Bibliography

Bibliography for Exercise Science ISU

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Bowerman, B. (n.d.). 13 Motivational Sports Quotes from Olympic Coaches | Reader's Digest. Reader's Digest. Retrieved June 10, 2014, from http://www.rd.com/slideshows/13-motivational-sports-quotes-from-olympic-coaches/#ixzz34ILlTDQk

Bowman-Kruhm, M. (2000). Everything you need to know about Down syndrome. New York: Rosen Pub. Group.

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Febrile Seizures Guide: Causes, Symptoms and Treatment Options. (n.d.). Febrile Seizures Guide: Causes, Symptoms and Treatment Options. Retrieved June 11, 2014, from http://www.drugs.com/health-guide/febrile-seizures.html

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Fragile X Syndrome . (n.d.). Fragile X Syndrome. Retrieved June 9, 2014, from http://emedicine.medscape.com/article/943776-overview

Fragile X syndrome. (n.d.). Genetics Home Reference. Retrieved June 10, 2014, from http://ghr.nlm.nih.gov/condition/fragile-x-syndrome

Down Syndrome Foundation. (n.d.). FAQ and Facts about Down Syndrome - Global Down Syndrome Foundation. Global Down Syndrome Foundation. Retrieved May 20, 2014, from http://www.globaldownsyndrome.org/about-down-syndrome/facts-about-down-syndrome/

Hayden Schunk saying the Special Olympic Oath. (n.d.). YouTube. Retrieved June 11, 2014, from https://www.youtube.com/watch?v=nD5j1vtSTMs

Health Supervision for Children With Fragile X Syndrome. (n.d.). Health Supervision for Children With Fragile X Syndrome. Retrieved June 9, 2014, from http://pediatrics.aappublications.org/content/127/5/994.long

How It All Began. (n.d.). Special Olympics: History of Special Olympics. Retrieved June 8, 2014, from http://www.specialolympics.org/history.aspx

Joosa, E., & Bertheleson, D. (n.d.). Parenting a Child With Down Syndrome: A  Phenomenographic Study. OADD. Retrieved May 22, 2014, from http://www.oadd.org/publications/journal/issues/vol12no1supp2/download/joosa_berthelsen.pdf

Kohen, D., Uppal, S., Guevremont, A., & Cartwright, F. (n.d.). Children with disabilities and the educational system — a provincial perspective. Children with disabilities and the educational system — a provincial perspective. Retrieved May 22, 2014, from http://www.statcan.gc.ca/pub/81-004-x/2007001/9631-eng.htm

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MedCare Cares!. (n.d.). : Atlanto-Axial Instability and Children with Down Syndrome. Retrieved June 11, 2014, from http://medcarepediatrics.blogspot.ca/2013/04/atlanto-axial-instability-and-children.html

Melillo, R. (2013). Autism: the scientific truth about preventing, diagnosing, and treating autism spectrum disorders-and what parents can do now. New York: Penguin Group.

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Down Syndrome Society. (n.d.). Caring for Your Family. - National Down Syndrome Society. Retrieved May 22, 2014, from http://www.ndss.org/Resources/Caring-for-Your-Family/

Oaths and Codes of Conduct - Special Olympics North Carolina. (n.d.). Special Olympics North Carolina RSS. Retrieved June 10, 2014, from http://sonc.net/oaths-codes/

Orlick, T. (n.d.). The Wheel of Excellence. Zone of Excellence -. Retrieved June 10, 2014, from http://www.zoneofexcellence.ca/free/wheel.html

Out of the Shadows: Events Leading to the Founding of The Special Olympics. (n.d.). Special Olympics. Retrieved June 10, 2014, from http://www.specialolympics.org/Sections/What_We_Do/Out_of_the_Shadows__Events_Leading_to_the_Founding_of_Special_Olympics.aspx

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Participation by individuals with Down Syndrome who have Atlantoaxial Instability. (n.d.). Special Olympics. Retrieved June 9, 2014, from http://www.specialolympics.ab.ca/uploads/files/Documents/Policy/M-3001%20Atlantoaxial%20Instability.pdf

Physical Problems in Fragile X Syndrome . (n.d.). Fragile X. Retrieved June 9, 2014, from http://www.fragilex.org/wp-content/uploads/2012/08/Physical-Problems-in-FXS2012-Oct.pdf

Physical features of autism spectrum disorder (ASD). (n.d.). KevinMD.com. Retrieved June 10, 2014, from http://www.kevinmd.com/blog/2010/07/physical-features-autism-spectrum-disorder-asd.html

Pueschel, S. M. (1990). A parent's guide to Down syndrome: toward a brighter future. Baltimore: P.H. Brookes.

Royston, A. (2010). Explaining Down syndrome. Mankato, Minn.: Smart Apple Media.

Santomauro, J. (2011). Friendships. Autism All-Stars (pp. 83-85). London and Philadelphia: Jessica Kingsley Publishers.

Small Steps, Great Strides - Eunice Kennedy Shriver. (n.d.). Small Steps, Great Strides - Eunice Kennedy Shriver. Retrieved June 9, 2014, from http://www.eunicekennedyshriver.org/bios/si

Special Olympics Gymnastics 2012 USA Championship Gala (Gabriel Beauchamp).mp4. (n.d.). YouTube. Retrieved June 11, 2014, from https://www.youtube.com/watch?v=u6-w7hmUDvQ

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Special Olympics: Special Olympics Program Locator. (n.d.). Special Olympics: Special Olympics Program Locator. Retrieved June 10, 2014, from http://www.specialolympics.org/program_locator.aspx

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Sports & Exercise | Down Syndrome WA. (n.d.). Sports & Exercise | Down Syndrome WA. Retrieved June 10, 2014, from http://dsawa.asn.au/children/recreation.html

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The Beauty of Chaos. (n.d.). : Lesson 3: Down Syndrome testing. Retrieved June 11, 2014, from http://asal-sakti.blogspot.ca/2008/12/down-syndrome-testing.html

Timeline Photos - Special Olympics | Facebook. (n.d.). Timeline Photos - Special Olympics | Facebook. Retrieved June 11, 2014, from https://www.facebook.com/photo.php?fbid=10152951432728782&set=pb.10331123781.-2207520000.1402462225.&type=3&theater

Tocci, S. (2000). The Family, The Future, Myths and Truths. Down syndrome (pp. 94-130). New York: Franklin Watts.

Training and Certification. (n.d.). Special Olympics Canada. Retrieved June 10, 2014, from http://www.specialolympics.ca/be-involved/coaches/training-and-certification/

Weber, J. D. (2000). Children with fragile X syndrome: a parents' guide. Bethesda, MD: Woodbine House.

