Barriers to and facilitators of physical activity for children with cerebral palsy in special education

Abstract

Aim To explore the barriers to and facilitators of physical activity for young people with cerebral palsy in specialist schools. Method Eleven focus groups involving 73 participants (10 young people with cerebral palsy, 13 parents of children with cerebral palsy, 27 teachers, 23 therapists) were held at two specialist schools. Focus groups were audio‐recorded and transcribed verbatim. Transcripts were analysed using inductive thematic analysis by two researchers, independently. Results Four main themes emerged from the focus groups: school priorities; student factors; staffing and environment; and roles and relationships. Physical activity was promoted when academic work and physical activity were seen as equally important school priorities. Student factors that reduced physical activity included fluctuating health, school absences, and protracted rehabilitation after surgery. The staffing and environment unique to specialist schools played a pivotal role in assisting students to be active, as was the importance of collaborative, relationship‐based care. Interpretation Physical activity programmes developed in specialist schools need to take into consideration complexities associated with the age, developmental stage, and academic requirements of young people with cerebral palsy. Particularly for adolescents, motivation was discussed as having a substantial influence on physical activity participation. These findings may assist school leadership teams, clinicians, and teachers in planning physical activity interventions. What this paper adds Specialist schools offer custom‐built environments that promote physical activity and inclusion for students with physical impairments. Therapists and teaching staff work creatively and collaboratively to incorporate an ‘all‐day’ approach to providing physical activity opportunities. Balancing time spent on physical activity versus academic work can cause tension.

Barriers and facilitators of physical activity in adolescents with intellectual disabilities: An analysis informed by the COM‐B model

“…In addition, they enable researchers to clearly replicate and evaluate their utility in changing behaviour (Hackman & Knowlden, 2014) have reported on the PA behavioural influences in youth with intellectual disabilities (Table 1). However, these studies often lacked a theoretical underpinning (e.g., Conchar et al, 2016;Cleary et al, 2019;Verschuren et al, 2012), or explored PA behavioural influences, through the lens of an individual-level theory of behaviour change (e.g., Self-Determination Theory; Stevens et al, 2017).…”

Functionality, school participation and quality of life of schoolchildren with cerebral palsy

“…These results reinforce nuances about the functionality of schoolchildren with CP classified in GMFCS IV and V, considering the development of inclusive strategies. For that, the school's partnership with other professional categories [26,27], structuring of collaborative consultancies [28], specific training on CP [29] and environmental readjustments [25,30] can be suggested.…”

Qualitative research in childhood neurodisability

“…Papers such as that by Cleary et al . provide a welcome step forward in an important topic for the field.…”

“…Papers such as that by Cleary et al 2 provide a welcome step forward in an important topic for the field. Whilst we take this step, it is critical that we ensure qualitative research is conducted with the same rigour that we would expect from quantitative research.…”

“…It can be difficult to capture the essence of experience (of the children and those who support them) using research methods that strive for reproducibility and generalizability, such as systematic measurement and ‘objective’ experimentation. In their paper, Cleary et al . provide an excellent example of a topic where qualitative research can provide opportunities for greater insight than quantitative methods: if conducted with an appropriate understanding and approach to qualitative research.…”