# Presentation: 362139

## Myths and Realities

**Dayle Hayes, MS, RD**
**Nutrition Consultant**
**Billings, Montana **
**EatWellMT@aol.com**

## To shape the eating habits and physical activity patterns of WIC families in ways that promote  healthy weights and reduce the risk of chronic diseases.

## MYTH #1:

**You have to “diet” to lose weight and get in shape.**

## REALITY:

** ****DELICIOUS**** ****NUTRITION****              helps your whole family enjoy good health.**** **

## MYTH #2:

**Nutrition is really complicated and expensive.**

## REALITY:

** ****EATING WELL****             is as simple as choosing             more brightly colored foods.**** **

## MYTH #3:

**Good nutrition and weight loss comes in a pill.**

## REALITY:

** ****WHOLE FOODS****             have the nutrition power that our bodies crave.**** **

## MYTH #4:

**You have to exercise to lose weight and get in shape.**

## REALITY:

**FUN ACTIVITY       **** can help every body move toward a healthy weight.**** **

## MYTH #5:

**You a need gym or fancy equipment to physical activity.**

## REALITY:

**MOVING MORE**** ****        is as simple as putting one foot in front of the other.**** **

## MYTH #6:

**Getting fit is nearly impossible in our busy lives.**

## REALITY:

**You can fit your **** ****FITNESS****                    ****into every day –anytime, anywhere. **

## MYTH #7:

**A pregnant woman has to make a decision to breast feed OR to bottle feed.**

**OR**

## REALITY:

**New moms can choose a ****COMBINATION****            of breast and bottle feeding.**** **

## MYTH #8:

**It’s very hard to keep kids from watching too much TV.**

## REALITY:

**SETTING LIMITS****            like on TV time – is a very important parental job.**** **

## MYTH #9:

**At WIC, we only have 15 minutes to do nutrition ed.**

## REALITY:

**15 minutes of  ****PERSUASION****            can make a big difference.**** **

## MYTH #10:

**If we give people enough facts, they will change.**

## REALITY:

**Using effective tools of ****INFLUENCE   ****    ****we can help**** **

## Keep your eye on the prize!

## Research Updates

**Susan L. Johnson, PhD**
**The Children’s Hospital of Denver UC Health Science Center,**
**Denver, Colorado**
**Susan.Johnson@uchsc.edu**

## Eating Uses all of our Senses

- Sight
- Smell
- Touching
- Hearing
- Tasting
- Balance
- Motor control
- Proprioception

- Frontal Lobe
**Smell**

- Parietal Lobe
**Touch**

- Temporal Lobes
**Hearing**

- Occipital
- Lobes
**Vision**

## Complementary Foods

- Sitting stably w/out help
- Extrusor reflex disappears
- Palmer grasp
- Pincer grasp
- Lateral tongue movement
- Gag reflex moves

## Innate Likes and DislikesSteiner, J (1977).  Taste and Development, Ed Wiffenbach, US Dept HEW

** ****We are born liking sweet**
** ****We are born disliking bitter and sour**

## Innate Likes and DislikesJ.A Mennella & G. Beauchamp (1991).  Pediatrics, 88, 737-44.

- Flavors from maternal diet are transferred to amniotic fluid
- Fetus swallows fluid by the 2nd trimester
- Flavors also present in breastmilk
- May ease transition to solid foods

## Breastfeeding may help prevent obesity

- Somewhat controversial
- Effects of environment and genetics may be as strong or stronger
- Duration of effects?
- Some report effects through adolescence
- Others say no effect after 5 y
- Strongest predictor of child weight is maternal weight
- Breast is definitely still _best_

## Look and Listen to the Messages

## Feeding behaviors and other motor development in healthy childrenCarruth and Skinner (2002).  J. Amer. Coll. Nutr. 

| Behavior | Mean Age
 (Months) | Age Range
(Months) |
| --- | --- | --- |
| Sitting unaided | 4.0 | 1-9 |
| Brings toy to mouth | 3.3 | 0.1-6.5 |
| Reaches for spoon | 5.5 | 2.5-9.5 |
| Feeds self cracker | 7.7 | 4-14 |
| Uses fingers to rake in food | 8.7 | 5-20 |
| Brings top lip down on spoon to remove food | 7.7 | 3.5-9.5 |
| Brings spoon to mouth | 14.4 | 9-20 |

## Do parents hear children’s messages?

- How can we help them listen?
- What are the consequences if parents delay introducing solid foods?
- What are the consequences if they start solids too early?

