Discover Inclusive Afterschool Health Promotion

1 ©Copyright 2019

All rights reserved. No part of this guide may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.

This guide is a collaborative project of the National Center on Health, Physical Activity and Disability (NCHPAD) and the Disability and Health Program of the Alabama Department of Public Health. The information provided in this guide was supported in part by Grant/ Cooperative Agreement Number U59DD000906 from the Centers for Disease Control and Prevention (CDC) and the Cooperative Agreement Number 5U59DD000947 from the Centers for Disease Control and Prevention. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

National Center on Health, Physical Activity and Disability

4000 Ridgeway Drive Birmingham, AL 35209

www.nchpad.org

800-900-8086

[email protected]

2 Part I. Inclusion in Afterschool Health Promotion Programs

All children – from all disability, racial, ethnic, and socioeconomic groups, through all grades, and in urban and rural settings – beneft from regular physical activity and good nutrition. National efforts have been implemented to reverse the trends of youth physical inactivity and childhood obesity by focusing on increasing physical activity and other health promotion efforts. Children and youth with disabilities are often not fully included in these efforts, yet often experience even greater rates of physical inactivity and obesity. The obesity rate for children with a disability is 38 percent higher than children without a disability. Focusing on health promotion and increasing physical activity during childhood can encourage lifelong habits that can decrease the risk of chronic disease in adulthood. When these interventions are applied in an afterschool setting, it offers a prime opportunity to promote physical activity and health promotion opportunities in youth2.

Participation in regular physical activity produces multiple physical and mental health fbene ts. For youth, regular physical activity participation builds healthy bones and muscles, decreases the likelihood of obesity and disease risk factors such as high blood pressure, reduces anxiety and depression and promotes positive mental health. In addition to these benefts, children and youth with disabilities experience additional physical, social and emotional benefts from increased physical activity. Improved strength and ftness can enable a greater independence and ability to perform activities of daily living. Physical activity is also an important factor in the prevention of secondary conditions. Secondary conditions occur as a result of a primary disability and can include pressure sores, pain, diabetes, hypertension, osteoporosis, and obesity. Obesity can be especially problematic for youth with disabilities because can it exacerbate secondary conditions, decrease independence and limit mobility.

Despite extensive evidence suggesting that afterschool programs promote positive child and youth development, support in-school learning and facilitate the growth of a skilled workforce, millions of children with disabilities do not participate in safe and enriching afterschool experiences⁴. Although participation in afterschool programs has increased; the demand for afterschool programs has not been satisfed⁵. The literature shows that youth with disabilities have fewer social connections and lower participation rates during in-school and out-of-school time (OST) activities than their peers without disabilities⁶. Barriers such as separate classes and school placements which limit opportunities for participation, insufficient teacher preparation, a lack of parental involvement, and a lack of transportation to OST opportunities prevent youth with disabilities from participation in OST programs⁷. Privately-owned or operated youth programs fall under Title III of the Americans with Disabilities Act (ADA), which requires that no youth are discriminated against or excluded from the program on the basis of their disability.

InclusionInclusion assumes assumes that that all all children, children, regardless regardless of of ability ability or or disability, disability, have have the the right right to: to:

• • BeBe respected respected and and appreciated appreciated as as valuable valuable members members of of the the school school community community • • FullyFully participate participate in in all all school school activities activities • • InteractInteract with with peers peers of of all all ability ability levels levels with with opportunities opportunities to to develop develop friendships friendships and and learn learn and and respect respect differences differences

Disability inclusion means understanding the relationship between the way people function and how they participate in society and making sure everybody has the same opportunities to participate in every aspect of life to the best of their abilities and desires. This involves more than simply encouraging people; it requires

3 making sure that adequate policies and practices are in effect in a community or organization. Full inclusion begins with the recognition that children and youth with disabilities are integral members of the school community and must be more than just acknowledged as an afterthought. The Guidelines for Disability Inclusion in Physical Activity, Nutrition, and Obesity Program Initiatives were developed to assist in the updating of community health programs and policies to be inclusive of the needs of people with disabilities. Schools or community organizations can use these same guidelines to promote inclusion within the school or recreation setting for children and youth with disabilities. The Guidelines can be viewed and utilized as part of a commitment to inclusion, learn more here: http://committoinclusion.org/9-guidelines-for-disability- inclusion/.

The Healthy Eating Physical Activity (HEPA) standards aim to improve the OST settings youth engage in. The standards were developed to advocate lifelong health and prevent chronic disease. They promote staff training that allows facilitators to learn about evidence-based strategies that include opportunities to adapt physical activity to include children and youth at all levels of ability including those with physical, sensory, or intellectual disability. The standards also provide social, program, and environmental support that accommodates individuals of all abilities.

The Comprehensive School Activity Program (CSPAP) provides the national framework for increasing physical activity in schools. To ensure youth with disabilities are included in these efforts the guide, Discover Inclusive School Wellness, provides additional information on the implementation of the CSPAP in each program area. Refer to this guide for more information on school wellness in all fve areas of physical education, physical activity during school, physical activity before and after school, family and community engagement, and staff involvement.

Afterschool Program Resources:

Resources for Community-Based Afterschool Programs: http://www.dcyf.org/modules/showdocument.aspx?documentid=155

How to Adapt Energizers to Include Students with Disabilities: http://forprevention.org/p2/what-we-do/be-active-legacy/energizers/

Afterschool Alliance: www.afterschoolalliance.org http://www.afterschoolalliance.org/STEM-curriculum.cfm

Boys & Girls Clubs of America www.bgca.org

A Resource Guide for Planning and Operating Afterschool Programs http://www.sedl.org/pubs/fam95/afterschool.pdf

Ohio Kids on the Move: Physical Activity Guidelines for Afterschool Programs http://www.pysc.org/resources/documents/OhioKidsontheMove.pdf

4 References:

¹Andersen LB, Harro M, Sardinha LB, et al. Physical activity and clustered cardiovascular risk in children: a crosssectional study (The European Youth Heart Study). Lancet. 2006;368(9532):299-304.

²Herrick, H., Thompson, H., Kinder, J., & Madsen, K. A. (2012). Use of SPARK to promote after-school physical activity. Journal of School Health, 82(10), 457-461.

³Yang X, Telama R, Viikari J, Raitakari OT. Risk of obesity in relation to physical activity tracking from youth to adulthood. Med Sci Sports Exerc. 2006;38(5):919-925.

⁴The Hours of Opportunity: Key Elements of Out-of-School Time System Building. (2011, September 12).

⁵Afterschool Alliance. (2014). America After 3PM. Washington, DC: Afterschool Alliance. Retrieved November 1, 2014, from http://www.afterschoolalliance.org/AA3PM/.

⁶Eriksson, L., Welander, J., & Granlund, M. (2007). Participation in Everyday School Activities For Children With and Without Disabilities. Journal Of Developmental & Physical Disabilities, 19(5), 485-502.

⁷Kleinert, H. L., Miracle, S. A., & Sheppard-Jones, K. (2007). Including Students With Moderate and Severe Disabilities in Extracurricular and Community Recreation Activities. Teaching Exceptional Children, 39(6), 33-38.

5 Part II. Adapting Afterschool Health Promotion Programs

The purpose of this section is to provide you with a framework and general guidance on how to adapt health promotion programs to be inclusive of children and youth with disability. The section also includes specifc curriculum adaptations for two common evidence-based physical activity and nutrition afterschool programs.

Consider the following broader concepts as related to ensuring inclusion of all potential participants:

The physical programmatic environment should be accessible for all participants and their family, friends, and caregivers. While this will vary based on the types of activities being performed, some key components of accessibility include ensuring program areas, entrances, and access routes are large enough for individuals who ambulate in a variety of methods to enter and move throughout without additional assistance or alteration to their typical movement style, and without facing additional ambulation barriers. It may also include the provision of intentionally located seating and balance aides, such as chairs, stools, and benches. Think also about sensory input provided by certain locations, for example amount of background noises or brightness of lighting.

The built environment includes not only the program or activity space, but also viewing/spectating areas, locker and restrooms, and other elements of the larger facility of which the space is a part, including access routes and entrances, public spaces, and parking lots and public transit stops. While facility accessibility may vary based on several factors, in general, always ensure all spaces are open, clear of mobility impediments, and that pathways and other routes are unbroken, seamless, slip-resistant, and feature occasional seating and balance options (e.g., chairs, couches, handrails). Several sources provide specifc requirement and recommendation resources for built environments, including the Americans with Disabilities Act, the United States Access Board, and the Center for Universal Design.

