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.

Physical activity promotion and adults with intellectual disabilities: A neglected area.

BACKGROUND: The objective was to review physical activity (PA) promotion interventions among individuals with intellectual disability and provide recommendations for increasing PA. METHODS: A systematic mapping review was conducted in which physical activity intervention studies for adults with a disability were identified, selected, and appraised. Data were extracted regarding the study design, results, and authors' recommendations. Data were analyzed using a social-ecological framework. RESULTS: A comprehensive search of the peer reviewed literature yielded 5 studies (3 quantitative, 1 mixed methods, and 1 pre-post delayed). Studies used physical activity promotion strategies at the intrapersonal, interpersonal, organizational, community, and policy levels have been used to date. CONCLUSIONS: Recommendations are presented for researchers and practitioners seeking to increase the level of PA of adults with intellectual disability.

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.

Latin American Physical Educators' Intention to Teach Individuals With Disabilities.

PURPOSE: To analyze Latin American physical education (PE) teachers' intentions toward teaching students with disabilities. PARTICIPANTS: 474 in-service PE teachers from 5 different Latin American countries. METHOD: Descriptive survey. Data were collected using a modified version of the Physical Educators' Intention Toward Teaching Individuals With Disabilities Survey. Multiple-regression analysis showed significant differences in the attitudes of teachers by gender, the number of adapted-PE courses taken, and years of experience working with individuals with disabilities. RESULTS: The predictor variables had a significant impact on the participants' intentions toward teaching children with disabilities; however, the effects of these predictor variables differed between countries.

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.

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.

A randomized parent-mediated physical activity intervention for autistic children.

The purpose of this study was to examine the immediate and post effects of a parent-mediated physical activity intervention on the fundamental motor skills of autistic children. We randomly assigned parent-child dyads (n = 31) of autistic children aged 4-11 years into three groups (workshop, an online, or control group). Each dyad participated in a 12-week intervention and was given adapted physical activity equipment and over 200 activities via a mobile application. Children were tested at the start and end of the intervention. The effect size (Cohen's d ) of the control group for pre-post locomotor and ball skill scores were 0.12 and 0.06, respectively, indicating small effect size. The effect size of the online group for pre-post locomotor and ball skill scores were 49 and 0.26, respectively, indicating medium and small effect sizes. The effect size of the in-person group for pre-post locomotor and ball skill scores were 1.18 and 0.82, respectively, indicating large effect sizes. The outcomes of this physical activity intervention suggest that parents may facilitate the acquisition of fundamental motor skills of their autistic children. Although these results are positive, there is a need to further identify effective interventions for fundamental motor skill development in autistic children. Clinical Trials ID: NCT05159102.

Prediction of energy expenditure from wrist accelerometry in people with and without Down syndrome.

This study examined the relationship between energy expenditure and wrist accelerometer output during walking in persons with and without Down syndrome (DS). Energy expenditure in metabolic equivalent units (METs) and activity-count rate were respectively measured with portable spirometry and a uniaxial wrist accelerometer in 17 persons with DS (age: 24.7±6.9 years; 9 women) and 21 persons without DS (age: 26.3±5.2 years; 12 women) during six over-ground walking trials. Combined groups regression showed that the relationship between METs and activity-count rate differed between groups (p<.001). Separate models for each group included activity-count rate and squared activity-count rate as significant predictors of METs (p≤.005). Prediction of METs appeared accurate based on Bland-Altman plots and the lack of between-group difference in mean absolute prediction error (DS: 17.07%; Non-DS: 18.74%). Although persons with DS show altered METs to activity-count rate relationship during walking, prediction of their energy expenditure from wrist accelerometry appears feasible.

Believe in You student empowerment program: A pilot study.

