The fitness program plan should center on one key component -- Do something! How one establishes a fitness routine will depend upon the readiness of the child or adult with developmental disabilities. For the individual with severely low levels of fitness or reduced mobility, a beginning approach may be indicated. Individuals with a greater capacity for movement may exercise at higher intensities for longer durations. Table 2 summarizes the two approaches.

Beginners

At the beginning level, exercise will be at a very low intensity with the goal of stimulating movement and building strength and endurance. Once a medical release is obtained, the program can be planned. Also, consider having input from a physical therapist or adapted physical educator for children with severe movement limitations. Proper environment for exercise is important. This not only concerns space, but lighting, and temperature as well, as some children may have temperature- regulating difficulties.

Music is an important consideration in any workout program. We all move better and can work harder to music. Children with spasticity have been observed to perform rhythmic movements to rhythmic cues in music. Select music to match the phases of the workout -- slow and soothing for warm-up and cool-down and livelier for the aerobic and resistance phases.

It is important to have enough personnel to provide one-to-one assistance, especially for those who need assistance completing the movements. Volunteers may be solicited from high school service clubs or scout troops, if friends or family are not enough. If one-to-one assistance can not be obtained, then employ a station approach, in which children can do something on their own while others are being assisted through the exercises for five minute intervals.

More advanced

The major difference between "beginner" and "advanced" lies in the movement capabilities of the participants. Additionally, more facility space will be needed.