Participation in Special Olympics reduces the rate for developing diabetes in adults with intellectual and developmental disabilities.

AIM: Adults with intellectual and developmental disabilities (IDD) have a significantly higher prevalence of Type 2 diabetes than the general population. Evidence that lifestyle and/or behavioural interventions, such as participation in Special Olympics, decreases the risk of developing diabetes in adults with IDD could help minimize health disparities and promote overall health in this population. METHODS: This was a 20-year retrospective cohort study of adults with IDD (30-39 years) in the province of Ontario, Canada, that compared hazard rates of diabetes among Special Olympics participants (n = 4145) to non-participants (n = 31,009) using administrative health databases housed at ICES. Using cox proportional hazard models, crude and adjusted hazard ratios were calculated for the association between the primary independent variable (Special Olympics participation status) and the dependent variable (incident diabetes cases). RESULTS: After controlling for other variables, the hazard ratio comparing rates for developing diabetes between Special Olympics participants and non-participants was 0.85. This represents a 15% reduction in the hazard among Special Olympics participants when followed for up to 20 years. This result was statistically significant and represents a small effect size. CONCLUSIONS: Special Olympics could be considered a complex intervention that promotes physical activity engagement through sport participation, health screenings, and the promotion of healthy eating habits through educational initiatives. This study provides evidence that Special Olympics participation decreases the rate for developing diabetes.

Young adults with intellectual and developmental disabilities who participate in Special Olympics are less likely to be diagnosed with depression.

PURPOSE: People with intellectual and developmental disabilities (IDD) experience high rates of depression. Evidence indicates that physical activity, or participation in a sports club, in a supportive social environment has mental and physical health benefits. Adults with IDD, on average, engage in low levels of physical activity. The purpose of this study was to compare the rates of depression among young adult Special Olympics participants with IDD compared to non-participants with IDD. METHODS: This was a 20-year retrospective cohort study of young adults (19-29 years) with IDD in the province of Ontario, Canada that compared rates of depression among Special Olympics participants (n = 8710) to non-participants (n = 42,393) using administrative health databases housed at ICES (formerly the Institute for Clinical Evaluative Sciences). Using cox proportional hazard models, the crude hazard ratios were calculated for the association between each independent variable and the dependent variable. RESULTS: After controlling for other variables, the hazard rate for depression among Special Olympics participants compared to the hazard rate for depression among non-participants generated an adjusted hazard ratio of 0.51. Over the 20-year follow-up, the participants were 0.51 times as likely to develop depression as non-participants; this represents a 49% reduction in risk among Special Olympics participants. This result was statistically significant and represents a medium effect size. CONCLUSION: Future research is needed on how much of this risk reduction is related to a physiological response to physical activity/exercise, and how much is related to the social connectedness of being part of a group participating in Special Olympics.

COVID-19 Pandemic and Individuals With Intellectual Disability: Special Olympics as an Example of Organizational Responses and Challenges.

The COVID-19 pandemic is a worldwide crisis. It has been, and is, an extreme challenge for our health care and prevention systems, and for society as a whole. Among many facets of life, physical activity and sport has been heavily impacted. The aim of this viewpoint article is to highlight the effect of the COVID-19 pandemic on individuals with an intellectual disability, with a particular focus on physical activity and Special Olympics. Specific objectives are (a) to share what the literature reveals about the impact of COVID-19 on the health and well-being of individuals with an intellectual disability, (b) to examine what is known about the impact of the pandemic on physical activity of individuals with an intellectual disability, (c) to describe Special Olympics program responses during the pandemic, and (d) to recommend areas for future research.

Body mass index and waist circumference of Latin American adult athletes with intellectual disability.

OBJECTIVES: To examine both body mass index (BMI) status and waist circunference (WC) in a large international sample of adult Special Olympics participants from Latin America. It also explored the association of age and sex with obesity in this population. MATERIALS AND METHODS: BMI and WC records from a total of 4174 (2683 male and 1491 female) participant records from the Special Olympics International Health Promotion database were examined. RESULTS: The prevalence of overweight and obesity was quite high (i.e. > 40%), but generally lower than studies involving adults with intellectual disabilities from Europe and the USA. Chi-square analyses revealed that both increasing age and being female significantly predicted levels of overweight, obesity, and WC. CONCLUSIONS: These results suggest that efforts need to be made to prevent and reduce rates of overweight and obesity among Latin American Special Olympics participants, particularly women.