There are also several elements of service provision, policy, and education and instruction that can tremendously impact inclusion of children with physical and intellectual disabilities. Ensure the availability of all materials, including registration and other forms, informational materials, and instructions are available on demand in multiple formats, including written, large-print, with pictures, Braille, captioned video, and audio. Consider the literacy level of materials you provide and the amount of writing included on each page. Additionally, plan for various methods through which to present and teach skills, instructions, and other information during programming and play to all participants and their parents/caregivers, including verbally,

6 using pictures or videos, physically modeling activities and skills, and utilizing hand signs (e.g., thumbs up or down, head nod or shake) and facial gestures (e.g., smile or frown to denote understanding or lack thereof). Present new skills in a step-by-step format, showing and allowing practice and profciency of one element at a time to help ensure learning and beneft memorization, rather than potentially overwhelming students by showing multiple elements of a sequence at once.

Finally, consider additional adaptations for individual sports and activities, such as modifying play areas, rules, and time limits, allowing for peer assistance, adapting target sizes and locations (e.g., lower a basketball goal, move a throwing target to ground if a participant is only able to roll an item at the target), and providing additional or modifed equipment (e.g., for a throwing activity, multiple kinds of projectiles (baseball, bean bag, balloon etc.). Note that when creating competitive environments (in and out of school recreation sports), be sure to teach and enforce rules to hold each participant accountable and ensure they are fully aware of rules and violations. This prevents confusion during competitive play.

A framework for adaptation was created utilizing the Guidelines, Recommendations, Adaptations Including Disability (GRAIDs). This framework is used to create recommendations for health promotion programs to highlight and add information, guidance, and resources on how to make the programs inclusive of people with disability so that they can enjoy the same health benefts from these programs as those without disability. The framework is made up of the fve domains: built environment, services, instruction, equipment and technology, and policy. Consider the following domains and examples when applied to a program or service to ensure all applicable areas are covered to be inclusive of individuals with disabilities.

1) Built Environment: This includes all structural features for the setting where the program is to be held. Examples include: elements of a building, ramps, clear paths/sidewalks, curb cuts, doorways, drinking foundations, adequate temperature and lighting. The built environment is not limited to buildings, but also includes places such as playgrounds and campgrounds.

2) Services: This includes person-to-person assistance. Examples include: transportation, aide for a person with a disability, and a peer assistant in a physical activity program. Services also include activities that would improve access to supports such as educational materials/handouts, program advertisements and communication materials.

3) Instruction (Training & Teaching): This includes any technique used to enhance learning. The training and teaching may be for the person working in the community (e.g., afterschool program provider or teacher) or the person with disability or their family member/caregiver.

4) Equipment & Technology: This includes any adapted equipment, products, materials, assistance technological devices or systems. Examples include sports or activity related equipment, signage, utensils, automatic sliding doors, bus lifts, and pedestrian transportation technology.

5) Policy: This includes any laws, regulations, rules, protocols, and procedures designed to guide or influence behavior. The policies can be either legislative or organizational in nature.

7 Afterschool Curriculum Adaptations

The following section provides curriculum adaptations for two evidence-based physical activity and nutrition afterschool programs to be inclusive of youth with disability. The adaptations are intended to be used in conjunction with the original curriculum and provide further information on inclusion.

SPARK is a research-based organization that disseminates evidence-based Physical Education, After School, Early Childhood, and Coordinated School Health programs to teachers and recreation leaders serving Pre-K through 12th grade students. SPARK was identifed by the Center for Disease Control (CDC) as a national model for programs designed to increase physical activity and combat childhood obesity. Coordinated Approach to Child Health (CATCH) is another evidence-based program with high successes of sustainable healthy behaviors for students participating in the afterschool program. This program has been supported for 25 years with 120 academic papers indicating as much as 11% decrease in overweight and obesity for youth participants.

SPARK After School (AS)

The purpose of this section is to provide inclusive strategies that can be useful to teachers and physical education specialists when using the SPARK After School (AS) program in order to promote inclusion to improve health outcomes for students with disabilities. The SPARK After School (AS) philosophy is to “Include ALL youth, actively engage ALL youth, and instill the love of lifelong movement in ALL youth.” SPARK strives to improve the health of children, adolescents, and adults by disseminating evidence-based after school programs to teachers and recreation leaders serving Pre-K through 12th grade students. The SPARK After School (AS) Physical Activity Program began in 1995 as part of an effort to take lessons learned from the successful SPARK PE program and apply them to “out-of-PE” settings. Today’s SPARK After School Program targets all out- of-school physical activity programs (e.g., after school, YMCA, Boys and Girls Club, recreation center, day care center, or camps). Years of research and extensive feld-testing throughout the country has shown SPARK After School (AS) to be effective for children and adolescents.

The information presented in this document is intended to help physical activity facilitators promote the inclusion of people with disabilities while using the SPARK AfterSchool Program (AS). Every class is unique in terms of the needs and abilities of the students, so it is paramount that physical activity facilitators gather all pertinent information prior to planning their activities.

General Curriculum Adaptations

In order to create appropriate adaptations to the curriculum teachers should consider making changes to the movement form, instruction, rules, equipment, and environment. One of the simplest ways of adapting an activity is to modify or substitute the movement involved. Table 1 includes a list of possible adaptations to adapt the movement form.

8 Table #1 Adaptation to Different Movement Forms

Instead of running or walking • Propelling in a wheelchair • Driving a powered wheelchair • Riding a tricycle • Pedaling a hand-bike • Walking with a partner • Rolling across a mat Instead of throwing or kicking a ball • Carrying a ball between two points • Dropping or releasing a ball at a certain marker • Rolling a ball along the floor • Sending a ball down a ramp or table-top Instead of catching a ball • Blocking a ball using the student’s own body • Intercepting a ball using a bat or racquet • Blocking a ball using netting held between a student and a partner • Capturing a moving ball through a hoop

Teachers may modify instructions by modeling what the student is expected to do. Instructions may be printed out in large print and hung up for the student to see during the time of the lesson. Oral prompts can be given.

Rules can be “relaxed” to allow the student to achieve the desired goal. If for instance, the students are to kick a ball into a net from 10 feet away, a student with a disability may need to get closer to be able to kick or throw the ball into the net. Time requirements and “outs” may be eliminated.

Modifcations toequipment may mean that bats or paddles have Velcro strapping, so that a student with gross motor difficulties may hold it easily. Other adaptations may include lowering a basketball net, using larger or smaller balls or utilizing a tee to hold a ball. Students might use scoops for catching balls instead of their hands. Targets could be made larger and placed closer to the students.

The environment in which students participate in must be safe, secure and welcoming. Padding, hand holds, and adaptive equipment should be readily available. The playing feld must be clearly defned. The use of taped or painted areas makes it easier for the student to see boundaries. Create a safe place for the students and make sure the students know how to fnd it.

Competition

In a well-organized adaptive physical activity setting, all students grow and develop needed skills. The most important consideration is to create a place that is not flled with the stress of being best, but rather creating

9 a space for achieving goals that everyone enjoys and succeeds in. The emphasis on being number one is taken away. Students are not in the program to compete with each other; rather, they are there to learn about themselves and each other while enjoying moving their bodies to the best of their ability. Adaptive physical activity programs allow students with disabilities to share sports and learn sportsmanship along with their peers. This is a win/win process. Competition could be useful to increase motivation, but it should not be the primary purpose of the activity.

Considerations for full inclusion:

• Always treat students with disability with the same respect as students without disability. • Speak directly to the student, rather than to a parent or para-educator. • Establish an open communication about the student’s abilities and limitations. • Do not be afraid to ask questions. • Do not assume the student has additional disabilities just because you can see that they have one. For example, do not assume an individual has an intellectual disability just because they have a physical disability. • Offer alternative choices only when appropriate; do not over-adapt. • Do not be afraid to seek out additional help if you do not know enough about a certain disability. • If necessary, allow extra time for students with disability to respond to your questions and ask questions of their own. • Never assume you know everything about a disability. Individual’s needs and abilities are unique from student to student. • Avoid being patronizing by giving additional praise or undo attention for accomplishment of simple, everyday tasks. • Do not portray disability as a negative.

