Many schools have developed programming to create opportunities for student-athletes with intellectual and physical disabilities. These programs have created inclusion opportunities for athletes in the school culture of extracurricular activities that are so important to the health and leadership development of all students.
Inclusion programs in Special Olympics Unified Sports® have a strong infrastructure nationally. As noted by Michael Furnish, president/CEO of Special Olympics Indiana, “Historically, people with intellectual disabilities have been left out of opportunities to enjoy fitness-related activities when they are young. We are learning that this inactivity by young people with intellectual disabilities leads to serious and expensive health issues later in life, such as obesity, high blood pressure, and a variety of other chronic health conditions. The movement toward more inclusive programs such as Special Olympics Unified Sports® in high schools where special-needs
students train and compete in sports alongside their nondisabled peers is changing the game in a way that will produce healthier and happier people who will contribute much more to society.”
Furthermore, the expansion of programming for athletes with physical impairments within the traditional arena is encouraging. Competitions such as wheelchair basketball that emphasize fair play and skill development are critical to the physical and social development of all participants.
The success of U.S. Paralympians, highlighted by USOC outreach to states, has helped increase the availability of resources to train and elevate the skill level of athletes with physical and developmental impairments. Statistics suggest that participation in sports can facilitate an active lifestyle beyond graduation, increase self-confidence and enhance leadership skills for all students. Further, providing the opportunity within school programming enhances the peer relationships for everyone.
There have been several examples in High School Today of different success programs for both Unified Sports® and physically impaired athletes in competition. One example is beautifully described in a video of the West Forks School Cross Country team in Kansas. The team’s head coach, Tiffany Surber, notes that coaches and responsible athletes guide the runners with pieces of cloth/soft rope during the workouts. The guide runner talks to the athlete during their runs letting them know of turns, speed bumps or objects in front of them.
Creating opportunities for all students can be challenging in small school communities with limited facilities. It may be difficult to coordinate practice schedules for boys and girls basketball, wrestling, cheer and wheelchair basketball if only one gym is available. Unique solutions have included cooperative partnerships between local school districts including facilities and personnel sharing. Coordinating transportation and schedules for the competitions can be challenging. Local programming, such as Sportable, in Richmond, Virginia, has been an excellent community partner with physically challenged programming, training and introduction to new sports that may not be available in the school system. (www.sportable.org).
Coaching and skill acquisition relies on many volunteers. Resources include the NFHSLearn.org courses, specifically Coaching Unified Sports with more than 24,500 courses delivered since its release in September 2012. Many athletes are able to compete without rule modification in the traditional sport’s arena, such as wrestling, baseball and swimming, and state-level determination is individually reviewed for safety of the athlete, contact nature of the sport, etc.
In the past, there have been athletes with hearing impairment and athletes with limb deficiency competing with their teammates in the traditional sport’s venues of wrestling, football, volleyball, baseball and swimming.
From a sports medicine standpoint, it is important to achieve understanding and medical clearance for issues pertinent to the intellectually or physically impaired athletes. The best option is for the athlete’s own physician to complete the pre-participation examination as this physician has established knowledge regarding the athlete’s impairments. Additionally, the school’s emergency action plan (EAP) should be updated if transport, access or unique medical emergencies (e.g., autonomic dysreflexia) in an athlete with a high spinal cord injury pertain to the competing athletes. (A few examples to consider are listed in the chart below.)
It is important to have the medical information and communication with the parent to further understand potential cognitive issues, response to heat stress, potential medications needed for emergency treatment and medications that may be potentially dehydrating. As with all athletes, understanding the athlete’s prior injuries or concurrent health issues remains important for optimal care in an emergency. If a certified athletic trainer is available, the EAP should be revised to ensure each athlete’s needs are completed in a team approach with venue-specific logistics.
All students can be athletes with a team approach combining care, coaching and competition. One of the greatest benefits of athletic participation is the development of confident, active community leaders.
|Visual||Active communication of emergency care being rendered||Assess field conditions or course that may require a visually-impaired athlete to avoid low branch, etc.|
|Limb Deficiency||Prosthesis fit/skin care||Assessment of prosthesis if used in high contact sports|
|Spinal Cord Injury||Insensate skin; heat tolerance||Cooling options other than tub/submersion|
|Hearing Impaired||Clear line of sight for coach or starter||Communication plan in emergency with athlete|
|Down’s Syndrome||Cervical spine films completed||Communication as above if concurrent hearing impairment|
Katherine Dec. M.D., is a professor in the Department of Orthopaedic Survey and the Department of Physical Medicine and Rehabilitation at Virginia Commonwealth University School of Medicine. She is a member of the NFHS Sports Medicine Advisory Committee.
Robert Faulkens is assistant commissioner of the Indiana High School Athletic Association. He is a member of the NFHS Sports Medicine Advisory Committee as well as the NFHS Football Rules Committee and NFHS Wrestling Rules Committee.