adventurous outdoor activities: an investigation into the benefits of adventure for seven people...

ADVENTUROUS OUTDOOR ACTIVITIES: AN INVESTIGATION INTO THE BENEFITS OF ADVENTURE FOR SEVEN PEOPLE WITH

SEVERE LEARNING DIFFICULTIES

Steven Rose South wark Consortium for People with Learning Difficulties,

27 Barry Road, London SE22 OHX

and Paul Massey

Strode College, Somerset

Introduction

People with learning difficulties have over the years been specifically excluded from many areas of mainstream living activity. This applies to housing, education, work, general medical and dental care, recreation and leisure. Fundamental to the exclusion from mainstream recreation and leisure is the lack of any real opportunity to form the normal relationships which occur at an early stage in development (Lewis & Rosenblum, 1979) which are the major influence on the life direction of the individual, and essential to an acceptable quality of life.

Leisure itself provides major opportunities to form, sustain or change relationships. The constraints on leisure opportunities, which still continue to affect people with learning difficulties can be seen as falling into external and internal factors (Wade & Hoover, 1985). External constraints include institutionalisation and societal attitudes, whilst internal constraints are characteristics such as motor skills deficits and lack of cognitive skills or physical fitness. Properly planned and supported programmes of recreation can assist the disabled individual to overcome constraints (Richardson, 1986; Gold, 1989; Rose, 1990; Massey & Rose, 1992). Participation in leisure activities by disabled people has frequently been reported as producing beneficial changes in the attitudes of others towards them (Hamilton &

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288 MENTAL HANDICAP RESEARCH

Anderson, 1983), with improvements to their self-esteem (Robbins, 1991), and to the level of relationships enjoyed by individuals with disabilities. This last may be seen as a measure of real acceptance into communities (Lutfiyya, 1988). The benefits of integrated activities are firmly stated in the literature (McAvoy et al., 1989).

Among such activities, mountaineering, canoeing and caving have for many years been recognised as providing a special range of benefits for the development of individuals (McAvoy & Dustin, 1986; Rohnke, 1986; McAvoy, 1987; and Mortlock, 1984). Adventurous outdoor activities are a field of leisure activity which produce benefits to overcome constraints for people with and without learning difficulties (Miles, 1978; Ewert, 1985; Moore, 1986; McAvoy, 1987).

Inherent in adventurous outdoor activities are varying degrees of challenge and risk. Although the degree of challenge is greatly influenced by the perception of the individual, it can be manipulated together with the element of risk, to appeal to all individuals regardless of skill level (Dattilo & Murphy, 1987). Thus it is possible for people with all levels of disability to engage in these activities and guidance manuals for staff are available (Schleien & McAvoy, 1989).

In a review of the literature, Dattilo & Murphy (1987) identified the following benefits of adventurous outdoor activities: increases in muscular strength and cardiovascular efficiency (McAvoy & Dustin, 1986); development of co-operation, trust and problem solving skills (Moore, 1986); enhancement of self-esteem and personal confidence (Rohnke, 1986); development of positive perception of self (Meier, 1978); opportunities to exercise choice and to accept the consequences of those choices (Miles, 1978).

Walker & Edinger (1988) identified an adequately organised and financed programme, individualised support, a recognition of the need of children with disabilities to participate and react with non-disabled friends, and small scale integrational exercises, as the key ingredients to a successful integrated camping activity. Non-disabled children and helpers may also benefit from integrational experiences (Schleien. et al., 1985), and the need for individualised support was stressed (Walker, 1990).

Rynders, Schleien & Mustonen (1990) evaluated a two week integrated camping experience for three children with severe mental and physical disabilities and found that the children demonstrated substantially improved skills in targeted activities. Those children without disabilities increased both their prosocial interaction bids and ratings indicative of friendship. Staff perceptions of integrated camp versus segregated camp, and ‘presence’ of participants with disabilities improved significantly.