10 Considerations for specifc disability types:

Visual Impairment • A guide-wire system can be set up in a gym or use of a sighted guide technique • Incorporate a balance program to reduce risk of falling. • Use light colored or larger equipment, preferably white, yellow, or orange. • Use balls that are equipped with bells. • Use students name before giving instructions. • Use descriptive verbal instruction. • Use different equipment to slow down the action. • Use a raised surface or equipment such as a poly-spot to indicate boundaries. • When throwing and catching, bounce the ball to give the receiver a sound clue. Hearing Impairment • The use of interpreters may be required to aid in facilitating communication. • Use illustrative means, such as paper and pencil or whiteboards. • Always face the student while talking. • Use visual cues and concrete examples. • Speak with a normal enunciation and volume. • Demonstrate the routine or activity. • Avoid loud, constant background noise. Intellectual Disability • Individuals may have poor muscle tone. • Provide a highly structured environment. • Use a variety of cues including pictures and symbols. • Use brightly colored equipment. • Keep instructions brief and simple. • Offer prompt, positive feedback and be consistent with motivators. • Be flexible and have patience. • Allow the individual to work with a peer. • Minimize wait time. Physical Disability • Use larger and lighter balls. • Use a noodle or other equipment to assist in expanding reach. • Attach equipment to a wheelchair or walker. • Use large scooter boards for mobility. • Use sitting or kneeling in place of standing activities. • Ask the individual how he or she might participate in the activity. • Focus on reaching, grasping and pushing.

11 Active as Soon as Possible (ASAP), Personal Best, and Fitness Fun

These sections within SPARK After School are designed to develop, maintain and improve the fve components of physical health related ftness. These include aerobic capacity, muscular strength, muscular endurance, flexibility, and body composition through immediate physical activity, fun games, and ongoing assessment.

Physiological and assessment considerations:

• Paralysis/paresis/plegia. • Decreased balance and mobility. • Speech and memory/cognition. • Weakness and fatigue. • Low level of ftness. • Depression and social isolation • Heart conditions and high blood pressure • Motor control, coordination and limited range of motion (ROM). • Spasticity. • Pressure ulcers/sores. • Poor thermoregulation. • Venous pooling and orthostatic hypotension • Autonomic dysreflexia (a sudden dangerous rise in blood pressure). • Decrease in functional muscle mass. • Decrease in bone density. • Maximum heart rate (MHR) falls within range of 115 to 130BPM for people with a spinal cord injury (tetraplegia). • Level of amputation determines functional ability. • Greater energy expenditure for cardiovascular activities in lower extremity amputation. • Urinary incontinence. • Hypermobility (joints may stretch farther than normal in students with Down syndrome), flexibility exercises are not recommended. • Strenuous exercise is not recommended for students with Multiple Sclerosis (MS) focus on low- impact activities at a comfortable pace.

Super Sports

Activities in this section are designed to provide physical activity leaders with modifed sport activities as a positive alternative to traditional sport experiences. Activities in the Super Sports section help develop sport- specifc skills and improve ftness levels while providing all players with equal opportunities to participate. In addition, activities integrate social skills by emphasizing cooperation above competition as well as reinforcing the importance of fair play.

Basketball

Wheelchair basketball is a sport played primarily by people with physical disabilities. In some countries such as Canada, Australia, and England, able-bodied athletes are allowed to compete alongside other athletes on mixed teams. The sport is based on basketball with some adaptations to reflect the presence of the wheelchair and to harmonize the different levels of disabilities players have.

12 General adaptations:

• Use various adaptations to balls (size, weight, texture, color). • Be flexible on rules by allowing a two handed dribble, light travelling calls, and three second lane violations. • Lower the goal or use a basket or trashcan for alternate scoring options. • Slow the pace, especially when students are playing for the frst time. • If a student uses a wheelchair, allow the ball to be placed in their lap while pushing the wheelchair. • Use a ball with a beeping or noise device and place a different noise device under the basket for students with a visual impairment.

Flying Disc

Flying disc or Frisbee is an inexpensive way to get a full body workout and also a great way to learn social skills while playing. Frisbee games could potentially have other benefts for children including improvements in agility, coordination, and core stability along with health and cognitive skills associated with physical activity.

General adaptations:

• Use a disc launcher that allows the user to throw a disc golf disc with less effort (i.e. Folf Club). The Folf Club is ideal for people with less coordination or decreased upper body mobility. • Use bigger and bright color discs and hoops. • Use bigger and bright color sports markers. • Reduce the perimeter of the playing areas. • Allow the students to score by touching a flying disc instead of catching it. • Allow the students to use a light basket to catch the flying disc instead of catching it with their hands only. • Allow students to hand the flying disc instead of throwing it on tag games. • Allow the students to tip objects with the disc in their hand instead of throwing the disc towards the objects. • Use of a foam frisbee.

Football

American wheelchair football is an adaptation of American football played by individuals in either manual or motorized wheelchairs. This potential for such a broad range of players and ability levels makes American wheelchair football a truly inclusive sport.

Benefts of Playing the Sport

The game offers many potential benefts to all of its players with and without disabilities. Players using manual wheelchairs must engage in many quick and powerful movements such as cutting, blocking, sprinting, and tackling that require and may help build cardiovascular and muscular strength. Participants who have difficulty or are unable to push and use designated pushers (individuals who push and maneuver their chairs) can reap the physical and many social and mental benefts associated with being included as part of a team in a competitive environment.

13 General adaptations:

• Field or court of play: Games must be played on a flat, rectangular surface. The teacher could use a standard-sized basketball court, using lines around the perimeter of the court and beneath the basket to represent boundaries and goal lines, respectively. Additionally, the basket may be incorporated as a modifed feld goal post and/or target. • Players: Games can vary tremendously in number of players, based on such factors as number of students in attendance and court size. • Students can use manual wheelchairs or power wheelchairs to participate. • A feld goal may vary from throwing a ball between the uprights on top of a basketball goal to hitting the back board of a basketball goal, to name two options. A point-after-touchdown may always count as one or two points, or may vary based on how it is scored (e.g. one point for rushing it in, two points for throwing it in). • Receiving: The teacher may require a ball to be physically caught. Others may allow, based on the physical ability level of a receiver (e.g. an individual with tetraplegia or limb loss), that a ball that hits the receiver in a designated area (chest, back, arm, leg, chair, etc.) which counts as a catch, while receivers with more complete use of their hands still have to physically catch a pass. • Tackling: Tackling rules may be very broad as well. A teacher may require that a two-hand touch be made to count as a tackle, but modify that rule so that individuals with limb loss or lower function can tackle with one hand. Some leagues use breakaway or velcro flag belts, like those used in flag football, attached around the wheelchair that must be removed to count as a tackle. • Kickoffs, punts, and feld goals can be replaced with throws.

Equipment

The only necessary items are a feld, wheelchairs, and a ball. As mentioned, the feld should include boundary and goal line markers, as well as a goal post/target for feld goals. Any type of chair can be used, from a standard daily use wheelchair to a sports wheelchair to a power wheelchair. Finally, the type of ball can vary greatly, from a softer, Nerf-type ball to a more traditional leather ball of any size. Additionally, if an individual with a visual impairment or blindness is playing, a noise-emitting ball may be used to help them know where it is throughout the game.

Net Sports

Tennis

Tennis is a competitive recreational activity in which participants hit a tennis ball back and forth over a net and attempt to outplay their opponent by placing the ball in strategic areas of the court. There are two versions of tennis within disability sport - ambulatory tennis and wheelchair tennis. The United States Tennis Association aims to provide, promote and develop opportunities for men, women, and children with disabilities to participate in recreational and competitive wheelchair tennis at all levels from novice to the professional player. Tennis is a very social activity and can be played indoors or outdoors, in teams with family and friends. Wheelchair tennis is a cross-disability activity. Profcient wheelchair users can play and actively compete against non-wheelchair users. Players can play the game on any regular tennis court and no modifcations are required for tennis rackets and balls.

14 Equipment

Wheelchair tennis requires only a few pieces of equipment: a tennis racquet, ball. and a wheelchair. No modifcations are necessary for the racket and the ball. Players use a sports wheelchair. A tennis wheelchair is lighter than everyday chairs to allow the athlete flexibility of movement, making the game more spectacular. The wheelchair is considered part of the player - therefore, general rules of contact apply. To keep the player stable on the chair use a positioning strap across the waist and/or thighs. Grip devices are designed specifcally for players who do not have the grip strength to hold a racquet. Athletic tape and an Ace bandage wrap are two simple solutions to maintain a proper grip. Orthopedic racquet holders and “grasping gloves” are available if more support is required. Arm and leg prosthetics are available for individuals who are amputees. Arm prosthetics can be adapted to grasp a tennis racquet.

