Parental Perceptions of Physical Activity Benefits for Youth With Developmental Disabilities

Parental physical activity support for parents of children with disabilities in Saudi Arabia

Physical activity (PA) is crucial for promoting physical, cognitive, and psychosocial health. Unfortunately, children with disabilities spend less time engaging in PA compared to their typically developing peers. Parents play a crucial role in supporting children with disabilities to increase their level of PA. However, there is scant research on the factors linked to parental support for PA among non-Western parents of children with disabilities, particularly in the context of Saudi Arabia. Therefore, to address this gap in the literature, the current study aimed to (i) measure parental support for encouraging PA in children with disabilities in Saudi Arabia, and (ii) examine the demographic factors associated with such support (e.g., family income, age of the child, type of disability, and parents' educational background). The sample included Saudi Arabian parents of children with disabilities (N = 239; fathers: n = 123; mothers: n = 116) who completed the Arabic version of the Parental Physical Activity Support Questionnaire for Parents of Children with Disabilities (PPSQ for PCD). The findings revealed that parental support for children with disabilities to engage in PA typically occurs less than once a week, indicating an inadequate level of support. A generalized linear model analysis demonstrated that several independent demographic variables are associated with overall parental support for PA among children with disabilities: participant age, educational background, parental engagement in PA, age of the child with a disability, disability status, club participation, knowledge of legislation or policies related to the rights of children with disabilities, and number of children in the family. The findings emphasize the significance of raising awareness among parents of children with disabilities to support their children in participating in PA, as well as addressing the barriers that hinder such support.

"I Can Do It": Perceived Competence of Parents of Autistic Children After Participating in a Physical Activity Intervention

BACKGROUND

Autistic children can benefit from physical activity (PA) in a variety of ways. However, autistic children tend not to meet PA recommendations and, consequently, may not experience the associated benefits. Parental PA support can facilitate PA participation among autistic children, but parents of autistic children may lack the skills to help their child engage in PA. Few studies, to date, have examined the outcomes of parent-mediated PA interventions for autistic children. The purpose of this study was to explore parents' perceived behavioral control (PBC) to support their autistic children in PA after their participation in a PA intervention.

METHODS

The theory of planned behavior served as the framework for this descriptive-qualitative investigation. Fifteen parents (each with 1 autistic child in the intervention) participated in semistructured interviews (3 wk after the intervention), which were transcribed and then analyzed using thematic line-by-line analysis.

RESULTS

Three themes characterized the changes to parents' PBC after completing the PA intervention. Those themes were: (1) I learned by son! (2) You are my coach! and (3) I can do it!

CONCLUSIONS

The results showed that by participating in a parent-mediated PA intervention, parents experienced improved confidence and awareness of their child's abilities, thus enhancing their PBC. Future research is needed to examine how these improvements in PBC may influence the actual PA behaviors of autistic children.

Organized Sports Activities Are Safe for Children With Sickle Cell Disease: A Pilot Intervention Study

Historically, children with sickle cell disease (SCD) are advised to refrain from sports activities, based on the assumption that physical exercise can trigger vaso-occlusive episodes. This pilot intervention study examined the safety (ie, no vaso-occlusive episodes) of a 10-week organized sports program for children with SCD. Eight children with SCD (5 boys/3 girls), aged 7 to 12 years old, received 10 training sessions (each 90 min) once a week. Training sessions were performed by a professional soccer club under the supervision of a medical team from the Wilhelmina Children's Hospital. During the study period, one child experienced a vaso-occlusive crisis, which could not be directly related to the organized sports program. None of the other children experienced vaso-occlusive episodes. The results of this study indicate that children with SCD can participate safely in moderate-intensity organized sports activities when personalized medical background and practical training information is shared with the trainer beforehand. All children continued their sports participation after the study period.

Validity and reliability of the Turkish version of the parent perceptions of physical activity scale

BACKGROUND

The Parent Perceptions of Physical Activity Scale (PPPAS) is a scale developed to measure the physical activity perceptions of parents of children with neurodevelopmental disorders about their children. Turkish version of the PPPAS has yet to be established. The purpose of the present study is to examine the validity and reliability of the Turkish version of the PPPAS.

METHODS

The study included 130 parents with neurodevelopmental children. In the validity analyses of PPPAS, language validity, content validity analysis, and confirmatory and explanatory factor analysis were performed for construct validity. In the reliability analyses, Cronbach alpha analysis was used for internal consistency analysis, and intraclass correlation (ICC) analysis was used for test retest.