## The Tasks of Early Childhood

| Age | Stage |
| --- | --- |
| Infancy | Trust vs. Mistrust
Reliance on consistency and security |
| Toddler | Autonomy vs. Shame and Doubt
Sense that they are separate human beings.
“Look at ME!”   “NO!” |
| Early Childhood | Initiative vs. Guilt
Taking risks within safe environments.
“I will try.” |

- Erik Erikson’s Psychosocial Stages.  www.internetmediator.com/divres/pg72.cfm

## Experience and Food Preference

- Sullivan and Birch demonstrated that children come to prefer foods after they have a number of experiences with them
- It takes around 8-10 tries of a new food before children come to accept it
- We decided to repeat this study looking at some different foods

## Natural History of Trying New Foods

**Children learn about new foods by gradual experience**

## How do we support children and parents to try new foods?

- Offer many chances to try foods.
- Don’t force children to take a bite.
- Allow children to serve themselves.
- Avoid bribing or scolding children.
- Don’t be disappointed if they don’t like it right away.  Hang in there!  It changes.
- Encourage learning with all senses.

## A Word about Self-regulation

**Infants can self-regulate the “how much” of eating**
**Toddlers and young children must learn skills to learn to self-regulate their eating**
**Motor**
**Behavioral**
**Emotional**
**Cognitive**

## Self-regulation of Eating is Supported by the Feeding Relationship

- Self-regulation of Eating is Supported by the Feeding Relationship

- Parent knowledge
- Support of child’s development & mastery
- Dynamic exchange

## Slide 39

| Age | Parent Job | Child Abilities
(Normally developing) |
| --- | --- | --- |
| Infants
Birth – 9 mo | Attend to cues
Offer appropriate food
Feed child
Child centered routine | Knows hunger/ fullness |
| Toddlers
9 – 24 mo
 | Routines for eating
Variety and experience
Utensils & physical structure
Opportunities for mastery | Knows hunger/ fullness
Self-feeding begins
Verbal communication |
| Early childhood
2 – 5 y | Routines for eating
Variety and experience
Utensils 
Opportunities for mastery
Eating with child | Knows hunger/ fullness
Self-feed
Self-serve
Conversation |

## Beverages & Self-Regulation

**Beverages & Self-Regulation**

_**Issues & Concerns**_
***Inadequate vs. excess intakes***
** ****Calories (or lack of)**
** ****Nutrients (Ca, Fe, Pro)**
** ****GI function (diarrhea)**
** ****Appetite / Satiety **
***Grazing***** **
** ****Dental caries**
** ****Habits (grazing)**

**9 oz**

**6 oz**

**4 oz**

## Infant Cues

## Relationship btwn. formula concentration & rate of growth of normal infants Fomon, et al. Journal of Nutrition. 98(2):241-54, 1969 

- Varied formula concentration
- High and low concentrations
- Infants given the concentrated formula consumed less volume
- High and low groups had essentially equal caloric intake

## Children can self-regulate in response to juice drinks

- Children who are given juice drinks before the meal eat less at mealtime
- The nutrient density of their diets tends to decrease since juice drinks are low in vitamins and minerals

## It’s not a perfect system...it can get off track

## Adults can help put it back on track

- Focus on internal cues of hunger and fullness
- Make internal cues a regular part of eating
- Attend when children say they are hungry
- Listen when children say they are full

## Optimal Environments

- Healthy emotional mealtimes
- Trust children’s abilities
- Repeated experience
- Variety and modeling
- Physical setup
- Consistent mealtime routines
- Recognize hunger and fullness

**Success!**

## Help parents provide environments to support mastering 

**the moment!**

## Working with Overweight Children and their Families:                     Hard Lessons Learned

**Susan L. Johnson, PhD**
**The GoodLIFE Clinic**
**The Children’s Hospital of Denver**** Denver, Colorado**
**Susan.Johnson@uchsc.edu**