General Adaptations

• Use larger and lighter balls. • Some students might need a larger racquet while others might need a smaller racquet. Ensure the racquets are light. • Lower the net or do not use a net. • Use brightly colored balls. • Hit ball off a tee. • Allow a drop serve. • Allow the student to stand closer to the net on serves. • Do not use a service court. • Use a peer for assistance. • Allow the ball to bounce multiple times.

Volleyball

Volleyball is an activity that can be played by individuals with different ability levels in either a recreational or competitive setting. Standing and sitting volleyball are the two main forms of this activity. The objective is to “volley” the ball over the net to cause the opposing team to miss- hit or be unable to hit the ball, all while keeping the ball inbounds. It is recommended that the following adaptations be used only when needed to maximize participation and success.

Sitting volleyball is a modifed discipline of volleyball that can be played by students with or without disabilities. Sitting volleyball is very similar to traditional volleyball with one main difference. In sitting volleyball, a part of the student’s body between the bottom and the shoulder must be touching the court when making or attempting a shot. Students use their hands to play the ball and to move on the floor. Teams are allowed three touches of the ball before it must cross over the net into the opposing team’s half of the court. The size of the court is reduced from 18 m x 9 m to 10 m x 6 m. The height of the net is lowered to 1.15 m for men and 1.05 m for women. As a result, the game is much faster than traditional volleyball. If you have a regulation sized volleyball court in the gym, you can divide the court in half length-wise by stringing a net or rope down the middle to create 3 sitting volleyball courts using those same lines.

15 General Adaptations:

• Allow for multiple hits beyond three for each side. • Allow the ball to bounce (like in the game of Newcomb). • Allow the server to serve closer to the net. • Allow the student to catch the ball frst and then put it back up for play. • Use larger, softer, brightly colored balls for motivation and fun. • Minimize unnecessary background noises. • Use a beeping volleyball, or alternative ball, with a noise-making device for students with vision loss. • Have students throw the ball in for a serve. • It is important to consider each student’s ability level and adapt only when needed and specifc to that individual. • Use smaller or lighter ball (ex: beach ball or foam ball). • Use a smaller net and lower net. • Place mats on floor to ease in scooting. • Play on scooter boards to help with movement. • Play variations of a standard volleyball game: two vs. two, toss and catch, skill building. • Minimize background noise during instruction and play. • Visually demonstrate skills. • Use flags instead of whistles. • Move serving line forward. • Use poly dots to help students fnd floor position. • Use a peer for assistance. • Reduce the playing court. • Allow for underhand passing (do not call for lifting the ball).

16 Soccer

Soccer is a game that offers ftness activity and motor skill development. Teams are allowed to make contact with the ball with every part of the body, except for their hands and arms. Teams each compete in order to outscore each other in goals during this game.

General Adaptations:

• Reduce the feld size. • Increase the size of the goal. • Use a lighter ball. • Change speed to walking only or fast walking. • Use a very large ball and allow players to use hands or push with wheelchair. • Provide wheelchairs with a bumper to protect the feet. • Use a beeping ball or one that has bells inside. • Play on a smooth service and remove any barriers. • Provide descriptive skills cues. • Allow push-ins or kick-ins instead of throw-ins for players using a wheelchair. • Provide a dry erase board or scoreboard for students with hearing impairments. • Use flags to signal fouls for players with hearing impairments. • Balls must stay on the ground for safety. • Play fve-a-side soccer. • If a student uses a wheelchair, allow use of hands to propel the ball. • Use a deflated ball to slow down the speed of the flight of the ball. • Place a noise device on the goals.

17 Softball

Wheelchair softball is a version of softball played by individuals using wheelchairs. It is very similar to standard softball, following the large majority of rules established by the Amateur Softball Association of America (ASA). However, to accommodate the use of wheelchairs and players with varying ability levels, a few changes exist in terms of classifcation of players,f eld of play, and rules to ensure games stay both competitive and fair.

Beep baseball is a version of softball that is played by individuals who are blind or have visual impairments. Beep baseball bears some similarities to softball in terms of hitting, felding, and pitching, but with modifed rules regarding scoring and outs. Additionally, sound emitting bases and balls, as well as audible pitchers and defensive spotters, are used so that individuals can play without any sight whatsoever.

General adaptations:

• Decrease pitching distance. • Students are allowed extra time to move between bases (e.g. after felding a student will count to five before attempting to tag a runner. • Students are allowed to use a batting tee to push or hit the ball. • Use a larger and lighter bat. • Use velcro to hold the bat. For safety purposes do not allow batters to run with the bat strapped to their hands. • Mark positions on playing feld. • Use scoops for catching instead of softball gloves. • Vary balls (size, weight, color, texture). • Eliminate outs and strike-outs. • Allow batter to sit in a chair. • Decrease distance of the bases. • Use well-defned boundaries. • Use velcro balls and mitts. • If an individual is in a wheelchair, allow them to push the ball off a ramp, off their lap, or from a tee. • Use beeper balls. • Provide peer assistance.

18 World Games

The SPARK World Games section was developed to expose players to active games they may not have experienced before. Learning games and traditions from other cultures can be an enlightening experience with the potential to foster socially responsible behaviors that can last a lifetime. Learning and playing multicultural games can also help players appreciate cultural diversity in their local and national communities. Encourage players to explore their own families and communities for more multicultural ideas and challenge them to search the globe for games that keep the world healthy and active.

Cricket

The objective for the batting side is to score the optimal number of ‘runs’ (points) before the bowling side has dismissed them. The objective for the bowling side is to dismiss the batsmen as carefully as possible. Runs can be scored in a number of ways. Each time that the batting pair is able to run between the wickets, after a ball has been bowled and before the stumps are or potentially can be touched with the ball, a run is scored. If the ball travels outside of the playing area, and it has touched the ground prior to leaving the playing area, four runs are scored. If the ball does not touch the ground on its way out, six runs are scored. Dismissal of the batsmen can occur in a number of ways. The batsman facing the bowler can be ‘bowled’ out, i.e. the ball will hit the stumps without him being able to prevent it. If the batsman strikes the ball with the bat and it is caught by the bowler or one of the bowler’s sides who are dotted around the ground to feld the ball before it hits the ground, then he is deemed to be out. A batsman can also be stumped by the specially equipped wicket-keeper, a player who stands immediately behind the batsman to retrieve balls coming through from the bowler. Either player can be ‘run-out’ if the wicket towards which they are running during the course of play is struck with the ball prior to their reaching the safety of the crease.

Blind Cricket

Blind Cricket is a version of the sport of cricket adapted for blind and partially sighted players. The major adaptation for equipment is the cricket ball, which is signifcantly larger than a standard cricket ball and flled with ball bearings. The rules of blind cricket are based on the standard laws of cricket with a few modifcations. Teams are composed of players from up to fve different sight categories B1, low partial, B2, B3, and B4. B1 is totally blind and the sight categories then move upwards in levels of sight. Each sight category is subject to different rules and compensations in order to make the playing feld as level as possible. The pitch is made of concrete and measures the same length and width as used in sighted cricket. The boundaries are measured 40 meters in a circle around the pitch and indicated by a white line with flags set at intervals. The wicket (stumps) is also larger, to allow partially sighted players to see and blind players to touch it in order to correctly orient themselves when batting or bowling. Verbal signals are widely used both by umpires and players. The delivery is required to pitch at least twice when bowled to a completely blind batsman (once when bowled to a partially sighted batsman), but must not be rolling. Totally blind batsmen cannot be out stumped and must be found to be LBW twice before going out. Totally blind felders are allowed to take a catch on the bounce.

Table cricket

Table cricket provides the opportunity to play in a competitive game of cricket. The emphasis is on teamwork and sportsmanship in an informal and enjoyable environment. The game is played on a table tennis table. Side panels and sliding felders are placed around the table to create an arena, a small ball and ramp are used to bowl, and a wooden bat enables players to score runs, simulating a game of cricket.

19 Deaf Cricket

Deaf cricket is a global branch of cricket, played at the league, club and national level all over the world. The rules stay the same as a traditional game of cricket, but it takes extra effort to overcome certain obstacles. On the feld, you have to keep your eyes on the action and your captain.

