Monday, 10 June 2013

Chocolate anyone?

Britain and the USA have, in the past few years, acknowledged that there is a huge rise in the number of obese children.

"Obese kids, blame it on overweight moms" -Daily News and Analysis, June 2013

"10 percent of children are obese by the time they start school" -Daily Express, Feb 2013

"42 percent of American adults will be obese by 2030" -Los Angeles Times, May 2012

Society argues that it's parents fault, some argue that it's more prevalent among working class families, other scientists blame genetics and poor environment.

It's not an unknown fact that many children with autism have strict food preferences as well, from only eating things that are a certain colour to only eating certain textures, and everything in between. I don't tend to deal a whole lot with eating issues, mainly because I haven't had much experience in the area so would rather consult with a professional who does first. Unfortunately, this is where I hit my brick wall.

I recently met a family who had asked me to come and help them with their child's behaviour.  During the parent interview, the parents also informed me that their child was a "picky eater". They told me that they had been to dietitians and nutritionists and that the last doctor they saw said " doesn't matter if he eats chocolate all day, as long as he's eating". It took me about 30 full seconds for me to close my mouth and utter a word when the parents told me this. And we wonder why there is an increase in childhood obesity?

As a behaviourist, I have to ask myself, why is obesity on the rise? How are we dealing with it?
I am NO expert in this area, as I don't often treat kids with eating disorders, but it has struck me that at least in the UK, the dietitians and nutritionists (that I have come across) do not seem to either 1) care as long as the child is eating something and/or 2) definitely don't look at environmental aspects when treating problems with eating.

I remember years ago watching a programme on TV that featured children with eating disorders. One of the children had a diet that consisted of chocolate and crisps. That's it. No bread, no fruit, no veg. She ate the same for all meals. For seven years until someone finally decided to do something.  The approach that was used was systematic desensitisation and a differential reinforcement procedure. By the end of the show, the girl went from not being able to look at toast to taking small bites. See the power behaviour analysis can have on any problem? You identify the environmental variables (in the above case, parents giving in to the child's requests until she restricted her diet down to two different foods) controlling the behaviour, manipulate them (in the above case by no longer honouring this, while at the same time slowly introducing new foods and providing rewards for each step), and viola! problem gets better and eventually goes away.

I'm by no means saying the above procedure is necessary or even appropriate in every situation, however I do think that dietitians and nutritionists, who are often given referrals for children with eating problems, could probably do with some training in behaviour analysis. Maybe then we can really tackle our childhood obesity problems.

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