## Learning the Story

**Elicit**

**Provide**

## Essential Principle—Being all EARS

_**E**_**xpress empathy**
_**A**_**void argumentation**
_**R**_**oll with resistance**
_**S**_**upport self-efficacy**
_**Develop discrepancy**_**: where the client is vs. where they want to be**

## Tips for Learning the Story

**Ask about a typical day**
**Include major events of day**
**Waking**
**Eating**
**Daycare/preschool?**
**Activity **
**Sedentary pastimes**
**Bedtime**

## Communicating Concerns to Parents

**Communicating Concerns to Parents**

## Avoid assigning blame

- If a client feels that you are blaming them they will become more resistant to change
- Ask them for their views on why their child is “getting ahead of himself”

## Identify areas for change

**If possible, have the client identify what they would like to change**
**Nutrition**
**Activity**
**Make the changes small and achievable **
**Provide a method so that the client can keep track of what they are changing**

## Avoid asking for too much change

- Examine the barriers and the benefits to change
- Have the client determine how much they think they can do
- Be ready to accept no change—as this may open the door for future change

## What’s our job?

**Providing “nothing but the facts”**
**Letting the clients choose all, some or none**
**It is NOT your burden to GET the client to change**

## Creating a referral network

**Pediatric endocrinologists**
**Psychologists—family and pediatric**
**Social workers**
**Pulmonologists**

## Helping clients come back for more

**RESPECT**
**EMPOWER**
**VISION **

## The Feeding Relationship

**Jane Peacock, MS, RD**
**Family Health Bureau Chief, New Mexico Department of Health.**
**Albuquerque, New Mexico**
**janep@doh.state.nm.us**

## One way to prevent overweight is to establish and maintaining a positive feeding relationship from birth. 

## Leane W/A O-30 months

## Leane W/H 2-6 years

## Leane BMI

## Leane weight for age

## The early intervention: 

**Teach positive feeding ****from *****birth***

## OPTIMUM FEEDING: INFANTS

- Time care and feeding for quiet alert state
- Feed in response to baby’s cues

- Ellyn Satter’s *CHILD OF MINE*, Ch 4, Understanding your newborn; Ch 5, Breastfeeding your baby; Ch 6, Formula-feeding your baby

## Feed baby as much or little as she wants

*Feed baby as much or little as she wants*
*Accept baby’s own growth inclinations*
- Understand impact of temperamental differences on feeding

- Ellyn Satter’s *CHILD OF MINE*, Ch 4, Understanding your newborn; Ch 5, Breastfeeding your baby; Ch 6, Formula-feeding your baby

## © 2003 From ELLYN SATTER’S FEEDING IN PRIMARY CARE PREGNANCY THROUGH PRESCHOOL: Easy-to-read Reproducible Masters. In press.

## © 2003 From ELLYN SATTER’S FEEDING IN PRIMARY CARE PREGNANCY THROUGH PRESCHOOL: Easy-to-read Reproducible Masters. In press.

**© 2003 From *****ELLYN SATTER’S FEEDING IN PRIMARY CARE PREGNANCY THROUGH PRESCHOOL: Easy-to-read Reproducible Masters. *****In press.**

## Optimum stage-related feeding: Birth to preschool

**Optimum stage-related feeding: Birth to preschool**

## DIVISION OF RESPONSIBILITY INFANT

- Parent: What
- Child: How much

- Satter, E. *How to Get Your Kid to Eat...But Not Too Much*

## DIVISION OF RESPONSIBILITYTODDLER AND OLDER

- Parent: What, when, where
- Child: How much, whether

- Satter, E. *How to Get Your Kid to Eat...But Not **Too Much*

## FOR CHILDREN TO EAT WELL, ADULTS MUST FEED WELL

- Choose and prepare food
- Have regular meals and snacks
- Make eating time pleasant
- Provide mastery expectations
- Let children grow up to get bodies that are right for them

## FEEDING WELL MANDATES TRUSTING CHILDREN TO DO THEIR JOBS WITH EATING

- Children will eat
- They know how much to eat
- They will grow predictably
- They will eat a variety
- They will mature with eating

## DIVISION OF RESPONSIBILITY IS EVIDENCE-BASED

- Satter, Ellyn, *Child of Mine; Feeding with Love and Good Sense, *Bull Publishing 2000
- Supports food acceptance
- Appendix I (10 Ref)
- Supports food regulation
- Appendix J (16 Ref)
- Supports healthy growth
- Chapter 2 (17 Ref)

## Key question: 

- What is interfering?