Handball

Handball is a physical and fast sport of intense physical contact. The object is to score more goals than the opponents by throwing the ball into a D-shaped net. Handball athletes are known for their speed, agility, physical strength and stamina. Team Handball is played on a regulation size high school or college basketball court with a goal of 5’ 6” wide and 5’ high at either end. The game is a combination of basketball and soccer, whereas most athletes throw the volleyball-sized ball at the goal, rather than kick it.

General adaptations:

• Modify the length of the court. • Beginner and lower ability players have to option to use a foam, air-flled ball. • For beginning players, youth and lower ability players, limit player contact. • For persons with disabilities who require the use of adaptive devices (walkers, crutches, wheelchairs), being in good physical condition enables them to use their modifed extensive devices more effectively, with less fatigue after engaging in longer activity. • Use the sound of a bell for students with vision loss. • Use special sounds for students with hearing loss. • Use flags with color for students with hearing loss. • Establish hand signals for students with hearing loss. • Allow the use of mobility devices.

Sepak Takraw

Modern Sepak Takraw or Takraw for short (also known as Kick Volleyball), began in Malaysia and is now its national sport. It combines elements of Soccer, Football, Volleyball, Baseball, Badminton, Gymnastics and the ancient sport of Sepak Raga. Three players on either side of a 5-foot high net, in a court that is the same dimensions as doubles badminton, have three chances to pass, set and spike the ball back to the opposing side who tries to block the spiked ball. The game is very much like volleyball, except without the use of hands or arms! In today’s game, the original balls hand-woven of rattan stems have been replaced by hand-woven synthetic balls, which are much safer and much more durable.

General adaptations:

• Allow the students to catch the ball. • Allow for more than three contacts before sending the ball over the net. • Increase the size of players per team. • Serve by kicking or tossing the ball instead of the traditional serve where one player tosses the ball to the server for him to kick it over the net. • Play with a lower net. • Use devices to hit the ball (i.e. tennis rackets). • Use bright and bigger balls instead of the traditional woven ball.

20 • Allow for the ball to bounce one time on the ground before a student contacts the ball. • Use a ball with a bell for students with vision loss. Kin Ball

Kin ball is a game that was invented in Quebec, Canada in 1986. The sport was created especially for physical education classes and has an emphasis on teamwork, cooperation, sportsmanship, and good health. Kin Ball is a competitive team game that requires a lot of cooperation to be successful. Since the skills used are so unlike any other games, it allows anyone to be successful. The three team concept works well to keep scores from getting out of control as the losing teams can work together to catch up to the winning team. Levels of fun and engagement should both be very high with this game. Kin ball sport is played with a ball of four feet (1,22 m) in diameter and that weighs 2 lbs (1 kg). The sport is played with three teams of four players. The goal of the game is to catch and control the ball before it touches the ground. Points are given when a team commits a fault such as dropping the ball.

One of the three teams is in possession of the ball and is known as the attacking team. The attacking team must call out one of the two other teams by saying “OMNIKIN®” and the color of the team and then throw the ball inside of the court’s surface. All team members must be in contact with the ball when the ball is hit.

Once the hit is made, the designated team must catch the ball before it touches the ground. Players can catch the ball with any part of their body. When a team is not able to catch the ball before it touches the ground, a point will be given to the two other teams and the team that dropped the ball will restart the game at the offensive.

General adaptations:

Due to the game’s simplicity, it can easily be adapted to include a greater number of participants. Students with differing levels of abilities are able to succeed playing this game. • Allow the use of mobility devices. All participants can use scooters. • Increase the number of players per team. • Decrease the size of the playing area. • Instead of catching the kin-ball allow the players to touch the ball with any part of their body. • Use bright colored balls. • Allow the ball to bounce one time before it is considered a fault. • Allow students to assist during serves.

Great Games

Games are an important part of all physical activity programs. In the Great Games section, new and traditional games are designed to give all participants many opportunities to practice skills and strategies in a highly active format. Participants enjoy these games because they are fast-paced and challenging. They also help to improve aerobic capacity, muscular ftness, and flexibility.

General adaptations:

• Go from less difficult to more difficult skills and breakdown skills into their component parts. (e.g. Catching a ball: Bounce the student the ball from a short distance away. Gradually increase the distance, but eliminate the bounce. Then increase the distance again.) • Decrease playing space to allow for more student involvement.

21 • Use a balloon instead of a ball to slow the action. • Use proper lighting and color contrast. A ball can be covered with bright yellow tape to contrast with the floor and walls. Color tape can be used to mark the playing areas on the floor or walls. • For tag games, use bells on the person who is “it”. • For boundaries, change the floors texture. For example: Use of a rug or rubber polydot on the floor to mark the space where exercises are to be performed. Place a rubber carpet runner next to the wall so that a child knows when they step onto the changed surface it indicates stepping out of bounds. The change in surface also signals a warning to the student that a wall or object is coming up so they need to slow down and stop. • For throwing and catching, give the receiver a sound clue. Bounce the ball instead of throwing it directly. Use different types of balls, such as a Nerf ball to lessen the impact when catching the ball. Balloons can also be used to slow down the action. When throwing at a target, provide a sound behind the target (e.g.; clapping or beeper.) • For striking and hitting, use a ball on a tee, a large whiffle ball and an oversized bat. The ball can be rolled on a table or the floor and bells can be put inside the ball to be heard when rolled. • For running, use a partner assist by holding hands, use brush contact (continuous touching of hand, forearm, wrist or any part of the arm), a loop of a flexible piece of material can be held between a guide runner and the student with a disability. A student can run by themselves holding onto a rope stretched between two points. • Modify the environment by using colored balls, mats, cones, and goals. • Ensure safety rules are known and followed by all students. • In unfamiliar surroundings, a student may be disoriented and lack confdence. The teacher may need to establish an understanding of the activity and the safety precautions needed. • Where necessary provide one-to-one or small group support. • Use a noodle or other piece of equipment to assist in expanding a student’s reach. • Use large scooters, large mat scooter, or scooter seats for mobility. • Modify locomotor patterns.

22 • Provide additional rest periods as needed. • Utilize sitting or kneeling in place of standing activities. References

• ABC Of Cricket o http://www.abcofcricket.com/cfb1/cfb4/cfb4.htm

• American Academy of Pediatrics (AAP) o https://www.aap.org/en-us/Pages/Default.aspx

• American Association of Adapted Sports Programs o http://www.adaptedsports.org/adaptedsports/athletics/athletics_wc_football.html o http://www.adaptedsports.org/adaptedsports/training/training_publications.html

• Aljazeera America o http://interactive.aljazeera.com/aje/2016/cricket-beyond-boundaries-blind-deaf-disabled- street/deaf-cricket-beyond-boundaries.html

• AUTISM SPEAKS o https://www.autismspeaks.org/what-autism

• Chicago 4 PLUS 1 o https://www.youtube.com/watch?v=Gklw4rJd0RA

• Disabled World o http://www.disabled-world.com/sports/blind/cricket.php

• Folf Club o http://folfclub.com/

• National Center on Health, Physical Activity and Disability o http://www.nchpad.org/1206/5839/ Physical~Activity~~~People~With~Disabilities~INFOGRAPHIC o http://www.nchpad.org/1322/6128/Physical~Activity~~~Kids~with~Disability~Infographic o http://www.nchpad.org/1320/6123/Inclusive~Physical~Education~~Disability~Awareness o http://www.nchpad.org/fppics/Discover%20Inclusive%20Physical%20Education-Final.pdf o http://www.ncpad.org/37/291/Wheelchair~Tennis o http://www.nchpad.org/63/466/Volleyball o http://www.nchpad.org/1073/5477/ Sitting~Volleyball~~A~Skill~Enhancing~and~Physically~Demanding~Activity o http://www.nchpad.org/1173/5756/Wheelchair~Softball o http://www.nchpad.org/1178/5782/Beep~Baseball

• Lords Taverners o http://www.lordstaverners.org/table-cricket o http://www.lordstaverners.org/a/js/third_party/tinymce/jscripts/tiny_mce/plugins/ flemanager/fles/TableCricketRules2012a.pdf

• NETPRO Sports o http://www.netprosports.com/store/index.php?route=information/information&information_

23 id=8

• North Carolina Physical Education Advisory Council o http://www.nc-ape.com/

• Olympic Tennis Centre o http://www.rio2016.com/en/paralympics/football-5-a-side

