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NCHPAD - Building Healthy Inclusive Communities

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Introduction to Intellectual Disabilities and Fitness


Bobby was a 13-year-old with a moderate intellectual disability and Spina Bifida at a level which made him dependent upon a wheelchair for locomotion with no feeling below his waist. A several year history of frequent skin breakdowns [pressure sores on his bottom] had resulted in more time spent out of school, lying prone and healing, than in. He participated in very little; had no interests. When well enough to sit in the chair, Bobby was given a timer to remind him to perform pressure reliefs every five minutes. This, he would never keep up with, forgetting to reset the timer and inevitably landing himself back in bed.

When a physical education teacher introduced him to weight training, however, things changed for Bobby. He began to focus upon how strong his upper body could be. He worked out and got stronger and bigger. Pressure reliefs, previously performed by leaning over on alternating elbows for 10 seconds, were now performed as full pushups from the armrests for a full minute, as Bobby would look over his shoulders to admire the development of his deltoid and tricep muscles. School attendance became regular. Bobby joined a swimming program and spent two winters participating in a downhill skiing program.

Benefits of Being Fit

Physical fitness is a critical component in the daily life of children with developmental disabilities. Although research has found that children with developmental disabilities tend to be less fit than their nondisabled peers, it also indicates that regular structured physical activity may:

  1. Improve health;
  2. Reduce negative behaviors;
  3. Enhance social behaviors; and
  4. Improve self-esteem in these same children.

Productive and safe use of leisure time, a significant need in these children, often depends upon adequate physical capabilities. In many children, their capacity for physical work exceeds their abilities in other areas. So maintaining health, strength, and endurance increases the likelihood of eventually contributing to the workforce.

Problems with developing and maintaining fitness

I. Motivation.

For an unfit child, most fitness activities do not feel good. The phrase, "No pain, no gain," has little relevance for someone who does not appreciate or understand what that gain might be, for whom "no pain" is a good thing. Like many children, Bobby's capacity for movement was much higher than he had thought. However, he had never been motivated to move; saw no good reason to do so. His sedentary lifestyle, which would present health risks to anyone, further endangered him because of his lack of sensation or concern for his own health.

II. Skill development.

Beyond motivational impediments, children with developmental disabilities may be hampered in fitness efforts, by delayed skill development and learning of fitness skills. A pushup may be a hard task for most children, but the able-bodied child is only limited by his or her shoulder strength. Children with learning problems may require many lessons to coordinate the skill and reversion to the old pattern, in which the hips only come off the floor after the shoulders are up [much easier], is a constant threat for a long time.

III. Opportunity.

Fitness is a goal which requires some dedication. A minimum of three days per week is required and more [every day], if workouts are less strenuous. For most children with disabilities, the opportunity to participate at this level depends upon someone else to transport, teach, or motivate them.


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