The Other 60 Percent

A few districts lead the way in tracking body mass index

With more than a quarter of Colorado children overweight or obese, schools are increasingly being asked to do their part to reverse the trend. A small number of Colorado school districts have responded with an approach that they believe is one piece of the puzzle: measuring students’ Body Mass Index or BMI.scale

While 21 states require and several others recommend that school districts collect data on students’ BMI, Colorado is not one of them. The absence of a state mandate means that districts like Denver, Poudre and a handful of others, are in the minority when it comes to such efforts.

In a sense, they are both pioneers and guinea pigs, taking the plunge with a practice that can provide valuable data but at the same time highlights the tricky task of talking about weight.

Several influential health organizations, including the Institute of Medicine, recommend that schools measure BMI, which is one way to determine if students are overweight or obese. Besides helping track overall trends, the results can arm parents with valuable information they may not get otherwise, particularly if they lack access to routine health care.

In Colorado, Denver Public Schools leads the way when it comes to BMI measurement, which is calculated using a person’s height and weight.

Not only was the district an early adopter of the practice, launching its program in 2007, it’s one of the few districts that reaches such a large proportion of students. Last year, the district collected BMI data for more than three-quarters of its students.

“In general, school districts just don’t provide this level of service,” said Donna Shocks, manager of nursing and student health services for DPS. “They don’t have the capacity, and then there’s the cost.”

Overall, it appears there are fewer than 10 districts that make a concerted effort to collect the data on a regular basis at multiple schools. In addition to Denver and Poudre, these include Cherry Creek, Steamboat Springs, South Routt, Hayden and Canon City. Individual schools in various districts sometimes conduct BMI screenings as well.

Collecting BMI may seem like an additional burden when districts are strapped for cash and time, but advocates believe there are compelling reasons to keep an eye on the weight of their students. In part, it’s because students who are obese are at higher risk for health conditions that can negatively impact school performance, such as sleep apnea, asthma and depression. Also, collecting school- or district-level data can help administrators craft initiatives to address the problem.

Nicole Turner-Ravana, a former district wellness coordinator and now a nutrition coordinator in Poudre, said BMI data showed principals, “OK, we do have an issue,” and validated the need for school wellness efforts.

About 23-25 percent of students were overweight or obese, according to the district’s BMI results.

“It mirrored what the state of Colorado was seeing,” said Turner-Ravana. “Typically, the lower-income schools have higher rates.”

Keeping feathers unruffled

BMI screening may have ardent champions in the public health community, but even after a decade of use in some states, it raises a raft of thorny issues. It’s indicative in the language used by anyone charged with running a BMI program. Besides repeated references to “privacy” and “confidentiality,” you’ll hear worries about kids feeling targeted, singled out or bullied, and parents reacting angrily to unwanted news.

Weight status based on BMI
BMI at or above the 95th percentile
BMI at or above the 85th percentile and under the 95th percentile
Healthy weight
BMI at or above the 5th and under the 85th percentile
BMI under the 5th percentile

In Poudre, where BMI collection began at some schools in 2007, organizers saw the effort as a way to collect aggregate data and track trends rather than alert families about possible problems. In other words, the purpose was surveillance not screening.

Organizers didn’t want students to sense undue attention to their weight or become the victims of teasing. In fact, at some grade levels, the scale’s digital display screen was turned around so students couldn’t see the weight reading. If students asked what it was, school staff or volunteers would write it down on a slip of paper.

“We would never say it out loud. That was a really strict policy that we had,” said Jessica Hinterberg, former obesity prevention coordinator for CanDo, a local anti-obesity organization that worked with the district to collect BMI data.

Renee Porter, obesity nurse coordinator at Children’s Hospital Colorado, believes schools should inform parents about BMI results to help educate them about potential weight issues. She said many parents of children who are overweight or obese mistakenly believe their children are in a normal weight range.

“You lose some opportunities by not sending out that letter,” she said, citing a common notification method among states that have adopted universal BMI screenings for students.

While agreeing that such letters have to be delicately worded, Porter said states that have long measured BMI in schools, such as Massachusetts and Arkansas, have created versions that don’t offend. But Denver Public Schools administrators say sending home letters never played well.

“We ditched that pretty quick,” said Shocks.

