Sport and active recreation is a key medium for creating new relationships among disparate social groups.

People with disabilities are often more susceptible to changes in body temperature and the effect of different weather conditions. Participants with physical disabilities are usually less mobile than other participants and their body metabolism responds differently to changing conditions.

The level of assistance required with personal care, will vary greatly from individual to individual. As a starting point it is advisable to gather as much information as possible from the participant you are assisting, or their parents/carers, as to how much and what type of support they require. This is best done prior to the start of the program.

Many participants with a disability require some form of medication. The Coordinator or an appointed leader usually has the responsibility for administering required medication. The person administering medication should have a first aid qualification.

The mealtime is an important experience within some sport and active recreation programs. It is a great time for participants to share their new endeavours. The mealtime provides the opportunity for development in a number of areas; it is not just the time for consuming food.

In working with people with disabilities, a great emphasis is placed on lifting techniques. There are three reasons for this. Firstly, in the interest of the safety of everyone involved, secondly, the comfort and dignity of the participant who is being lifted and thirdly the physical welfare of the person doing the lifting.

On any given program, the participants will usually have a range of disabilities; some of these will affect the ability to be mobile and to independently move from place to place. Some may have aids that assist them to move about independently, others may require the assistance of the leader. This assistance may range from providing a steady arm for support to pushing a wheelchair.

This communication aid is usually in the form of a card that has been tailor made for the participant by a speech pathologist. They may list just a few words or may have a combination of letters, numbers and commonly used words and phrases.

This form of sign language originated in England and has been adapted for use by people with disabilities. It provides a basic means of communication and is accompanied by normal speech, appropriate facial expressions and general body language. The signing vocabulary is taught in stages and it is useful for leaders to know the basic signs for things such as toilet, drink, food, etc.

The ability to communicate with others is something many of us take for granted. We have the skills and abilities to speak, and use body movements to communicate what we feel and want, when we want. Auditory skills enable us to hear what others are saying to us and visual abilities help us to see what others maybe communicating to us and give us feedback on our communication with them.

A small number of people with a disability are subject to restrictive interventions (such as restraint or seclusion). The Disability Act 2006 provides strong requirements that the rights of these people are protected.

On occasion it may be necessary to deal with behaviours that are physically aggressive. These behaviours may harm the participant, other participants, property or yourself.

Threatening situations like these will give rise to a number of emotions including anger and fear. It is important to acknowledge these emotions and recognise that acting on them may result in unnecessary injury to yourself or you may run the unnecessary risk of an injury to the participant.

In responding to this type of challenging behaviour the first priority is the safety of the participants (though you are not expected to jeopardise your own safety in doing this)

  • Move other participants to a safe area if this is appropriate;
  • Do not risk personal safety if damage to property is involved;
  • Be aware of the legal consequences of using physical force;
  • Physical intervention is only justified in self-defence or in the defence of other participants;
  • Use only the physical force necessary to control the situation;
  • Be aware of individual behaviour program plans that may have been developed for the participant; and
  • Develop a behaviour modification program.

Types of incidents and how to respond to them

  1. A participant, who threatens to kick, hit, punch, pull hair or scratch should be controlled through verbal communication strategies.
  2. Participants, who actually punch, pull hair or scratch should be controlled through evasive self-defence action that minimises the impact of the assault and does not physically control the participant.
  3. Where a participant purposefully attempts to injure someone who as a result would require medical attention, such as repeated blows and attacks with heavy objects, the leader should use reasonable force in restraining the participant.

Note: There is a fine line between behavioural issues and criminal issues. Behaviour modification is preventative and not punitive. Where assault is occurring it is the police and not the program leader who should be called in to take appropriate action.

At times leaders may be confronted with challenging behaviours of participants that interfere with the program's aims and objectives or other participant's right to enjoyment of the programme experience. Under these circumstances there is a need to deal with these behaviours in the best interests of the participant concerned and also to maintain the rights and safety of the other participants.

