiatry, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Reymundo Lozano
- Department of Genetics and Genomic Sciences, Pediatrics and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy N Esler
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Richard E Frye
- Section of Neurodevelopmental Disorders, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
| | - Howard Andrews
- Data Coordinating Center, Columbia University-Mailman School of Public Health, New York State Psychiatric Institute, New York, New York, USA
| | - Milen Velinov
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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19
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Involvement of Intestinal Goblet Cells and Changes in Sodium Glucose Transporters Expression: Possible Therapeutic Targets in Autistic BTBR T +Itpr3 tf/J Mice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111328. [PMID: 34769857 PMCID: PMC8583041 DOI: 10.3390/ijerph182111328] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/22/2022]
Abstract
Autism spectrum disorder is a neurodevelopmental syndrome with a complicated etiology and could be responsible for disrupted gastrointestinal tract microbiota. The aim of this work was to study intestinal samples from an autistic animal model (BTBR mouse strain) to better describe gastrointestinal alterations. We performed a morphological and biological evaluation of small intestine samples. In terms of morphology, we studied the goblet cells, cells of intestinal mucosal responsible for the production and maintenance of the protective mucous blanket. Alterations in their secretion may indicate an altered rate of mucus synthesis and this is one of the possible causes of gastrointestinal problems. In terms of biological evaluation, impaired regulation of glucose homeostasis regulated by sodium-glucose transporters has been suggested as an important component of obesity and associated comorbidities; therefore, this study analyzed the expression of sodium/glucose transporter-1 and -3 in BTBR mice to better define their role. We demonstrated that, in BTBR mice as compared to C57BL/6J (B6) strain animals: (1) The goblet cells had different protein content in their vesicles and apparently a larger number of Golgi cisternae; (2) the expression and level of sodium/glucose transporters were higher. These findings could suggest new possible targets in autism spectrum disorder to maintain mucus barrier function.
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20
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Correlates of obesity in adolescents with and without autism spectrum disorder: The 2017-2018 National Survey of Children's Health. Disabil Health J 2021; 15:101221. [PMID: 34654677 DOI: 10.1016/j.dhjo.2021.101221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/28/2021] [Accepted: 10/03/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The prevalence of autism spectrum disorder (ASD) and childhood obesity are increasing, and youth with ASD are at an increased risk of obesity compared to typically developing youth. Specific obesity risk factors in adolescents with ASD remain poorly understood. OBJECTIVE This study examined correlates of obesity among adolescents with and without ASD using extant 2017-2018 National Survey of Children's Health (NSCH) data. METHODS This cross-sectional study examined the co-occurrence of obesity among US adolescents with ASD aged 10-17 years compared to those without ASD, adjusting for sociodemographic characteristics, co-occurring conditions, and relevant covariates, using 2017-2018 NSCH data. Multiple logistic regression was used to compare the odds of obesity among children with mild ASD, moderate/severe ASD, and without ASD. RESULTS Odds of obesity were higher in adolescents with ASD compared to adolescents without ASD (cOR 1.9, CI 1.3-2.7). In the adjusted model, the odds of obesity were not significantly higher in those with mild or moderate/severe ASD compared to those without ASD. Odds of obesity were higher for all adolescents who were Hispanic or Black, as well as those with lower household income or with one or more co-occurring conditions. CONCLUSIONS The association between obesity and ASD in this study highlights the need for greater attention to nutrition, physical activity, and co-occurring conditions among adolescents with ASD. Effective interventions to curtail the risks among racial/ethnic minority adolescents and adolescents with lower household income are needed. Further research is needed to examine additional factors associated with obesity in adolescents with ASD, including family, community, organizational, and policy factors.
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21
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Killian HJ, Pallotto IK, Sweeney BR, Dreyer Gillette ML. Weight Management Outcomes of Youth with Autism Spectrum Disorder Seeking Treatment from a Multidisciplinary Team. J Autism Dev Disord 2021; 52:791-799. [PMID: 33791886 PMCID: PMC8011772 DOI: 10.1007/s10803-021-04982-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 12/02/2022]
Abstract
Youth with Autism Spectrum Disorder (ASD) are at an increased risk for developing obesity when compared to their typically developing peers. Given higher prevalence of obesity in youth with ASD, understanding factors relating to success in obesity treatment provides insight into implementing efficacious treatments for youth. The current study examines age, sleep, and metabolic factors potentially affecting success in 74 youth (Mage = 11.66) attending a multidisciplinary weight management treatment program over a year. Multilevel modeling indicated that higher baseline BMI class category, medications at baseline, and absence of sleep difficulties predicted greater reduction in BMI after a year of treatment.
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Affiliation(s)
- Haley J Killian
- Department of Psychology, The University of Missouri - Kansas City, 5030 Cherry St, Kansas City, MO, 64110, USA
| | - Isabella K Pallotto
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC, 27599, USA
| | - Brooke R Sweeney
- Department of Pediatrics, Weight Management and Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City/University of Missouri Kansas City School of Medicine, 2401 Gillham Rd., Kansas City, MO, 64108, USA
| | - Meredith L Dreyer Gillette
- Department of Pediatrics, Developmental and Behavioral Health and Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City/University of Missouri Kansas City School of Medicine, 2401 Gillham Rd., Kansas City, MO, 64108, USA.
