In Able Lives (2003), a book based on a series of interviews, and written by Fiona Murdoch, the achievements of people with disabilities living in Ireland are celebrated. Their achievements include their ability in leisure and sport. Eamonn Prunty, one of those interviewed in the book, is an Irish competitive water skier. Born with a spinal abnormality he has almost no movement in his legs. He has won many competitions, including "winning gold" (1999) competing against non-disabled athletes in the under-sixteen category of the Irish National Water Ski Championships. Injuries are an occupational hazard of water-skiing and Eamonn has broken a leg and dislocated his knee doing slalom. Eamonn's dad supports him and has built a man-made lake at Summerhill, near Trim, in County Meath. It is designed for people with disabilities including people who use a wheelchair or are blind. Eamonn and his dad want to build up a national disabled water ski team with people from all over Ireland. Eamonn, studying at the Dublin Business School, is Ireland's only competitive disabled water skier. Barry Galvin, Ireland's national ski champion for the past 17 years is Eamonn's trainer (Murdoch, 2003). Such books are important as they contribute to dispelling ignorance and changing attitudes through information and education. Similarly, adequate media coverage of the real achievements of athletes with disabilities is an important contribution to general education and can be an important factor in changing negative attitudes that result from a lack of information and experience.
Some respondents thought that good local facilities increase participation as they overcome the obstacles faced by would-be participants. They pointed out that facilities are improving with a good number of new public swimming pools and leisure centres built or in the process of being built. At the same time there are parts of the countryside where facilities are lacking and where new buildings are not accessible.Some people with disabilities have to travel long distances to an accessible facility. In the countryside travel distances can be considerable. People could drive 60, 80 kms or more once a week and because of the lower population density of rural areas it can also be harder to find the numbers of people to form a team. They also have to travel around to check out if facilities are accessible. "Ringing up is no good. One may be told, it's accessible, but when one goes while one can enter door one can't go further etc. So one has to check out facilities each time. Thus, if you're really not that committed, "you just won't go", the obstacles will defeat you". Respondents pointed out that because of barriers - travel, finding out information, increased time and cost involved, people with disabilities need to be more committed to participating in physical activity and sport if they are going participate.People participating in leisure or recreational sport spoke of difficulties with facilities and access to swimming pools and gyms etc. Timetables were often restricted to once a week even in pools that are for people with disabilities. While the slowly improving situation was acknowledged
"There are definitely more leisure centres that are pro-active""This pool is accessible. There are still things that are lacking but this is one of the first buildings that has been accessible - the doors, the changing rooms..."Participants spoke of how professionals can be very responsive to information and requests. One respondent described writing to the manager of a new public pool in Dublin explaining that a friend of his who swims but works during the day needed a hoist and bench/bed for changing. He subsequently met the manager who agreed to get a hoist etc within a month. At the same time respondents felt that all services, public and private, educational and otherwise, should be brought more quickly to the stage where they consider the needs of all "up-front".
More professionals in the sport and leisure industry could be pro-active in considering and attending to the needs of all from the conceptual and planning stage onwards, seeking out, from the beginning, the requisite expertise in terms of developing appropriate integrated and inclusive leisure and sports facilities and programmes and services."The critical thing is access and the adaptability of the equipment" (and, of course, "the adaptable equipment is used by non-disabled people too").People questioned whether progress really needed to be at the pace of baby-steps. While there are more gyms with staff capable of providing adapted physical activity all gyms should be able to provide this service. Some people explained how stiff they became because of conditions that they had if they didn't get these forms of exercise in sufficient quantities.
"When I checked if I could access pool to swim I was told there was a slot once a week that I could attend. I was surprised at the name of this slot "therapy session. We should have the right to chose a pool rather than being handed out limited choice with restricted times, place etc"."It is disappointing that newly constructed and renovated accessible facilities so often do not get it right, often times because they fail to have people with disabilities involved in checking out design"."The steps into the newly renovated pool weren't built properly and they are very awkward and I hit my knees several times - in spite of renovations it is difficult to access from a wheelchair - we don't know if they ever consulted before they did the renovations - you have to go backwards into it and there are two steps and very big gaps between them - why aren't people with a disability consulted for new buildings and for renovations?"Some considered that
"The root of the problem is getting the staff trained. Everybody should be trained to work with hoists etc then everyone would have choice of time. Why wouldn't staff be able to use hoist? It should be part of routine training."Some respondents spoke about the need to improve all community facilities - including playgrounds - and to make them inclusive. Some respondents spoke of how difficult it can be for athletes in Ireland who have to carry around equipment and to adapt the pitch each time they want to train. It could so easily be set up as a pitch for everyone as in other countries. Some people considered the outdoor facilities for athletics as being particularly poor in Ireland. Examples were given of athletes with quadriplegia who shot putts/ did discus and who were discouraged from doing it in the community facility because it is increasingly used for soccer and they "might damage the "soccer" pitch" and another athlete who was allowed to throw the javelin only one hour a week in the same facility.