ADVENTUROUS OUTDOOR ACTIVITIES 289

McAvoy et al. (1989) examined the effects of integrated wilderness canoe trips lasting from four to twelve days on 180 people both with and without disabilities. Six positive lifestyle changes were identified including improvements in interpersonal relationships, recreational skills and patterns, attitudes towards persons with disabilities, tolerance of others, tolerance of stress, and skills in approaching new situations.

The parents of campers with learning difficulties have identified specific benefits of integrated summer camps (McCormick et af., 1992), and the attitudes of non-disabled campers towards disability changed following participation (Sable, 1992).

Method

The Kilimanjaro group

In February 1990 a party, which included two individuals with learning difficulties, had reached the 20,OOOft summit of Kilimanjaro, the highest mountain in Africa. The overall team of 21 climbers, including seven young adults with learning difficulties, came from the MacIntyre Centre, Milton Keynes. Each of the individuals from the Kilimanjaro Group had a level of social, communication and self-help skills, far in excess of the subject group of this study, but given the rarity of the activities it was fortunate to find any comparisons at all. The Kilimanjaro Group was used as a pilot study to identify anticipated benefits prior to the present research.

Hitherto, no attempt has been made to evaluate the quality of mountaineering activities for people with severe learning difficulties.

The Alps group

In August 1990 an integrated expedition to the French Alps was undertaken by the author, and the benefits of this expedition are reported in the present study by: (1) the use of interviews with people who know the individuals with learning difficulties well; (2) the measurement of engagement levels taken from video film of the expedition; (3) a review of diary observations. There is a comparative analysis with the Kilimanjaro Group, but it is the data from the Alps Group which are presented in this paper.

Participants

(names have been changed) together with 14 non-disabled people. The participants included seven people with severe learning difficulties


Peter was 25 years old. He has autism and no verbal communication, having a vocabulary of three signs. He has an active history of self-injurious behaviour, particularly banging his head. He usually reacts adversely to changes to lifestyle or routine.

Mark was 26 years old. He has autism and no verbal communication, and only limited non-verbal communication. He is subject to extreme cyclical swings in his mood, and displays a range of obsessional behaviours in relation to food and drink. Mark has previously been physically aggressive towards others, causing actual injuries on some occasions.

Michael was 24 years old. He has autism and has no verbal communication, having a vocabulary of three signs. He appears to be very intelligent, with a comprehension level far in excess of his social functioning. Michael displays an obsessive compulsive desire for order and tidiness, and will relocate any object which has been moved to its original position.

David was 31 years old and has been diagnosed as suffering from a manic depressive disorder; he can become extremely over excited at times. David has an extensive verbal vocabulary, enabling him to hold conversations in a range of settings. His over-excitability how Ver, together with a tendency to become repetitive produces behaviour which others often find socially unacceptable.

Simon was 24 years old. He has a diagnosis of microcephaly, a duodenal ulcer and oesophageal reflux syndrome. He has good comprehension concerning everyday matters relating to his immediate environment. He usually expresses himself in single words, or two or three word sentences. He had a previous, though currently non-active, history of threatening behaviour including physical aggression to himself and others.

Keith was 20 years old. Although he displays none of the classic behaviours associated with the condition, he has been labelled ‘autistic’. His vocabulary is good, though he often lacks confidence and trust in himself and others, and will say very little for long periods. He has a history of self- injurious behaviour which is thought to be associated with conflicts about becoming more independent.

Tony was in his forties and thought to have epilepsy. He is very unsteady on his feet, but shows extreme levels of determination to join in physical activity, even when exhausted. He has good comprehension, though his speech is very hard to understand.

Data collection

Interviews with the Kilimanjaro Group During the course of two visits to the MacIntyre Centre the seven

individuals with learning difficulties, three members of staff and one parent

ADVENTUROUS OUTDOOR ACTIVITIES 29 1

who had been on the expedition were interviewed. One individual had cerebal palsy, another epilepsy, and the management of continence had to be coped with whilst on this expedition.

