Course:KIN366/ConceptLibrary/SpecialOlympics

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Movement Experiences for Children
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KIN 366
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Special Olympics is an international program involving more than 3.1 million athletes in nearly 200 countries participating in 32 Olympic-type summer and winter sports for children and adult (Special Olympics, 2009a). Unlike the competitive nature of the Olympics, the Special Olympics are grounded on the ideals of acceptance, participation, inclusion, advocacy, and development (Special Olympics, 2003e). Special Olympics aims to provide all persons with intellectual disabilities year-round sports training organized by qualified local-level volunteers. Regardless of economic status, gender, political philosophy, age, race, nationality, and geographical boundaries, each individual with intellectual disability are afforded the chance to participate in sports training, competition, and among other artistic, social, and cultural experiences. In addition, they aim to shed light on the various issues facing people with intellectual disability; thus, to change social norms and foster a society where the intellectual disabled are accepted, respected, and given a chance to become productive citizens.

History:

The Special Olympics program was the brainchild of Eunice Kennedy Shriver. In the summer of 1963, she started a day camp called Camp Shriver in the state of Maryland for children with intellectual disabilities (Siperstein, et al., 2007). The camp’s aim was to fulfill the potential for sport and physical activity for intellectual disabled children (Special Olympics, 2009a). Over the years, the program grew in scope within North America as the first international Special Olympics summer game was held in Chicago, Illinois with athletes from both the United States and Canada participating (Special Olympics, 2009a). The years of service and advocacy by the Special Olympics organization was recognized by the International Olympic Committee (IOC) in 1988 as they officially endorsed and recognized the ‘Special Olympics’ name (Special Olympics, 2015b). With it, the Special Olympics is now in accordance with ‘the ideals of the international Olympics movement.’ The Summer Games were all held in various cities within the United States up until 2003 where it was held in Ireland (Special Olympics, 2009a). The latest Summer and Winter Special Olympics were held in Athens, Greece (2011) and Pyongchang, South Korea (2013) respectively.

Canadian Statistics on Children with Intellectual Disability:

  • In Canada, an estimated prevalence of about 1.3% of children from birth to 14 years of age show some form of intellectual disability (Statistics Canada, 2006) while the general population was 0.7% to about 3% (Crawford, 2008).
  • Prevalence of intellectual disability was estimated to be 4.7 per 1,000 in Manitoba (Ouellette-Kuntz, et al., 2010).
  • Prevalence of intellectual disability in Ontario was estimated to be 7.18 per 1,000 (Bradley, Thompson, & Bryson, 2002).
  • The Ministry of Children and Family Development in British Columbia (2001) estimated that 1% of British Columbians suffer from intellectual disability.
  • Prevalence of intellectual disability was estimated to be about 2% to 2.5% in Alberta (Crawford, 2008).

Offered Sports:

Special Olympics presents opportunities for training and competition in 32 Olympic-type sports for children and adults with intellectual disabilities all year long (Special Olympics, n.d.-c). Below is a comprehensive list with locally recognized sports included (Special Olympics, n.d.-c).

Summer Sports Winter Sports Recognized Sports
Aquatics Judo Alpine Skiing Cricket
Artistic Gymnsatics Powerlifting Cross-Country Skiing Kayaking
Athletics Roller Skating Figure Skating Netball
Badminton Rhythmic Gymnastics Floorball
Basketball Sailing Short Track Speed Skating
Bocce Softball Snowboarding
Bowling Table Tennis Snowshoeing
Cycling Tennis Curling
Equestrian Indoor Volleyball
Football (Soccer) Beach Volleyball
Gold Handball

Special Olympics competition are designed to provide equitable opportunities and fairness for success by categorizing athletes based on their age, gender, and equitable ability level through the process called 'divisioning' (Special Olympics, 2007d). This allow for recognition of an athlete’s performance from across each skill level to foster greater participation and sense of achievement for one’s own personal development. From grass root level, athletes are encouraged to achieve the best they can to move from regional, national, and to the world games (Special Olympics, n.d.-c).

Justification:

Early childhood development forms the fundamental groundwork for all future endeavors (Lake, 2011). Infants and adolescents discover new information through interaction with their surrounding simply by playing (Gabbard, 2011); however, children with intellectual disability are predisposed to circumstances that do not allow them to fully explore one’s environment (Dekker, Koot, van der Ende, & Verhulst, 2002; Emerson, 2003). Whether it is physical, psychological or socioeconomically, without these essential behaviours, gross and find motor development would suffer, and thus, have a profound implication on overall development as a whole.

