Why Pediatricians Are Being Urged to Write ‘Physical Activity Prescriptions’ for Children
By Dan Gray
Pediatricians are being urged to start writing "exercise prescriptions" for the children they see in their office.
That's the recommendation of a report published Sunday by the American Academy of Pediatrics (AAP) titled Physical Activity Assessment and Counseling in Pediatric Clinical Settings.
In it, AAP officials encourage pediatricians to go beyond simply recommending that kids get exercise and take the step of actually issuing a prescription for physical activity.
"Currently, most pediatricians recommend that children get 60 minutes per day of physical activity, but this is not commonly elaborated upon or provided as a prescription," Dr. Natalie D. Muth, a co-author of the clinical report who's also a pediatrician and registered dietitian in California, told Healthline.
"Additionally, there is an important opportunity to consider physical activity as a routine part of the treatment plan for many conditions, such as ADHD," she added.
Another pediatrician interviewed by Healthline agrees with the recommendations.
"In reading through the clinical report, what they do is recommend the prescription in the first 2 years," Dr. David Fagan, vice chair of the department of pediatrics at Cohen Children's Medical Center in New Hyde Park, New York, told Healthline.
"I think the reason they are going to that extreme is to promote the idea of physical literacy to impart on a family, even at that early age, the importance of being physically active," he said.
Fagan also notes the report represents a shift toward more directly confronting the rising rates of childhood obesity.
"Previously, we've focused on healthy nutrition in combating obesity and then focusing on kind of eliminating the sedentary behaviors — gaming and things like that," he said. "But this report states that we need to be more proactive in promoting activity."
The AAP points to a few statistics in their report.
For starters, only 1 in 4 children reports getting the recommended 60 minutes of physical activity per day.
Additionally, in their 2017 Youth Risk Behavior SurveillanceTrusted Source, the Centers for Disease Control and Prevention (CDC) found that only slightly more than a quarter of teens in the U.S. are getting the recommended amount of activity per day.
In addition, 15 percent of teens said they hadn't been physically active for even a single hour of the previous week.
The AAP also reports that the average preschooler is sedentary for more than 6 hours a day, and more than 40 percent of schoolchildren spend 3 or more hours in front of a television per school day.
In 2016, the AAP rolled out new guidelines that recommended minimal screen time for young kids and zero screen time for the first 18 months of life.
"Some people may say that it's extreme or not realistic in this day and age, but the emphasis of the message there is that we want children — infants and toddlers — to be on the floor, playing with toys, and moving around from an early age," Fagan said.
"That's what we're really imparting on families: the importance of being physically literate and understanding how vital physical activity is to the development of children," he added.
Academic pressures can also prevent children from getting the physical activity they need, says Muth.
"Physical activity in the school day has been compromised by a push toward more 'academic' subjects, even though we know well that physical activity in the school day improves concentration and attention, improves academic performance, improves behavior, and helps children and adolescents adopt habits for lifelong health," she said.
How Can Families Help?
As a pediatrician, Fagan says he tries to motivate his young patients by asking them what activities they like.
Sedentary activities, such as video games and social media, are a nonstarter.
"I ask, 'Besides video games, what do you like to do?' and then offer some suggestions. You have to find something that they like," he said.
"If you tell a child or teen that they need to be on a treadmill 60 minutes a day, 3 days a week, and it's not something they like, they're not going to do it. So I think it's critical to find out what the child or teenager enjoys doing in terms of physical activity. Even going out for a walk for 15 or 20 minutes is a step in the right direction," Fagan said.
The AAP notes in their report the importance of role models when it comes to physical activity.
Muth points out that kids who grow up in active households are more likely to be active themselves. She offers some suggestions for parental role modeling.
"Parents can help kids build activity into their day, whether that's walking or biking to school when possible, taking family walks together after dinner, and helping kids get to sports or active hobbies. The key is to help kids find physical activities that they enjoy doing," she said.
With childhood obesity rates on the rise, it's more critical than ever to encourage kids to get active — and a formal prescription, rather than a recommendation, may help spur them into action.
