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Recreation and Inclusion: Are Recreation and Inclusion: Are Children with Disabilities Having Children with Disabilities Having
Fun Yet?Fun Yet?
Dot Nary, MADot Nary, MAProject Workout on WheelsProject Workout on Wheels
University of KansasUniversity of Kansas
For the For the Opening Doors State of the Science ConferenceOpening Doors State of the Science Conference
November 10, 2008November 10, 2008Bethesda, MS Bethesda, MS
OverviewOverview
Review definitionsReview definitions Discuss benefits of recreationDiscuss benefits of recreation Describe Contextual and Environmental Describe Contextual and Environmental
issues related to inclusive recreationissues related to inclusive recreation Use Human Rights of Children with Use Human Rights of Children with
Disabilities as a framework for further Disabilities as a framework for further discussion of increasing recreation discussion of increasing recreation opportunities for children with disabilities opportunities for children with disabilities
InclusionInclusion
Children are placed in general Children are placed in general educational or program settings with educational or program settings with same-age peers and received same-age peers and received services congruent with their short- services congruent with their short- and long-term goalsand long-term goals
Blackman, 1992Blackman, 1992
ParticipationParticipation
Involvement in a life-situation—Involvement in a life-situation—includes personal and environmental includes personal and environmental factorsfactors
Essential aspect of child health and Essential aspect of child health and well-beingwell-being
International Classification of Functioning, Health and International Classification of Functioning, Health and Disability, WHO, 2001Disability, WHO, 2001
More definitionsMore definitions Participation: feeling of belonging and Participation: feeling of belonging and
engagementengagement Eriksson & Grandlund, 2004Eriksson & Grandlund, 2004
Self-determination: Acting as the Self-determination: Acting as the primary causal agent in one’s life and primary causal agent in one’s life and making choices and decisions regarding making choices and decisions regarding one’s quality of life free from undue one’s quality of life free from undue external influence or interferenceexternal influence or interference
Wehmeyer & Kelchner, 1995Wehmeyer & Kelchner, 1995
Goals for Our ChildrenGoals for Our Children
InclusionInclusion
ParticipationParticipation
Self-Self-determinationdetermination
Physical and Psychological Physical and Psychological HealthHealth
Physical Physical ConditioningConditioning
Motor CoordinationMotor Coordination EnduranceEndurance Self-esteemSelf-esteem Social skillsSocial skills
Veatch, 1993Veatch, 1993
Quality of LifeQuality of Life
Personally meaningful recreation is recognized as an important element of life quality for people of all ages and abilities
Mactavish & Schleien, 2004
Bronfenbrenner’s Ecological Bronfenbrenner’s Ecological Theory of Human DevelopmentTheory of Human Development
LevelLevel Area of FocusArea of Focus VariablesVariables
MacrosystemMacrosystem CommunityCommunity Values, Beliefs, Values, Beliefs, CultureCulture
ExosystemExosystem OrganizationOrganization Meetings, Meetings, legislative legislative settings, policy settings, policy boardsboards
MesosystemMesosystem RelationshipsRelationships Parent/teacher, Parent/teacher, among families, among families, among childrenamong children
MicrosystemMicrosystem ChildChild Classroom, child Classroom, child with disabilitieswith disabilities
Formal versus Informal Formal versus Informal ActivitiesActivities
Community survey reported low participation Community survey reported low participation rates of children with physical disabilities rates of children with physical disabilities
Inclusion of children with disabilities in Inclusion of children with disabilities in informal community-based activities, such as informal community-based activities, such as scouts, martial arts, or ballet, with their peers scouts, martial arts, or ballet, with their peers requires educating and increasing the requires educating and increasing the awareness of the larger communityawareness of the larger community
Rosenberg, 2000Rosenberg, 2000 Participation of children with disabilities is Participation of children with disabilities is
especially restricted in ‘free activities”, i.e., especially restricted in ‘free activities”, i.e., activities not structured by adultsactivities not structured by adults
Eriksson, 2005Eriksson, 2005
Model of Factors Affecting Recreation Model of Factors Affecting Recreation
Participation of Children with DisabilitiesParticipation of Children with Disabilities (King et al., 2003)(King et al., 2003)
Federal Policy Related to Recreation for Federal Policy Related to Recreation for People with DisabilitiesPeople with Disabilities
YearYear LegislationLegislation InfluenceInfluence19901990 Americans with Disabilities ActAmericans with Disabilities Act Expands civil rightsExpands civil rights
19901990 Individuals with Disabilities Individuals with Disabilities Education ActEducation Act
Identifies therapeutic Identifies therapeutic recreation as part of recreation as part of transition planstransition plans
19861986 Education for All Handicapped Education for All Handicapped Children Act AmendmentsChildren Act Amendments
Mandates early Mandates early intervention programsintervention programs