RESULTS

The validity index was calculated as 0.94. Since the factor loading of the three questions in the survey remained below 40%,these questions were removed. Construct validity was achieved for two primary subscales of the PPPAS. It was found that the ICC valuesfor the reliability analysis of the PPPAS showed a perfect fit at the level of 0.918 for the benefits of the physical activity subdimension, and the physical activity barriers subdimension showed a perfect fit at the level of 0.916 (p = 0.001).

DISCUSSION

The Turkish PPPAS, which consists of two subscales, namely the benefits and barriers of physical activity, is valid and reliable. This tool can measure the physical activity perceptions of parents with preschool-age children with neurodevelopmental disorders in the Turkish population.

Dyadic Predictors of Willing to Engage in Physical Activity and Emotional Eating in Children and Adolescents with Mild and Moderate Intellectual Disability

Intellectual disability is associated with increased risk for childhood obesity, and the factors most often associated with this risk are incorrect eating behavior and insufficient amount and intensity of physical activity. As is well known, there area whole range of factors determining lifestyle, but many currently available reports in this field refer to the functioning of children without a diagnosis of intellectual disability, and, as we know, due to numerous individual and environmental barriers, children with ID may function differently in this context than their peers. Therefore, we examined the relationships between the selected variables and divided them into two models: (1) first regression model: child's willingness to engage in physical activity (dependent variable), child's physical limitations related to disabilities and/or comorbidities, child's independence, parents' willingness to engage in physical activity, child's body dissatisfaction (independent variables/predictors); (2) second regression model: child's emotional eating (dependent variable), child's coping with emotions, parents' attitudes, beliefs, and practices about child feeding (restriction and pressure to eat), parents' emotional eating, parents' happiness (independent variables/predictors). A group of 503 parents (of children and adolescents with mild and moderate intellectual disability) completed: the Contour Drawing Rating Scale, the Child Feeding Questionnaire, the Emotional Overeating Questionnaire, the Scale of Experiencing Happiness, and the supplementary survey. Our results allow partial confirmation of the hypotheses related to both of these models: (1) model I: the relationships between the child's willingness to engage in physical activity and all predictors are significant, but the direction of the relationship between the dependent variable and one of the predictors-body dissatisfaction-is opposite to the assumed one (negative relationship); (2) model II: the relationships between the child's emotional eating and almost all predictors are significant, except for the relationship between the dependent variable and pressure to eat. In conclusion, (to the authors' knowledge) this study is the first to assess dyadic predictors of willingness to engage in physical activity and emotional eating in children and adolescents with mild and moderate intellectual disability. It allows for a better understanding of the attitudes, beliefs, and experiences of children with intellectual disabilities and their parents, which gives the opportunity (taking into account factors from both individuals from the child-parent dyad) to better design strategies to support pro-health behaviors in children and adolescents from this group (which may improve the effectiveness of overweight prevention and obesity). These findings emphasize how important it is to consider the dynamic of the child-parent dyad when considering how parenting contributes to a child's willingness to engage in physical activity, as well as thatchild's emotional eating.

Nutrition as Prevention of Diet-Related Diseases-A Cross-Sectional Study among Children and Young Adults with Down Syndrome

BACKGROUND

The aim of this study was to assess the diet of children with Down syndrome (DS) and to identify potential dietary mistakes made by their parents.

MATERIALS AND METHODS

The study was conducted among 195 parents of people with DS between November 2020 and March 2021. Data for the study were collected anonymously using the CAWI method.

RESULTS

122 (62.6%) people with DS did not eliminate any nutrient from their diet. By contrast, in the study group, the following numbers of people reported the following dietary restrictions: 51 (26.2%) gluten, 56 (28.7%) lactose, 17 (8.7%) casein, 26 (13.3%) sucrose, 2 (1.0%) histamine, 2 (1.0%) lectins, and 1 (0.5%) dairy. The most frequent response for vegetable and fruit consumption was once a day, with 83 (42.6%) and 87 (44.6%) parents indicating this. The most frequent response for dairy product consumption was every day, with 72 (36.9%) parents indicating this, while 36 (20%) parents stated that their children do not eat dairy products at all. In the study group, the most frequent response for meat consumption was several times a week, this was indicated by 107 (54.9%) parents, while 1 (0.5%) of them said that their children do not eat meat products at all. The most frequent response for fish consumption was 1-2 times a week, this answer was indicated by 101 (51.8%) parents, while 13 (6.7%) said that their children do not eat these products at all.

CONCLUSIONS

A majority of the subjects with DS are usually fed in a normal way, but nutritional mistakes are made by the parents. Special attention should be paid to prolonging the period of natural feeding.