## Leane W/A 0-36 months

- 9 months

## ASK FEEDING QUESTIONS

- How is feeding going?
- How do you feel about feeding?
- How do you feel about your child’s size and shape? Growth?
- Is there anything about feeding you would like to be different?

## CROSSING DIVISION OF RESPONSIBILITY: Food restriction scares children and makes them overeat when they can

***ELLYN SATTER’S FEEDING WITH LOVE AND GOOD SENSE Video and Teacher’s Guide   *****“Older Baby”**

## ACCEPT CHILD’S DRIVE TO “DO IT MYSELF” 

- Include child at family meals
- Choose “safe”  food to pick up, chew, swallow
- Give many chances to experiment, learn to like food
- Time snacks so child can be hungry, not *too *hungry, at meals
- Let child eat much or little

- Ellyn Satter’s *CHILD OF MINE*, Chapter 7, Feeding your older baby

## © 2003 From ELLYN SATTER’S FEEDING IN PRIMARY CARE PREGNANCY THROUGH PRESCHOOL: Easy-to-read Reproducible Masters. In press.

**© 2003 From *****ELLYN SATTER’S FEEDING IN PRIMARY CARE PREGNANCY THROUGH PRESCHOOL: Easy-to-read Reproducible Masters. *****In press.**

## 17 months

- Leane W/A 0-36 months

## LEANE 17 MO: ANSWERS TO FEEDING QUESTIONS

- She is sneaking food
- Leanne’s food demands are constant
- Limit at meals, no snacks
- They are worn out

## TODDLER: TEACH TO BE PART OF FAMILY

- Have family meals; scheduled snacks
- Not let the child graze
- Eat with the child
- Teach the child to behave at mealtimes
- Not short order cook
- Let the child experiment, eat much or little

- Ellyn Satter’s *CHILD OF MINE*, Chapter 8, Feeding your toddler

## PRIMARY INTERVENTION: Education and early problem-solving

- Teach stage-related feeding
- Teach about normal growth
- Intervene at the first sign of growth disruption
- Even if treatment is called for, keep the intervention primary

## LEVELS OF INTERVENTION WITH FEEDING

- Primary—Education, early problem-solving
- Secondary—Detailed evaluation and treatment
- Tertiary—Detailed evaluation and treatment of complex or entrenched problems with adjunct specialists, ie, physician, psychotherapist

## WIC’s job is to get children started right

## Emphasize Growth, not Weight

**Jane Peacock, MS, RD**
**Family Health Bureau Chief, New Mexico Department of Health.**
**Albuquerque, New Mexico**
**janep@doh.state.nm.us**

## Interfering with normal growth may precipitate weight gain. 

## Children are excellent regulators and tend to grow in accordance with their genetic endowment. 

## Weight for age 0-24 months

- Length for age

**CHILDREN TEND TO GROW PREDICTABLY**

## NORMAL GROWTH CAN BE CONSISTENTLY AT THE MEAN50th %TILE W/L

- Weight for Length

## NORMAL GROWTH CAN BE LOW AND SLOWLOW CONSISTENT W/L

- Weight for Length

## NORMAL GROWTH  CAN BE HIGH AND FAST—IF IT IS CONSISTENT

- Weight for height

- BMI

## BMI PLOTTINGS MAY DISTORT  PATTERNS

- High consistent W/H...

- ...inconsistent  on BMI curve

## EVIDENCE-BASED 

- Satter, Ellyn, *Child of Mine; *Chapter 2 —Your Child Knows How to Eat and Grow
- High or low consistent growth is normal
- A single growth point tells nothing

## Arbitrary growth cutoffs put pressure on feeding and distort growth.

## ERICA 10 MONTHS

- Food restriction

- Weight for length

## © 2003 From ELLYN SATTER’S FEEDING IN PRIMARY CARE PREGNANCY THROUGH PRESCHOOL: Easy-to-read Reproducible Masters. In press.

