A Welcome Inclusion

Invisible Disabilities Get Hands-On Attention

By Kelli Anderson

A little appreciation goes a long way—sometimes all the way to the press room. For the Access and Inclusion Department in the City of Boulder's park district in Boulder, Colo., appreciation for a job well done often finds its way into the local and regional news.

"We're the feel-good stories in the paper," admitted Colleen Fitzgerald, recreation administrator for the parks and recreation department. "Every two weeks something comes up. One of the things I always say is that we're the good PR."

And while getting good press is a good thing, sometimes what the public doesn't see is what's most appreciated.

"We had a new parent with an 8-year-old son with an (autism) spectrum disorder in a gymnastics class call us because she was so excited," Fitzgerald said. "The other parents noticed that their kids were getting two teachers instead of one and were thrilled, but hadn't realized that the additional teacher was there to assist her son. Instead, what they saw was a staff person working with all the kids, and it was a positive experience for everyone. We're proud that the other parents didn't know—we try to work hard on that."

For millions of Americans who struggle with the social/emotional challenges associated with "invisible" disabilities—ADHD, bipolar disorders, spectrum disorders and sensory integration disorders, to name a few—being different isn't always apparent. Statistics show that one in four Americans is struggling with various forms of mental illness, according to recent figures by the National Institute of Mental Health (NIMH) in Bethesda, Md.

"They are huge in number, and we don't recognize them with a disability and, therefore, have different expectations because they look 'normal,'" said John McGovern, president of Recreation Accessibility Consultants in Hoffman Estates, Ill. "We assume they'll function 'normally.'"

Needing help to navigate the social and emotional world many of us take for granted, this is a population for which inclusion—the prime directive of the 20-year-old Americans with Disabilities Act (ADA)—can be so ideal, but whose effective implementation is among the least understood.

Thankfully, a growing number of park districts, organizations and resources are making practical help for those with invisible disabilities a successful part of their programming as well. Best of all, when done well, these same strategies, teaching methods and management styles improve the recreation experience for everyone.

All Aboard

For many recreation facilities and park districts, getting on board the ADA train can be a challenge. For those who have embraced the journey, however, they will tell you that training all the staff—not just a select few—is vital.

"All our staff is trained about ADA, not just our inclusion staff," said Alayne Kazin, service area coordinator for the division of therapeutic recreation in Cincinnati, one of the oldest inclusion programs in the country. "It becomes everyone's responsibility."

For the park district in Boulder, successful inclusion training begins with, well, inclusion. "First, our five access and inclusion staff [members] are not all in the same building," Fitzgerald explained. "Our goal is to integrate the special needs staff [with] the general staff so that the relationships are right there. In my opinion, it fosters inclusion so much more rather than just telling others what they have to do."

At staff meetings, for example, inclusion staff members take their turn among the regular staff to offer training in their area of knowledge, enabling a regular exchange of ideas. Whether giving teaching tips for a specific program—like gymnastics—or a general subject like implementing effective structure and its vital importance for kids with ADHD and high functioning autism—the inclusion staff is there to share the information with those who see them as a part of the team rather than an adjunct of the park district staff.

For the community in Las Vegas, successful inclusion in all of its programs is the result of visionary leadership that began in 1990. The city's Adaptive Recreation division today provides more than 100 hours of disability and sensitivity training to staff, participants, nonprofits and other municipalities each year.

"I think other park districts can learn that inclusion needs to be an organizational approach," said Lonny Zimmerman, CPRP and deputy director of leisure services for the city [of Las Vegas]. "It's not a program; it's a process. The environment has to be welcoming from top to bottom for individuals with disabilities."

Then, of course, there's the enviable special recreation association (SRA) model that's unique to Illinois.

"Senator Fawell passed legislation in 1969 and had an allocation of property taxes for special needs and set the groundwork for Illinois to have this. There are now 29 associations," said Carolyn Nagle, executive director of the Fox Valley Special Recreation Association (FVSRA) in Aurora, Ill. "With 4 cents per $100 on property taxes (but most districts are still at 2 cents), it is an economic way to provide inclusion as well as separate programs, funds for accessibility, access vehicles and more."

With the funds raised by the property taxes, special recreation associations are formed from which several communities will share services to benefit the special needs of those in their community. They can offer separate programs for those who need them, but also provide training and support for inclusion within the park districts for the many who prefer to participate in the general population.

"The FVSRA has 220,000 in its servicing population and they have 19 full-time employees," McGovern said. "Los Angeles County has 4 million and has one therapeutic recreation specialist employee. So, the model in Illinois is unlike anything in the U.S."

Good Training = A Good Plan

When the 8-year-old second baseman began to do the breaststroke instead of paying attention to the play, the coach didn't bat an eye. He'd seen this before. He didn't yell. He didn't scream, and he didn't draw attention to the child's momentary lapse in concentration. He waited to catch the child's eye, and said,

"OK, let's get back to it," and the child, with that simple reminder, got his head back into the game. No harm done.

"Impulsivity happens," said John Willson, director of LD and ADHD service at the wilderness camp called SOAR in Balsam, N.C., a camp that specializes in children with ADHD and other similar social/emotional/learning challenges. "Thinking that yelling or punishing an executive function disorder makes no sense. Why would you consequence that? Would you consequence a low-blood sugar diabetic? What you have to have is a plan."

And a good plan begins with good training.

