Welcome to the Adapted Page
of PELINKS4U!
First of all, we would like to remind our readers to visit the
APENS website
to apply to take the APENS test this coming JUNE 4th, 2005, to become
a nationally Certified Adapted Physical Educator, or CAPE. The deadline
is approaching quickly (April 30th!).
Secondly, in keeping with the theme for this month, "Drugs
and Alcohol," we have TWO mini-articles. One summarizes the
serious consequences (death and disability) from drinking and driving,
and thus the need for prevention programs targeted at our public
school aged students. The other article, somewhat fitting this theme,
is on Acute Lymphocytic Leukemia (as chemotherapeutic drugs play
a major role in its treatment, but of course, our main message will
be the need for, and the benefit of, adapted games and activities
and how to effectively carry out these adaptations).
Finally, we end with an article summarizing a very effective stretching
technique, one that is applicable to the young and old, elite athletes,
people with disabilities...virtually everyone. Since physical activity
is one of our most effective "anti-drugs," we included
this feature as this stretching technique is helpful for everyone.
ENJOY!
Chris Stopka
Adapted Section Editor |
| High School and College
Age Drinking and Driving: A Significant Cause of Death & Disability
- By Travis Broome & Christine Stopka
Motor vehicle injuries and deaths affect thousands of Americans
every year. Unfortunately over 40% of the deaths are caused by alcohol-related
crashes. In a survey conducted by Caetano & McGrath (2000) it
was found that over 20% of male drivers have driven while intoxicated
in the past year, and over 11% of female drivers have driven while
under the influence of alcohol.
According to Usdan, Schumacher, McNamara and Bellis (2002), drinking
and driving causes over 300,000 injuries and 16,000 deaths each
year. This issue is disproportionately present in the 15-20 year
old age range, thus significantly impacting the college
community with statistics as high as 25%-35% of students reporting
having driven under the influence of alcohol (Usdan et al., 2002;
Wright, Norton, Dake, Pinkston, & Slovis, 1998). Given that
injuries can be prevented, the issue of drinking and driving has
become particularly pertinent to public health (Borges, Cherpitel,
Mondragon, Poznyak, Peden, & Gutierrez, 2004).
Binge drinking, defined as the consumption of five or more drinks
on a single occasion in a two-week period, is a major public health
issue related to college campuses (Wright, et al., 1998). Recent
studies indicate that 44% of college students are binge drinkers
and 19% are frequent binge drinkers (Wright, et al., 1998).
What defines someone as being drunk or unable to operate a motor
vehicle differs by state. Some states view having a blood alcohol
content of over 0.10 as being impaired, while other states, such
as Florida, set the legal limit at 0.08 (National Highway Transportation
Safety Administration, 2001). The state must prove that a person
had blood alcohol content over the legal limit at the time of vehicle
operation to charge them with driving under the influence, or driving
while intoxicated.
The consumption of alcohol has a significant negative impact on
the outcomes of motor-vehicle accidents. Although 4% of alcohol-related
crashes in 2002 resulted in death and 42% resulted in injury, only
0.6% of crashes that did not involve alcohol resulted in death and
31% in injury (Hingson & Winter, 2003).
In varying studies drunk driving has been linked to college-aged
students ranging in ages from 18-24. Steptoe,Wardle, Bages, Sallis,
Sanabria-Ferrand, & Sanchez (2004) conducted a study on drinking
and driving primarily because drunk driving has been linked to many
traffic accidents, and an increase in automobile mortality rates.
In one case, 43% of male students surveyed drove while intoxicated
and 28% of females drove while under the influence of alcohol. This
is definitely a problem because it showed that over ¼ of
college students who drank in the last thirty days, drove home afterwards.
Once again statistics focus on college-aged students, where much
of the drinking and driving behavior begins. Hingson, Heeren, Zakocs,
Winter, & Wechsler (2003) were intrigued by how many drinking
and driving trips were made each year, and the lack of arrests made.