## ERICA

- Weight/height 2-3 years

## ERICA 5 YEARS

- Optimum feeding age three years

- Weight/height

## ERICA

- BMI

- Optimum feeding

**ERICA**

## PARENTS WHO CAN UTILIZE PRIMARY INTERVENTION

- Can self-evaluate
- Can accept the child's point of view
- Can set aside agendas
- Can change with advice, information

## EVIDENCE-BASED 

- Satter, Ellyn, *Child of Mine; *Chapter 2—Your Child Knows How to Eat and Grow
- Food restriction likely to  weight
- Parental self-restraint  child obesity risk

## INFORMING THE PARENT

- Child relatively large
- Certified for WIC on that basis
- Parents worry, try to  feeding
- We’ll help you feed well

## Slide 106

## Growth divergence may or may not be normal.

## SLOW DIVERGENCE OVER TIME IS LIKELY TO BE NORMAL

- Weight for Age 2-20 yr

## RAPID GROWTH DIVERGENCE MAY NOT BE  NORMAL

- Leane weight for age 0-36 mo

## RAPID GROWTH DIVERGENCE MAY BE NORMAL 

- Adele weight for length 0-18 months

## DIVERGENT WEIGHT IN WIC	

- Ask feeding questions
- Optimize feeding
- Do *not* limit food intake—even indirectly

## CHILDREN COME IN ALL SIZES

## The Principles of Influence

**Pam McCarthy, MS, RD**
**Change Agent **
**St. Paul, Minnesota**
**pammccarthy@attbi.com**

## Principle of Influence:  Be likable Actions that make you likable:  ·	Make your client feel good about herself

**·****	****Accept and like your clients**
**·****	****Make your client feel comfortable, welcome ****	****and relaxed**
**·****	****Talk about things you share in common**

## Principle of Influence:  Be likable  Actions that make you likable:  ·	Be positive.  

**·****	****Avoid words that have harsh or negative ****	****connotations.**
**·****	****Present situations as temporary.**

## Principle of Influence:  Give them something. Give them something — but use emotion. 

## Principle of Influence:  Give them “exclusive” information, tips and messages

## Principle of Influence:  Let them know what others are doing. 

## Formula for success:	Describe action.	Talk about the emotional benefits 	of taking that action.	Add a dash of facts or logic.	Tell them others are already 	doing it. 

## Principle of Influence:  The desire for consistency is a central motivator of behavior. 

## Ask questions like:

- 	**“****What will you do first?” **
- 	**“****When do you plan to start?”**
- 	**“****How do you think it will unfold?”**

## Try verbal confirmations like:

**·****	****“Are you willing to give (action) a try?”**
**·****	****“Can I count on you to give me feedback ****on (action) next time?”**
**·****	****“Will Annie get to try (action) this month?”**

## End the encounter on a high note.  

## TV Time:            Helping WIC Families Make Better Choices

**Carolyn Dunn, PhD.**
**NC Cooperative Extension Service**
**NC State University, **
**Raleigh, North Carolina**
**carolyndunn@ncsu.edu**

## TV Time...Helping WIC families make better choices

**TV Time...****Helping WIC families make better choices**

**Notes:**
TRANSITION FROM THE VIDEO PRIOR TO TALK – COMMENTS WILL BE WRITTEN WHEN I SEE THE VIDEO.

The issue of childhood overweight has been all over the news.

Everyone continues to ask the question WHY?

The answers are complicated and no one issue is to blame. However, one issue, TV viewing, can be held up as ONE of the causes. 

Today I would like to discuss how much TV we are watching, the effects that TV is having on our brains, our families and our bodies and also offer some solutions that you can use in your own life and in helping WIC families make better choices about their TV viewing. 

Before we get started I want to clarify when I say TV viewing or screen time what I mean. That means watching TV, videos, DVDs, playing video games, using the computer....screen time...not just TV. Also, the issue of violence in the media is an issue of grave concern, however, today I will focus only on the effects TV is having on children with respect to physical activity and healthy eating. 