Each individual was interviewed separately, and the interviews were tape recorded. Each interviewee was invited to give an account of the expedition, the elements which she or he enjoyed and those which he or she did not. Interviewees were encouraged to describe their emotions regarding both their own and others’ successes and failures. The members of staff and parent were also asked to comment on the observed benefits of the expedition both to the client group and to the overall group. The clients, staff and parent were asked to discuss, and base their responses on, the previous year’s training for the expedition, the actual expedition, and the period subsequent to the expedition. The information given was then compared with the benefits identified in the Dattilo & Murphy (1987) review of the literature.

Interviews with the Alps Group On returning from the Alps expedition, a series of interviews were carried

out with their staff, and helpers. Unlike the Kilimanjaro Group, the people with severe learning difficulties in the Alps Group were not readily able to speak for themselves (three used no spoken language, and limited sign language). The interviews were therefore conducted with four members of staff who knew the clients very well, and one volunteer. The interviews were structured around the 12 benefits which had been identified in the interviews with the Kilimanjaro Group, and there were no formal pre-set questions. This allowed maximum spontaneity and creativity in the responses, whilst keeping those being interviewed to the subject in question. Each interview lasted between one and two hours, and took place within one month of returning from the Alps.

The interviewees were asked to reflect on the previous year’s preparation, the expedition itself and the period immediately after the expedition. They were prompted to comment on any examples of the 12 reported benefits from the Kilimanjaro expedition, but also allowed to add any other information which they considered relevant.

Extensive notes were taken during the interviews, and the information given was sorted into statements and matched against the 12 previously identified benefits. Some of the respondents made more than one positive statement associated with a particular benefit, whilst others made none.

MENTAL HANDICAP RESEARCH

Levels of engagement

An attempt was also made to evaluate the quality of the experience to each individual through the measurement of levels of engagement. Engagement in activity gives a measure of what the individual is doing from moment to moment, including being occupied at a particular task, engaged in a leisure or social activity, interacting with another person, or just doing nothing. To measure engagement levels it is necessary to undertake detailed observation.

Measures of engagement have been regularly used as an evaluative tool for measuring the work and living environments of people with learning difficulties, Risley & Cataldo (1972, 1974); Porterfield & Blunden (1978); Dalgliesh & Mathews (1980); Felce, Kushlick & Mansell (1980), Mansell et al. (1984); Brigden & Heggs (1988); and Hughes & Mansell (1990).

Various members of staff used a video camera, and at the time of recording they were unaware that the recording would be used to measure interaction.

Diary observations

A diary of personal observations on the trip to the Alps was also kept and material from this is presented. The staff and helpers had been asked to keep diaries of the expedition, and accounts of incidents where the participating author was not present were combined with the author’s personal diary.

Results Pre-expedition pilot interviews with the Kilimanjaro group

The seven clients, three members of staff, and one parent reported positive benefits from their experiences five months previously. Those benefits included the eight benefits reported by Dattilo & Murphy (1987), together with an additional four benefits.

Sense of achievement

All of the participants on the expedition reported a strong sense of achievement, on an individual basis, for those who reached the top of Kilimanjaro, and for the group as a whole.

ADVENTUROUS OUTDOOR ACTIVITIES

Table 1 Identified benefits of adventurous outdoor activities

293

Number of Reports

Clients Staff/parent Possible total 7 4

Dattilo & Murphy (1987) Benefits (1) Muscular Strength/Cardiovascular efficiency (fitness) 5 4 (2) Development of co-operation 2 4 (3) Trust 3 4

4 (4) Problem solving skills - (5) Enhancement of self esteem 2 3 (6) Enhancement of personal confidence 4 4

2 (7) Development of positive perception of self -

(8) Exercising choice and accept consequences 2 2

The Kilimanjaro group identified the following four benefits of adventurous outdoor activities in addition to those identified by Dattilo & Murphy (1987)

2 (9) Role reversal experience -

2 (10) More attention to personal hygiene (11) Deeper understanding of each other 1 4 (12) Sense of achievement 7 4

-

Enhanced understanding

A deeper understanding of each other was described by all members of staff, and the parent, though only one client. It was generally described as ‘having got to know the other people better’.

