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Investigating Parental Beliefs Concerning Facilitators and Barriers to the Physical Activity in Down Syndrome and Typical Development:

Investigating Parental Beliefs Concerning Facilitators and Barriers to the Physical Activity in... Family is a crucial factor to determine the amount, the duration, and the complexity of children’s sport activities. This study aims at comparing the beliefs concerning the involvement in sport activities among parents of children with Down syndrome (DS) and parents of typically developing children (TDC). A phenomenological theoretical framework was adopted to realize semistructured interviews with the parents. The participants were 35 parents: 19 with children and adolescents with DS and 16 with TDC. The main facilitation/barrier themes identified by the parents of children with DS were the family and the expert at Adapted Physical Activity (APA) instructors. Conversely, the parents of TDC identified social factors related to family as the only barrier. One of the issues that emerge from this study is the lack of home-based physical activity (PA) intervention programs aimed at involving families and children. Keywords family, DS, physical activity, facilitators, barriers high levels of inactivity are stated in typically developing Introduction people despite data demonstrating physiological and psy- The present study extends previous research, which aimed to chological gains from PA. A 60% of inactivity is reported in explore parental beliefs concerning involvement, facilitators/ Italy, as shown by data from the Special Eurobarometer 412 barriers, and benefits of physical activity (PA) in young peo- (March 2014) on the issue “Sport and Physical Activity.” ple with Down syndrome (DS; Alesi & Pepi, 2015). Nevertheless, the participation in sport activities is a mul- Specifically, the sample was enlarged to compare beliefs tidimensional construct that involves a variety of facilitators concerning the involvement in sport activities among the and barriers. The first are positive factors enhancing the par- parents of children with DS and the parents of typically ticipation of people with DS in PA, for example, parental developing children (TDC). support, opportunities and programs for participation, acces- Benefits of regular PA in people with DS have recently sible transportation, access to resources, and so on. The lat- been addressed in several research (Alesi, Battaglia, et al., ter, the barriers, are adverse factors that limit this participation, 2014; Golubovic, Maksimovic, Golubovic, & Glumbic, such as narrowed information about PA; developmental 2012; Palisano et al., 2001; Vogt, Schneider, Abeln, delays; health problems; lack of transport and independence; Anneken, & Strüder, 2012). Population with DS was found beliefs about the disability of parents, coaches, and teachers; to have typically sedentary lifestyle, to participate less in insufficient programs of social inclusion; few adapted equip- sport activities, and to fail the Chief Medical Officer’s ment; and so on. (2011) recommendation of 60-min moderate to vigorous PA a day (Frey, Stanish, & Temple, 2008; Gonzalez-Aguero et al., 2010; Phillips & Holland, 2011; Shields, Dodd, & 1 Università degli Studi di Palermo, Italy Abblitt, 2009; Temple & Stanish, 2009). The direct conse- Corresponding Author: quence is the risk of intensifying clinical diseases by devel- Marianna Alesi, Dipartimento di Scienze Psicologiche, Pedagogiche e della oping specific health-related complications such as the Formazione, Università degli Studi di Palermo, V.le delle Scienze, Edificio accumulation of bone mass, the type 2 diabetes, and motor 15, 90135 Palermo, Italy. functional impairments (Barr & Shields, 2011). Similarly, Email: marianna.alesi@unipa.it Creative Commons CC-BY: This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 SAGE Open A number of research investigating factors underlined the differences by promoting the access to active lifestyle and engagement in PA by the adapted model of the Youth Physical sport encompassing gymnastics, dance, movement, exercise, Activity Promotion (YPAP) designed by Welk (1999). In the sports, games, recreation, and physical education. original model, higher predictors of child engagement in PA Consequently, the APA employs adapted methods, such as are the predisposing factors, such as child’s self-efficacy, peer tutoring, in the context of large size class teaching; attitudes and personal beliefs on PA, and physical self-com- adapted equipment and rules, such as bigger balls to enable petence. Moreover, reinforcing factors are conditions sup- bouncing; adapted environmental variables such as a lower porting PA behaviors in childhood, such as family, peer, and net height for the volleyball; and qualified and expert at dif- teacher/coach influence. Equally important are enabling fac- ferent kinds of disabilities coaches (Hutzler & Sherrill, tors such as the child’s physical skills and fitness level as 2007). well as the access to gyms and environment. Indirect influ- To sum up, personal, familiar, and environmental charac- ence is played by personal demographics, such as age, eth- teristics are interrelated by reciprocally reinforceing links. nicity, and socioeconomic status. Recently, an adapted model For example, the few number of gyms offering APA exercise of the YPAP was developed by Downs, Boddy, Knowles, programs can oblige families to move for long distances by Fairclough, and Stratton (2013). It included enabling, predis- enhancing the costs of transportation and, in the long run, posing, and reinforcing factors to PA for children with DS. decreasing the motivation to engage in PA. Enabling factors involved environment, seasonal variation However, barriers and facilitators are to be found by such as decrease in PA during winter months, access and focusing on factors influencing parents’ decisions to stimu- transport, level of fitness and kind of activity (swimming, late their children in sport participation. Family support trampolining, dance, bowling), skills, and independence. revealed to be a crucial factor influencing the choice of sport Predisposing factors to PA engagement included enjoyment and leisure activities and the subsequent maintenance of and play, social interaction, understanding of PA, and to be compliance to exercise programs in the population with DS able to follow the instructions. Finally, reinforcing factors to (Inglis, Lohn, Austin, & Hippman, 2014). PA were support and opportunities, and parents and care pro- Menear (2007) investigated parental beliefs concerning viders’ education about the importance of PA. PA needs in DS by interviewing parents of children with DS So, as for children with intellectual disability, three main from preschool age to adolescence. She compared themes category factors influence the engagement in PA: individual, derived from four focus groups (preschoolers’ parents, ele- familiar, and environmental variables (Downs et al., 2013; mentary-age children’s parents, teenagers’ parents, and Mahy, Shields, Taylor, & Dodd, 2010). Individual character- mixed age groups). Four themes were quite frequent across istics include age, gender, the level of sport motivation, all four of the focus groups: (a) short- and long-term health motor and cognitive abilities, and the kind and the severity of benefits of PA on their children, (b) social benefits from rela- disability. Females, older individuals, and people with lower tionship with peers, (c) sport opportunities to play an indi- level of education and higher level of severity of disability vidual sport for teenagers, and (d) need to receive parent are more likely to show decrease in variety, frequency, and education concerning home-based PA intervention programs duration of PA (Kristen, Patriksson, & Fridlund, 2002; or to enhance community-based PA programs delivered for Lippold & Burns, 2009). Therefore, personal factors which children with DS. So, Menear pointed out the need to edu- encourage greater participation are higher level of self- cate parents and care providers on the benefits of PA and esteem or self-determination and mastery motivation to face active lifestyle. challenging motor tasks (Badia, Orgaz, Verdugo, Ullan, & Based on these issues, this study aims at comparing the Martìnez, 2011; Hutzler & Korsensky, 2010; Kwan, Cirney, beliefs on facilitators and barriers to participation in PA Hay, & Faught, 2013). Second, family variables that might among parents of children with DS and parents of TDC. encourage greater participation in PA are mainly emotional A phenomenological theoretical framework was