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22
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Kupis L, Goodman ZT, Kircher L, Romero C, Dirks B, Chang C, Nomi JS, Uddin LQ. Altered patterns of brain dynamics linked with body mass index in youth with autism. Autism Res 2021; 14:873-886. [PMID: 33616282 DOI: 10.1002/aur.2488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/10/2021] [Indexed: 12/18/2022]
Abstract
Children with autism spectrum disorder (ASD) have higher rates of overweight and obesity (OWOB) compared with typically developing (TD) children. Brain functional connectivity differences have been shown in both ASD and OWOB. However, only one study to date has examined ASD and OWOB concurrently, so little is known regarding the neural mechanisms associated with the higher prevalence of OWOB and its behavioral impacts in ASD. We investigated co-activation patterns (CAPs) of brain regions identified by independent component analysis in 129 children and adolescents between 6 and 18 years of age (n = 68 ASD). We examined the interaction between body mass index (BMI) and diagnosis in predicting dynamic brain metrics (dwell time, DT; frequency of occurrence, and transitions between states) as well as dimensional brain-behavior relationships. The relationship between BMI and brain dynamics was moderated by diagnosis (ASD, TD), particularly among the frequency of CAP 4, characterized by co-activation of lateral frontoparietal, temporal, and frontal networks. This pattern was negatively associated with parent-reported inhibition skills. Children with ASD had shorter CAP 1, characterized by co-activation of the subcortical, temporal, sensorimotor, and frontal networks, and CAP 4 DTs compared with TD children. CAP 1 DT was negatively associated with cognitive flexibility, inhibition, social functioning, and BMI. Cognitive flexibility moderated the relationship between BMI and brain dynamics in the visual network. Our findings provide novel evidence of neural mechanisms associated with OWOB in children with ASD. Further, poorer cognitive flexibility may result in increased vulnerability for children with ASD and co-occurring OWOB. LAY SUMMARY: Obesity is a societal epidemic and is common in autism, however, little is known about the neural mechanisms associated with the higher rates of obesity in autism. Here, we find unique patterns of brain dynamics associated with obesity in autism that were not observed in typically developing children. Further, the relationship between body mass index and brain dynamics depended on cognitive flexibility. These findings suggest that individuals with autism may be more vulnerable to the effects of obesity on brain function. Autism Res 2021, 14: 873-886. © 2021 International Society for Autism Research, Wiley Periodicals LLC.
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Affiliation(s)
- Lauren Kupis
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Zachary T Goodman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Leigha Kircher
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Celia Romero
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Bryce Dirks
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Catie Chang
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.,Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
| | - Jason S Nomi
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, Florida, USA.,Neuroscience Program, University of Miami Miller School of Medicine, Miami, Florida, USA
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Sanner CM, Neece CL, Herbozo S, Baum MF. A pilot study of enhanced operation fit: The feasibility of a camp-based health intervention for ethnically diverse families of children with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:624-633. [PMID: 33236510 DOI: 10.1111/jar.12832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Obesity rates are higher in children with intellectual and developmental disabilities (DD) compared to typically developing (TD) children. In TD children, family-based (FB) interventions for obesity are the most effective interventions. Research addressing obesity interventions for children with IDD is limited. METHOD We adapted a community-based obesity intervention created for TD children for children with IDD and added a parent education component. The current study examined the feasibility of Enhanced-Operation Fit, a camp-based intervention created in order to reduce weight, and improve health behavior outcomes. Participants were 16 children (68.8% male; Mage = 13.15, SDage = 1.62) and their parents. RESULTS Results indicated that incorporating a daily parent education group limited recruitment potential, but showed promising preliminary improvements in parent feeding and child eating behaviors. CONCLUSIONS Health interventions for children with IDD are greatly needed and the current study may be a cost and time-efficient intervention to help address this public health crisis.
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Affiliation(s)
| | - Cameron L Neece
- Department of Psychology, Loma Linda University, Loma Linda, CA, USA
| | - Sylvia Herbozo
- Departments of Psychiatry and Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Marti F Baum
- Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA
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Rubin MB, Miller CM, Bauer SC, Ariza AJ, Binns HJ. Identifying characteristics and outcomes in youth with obesity and developmental disabilities. Disabil Health J 2020; 14:100988. [PMID: 32980288 DOI: 10.1016/j.dhjo.2020.100988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/20/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Youth with developmental disability are at increased risk of obesity; literature focusing on the two is rare. OBJECTIVE To identify characteristics and outcomes of youth presenting for obesity care having a disability as compared to without. METHODS A medical record review of youth aged 2-18 years initiating obesity care 2013-2015 at a tertiary care obesity management program. Youth were grouped by disability status to identify differences in presenting characteristics and factors associated with a reduction in body mass index (BMI) percent of the 95th BMI percentile (BMIp95) over 12 months. Logistic regression (LR) models examined associations with BMIp95 drop (<5-points versus ≥5-points) for each disability group. RESULTS Of 887 subjects, 253 (28.5%) had a disability. At presentation, youth with disability were more often (p < 0.01) male (58.5% versus 47.9%), had birth weight <2500 g (14.1% versus 8.4%), had a father who was not obese (61.6% versus 47.4%), and were on weight influencing medications. Overall, 182 subjects (20.5%) completed 12-month follow-up. At follow-up, the with disability group (n = 63) had mean -2.3 (SD 10.7) BMIp95 change (p = 0.679); youth having a motor disability less often had ≥5-point BMIp95 drop (odds ratio 0.15, 95% confidence interval 0.04-0.59). At follow-up, the no disability group (n = 119) had mean -2.9 (SD 8.5) BMIp95 change; youth identified as having initial severe obesity status and not having a parent with diabetes more often had ≥5-point BMIp95 drop. CONCLUSION Youth with developmental disabilities were as successful in obesity care as those without disabilities. Predictors of success differed between the groups.
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Affiliation(s)
| | | | - Sarah C Bauer
- Advocate Children's Hospital and the Pediatric Developmental Center at Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Adolfo J Ariza
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Helen J Binns
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
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25
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Buro AW, Gray HL, Kirby RS, Berkman K, Agazzi H, Shaffer-Hudkins E. Diet quality in an ethnically diverse sample of children and adolescents with autism spectrum disorder compared with nationally representative data. Disabil Health J 2020; 14:100981. [PMID: 32811783 DOI: 10.1016/j.dhjo.2020.100981] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children with developmental disabilities are at an increased risk of unhealthy eating habits, which may contribute to compromised growth and development. Children with autism spectrum disorder (ASD) exhibit unique risk factors for unhealthy dietary patterns, including sensory issues and cognitive rigidity at mealtimes. OBJECTIVE This cross-sectional study examined diet quality in a sample of children with ASD in Florida compared to nationally representative National Health and Nutrition Examination Survey (NHANES) 2009-2014/2013-2014 data using the Healthy Eating Index-2015 (HEI-2015). METHODS A 24-h food record was completed by 41 parents of children with ASD aged 2-17 years, and food and beverage items consumed by each child were reported per standardized 24-h recall protocol. Two models were used to compare mean total and component HEI-2015 scores to NHANES means: (1) comparing means for our full sample to published NHANES means for children aged 2-18 years and (2) a matched model with subjects matched 1:1 by age, gender, race/ethnicity, and parent education level. RESULTS HEI component scores were significantly lower (poorer) in children with ASD for whole fruit, total vegetables, dairy, total protein foods, and seafood and plant protein. Whole grains, fatty acids, added sugars, and refined grains scores were higher (better) in our sample. However, total HEI scores and HEI scores for all 13 components were similar among children with ASD and the matched cases from the NHANES data. CONCLUSIONS There are potential discrepancies in diet quality between children with ASD and general population. Further research with a larger sample size, reporting both total and component HEI scores, is needed.