"I think the importance of this clinical report is giving the pediatrician the tools to dive deeper, so we can offer more specific recommendations in terms of how much moderate to vigorous physical activity a child should achieve," Fagan said.
"This can be promoted through referral to community-based organizations and providing families with lists of resources in the community, whether it's parks or recreation centers," he added.
Reposted with permission from Healthline.
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By Kristen Fischer
It's going to be back-to-school time soon, but will children go into the classrooms?
The American Academy of Pediatrics (AAP) thinks so, but only as long as safety measures are in place.
Keeping Schools Safe<p>What will safer schools look like?</p><p>In a <a href="https://jamanetwork.com/journals/jama/fullarticle/2766822" target="_blank">JAMA article</a> published last month, <a href="https://www.jhsph.edu/faculty/directory/profile/1781/joshua-m-sharfstein" target="_blank">Dr. Joshua Sharfstein</a>, a pediatrician and professor at the Johns Hopkins Bloomberg School of Public Health, outlined suggestions — many of which are similar to AAP's.</p><p>Remote learning protocols must stay in place, especially as some schools stagger home and in-building learning. If another shutdown needs to occur, children will rely on distance learning completely, so it must be easy to switch to, he said.</p><p>He suggested giving parents a daily checklist to document their child's health. Kids should be screened quickly on arrival and be given hygiene supplies. Maintenance staff should use appropriate PPE and have regular cleaning schedules. A notification system should be in place if a case is identified, Sharfstein recommended.</p><p><a href="https://www.albany.edu/rockefeller/faculty/erika-martin" target="_blank">Erika Martin</a>, PhD, an associate professor of public administration and policy at University at Albany, said nutrition assistance and health services should be included. She called for tutoring programs with virtual options as well as technology access.</p>
Supporting Staff<p>Teachers and staff will be affected by safeguarding measures, noted <a href="https://directory.sph.umn.edu/bio/sph-a-z/rachel-widome" target="_blank">Rachel Widome</a>, PhD, an associate professor of epidemiology and community health at University of Minnesota.</p><p>"In order for all of the in-school precautions to work well, we'll be asking a lot of teachers and staff," Widome told Healthline. In addition to their usual workload, they'll now be asked to monitor mask-wearing, ensure children are keeping distance, and be aware of any symptoms.</p><p>Along with Sharfstein, Widome called for an increase in financial support. More employees will likely be required so teachers and staff members can keep up with the added demands.</p>
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What Parents Can Do<p>Parents should ask for and receive frequent updates from schools about plans for the fall. They should also be informed about plans if and when COVID infections are identified, Sharfstein said.</p><p>"I'd like to see parents investing now, during the summer, in doing things that can slow and stop the spread of the virus in their communities," Widome said.</p><p>"Now is a good time for kids to practice wearing masks and get used to them as they may be wearing them for longer stretches if school starts up in person," Widome suggested.</p><p>She recommends parents try different mask designs and materials to see what children are more comfortable wearing.</p><p>"If you are using cloth face coverings, it's good to have extras on hand," Widome added.</p><p>Parents should model healthy behavior at home and while out in public — another thing that could affect how well children adapt to reopening practices, Sorensen said.</p><p>"Children may want to know more about face coverings," added <a href="https://www.linkedin.com/in/leescott/" target="_blank">Lee Scott</a>, chairwoman of the Educational Advisory Board at <a href="https://www.goddardschool.com/" target="_blank">The Goddard School</a>. "Dramatic play, such as creating or wearing a face covering, may help some children adjust to this concept." Schools can also show children photos of what faculty members look like in their masks so the students are familiar with that appearance.</p><p>Johns Hopkins University recently released its eSchool+ Initiative, a slew of resources surrounding education during the pandemic. These include a <a href="https://equityschoolplus.jhu.edu/reopening-checklist/" target="_blank">checklist for administrators</a>, report on <a href="https://equityschoolplus.jhu.edu/ethics-of-reopening/" target="_blank">ethical considerations</a>, and a tracker of <a href="https://equityschoolplus.jhu.edu/reopening-policy-tracker/" target="_blank">state and local reopening plans</a>.</p>
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