DPS contacts parents if their children fall into the obese, overweight or underweight categories, but not if their children are in the healthy weight range. No matter how they worded the letters, parents assumed the district was calling their children fat, said Shocks. Now, school nurses try to set up face-to-face meetings to discuss the results. If that doesn’t work, they talk with them over the phone or at school events.

“We find that to be much more effective than sending letters,” said Shocks. “That was a hard lesson that we learned.”

The value of BMI screening

Porter believes school-based BMI screenings provide universal access to an important health indicator. And since all kids are being screened regardless of weight or size, there’s no stigma attached.

As for the prospect of a student being teased or bullied because of a BMI measurement, some advocates note that children who are obese are already being bullied because of their weight. The screening could prompt interventions that could improve their health and ultimately their social lives.

Porter said she has had many young patients with significant weight problems, but their primary care doctors never brought the issue up to parents.

So, whose responsibility is it to sound the alarm about a child’s potential weight problem? It can be a knotty question even for school health leaders.

“I would say it’s probably the parents’ role, but the reality is we work in an inner city school district,” said Shocks, adding that increasing access to good health is part of the district’s mission.

How it’s done

Typically, BMI data is either collected at the same time as state-mandated hearing and vision screenings or during fitness testing in physical education class. However they’re conducted, parents can usually opt their children out of the screenings if they choose.

Until this year, Poudre School District conducted BMI screenings in conjunction with hearing and vision screenings, but not at every school. Each year, up to 12 of the district’s 50 schools participated.

Starting next spring, the district will collect BMI data during physical education class as part of an overall fitness assessment called FitnessGram. The program, which costs around $600 the first year and $150 in subsequent years, also yields information on aerobic capacity, flexibility, endurance and muscle strength. The results are accessible to parents and students online via a private login.

“This program works with our Colorado state standards,” said Conrad Crist, the district’s P.E. curriculum facilitator and a high school p.e. teacher.  “It allows the district to see trends and guide curriculum, guide instruction.”

While FitnessGram will be used in fourth- to 12th-grade, only sixth- to 12th-graders will have the BMI measurements taken, said Crist. FitnessGram will send progress report e-mails to parents with suggestions if their children fall into the red “needs Improvement zone” instead of the green “healthy fitness zone.”

Poudre is not the only Colorado district to use FitnessGram. Next door in the Thompson School District, the health and wellness-focused B.F. Kitchen Elementary has been using the program since 2008. In addition to tracking school-level BMI data, FitnessGram reports are sent home with student report cards. In addition, 13 schools in Cherry Creek use FitnessGram thanks to grant funding from the Denver Broncos.

In Denver, BMI was added to the hearing and vision screening process six years ago in response to the rise in childhood obesity. Now, there is one BMI specialist on all four district screening teams. DPS spends about $100,000 a year to pay the four BMI screeners.

Last year, the district collected BMI data on about 66,000 of its 84,000 students, including children in kindergarten through third grade, fifth-graders, seventh-graders, ninth-graders, preschoolers, special education students and those new to the district.

“Without those mandated screenings, I don’t know if I would have taken the plunge,” said Shocks.

Frequently asked

There are lots of ways schools teach English learners. Here’s how it works.

PHOTO: Andy Cross/The Denver Post
Lindsey Erisman works with 6-year-old students in an English Language Acquisition class at Denver's Cole Arts & Science Academy.

School district officials in Westminster this year signed an agreement with federal officials to change how they educate students who are learning English as a second language.

Similar agreements have also shaped how districts in Denver, Aurora, Adams 14, and Adams 12 educate their English language learner students. But many people, including parents and district insiders, may still have questions about the various complicated programs and requirements.

Although many of the language-education agreements are years old, most of the issues haven’t been resolved. In Adams 14, for instance, parents and advocates have protested a district decision to stop biliteracy programming, and have questioned the district’s compliance with its agreement to better serve English learners. District officials have pointed out that their obligation is teaching students English, not making them bilingual.

Now at least one charter school, KIPP, is looking to fill in that programming gap. Many other states have had a number of biliteracy and other bilingual programs at various schools for years, but Colorado has only more recently started to follow those trends.

So what’s the difference between the various language programs and services? And what is required by law and what isn’t? The following questions and answers might help clarify some of those questions as you follow the news around these issues.

Which students are designated as English language learners? Do parents get to decide, or do schools decide?