Interventions to promote physical activity for youth with intellectual disabilities.

OBJECTIVE: To describe interventions designed to promote physical activity for youth with intellectual disabilities. MATERIALS AND METHODS: A systematic review of nine databases until January 31, 2015 identified 213 citations. The inclusion criteria were: a) the study sample consisted of youth with intellectual disabilities, b) the study implemented an intervention to initiate, increase, or maintain physical activity, and c) quantitative or qualitative data were used to report the effectiveness of the intervention. Eleven articles from the 213 citations met this criterion. RESULTS: Nine studies reported significant increases in physical activity behavior. CONCLUSIONS: Conclusions cannot be made regarding intervention components that impacted outcome variables, if the observed effects were specifically due to the intervention or if interventions could be maintained long-term. To advance the knowledge base in this area, a concerted effort should be made to increase rigor in study conceptualization and research design.

Interventions to promote physical activity for adults with intellectual disabilities.

OBJECTIVE: To describe interventions designed to promote physical activity for adults with intellectual disabilities and the effects on overall physical activity levels and on health outcomes. MATERIALS AND METHODS: A systematic review of eight databases until January 31, 2015 identified 383 citations. The inclusion criteria were: a) the study sample consisted of adults with intellectual disabilities, b) the study implemented an intervention to initiate, increase, or maintain physical activity, and c) quantitative or qualitative data were used to report the effectiveness of the intervention. Six articles from the 383 citations met this criterion. RESULTS: Three studies resulted in significant increases in physical activity behaviour; however well-controlled trials designed to improve weight status by increasing physical activity did not produce significant effects. CONCLUSION: Overall, the results indicate that interventions to increase physical activity should simultaneously target the individual with intellectual disability as well as their proximal environment over a sustained period of time.

Barriers and Facilitators for Generalizing Cycling Skills Learned at Camp to Home.

Many children with disabling conditions do not acquire the skills to successfully ride a 2-wheeled bicycle. The aim was to describe cycling patterns before and after an innovative learn-to-ride bike camp and factors that facilitate or hinder the generalization of skills developed at camp to home. Parents and children participated in semistructured interviews 3-4 mo postcamp. Transcripts were examined deductively for participation and contextual influences using a template of codes approach. None of the children were successfully riding a 2-wheeled bicycle before camp. Two patterns of participation were evident from narrative descriptions of postcamp riding: "riders" and "not there yet." Major facilitating factors were the camp itself, the interaction between the camp and the health service, and continued parent involvement. The program transferred well to home for children who were riding independently on the last day of camp. Ongoing support is needed for children "not there yet."

Body mass index of children and youth with an intellectual disability by country economic status.

OBJECTIVE: Individuals with intellectual disabilities are at higher risk for health disparities including overweight and obesity; however, little is known at the population level about the BMI status of children and youth with intellectual disabilities. This study is a secondary analysis of BMI status (underweight, normal weight, overweight and obese) in children and youth (8-<18years) participating in Special Olympics by country economic status. METHODS: A total of 14,032 participants (n=8,856 male) measured height and weight records were available from the Special Olympics International Health Promotion database. The 141 countries in the database were re-coded according to the World Bank's classification of country economic status. BMI prevalence rates were calculated for underweight, normal weight, overweight, and obesity for children and youth using IOTF cutoffs by economic status. Chi-squared analyses and Fisher's exact test were used to examine differences in weight status by economy and sex. FINDINGS: Overall, 27.87% of Special Olympics participants from low-income economies, 31.04% from lower middle-income, 25.29% from upper middle-income, and 42.36% from high-income economies had BMI levels outside of the normal range. The low-income countries had higher rates of underweight and the high-income countries had higher rates of obesity. CONCLUSIONS: The high levels of both underweight and overweight/obesity found in this population of children and youth participating in Special Olympics represents a double burden of health risk. More research is needed to understand why this population experiences such disparities in BMI status and to develop health promotion initiatives targeted at this population.

Enhancing the capacity to facilitate physical activity in home-based child care settings.