Intrapersonal, interpersonal and environmental correlates of moderate to vigorous physical activity and sedentary time in adolescents with intellectual and developmental disabilities

BACKGROUND

Although correlates of physical activity (PA) have been extensively examined in both children and adolescents who are typically developing, little is known about correlates of moderate to vigorous physical activity (MVPA) and sedentary time in adolescents with intellectual and developmental disabilities (IDD). Therefore, we examined intrapersonal, interpersonal and environmental factors and their association with device-based MVPA and sedentary time in adolescents with IDD.

METHODS

MVPA and sedentary time was assessed using a hip-worn ActiGraph model wGT3x-BT tri-axial accelerometer across a 7-day period in adolescents with IDD and one of their parents. Pearson and point-biserial correlations were calculated to inspect the associations of PA (MVPA, sedentary time) with intrapersonal factors (demographic characteristic, BMI, waist circumference, motor ability, muscle strength, grip strength, cardiovascular fitness and self-efficacy for PA), interpersonal factors (parent demographics, parent BMI, parent MVPA and sedentary time, family social support for PA, parent barriers and support for PA, parent's beliefs/attitudes towards PA and number of siblings), and environmental factors (meteorologic season and COVID-19). Ordinary least squares regression was used to estimate the unique contributions of key factors to PA after controlling for participants' age, sex, race, waist circumference and total wear time.

RESULTS

Ninety-two adolescents (15.5 ± 3.0 years old, 21.7% non-White, 6.5% Hispanic, 56.5% female) provided valid accelerometer data. Average sedentary time was 494.6 ± 136.4 min/day and average MVPA was 19.8 ± 24.2 min/day. Age (r = 0.27, P = 0.01), diagnosis of congenital heart disease (r = -0.26, P = 0.01) and parent sedentary time (r = 0.30, P = 0.01) were correlated with sedentary time. BMI (r = -0.24, P = 0.03), waist circumference (r = -0.28, P = 0.01), identifying as White (r = -0.23, P = 0.03) and parent MVPA (r = 0.56, P < 0.001) were correlated with MVPA. After adjusting for the adolescent's age, sex, race, waist circumference, and total wear time, the association between parent and adolescent MVPA remained significant (b = 0.55, P < 0.01, partial η2  = 0.11).

CONCLUSION

The results of this study provide evidence that race, waist circumference and parental MVPA may influence the amount of MVPA in adolescents with IDD. The limited available information and the potential health benefits of increased MVPA highlight the need to evaluate the effectiveness of multi-component interventions targeting both intrapersonal and interpersonal levels to promote increased PA in adolescents with IDD.

Barriers and Facilitators of Physical Activity Participation among Children and Adolescents with Intellectual Disabilities: A Scoping Review

Background: Children and adolescents with intellectual disabilities (ID) have low levels of physical activity (PA). Understanding factors influencing the PA participation of this population is essential to the design of effective interventions. The purposes of this study were to identify and map the barriers and facilitators of PA participation among children and adolescents with ID. Methods: A scoping review was conducted in accordance with established methodology. Articles were evaluated for relevance using predetermined inclusion criteria in eight databases. Extracted barriers and facilitators were classified using the social ecological model as individual, interpersonal, or environmental factors. Results: Thirty-two studies published between 1992 and 2020 were included (24 quantitative, 6 qualitative, and 2 mixed-method). Thirty-four factors were identified. The most commonly reported barriers included disability-specific factors, low self-efficacy, lack of parental support, inadequate or inaccessible facilities, and lack of appropriate programs. The most commonly reported facilitators included high self-efficacy, enjoyment of PA, sufficient parental support, social interaction with peers, attending school physical education (PE) classes, and adapted PA programs. Conclusions: Continued exploration of factors influencing PA participation is required among children and adolescents with ID. Future interventions should involve families, schools, and wider support network in promoting their PA participation together.