• OMNIKIN INC. o https://docs.google.com/viewerng/viewer?url=http://www.gophersport.com/fles/original/ GS10999-KinballOFRuleBk1.pdf

• SPARK After School o http://www.sparkpe.org/after-school/

• Sports Singapore (Active SG) o https://www.myactivesg.com/sports/sepak-takraw/how-to-play/sepak-takraw-for-beginners/ rules-and-regulations-of-sepak-takraw

• Special Olympics o http://media.specialolympics.org/soi/fles/resources/Sports-Rules-Competitions/FactSheet/ FactSheet-Handball.pdf o http://digitalguides.specialolympics.org/handball/

• The International Paralympic Committee o https://www.youtube.com/watch?v=NcRqM3_faOk&nohtml5=Falsehttp://digitalguides. specialolympics.org/handball/#/58

• Universal Wheelchair Football Association o http://www.ucblueash.edu/kraimer/PAGE1.HTM

• Wheelchair Sports Federation o http://www.wheelchairsportsfederation.org/adaptive-sports/football

• Wikispaces o https://nontraditionalgamesinpe.wikispaces.com/ Kin+Ball

Catch Kids Club

Coordinated Approach To Child Health (CATCH)® is viewed as one of the most cost-effective programs to prevent childhood obesity. It has been proven to reduce rates of obesity and overweight in children and adolescents. A replication study of CATCH in El Paso, Texas, reported a signifcant 11 percent difference between treatment and control groups of children in preventing the onset of overweight and obesity (Coleman, 2005). It has also shown sustainable behavior change for reducing fat consumption and increasing physical activity in children and adolescents (Luepker, 1996). The CATCH Kids Club (CKC) afterschool program targets children, kindergarten through eighth grade, to participate in physical activity and learn the basics of nutrition. The purpose of this section is to provide adaptations for this successful evidence-based afterschool

24 physical activity curriculum to ensure it is inclusive of youth with disability.

The Importance of Including All Abilities

Afterschool programs provide students with the opportunity to create relationships with other peers, participate in physical activity, and practice nutrition knowledge. CATCH promotes physical activity and healthy food choices in preschool- through middle school-aged children and their families. CATCH is based on the Centers for Disease Control and Prevention’s (CDC) Whole School, Whole Community, Whole Child model, in which health education and the creation of a healthy school environment and family/community involvement work in tandem to support youth in learning and leading a healthy lifestyle. By developing an inclusive program that involves complete activities, students’ self-efficacy can increase and wholesome decision-making becomes more sustainable. Inclusive programs provide individuals with a sense of belonging, better social experiences, and educational opportunities.

Where Do I Need an Adaptation?

When reviewing handouts and activities, it is important to think about what, if any, adaptations need to be made in order for the program to be completely inclusive. An adaptation is a change made to the built environment, equipment, programs, and/or policies that allows equitable access for all users. If a student with a disability can fully participate in the activity in the same way as a student without a disability, then no adaptation is needed. If the student with a disability cannot participate in the same way a student without a disability can, then some type of adaptation is necessary to provide equal opportunity to participate. The following would be necessary adaptations to allow students to fully participate in programs:

• Physical, sensory and emotional environment • Materials and curriculum content (pictures, videos, demonstrations) • Support and teaching methods (language, instruction, learning styles and visuals) • Expectations, roles, and rules

The CATCH Kids Club Activity Boxes, both K-5 and 5-8 versions, include sections on inclusion. These sections provide ideas for inclusion, general tips, safety tips and considerations, and how to adapt certain activities; however, not all activities in the box have adaptations. The next section of this Guide provides examples for additional adaptations.

Kids Club Activity Box and Kids Club (Grades 5-8) Activity Box

The CATCH Kids Club activity boxes both include over 400 activity cards that contain detailed instructions for age- appropriate games that keep kids moving and having fun. All games are non-elimination, so everyone is able to stay engaged. Some of the cards provide variations to the activities or particular teaching techniques for adapting the activities.

Incorporate the following specifc sports and program elements and adaptations into individual and broader programming as appropriate to ensure that you create inclusive, equitably-benefcial environments and opportunities for all kids.

25

Aerobic Games

Aerobic games include activities that promote cardiovascular ftness and motivating participation.

• Provide task cards that include inclusive pictures and instructions (e.g. students who use wheelchairs or wear leg braces completing tasks or modifcations to exercises) • Perform activities in seated position • If a student has a visual impairment, consider providing them with a peer guide runner • When cardiovascular ftness is the focus of the lesson, provide various options to match coordination levels to ensure participants can do the activity continuously • Alter or include additional locomotion terms like “running” and “walking”, such as: o Pedaling a hand cycle o Pushing a wheelchair o Scooting on floor o Riding a tricycle o Rolling across a mat o Sliding on a scooter

Basketball

The basketball section provides games and drills that improve ball handling, passing, and shooting skills depending on the individual’s ability level.

• Use various types of balls (e.g., different sizes, colors, textures, weights) • Lower the hoop; use trash can or other bucket-like equipment if goal will not go low enough • Use larger hoop • Allow extra time to shoot or pass • Allow two-hand dribbling • If a student uses a wheelchair, allow him or her to hold the ball on his or her lap while pushing wheelchair; consider teaching students what constitutes a legal dribble in wheelchair basketball • If a student is using a manual wheelchair to play be sure they have an anti tip bar installed to prevent injury and falls. • If a student has a visual impairment, use a ball equipped with a noise device and provide a different noise maker under the basket indicating when the ball hits the court

26 Bean Bag

Bean bag activities encourage catching, throwing, and balancing skills with bean bags or light objects.

• Toss bean bags from only one side of the play area to avoid collisions or students getting hit • Move target closer • Create a larger target • Lower target • Allow students who use wheelchairs to catch bag in lap • Perform tasks blindfolded • Use bright colored bags for students with low vision. • Use balloons, scarves, foam balls, or other lightweight objects to practice catching skills as an alternative to bean bags when working on building reaction time

Dance

Dance activities provide individual and group dance moves and encourage no “wrong” way to move. This section encourages students to recognize rhythms and move their bodies freely.

• Provide modifcations for dance movements • Provide imagery of seated positions • Use pads/floor markers for students to locate their designated spots • Encourage freestyle dancing • For students embarrassed about dancing in front of other students, consider dancing in the dark • For choreographed moves, provide specifc instructions (e.g., instead of saying “move forward,” say “take three steps forward”) • Choose music with a slower tempo when teaching rhythm or choreographed routines

Fast Games

Fast games are quick 10- to 15-minute games that require little or no equipment.

• Consider locomotion movements students are able to complete • Adjust the size of the playing area to control flow of games and allow for greater individual participation (more time moving or in contact with ball) • Use boundaries that change the surface (e.g., a basketball court surrounded by a different-textured running track) for those with visual impairment

27 • Use scooters, rolling chairs, scooter boards, etc. to move around the play area • Create small teams that include each peer working together

Football

The football section provides games and drills that improve basic ball carrying, throwing, and defending skills depending on the individual’s ability level.

• Based on group size and student ability levels and assistive devices, play on flat, rectangular surface with clearly marked boundaries (e.g., basketball or tennis court) • Kickoffs, punts, and feld goals can be replaced with throws • Use lighter, softer, or larger balls that are easier to catch • Use chairs to create games and activities that are stationary • Allow students to use sports or motorized wheelchairs • Use a noise-emitting ball to help student with visual impairment locate the ball throughout the game • Vary the number of players on the feld • Provide a play area that is smooth and barrier-free • Vary the receiving rules based on the physical ability levels of receivers (ex: an individual with tetraplegia or limb loss), and allow the ball to hit the receiver in a designated area (e.g., chest, back, arm, leg, chair) to count as a catch, while receivers with more complete use of their hands still have to physically catch a pass • Allow two-hand touches to count as a tackle; allow one-hand touches for students who may have limb loss or limited use of one or both arms • For activities using flags, attach flag that must be removed to count as a tackle around the wheelchair as opposed to the waist

Formations

This section provides ways to organize students in a play area.

• Provide smooth, barrier-free play areas • Objects for barriers, checkpoints, or boundaries should be clearly marked in bright color, have a change in surface, or noise-device • Use pads/floor markers for students to locate their designated spot

Jump Rope

Jump rope games provide rhythm, timing, muscular strength, and cardiovascular ftness.