chosen and economic support. The first arouses the children’s sense to carry out semistructured interviews with the parents. of competence and determination, while the latter allows to bear the costs of Adapted Physical Activity (APA) programs Method (George, Shacter, & Johnson, 2011; Trost, Kerr, Ward, & Pate, 2001). Finally, environmental characteristics might Participants concern the availability of APA programs for children with DS (Badia et al., 2011; Barr & Shields, 2011). From now on, The participants were 35 families subdivided into two groups: PA and APA will be used in an interchangeable way. As com- the first group was composed of 19 families with children and pared with traditional, the APA is an individualized PA that is adolescents with DS and the second one was composed of 16 specifically modified to address the needs of people with dis- families with TDC. In the first group, there were 11 mothers abilities in accordance with the international classification of and 8 fathers. The parents’ median age was 54.59 years (range functioning (ICF) model (World Health Organization = 37-69; ±8.82). The children were 10 boys and 9 girls with a [WHO], 2001). It enhances the acceptance of individual median age of 20.94 years (range = 7-31; ±9.5). All the Alesi 3 children had the diagnosis of Trisomy 21 and from early childhood had been engaged in structured speech therapy or psychomotor activities or music therapy. Parents’ inclusion criteria were (a) to be a parent of a child with DS, (b) to have present or past experience with their children’s engagement in sport activities, (c) to be an Italian speaker, and (d) to be Caucasian race. In the second group, there were 13 mothers and 3 fathers. The parents’ median age was 40.54 years (range = 25-43; ±7.23). The children were eight boys and eight girls with a Figure 1. Facilitators to PA identified by the parents of children median age of 8.25 years (range = 5.2-10.11; ±4.5). All the with DS. children were typically developing. These parents were Note. PA = physical activity; DS = Down syndrome; APA = Adapted matched to those of the first group along with their chil- Physical Activity. dren’s, here hypothesized, cognitive profile. We chose this criterion, despite their chronological age, because of the big difference in lifestyle among adolescents and young ones with DS and typically developing peers. All the parents were from medium socioeconomic level. The parents of children with DS were recruited through gyms or nonprofit associations offering support and commu- nity resources for people with DS and their families. They were invited to meet with researchers, to become familiar with the goals of the study and its procedures. Following this first meeting, the participation rate to the interview was of about 60%, while the parents of TDC were recruited through Figure 2. Facilitators to PA identified by the parents of TDC. schools attended by their children. Note. PA = physical activity; TDC = typically developing children. Prior to the start of the study, appropriate local ethics committee approval provided by the University of Palermo was obtained. Interview A semistructured interview was developed to investigate the parental beliefs on facilitators/barriers to activities as well as physical and psychological benefits of sport in children. First, data were collected on the children’s history and the family background by the evaluation of parameters such as parents’ academic history and jobs. Second, the interviewer followed a schedule of focused and open questions on facili- Figure 3. Barriers to PA identified by the parents of children tators/barriers and benefits of PA. with DS. Note. PA = physical activity; DS = Down syndrome; APA = Adapted All the interviews were conducted by the same researcher Physical Activity. and lasted no more than 25 min. The identified themes were displayed into four figures: Data Analysis Two figures show facilitators to PA identified by the parents All the interviews were transcribed to allow the thematic of children with DS and TDC (Figures 1 and 2), and two analysis of answers. Transcripts were read independently by figures show barriers to PA identified by the parents of chil- two researchers to identify quotes revealing meaningful dren with DS and TDC (Figures 3 and 4). themes and remove inappropriate quotes. Consequently, the accepted quotes were clustered into categories highlighting Results common themes which were classified on the basis of their frequency of occurrence to identify the most important In the group of parents with children with DS, three main themes as facilitation or barrier. Similar procedure was fol- facilitation themes were identified: (a) the support from fam- lowed for both the groups. ily, (b) the presence of expert at APA instructors and coaches 4 SAGE Open Figure 5. Benefits identified by the parents of children with DS. Note. DS = Down syndrome. Figure 4. Barriers to PA identified by the parents of children with TDC. Note. PA = physical activity; TDC = typically developing children. and the availability of gyms, and (c) the challenging nature of sport activities (Figure 1). The family revealed to be considered the first facilitator. The parents of children with DS showed to recognize the key role of siblings (11) and themselves (18) to motivate their children in sport participation. However, the majority (13) of Figure 6. Benefits identified by the parents of children with TDC. them judged not relevant to their personal engagement as a Note. TDC = typically developing children. model for children. The second facilitator was the availabil- ity of instructors able to train children with DS using the APA (18). This factor was strictly associated to gyms with special- were the main barriers. Moreover, the scarce presence of ized sport machines and without architectural barriers (13). expert at APA coaches was acknowledged (13). The last facilitating theme identified in our interviews was Another significant barrier concerned the physical and the nature of PA: socialization (19), challenging (15), or medical characteristics of DS, such as gross motor impair- enjoying (11). Sport activities were considered as an oppor- ments (11), hypotonicity (9), weight (8), heart impairments tunity to experiment successes by facing up to themselves (7), and coordination difficulties (4). With regard to psycho- and the others with similar characteristics. logical domain, limited cognitive abilities (7) were consid- In the group of parents with TDC, two main facilitation ered as a barrier to the engagement in sport more than the themes were identified: (a) the support from family and (b) limited communication abilities (2). Taken together, these the characteristics of sport activities (Figure 2). factors increased the worries of parents (7) by creating an In this group, the family revealed to be considered the extra obstacle. first facilitator. The key role of siblings (5) and them- The parents of TDC recognized the family as the selves (16) to motivate their children in sport participa- main barrier: no time to spend for sport activities (13), tion and to act as a model (11) was recognized. The the difficulties of transportation (13), the economical second facilitator was the expertise of instructors at PA resources (10), and the worries about eventual failures (14) as well as the nature of PA characterized by chal- (9) (Figure 4). lenge (13), enjoyment (10), experience of success (13), Finally, similar physical and psychological benefits were and agonistic activity (5). advanced by all our interviewed parents (Figures 5 and 6). With concern to the barriers, the parents of children with For the parents of children with DS, the physical benefits DS identified three main themes: (a) the lack of expert at included reducing the obesity (12) and improving the motor APA instructors and coaches, (b) the DS characteristics, and coordination (9). The psychological benefits concerned (c) the worries of parents (Figure 3). increasing self-esteem (16) and self-image (13), and improv- Parents argued that the lack of adapted exercise classes ing socialization skills (13) and cognitive functions such as (13) and programs of inclusion (10) for children with DS memory and attention (8). Alesi 5 For the parents of TDC, the physical benefits were reduc- services and facilities such as gyms and buildings with spe- ing the obesity (15), improving the motor coordination (16), cialized sport machines and without architectural barriers. preventing the diabetes (15), and decreasing the insomnia Other differences in parental beliefs between our two (12). The psychological benefits included increasing