Promoting the Participation of Children and Adolescents With Disabilities in Sports, Recreation, and Physical Activity

The benefits of physical activity are likely universal for all children, including children and adolescents with disabilities (CWD). The participation of CWD in physical activity, including adaptive or therapeutic sports and recreation, promotes inclusion, minimizes deconditioning, optimizes physical functioning, improves mental health as well as academic achievement, and enhances overall well-being. Despite these benefits, CWD face barriers to participation and have lower levels of fitness, reduced rates of participation, and a higher prevalence of overweight and obesity compared with typically developing peers. Pediatricians and caregivers may overestimate the risks or overlook the benefits of physical activity in CWD, which further limits participation. Preparticipation evaluations often include assessment of health status, functional capacity, individual activity preferences, availability of appropriate programs, and safety precautions. Given the complexity, the preparticipation evaluation for CWD may not occur in the context of a single office visit but rather over a period of time with input from the child's multidisciplinary team (physicians, coaches, physical education teachers, school nurses, adaptive recreation specialists, physical and occupational therapists, and others). Some CWD may desire to participate in organized sports to experience the challenge of competition, and others may prefer recreational activities for enjoyment. To reach the goal of inclusion in appropriate physical activities for all children with disabilities, child, family, financial, and societal barriers to participation need to be identified and addressed. Health care providers can facilitate participation by encouraging physical activity among CWD and their families during visits. Health care providers can create "physical activity prescriptions" for CWD on the basis of the child's preferred activities, functional status, need for adaptation of the activity and the recreational opportunities available in the community. This clinical report discusses the importance of participation in sports, recreation, and physical activity for CWD and offers practical suggestions to health care providers.

"Oh I try, but it's so hard": parental experiences of health promotion in children withdisabilities

PURPOSE

The purpose of this study was to explore how parents support the health behaviours of their child with a disability, and their motivations for registering their child in a health promotion program for children with physical and/or intellectual disabilities.

METHODS

Using a descriptive qualitative design, semi-structured face-to-face interviews were conducted with individual parents (n = 8) and one group (n = 3) to explore their experiences of health promotion for their child with a disability. Data were analyzed using thematic analysis to identify themes and patterns to develop an understanding of parental perspectives.

RESULTS

Three themes were identified in the analysis of parents' experiences supporting their children in health behaviours and registering them in a disability health promotion program: (1) Parents struggle to meet all of their child's health promotion needs; (2) Parents recognize the social components of healthy behaviours; and (3) Health promotion opportunities tailored for children with disabilities are limited. These themes were not mutually exclusive and had overlapping factors that influenced parental experiences.

CONCLUSION

Parents experience many challenges supporting the health behaviours of their children with disabilities. This study reinforces the need for accessible, developmentally appropriate, social health promotion programs for children with disabilities.IMPLICATIONS FOR REHABILITATIONChildren with disabilities frequently demonstrate significantly higher sedentary behaviours, lower rates of physical activity and consumption of high-fat foods than their typically developing peers.Promoting healthy behaviours such as healthy eating and physical activity among children with disabilities and their families is therefore crucial to the child's physical and psychosocial wellbeing.Parents of children with disabilities have sufficient health literacy and knowledge but report a lack of appropriate opportunities and strategies to support their child in developing healthy behaviours.Parents need increased availability and accessibility of socially inclusive programs that promote healthy behaviours for children of all physical and cognitive abilities.

Physical activity among children with down syndrome: maternal perception

Purpose: Studies have shown that children with Down syndrome (DS) are at high risk for physical inactivity and obesity. This study aimed to explore mother’s perceptions of the physical activity levels, needs, benefits, facilitators, and barriers in their children with DS.

Methods: For this descriptive qualitative study, 17 participants were recruited through centres for children with DS in the Kingdom of Saudi Arabia. Semi-structured interviews were conducted with mothers who were able speak Arabic or English and have a child with a confirmed diagnosis of Trisomy 21 (DS) between ages three and 17 years. Thematic analysis was used to analyse the study data.

Results: Data analysis revealed the following themes regarding children with DS: 1) their physical functioning level; 2) daily physical activity at home; 3) physical activity at school; 4) physical activity benefits; 5) physical activity facilitators; and 6) physical activities barriers.

Conclusion: Findings from this study can help health professionals gain insight on the physical activity facilitators and barriers for children with DS in order to design tailored intervention programmes to improve the support and the engagement of children with DS into regular physical activities.

Physical activity behaviors in parents of children with disabilities: A systematic review

BACKGROUND

Even though it has been widely known that parents influence physical activity (PA) behaviors of children without disabilities, there is no consensus about the effects of parents on PA behaviors of children with disabilities.

AIMS

The purpose of this study was to systematically review published literature examining the effects of parents on PA behaviors of children with disabilities.

METHODS

A systematic literature search was performed in three databases.

