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Physical Activity and
Social Engagement Patterns
During Physical Education
of Youth With
Visual Impairments
HYUN-KYOUNG OH, MEHMET A. OZTURK, AND
FRANCIS M. KOZUB
All individuals, with and without disabilities, focus on their quality of life and well-
being (Williams, 1990). Physical activity enables them to reduce the risk of coronary
heart disease, diabetes, and obesity (U.S. Department of Health and Human Services,
1996).
Through physical education, individuals with disabilities receive a variety of oppor-
tunities to learn motor skills, to develop physiological systems, to impact their psy-
chological processes, to increase social skills; and generally to affect their emotional
well-being (Cooper & Quatrano, 1999). For individuals with visual impairments, an
increased tendency toward a more sedentary lifestyle exists, making physical activity
an important concern (Longmuir & Bar-Or, 2000). Social engagement is another criti-
cal area for individuals with visual impairments: If they lack the skills to participate in
community offerings, they limit their opportunities as adults to build relationships with
peers (D’Allura, 2002; Zanandra, 1998). Promoting physical activity and social
engagement among children with visual impairments is important for creating a foun-
dation for later satisfaction as adults. As an avenue to influence both social and fitness
goals, educators should focus on the potential impact of physical education instruction
for children with visual impairments (Sherrill, 1998; Winnick, 2000).
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Physical Activity in Individuals With Visual Impairments
Individuals with visual impairments are prone to inactivity throughout their life span,
and studies focusing on children with visual impairments indicate that they engage in less
physical activity than peers with other disabilities (Longmuir & Bar-Or, 2000; Sit, Lind-
ner, & Sherrill, 2002). Longmuir (1998) reported data indicating that daily physical activ-
ity levels using both self-report and more objective means (such as pedometer counts)
were significantly lower for children with visual impairments, putting this target group at
a heightened risk for inactivity. Previous research showed that children with visual
impairments had significantly lower motor skills and physical competence than their
sighted counterparts (Brambring, 2001; Gronmo & Augestad, 2000).
Individuals with visual impairments have a greater need to be physically fit because
in comparison to sighted peers they have increased demands for energy to carry out
everyday tasks (Lieberman & McHugh, 2001). Further, their level of vision influences
many critical areas such as motor learning, ability to interact in games, and under-
standing of spatial concepts. Learning deficits coupled with a lack of visual cues make
movement less efficient and even hazardous.
Social Engagement and Children With Visual Impairment
Researchers have found deficits in social areas in younger individuals with visual
impairments (Jindal-Snape, Kato, & Maekawa, 1998). Children learn to play and to
develop social behaviors by watching and imitating peers; however, many children
with visual impairments lack the opportunity to learn using visual cues (Zanandra,
1998). Students with visual impairments can, nevertheless, benefit from experiences in
physical activity including health-related gains, opportunities for self-expression,
social interactions, and the ability to find group membership through physical activity,
thus facilitating the long-term outcomes identified for students without disabilities
(National Association for Sport and Physical Education, 1995).
Obesity threatens both health and social outcomes. Inactivity can result in poor pos-
ture and weight gain that negatively affect the ability of individuals with visual impair-
ments to establish friendship and social circles (Nagle, 2001). The cumulative effects
of inactivity can lead to an adult life with few friendships, poor ability to develop rela-
tionships with work colleagues, and an inability to develop the necessary social skills
to maintain successful employment (Leonard & D’Allura, 1997). Physical activity is a
useful tool for mediating social development in many segments of the population from
both an interactive and an aesthetic perspective.
We undertook this study to identify relationships between social engagement and
physical activity in school-age children who attend a mid-western school for the blind.
We also investigated the association of curricular offering in physical education with
levels of physical activity. In the study we asked the following questions: (a) what is
the relationship between social engagement and physical activity? (b) is the level of
vision related to physical activity? (c) is the level of vision related to social engage-
ment? (d) what role does age play in levels of physical activity and social engagement
in physical education class for children with visual impairments? and (e) is the level of
physical activity dependent on curricular offering?
Method
Participants
Nineteen students (10 girls and 9 boys) aged 6 to 18 (M = 12.58) from a mid-western
state school for the blind participated in this study. The school categorized the partici-
pant’s vision levels as blind (n= 3), low vision (n= 4), and high vision (n= 12). These
categories were forwarded to the investigators without any specific information on the
nature of these categories or Snellon scores indicating level of visual acuity.1None of
the participants were diagnosed with other impairments that would have impacted on the
outcomes of the study.
Procedures
After securing informed consent from parents, we collected data on the participants’
activities during physical education classes by placing a video camera in the corner of
the physical education teaching station. We observed all of the participants during their
normal instructional activities. We categorized the physical activities into four differ-
ent types: games and sports (archery, basketball, and volleyball), recreational sports
(bowling and horseshoes), dance, and fundamental movements (scooter activities and
running).
Instrumentation
The Engagement Check. The Engagement Check (EC) is an observational tool that
measures group and individual engagement levels (McWilliam, 1990). It is designed
for 40 observations (one every 15 seconds) over 10-minute periods. Engaged behavior
is divided into three types: engaged with adults,engaged with peers,and engaged with
materials. Each of these types has two subcategories—interactive and noninteractive
(McWilliam, 1990; McWilliam & Bailey, 1995). Because our study was interested in
the social engagement of children with visual impairments, we gathered data on the par-
ticipants’ interactive and noninteractive engagement with adults and with peers.