self- groups emerged in the perception of features characterizing esteem (16) and self-image (16), and improving socializa- sport activities. The parents of children with DS evidenced tion skills (16) and cognitive functions such as memory and characteristics such as socialization, challenge, and enjoy- attention (16). ment. This result agrees with research on this issue. Socialization features derive from social opportunities in sport including cooperating with others, respecting rules, Discussion mastering new skills suitable for everyday life, experiencing The main goal of the described study was to investigate the personal achievement, and obtaining the encouragement of parental beliefs concerning facilitators/barriers and benefits other people with the same disorder (Battaglia et al., 2013). of PA among the families of children with DS and the fami- PA is also judged enjoyable because of the opportunity to lies of TDC. experiment leisure experiences and execute lovely and excit- On the whole, all the interviewed parents stated that fam- ing exercises with music and games (Mahy et al., 2011). ily plays a key role to influence children’s engagement in PA. Nevertheless, the nature of sport allows to develop indepen- The parents of children with DS recognized the role of fam- dence skills by facing challenging tasks and experimenting ily both as facilitator and barrier to the participation of chil- the sense of competence and self-empowerment (Badia et al., dren in PA. This result is consistent with previous research, 2011; Downs et al., 2013). which demonstrated how parents deliver emotional/motiva- The parents of TDC introduced in this category two new tional and economic support. These are necessary to face characteristics such as having successful experiences and par- challenging tasks as well as the transportation and the costs ticipating in agonistic activities. This last result is explained of activities (Badia et al., 2011; Downs et al., 2013; Mahy as the product of stereotypes widely spread in Western societ- et al., 2010; Shikako-Thomas, Shevell, & Schmitz, 2013). ies which associate sport and values such as success, power, The costs of sports programs, the equipment, and the trans- competition, and the importance of winning. portation are expensive and rely on family available econom- All our interviewed parents stated the physical and psy- ical resourcess (Cordes & Howard, 2005; Van Naarden chological benefits of PA. For the parents of children with Braun, Yeargin-Allsopp, & Lollar, 2006). DS, physical benefits were the prevention or the control of However, as previously mentioned, family is consid- medical diseases such as obesity and motor coordination ered as a barrier at the same time because of parental wor- impairments. Specifically, the control of the obesity was con- ries regarding gross motor impairments, hypotonicity, sidered the main benefit. It is now largely recognized how overweight, heart impairments, and limited cognitive and high levels of overweight and obesity among people with communication abilities linked to the specific disability of intellectual disability are closely associated to higher level of their children. All these factors may increase the family inactivity and unhealthy dietary practices (Battaglia et al., overprotection by limiting the participation to sport activ- 2013). So, PA was acknowledged by parents as a worthy ity in their children (Frey et al., 2008). These parents, as weight control intervention as an alternative to medicine ther- opposed to the parents of TDC, did not recognize their role apies (Slevin, Truesdale-Kennedy, McConkey, Livingstone, of model to influence the starting and maintaining compli- & Fleming, 2014). ance to exercise programs by their children. Research For the parents of TDC, physical benefits were more gen- describes the family modeling as an important factor in eralized. They not only included the prevention of over- determining the amount, the duration, and the complexity weight, but they also take account of other factors such as the of their children’s sport activities (Temple & Stanish, prevention of diabetes and the decreasing of insomnia. On 2011; Trost et al., 2001). the whole, the great importance attributed by all parents to The study findings showed that the availability of expert PA in the control of overweight confirms the awareness of at APA instructors and coaches is another main factor, both the crucial role of family in the weight management by con- as facilitator and barrier, which plays a crucial role in the trolling the quantity and the quality of food, making the rules engagement in PA by children with DS. This staff was on food and meals, and outlining a healthy home environ- required to be specifically trained for the special needs of ment (Prussing, Sobo, Walker, & Kurtin, 2005). their children. Our parents identified that a support staff may Psychological benefits concerned for all parents the initiate and sustain the participation in PA over the time. increase of self-esteem and self-image, as well as the These findings are in agreement with other research that improvement of cognitive functions such as memory and found a close relationship between the limited opportunities attention. The main difference between the two groups was to participate in PA and the lack of specific training programs that the parents of children with DS attribute more impor- addressed to people with DS (Mahy et al., 2011). Moreover, tance to motivational benefits rather than cognitive improve- this barrier is often strengthened by the lack of accessible ments. In recent years, researchers have shown how regular 6 SAGE Open PA is useful to face the fear of humiliation, the low athletic Funding self-perception, and low self-efficacy because it allows self- The author(s) received no financial support for the research and/or evaluation by comparing oneself performance with others on authorship of this article. a variety of physical and motor tasks (Alesi & Pepi, 2013; Pepi & Alesi, 2005). Note Moreover, parents of TDC stated positive effects of PA on 1. The term children refers to sons and daughters of any age. memory and attention. This is consistent with results from studies using magnetic imaging techniques (functional mag- References netic resonance imaging [fMRI]) which demonstrated how Alesi, M., Battaglia, G., Roccella, M., Testa, D., Palma, A., & regular aerobic exercises modifie the brain function in the Pepi, A. (2014). Improvement of gross motor and cognitive anterior cingulate cortex withimprovements in cognitive per- abilities by an exercise training program: Three case reports. formances such as speed of processing, working memory, Neuropsychiatric Disease and Treatment, 10, 479-485. planning and control strategy employ (Alesi, Bianco, et al., Alesi, M., Bianco, A., Padulo, J., Vella, F. P., Petrucci, M., Paoli, 2014; Best, 2010). A., . . . Pepi, A. (2014). Motor and cognitive development: On the whole, the current findings are added to a grow- The role of karate. Muscle, Ligaments and Tendons Journal, 4, ing body of literature on the parental beliefs of PA as a key 114-120. factor to contribute to well-being of their children. It is Alesi, M., & Pepi, A. (2013). Self-esteem and self-perception profile: A comparison between children attending sport and widely accepted by researchers and practitioners that a sed- sedentary children. European Journal of Sport Studies, 1, 2. entary lifestyle is an important risk factor able to exacer- doi:10.12863/ejssbx1x2-2013x5 bate medical diseases and enhance welfare assistance and Alesi, M., & Pepi, A. (2017). Physical activity engagement in young use of medical services. So, high economic health costs are people with Down syndrome: Investigating parental beliefs. the consequence. Journal of Applied Research in Intellectual Disabilities, 30, The main shortcoming of this study is the age range of the 71-83. doi:10.1111/jar.12220 children which is widely disparate, with young adults Badia, M., Orgaz, B. M., Verdugo, M. A., Ullan, A. M., & Martìnez, included in the group of people with DS, and only children M. M. (2011). Personal factors and perceived barriers to par- younger than teen age years in the TDC group. However, this ticipation in leisure activities for young and adults with devel- may be the strength of this study as the results within each opmental disabilities. Research in Developmental Disabilities, group are homogeneous. What parents think about PA may 32, 2055-2063. Barr, M., & Shields, N. (2011). Identifying the barriers and facilita- not be influenced by the age of their children but by their tors to participation in physical activity for