William J. Harvey

Effectiveness of a Therapeutic Summer Camp for Children With ADHD Phase I Clinical Intervention Trial

Objective: The objective of this study was to evaluate the effectiveness of a 2-week therapeutic summer day camp for children with ADHD, which included a social skills training program and parent psychoeducation and training program. This was an open-label, nonrandomized Phase I Clinical Intervention Trial. Method: Parents completed the Weiss Functional Impairment Rating Scale (WFIRS) and the Conners’ Global Index–Parent Version (CGI-P), and children completed the Index of Peer Relations (IPR). All questionnaires were completed prior to the camp and 3 weeks after starting school. A total of 33 children who attended the camp were compared with a group of 15 children with ADHD who did not attend camp. Results: CGI-P, IPR, and WFIRS significantly improved in the group that attended the camp but not in the control group. Effect sizes were between 0.7 and 1.6. Conclusion: The therapeutic summer day camp is effective in improving ADHD symptoms, peer relationships, and overall functioning of children.

Body weight and ADHD: examining the role of self-regulation.

Objective Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex and heterogeneous childhood disorder that often coexists with other psychiatric and somatic disorders. Recently, a link between ADHD and body weight dysregulation has been reported and often interpreted as impaired self-regulation that is shared between the two conditions. The objective of this study is to investigate the relation between body weight/BMI and cognitive, emotional and motor characteristics in children with ADHD. Methods 284 ADHD children were stratified by weight status/BMI according to WHO classification and compared with regard to their neurocognitive characteristics, motivational style, and motor profile as assessed by a comprehensive battery of tests. All comparisons were adjusted for demographic characteristics of relevance including, socioeconomic status (SES). Results Both Obese and overweight ADHD children exhibited significantly lower SES compared to normal weight ADHD children. No significant differences were observed between the three groups with regards to their neurocognitive, emotional and motor profile. Conclusions Our findings provide evidence that differences in weight/BMI are not accounted for by cognitive, motivational and motor profiles. Socio-economic characteristics are strongly associated with overweight and obesity in ADHD children and may inform strategies aimed at promoting healthier weight.

Social Isolation and Physical Inactivity in Older US adults: Results from the Third National Health and Nutrition Examination Survey

Abstract Physical inactivity is a risk factor for cardiovascular and other chronic diseases. It has been shown that both physical inactivity and social isolation increase with age, and that these factors are detrimental to physical and mental well-being. The purpose of the present study was to examine the relationship between physical inactivity and social isolation in older US adults. Using data from a nationally representative cross-sectional survey, the Third National Health and Nutrition Examination Survey, 1988–1994, we assessed the age- and race-specific prevalence of no leisure-time physical activity in relation to various forms of social interaction. The prevalence of no leisure-time physical activity increases with age in both men and women. In non-Hispanic whites, non-Hispanic blacks, and Mexican Americans, the prevalence of no leisure-time physical activity is increased in older US adults who are socially isolated. Social isolation is related to physical inactivity among persons 60 years and older. Longitudinal and intervention studies are needed to establish whether increased social support translates to a more active population of older adults.

Children say the darndest things: physical activity and children with attention-deficit hyperactivity disorder

Background: Physical educators suggested that they are not well-informed about behaviors of children with disabilities, especially attention-deficit hyperactivity disorder (ADHD). Children with ADHD represent a significant number of students in school systems worldwide who often experience difficulties in performing fundamental movement skills. Reasons for these challenging movement behaviors are not clearly understood. There were no significant effects of stimulant medication on performance of the Test of Gross Motor Development-2 (TGMD-2) for 22 children with ADHD. Six boys with ADHD possessed superficial content knowledge about physical activity (PA) participation. Poor movement skills may be related to a mismatch between content knowledge and specific skill performance, which can be problematic at individual skill levels. Purpose: To explore how children with ADHD regulate PA participation by listening to PA stories. Participants and setting: Ten children with ADHD participated in this study. They were identified by qualified child psychiatrists from an ADHD clinic at a major mental health institute in a large urban Canadian city. Research design: A concurrent mixed methods design explored the PA experiences of the children. The qualitative data were given a higher priority. Data collection: The quantitative research component was individualized assessments of fundamental movement skills with the TGMD-2 and Movement Assessment Battery for Children-2. The qualitative research component included: (1) PA self-reporting where each child recorded daily experiences for a two week period and (2) concurrent scrapbook interviews that enhanced participant recall/reflection to generate rich discussions about individual PA experiences. Data analysis: Quantitative skill assessments provided movement-related descriptions of participants. Individual skill levels were labeled with normative test descriptors linked to each respective assessment instrument. These qualitized descriptors were mixed with interview data only after all movement skill assessments and scrapbook interviews were completed. Interviews were transcribed verbatim and a within group thematic analysis was conducted. Findings: Many of the children demonstrated movement skill problems on both tests but skill performance was worse on the TGMD-2. Three qualitative themes emerged. The participants with ADHD spoke about their PA experiences in many different individual physical activities (play theme) and various settings (context theme). All children expressed personal wishes to be included in PA with other children in the community. A range of perceived self-regulatory behaviors emerged for planning PA (organization theme). The findings suggest some of the children with ADHD chose and organized their own PA while other children performed PA that was immediately in front of them with minimal organization of their PA behaviors. Conclusions: Children with ADHD told PA stories that many children without disabilities would tell. However, many of the children with the disorder described experiences related to exclusion from PA. They also lacked conceptual understanding of the purpose and goals related to general participation in various PA. Physical education teacher interventions, leisure counseling and community-based participatory research projects in PA are among the recommendations discussed for children with ADHD.