Physical Activity and the Intellectually Disabled:

Barriers to Physical Activity

Many barriers exist for people with intellectual disabilities. It ranges from physiological (Fernhall & Tymeson, 1988), psychological (Barr & Shields, 2011), and social constraints (Shields, Synnot, & Barr, 2012).

Social Barrier

Many social factors affect one’s ability for physical activity. For instance, a community’s built-in environment must allow for physical activity by being accommodating and providing tangible emotional support (Bodde & Seo, 2009) to family and the child. Often, participation in physical activity with their peers for children with intellectual disabilities is hindered by stigmatization (Cooney, Jahoda, Gumley, & Knott, 2006). Furthermore, a substantial proportion of intellectual disabled children live in families of low socioeconomic status (Emerson, Hatton, Llewellyn, Blacker, & Graham, 2006). As a result, affordance for play and maternal bonding are limited as family suffer from material deprivation and loss of leisure time.

Physiological / Physical Barrier

Children with intellectual disability commonly encounter adversity when performing motor skills (Vujik, Hartman, Scherder, & Visscher, 2010) like balance and executive functions (Pace & Bricout, 2015). Along with motor difficulties, aerobic capacity (Fernhall, Pitetti, Stubbs, & Stadler, 1996), and muscular strength (Pitetti, Climstein, Mays, & Barrett, 1992) also contribute to a general decline in physical fitness when compared to typically developing children (Golubovic, Maksimovicm Golubovic, & Glumbic, 2012). These limitations act as deterrents for engaging in physical activity, and thus, lead to greater sedimentary behaviors (Graham & Reid, 2000).

Psychological Barrier

Numerous psychological factors limit a child’s participation and enjoyment of physical activity. In a study performed by Wuang and colleagues (2008), children with mild ID have difficulties with sensory discrimination and sensory searching. This resulting decrease in responsiveness to bodily and environmental sensations might be a deterrent towards active play or physical activity (Wuang & Su, 2011). Another psychological aspect is the attention deficit seen in many intellectual disabled children as this issue can impact a child’s interest for physical activity (Ahuja, Martin, Langley, & Thapar, 2013). In addition, deficits in attention were also associated with motor-perceptual delays in areas of daily tasks (Hemgren & Persson, 2007) making physical activity hard to accomplish.

Benefits of Physical Activity

Physical activity has been consistently shown to positively impact one’s physical fitness and well-being through physiological, psychological, and social means (Golubovic et al., 2012). As these health-promoting factors accumulate, they lead to an increase in one’s health trajectory; thus, allow for a decrease in morbidly (American College of Sports Medicine [ACSM], 2013) in a population plagued by a sedimentary lifestyle (Graham & Reid, 2000).

Social Benefits

The social aspect of physical activity is critical in any physical activity program. One beneficial aspect is the that participation in physical activity with Special Olympics offer social support from coaches, volunteers and peers (Farrell, Crocker, McDonough, & Sedgwick, 2004). This is important in maintaining a physically active lifestyle among children, and decreasing the amount of time spend in sedentary behaviors (Springer, Kelder, & Hoelscher, 2006). Family involvement within the Special Olympic programs have also fostered positive social benefits. As families feel a sense of hope and optimism through stronger family bonds (Kersh & Siperstein, 2008).

As important as social bonding have on physical activity, it is also vital to note the effect Special Olympics has on social norms. In a ‘unified sport’ setting where children with intellectual disability were paired with typically developing children, the ‘normal’ youths reported a more positive change in attitude on their perception of towards the intellectually disable (Special Olympics, 2009i). Furthermore, these children also stated greater intention towards interacting with peers with intellectual disability. In a way this is the greatest impact Special Olympics’ physical activity programs have on intellectually disabled children because it is changing the way a new generation of people view this population; thus, eliminating the stigma.

Physiological Benefits

Improvements to physiological well-being for children with intellectual disabilities is linked to benefits to functional fitness (Lotan, Isakov, Kessel, & Merrick, 2004). In the study conducted by Giagazoglou (2013), balance and motor skills were improved following a 12-week trampoline intervention program. Similarly, low-extremity muscle strength and agility also improved after a 6-week training period (Lin & Wuang, 2012). Benefits from physical activity is also not limited to ground-based activities as Yilmaz (2009) demonstrated that water-based exercises improved muscular straight and agility as well.