Healthy Opportunities for Preschoolers (HOP) is a physical activity and movement skill intervention that was developed to address the unique needs of home-based child care providers. The authors used a train-the-trainer approach to enhance local uptake and implementation of HOP and examined the impact on the trainers' (workshop leaders') perceived knowledge, confidence, and intention to implement community workshops and subsequently on the knowledge, confidence, and intentions of workshop participants. This study also assessed feasibility: reach, satisfaction, and facilitators and barriers to workshop implementation. Overall, 92% and 89.5% of the leaders were very or extremely satisfied with the workshop content and delivery, respectively. Training significantly increased their self-reported knowledge (p < .001) and confidence (p < .001). Subsequently, 73% of workshop participants (48 workshops, n = 321) took part in the evaluation; intention to use what they learned after the workshop was high (86%) and perceived knowledge, confidence, and attitude all increased significantly (p < .001). The HOP train-the-trainer approach was feasible and enhanced knowledge, confidence, and readiness to change among home-based child care providers. This approach should be considered as a component of an overall strategy to enhance the promotion of physical activity and movement skills in home-based child care settings.

The Six-Minute Walk Test for adults with intellectual disability: a study of validity and reliability.

BACKGROUND: The Six-Minute Walk Test (6MWT) has been used with clinical and healthy populations to assess functional capacity and cardiovascular fitness. The aim of this study was to determine the test-retest reliability of a modified-6MWT as well as concurrent validity of walk distance with peak oxygen uptake (VO2 peak). METHOD: Participants were 13 adults (males = 7) with intellectual disability aged 18-44 years recruited from Special Olympics, and with no medical contraindications to exercise. The 6MWT was modified to include familiarisation, a 1:1 pacer, and encouragement every 15 s. Each participant performed the graded maximal treadmill test and the modified-6MWT twice. RESULTS: Test-retest reliability of the modified-6MWT was ICC = .98, and linear regression revealed that the modified- 6MWT distance was significantly related to VO2 peak (R = .84, p < .001). CONCLUSIONS: The modified-6MWT is easy to administer and score and shows acceptable validity and excellent reliability for assessing cardiovascular fitness in adults with intellectual disability.

Body mass index trends among adult U.S. Special Olympians, 2005-2010.

This study examined temporal trends in body mass index (BMI) among United States adults with intellectual disability (ID) participating in Special Olympics from 2005 to 2010. In addition, the prevalence of obesity was compared with published National Health and Nutrition Examination Survey (NHANES) statistics. After data cleaning, 6,004 height and weight records (male = 57%) were available from the Special Olympics International Healthy Athletes Health Promotion database for the calculation of BMI. Rates of overweight and obesity were very high but generally stable over time. Compared with NHANES statistics, the prevalence of obesity was significantly higher for Special Olympics female participants in each data collection cycle. Integrated efforts to understand the social, environmental, behavioral, and biological determinants of obesity and among Special Olympics participants are needed.

The Influence of Perceptions of Competence on Motor Skills and Physical Activity in Middle Childhood: A Test of Mediation.

The mediating effect of perceptions of physical competence (PPC) on the relationship between motor competence and physical activity levels is documented in adolescence. However, it is unclear at what age this begins. In this study, we examined whether PPC mediated the relationship between moderate-vigorous physical activity (MVPA) or sedentary behaviour and motor competence in middle childhood. The participants were 129 children (mean age = 8.3 years) from eight elementary schools. MVPA and sedentary behaviour were measured using Actigraph accelerometers, and motor competence was assessed using the Test of Gross Motor Development, Second Edition. The Pictorial Scale of Perceived Competence and Social Acceptance for Young Children and The Self-Perception Profile for Children were used to assess PPC. In this study, PPC did not predict either MVPA or engagement in sedentary behaviours. Further, structural equation modelling revealed that PPC did not mediate the relationship between motor competence and MVPA or between motor competence and sedentary behaviour. These results suggest that at 8 years of age, children's perceptions do not influence their participation in physical activities. It is possible that factors influencing PPC, such as peer comparisons and performance outcomes, have more impact in later childhood or adolescence. In turn, those perceptions may affect children's or adolescents' choices to opt in or out of physical activities.

Examining the Canadian 24-Hour Movement Guidelines among Adults with Intellectual Disability: A Pilot Study.