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Affiliation(s)
- Acadia W Buro
- College of Public Health, University of South Florida, Tampa, FL, 33612, USA.
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Karen Berkman
- Center for Autism & Related Disabilities, Department of Child and Family Studies, University of South Florida, 13301 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Heather Agazzi
- Department of Pediatrics, University of South Florida, 13101 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Emily Shaffer-Hudkins
- Department of Pediatrics, University of South Florida, 13101 Bruce B Downs Blvd, Tampa, FL, 33612, USA
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26
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Martínez-Espinosa RM, Molina Vila MD, Reig García-Galbis M. Evidences from Clinical Trials in Down Syndrome: Diet, Exercise and Body Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124294. [PMID: 32560141 PMCID: PMC7344556 DOI: 10.3390/ijerph17124294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
Down syndrome (DS) is related to diseases like congenital heart disease, obstructive sleep apnea, obesity and overweight. Studies focused on DS associated with obesity and overweight are still scarce. The main objective of this work was to analyze the relationship between dietary intervention, physical exercise and body composition, in DS with overweight and obesity. This review is based on the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Selection criteria for this analysis were: publications between January 1997 and December 2019; DS individuals with overweight and obesity; clinical trials using dietary intervention and physical exercise paying attention to changes in body composition. Selected clinical trials were focused on an exclusive intervention based on physical exercise. The anthropometric measures analyzed were body fat, BMI, waist circumference, body weight and fat free mass. The main conclusion is that prescribing structured physical exercise intervention may be related to a greater variation in body composition. Despite limited number of clinical trials analyzed, it can be assumed that the reported studies have not achieved optimal results and that the design of future clinical trials should be improved. Some guidelines are proposed to contribute to the improvement of knowledge in this field.
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Affiliation(s)
- Rosa María Martínez-Espinosa
- Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain;
- Applied Biochemistry Research Group AppBiochem, University of Alicante, 03690 Alicante, Spain;
| | - Mariola D Molina Vila
- Applied Biochemistry Research Group AppBiochem, University of Alicante, 03690 Alicante, Spain;
- Department of Mathematics, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain
| | - Manuel Reig García-Galbis
- Applied Biochemistry Research Group AppBiochem, University of Alicante, 03690 Alicante, Spain;
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama, Avda. Copayapu 2862, III Region, Copiapó 1530000, Chile
- Noncommunicable Diseases Research Group, Atacama 1410000, Chile
- Correspondence: ; Tel.: +34-52-225-5647
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Abstract
Many adults with autism spectrum disorders (ASDs) are admitted as an inpatient, and much has been reported on their ASD-related characteristics and aggressive behaviors that complicate their care during hospitalizations. A variety of surgical and medical clinical conditions have required their admissions in the critical care unit. A limited number of case studies are present for hospitalized adults with ASD; most literature about young children was on how to provide care for them. An interdisciplinary approach with a focus on determining information specific to adult patients with ASD, medical problems or common causes of challenging behaviors, and medication history, as well as nutritional needs, is essential in meeting the care needs of autistic adults. Suggestions informed by multiple sources of evidence are presented to assist critical care nurses on how to provide support to care needs of adult patients with ASD during their hospital stay and transition to home.
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Scifo L, Chicau Borrego C, Monteiro D, Matosic D, Feka K, Bianco A, Alesi M. Sport Intervention Programs (SIPs) to Improve Health and Social Inclusion in People with Intellectual Disabilities: A Systematic Review. J Funct Morphol Kinesiol 2019; 4:jfmk4030057. [PMID: 33467372 PMCID: PMC7739438 DOI: 10.3390/jfmk4030057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/05/2019] [Accepted: 08/10/2019] [Indexed: 11/16/2022] Open
Abstract
Inactivity is a major issue that causes physical and psychological health problems, especially in people with intellectual disability (ID). This review discusses the beneficial effects of sport intervention programs (SIPs) in people with ID, and aims to provide an overview of the scientific literature in order to identify the main factors influencing the participation of people with ID in SIPs. Twelve papers were analyzed and compared. The results show a large variety in examined SIPs, concerning participants' age and disability, intervention characteristics and context, as well as measures and findings. The main factors essential for people with ID partaking in SIPs appeared to be suitable places for the SIP development, adequate implementation of physical activity (PA) programs in school and extra-school contexts, education, and the training of teachers and instructors. The literature review highlights the relevance of using SIPs in order to improve physical and psychological health, as well as increase social inclusion in populations with ID. SIPs should be included in multifactor intervention programs. Nevertheless, the need is recognized for stakeholders to adopt specific practice and policy in promoting social inclusion in order to organize intervention strategies which are able to provide quality experiences in sport and physical activity for people with ID.