Tourette Syndrome (TS) is a neurological disorder, which most often begins between the ages of 2 & 21 years. and lasts for life. TS is characterised by rapid, repetitive, involuntary muscle movements and vocalisations, called ‘tics’. TS often involves behaviour difficulties.

Attention Deficit Hyperactivity Disorder(ADHD) is a behavioural disorder that affects a young child’s behaviour or development. It is not an illness or a sign of low intelligence. The 3 main characteristics are:

Down Syndrome is a genetic condition. People living with Down Syndrome are born with an extra copy of chromosome 21. This leads to altered physical characteristics, some level of developmental delay and intellectual disability.

An acquired brain injury is an injury to the brain tissue or nerve fibres that is permanent in nature and results in some impairment to an individual's physical, behavioural or emotional function. It may be acquired through an accident; infection or disease; poisoning through alcohol, drug or household chemicals; or other causes such as stroke, coma, epilepsy, aneurism, or depleted oxygen supply.

Epilepsy is a disorder that takes the form of recurring seizures caused by sudden excessive discharge of electrical energy in the brain. Under certain circumstances, anyone can have a seizure. A diagnosis of epilepsy occurs after recurrent seizures. It can affect any person at any age, and many factors can contribute to the development of epilepsy including: brain infections; head injuries; cerebral tumours; and strokes.

There are many different forms of heart disease. The most common cause of heart disease is narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself. This is called coronary artery disease. It happens slowly over time, and is the major reason people have heart attacks.

Diabetes is a disorder of the body's system that regulates the amount of sugar in the blood. For our bodies to work properly we need to convert the glucose (sugar) from food we eat, into energy. A hormone called insulin is required to convert the sugar to energy. People with diabetes do not produce enough, or any insulin, to make this conversion happen, and therefore the glucose travels around their body in their blood, and causes the blood sugar level to rise above normal.

There are two types of diabetes:

Type 1 diabetes– occurs in 10 -15% of people with diabetes and is more common in children and young adults. People with Type 1 diabetes do not produce insulin and treatment involves daily injections of insulin, diet control and exercise.

Type 2 diabetes– 80 – 90% of people living with diabetes have Type 2 diabetes It is more common in middle aged or elderly people, and occurs when insulin production occurs, but not at a rate high enough to do what is required. Type 2 diabetes is increasingly occurring in younger people, and is very much a life style related disease. People, who are overweight, do not exercise, have high blood pressure, have poor diets, and carry weight around their stomach are at risk of developing Type 2 diabetes. It can be controlled with diet and exercise, and medication for some.

Diabetics can possibly suffer three reactions:

Hypoglycaemia - the most common complication of diabetes is due to a drop in blood sugar levels and can be caused by:

  • not eating enough, missing meals or delaying meals;
  • missing or delaying morning or afternoon tea;
  • too high a dose of insulin injected;
  • unusual strenuous exercise, emotional shock, impact of alcohol; 
  • change in injection procedure; or
  • drinking alcohol.

An insulin reaction may involve the following symptoms: sweatiness, light-headedness, headache and dizziness, lack of concentration, irritability, intense hunger, numbness around lips and fingers.

A diabetic usually knows the warning symptoms and how to avoid a reaction -usually by eating sweet things - sugar, orange juice, soft drinks or chocolate will increase the blood sugar. If there is no improvement in 10- 15 minutes, give more sweet food and seek urgent medical help.

Hyperglycaemia - occurs when the blood sugar level is too high. This can take several days to happen, and can only be confirmed with a finger prick blood test. It can be caused by sickness, infection, too little insulin, and too much carbohydrate food at once, stress.

Symptoms include:

  • Excessively thirst;
  • Passing high amounts of urine;
  • Blurred vision;
  • Feeling tired;
  • Weight loss;
  • Infections.

Ketoacidosis - a serious complication in people with Type 1 diabetes, due to insufficient insulin. This may have been caused by:

  • omission of insulin dose or insufficient insulin in dose;
  • infections such as flu, gastric upset, not maintaining diet; or
  • injury or excessive alcohol.