children with DS. developmental age and disability. All parents recognized the Journal of Intellectual Disability Research, 55, 1020-1033. physical and psychological benefits associated with chil- Battaglia, G., Alesi, M., Inguglia, M., Roccella, M., Caramazza, G., dren’s participation in PA. However, the primary benefits Bellafiore, M., & Palma, A. (2013). Soccer practice as an add- identified by the parents of children with DS concerned on treatment in the management of individuals with a diagnosis physical themes as reducing obesity or improving motor of schizophrenia. Neuropsychiatric Disease and Treatment, 9, coordination as well as psychological gains like increasing 595-603. self-esteem, self-image, and socialization skills. These par- Best, R. J. (2010). Effects of physical activity on children’s execu- ents wished for APA intervention programs that better met tive function: Contributions of experimental research on aero- their children’s needs and encouraged their participation. On bic exercise. Developmental Review, 30, 331-551. the contrary, the parents of children with TDC stated other Chief Medical Officer. (2011). Start active, stay active—A report on physical activity for health from the four home countries. Retrieved benefits as decreasing the insomnia or increasing memory from http://www.dh.gov.uk/en/Publicationsandstatistics/ and attention. So the findings of this study, although prelimi- Publications/PublicationsPolicyAndGuidance/DH_128209 nary, suggest some interesting implications on the educa- Cordes, T. L., & Howard, R. W. (2005). Concepts of work, lei- tional field for future practice. First, it is crucial to organize sure and retirement in adults with an intellectual disability. settings aimed at encouraging the sport participation in typi- Education and Training in Developmental Disabilities, 40(2), cal and atypical population. Second, it would be decisive to 99-108. develop specially designed programs and training aimed at Downs, S. J., Boddy, L. M., Knowles, Z. R., Fairclough, S. J., & increasing participation in PA involving both children with Stratton, G. (2013). Exploring opportunities available and per- DS and their parents. ceived barriers to physical activity engagement in children and young people with DS. European Journal of Special Needs Acknowledgments Education, 28, 270-287. European Commission. (2014). Sport and Physical Activity. Special The author thanks all families who participated. Eurobarometer 412 (March 2014). EU. TNS. Opinion & Social/Brussels. Declaration of Conflicting Interests Frey, G. C., Stanish, H. I., & Temple, V. A. (2008). Physical activ- The author(s) declared no potential conflicts of interest with respect ity of youth with intellectual disability: Review and research to the research, authorship, and/or publication of this article. agenda. Adapted Physical Activity Quarterly, 25, 95-117. Alesi 7 George, V. A., Shacter, S. D., & Johnson, P. M. (2011). BMI and Phillips, A. C., & Holland, A. J. (2011). Assessment of objectively attitudes and beliefs about physical activity and nutrition of measured physical activity levels in individuals with intel- parents of adolescents with intellectual disabilities. Journal of lectual disabilities with and without Down’s syndrome. PLoS Intellectual Disability Research, 55, 1054-1063. ONE, 6, e28618. doi:10.1371/journal.pone.0028618 Golubovic, S., Maksimovic, J., Golubovic, B., & Glumbic, N. Prussing, E., Sobo, E. J., Walker, E., & Kurtin, P. S. (2005). (2012). Effects of exercise on physical fitness in children with Between “desperation” and disability rights: A narrative analy- intellectual disability. Research in Developmental Disabilities, sis of complementary/alternative medicine use by parents for 33, 608-614. children with Down syndrome. Social Science and Medicine, Gonzalez-Aguero, A., Vicente-Rodrıguez, G., Moreno, L. A., 60, 587-598. Guerra-Balic, M., Ara, I., & Casajus, J. A. (2010). Health- Shields, N., Dodd, K., & Abblitt, C. (2009). Children with Down related physical fitness in children and adolescents with DS syndrome do not perform sufficient physical activity to main- and response to training. Scandinavian Journal of Medical tain good health or optimize cardiovascular fitness. Adapted Science and Sports, 20, 716-724. Physical Activity Quarterly, 26, 307-320. Hutzler, Y., & Korsensky, O. (2010). Motivational correlates of Shikako-Thomas, K., Shevell, M., & Schmitz, N. (2013). physical activity in persons with an intellectual disability: A Determinants of participation in leisure activities among systematic literature review. Journal of Intellectual Disability adolescents with cerebral palsy. Research in Developmental Research, 54, 767-786. Disabilities, 34, 2621-2634. Hutzler, Y., & Sherrill, C. (2007). Defining adapted physical activ- Slevin, E., Truesdale-Kennedy, M., McConkey, R., Livingstone, ity: International perspectives. Adapted Physical Activity B., & Fleming, P. (2014). Obesity and overweight in intel- Quarterly, 24, 1-20. lectual and non-intellectually disabled children. Journal of Inglis, A., Lohn, Z., Austin, J. C., & Hippman, C. (2014). A “cure” Intellectual Disability Research, 58, 211-220. for Down syndrome: What do parents want? Clinical Genetics, Temple, V. A., & Stanish, H. I. (2009). Pedometer-measured physi- 86, 310-317. cal activity of adults with intellectual disability: Predicting Kristen, L., Patriksson, G., & Fridlund, B. (2002). Conceptions weekly step counts. American Journal on Intellectual and of children and adolescents with physical disabilities about Developmental Disabilities, 114, 15-22. their participation in a sports programme. European Physical Temple, V. A., & Stanish, H. I. (2011). The feasibility of using Education Review, 8, 139-156. a peer-guided model to enhance participation in community- Kwan, M. Y., Cirney, J., Hay, J. A., & Faught, B. E. (2013). based physical activity for youth with intellectual disability. Understanding physical activity and motivations for children Journal of Intellectual Disabilities, 15, 209-217. with developmental coordination disorder: An investigation Trost, S. G., Kerr, L. M., Ward, D. S., & Pate, R. R. (2001). Physical using theory of planned behavior. Research on Developmental activity and determinants of physical activity in obese and Disabilities, 34, 3691-3698. non-obese children. International Journal of Obesity, 25, Lippold, T., & Burns, J. (2009). Social support and intellectual 822-829. disabilities: A comparison between social networks of adults Van Naarden Braun, K., Yeargin-Allsopp, M., & Lollar, D. (2006). with intellectual disability and those with physical disability. A multi-dimensional approach to the transition of children with Journal of Intellectual Disability Research, 53, 463-473. developmental disabilities into young adulthood: The acquisi- Mahy, J., Shields, N., Taylor, N. F., & Dodd, K. J. (2010). tion of adult social roles. Disability and Rehabilitation, 28, Identifying facilitators and barriers to physical activity for 915-928. adults with Down syndrome. Journal of Intellectual Disability Vogt, T., Schneider, S., Abeln, V., Anneken, V., & Strüder, H. K. Research, 54, 795-805. (2012). Exercise, mood and cognitive performance in intellec- Mahy, J., Shields, N., Taylor, N. F., & Dodd, K. J. (2011). tual disability—A neurophysiological approach. Behavioural Identifying facilitators and barriers to physical activity for Brain Research, 226, 473-480. adults with Down syndrome. Journal of Intellectual Disability Welk, G. J. (1999). The youth physical activity model: A con- Research, 54, 795-805. ceptual bridge between theory and practice. Quest, 51(1), Menear, K. S. (2007). Parents’ perceptions of health and physi- 5-23. cal activity needs of children with Down syndrome. Down World Health Organization. (2001). International classifica- Syndrome Research and Practice, 12, 60-68. tion of functioning, disability, and health (ICF). Geneva, Palisano, R. J., Walter, S. D., Russell, D. J., Rosenbaum, P. L., Switzerland: Author. Retrieved from http://www3.who.int/ Gémus, M., Galuppi, B. E., & Cunningham, L. (2001). Gross icf/icftemplate.cfm motor function of children with Down syndrome: Creation of motor growth curves. Archives of Physical Medicine and Author Biography Rehabilitation, 82, 494-500. Pepi, A., & Alesi, M. (2005). Attribution style in adolescents Marianna Alesi is an associate professor of Development and with Down’s syndrome. European Journal of Special Needs Education Psychology at the University of Palermo. Her main Education, 20, 341-353. reserch area is: typical and atypical development. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png SAGE Open SAGE

