Health-Related Fitness Assessment for Students with Disabilities

This article will discuss the application and principles of health-related fitness (HRF) assessment testing for students with disabilities. While physical educators are used to assessment testing the general population, very few have the knowledge and skill to test special populations. As with any good programming, assessment is necessary for proscription. However, physical educators should recognize there is a greater need for individualization through assessment for students with disabilities for program development and personal improvement.

The Surgeon General reports that students with disabilities are in comparatively poorer physical health, and are at a greater risk of health-related diseases than the general population. This article will discuss 10 HRF issues: 1) assessment guideline, 2) changing norm-based tests to criteria-based tests, 3) cardiovascular evaluation adjustments, 4) legislative mandates toward assessment, 5) the importance of HRF assessment before participation, 6) what should instructors do prior to selecting a HRF assessments, 7) things for instructors to think about during HRF testing, 8) reporting the results, 9) norm-based fitness tests composite example, and 10) additional assessments used in adapted physical activity.

This article will give readers a greater appreciation for individualization of prescription through assessment, how laws impact assessment, and the benefits of health-related fitness testing for students with disabilities. There are supportive web sites for the topics being discussed, course information about APENS certification, and IDEA (Individuals with Disabilities Education Act) update guidelines.

Phillip Conatser
Adapted Physical Education Editor
downloadable copy of the article (Word)

General Guidelines for Successful Health-Related Fitness Testing

Motivation can be a problem for many students with disabilities because they do not understand fully the concept of giving "100%" effort. To help with this problem, the instructor can, for example, have students with disabilities reach out to or jump to a buddy, jump out for a favorite toy, or jump over a colored rope or disc during a broad jump test. Students could also reach for a ball or toy during sit-ups and sit & reach tests, or listen to their favorite music on a treadmill test for motivation. Note: treadmills are an excellent means for testing cardiovascular endurance because they provide a "steady pace" for the students.

For attention deficits issues, more verbal and physical cues may be needed, as well as shorter periods of on-task time and/or more frequent changes of task.

Over heating during vigorous activity can especially be a problem for students who use wheelchairs, or have spinal cord injuries. Keeping their bodies "cool" is important, and maintaining body temperature can be achieved with good air-conditioning, wet towels, and/or intermittent activity breaks.

For students with spinal cord injury, bladder and bowel evacuation should be implemented prior to exercise testing.

For students that use a wheelchair, straps may be applied to improve stability, and abdominal binders and leg wraps will aid in venous return.

For some tests, gloves, kneepads, and bracing should be used to avoid injuries.

To achieve more natural breathing patterns, have the student use a full face mask during the treadmill test.

More attempts should be given to understand/learn the task. Learning tasks may take several days of practice. Practice sessions should be scheduled prior to the actual test.

Use a buddy for demonstration of skills.

Use visual and physical cues for starting/stopping signals.

Use a buddy to help with encouragement and pacing on aerobic activities.

Use a buddy to keep count and time.

Use a buddy to hold the student's feet during sit-ups.

Extra spotters and safety mats should be used.

Students with respiratory conditions affected by allergens may need to be tested indoors.

To weigh a person that cannot stand, have an assistant hold the student, weigh them together, then subtract the weight of the assistant.

For students not able to stand, lay them down on a mat to measure their height.

New course designed to prepare individuals for successful completion of the APENS certification. This on-line experience is a great, exciting, and easy way to advance your credentials. The course is endorsed by APENS and NCPERID. Register now online, or contact Dr. Scott Pedersen (505) 646-2071.

For more information on what is adapted physical education, what the National Standards are, why and how to take the exam, and how to become certified, including exam dates and places for APENS, visit SUNY Cortland, the online guide, or contact Dr. Tim Davis (607) 753-4969

Individual with Disabilities Education Act

Office of Special Education Programs (OSEP) officially launched a new Web site for information; a "one stop shop" for IDEA 2004 can be found at: http://idea.ed.gov.

Final version of IDEA Part B regulations in the Federal Register can be found here.

For more information on IDEA 2004 visit: http://www.nichcy.org/idea.htm.

Changing Tests Around

Instructors can create their own criteria-based tests from norm-based tests. For example, instead of using the sit & reach test, the instructor can use other methods to determine if a student with cerebral palsy can or cannot touch their nose, head, or subscapula for flexibility.

