Incidence, Diagnoses, Characteristics and Safety Considerations Involved in the Provision of Physical Education Activities to Students with Mental Retardation with Autism
An Examination of the Incidence, Diagnoses, Characteristics and Safety Considerations Involved in the Provision of Physical Education Activities to Students with Mental Retardation With and Without Autism
To excuse students from physical education is the safe way out, but it does not meet their needs since it becomes costly to them in the long run. The inference here is not to say that physical educators advocate placing children in a program of physical education which will aggravate an injury, cause frustration, or to make him do things which are beyond their ability. -- Nancy Allison Close, Donald K. Matthews, 1973
This paper provides an overview of what physical education (PE) teachers should consider when developing activities and lesson plans for students with the cognitive and physical constraints associated with mental retardation with and without and autism. Relevant definitions and the etiologies of mental retardation in general and autism in particular are followed by a description of the typical characteristics of these syndromes. A discussion of the various health and safety precautions and considerations that should be taken is followed by an assessment of the modifications to physical activity and tips for inclusion into a general physical education using real-world examples from the literature. Finally, considerations that are specific to these disabilities and its characteristics and a list of sports and physical education organizations conclude the analysis.
Autism and Physical Education.
Definition. Providing a comprehensive definition of mental retardation, with or without autism, is problematic; for instance, MacMillan, Siperstein, and Gresham (1996) note that over the past several decades, educators and scientists have debated the concept of mental retardation, especially as it concerns its etiology, prevalence, and viability as a discrete and reliable diagnostic category. According to these authors, "At the heart of the debate is the fact that mild mental retardation (MMR), as a diagnostic category, subsumes cases with biological and psychosocial etiologic patterns. Some researchers have termed the latter etiology 'mental retardation of unknown origins'" (356). Recently, this controversy has assumed new levels of importance as a result of the decision by the American Association on Mental Retardation (AAMR) to eliminate the levels of mental retardation based on cognitive dysfunction (e.g., Mild, Moderate, Severe, and Profound). According to MacMillan and his colleagues, the AAMR now differentiates cases of mental retardation based on the levels of support students will require across four domains. In fact, the new definition tends to cloud these previous distinctions between subgroups regarding their etiology given that: (a) the majority of cases of mild mental retardation (MMR) are of unknown etiology while a much larger percentage of cases of more severe retardation have "known etiologies"; and (b) students with mild mental retardation do not generally have the same types of impairments and problems that typify students with more severe forms of mental retardation (MacMillan et al. 1996).
Further complicating matters for definition purposes is the fact that autism is also frequently used as an umbrella term to describe a wide range of conditions and syndromes, many of which do not fit the more precise medical criteria required for such diagnoses. "The inherent challenge for any definition of mental retardation," Gresham et al. say, "is that it must take into account two groups of people: (a) those whose diagnoses are an issue only with regard to what types of services to provide and (b) those whose diagnoses determine whether the disorder is present, and only then, what services should be provided" (366). According to Siegel (1998), autism is a developmental disorder that typically affects various aspects of how a child sees the world and learns from his or her experiences. "Children with autism lack the usual desire for social contact," he says, and "The attention and approval of others are not important to them in the usual way. Autism is not an absolute lack of desire for affiliation, but a relative one" (Siegel 1998:9). Tustin (1995) notes that, "Autism literally means living in terms of the self. To an observer, a child in a state of autism appears to be self-centered since he shows little response to the outside world. However, paradoxically, the child in such a state has little awareness of being a 'self'" (1). Generally speaking, autism is used to denote an early developmental situation, as well as some type of development that has not proceeded along normal lines (Tustin 1995).
Children who suffer from mental retardation with autism, though, are just like their normally endowed peers in wanting to participate in physical education activities, to play games, and to participate in sports. To date, more and more educators have shown that autistic students can be mainstreamed according to their various abilities by using "adapted physical education." "Across the nation," Bauman says, adapted physical education is providing new opportunities for children with a wide range of disabilities to be integrated into mainstream physical educational settings. Furthermore, it is a disabled student's absolute right to be integrated into the mainstream classroom to the maximum extent possible. According to a Position Statement released by the Council on Physical Education for Children (COPEC) of the National Association for Sport and Physical Education (NASPE) and the Adapted Physical Activity Council (APAC) of the American Association for Active Lifestyles and Fitness (AAALF): "NO student should have to earn his/her way into physical education. In other words, inclusion in physical education means that all students, including students with disabilities, start in regular physical education" (2005:2).
Adapted physical education is an individualized program of physical and motor fitness; fundamental motor skills and patterns; and skills in aquatics, dance and individual and group games and sports designed to meet the unique needs of individuals" (6). Citing Winnick (2000), Bauman says that such programs are generally designed to meet the long-term (i.e., greater than 30 days) needs of students with the entire range cognitive disabilities that may be present in mentally retarded students with or without autism. The physical education activities are still provided by a regular physical education teacher, or preferably by a full-time adapted physical education teacher. According to Bauman, "Adapted physical education provides students with the opportunity to participate in a regular physical education program" (6-7). Professional physical educators and the growing body of research in the field support the use of the term "adapted physical education" for students who require "individualized physical education" (Close & Matthew 423). In sum, the term adapted physical education is accurate and timely because students' success or failure will largely depend on the extent to which a program is able to recognize their limitations or capabilities. As a result, an effective adapted physical education can provide a student with any or all of the following: improved physical fitness; psychological adjustment; social adjustment; recreational fitness, in the light of acquisition of sports skills with carryover for later life; increased self-confidence and personal security (Close & Matthew 1973).
Causes or Theories of Causes. While the condition of mental retardation is better described in the literature than it is understood, much has been learned in recent years that can help educators in their quest to provide safe and effective learning opportunities for mentally retarded students with autism. According to MacMillan et al., "In the past, educators have argued that the classification system used for 'diagnosis' should reflect this difference through use of such terms as educable mental retardation." When the syndrome of autism was first described by Kanner in 1943, he suggested that it was caused by an inborn defect of presumably constitutional origin; according to Rutter (2000), for the next 30 years, the potential role of genetic factors was largely dismissed by the scientific community due to the prevailing mindset of the time: "This was the era of supposed 'refrigerator' parents of autistic children and of 'schizophrenogenic' mothers" (3). Even the reviews by geneticists failed to attribute any real significance to a genetic component, based largely on the technology available at the time. According to Rutter, at this point in time, "Emphasis tended to be placed on the lack of vertical transmission (i.e., the rarity with which children with autism had parents with autism), on the very low rate of autism in siblings (estimated at that time at about 2%), and the lack of identified chromosome anomalies associated with autism" (4). In recent years, there has also been a growing body of evidence that suggests there is a genetic factor involved, but that there are a number of conditions that mirror autism but are not due to the same genetic component (Rutter 2000). As a result, atypical syndromes of autism have been found to be associated with congenital blindness, with profound institutional privation, and with a mixed collection of medical conditions or with profound mental retardation; however, the evidence to date does not indicate positively that these syndromes do not involve any of the same genetic liability but that is the thrust of the…