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CAE the journey continues

OET Practice Reading Test Part A: -Childhood Obesity

Read the four texts and then complete the summary task at the end by filling in
the missing words: Write your answers in the answer column on the right hand
side. Each answer may require one word or a phrase.

TURN OVER

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Copyright CAE 2010 1

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TEXT 1
'When does severe childhood obesity become a child
protection issue?

Shirley M Alexander, Louise A Baur, Roger Magnusson and Bernadette Tobin

MJA 2009; 190 (3): 136-139

Abstract
• Severe childhood obesity and its associated comorbidities are
increasing in prevalence.

• Extreme childhood obesity may be viewed as a mirror image

of severe non-organic failure to thrive. Parental neglect may be a
causative factor in both circumstances.

• When suspicion of parental neglect arises, health care

professionals may have both an ethical obligation and a statutory
duty to notify child protection services.

• Guidelines on the point at which medical practitioners should

seek state assistance in cases of severe childhood obesity would
be helpful, not only for medical practitioners, but also for child
protection sentices.

Severe childhood obesity is a common problem, also often multifactorial in

origin, and may result in both acute and chronic life-threatening
complications. In extreme cases of severe obesity, where parents seem
unable or unwilling to adhere to management programs aimed at weight
loss for their affected child, the question arises: Is this a form of medical
neglect? Should child protection services be notified?

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 (;~
TEXT2

Case

At the age of 4 years, Jade* was referred to child Weight Management Services.
She was 110 em tall, weighed 40 kg, and had a body mass index (BMI) of 33
kg/m2 (1 OOth percentile for age; BMI z score, 4.05). She had acanthosis nigricans,
hyperinsulinaemia, fatty liver identified on ultrasound, and abnormal sleep study
results indicative of moderate obstructive sleep apnoea.

Jade came from a family with a strong history of obesity and obesity-related
disorders. Her mother had a history of gestational diabetes and postnatal
depression, and her father had a history of abuse as a child. Jade's parents were
separated and a social worker was already supporting the family. Jade led a very
sedentary lifestyle, watching television up to 6 hours a day, and there were issues
about food, with Jade having temper tantrums if not allowed whatever she wanted
to eat.

A family-focused multidisciplinary approach was taken, involving both parents

with input from a clinical nurse consultant, dietitian, physiotherapist, clinical
psychologist and paediatrician. The family found it very difficult to keep
appointments and adhere to lifestyle changes, and Jade's mother felt unsupported
by her ex-partner who continued to allow Jade to snack on high-energy foods and
watch television. Jade's weight steadily increased.

Twenty months after initial referral, Jade, now hypertensive with symptoms of
marked~obstructive sleep apnoea, was referred to the hospital's Department of
Psychological Medicine, for assessment of her progressively violent behaviour,
and Child Protection Unit, because of concerns about her persistent weight gain.
Subsequently, because all these interventions had not led to any significant
improvement in Jade's condition, the relevant state child protection authorities
were notified. Notification led to hospital admission, during which Jade
underwent an adenotonsillectomy. With the institution of simple weight-
management interventions of reduced dietary intake and a daily program of
physical activity, Jade lost 3 kg in 2 weeks. Community-based support was
established, visits to the father were supervised, and Jade continued to lose weight
as an outpatient. At her most recent clinic visit, Jade had reduced a dress size, and
her mother now feels much more confident in making healthy food and lifestyle
choices.

Copyright CAE 2010 3

 * Patient and case details are an amalgamation of those from several different
patients to protect patient confidentiality.

Copyright CAE 2010 4

TEXT 3 ·
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At the Frontline -Letter

Using child health checks to assess the prevalence of

overweight and obesity among urban l.ndigenous ~---~.:.:;::._-:?-

children

Annie R Fonda, Geoffrey K Spurling, Deborah A Askew, PeterS

W Davies and Noel E Hayman
MJA 201 0; 192 (1 0): 596

To THE EDITOR: Childhood obesity is a growing concern, with an

estimated 2:2% of Australian children considered to be overweight or
obese.1 Overweight and obese Indigenous children are at high risk of
developing chronic conditions such as ischaemic heart disease and
type 2 diabetes,~ contributing to increased mortality.~

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TEXT4

'Neight categories of chi.ldren from the lnala Indigenous Health Service

:study and the Healthy l<ids Queensland Survey

80% D loala lndigenc•us

70% Heal.ih Ser.r1ce, 2008
(n=50)
=
w 6QDI;()
""'
'= El Healthy Kids
:.<= 50%
0""' OuetJns1and Surv&y, 2006
= 40%
0· {n=3561 :1
~
6..
30D,'~~
2
~ •")(101
(., •'0

10~10

0
Under~wlight Healthy we:ight Oveweight Obese

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 z_,.
Summary Answers .v~
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An estimated 1 . of 1. ( .. '/ '
--
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Australian children are considered to be ··,
either overweight or 2. 2. ',
-- '/
Overweight and obese I

3. children are 3. lv ·, ! (\
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particularly at risk of developing life-

threatening conditions

The combined results of two studies show

-----------------·--- ..

disparities between the

4. 4. \. '· \. t l,! '· (_ .•. £.\ I,. ·.~ : ; ~# (~
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of indigenous and non-indigenous .. I

5. in 5. I
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6. . While the 6.
proportion of 7. I
L\o•r ...
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7. children was found
( '). \ '
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.· .
) l . to be roughly the same, around .~5'cl[o more
•- ~ !, e \ \( ,•'

\ l •, l non-indigenous children were assessed as \

being of a 8. weight. 8. \ ~
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While slightly more non-indigenous

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children were found to be 9. ( l' ( ' ~ • ( .. t. ~
/

9. , a much --
10. \\,,·l_.r .. I .. , ' < ,~ I,~rt- c·t~
10. of 11. 11. .;_] ) 'I' ...
I ' i ',, ' . ' ' ,__:__,.___
children were
- 12.
found to be 12. t' ~ \'I" \
--

I The case of one 13. f ....... I

\,"' 13. .I'' ;
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--
,
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child illustrates the dangers of

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I

14. obesity. When first 14.

--
examined, she weighed 15. 15. '. / ,• /, /j J

--
and was found to be suffering from multiple
health problems, including
16. and 16. .. ' \ ~ I:) • ' ~ ' I /\. \./-r). /:, ··~· .' //
~_;___;_

17. . There_was 17. ' ; ' /' ' ' ,.,. ':cf~
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a strong 18. of 18. .... /' .
"'I,:-·,/·
.

19.
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and 19. ·' -~

20. . Jade 20. ,.

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,/•"

{' (/1
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r...-_:_~1; ' cf< .•
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watched far too much
-
i
21. and H did almost/no
--- . ___ . ______ ..~,._" 21
22. . er --
22. .. j,·
•·

'

Copyright CAE 2010 7

 23. was very poor. 23. --
Over the next 20 months, Jade became
increasing 24. and she 24.
was eventually referred to both a hospital
25. department and to 25. ·'
~-
( \, the 26. . She was 26.
eventually hospitalised and underwent an 27. ' '
'
,{'
27. . She
was then placed on a 28. / ./
,.

r''"- 28. and started on a 29 29.

program. Jade has 30.
continued to lose 30. as a
result.

Severe childhood obesity is

31. in origin. 31.
32. may be a --
32.
causative factor. Healthcare professionals
may have both an
33. and a 33. / '
34. to notify child
34. i
protection services if
35. , in the form of
35. i
failure to follow weight management
programs for their children, is suspected.
-------

THAT IS THE END OF THE READING TEST

TOTAL SCORE: /35

Copyright CAE 2010 8