They found that there were thousands of fatal accidents that involved
college aged students every year. Statistics show that 65% of students
who have consumed more than five or more drinks drove afterwards,
48% of students who consumed more than five drinks rode with someone
who was either drunk or high, and 10% of those who consumed more
than five drinks were seriously injured in an automobile accident
(Hingson et al., 2003).
College-aged students are always a target for drunk driving, mainly
because college students have always been linked with drinking and
risky behavior. There have been 3,674 deaths due to alcohol related
motor vehicle crashes associated with people between the ages of
18-24, 31% of those were in college (Hingson, Heeren, Zakocs, Kopstein,
& Wechsler, 2002). The number of deaths for students between
the ages of 18-24 reached 1,138 out of a survey of over 20, 000
college students (Hingson et al., 2002). The disturbing thing about
college-aged students and drinking is that many of them are under
the legal drinking age.
In another study, concerns about drinking and driving arose because
the researchers felt that college aged students were more at risk
for risky behaviors. In a survey of undergraduate students over
27% of females drove while intoxicated during the past 30 days and
over 41% of males drove while under the influence (Joly, McDermott,
& Westhoff, 2000). This means that from the survey over 25%,
or ¼, of the participants drove home while intoxicated during
the past 30 days (Joly et al., 2000).
In another study by Everett, Lowry, Cohen, & Dellinger (1999),
it was found that over 27% of college students drove after drinking
alcohol (Joly et al., 1999). Everett's study was focused on college
students because college is a time where many people are legally
allowed to drink.
Drinking and driving has become a problem that has affected and
changed the lives of many. Unfortunately most changes have been
because of great loss. Drinking and driving must be looked upon
as a serious problem, one that needs to be researched and improved.
Indeed, getting the attention of our public school aged students,
before they reach the driving age, is worth the time and energy.
Programs resulting in significant reductions of this risky, addictive
behavior are sorely needed to prevent the extraordinary frequency
of death and disability due to his practice.
References
|
| Free
Posters & Give-Aways - Educational material,
posters, guidelines for women who drink during their childbearing
years. Drinking? Who pays the price?
Teaching
Students with Fetal Alcohol Syndrome/Effects - A
Resource Guide for Teachers. This site will help the educator
better understand FAS and FAE, and help prepare to teach children
who have this disorder.
The number of children born each year with this preventable disorder
number far higher than any other disabilities combined. Teachers
need preparation, as many of these children go undiagnosed. This
site includes checklists and other resources.
|
| The
Schoolhouse - Educators Consortium
This is a site really worth reading through. The information
provided informs on the difficulties a child with Fetal Alcohol
Syndrome goes through, how secondary disabilities can develop,
and what will and won't work when working with children with
this disorder. Good adaptive strategies.
Fetal
Alcohol Syndrome & Fetal Alcohol Effects: These
Guidelines of Care for Children with Special Health Care
Needs are written for families and health care professionals.
They can also be used by anyone who cares for a child with Fetal
Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE). This
includes teachers, other school personnel, friends and relatives.
Readers may find different sections of the booklet (114 pages)
useful at different times during the child's development. -
source: site
Fantastic
Antone Succeeds!: Experiences in Educating Children With
Fetal Alcohol Syndrome. A book from amazon.com. Listed here
because it has 5 star reviews.
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Are you a teacher, or physical educator, who teaches physical
education/activities to children with autism? Please share
your experience in the
forum. |
|
Acute
Lymphocytic Leukemia
An overview of the medical condition, with special emphasis
on adaptation ideas to maximize the potential for physical activity
and PLAY!
- By, Jenny Kress Undergraduate Student,
University of Florida, and Boggy Creek Camp Volunteer
She was a beautiful nine-year-old girl with a pure heart, maturity
beyond her years, and leukemia. Due to her illness and side effects
due to treatments and medications “my buddy” was extremely
fatigued, itchy, and used a wheelchair to help her get around.
