Online Quick Course
Exercise for Individuals with Developmental Disabilities (OQC)
By Gwen Hyatt, MS , Paul Spicer, QMRP
Course Objectives
- Define characteristics of individuals with developmental disabilities.
- Discuss the importance of exercise and physical activity for individuals with disabilities.
- Identify the importance of including individuals with disabilities in the classroom, workout arena, and community.
- Discuss effective teaching practices and accommodations for individuals with developmental disabilities.
- Outline strategies for optimizing exercise for individuals with developmental disabilities for physical activities.
FULL POTENTIAL
Exercise is for everyone! Exercise provides an opportunity to develop an individual's full physical and mental potential despite having a developmental disability. For this reason scores, performance times and win-loss records are not the only measures of success. The importance of activities of leisure, recreation, and sport are seen in the opportunity for social growth and personal development. An exercise routine or fitness plan can inspire a person with a developmental disability to overcome misperceived limitations and allow for the opportunity to experience true growth.
A relatively short time ago, the perception that people with developmental disabilities needed to be kept separate form the general population was pervasive. Today, communities are beginning to understand that having a developmental disability is merely based on not achieving certain developmental milestones of functioning by a specific age and that it does not warrant any form of segregation (DiLeo, 1993). Theoretically, there is no perfect definition of developmental disabilities due to the fact that every state develops their own legal definition. The general characteristic running through each state, or agency, definition is a childhood onset of a condition affecting general intellectual functioning or adaptive behavior that lasts a lifetime. Individuals with developmental disabilities often exhibit challenges in life areas such as self-care, expressive/receptive language, learning, mobility, and economic self-sufficiency. Mental retardation is most often associated with the label but the label also covers conditions such as cerebral palsy, epilepsy, autism, Down's Syndrome, and other neurological disorders. The label of disability does not mean that the person is incapable of living, working, and participating in life given the proper support system.
Surprisingly, the barrier to achieving optimal physical health for individuals with developmental disabilities is often the lack of knowledge held by a person's support system. People with developmental disabilities are not generally encouraged by those around them to exercise, join health clubs, or participate in sporting events (Lovett and Harris, 1987). At times, attempts by individuals with disabilities to become physically active are met with resistance from instructors or coaches who do not fully understand how to develop beneficial exercise opportunities. Directly linked to this problem is the unfortunate fact that the level of physical fitness among people with developmental disabilities staggers far behind that of the general population. However, it is entirely possible for persons with developmental disabilities to vastly improve their physical condition. In fact, studies have shown that most people with developmental disabilities can improve their physical health, flexibility, coordination, motor control, endurance, and cardiovascular efficiency within several weeks of training. Perhaps even more striking are the improvements made in self-esteem, independence and the sense of accomplishment when a regular exercise routine is implemented. An appropriate and integrated fitness plan for people with developmental disabilities can only be developed once the barrier in the minds of support staff, families, teachers, and fitness professionals has been erased.
EFFECTIVE TEACHING PRACTICES
The foundation of all teaching and training should be respect and equal community partnership. The goal in teaching and training a person with a disability is never to fix that person to be like an able-bodied individual, but rather to empower the person by celebrating his or her own uniqueness and particular talents. The following are effective teaching practices that will allow you to provide optimal learning environments for people with developmental disabilities.
Use Age-Appropriate Activities
Individuals with developmental disabilities are at risk for being stigmatized or misunderstood. For this reason, be mindful of teaching methods that may make a person with a disability look childish or different. All lesson plans, activities, and events involving people with disabilities should be age-appropriate.
Your Role:
- Encourage individuals with disabilities to participate in team sports that are played exactly the same, or as closely possible, as that of an athlete without a disability.
- Do not use childlike toys, games, or teaching tools.
- Understand that your interactions and teaching practices affect the public perception toward people with disabilities.
Use Natural Environments
Too often instructors are quick to overcompensate for a person with a disability by creating specialized classes, events, and unnatural learning environments. Instead, learning should take place through natural opportunities and in real situations.
Your Role:
- Arrange activities to take place within a natural environment to eliminate potential transference barriers as individuals with developmental disabilities sometimes have difficulty applying skills from one activity or environment to another.