OUTCOMES AND RESULTS

The search identified 13 studies which met predetermined inclusion criteria. Of the 13 studies, 10 studies were conducted in United States and Canada. The remaining three studies were from three different countries: Italy, Australia, and Hong Kong. From the 13 studies, 24 parental factors were identified and categorized into four different dimensions: a) participating in PA intervention (four factors included), b) parental support (three factors included), c) parental PA role modeling (five factors included), and d) parental importance of child's PA (three factors included). Six factors across three dimensions (i.e., participating in PA intervention, parental support, parental importance of their child's PA) were significantly and positively associated with PA behaviors in children with disabilities, but no factor in parental PA role modeling was significantly associated with PA behaviors in children with disabilities.

CONCLUSIONS AND IMPLICATIONS

The associations between parental factors and PA behaviors in children with disabilities varied depending on the dimensions of the parental factors. Further studies are warranted to confirm the association between parental factors and PA behaviors in children with disabilities, including cross-cultural comparisons.

Parental Influence on the Physical Activity Behaviors of Young Children With Developmental Disabilities

The purpose of this study was to test a modified conceptual model of the associations between parental supports and physical activity (PA) orientations and the PA behaviors of young children with developmental disabilities (DDs). In total, 135 parents of young children with DDs completed a questionnaire, which consisted of 67 questions. A pathway analysis indicated that tangible and intangible parental supports were significantly associated with PA behaviors in young children with DDs (β = 0.26, p = .01, and β = 0.24, p = .02, respectively). Tangible parental support was positively associated with parents' PA behaviors and PA enjoyment (β = 0.22, p < .001, and β = 0.13, p = .04, respectively). Intangible parental support was positively associated with parents' PA behaviors and PA importance (β = 0.19, p = .05, and β = 0.33, p < .001, respectively). In addition, parental PA behaviors and parents' perceptions of their children's motor performance were both directly associated with PA behaviors in young children with DDs. These results highlight the importance of parental support and PA orientations in relation to the PA behaviors of young children with DDs.

The promotion of physical activity for the prevention of Alzheimer's disease in adults with Down Syndrome: Rationale and design for a 12 Month randomized trial

Nearly all individuals with Down Syndrome (DS) display pathology associated with Alzheimer's disease (AD) beginning as early as age 30. Previous research in typically developed adults suggests that increased moderate-to-vigorous physical activity (MVPA) may improve cognitive function and protect against age-related structural and functional changes in the brain; however, the potential impact of increased MVPA on the development of AD in adults with DS has not been evaluated. Despite the potential positive impact of MVPA on cognition and AD risk, participation in MVPA among young adults with DS is low. The limited research evaluating strategies for increasing MVPA in adults with DS has been unsuccessful in increasing MVPA. Results from our preliminary investigation where we remotely delivered real-time MVPA, led by a trained health educator, to groups of adults with DS in their homes via video conferencing on a tablet computer demonstrated high attendance, increased MVPA during group sessions, and improvements in cognitive function. However, the sustainability, impact on total daily MVPA, optimal session frequency, and potential impacts on cognitive function and brain health of remotely delivered group MVPA sessions in adults with DS are unknown. Therefore, we will conduct a trial in 80 non-demented adults with DS to determine the feasibility and potential efficacy of remotely delivered group MVPA sessions to increase daily MVPA, relative to a usual care control. Secondarily we will assess the impact of MVPA on cardiovascular fitness, quality of life, cognitive function and brain parameters related to AD.

NCT REGISTRATION

NCT04048759.

Maternal Feeding Practices, Health Cognitions, and Children's Eating Styles and Weight Status

OBJECTIVE

To examine the relationship between maternal cognitions related to promoting a healthy lifestyle in their child, maternal feeding practices, children's eating styles, and child weight status in children aged 4 to 6 years.

METHODS

Cross-sectional questionnaire data were collected in 251 Dutch mothers of preschoolers. Structural equation modeling was used to test the fit of a model that assumed maternal health cognitions would predict maternal feeding practices, which in turn would predict children's eating styles and child weight status. Explorative analyses were conducted to examine child characteristics as predictors of maternal health cognitions and feeding practices.

RESULTS

Mothers with higher self-efficacy used fewer pressure-to-eat feeding techniques, which in turn was related to less avoidant eating styles in children. In addition, mothers who perceived more benefits of a healthy lifestyle used more restriction techniques, which in turn predicted a more approach-oriented eating style in children, which was also related to higher child standard deviation scores body mass index. Finally, children with an avoidant eating style had mothers who perceived more barriers and reported less self-efficacy.

CONCLUSION

Self-efficacy and perceived benefits relate to maternal feeding practices and eating styles of the child. However, more perceived benefits of a healthy lifestyle were associated with inadequate feeding practices. Therefore, interventions targeted at mothers to reduce child overweight should focus not only on reinforcing perceived benefits of a healthy lifestyle but also on how the mother can translate her attitudes into adaptive parenting to achieve the desired health outcomes.

