The Pica Perspective

Sleep: An Important Part of Healthy Development

A couple of weeks ago I blogged about the need for relaxation in children's lives. Today I came across a wonderful article on the value of sleep. With the same title as this post, the article was published by Child Care Aware, and it addresses the value of sleep, how much sleep children need, healthy sleeping practices, and "the big sleep problems."

Although we're certainly aware that babies need a lot of sleep, I think we sometimes forget these days that even older children need adequate sleep. A couple of years ago I read a Washington Post article in which it was reported that the chief of Prince George's County schools told Maryland legislators that nap time in preschool had to be done away with. "We need to get rid of all the baby school stuff they used to do," he said.

But when, exactly, did children change? At what moment did their need for sleep -- or at least quiet time -- cease to exist? When did preschoolers stop being "babies?" They are still babies when we consider a typical lifespan. Young children -- especially those enrolled in full-day preschools -- need rest. Moreover, because relaxation is a learned skill, it's the responsibility of the adults in their lives to ensure that children have the time and opportunity to learn how to relax. Forcing preschoolers to power through their fatigue -- as we adults must so often do -- is not only irresponsible but cruel as well.

According to the Child Care Aware article:

Sleep is an important part of good health. It plays a role in every part of a child's development – physical, cognitive, social and emotional. However, it is easily overlooked. You may naturally assume your child is getting enough sleep because you are. Children need many more hours of sleep than adults. Without enough sleep, children can be grouchy, teary, accident prone, aggressive or not be able to focus or learn and even fall asleep while at child care or in school.

Make sure your child is getting the recommended amount of sleep. Establishing good sleep practices while she is young will not only benefit you, but it will help her for many years to come.

And, certainly, if you're looking for a preschool for your child, don't forget to ask about nap time in your interviews. If a director tells you they've done away with that "baby stuff," let her know why you won't be sending your child to her school!

My Last Word -- for Now -- on Childhood Obesity

Finally, some good news -- I hope. Reports this week have heralded the news that the childhood obesity crisis has leveled off. After 25 years of increasing, the percentage of American children who are overweight or obese appears to have held steady in 2003-2004 and 2005-2006.

However, as much as I want to believe this means things are turning around, I'm only cautiously optimistic. As some have pointed out, this could indicate a statistical flaw. And Dr. David Ludwig, director of the obesity clinic at Children's Hospital Boston (and whom I interviewed for BAM), points out that "the full impact of the childhood epidemic will continue to mount in coming years" because it can take many years for obesity-related complications to translate into life-threatening events, including heart attacks and kidney failure.

I'm going to take a wait-and-see attitude. As Dr. Ludwig said, the CDC's analysis of data for 2007-08, due next year, may be the best evidence for determining what direction children's rates are really heading. In the meantime, we should continue to do all we can to ensure children eat right and are physically active!

With that in mind, here's some interesting information about how many calories you and your children can burn doing simple, everyday things!

Activity/Calories Burned After 30 Minutes*
Watching TV	34
Office Work	51.5
Stroller Push	129.5 (17 minute mile)
Sandbox Digging	170.4
Catch	85.2
Jumping Rope	340.9
Soccer	238.6
Basketball	272.2
Gardening	136.3
Playing with children/baby	136.3
Cleaning House (light dusting/etc)	85.2
Dancing	153.2
Stretching	85.2
* For a 150-pound adult, from http://www.primusweb.com/cgi-bin/fpc/actcalc.pl

Childhood Obesity -- What's Responsible for It?

Following on the heels of my post concerning who is responsible for the childhood obesity crisis is a new study that's determined lack of physical activity doesn't play a role in reducing weight in overweight children. The subtitle of the article I read was:

Encouraging overweight children to exercise has no impact on weight loss and they should be encouraged instead to eat more healthily, according to new research.

The researchers, who studied 300 children over a five-year period, stated:

"The most cost-effective way of easing the problem would be to put all the money into getting kids to stop eating junk food rather than splitting it between that and getting them active.