What Is Fragile X Syndrome?. (n.d.). Special Olympics: FragileX. Retrieved June 9, 2014, from http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx

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What is the Healthy Athletes Program. (n.d.). healthy athletes program. Retrieved June 11, 2014, from http://www.sotx.org/programs/healthy-athletes-program.html

Who Are Our Athletes?. (n.d.). Special Olympics: Our Athletes. Retrieved June 9, 2014, from http://www.specialolympics.org/athletes.aspx

A division of Future Horizons, Inc.. (n.d.). Autism Aspergers Digest RSS. Retrieved June 10, 2014, from http://autismdigest.com/sports-and-autism-thinking-outside-the-bounds/

Chapter 5: Conclusion

Chapter 5: Conclusion

The Special Olympics supports the athletes in doing their best and giving it their all, this also is a lesson for all the wonderful people in their lives that they do have potential, and their potential is incredible.
(http://babyboomertalkonline.com/2011/do-it-wellyour-inspirational-quote-wednesday-july-20-2011/)

         The Special Olympics have been found to be a powerful force of change for people with developmental disabilities around the world. These events have brought awareness to the struggles of these individuals, and also their potential. Society has become more informed on their circumstances and has become better able to integrate them into our society and be more welcoming. The athletes themselves are also benefited as they gain health benefits from becoming more active and living a healthy life style, as well as psychological benefits as they learn how to become engaged, focused, and can learn passion for their sports or for other areas of their lives.

            On the Special Olympics Official Website they state "Ours is an urgent mission. That’s because people with intellectual disabilities are among the most vulnerable in the world. They are often ignored, neglected and excluded from schools and society. Special Olympics may be the only place where people with intellectual disabilities get the chance to become part of their communities and develop belief in themselves." (http://www.specialolympics.org/changingattitudes.aspx)

            These people need someone to believe in them, just as everyone else does. When they have the chance to prove themselves, they can succeed. Although they face a number of biomechanical challenges, or mental challenges, and take longer time to process information, exercise is incredibly beneficial.

            In my experience, working with developmentally disabled children and youth is an experience unlike all others. Often times they have so much desire to learn, to gain new experiences and develop skills. They will see something and attempt to mimic the action. When someone can take time to be patient with them and give them the chance to learn, they take the opportunity and can succeed. With obesity levels raising in so many developmentally disabled individuals, exercise is important for them. Athletic involvement is important for these individuals as it helps them physically, mentally, socially and emotionally develop. They gain better control of their body, better mental focus, create relationships with coaches/team members/other participants, gain social skills, learn to communicate better, and to be able to express themselves and demonstrate emotions in a controlled way.

            In the end, for all Special Olympic athletes whether with Down Syndrome, Autism, Fragile X Syndrome or any other number of developmental disabilities, what it comes down to is the effort they put in. Olympic coach Bill Bowerman states 

"Victory is in having done your best. 

If you've done your best, you've won." 

 (http://www.rd.com/slideshows/13-motivational-sports-quotes-from-olympic-coaches/#ixzz34ILlTDQk)

Chapter 4: Fragile X Syndrome

Chapter 4: Fragile X Syndrome

Our Special Olympic Superstar Athlete with Fragile X Syndrome is Jonathan

            "When Jonathan was a little boy, he'd stay alone in his room, never wanting to talk or interact with family members or anyone else. He spent most of his time lining up his toys in straight lines. Like other children with  Fragile X, he avoided eye contact and shunned any physical contact, even with loved ones.

            When Jonathan's parents got him started in Special Olympics, this gave him a unique outlet. The coaches understood his disability and helped him find a comfort zone -- and soon he was playing whatever sport was in season -- softball, speed skating, golf, swimming and tennis. He began making direct eye contact and even shaking people's hands, despite his tactile sensitivity issues.

            The lessons he has learned through his sports training and practice have had impact on other aspects of Jonathan’s life. He began to be more interested in school and he learned now to persevere – and not give up on something if it seems difficult. He also began setting realistic goals for himself, and learned that if he works hard and is determined enough, he will eventually succeed - just as he did in sports.

            Jonathan has graduated from high school with an academic diploma and completed an associate’s degree in computer science, persevering through eight years to earn that degree. He has also been a long time employee of Publix Supermarkets. These are accomplishments that his parents were told he could never hope to achieve. Says mom, Kathy: "We truly believe that his personal success, his transformation, is due primarily to his participation in Special Olympics.""

(http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

Jonathan after winning a medal at the Special Olympics.
(http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

Diagnosis

           

            Fragile X Syndrome is a developmental disability caused by an expansion mutation within the Fragile X Mental Retardation gene. This mutation of the gene on the X chromosome causes limited mental capabilities. The diagnosis of Fragile X Syndrome is confirmed by molecular testing of the Fragile X Mental Retardation gene. This testing can be done through prenatal testing. For full Fragile X Syndrome to be present they must have a full mutation (more then 200 repeats of the CGG trinucleotide in the individual's DNA). Fragile X Syndrome is a Sex linked disorder and therefore is passed by sex chromosomes, in this case the X chromosome. When there is medical history of the disorder in the family, they can be consulted on the likelihood of their baby inheriting the disorder. (http://www.aafp.org/afp/2005/0701/p111.html; http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

            As females have two X chromosomes their bodies are still able to produce some Fragile X Mental Retardation Protein (FMRP) and therefore reduce severity of symptoms.  (http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

            Approximately 1 in 4,000 males and 1 in 8,000 females are diagnosed with Fragile X Syndrome. (http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx; http://ghr.nlm.nih.gov/condition/fragile-x-syndrome )

            When a baby is born, certain physical characteristics and health concerns will become prevalent in the child.

Outward physical characteristics and health concerns

            This genetic disorder presents itself physically mainly after puberty is hit. During puberty these individuals often develop a narrow face, larger head in proportion to their body, large ears, more flexible joints, looser connective tissue, flat feet, a prominent forehead, and males will often have larger testicles after puberty (called macroorchidism). (http://www.fragilex.org/fragile-x-associated-disorders/fragile-x-syndrome/; http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

            Fragile X Syndrome is a known genetic cause of Autism. Although not all individuals with Fragile X Syndrome have Autism, nor does all Autism stem from Fragile X Syndrome as Autism is caused by both environmental and genetic factors. Tremor/ Ataxia Syndrome is a condition that creates balance, memory, and tremor problems in older males and sometimes females. This disease is caused by the premutation of the Fragile X Mental Retardation gene.