- Whenever possible, maintain the same rules, strategies, and steps of an activity that are followed by a person without a disability.
- Emphasize cues that naturally occur within the environment to signal the start of an activity or a change from one step in a task to the next step.
Show Instead of Tell
The use of a variety of tactile and visual techniques often proves to be more beneficial for learning than the use of auditory teaching methods. A kinesthetic cue, such as a tap on the shoulder or physically leading a student through a desired motion, can drastically improve the student's ability to grasp the new skill.
Your Role:
- Practice a relaxed, yet enthusiastic, demeanor while acting as a model and motivator.
- Make use of demonstrations and visual signals, such as raising and lowering hands, blinking the room lights, and blowing a whistle to signal the start and stop of specific activities. ·
- When needed, and permission is granted, physically assist the participant with the desired range of movements by manipulating their trunk and limbs in the appropriate fashion.
Incorporate Reinforcements
The likelihood of a desired or nondesired behavior taking place is often a result of the manner in which an instructor reacts to that behavior. The frequency in which a person's behavior is decreased, increased, or maintained is a result of the consequences after that particular behavior has occurred (DiLeo, 1993). Reinforcements handled correctly, and in a swift manner, after the behavior has occurred can teach new skills and change ineffective behaviors.
A cautionary note on reinforcers: Artificial reinforcement, such as awarding food, "points" or "stars" for a desired action, make it difficult to transfer a desired skill to a natural environment that does not recognize rewards in such a way. In addition, singling a person out by receiving an artificial, inappropriate, or childlike reinforcement further distorts public perception of people with developmental disabilities.
Your Role: Ensure that all reinforcers are delivered in the following manner:
- Individualized to fit the person's unique skills and characteristics.
- Delivered in a manner free of physical, emotional, or psychological harm.
- Enthusiastic and positive in scope. ·
- Appropriate to the time, place, and setting.
Use the Least Intrusive Measures
Training and assistance techniques should be implemented in a fashion that is respectful and delivered in the least intrusive fashion to meet the person's preferences. Often instructors will attempt to do too much, speak with a loud tone of voice, or exaggerate facial expression when working with an individual with a disability. As with interacting with any individual, it is always best to determine the boundaries and teaching techniques that are most acceptable to the person.
Your Role:
- Provide the least amount of support needed for the person to be successful and that allows for personal growth and independence.
- Ask for advice, input, suggestions, and permission before assuming teaching roles.
- Fade out of the picture by providing less prompting as the person begins to grasp the skill.
- Understand that the manner in which you interact with an individual tells the person, and the public, a lot about how you view that person.
Consider the following scenario as an example of taking the least intrusive measures in the learning environment:
David, a 29-year-old male with mild mental retardation, joins a beginner's aerobic class at the local YMCA. He is able to participate in the class and follow the instructor's verbal directions. However, he has difficulty understanding the appropriate clothing to wear during exercise class and will often arrive in jeans, sweater, and boots. The instructor, without calling attention to David and desiring to respect his dignity, chooses to speak with him after class about appropriate fitness attire. David expresses to the instructor that he wants to dress like everyone else but often is confused about what to wear. The instructor provides David with a picture of a person in workout clothing and gives it to him as reference when preparing for the aerobics class at home.
Use Concrete Communication
In order to be more precise, the instructor should consider the use of short, direct, and concrete language. Changing words, verbal instructions, and technical terms can complicate the task.
Your Role:
- Use words and phrases that are most commonly understood by the listener.
- Be consistent with terminology and descriptions. Start an activity using the same words and phrases on each occasion.
- Think of alternate ways to describe or break down a topic into smaller more manageable concepts.
Eliminate Distractions
The environment very often influences behavior in a more complicated way than most instructors realize. Instructors should survey the learning environment for environmental factors such as adequate lighting, proper ventilation, and a comfortable working area. Other barriers involving audio distractions, too many objects in the line of sight, or the teacher's own disorganization can also interfere with a student's ability to concentrate and grasp concepts. The success of an activity or task is highly dependent on the instructor's ability to plan and organize the event thoroughly to eliminate those outside distractions.
