© Borgis - New Medicine 2/2011, s. 39-45
*Irena Momola, Agnieszka Szybisty
INTELLECTUALLY HANDICAPPED CHILDREN Vs. THEIR MOTOR ABILITIES
Physical Education Department, University of Rzeszów
Head of Department: Prof. Kazimierz Obodyński, PhD
Aim. More severe mental handicaps such as mild, severe and profound mental handicap, although perceived early in children’s development, cause in most cases psychomotor development disorders and difficulties in adjusting to society. Purpose of this work is to present morphological and physical development of a group of 12-18 year old children with mild and severe intellectual handicap. Presented dimorphic differences in motor development level will help to understand an intellectually handicapped child and should allow adjusting the requirements to its motor abilities.
Material and methods. Material for the research was formed of 201 intellectually handicapped children, aged 12-18 years-old originating from Polish part of Carpathian Euroregion. The survey explored morphological characteristics and motor abilities with Eurofit Special Test.
Results. Motor skills level depends on sex and level of mental handicap. Boys in average have better motor skills, which are confirmed by better and higher results in physical fitness. Sex does not differentiate flexibility and similar results were found regardless of intellectual handicap level. The biggest difference in moderately handicapped boys’ motor possibilities was observed in upper limbs strength, abdominal muscles strength endurance. As for girls, biggest differences were found in explosive strength of lower limbs.
Conclusions. It was demonstrated that children with mild and severe handicap aren’t deprived of motor abilities. These abilities should be extended to improve handicapped people self-acceptance and better life in society.
Man comes to this world with a determined potential to develop. Its implementation depends not only on biological factors in the means of body build and functioning, but is also determined by environmental and psychological elements. These factors and their mutual interactions define the uniqueness of each human being. However they can also cause pathological course of prenatal and afterbirth development process resulting in mental handicap (1).
IQ factor is a basic determinant of mental disability, however it cannot be an absolute base to state severity of handicap. Test results are influenced by personal factors and motivations (2).
Severe mental handicap is believed to be caused by a factor inducing organic changes in brain, whereas less severe mental handicap is multifactorial, with no visible brain changes (3).
The mildest handicap shows up at the latest. Such situation influences mental handicap prevalence index, which due to life requirements, is the highest in ages 9-14 and constitutes 2-3% of Polish children, with 1-2% quota in general population. That is why the part of children with mild handicap experiences no major difficulties to function in population in adulthood (4). This kind of mental handicap makes it a little difficult for kindergarten children to perform everyday tasks. The first and the most visible symptom of this intellectual malfunction manifests usually in difficulties with implementing scholastic duty. This type of handicap appears among 80% of all disabled population (5).
More severe mental handicaps, such as moderate, severe and profound are observed in early period of child’s development. These handicaps cause in most cases very early psychomotor disorders. It is estimated that 13% of all mentally handicapped people have serious limitations and need help (6).
People with such problems do not understand speech or any instructions, they need constant care as they are usually unable to learn self-service activities and in consequence they are incapable of self-existence (7). They require complex therapeutic activity because of difficulties in adjusting to their environment. Lack of reaction and therapy will deepen the problems and create new ones caused by improper environmental influences.
With a proper support from their families and society, stimulation by reasonable educational process and the possibility of employment, 90% of mentally handicapped people have a chance to lead a happy, healthy and productive life (8). Mentally handicapped people cannot be separated from and be neglected by the society. They constitute a group too numerous to be ignored and that is why their motor abilities need to be carefully examined in many directions. Sit, McManus, McKenzie and Lian (9) claim that although children physical activity was widely surveyed, there is still too little reference on mentally handicapped children. Based on research, authors claim that the level of physical activity in special schools is insufficient and only cooperation between educational unit, home and social organizations can help to achieve advisable level of physical activity (PA) among children in special schools. Prevalence of mental handicap in children is of 2-3% in population (10). Within this group 20-30% children represent more severe level of intellectual handicap and the rest are those with mild intellectual handicap (11).
Ministry of National Education pilot program entitled “Early, multi-specialized, complex, coordinated and constant help for children endangered with handicap, handicapped children and their families”, which was to determine quantity and quality of needs and medical, social and educational problems concerning 0-7 year old children with handicap, includes series of statistical data. Among others, the program states that in 1996 almost 73 thousand Polish people including 15 thousand 0-14 year old children were subject to a survey on population health conducted by Central Statistical Office. It states that 3,4% of all 0-14 year old children are handicapped and that the handicap appears more often in families in bad material condition (12). Among 6 941 652 0-14 year old children, 184 206 are handicapped including 99 843 of those aged 0-9.