19751975 Education for All Handicapped Education for All Handicapped Children ActChildren Act
Identifies recreation, Identifies recreation, PT and OT as related PT and OT as related servicesservices
19731973 Rehabilitation ActRehabilitation Act Prohibits Prohibits discrimination in rec discrimination in rec programs on the basis programs on the basis of disabilityof disability
19681968 Architectural Barriers ActArchitectural Barriers Act Requires accessible Requires accessible recreation facilitiesrecreation facilities
Economic IssuesEconomic Issues U.S. families raising children with U.S. families raising children with
disabilities are reporting disabilities are reporting • Higher income families affected by financial Higher income families affected by financial
hardshiphardship• Challenged by food, housing and health Challenged by food, housing and health
expensesexpenses• Many struggle to pay phone billsMany struggle to pay phone bills• Forty percent experience food hardshipForty percent experience food hardship• Sometimes results in postponing medical, Sometimes results in postponing medical,
dental caredental care• University of North Carolina at Chapel Hill, University of North Carolina at Chapel Hill,
20082008
Economic IssuesEconomic Issues
Report on children with disabilities and their Report on children with disabilities and their families receiving SSI:families receiving SSI:• SSI was the most important source of family SSI was the most important source of family
income, with earnings a close secondincome, with earnings a close second• Less than 4% of children lived with adults who Less than 4% of children lived with adults who
owned stocks, mutual funds, notes, CDs, or owned stocks, mutual funds, notes, CDs, or savings bondssavings bonds
• SSI payments are used to cover expenses other SSI payments are used to cover expenses other than medical bills for the majority of childrenthan medical bills for the majority of children
• Most children lived in a household headed by a Most children lived in a household headed by a single mothersingle mother
Rupp et al., 2005-2006Rupp et al., 2005-2006
Health IssuesHealth Issues Obesity rate of adolescents with mobility Obesity rate of adolescents with mobility
limitations (29%) almost double that of those limitations (29%) almost double that of those without mobility limitationswithout mobility limitations
Related health issues: Related health issues: • Lower levels of physical activityLower levels of physical activity• Higher levels of secondary health conditionsHigher levels of secondary health conditions• Barriers to consuming nutritious dietsBarriers to consuming nutritious diets• Lack of knowledge of healthy lifestyle Lack of knowledge of healthy lifestyle
behaviorsbehaviors• Limited opportunity for social engagementLimited opportunity for social engagement
Rimmer, Rowland, & Yamaki, 2007Rimmer, Rowland, & Yamaki, 2007
Quality of LifeQuality of Life Youth Quality of Life Disability Screener used with Youth Quality of Life Disability Screener used with
2801 72801 7thth to 12 to 12thth graders with and without disabilities graders with and without disabilities in rural communityin rural community
Those with disabilities reported lower QOLThose with disabilities reported lower QOL Forty-six percent of adolescents with disabilities Forty-six percent of adolescents with disabilities
reported missing out on desired activities often or reported missing out on desired activities often or fairly often versus 16% of non-disabled fairly often versus 16% of non-disabled
Nineteen percent of adolescents with disabilities Nineteen percent of adolescents with disabilities reported being made to feel unwelcome by others reported being made to feel unwelcome by others their age fairly often or very oftentheir age fairly often or very often
Reduction of social and environmental barriers to Reduction of social and environmental barriers to promote inclusion in school, family and community promote inclusion in school, family and community activities recommendedactivities recommended
• Edwards, Patrick, & Topolski, 2003Edwards, Patrick, & Topolski, 2003
Federal Initiatives Regarding Federal Initiatives Regarding Disability and HealthDisability and Health
Surgeon General’s Call to Action to Surgeon General’s Call to Action to Improve the Health and Wellness of Improve the Health and Wellness of Persons with Disabilities, 2005Persons with Disabilities, 2005
Healthy People 2010, 2000Healthy People 2010, 2000 Report of the Surgeon General on Report of the Surgeon General on
Physical Activity and Health, 1996Physical Activity and Health, 1996
Barriers to Inclusive Barriers to Inclusive RecreationRecreation
Common barriers includeCommon barriers include• Child’s functional limitations (18%)Child’s functional limitations (18%)• High costs (15%)High costs (15%)• Lack of nearby facilities or programs (10%)Lack of nearby facilities or programs (10%)
Other factors: Other factors: • Inactive role modelsInactive role models• Competing demands and time pressuresCompeting demands and time pressures• Unsafe environmentsUnsafe environments• Lack of adequate facilitiesLack of adequate facilities• Insufficient fundsInsufficient funds• Inadequate access to quality daily physical Inadequate access to quality daily physical
educationeducationMurphy, Carbone, & Council on Children with Murphy, Carbone, & Council on Children with
Disabilities, 2008Disabilities, 2008