"It is tempting to make kids more active but it doesn't produce the expected results."

The study found that being overweight influences activity more than activity influences being overweight, and argues that this is why attempts to promote physical activity as a way of combating childhood obesity have failed.

Naturally, as a children's physical activity specialist, I'm not happy to read such statements.

I understand, of course, that once a child is overweight, physical activity becomes a greater problem. Many of us have nightmarish recollections of trying to climb the rope, or being forced to run laps until overcome with nausea, during old-fashioned and developmentally inappropriate "gym" classes. Surely any kind of physical activity would feel equally nightmarish to an overweight child. Even if they're inclined to move, overweight children are often physically incompetent. According to an article at the website of the International Play Equipment Manufacturers Association, during one study approximately 120 children ages 3 to 10 were observed traversing an overhead ladder. The only children unable to cross the ladder successfully were obese. In another study it was determined that even children's walking patterns were affected by overweight, with obese children walking slower, asymmetrically, flat-footed, and with toes turned out. Over time these poor walking habits can result in structural deformities and damage to body tissue. And, of course, if even walking is a challenge, anything beyond that could be perceived as overwhelming.

Still, it frightens me to think that this study could be misconstrued and misapplied. The formula is: Energy in/energy out! That means we have to ensure the number of calories burned is equal to the number of calories consumed.

In fact, there have been studies both here and abroad that have indicated the greater problem lies with the second half of the equation: energy out. For example, in the United Kingdom, while the proportion of overweight or obese children remained the same between 1974 and 1984, there was a marked increase in the following decade. The research, reported in the British Medical Journal, determined the change was due not to increased energy (caloric) intake but rather to a decrease in energy output.

Studies in the United States have made the same determination. An increase in childhood obesity of 20% over the last decade has occurred despite a decrease in overall fat consumption and little change in caloric intake.

I have a friend who says you can find research pointing to either side of an argument, and I'm beginning to understand how true that is. My estimation is that lack of physical activity certainly contributes to children becoming overweight and obese -- and that once they're overweight or obese, children are less likely to be physically active. But would I suggest that all monies be appropriated toward the elimination of junk food? Not on your life!

Once again, my advice -- as it often is -- is to maintain a balance!

Childhood Obesity -- Whose Responsibility Is It?

This morning I came across something in the "what were they thinking" category that prompted this post.

Here's the description:

Spinning Cone
The answer for lazy lickers! This motorized ice cream cone will have your whole family fighting for them… so you’d better get one for everyone!

That's right -- a spinning ice cream cone, so your child doesn't even have to move her arm while consuming calories!

Now, I love ice cream as much as -- or maybe even more than -- the next guy. And I certainly wouldn't advise denying children the occasional scoop. But I would love to know why someone thought this was a good idea considering we've got a childhood obesity crisis on our hands!

It brought to mind a piece Brian Doherty wrote in the Los Angeles Times in 2001, in which he ridiculed former surgeon general David Satcher's "fat war." He called on taxpayer-funded agencies to think twice about spending Americans' money to lecture us on what he considers a matter of private health. He believes obesity is a condition "caused by freely chosen behavior" and maintains people can simply cure themselves of obesity by eating less and exercising more.

It would be wonderful to imagine that if everyone simply took personal responsibility for her or his own weight gain, we wouldn't have to spend $100 billion dealing with obesity. But David Satcher told us that this is "the most overweight, obese generation of children in our history." Exactly whose responsibility is that? Let's think about it.

Without even taking into consideration the $100,000 paid to schools by soft drink companies to fill our children's bodies with empty calories, there's still the issue of recess and physical education disappearing from the schools. Who's making the decisions to eliminate all physical activity from the school day (where children spend most of their waking hours) despite mounting evidence that children need to move -- for the health of both their bodies and their minds? Not the children. Given a choice, they'd happily decide to mix more movement into the day.