Introduction: The social and emotional health of youth is important, especially after students experience the COVID-19 pandemic. The purpose of this study was to understand the influence that the Believe In You Student Empowerment Program had on students social emotional learning (SEL) behaviors over a 10 week period during the COVID-19 pandemic. Materials and methods: A part of this quantitative study, one school in each the intervention and the control group (delayed intervention; 2 schools total) participated in the study. Students enrolled in physical education within each school participated (n = 166; Intervention = 88). Students in each group took a survey at week 1 (baseline measure), week 5, and week 10. Students who were in the intervention group started the program after week 1, while the delayed intervention group began the program in week 5. Results: A series of ANCOVA's examined the difference of social emotional learning knowledge and social emotional learning scales between the treatment and control groups. Self-awareness (F = 13.91, p < .01), self-management (F = 6.14, p < .01) & relationship skills (F = 5.50, p < .05) saw significant differences over time compared to the control group. The second series of analyses looked only at the intervention group and analyzed to determine significant differences in mean scores of SEL variables between weeks one and ten. Emotional regulation saw significant differences (t = 2.5, p < .01). The final set of analyses conducted were with the delayed intervention group and examined the difference in mean SEL scores over the three time periods. Again, emotional regulation saw significance with an interaction of time and gender (F = 4.162, p < .01). Discussion and Conclusion: In a short period of time, Believe in You Student Empowerment Program has shown the potential to have a positive influence on students social emotional learning behaviors, even during the COVID-19 pandemic. More research should be conducted over a longer period of time, in-person, and with an experimental design to better understand the effects of the Varsity Brands Believe in You Student Empowerment Program and its implications with student social emotional learning behaviors.

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.

A prospective evaluation of balance, gait, and strength to predict falling in women with multiple sclerosis.

OBJECTIVE: To identify measures of balance, gait, and strength that predict falls in women with multiple sclerosis (MS). DESIGN: This prospective study followed participants for 1 year. SETTING: University research laboratories. PARTICIPANTS: A convenience sample of women with MS (N=99). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Balance was assessed with the limits of stability (LOS) test and the Sensory Organization Test. Peak force, torque, and power of knee flexors and extensors as well as hip abductors and adductors were also measured. Temporal-spatial parameters of gait were measured by an instrumented walkway system. For 1 year after baseline assessments, the participants reported their falls. Participants were then classified based on the number of reported falls for use in logistic regression models to predict either people with at least 1 fall or people with at least 2 falls (recurrent fallers). RESULTS: A total of 159 falls were reported by 48% of the participants. Expanded Disability Status Scale scores, leaning forward to the LOS, and standing sway within a visually referenced surround significantly predicted people with at least 1 fall as well as recurrent fallers. Stance-phase asymmetries and base-of-support width during gait, as well as the force and power produced during leg extension or flexion additionally predicted recurrent fallers. The models' overall predictive accuracy ranged from 69% to 85%. CONCLUSIONS: This prospective study confirmed the prevalence and multifactorial nature of falls in this MS sample. In addition to advancing disease status, impaired forward LOS and visually dependent sway (as well as gait asymmetries and leg flexor-extensor weakness for recurrent fallers) predict future falls in women with MS.

A Randomized Feasibility Trial of a Fundamental Motor Skill Parent-Mediated Intervention for Children with Autism Spectrum Disorders.

The purpose of this pilot study was to examine the feasibility of a fundamental motor skills (FMS) intervention with two groups on the acquisition of FMS of children with autism spectrum disorders (ASD). We randomly assigned families (n = 15) of children with ASD aged 4-11 years into two groups (a workshop or a home-based group) focused on FMS development. Both groups participated in a 10-week intervention and were given the same instructional manual and adapted physical activity equipment. The workshop group also attended four in-person workshops targeting the needs of children with ASD and their parents. Children were tested on their FMS using the third edition of the Test of Gross Motor Development at the start and end of the intervention and then three months following the intervention. The recruitment rate was 50%, and the retention rate was 80% for all participants. The intervention for groups was safe and accepted by the participants as evaluated by post-program interviews. The outcomes of this pilot study suggest that parents can facilitate the acquisition of FMS of their children with ASD. Although these results are positive, there is a need to further identify effective interventions for FMS development in children with ASD.