Your Role:
- Assemble materials beforehand in order to prevent unnecessary delay.
- Keep the learning environment as simple as possible. ·
- Eliminate outside noise and distraction.
Consider the following scenario as an example of eliminating distractions in the learning environment:
Ryan, an 18-year-old male with a learning disability and attention deficit disorder, participates in a weekly rock climbing class at an indoor climbing gym. The instructor, noticing Ryan's lack of attention and difficulty in grasping concepts, begins to implement a more structured teaching practice. The instructor scans the learning environment to eliminate excess noise and distractions, rotates active and passive activities to prevent boredom, and varies the length of lesson plans to accommodate Ryan's attention span. In addition, the instructor plans activities to flow from one to another to avoid a quick change in teaching practices.
People-First Language
Referring to a person as "handicapped," "retarded," and "crippled" perpetuates misconceptions about people with disabilities and fosters stereotypical perceptions. A person should always be defined as a person first, instead of as a disability.
Your Role:
- Realize and understand that a disability is merely a body function that operates differently and should therefore not define a person.
- Refrain from the use of labels. The only label that is required in addressing a person with a disability is their birth name.
- A disability is simply a medical diagnosis; it is not what a person is. Someone with mental retardation is not "retarded" but rather a "person with a disability." ,
Provide Natural Support
Individuals with disabilities are often inundated with services from staff members and caregivers. However, family, friends, neighbors, classmates, and coworkers are often better able to reinforce skills than a trained professional, and these relationships should always be encouraged as a source of support.
Your Role:
- Assist a student with a disability in conversation skills through role-play so that friendships can be made with other classmates and peers.
- Recruit volunteers, promote the "buddy system," or pair up students with similar interests.
- Observe and encourage the natural bonds that occur between a person with a disability and a new acquaintance.
Make Accommodations
A good instructor has the ability to work around a student's weakness by finding different ways for the student to perform a difficult task. In such a case, the learning environment and the task at hand must be closely observed for potential accommodations. When a problematic area has been identified, for example, learning a new physical skill or screening out extraneous stimuli, it is possible to develop accommodations that compensate for the deficit in the person's ability to perform the task.
Your Role:
- Consider all factors involved in the task to identify specific problematic areas.
- Perform a task analysis by breaking the skill down to each basic step.
- Consider assistive devices, technology, or homemade devices such as pictures, symbolic reminders, and color codes.
Consider the following scenarios as examples of making accommodations in the learning environment:
Todd, a thirty-five year-old male with mild mental retardation and epilepsy, joins a Special Olympics basketball team. The team, made up of new players with and without disabilities, practices each week. The coach, realizing the need for accommodations to better suit the new players' strengths, decides to shorten the basketball court to 75 feet in length. A smaller, mini-sized ball (size #5) is also used so that the new athletes can gain a better feel for passing and dribbling during the first stages of learning. Robin, a twenty-two-year-old female with mental retardation, works with a personal trainer to address her desired health outcomes. The trainer has spent a considerable amount of time working with Robin on a set exercise routine and now feels it is time to fade out and allow more independence. However, Robin cannot remember the exercise routines she is to perform during each workout session. The trainer provides Robin with a color-coded flip chart that explains each exercise one step at a time with pictures and short phrases. Robin keeps the flip chart with her while at the gym to use when needed.
SPORT-SPECIFIC ACTIVITIES: A noninclusive list of suggestions and strategies
Cautionary Note: A functional graded exercise test, body fat assessment, as well as heart rate and blood pressure responses to exercise are always advisable before starting fitness training. Epileptic conditions, health concerns, and current medications should always be discussed.
Weightlifting
The American College of Sports Medicine (ACSM) and the National Strength and Conditioning Association (NSCA) support fitness training for adults, with or without developmental disabilities. Weightlifting, when performed properly, not only can improve the fitness and health of an individual with a disability but also can increase body awareness, control, balance, and reduce the susceptibility to injury.
- A participant who is new to strength training may require prompting to adhere to suitable attire (t-shirts, shorts, shoes, sweats, etc.), rules against food and drink in the weight room, and proper locker/shower usage.
