Physical activity, sedentary and playtime behaviours in children and adolescents with intellectual disabilities

Abstract

Despite the wealth of research examining physical activity (PA) in children and adolescent without disability, there is a lack of research that has focussed on PA related to children and adolescents with intellectual disabilities (ID). The evidence that does exist in this area suggests that children and adolescents with ID are less active than their non-ID peers. The school environment offers numerous opportunities to engage in PA regularly, yet to date, school-based research focussing on PA in children and adolescents with ID is limited. Thus, the primary aim of this thesis was to investigate PA, sedentary time (ST) and playtime behaviours in children and adolescents with ID.Four study chapters are included in the thesis. Study 1 used uniaxial accelerometers to investigate habitual PA levels, sedentary behaviour and PA patterns in children and adolescents with severe and moderate ID. Results demonstrated that participants engaged in low amounts of PA, spent a large proportion of waking hours in ST and mainly engaged in short, sporadic bursts of PA.Study 2 investigated the PA levels of children and adolescents with severe and moderate ID during playtime and PE contexts using direct observation techniques. Participants engaged in similar levels of moderate to vigorous PA (MVPA), and spent minimal amounts of time engaging in sport based activities during playtime and PE. At playtime participants spent the majority of time playing alone or in small groups and no participants engaged in any large group play.Study 3 explored teachers’ perceptions of PA engagement for children and adolescents with ID. Teachers reported that pupils prefer to engage in fun, unstructured activities. Parents and teachers were identified as key role models who can influence PA engagement for this population and teacher participants explained that pupils with ID have limited understanding around PA and the benefits to health.Study 4 evaluated the effectiveness of a school-based PA intervention, delivered in two primary special educational needs (SEN) schools. The intervention demonstrated promising results, with an increase in accelerometer assessed MVPA levels between baseline and follow up of ~18mins. However, these findings were not statistically significant, possibly due to the small sample size involved. Minimum clinically important difference analysis suggested that changes in MVPA were likely to be beneficial to heath. Furthermore, qualitative data generated through teacher interviews highlighted positive intervention effects across the school.Overall the studies presented in this thesis provide an overview of PA engagement and associated behaviours in children and adolescents with ID. The major findings presented suggest that children and adolescents with moderate and severe ID are not sufficiently active, and the SEN school environment may be an important area to target PA interventions. The current thesis has made a significant contribution to our understanding related to the PA in children and adolescents with ID and has highlighted a number of recommendations for future research.