Prevalence of overweight among youth with chronic conditions in the United States: An update from the 2016 National Survey of Children's Health.

BACKGROUND: Surveillance of overweight trends among youth with chronic conditions can inform the prioritization of funding, research and intervention. OBJECTIVES: The primary objective of this study was to utilize the 2016 National Survey of Children's Health (NSCH) data to provide current estimates of the prevalence of overweight among US youth with common chronic conditions. A secondary purpose was to examine parental concern about weight status among youth with chronic conditions who were overweight. METHODS: This study included children aged 10 to 17 years with (n=10 997) and without (n=13 408) chronic conditions from the 2016 NSCH. Estimates of overweight, and parental concern for weight status, were compared among youth with 19 common chronic conditions and youth without chronic conditions. RESULTS: Overall, youth with chronic conditions were significantly more likely to be overweight compared with youth without chronic conditions (35.4% vs 27.8%). Overweight was most prevalent among youth with diabetes (56.4%), intellectual disabilities (53.6%) and hearing impairments (46.1%). Parents of youth with chronic conditions who were overweight were significantly more concerned that their child's weight was too high than those without chronic conditions. CONCLUSIONS: This study identifies youth with chronic conditions, particularly those with certain conditions, as being in need of prioritization of funding, research and intervention.

Obesity across the lifespan among persons with spina bifida.

PURPOSE: Identify risk factors for obesity across the lifespan for individuals with spina bifida. METHODS: Cross sectional chart review study of 203 patients aged 6-58 years. Obesity was based on body mass index. Rates were calculated for children aged 6-11 years; adolescents aged 12-19 years and adults aged > 20 years. Chi-square analyses were used to determine differences in obesity rates among subgroups. An ordered logistic regression model was developed for the three age groups to estimate the probability of a change in BMI classification from normal weight to overweight or overweight to obese, controlling for sex, functional motor level, shunt status and insurance status. RESULTS: Obesity rates for children, adolescents and adults were 18, 8 and 37%, respectively. Obesity rates were higher among adults (chi2 = 27, p < 0.01) and for individuals who were publicly insured (chi2 = 7.2, p < 0.03). The ordered regression model for children demonstrated no independent association between sex, shunt status, functional motor level or insurance status and change in BMI category. For adolescents, lower functional motor level (i.e. sacral) increased the risk of becoming obese (Odds Ratio: 2.13; 95% CI: 1.12-4.06; p < 0.02). Among adults, female sex increased risk (OR = 2.28; 95% CI: 1.03-5.04; p < 0.04). CONCLUSIONS: Obesity rates for children and adolescents with spina bifida are similar to the general population; however, obesity rates are higher among adults, particularly women. Risk factors are similar to those observed in the general population.

An exploratory study of after-school sedentary behaviour in elementary school-age children with intellectual disability.

BACKGROUND: The purpose of this study was both to investigate if children with intellectual disability (ID) spend more time watching television and on the computer than their peers without disabilities and if total screen time correlates with physical activity in these same children. METHODS: Participants were 9 children with ID matched with 9 children without ID, aged 7-12 years. Participants were matched by gender, age, and body mass index (BMI). Parents logged after-school television and computer time. Physical activity was recorded with accelerometers. RESULTS: Mann-Whitney tests revealed no difference between television or computer time between the groups. Correlations between physical activity and screen time revealed that children without ID had a low relationship between physical activity and screen time (tau = -.11, p = .64). Conversely, children with ID had a moderate relationship between physical activity and screen time (tau = .56, p = .04). CONCLUSIONS: These results suggest that there might be different patterns of sedentary behaviours between children with and without ID, indicating that unique interventions may be needed for individuals with ID.

Association of father involvement and neighborhood quality with kindergartners' physical activity: a multilevel structural equation model.

