“It’s not just a matter of the individual making the right choices. We need public policies that support physical activity programs for people with disabilities. We need more investment in programs both public and private. And we need private sports and fitness clubs to offer choices for people with disabilities.”

In writing about the impact of the obesity epidemic on children with special health care needs, the researchers Paula M.Minihan, Sarah N. Fitch andAviva Must deployed an ecological model describing five overlapping spheres of influence that impact each individual child. A child’s weight is impacted by a variety of factors, some close to home, othersinfluenced by public policies made hundreds or thousands of miles away. Just as each sphere of influence can be part of the problem; it can also be part of the solution.

Individual
Children have to be involved in decisions about their own health and fitness. Parents can talk with them about healthy eating and the importance of physical activity and engage them in the quest for enjoyable healthy foods and pleasurable fitness activities. Children can set goals for themselves. These should not be weight loss goals, but goals for new behaviors – “eat fruit and vegetables every day” or “go to a yoga class once a week” or “learn how to swim.” As the mother of a young man with Down syndrome observes, “The most important thing is you have to get the ‘wantto’ in them for it to work. You have to talk with them and not preach at them and tell them what to do.”