## eleV

**TV is the #1 source of news and understanding about current events for the nation’s children.**

- eleV

- T

- ision

**Notes:**
Television is very pervasive in our society. 98% of all US homes have at least one TV. TV is the #1source of news and understanding about current events for the nation’s children. 

## You Know You May Be Watching Too Much TV When...

- The first thing you do when you enter the room is turn on the TV.
- You eat all your meals in front of the TV.
- There are as many TVs in your home as people.

**Notes:**
Television has become so much a part of our society and culture it’s sometimes difficult to estimate its hold on our everyday lives. Let’s take a look at one of the handouts you have entitled “You know you may be watching too much TV when.” This is meant to poke fun at our obsession with TV but at the same time help us realize just how much television we are actually watching.

You Know You May Be Watching Too Much TV When...
The first thing you do when you enter the room is turn on the TV.

You eat all your meals in front of the TV.

There are as many TVs in your home as people. Sometimes this number may be larger than the number of people. Look at the picture on this slide, the new craze is a TV or video devise in the car or van. These children each have their own viewing devise. You can see the crayons stuck in the pocket to the girl’s seat but they are no competition to a DVD!

## You Know You May Be Watching Too Much TV When...

- You’re watching a show you don’t like when you realize it’s a repeat and you didn’t like it the FIRST time either.
- You know the theme songs to all the shows in prime time.

## You Know You May Be Watching Too Much TV When...

- The number of shows you absolutely cannot miss is equal to or greater than the number of days in the week.
- The clerk at the video store knows you on a first name basis.

## You Know You May Be Watching Too Much TV When...

- Your cable goes out and you have the cable company on speed dial.
- The hall closet is dedicated not to coats and hats but to DVDs, videotapes and video games.

## You Know You May Be Watching Too Much TV When...

**Notes:**
...and the number one way to know you may be watching too much TV is when the last thing you do at night before closing your eyes is to turn off the TV.

## On average, children 2-11 watch 23 hours/week (teens 22 hours). This does not include videos and playing video games.
Average more than 4 hours/day.  

**On average, children 2-11 watch 23 hours/week (teens 22 hours). This does not include videos and playing video games.**
**Average more than 4 hours/day.  **

**Notes:**
Let’s look specifically at how much television American children are watching.

On average, children 2-11 watch 23 hours per week, teens watch about 22 hours, This does not include videos and playing video games.

Children average more than 4 hours per day.  

American children aged 2-17 spend up to 1/3 of their waking hours in front of the television.

20% of 9 year olds watch 6 hours per day!

## How Much?

**American children 2-17 spend up to 1/3 of their waking hours in front of the television.**
**20% of 9 year olds watch 6 hours per day!**

## 1984

**1984**

**1990**

**AAP suggested that TV has potential to increase violent behavior and may contribute to obesity. Cautions parents to limit the time watching TV and monitor viewing choices**.

**AAP reaches same conclusion about TV viewing in children and makes similar suggestions to parents.**

**Television Over The Years**

**Notes:**
Over the years the American Academy of Pediatrics has spoken out on television viewing. Way back to 1984 they were warning about the perils of too much TV.

In 1984, AAP suggested that TV has potential to increase violent behavior and may contribute to obesity. Cautions parents to limit the time watching TV and monitor viewing choices.

In 1990, they reached the same conclusion about TV viewing in children and make similar suggestions to parents.

In 1993, despite concerns from the AAP and others most children in the US spent more time watching TV than any other activity besides sleeping.

In 1998, children spent an average of 900 hours per year in school and an average of 1500 hours watching TV.

## 1993

**1993**

**1998**

**Most children in the US spend more time watching TV than any other activity besides sleeping.**

**Children spend an average of 900 hours per year in school and an average of 1500 hours watching TV (21-23 hours per week).**

**Television Over The Years**

## < 2 years old – none

**< 2 years old – none**
**> 2 years old – no more than 2 hours per day**

**Notes:**
Current recommendations from the American Academy of Pediatrics are well below what children are actually watching. For children under two years old they suggest no television or video viewing whatsoever. For children over two, they recommend no more than 2 hours per day. 