There's also the matter of loading children's days with activities that preclude exercising more. Given a choice -- and the opportunity -- children might well opt to spend more of their time running, jumping, and breathing hard. But they're not being allowed to "choose freely." Rather, adults are choosing for them.

Are the children responsible for the fact that 32% of 2- to 7-year-olds -- and 65% of 8- to 18-year-olds -- have TVs in their bedrooms? Is it their fault they're not born with self-limiting mechanisms -- and that too often parents have forgotten how to say no? If young children were able to set their own limits with regard to television viewing and computer and video use, they'd need parents only to provide food, clothing, and shelter.

The problem is, once a child is obese because of all these adult-made decisions, the odds are pretty much stacked against him. Not only are behavior patterns, like eating and physical activity habits, established in childhood (educational psychologist Benjamin Bloom contended that 90% of an individual's habits and traits are set by age 12), but long-term studies have also shown that excess body fat tends to persist throughout childhood and into adulthood.

So whose responsibility is the childhood obesity crisis? Among others, I'd say it's companies like the one making the spinning ice cream cone -- and anybody who buys one for a child!

Celebrate Earth Day!

It probably won't surprise you to learn that, according to reports, fewer than 10% of U.S. children currently learn about nature from being outside. Instead, one-third of them learn about it at school, and more than one-half of them learn about it via such electronic devices as computers and television!

Surely you don't need me to convince you that books and electronics offer no substitute for the real thing. Being outdoors is an experiences of the senses (which is how much of young children's learning takes place). Outside there are myriad amazing things to see: creatures in the clouds, hummingbirds hovering, and four-leaf clovers. To hear: birdsong, leaves rustling in the breeze, brooks babbling. To smell: lilacs, the rain-soaked ground, and Concord grapes (a favorite scent from my childhood; every time I smell it I'm transported back in time). To touch: the velvety softness of a petal, the fuzziness of a pussy willow, a fallen feather, the bark of a tree, or mud puddles. There are even things to taste, like a freshly picked blueberry or, in the winter, freshly fallen snow.

Do you remember how even the simplest foods taste better outside? Somehow, a peanut butter sandwich is just a sandwich when it's eaten in the kitchen. But make it part of a picnic, and suddenly it's special!

If T-ball and soccer are among your child's activities, you may believe she is indeed spending plenty of time outdoors. And while it's true she may be getting fresh air and sunshine (both important!), such organized activities don't allow for the appreciation of nature that outdoor experiences are meant to provide. When free to explore the outdoors on her own, she can lie on her back and absorb the feel of the grass against her skin, or track a caterpillar's progress. Heaven forbid she be doing either of those things during an organized game!

How about taking a "senses walk" on this Earth Day? Whether you walk around the backyard or around the block, you and your child can discover how many things you can hear, smell, or touch. How many red things can you see? How many natural things? An activity like this serves so many purposes! It stimulates the senses, provides physical activity, heightens awareness of the surrounding beauty, offers science lessons, and fosters a love of nature. Choose one sense to focus on today and then tomorrow, when it's no longer Earth Day, go outside and choose another to explore!

Time Just to Be

The stories I hear from parents never cease to amaze me. Like the one from the mom who was feeling pressured to enroll her two-and-a-half-year-old in the local soccer program -- the local, competitive soccer program!

"Our town," she said, "is very much into pushing children to compete and succeed. And I know other parents are looking at me as though I'm failing my child, but I'm not going to give in to the pressure. I'm not enrolling her in all these programs at age two."

Good for her! Whether it's a fear that their children won't get into the college of their choice, fear that they'll never find their passions, or fear that a child who isn't constantly engaged in organized activities will become lazy and unmotivated -- too many of today's parents are responsible for their children being overscheduled, with no time just to be.