The purpose of this pilot study was to investigate the extent to which adults with intellectual disability (ID) met the 2020 Canadian 24-Hour Movement Guidelines. Fifteen adults (six females and nine males) participated in this nine-day observational study (age = 20-64 years) in 2021-2022, during the COVID-19 pandemic. Moderate-to-vigorous physical activity (MVPA), sedentary time, and total sleep time were measured with a smartwatch to compare to the guidelines. A diary subjectively tracked physical activity. Of the 15 participants, 11 met the MVPA guidelines (73%), 4 met the sedentary behaviour guidelines (27%), 7 met the sleep guidelines (47%), and only 1 participant met all 3 of the guidelines (7%). There were no differences in physical activity or sleep between weekends and weekdays, or between males and females. Walking, cleaning dishes, and swimming were the most common types of physical activity performed by the participants. The findings of this pilot study indicate the need to improve sleep and reduce sedentary time in adults with ID. As most participants met the MVPA guidelines, few met the sedentary behaviour guidelines, and nearly half met the sleep guidelines, these data also demonstrate how important it is to assess all three aspects of the movement guidelines. All these behaviours have independent health benefits and risks, which interact to influence overall health.

A window of opportunity? Motor skills and perceptions of competence of children in kindergarten.

BACKGROUND: Our aim was to examine the relationship between motor skill proficiency and perceptions of competence of children in their first year of school. We also explored gender-based differences. FINDINGS: Participants were 260 kindergarten children (mean age = 5y 9 m; boys = 52%) from eight schools; representing 78% of eligible children in those schools. Motor skills were measured using the Test of Gross Motor Development-2 and perceptions of physical competence were assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children. Motor skill scores were generally low (percentile ranks ranged from 16 - 24) but perceptions of physical competence were positive (boys = 18.1/24.0, girls = 19.5/24.0). A MANOVA showed a significant overall effect for gender (Wilk's lambda = .84 with F (3, 254) = 15.84, p < 0.001) and univariate F tests were significant for all outcome variables. The relationship between object control skills and perceptions of physical competence among girls was not significant; however all other correlations were modest but significant. CONCLUSIONS: Although motor skill levels were quite low, the children generally held positive perceptions of their physical competence. These positive perceptions provide a window of opportunity for fostering skillfulness. The modest relationships between perceptions of competence and motor skill proficiency suggest that the children are beginning to make self-judgments at a young age. Accordingly, opportunities for children to become and feel physically competent need to occur early in their school or preschool life.

Pilot study of a dog walking randomized intervention: effects of a focus on canine exercise.

OBJECTIVE: The promotion of dog walking among owners who do not walk their dogs regularly may be a viable physical activity intervention aperture, yet research is very limited and no intervention studies have employed control groups. Therefore, the purpose of this pilot study was to examine the viability of dog walking for physical activity intervention using messages targeting canine exercise. METHOD: Inactive dog owners (n=58) were randomized to either a standard control condition or the intervention (persuasive material about canine health from walking and a calendar to mark walks) after completing a baseline questionnaire package and wearing a pedometer for one week. Participants (standard condition n=28; intervention condition n=30) completed the six and 12 week follow-up questionnaire packages. RESULTS: Intention to treat analyses showed that both groups increased physical activity significantly across the 12 weeks (η(2)=0.09 to 0.21). The intervention group resulted in significantly higher step-counts compared to the control group (Δ 1823 steps) and showed significantly higher trajectories from baseline to 12 weeks in the self-reported physical activity measures (η(2)=0.11 to 0.27). CONCLUSION: The results are promising for the viability of increasing dog walking as a means for physical activity promotion and suggest that theoretical fidelity targeting canine exercise may be a helpful approach.

Efficacy of a peer-guided exercise programme for adolescents with intellectual disability.

BACKGROUND: Peer support is strongly associated with physical activity of adolescents. This study examined the efficacy of a YMCA-based, peer-guided exercise training programme for increasing health-related physical fitness among adolescents with intellectual disabilities. MATERIALS AND METHODS: Adolescents with intellectual disabilities and typically developing peer partners provided reciprocal support during 1-h exercise sessions that included aerobic exercise, weight training and stretching activities. The programme was conducted 2 days/week for 15 weeks and pre- and post-test fitness testing was conducted. RESULTS: Participants demonstrated significant improvements in curl-ups, 6-min walk and BMI. Exercise session attendance was high and participants typically completed all of the prescribed aerobic and stretching exercises, whereas weight training exercises were completed less consistently. CONCLUSIONS: This peer-guided model integrates social and instructional support for adolescents with intellectual disabilities and may encourage exercise participation in community settings.

Matching Special Olympics registration data with administrative health databases: Feasibility and health status differences in children and youth with IDD.