Exploring relationships among distress, psychological growth, motivation, and physical activity among transplant recipients.

Abstract Purpose: To examine relationships among transplant-specific psychological growth and distress, motivational regulations and health-enhancing physical activity (HEPA) among transplant recipients. Methods: Participants (N = 138; Mage = 48 years; 58% male), who were primarily heart, liver, lung, and kidney transplant recipients, completed scientifically-supported questionnaires. The associations among transplant-specific emotional health, motivation, and HEPA were examined in a path model. Results: In the path model (Χ2(3) = 2.12, RMSEA = 0.02, CFI = 0.98, NNFI = 0.97, SRMR = 0.04), distress was significantly related to introjected regulation and psychological growth was associated with autonomous self-regulation (a combined score of identified and intrinsic regulations), which was a significant correlate of HEPA (R2 = 0.12). There were no significant direct associations between distress, psychological growth, and HEPA. Conclusion: Transplant-specific distress and psychological growth may be factors to target in clinical intervention and rehabilitation. Furthermore, exercise motivation regulations are modifiable factors that relate to HEPA among transplant recipients and could be targeted in the development of rehabilitation strategies aimed at enhancing physical activity in this population. Implications for Rehabilitation Organ transplant recipients should maintain a healthy lifestyle in order to prevent rejection and other risk factors associated with transplantation. Physical activity is a promising lifestyle factor linked to many health benefits. This study shows how a mix of stress and growth following transplantation is related to physical activity motivation and behavior.

Adapting the Sport Education Model for Children with Disabilities

JOPERD • Volume 82 No. 3 • March 2011 T he sport education model (SEM) is a student-centered curriculum and instructional model that aims to provide students with authentic and educationally rich sport experiences in physical education (PE; Siedentop, 1998, 2002; Wallhead & O’Sullivan, 2005). This model has recently been referred to as the pedagogical approach to sport education (PASE), because it allows for many curricular variations to be implemented (Bulger, Mohr, Rairigh, & Townsend, 2007; Siedentop, 2002) and provides the opportunity to infuse various concepts not found in traditional teacher-directed learning. For example, fitness concepts using the SEM can be learned through students’ collective efforts in the creation of an obstacle course (Sluder, Buchanan, & Sinelnikov, 2009). The SEM originated from Siedentop’s doctoral dissertation on the “play education” curriculum theory, with the objective to link collective social life and sound pedagogical practices (Siedentop, 2002). The three goals of the model are for students to become competent, literate, and enthusiastic sportspersons (Siedentop, 1998). The model has six unique features to achieve these goals: (1) seasons, (2) affiliation, (3) formal competition, (4) record keeping, (5) a culminating event, and (6) festivity. Siedentop (1998) described the six characteristics as follows: 1. Seasons are synonymous to PE units; however, they are longer and cover more depth. 2. Students are affiliated to a team (having a team name, colors, cheers, and t-shirts). 3. Students play in formal competitions such as round-robin tournaments and league schedules, with no elimination rounds. 4. Record keeping provides individual and group feedback and can help reevaluate program goals. 5. At the end of the season, there is a culminating event such as a gymnastic show or a basketball championship. 6. End-of-season festivities are created to celebrate values such as individual improvement and fair play. The six features of the SEM can be modified to help teachers meet student needs (Knop & Pope, 1998; Penney & Clarke, 2005). The SEM can be used with a variety of physical activities such as golf, dance, fitness, gymnastics, orienteering, and bowling (e.g., Graves & Townsend, 2000; Pritchard & McCollum, 2008). A unique aspect of this model is that students learn diverse roles, such as being a coach, captain, scorekeeper, statistician, publicist, fitness trainer, equipment manager, sport-council member, or broadcaster. All students are encouraged to rotate among the various Adapting the Sport Education Model for Children with Disabilities

Student teacher experiences in a service-learning project for children with attention-deficit hyperactivity disorder

