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Including All Children: Health for Kids With Disabilities

Children with special needs are about twice as likely as other children to be overweight or obese often due to the related greater likelihood of being sedentary. Some conditions, such as cerebral palsy, increase the difficulty in eating thus leading to underweight but others, such as Down syndrome, may contribute to overeating and overweight or obesity. However, the general trend of obesity in children with disabilities is much greater than underweight.

Nearly 20% of all children and adolescents have a chronic condition or disability (National Center on Physical Activity and Disability), and the levels of participation in recreational or school sport, and physical activity programs are much lower than their non-disabled counterparts. It is therefore critical that all children with disabilities engage in healthy eating and regular, adequate physical activity. These children, as much or more, than other students must learn what about the steps to leading a healthy lifestyle, often within the context of the abilities and limitations of their respective conditions.

Unfortunately, children and youth with special needs are often overlooked or systematically excluded when school physical activities are planned and implemented. Usually, this is not due to intentional efforts to exclude or ignore. This exclusion, which significantly limits the experiences of these children, is more likely due to the lack of understanding of the abilities of the student(s) or/and fear of potential injury related to the limitations of various conditions suffered by students with disabilities.

Benefits of Physical Activity

The benefits of physical activity participation for students with special needs are the same as for other students. They include:

  • Improved physical fitness
  • Reduction of disease risk
  • Skill development
  • Socialization
  • Social-emotional well-being
  • Greater confidence
  • Decreased body fat
  • Greater attention

In addition, specific benefits to students with special needs may include:

  • Controlling the progress of chronic disease
  • Managing functional decline
  • Mediating the psychological and social impact of disability
  • Increasing independence
  • Facilitating life skill competencies
  • Improving overall inclusion in family/community life
  • Enhancing socialization

Barriers to Participation

  • The range and diversity of special needs requires a detailed review of student Individualized Educational Plans (IEPs) in planning each activity
  • Concern about risk and liability for injury to self or others (even though rates for injury in sports is similar for both disabled and non-disabled individuals)
  • The interests and perceived incompetence of the child
  • Lack of staff expertise
  • School waiver procedures
  • Lack of physician support
  • Lack of social support
  • Cost
  • Safety concerns
  • Need for special equipment or facilities

Special Needs Categories

Game On supports kids by creating healthier school environments. The following classification consolidates the 12 federally recognized categories of disabling conditions (IDEA Sec. 300.8) into five general categories based on consideration of the impact special needs may have on physical activity participation in Game On activities for both students with special needs and their peers. It is important to remember that each individual is unique and plans should be made based on specifically identified disabilities for each individual.

Medical: Includes asthma, diabetes, cancer, heart disease or other chronic illness

Possible Physical Activity Limitations: Students who have these conditions vary greatly in their physical fitness and general physical skills and in specific situations. They may tire easily; have low strength and endurance. Continuous vigorous activity is often not recommended. They may also have special dietary needs and take medications that must be monitored carefully.

Inclusion Tips: Medical disabilities do not preclude doing most skills but may limit the duration and intensity (time, distance or repetitions) of participation. These students may need frequent rests and they may wear heart rate monitors to measure the level of exercise intensity they experience. Their medications may require adjustments when they are to engage in moderate to vigorous physical activities. School attendance may be irregular in severe cases due to acute symptoms or medical treatment. However, including them in physical activity may help to improve attendance. It is important to keep these students connected to their peers so they are as involved as possible. Social networking can be very helpful in allowing communication between and among classmates and the student(s) who are unable to attend school fulltime.

Sensory – Communication: Blindness, deafness, speech problems, autism, traumatic brain injuries, ADHD

Possible Physical Activity Limitations: Students with sensory and communication-related disabilities run on a continuum from no physical mobility limitations to some coordination difficulties, physical mannerisms, or limited flexibility. The primary restriction for communication disabilities is limitations in the ability to gather information or provide feedback. Students cannot participate if they do not know what is expected and it may take longer to understand directions. Medication may affect energy levels or appetite.

Inclusion Tips: It may be helpful to identify supports for communicating through auditory and tactile means for blind students and to use cue cards and sign language for deaf students. Strategies such as repetition, demonstrations, and physical assistance may be needed to increase the ability to participate. These students may need additional time and limited directions at a time. Providing step-by-step opportunity to practice all the parts of a movement task will allow students with communication disabilities to learn what is required to be successful.

Social-psychological: Autism, self-management issues, low self-esteem, phobias

Possible Physical Activity Limitations: Students with these disabilities may have difficulties related to interactions with other students, fear certain activities or lack confidence in new situations. They may be unwilling or unable to try physical activities. They may compensate for what they believe is the inability to perform by acting out or not following rules or directions.

Inclusion Tips: Prepare the student by having one-on-one communication between the teacher and student about what is to occur. Offer the opportunity to pre-practice without the pressure of others watching, or understand that the larger group may help these students feel comfortable when participating in a group activity. Identify areas of strength and competence as starting places for greater integration into the group, and realize that possible leadership opportunities may help these students. These students may be particularly responsive to peer-helpers.

Mobility – balance – coordination: Cerebral palsy, paraplegia, spina bifida, dwarfism, use of wheelchairs and walkers

Possible Physical Activity Limitations: Mobility challenged students cannot move freely and safely in some physical activity situations. Their safety, as well as the safety of others, may be at risk. The safe use of walkers, crutches, and wheelchairs in crowded spaces and while others are moving requires creative planning. Accommodations are needed to allow more time and greater space for students using special equipment. Many of these students will have mobility goals in their IEP, such as unassisted transfer from chair to a walker, that lead to more independent activity.

Inclusion Tips: These students can often share their ways of adapting when they understand what is going to occur. Using activities that can be done with all participants seated may be helpful. These students can be more a part of activities if they have a peer-helper where the peer-helper can assist the disabled students with exercises to increase mobility.

Cognitive: Intellectual disability, Down syndrome, learning disabilities

Possible Physical Activity Limitations: These students have cognitive limitations and information processing problems that reduce their ability to follow directions or carry out activities that require complex decision-making. They may have short attention span and difficulty grasping the intent of activities or the multiple aspects of a game. Some cognitive learning disabilities that may have an impact on classroom activities will limit full physical activity participation.

Inclusion Tips: Providing careful directions and simplifying steps involved in activities can help students with cognitive limitations understand what is to be done in a particular activity. Limit requirements to 1-3 practiced in sequential order (for example, play kickball or whiffle ball with one base instead of three). Opportunities to practice the movements before engaging in large group play will prepare students to play a team role. Having a peer helper can also be a helpful strategy for supporting the participation of students with cognitive disabilities, as they can provide cues to help them make the necessary moves safely.

Check out the Five-Step Plan for promoting physical activity for students with special needs, and learn ways to adjust physical activities to include students with special needs.