People who have seen and used facilities abroad realise how easy it is to have facilities that are adapted for everyone. It was pointed out, however, that in some places where sport facilities were good, accommodation and other services can leave much to be desired and are worse than Ireland. One example was given of a venue in Italy outside Venice, hosting the European Championships in 2005, where there was one accessible toilet for 150 people in wheelchairs.Increased participation also means increased identification and nurturing of talent."In Ireland we are more like the Americans than other Europeans. When we're planning facilities we over-specify, we think "spectators" and we are big into seats for watching and viewing but not for participating. Croke Park may have given us images of grandeur. I've been to sporting events in European countries and there is much more emphasis on participating and the facilities are built accordingly. Sometimes the stands are rudimentary but the facilities are for integrated activities with competitive and leisure activities running side by side - good basic facilities that cater for all including people with disabilities. The emphasis is on participation. In Holland there are 300 artificial surface tracks. Even in Eastern European countries like the Czech Republic the facilities are much better than here. Cardiff has two international tracks and it is half the size of Dublin! It is essential for the Irish to begin to "think basic, community, multipurpose, for everyone".Some participants spoke of the difficulties in competitive sport - in addition to suitable training venues, the difficulty of sponsorship in Ireland, difficulties in getting the personnel to support the hosting of events, difficulties in getting the numbers to make a squad etc. For those who travel abroad it is inevitable that they make comparisons with structures in other countries.
"I was in Holland. There, there seems to be huge corporate sponsorship for their athletes with a disability." One person spoke of how the national games in another country are under the auspices of the mainstream national bodies and have access to all the "mainstream" personnel, support etc."Disabled sports are very competitive. We need to be able to train and we train just as much as non-disabled athletes but sometimes we don't have the facilities."Participants spoke of a wide range of factors and combinations of factors that prevented them from taking part in physical exercise programmes including "fear",
"self-consciousness", "turn-off", physical access and "not feeling welcome""There are no changing rooms and no privacy and everyone likes privacy."There were differing opinions about cost as a barrier to participation.
"Cost is an issue for all of us who are on a disability allowance - there is no sliding scale and no reductions and even the student rate is expensive for us and the price at night is scandalous - the price of a gym downtown would put me off."Those involved in competitive or more intensive levels of sport described the price of basketball or rugby wheelchairs etc.
Others felt that cost could be used as an excuse or could conceal fears that need to be addressed."People don't feel that physical exercise and sport is for them. They have fears and excuses. They need to be supported and their fears addressed. Cost can sometimes be an excuse."
People with disabilities and professionals expressed a need for accurate information around the kinds of sport and physical exercise that would be most appropriate and safe for them according to their tastes and the opportunities that existed in the locality. Only when they can access adequate information and expertise will they be in a position to make informed choices. This requires that mainstream and disability specific sports NGBs as well as disability organisations and other service providers such as the HSE have the knowledge and expertise and are able to work out in partnership with the person in questions appropriate physical exercise and sports programmes and pathways. While some people with disabilities expressed disinterest in physical activity and sport some of them during the course of a focus group or interview expressed the opinion that if they were informed and if they knew it would be of benefit, safe etc they would consider engaging in physical activity/sport.One respondent pointed out that if he had not had the opportunity to participate in an adapted physical activity programme where he had accessed accurate information and advice he would have lived his life without ever considering going into a swimming pool or the sea.
"I was always advised until now never to go near water because of my epilepsy so I never went to the beach or a pool before."Individuals raised the issue of not being sufficiently informed of what was involved in a particular programme. People with disabilities need to be sufficiently consulted and informed and listened to about their legitimate interests. Negative experiences were described where people with disabilities were involved in unsuitable activities sometimes where there was a real lack of expertise and skill regarding what should be done or not attempted.
"They wanted everyone to join in. It was too intensive".
"People shouldn't be pushed. If someone is able let them try but don't force them. Most people know their own strengths and limitations. We are experts in this sense
so we should be involved in choosing, though of course, like everyone, we need help, information, advice.""Problem was I didn't have chance to say no. If I knew what was involved I mightn't have gone. I needed clearer information."There are people who do obtain opportunities appropriate to their needs and wishes because they do access the relevant information.