Federal guidance requires school districts have some way to identify English learners. Most commonly, districts survey all parents at school registration about their home language and the student’s first language. If that survey finds there might be an influence of another language at home, the student must be assessed to determine fluency in English. While the district has to identify all students who aren’t fluent in English as language learners, parents in Colorado can choose to waive the federally required services for their children. If so, the district doesn’t have to provide special services, but would still be required to monitor that the student is making progress toward acquiring English.

What educational rights do English language learners have?

English language learners have specific rights under the Lau v. Nichols Supreme Court case from 1974 and the subsequent Castañeda standards released in 1981. State laws also outline some requirements for school districts. Specifically, school districts must provide programs for all identified language learners to give them the opportunity to learn English and to access a comprehensive curriculum. The government does not state what that program should be, but provides some standards requiring that any program is theoretically sound and has a research base to support it. The program has to have qualified teachers, and a way to demonstrate that students are making progress in learning English and their academic content. While the civil rights officials consider many details to verify compliance, simply put, school districts have the legal obligation to identify students, serve them in a sound program, and monitor their progress.

What is the difference between bilingual education and “ELL services?”

Bilingual education (which is the program that has the most support for efficacy from the research community) offers students opportunities to learn in their native language while they are learning English. Bilingual programs can vary from short-term, or early-exit programs, to more longer-term developmental programs.

English language learner services do not need to provide opportunities for students to learn in the native language. Most commonly these services only offer English language development classes (generally 45 minutes per day). All other content instruction is offered only in English. ELL services are not bilingual.

What is English language development?

English language development must be a part of any program or model a district or school adopts. It is the class time when students are taught the English language. The government wants to see that English learners are given a dedicated time to learn English, when they are not competing with native English speakers. That means, often, English language development is offered as a time when students are pulled out of class to practice English, or as a special elective period students must take without their English-speaking peers.

The structure of this time period, who has access to it, or who teaches it, are areas commonly cited as problems by the federal Department of Education’s Office for Civil Rights.

Do students who are identified as English language learners retain that designation forever? What does it mean to be an “exited ELL?”

They’re not supposed to. Students who are English learners should be tested at least once a year to determine their English proficiency. When a student reaches a high enough level, school staff must determine if the student is now fluent in English. If so, the student becomes an “exited ELL.” The law requires districts to monitor for two years students who have exited and are no longer receiving services. There are, however, students who do not reach English fluency before graduating or leaving school.

What is the difference between being bilingual and being biliterate?

Bilingual generally refers to oral language in that bilingual people can understand and speak two languages but may not be able to read and write in those languages. Biliterate refers to being able to understand, speak, read, and write in two languages. Many people are bilingual but not biliterate. Biliteracy is considered to be a higher form of bilingualism.

What is the difference between dual language and biliteracy models?

Dual language and biliteracy models share many common components. Both models usually have biliteracy as their end goal for students. Dual language models may be “one-way” or “two-way.” One-way programs generally serve students who are designated as English language learners (also sometimes called emerging bilinguals). Two-way dual language programs include students who are native English speakers. The only major difference is that biliteracy models focus on using two languages in the language arts or literacy classes (reading and writing in two languages) whereas dual language focuses on using two languages across the entire school day’s curriculum.

What is an immersion model?

Immersion models traditionally are thought of as referring to programs primarily intended for students from the dominant language population to learn a second language. This is different from programs meant to teach English.

While native English students can choose whether or not to learn a second language, students who are English language learners do not have a choice in learning English.

What is sheltered instruction?

This type of instruction takes place in non-dual language schools, during regular content classes (such as math or science), and it’s one way schools try to make the content understandable to students who aren’t yet fluent in English.

This is especially common in schools where English learners speak a variety of languages. Crawford Elementary in Aurora, for instance, has had up to 35 different languages represented among its approximately 560 students. If there aren’t enough students who speak a common first language and also a teacher who speaks the same language as those students, then schools must teach through English, while making the English as accessible as possible.

In practice, this means an English-speaking teacher would use sheltered instruction techniques to help all children understand the lessons such as, physical props, a focus on building vocabulary, and sentence stems.

Denver designates schools as TNLI schools. What does that mean?

Denver created the TNLI label in 1999 to set the district apart from other bilingual program models. TNLI stands for Transitional Native Language Instruction. The Denver TNLI program is a transitional bilingual education program model with a label created just for Denver. It’s a model where instruction in Spanish is used to help students learn while they’re acquiring English, but still has a goal of making students fluent in English as soon as possible, at which point students move into mainstream English classrooms.