Based on GUS (Central Statistical Office) data from 2001, assuming that the population of children aged 0-7 is of approximately 3,4 million, 3,4% of handicapped children equals around 115 thousand of handicapped children, including 52 thousand of them from rural areas.
Handicap index for European countries is estimated to 2,2-3,2% and mental handicap concerns 60-70% of all handicapped children (2, 10).
Among individuals handicapped at moderate and severe level, children with Down’s syndrome constitute the most homogenous group. The frequency of Down’s syndrome is estimated at around 10% (13), assuming that 75% of people with Down’s syndrome are more severely handicapped (moderate and severe handicap), 20% are profoundly handicapped, and only 5% mildly.
Down’s syndrome was described in 1866. It is characterized by typical morphological features like short height, smaller skull size, slanting eyes and small nose and ears. Transverse palmar crease is observed, called monkey crease. There are many defects in internal organs, speech is mumbling and inarticulate. Movements of these people are clumsy and not precise. According to the survey carried out in London and in its suburbs the frequency of Down’s syndrome births is of 1/666. J. Zaremba (1975) reports that the risk of Down’s syndrome birth in Poland is at 1/700 births, and the number of children aged 3 to 18 with moderate and severe handicap is of around 50 thousand (11).
Even in this group, positive effects concerning muscles strength growth and physical fitness during progressive load trainings are possible (14).
Increasing physical fitness of mentally handicapped child should be perceived in several aspects. Obtaining at least minimal independence from the environment in order to gain its acceptance is one of them. Siguan (15) emphasizes that the main problem of these children is not their intelligence development but shaping their personalities.
Acknowledging their motor skills will let to choose appropriate loads during therapeutic training, physical education and during activities increasing physical fitness – as a health factor, essential in proper physical development of every child (16).
Aim of this work
The present work aims to introduce morphological and physical development of boys and girls aged 12-18, with moderate and severe intellectual handicap and to present dimorphic differences in the level of motor development. This will help to understand and to adjust requirements to individual motor skills of mentally handicapped child.
Research hypothesis: Standard of morphological features and motor skills depends on sex and level of intellectual handicap.
Material and research methods
The research was continuous and carried out in 2000-2007. At the beginning only girls aged 8 to 18 years old were examined and the results were published in monography (17). Later on, in 2006, the research was completed among boys in order to reveal dimorphic differences in morphological and motor features.
The present study shows the results analysis of morphological and motor features in equal age groups. Examined groups included boys and girls aged 12 to 18. All examined children originated from Polish site of Carpathian Euroregion. The study group counted 201 individuals including 117 boys (tab. 1).
Table 1. Characteristic of examined individuals considering their age, sex and handicap level.
The most numerous group were the children with moderate intellectual handicap, including 67,8% of girls and 68,3% of boys
Morphological measurements included:
– body mass (kg),
– height (cm).
Obtained results served to calculate BMI, which was then used to classify examined children considering body mass deficiency, excess or norm. Due to small quantity of participants in every age group, children were joined to form two groups of boys and girls, with the average age of 15 years.
Examined children motor skills were determined using Eurofit Special Test results (18).
Measurement of individual skills in physical fitness research was carried out in the following order:
– long jump from standing position – explosive strength of lower limbs test,
– sitting from lying position – stomach muscles strength test,
– bending forward in sitting position – flexibility test,
– 25 meters run – speed test,
– pushing medicine ball – strength of upper limbs test.
Mollison index was used to mark sex dimorphism level.
It allows to set the differences of examined features with various titres and variability level (17) as well as it presents similarities or differences between sexes.
Basic statistic methods were used to analyze test results: arithmetic mean, standard deviation, one-way ANOVA – Snedecor F-test (19).
Basic morphological features results such as body mass, height were presented with consideration of sex and mental handicap level in table 2.
Table 2. Sex dependent average level of examined boys’ and girls’ morphological features and motor skills.
|Body mass (kg)||x||43.71||47.08||2.015||0.197|
|1. Lower limbs explosive strength (cm)||x||66.61||73.24||1.235||0.148|
|2. Abdominal muscles strength (numbers of bending forward)||x||5.167||7.402||8.844*||0.385|
|3. Flexibility (cm)||x||-0.089||-0.184||0.004||-0.010|
|4. Speed (s)||x||11.84||9.20||3.767*||-0.609|
|5. Upper limbs strength (cm)||x||225.0||307.8||17.462*||0.507|
* – statistically relevant value F (α = 0.05).
Powyżej zamieściliśmy fragment artykułu, do którego możesz uzyskać pełny dostęp.