Role reversal

The first role reversal experience was described by a member of staff, who in order to continue climbing had to give her rucksack to one of the clients to carry. She described this as a powerful and lasting emotional experience as she had never had to seek assistance from a client before. The second description of role reversal was described by the parent, who had to give up the climb at 17,000 feet due to altitude sickness and general fatigue. Her daughter went on to climb a further 1000 feet up the mountain, before dropping out of the climb herself. This was the first time that the daughter had ever succeeded at something where the mother had failed.

Hygiene and dressing

Two members of staff observed that since returning from the expedition, some of the male clients were paying more attention to their personal hygiene and dressing more smartly.


The expedition had clearly been a valuable experience. During the second series of interviews, however, two individuals seemed indifferent to the event, and were only vaguely tolerant of the interruption of their normal routine occasioned by the interview.

Interviews with the Alps group

The positive statements, relating to each of the 12 identified benefits, made by the staffholunteers from the Alps Group are detailed in Table 2.

Table 2 Total numbers of positive statements per benefit

No from Table 1 Rank

(12) Sense of achievement (2) Development of co-operation (1) Muscular Strength/Cardiovascular efficiency (fitness) (9) Role reversal experience (3) Trust ( 5 ) Enhancement of self-esteem Benefits not identified in the study group (1 1) Deeper understanding of each other (4) Problem solving skills (6) Enhancement of personal confidence (7) Development of positive perception of self (8) Exercising choice and accept consequences (10) More attention to personal hygiene

The statements were abbreviated from lengthy hand written notes made at the time of interviews. The low scores in some areas may be because those aspects are less easy to measure, using the approach adopted. The following statements are included to illustrate the positive benefits identified. Achievement was the most frequently reported benefit.

Sense of achivement

All of the club members have a high sense of achivement after France. It was an emotional moment for us to watch the party set off for the summit of Mont Blanc.


The development of co-operation, in common with enhancement of self- esteem, and a sense of achievement, were also relatively easy to observe, and experiences which could be shared by staff and volunteers. This may explain the higher level of reporting.

Co-operation

The Alps expedition was a new experience for staff and clients, and we had to learn together. We learnt that we were only as strong as the weakest member, who was not always a disabled member.

Fitness

benefits to observe and measure and were frequently reported. Clients’ muscular strength and cardiovascular fitness were the simplest

Mark used to get out of breath just walking to the Training Centre, now he can do a twenty mile walk. Group performance has steadily improved on Ten Tors (an annual endurance walk) over three years, now one hour faster.

The Role reversal experience was reported to a notable level, and in common with the pilot group, was identified with considerable emotion.

Role reversal

TR (staff) stated that she had handicapped Michael and Peter by her inability to keep up. I now appreciate that Michael may have done better than I would have on Mont Blanc, if I had been in the party. SM showed admiration for clients who did the rock climb that he had problems on, due to his fear of heights. KB, says that Michael was able to go on when he (KB) was ill with altitude sickness.

Self-esteem

Those able to articulate said ‘We have done it’, when they got medals on the Ten Tors annual endurance walk. Tony was nervous before he abseiled at the Red Ridge Centre,


afterwards he said ‘I have done it’. He was walking around waving his clenched fist, very excited, this was away from the rest of us, he was not doing it in front of other people.

However, there are lower levels of reporting for trust, a deeper understanding of each other, and problem solving skills.

Trust

When on the ascent to Refuge Albert from Le Tour it was necessary for the clients with limited communication’ to put their total trust in staff and helpers, due to the various dangers; they did so without question, due to all of our previous shared experiences. Michael let us put on his harness and crampons which was an entirely new experience; he would not have tolerated this in previous years.

Deeper understanding

We all learn more about each other on every trip.

Problem solving skills were also reported at a lower level.

