Designing a weight management course for children with learning difficulties

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There’s no such thing as a child with simple needs. But developing a learning difficulties-focussed weight management programme has shown us how complex the world can be for some of the most challenged children in our community…

More and more children with learning difficulties are obese. In 2016 the British Paediatric Neurology Association and British Academy of Childhood Disability measured 264 pupils attending a local Special Educational Needs (SEN) secondary school. They reported 40% of pupils with learning disability were overweight or obese, which is much higher than published reports for the general population of the same age at 33%. And SHINE have been partnering with Sheffield Mencap & Gateway on a new project to adapting our materials to deliver weight management programmes for this important specialist group.

With the support of Mencap Chief Exec Janet Sullivan and funding from Children in Need, we’ve trained four Mencap staff teachers here in Sheffield to deliver a new SHINE weight management programme, which includes an increased visual focus and more interactive exercises and games.

Textures, colours and aromas all play a massive part in eating for children with learning difficulties so understanding sensory eating has been really important for this. Through engagement and observations we’ve found out loads about how children with learning difficulties can be selective or fussy eaters, disliking ‘wet’ food like gravy, sauces and yoghurt and preferring ‘beige’ foods like potatoes, bread and pasta. Children with learning difficulties can have entrenched disordered eating patterns at mealtimes, further complicated by medical conditions such as Pica and Prader-Willi Syndrome.

We’ve also learnt a lot from parents, who’ve openly discussed how difficult it is to manage these behaviours and how tempting it can be to give in to demands for a ‘quiet life’. But with guidance and support from SHINE staff, our parents have made amazing changes – challenging demands, setting boundaries around family mealtimes and introducing new foods in a fun way. Following positive results, we’re about to progress to our September course with new learning and greater confidence in our ability to help families make changes. Well done to our first group – you did us proud!

SHINE told parliament about childhood obesity. What happened next?

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Why is the government decommissioning weight management services for children when obesity rates are increasing? Why are there still no tier three services for children? When will the government move beyond prevention to providing help and support for children who are overweight now? Who will fund this work?

Everyone wants to feel like they’re listened to. SHINE’s recent visit to London to share our thoughts with members of the UK Parliament’s Health and Social Care Committee was a chance for us to get the ear of people with the power to change the direction of UK obesity policy.

The call to visit came about as a result of our recent petition to fund obesity services for UK children and young people and it’s just one step in a larger process. But when we went down we tried to provide the committee with useful answers to their questions, as well as asking a few of our own.

That committee included some big names, including Diana Johnson, who’s member of the UK Parliament’s Health and Social Care Select Committee, Andrew Selous, who’s Chair of the All Party Parliamentary Group on Obesity and Shadow Health Minister, Sharon Hodgson.

We presented alongside MoreLife with support from Dr James Nobles and Professor Paul Gately from Leeds Beckett University and brought seven young people from SHINE along with us. Destiny – one of the young people on our maintenance programme – told the story of her battle with binge eating and powerfully highlighted the need for more complex interventions for young people in addition to promoting healthy eating and physical activity.

The committee’s report ‘Childhood Obesity: A time for action’ came out shortly after our visit (link) and as expected concentrates mainly on preventative action. Marketing, advertising and sugar tax all feature heavily. But our eye did go to a brief statement on page 33, which read, ‘The Government must ensure there are robust systems in place not only to identify children who are overweight or obese, but to ensure that these children are offered effective help. Addressing health inequalities must include providing help for those children who are already obese…’ Our hopes for meaningful change to policy were pinned on this sentence but the ‘Obesity Strategy :Chapter 2′, subsequently published in June 2018, didn’t pick up this thread. There was no mention of any guidelines for intervention pathways or strands of funding. This leaves us wondering how on earth they will achieve their target of reducing childhood obesity by half by 2030.

Huge thanks to Labour MP Paul Blomfield for helping us get SHINE’s voice – and those of Sheffield’s young people – heard and also to Ben Mackay for all his support.

Healthy Schools Research Project – July 2018 Update

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One in five children enter school overweight or obese, increasing to one in three when they leave school at Year 6. What’s going on?

Over the last three years we have been working with two schools in Sheffield to find out.

Our project involves measuring children every year to see if we can pick up any patterns with an aim of changing this upward trend. Children spend approximately a quarter of their life in school, so they’re are a great place to promote, encourage and build good health and wellbeing. Leeds Beckett University have been helping us to find out if this whole school approach is beneficial.