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Affiliation(s)
- Lidia Scifo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
- Correspondence:
| | - Carla Chicau Borrego
- Escola Superior de Rio Maior, CIEQV, Av. Mário Soares, 2040-413 Rio Marior, Portugal
| | - Diogo Monteiro
- Escola Superior de Desporto de Rio Maior (ESDRM-IPSantarem), Centro de Investigação em Desporto, Saúde e Desenvolvimento Humano (CIDESD), 2040-413 Rio Marior, PORTUGAL
| | - Doris Matosic
- Faculty of Kinesiology, University of Split, Teslina 6, 21000 Split, Croatia
| | - Kaltrina Feka
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
| | - Antonino Bianco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
| | - Marianna Alesi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
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A school-based mentoring program developing healthy behaviors of adolescents with intellectual and developmental disabilities: A pilot feasibility study. Disabil Health J 2019; 12:727-731. [PMID: 30987820 DOI: 10.1016/j.dhjo.2019.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 03/22/2019] [Accepted: 03/27/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies have reported that adolescents with intellectual and developmental disabilities (IDD) have a higher prevalence of obesity due to medication intake, poor diet, and physical inactivity. More importantly, they lack awareness and comprehension to prevent weight problems. Thereby, health-promoting practices should be offered in schools for adolescents with IDD. OBJECTIVE/HYPOTHESIS This pilot study examined the feasibility of a school-based intervention using the I Can Do It! (ICDI) national health promotion model to promote healthy behaviors of adolescents with IDD. METHODS A pretest-posttest design was employed. Fourteen adolescents (9 males, 5 females) aged 12-15 years (mean = 13.4, SD = 0.9) from self-contained classrooms completed a 14-week intervention (60-70 min/session) over 4-month period. Healthy behaviors were evaluated by body composition (waist circumference and BMI z-score), physical activity level and nutrition behaviors. RESULTS Body composition did not change as a result of the intervention. The intervention increased the amount of time spent in physical activity, but not the frequency. In contrast, the children's water consumption did significantly increase after the intervention (d = 3.39). The amount of fruit and vegetables also significantly increased after the intervention, where only 7% reported eating these daily before the intervention and afterwards 86% reported eating fruits and vegetables daily (p < .0001). CONCLUSIONS The results demonstrate that it is feasible to conduct a goal-driven, mentor-based intervention in school for adolescents with IDD. While preliminary effectiveness results are promising, future research should focus on rigorously testing the effectiveness of the ICDI model and examining the programs long-term sustainability.
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Fang Q, Aiken CA, Fang C, Pan Z. Effects of Exergaming on Physical and Cognitive Functions in Individuals with Autism Spectrum Disorder: A Systematic Review. Games Health J 2019; 8:74-84. [DOI: 10.1089/g4h.2018.0032] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Qun Fang
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - Christopher A. Aiken
- Department of Kinesiology & Dance, New Mexico State University, Las Cruces, New Mexico
| | - Chao Fang
- Department of Pharmacology, School of Pharmacy, Institute of Neurosciences, the Fourth Military Medical University, Xi'an, China
- F. M. Kirby Neurobiology Center, Harvard Medical School, Boston, Massachusetts
| | - Zhujun Pan
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
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31
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Lee RLT, Brown M, Leung C, Chen H, Louie L, Chen JL, Lee PH. Family carers' experiences of participating in a weight management programme for overweight children and adolescents with intellectual disabilities: An exploratory study. J Adv Nurs 2018; 75:388-399. [PMID: 30187576 DOI: 10.1111/jan.13845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 06/04/2018] [Accepted: 06/08/2018] [Indexed: 11/29/2022]
Abstract
AIM To gain insight into the experiences of family carers participating in a weight management programme via mHealth tools for overweight children and adolescents with intellectual disabilities. BACKGROUND Many weight reduction programs fail to show positive and sustainable impacts due to not involving parents, who are usually unavailable to attend school-based health programs. The mHealth interactive interventions were carried out in September 2015-August 2016, engaging carers to monitor and sustain their children's healthy lifestyle behaviours at home being one way to achieve this. DESIGN Qualitative research design to conduct focus group discussion with family carers involved in a school-based weight management programme via the mHealth interventions. METHODS An exploratory study was used to examine family carers' views of participating in a weight management programme. Focus group interviews examined the in-depth experiences of 20 family carers in providing social support and monitoring lifestyle behaviours via the mHealth interactive interventions. RESULTS Twenty family carers were recruited and four themes emerged: (a) improving family carer-child interactions and communications; (b) gaining useful and practical health information from experts; (c) supporting each other via an mHealth platform; and (d) appreciating the collaborative effort between school personnel and family carers. Family carers stressed the usefulness of the mHealth interactive interventions in monitoring and sustaining the children's healthy lifestyle behaviours at home. CONCLUSION The mHealth interactive interventions for increasing family carers' involvement and monitoring were well received. The findings provide new insights into using mHealth interventions in future weight management programmes involving parental participation in the home environment.
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Affiliation(s)
- Regina L T Lee
- Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Michael Brown
- School of Nursing and Midwifery, Queen's University, Belfast, UK
| | - Cynthia Leung
- Department of Applied & Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Hong Chen
- Department of Health, Center for Health Protection, Hong Kong, Hong Kong
| | - Lobo Louie
- Department of Physical Education, Hong Kong Baptist University, Hong Kong, Hong Kong
| | - Jyu-Lin Chen
- Faculty of Nursing, University of California San Francisco, Berkeley, California
| | - Paul H Lee
- World Health Organization Collaboration Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Chow BC, Choi PHN, Huang WYJ. Physical Activity and Physical Fitness of Adults with Intellectual Disabilities in Group Homes in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071370. [PMID: 29966299 PMCID: PMC6068912 DOI: 10.3390/ijerph15071370] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 01/27/2023]
Abstract
Adults with intellectual disabilities (ID) typically have a sedentary lifestyle and higher rates of overweight and obesity. This study describes the habitual daily physical activity (PA) and the health-related physical fitness (PF) of adults with mild and moderate ID who resided in four group homes and worked in sheltered workshops. We also assessed the contribution of PF variables towards PA levels and sedentary behavior of this population subgroup. Adults with mild and moderate ID (N = 114) were assessed on PF tests (percent body fat, waist and hip circumferences, 6-min walk (6MWT), arm curl, and sit and reach). PA and sedentary behavior on weekdays were determined using Actigraph accelerometers. Results showed these adults averaged 2% of their daily time (or 10 min) engaged in moderate-to-vigorous PA (MVPA) and 67% of the time (495 min) being sedentary. No significant differences between mild and moderate ID were found for any PA or PF variable. Linear multiple regression analyses showed 6MWT to be the only significant PF variable contributing to the variance of PA and sedentary behavior. In conclusion, adults with ID reside in group home have low PA and low fitness levels. Among fitness variables, the walking test (i.e., cardiovascular fitness) had the highest positive association with participants’ daily PA, MVPA, and negative association with sedentary behavior. Future intervention studies in promoting PA and fitness for adults with ID are warranted.