As a volunteer at Boggy Creek Camp, I have worked with children
who have shown incredible strength and unwavering perseverance in
the face of terminal illnesses. I have come to realize that these
special children often grow up fast dealing with their diseases,
but they are still just children. They deserve to have the chance
to participate in everyday activities, such as sports. I now believe
in using adaptations rather than setting limitations.
I would like to share with you various adaptations that can be
used to allow these special children to feel as if they can do anything.
I will start with a description of the human blood, acute lymphocytic
leukemia (ALL), and side effects of leukemia treatments. I will
finish with a generalized description of adaptations possible to
assist these children, and guidelines to manipulate adaptations
to fit your child’s needs.
BLOOD
Blood is a fluid connective tissue that is pumped by the heart muscle
through the vessels of the cardiovascular system. The primary functions
of blood include transport of oxygen and nutrients, acid-base regulation
through the bicarbonate buffer system to prevent acidosis (low pH)
or alkalosis (high pH), thermoregulation, immunity, and hemostasis
or clotting (Graaff and Rhees, 1997). Blood is composed of a liquid
matrix of blood plasma, as well as red blood cells, white blood
cells, and platelets.
Important chemicals are dissolved in the blood including proteins
(e.g., globulins), hormones (e.g., thyroid hormone), minerals (e.g.,
iron), vitamins (e.g., folic acid), and antibodies, including those
we develop from our immunizations (The Leukemia and Lymphoma Society,
2004). Red blood cells, which make up half the volume of blood,
are filled with hemoglobin. Hemoglobin is the oxygen transporter
of the body (Graaff and Rhees, 1997).
Platelets are tiny blood cells released from the marrow that aid
in the clotting of blood at a site of injury. White blood cells
act as phagocytes (or eating cells), and ingest invading bacteria
or fungi to destroy them and help cure infection (Graaff and Rhees,
1997). The main types of phagocytic cells are neutrophils and monocytes.
Blood cells are made in the bone marrow, and leave the marrow to
enter the blood when the cells are fully formed (Graaff and Rhees,
1997). Stem cells are a small group of cells that are responsible
for making all the blood cells in the marrow. In healthy individuals
stem cells produce new blood cells constantly. The presence of stem
cells in the blood is important because they can be collected by
special techniques and transplanted into a recipient who needs blood
to help make more blood cells (The Leukemia and Lymphoma Society,
2004).
ACUTE LYMPHOCYTIC LEUKEMIA
According to the Leukemia and Lymphoma Society, Leukemia kills more
children between the ages of 1 and 15 than any other disease. Acute
lymphocytic leukemia (ALL) results from a genetic injury to the
DNA of a cell in the bone marrow that is acquired, not inherited
(Palka, 1987). Due to this genetic injury, immature cells called
lymphoblasts replace the normal marrow (Palka, 1987). These lymphoblasts
fail to function as normal blood cells and they grow uncontrollably
(Sallan, 1981). This uncontrolled growth of the lymphoblasts results
in blockage of the production of normal marrow cells (Sallan, 1981).
This leads to a shortage of red cells, platelets, and normal white
cells such as neutraphils in the blood (Sallan, 1981).
SYMPTOMS OF THE DISEASE
The cause of acute lymphocytic leukemia is unknown in most cases,
and acute lymphocytic leukemia is seen most often in the first ten
years of life (Wiernik, 2004). Patients may experience a loss of
well-being & become easily fatigued (Marcoullis, 2004). If anemia
is present the patient will have a pale complexion. Bleeding will
occur easily due to a very low platelet count, and bruises may occur
for no reason due to internal bleeding (Sallan, 1980).
Petechiae bruises, or red spots under the skin, may appear and
the child may bleed extensively from minor cuts (Sallan, 1980).
Other signs and symptoms include joint discomfort, fever, enlarged
lymph nodes, headache, and vomiting (The Leukemia and Lymphoma Society,
2004).