Psychological Benefits

Prolonged physical activity influences psychological well-being through reduced anxiety and healthier sleeping patterns (North, McCullagh, & Tran, 1990). In addition, there has been an association between improved cognitive functioning with periodic physical activity (Biddle & Asare, 2011). The summation of beneficial psychological effect is a way to promote mental health in intellectual disabled children, which tends to exhibit emotional or depressive disturbance (Linna et al., 1999).

Guide for Parent about the Special Olympics:

Special Olympics Programs

Unified Sports

The Unified Sports program brings athletes with intellectual disabilities with those without to train and compete on the same team. This setting allow Special Olympic athletes, and their partner, to learn, develop, and experience social inclusion through empowerment (Special Olympics, 2003e). Under the Unified Sports Handbook (2003), seven benefits has been identified.

  • Sport-Specific Skill Development: Opportunity to develop and improve sport-specific skills.
  • Competition Experience: Develop a sense of understanding for the mental and physical challenges to better deal with competitive environments in sports and life.
  • Meaningful Inclusion: Divisioning of age, gender, and skill level ensures impactful involvement and sense of value within the program.
  • Community-Based Participation: Partnerships with schools, parks, recreational centres, youth organizations, and community organizations presents opportunities for intellectual disabled athletes to contribute and become a part of their community.
  • Transition and Choice: Advocacy to and experience with non-intellectual disabled allow Special Olympics athletes a choice to transition to more mainstream community at large.
  • Public Education: Developing an awareness for the perseverance and abilities of individuals with ID.
  • Personal Development: Improvements to one’s self-efficacy, foster life-long friendships, and development of interpersonal skills.

Healthy Athletes

Healthy Athletes is an initiative aimed at providing health care services to Special Olympics athletes across the world. It is a comprehensive service which includes: vision, hearing, dental, prevention care, and nutritional education (Special Olympics, 2012a). Conducted by volunteer healthcare professionals, they provide a much needed health service to a population faced with greater health issues (May & Kennedy, 2010), yet often receive inadequate care (Krahn, Hammond, & Turner, 2006).

Childhood Specific Programs

Special Olympics Canada identified the pressing need for physical literacy in children with intellectual disabilities (Special Olympics, 2007d). As a result, three programs were implemented that builds upon one another to support motor development for children ages 2 to 18. Furthermore, in keeping with the Special Olympics attitude, the emphasis is on fun which has shown to be an important factor in facilitating physical activity interventions (Giagazoglou et al., 2013).

Active Start

The Active Start program is designed for ages 2 to 6 to develop physical literacy through structural play (Fevens, McGillivray-Elgie, & Kishiuchi, 2010). It provides early opportunities in basic motor skills and developmentally appropriate play for children with intellectual disabilities to cultivate physical, cognitive, and social abilities (Fevens, McGillivray-Elgie, & Kishiuchi, 2010). Active Start settings focuses on six components of motor development for youths:

  • Development is Qualitative: Mechanical efficiency increases with more movement patterns; quality of performance increases with practice.
  • Development is Individualized: Each stage of development is dependent on individual experience and thus a progress is based on the child.
  • Development is Sequential: Progress from simple to complex motor skills is fairly sequential.
  • Development is Cumulative: Prior skills build upon each other for the development of new skills.
  • Development is Directional: Development can be progressive with practice or regressive with lack of practice.
  • Development is Multi-Factorial: Learning of motor skills is the accumulation of many factors.

Here is a list of fundamental motor skills identified by Special Olympics’ Active Start program (Fevens, McGillivray-Elgie, & Kishiuchi, 2010)

  • Running
  • Jumping
  • Ball Rolling
  • Underhand Throw
  • Catching and Trapping
  • Overhand Throw
  • Kicking
  • Striking
  • Advanced Skills: Dribbling, Punting, Galloping, and Skipping
FUNdamentals

For children ages 7 to 11, it is an extension to the Active Start program. The goal of this program is to translate the acquired basic movement skills into basic sport skills. While maintaining an enjoyable and meaningful environment, adolescents are exposed more extensively to sport-related motor skills through training and competition (Special Olympics, n.d.-f). This program, along with Active Start, aims to provide basic motor and sport skills during the window of opportunity when the nervous system is maturing (Gabbard, 2011).