Problem solving skills

Peter initiated going into a canoe. He pulled my arm to show that he wanted to go in, tried to put on a life jacket and sat in the canoe and tried to paddle. In all the years that I have known him I have never known him to initiate anything like that himself.

Enhancement of personal confidence, development of positive perception of self, and exercising choice and accepting consquences are barely reported at all for the study group. It is possible that communication problems precluded expression in those areas, and if this is the case, then the study methods adopted were not adequate to test for these benefits.

More attention to personal hygiene is hardly reported in the study group, and problably irrelevant. The two reports from the Kilimanjaro Group are likely to be due to increased attention from the media, as well as attracting further attention during the pilot interviews, rather than a direct benefit of adventurous outdoor activity.


Levels of engagement

A total of 42 minutes of video film was randomly taken during the two week expedition. 27 minutes 18 seconds of film featuring clients involved in either mountaineering activity, or preparation for mountaineering activity were selected excluding incidental activities such as views of scenery.

The total time of engaged client activity was 18 minutes 8 seconds, which represented a 66% level of engagement, for the mountaineering activities.

Diary observations

A personal diary of the expedition was kept by the participating author. One of the following two extracts is from this diary, whilst the other is from the diary of a member of staff.

The Tete Rousse Hut It is necessary to appreciate the nature of Alpine Huts. Temperatures, even inside the hut, which is at an altitude of 10,000 feet, plummet to sub-zero levels at night.

Accommodation is basic and cramped. Beds are bunk style with up to ten climbers sharing each bunk. There is very little space to move; any area that is not occupied by people is occupied by climbing equipment, a combination of wet ropes and clothing, boots, ice axes and other items of climbing hardware.

Peter, Mark and Michael, all in their twenties, were brought up in mental handicap hospitals. They have in the past been classified as presenting challenging behaviour, including in the case of Mark and Michael, violence towards others. Aspects of their institutional behaviour had already occurred on the trip. The waitresses at the hotel had been intrigued all week, as Mark and Michael re-arranged the cutlery with minute detail at tables laid for thirty guests. All three are individuals who tend to operate using plenty of space, often bounding around with seemingly endless supplies of energy.

How they would cope with spending an afternoon and night in an Alpine hut, was a matter of some concern. Once the hut had been reached it would not be possible to leave with safety until the following morning. The party was committed to spending some sixteen hours there come what may. In the event, the overnight stay in the hut was problem free and all of the party thoroughly enjoyed themselves. Peter, Mark and Michael took everything in their stride. The low expectations of the clients held by staff and helpers had been proved totally unfounded.

MENTAL HANDICAP RESEARCH

The Ascent

of the serious nature of the feats undertaken. The following description of the dangers of the climb gives an awareness

Michael, together with three non-disabled climbers, set off from the top of the tram-way (7,500 feet) to climb Mont Blanc. Unfortunately, one of the three non-disabled support climbers began to suffer badly from altitude sickness, and exhaustion, and the early section of the climb took longer than had been anticipated. The party eventually reached the Goutier Hut (12,000’) at 4.30 am. The extra 4 % hours climb meant that the Goutier Ridge had to be ascended in darkness. The leader of the party stated that he would not normally have chosen to make this ascent under those conditions with a more experienced and non-disabled group.

The slow moving party were exposed to several hours of uncomfortable and adverse conditions, the extreme cold causing everyone some discomfort. As it became dark, each 100’ section was negotiated using ropes, bringing the party up one at a time. This had a cumulative effect, both in terms of slowing the party down, and everyone having to remain in one place for periods in the intense cold.

Nobody had anticipated that the attempt would eventually fail because of the incapacity of one of the non-disabled climbers. The member of staff reported that one of the things that made him force himself to go on for several hours, whilst suffering the agonies of altitude sickness, was a desire not to let Michael down. Other members of the party also reported that they were able to establish levels of communication with Michael beyond those previously reached.