The two schools involved are from the same area; with one ‘working as usual’ and the second working together with SHINE to become healthier. Here are some of the things we’ve delivered together so far –

  1. Improved breakfast clubs by providing age related food portions and by reducing sugary cereals.
  2. Increased availability and range of healthy snacks.
  3. Encouraged teachers to avoid rewarding achievements with sweets and chocolate.
  4. Increased the level of physical activity through walking buses, running a mile a day, offering ‘stay and play’ sessions for children and their parents and teaching curriculum subjects through physical activity.

We’ve also trained up four SHINE Healthy Weight Leaders (teachers and classroom assistants) to have the appropriate knowledge and skills to talk with parents about the weight of children, and to do so in a sensitive and confident manner without judgement or stigma. Lastly, we’ve helped children who have experienced weight gain by offering family-based support.

The results so far suggest that the programme is working. In both schools, we’ve seen that rates of obesity have not increased. But in the school that is having additional support from SHINE, it looks like the programme is really helping to support the children in maintaining a healthy weight. We have noticed though that some children would benefit from additional support from SHINE, and this is what we will be looking to offer as we enter our third year.

Accepting additional support isn’t easy and we do face some initial resistance from parents. That’s normal though as children’s health and wellbeing is seen as a personal matter. Over the next year we’ll be focussing on building relationships so that our input will be viewed as helpful rather than intrusive

SHINE is saved – and launching new programmes!

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Huge, out of this world thanks to Children In Need, who’ve provided SHINE with funding for the next three years. Their contribution will keep our doors open (and more – read on for the new courses we’re launching) but we’re thankful to EVERYONE who raised their voice to support us over the last few months of nail biting tension. Thankyou all!

We’re currently preparing to launch two new programmes for 2018 – an expansion of our current psycho social programme to include younger children and a new pilot with Sheffield MENCAP and Gateway which we’d love to tell you about.

Since SHINE started 15 years ago the profile of our recruits has changed significantly. Originally referrals to us were mainly low level obesity. Few of the young people we worked with had illness-related excess weight. Today ALL our referrals have severe obesity and 22% are morbidly obese with severe co-morbidities – such as type 2 diabetes, fatty liver and high blood pressure. We’re actually now seeing children as young as six years with these conditions.

The number of children with learning disabilities referred to us has also increased. Every child is different but children with learning disabilities in particular can exhibit sensory eating difficulties where specific colours, textures and smells can prevent them from eating nutritional food, for instance. Although there’s overlaps with our psychosocial programme’s approach there’s also lots of specialist work needed to provide a service for these special young people.

SHINE needs to change to make sure we continue to help children with complex needs appropriately. The new funding from Children In Need enables us to expand our services to include younger children with severe levels of obesity. We’re hoping this will provide early intervention to help reduce the number of referrals for older children with severe and co-morbid conditions.

Excitingly the funding has also offered us the opportunity to develop a pilot project with Sheffield MENCAP & Gateway to adapt SHINE to meet the specific needs of children with learning disabilities. We’re currently training four learning disability staff to deliver an adapted SHINE programme.  Right now they’re gaining insight from families of children with learning disabilties, finding out what will and won’t work for this specialist client group.

We’re accepting referrals for this new programme now. Fill in the referral form here or contact us for more information.

Sign SHINE’s petition to fund obesity services for UK children and young people

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A third of children in the UK are overweight or obese; for those with severe weight problems this can greatly impact on their life.  Children with weight issues have high risk of type 2 diabetes, fatty liver and high blood pressure and are more likely to have low self esteem, depression and be vulnerable to bullying.

SHINE has been providing services for children and young people with severe levels of obesity for the past 14 years and have been dependant on Grant funding to enable us to provide a range of interventions including psychosocial intervention courses (PSIs) and a much needed counselling service, for children with emotional issues that leads to further weight gain. As funding becomes more difficult SHINE have been working closely with local MP Paul Blomfield to get Tier 3 services recognised at government level in order for them to provide clearer guidance on commissioning and appropriate funding to provide much needed services for these vulnerable young people not just locally but on a national basis.

At present specialist services for severely overweight children is only provided in 7% of Local Authorities throughout the UK.  We are urging the Government to provide adequate funding so that more specialist services can be offered for obese children with complex needs. We need them to invest in the treatment services that are urgently needed to improve quality of life.

Please support our e-petition:

We need 100,000 support signatures to get this issue debated in parliament – please give us your support.

Sign the petition here (link)!

You can stop SHINE from closing

By | People, Results | No Comments

From MPs to NHS Clinical Directors, the great and the good all agree that SHINE’s approach to Tier 3 obesity makes a significant difference to the lives and health of at risk children and young people. But as it stands SHINE Health Academy’s positive impact could end in December. That’s when our current funding ends as it stands.

