The range of social and medical issues that children with disabilities face may provide an intimidating backdrop for exercise professionals to launch physical activity programs, especially given that many children with disabilities are inactive. A Canadian study assessed the health promotion behaviors of 101 adolescents with physical disabilities, comparing them to a large national sample. Steele et al. (1996) found that 39% of those surveyed reported that they never exercised, compared to only 6% of the non-disabled sample. Those with physical disabilities were also significantly less likely to participate in activities that "provide opportunities for exercise, self-improvement and socialization" (Steele et al., 1996). The only activity in which children with physical disabilities outscored their nondisabled peers was in watching television more than 4 hours per day (39%) compared to 13% (Steele et al., 1996). It would appear that participation in any physical activity program, even one with a minimal time outlay, would be a monumental lifestyle change for children with disabilities and their families.

Of course, some children with disabilities are active, and sports program planners should have a sense of the activities that children with disabilities and their families have been able to incorporate into their lives. A study by Modell, Rider and Menchetti (1997) surveyed the parents of 28 children with developmental disabilities regarding their children's physical activity pursuits and the settings in which they occurred. Results showed that 55% of the children's sports activities occurred with their families; 22% took place in inclusive settings, defined as outlets with non-disabled children, and 23% took place in noninclusive settings, defined as segregated, or those solely with children with disabilities (Modell, Rider & Menchetti, 1997). It may be that too many barriers face families who might want their child with a disability to participate in an activity outside of "family time." According to the survey, the most common physical activity pursued was swimming (25 incidences), followed by walking/jogging (16), bicycling (10), bowling (9), and basketball (9) (Modell, Rider & Menchetti, 1997). What is interesting is that the top three activities are all individual, rather than team-oriented sports. Coaches or program leaders may opt to use an "individual sport" with this population and may need to employ creative strategies to promote interaction and teamwork among participants, if those socio-relational goals are a priority.

One challenge in outlining very general program considerations for children with disabilities is keeping in mind that children with disabilities encompass a tremendous range of disabilities, ages, barriers and personalities. A more recent Canadian study drives this point home by uncovering some of the differences in physical activity patterns among children who have different chronic medical conditions. Longmuir and Bar-Or (2000) found that physical activity patterns in children with physical disabilities or chronic medical conditions significantly differed by age. Younger children were more active (Longmuir & Bar-Or, 2000). The authors suggest this may stem from the physical education requirement found in the elementary schools, but not in the high schools, in the areas they surveyed (Longmuir & Bar-Or, 2000). Significant differences were also found in habitual physical activity levels depending on disability type; youths with chronic medical [CM] conditions (i.e. cardiac defects, arthritis, kidney problems) (47%), and those who were hearing-impaired [HI] (53%), were significantly more active than children with physical disabilities [PD] (26%) or those with vision impairment [VI] (27%). A further differentiation provides an even clearer picture of physical activity trends in one subpopulation. Within the PD category, significant differences were found in regard to diagnostic category. Children with HI (49%) or spina bifida [SB] (40%) were significantly more active than those with CP (18%) or muscular dystrophy [MD] (13%). This type of study may help exercise professionals recognize which sub-populations of children with disabilities are in dire need of health intervention strategies or exercise barrier remediation.