Here is the list of fundamental movement and sports skills identified by Special Olympics’ FUNdamentals program (Special Olympics, 2007d).

ABCs KGBs CKs
Agility Balance Coordination
Kinesthetic Gliding Buoyancy
Catching Kicking Striking with an Implement
Sport Start

Sport start is a sport-specific program designed for ages 12 to 18. This program builds upon the FUNdamentals program but converting the basic sports skills into sport-specific skills for competition and play (Special Olympics, n.d.-g).

Youth Games

The Youth Games event is a half-day, family-oriented, and locally organized events for children age 6 to 13. Modelled after an Olympic games, it is intended to expose youths with intellectual disability to the Special Olympics movement. By incorporating developmentally appropriate games in an enjoyable, friendly, and engaging manner, it offers a way for intellectual disabled children and their family to explore what Special Olympics has to offer (Special Olympic, n.d.-h).

Safety

Volunteer Screening

Volunteers whom will be in physical contact, supervision, handle financial matters, and access to personal information will be screened through a criminal records check (Special Olympics, n.d.-j). Individuals that has been convicted of crimes such as: murder, kidnapping, sexual abuse, felony assault, arson, and manslaughter will be disqualified from volunteering (Special Olympics, n.d.-j).

Protective Behavior Training

Protective behavior training is taken by volunteers whom have physical contact with athletes. They are taught how to identify inappropriate behavior, signs of abuse, and what actions to take in an event of abuse or inappropriate behavior (Special Olympics, n.d.-j). This training provides the necessary tools for all volunteers in taking the responsibility to ensure the safety of all athletes.

What Can Parents Do

  1. Develop a working knowledge on the range of opportunities Special Olympics have to offer for parents and child to connect in a physically active setting. This will allow parents to get involve in Special Olympics activities with their child and strengthen emotion bonds (Kersh & Siperstein, 2008). Furthermore, parents will have a deeper appreciation and trust towards their child's capacity (Favazza & Siperstein, 2006).
  2. Understand the 'red flags' when participating in Special Olympics activities. Although the organization take precaution in creating a safe environment, parents should be aware of the increased risk for injury (Sherrard, Tonge, & Ozanne-Smith, 2001), especially when performing physical activity.

References:

American College of Sport Medicine. (2013). ACCSM’s Guidelines for Exercise Testing and Prescription (9th ed.). Philadelphia: Wolters Kluwer

Ahuja, A., Martin, J., Langley, K., & Thapar, A. (2013). Intellectual disability in children with attention deficit hyperactivity disorder. The Journal of Pediatrics, 163(3), 890-895.e1. doi:10.1016/j.jpeds.2013.02.043

Barr, M., & Shields, N. (2011). Identifying the barriers and facilitators to participation in physical activity for children with down syndrome. Journal of Intellectual Disability Research, 55(11), 1020-1033. doi:10.1111/j.1365-2788.2011.01425.x

Biddle, H.J.S., & Asare, M. (2011). Physical activity and mental health in children and adolescents: A review of reviews.British Journal of Sports Medicine, 45(11), 886-895. doi:10.1136/bjsports-2011-090185

Bradley, E. A., Thompson, A., & Bryson, S. E. (2002). “Mental retardation in teenagers: Prevalence data from the Niagara region, Ontario.” The Canadian Journal of Psychiatry, 47, 652–659.

Cooney, G., Jahoda, A., Gumley, A., & Knott, F. (2008). Young people with intellectual disabilities attending mainstream and segregated schooling: Perceived stigma, social comparison, and future aspirations. Journal of Intellectual Disability Research, 50(6), 432-444. Received from http://www.ncbi.nlm.nih.gov/pubmed/16672037

Crawford, C. (2008). No place like home: A report on the housing needs of people with intellectual disabilities. Retrieved from http://www.communitylivingbc.ca/wp-content/uploads/NoPlaceLikeHome.pdf

Dekker, C.M., Koot, M.H., van der Ende, J., & Verhulst, C.F. (2002). Emotional and behavioral problems in children and adolescents with and without intellectual disability. Journal of Child Psychology and Psychiatry, 43(8), 1087-1098. doi:10.1111/1469-7610.00235

Emerson, E. (2003). Mothers of children and adolescents with intellectual disability: social and economic situation, mental health status, and the self-assessed social and psychological impact of the child's difficulties. Journal of Intellectual Disability Research. 47(4-5), 385-399. doi:10.1046/j.1365-2788.2003.00498.x

Emerson, E., Hatton, C., Llewellyn, G., Blacker, J., & Graham, H. (2006). Socio-economic position, household composition, healthy status and indicators of the well-being of mothers of children with and without intellectual disabilities. Journal of Intellectual Disability Research, 50(12), 862-873. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17100947

Gabbard, P.C. (2011). Lifelong motor development. San Francisco, CA: Pearson Benjamin Cumming.

