Autism & Developmental

Feasibility of a school-based exercise intervention for children with intellectual disability to reduce cardio-metabolic risk.

Bellamy et al. (2020) · Journal of intellectual disability research : JIDR 2020
★ The Verdict

A twice-weekly 30-minute school exercise club is safe and doable for kids with moderate-severe ID, yet four months is too short to trim waistlines or boost fitness scores.

✓ Read this if BCBAs running school programs for students with intellectual disability.
✗ Skip if Clinicians seeking rapid cardiometabolic gains in under-four-month windows.

01Research in Context

01

What this study did

Researchers ran a 16-week exercise club inside a special-ed school. Kids with moderate to severe intellectual disability met twice a week for 30 minutes.

Each session was 60% aerobic games, 20% strength moves, and 20% balance skills. The team tracked how many kids joined, stayed, and showed up.

02

What they found

The club was easy to run. Fifty-five percent of invited students signed up, 91% finished, and attendance averaged 86%. No injuries happened.

Despite the good turnout, body weight, waist size, and heart-lung fitness scores did not change after four months.

03

How this fits with other research

Wu et al. (2017) saw BMI drop in overweight teens with ID after a similar 12-week school program. The difference: their kids were older, heavier, and exercised three times a week, hinting that dose and start weight matter.

Ogg-Groenendaal et al. (2014) pooled 20 studies and found exercise cuts challenging behavior about 30% in people with ID. The target study did not measure behavior, so the club may still have hidden social benefits.

Golubović et al. (2012) reported lower fitness test scores for kids with ID versus peers. Their negative result looks opposite, but they tested existing fitness, not an intervention, so the outcomes simply set a low baseline.

04

Why it matters

You can launch a safe, low-cost exercise club in your school with high retention. Just do not promise parents smaller waistlines in one semester. Instead, sell the social fun, possible behavior perks, and the stepping-stone toward longer, maybe stronger, programs later.

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→ Action — try this Monday

Schedule two 30-minute group sessions this week, mix aerobic tag with simple strength stations, and track attendance as your first fidelity metric.

02At a glance

Intervention
other
Design
pre post no control
Sample size
10
Population
intellectual disability
Finding
positive

03Original abstract

BACKGROUND: People with intellectual disabilities (ID) are at increased risk of secondary health conditions, reduced quality of life and life expectancy. Children with ID demonstrate low levels of physical activity in association with a higher prevalence of obesity, a modifiable risk factor associated with secondary health conditions including type 2 diabetes and cardiovascular disease. Despite this, physical activity interventions addressing weight and weight-related complications in this population are limited. This study aimed to establish the feasibility of a school-based group exercise intervention for children with moderate to severe ID. METHODS: A single-arm intervention study was used to establish the feasibility of a 16-week exercise intervention. Children attending a School for Specific Purposes in Sydney, Australia, participated in two 30-min exercise sessions per week across the intervention period in addition to their regular physical education class. Each exercise session was 60% aerobically based, 20% strength based and 20% targeted towards fundamental movement skill development. We used two facilitation strategies to assist the delivery of the intervention, including the implementation of a variety of communication resources and promotion of social interaction. Feasibility was assessed through recruitment rates, program retention, adverse effects, attendance, group size feasibility and non-compliance. Anthropometric measures included height (m), weight (kg) and waist circumference (cm; umbilicus), with body mass index (BMI) and waist-to-height ratios (WtHR) used to determine cardio-metabolic risk. Aerobic capacity was assessed using the submaximal 6-min walk test (6-MWT). Intensity of physical activity sessions was measured through the use of tri-axial accelerometers and compared to physical activity recommendations. RESULTS: Ten children aged between 9 and 13 years completed the 16-week intervention, with a 55% recruitment rate, 91% program retention, 86% attendance and with no adverse effects reported. Sessions commenced as 1:1 supervisor to child ratios before progressing to established small groups of 2:7 (supervisor : child). Children spent 38.4% (11.5 min) of each session in moderate to vigorous physical activity (MVPA), equating to 20% of their MVPA recommended daily physical activity levels (twice per week). There was a significant change in weight across the intervention period, with a trend towards increased weight between mid-intervention and 3-month follow-up time points. There were no significant changes in child BMI, WtHR or aerobic capacity. CONCLUSIONS: A school-based group exercise intervention for children with moderate to severe ID is feasible and safe, with high retention rates and physical activity participation. No significant improvements in body composition or aerobic capacity were determined. The present study demonstrates that engaging children with moderate-severe ID in school-based group exercise is feasible to assist in physical activity participation.

Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12690