PURPOSE: Examine the effects of father-child involvement and neighborhood characteristics with young children's physical activity (PA) within a multilevel framework. DESIGN: Cross-sectional analysis of the Early Childhood Longitudinal Study-Kindergarten Cohort 1998. SETTING: Nationally representative sample. SUBJECTS: Data were available for 10,694 kindergartners (5-6 years; 5240 girls) living in 1053 neighborhoods. MEASURES: Parental report of child's PA level, father characteristics (e.g., time spent with child, age, education, socioeconomic status, hours worked), family time spent doing sports/ activities together, and neighborhood quality (e.g., safety, presence of crime violence, garbage). Child weight status, motor skills, ethnicity, and television viewing were used as covariates. ANALYSIS: Multilevel structural equation modeling with children nested within neighborhoods. RESULTS: At the child level father-child time and family time doing sports together were positively associated with children's PA. At the neighborhood level parental perception of a neighborhood's safety for children to play outside fully mediated the effect of neighborhood quality on children's PA. Overall 19.1% and 7.6% of the variance in PA was explained at the child and neighborhood levels, respectively. CONCLUSIONS: Family-based interventions for PA should consider father-child time, with this contributing to a child's overall PA level. Further, neighborhood quality is an important predictor of PA only to the extent by which parents perceive it to be unsafe for their child to play outdoors.

Maximizing the use of Special Olympics International's Healthy Athletes database: A call to action.

There is a critical need for high-quality population-level data related to the health of individuals with intellectual disabilities. For more than 15 years Special Olympics International has been conducting free Healthy Athletes screenings at local, national and international events. The Healthy Athletes database is the largest known international database specifically on the health of people with intellectual disabilities; however, it is relatively under-utilized by the research community. A consensus meeting with two dozen North American researchers, stakeholders, clinicians and policymakers took place in Toronto, Canada. The purpose of the meeting was to: 1) establish the perceived utility of the database, and 2) to identify and prioritize 3-5 specific priorities related to using the Healthy Athletes database to promote the health of individuals with intellectual disabilities. There was unanimous agreement from the meeting participants that this database represents an immense opportunity both from the data already collected, and data that will be collected in the future. The 3 top priorities for the database were deemed to be: 1) establish the representativeness of data collected on Special Olympics athletes compared to the general population with intellectual disabilities, 2) create a scientific advisory group for Special Olympics International, and 3) use the data to improve Special Olympics programs around the world. The Special Olympics Healthy Athletes database includes data not found in any other source and should be used, in partnership with Special Olympics International, by researchers to significantly increase our knowledge and understanding of the health of individuals with intellectual disabilities.

Association of poverty and social exclusion with body mass index among Special Olympics athletes in Europe.

OBJECTIVES: To examine the association of a risk of poverty and social exclusion (AROPE), age, and gender with the body mass index (BMI) status of European Special Olympics athletes. METHODS: BMI records were available for 1905 children and youth and 5517 adults from the Special Olympics International (SOI) Health Promotion database. AROPE was extracted from EU Eurostat statistics. Logistic regression analyses were used to predict BMI status. RESULTS: For children/youth and adults, respectively, 9.4 and 6.3% were underweight and 25.3 and 44.6% were overweight/obese. Being underweight was significantly associated with higher AROPE rates. Being female and lower AROPE rates were significantly associated with overweight/obesity for both children/youth (OR 1.27; 95% CI 1.07-1.50 and OR 0.97; 95% CI 0.96-0.98) and adults (OR 1.55; 95% CI 1.39-1.72 and OR 0.96; 95% CI 0.95-0.98). CONCLUSIONS: The Europe 2020 "platform against poverty" strategy aims to ensure that those experiencing poverty and social exclusion share the benefits of economic growth. These findings suggest that SOI health promotion efforts to foster healthy BMI are needed and should be tailored to specific social and economic circumstances in Europe.