SYMPTOMS OF THE TREATMENTS
According to facts compiled by the Leukemia and Lymphoma Society,
drug treatment has extended the life expectancy for children with
this disease, and about 80% are cured. However, the chemotherapy
treatment aimed at destroying leukemia cells to permit remission
can intensify the symptoms of leukemia (Simone, 1972). This treatment
leads to severe decreases in phagocytes, red cells, and platelets
causing severe anemia, bleeding, and infection. It may take several
weeks to see any benefit from chemotherapy and for the blood count
to return to normal (Marcoullis, 2004).
Severe infections after chemotherapy can be combated with red cell
and platelet transfusions in children (The Leukemia and Lymphoma
Society, 2004). Chemotherapy affects tissues with rapidly dividing
cells such as the lining of the mouth and intestines, the skin,
and the hair follicles. Ulcers, nausea, vomiting, skin rashes, diarrhea,
and hair loss are common side effects of chemotherapy (The Leukemia
and Lymphoma Society, 2004).
IMPORTANCE OF ADAPTED GAMES
As these children struggle with these side effects, it is important
for their emotional well being to allow them to play and have fun
like healthy children. Playing a game is much more exciting and
beneficial than idly watching a game. Movement games are more pleasurable
and much more motivating than working on skills individually.
Adaptations allow special children to feel included rather than
left out. It is inspiring to witness the "I did it" look
in a child’s eyes when they have accomplished a task they
never dreamed they could do. Participation in movement games also
has physical benefits due to the increased activity. Games serve
as a tool to improve motor coordination in a fun situation. Benefits
include improved cardio vascular endurance, body composition, muscular
strength and endurance, and flexibility (Kasser, 1995).
Participation games also foster a social sense of belonging within
the group participating. Participation also emotionally builds self-esteem
regardless of physical ability. Inclusive games teach each person
involved to accept other people despite any limitations they may
have, and to work in a group (Kasser, 1995).
GUIDELINES FOR ADAPTATIONS
Step 1: Understand your children and their limitations.
Major side effects of Leukemia, and its treatment that you may have
to address are, as previously stated, fatigue, nausea, joint discomfort,
headache, skin rashes, diarrhea, and easy bruising and bleeding.
It is important to ask your participants how they are feeling at
the moment. Identify the symptoms they are feeling so you know what
you must take into consideration when adapting your games. For example
a child who is complaining of fatigue, nausea, and diarrhea should
not be running in circles, but may be able to play a catching game
easily.
Step 2: Understand the activity you are to be
performing, and the elements to that activity that may be altered
based on the child’s needs.
Equipment: One of the simplest, and yet most effective
tricks I have learned, is to change the size and weight of the ball
or the target being used. Start playing with a huge ball that everyone
could easily hit. This will build confidence and motivate your participants
to play hard. As the skill of the group improves the target and
ball can get a bit smaller, the net can go a bit higher, etc.
We also want to preserve the challenge for everyone involved. Your
game and equipment can, and should, evolve with the skill level
of your group. In archery we put up a ton of balloons and the purpose
was to touch the balloon with the arrow, not to pop the balloon.
When the arrow came close to the balloon we would cheer. We also
used a stand for the bow so the children had the added stability
and support.
If children have trouble gripping then strap the racquet to their
hand in ping-pong, or any other sport. It is important to the children
to know that equipment can be adjusted to work for them.
Time: Vary the number of repetitions required,
or the time in which the game is played. You are in control, and
if you see your participants becoming fatigued and getting frustrated
then take a break. In this break you can do an “extra credit”
exercise challenge to keep the children’s attention. Keep
these exercises low impact and less strenuous than the original
game or else you aren’t truly giving the children a break
at all. Space:
The boundaries of a game can be adjusted. Utilize less space, or
more space, depending on the needs. If you want children to run
less, work in a smaller area. If you are having trouble keeping
a ball in bounds, increase the boundaries or put up a net to keep
the ball in. In archery, bringing a target closer to your participants
is a great adaptation. In tennis using half courts instead of whole
courts is a good idea.
Force: This is very important for children with
Leukemia, because they bruise so easily. Steer clear of contact
sports. Substitute stationary tasks for moving ones, and slow the
activity down if needed. Remember we are concerned with helping
the child and improving their health. Be smart and do your best
to keep your child safe in the activities you play.