Is one of these models best suited for English learners?

Among researchers, it is commonly accepted that dual language or biliteracy models are the most effective to put English learners on par with their native speaking peers, in the long run.

Why do teachers have to be trained specifically to teach this population of students? What are teachers learning?

Educators and researchers say that teachers need to learn the differences and similarities between learning in one language and learning bilingually. Teachers need to learn about literacy methodology and how teaching literacy in Spanish (for example) is the same and different as teaching literacy in English. They have to learn how to teach English language development to students who are beginning to learn English (it is different than just teaching in English). These trainings also help teachers learn about cultural similarities and differences and about sources of culture conflict. Teachers need to be able to teach children English; how to use English to learn; and how the English language works. In bilingual settings teachers need to learn those three things for two languages. In short, the training needed to be a bilingual teacher is quite different. Colorado will soon require some of this training for all teachers.

What are the challenges districts have in offering these different programs? How do schools decide which type of model to offer?

The demographics of a district’s student population, and district politics play a large part in helping a district decide what model or program to use. Resources can also be a factor in deciding how to structure services or what programs to offer. In Adams 14, when the district leadership decided to pause the roll out of a biliteracy program, the district cited a lack of qualified bilingual teachers, among other things.

In Westminster, the school district’s unique competency-based approach, which removes grade levels and seeks to personalize instruction, was cited as a reason why the district had structured its English language development the way it had before the investigation by the Office for Civil Rights sought to change it.

Does Colorado provide guidance or oversight for how districts are doing this work?

The Colorado Department of Education offers some guidance for districts, but oversight of the districts’ compliance with what is required is limited. In practice, when parents suspect their children aren’t educated well, they have filed complaints with the federal government. In Denver, the complaints went through the Department of Justice. Investigations of most other metro-area districts have been conducted by the Department of Education’s Office for Civil Rights.

task force

Jeffco takes collaborative approach as it considers later school start times

File photo of Wheat Ridge High School students. (Photo by Nic Garcia/Chalkbeat)

The Jeffco school district is weighing pushing back start times at its middle and high schools, and the community task force set up to offer recommendations is asking for public input.

Nearby school districts, such as those in Cherry Creek and Greeley, have rolled out later start times, and Jeffco — the second largest school district in Colorado — in December announced its decision to study the issue.

Thompson and Brighton’s 27J school districts are pushing back start times at their secondary schools this fall.

The 50-person Jeffco task force has until January to present their recommendations to the district.

Supporters of the idea to start the school day later cite research showing that teenagers benefit from sleeping in and often do better in school as a result.

Jeffco is considering changing start times after parents and community members began pressing superintendent Jason Glass to look at the issue. Middle and high schools in the Jeffco district currently start at around 7:30 a.m.

The task force is inviting community members to offer their feedback this summer on the group’s website, its Facebook page, or the district’s form, and to come to its meetings in the fall.

Katie Winner, a Jeffco parent of two and one of three chairs of the start times task force, said she’s excited about how collaborative the work is this year.

“It’s a little shocking,” Winner said. “It’s really hard to convey to people that Jeffco schools wants your feedback. But I can say [definitively], I don’t believe this is a waste of time.”

The task force is currently split into three committees focusing on reviewing research on school start times, considering outcomes in other districts that have changed start times, and gathering community input. The group as a whole will also consider how schedule changes could affect transportation, sports and other after school activities, student employment, and district budgets.

Members of the task force are not appointed by the district, as has been typical in district decision-making in years past. Instead, as a way to try to generate the most community engagement, everyone who expressed interest was accepted into the group. Meetings are open to the public, and people can still join the task force.

“These groups are short-term work groups, not school board advisory committees. They are targeting some current issues that our families are interested in,” said Diana Wilson, the district’s chief communications officer. “Since the topics likely have a broad range of perspectives, gathering people that (hopefully) represent those perspectives to look at options seems like a good way to find some solutions or ideas for positive/constructive changes.”

How such a large group will reach a consensus remains to be seen. Winner knows the prospect could appear daunting, but “it’s actually a challenge to the group to say: be inclusive.”

For now the group is seeking recommendations that won’t require the district to spend more money. But Winner said the group will keep a close eye on potential tax measures that could give the district new funds after November. If some measure were to pass, it could give the group more flexibility in its recommendations.