Family Life and RecreationFamily Life and Recreation Study using both a survey and interviews Study using both a survey and interviews
of parents of children with developmental of parents of children with developmental disabilities revealed:disabilities revealed:• Recreation typically involved small Recreation typically involved small
combinations of family members in physical combinations of family members in physical recreation (swimming, walking, bike-riding)recreation (swimming, walking, bike-riding)
• Parents view these interactions as beneficial in Parents view these interactions as beneficial in many waysmany ways
• Planning and finding activities to accommodate Planning and finding activities to accommodate wide ages and skill ranges can be stressfulwide ages and skill ranges can be stressful
• MacTavish & Schlein, 2004MacTavish & Schlein, 2004
Human Rights of Children Human Rights of Children with Disabilitieswith Disabilities
To downplay the disability as just another To downplay the disability as just another human difference or deny it altogether…human difference or deny it altogether…fails to help the child learn to live with a fails to help the child learn to live with a stigmatized condition, cope with stigmatized condition, cope with discrimination, and become inoculated discrimination, and become inoculated against oppression, all tasks that are against oppression, all tasks that are fundamental to successful living with a fundamental to successful living with a disability.disability.
Olkin, 1999Olkin, 1999
Right # 4Right # 4
To see positive role models of adults To see positive role models of adults and children with disabilitiesand children with disabilities
Right # 5Right # 5
To have a positive identity that To have a positive identity that includes and incorporates the includes and incorporates the disabilitydisability
Right # 8Right # 8
To be allowed to experience a full To be allowed to experience a full range of emotions range of emotions
Right # 10Right # 10
To affiliate with peers both with and To affiliate with peers both with and without disabilitieswithout disabilities
Right #12Right #12
To live in a barrier-free, To live in a barrier-free, accommodating, and tolerant accommodating, and tolerant physical and social environmentphysical and social environment
SummarySummary Inclusion, participation and self-Inclusion, participation and self-
determination are important for the healthy determination are important for the healthy development of children with disabilitiesdevelopment of children with disabilities
Recreation is key to physical and Recreation is key to physical and psychological health, as well as quality of psychological health, as well as quality of lifelife
Numerous contextual issues impact Numerous contextual issues impact opportunities for recreationopportunities for recreation
Children with disabilities are more alike than Children with disabilities are more alike than different from children who are not disabled, different from children who are not disabled, but their disability-related needs including but their disability-related needs including those related to recreation, must be those related to recreation, must be considered for healthy developmentconsidered for healthy development
““The challenge…is to continue the The challenge…is to continue the revolution so that it truly meets the revolution so that it truly meets the needs of those at the bottom of the needs of those at the bottom of the disability ladder, not just the disability ladder, not just the “talented 10%.” “talented 10%.”
Litvak & Martin, 2000Litvak & Martin, 2000
ReferencesReferences Blackman, H. 1992. Surmounting the disability of isolation. Blackman, H. 1992. Surmounting the disability of isolation.
School Administrator, 49, 28-29. School Administrator, 49, 28-29. Bronfenbrenner, U. (1979). The ecology of human development: Bronfenbrenner, U. (1979). The ecology of human development:
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Edwards, T.C., Patrick, D.L., & Topolski, T. (2003). Quality of life Edwards, T.C., Patrick, D.L., & Topolski, T. (2003). Quality of life of adolescents with perceived disabilities. Journal of Pediatric of adolescents with perceived disabilities. Journal of Pediatric Psychology, 28, 233-241.Psychology, 28, 233-241.
Eriksson, L. The relationship between school environment and Eriksson, L. The relationship between school environment and participation for students with disabilities. participation for students with disabilities. Pediatric Pediatric Rehabilitation, 8Rehabilitation, 8, 130-139., 130-139.
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and balance in family life: parents’ perspectives on recreation in and balance in family life: parents’ perspectives on recreation in families that include children with a developmental disability. families that include children with a developmental disability. Journal of Intellectual Disability Research, 48Journal of Intellectual Disability Research, 48, 123-141., 123-141.
Murphy, N.A., Carbone, P.S., & the Council on Children with Murphy, N.A., Carbone, P.S., & the Council on Children with Disabilities. (2008). Promoting the participation of children with Disabilities. (2008). Promoting the participation of children with disabilities in sports, recreation, and physical activities. disabilities in sports, recreation, and physical activities. Pediatrics, 121Pediatrics, 121, 1057-1061., 1057-1061.
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