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

DefinitionsDefinitions

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

Benefits of RecreationBenefits of Recreation

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

Contextual/Contextual/Environmental IssuesEnvironmental Issues

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

Right # 13Right # 13

To be a childTo be a child

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

Are children with Are children with disabilities having disabilities having fun yet? fun yet?

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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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