‘It was 2.00am in the morning, minus 12C, and I was worried that Michael might get frost bite in his fingers. He has no speech, though he can sign for the word “yes”. He signed that his fingers were not cold, but I still considered it necessary to feel his fingers. This meant taking off both our gloves. Whilst I was doing this it suddenly became clear that he had indicated that his fingers were OK, and there was no need to keep checking. I took his word for things after that, and somehow I sensed that he appreciated this’.

After reaching the Goutier Hut 6% hours late at 4.30am, the attempt on Mont Blanc was given up. During the descent, Michael often waited for the semi-incapacited member of staff. The following day Michael was keen to go climbing again.


Discussion

outdoor activities for people with severe learning difficulties. The results give an overall indication of the benefits of adventurous

The interviews

Whilst no statistical significance can be attached to the interviews, there are clear indications based on the observations of staff, that positive benefits exist. Each of the benefits (Table 2) stands in its own right. However, they also have knock-on effects, in terms of other linked benefits. Muscular strength, cardiovascular efficiency and general fitness for instance, all contributed to increasing the individual’s ability to manage stress and resist infection. Increased co-operation gave mutual benefits both to the client group and the staff who worked with them. There was an increase in the likelihood of successful and meaningful relationships, as well as community participation, which enhanced the quality of life for each individual.

The benefits of ‘role reversal’ and ‘sense of achievement’ as described in the paper speak for themselves. An extension of role reversal was that the client group were continually improving their skill in outdoor activities; new staff with no previous experience in these areas were exposed to clients who had higher levels of skill than the staff. The new staff had to learn new skills, with and from the client group. This took place in the outdoors, which is a special and potent learning environment in its own right. So, the whole learning experience for new staff becomes a useful tool for revaluing a devalued group.

The results relating to the other areas of benefits range from indicating that no beneficial effects were identified to being inconclusive.

Quality of the Alps experience

The 66% level of engagement is a firm indication of the quality of the activities. There is room for development and further sophistication in methods of measurement in future studies. The results to date and simplicity of the technique make this approach attractive and promising.

Diary observations

The need for caution when considering staff diary accounts is to some extent obviated by the size of the group and the direct involvement of the author. Whilst these individuals were engaged in adventurous outdoor


activities they demonstrated levels of flexibility and adaptability which greatly surprised staff who knew them well. These accounts relate to what were enjoyable quality experiences. Additionally, they describe feats which would be considered exceptional for non-disabled individuals. As noted above, participation in leisure activities by disabled people brings about positive changes in the attitudes of others towards them. These positive changes to attitudes are certainly reflected in the staff diaries. As accounts of the expedition have been spread, both formally and informally, benefits have been achieved in terms of enhancing the image of a devalued group of people.

Recommendations

There is scope to develop the use of adventurous outdoor activities in an integrated fashion in the UK. Nevertheless, it is important to avoid the danger of turning leisure into ‘therapy’. People with severe learning difficulties often need skilled assistance to help them meet their needs and wants. People undertaking adventurous outdoor activities need skilled training and sometimes leadership. When people with severe learning difficulties undertake adventurous outdoor activities, the requirement for both types of skilled intervention must be recognised and met. However, the activity should not be ‘over-professionalised’ or treated purely as some form of therapy. The benefits of adventurous outdoor activities come from informality and spontaneity, and these, together with the leisure and recreational aspects, should be retained.

This study did not set out to evaluate the relative benefits of integrated over segregated leisure activities. If doubts are held regarding the feasibility of iiitegrated activities which include high levels of ambition and risk, this research indicates that they are misplaced.

More specific research relating to the relative benefits of the integrational and segregational approaches is highly desirable. The use of measurement of engagement levels as an indicator of quality, in this type of activity, represents a new use for a well established evaluative technique which now needs further refinement.

The results of this study are promising but not conclusive. Further research is required to establish the beneficial effects for the client group in question. This research will need to focus on more accurate methods of measurement, especially with regard to further evaluation of those benefits with low levels of reporting, which may have been due to the methods of measurement adopted.


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