Ketoacidosis may involve the following symptoms: thirst, flushed cheeks, abdominal pain, deep rapid breathing, vomiting and may result in coma if not treated. It is very important to seek urgent medical treatment.

It is important to find out from parents/caregivers, the symptoms associated with a participant's diabetes and what treatment is most appropriate.

Programming Considerations

  • Some diabetics have to adhere to very strict meal times and this needs to be taken into account when programming activities.
  • Important to have constant breaks for fluid and fuel replacement during exercise and eating quality carbohydrates at each break.
  • Be aware of triggers and monitor the participants, as they will not be able to explain what they need once are action starts.

Strategies for Inclusion

  • Educate all participants about diabetes and tell them what to do if the participant with diabetes has an insulin reaction.

Further information

Diabetes Australia – www.diabetesaustralia.com.au

Arthritis means inflammation of the joint. However, arthritis is not a single condition. There are well over 100 kinds of arthritis, all of which affect one or more joints in the body, and some forms of arthritis do not involve any inflammation.

Dr James Fries has developed eight categories of arthritis, which help explain how arthritis affects different structures in the body. Pain, stiffness and inflammation are hallmarks of arthritis with the two common forms being osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA), the most common form of arthritis, is a progressive degenerative joint disease characterized by the breakdown of joint cartilage associated with risk factors, such as overweight/obesity, history of joint injury and age. Symptoms include pain, stiffness, muscle weakness and cramps or muscle spasm around the infected joint.

Rheumatoid Arthritis (RA), a systemic disease characterized by the inflammation of the membranes lining the joint, which causes pain, stiffness, warmth, swelling and sometimes severe joint damage. Rheumatoid arthritis is a complex, frequently progressive disease.

The types of medication used to treat arthritis range from analgesics such as paracetamol and aspirin (also an anti-inflammatory)to prescription medications such as the non-steroidalanti-inflammatory drugs. Physical activity and weight management are important and can help manage the pain and stiffness from many forms of arthritis.

Programming Considerations

  • When joints are inflamed, rest is needed but if joints are stiff, they need more activity and movement to relieve the stiffness.
  • Altering activities or ensuring adequate rest breaks should be considered when participant suffering from arthritis are involved inactive recreation activities.
  • Mobility may be an issue with some people so too much walking is not desirable.
  • Swimming in warm water is an excellent activity to relieve the symptoms.
  • Bike riding encourages muscle development without straining inflamed joints.
  • Arthritis in the hands may affect the ability to grip everyday items and sport and recreation equipment.
  • It may be necessary to spend sometime learning how much modification is required for a person with equipment, etc.

Strategies for Inclusion

  • Be aware of the limitations and what assistance is needed to participate successfully.
  • Avoid activities requiring fine motor skills.

Behaviour Management Issues

  • Provide continuous encouragement.

Further information

Arthritis Victoria - www.arthritisvic.org.au

Multiple Sclerosis (MS) is a disease of the central nervous system - the brain and spinal cord. The material surrounding nerve fibres is destroyed causing interruption to messages from the brain to other parts of the body hence affecting motor and sensory functions. The course of the disease is often unpredictable and the progression varies greatly from individual to individual.

Asthma is a treatable health condition. It is caused by the narrowing of the small breathing tubes in the lungs due to the tightening of the muscles in the tube wall, the swelling of tube lining and an increase in mucus production, creating a difficulty in breathing.

Asthma attacks can be bought on by many factors and these will vary for each individual affected. These factors include:

  • allergens, e.g. grass, pollens, house dust mites, pet fur, etc.
  • sudden changes in temperature;
  • dry hot winds;
  • nervous tension;
  • cold air;
  • stress and anxiety;
  • exercise;
  • smoking; and
  • sensitivity to certain types of food or food additives such as preservatives.

Exercise is a medically recognised trigger factor for asthma and may place limitations on participation in a range of activities. Most asthmatics can be fully involved in physical activities if they are aware of how they can control their wheezing.

Some forms of medication have been found to be effective in preventing the symptoms of asthma and enable participants to participate in activities.