BACKGROUND: Children and youth with intellectual and developmental disabilities (IDD) experience health disparities. What is unknown is if data collected from children and youth with IDD who participate in Special Olympics is representative of children and youth with IDD who do not. OBJECTIVES: Aim 1: determine the feasibility of matching a database of registrants from Special Olympics Ontario (SOO), with population-based health services databases in Ontario, Canada housed at ICES. Aim 2: evaluate the differences between the database sources with regards to demographic variables and clinical status. METHODS: Using deterministic and probabilistic matching, registration data from SOO were matched to administrative health databases. Established algorithms were used to determine the prevalence of asthma, diabetes, and mental disorder in addition to demographic variables. RESULTS: The matching rate was over 90%; 8404 were attributed to children and youth between the ages of 0-19 years. When comparing SOO participants with IDD to non-SOO participants with IDD, children and youth who participate in SOO were, on average, older with no further differences between groups on clinical or demographic variables. When comparing those previously not identified in the health services databases (from SOO) to those with IDD identified by ICES, the SOO participants appear to use the health system less, possibly indicating a better health status. CONCLUSIONS: Research conducted on child and youth who participate in Special Olympics Ontario can be generalized to the broader population of children and youth with IDD in Canada when adjusted for age; however, care should be taken when comparing levels of overall morbidity.

Nutrition needs assessment of young Special Olympics participants.

BACKGROUND: Children with intellectual disability (ID) are at increased risk for obesity and nutrition-related health concerns, yet there is a paucity of data describing their nutrition status. The purpose of this study was to evaluate nutritional challenges of young participants (2?10 years of age) enrolled in Special Olympics Canada (SOC) programs. METHOD: A validated nutrition screening tool was mailed to 52 parents/caregivers of participants across 18 SOC programs in British Columbia, Canada. RESULTS: Of the 29 (55.8%) questionnaires returned, 62.1% scored as "high" nutrition risk. Nutrition concerns included feeding (84.2%), oral motor (57.9%), and dental problems (26.3%), food allergies/intolerances (26.3%), constipation (15.8%), anaemia (10.3%), and diarrhoea (5.3%). Body mass index (BMI) for age data classified 16.7% of participants as overweight/obese and 22.2% as underweight. CONCLUSIONS: This study identifies some of the unique nutrition issues faced by children with ID. These data can help inform future ID health-related nutrition, prevention, and treatment programs.

The feasibility of using a peer-guided model to enhance participation in community-based physical activity for youth with intellectual disability.

We examined the feasibility of a using a peer-guided model to foster participation of youth with intellectual disability in community-based exercise. The intervention was designed to address personal barriers to exercise commonly faced by individuals with intellectual disability. Twenty adolescents with mild-moderate intellectual disability and 14 typically developing peers exercised in groups of two or three, 2 days per week for 15 weeks at YMCAs. Each dyad or triad provided reciprocal support during structured, individualized exercise sessions led by certified fitness trainers. Adherence to the program was high and youth with intellectual disability showed a significant reduction in personal barriers. They also felt they had learned new skills and made new friends. Typically developing youth were also positive about their experience as a volunteer. Our findings suggest that a peer-guided exercise model is useful for enhancing participation in community-based exercise.

Motor Skills and Participation in Middle Childhood: A Direct Path for Boys, a Mediated Path for Girls.

BACKGROUND: Beyond the often examined perceptions of competence and motor skill proficiency, perceived value and children's expectations for success are thought to affect engagement in physical activities. We used parallel mediation models to examine the direct effect of motor skill proficiency on participation in physical activities, as well as whether children's beliefs and value for physical activities mediated this relationship. METHODS: The participants in this cross-sectional study were a total of 398 grade 3 children (201 girls) from 8 schools. Motor skills were assessed using the Test of Gross Motor Development-2, the Value Expectancy Questionnaire measured the psychological variables, and the Children's Assessment of Participation and Enjoyment measured physical activities. RESULTS: Motor skill proficiency predicted all 3 psychological constructs for the boys and the girls, and boys' participation in physical activities. However, the psychological variables did not mediate the relationship between motor skills and participation among the boys. For the girls, task value mediated the relationship between motor skills and physical activity participation. CONCLUSION: It is possible that the girls are further along in their ability to reflect on their competence, successes, and failures; it is also possible that the lower motor skill levels of girls had a deleterious effect on their feelings about participating.