            Primary Ovarian Insufficiency can also be caused by Fragile X Syndrome. This disease causes decreased ovarian function which often leads to infertility and/or early menopause in females. (http://www.fragilex.org/fragile-x-associated-disorders/) The increase in size of the testicles, macroorchidism, does not lead to any fertility issues. The males will pass along the gene for fragile x syndrome only to their daughters as it is an X linked chromosome trait.  (Weber, 2000)

            Individuals with Fragile X Syndrome are also more susceptible to ear infections. Recurrent ear infections are common, called otitis media, are due to these people having collapsible eustachian tubes which run from the ear to the back of the throat, and are meant to drain fluid. As the tubes collapse, the fluid is unable to be drained and therefore bacteria grows causing the infection. (Weber, 2000)

            Due to their loose and flexible joints, these individuals are more likely to develop scoliosis, a curvature of the spine, or have joint dislocations. The loose joints are mainly due to having looser connective tissue. Most joints work properly because of the ligaments restricting their range of motion to a set amount. Ligaments are made of thick fibrous connective tissue. When this tissue is loose, the whole ligament is loose thus increasing susceptibility to injury and more specifically joint dislocation. (Weber, 2000; http://www.fragilex.org/wp-content/uploads/2012/08/Physical-Problems-in-FXS2012-Oct.pdf)

            Heart conditions are present in approximately 50% of individuals with Fragile X Syndrome. Most common is a mitral valve prolapse. The mitral valve, which separates the left atrium and left ventricle, can open upwards when the heart contracts, allowing a back flow of blood. This can lead to extra stress on the left ventricle and can be damaging when recurring over a long period of time. (Weber, 2000)

            Vision concerns including near sightedness, farsightedness, and strabismus can be prevalent. Strabismus occurs in 10-30% of children with Fragile X Syndrome due to weak eye muscles which creates difficulty in focussing both eyes on a single object. This can require surgery if severe or it will result in permanent vision loss in the affected eye. (Weber, 2000)

            Seizures occur in up to 20% of males, less so in females but still happen. These seizures are brought on quickly, caused by periodic unusual bursts of electrical activity within the brain. (Weber, 2000) Sports activities are still encouraged even when an individual can have a seizure disorder. The exercise can actually help with seizure frequency and severity. Being in shape and having a feeling of well-being has been determined to help reduce seizure frequency. Individuals can gain more control over their seizures as they enter into a routine of regular exercise and improve their self-esteem , self-control and social integration which can help reduce stress, fatigue, depression, joint or muscle pain, and sleeping problems which could be triggers for seizures. (http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Epilepsy_and_exercise)

            Despite health challenges the individual faces, physical exercise is important to maintain as it is beneficial to overall health. The type of activity needs to be suited for individual needs. Physical activity can have positive impacts physically as weight is maintained at a healthy level, muscles can be strengthened to support loose joints and overall fitness has been shown to reduce seizure frequency.  (http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Epilepsy_and_exercise)

Brain while functioning normally, and when having a seizure.
(http://www.drugs.com/health-guide/febrile-seizures.html)

Affects on Mental Abilities

            The affect on mental abilities varies and can range from learning disorders to full intellectual disabilities. This can slow developmental stages such as learning to talk and communicate. Their developmental delay also makes it more difficult to read body language, make eye contact, concentrate and can become very afraid or anxious in situations. (http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

            Males in particular may have trouble paying attention or have aggressive behaviour. Females may act shy around new people, or those they have not developed a long relationship with.

            A clinical report from the American Academy of Pediatrics explains the varying features, both positive and negative, on individuals behaviour due to their intellectual disorder.

            "Features of attention-deficit/hyperactivity disorder, including hyperactivity, inattentiveness, distractibility, restlessness, and impulsivity, are present in 80% of patients with fragile X syndrome. Affected children also can exhibit anxiety-related symptoms including obsessive-compulsive–like and preservative behaviours. Emotional liability is common. Aggressive and self-injurious behaviours can occur, related to a difficult temperament, with irritability and frequent temper tantrums. Hypersensitivity to sensory stimuli can lead to heightened and prolonged arousal in situations in which there is excessive auditory, visual, or tactile stimuli. This behaviour can lead to an increase in tantrums, hyperactivity, oppositionality, and restricted verbal output. On the other hand, affected males often have a good sense of humour, are persistent and hardworking, and have an endearing quality." (http://pediatrics.aappublications.org/content/127/5/994.long)

            Physical activity can help channel a great amount of the excess energy or hyperactivity of individuals with Fragile X syndrome. Mental focus can also be improved through the hands on approach of being physically active and learning to use the body for specific movements. (Weber, 2000)

Coaching and Training Methods

The Special Olympic Coach Oath

            “In the name of all coaches and in the spirit of sportsmanship, I promise that we will act professionally, respect others, and ensure a positive experience for all.  I promise to provide quality sports and training opportunities in a safe environment for all athletes.”( http://sonc.net/oaths-codes/)

          Coaching methods for Fragile X Syndrome are very similar to those of coaching for Autism as the two developmental disorders are closely related. However, special attention needs to be given to the individuals who are prone to having seizures. Swimming is not a good idea for these athletes. William R. Turk, MD, chief of the Neurology Division at the Nemours Children's' Clinic in Jacksonville, Florida states that he will " generally tell kids that, if it's above their head, they shouldn't be on it." (http://www.webmd.com/epilepsy/guide/children-sports-safety ) This also eliminates certain rhythmic gymnastics routines and diving. Therefore coaches need to adjust the exercises they put athletes prone to seizures through as they need to be careful and protect the athlete's health.

            Therefore coaches must be encouraging in their training sessions focussing in on the individuals abilities and reinforcing ideas with positive feedback to help improve the athletes performance as well as their mental state. This leads back to Terry Orlick's wheel of excellence and trying to create a chain of positive feedback in the mind, eliminating distractions and being fully focussed and being fuelled by belief and commitment to give any performance full energy and effort.

            When coaching individuals with Fragile X Syndrome, it is important to help them find their comfort zone, a place where they can play and not become overly anxious or nervous. (http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

            When coaches develop a strong relationship with their athletes, they can help their athletes with their mental focus and having a positive self-image. By participating in sporting events where they can excel, a feeling of accomplishment can be achieved and lead to psychological positive impacts including a greater desire to try new things and be more willing to participate.

