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A recent report by the Surgeon General cited obesity as a major concern among adults with mental retardation and underscored the need to prevent obesity and increase physical activity. (Satcher, 2001.) Body mass index-for-age is the recommended method of screening for overweight, as well as for risk of overweight in children 2-20 years. Conditions, such as trisomy 21, spina bifida, and cerebral palsy are commonly associated with reduced growth in length and/or stature compared to that of typically-developing children (Cloud, 1997; Scott, 1997; Ekvall, 1993). Weight gain of children with reduced linear growth may be similar to typically-growing children; this increases the potential for problems with overweight. Prevention and management of overweight in children with special health care needs is often a large component of the medical plan. Thus, detection of risk for overweight is critical, and the use of BMI-for-age can be very helpful.
Differences in bone size and fat and muscle distribution make the use of the reference data for many estimators of body composition inappropriate for many children with special health care needs. For example, BMI-for-age may not identify overweight in some children who are "overfat" because of decreased muscle mass. Since the body composition of a child with special health care needs may differ from that of the reference population, skinfold measurements, along with BMI-for-age, may provide additional critical information about a child's body composition. This information can be useful for monitoring changes in an individual's body composition and growth pattern.
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