Investigating Parental Beliefs Concerning Facilitators and Barriers to the Physical Activity in Down Syndrome and Typical Development:

SAGE Open , Volume 7 (1): 1 – Jan 1, 2017

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Abstract

Family is a crucial factor to determine the amount, the duration, and the complexity of children’s sport activities. This study aims at comparing the beliefs concerning the involvement in sport activities among parents of children with Down syndrome (DS) and parents of typically developing children (TDC). A phenomenological theoretical framework was adopted to realize semistructured interviews with the parents. The participants were 35 parents: 19 with children and adolescents with DS and 16 with TDC. The main facilitation/barrier themes identified by the parents of children with DS were the family and the expert at Adapted Physical Activity (APA) instructors. Conversely, the parents of TDC identified social factors related to family as the only barrier. One of the issues that emerge from this study is the lack of home-based physical activity (PA) intervention programs aimed at involving families and children. Keywords family, DS, physical activity, facilitators, barriers high levels of inactivity are stated in typically developing Introduction people despite data demonstrating physiological and psy- The present study extends previous research, which aimed to chological gains from PA. A 60% of inactivity is reported in explore parental beliefs concerning involvement, facilitators/ Italy, as shown by data from the Special Eurobarometer 412 barriers, and benefits of physical activity (PA) in young peo- (March 2014) on the issue “Sport and Physical Activity.” ple with Down syndrome (DS; Alesi & Pepi, 2015). Nevertheless, the participation in sport activities is a mul- Specifically, the sample was enlarged to compare beliefs tidimensional construct that involves a variety of facilitators concerning the involvement in sport activities among the and barriers. The first are positive factors enhancing the par- parents of children with DS and the parents of typically ticipation of people with DS in PA, for example, parental developing children (TDC). support, opportunities and programs for participation, acces- Benefits of regular PA in people with DS have recently sible transportation, access to resources, and so on. The lat- been addressed in several research (Alesi, Battaglia, et al., ter, the barriers, are adverse factors that limit this participation, 2014; Golubovic, Maksimovic, Golubovic, & Glumbic, such as narrowed information about PA; developmental 2012; Palisano et al., 2001; Vogt, Schneider, Abeln, delays; health problems; lack of transport and independence; Anneken, & Strüder, 2012). Population with DS was found beliefs about the disability of parents, coaches, and teachers; to have typically sedentary lifestyle, to participate less in insufficient programs of social inclusion; few adapted equip- sport activities, and to fail the Chief Medical Officer’s ment; and so on. (2011) recommendation of 60-min moderate to vigorous PA a day (Frey, Stanish, & Temple, 2008; Gonzalez-Aguero et al., 2010; Phillips & Holland, 2011; Shields, Dodd, & 1 Università degli Studi di Palermo, Italy Abblitt, 2009; Temple & Stanish, 2009). The direct conse- Corresponding Author: quence is the risk of intensifying clinical diseases by devel- Marianna Alesi, Dipartimento di Scienze Psicologiche, Pedagogiche e della oping specific health-related complications such as the Formazione, Università degli Studi di Palermo, V.le delle Scienze, Edificio accumulation of bone mass, the type 2 diabetes, and motor 15, 90135 Palermo, Italy. functional impairments (Barr & Shields, 2011). Similarly, Email: marianna.alesi@unipa.it Creative Commons CC-BY: This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 SAGE Open A number of research investigating factors underlined the differences by promoting the access to active lifestyle and engagement in PA by the adapted model of the Youth Physical sport encompassing gymnastics, dance, movement, exercise, Activity Promotion (YPAP) designed by Welk (1999). In the sports, games, recreation, and physical education. original model, higher predictors of child engagement in PA Consequently, the APA employs adapted methods, such as are the predisposing factors, such as child’s self-efficacy, peer tutoring, in the context of large size class teaching; attitudes and personal beliefs on PA, and physical self-com- adapted equipment and rules, such as bigger balls to enable petence. Moreover, reinforcing factors are conditions sup- bouncing; adapted environmental variables such as a lower porting PA behaviors in childhood, such as family, peer, and net height for the volleyball; and qualified and expert at dif- teacher/coach influence. Equally important are enabling fac- ferent kinds of disabilities coaches (Hutzler & Sherrill, tors such as the child’s physical skills and fitness level as 2007). well as the access to gyms and environment. Indirect influ- To sum up, personal, familiar, and environmental charac- ence is played by personal demographics, such as age, eth- teristics are interrelated by reciprocally reinforceing links. nicity, and socioeconomic status. Recently, an adapted model For example, the few number of gyms offering APA exercise of the YPAP was developed by Downs, Boddy, Knowles, programs can oblige families to move for long distances by Fairclough, and Stratton (2013). It included enabling, predis- enhancing the costs of transportation and, in the long run, posing, and reinforcing factors to PA for children with DS. decreasing the motivation to engage in PA. Enabling factors involved environment, seasonal variation However, barriers and facilitators are to be found by such as decrease in PA during winter months, access and focusing on factors influencing parents’ decisions to stimu- transport, level of fitness and kind of activity (swimming, late their children in sport participation. Family support trampolining, dance, bowling), skills, and independence. revealed to be a crucial factor influencing the choice of sport Predisposing factors to PA engagement included enjoyment and leisure activities and the subsequent maintenance of and play, social interaction, understanding of PA, and to be compliance to exercise programs in the population with DS able to follow the instructions. Finally, reinforcing factors to (Inglis, Lohn, Austin, & Hippman, 2014). PA were support and opportunities, and parents and care pro- Menear (2007) investigated parental beliefs concerning viders’ education about the importance of PA. PA needs in DS by interviewing parents of children with DS So, as for children with intellectual disability, three main from preschool age to adolescence. She compared themes category factors influence the engagement in PA: individual, derived from four focus groups (preschoolers’ parents, ele- familiar, and environmental variables (Downs et al., 2013; mentary-age children’s parents, teenagers’ parents, and Mahy, Shields, Taylor, & Dodd, 2010). Individual character- mixed age groups). Four themes were quite frequent across istics include age, gender, the level of sport motivation, all four of the focus groups: (a) short- and long-term health motor and cognitive abilities, and the kind and the severity of benefits of PA on their children, (b) social benefits from rela- disability. Females, older individuals, and people with lower tionship with peers, (c) sport opportunities to play an indi- level of education and higher level of severity of disability vidual sport for teenagers, and (d) need to receive parent are more likely to show decrease in variety, frequency, and education concerning home-based PA intervention programs duration of PA (Kristen, Patriksson, & Fridlund, 2002; or to enhance community-based PA programs delivered for Lippold & Burns, 2009). Therefore, personal factors which children with DS. So, Menear pointed out the need to edu- encourage greater participation are higher level of self- cate parents and care providers on the benefits of PA and esteem or self-determination and mastery motivation to face active lifestyle. challenging motor tasks (Badia, Orgaz, Verdugo, Ullan, & Based on these issues, this study aims at comparing the Martìnez, 2011; Hutzler & Korsensky, 2010; Kwan, Cirney, beliefs on facilitators and barriers to participation in PA Hay, & Faught, 2013). Second, family variables that might among parents of children with DS and parents of TDC. encourage greater participation in PA are mainly emotional A phenomenological theoretical framework was chosen and economic support. The first arouses