Early signs of an asthma attack -

  • breathing becomes more difficult and a wheezing sound develops;
  • breathing is rapid and sometimes with a rasp; and
  • the person becomes distressed, pale and sweaty and has a rapid pulse.

During an asthma attack the participant requires a quiet environment with clean air and access to treatment. The person's medication should always be available. The instructions will prescribe dosage and the procedure for taking medication. Medication involving inhalants usually work quickest. If no medication is available, it is important to seek medical attention immediately.

Programming Considerations

  • Participants with asthma should be able to participate fully in sport and active recreation activities if the condition is under control.
  • This will involve knowledge of the activity that brings on an asthma attack and taking account of these in program planning.
  • The leader should be aware of a person's medication requirements and the procedure to follow during an attack.

Further information

Asthma Foundation Victoria- www.asthma.org.au

People with severe or multiple disabilities may exhibit a wide range of characteristics, depending on the combination and severity of disabilities and the person's age. Some of these characteristics may include:

Asperger's Syndrome is an Autism Spectrum Disorder and is 4 times more common in males than females. It is characterized by an inability to fit into peer groups due to a lack of social skills and language skills. It is sometimes considered that higher functioning Autism is equivalent to Asperger's Syndrome.

An Autism Spectrum Disorder (ASD) is a developmental condition that affects the ability of the individual to:

Obsessive Compulsive Disorder (OCD) is a mental illness characterized by the presence of recurrent, unwanted ideas or impulses (obsessions) and an urge or compulsion to do something to relieve the discomfort caused by the obsession.

Bipolar disorder, also known as manic depression, is a mental illness characterized by wide mood swings from mania to depression. The person may be affected so much that he or she experiences the symptoms of psychosis, and is unable to distinguish what is real.

Schizophrenia is a mental illness that affects the normal functioning of the brain, interfering with a person’s ability to think, feel and act. The brain is made up of nerve cells, called neurons, and chemicals, called neurotransmitters. An imbalance of one neurotransmitter, dopa mine, is thought to cause the symptoms of schizophrenia.

A mental illness is characterized by a significant disturbance of thought, mood, perception and memory. It is a health problem that affects how a person thinks, feels, behaves and interacts with others. About 1 in 5 people will suffer from a mental illness, however many people will suffer from a mental health problem at some stage in their lives. A mental health problem can also affect how a person thinks and behaves, but it is generally much less severe, and is in reaction to a stressful situation occurring in a person’s life. A mental health problem is usually temporary, however if it is not dealt with, it can become a mental illness.

Fragile X Syndrome (FXS) is a genetic condition that causes intellectual disability, behaviour and learning challenges and various physical characteristics. It is more common in males than females, and it is estimated that 5% of people diagnosed with an Autism Spectrum disorder also have Fragile X.

Angelman Syndrome (AS) is a rare Neuro-genetic disorder that occurs in about one in 20,000 births.

Williams Syndrome (WS) is a genetic condition that is present at birth, and can affect anyone. Characteristics include: cardiovascular disease, developmental delay and learning disabilities. These occur side by side with exceptional verbal abilities, highly social personalities and an affinity for music.

Prader–Willi Syndrome (PWS) is a medical condition that affects both males and females, and will affect them all their lives. People with PWS have an obsession with food and eating, low muscle tone & balance, learning difficulties, lack of normal sexual development, emotional instability and lack of maturity. PWS is a genetic disorder and in 99% of cases is not inherited.

People with intellectual disabilities usually have a lower level of intellectual function, and are generally limited in personal skills, self-care skills and communication skills. These characteristics must show up in the first eighteen years of a person's life to be called 'intellectual disability'.

An amputation is the removal of any protruding part of the body but usually refers to an arm or leg. The limb may be removed for a number of reasons including an injury, chronic infection,trauma or vascular disease. The person may also be born with one or more limbs missing. The position of the amputation is important; people with an amputation above the knee or elbow may have more limited use of the limb, than those with an amputation below the joint.