"As time goes by with the help and information we are getting in the adapted physical activity programme we are learning to know what we need and to voice it."
"A full time karate teacher came around here and explained to all of us about the sport and I went for it. It's really good fun. I am developing skills all the time. The best things are meeting more people and getting yourself stronger. I am able to transfer better."
Respondents who were physically active thought that personal level factors must be acknowledged as well as social and environmental ones. A lot depends on the individual, natural talent, interest etc as well as on ones family and friends. Several young people with disabilities, who were involved in sport, considered that some children with disabilities are too protected. They need to be given the chance "to socialise themselves and to be treated as everyone else".
"Parents are so important. I was lucky. My parents put me into everything. Between the ages of 10 year to 16 years I did archery every Monday, basketball every Wed and music etc. Then I had the drive and enthusiasm and the talent I had was nurtured from a young age...People can be nannyied too much...the greatest gift to a child is independence ""It's an attitudinal thing. If you really want to do something there are fewer obstacles. Sometimes access can be a bit of an excuse. I have done scuba diving and kayaking. I go fishing. There are so many things you can do with a little bit of creativity. Clubs are more than willing to help. There are no problems with volunteers or coaches. The problem now is to get people with disabilities who want to give things a go".This raises the issue of the need for marketing to induce behaviour change. As with so many of their non-disabled counterparts some people with disabilities are not interested in physical exercise and sport. They don't feel up to it. It doesn't attract them. As with so many others, it can be difficult to entice people with disabilities to contemplate engaging in physical exercise. This is an issue that must also be addressed. The benefits of exercising and sport must be marketed.
The benefits of sport and physical exercise are huge for everyone, for those with acquired disabilities as well as those with a disability from birth. There is a need to find ways of convincing people with disabilities of the benefits of sport and physical exercise.The benefits of sport to me are huge. It gives you a sense of who you are. It's about being involved. It's a common interest you can share with others. Others see beyond your disability. They see you as an angler or whatever. The sense of achievement is great. You feel that if I can do this, why can't I do these other things? Of course there are also the health benefits. But sometimes it is difficult to convince others" (Person with a disability)."Basically I participate in sport because I don't want to become one of those disabled people who sit around watching TV and getting fat. Sport is also a way of meeting people" (Person with a disability).Some professionals suggested the importance of stressing the costs of inactivity economically as well as in terms of personal health and quality of life.
"When people with mobility impairments are overweight there can often be added cost implications. For example, people may need more (and more expensive) equipment like hoists that they would otherwise not need if they were a more suitable body weight and the costs of treating complications such as pressure sores are often greater in people who are overweight because healing can be slower" (physiotherapist).
The findings in this study regarding school PE are similar to other experiences described in school research in an Irish context, e.g., "I think most of us were excluded especially in sports - the school wasn't equipped to cope. They tried, but the majority of times you had to stay out" (Kenny et al, 2005, interviews with Irish students). In this study many examples were given of teachers trying. They did make an effort. They did what they could but they didn't have the expertise." The cultural environment, the example of others "like me" influences participation.
"I didn't see myself as being able. I had no peers doing sport or physical exercise. There was one other student with a disability who didn't do anything either. Outside school I didn't see and so I didn't do anything either. I played with my friends outside school but I didn't think of sport as such until the IWA began to encourage me. The turning point was when I met a wheelchair racer and we got on really well. It was only then that I saw the glamour and excitement of it. And only when I got involved and began to participate did I see the fun of it all".Sometimes students with disabilities were not allowed to go into the playground with the others. In some schools where other students had to accompany students with disabilities at break times or sports resentment could arise on the part of the accompanying student if they did not willingly take on this assigned accompanying role.
Respondents with disabilities described their participation in physical education in school."I went to a mainstream primary school and during physical education they did mostly games I couldn't play. While teachers and other students tried to include me and help me get involved, I wanted more involvement than being the referee or umpire etc. In the final years they set up leagues and I was not involved at all."One student suggested that
"It might be better if there is more than one student with a disability in a school. When another student in a wheelchair came to my school (who played wheelchair basketball for the Irish team) it gave me inspiration. He started a group in the school to show them how to adapt games for people with disabilities and this gave me confidence"There were positive experiences where children were welcomed and included. In terms of early childhood education/childcare, many of those that willingly took on children with disabilities and who accommodated and included them in activities had personal experience of people with disabilities and/ or professional training and experience in working with people with disabilities.