Mothers supporting play as a choice for children with disabilities within a culturally and linguistically diverse community

Background: Play is a right for children; an essential childhood occupation influenced by their family environment. Despite increasing recognition of unstructured outdoor play benefits, children with disabilities experience limited play opportunities.Aim: To apply a capabilities approach lens to understand outdoor play decision-making by mothers of children with disabilities within a culturally and linguistically diverse community.Materials and methods: Data collection for this case study involved semi-structured interviews with five mothers of primary school-aged children with disabilities and a week-long survey that profiled their children's outdoor play. Analysis was thematic and involved identifying barriers and opportunities at each ecocultural layer, aggregating strategies families used to address the barriers, and understanding their overall play decision-making.Findings: Mothers considered the child's interests and abilities, valued play as both a means and ends, planned for play, and facilitated in the moment as required. Multiple factors influenced mothers' outdoor play decisions. Mothers' values were child-centred, positively influencing the child's play opportunities.Conclusion and significance: This study's capabilities lens could inform professions such as occupational therapy to support families of children with disabilities from culturally diverse communities to advocate for play opportunities across settings.

The perspectives of parents of youth with disabilities toward physical activity: A systematic review

BACKGROUND

Parents' perceptions of physical activity (PA), in particular, are critically important because children with disabilities are often dependent on their families to be able to engage in physical activities. Thus, adapted physical activity scholars have acknowledged the need for research addressing the perceptions of parents of youth with disabilities regarding their child's PA engagement.

PURPOSE

The purpose of this review was to examine published research literature pertaining to parents' perspectives toward physical activity of youth with disabilities by describing study characteristics and major findings.

METHODS

Electronic database searches were conducted to identify relevant articles published between January 2007 and January 2018.

RESULTS

Thirty-two articles met all inclusion criteria, and relevant data such as participant characteristics, theories, measurements, and dependent variables were extracted from them. Of the 32 studies, 26 were descriptive, and six were correlational. Seventeen studies explicitly stated a theoretical or conceptual framework.

CONCLUSIONS

Major findings suggest that parents have reported multiple motives to engage their children with disabilities in physical activity. However, numerous barriers (e.g., lack of program, lack of time, children's disability) were reported that negatively impact physical activity participation. As such, parents are calling for the need for training provided by qualified professionals to enhance participation for their children with disabilities.

Individual and family-based approaches to increase physical activity in adolescents with intellectual and developmental disabilities: Rationale and design for an 18 month randomized trial

Adolescents with intellectual and developmental disabilities (IDD) are less physically active and have lower cardiovascular fitness compared with their typically developing peers. This population faces additional barriers to participation in moderate-to-vigorous physical activity (MVPA) such as reliance on parents, lack of peer-support, and lack of inclusive physical activity opportunities. Previous interventions to increase MVPA in adolescents with IDD have met with limited success, at least in part due to requiring parents to transport their adolescent to an exercise facility. We recently developed a remote system to deliver MVPA to groups of adolescents with IDD in their homes via video conferencing on a tablet computer. This approach eliminates the need for transportation and provides social interaction and support from both a health coach and other participants. We will conduct a 18-mo. trial (6 mos. active, 6 mos. maintenance, 6 mos. no-contact follow-up) to compare changes in objectively assessed MVPA in 114 adolescents with IDD randomized to a single level intervention delivered only to the adolescent (AO) or a multi-level intervention delivered to both the adolescent and a parent (A + P). Our primary aim is to compare increases in MVPA (min/d) between the AO and A + P groups from 0 to 6 mos. Secondarily we will compare changes in MVPA, sedentary time, cardiovascular fitness, muscular strength, motor ability, quality of life, and the percentage of adolescents achieving the US recommendation of 60 min. MVPA/d across 18 mos. We will also explore the influence of process variables/participant characteristics on changes in MVPA across 18 mos. NCT registration: NCT03684512.

Organized Sports for Children, Preadolescents, and Adolescents

Interest and participation in organized sports for children, preadolescents, and adolescents continue to grow. Because of increased participation, and younger entry age, in organized sports, appropriate practice, game schedules, and content become more important, taking into account athlete developmental stage and skills. Parental support for organized sports in general, with focus on development and fun instead of winning, has emerged as a key factor in the athlete's enjoyment of sports. Schools and community sports organizations who support multiple levels of sport (eg, recreational, competitive, elite) can include more youth who want to play sports and combat sport dropout. This report reviews the benefits and risks of organized sports as well as the roles of schools, community organizations, parents, and coaches in organized sports. It is designed to complement the American Academy of Pediatrics clinical reports "Physical Activity Assessment and Counseling in Pediatric Clinical Settings" and "Sports Specialization and Intensive Training in Young Athletes" by reviewing relevant literature on healthy organized sports for youth and providing guidance on organized sport readiness and entry. The report also provides guidance for pediatricians on counseling parents and advocating for healthy organized sports participation.

