Physical & Occupational Therapy in Pediatrics, 34(3):335–337, 2014 C 2014 by Informa Healthcare USA, Inc. Available online at http://informahealthcare.com/potp DOI: 10.3109/01942638.2014.932613
LETTER TO THE EDITOR
Phys Occup Ther Pediatr Downloaded from informahealthcare.com by Fudan University on 05/09/15 For personal use only.
Occupation-Focused Family Intervention and Expanding the Role of Occupational Therapy in Childhood Obesity
Childhood obesity is a serious public health concern in the United States. Primary role models for children are their parents as they are the ones who can work to prevent their child from becoming overweight. Wilcock (2006) states that “an essential belief is that health and life satisfaction are promoted and maintained by daily occupations” (p. 42). What a child does every day stems from how their parents work to participate in occupations as a family. In the study Changes in Parent’s Time Use and Its Relationship to Child Obesity by Orban et al. (2014), an occupation-focused family intervention was provided. Parents were instructed to interact with their young children who were obese through co-occupations; when both the mother and father interact and participate in activities with the children together. Orban et al. (2014) reported that during the one-year intervention, parents adjusted their lifestyle to spend more time with their children in preparing and eating meals, and engaging in physical activities with their children. Children’s body mass index decreased although the change was not statistically significant. The results suggest parent engagement in co-occupations with their children may have a positive impact on the child’s weight. The role of an occupational therapist (OT) is to assist patients/clients in developing skills that are important for health, well-being, and independent functioning. OT practice need not be limited to physical and cognitive functioning. Therapists collaborate with patients/clients, family members to address issues related to mental and psychosocial factors, and promote overall well-being. In regards to childhood obesity, there are a plethora of different approaches that OTs can utilize, both with children and their parents (Clark et al., 2007). Co-parenting as investigated by Orban et al. (2014) may be very difficult in single parent households. Children in a single parent family have been shown to have higher BMIs and a greater risk of obesity (Garasky et al., 2009). When compared with children of non-divorced families, children from divorced families were more likely to display internalizing disorders, externalizing disorders, have academic issues, a decrease in self-esteem, and be less socially competent (Yannakoulia et al., 2008). Children’s behavioral problems associated with divorce increased their risk of becoming overweight (Yannakoulia et al., 2008). Research is recommended to identify OT interventions that help families going through divorce maintain a healthy lifestyle. OTs can assist families by meeting with each parent separately and 335
Phys Occup Ther Pediatr Downloaded from informahealthcare.com by Fudan University on 05/09/15 For personal use only.
336
Northrop
creating a plan to keep the child healthy and active. Specific strategies might include assisting a child to resume regular routines, encouraging participation in low-stress activities to minimize feelings of isolation, and encouraging participation in activities that foster self-expression such as drawing, painting, and journaling (Poulsen & Ziviani, 2004). OTs have a vital role in consulting to teachers, nutritionists, and other professionals to enhance healthy lifestyles in children. Three settings where OTs provide interventions to promote a healthy lifestyle are in the schools, community, and home. OTs can promote antibullying in the school setting by teaching children to use respectful language when referring to overweight individuals, such as “above average weight” as opposed to “chunky” (The American Occupational Therapy Association, 2013, p. 2). OTs working in the school setting can advocate for decreased availability of vending machines that contain high calorie and sugar foods. Regarding community interventions, OTs can encourage physical activities such as walking networks, cycling networks, and recreational facilities. Participation in noncompetitive sports teams also can be encouraged to promote confidence, friendships, and self-esteem (Poulsen & Ziviani, 2004). The American Occupational Therapy Association (2013) has recommended that OTs expand their services to families. OTs can support families to promote healthy routines and meal choices, and encourage family dinners and physical activities. It is suggested that therapists analyze family’s routines and suggest healthy strategies. For example, OTs can promote healthy choices by teaching families how to read food labels and ensure that families know the signs of stroke, heart attack, and other conditions. OTs also can encourage physical activities the whole family enjoys. For children who are experiencing pain in their joints, low-impact activities such as swimming or ping pong are recommended. Childhood obesity is a severe epidemic and there are many interventions and strategies that OTs can use to minimize childhood obesity. I commend Orban et al. (2014) for their occupation-focused family intervention for childhood obesity. I truly appreciate and value the opportunity to share my beliefs on expanded roles of OTs in addressing childhood obesity from a family systems and occupations perspective. Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of this article. Hannah Northrop Student in Occupational Therapy Master’s Degree Program Utica College, Utica New York
REFERENCES American Occupational Therapy Association (2013). Occupational therapy’s role in addressing childhood. American Occupational Therapy Association, Inc. Retrieved from http:// www.aota.org/-/media/Corporate/Files/Practice/Children/SchoolMHToolkit/Childhood% 20Obesity.pdf
Phys Occup Ther Pediatr Downloaded from informahealthcare.com by Fudan University on 05/09/15 For personal use only.