## TV viewing slows the brains alpha waves so you feel relaxed and passive – which explains why the longer you watch, the harder it is to stop.
The longer a child watches the more difficult they are to distract. 

***What TV Does To Our Brains...***

- TV viewing slows the brains alpha waves so you feel relaxed and passive – which explains why the longer you watch, the harder it is to stop.
- The longer a child watches the more difficult they are to distract.

**Notes:**
Now that we know how much we are viewing let’s look at what that is doing to our children, and to us as adults.

First let’s look at what it does to our BRAINS.

TV viewing slows the brains alpha waves so you feel relaxed and passive. This explains why the longer you watch the harder it is to stop. Vegging out in front of the TV is just that – you are so passive and relaxed it’s hard to think about stopping to do anything else.

Studies have shown that the longer a child watches the harder they are to distract and get their attention to begin some other activity. 

## TV viewing is negatively related to children’s academic achievement (less homework/reading).
Amount of time spent in front of the TV relates to how well children do on standardized tests.

***What TV Does To Our Brains...***

- TV viewing is negatively related to children’s academic achievement (less homework/reading).
- Amount of time spent in front of the TV relates to how well children do on standardized tests.

**Notes:**
Television viewing is negatively related to children's academic achievement. Children who watch more TV do less homework and less reading.

The amount of time spent in front of the TV relates to how well children do on standardized tests – with the children who view more doing poorer than children who view less.

Children’s reading skills are not developed or enhanced while watching TV.

Children who view too much TV and don’t interact with friends don’t learn the social skills they need for positive classroom interaction.

## Children’s reading skills are not developed while watching TV.

***What TV Does To Our Brains...***

- Children who don’t play with friends don’t learn the social skills needed for classroom interaction.

## What TV Does To Family Time...

***What TV Does To Family Time...***

**Notes:**
Television viewing also effects the family. If there are two sets – one for the adults and one for the children. It serves to split the family. But even if the family views together, it is not a time of family interaction and conversation. They just happen to be in the same room at the same time.

## What TV Does To Our Bodies...

***What TV Does To Our Bodies...***

**Overweight in children has almost doubled in the past decade.**

**Notes:**
That is what TV does to our brains and to our families but the real attention to TV viewing has been given to what TV does to our bodies.

Overweight in our children has reached epidemic proportions in the US. The number of overweigh children have almost doubled in the past decade. Inactivity is of course, one of the reasons. A large contributor to the inactivity of our children is the vast amount of television that is watched on a daily basis. 

## What TV Does To Our Bodies...

**Link between overweight ****in children ****and TV ****viewing.**

***What TV Does To Our Bodies...***

**Notes:**
Remember that the AAP back in 1984 spoke of the link between TV viewing and overweight. We know NOW that link is even stronger than ever. 

## What TV Does To Our Bodies...

**Stanford study – children who were involved in a one-year curriculum to decrease TV viewing gained significantly less body fat than control (did not suggest other activities just decrease video games, videos and TV viewing).**
** **

***What TV Does To Our Bodies...***

**Notes:**
A study at Johns Hopkins found that children who watched TV 4+ hours a day were significantly heavier than children who watched 2 or less.

Another study conducted at Stanford University engaged children in a year long curriculum geared to decrease TV viewing. These children gained significantly less body fat than controls. The interesting part of this study was that the curriculum did not suggest other activities to replace TV viewing but just that the children should watch less. The researchers indicated that any activity that the children chose besides screen time was more active than sitting in front of the TV. 

## Slide 144

**Notes:**
TV watching is replacing going outside, playing with friends, and imaginary play that used to be such a large part of childhood. The children of Family Circus are content to watch the nature channel instead of experiencing nature first hand by going out and playing. 

## Slide 145

**Notes:**
Again Family Circus shows us the typical afternoon of a school age child. While on his way home he dreams of all he will do. What happens instead is habit takes over and he plops in front of the TV for an afternoon of inactivity. 