the children’s sense to carry out semistructured interviews with the parents. of competence and determination, while the latter allows to bear the costs of Adapted Physical Activity (APA) programs Method (George, Shacter, & Johnson, 2011; Trost, Kerr, Ward, & Pate, 2001). Finally, environmental characteristics might Participants concern the availability of APA programs for children with DS (Badia et al., 2011; Barr & Shields, 2011). From now on, The participants were 35 families subdivided into two groups: PA and APA will be used in an interchangeable way. As com- the first group was composed of 19 families with children and pared with traditional, the APA is an individualized PA that is adolescents with DS and the second one was composed of 16 specifically modified to address the needs of people with dis- families with TDC. In the first group, there were 11 mothers abilities in accordance with the international classification of and 8 fathers. The parents’ median age was 54.59 years (range functioning (ICF) model (World Health Organization = 37-69; ±8.82). The children were 10 boys and 9 girls with a [WHO], 2001). It enhances the acceptance of individual median age of 20.94 years (range = 7-31; ±9.5). All the Alesi 3 children had the diagnosis of Trisomy 21 and from early childhood had been engaged in structured speech therapy or psychomotor activities or music therapy. Parents’ inclusion criteria were (a) to be a parent of a child with DS, (b) to have present or past experience with their children’s engagement in sport activities, (c) to be an Italian speaker, and (d) to be Caucasian race. In the second group, there were 13 mothers and 3 fathers. The parents’ median age was 40.54 years (range = 25-43; ±7.23). The children were eight boys and eight girls with a Figure 1. Facilitators to PA identified by the parents of children median age of 8.25 years (range = 5.2-10.11; ±4.5). All the with DS. children were typically developing. These parents were Note. PA = physical activity; DS = Down syndrome; APA = Adapted matched to those of the first group along with their chil- Physical Activity. dren’s, here hypothesized, cognitive profile. We chose this criterion, despite their chronological age, because of the big difference in lifestyle among adolescents and young ones with DS and typically developing peers. All the parents were from medium socioeconomic level. The parents of children with DS were recruited through gyms or nonprofit associations offering support and commu- nity resources for people with DS and their families. They were invited to meet with researchers, to become familiar with the goals of the study and its procedures. Following this first meeting, the participation rate to the interview was of about 60%, while the parents of TDC were recruited through Figure 2. Facilitators to PA identified by the parents of TDC. schools attended by their children. Note. PA = physical activity; TDC = typically developing children. Prior to the start of the study, appropriate local ethics committee approval provided by the University of Palermo was obtained. Interview A semistructured interview was developed to investigate the parental beliefs on facilitators/barriers to activities as well as physical and psychological benefits of sport in children. First, data were collected on the children’s history and the family background by the evaluation of parameters such as parents’ academic history and jobs. Second, the interviewer followed a schedule of focused and open questions on facili- Figure 3. Barriers to PA identified by the parents of children tators/barriers and benefits of PA. with DS. Note. PA = physical activity; DS = Down syndrome; APA = Adapted All the interviews were conducted by the same researcher Physical Activity. and lasted no more than 25 min. The identified themes were displayed into four figures: Data Analysis Two figures show facilitators to PA identified by the parents All the interviews were transcribed to allow the thematic of children with DS and TDC (Figures 1 and 2), and two analysis of answers. Transcripts were read independently by figures show barriers to PA identified by the parents of chil- two researchers to identify quotes revealing meaningful dren with DS and TDC (Figures 3 and 4). themes and remove inappropriate quotes. Consequently, the accepted quotes were clustered into categories highlighting Results common themes which were classified on the basis of their frequency of occurrence to identify the most important In the group of parents with children with DS, three main themes as facilitation or barrier. Similar procedure was fol- facilitation themes were identified: (a) the support from fam- lowed for both the groups. ily, (b) the presence of expert at APA instructors and coaches 4 SAGE Open Figure 5. Benefits identified by the parents of children with DS. Note. DS = Down syndrome. Figure 4. Barriers to PA identified by the parents of children with TDC. Note. PA = physical activity; TDC = typically developing children. and the availability of gyms, and (c) the challenging nature of sport activities (Figure 1). The family revealed to be considered the first facilitator. The parents of children with DS showed to recognize the key role of siblings (11) and themselves (18) to motivate their children in sport participation. However, the majority (13) of Figure 6. Benefits identified by the parents of children with TDC. them judged not relevant to their personal engagement as a Note. TDC = typically developing children. model for children. The second facilitator was the availabil- ity of instructors able to train children with DS using the APA (18). This factor was strictly associated to gyms with special- were the main barriers. Moreover, the scarce presence of ized sport machines and without architectural barriers (13). expert at APA coaches was acknowledged (13). The last facilitating theme identified in our interviews was Another significant barrier concerned the physical and the nature of PA: socialization (19), challenging (15), or medical characteristics of DS, such as gross motor impair- enjoying (11). Sport activities were considered as an oppor- ments (11), hypotonicity (9), weight (8), heart impairments tunity to experiment successes by facing up to themselves (7), and coordination difficulties (4). With regard to psycho- and the others with similar characteristics. logical domain, limited cognitive abilities (7) were consid- In the group of parents with TDC, two main facilitation ered as a barrier to the engagement in sport more than the themes were identified: (a) the support from family and (b) limited communication abilities (2). Taken together, these the characteristics of sport activities (Figure 2). factors increased the worries of parents (7) by creating an In this group, the family revealed to be considered the extra obstacle. first facilitator. The key role of siblings (5) and them- The parents of TDC recognized the family as the selves (16) to motivate their children in sport participa- main barrier: no time to spend for sport activities (13), tion and to act as a model (11) was recognized. The the difficulties of transportation (13), the economical second facilitator was the expertise of instructors at PA resources (10), and the worries about eventual failures (14) as well as the nature of PA characterized by chal- (9) (Figure 4). lenge (13), enjoyment (10), experience of success (13), Finally, similar physical and psychological benefits were and agonistic activity (5). advanced by all our interviewed parents (Figures 5 and 6). With concern to the barriers, the parents of children with For the parents of children with DS, the physical benefits DS identified three main themes: (a) the lack of expert at included reducing the obesity (12) and improving the motor APA instructors and coaches, (b) the DS characteristics, and coordination (9). The psychological benefits concerned (c) the worries of parents (Figure 3). increasing self-esteem (16) and self-image (13), and improv- Parents argued that the lack of adapted exercise classes ing socialization skills (13) and cognitive functions such as (13) and programs of inclusion (10) for children with DS memory and attention (8). Alesi 5 For the parents of TDC, the physical benefits were reduc- services and facilities such as gyms and buildings with spe- ing the obesity (15), improving the motor coordination (16), cialized sport machines and without architectural barriers. preventing the diabetes (15), and decreasing the insomnia Other differences in parental beliefs between our two (12). The psychological benefits included increasing self- groups emerged in the perception of features