Athletes who have strong relationships with their coaches perform better because they know someone believes in them.
(https://www.facebook.com/photo.php?fbid=10152951432728782&set=pb.10331123781.-2207520000.1402462225.&type=3&theater)

Abilities in Designated Sports

            Abilities in specific sports once again depends more on the individual than the fact that they have Fragile X Syndrome. All individuals with Fragile X Syndrome should avoid contact sports as they are more prone to injuries, in particular joint dislocations, due to their loose ligaments. (Weber, 2000)

            Individuals prone to seizures should avoid rhythmic gymnastics, swimming, diving, and weight lifting. All of these would prove to be dangerous situations should a seizure arrive. Special Olympics referees are all well trained and able to take care of seizures should they happen in a game situation. Weightlifting is also a bad choice for individuals with Fragile X Syndrome overall  due to their loose ligaments. (http://www.webmd.com/epilepsy/guide/children-sports-safety)

            Their willingness to participate in other sports team or individual, depends on the person wishing to play. Sports teams can provide a sense of belonging and give social experiences, whereas individual sports can allow the person to gain better understanding of their own body, their capabilities, and focus on being athletic while not having to feel uncomfortable due to others around them. (http://www.specialolympics.org/Sections/Who_We_Are/FragileX.aspx)

            Through finding a sport that is best suited for the individual, that person gains physical health benefits, mental benefits, such as better mental focus or the ability to participate as a team member, and social benefits as they learn how to show appreciation for others.  

Chapter 3: Autism

Chapter 3: Autism

Our Special Olympic Superstar Athlete with Autism is Dylan

          "As a  mother of a five-year-old son with Autism, Anissa Bennett was eager to hear what the Special Olympics Young Athletes programs have to offer during an information session in Corner Brook Friday...The programs apply sport specific-activities with the goal of improving basic motor skills to help children develop social and physical skills through sport.  Eventually, many children will be able to use these skills and move on to other Special Olympics programs...This would be good news for Bennett’s son Dylan, who already participates in a local gymnastics program for autistic children.            

            “He looks forward to going to that every week and this could be an extra thing for him,” Bennett told The Western Star after the session. “I like that they say they have ways of modifying the program so that anybody can do it.”                                          

            Like many autistic children, Dylan has a hard time following structure and listening to instruction. Bennett said these sports programs could go a long way toward making her son feel more comfortable socializing.                                                           

            “The more things I put him in, the more he’s going to get out of it,” she said. “He may never have 100 friends but if he can have one or two good ones, if he’s out functioning in society, that’s what I’m looking for.”" (http://www.thewesternstar.com/News/Local/2014-05-24/article-3736075/Young-Athletes-programs-bridging-the-gap-towards-Special-Olympics/1)

Diagnosis

Autism is not a genetic specific disorder as it has commonly thought to have been. Within the last few years a number of studies have been done to determine the nature of autism. It has been discovered autism arrives due to both nature and nurture, a study now recognized as epigenetics. "Epigenetics has revolutionized the way scientists look at human biology and chronic disease." (Melillo, 2013) Francis S. Collins, MD, and director of the National Institutes of Health and the architect of the Human Genome Project states, “Genes alone do not tell the whole story...recent increases in chronic diseases like diabetes, childhood asthma, obesity, or autism cannot be due to major shifts in the human gene pool as those changes take much more time to occur. They must be due to changes in the environment, including diet and physical activity, which may produce disease in genetically predisposed persons." (Melillo, 2013)

Epigenetics are believed to account for the majority of autism cases however, genetics do play a role in a number of cases and about 10% of cases are results of what is named sporadic autism. Sporadic autism is caused by genetic mutations and have no link to the genetics of the parents of origin. (http://www.autismspeaks.org/what-autism/diagnosis)

Autism is becoming more and more prevalent in our society nowadays. This disorder is approximately five times more common among boys than girls, having a ratio of 1 in 42 boys versus 1 in 189 girls. ( http://www.healthychildren.org/English/health-issues/conditions/developmental-disabilities/Pages/Autism-Spectrum-Disorders.aspx)

            Currently, there is no medical test to determine whether an individual has autism. Medical professionals, including specially trained physicians and psychologists, will administer tests to evaluate autism-specific behaviours. These tests will determine whether the individual has autism or not.

            Once a child with autism is born, certain physical characteristics and health concerns will become prevalent.

Outward Physical Characteristics and Health Concerns

Some of the most common physical features of autism are:

• Sandal gap space between  toes (59%)
• Facial asymmetry (46%)
• Abnormal non-frontal hair whorl (39%)
• High narrow palate (37%)
• Attached ear lobes (35%)
• Hyper mobile joints (33%)

Other physical characteristics which are fairly common are :

• Brachycephalye (a relatively short, broad skull)
• Mouth asymmetry
• Eyes asymmetry
• Ear lobe crease
• Macrostomia (large mouth)
• Limited facial expression
• Open mouth appearance
• Prominent lower jaw

(http://www.kevinmd.com/blog/2010/07/physical-features-autism-spectrum-disorder-asd.html)

            Health concerns vary greatly within individuals with Autism, very few health risks have been specifically linked to having Autism. Maintaining physical activity is highly important for individuals with Autism despite any physical characteristics, such as hyper mobile joints, which could increase physical challenges. Physical exercise is also positive for mental well being of individuals.  

 Affects on Mental Abilities

  Autism is a developmental disorder which changes many things about individuals social, mental, and behavioural patterns. The Healthy Children Organization which stems from the American Academy of Pediatrics gives a detailed list of common signs to identify Autism.

Social differences

• Does not keep eye contact or makes very little eye contact
• Does not respond to a parent's smile or other facial expressions
• Does not look at objects or events a parent is looking at or pointing to
• Does not point to objects or events to get a parent to look at them
• Does not bring objects of personal interest to show to a parent
• Does not often have appropriate facial expressions
• Unable to perceive what others might be thinking or feeling by looking at their facial expressions
• Does not show concern (empathy) for others
• Unable to make friends or uninterested in making friends

Communication differences

• Does not point at things to indicate needs or share things with others
• Does not say single words by 16 months
• Repeats exactly what others say without understanding the meaning (often called parroting or echoing)
• Does not respond to name being called but does respond to other sounds (like a car horn or a cat's meow)
• May mix up pronouns (refers to self as "you" and others as "I")
•  Often doesn't seem to want to communicate
• Does not start or can not continue a conversation
• Does not use toys or other objects to represent people or real life in pretend play
• May have a good rote memory, especially for numbers, letters, songs, TV jingles, or a specific topic
• May lose language or other social milestones, usually between the ages of 15 and 24 months (often called regression)

Behavioral differences (repetitive and obsessive behaviors)

• Rocks, spins, sways, twirls fingers, walks on toes for a long time, or flaps hands (stereotypic behaviour)
• Likes routines, order, and rituals; has difficulty with change
• Obsessed with a few or unusual activities, doing them repeatedly during the day
• Plays with parts of toys instead of the whole toy (for example, spinning the wheels of a toy truck)
• Does not seem to feel pain
• May be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touch
• Unusual use of vision or gaze—looks at objects from unusual angles (http://www.healthychildren.org/English/health-issues/conditions/developmental-disabilities/Pages/Autism-Spectrum-Disorders.aspx)

These signs are things to look for in children with Autism and they are different for every case depending on the mental capacity of the individual and how they are impacted by their autism. (http://www.healthychildren.org/English/health-issues/conditions/developmental-disabilities/Pages/Autism-Spectrum-Disorders.aspx) Maintaining physical exercise as a part of daily routine is very important for individuals with Autism. Autistic individuals focus on patterns and routines. Incorporating physical activity as a part of the routine has positive impacts mentally as they learn better control of their body, how to participate and work as a part of a time (where they would otherwise not feel inclined). 