## What Are Our Children Watching?

**What Are Our Children Watching?**

**90% of viewing by children is of programs that are not designed for children.**

**Notes:**
The fact that children are watching TV, videos, playing video games, etc. for so much of their day is one part of the issue. The other aspect of the issue is what are they watching.

While there are many quality programs on the air that are specifically for children, 90% of the viewing by children is of programs that are not designed for children. 

## What Are Our Children Watching?

**What Are Our Children Watching?**

**Children learn behavior by mimicking what’s on TV**

**Notes:**
We know that children learn behavior by mimicking what’s on TV. Think about the shows that are on TV. Are we exposing our children to positive role models on TV with respect to healthy eating and physical activity? Often physical activity and healthy eating are not portrayed in popular culture as cool or hip. How often do we see characters on TV eating healthy foods or engaging in physical activity?

## What Are Our Children Watching?

**What Are Our Children Watching?**

**24% increase between 1991 and 1998 of commercials and promotions aired by broadcast networks**

**Notes:**
There is a bombardment of commercials, especially those aimed at children. There has been a 24% increase between 1991 and 1998 of commercials and promotions aired by broadcast networks. Often younger children don’t know the difference between the show and the commercial. 

## we all eat more

***if they are successful... ***
**we all ****eat**** more**
**Advertisers for video/film industries **
** *****if the are successful...***
** ****we all ****buy**** more**
**Television industry**** **
***if they are successful...***
** ****we all ****watch**** more**

**Notes:**
We as adults need to keep in mind the Keep in mind the goals of advertisers and help our children see what the advertisers want. .  

If the food producers and the fast food industry are successful in their advertising...we eat more

If the video and film are successful in their advertising...we all buy more

If the television industry is successful in their advertising...we all watch more

Let’s look at some images that are used in advertising to illustrate just how successful advertisers are at getting us to remember their products. I am going to show you part of some familiar images. You tell me what company they represent. 

## 1

**Simple Solutions To Turn **
**            ****Off The  **

**Get The TV Out Of The Bedroom **

**Notes:**
#1 – get the TV out of the bedroom 1/3 of 2-7 year olds and 23 of 8-18 year olds have a TV in their bedroom. We saw the effect it had on Dillon – get the TV out and encourage parents to never allow TV in the bedroom.

## 2

**Simple Solutions To Turn **
**            ****Off The  **

**Agree On A Media Budget**

**Notes:**
Agree on a media budget. How much TV, video watching, video games and computer use for fun is allowed? Let children have some input into the decision.

## 3

**Simple Solutions To Turn **
**            ****Off The  **

**Set Clear Limits**

**Notes:**
Set clear limits and stick to them. For example, no TV on school nights, no TV after 7pm, etc. Keep the limits – don’t waiver. Be a good media role model and set limits for the adults in the house as well. 

## 4

**Simple Solutions To Turn **
**            ****Off The  **

**Make lists of things you want to do – involve children in talking about other things they can do.**

**Notes:**
Make a list of things you want to do instead of watching TV. Involve the children – come up with things you can do in different seasons or some things that could become a family ritual such as walking after dinner twice a week.

## 5

**Simple Solutions To Turn **
**            ****Off The  **

**Don’t keep the TV on all the time – tune into specific shows**

**Notes:**
This is a big one. I guarantee if you try this it will make a huge difference. Don’t keep the TV on all the time! If you have a media budget and have clear limits, you will know when you are going to be watching TV and what you are going to watch. Turn the TV on during that show then turn it OFF!

## 6

**Simple Solutions To Turn **
**            ****Off The  **

**Don’t watch TV during meals.**

**Notes:**
Don’t watch TV during meals. Meals should be a time for family interaction not silence while you watch a show.

## 7

**Simple Solutions To Turn **
**            ****Off The  **

**Watch with children**

**Notes:**
Very important. When the children do watch – watch with them. Talk with them about the characters they see on TV as well as the advertising they see on TV.

## TV Time...Helping WIC families make better choices

**Notes:**
Transition to the video segment: Comments will be something like.

A few minutes ago we saw a video clip of how one family deals with television. We saw the children miss opportunities to do other activities because TV is such a huge part of their life. We also observed a family with little or no rules about TV viewing. NOW let’s look at a family that has established some TV limits.