28 • Provide inclusive pictures of performing jumps in seated position • Provide split ropes or ropes with large handles • Provide jump rope skill options for all ability levels: o Jump over a line, rope, or obstacle on the floor o Practice jumping to a clapping rhythm o Practice swinging rope and stepping over o Practice jumping in small groups of three where two participants are turning the rope and one is jumping (students alternate tasks)

Limited Space

Limited space activities take place when a play area is kept small and space is restricted. These are typically played inside a classroom.

• Remove any barriers or obstructions within the small play area • Change speed of locomotion movements • Game cues should be inclusive of seated positions • Thrown objects should be brightly colored • Thrown objects should have some noise-device or beeper (e.g., attach beads or bell to object, or wrap object in plastic bag or other noise-making material) • Allow students to catch objects in lap • Move targets closer • Make targets larger • Provide ground targets for students who may only be able to accurately roll objects • Pay attention to the amount of sensory input in a small space (noise, lighting, amount of people moving at once, etc)

Parachute

Parachute activities involve using a large parachute. This engages students in cooperating with others and developing listening skills.

• Sit on stools or in chairs in a circle • Perform activities in a smooth, barrier-free play area • Provide clear directions in open light areas before going under the parachute • For mobile activities, change speed to walking/ambulating at a moderate pace • Vary the balls used in activities (e.g., size, color, weight, texture) • Use a beeper ball for students with visual impairment • Provide large straps or handles that are easier to grab for students with limited dexterity

29 Plastic Hoop

Plastic hoop activities utilize several different sizes of hoops to engage students in a variety of movements and games.

• Provide different sized hoops depending on students’ ftness levels • Allow students who use wheelchairs to lay hoop in lap as they push chairs • Provide hoops with beads inside for noise • Allow students to play with hoop around arms if activity includes legs or vice versa • Provide distance options target tosses • Provide pictures of seated exercises with hoop • Hoop jumps can be done by laying the hoop on the ground and having the student steer their wheelchair in and out of the hoop • Allow hoop spins on various parts of the body

Rhythms

The rhythm activities provide individual and group dance moves and encourage no “wrong” way to move. This section encourages students to recognize rhythms and move their bodies freely.

• Allow students to clap hands or tap feet instead of jumping • Obstacles should be clearly marked by either noise-making devices or changes in surface height or texture • Allow participants to perform the dance moves in seated position • Practice slower or less complex rhythms before moving to more complex rhythms

Soccer

The soccer section provides games and drills that improve basic ball dribbling, trapping, and passing skills depending on the individual’s ability level.

• Reduce the length of game • Reduce the size of the play area • Provide boundaries that have a change in surface • Use a lighter or larger ball • Use a beeping ball or one that has bells inside • Increase size of goals and other targets • Allow use of hands to dribble, pass, and shoot ball for those in wheelchairs or other rolling chairs

30 • Provide bumpers that allow chairs to move ball instead of hands or feet • Change speed to walking only • Allow push-ins or kick-ins instead of throw-ins for players who may not be able to perform throw-ins • Use flags for signals and cues for players with hearing impairments • Play on a smooth, barrier-free surface

Softball

The softball section provides games and drills that improve basic throwing, felding, batting, and pitching skills depending on the individual’s ability level.

• Vary the ball (e.g., size, weight, color, texture) • Use a larger and lighter bat • Allow students to push or hit off of a tee • Allow batters to sit in chair • Use Velcro balls and mitts • Provide grip devices (e.g., athletic tape, Ace bandage, Velcro cuff) for players who do not have the grip strength to hold a bat; for safety, do not allow players to run with bat • Use scoops or other non-glove items for catching that may be more appropriate for certain students • Use balls that make noise (e.g., beep baseball); provide bases that have a sound-emitting device • Increase or decrease distance of bases and pitching area • Allow extra time to run the bases by requiring felders to hold ball for X amount of time before throwing or tagging • Provide a peer for assistance • Mark positioning in the feld for various positions • Allow everyone to bat before switching innings; consider eliminating traditional outs and strikeouts to ensure more engagement and physical activity for each student • Use well-defned boundaries • Play on a flat, level surface, such as a gym floor, outdoor basketball court, or smooth parking lot to accommodate for students using a wheelchair

Task cards

Task cards are exercises, movements, or activities that students must complete individually. Task cards provided in the activity boxes include the following topics:

• Aerobic dance, jump rope, locomotion, step station/aerobic, muscular strength and endurance, and flexibility o Provide movement terms that can be done in seated position (e.g. seated marching, seated jumping jacks, arm 31 circles) o Provide modifcations or options to each locomotion task o Include imagery of adapted movements (e.g., student who uses a wheelchair or other assistive device, seated exercise, using a resistance band instead of a dumbbell) o Provide clear instructions and pictures of tasks o Make sure all tasks have been demonstrated previously o Allow students to partner up

Tennis

The tennis section provides games and drills that improve forehand, backhand, volley, and ready position skills depending on the individual’s ability level.

• Ensure racquet size and weight are appropriate for each student • Use larger and lighter balls • Use balls that travel slower • Use brightly colored ball • Hit ball off tee • Allow a drop serve • Allow serving from a closer distance • Allow ball to bounce multiple times • Use a peer for assistance • Use chairs to allow for students to play while sitting • Provide grip devices (e.g., athletic tape, Ace bandage, Velcro cuff) for players who do not have the grip strength to hold a racquet • Lower or remove net • Play on a smooth, barrier-free surface

Volleyball

The volleyball section provides games and drills that improve passing, setting, hitting, and serving skills depending on the individual’s ability level.

• User lighter and/or softer ball (e.g. beach or foam ball) • Use a larger and/or brightly colored ball • Use beep or other noise-emitting ball • Use a smaller and/or lower net • Place mats on floor to ease in scooting • Play on scooter boards to help with movement • Play variations of a standard volleyball game (e.g., two vs. two, catch and toss, skill building) • Play seated (sitting volleyball) • Allow for multiple (e.g., more than the traditional three) hits for each side • Allow the ball to bounce 32 • Move serving line forward • Allow throwing serves • Use poly dots to help students fnd floor position • Use a peer for assistance • Require every player to touch the ball before passing it over the net • Minimize background noise during instruction and play • Visually demonstrate skills • Use flags instead of whistles

CATCH Kids Club (CKC) Healthy Habits & Nutrition Manuals for Grades K-5 and 5-8

Healthy eating is one of the most powerful tools we have to reduce the onset of disease; therefore, nutrition education should begin at early stages of life. The younger an individual is who starts practicing healthy eating, the more likely he or she is to continue this behavior throughout adulthood. Nutrition education should be accessible to and inclusive of people of all abilities. This means including people with disabilities, both physical and intellectual, in the planning process, considering and addressing any challenges or modifcations needed for people with disability and ensuring that accessibility is guaranteed throughout implementation. Specifcally, instructional techniques in the classroom, worksheet and material design, and adaptions to kitchen tools and modifcations of recipes should be considered. Additionally, chewing and swallowing difficulties can be a common condition in certain disabilities; therefore, a registered dietitian or other qualifed health professional who makes recommendations for special therapeutic diets should be utilized. Programs should be designed to fully reach and impact participants with different types of disability and to adapt to their diverse needs.

Designed for the teacher and non-professional instructor, the CKC Manuals for Grades K-5 and 5-8 feature easy-to-teach lessons with stories, rhymes, games, and songs. The lessons are intended to help reinforce positive nutrition- and physical activity-related behaviors at home, and incorporate a variety of teaching strategies, including movement-based activities, individual practice, cooperative learning groups, large-group discussions, educational games, goal setting, and hands-on snack preparation. The manuals also contain family tip sheets that reinforce parental participation, which contributes to the effectiveness of positive changes in eating and physical activity behaviors.

Even though common practice is for grades fve through eight students to begin using more text within assignments, it is important to consider a student with an intellectual disability or a student with multiple disabilities. The manual designed for the older age group is age-appropriate with nutrition content; moreover, considerations for inclusive handouts and activities will also beneft this manual. The K-5 nutrition manual has been created with many pictures and short-sentence handouts; this can often assist the learning capacity of a student who has an intellectual disability.

