1. Chapter 34 Physical Activity, Exercise, and Sports
Overview
Benefits of exercise for the child with developmental disabilities
Laws regarding inclusion in physical education and community programs
How to incorporate physical education adaptations into a child’s IEP based on abilities
Community sports and recreation programs available to children with special needs
Preparticipation evaluation
Types of injuries encountered in athletes with disabilities
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

2. Introduction
Physical activity is especially important for children with developmental disabilities because of greater risk for inactivity
Benefits: general and cardiovascular health, weight management, development of strong muscles, psychological health
Centers for Disease Control and Prevention (2010) recommends 60 minutes a day, three times per week
Research suggests many students are not getting enough exercise
Greater opportunities for participation and improved understanding of effective strategies needed
See the textbook Children with Disabilities, Seventh Edition, for full citation and reference information.
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

3. Health Risks Related to a Lack of Physical Activity
Community access and barriers
Less opportunity for in- and after-school exercise
Inaccessible facilities and playgrounds
Attitudes of coaches, physical education instructors, teachers—including emphasis on winning
Specific needs of individual children
Lack of knowledge about importance of physical activity
Need to consider child’s desires and enjoyment
These children participate less than typically developing children
Risk of adverse health consequences (secondary conditions; loss of functional skills due to lack of physical activity)
Parental reluctance
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

4. Considerations for Specific Disabilities
Children with disabilities need opportunities to participate, be active and exercise, and enjoy the benefits in terms of physical health and psychological well-being.
Autism spectrum disorders
Specific concerns: movement difficulties including motor skill and coordination
Moderate and vigorous levels of physical activity helpful in reducing undesirable behavior
Group program more effective than individual
Visual displays for self-monitoring, daily activity logs, social stories, social reinforcement, and behavioral reinforcement useful
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

5. Considerations for Specific Disabilities (continued)
Down syndrome and intellectual disabilities
Specific concerns: chronotropic incompetence, low strength
Structured strengthening improves cardiorespiratory endurance, functional skills, vocational performance, athletic performance
Resistance training improves muscle strength and cardiovascular fitness
Children with special health care needs
Extremely low birth weight: significant motor coordination difficulties
Psychiatric disorders: motor impairments, poorer neuromotor and aerobic fitness
Clear relationship exists between motor proficiency and participation in physical activity or sedentary behaviors
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

6. Community Programs
Parents should consult physician, therapist, or other health professional to decide which activities or programs are best for their children
Community sports programs
Specialized sports associations
Paralympics
Little League Baseball’s Challenger Division
Disability Sports Alliance
Sample program models
Special Olympics: sports activities and competitions worldwide
Horseback riding therapy (hippotherapy): integrated activities to address specific developmental, therapeutic, and functional skills
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

7. Policies Affecting Participation in Physical Activity
School-based physical education requirements vary from state to state
Must consider whether IEPs need specific recommendations related to PE and physical activity, including adapted services and levels of access
Parents may need to evaluate after-school and weekend activities to achieve recommended physical activity
Transition planning begins at age 16 and should take into account that physical activity declines with age
Important laws when considering access:
Americans with Disabilities Act of 1990
Architectural Barriers Act of 1968
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

8. Choice and Preparation for Physical Activity, Exercise, or Sports
Consider child’s interests, availability of activities, and what would be successful
Exercise program for all children should include warm-up, aerobic, balance, strength training, and cool-down activities (total of 60–75 minutes)
Preparticipation examinations (PPE)
Medical exam prior to sport or exercise participation (junior high or high school)
Evaluates athletes with special needs
Outcome determines clearance level for participation
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

9. Injury Risk in Children
Major reason: repetitive microtrauma (overuse)
Training errors (sudden transitions, repetitive demands)
Developmental conditions (poor posture, joint limitation or deformity, increased curvature of lower spine, excess knee extensions, flat feet)
Major cause: growth
Injuries in children with disabilities
Minimal information exists, with some studies suggesting lower injury rate and others suggesting higher injury rate
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

10. Disorder-Specific Injuries and Strategies for Prevention
Children with the following disabilities may need modifications for training and participation in physical activities
Spinal cord injury and spina bifida
Risks: may not perceive pain below injury level; soft-tissue damage; autonomic dysreflexia; trunk balance and stability
Cerebral palsy
Risks: ligament and muscle strains
Muscular dystrophy
Risks: fatigue from maintaining muscle strength
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

11. Disorder-Specific Injuries and Strategies for Prevention (continued)
Down syndrome and intellectual disability
Risks: neck injuries, orthopedic conditions that become painful; cardiac problems; seizures
Vision or hearing impairments
Lower level of physical activity can be increased/improved with modifications
Children using assistive technologies
Risks: upper extremity injuries for children in wheelchairs
Low bone density
Risks: fractures
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

12. Equipment and Support
The use of proper equipment should be mandated and enforced for safety of all children:
Activity-appropriate, high-quality, and proper fit
Protective padding, headgear, eye protectors, mouth guards
Environmental assessment:
Well-lit, smooth, and obstacle-free; shock-absorbing surfaces
Equipment modification
Monitoring of temperature and humidity
Proper hydration
Proper supervision
Chapter 34 slides in Children with Disabilities, Seventh Edition, Online Companion Materials. Copyright © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.