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Affiliation(s)
- Bik C Chow
- Department of Physical Education, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
| | - Peggy H N Choi
- Department of Sports and Recreation Management, Technological and Higher Education Institute of Hong Kong, Chai Wan, Hong Kong.
| | - Wendy Y J Huang
- Department of Physical Education, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
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Criado KK, Sharp WG, McCracken CE, De Vinck-Baroody O, Dong L, Aman MG, McDougle CJ, McCracken JT, Arnold LE, Weitzman C, Leventhal JM, Vitiello B, Scahill L. Overweight and obese status in children with autism spectrum disorder and disruptive behavior. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 22:450-459. [PMID: 28325061 PMCID: PMC5581311 DOI: 10.1177/1362361316683888] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Overweight and obesity are common in pediatric populations. Children with autism spectrum disorder and disruptive behavior may be at higher risk. This study examined whether children with autism spectrum disorder and disruptive behavior are more likely to be overweight or obese than matched controls. Baseline data from medication-free children with autism spectrum disorder who participated in trials conducted by the Research Units on Pediatric Psychopharmacology Autism Network (N = 276) were compared to 544 control children from the National Health and Nutrition Examination Survey database matched on age, sex, race, parent education, and era of data collection. The mean age of the children with autism spectrum disorder was 7.9 ± 2.6 years; 84.4% were males. In the autism spectrum disorder group, the prevalence was 42.4% for overweight and 21.4% for obesity compared to 26.1% for overweight and 12.0% for obesity among controls (p < 0.001 for each contrast). Within the autism spectrum disorder sample, obesity was associated with minority status and lower daily living skills. These findings suggest that children with autism spectrum disorder and disruptive behavior are at increased risk for obesity and underscore the need for weight management interventions in this population.
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Affiliation(s)
- Kristen K Criado
- Department of Pediatrics, Emory University School of Medicine, USA
- Marcus Autism Center, USA
| | - William G Sharp
- Department of Pediatrics, Emory University School of Medicine, USA
- Marcus Autism Center, USA
| | | | | | - Liansai Dong
- Rollins School of Public Health, Emory University, USA
| | | | - Christopher J McDougle
- Lurie Center for Autism, Massachusetts General Hospital, USA
- Department of Psychiatry, Harvard Medical School, USA
| | - James T McCracken
- Division of Child Psychiatry, University of California at Los Angeles, USA
| | | | | | | | | | - Lawrence Scahill
- Department of Pediatrics, Emory University School of Medicine, USA
- Marcus Autism Center, USA
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Rivera J, McPherson AC, Hamilton J, Birken C, Coons M, Peters M, Iyer S, George T, Nguyen C, Stinson J. User-Centered Design of a Mobile App for Weight and Health Management in Adolescents With Complex Health Needs: Qualitative Study. JMIR Form Res 2018; 2:e7. [PMID: 30684409 PMCID: PMC6334679 DOI: 10.2196/formative.8248] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 01/14/2018] [Accepted: 01/26/2018] [Indexed: 12/31/2022] Open
Abstract
Background Growing research has been conducted into the deployment and evaluation of mobile technology interventions for weight management in adolescents. However, no work has yet been conducted toward the development of these technologies for adolescents with complex health needs receiving specialized tertiary-level health care. Objective The aim of this study was to conduct a user-centered needs assessment of adolescents interested in weight management with complex health needs requiring specialized health care services, their parents, and health care providers (HCPs) to inform the design and development of a mobile app for weight and health management. Methods A qualitative study design was employed. Participants were recruited from two tertiary health care centers. Separate audiotaped focus group interviews were conducted with adolescents aged 12 to 18 years, parents, and HCPs. Interviews were transcribed, and field notes were collected by research staff. Iterative simple content analysis was performed independently by 4 research team members using computer software NVivo (QSR International) 10.0. Results A total of 19 adolescents, 16 parents, and 21 HCPs were interviewed. Qualitative analysis revealed seven major themes related to app functionality: healthy eating, social support, self-monitoring, communicating with HCPs, supporting mental health, gamification and incentives, and user interface (UI) design. Adolescents provided several ideas related to each feature, whereas parents’ views focused on assistance with meal planning and greater access to HCPs. HCPs viewed the app as a novel and more acceptable platform to connect remotely with adolescents than conventional methods. They also strongly endorsed the value of social support capabilities and the ability to connect with an HCP. Conclusions This is the first study to conduct a qualitative needs assessment in adolescents receiving specialized health care services toward the design of a mobile app for weight and health management. Our results indicate that core components of the app should include tailored meal recommendations and assistance with meal planning, social networking for peer support, customized and convenient tracking, remote access to HCPs, features to support mental health, and an attractive and engaging UI. These findings will be used to develop and evaluate a mobile app targeting adolescents with complex health needs.
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Affiliation(s)
- Jordan Rivera
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,The Hospital for Sick Children, Toronto, ON, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | | | - Michael Coons
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michelle Peters
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Tessy George
- The Hospital for Sick Children, Toronto, ON, Canada
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Eden K, Randle-Phillips C. Exploration of body perception and body dissatisfaction in young adults with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:88-97. [PMID: 29032289 DOI: 10.1016/j.ridd.2017.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 08/30/2017] [Accepted: 09/17/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are more likely to be overweight or obese. Research has shown that body dissatisfaction is a key factor in influencing unhealthy eating behaviour. More evidence is needed relating to how people with ID perceive their bodies in order to provide effectively targeted weight management programmes. AIMS This study aimed to investigate whether people with ID have concepts for underweight, overweight and healthyweight, and whether they can apply these concepts to themselves. It also aimed to explore body perception bias through comparison of perceived self to independent figure ratings, and body dissatisfaction through perceived-ideal body discrepancy measurement and a series of open-ended questions. METHOD Mixed methodology was used to explore body perception and body dissatisfaction in 40 young adults with ID compared to 48 individuals without ID. The Stunkard Figure Rating Scale assessed how participants would like to look, and their concepts of weight categories. RESULTS Young adults with ID tend to hold positive beliefs about their bodies. Females with ID were likely to underestimate their body size. Individuals with ID understood what is meant by 'overweight', 'healthy-weight' and 'underweight' although these concepts were different to those without ID. Individuals with ID were unable to accurately apply these body size categories to themselves. CONCLUSION These findings suggest that individuals with ID will first need support to understand how concepts of body size apply to themselves in order to facilitate weight management.
