A Randomized Controlled Cluster Trial of an Obesity Prevention Program for Children with Special Health Care Needs: Methods and Implications.

Children with disabilities have higher prevalence estimates of obesity than typically developing children. The Healthy Caregivers-Healthy Children Phase 3 (HC3) project implemented an obesity prevention program adapted for children with special health care needs (CSHCN) that includes dietary intake and physical activity (PA) components. The primary outcome was a change in dietary intake, PA, and the body mass index (BMI) percentile. Ten childcare centers (CCCs) serving low-resource families with ≥30 2- to 5-year-olds attending were randomized to either the intervention (n = 5) or control (n = 5). The HC3 CCCs received (1) snack, beverage, PA, and screen time policies via weekly technical assistance; (2) adapted lesson plans for CSHCN; and (3) parent curricula. The control CCCs received a behavioral health attention curriculum. HC3 was delivered over three school years, with data collected at five different timepoints. It was delivered weekly for six months in year one. To ensure capacity building, the HC3 tasks were scaled back, with quarterly intervention delivery in year 2 and annually in year 3. Adaptations were made to the curriculum to ensure appropriate access for CSHCN. Given that the program was being delivered during the COVID-19 pandemic, special modifications were made to follow CDC safety standards. The primary outcome measures included the Environment and Policy Assessment and Observation (EPAO) tool, standardized dietary intake and PA assessments, and the child BMI percentile. CCCs are an ideal setting for targeting CSHCN for obesity prevention efforts as they provide an opportunity to address modifiable risk factors.

Social Challenges as a Consequence of the COVID-19 Pandemic among South Florida Preschool Children with Disability and Obesity.

The COVID-19 pandemic has negatively impacted the childcare industry over the past two years. This study examined how pandemic-related challenges impacted preschool-aged children by disability and obesity status. Participants were 216 children (80% Hispanic, 14% non-Hispanic Black) aged 2 to 5 years in 10 South Florida childcare centers. In November/December 2021, parents completed a COVID-19 Risk and Resiliency Questionnaire, and body mass index percentile (BMI) was collected. Multivariable logistic regression models examined the association of COVID-19 pandemic-related social challenges (transportation, employment) and child BMI and disability status. As compared to normal-weight children, those families with a child who was obese were more likely to report pandemic-related transportation (OR: 2.51, 95% CI: 1.03-6.28) challenges and food insecurity (OR: 2.56, 95% CI: 1.05-6.43). Parents of children with disabilities were less likely to report that food did not last (OR: 0.19, 95% CI: 0.07-0.48) and that they could not afford balanced meals (OR: 0.33, 95% CI: 0.13-0.85). Spanish-speaking caregivers were more likely to have a child who was obese (OR: 3.04, 95% CI: 1.19-8.52). The results suggest that COVID-19 impacts obese preschool children from Hispanic backgrounds, while disability was a protective factor.

Motor response investigation in individuals with cerebral palsy using near infrared spectroscopy: pilot study.

Cerebral palsy (CP) describes a group of motor impairment syndromes secondary to genetic that may be due to acquired disorders of the developing brain. In this study, near infrared spectroscopy (NIRS) is used to investigate the prefrontal cortical activation and lateralization in response to the planning and execution of motor skills in controls and individuals with CP. The prefrontal cortex, which plays a dominant role in the planning and execution of motor skill stimulus, is noninvasively imaged using a continuous wave-based NIRS system. During the study, 7 controls (4 right-handed and 3 left-handed) and 2 individuals with CP (1 right-handed and 1 left-handed) over 18 years of age performed 30 s of a ball throwing task followed by 30 s rest in a 5-block paradigm. The optical signal acquired from the NIRS system was processed to elucidate the activation and lateralization in the prefrontal region of controls and individuals with CP. The preliminary result indicated a difference in activation between the task and rest conditions in all the participant types. Bilateral dominance was observed in the prefrontal cortex of controls in response to planning and execution of motor skill tasks, while an ipsilateral dominance was observed in individuals with CP. In conjunction, similar contralateral dominance was observed during rest periods, both in controls and individuals with CP.