A few years ago, I was speaking in Baltimore on the importance of inclusive sports and fitness communities for people with disabilities. One of my colleagues approached me after the presentation to reflect on her experiences with youth sports. She commented that she felt inclusive sports and games were a terrific idea for elementary school children, but that once a child reached junior high school, the transition from playing for fun to playing to win would preclude most youth with disabilities from participating.

My colleague was absolutely correct: many youth -- and their parents and coaches -- play to win. There is that break point in youth sports where winning becomes the primary reason for playing, which is no different psychologically or motivationally from what people do when they go to Las Vegas. The thrill of victory is worth the potential failure of losing money or the game. Winning feels good and losing feels bad. That's all there is to it. But that may be precisely what is wrong with the structure of youth sports today. Those who lose, and lose often, quit. And those who win, and win often, keep playing. Think of the irony of that; the winners keep playing and the losers are relegated to the sidelines. Shouldn't it be the opposite way? Those who lose need more time to play and practice rather than less time!

Junior high seems to be that critical juncture where the 'wheat' is separated from the 'chaff.' Those with the most talent move on, while others with less body weight, height, strength, and coordination drop out. With rising obesity rates among youth with and without disabilities and the diminished opportunity to participate in youth sports, we're heading down a path of disaster. Parents and coaches are often to blame by placing great amounts of pressure on youth to win. There is nothing wrong with wanting to win, but where it creates a problem is when youth are shut out of the opportunity to participate because no one is willing to make the necessary ADA accommodations to 'level the playing field' for all children. High-level competition should be left to the traveling teams, while park district and school-based sports programs -- paid for by the local citizens who include parents of youth with disabilities -- should have the same opportunities as the rest of the community.

The attitudes of parents and coaches who emphasize to youth that winning isn't everything, it's the only thing is the wrong approach to combating the rising tide of childhood obesity in this nation. We pride ourselves on being the most technologically advanced nation in the world, yet we have difficulty finding solutions to a pervasive and often self-efficacy deflating problem for many youth with and without disabilities -- lack of opportunity to play sports in junior high and high school. It may sound like a trivial matter, but when you speak to the health experts they'll tell you that the cost of physical inactivity in adolescence wages a heavy burden on our healthcare system in adulthood. For many youth, sports are something to avoid -- even lifetime sports like tennis, golf, and hiking. It's no different for some youth who fail at math; the more they fail, the less likely they'll continue taking math courses. The things we fail at, we avoid; the things we excel at, we continue. Once you get that bad failure taste in your mouth, it's hard to get rid of. Through all my pontification on the topic, nothing comes close to the lived experience of one parent:

I am a parent of twin girls who will turn 16 in 2 weeks and who both have Down syndrome. I was preparing for a training that I am doing on diabetes and nutrition and I ran across several pieces of work that you have done regarding obesity issues in people with disabilities and it has sparked a great interest.

We provide trainings to providers on health-related issues, monitor health care for individuals, offer technical assistance to providers, and promote capacity building for community activities. I am very interested in health promotion, weight management, and physical activity and in the one article you discussed how fitness centers will need to become that avenue for people. We were fortunate to find many community sports opportunities for my daughters when they were younger. When they approached their teen years, it became more difficult to find activities for them because of the degree of competition in community sports. What happened over the next few years was my one daughter became a couch potato and began to put on weight. We have been struggling to find ways to keep them active.

I am not really sure how you can help me at this point. I would really like to focus on some sort of way to promote health locally for people with developmental disabilities. I have found a majority of people that I know with developmental disabilities to be overweight and I would like to find a way to reach fitness centers and open the doors. I wrote a letter today to a local fitness center presenting this challenge to them. If you have any ideas, any contact people here in the Pittsburgh area or any comments, I would love to hear them.-Pam DeGeorge (degeorgep@upmc.edu)

There are creative ways to afford youth with disabilities the opportunity to compete in sports in junior high and high school if, and that's a big if, communities and schools make a commitment to the concept of inclusion. I hope Ms. George and others like her will continue the good fight on behalf of the rest of our nation. As Margaret Mead once said, "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."