What happens when a child's time is scheduled and programmed -- directed by someone else -- from morning 'til night, day after day? As one mother wrote to me: "If the parents work a full day and the children are in a traditional school, the child goes to care before school at around 7:30 AM, then goes to school, then goes to after-school care until around 5:30 PM. Then they have two hours of homework. If you add in one sport per season, they have two hours of practice/games once or twice a week. So the child's 'workday' is more than twelve hours!"

In addition to the stress is causes, an overscheduled, overprogrammed life at an early age assures that the child will never be able to entertain herself. Will never be able to live inside her own head. To deal with solitude or quiet time. She may not get much of it as an adult, but for her sake I hope there will be some. And when there is, it would be awfully sad if she felt panicked at the idea of having to keep herself amused. If she felt she absolutely had to be in the company of others.

If parents want their children to grow up to be resourceful, they have to make sure their kids start practicing now. That means they have to ensure their children have plenty of unstructured time -- preferably in big, uninterrupted chunks.

Rebecca Isbell, early childhood educator and author, says that the chunks of time children need for uninterrupted play will vary according to their level of development. Toddlers, she maintains, require a minimum of 30 minutes to remain in play activities that interest them. Preschoolers need 45 to 60 minutes. And early elementary children who are focused on their play may need an hour or more to bring their work to a conclusion.

Here are some questions excerpted from my book, A Running Start:

• If children begin living like adults in childhood, what will they have to look forward to?
• What's to ensure they won't be burned out from all the pushing and pressure before they've even reached puberty?
• If we've caused them to miss the magic of childhood, what will kids later draw upon to cope with the trials and tribulations of adulthood?
• What will become of the childlike nature adults call on when they need reminding of the delight found in simple things -- when they need to bring out the playfulness that makes life worth living?
• What joy will our children find as adults if striving to "succeed" becomes life's sole purpose?

Inactivity & Heart Disease

Here are the findings of a frightening new study published in Dynamic Medicine: the risk of developing  heart diseases during the teenage years increases about 600% if the individual has history of inactivity during childhood!

The study followed approximately 400 children (ages 7 to 10) for 7 years in North Carolina. Different factors were evaluated in those children. Among them: height, body mass, percentage body fat, blood pressure and cholesterol levels. Also, their activity level was evaluated by means of surveys, interviews, and a fitness test.

Almost 7 years later, the same kids were evaluated again. The results? Children with low levels of exercise (less than 20 minutes a day of intense physical activity) were 500-600% more prone to have developed three or more of the characteristics of what is known as metabolic syndrome (MS).

Metabolic syndrome is a medical disorder or a group of medical disorders of unknown causes associated with an increased the risk of cardiovascular disease  and diabetes. High blood pressure, visceral adiposity (central obesity), low HDL cholesterol, and low high triglycerides in blood are the main signs of metabolic syndrome, although a complete diagnosis is difficult to do since it is a syndrome and not a well-characterized disease. The study found that at least three of these  characteristics of MS were observed in teenagers who had a very low physical activity during childhood.

Dr. Robert McMurray, lead investigator and professor of sports science at the University of North Carolina department of exercise and sports science, said (according to the study) that this is the first time a research study has tracked a group of children over time to investigate if childhood activity levels had something to do with the risk of developing heart disease during the teen years.

Television & Children's Bedrooms Don't Mix!

An article by Tara Parker-Pope in today's New York Times certainly caught my attention. It's called "A One-Eyed Invader in the Bedroom," and despite the fact that this stuff is involved in how I make my living, its statistics surprised even me.

Here's one: According to a study of 80 4- to 7-year-olds, having a TV in the bedroom increased a child's viewing time by almost 9 hours a week! Not surprisingly, parents were unaware of just how much time their children were watching TV and seriously underestimated viewing time.

I guess what I found most puzzling was the study's finding that decreased viewing time did not lead to an increase in physical activity levels. That's the bad news, from my perspective. The good news is that children who viewed less snacked less, consuming over 100 fewer calories  per day. Since preschoolers with bedroom TVs are more likely to be overweight, with higher body fat and body mass index, that truly is good news.