Farrell, C., Crocker, E.R.P., McDonough, H.M., & Sedgwick, A.W. (2004). The driving force: Motivation in Special Olympians. Adapted Physical Activity Quarterly, 21(2), 153-166. Retrieved from http://journals.humankinetics.com/apaq-back-issues/apaqvolume21issue2april/thedrivingforcemotivationinspecialolympians

Favazza P, Siperstein G. (2006). ‘’Evaluation of Young Athletes program’’. Washington: Special Olympics and University of Massachusetts-Boston.

Fernhall, B., Pitetti, K., Stubbs, N., & Stadler, L. (1996). Validity and reliability of the 112-mile run-walk as an indicator of aerobic fitness in children with mental retardation. Pediatric Exercise Science, 8(2), 130-142. Retrieved from http://journals.humankinetics.com/pes-back-issues/pesvolume8issue2may/validityandreliabilityofthe12milerunwalkasanindicatorofaerobicfitnessinchildrenwithmentalretardation

Fevens, S., McGillivray-Elgie, K., & Kishiuchi, G. (2010). Active start program leaders guide. Retrieved from http://www.sons.ca/user/File/Active%20Start%20Guide%20%28English%29%281%29.pdf

Golubovic, S., Maksimovic, J., Golubovic, B., & Glumbic, N. (2012). Effects of exercise on physical fitness in children with intellectual disability. Research in Developmental Disabilities, 33(2), 608-614. doi:10.1016/j.ridd.2011.11.003

Graham, A., & Reid, G. (2000). Physical fitness of adults with an intellectual disability: A 13-year follow-up study. Research Quarterly for Exercise and Sport, 71(2), 152-161. doi:10.1080/02701367.2000.10608893

Hemgren, E., & Persson, K. (2007). Associations of motor co-ordination and attention with motor-perceptual development in 3-year-old preterm and full-term children who needed neonatal intensive care. Child: Care, Health and Development, 33(1), 11-21. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17181748

Kersh, J., & Siperstein, N.G. (2008). The positive contributions of special olympics to the family. Boston: University of Massachusetts.

Krahn, G.L., Hammond, L., & Turner, A. (2006). A cascade of disparities: health and health care access for people with intellectual disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 12(1), 70-82. doi:10.1002/mrdd.20098

Lake, A. (2011). Early childhood development-global action is overdue. The Lancet, 378(9799), 1277-1278. doi:10.1016/S0140-6736(11)61450-5

Lin, C.H., & Wuang, P.Y. (2012). Strength and agility training in adolescents with down syndrome: A randomized controlled trial. Research in Developmental Disabilities, 33(6), 2236-2244. doi:10.1016/j.ridd.2012.06.017

Linna, L.S., Moilanen, I., Ebeling, H., Piha, J., Kumplainen, K., Tamminen, T., & Almqvist, F. (1999). Psychiatric symptoms in children with intellectual disability. European Children & Adolescent Psychiatry, 8(4), S77-S82. doi:10.1007/PL00010704

Lotan, M., Isakov, E., Kessel, S., & Merrick, J. (2004). Physical fitness and functional ability of children with intellectual disability: Effects of a short-term daily treadmill intervention. The Scientific World Journal, 14(4), 449-457. doi:10.1100/tsw.2004.97

May, E.M., & Kennedy, H.C. (2010). Health and problem behavior among people with intellectual disabilities. Behavior Analysis in Practice, 3(2), 4-12. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22532888

North, T.C., McCullagh, P., and Tran, Z.V. (1990) Effect of exercise on depression. Exercise and Sport Sciences Reviews, 18(1), 379–415. Retrieved from http://journals.lww.com/acsm-essr/Citation/1990/01000/Effect_of_Exercise_on_Depression_.16.aspx

