Background
The 2020 World Health Organisation guidelines recommend that all children, including those with disabilities, engage in at least an average of 60-min of moderate-to-vigorous physical activity (MVPA) per day and limit the amount of time spent engaged in sedentary behaviour [
1]. Engagement in physical activity (PA) is associated with a myriad of developmental benefits in physical, emotional, individual, social, intellectual and even financial domains, as outlined in the Human Capital Model proposed by Bailey and colleagues [
2]. That is, PA is a means that can contribute to “whole child” development [
3]. However, many children with disabilities do not engage in sufficient levels of daily PA and spend a large amount of time in sedentary activities [
4‐
6]. Physical inactivity increases the risk of experiencing poor health outcomes and is therefore a major public health issue [
7]. Given children with disabilities are subject to high rates of adverse secondary conditions including physical (e.g., obesity) [
8] and psychological (e.g., emotional and conduct problems) [
9] health difficulties, Anderson and Heyne [
10] demonstrate the “amplified” importance of ensuring these children experience the benefits of PA. Therefore, programs targeting the physical and psychological health of children with disabilities by increasing PA would be of benefit, possibly more so than for typically developing children.
Children with disabilities experience numerous barriers to participation in community-based PA such as unsuitable environments, low perceived levels of community supportiveness and inexperience of coaches in including children with disabilities [
11‐
14]. This suggests that other settings may be particularly important for supporting children with disabilities to participate in PA. Indeed, these children have been shown to depend on their school setting to participate in PA more than typically developing peers [
15]. For example, Einarsson et al. [
15] found that children with disabilities were more active during school time compared to after school, whereas there was no statistical difference for typically developing children. Thus, the school setting is a critical venue for children with disabilities to engage in PA [
16].
Majority (approximately 89%) of students with disability in Australia attend a mainstream school [
17] (which enrol children with and without disability) with specialist education services and supports to assist, if required [
18]. However, a small portion of children with disabilities around the world attend specialist schools, which, for the purposes of this research, refer to schools that enrol only students with disabilities or special needs [
18]. For example, approximately 9% of children with special educational needs in England [
19], 3% of students supported by the Individuals with Disabilities Education Act in the United States [
20] and 12% of students with disability in Australia [
17] attend specialist schools. In Victoria, Australia, it is up to the family to choose whether a child with disability attends a mainstream or specialist school [
21]. Victorian specialist schools are specifically designed, resourced and staffed to support children with disabilities that may have high needs, with class groups generally being smaller than those in mainstream schools and formed according to children’s abilities and educational needs [
18,
22].
Research suggests that children with disabilities generally spend little time at school doing MVPA, only 50% of the approximately 30 min done by typically developing peers [
15]. Additionally, while research on PA engagement in Australian specialist schools is limited, Sit and colleagues [
23] found that students ranging from childhood to young adulthood at specialist schools in Hong Kong spent only 4% of the school day in MVPA and 26% in light PA. MVPA was also limited during active opportunities such as Physical Education (PE; 13% of the class), recess (9%) and lunch breaks (5%) [
23]. Youth (aged 6–23 years) were further found to spend 70% of the school day being sedentary [
23]. Although research indicates that both children with disabilities and typically developing children spend large portions of the school day being sedentary, it may be particularly necessary to increase PA opportunities at school for children with disabilities, given they participate in less PA at school compared to typically developing peers despite being more reliant on the school setting to accrue PA [
15]. Moreover, low amounts of PA and high amounts of sedentary behaviour appear to have independent negative effects on a range of health outcomes for all individuals [
24], although, this is an issue of “amplified importance” for children with disabilities [
10]. Given children spend much of their waking time at school, the provision of additional school-based PA programs may be valuable in strengthening attempts to increase PA engagement for children with disabilities [
25‐
27], which may assist in reducing adverse health effects.
A promising method of increasing in-school PA is through the use of classroom-based PA. Classrooms are well-placed to support PA participation given the considerable portion of time students spend in this setting [
28]. Moreover, classroom-based PA fits within State and national initiatives around the world to increase children’s PA [
29,
30]. Notably, classroom-based PA programs not only attempt to increase PA but can also interrupt prolonged sitting time [
27]. They have been widely implemented in mainstream schools and have shown to contribute to several benefits including health- (e.g., for PA levels) and academic-related (e.g., for classroom behaviour and academic achievement) benefits (e.g., [
31‐
34]). As such, literature suggests that classroom-based PA should be viewed by schools as best practice [
35]. Classroom-based PA can be implemented in various forms including active lessons (i.e., integrating PA into academic content) or active breaks (e.g., brief stand-alone PA sessions between or during academic lessons) [
28].
