Physical activity for individuals with disabilities

Does promoting physical activities help our kids?

As some readers know, I’ve been an exerciser for many years. I like its effects on my body and my subjective evaluation of my thinking-feeling. So it’ll come as little surprise that I have an interest in the effects of physical activities, especially exercise) on individuals with disabilities.

For this reason, I often refer people to a near-classic review by Lang et al (2010) that examined the topic. Lang and colleagues systematically reviewed results of 18 studies, mostly abut individuals with autism, to assess whether antecedent exercise affected behavior. They found that students displayed lower levels of stereotypy, aggression, off-task behavior, and elopement (wandering or running away) after exercise as compared with periods when they did not engage in antecedent exercise. Importantly, they also found that other behaviors such as responding on academic tasks, staying on task, and such were not decreased; that is, the improvements seemed to be focused on inappropriate behavior.

Page and colleagues (2021) reported the results of a meta-analytic review of physical activity interventions for people with intellectual disabilities. Here's a quote from their article:

One theme that emerged from the review was studies that taught or used multiple forms of physical activity had the largest effect size or a high success estimate (e.g., Cannella-Malone et al., 2013; Cannella-Malone et al., 2011; Favazza et al., 2013). Whereas studies that focused only on walking, particularly group design studies, reported lower effect sizes (Chen et al., 2015; Melville et al., 2015; Shields & Taylor, 2015). This finding indicated that teaching multiple topographies of physical activity could lead to clearer outcomes for people with ID.

These two reviews provide reasonable evidence that having students exercise also is likely to result in improved behavior. That's great! Let's go for it!

Words of Caution

However, I advise caution in interpreting these findings. Let's not get carried away with them. A brief examination of historical work in special education provides a caveat.

When I was coming up as a special educator in the 1960s, some popular ideas about learning disabilities, autism, intellectual disability, and similar problems involved physical activity, use of sensory data, and the like. The ideas of authorities (some of whom were widely published scholars) about sensory integration (e.g., Ayers, 1963, 1969, 1972), perceptual-motor learning (e.g., Kephart, 1960, 1964), and aspects of physical development (e.g., Doman, 1964) became the basis for school activities.

In a nutshell, the idea was that children needed to have sensory-perceptual-motor competence before they would be able to master academic skills such as reading, writing, and the like. So, we had children walking on balance beams, created obstacle-course-like paths around playgrounds with stops where students were to perform some actions (make "angels in the snow"), and designed activities to help children understand their bodies (e.g., develop laterality). Sometimes these activities have new names referring to "brain-based learning" (see, for example, Brain Gym®), but they are widespread; for example, in an examination of schools' Web sites, Stephenson et al. (2007) found that the same or similar ideas were still being recommended in schools in Australia.

Subsequent examination of foundational research about ideas like Ayer's sensory integration theory found little support for it (e.g., Cummins, 1991). Literature reviews of studies of the benefits of perceptual-motor training activities showed disappointing outcomes (Goodman & Hammill, 1973; Hammill et al., 1974; Kavale & Mattson, 1983). Even the newer versions such as Brain Gym® have disappointing results (Spaulding et al., 2010). Generally, children may get better on tests of perceptual-motor learning, sometimes on broader tests of development (e.g., “readiness”), but not on tests of academic performance.

Recommendations

So, because benefits physical activities do not transfer to important outcomes such as reading, should we abandon sensory-perceptual-motor activities? I do not think that is a sensible conclusion. I think we should abandon the fanciful notions that sensory-perceptual-motor activities are foundational for other learning and that training them helps with academic learning. But, I still think that it's beneficial for our kids to learn co-ordination, not look clumsy, stay upright, get exercise, have chances to participate in sports, and acquire life-long fitness habits (Kelly et al., 2017). Those are worthwhile goals in their own right.

And, given the findings in Lang et al. (2010) and Page et al. (2021) about benefits of diverse aerobic exercise for behavior. I think educators have the data to promote well-rounded programs of physical activity. Let's just not get carried away with our rationale for such programs.

References

Ayres, A. J. (1963). The development of perceptual motor abilities: A theoretical basis for treatment of dysfunction. American Journal of Occupational Therapy, 17, 221–225. https://pubmed.ncbi.nlm.nih.gov/14072429/

Ayres, A. J. (1969). Deficits in sensory integration in educationally handicapped children. Journal of Learning Disabilities, 2(3), 160–168. https://doi.org/10.1177%2F002221946900200307

Ayres, A. J. (1972). Improving academic scores through sensory integration. Journal of Learning Disabilities, 5, 338–343. https://doi.org/10.1177/002221947200500605.

Cummins, R. A. (1991). Sensory integration and learning disabilities: Ayre's factor analyses reappraised. Journal of Learning Disabilities, 24(3), 160-168. https://doi.org/10.1177%2F002221949102400304

Doman, G. (1974). What to do about your brain-injured child. The Better Baby Press.

Goodman, L., & Hammill, D. (1973). The effectiveness of the Kephart-Getman activities in developing perceptual-motor and cognitive skills. Focus on Exceptional Children, 4(9), 1-14.

Hammill, D., Goodman, L., & Wiederholt, J. L. (1974). Visual-motor processes: Can we train them?. The Reading Teacher, 27(5), 469-478. https://www.jstor.org/stable/20193536

Kavale, K., & Mattson, D. (1983). "One jumped off the balance beam": Meta-analysis of perceptual-motor training. Journal of Learning Disabilities, 16(3), 165-173. https://doi.org/10.1177%2F002221948301600307

Kelly, L. E., Block, M. E., & Colombo-Dougavito, A. M. (2017). Physical education. In J. M. Kauffman, D. P. Hallahan, & P. C. Pullen (eds.), Handbook of special education (pp. 586-605). Routledge.

Kephart, N. C. (1960). The slow learner in the classroom. Charles E. Merrill.

Kephart, N. C. (1964). Perceptual-motor aspects of learning disabilities. Exceptional Children, 31(4), 201-206. https://journals.sagepub.com/doi/pdf/10.1177/001440296403100406

Lang, R., Koegel, L. K., Ashbaugh, K., Regester, A., Ence, W., & Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565-576. https://doi.org/10.1016/j.rasd.2010.01.006

Page, E. J., Massey, A. S., & Rzeszutek, M. J. (2021). Systematic review and meta-analysis of between-group and single-case physical activity interventions for people with intellectual disabilities. Behavior Analysis: Research and Practice, 21(3), 248–272. https://doi.org/10.1037/bar0000216

Spaulding, L. S., Mostert, M. P., & Beam, A. P. (2010). Is Brain Gym® an effective educational intervention?. Exceptionality, 18(1), 18-30. https://doi.org/10.1080/09362830903462508

Stephenson, J., Carter, M., & Wheldall, K. (2007). Still jumping on the balance beam: Continued use of perceptual motor programs in Australian schools. Australian journal of Education, 51(1), 6-18. https://doi.org/10.1177%2F000494410705100102