General adaptations while teaching*

• Speak audibly and clearly • Avoid background noises and eliminate distractions • Provide extra time to complete the lesson • Use food models and other objects for students to physically touch and/or visually see 33 • Allow answers to be given orally • Speak directly to the student • Use gestures, facial expressions, and common cues (thumbs up or down) to communicate with students • Demonstrate tasks or fnal outcome expected • Consider how long lessons are or how much information is provided; allow sufficient learning time • Use person-frst language and terminology • Provide activities that promote inclusion, such as seated movements or arm stretches • Teach one concept or activity component at a time; this also supports memorization

*Note that these general teaching tips and strategies can also be utilized in physical activity settings as well. Effective communication and instructions will enhance the learning experience of all students.

General adaptations for handouts/worksheets

• Provide large pictures and lettering for clear directions or examples o Types of foods o Types of physical activity o Keywords • Keep directions short and easy to understand; break up instructions into small, attainable steps • Use high contrast colors and bold fonts • Provide Braille or different textures • Defne words or directions with pictures • Consider categorizing foods similar to a stoplight (associated with GO, SLOW, WHOA model) • Allow students to practice knowledge by answering worksheet questions orally • When comparing different portion sizes, show pictures of correct and incorrect sizes, preferably of similarly sized and easily recognized objects (e.g. a golf ball for a serving of cheese or nits or a baseball for a serving of fruit, vegetable or rice) • Demonstrate grams of sugar with sugar cubes • Reduce answer choices (e.g., provide three answer choices instead of four) • For handouts with song lyrics, use gestures and move lips clearly for students with hearing impairments; provide music or sing audibly and clearly for students with visual impairments • Consider the amount of text per page on handouts. A page full of writing can be intimidating and difficult for students with ID or reading challenges. Sometimes just breaking up text into multiple pages by adding more white space to the pages makes all the difference.

General adaptations for recipes

• Provide pictures of ingredients • Provide pictures of utensils and measuring tools • Keep each step as short as possible (less words/short phrases) • Provide a demonstration, video, or guide to assist with directions • Be aware of food allergies and texture issues and provide substitutes as needed • Provide utensils with thicker handles, straps, and other grippers • Be aware of any chewing or swallowing difficulties and refer to a qualifed health professional as needed • Think through cooking and preparation methods and suggest recipes that lead to the most autonomy for each age group (for example, sharpness of knives involved, cook-free options, microwave recipes rather than stove top or oven)

34 Final Remarks

The purpose of the presented information is to help physical activity facilitators and afterschool coordinators promote the inclusion of students with disability while using the CATCH Kids Club program. Recommendations in this document should be tailored to include all abilities during class, and instructors should be able to make appropriate adaptions to lessons and activities to ft all participants’ needs.

References

• Adaptive Sports. NCHPAD – Building Healthy Inclusive Communities. (n.d.). Retrieved February 13, 2017, from http://www.nchpad.org/1412/6288/NCHPAD~Glossary

• After-School. Coordinated Approach To Child Health (CATCH). (2014). Retrieved on February 3, 2017 from http://catchinfo.org/programs/after-school/

• Coleman KJ, Tiller CL, Sanchez MA, et al. Prevention of the epidemic increase in child risk of overweight in low-income schools: the El Paso coordinated approach to child health. Arch Pediatr Adolesc Med. 2005;159:217-222.

• Defnition of Inclusion. NCHPAD – Building Healthy Inclusive Communities. (n.d.). Retrieved February 13, 2017, from http://www.nchpad.org/1456/6380/Defnition~of~Inclusion

• Luepker RV, Perry CL, McKinlay SM, et al. Outcomes of a feld trial to improve children’s dietary patterns and physical activity: The Child and Adolescent Trial for Cardiovascular Health (CATCH). J Am Med Assoc. 1996;275:768-776.

• NCHPAD Glossary. NCHPAD – Building Healthy Inclusive Communities. (n.d.). Retrieved February 13, 2017, from http://www.nchpad.org/1412/6288/NCHPAD~Glossary

• Scope About Disability. (2017). Retrieved on February 12, 2017, from www.scope.org.uk

• Sitting Volleyball: A Skill Enhancing and Physically Demanding Activity. NCHPAD – Building Healthy Inclusive Communities. (n.d.). Retrieved February 17, 2017, from http://www.nchpad. org/1412/6288/NCHPAD~Glossary

• SNIP Training Toolkit Part 5: Adapting Activities for All Learners. (August 7, 2013). Retrieved on February 12, 2017, from http://www.snipsf.org/wp-content/uploads/2011/08/SNIP-Training-Toolkit- Part-5-Adapting-Activities-for-All-Learners_8-2013.pdf

• Taras, H, Potts-Datema, W. Obesity and student performance at school. Journal of School Health. 2005;75(8):291-295.

• The Health and Physical Education Website for Teachers. PE Central. (1996-2016). Retrieved February 12, 2017, from www.pecentral.org

35 Part III. Afterschool Health Promotion Programs Glossary

Americans with Disabilities Act - The Americans with Disabilities Act of 1990 (ADA) prohibits discrimination and ensures equal opportunity for persons with disabilities in employment, State and local government services, public accommodations, commercial facilities, and transportation. It also mandates the establishment of TDD/telephone relay services. The current text of the ADA includes changes made by the ADA Amendments Act of 2008 (P.L. 110-325), which became effective on January 1, 2009. The ADA was originally enacted in public law format and later rearranged and published in the United States Code.

Autism spectrum disorder (ASD) and autism - group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.

Autonomic Dysreflexia - is a potentially dangerous clinical syndrome that develops in individuals with spinal cord injury, resulting in acute, uncontrolled hypertension

Cerebral Palsy (CP) - are non-progressive neurological disorders that appear in infancy or early childhood that permanently affect body movement and muscle coordination.

Disability - A physical or mental impairment that substantially limits one or more major life activities.

Hearing Impairments - hard of hearing is a mild to severe level of hearing loss in which individuals have some range of useful hearing, and possibly use a communication device. Individuals who are deaf have complete hearing loss and are unable to use residual hearing for processing information or communicative purposes, even with the use of amplifcation devices.

Individualized Education Plan (IEP) - is a legally binding document that has been tailored specifcally to a child’s educational needs, including his or her physical education needs. An IEP should state specifc goals and objectives for physical education as delineated in the student’s IEP meeting, which involves parents, teachers and other professionals. As the physical educator, you should be present at the meeting and take part in the discussion by suggesting accommodations that are age - and ability-appropriate.

Individuals with Disabilities Education Act (IDEA) - requires public schools to make available to all eligible children with disability a free, appropriate public education in the “least restrictive environment” alongside their peers without disability as is appropriate to their individual needs.

Instrumental activities of daily living (IADLs) - complex skills needed to successfully live independently. These skills are usually learned during the teenage years.

Intellectual disabilities - signifcant limitation in intellectual function that is represented by an IQ lower than 70.

Least Restrictive Environment - “to the maximum extent appropriate, children with disabilities… are educated with children without disabilities, and that special classes, separate schooling, or other removal of children with disabilities from regular education environments occur only when the nature or severity of the disability

36 is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily.” -Federal Register, August, 1977, p. 42497

Muscle Atrophy - decrease in muscle mass.

Muscular Dystrophy (MD) – is a progressive genetic disorder of the muscular cells characterized by muscle degeneration and regeneration.

Paralysis - loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage as well as motor.

Section 504 of the Rehabilitation Act of 1973 - states that “no qualifed individual with a disability in the United States shall be excluded from, denied the benefts of, or be subjected to discrimination under” any program or activity that receives Federal fnancial assistance. Section 504 covers every student with a disability.

Spasticity - Exaggeration of normal reflexes that occur when the body is stimulated

Spina Bifida (SB) - condition present at birth that results from an abnormality in the development of the neural tube, which forms the spinal cord.

Spinal Cord Injury (SCI) - is a complete or partial lesion to the spinal cord. The result of SCI is functional loss (sensory motor and autonomic dysfunction); severity depends on the level and completeness of the lesion.

The Office of Civil Rights (OCR) Dear Colleague Letter - does not specifcally speak to physical educators; however, it affects athletic opportunities in all schools and may affect the goals and outcomes for some of your students. On January 24, 2013, the OCR issued a Dear Colleague Letter clarifying schools’ obligations under the Section 504 Rehabilitation Act of 1973 to provide extracurricular athletic opportunities for students with a disability.

Thermoregulation - the ability of an organism to keep its body temperature within certain boundaries, even when the surrounding temperature is very different.

Visual Impairments – any visual condition that impacts an individual’s ability to successfully complete the activities of everyday life.

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