Author: Darlene K. Sekerak, PT, PhD
Shelly is the youngest of three children. She is four years old and attends a morning pre-kindergarten program at her neighborhood school. She is a quiet child who needs frequent encouragement to join in physical activities with the other children at the preschool. She is most active when playing with her seven year old twin brothers, Chad and Tyler. If allowed to make her own choices, she would spend most of her time snacking in front of the television, drawing, or looking at picture books. Shelley has Downs syndrome.
Shelly?s mom is very conscientious about her own and her families physical fitness and is concerned that Shelly is over weight and inactive. She asked the physical therapist who visits Shelly?s preschool about her concerns. The physical therapist acknowledged that mom?s concerns were valid and agreed to work with her to develop a plan to try to help Shelly develop a more physically active lifestyle.
They contacted Shelly?s pediatrition to confirm that there were no limitations on physical activity for Shelly because of heart problems, cervical instability, or other health conditions sometimes associated with Downs Syndrome. They then wrote out a daily schedule of Shelly?s activities based on a typical day from waking up in the morning until going to bed at night. Mom was shocked at how in-active Shelley really was. Quiet play (rather than active physical play) occupied more than 90% of her free time. Mom also discovered how much family members were doing for Shelly that she could do for herself because it was more efficient or because they had just gotten into a habit. Shelley was great at avoiding work.
Mom decided that she wanted to 1) make Shelley do more for herself and 2) get her involved in a sport or recreational activity. The therapist suggested that she move slowly and only change one thing at a time. This would give Shelly time to adjust and to develop endurance and skill. They developed a calendar for the next six months. Every three weeks a new physical activity would be substituted for a previously less active activity. Over the next months Shelly was expected to dress herself, make her bed, carry her dirty cloths to the laundry room, and carry her own plate from the table to the kitchen after meals. Her mother started to walk with her to and from preschool (four blocks away) instead of driving. He brothers played with her in the back yard for 30 minutes after school everyday- teaching her about soccer. Mom suggested that Dad take Shelly to the playground instead of reading the paper before dinner. Mom became more and more creative about ways to keep Shelly moving rather than letting her sit. She discovered that as long as someone kept Shelly interested and gave her attention she was a willing participant. When left on her own she continued to make inactive choices. While the boys were in summer camp, Mom enrolled Shelly in dance classes and swimming lessons at the YMCA. She noticed that Shelly seemed to be making friends and enjoying herself.
By the end of six months Shelly was active for more than 50% of her free time. She was eating healthier meals and fewer snacks and mom felt much better about her weight and general fitness.
|