While a simple list is not a replacement for good training and sound judgment, the following list is an example of just some of the no-nonsense, effective strategies that can help make the recreational experience a positive one for someone with ADHD or similar challenges:

  • Structure: First and foremost, these kids benefit from consistency that eliminates down time.
  • Quality personnel: Patient, well-informed and those experienced with all types of kids bring out the best in those with and without challenges.
  • Simple instructions: Use short, concise, clear instructions and allow lots of practice to master skills. Avoid multi-stepped instructions and long lecture.
  • No medication holidays: Tell parents that kids need to stay on their meds (if they take them) to be able to function for recreation just like they do for school.
  • Redirection: Redirection is critical for success. Impulsivity happens so be prepared to redirect a child's attention using understandable cues, signals, words, etc.
  • Behavior modification plan: Know what behaviors may be troublesome, how to recognize the warning signs and what is most effective at redirecting, motivating and channeling that behavior into something more acceptable.
  • Bad choices are different than impulses: Recognize the difference between impulsive behaviors that are inevitable versus bad choices that should be consequenced.
  • Become an expert: Go to conferences, read, find out what works, and follow the trends.

Some of the world's greatest athletes, like Michael Jordan and Bruce Jenner, are those with invisible disabilities, such as ADHD.

"With the right structure and support," Willson said, "our kids can do incredible things."

More Bang for Your Buck with TRS

But what if you don't have funding to create an entire department or for several inclusion staff members?

Hire a Therapeutic Recreation Specialist (TRS).

"If you're working with the disabled, the wrong person for the job is one who has no disability experience. A TRS knows disabilities and recreational parks," McGovern said.

The good news is that when it comes to inclusion—especially for those who are high functioning with emotional/social needs—a TRS is a professional resource by which all staff can be trained to do their jobs more effectively.

The result? Park districts and recreational programs get a pretty amazing bang for their buck.

Contrary to some misconceptions about inclusion, many of those with invisible disabilities don't require specialized equipment, separate programs or extra staff. Often, just having someone evaluate their needs to pass along some key information to teachers and coaches is sufficient.

"Not every kid needs one-to-one staff support," McGovern explained. "Just because it may be needed at school doesn't mean it's necessarily needed in recreation. They're very different. The model I've seen is to have a TRS supervising. They oversee the other staff."

A TRS also is especially important for assessing the needs of each individual with a disability in recreational programs because if there is one rule of thumb about special needs it's that there is no rule of thumb.

If your program has seen one child with PDD-NOS, it simply means they've seen one child with PDD-NOS. From child to child and adult to adult, no disorder's symptoms will manifest themselves the same way. The hard truth is that there can be no cookie-cutter approach. Each person must be evaluated and their needs assessed one person at a time.

"Essential to success is that we do an assessment," Kazin said. "We have our CTRS take the assessment information and develop a plan so staff at the center can include that particular child. It requires training because every person learns differently. Some are more auditory, some more tactile and some more visual. It's really important to know what you're dealing with and know the issues."

Assessments make knowing the issues and their solutions for each child possible. A child might simply need directions provided in a different way. They might require a certain kind of motivation or it might just be a case of fitting them with the right personality of the coach or instructor who makes them feel supported.

In some cases, certain behaviors exist that staff members need to be made aware of in order to know how to cue the child to stop the behavior or redirect it. This helps preserve children's dignity so they can interact with their peers, be successful in their efforts and just have fun.

Conventional Wisdom

On Nov. 8, suburban Chicago will host the third annual National Institute on Recreation Inclusion (NIRI), a conference sponsored by the National Parks and Recreation Association designed to provide practical tools and cutting-edge ideas for those wanting to learn about or improve their programs for those with and without disabilities.

"We did a survey about readiness and asked what people would want to get ready," said John McGovern, inclusion expert with the conference and president of Recreation Accessibility Consultants. "Ninety-nine percent answered, 'Give us a practical school.' No theory. We prefer to have people teaching who do inclusion every day."

The convention has grown each year with an anticipated attendance of 300 for 2010. Ultimately, McGovern's prediction is that the demand for inclusion will continue to grow.

"When you get four (inclusion) kids one summer and it's a good experience? Their families tell four more. Trust is huge," McGovern said. "Those four families will tell four more. Then it's 16, then 32. Before you know it, it's 100. We're at the tip of an iceberg."

To find out more about practical inclusion practices for your programs and staff, here are just a few resources to help you get started:

Online training courses: www.nrpa.org

NIRI convention information: www.nrpa.org/NIRI/

CDs and information from Illinois SRAs: www.specialrecreation.org

Recommended reading: Teenagers with ADHD, by Chris A. Dendy; The Motivation Breakthrough, by Rich Lavoie

The Right Attitude and Training

Even if a TRS is not in the cards, there is one characteristic that successful inclusion can't do without: the right attitude.

"Attitude is the biggest pitfall," Fitzgerald concluded. "There are plenty of communities who have a person with the right attitude who can do the research and figure out how to do accommodation. They can do it. Ultimately, however, it's a team approach."

To learn more about inclusion and acquire proper training, annual conferences like NIRI (National Inclusion Recreation Institute) that will be hosted this fall in Schaumburg, Ill., offer the real-life nuts and bolts of inclusion, as well as Web sites such as www.nrpa.org for the National Recreation and Park Association that offers online inclusion training, staffing tips and practices.

Such conferences and Web sites offer up the latest information and training for inclusion that can help those with invisible disabilities to succeed, as well as improve the learning environment for all participants, even those without disabilities. Those who struggle with attention disorders, with auditory processing dysfunctions, with anxiety or the myriad of other common emotional and social challenges tend to thrive when instructors are calm, consistent, offer clear and concise instructions and who have a methodical approach to their teaching. They also are more likely to succeed when programs and events are well structured. But, who doesn't benefit from that?

And, that's the point.

"The good news is that the techniques and strategies will work better for everybody," said John Willson, director of the learning disabilities and AD/HD services of SOAR, a wilderness camp for children with LD and AD/HD in Balsam, N.C. "Everyone benefits from them."

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