The problem with funding our work is that no-one at local or government level appears to recognise or accept financial responsibility for Tier 3 work with children who have a BMI of over 99.6 centile. There is a false belief that there is no demand for such services and that children do not require this level of input. But the 200 families SHINE works with every year would suggest otherwise.

This year SHINE has seen more families than at any time in our history. We’ve a backlog of young people wanting our services – and hospital admissions for obesity related illnesses in children are rising…

Three years ago we were successful with our Children in Need bid and avoided closure. If we do not receive future funding health professionals will no longer have access to our consultancy service, other providers who don’t fit the criteria for access to Tier 2 services will be unable to refer more vulnerable obese children to us, parents will lose a pivotal support network – and most importantly young people will become lost in a system that does not fully understand the complex journey of a morbidly obese child.

If you’re going to be affected by our potential closure, please let us know by emailing. Your voice might just save us.

What’s the one thing parents really hate?

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We’re coming to the end of our first year of research at Wybourn and Manor Lodge Primary Schools in collaboration with researchers at Leeds Beckett University.

So what are the key things we’ve learnt? Building trust with families takes a lot of TIME and parents really do seem to value honest feedback. It also turns out nutrition sessions are NOT a parent favourite. Having your knowledge tested is often useful but its also rarely the most comforting experience and the parents taking part in our research highlighted the worry that their eating behaviours will be judged. So we’ve looked for opportunities to adjust our approaches. That’s meant providing monthly physical activity sessions for families to enjoy spending active time together (which they love!) and using the mobile, friendly space of the SHINE Health Bus to discuss health assessment results.

Our parents have also prompted the development of new feedback tools too. Last year’s assessments coincided with the NHS’s National Child Measurement Programme in Reception and a very clear message from parents was that they did not like the feedback letter they received from them. So we’ve designed a simple sheet outlining age specific norm ranges of Body Mass Index (BMI), body fat percentage and waist circumference. Parents can then use these simple grids to compare the results of their child’s assessments. The great thing about this is that it enables parents to make their own judgements based on their own comparisons, rather than some well meaning professional who thinks they know best. We’ve had a great response to this in schools.

More results are coming in September and we’ll have further updates in our next newsletter so watch this space!

How to change a parent’s mind

By | Evidence based practice, Parents | No Comments

It might be shocking to discover that one in five children enter school obese when measured in Reception Year and that one in three children are obese when they leave in Year six but the really shocking thing is how little anyone knows about the factors contributing to these significant gains…

We’re partnering with Leeds Beckett University and two Sheffield schools on a seven year study to find out more. But six months in, one of our biggest challenges is getting parents involved in education around health and well being. Our first attempt to provide monthly nutritional sessions was not a success – just four out of 100 sets of parents attended. Time to try a different tack!

Although the sessions were designed to be interactive and fun it seemed like nutrition wasn’t an attractive theme. Wybourn School had another idea: switch from telling people what to do to helping them make a difference themselves. So our nutritional sessions become ‘activity mornings’ where parents could attend with their child and experience activities such as dance, play, aerobics and circuits.

The result was startling – from four in 100 we went to a quarter of our parents attending our first activity session. We hope these sessions will build up trust and confidence so that in July we can spend some time with parents to help understand what makes a difference and if there are any themes or patterns emerging.

We’re really excited and intrigued to find out more about this. Look out for a report in the next newsletter.

SHINE help Gok Wan break body confidence record

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SHINE work with presenter on campaign for body confidence classes in schools

We love Gok Wan here at SHINE. He’s a fun and cool TV presenter whose shows make a real difference to people’s self-confidence and body image. We’ve been lucky enough to work with him on previous projects including the documentary ‘Too Fat Too Young’ but his latest>Gok’s Teens – is his best yet.  How do we know?  We’re in it!

This summer, SHINE Managing Director Kath Sharman was one of ten specialist tutors invited to London to teach what was described as ‘the biggest body confidence class ever’. Over a hundred pupils from around the country were taught on London’s Westminster Green, the event filmed as part of  a campaign to get ‘Body Confidence’ added as a weekly lesson in the National Curriculum for secondary schools.
Afterwards Kath joined Gok and the ‘teens’ involved in the documentary (including SHINE members Kyle and Jake) in the Houses of Parliament where they met with MPs to discuss the campaign.  It was an exciting, challenging and emotional experience and one everyone involved will remember for a long time.

Gok’s Teens  airs in early 2012 as a three part series on Channel 4. We’ll be talking about it more when it launches.  Don’t miss it!