Brief classroom-based PA breaks (e.g., 5–10 min; often referred to as ‘active breaks’ or ‘movement breaks’) are particularly attractive to teachers given the time constraints they often operate under [
36], and have the potential to increase children’s PA in both mainstream and specialist schools [
27,
34]. Literature demonstrates the feasibility and acceptability of implementing PA breaks in mainstream classrooms (e.g., [
37,
38]). Notably, McMinn et al. [
39] and Mazzoli et al. [
27] demonstrate the potential for classroom-based PA breaks to also be used with children with disabilities and special educational needs. However, literature identifies differences between mainstream and specialist schools that indicate why classroom-based PA breaks implemented in mainstream schools may not necessarily transfer to specialist schools. For example, specialist schools utilise specialised, intensive instruction [
40] and have significant heterogeneity between students [
41]. Differences in environments and developmental age of students may also influence the implementation of classroom-based PA breaks. Indeed, McMinn et al. [
39] and Mazzoli et al. [
27] identified factors to be considered before implementing classroom-based PA breaks with children with disabilities and special educational needs including their various needs (e.g., in relation to cognitive functioning), level of physical and emotional development, and potential apprehension towards new activities. These considerations align with the postulates of the Universal Design for Learning (UDL) framework, which state that no two students are the same and that learning should be tailored to individual students [
42].
It is therefore not appropriate to directly apply what is known about classroom-based PA breaks in mainstream schools to specialist schools. This demonstrates the importance of understanding the landscape of classroom PA in specialist schools separately. A systematic mapping review of class time PA programs that have been implemented in specialist school settings revealed that only 11 out of 34 programs identified had been implemented through short (≤ 20 min) sessions and only seven of these were delivered by the classroom teacher [
43]. Additionally, the review found that class time PA programs in specialist schools of
any length had not been extensively evaluated, identifying only 23 programs involving a PA component that had been evaluated, four of which were implemented through brief sessions by the classroom teacher [
43], representing an active break. Thus, further evaluation of PA break programs in specialist school classrooms is required to advance the limited evidence base and inform classroom practice.
Moreover, to the best of our knowledge, only one study has specifically investigated the feasibility of an active break in specialist schools [
38]. That is, while studies have evaluated outcomes associated with children participating in brief class time PA sessions in specialist classes (see [
43]), Mazzoli and colleagues [
38] were the first to conduct a feasibility study of an active break in a specialist school. The active break consisted of a cognitively challenging motor task, whose feasibility seems lower in specialist compared to mainstream schools, but may increase if motor tasks are tailored to children’s specific needs [
38]. Understanding whether a practice is feasible plays an important role in scaling-up program implementation for widespread adoption in special education [
44], and is therefore vital to progressing this field of research. Additionally, the implementation and success of classroom-based PA programs is significantly influenced by the decisions of classroom teachers [
35]. Thus, limited research into the feasibility and acceptability of these activities from the teachers’ perspective in specialist schools is a considerable gap in current literature.
To summarise, (a) literature describes factors to be considered before implementing classroom-based PA breaks in specialist schools including children’s physical and emotional development and apprehension towards new activities [
39], (b) the implementation and evaluation of classroom-based PA breaks in specialist schools to date is limited, and (c) feasibility evaluations are particularly lacking, hindering the ability to understand whether programs are scalable. Given this, the current research evaluates the feasibility and acceptability of implementing a classroom-based PA break program in specialist schools. Specifically, the Australian Joy of Moving (AJoM) program will be implemented, as it is a novel and psychologically-focussed classroom-based PA break program containing elements aligned with the implementation considerations identified by McMinn and colleagues [
39]. For example, the AJoM program contains psychoeducation emphasising the benefit of PA for psychological wellbeing using storybooks, which provide a visual support that could assist with students’ anxiety and apprehension of transitioning to a new activity [
45,
46]. The program also takes a flexible approach to implementing movement activities to allow tailoring to the developmental abilities of the class.
The aim of this pilot study is to investigate the feasibility and acceptability of implementing a classroom-based PA break program in Australian specialist primary/junior school classrooms (which consist of students approximately 5–12 years of age). This research is conducted alongside a trial of the AJoM program in mainstream primary schools after undergoing some adaptation. Since literature indicates that classroom-based PA break programs developed for mainstream schools may not directly transfer to specialist schools, a distinct evaluation of feasibility and acceptability is warranted. Additionally, this research may inform considerations required for the future use of these programs and subsequent efficacy and effectiveness studies necessary to scale classroom-based PA break programs with children attending specialist schools.
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