Ouellette-Kuntz, H., Shooshtari, S., Temple, B., Brownell, M., Burchill, C., Holden, J.J.A., & Hennen, B. (2010). Estimating administrative prevalence of intellectual disabilities in Manitoba. Journal on Developmental Disabilities, 15(3), 69-79. Retrieved from http://www.oadd.org/docs/Ouellette-Kuntz_15-3.pdf

Pace, M., & Bricout, A.V. (2015). Low heart rate response of children with autism spectrum disorder in comparison to controls during physical exercise. Physiology & Behavior, 141, 63-68. Retrieved from https://www-clinicalkey-com.ezproxy.library.ubc.ca/#!/content/journal/1-s2.0-S0031938415000256

Pitetti, H.K., Climstein, M., Mays, J.M., & Barrett, J.P. (1992). Isokinetic arm and leg strength of adults with down syndrome: A comparative study. Archives of Physical Medicine and Rehabilitation, 73(9), 847-850. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1387522

Sherrard, J., Tonge, J.B., & Ozanne-Smith, J. (2001). Injury in young people with intellectual disability: Descriptive epidemiology. ‘’Injury Prevention’’, 7(1), 56-61. doi:10.1136/ip.7.1.56

Shields, N., Synnot, J.A., & Barr, M. (2012). Perceived barriers and facilitators to physical activity for children with disability: A systematic review. British Journal of Sports Medicine. 46(14), 989-997. doi:10.1136/bjsports-2011-090236

Shields, N., King, M., Corbett, M., & Imms, C. (2014). Is participation among children with intellectual disabilities in outside school activities similar to their typically developing peers? A systematic review. Developmental Neurorehabilitation. 17(1), 64-71. doi:10.3109/17518423.2013.836256

Special Olympics. (2012a). Our Story [Brochure]. Washington, DC: Author.

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Special Olympics. (n.d.-c). Sports [Fact sheet]. Retrieved from http://media.specialolympics.org/resources/brand-awareness-and-communication/marketing/Sports%20Fact%20Sheet%202014.pdf

Special Olympics. (2007d). Long-term athlete development for athletes with an intellectual disability. Retrieved from http://www.specialolympics.ca/wp-content/uploads/2011/07/SOC_LTAD_Dec_4_2007_English1.pdf

Special Olympics. (2003e). Special Olympics handbook: Unified Sports. Retrieved from http://www.specialolympics.org/uploadedFiles/UnifiedSports.pdf

Special Olympics. (n.d.-f). For the Young Athlete. Retrieved from http://www.specialolympics.ca/be-involved/athletes/for-the-young-athlete/

Special Olympics. (n.d.-g). Sport Start. Retrieved from http://www.specialolympics.bc.ca/what-we-do/sports-programs-18

Special Olympics. (n.d.-h). Youth Games. Retrieved from http://www.soor.org/Sub-Page.aspx?PID=21

Special Olympics. (2009i). The universal impact of the special olympics: Challenging the barriers for people with intellectual disability. Retrieved from http://www.specialolympics.org/uploadedFiles/LandingPage/WhatWeDo/Research_Studies_Desciption_Pages/Impact%20Policy%20Brief_feb3.pdf

Special Olympics, (n.d.-j). Guide for parents and care providers to help keep our athletes safe. Retrieved from http://www.specialolympicspa.org/images/site_pages/SOPAs_Guide_for_Parents_and_Care_Providers_Sep_2013.pdf

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Vuijk, J.P., Hartman, E., Scherder, E., & Visscher, C. (2010). Motor performance of children with mild intellectual disability and borderline intellectual functioning. Journal of Intellectual Disability, 54(11), 955-965. doi:10.1111/j.1365-2788.2010.01318.x

Wuang, P.Y., Wang, C.C., Huang, H.M., & Su, Y.C. (2008). Profiles and cognitive predicators of motor functions among early school-age children with mild intellectual disabilities. Journal of Intellectual Disability, 52(12), 1048-1060. doi:10.1111/j.1365-2788.2008.01096.x

Wuang, P.Y., & Su, Y.C. (2011). Correlations of sensory processing and visual organization ability with participation in school-aged children with down syndrome. Research in Developmental Disabilities, 32(6), 2398-2407. doi:10.1016/j.ridd.2011.07.020

Yilmaz, I., Ergy, N., Konukman, F., Agnuga, B., Zorba, E., & Cimen, Z. (2009). The effects of water exercises and swimming on physical fitness of children with mental retardation. Journal of Human Kinetics, 21, 105-111. doi:10.2478/v10078-09-0013-6

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