Often, children with low functioning Autism have difficulty learning behavioral patterns.
(http://childwithautism.wordpress.com/)

Coaching and Training Methods

The Special Olympic Coach Oath

            “In the name of all coaches and in the spirit of sportsmanship, I promise that we will act professionally, respect others, and ensure a positive experience for all.  I promise to provide quality sports and training opportunities in a safe environment for all athletes.”( http://sonc.net/oaths-codes/)

            Autism is a spectrum disorder. It affects people in a variety of ways and therefore coaching methods vary greatly on the needs of the individual. The coach needs to get to know the individual athlete in order to know their strengths, weaknesses, areas of improvement, mental capacity and to recognize their potential.

            A number of questions that the coach should ask themselves are:

• What are the athlete’s strengths and weaknesses?
• What have they already accomplished?
• How do they best seem to learn?
• Do they have ADHD (Attention….) or difficulty with focusing?
• How do any environmental issues affect their learning or coaching?
• Are there any triggers to certain behaviours or any problems that may hinder progression or development?

• How should coaching be approached?
• What should be included in lessons to keep the athlete(s) engaged?
• How can a connection between coach and athlete be accomplished?
• How will the athlete stay engaged?
• How does the athlete communicate?
• How does the athlete react to frustration, challenges, or difficulties?
• How is the athlete best motivated?

(https://www.sportscoachuk.org/blog/coaching-people-autism)

Once the coach has determined answers to these questions they are better able to find an approach to coaching.

The first two questions develop an understanding of the individual, often people like to do what they are good at. Knowing the strengths of the individual gives a starting point, a place where the athlete is comfortable and can show what they know. This is also useful for positive reinforcement. When trying to work on weaknesses, frustration often arises and during this time coaches can bring back activities the athlete knows how to do in order to keep their spirits up and remind them they can learn, they are good at what they are trying to do. Knowing what the weaknesses of the individual are is also important as it provides a point to work on, a place where there is room and need for improvement. (https://www.sportscoachuk.org/blog/coaching-people-autism; Melillo, 2013)

Everyone learns in a different way, this is the same for individuals with autism. Coaches need to learn how their athletes’ best pick up information. As ADHD is very common in individuals with autism, kinetic learning often is a necessity. (Santomauro, 2011) Being able to see what is happening and actually do it is very important. Having reinforcement of ideas by other visual aids (videos) and spoken words are also useful processes. Speaking directions alone are not enough. Autism can cause problems with hearing or the athlete could simply be distracted and not listen well. Keep them engaged.

Environmental issues and triggers need to be considered when coaching as these are huge barriers in learning. For example, the area which you train in affects the individual. Often individuals with autism would rather work alone, or not have people looking at them. Especially when first beginning to try a new sport or exercise the individual may want to be in a less busy area, being trained with 100 other people would not be ideal. Triggers are anything which create a distinct reaction in the individual, for example, loud noises, lack of organization, or hunger. Some triggers are easier to control than others. Music can help with other noise distraction as well as finding a more secluded area to train in. Making sure the individual is well prepared and ready to exercise also helps. This includes checking for proper attire (clothing, footwear, hair tied back if necessary) and ensuring they have had proper sleep, sufficient food and water and are in a good mental state. (https://www.sportscoachuk.org/blog/coaching-people-autism; http://www.helpguide.org/harvard/autism_revolution.htm)

Coaches need to determine an approach to teaching new skills. They also must find a way to incorporate different aspects of interest to maintain the individuals engagement. People with autism focus a great deal on patterns and repetition, therefore these are great things to incorporate into exercises. Relays are an awesome way to do this. Also giving specific instructions are more effective.

A connection needs to be established between coach and athlete to be able to work together as a team. This is primarily a responsibility of the coach, the coach needs to put out the effort to show they want to help the individual, to work together. Individuals with autism do not often feel inclined to reach out to make friends. Once they establish relationships they often are very happy with them, but do not feel inclined to be the one to initiate them. To create a relationship they also need to understand how their athlete communicates. Sometimes autism limits verbal capability and therefore other methods of communication are used to supplement spoken word or replace it entirely. Cue actions can be created to help with communication, or sigh language can be used in some cases.

Lastly, the coach needs to know how to best help the athlete stay motivated, and learn how they respond to challenges, frustration and distractions. When competing, athletes need to be able to focus in on the task ahead of them. To be able to perform at their highest level, they need to accomplish the 7 parts of the wheel of excellence by Terry Orlick. (http://www.zoneofexcellence.ca/free/wheel.html) These seven parts are:

Wheel of Excellence. (http://www.zoneofexcellence.ca/free/wheel.html)

1. Distraction Control

This is highly important in those with mental disorders as they are more easily distracted and the distractions can completely pull them away from where their focus should be. Distractions can also be triggers which could lead to disruptive behaviour.

2. Constructive Evaluation

Coaches need to be able to help their athletes improve form and energy behind movements. Once an individual with autism has learned a certain activity, they try to perform at the same peak level every time as they are set on the pattern of activities. This enables them to be highly effective in sports.

3. Positive Images

This next point enables the mind to focus in on an aspect which can give the individual joy, excitement and motivation. The positive images in their mind allow them to focus on the task at hand, remove doubts and worries from the mind and help block out distractions.

4. Mental Readiness

This aspect combines previous steps to perform at a high level. Being mentally prepared for an activity means the individual knows what to expect and how to handle pressure. Coaches need to help their athletes feel comfortable in front of others when performing, this for some is incredibly uncomfortable but if they want to compete they need to develop the skill. Preparing them mentally to perform means they need to do the exercise before hand. Practicing in front of others before hand, or training in a similar (or the same) facility they will compete in is incredibly helpful as they focus so much on patterns, routines and repetition.