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Affiliation(s)
- Kate Eden
- University of Bath, Claverton Down, Bath, North East Somerset, BA2 7AY, United Kingdom.
| | - Cathy Randle-Phillips
- University of Bath, Claverton Down, Bath, North East Somerset, BA2 7AY, United Kingdom.
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Pona AA, Dreyer Gillette ML, Odar Stough C, Gerling JK, Sweeney BR. Long-Term Outcomes of a Multidisciplinary Weight Management Intervention for Youth with Disabilities. Child Obes 2017; 13:455-461. [PMID: 28719232 DOI: 10.1089/chi.2016.0334] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Youth with disabilities are at increased risk for obesity compared with their typically developing peers and face unique barriers to healthy lifestyles. A limited number of weight management programs have been specifically tailored to accommodate youth with disabilities, and outcomes research in this population is scarce. We investigated the effectiveness of a specialized multidisciplinary weight management program for children with disabilities. METHODS Youth (N = 115) ages 2-18 years (mean age = 10.46) and their families receiving care in the Special Needs Weight Management Clinic (SNWMC) were followed over a period of 12 months. Child height and weight were measured by trained clinicians and used to calculate Body Mass Index z-scores (BMIz). A two-level multilevel model was estimated with repeated measurements of BMIz nested within patients. RESULTS Significant BMIz reductions of 0.02 per month were observed over the course of treatment when controlling for child age and baseline BMIz. A significant interaction between child age and time revealed that younger (vs. older) children exhibited greater decreases in BMIz over the course of treatment. Sex, ethnicity, disability diagnosis, and insurance moderated change in BMIz over the course of treatment. CONCLUSIONS Outcomes of the SNWMC revealed significant decreases in BMIz with <5 sessions on average over 12 months and indicated the increased efficacy of early intervention in youth with disabilities. Future research should continue to modify interventions for families with adolescent children with disabilities as well as investigate additional variables that may impact success in treatment.
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Affiliation(s)
- Ashleigh A Pona
- 1 Department of Pediatrics, Center for Children's Healthy Lifestyles and Nutrition , Kansas City, MO.,2 Department of Psychology, University of Missouri-Kansas City , Kansas City, MO
| | - Meredith L Dreyer Gillette
- 1 Department of Pediatrics, Center for Children's Healthy Lifestyles and Nutrition , Kansas City, MO.,3 Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO
| | - Cathleen Odar Stough
- 4 Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH
| | - Janelle K Gerling
- 1 Department of Pediatrics, Center for Children's Healthy Lifestyles and Nutrition , Kansas City, MO.,3 Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO
| | - Brooke R Sweeney
- 1 Department of Pediatrics, Center for Children's Healthy Lifestyles and Nutrition , Kansas City, MO.,3 Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO
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Bennett EA, Kolko RP, Chia L, Elliott JP, Kalarchian MA. Treatment of Obesity Among Youth With Intellectual and Developmental Disabilities: An Emerging Role for Telenursing. West J Nurs Res 2017; 39:1008-1027. [PMID: 28349744 DOI: 10.1177/0193945917697664] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Childhood obesity is a serious health issue, associated with medical comorbidity and psychosocial impairment that can persist into adulthood. In the United States, youth with intellectual and developmental disabilities are more likely to be obese than youth without disabilities. A large body of evidence supports the efficacy of family-based treatment of childhood obesity, including diet, physical activity, and behavior modification, but few interventions have been developed and evaluated specifically for this population. We highlight studies on treatment of obesity among youth with intellectual and developmental disabilities, including both residential/educational settings as well as outpatient/hospital settings. All interventions were delivered in-person, and further development of promising approaches and delivery via telenursing may increase access by youth and families. Nursing scientists can assume an important role in overcoming barriers to care for this vulnerable and underserved population.
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Krause S, Ware R, McPherson L, Lennox N, O’Callaghan M. Obesity in adolescents with intellectual disability: Prevalence and associated characteristics. Obes Res Clin Pract 2016; 10:520-530. [DOI: 10.1016/j.orcp.2015.10.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 10/09/2015] [Accepted: 10/11/2015] [Indexed: 11/25/2022]
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Objective Physical Activity Measurement for a Child With Special Health Care Needs. J Pediatr Nurs 2016; 31:548-53. [PMID: 27411293 DOI: 10.1016/j.pedn.2016.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 05/25/2016] [Indexed: 11/23/2022]
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Chow BC, Huang WYJ, Choi PHN, Pan CY. Design and methods of a multi-component physical activity program for adults with intellectual disabilities living in group homes. J Exerc Sci Fit 2016. [PMID: 29541116 PMCID: PMC5801709 DOI: 10.1016/j.jesf.2016.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Adults with intellectual disabilities (ID) often live a sedentary lifestyle and have higher rates of overweight and obesity. The purpose of this report is to describe the design and methods of a multi-component physical activity (PA) intervention program that aims to increase PA levels in adults with ID who live in group homes. The study employed a multi-component delayed treatment control group design involving adults with ID who lived in two group homes. Interventions included 30 exercise sessions in groups over a 10-week period and three educational lessons based on social cognitive theory that aimed to improve self-efficacy and social support for PA in the participants. In addition, staff training in exercise and advice on institutional PA policies were provided to the caregivers working in the group homes. Outcome measures on three aspects were collected: (1) physical fitness, (2) PA as assessed by an ActiGraph accelerometer, and (3) self-efficacy and social support for PA. Our major objective was to develop the intervention protocol, and the successful completion of this study will provide valuable evidence on how to promote active lifestyles in adults with ID.