Płatny dostęp do wszystkich zasobów Czytelni Medycznej
1. Reiss S: Issues In Defining Mental retardation. Am J Ment Retard 1994; 99(1): 1-77. 2. Zigler E, Balla DA: Mental retardation, the developmental-difference controversy. Hillsdale, New Jersey: Erlbaum 1982; 4-20, 22: 27-37. 3. Sękowska Z: Introduction to special pedagogics. Warsaw: Wyższa Szkoła Pedagogiki Specjalnej 1989; 215-218. 4. Michałowicz R, Jóźwiak S: Child neurology. Wrocław: Urban & Partner 2000. 5. Wald I., Stoma D. Mental handicap. [In:] A. Popielarska, Ed. Psychiatry of developmental age. Warsaw, PZWL 1989. 6. Skinner JS: Exercise testing and exercise prescription for special cases: theoretical basis and clinical application. Philadelphia: Lippincott Williams & Wilkins 2005; 392. 7. Obuchowska I: A handicap child in a family. Warsaw, WSiP 1999; 257. 8. Ainsworth P, Baker PC: Understanding mental retardation. Jackson: The University Press of Mississippi 2004; 8. 9. Sit CHP, McManus A and others. Physical activity levels of children in special schools. Prev Med 2007; 45 (6): 424-431. 10. Daily DK, Ardinger HH and others. Identification and evaluation of mental retardation. Am Fam Physician 2000; 61(4): 1059-1067. 11. Wyczesany J: Oligophrenopedagogics. Kraków: Oficyna wydawnicza Impuls 1998; 37. 12. Department of National Education (http://www.men.gov.pl/content/view/12214/23/) 13. Berg JM: Etiological aspects of mental handicap. Pathological factors. In: A.M. Clarke, A.D.B. Clarke, Eds. Mental handicap. Warsaw, PWN 1971. 14. Shields N, Taylor NF and others. Effects of a Community-Based Progressive Resistance Training Program on Muscle Performance and Physical Function in Adults With Down Syndrome: A Randomized Controlled Trial. Arch Phys Med Rehabil 2008; 89: 1215-1220. 15. Siguan M: La personalidaddel deficiente mental. Anuario de la Psychologia 1970; 71, 2. 16. Winnick JP Adapted physical education and sport. Champaign: Human Kinetics 2005; 144- 145. 17. Momola I: Somatic development, body posture and motor skills among mentally retarded girls. Rzeszów: Wydawnictwo Uniwersytetu Rzeszowskiego 2007. 18. Skowroński W, Horvat M: Eurofit special: European fitness battery score variation among individuals with intellectual disabilities. Adapt Phys Activ Q 2009; 26(1): 54-67. 19. Stanisz A: Approachable statistic course with application of Statistica PL program based on medical examples: Basic statistics. Krakow, Statsoft 2006. 20. O’Brien C: Sport for children with intellectual disabilities. [In:] Maffuli N, Ming Chan K. and others, Eds. Sport Medicine for specific ages and abilities. London: Harcourt 2001; 447-453. 21. Frey GC, Chow B: Relationship between BMI, physical fitness, and motor skills in youth with mild intellectual disabilities. Int J Obes 2006; 30(5): 861-867. 22. Melville CA, Cooper SA and others. Obesity in adults with Down syndrome: a case-control study. J Intellect Disabil Res 2005; 49(2): 125-133. 23. Lewis CL, Fragala-Pinkham MA: Effects of aerobic conditioning and strength training on a child with down syndrome: a case study. Pediatr Phys Ther 2005; 17(1): 30-36. 24. Foley JT, Harvey S and others. The relationships Among Fundamental Motor Skills, Health-Related Physical Fitness, and Body Fatness in South Korean Adolescents With Mental Retardation. Res Q Exerc Sport 2008; 79(2): 149-157. 25. Vlaskamp C, Reynders K and others. Movement skill assessment In children with profound multiple disabilities: a psychometric analysis of the Top Down Motor milestone Test. Clin Rehabil 2005; 19(6): 635-643. 26. Chrzanowska M, Gołąb S and others. Children in Krakow in 2000: Biological development of children and teenagers from Krakow. [In:] Gołąb S., Chrzanowska M, R. and others, Eds. Studia i Monografie AWF Kraków. Kraków, AWF Kraków 2002; 19: 25. 27. Bouchard C: Heredity, fitness and health. Exercise, fitness and health. Champaign: Human Kinetics 1990; 147-153. 28. Bouchard C, Depres IO: Physical activity and health: arteriosclerosis, metabolic and hypertensive diseases. Res Q Exerc Sport 1999; 4, 66, 273. 29. Osiński W: Health-related fitness concept as a theoretical base in modern system of Physical Education. [In:] Puszkieta P., Bronikowski M. Eds, Physical Education in modern educational system. Poznań: AWF Poznań 2000; 47-55. 30. Biddle SJH: Exercise psychology. Sport Review 1992; 1(2): 79-92.