"I approached the local play group for X and they were more than happy to take her on and she does activities with a group of 9 or 10 kids every week and doing fantastic. She looks forward to it every week and she participates in the activities that she is able to do."The limited curriculum and poor resources for physical education and sport in school is of widespread concern. In the NCTC consultation process in 2001 regarding the adequacy of the provision currently made to develop fundamental motor skills and coordination before 12 years of age in the Irish system, concern regarding the curriculum was expressed, e.g. "School provision is in my opinion is either non-existent or totally inadequate" or "Provision totally inadequate - Pride of Nation would be far greater (self-belief) if young people between 8-12 years were included in a PE structure that guaranteed better co-ordination. Whatever sports the athletes take up they will have a far greater chance of making it to the top" (www.nctc.ul.ie).
"I think it's easier to get those of us with spinal injuries who were previously into sport and exercise to participate in sport afterwards. At least we had the skills, we had the opportunities while many people with disabilities from birth never had the opportunity and didn't develop their physical potential in school or at home, they've never trained, and so it is harder for them as adults to start from scratch. It is even hard for them, as it is for those who didn't do PE or sport, to realise what is involved, that it is a matter of skill as well as strength etc. It is best to start young."A limited PE curriculum can be an issue for many children and not just children with disabilities. Sometimes, what is on offer, for example in a school or in a community programme, or in a programme provided by a disability organisation, is not of interest to a particular individual or to all individuals.
Parents and professionals raised the well-known educational principle that programmes that address needs and interests are the programmes that prove successful in terms of both satisfaction and achievement."In this rural area there are not so many activities available. There are a number of volunteers from a disability sports organisation who want to teach tennis but none of the children are interested in tennis. This is an issue. Providers and volunteers and teachers have to learn to identify and address individual preferences and needs."Addressing individual preferences and needs is critical to the success of people with disabilities. Learning how to adapt activities to meet individual need is becoming crucial in an increasingly diverse and multicultural society. Everyone, including people with disabilities, parents, educators, leisure and tourism providers and health personnel, have to learn to respond and to adapt activities and approaches to meet individual needs in a meaningful way. If children with a disability need particular support, motivation, stimulation and information to attain developmental milestones and to participate in physical activity and sport, and if this is not provided, they cannot exploit their potential.
"I deliberately avoided getting involved in wheelchair sports. I wanted to be in activities with everyone else and not only with people with disabilities. It's an individual thing..."
Frequently, teachers and students assume that students with disabilities can't participate in physical education or don't' want to or only need to do so in a token manner in order to feel included but not to develop skills, to compete etc.
"When I went to an integrated secondary school it was hard to be involved. Awareness was an issue. People told me I couldn't do certain things and so I had to work harder to prove that I could."Teachers often wouldn't know or think of the need to make activities challenging for all. Parents pointed out that oftentimes teachers didn't realise that they should consider the needs of everyone and that it doesn't take too much thought or awareness to find out the interests and aptitudes of each student and find ways of involving all.
"You've got to look at each individual child and what the nature of the disability is and see how the child can be included. My own experience of sending X to a mainstream school has been painful. There is still a huge attitude problem."One mother described how a school excursion with children and families always seemed to take place in difficult-to-access locations. She had to plead that it would occasionally be to an accessible location which of course facilitated the participation of families with young children and buggies as well as older people and students with disabilities.
"Awareness is important in all areas not just in gyms etc but also in cafes and other places - everywhere."Respondents described how assumptions about inability could change through witnessing what people with disabilities could do.
"I took part in a Gaisce programme in school and went on an adventure weekend. The teacher got advice from the canoeing center... they asked regarding my requirements and said they would do whatever was necessary...I tried everything... water polo ...canoeing. Until this trip I felt left out but on this trip the others learned that I could participate...that it was possible for me."Sometimes the activities in which children and adults are interested in are simply not available to them because they do not have the required personnel to assist or to accompany them or because personnel think it is not their responsibility.
"Attitude is the biggest block. Almost everything can be done - it just might need to be done in a different time frame and a different way. Everyone needs an adapted programme. The adaptations that have to be made are often not huge."Respondents described positions that could change, sometimes radically with e.g. new management or new teachers. The same ad hoc application or invention of positions, rules and regulations was the case with leisure centres and gyms as well.
"In school my parents were told insurance didn't cover me participating. Then I found out that someone else like me had been in the school before and had participated in everything. It depends on the teachers at the time and their attitude."In my experience attitudes towards participation are also important. I went to a "normal" school and for the most part I participated all the time right up to 6th Year except in 2nd class I wasn't allowed "in case I might get hurt."