- Monitor beginners, with and without disabilities, who have a tendency to see how much they can lift without regard to injury. A person with a developmental disability may not fully conceptualize the weight of an object or the inner workings of a piece of exercise equipment.
- Emphasize and encourage the use of stretching and aerobics. Make stretching exciting with verbal praise, an energetic delivery, and music.
- Develop a step-by-step schedule, visual aides, pictures, and instructions written in the primary language used by the participant so that he or she has a resource available to check off the correct combinations of exercises, sets, weights, and repetitions.
- Heavy weights with fewer repetitions put too much strain on untrained muscles. Light weights with more repetitions should be encouraged. One set of 15-20 repetitions at a lighter weight is preferable for individuals who are first beginning weight training. When the exerciser has become more conditioned, progress to 8-12 repetitions using a heavier weightload. Resistance rubber bands and weighted bars offer acceptable alternatives to free weights and machines.
Aerobics
Aerobic exercise using cardiovascular equipment such as an Air Dyne bicycle, stair climber, elliptical trainer, or treadmill is always an exciting and beneficial exercise option. Using this type of equipment or participating in an aerobics class set to music is a fun and unique way to introduce a person to aerobic exercise.
- Use music to encourage and inspire rhythmic aerobic movement. Percussion instruments produce vibrations, which can be felt easily. New students should be encouraged to associate the rhythmic patterns with the desired tempo of the aerobic activity.
- When using a treadmill, instruct the individual in the correct techniques and foot placement for getting on and off the treadmill.
- When working with an individual with epilepsy, make sure that the intensity of exercise will not elicit an epileptic attack.
- Avoid using "left" and "right" terms. Instead, use directional arm signals and encourage students to imitate what the instructor is doing to the best of their ability.
- With permission, physically guide the student's body through a movement or sequence to introduce a new exercise.
- Provide take-home videos that the student can use to practice in private.
- Provide visual cues, color coded buttons, and/or large print on equipment to highlight "on" and "off" functions, emergency stop controls, and control settings.
Dance
Many individuals who are uninterested in sports and game-like events often find dance an inspiring form of exercise. The rhythmic sounds of contemporary music, oldies, gospel, and movie soundtracks can be a motivating factor for individuals of all ability levels.
- Always start by training the student to perform an initial basic step. Do not change the familiar step with special kicks or fancy alterations until the student is ready.
- Don't overemphasize terminology such as "lead" foot or specific names of dance steps.
- Emphasize basic steps in counts of four and eight.
- Demonstrate good posture when standing and moving.
- Encourage shoes that are appropriate for side to side movements of dance.
Swimming and Aquatic Exercise
- Continuously emphasize safety. The use of symbols, pictures, and sign postings should be used to mark deep water, prohibited areas, and safety concerns. Familiarize the individual with the layout of the pool and water depth.
- With permission, demonstrate proper movements through the physical guidance and manipulation of the swimmer's limbs and trunk.
- Set up a buddy system and perform periodic buddy checks. Yoga Perhaps no other form of exercise or recreational pursuit provides the wealth and variety of benefits as does yoga. The therapeutic and physiological benefits of yoga include reduced stress, enhanced emotional well-being, improved balance, and positive effects on asthma, carpal tunnel syndrome, arthritis, and cardiac risk factors. Yoga is one of the best vehicles for improved health and well-being for everyone, especially those prone to living a sedentary lifestyle.
- Emphasize the importance of wearing lose clothing and appropriate attire.
- Encourage the practice of yoga on an empty stomach.
- Create an airy, spacious, and comfortable environment free from the distractions of telephones, television, and the noise of other activities. Keep class size small and the duration of time to approximately twenty minutes for beginning students.
- Teach each student to work at his/her own rate and apply individualized attention.
- Emphasize the importance of proper breathing techniques by demonstrating the correct manner of inhaling and exhaling. Students may feel the effects of air entering their bodies by placing one hand on their stomach to "feel the balloon" rise and fall of their diaphragm while inhaling and exhaling.
- Demonstrate to students the flowing style of sequencing postures while linking the breath component to each movement. Make sure students do not hold their breath after attaining the final posture.
- Prompt students to release the posture or stretch if steadiness is lost or muscles feel uncomfortable or begin to quiver.
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