Occupation-Focused Family Intervention
337
Clark F, Reingold FS, Salles-Jordan K. (2007). Obesity and occupational therapy (position paper). American Journal of Occupational Therapy 61:701–703. Garasky S, Stewart S, Gundersen C, Lohman B, Eisenmann J. (2009). Family stressors and child obesity. Social Science Research, 38, 755–766. doi: 10.1016/j ssresearch.2009.06.002 Orban K, Edberg A, Thorngren-Jerneck K, Onnerfalt J, Erlandsson L. (2014). Changes in parents’ time use and its relationship to childhood obesity. Physical & Occupational Therapy in Pediatrics 34:44–61. doi: 10.31.09/01942638.2013.792311 Poulsen A, Ziviani J. (2004). Health enhancing physical activity: factors influencing engagement patterns in children. Australian Occupational Therapy Journal 51:69–79. doi: 10.1046/j.1440–1630.2004.00420.x Wilcock, A (2006). An occupational perspective of health (2nd ed). Thorofare, NJ: Slack. Yannakoulia M, Papanikolaou K, Hatzopoulou I, Efstathiou E, Papoutsakis C, Dedoussis G. (2008). Association between family divorce and children’s BMI and meal patterns: a GENDAI study. Obesity 16:1382–1387. doi: 10.1038/oby.2008.70
LETTER TO THE EDITOR
Phys Occup Ther Pediatr Downloaded from informahealthcare.com by Fudan University on 05/09/15 For personal use only.
Occupation-Focused Family Intervention and Expanding the Role of Occupational Therapy in Childhood Obesity
Childhood obesity is a serious public health concern in the United States. Primary role models for children are their parents as they are the ones who can work to prevent their child from becoming overweight. Wilcock (2006) states that “an essential belief is that health and life satisfaction are promoted and maintained by daily occupations” (p. 42). What a child does every day stems from how their parents work to participate in occupations as a family. In the study Changes in Parent’s Time Use and Its Relationship to Child Obesity by Orban et al. (2014), an occupation-focused family intervention was provided. Parents were instructed to interact with their young children who were obese through co-occupations; when both the mother and father interact and participate in activities with the children together. Orban et al. (2014) reported that during the one-year intervention, parents adjusted their lifestyle to spend more time with their children in preparing and eating meals, and engaging in physical activities with their children. Children’s body mass index decreased although the change was not statistically significant. The results suggest parent engagement in co-occupations with their children may have a positive impact on the child’s weight. The role of an occupational therapist (OT) is to assist patients/clients in developing skills that are important for health, well-being, and independent functioning. OT practice need not be limited to physical and cognitive functioning. Therapists collaborate with patients/clients, family members to address issues related to mental and psychosocial factors, and promote overall well-being. In regards to childhood obesity, there are a plethora of different approaches that OTs can utilize, both with children and their parents (Clark et al., 2007). Co-parenting as investigated by Orban et al. (2014) may be very difficult in single parent households. Children in a single parent family have been shown to have higher BMIs and a greater risk of obesity (Garasky et al., 2009). When compared with children of non-divorced families, children from divorced families were more likely to display internalizing disorders, externalizing disorders, have academic issues, a decrease in self-esteem, and be less socially competent (Yannakoulia et al., 2008). Children’s behavioral problems associated with divorce increased their risk of becoming overweight (Yannakoulia et al., 2008). Research is recommended to identify OT interventions that help families going through divorce maintain a healthy lifestyle. OTs can assist families by meeting with each parent separately and 335
Phys Occup Ther Pediatr Downloaded from informahealthcare.com by Fudan University on 05/09/15 For personal use only.