characterizing esteem (16) and self-image (16), and improving socializa- sport activities. The parents of children with DS evidenced tion skills (16) and cognitive functions such as memory and characteristics such as socialization, challenge, and enjoy- attention (16). ment. This result agrees with research on this issue. Socialization features derive from social opportunities in sport including cooperating with others, respecting rules, Discussion mastering new skills suitable for everyday life, experiencing The main goal of the described study was to investigate the personal achievement, and obtaining the encouragement of parental beliefs concerning facilitators/barriers and benefits other people with the same disorder (Battaglia et al., 2013). of PA among the families of children with DS and the fami- PA is also judged enjoyable because of the opportunity to lies of TDC. experiment leisure experiences and execute lovely and excit- On the whole, all the interviewed parents stated that fam- ing exercises with music and games (Mahy et al., 2011). ily plays a key role to influence children’s engagement in PA. Nevertheless, the nature of sport allows to develop indepen- The parents of children with DS recognized the role of fam- dence skills by facing challenging tasks and experimenting ily both as facilitator and barrier to the participation of chil- the sense of competence and self-empowerment (Badia et al., dren in PA. This result is consistent with previous research, 2011; Downs et al., 2013). which demonstrated how parents deliver emotional/motiva- The parents of TDC introduced in this category two new tional and economic support. These are necessary to face characteristics such as having successful experiences and par- challenging tasks as well as the transportation and the costs ticipating in agonistic activities. This last result is explained of activities (Badia et al., 2011; Downs et al., 2013; Mahy as the product of stereotypes widely spread in Western societ- et al., 2010; Shikako-Thomas, Shevell, & Schmitz, 2013). ies which associate sport and values such as success, power, The costs of sports programs, the equipment, and the trans- competition, and the importance of winning. portation are expensive and rely on family available econom- All our interviewed parents stated the physical and psy- ical resourcess (Cordes & Howard, 2005; Van Naarden chological benefits of PA. For the parents of children with Braun, Yeargin-Allsopp, & Lollar, 2006). DS, physical benefits were the prevention or the control of However, as previously mentioned, family is consid- medical diseases such as obesity and motor coordination ered as a barrier at the same time because of parental wor- impairments. Specifically, the control of the obesity was con- ries regarding gross motor impairments, hypotonicity, sidered the main benefit. It is now largely recognized how overweight, heart impairments, and limited cognitive and high levels of overweight and obesity among people with communication abilities linked to the specific disability of intellectual disability are closely associated to higher level of their children. All these factors may increase the family inactivity and unhealthy dietary practices (Battaglia et al., overprotection by limiting the participation to sport activ- 2013). So, PA was acknowledged by parents as a worthy ity in their children (Frey et al., 2008). These parents, as weight control intervention as an alternative to medicine ther- opposed to the parents of TDC, did not recognize their role apies (Slevin, Truesdale-Kennedy, McConkey, Livingstone, of model to influence the starting and maintaining compli- & Fleming, 2014). ance to exercise programs by their children. Research For the parents of TDC, physical benefits were more gen- describes the family modeling as an important factor in eralized. They not only included the prevention of over- determining the amount, the duration, and the complexity weight, but they also take account of other factors such as the of their children’s sport activities (Temple & Stanish, prevention of diabetes and the decreasing of insomnia. On 2011; Trost et al., 2001). the whole, the great importance attributed by all parents to The study findings showed that the availability of expert PA in the control of overweight confirms the awareness of at APA instructors and coaches is another main factor, both the crucial role of family in the weight management by con- as facilitator and barrier, which plays a crucial role in the trolling the quantity and the quality of food, making the rules engagement in PA by children with DS. This staff was on food and meals, and outlining a healthy home environ- required to be specifically trained for the special needs of ment (Prussing, Sobo, Walker, & Kurtin, 2005). their children. Our parents identified that a support staff may Psychological benefits concerned for all parents the initiate and sustain the participation in PA over the time. increase of self-esteem and self-image, as well as the These findings are in agreement with other research that improvement of cognitive functions such as memory and found a close relationship between the limited opportunities attention. The main difference between the two groups was to participate in PA and the lack of specific training programs that the parents of children with DS attribute more impor- addressed to people with DS (Mahy et al., 2011). Moreover, tance to motivational benefits rather than cognitive improve- this barrier is often strengthened by the lack of accessible ments. In recent years, researchers have shown how regular 6 SAGE Open PA is useful to face the fear of humiliation, the low athletic Funding self-perception, and low self-efficacy because it allows self- The author(s) received no financial support for the research and/or evaluation by comparing oneself performance with others on authorship of this article. a variety of physical and motor tasks (Alesi & Pepi, 2013; Pepi & Alesi, 2005). Note Moreover, parents of TDC stated positive effects of PA on 1. The term children refers to sons and daughters of any age. memory and attention. This is consistent with results from studies using magnetic imaging techniques (functional mag- References netic resonance imaging [fMRI]) which demonstrated how Alesi, M., Battaglia, G., Roccella, M., Testa, D., Palma, A., & regular aerobic exercises modifie the brain function in the Pepi, A. (2014). Improvement of gross motor and cognitive anterior cingulate cortex withimprovements in cognitive per- abilities by an exercise training program: Three case reports. formances such as speed of processing, working memory, Neuropsychiatric Disease and Treatment, 10, 479-485. planning and control strategy employ (Alesi, Bianco, et al., Alesi, M., Bianco, A., Padulo, J., Vella, F. P., Petrucci, M., Paoli, 2014; Best, 2010). A., . . . Pepi, A. (2014). Motor and cognitive development: On the whole, the current findings are added to a grow- The role of karate. Muscle, Ligaments and Tendons Journal, 4, ing body of literature on the parental beliefs of PA as a key 114-120. factor to contribute to well-being of their children. It is Alesi, M., & Pepi, A. (2013). Self-esteem and self-perception profile: A comparison between children attending sport and widely accepted by researchers and practitioners that a sed- sedentary children. European Journal of Sport Studies, 1, 2. entary lifestyle is an important risk factor able to exacer- doi:10.12863/ejssbx1x2-2013x5 bate medical diseases and enhance welfare assistance and Alesi, M., & Pepi, A. (2017). Physical activity engagement in young use of medical services. So, high economic health costs are people with Down syndrome: Investigating parental beliefs. the consequence. Journal of Applied Research in Intellectual Disabilities, 30, The main shortcoming of this study is the age range of the 71-83. doi:10.1111/jar.12220 children which is widely disparate, with young adults Badia, M., Orgaz, B. M., Verdugo, M. A., Ullan, A. M., & Martìnez, included in the group of people with DS, and only children M. M. (2011). Personal factors and perceived barriers to par- younger than teen age years in the TDC group. However, this ticipation in leisure activities for young and adults with devel- may be the strength of this study as the results within each opmental disabilities. Research in Developmental Disabilities, group are homogeneous. What parents think about PA may 32, 2055-2063. Barr, M., & Shields, N. (2011). Identifying the barriers and facilita- not be influenced by the age of their children but by their tors to participation in physical activity for children with DS. developmental age and