In some cities many leisure centres and gyms facilitate people with disabilities and, increasingly, there are facilities that are pro-active in trying to increase access for all and have forged links with disability organisations while in another city leisure centres would not consider hosting adapted physical activity programmes in swimming even if the participants had lots of individual support with volunteers, experts etc. They said their insurance wouldn't cover it. So much depends on individuals, their knowledge or lack of it, their fears and their interests."In our school we're very lucky that we now have a good board of management and parents' committee. Teachers facilitate people coming into the school to provide what is lacking. For example someone comes in and does gymnastics. This person has a school of gymnastics and goes to other schools. It's up to boards of management and parents' committees really. We have young enthusiastic teachers too and they're ready to work with you and with each child."In some residential settings there is understaffing and physical exercise programmes are limited while in other places there are increasing numbers of programmes and opportunities available. In some residential settings people with disabilities are only beginning to get opportunities to participate in leisure, sport and physical exercise as previously some of these institutions were run on the lines of hospitals where people were cared for and their needs and issues medicalised even if they were not ill.
"It is only in the last few years that anything apart from daily living activities has been thought of here.""The integrated arts programme brought visually impaired and sighted people together - brought two worlds together to create a new world of integration... We did a 20 min production on stage that included dance routines and it was hugely successful - the people involved with visual impairment developed spatial and mobility skills as well as communication and confidence skills...I think this programme was an eye-opener for all - it started an awareness process all round - and showed how a local community can be more diverse and open and that huge adaptations don't have to be made to include everyone - perhaps the biggest adaptation will really always be one of attitude."Respondents, particularly those involved in competitive sport, spoke of the role of the media in increasing awareness, providing information, encouraging others to participate - reflecting full reality and society - not blocking out parts of society. The role of both national and local media was spoken about. People need to hear what's going on before they can even begin to contemplate participating. This year an Irish league was re-established in wheelchair basketball with players with and without disabilities on every team. Respondents spoke about archery as a sport where people with and without disabilities could compete. Other people believe that the most powerful role models are those close to home. "I don't believe in role models on TV or anything. My Mum and Dad got into swimming when I was very small and eventually I got quite good at it."
Appropriate support includes not only special needs assistant but also volunteer, buddy, family and peer support as well as adequate help in leisure centres, gyms including one-to-one attention to get a person to the machines e.g. and to get started. It includes staff "who are willing and inviting" and who are trained to assess and address individual needs and preferences.
"One should be able to go along and ask staff for assistance and yet I feel uncomfortable. I don't know if this is just me.""The ideal situation is that all the staff in gyms, swimming pools etc have education and training so that they know what to do.""Some people with disabilities have difficulty admitting their disability and asking for help. The staff has a part to play in helping people with disabilities to feel comfortable. I don't see any reason why people with disabilities couldn't work in gyms, swimming pools etc. It would help if there were people with disabilities who have training/degree to work in leisure and sports area. Other people with disabilities would see how they cope with machines and might feel more at home. However, I have lots of friends with disabilities and none of them would consider working in leisure, gym etc.""There is no network available to provide a volunteer or PA to accompany me. The need for assistance will never go away."A suggestion made is that there would be a pool of volunteers who could e.g., be available to the gym to bring people who are blind like me to machines, who have the list of exercises and who can help the person get started i.e. "to help persons to get to the right place and to do the right thing.
"I always need the company of a friend to go to an aerobic class or whatever."Some parents described the need their children had for one on one instruction in physical education, at least initially, and, oftentimes, this was simply not available. In one school, parents offered to assist in the playground etc to facilitate participation but the school said it was not possible. Parents discussed the merits of having instructors come into schools that are more capable of incorporating all into interesting and stimulating experiences.
"Instead of current teachers have alternatively trained people come into schools and work with parents and children to take a step forward.""A lot of these children can be alone in a crowd. They need one to one instruction. We couldn't have sent him to ordinary swimming lessons because he needs individual tuition"."We had him in the water ourselves but we couldn't advance him and now he is totally into it and making progress. The individual attention is great.""X is happy in his own world. He is an individual and he doesn't like playing with a lot of others. A lot of these children can be alone in a crowd. He has come on in leaps and bounds through the swimming. The individual attention is great. No one offered any suitable programme before. There aren't even classroom assistants - that's how bad it is. In local clubs there can be 15 or 20 children playing football with perhaps 2 or 3 adults with them - it's hard to get volunteers now - so the personnel required to give children like my son the attention they need are just not there"Adults described people in mainstream clubs and sporting bodies for outdoor adventure sports as often being "super-agreeable" as long as they know the expertise is there to advise them on the technical aspects of a person's disability - risks, limitations etc. Once they are reassured that the experts on a disability know what they are talking about they are more than willing. Spinal Injuries Ireland among other other groups organise all kinds of adventure sports including scuba diving.