Background: Service learning (SL) is a collaborative relationship between university professors, their students, and community partners who combine academic learning and active participation to address community issues. Previous studies in SL and physical education teacher education (PETE) found SL projects increased opportunities for learning and applying pedagogical methods, prepared PETE students to teach children from diverse backgrounds, and promoted an understanding of individual teaching responsibilities. Given the number of PETE university programs in SL emerged over the past decade, minimal research has supported the specific use of SL in PETE. It was suggested that PETE programs provided content knowledge and pedagogical strategies to deal effectively with immediate instructional challenges but paid less attention to anticipate future challenges through student teaching experiences. A SL project for children with attention-deficit hyperactivity disorder (ADHD) was designed which enabled PETE students to learn how to manage behavior while teaching physical education. Purpose: To explore the experiences of PETE students in a SL project for children with ADHD. Participants and setting: Four female and two male PETE students were the participants in this study which investigated their project experiences in SL at a major mental health institute in a large urban Canadian city. Research design: A phenomenological approach was used to describe the lived experiences of PETE students in the SL project. Data gathering: Individual semi-structured interviews were conducted and videotaped to acquire rich and deep knowledge of PETE students’ SL experience. Each student was requested to bring unit plans, lesson plans, written reflections, and final term papers to enhance the interview process. Data analysis: Each interview was transcribed verbatim and a line-by-line thematic analysis was performed. Findings: Three higher-order themes emerged from thematic analysis. The ‘where have I been’ theme suggested past teaching and community work experiences shaped decisions to become physical educators. The ‘its all about caring’ theme involved reduction of stigma linked to teaching children with ADHD and merging theory and practice through application of instructional models and deliberate lesson plans. The ‘teaching to play’ theme revealed various benefits linked to PETE student participation in SL and challenges inherent with team teaching. Conclusions: Future research recommendations include capturing the experiences of other participants in the SL project for children with ADHD to gain much greater insight into the whole SL experience and help to shape future projects. Much research remains to be performed in SL and adapted physical education (APE) or local community recreation centers where students from allied health disciplines could participate together. A variety of different qualitative research approaches were also recommended to explore participant experiences in SL projects. Similar SL projects, conducted in multidisciplinary environments, may also be exciting new venues for PETE programs. Finally, the participants’ stories led us to suggest that SL is a contemporary pedagogy that addresses calls for the development of caring pedagogies that prepare future teachers for the realities and challenges of a changing world.

Involvement in Physical Activity: Adolescents' Perceptions of Outcomes

A total of 1,096 adolescents participated in 123 focus groups regarding the perceived outcomes of their involvement in sports and physical activity (PA). The groups, segmented by grade level, sex, and school types, were conducted in both public and private high schools in Montreal, Quebec. We sought to understand, through the participants’ own words, their perception of the outcome matrix of involvement in sports and PA. Focus group questions emphasized changes that adolescents associated with such engagement. In particular, participants were asked how sports and PA might influence behaviors, emotional states, personal characteristics, and other outcomes. Twelve themes were identified in the responses: Positive Health and Physical Changes (18.5%), Activity-Related Positive Emotions (15.6%), and Personal Learning (11.3%) were most prevalent in the discussions. A cluster of deeper personal changes thematically described as Self-Identity, Autonomy, and Positive Character Development accounted for another 16.5% of the responses. Relatively few commentaries emphasized negative effects (7.1%). Converting the proportions of qualitative data into a quantitative index allowed us to analyze potential differences in emphasis according to sex, age, and school type. Though a few significant findings emerged, the larger pattern was of a uniform perceptual map across the variables for this adolescent sample. Implications drawn from this investigation highlight the need to clearly articulate concrete pathways to positive nonphysical changes (e.g., mood states, autonomy, positive character development) from engagements in sports and PA.

Scrapbook interviewing and children with attention-deficit hyperactivity disorder

Interviewing children about their physical activity (PA) experiences can be a challenging research undertaking. A new visual research method in qualitative research, scrapbook interviewing, was created to explore the PA experiences of children. Six children with attention-deficit hyperactivity disorder shared their PA stories in semi-structured interviews through the use of a PA scrapbook. A comparison of a consecutive and concurrent scrapbook interviewing techniques was performed between two groups of three children. The concurrent technique produced substantially more data than the consecutive technique to address problems of limited data to analyse when performing child-PA interviews. Since children in the concurrent technique expressed themselves at greater lengths, their PA voices emerged in a deeper and richer fashion. Preliminary findings suggested both groups spoke about similar PA experiences but differences in positive outcomes and planning were revealed. Challenges of using this new and exciting hybrid method in qualitative research methods are discussed.

A comparative study of Canadian and Scottish students’ perspectives on health, the body and the physical education curriculum: the challenge of ‘doing’ critical

ABSTRACT Physical education (PE) curricula in many countries explicitly task teachers with the responsibility to support the health of their pupils. However, there are concerns that a prevailing ‘healthism’ discourse is influencing how PE curricula are enacted. Although we know something about how PE teachers understand and ‘teach’ health, little is known about the perspectives of student PE teachers. We carried out semi-structured interviews with PE student teachers from Canada and Scotland to explore how they conceptualised health and the body. Furthermore, we investigated how their understandings of health and the body influenced their perceptions of teaching ‘health’ in their respective PE contexts. Our post-structural analysis demonstrates how the students’ Initial Teacher Education (ITE) contexts influenced their perceptions of where the responsibility lies for addressing the health of young people. These different perceptions have enabled and constrained practice in various ways. The Scottish students critically deconstructed dominant healthism and obesity discourses but this process did not result in the articulation of critical practice. The Canadian students were less likely to engage in critical inquiry but evidenced creativity and divergent thinking in relation to how they would integrate health outcomes in their teaching. We conclude by exploring the implications of these findings for ITE programs by advocating an applied approach to critical inquiry.