For students with autism or mental retardation, instead of using the Pacer test, the instructor can assess students' abilities (unassisted or assisted) on given skill requirements, such as lining-up on the starting line, running to the opposite sideline and back, or reacting to the pacing signal. Although comparable flexibility scores or cardiovascular capabilities are not being tested, skills to perform the test are being evaluated, thereby giving some means for assessing improvement and program planning.

Instructors can also measure how many successful attempts a student makes performing the skill, how long it takes them to perform the skill, and/or the exact angle and distance achieved. Instructors can virtually give numerical values to any skill to facilitate assessment. Note: in most cases, self-comparison on the level of improvement for a disabled student is more appropriate than a comparison to "national norms."

The normal guidelines for predicting Target Heart Rate Zone (THRZ) involves subtracting the individual's age from a Heart Rate maximum (HRmax) of 220, then multiplying by 65% to 85% for the range. For students with disabilities, however, the VO2 max values are typically lower than in the general population. Suggested adjustments are:

	Individual that uses arms only: HRmax 200 – (age) = ??
	Spinal cord injuries: HRmax 180 – (age) = ??
	Mental Retardation: HRmax 190 to 210 - (age) = ??
	Quadriplegics: HRmax 130 to 140 - (age) = ?? Or 20 to 30 beats above their resting value for THRZ.
	Water exercise (horizontal): HRmax 190 – (age) = ??
	Target Heart rate zone of 65% to 85% of Hrmax

Individual Education Act 2004 & Assessments

There should be a minimum of two types of tests administered such as a) a norm-based test (e.g., Physical Best and Individuals with Disabilities) and b) a criteria-based test (e.g., I CAN or create your own).

An informal observation of cooperation skills, interactive abilities, and emotional behaviors should be performed during activity testing.

The person administering the tests must be qualified.

The person interpreting the results must be qualified.

The person writing the IEP goals and objectives should be qualified.

In general, scoring two standard deviations below the mean, two to three age levels behind, and/or the inability to interact in a "normal" environment will result in some form of help/intervention.

Note: each state determines the definition for who "qualifies," however, many states are very vague with the definition, therefore, physical educators should take it upon themselves to adopt this role. Special education teachers, counselors, and/or diagnosticians should not be the ones assessing, determining placement or services, or writing IEP objectives for physical activity.

The importance of health-related fitness assessment before participation?

	Safety.
	Helps instructors to develop goals and objective that builds on ability already taught.
	Helps in placement.
	Helps in instructional planning.
	Helps students, caregivers, and instructors experience a sense of accomplishment when goals and objectives are met or maintained.

What should instructors do prior to selecting health-related fitness assessments?

	Decide which fitness skills the instructor wants to assess?
	What fitness skills are of interest to the student with a disability?
	What fitness skills are other students doing?
	What fitness skills does the caregiver feel are important?
	Is this fitness test measuring what I want it to test?
	Is the fitness test valid and reliable?
	Does the fitness test have ecological value?
	Is this fitness test going to help the instructor write the Individual Educational Program (IEP)?
	Is this fitness test going to help the student receive special services if needed?
	Is this an appropriate fitness test given the student's disability, age, sex, and behavior?
	What is the student's present level of health, and is he or she taking any medication?
	What is the student's best mode of communication, and are there any other personal attributes that should be considered?

Things for the instructor to think about during HRF testing

	Fitness tests should be in a natural environment (e.g., during play, outside or inside, grass or turf, competitive or cooperative).
	Limit distractions and noise, as well as excess or unused equipment from the environment.
	Plan ahead for the personnel and equipment necessary, and familiarize yourself with the test.
	Explain test questions clearly and understandably to students (physically shaping, physical prompt, demonstration, verbal clues, pictures).
	Allow the student opportunities to ask questions.
	Allow the student ample practice time.
	Present skills in a friendly, encouraging, playful fashion.
	Testing should not exceed 45 minutes to an hour.
	Tests should take place over several days in different environments (inside, outside, game situation, individual skills).
	Different types of assessments should be used.
	Instructors should be sensitive to cultural diversity.

Norm-Based Fitness Tests Composite Example

Instructors can use these tests in conjunction with a criteria-based assessment (ICAN), and an informal observation, to establish a comprehensive evaluation of the student with a disability. Using a variety of tests is not only recommended, but often necessary to capture a true and accurate picture of disabled students' abilities.