Rules: Rules are made to be broken. You are in
charge of the game. You can change the rules to better suit your
group. SIMPLIFY the game, and eliminate rules if it will help. You
can also make different rules, for different participants, as long
as you explain your reasoning thoroughly as to avoid jealousy. If
you have participants in wheel chairs let them use a lower net than
children who are standing.
...continued top of next
column
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...continued
from previous column
Acute Lymphocytic Leukemia
Due to decreased hand/eye coordination ping-pong was impossible
for one of my participants. We eliminated the rules, and focused
on hitting the ball towards a target. This proved to be enough of
a challenge and kept her interested without frustrating her.
Step 3: You don’t have to make up new games!
You can adapt games that already exist. This is good for you (less
work) and great for the kids, because they are participating in
games that an average person would play.
CONCLUSION
The most important part of successfully adapting games for special
needs children is understanding that you are in control, and you
have the right to change the game to better suit the needs of your
participants. My advice is to be creative and think about the needs
of the children involved. Take into consideration the emotional,
physical, social, and medical needs of your individual participants.
Leukemia is a horrible disease and, despite the encouraging 80%
cure rate for children, we want to make every moment fun and worthwhile.
My "buddy" I met at camp, was one of the ones who did
not live to see her next birthday, but when she worked with me you
could see it in her eyes that she had accomplished something big.
It may take a little work and flexibility on your part, but by giving
these children a chance to be involved in adapted games you could
make their lives happier. Adaptive games foster physical improvements,
greater self-esteem and confidence, and pleasure for all involved.
Now, get out there and PLAY WITH KIDS!
References
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| The Ultra-Stretch
The next time you stretch with your students, remember to use
the "ultra-stretch" method. It safely and effectively enhances
flexibility for everyone.
- By: Coleen Martinez & Christine Stopka
There are many categories of stretching; ballistic and static
stretches are the most common. Ballistic stretching is the typical
"bounce" stretch which was common years ago, and is
being replaced by the static stretch as a means to increase flexibility.
Most of us understand that bounce stretching only causes the muscle
to contract to protect itself (Nelson & Bandy, 2005), and
it doesn’t allow for the muscle to stretch, so the technique
is rarely used in PE classes and sport programs.
What we see now as educators and coaches is the static stretch,
where a student or athlete sustains a stretch for 30 seconds without
bouncing or moving. The static stretch has been found to increase
flexibility when compared to not stretching at all (Nelson &
Bandy, 2005). But, there is another way to stretch that is active
and found to be better than all the other types of stretches mentioned
here (Nelson & Bandy, 2005).
Proprioceptive Neuromuscular Facilitation, otherwise known as
PNF stretching, has been shown to increase flexibility when used
as a comparison to static and ballistic stretching (Nelson &
Bandy, 2005). Stopka (1995) coined the term "ultra-stretch"
to describe the "hold-relax" PNF method where the inverse
myotatic stretch reflex is used to facilitate an increase in range
of motion. Since independent, partner free, options were described,
unlike the typical PNF stretching requiring a trained partner,
the name "ultra-stretch," suggested by the participants,
caught on. This method is painless (Stopka, 1995; 2001), simple,
and can be used with or without equipment, and with or without
another person!
The ultra-stretch stimulates the Golgi Tendon Organs (GTOs),
which results in a relaxation of the muscle being stretched (as
opposed to the ballistic stretch, which stimulates the muscle
spindles, resulting in a contraction of the muscle being stretched).
The difference between the two is important to understanding the
stretch.
The muscle spindles are activated when a sudden stretch occurs,
for example, almost everyone has experienced the "knee jerk
response" at the doctor’s office when the physician
taps on your knee and your leg extends. This occurs due to the
activation of the muscle spindles after a sudden stretch of the
muscle. The doctor’s tapping causes the patellar tendon
to stretch suddenly, and the quadriceps muscles respond in a protection
response that results in the quadriceps contracting. When you
bounce stretch, the same event happens, The bouncing causes a
sudden stretch and the muscles react by contracting, so there
is not an opportunity for the muscle to relax enough to stretch.