Here are some of the results of other studies related to television in children's bedrooms:

• A television in the bedroom has a negative impact on schoolwork, with 70% of the 400 children in a 2005 study scoring "significantly and consistently lower on math, reading and language-arts tests."
• Kindergartners with televisions in their bedroom have more sleep problems.
• Kids ages 12 to 14 with bedroom TVs are more than twice as likely to start smoking!

Bottom line: If children are going to watch TV, it's best for them to do it in common areas, at common times, with other family members.

This week's featured interview on Body, Mind and Child is with Sara Bennett, co-author of The Case Against Homework. I blogged about this topic on February 5th!

Sensory Integration

Yesterday I interviewed Christy Isbell for Body, Mind and Child. Christy's a pediatric occupational therapist and co-author of a book called Sensory Integration: A Guide for Preschool Teachers. Although sensory integration is certainly a hot topic in education these days, I must admit that I didn't know as much about it as I should -- especially considering I'm a movement person, and movement is involved on so many levels when there are problems with sensory integration.

Let me start at the beginning. Sensory integration occurs in the central nervous system as the body gathers information through the ears, eyes, nose, mouth, skin, muscles, and joints. Christy explains that although we're taught all through school that there are five senses, there are actually seven. The other two are "hidden." They're the vestibular sense, which has to do with movement and balance sensation, and the proprioceptive sense, which alerts us to our body's position in space.

When there are problems using the information that comes in via the seven senses, it's called Sensory Processing Disorder (SPD). Children with SPD fall into three categories: sensory avoiders (the most common), sensory seekers, and sensory under-responders.

Although there are a variety of ways in which these problems manifest themselves, according to Christy they all have "an enormous impact on children's overall development." SPD in its many forms also has a tremendous influence on a child's ability to learn. Among the symptoms are poor attention span, difficulty focusing, poor handwriting, and low self-esteem. I was particularly fascinated by Christy's description of sensory seekers who are in constant motion and often misdiagnosed as having ADHD. For such children, she said, drugs like Ritalin won't have any effect.

Because SPD is still not commonly understood and too often results in the children who suffer from it being misunderstood, it's an important topic for both educators and parents. Watch for Christy's interview to go live on BAM Radio. In the meantime, I highly recommend her wonderful book on the subject!

What Causes Childhood Obesity?

As I may have mentioned before, I've signed up to receive Google alerts on topics that are of interest to me. "Childhood obesity" is one such topic, and it's certainly the one for which I receive the most alerts!

Every day there are stories from all around the world about the problems associated with and the causes of this epidemic. But today I found it particularly interesting because, in one e-mail, there were stories pointing in two different directions. One study has determined that children who get the least sleep have a 92 percent higher chance of being overweight or obese than children who sleep enough, while another determined that children who get fat tend to do so because they have a genetic predisposition towards obesity. In other words, the first study pointed toward "nurture" as the culprit and the other pointed toward "nature."

So what's the truth? What really causes childhood overweight and obesity? I don't think anybody can say for sure! But here's what I think:

• It only makes sense that heredity would play a role in a child's weight. My concern is that news of this study may convince some parents that they have no control over the situation. That they're relieved of the responsibility of ensuring their children eat right and get the appropriate amount of physical activity. The truth is, every child needs to eat right and be physically active in order to achieve optimal health. Weight shouldn't be the only motivation!
• Whether or not it plays a role in an individual's weight, children need a lot of sleep -- and often much more than they're currently getting! Children from birth to age four require 12 to 15 hours of sleep in a 24-hour period! Children ages 5 to 12 need 10 to 11 hours of sleep. According to the National Sleep Foundation, sleep is especially important for children as it directly impacts mental and physical development.

Yes, these studies are important; I don't think we as a society should ever stop looking for answers and solutions. But for every problem there will surely be conflicting answers and solutions. Our only choice, therefore, is to use common sense -- and common sense, as it regards children's health, is that kids need to eat right, move often, and get enough rest.