	Broad Jump, MR, (Physical Fitness & Motor Skill Level Individuals with Mental Retardation)
	Grip Strength, Wheelchair, MR, (Project UNIQUE, Physical Fitness & Motor Skill Level Individuals with Mental Retardation)
	Flex Arm Hang, Wheelchair, MR (Project UNIQUE, Physical Fitness & Motor Skill Level Individuals with Mental Retardation)
	Knee Push-ups, (Bruininks-Oseretsky Test Motor Proficiency)
	Modified Pull-ups (Prudential FITNESSGRAM)
	Sit & Reach, Wheelchair, MR, (Project UNIQUE, Physical Fitness & Motor Skill Level Individuals with Mental Retardation)
	Long Distance Run, Wheelchair, (Project UNIQUE)
	Distance Run -Walk, MR, (Physical Fitness & Motor Skill Level Individuals with Mental Retardation)
	Height & Weight Composition, MR, (Physical & Health Related Fitness Test California)
	Skinfold, Wheelchair, (Project UNIQUE)

Additional Assessments Used in Adapted Physical Activity

A.	Physical fitness and sports tests.
	Test of Physical Fitness
	Physical Best and Individuals with Disabilities: A Handbook for Inclusion in Fitness Programs.
	Physical Best: A Physical Fitness Education & Assessment Program
	The Brockport Physical Fitness Test Manual
	The Fitness Appraisal
	ICAN health/fitness module
	Motor Fitness Testing Manual for the Moderately Retarded
	Project Active: Physical Fitness Test Battery
	Project Mobility
	Project Unique: Physical Fitness Test for the Disabled
	Special Fitness Test Manual for Mildly Mentally Retarded Persons
	The Step Test
	12 minute walk/run test
	Test of Sport Skills
	Conatser Adapted Aquatics Swimming Screening Test
	Project ICAN: Team Sports, Dance and Individual Sports Module, Backyard/Neighborhood Activities Module, Outdoor Activities Module
	Project Mobility
	AAHPERD Skill Test Manual: Basketball, Volleyball, Softball, Football
	Special Olympics Program Guides for: Alpine Skiing, Gymnastics, Unified Sports, Volleyball, Aquatics, Hockey, Football, Tennis, Aerobics, Horseshoes, Figure Skating, Equestrian, Athletics, Motor Activity Cycling, Soccer, Basketball, Nordic Skiing, Distance, Rowing, Bocce, Power lifting, Running, Softball, Croquet, Bowling, Roller skating, Team Handball
B.	Motor skills test
	Developmental Scales & Schedules
	NCAST feeding & Teaching Scale
	Battelle Developmental Inventory (BDI)
	Bayley Scales of Motor Development
	Brigance Diagnostic Inventory of Early Development
	Denver Developmental Screening Test II (DDST II)
	Early Intervention Developmental Profile
	Geddes Psychomotor Inventory (GPI)
	The Milani-Comparetti Motor Development Screening Test
	Peabody Developmental Motor Scales (PDMS)
	Primitive Reflex Profile
	Test of Fundamental Motor Patterns
	Test of Gross Motor Development (TGMD II)
	Project ICAN-Fundamental Skills
	Body Skills
	Test of Motor Ability
	Project Active
	Project Compact
	Bruinink-Oseretsky Test of Motor Proficiency
	Basic Motor Ability Test (BMAT)
	Test of Motor Impairment (TOMI)
	Test of Perceptual-Motor Competency
	Bender Visual-Motor Gestalt Test
	Block Perceptual-Motor Development Checklist
	Block Perceptual-Motor Screening for Individuals with Multiple Handicaps
	Dayton Sensory Motor Awareness Survey for four and five year olds
	Informal Screening of Perceptual-Motor Skills
	Kansas Test of Perceptual-Motor Dysfunction
	Motor Perceptual Survey
	Moving Embedded Figures Test
	The Purdue Perceptual-Motor Survey (PPMS)
	Sensorimotor Integration for Developmentally Disabled Children: Handbook
	Sherrill Perceptual-Motor Task for Physical Education
	Southern California Perceptual Motor Test (SCPMT)
C.	Physical fitness and sports tests.
	Test of Physical Fitness
	New York Posture Rating Chart
	I CAN Poster Testing