On January 24, 2013, the Office for Civil Rights (OCR) issued a Dear Colleague Letter clarifying school's obligations under the Rehabilitation Act of 1973 to provide extracurricular athletic opportunities for students with disabilites. The guidance creates a clear roadmap for how schools can integrate students with disabilities into mainstream athletic programs and create adapted programs for students with disabilities.

"OCR's guidance is a landmark moment for individuals with disabilities, as it sends a loud message to educational institutions that students with disabilities must be provided opportunities for physical activity and sports equal to those afforded to students without disabilities," said Terri Lakowski, policy chair of the Inclusive Fitness Coalition (IFC) and nationally recognized sports policy advocate.

You may have seen this announcement in the media or through your organization, but what does it all mean and how will this impact extracurricular athletics?

The road towards victory for student athletes with disabilities was relentless. The letter released by the OCR came after ten years of advocacy to level the playing field in school-based athletic programs. The release of the Dear Colleague letter is merely further guidance on what should already be happening for students with disabilities, based on section 504 of the Rehabilitation Act of 1973. The purpose is to clarify school's responsibilities under the law; it does not provide any additional legislation. Similar to Title IX, which paved the way for women to have equal opportunities in sports, the updated guidance will hopefully provide a similar effect for student athletes with disabilities.

Above: Wheelchair athelete Tatyana McFadden, front, races in her first high school track meet alongside able-bodied runners, April 2006 in Rockville, MD. Photo courtesy of (Chris Gardner/AP)

Why are these guidelines important? The benefits of providing ALL students with opportunities for exercise and sports participation goes beyond justice and individual opportunity. There is a major epidemic of obesity among our youth and even more so among youth with disabilities.

"Inclusion in athletics is how children learn from each other, build social skills and optimize their growth and development. The OCR guidance is a clear indication that athletics is an extremely important part of our educational system and that youth and young adults with disabilities must be afforded the same opportunities as their non-disabled peers," said James Rimmer, Ph.D., who co-chairs the IFC and directs the National Center on Health, Physical Activity and Disability. "This should be part of a national strategy to lower obesity rates, which are disproportionately higher among youth with disabilities compared to their non-disabled peers." By providing equal access in extracurricular activities for students with disabilities, maybe we can begin to break down the common barriers to physical activity, and create a new culture of inclusion in our schools and communities.

To ensure equal opportunity does not mean a fundamental alteration to the program, but simply providing a reasonable modification to allow the student athletes with a disability to participate alongside their peers. The Dear Colleague Letter document outlines what constitutes a reasonable modification. One example is to provide a visual cue at the start of high school track races, simultaneously wtih the starter pistol sound, to be inclusive of students with hearing impairments. Another example of a reasonable modification is to allow an individual born with only one hand to be allowed to finish a swim race with a "onehand touch" as opposed to the "two-hand touch" finish rule for certain strokes. As you can see, inclusion can be a reality in all aspects of physical activity. The message is simple: Prevent Obesity, Be Inclusive.

The IFC, led by the Lakeshore Foundation in partnership with the American College of Sports Medicine, comprises over 200 organizations representing a cross-section of disability rights, sports, health/fitness, and civil rights communities. Recognizing the barriers that continue to limit opportunities for physical activity for individuals with disabilities in the school setting, the IFC works to expand opportunities for physical activity, exercise and athletics for individuals with disabilities. For more information, please visit www.incfit.org and www.lakeshore.org.

One of my favorite things to do during the summertime when I was in grade school was going to the pool at my community's recreation center. It was convenient because I lived in town and it was a place where I could socialize with friends.

Looking back almost 20 years later, I realize the importance of the recreation center for me and rest of the community. I grew up in a family where I was encouraged and pushed to be active, regardless of my physical disability. Today, children are less physically active, and instead, playing video games and watching TV. As someone who loves various physical activities, I understand the positive impact physical activity has on an individual's physical and mental well-being. I think this is especially true for children with disabilities. One of the biggest issues is the availability of community physical activity programs for children with disabilities.

With the high obesity rate among Americans - even higher in people with disabilities - communities have the responsibility to provide fitness or physical activity programs for people of all abilities. Today, it's amazing to find so many adaptive sports and recreational opportunities available to people with disabilities, while twenty years ago many of these opportunities were non-existent.

Many of these adaptive sport and physical activity programs are run by non-profit organizations, and now park districts are providing programs. However, it's still not enough. Local communities should be collaborating with school districts to provide programs. Disabilities in general are more "visible" and recognizable in mainstream society now. And, people with disabilities who are living in every community have the right to have fitness/physical activity programs be available to them - just like individuals without disabilities.

Besides the availability of community fitness/physical activity programs, there lies another issue - getting the word out to people. One of the complaints among parents and people with disabilities is that they are unaware these kinds of programs exist. One of the reasons why so many individuals with disabilities do not participate in physical activity is because they don't realize they can, and that it's available. Agency outreach activity needs to be expanded.

In order to get people with disabilities to participate in fitness/physical activity programs they need to be available in communities. This would eliminate people having to search for programs, and accessing them would be easy. One challenge that seems to occur is engaging people with disabilities. I believe that the solution starts in communities, and in collaboration with school districts.

In addition, providing inclusive programs, as well as programs for young children, is a great start. By exposing children to fitness/physical activity programs at an early age, they will continue the behavior as they get older, and receive the health benefits from it. The key is to have programs be available and accessible - the community is a perfect place to start!

What are other ways communities can engage people with disabilities to be physically active?

"If you always put limits on everything you do, physical or anything else, it will spread into your work and into your life. There are no limits. There are only plateaus, and you must not stay there, you must go beyond them." - Bruce Lee

As important as it is for health and fitness professionals to know what limitations an individual may have in terms of creating appropriate activities, especially for safety and medical considerations, it's also important to consider what that individual CAN do, and what they can do in context with their environment. The social model of disability has taught us that systemic barriers, negative attitudes and exclusion by society (whether purposely or not) are the main contributing factors in disabling people, not the disability itself.

The International Classification of Functioning, Disability, and Health, or ICF, is a comprehensive framework used by the World Health Organization (WHO) for describing and measuring health and disability at both the individual and population levels. This framework is used to assess the relationship among an individual's function, activities, and participation while also considering these in the context of the environmental and personal factors that influence an individual's overall health. 

The ICF puts the idea of 'health' and 'disability' in a new light and recognizes that any person can experience peaks and valleys in health, and therefore any person is prone to experiencing some kind of disability. It shifts the focus from what caused a disability to the impact that it has on the person. In addition, ICF considers the social aspects of disability and does not see disability as a medical condition. By including these contextual factors, the ICF helps us to assess the impact of the environment on the person's functioning, and therefore possibly assess potential "limitations" a bit differently.

The health domain and health-related domain contained in the ICF are described fromt he perspective of the body, the individual, and society in two basic categories: (1) Body Functions and Structures (system level); and (2) Activities and Participation (person level and person-environment interaction). The ICF can be used as a tool in exercise physiology to conduct a needs assessment or as an outcome evaluation. It allows the fitness professional to identify the barriers and facilitators that affect the health of the client with the disability and then find or create modifications for the specific individual in order to facilitate participation in an activity. The ICF emphasizes function, NOT the health condition, and categorizes the situation, NOT the person. Here is an example.

Do you see the ICF as having application in your field?

Reference: http://www.who.int/classifications/icf/en