Parents spoke of the need for services to keep a service focus on the best interests of the client.
"When X tried to set up an adapted physical activity programme in this city for children with a disability there was a poor response from some of the groups who provide services. Some of the centres, at the end of the day, have their own agenda and, while they do great things, a few people in these centres are looking out for themselves big time rather than for the needs of the individuals they look after. As a parent I was anxious that this programme would start because I had tried several years ago to no avail and so I started contacting certain people in different centres - people who would make things happen in our childrens' interest. Now, because this programme has been so successful and has got considerable media coverage, some of these bodies who were unhelpful at the start, are in the process of organising swimming lessons themselves because they see it has answered a real need."There is scope for professionals in disability organisations and HSE to get parents more actively and constructively involved and to assist them in the important educational role they play in the lives of their children.
"There is a huge lack of support for parents to help their children. Some of these new developmental centres are not worth a toss for this reason. We need, above all, to know how to train our children"."The system often doesn't help the parents or give them the tools to help their children. There is a lot of being cut off and a lot of barriers erected when you are just trying to do the best for your child. Sometimes you are left out there with nothing. When we said we were going to try primary movements with X the organisation who had been looking after him said okay fine but don't come back here anymore and they cut us off. It seems to be the general trend with the health board. I learned that if you are getting something within the Health Board don't tell any other person in the Health Board because they will immediately say oh you're getting something somewhere else that's fine good luck you wont get anything more from us.""There can be parent apathy with parents who feel that once their children are in the system the system will take care of their children and they sit back. But there are also many parents who are willing and really want to do all that they can to ensure that their children progress""Parents need help on different fronts".Physical activity programmes and active leisure opportunities for people with disabilities are currently provided mainly through specific disability organisations and the HSE disability services. There are also a few community adapted physical activity programmes provided in community facilities. Some sports NGBs facilitate the participation of people with disabilities. In County Kerry, St John of God Services provides an innovative leisure service that is responsive to the clients interests and engages in leisure sampling and support for the client to pursue their interests. In different parts of the country individuals, leisure centres, gyms, or institutions such as the IT Tralee or DCU in Dublin provide adapted physical activity programmes for students and the wider community and a wide range of people with disabilities participate in these programmes largely in mainstream community facilities.
Those who had the opportunity or whose children had the opportunity to participate in adapted physical activity programmes from people trained in this field were happy with the experience. Some of the other positive experiences/comments around participating in the adapted physical activity programme included the following: "The happiness that comes from exercising", "Programme made me aware of my body and I felt good" "Meeting new people" "Having toned-up body" "Learning to work together with others" "The joy of working and listening to the students - they are really good teachers - they are pleasant and patient and help you in ways you couldn't possibly imagine and some of them are very young - we had fun - you might be afraid to ask but they would explain everything in detail - they are interested and encouraging, they are not cross. I feel at ease with them- it is nice to be with them - they are funny, positive, helpful -they make exercise enjoyable - good fun, very relaxed, not too serious -I feel safe and comfortable" "We learnt about the different muscles of our body" "This activity will lead to good health" "My exercise levels have increased" "The feel good factor" "This programme has made a difference to me now because going to the gym I am enticed to go back in every way - I walk now as well but I didn't do it before the programme" "We had fun"Some of the comments from parents included"We would do anything for him that he liked but he just hasn't been interested in anything 'till now"."The original idea was that X would provide volunteers in mainstream clubs but the clubs didn't want children with disabilities. Even if these clubs were provided with all the volunteers they needed it was a closed-door situation"."Our child is not an active child and he is not a team player but he loves swimming but this is the first opportunity we've had to enrol him in swimming lessons"."We've really tried to encourage X. We took him to a wheelchair event organised by the Irish Wheelchair Association. It was very organised and very good. Everyone was very welcoming but X was just not interested. We would do anything with him that he liked but he just hasn't been very interested in anything until now. That is why this swimming programme has been brilliant - we had him in the water ourselves before but we couldn't advance him and now he is totally into it and making progress. He loves it.""Because we are doing physiotherapy with him at home ourselves every day he actually gets to the stage where he hates anything that involves work and so the swimming lessons that he loves provides him with at least one good hour of physio a week that he loves and during which he sings""A lot of other places couldn't provide anything like these individual swimming lessons for children with a disability alongside other groups""Our son loves the programme"Comments from adults on adapted programmes are revealing
"Some of us would have been very limited in our activity until now. The programme has been great in terms of the social aspect, confidence giving, & the physical aspect, developing a sense of control over our bodies, giving us confidence in space & improving upper body mobility. A lot of us had mobility training but not the opportunity to practice it until now.""The individualised adapted physical activity programme in the gym has been great in terms of both the social aspect - confidence giving and the physical aspect - developing a sense of control over our bodies, giving us confidence in space and improving upper body mobility because we tend not to use the upper body. A lot of us had mobility training but we didn't get the opportunity to put it into practice until now. We have to earn to manage space in different environs. Some of us would have been very limited in our activity until now - even our walking was limited - maybe to the gate and back for some. As time goes by we are learning to know what we need and to voice it. Some of us have walked on the treadmill without holding onto the bar"."There is a whole process that must be gone through in order to acquire independent living skills. There are people who for 20, 25 or 45 years have not had a great voice in terms of what they want and what they need. They can't suddenly enter a gym or anywhere else and say "I want this of that" but they have articulated their sense of isolation and their desire to be included and to be able to participate and this is the driving and the motivating factor to take part in the adapted physical activity programmes etc."Parents spoke about taking their children to a wide range of "Movement Therapists".