5. Full Focus

All these aspects lead up to full focus which is necessary in competitions to perform at the peak level. “You cannot run at full throttle when applying your mindset to all of the different things running through your head. Focusing is the key to manifesting your desires.” (http://www.goodreads.com/quotes/tag/focusing)

6. Belief

All of these mental processes are fuelled by a belief in oneself. The athlete needs to believe in themselves and have someone believing in them pushing them forward. Without a belief they can do it they won't be able to. This belief ties into the Special Olympics oath which says, "Let me win. But if I cannot win, let me be brave in the attempt." (http://www.specialolympics.ca/be-involved/athletes/) The athletes have to strive to do their best and believe in themselves, having courage to do their best.

            7. Commitment                                                                                               "Commitment is the enemy of resistance, for it is the serious promise to press on, to get up, no matter how many times you are knocked down." (http://www.leadershipnow.com/commitmentquotes.html) This quote by David McNally perfectly embodies why Special Olympic athletes need to be committed to their event. There is a stigma still in our society that these individuals are incapable of the same things other people do. However they can do so much, their potential is huge. There is resistance against them, therefore they need to be fully committed in order to achieve all that they can. Coaches need to instil this by channelling the athletes passions and why they want to compete into their motivation and help their athletes be successful.

            Through this, coaches help increase the desire to succeed and maximize benefits gained from physical training for their athletes with Autism.

Abilities in Designated Sports

            The sports recommended for individuals with Autism depend on the individual themselves. Autism is a spectrum disorder and therefore has many degrees to it. As Autism is a spectrum disorder it means that people have it to varying degrees. High functioning autistic individuals would not qualify for the Special Olympics as their mental capacity is high, resulting in a high IQ. Those with low functioning autism can qualify for the Special Olympics and are generally successful in it. The main sports they compete in are more individually based as team sports rely so heavily on communication and working together with team mates. Many people with autism find this uncomfortable or not enticing as they feel inclined to be less social and are more introverted by nature. (http://www.autismfamilyonline.com/public/613.cfm)

            Sports such as skiing, running, swimming, martial arts, bowling and skating are preferred by these individuals with lower functioning autism. They can excel in these sports.

        

Gymnastics provides huge mental improvements with focus and a sense of space and body understanding.
(http://www.mumsnchums.com/blog/benefits-of-gymnastics-for-autism-spectrum-disorder-asd)

Video of Autistic Gymnast Performance in Special Olympics

(https://www.youtube.com/watch?v=u6-w7hmUDvQ)

              Not all autistic individuals keep to themselves, some do enjoy the company of others and like to be part of a functioning unit. For these individuals sports can be good for them and they enjoy their time playing. These people can enjoy team sports such as hockey, basketball, soccer and curling. (http://autismdigest.com/sports-and-autism-thinking-outside-the-bounds/) Non-contact is still necessary though as physical contact is not comfortable for most autistic individuals and it can cause them to be very uncomfortable or afraid. Team sports can help create friendships which are otherwise very hard to make. (Santomauro, 2011) One individual with autism wrote a poem on friends which reads:

"I want to be a good friend to you,

This is a good idea.

Will you be my friend too?

Will you, will you, will you?

I know I can be stubborn,

At times you can be too.

I want to have a friend like you,

Do you, do you, do you?

I will be loyal, trustworthy and true.

I will be single minded,

I will be there for you.

Will you be there too, too, too?

You be my friend, I'll be your friend.

We will learn it's true.

Let's take our time to discover...

Thank you, thank you, thank you." (Santomauro, 2011)

            This poem demonstrates the desire some have to gain good friends and to be a good friend. Sports gives the opportunity to make friends and plays a huge role in team sports for the Special Olympics. This desire can help the team perform better in competition as they work together and therefore can enhance their ability to perform in team sports.

            Therefore, with autism, the best sports really depends on the individual.

            Through finding a sport that is best for the individual, that person gains physical health benefits, mental benefits, such as greater focus or the ability to participate as a team member, and social benefits as they develop a relationship with their coach and potentially others competing on the same team or in the same event.

Chapter 2: Down Syndrome

Chapter 2: Down Syndrome

Our Special Olympic Superstar Athlete with Down Syndrome is Joseph

            19 year old Joseph has been actively involved in sports from a very young age. He finds the benefits of sports to be a huge influence in his life. He states "Swimming is good. I'm good at it. I like diving in and relays. I swim about 5 times a week and my best mate is my coach John. I like winning medals at galas. I swam in Rome in 2006 at the Special Olympics European Youth Games and won 1 gold and 2 silvers. I've swam in Scotland, Wales, and different places in England and I'm in the DSISO (Down Syndrome International Swimming Organization) GB Squad. In 2008 I won 2 medals in Pila, Italy at the Special Olympics GB Winter Games doing skiing. I go to Magpie Dance and learn technique and dance and I'm doing an Arts Award at Corali Dance. I play snooker (a game similar to pool) and I love football (soccer). Chelsea is the best! ...I play football at Friday Friends. I go on trips with my school and with my youth club. I went to athletics but now I do dance instead...My girlfriend is Hannah. She's a lovely girl. We do sports and dance together." (Royston, 2010)

Diagnosis

            Down syndrome is a genetic disorder that occurs due to excess of chromosome 21. It can occur in three different ways. The first way which accounts for 95% cases of down syndrome is that every cell throughout the body has an extra copy of chromosome 21, this is called Trisomy 21 Down Syndrome. The next type of down syndrome is called Translocation which accounts for 3% of cases. In this instance, extra material attaches and/or replaces a portion of chromosome 21. The last way Down Syndrome presents itself is through Mosaicism, in which there is an extra copy of chromosome 21 in certain cells in the body, but not all cells. This accounts for 2% of Down Syndrome cases. (Bowman-Kruhm, 2000)  This disorder is a developmental disability which impacts intellectual capacity as well as physical capabilities. Down Syndrome affects muscle strength, muscle tone, joints, and overall physical appearance and increases health risks including diabetes, epilepsy, hypothyroidism and eye, ear and heart problems.  

