Bright Futures at Georgetown University
 
Bright Futures in Practice: Physical Activity

CHILDREN AND ADOLESCENTS WITH
SPECIAL HEALTH CARE NEEDS

Issues and Concerns

BFPAIC_PB54Chronic conditions and disabilities range in severity from minor (i.e., no obvious signs of the condition or disability) to severe (i.e., multiple physical and psychological conditions or disabili ties). Medical advances are helping children and adolescents with special health care needs live longer. Promoting physical activity in early childhood can help children and adolescents improve their physical fitness, reduce the negative consequences of their condition or disability, and ultimately enhance their quality of life.

Health professionals need to counsel children and adolescents with special health care needs and their parents about the benefits and risks of participating in physical activity. The benefits and risks vary depending on the child's or adolescent's condition or disability; however, in general, the benefits overwhelmingly outweigh the risks. Benefits include weight control, increased flexibility, and improved cardiovascular functioning. There are also psychological benefits, such as increased self-esteem and improved social skills. The benefits and risks of physical activity for children and adolescents with specific special health care needs are presented in Table 16.


Screening and Assessment

Children and adolescents with special health care needs vary in their ability to participate in physical activity. To select appropriate activities and duration, health professionals, along with children, adolescents, and parents, must consider the child's or adolescent's needs and concerns, as well as adaptations that may be needed for specific activities.

Individual screening and assessment should be conducted before a child or adolescent with special health care needs begins any physical activity. The cognitive abilities and social skills of the child or adolescent should be evaluated, and the impact of the special health care need and treatment on the child's or adolescent's participation in any given activity should be taken into account. Activities
BFPAIC_ILP52 may need to be adapted to help ensure that the child or adolescent has a positive experience participating in them. Working together with the child or adolescent and parents is essential in order for the health professional to determine which level of participation is best. Table 17 provides guidelines for the screening and assessment of children and adolescents with special health care needs.5 These guidelines also include additional information related to physical activity participation.


Counseling

Health professionals need to promote physical activity in children and adolescents with special health care needs and their parents to help them adopt a physically active lifestyle. Physical activities that can be done together as a family (e.g., walking, biking, hiking) provide physiological and psychological benefits for children, adolescents, and parents.

Participation in physical activity with others (e.g., baseball, soccer) helps children and adolescents enhance their cognitive, creative, and motor skills. These activities are especially important for children and adolescents with special health care needs because they offer opportunities for them to socialize with their peers.

When children and adolescents with special health care needs participate in physical activity, they should be supervised by adults who are trained to work with them. Professional and volunteer organizations (e.g., Disabled Sports USA, National Sports Center for the Disabled) provide information on specific conditions and disabilities as well as information on appropriate physical activities and adaptations that may be needed (see Tool F: Physical Activity Resources). Creative and collaborative strategies can enable children and adolescents with special health care needs to participate in physical activity (e.g., children and adolescents with Down syndrome playing baseball). Counseling strategies for children and adolescents with special health care needs are provided in Table 18.

Referral

Schools are an excellent community resource for families. To ensure that physical activity issues and concerns are addressed in the child's or adolescent's school, specific goals, objectives, and supports can be incorporated into their Individualized Education Plan (IEP). The IEP was established through Part B of the Individuals with Disabilities Education Act (IDEA).

 

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