Vision loss is any reduction in the ability to see, including blurred vision, cloudy vision, double vision, blind spots, poor night vision, and loss of peripheral vision (tunnel vision). Vision loss may affect one or both eyes, it may occur gradually or suddenly, and it may be partial or complete. Vision changes may originate in the eyes themselves or may be caused by many different conditions that affect the brain or even the whole body.

People with hearing impairment will in most circumstances have participated in or are currently participating in education programs that have enabled them to develop skills and to understand their capabilities. A young person with a hearing impairment may not consider deafness to be a disability. Appropriate support is important to enable a person with hearing impairment to participate fully.

These conditions are characterized by: a paralysis to the lower limbs and part or whole of the trunk of the body; or paralysis of all four limbs and the trunk of the body respectively. It is caused by injury to the spinal cord, usually as the result of an accident. The impairment to the body can range from weak hand, arm and leg muscles to non-functioning of hip, knee and ankle muscles. Incontinence and loss of sensation are also features. Most people with spinal cord injuries use a wheelchair or rely on walking aids for mobility. Some will require assistance with lifting and personal care.

Programming Considerations

  • Be aware of each individual’s capabilities
  • Ask what support is required - do not assume without asking.
  • Think about what other tasks individuals could also assist with in an activity, if they cannot actively participate
  • Be aware of what type of modified or supportive equipment is available.
  • Ensure there is adequate chair access for program areas.
  • Check provisions to carry and/ or fold chair if required.
  • Check if the person likes to be transferred or is happier remaining in their chair.
  • Allow extra time to complete activities
  • 1:1 support may be required, so make allowance for this when developing staff rosters

Strategies for Inclusion

  • Get other participants to provide assistance if appropriate.
  • Design activities that cater for limited movement.

Further Information: Independence Australia- www.independenceaustralia.com

Spina bifida is the incomplete formation of the spine and spinal cord that occurs during the first month of a baby’s development in the womb. It is a common form of neural tube defect (NTD). The defect affects people differently, some have minimal effects, others have severe multiple effects.

Cerebral Palsy is a physical disability that affects movement and posture. It is a life long condition that does not generally get worse. It is due to damage to the developing brain either during pregnancy or after birth.

No two people with a disability are the same. The same disability can affect people in different ways. This can make it difficult and confusing for the leader to prepare him or her self to work with participants. Developing a broad understanding of a disability and how it may affect an individual will assist leaders. Learning how an individual is affected by their disability will provide a broader understanding of what their needs may be. This learning can be obtained by meeting with the participant and their parents/caregivers, before the program. This information will be invaluable but must be treated as confidential.

Disabilities can be grouped into three areas:

  • Physical disability including sensory disability;
  • Intellectual disability; or
  • Mental Illness.

It is important to also note that people may have more than one disability and there is a section in this resource kit devoted to multiple disabilities.

Individuals may also experience limitations while participating in sport and active recreation programs due to a medical condition, and a number of the more common ones are discussed in this resource kit.

Physical disabilities vary greatly and can affect people differently. Some participants are very accepting of their disability. They acknowledge their limitations and participate to their fullest ability. Others are more self-conscious of their disability and may be reluctant to participate in some activities. These participants may need a lot of encouragement from leaders and other participants and also the opportunity to explore their potential ability in contrast to their limitations.

Sport and active recreation provides a great opportunity for them to do this in a safe and reinforcing environment. Be aware of participants who may have a reduced insight into their limitations, because they will need to be assisted to become aware of these limitations for their own safety.

The following sections outline the more common types of disabilities and conditions. These have been grouped according to:

  1. Physical disabilities;
  2. Intellectual disabilities;
  3. Mental illness;
  4. Autism spectrum Disorders;
  5. Multiple disabilities;
  6. Medical Conditions;
  7. Challenging Behaviours;
  8. Communication Issues; and
  9. Personal Care.

For each disability type, a brief description of the disability, issues to consider when programming sport and active recreation activities, strategies for inclusion and a discussion of behaviour management issues is provided.