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Affiliation(s)
- Bik C Chow
- Department of Physical Education, Hong Kong Baptist University, Hong Kong
| | - Wendy Y J Huang
- Department of Physical Education, Hong Kong Baptist University, Hong Kong
| | - Peggy H N Choi
- Department of Physical Education, Hong Kong Baptist University, Hong Kong
| | - Chien-Yu Pan
- Department of Physical Education, National Kaohsiung Normal University, Taiwan
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Maïano C, Hue O, Morin AJS, Moullec G. Prevalence of overweight and obesity among children and adolescents with intellectual disabilities: a systematic review and meta-analysis. Obes Rev 2016; 17:599-611. [PMID: 27171466 DOI: 10.1111/obr.12408] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/30/2016] [Accepted: 02/23/2016] [Indexed: 01/06/2023]
Abstract
Although there have been numerous studies examining the prevalence of overweight and obesity among children and adolescents with intellectual disabilities, they have not yet been integrated and synthesized through a systematic quantitative review process. The purpose of this systematic review and meta-analysis was to determine: (i) the prevalence of overweight/obesity among children and adolescents with intellectual disabilities; (ii) the sources of heterogeneity in studies reporting the prevalence of overweight/obesity in this population; and (iii) the risk of overweight/obesity in this population compared with their typically developing peers. A systematic literature search was performed and 16 studies, published between 1985 and 2015, met the inclusion criteria. The resulting pooled prevalence estimates for overweight, overweight-obesity and obesity were respectively: (i) 15%, 30%, and 13%, in children; and (ii) 18%, 33%, and 15% in adolescents. Subgroup analyses showed significant variations in the pooled prevalence estimates as a function of geographical region, recruitment setting, additional diagnoses, and norms used to define overweight or obesity. The findings also showed adolescents with intellectual disabilities to be respectively 1.54 and 1.80 times more at risk of overweight-obesity and obesity than typically developing adolescents. Unfortunately, no such comparison is available for children. © 2016 World Obesity.
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Affiliation(s)
- C Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada.,Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia.,Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada
| | - O Hue
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - A J S Morin
- Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia
| | - G Moullec
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada.,Research Center, Hôpital du Sacré-Coeur de Montréal, Affiliated Hospital of Université de Montréal, Montréal, Canada
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Cantarero A, Myers O, Scharmen T, Kinyua P, Jimenez EY. Trends in Early Childhood Obesity in a Large Urban School District in the Southwestern United States, 2007-2014. Prev Chronic Dis 2016; 13:E74. [PMID: 27253637 PMCID: PMC4894724 DOI: 10.5888/pcd13.150594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Although recent studies indicate that rates of childhood obesity and severe obesity may be declining, few studies have reported prevalence trends in early childhood or differences in trends across sociodemographic groups. The primary aim of this study was to report trends in prevalence of early childhood obesity and severe obesity 2007 through 2014 in a diverse, metropolitan school district in the southwestern United States and determine whether these trends vary by race/ethnicity, socioeconomic status, and disability status. METHODS We analyzed height, weight and demographic data from 43,113 kindergarteners enrolled in a large, urban school district in the southwestern United States for 7 school years. Adjusted odds of obesity and severe obesity were calculated to assess changes in prevalence for non-Hispanic white, Hispanic, and American Indian students; free or reduced-price lunch participants and nonparticipants; and students with and without disabilities. To test for differences in obesity trends, interaction terms were added to the logistic regressions between school year and sex, race/ethnicity, free or reduced-price lunch participation, and disability status. RESULTS The adjusted prevalence of both obesity (from 13.1% in 2007-2008 to 12.0% in 2013-20014) and severe obesity (from 2.4% in 2007-2008 to 1.2% in 2013-2014) declined overall. We found no significant interactions between the adjusted prevalence of obesity over time and any of the sociodemographic subgroups. Obesity prevalence declined more among American Indian students than among Hispanic or non-Hispanic white students. CONCLUSION In this district, from 2007 through 2014, severe obesity decreased and obesity did not increase, overall and across all sociodemographic subpopulations for kindergarten students.
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Affiliation(s)
- Andrea Cantarero
- Prevention Research Center, University of New Mexico, 2703 Frontier NE - RIB 120, MSC 11 6145, Albuquerque, NM 87131.
| | - Orrin Myers
- University of New Mexico, Albuquerque, New Mexico
| | | | - Peter Kinyua
- Albuquerque Public Schools, Albuquerque, New Mexico
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Abstract
OBJECTIVE Overweight and obesity are increasingly prevalent in the general pediatric population. Evidence suggests that children with autism spectrum disorders (ASDs) may be at elevated risk for unhealthy weight. We identify the prevalence of overweight and obesity in a multisite clinical sample of children with ASDs and explore concurrent associations with variables identified as risk factors for unhealthy weight in the general population. METHODS Participants were 5053 children with confirmed diagnosis of ASD in the Autism Speaks Autism Treatment Network. Measured values for weight and height were used to calculate BMI percentiles; Centers for Disease Control and Prevention criteria for BMI for gender and age were used to define overweight and obesity (≥85th and ≥95th percentiles, respectively). RESULTS In children age 2 to 17 years, 33.6% were overweight and 18% were obese. Compared with a general US population sample, rates of unhealthy weight were significantly higher among children with ASDs ages 2 to 5 years and among those of non-Hispanic white origin. Multivariate analyses revealed that older age, Hispanic or Latino ethnicity, lower parent education levels, and sleep and affective problems were all significant predictors of obesity. CONCLUSIONS Our results indicate that the prevalence of unhealthy weight is significantly greater among children with ASD compared with the general population, with differences present as early as ages 2 to 5 years. Because obesity is more prevalent among older children in the general population, these findings raise the question of whether there are different trajectories of weight gain among children with ASDs, possibly beginning in early childhood.
