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Nutritional challenges and a lack of activity can lead to health problems across the lifespan for people with spina bifida. Children and adults with spina bifida are also at greater risk of being classified as overweight or obese compared to their peers without the condition. Therefore, early recognition of nutrition problems, weight management counseling, and timely referrals for evaluation and management of diet and activity can help those with spina bifida and their families achieve a healthy lifestyle. This article details the development of the Nutrition, Metabolic Syndrome and Obesity Guidelines, which are part of the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida. It discusses the identification and management of poor nutrition and prevention of obesity for children, adolescents, and adults with spina bifida and highlights areas requiring further research.

Unlabelled: Childhood obesity is a global health concern, but children with spina bifida in particular have unique interacting risk factors for increased weight., Purpose: To identify and explore current clinical practices around weight assessment and management in pediatric spina bifida clinics., Methods: An online, self-report survey of healthcare professionals (HCPs) was conducted in all pediatric spina bifida clinics across Canada (15 clinics). Summary and descriptive statistics were calculated and descriptive thematic analysis was performed on free text responses., Results: 52 responses across all 15 clinics indicated that weight and height were assessed and recorded most of the time using a wide variety of methods, although some HCPs questioned their suitability for children with spina bifida. Weight and height information was not routinely communicated to patients and their families and HCPS identified considerable barriers to discussing weight-related information in consultations., Conclusion: Despite weight and height reportedly being measured regularly, HCPs expressed concern over the lack of appropriate assessment and classification tools. Communication across multi-disciplinary team members is required to ensure that children with weight-related issues do not inadvertently get overlooked. Specific skill training around weight-related issues and optimizing consultation time should be explored further for HCPs working with this population.

Children with autism spectrum disorders appear to be at a higher risk of having obesity than their typically developing peers. Although it has been recommended that healthcare providers speak to children with autism spectrum disorders about the potential health risks of unhealthy weight, no previous research has explored how healthcare providers communicate with them about this topic. The purpose of this study was to explore children's perspectives and experiences of discussing weight-related topics in healthcare consultations. Eight children were interviewed, and an interpretive phenomenological analysis informed the research approach and analysis of the data. Results indicated that weight-related discussions with healthcare providers were often met with trepidation, anxiety, anger, and frustration. Children also expressed that they experienced weight stigma in clinical visits and everyday interactions. Weight stigma was often (unwittingly) projected by healthcare providers during appointments and had debilitating effects on children. Finally, higher weights emerged as a repetitive/restricted interest, and children reported body image challenges regarding their higher weights. Frameworks and tools that are specific to the needs and abilities of children with autism spectrum disorders are needed for healthcare providers to foster positive conversations about weight-related topics in an effort to promote lifelong wellness.

Children with autism spectrum disorders appear to be at a higher risk of having obesity than their typically developing peers. Although it has been recommended that healthcare providers speak to children with autism spectrum disorders about the potential health risks of unhealthy weight, no previous research has explored how healthcare providers communicate with them about this topic. The purpose of this study was to explore children's perspectives and experiences of discussing weight-related topics in healthcare consultations. Eight children were interviewed, and an interpretive phenomenological analysis informed the research approach and analysis of the data. Results indicated that weight-related discussions with healthcare providers were often met with trepidation, anxiety, anger, and frustration. Children also expressed that they experienced weight stigma in clinical visits and everyday interactions. Weight stigma was often (unwittingly) projected by healthcare providers during appointments and had debilitating effects on children. Finally, higher weights emerged as a repetitive/restricted interest, and children reported body image challenges regarding their higher weights. Frameworks and tools that are specific to the needs and abilities of children with autism spectrum disorders are needed for healthcare providers to foster positive conversations about weight-related topics in an effort to promote lifelong wellness. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) are at a higher risk of having obesity than their typically developing peers. Although it has been recommended that health care providers (HCPs) speak to caregivers and children about the risk of higher weights, no research has examined how HCPs communicate weight‐related information. Furthermore, there is a dearth of evidence regarding how to approach and deliver optimal weight‐related discussions among children with ASD and their caregivers. Given these knowledge gaps, 21 in‐depth interviews were conducted with children with ASD, their caregivers, and HCPs. Using a qualitative analytic approach, data from interviews were analyzed thematically. Results suggest that HCPs at times projected weight stigma during clinical encounters, which did not motivate children and caregivers to work toward work loss or wellness. HCPs also described reticence in engaging families in weight‐related conversations due to limited training, and lack of clinical tools to guide these conversations. All stakeholders identified a need to work together to establish a therapeutic partnership to discuss weight‐related issues without blame or shame. The combination of strength‐based communication approaches, establishing a strong therapeutic partnership, and development of clinical tools facilitating weight‐related discussions for HCPs outlined in this article are potential vehicles to foster successful weight‐related discussions while promoting lifelong wellness. Autism Research2018, 11: 1500–1510. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Children with autism spectrum disorder (ASD) are at a higher risk of having obesity. Yet, it is unknown how healthcare providers (HCPs) should deliver weight‐related information. Findings suggest children and caregivers experienced weight stigma and were uncomfortable discussing weight‐related issues. HCPs identified that they did not have sufficient training, and did not feel confident identifying/addressing weight issues. Tools are needed to facilitate weight‐related discussions among children, caregivers and HCPs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the experiences of children with spina bifida (SB), their families and healthcare professionals (HCPs) when discussing weight-related topics. Method: In-depth qualitative interviews were conducted with HCPs from Canadian outpatient SB clinics (n = 13), children aged 6–18 years with SB (n = 17) and their parents (n = 20). Data were analyzed using a phenomenological approach within an interpretative paradigm. Results: Many HCPs were not confident talking about weight, concerned that they would damage relationships with children and families. Parents wanted routine weight surveillance, but were worried about their children's self-esteem if their weight was discussed. They wanted HCPs to acknowledge the challenges of weight management in children with a physical disability and provide specialized solutions. Children wanted a positively framed and tailored approach to weight discussions, although this had generally not been their experience. Conclusions: Stakeholders describe therapeutic relationships that are currently disconnected around the issue of weight and obesity. However, children, parents and HCPs all believed that discussing this topic was critical. Positively framed, strengths-based and tailored approaches to weight-related discussions are warranted. Rates of overweight and obesity in children and youth with physical disabilities are substantially higher than their typically developing peers. Healthcare professionals, children with physical disabilities and families often find weight-related discussions challenging and disconnected. Weight-related discussions should be tailored to the child and family's circumstances and priorities. Positively framed and strengths-based approaches to weight-related discussions are warranted. [ABSTRACT FROM AUTHOR]