"My Child May Be Ready, but I Am Not": Parents' Experiences of Their Children's Transition to Inclusive Fitness Settings

Parents play an essential role in the transition from separate physical activity programs to inclusive settings for their children. The purpose of this study was to explore experiences of parents as they anticipate and prepare for their children experiencing disability to transition, understand strategies used to address transition, and gain insights into the supports important to families during transition. Using an interpretative phenomenological analysis research approach, semistructured one-on-one interviews were conducted with 8 parents whose children were undergoing the transition from separate to inclusive community fitness contexts. Four themes described the experiences of parents as they anticipated, prepared for, and supported their child to transition: My child may be ready, but I am not; fear of outside judgment; playing by their rules; and reframing our thinking. Using Schlossberg's model, the tensions parents faced as they negotiated new roles, relationships, routines, and assumptions as they moved through the transition process were uncovered. The parents experienced transition alongside their children, providing insights for fitness and health-promotion professionals. Without preparation for transition, apprehensions and hesitancy may postpone or prevent their children's transition to community programs.

Perceptions of Inclusivity: The Canadian 24-Hour Movement Guidelines for Children and Youth

The Canadian 24-Hour Movement Guidelines for Children and Youth (age 5-17 yr) consolidate evidence-informed daily requirements for physical activity, sedentary behavior, and sleep into 1 comprehensive resource. The primary objective of this study was to explore how parents of children and youth with disabilities (CYWD) perceive the guidelines. The secondary objective was to explore whether parents consider the guideline branding to be inclusive. A total of 15 mothers of CYWD participated in one 60-min semistructured interview, either in person or by telephone. The diffusion-of-innovation theory provided a theoretical basis for the interview guide. Mothers' perspectives of the guidelines and branding are represented as seven themes. The results indicate that the guidelines and the branding are not inclusive or compatible with the abilities and needs of CYWD. Findings from this study provide a foundation for ongoing knowledge-translation activities aiming to address these limitations. Further revisions are necessary to promote full inclusion and uptake of the guidelines among CYWD.

Parents' Beliefs About Physical Activity for Their Children With Visual Impairments

Despite having the desire to become physically active as a family, parents of children with visual impairments often lack the skills and resources needed to provide appropriate physical activities (PAs) for their children. The purpose of this study was to explore the intentions of parents of children with visual impairments toward including their children in PAs after participating in a PA program. In this descriptive qualitative study, the participants were 10 parents of children with visual impairments. A series of workshops were designed to provide parents with the skills and resources needed to promote PA for their family. Upon completion of the workshops, parents took part in one-on-one semistructured interviews that were subsequently transcribed and analyzed using a thematic line-by-line process. Two interdependent themes emerged from the data analyses: (a) eye-opening experiences and (b) transformed, more hopeful, and optimistic outlook. The results revealed that through the PA intervention, parents learned teaching strategies that were intended to increase their PA opportunities and garnered resources that allowed them to teach their children to participate in PA.

Physical Activity for Disabled Youth: Hidden Parental Labor

Locating suitable, inclusive community physical activity programs for disabled children can be challenging for parents. The aim of this study was to uncover everyday hidden labor experienced by parents, as they sought inclusive physical activity opportunities for their children. Focus group interviews with eight families of youth aged 13-19 years were completed using an interpretative phenomenological case study research approach. Four themes, interpreted through the framework of relational ethics, captured their experiences: (a) inclusion is immensely effortful; (b) judged by their impairments, not their possibilities; (c) ongoing education needed to open doors and sustain participation; and (d) the guilt of staying home. Reliance on hidden parental labor highlighted an exclusion agenda in community, accentuated by ableist belief systems.

Parental perceptions of facilitators and barriers to physical activity for children with intellectual disabilities: A mixed methods systematic review

BACKGROUND

There is a need increase our understanding of what factors affect physical activity participation in children with intellectual disabilities (ID) and develop effective methods to overcome barriers and increase activity levels.

AIM

This study aimed to systematically review parental perceptions of facilitators and barriers to physical activity for children with ID.