Primary Movement therapy is a burgeoning field of physical therapy/physical movement that is currently unregulated. There are increasing numbers of private primary movement therapists providing services to children with disabilities and training to their parents. Inadequate physiotherapy services in the public health system are, in part, encouraging the use of alternative services including a range of private movement therapy services.Efforts are being made to increase the number of training places for physiotherapists in the Irish University System. A major rationalisation of existing health service agencies came into effect in January 2005.The HSE provides physiotherapy, occupational therapy, speech therapy and physical activity programmes as part of their multidisciplinary support services for children with a disability. In some areas the HSE contract out these services to voluntary organisations. The provision of services by disability organisations and the services provided by the HSE varies considerably in different parts of the countryside. In the former North West Health Board area, for example, there are special needs counsellors that work with the families of children with disabilities from birth. They help with the coordination of services and act as advisors, mediators and advocates.Much satisfaction was expressed regarding the service provided by some of special needs counsellors. Other HSE areas do not have this kind of service at all. In some places there were delays in accessing an assessment to get advice about movement and exercise while, in others, an early intervention HSE team saw the child promptly. In some settings including some residential services limited physiotherapy was available and was, e.g., provided late at night with physiotherapists who had already done a full day's work elsewhere. Some respondents said that it would never be the hour they would have picked as the optimal time to have physiotherapy.It is important that the development and reform of the health services will take the requirements of people with disabilities into account. It is important to identify current best practice such as the counsellors for children with special needs in the North West and to roll this practice out across the country. Such a service facilitates access to physiotherists etc. and can be of help to parents in their deliberations around the usefullness of particular services or complementary therapies for their child.
W.H.O. (2004) cite lack of awareness of benefits of physical activity, lack of political support, insufficient cooperation between sectors and inaccessibility of leisure and sports facilities as common obstacles to participation.In Ireland, Fahy et al (2004) found that 20% of adults take no leisure physical activity whatsoever and that only 40% take enough leisure exercise to meet the minimum standards of physical activity recommended by W.H.O. Similarly, in the data from the National Health and Lifestyle Surveys (SLAN, 1998 and 2002), almost half the adult Irish population engage in little or no physical activity (SLAN), while in school-going children, aged 11 -17 years, (HBSC) activity rates (vigorous activity outside class four or more times a week) are lower for girls than for boys while lower levels of activity (vigorous activity only once or less than once a week) are found in 7% of boys but 21% of 15-17 year olds. While activity rates decrease with age in both boys and girls, there is a much sharper drop at age15 years among girls. In the United States 29% of adults report no leisure time regular physical activity and only 25% of adults report engaging in the recommended physical activity levels i.e. 30 mins of moderate intensity activity on 5 days/week or 20 mins of vigorous-intensity physical activity on 3 days/week (US Dept of Health and Human Services, 2000). In the United Kingdom 70% of men and 80% of women are insufficiently active to benefit their health (Allied Dunbarr National Fitness Survey, 1992).From the international literature Aarnio et al (2002) cites a range of factors that predict consistent physical activity in adolescents including social relationships, parents' interest in physical activity, parental exercise habits, parental encouragement, the local environment, non-smoking, school grades, participation in organised sports and playing sport for school. There were associations between patterns of physical activity and the type of school. In an Icelandic Study (Vilhjalmsson et al, 1998) more involvement in leisure time physical activity was associated with male sex, sociability and satisfaction with mandatory physical education classes in school and perceived importance of sports and health.General socio-ecological factors also influence participation such as hobbies and interests of parents and friends and the family and general culture e.g. a culture of watching or participating. The Limerick City Sport Partnership carried out a Household Survey in 1100 households with regards participation in sport. The results show a striking trend towards people choosing more leisurely and more individual or lone physical activities. Swimming in a traditional pool was the most popular sport (12%) followed by golf (8%) while swimming in a leisure centre (7%) also figured in the top five most popular sports in Limerick (Limerick City Sports Partnership Strategic Plan 2003 -2006).Barriers to sport participation among ethnic minority communities in Scotland and elsewhere (Sports Scotland, 2001) include attitudes and expectations of significant others, particularly parents and teachers; cultural traditions including a lack of acceptance of the value of sport, particularly compared to other aspects of life such as earning a living and family commitments; a lack of awareness of others `like me´ participating in sport and a lack of role models at a higher level; lack of confidence in relation to appearance, communication and ability; lack of awareness of appropriate sporting environments, lack of appropriate facilities or activities; difficulty in accessing information; cost and racial discrimination (including overt racial abuse, covert racial abuse or lack of understanding of or sympathy with needs). Again, there were differences in participation rates between males and females as well as differences between ethnic groups.In the Sports Scotland study (2001) researchers identified barriers that exist according to the "stage of change" of the participants. The "stages of change" or trans-theoretical model (Prochaska and DiClemente, 1986; Andreasen, 1995), used in health promotion and social marketing, postulates that change e.g. from being a non-participant to participant in physical activity or vice versa, occurs in stages and that different strategies are required depending on the stage (pre-contemplation, contemplation, decision, action, relapse and maintenance). The model is used to identify the stage people are at and then deciding on the appropriate strategies for that stage to achieve desired behaviour modification. In the Sports Scotland Study barriers found at every stage of the model included several of the factors outlined above including attitudes/expectations of significant others, lack of appropriate facilities/activities; difficulty in accessing information; cost and racial discrimination.
The report by Fahy et al (2004) on physical activity and sport among the adult Irish population[6] showed that participation in sport varied by gender and also with age, particularly among women. Sports participation was associated with lower levels of cigarette smoking but, notably, with higher consumption of alcohol. The national Irish adult surveys (SLAN, 1998, 2002) also showed gender and age differences in physical activity and also an inverse relationship between physical activity levels and formal education and socio-economic status. The strong trend towards inactivity with increasing age was greater among those with the least formal education. National adolescent studies of 11 to 17 year olds in Ireland and carried out at the same time as SLAN (HBSC, 1998, 2002) also show that physical activity decreases rapidly with increasing age and that there is a strong gender difference. However, unlike the results for adults in the SLAN data, in the HBSC surveys the association in the young between participation rates and social class is not consistent.
The main reasons people gave for non-participation in physical activity in the Irish adult study carried out by Fahy et al (2004) had to do with lack of interest or willingness or time, while sense of ability only had a very small influence on participation rates. While adults did not cite lack of facilities as impediments to participation this does not mean that supply side problems do not play a role in determining participation since most people might never consider swimming or cycling or walking unless there was a local swimming pool, cycle-ways or footpaths (Fahy et al, 2004). The fact that participation patterns change with age and that non-participation in sport in adult life occurs even among those who were very active in sport when they were younger has implications for physical activity and sports policy (Fahy et al, 2004).In 1997, as part of a pan EU survey of consumer attitudes to physical activity, body-weight and health, 1000 Irish adults aged 15 years and older were surveyed. Out of 16 factors listed that might prevent people from becoming involved in physical activity, the most frequently chosen responses were 'not being the sporty type', 'work or study commitments' and 'looking after children/elderly relatives'. These responses varied according to gender, age group and education level. Almost one-third of the sample was over-weight and a further 8% were obese and the main barrier selected by these groups was 'not being the sporty type.' Like the Sports Scotland Study (2001) this Pan-EU Survey (1997) investigated the relationship between individual attitudes and participation and tried to see if the barriers to physical activity that people identified varied with their stage on the Prochaska and DiClemente Behavioural Change Model (check out their results on this and insert).Similar results were found in a more recent European Commission Eurobarometer survey, the Citizens of the European Union and Sport (November 2004) asked interviewees why they did not practice a sports activity. "The result for Ireland showed that 31% cited a lack of time as the reason. EU-wide, access to facilities was onlycited by 3% of respondents as the reason for non-participation. This finding suggests that providing facilities locally is only part of the solution to achieving higher participation levels. Further information on the main factors inhibiting regular participation should be collected" (Draft CSO report, 2005, which analyses the Statistical Potential of Administrative Records and Survey Data Sources in selected Government Departments).