            The incidence rate for Down Syndrome worldwide is approximately 1 in 800. Over the past few decades huge progress has been made in the knowledge of developmental disorders, Down Syndrome in particular. (Down Syndrome Foundation, n.d.; http://www.alzheimertoronto.org/ad_riskFactors_DownSyndrome.htm)

            This developmental disability can be tested for through a blood test, while a mother is pregnant between weeks 10 and 18. Ultrasounds during later stages of the pregnancy can also give indications as to whether their baby has Down Syndrome. Health care providers will measure the thickness at the back of the baby's neck through the ultrasound. All babies have some fluid at the back of their neck, but in individuals with Down syndrome there is a greater amount of fluid, causing the space to look thicker.  Some other indicators are problems with the heart, kidneys, or digestive system, which are more common in Down Syndrome children. Mothers over age 35 have an increased risk of giving birth to babies with Down Syndrome. (Bowman-Kruhm, 2000; http://www.nlm.nih.gov/medlineplus/ency/article/007561.htm; http://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html )  

Retrieving amniotic fluid for testing
(http://asal-sakti.blogspot.ca/2008/12/down-syndrome-testing.html)

          Another way to test for Down Syndrome before the child is born is by collecting a sample of amniotic fluid, placenta or umbilical cord from the mother as these all have the same genes the child will have rather than the genes of the mother alone. If extra chromosome 21 is present, the baby has down syndrome. (Bowman-Kruhm, 2000; http://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html )

            Once a baby is born, a doctor or nurse can easily tell if they have Down Syndrome by their limp body, distinctive eye shape, or single crease of the palm. When these signs are noticed a blood sample is taken to make a definite diagnosis. (Bowman-Kruhm, 2000; http://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html; Royston, 2010 ) 

            Once the baby is born, certain physical characteristics and health concerns will become prevalent in the child.

Outward Physical Characteristics and Health Concerns

            Physical appearances of individuals with Down Syndrome do vary, but they are often similar due to hypotonia, poor muscle tone. Some common outward physical features are wide spaced slanted eyes, flat nose, shorter arms, shorter legs, short neck, loose joints, eyes slanting upwards. small low set ears, broad feet, broad hands, short phalanges (fingers and toes), single palm crease, and a large tongue in proportion to mouth size. Due to the poor muscle tone and loose joints, individuals with Down Syndrome have a huge range of flexibility but can be more prone to injury for this reason, therefore they need to work hard to develop muscle strength and protect their joints. (Royston, 2010; http://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html; http://www.mayoclinic.org/diseases-conditions/down-syndrome/basics/symptoms/con-20020948; http://www.webmd.com/children/understanding-down-syndrome-symptoms )

            A range of health concerns arise as they have been found to correlate with down syndrome over the years.  50% have heart problems, most commonly a hole in the heart also known as Atrioventricular Septal Defect. This is caused by tissue failing to come together in the heart during the embryonic state of life. When the tissue fails to connect, a large hole is created between 2 chambers of the heart. The heart can in some instances begin to heal itself, but will most likely require surgery to ensure the baby will be able to live with a higher quality of life. (http://www.ndss.org/Resources/Health-Care/Associated-Conditions/The-Heart--Down-Syndrome/; Royston, 2010)  Over 75% of individuals have vision problems and over 50 % have hearing problems. The risk for diabetes also increases as well as the risk for epilepsy, hypothyroidism, and digestive problems. (Royston, 2010)

            One common health issue apparent in up to 30% of Down Syndrome cases is atlanto-axial instability. (Bowman-Kruhm, 2000; http://ndsccenter.org/worpsite/wp-content/uploads/2012/02/AtlantoAxial_Instability.pdf; http://emedicine.medscape.com/article/1180354-overview) Individuals with this instability have abnormally large spaces between the upper vertebrae of the spine. For this reason in particular, many who fear down syndrome children playing sports and becoming very physically active. However, these individuals can be as active as they would like and this instability should not limit them. As long as they wear proper equipment for sports, and are aware of their capabilities they can keep their bodies protected. In some cases, activities bearing a lot of weight on the shoulders should be avoided as well as any huge spinal rotations or impact to the spinal cord that could be caused by jumping. (Tocci, 2000)

Upper portion of cervical spinal section
(http://medcarepediatrics.blogspot.ca/2013/04/atlanto-axial-instability-and-children.html)

These are the Special Olympics complete standards on atlanto-axial instability:

Participation by Individuals with Down Syndrome Who Have Atlanto-axial Instability.

(article 1, Section F, Special Olympics Sports Rules)

            “In light of medical research indicating that up to 15% of individuals with Down syndrome have a mal-alignment of the cervical vertebrae C-1 and C-2 in the neck known as Atlanto-axial instability, exposing them to possible injury if they participate in activities that hyperextend or radically flex the neck or upper spine, all Accredited Programs must take the following precautions before permitting athletes with Down syndrome to participate in certain physical activities:

            1) Athletes with Down syndrome may participate in most Special Olympics sports training and competition, but shall not be permitted to participate in any activities which, by their nature, result in hyper-extension, radical flexion or direct pressure on the neck or upper spine, unless the requirements of subsections (2) and (3) below are satisfied.

Such sports training and competition activities include: butterfly stroke and diving starts in swimming, diving, pentathlon, high jump, squat lifts, equestrian sports, artistic gymnastics, football (soccer), alpine skiing and any warm-up exercise placing undue stress on the head and neck.

            2) An athlete with Down syndrome may be permitted to participate in the activities described in subsection (1) above if that athlete is examined (including x-ray views of full extension and flexion of neck) by a physician who has been briefed on the nature of the Atlanto-axial instability condition, and who determines, based on the results

of that examination, that the athlete does not have an Atlanto-axial instability condition.

3) An athlete with Down syndrome may be permitted to participate in the activities described in subsection (2) above if that athlete is examined (including x-ray views of full extension and flexion of the neck) by a physician who has been briefed on the nature of the Atlanto-axial instability condition, and who determines, based on the results of that examination, that the athlete does not have an Atlanto-axial instability condition; or

4)An athlete with Down syndrome who has been diagnosed by a physician as having an Atlanto-axial instability condition may nevertheless be permitted to participate in the activities described in subsection (1) above if the athlete, or the parent or guardian of a minor athlete, confirms in writing his or her decision to proceed with these activities notwithstanding the risks created by the Atlanto-axial instability, and two (2) Licensed Medical Professionals certify in writing that they have explained these risks to the athlete and his/her parent or guardian, and that the athlete's condition does not, in their judgment, preclude the athlete from participating in Special Olympics.”( http://www.specialolympics.ab.ca/uploads/files/Documents/Policy/M-3001%20Atlantoaxial%20Instability.pdf)

            Maintaining physical activity despite health issues is highly important for individuals with Down Syndrome. Obesity is a growing problem amongst those who have Down Syndrome and can lead to further health risks including hypothyroidism, and type 2 diabetes. Physical exercise is also positive for mental well being of individuals. (http://www.medscape.com/viewarticle/734672_2)

Affects on Mental Abilities

            Down Syndrome also slows progress mentally and therefore individuals take a longer period of time learning how to do certain tasks such as talking, standing, crawling, supporting body weight, grasping, and walking. (Down Syndrome Society, n.d.)