METHODS

A systematic search of Embase, Medline, ERIC, Web of Science, and PsycINFO was conducted (up to and including August, 2017) to identify relevant papers. A meta-ethnography approach was used to synthesise qualitative and quantitative results through the generation of third-order themes and a theoretical model.

RESULTS

Ten studies were included, which ranged from weak to strong quality. Seventy-one second-order themes and 12 quantitative results were extracted. Five third-order themes were developed: family, child factors, inclusive programmes and facilities, social motivation, and child's experiences of physical activity. It is theorised that these factors can be facilitators or barriers to physical activity, depending on the information and education of relevant others, e.g. parents and coaches.

CONCLUSIONS

Parents have an important role in supporting activity in children with ID. Increasing the information and education given to relevant others could be an important method of turning barriers into facilitators.

Physical activity participation among families of children with visual impairments and blindness

PURPOSE

Physical activity (PA) provides multiple benefits to children with visual impairments (VI) and their families. However, the empirical literature base is underdeveloped on how family PA experiences impact participation for children with VI. The purpose of this study was two-fold; that is: (a) to explore why families with children with VI seek out and participate in PA, and (b) to describe the strategies and supports needed by families of children with VI to improve PA participation.

METHOD

The research method was descriptive-qualitative positioned in the theoretical framework of the theory of planned behavior. Participants were parents of children with VI (n = 10) who took part in one-on-one semi-structured telephone interviews. Interview recordings were transcribed and analyzed using a thematic line-by-line analysis.

RESULTS

Three salient, recurrent, and interrelated themes emerged from the data analyses. These themes were: (a) committed, (b) challenged, and (c) access.

CONCLUSIONS

Findings revealed that parents valued PA, but they lacked the skills to teach and advocate for their children regarding PA. As a consequence, parents voiced the need for a support system that would allow their families to be more physically active. Implications for Rehabilitation Results of this study demonstrated that parents valued physical activity, but they lacked the skills necessary to confidently engage their children in physical activity. Physical activity interventions are needed to enhance the quality of life of children with visual impairments and their families. Physical activity programs and interventions are most likely to enhance intentions to engage in physical activity among children with visual impairments and their parents. Results demonstrated that parents of children with visual impairments were interested to work side-by-side with physical activity professionals to enhance recreational physical activity opportunities available to their children.

Assessing Parent Perceptions of Physical Activity in Families of Toddlers With Neurodevelopmental Disorders: The Parent Perceptions of Physical Activity Scale (PPPAS)

PURPOSE

The purpose of this study was to examine a new tool (PPPAS = Parent Perceptions of Physical Activity Scale-Preschool) developed to study parental perceptions of physical activity (PA) among parents of toddler and preschool age children.

METHOD

143 children (mean age 31.65 months; 75% male) and their parents were recruited from a neurodevelopmental clinic. Parents completed questionnaires, and both a psychologist and a physician evaluated the children. Eighty-three percent of the children received a diagnosis of Autism Spectrum Disorder; 20% of the children had a BMI > 85th percentile. Analyses were conducted to evaluate the reliability, concurrent validity, discriminant validity, and predictive validity of PPPAS scores.

RESULTS

Results supported a two-factor structure: Perceptions of the Benefits of PA and the Barriers to PA. The internal consistency of scores was good for both PPPAS subscales, derived from the two factors. Parent perceptions of barriers to PA were significantly correlated with delays in overall adaptive functioning, daily living skills, socialization, and motor skills. When a child's motor skills were delayed, parents were less likely to believe PA was beneficial and perceived more barriers to PA. Parent perceptions of barriers to PA predicted parent-reported weekly unstructured PA and ratings of how physically active their child was compared with other children.

CONCLUSION

We present the PPPAS-Preschool for use in pediatric exercise research and discuss potential applications for the study of parent perceptions of PA in young children.

Parents’ perceptions of physical activity experiences for their families and children with visual impairments

Acknowledging and understanding parental perceptions and experiences surrounding physical activity (PA) is crucial to promoting participation in PA for children with visual impairments (VI) given that parents strongly influence their children’s participation in physical activities. The purpose of this study was to understand parents’ perceptions regarding PA experiences for their family and children with VI. Participants in this study were parents of children with VI ( N = 10) who took part in one-on-one semi-structured phone interviews that were transcribed and then analyzed through a thematic line-by-line analysis. Two themes emerged from the analysis of the data: (1) Health, Social, and Psychological Benefits and (2) Multifaceted Barriers. The parents in this study valued PA and had high PA expectations for their children; however, they struggled to overcome multiple barriers - most notably their limited ability to motivate their children to be physically active.