336
Northrop
creating a plan to keep the child healthy and active. Specific strategies might include assisting a child to resume regular routines, encouraging participation in low-stress activities to minimize feelings of isolation, and encouraging participation in activities that foster self-expression such as drawing, painting, and journaling (Poulsen & Ziviani, 2004). OTs have a vital role in consulting to teachers, nutritionists, and other professionals to enhance healthy lifestyles in children. Three settings where OTs provide interventions to promote a healthy lifestyle are in the schools, community, and home. OTs can promote antibullying in the school setting by teaching children to use respectful language when referring to overweight individuals, such as “above average weight” as opposed to “chunky” (The American Occupational Therapy Association, 2013, p. 2). OTs working in the school setting can advocate for decreased availability of vending machines that contain high calorie and sugar foods. Regarding community interventions, OTs can encourage physical activities such as walking networks, cycling networks, and recreational facilities. Participation in noncompetitive sports teams also can be encouraged to promote confidence, friendships, and self-esteem (Poulsen & Ziviani, 2004). The American Occupational Therapy Association (2013) has recommended that OTs expand their services to families. OTs can support families to promote healthy routines and meal choices, and encourage family dinners and physical activities. It is suggested that therapists analyze family’s routines and suggest healthy strategies. For example, OTs can promote healthy choices by teaching families how to read food labels and ensure that families know the signs of stroke, heart attack, and other conditions. OTs also can encourage physical activities the whole family enjoys. For children who are experiencing pain in their joints, low-impact activities such as swimming or ping pong are recommended. Childhood obesity is a severe epidemic and there are many interventions and strategies that OTs can use to minimize childhood obesity. I commend Orban et al. (2014) for their occupation-focused family intervention for childhood obesity. I truly appreciate and value the opportunity to share my beliefs on expanded roles of OTs in addressing childhood obesity from a family systems and occupations perspective. Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of this article. Hannah Northrop Student in Occupational Therapy Master’s Degree Program Utica College, Utica New York
REFERENCES American Occupational Therapy Association (2013). Occupational therapy’s role in addressing childhood. American Occupational Therapy Association, Inc. Retrieved from http:// www.aota.org/-/media/Corporate/Files/Practice/Children/SchoolMHToolkit/Childhood% 20Obesity.pdf
Phys Occup Ther Pediatr Downloaded from informahealthcare.com by Fudan University on 05/09/15 For personal use only.
Occupation-Focused Family Intervention
337
Clark F, Reingold FS, Salles-Jordan K. (2007). Obesity and occupational therapy (position paper). American Journal of Occupational Therapy 61:701–703. Garasky S, Stewart S, Gundersen C, Lohman B, Eisenmann J. (2009). Family stressors and child obesity. Social Science Research, 38, 755–766. doi: 10.1016/j ssresearch.2009.06.002 Orban K, Edberg A, Thorngren-Jerneck K, Onnerfalt J, Erlandsson L. (2014). Changes in parents’ time use and its relationship to childhood obesity. Physical & Occupational Therapy in Pediatrics 34:44–61. doi: 10.31.09/01942638.2013.792311 Poulsen A, Ziviani J. (2004). Health enhancing physical activity: factors influencing engagement patterns in children. Australian Occupational Therapy Journal 51:69–79. doi: 10.1046/j.1440–1630.2004.00420.x Wilcock, A (2006). An occupational perspective of health (2nd ed). Thorofare, NJ: Slack. Yannakoulia M, Papanikolaou K, Hatzopoulou I, Efstathiou E, Papoutsakis C, Dedoussis G. (2008). Association between family divorce and children’s BMI and meal patterns: a GENDAI study. Obesity 16:1382–1387. doi: 10.1038/oby.2008.70