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Affiliation(s)
- Alison Presmanes Hill
- Center for Spoken Language Understanding, Institute for Development & Disability, Department of Pediatrics;
| | | | - Eric Fombonne
- Department of Psychiatry, Institute for Development & Disability, Oregon Health & Science University, Portland Oregon
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Availability of state-based obesity surveillance data on high school students with disabilities in the United States. Matern Child Health J 2014; 19:1152-61. [PMID: 25303806 DOI: 10.1007/s10995-014-1616-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study was to assess the availability of public health surveillance data on obesity among American children with disabilities in state-based surveillance programs. We reviewed annual cross-sectional datasets in state-level surveillance programs for high school students, implemented 2001-2011, for the inclusion of weight and height and disability screening questions. When datasets included a disability screen, its content and consistency of use across years were examined. We identified 54 surveillance programs with 261 annual datasets containing obesity data. Twelve surveillance programs in 11 states included a disability screening question that could be used to extract obesity data for high school students with disabilities, leaving the other 39 states with no state-level obesity data for students with disabilities. A total of 43 annual datasets, 16.5 % of the available datasets, could be used to estimate the obesity status of students with disabilities. The frequency of use of disability questions varied across states, and the content of the questions often changed across years and within a state. We concluded that state surveillance programs rarely contained questions that could be used to identify high school students with disabilities. This limits the availability of data that can be used to monitor obesity and related health statuses among this population in the majority of states.
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Dickinson K, Place M. A Randomised Control Trial of the Impact of a Computer-Based Activity Programme upon the Fitness of Children with Autism. AUTISM RESEARCH AND TREATMENT 2014; 2014:419653. [PMID: 25400946 PMCID: PMC4220566 DOI: 10.1155/2014/419653] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/16/2014] [Accepted: 09/07/2014] [Indexed: 11/18/2022]
Abstract
The poor levels of fitness in children with autism are prompting concern for the children's future health. This study looked to assess if a computer-based activity programme could improve fitness levels (as reflected in cardiopulmonary function) of these children, and achieve a reduction in their body mass index. In a randomised controlled trial, 50 children with autism (of which 33 were under the age of 11 years and 39 were boys) were allocated to an intervention group which encouraged them to use the Nintendo Wii and the software package "Mario and Sonics at the Olympics" in addition to their routine physical education classes. 50 children with autism (34 under the age of 11 years and 40 being boys) acted as controls. At the end of one year, analysis of the changes in scores using analysis of covariance (ANCOVA) on the Eurofit fitness tests showed that the intervention group had made statistically significant improvement on all tests other than flexibility. These improvements were also significantly better than controls. This type of intervention appears to be an effective addition to standard fitness training in order to help children with autism improve their fitness levels.
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Affiliation(s)
- Kathleen Dickinson
- School of Health and Life Sciences, Northumbria University, Coach Lane Campus, Newcastle Upon Tyne NE7 7XA, UK
| | - Maurice Place
- School of Health and Life Sciences, Northumbria University, Coach Lane Campus, Newcastle Upon Tyne NE7 7XA, UK
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46
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Maïano C, Normand CL, Aimé A, Bégarie J. Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1914-1926. [PMID: 24830882 DOI: 10.1016/j.ridd.2014.04.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 04/07/2014] [Accepted: 04/08/2014] [Indexed: 06/03/2023]
Abstract
Over the past three decades, the potential effects of lifestyle interventions targeting changes in body weight and composition (weight, body mass index, fat mass, waist circumference) among adults with an intellectual disability (ID) have been examined in various systematic reviews. Nevertheless, since the middle of the 1980s, the potential effects of these interventions for youth with an ID remain an open question. The purpose of this article is to review the effects of lifestyle interventions targeting changes in body weight and composition among youth with an ID. This review will focus on changes in body weight and composition, healthy lifestyle, and secondary health conditions. A systematic review of English- and French-language studies, published between 1981 and 2013, was performed on Academic Search Complete, PsycARTICLES, Medline and Scopus. The nine studies included in this review focused mainly on: a sample with a wide age range (e.g., 7-22 years); males; overweight-obese youth having a mild-to-moderate ID with Down or Prader-Willi syndrome; physical activity interventions; cohort pre- and post-test designs with/without a control group; and changes in body weight and composition. Taken together, results from these studies suggest successful changes in weight, body mass index and fat mass. However, intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive. Given the weaknesses of the reviewed studies, the present findings should be considered preliminary and indicative of the need for future research.
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Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Canada.
| | - Claude L Normand
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Canada
| | - Annie Aimé
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Canada
| | - Jérôme Bégarie
- Croix-Rouge française, Complexe de L'Escarène, 06440 L'Escarène, France
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Pikora TJ, Bourke J, Bathgate K, Foley KR, Lennox N, Leonard H. Health conditions and their impact among adolescents and young adults with Down syndrome. PLoS One 2014; 9:e96868. [PMID: 24818963 PMCID: PMC4018436 DOI: 10.1371/journal.pone.0096868] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/12/2014] [Indexed: 11/18/2022] Open
Abstract
Objective To examine the prevalence of medical conditions and use of health services among young adults with Down syndrome and describe the impact of these conditions upon their lives. Methods Using questionnaire data collected in 2011 from parents of young adults with Down syndrome we investigated the medical conditions experienced by their children in the previous 12 months. Univariate, linear and logistic regression analyses were performed. Results We found that in addition to the conditions commonly experienced by children with Down syndrome, including eye and vision problems (affecting 73%), ear and hearing problems (affecting 45%), cardiac (affecting 25%) and respiratory problems (affecting 36%), conditions also found to be prevalent within our young adult cohort included musculoskeletal conditions (affecting 61%), body weight (affecting 57%), skin (affecting 56%) and mental health (affecting 32%) conditions and among young women menstrual conditions (affecting 58%). Few parents reported that these conditions had no impact, with common impacts related to restrictions in opportunities to participate in employment and community leisure activities for the young people, as well as safety concerns. Conclusion There is the need to monitor, screen and provide appropriate strategies such as through the promotion of healthy lifestyles to prevent the development of comorbidities in young people with Down syndrome and, where present, to reduce their impact.
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Affiliation(s)
- Terri J. Pikora
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Jenny Bourke
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Katherine Bathgate
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Kitty-Rose Foley
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Nicholas Lennox
- Queeensland Centre for Intellectual and Developmental Disability, University of Queensland, South Brisbane, Queensland, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
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