In contrast, the ultra-stretch uses the GTOs instead of the
muscle spindles. When stretching, hold the stretch at a comfortable
position, without pain. Then contract this stretched muscle, for
about 10 seconds isometrically, that is, without moving it. This
isometric contraction, in the stretched position, stimulates the
GTOs (to prevent fatigue). Since the stimulation of the GTOs results
in an inhibition of the contracting muscles, the muscles relax.
This relaxation results in an increased range of motion, or flexibility,
of these muscles. Now the muscles can stretch farther. Flexibility
is increased more rapidly and effectively than with the static
stretching, and without the pain and injury of ballistic stretching
(Nelson & Bandy, 2005; Stopka, 1995; Stopka, et al, 2002).
Quite a different result then the ballistic stretching response!
How to perform the ultra-stretch.
| Step 1: |
Assume a gentle stretch position. |
| Step 2: |
Isometrically contract the stretched muscle group
for about 10 seconds, without moving. |
| Step 3: |
Relax the stretched muscles by ceasing the contraction;
do not move yet. |
| Step 4: |
Now, see how much farther the muscles can stretch. |
| Step 5: |
Repeat the above. |
These steps can be repeated approximately three times to gain
the desired range of motion for that muscle group (Stopka, 2001).
PNF stretching has been seen as a limitation in stretching techniques
because it requires two people (Nelson & Bandy, 2005), the
"stretcher" and "stretchee." The ultra-stretch
can be done with one person. Picture the sit and reach test, also
a common hamstrings stretch. While stretching, a towel can be
used by the "stretchee" in the place of a "stretcher."
For the contraction needed in Step 2, simply place a towel around
the soles of your feet, grasp the towel as close to your feet
as is comfortable, sit up, and pull back on the towel. Then relax
(cease pulling back). Now you should be able to stretch farther
forward toward your toes. Then re-grasp the towel (closer to your
feet) and repeat.
The "ultra-stretch" is not a position; it is a technique
(i.e., the application of the hold/relax PNF technique, but without
a partner). So, all stretches using this technique can be done
without the aid of another person. Finding trained, trustworthy
"stretchers" is no longer needed. Teach your students
to gently stretch without pain, contract in that position, relax,
and stretch again…and your students can learn to use the
ultra-stretch and be completely independent of another person.
It is important to note that proper stretching before physical
activity is very essential. Stretching warms up the muscles before
use, and this in turn greatly enhances injury prevention. But,
if a muscle is statically stretched, it will not experience a
warming effect (Nelson & Bandy, 2005). The only way to experience
a warming effect while stretching is to perform an active contraction
while stretching (Nelson & Bandy, 2005). The ultra-stretch
successfully achieves an active contraction while stretching,
thus creating a warming effect for the muscles prior to beginning
physical activity and ultimately decreases the chances of injury.
Furthermore, when muscles do become sore due to over-training,
this technique is very effective in relaxing the spasms of the
tight, strained muscles; a careful ultra-stretch will immediately
relieve the pain due to a tight, sore muscle (Stopka, 1995; 2001;
2004).
The ultra-stretch is a very safe, and a simple way to increase
flexibility for your students. Individuals with cerebral palsy,
arthritis, and virtually any other condition leading to tightened
muscles, can benefit by this technique (Stopka, 1996). Rather
than deciding not to stretch because your students are bored and
tired of the more painful, time consuming, old stretching methods…use
the "ultra-stretch!" It is an active and fun stretch
that can literally be finished in 5-10 seconds, rather than the
30 seconds to two minutes required by other techniques. Your students
will love to have fun while they stretch, and they will become
more flexible "magically" before their eyes and yours!
References
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| If you have ideas, comments,
letters to share, or questions about particular topics, please email
one of the following Adapted PE Section Editors: |
|