 This can be attributed to a number of things. First of all, there is mental delay increasing difficulty in learning new activities. The body of down syndrome babies are usually smaller than average and due to poor muscle strength and tone, they take longer periods of time to learn how to gain control of their muscles and the actual activity itself becomes more difficult. Due to the amount of individuals with hearing deficiencies, spoken cues are harder to pick up. Despite their challenges, these children still have great potential and can reach these stages and master activities; it will most often just take longer. (Bowerman, n.d.; Down Syndrome Society, n.d.)

            The poor muscle tone and strength creates great difficulty in children with Down Syndrome learning how to put themselves in good positions biomechanically. The ability to learn new skills also takes longer due to their slowed learning. (http://dsawa.asn.au/children/recreation.html)

            By participating in physical activity, the individuals are better able to grasp concepts at an earlier stage. They can gain better control over their body. Physical exercise also keeps the mind stimulated and more alert leading to better mental thinking processes. Skills are also learned during the training stages which can have a positive impact on mental abilities.

Coaching and Training Methods

The Special Olympic Coach Oath

            “In the name of all coaches and in the spirit of sportsmanship, I promise that we will act professionally, respect others, and ensure a positive experience for all.  I promise to provide quality sports and training opportunities in a safe environment for all athletes.”( http://sonc.net/oaths-codes/)

            "Don't walk in front of me, for I may not follow. Don't walk behind me, for I may not lead. But walk beside me and be my friend." (http://danielaclapp.com/coaching/coaching) 

Be their friend.
(http://www.couriermail.com.au/questnews/south/swimmer-michael-cox-will-not-let-down-syndrome-stand-in-his-way-as-he-seeks-more-success-in-the-pool/story-fn8odwua-1226444188224)

           This is the mentality that is needed when approaching coaching individuals with Down Syndrome. The way of teaching and coaching people with Down Syndrome is easiest when using these 5 principles. (Tocci, 2000)

            1. Divide Big Learning Tasks into Smaller Steps

            The first is dividing learning tasks into small steps with cue words and plentiful repetition. By doing this the individual can grasp the small concepts that lead up to the larger ones. The repetition increases muscle memory, it associates certain things into a group or series of events. For example, when learning to kick a ball, first the movement of the leg would be learned and repeated many times until the motion is well understood and mastered. The next thing to do would be to try kicking the ball on its own. Learning how to kick the ball and what position your foot should be in to kick it so the ball is hit is important. Some individuals with down syndrome have bad space and depth perception which could lead to them missing the ball altogether. Once the skill of kicking the ball is mastered, it can be combined with the kicking skill before including a proper pre stretch. (Tocci, 2000)

            2. Repeat Learning Tasks

            This leads right into the next coaching method of repeating instructions, repeating demonstrations, and having the individual repeat the activity. In the soccer example, the series of activities will need to be repeated on that day for a set amount of time and repeated in days after to fully commit the exercise to memory. (Tocci, 2000)

            3. Patience and Persistence are Required

            Next, and also very important is using patience and persistence while teaching sport principles. Due to the delayed mental ability, down syndrome individuals have a shorter attention span. Therefore tasks need to be broken down into simple steps that can be accomplished and allow the individual to see improvement so they are more inclined to continue working and progressing in their skill learning. Coaches need to be engaging while continuously encouraging the individual to work hard. Patience is needed particularly when learning a new skill which can be incredibly difficult and when they are first unable to achieve their goal, frustration occurs. This frustration can take over if not dealt with in a positive manner. This is why patience and persistence are so necessary in coaching. (Tocci, 2000)

            4. Expectations Must be Well Defined

            Well defined expectations are needed so the student knows what is expected and the coach has a specific goal to accomplish. This allows the individual to really focus in on the task at hand. Having set expectations enables them to know what to do, and the feedback given by coaches should be to improve the given task and accomplish the goal. (Tocci, 2000) For example, shooting a hockey puck into the hockey net on the opposite side of the rink. This defines a specific goal and can provide room for improvement (e.g. shoot the puck in the middle without touching the edge of the net).

            5. Consistency and a Positive Approach are Critical

            Individuals with Down Syndrome have been found to like consistency, patterns and routines. This actually allows them to be very successful in sports as they have well established rules which are to be followed. Once the individuals have been well taught the principles of the sport they are able to perform well within their sport. Coaches need to help set these rules and regulations out for their athletes.

            A set practice routine is also very helpful and practicing in game situations. The practice routine allows the down syndrome individuals to know what is coming next. Positive approach to teaching is needed as those with down syndrome in a way respond much as children do. When they are taught pleasantly with patience and understanding, they respond by having patience with themselves as they try to learn. Coaches also need to be able to give positive feedback, helpful specific comments to help improve and time to recuperate before trying activities again. (Tocci, 2000)

Abilities in Designated Sports

            Down Syndrome individuals should be physically active and participate in sports and activities appropriate for their physical well being.

            One major limitation that occurs in individuals with down syndrome is atlanto-axial instability. Before being able to compete in the special Olympics, athletes must have an X-ray taken to determine if they have this condition. This instability is found within the joint connecting the atlas, the first spinal vertebrae, and the axis, the second vertebrae both of which are in the upper cervical section of the spine.

The rules regarding special Olympic athletes are as follows, they are eligible to compete in the special Olympics but may be limited as to which activities they can compete in to help keep them safe. The full set of rules can be found above in the "Outward Phyiscal Characteristics and Health Concerns" section.

            Individuals with down syndrome have most often been found competing in the water. The biggest sport industry for them is in swimming. ( www.dsiso.org/) They excel in swimming, and it is incredibly beneficial to them. Swimming involves a complete body workout and improves cardiovascular conditioning, strengthening/toning of muscles (incredibly important due to muscle weakness), endurance, posture and flexibility. With swimming comes a low risk of injury. It is also therapeutic for individuals with down syndrome as there is no stress on your bones, joints or connective tissues due to the buoyancy of the water. Being in water also has been found to be therapeutic as the water can help reduce stress and allow for physical exercise without having sweat occur and become a distraction. Water exercise has been found to have benefits on blood circulation and blood pressure which can be issues for individuals with down syndrome as their hearts are commonly affected. (http://downsyndrome-singapore.org/content/view/42/108/)

           

The love of swimming and its benefits are seen through so many individuals with Down Syndrome.
(http://www.elpasotimes.com/ci_21876489/down-syndrome-doesnt-slow-swimmer-training-tourney)­ 

           Swimming is a huge part of the Special Olympics and one type of event in which Down Syndrome individuals commonly compete in.

            Therefore, positive mental and physical effects can be seen through participation of individuals in the water. Their participation is incredibly beneficial and they can succeed in swimming events and feel a sense of accomplishment.