disability. All parents recognized the Journal of Intellectual Disability Research, 55, 1020-1033. physical and psychological benefits associated with chil- Battaglia, G., Alesi, M., Inguglia, M., Roccella, M., Caramazza, G., dren’s participation in PA. However, the primary benefits Bellafiore, M., & Palma, A. (2013). Soccer practice as an add- identified by the parents of children with DS concerned on treatment in the management of individuals with a diagnosis physical themes as reducing obesity or improving motor of schizophrenia. Neuropsychiatric Disease and Treatment, 9, coordination as well as psychological gains like increasing 595-603. self-esteem, self-image, and socialization skills. These par- Best, R. J. (2010). Effects of physical activity on children’s execu- ents wished for APA intervention programs that better met tive function: Contributions of experimental research on aero- their children’s needs and encouraged their participation. On bic exercise. Developmental Review, 30, 331-551. the contrary, the parents of children with TDC stated other Chief Medical Officer. (2011). Start active, stay active—A report on physical activity for health from the four home countries. Retrieved benefits as decreasing the insomnia or increasing memory from http://www.dh.gov.uk/en/Publicationsandstatistics/ and attention. So the findings of this study, although prelimi- Publications/PublicationsPolicyAndGuidance/DH_128209 nary, suggest some interesting implications on the educa- Cordes, T. L., & Howard, R. W. (2005). Concepts of work, lei- tional field for future practice. First, it is crucial to organize sure and retirement in adults with an intellectual disability. settings aimed at encouraging the sport participation in typi- Education and Training in Developmental Disabilities, 40(2), cal and atypical population. Second, it would be decisive to 99-108. develop specially designed programs and training aimed at Downs, S. J., Boddy, L. M., Knowles, Z. R., Fairclough, S. J., & increasing participation in PA involving both children with Stratton, G. (2013). Exploring opportunities available and per- DS and their parents. ceived barriers to physical activity engagement in children and young people with DS. European Journal of Special Needs Acknowledgments Education, 28, 270-287. European Commission. (2014). Sport and Physical Activity. Special The author thanks all families who participated. Eurobarometer 412 (March 2014). EU. TNS. Opinion & Social/Brussels. Declaration of Conflicting Interests Frey, G. C., Stanish, H. I., & Temple, V. A. (2008). Physical activ- The author(s) declared no potential conflicts of interest with respect ity of youth with intellectual disability: Review and research to the research, authorship, and/or publication of this article. agenda. Adapted Physical Activity Quarterly, 25, 95-117. Alesi 7 George, V. A., Shacter, S. D., & Johnson, P. M. (2011). BMI and Phillips, A. C., & Holland, A. J. (2011). Assessment of objectively attitudes and beliefs about physical activity and nutrition of measured physical activity levels in individuals with intel- parents of adolescents with intellectual disabilities. Journal of lectual disabilities with and without Down’s syndrome. PLoS Intellectual Disability Research, 55, 1054-1063. ONE, 6, e28618. doi:10.1371/journal.pone.0028618 Golubovic, S., Maksimovic, J., Golubovic, B., & Glumbic, N. Prussing, E., Sobo, E. J., Walker, E., & Kurtin, P. S. (2005). (2012). Effects of exercise on physical fitness in children with Between “desperation” and disability rights: A narrative analy- intellectual disability. Research in Developmental Disabilities, sis of complementary/alternative medicine use by parents for 33, 608-614. children with Down syndrome. Social Science and Medicine, Gonzalez-Aguero, A., Vicente-Rodrıguez, G., Moreno, L. A., 60, 587-598. Guerra-Balic, M., Ara, I., & Casajus, J. A. (2010). Health- Shields, N., Dodd, K., & Abblitt, C. (2009). Children with Down related physical fitness in children and adolescents with DS syndrome do not perform sufficient physical activity to main- and response to training. Scandinavian Journal of Medical tain good health or optimize cardiovascular fitness. Adapted Science and Sports, 20, 716-724. Physical Activity Quarterly, 26, 307-320. Hutzler, Y., & Korsensky, O. (2010). Motivational correlates of Shikako-Thomas, K., Shevell, M., & Schmitz, N. (2013). physical activity in persons with an intellectual disability: A Determinants of participation in leisure activities among systematic literature review. Journal of Intellectual Disability adolescents with cerebral palsy. Research in Developmental Research, 54, 767-786. Disabilities, 34, 2621-2634. Hutzler, Y., & Sherrill, C. (2007). Defining adapted physical activ- Slevin, E., Truesdale-Kennedy, M., McConkey, R., Livingstone, ity: International perspectives. Adapted Physical Activity B., & Fleming, P. (2014). Obesity and overweight in intel- Quarterly, 24, 1-20. lectual and non-intellectually disabled children. Journal of Inglis, A., Lohn, Z., Austin, J. C., & Hippman, C. (2014). A “cure” Intellectual Disability Research, 58, 211-220. for Down syndrome: What do parents want? Clinical Genetics, Temple, V. A., & Stanish, H. I. (2009). Pedometer-measured physi- 86, 310-317. cal activity of adults with intellectual disability: Predicting Kristen, L., Patriksson, G., & Fridlund, B. (2002). Conceptions weekly step counts. American Journal on Intellectual and of children and adolescents with physical disabilities about Developmental Disabilities, 114, 15-22. their participation in a sports programme. European Physical Temple, V. A., & Stanish, H. I. (2011). The feasibility of using Education Review, 8, 139-156. a peer-guided model to enhance participation in community- Kwan, M. Y., Cirney, J., Hay, J. A., & Faught, B. E. (2013). based physical activity for youth with intellectual disability. Understanding physical activity and motivations for children Journal of Intellectual Disabilities, 15, 209-217. with developmental coordination disorder: An investigation Trost, S. G., Kerr, L. M., Ward, D. S., & Pate, R. R. (2001). Physical using theory of planned behavior. Research on Developmental activity and determinants of physical activity in obese and Disabilities, 34, 3691-3698. non-obese children. International Journal of Obesity, 25, Lippold, T., & Burns, J. (2009). Social support and intellectual 822-829. disabilities: A comparison between social networks of adults Van Naarden Braun, K., Yeargin-Allsopp, M., & Lollar, D. (2006). with intellectual disability and those with physical disability. A multi-dimensional approach to the transition of children with Journal of Intellectual Disability Research, 53, 463-473. developmental disabilities into young adulthood: The acquisi- Mahy, J., Shields, N., Taylor, N. F., & Dodd, K. J. (2010). tion of adult social roles. Disability and Rehabilitation, 28, Identifying facilitators and barriers to physical activity for 915-928. adults with Down syndrome. Journal of Intellectual Disability Vogt, T., Schneider, S., Abeln, V., Anneken, V., & Strüder, H. K. Research, 54, 795-805. (2012). Exercise, mood and cognitive performance in intellec- Mahy, J., Shields, N., Taylor, N. F., & Dodd, K. J. (2011). tual disability—A neurophysiological approach. Behavioural Identifying facilitators and barriers to physical activity for Brain Research, 226, 473-480. adults with Down syndrome. Journal of Intellectual Disability Welk, G. J. (1999). The youth physical activity model: A con- Research, 54, 795-805. ceptual bridge between theory and practice. Quest, 51(1), Menear, K. S. (2007). Parents’ perceptions of health and physi- 5-23. cal activity needs of children with Down syndrome. Down World Health Organization. (2001). International classifica- Syndrome Research and Practice, 12, 60-68. tion of functioning, disability, and health (ICF). Geneva, Palisano, R. J., Walter, S. D., Russell, D. J., Rosenbaum, P. L., Switzerland: Author. Retrieved from http://www3.who.int/ Gémus, M., Galuppi, B. E., & Cunningham, L. (2001). Gross icf/icftemplate.cfm motor function of children with Down syndrome: Creation of motor growth curves. Archives of Physical Medicine and Author Biography Rehabilitation, 82, 494-500. Pepi, A., & Alesi, M. (2005). Attribution style in adolescents Marianna Alesi is an associate professor of Development and with Down’s syndrome. European Journal of Special Needs Education Psychology at the University of Palermo. Her main Education, 20, 341-353. reserch area is: typical and atypical development.

Journal

SAGE OpenSAGE

Published: Jan 1, 2017

Keywords: family; DS; physical activity; facilitators; barriers

References