Interdependent play, mutual organization, gestures, and talking are examples of inter-
active engagement, whereas parallel play, looking, orienting, tracking, or listening are
examples of noninteractive engagement.
The EC coding system uses momentary time sampling methods. The guidelines pro-
vided by McWilliam and Bailey for coding involved watching a particular child for 15
Volume 36, Number 1, Spring 2004 41
seconds, taking a mental snapshot (2 seconds), making a decision about the child’s
activity (2 seconds), and checking the appropriate spaces on the coding sheet (3 sec-
onds). Eight seconds remain before the next time sample. McWilliam and Bailey have
reported suitable reliability and validity estimates on children with autism using EC.
McWilliam also suggested that the use of EC on different populations such as children
with visual impairments and blindness was appropriate.
Children’s Physical Activity Form. We used the Children’s Physical Activity Form
(CPAF) as an observational estimate of different levels of intensity of physical activity
(O’Hara, Baranowski, Simmons-Morton, Wilson, & Parcel, 1989). The CPAF consists
of four categories of physical activity and provides a numeric value for an observational
period based on 1-minute intervals. Categories and activity counts are assigned to inter-
vals based on observing one or more of four types of movements including: (a) sta-
tionary, no movement (SNM); (b) stationary, limb movement (SLM); (c) slow trunk
movement (STM), and (d) rapid trunk movement (RTM). The observer selects from the
list of categories during each 1-minute interval; however, a category cannot be checked
more than once in the same minute interval. The total activity points within a 1-minute
interval can range from 60 points to a maximum of 240 points. In scoring, SNM is 1
point, SLM is 2 points, STM is 3 points, and RTM is 4 points. These values are multi-
plied by 60 seconds divided by the number of categories checked. For example, if the
observer checks categories totaling 3 points (SNM and SLM) in a 60-second interval,
each category of activity points is multiplied by 20 seconds.
Interobserver Agreement
To code and to obtain interobserver agreement, we used Observer 4.0®(Noldus
Information Technology, Inc.), a computer software system used for analysis, presen-
tation, and management of observational data. With this software, researchers can col-
lect frequency, duration, interval, time sample, latency, and interresponse time data as
well as interobserver reliability (Kahng & Iwata, 2000). For the present study, we used
point-by-point agreement to estimate reliability of scoring for both EC and CPAF
scores. This method consists of the agreements between scorers on specific trials.
These values are calculated by adding the number of agreements and disagreements
and then multiplying by 100 (Kazdin, 1982).
Two researchers coded the CPAF for the reliability. The first rated all 19 cases and
the second coded a random sample of 25 percent of the cases to achieve an acceptable
interobserver agreement. The interobserver agreement was attained when the two
observers identified the same movement categories for a minute interval; the
researchers reached an overall agreement of 81% agreement for these data.
We calculated a similar observer agreement score for EC. One researcher coded all
19 cases and a second coded 9 cases randomly selected from the sample. The interob-
server agreement of the EC was 84%, using point-by point agreement method.
42 RE:view
Results
We used total CPAF and percentage of social engagement scores in the data analy-
ses. Physical activity values found in Table 1 represent mean CPAF activity counts per
minute. We then used these in correlational analysis using Spearmen rank order coef-
ficients to determine the relationships between key variables (e.g., level of vision, age,
CPAF, and EC scores). Chi-square was used to determine the dependence of curricular
offerings on CPAF scores. Engagement check scores were calculated by totaling the
number of intervals in which each child was observed in interactive behavior towards
adults and peers. For our purposes, social engagement was operationally defined as
combined intervals in which interaction with adults or peers occurred divided by 40
observations over the 10-minute data collection period (Table 1).
Mean CPAF scores per minute ranged from 85.59 to 183.71 (M= 119.38, SD =
27.53) for the 19 participants, and the percentages of social engagement ranged from 0
to 39% (M= 16.36, SD = 12.76) in relation to interactive/noninteractive engagement
with adults and peers (Table 1). The results indicated a significant relationship between
age and CPAF scores (rs= -.70, p< .01). These values support the data that as ages
increase CPAF scores decrease in physical education class. However, the relationships
between age and social engagement were not significant (rs= .31, p= .19). Also, youth
vision level (blind, low vision, and high vision) was not significantly related to either
social engagement (rs= -.32, p= .19) or physical activity (rs= -.14, p= .56). Results
showed that there were no significant relationships between physical activity and social
engagement (rs= -.21, p= .38). Our hypothesis of a dependence between physical
activity and curricular offering was not supported (
χ
2(6, N= 19) = 10.93, p= .09).
Discussion
The current data show that participant’s age is a determinant of physical activity for
students with visual impairments. For example, the highest scorers were an 11-year-old
boy (183.71) and a 10-year-old girl (156), whereas the lowest scorers were boys aged
15 (85.51) and 14 (86.05). This is supportive of Kozub and Oh’s findings (2004) of
negative relationships between age and total bouts of moderate to vigorous physical
activity level over 4 days for individuals with visual impairments. As is the case with
individuals with other types of disabilities and peers without disabilities, older students
with visual impairments were less active than younger students (Longmuir & Bar-Or,
1994; Longmuir & Bar-Or, 2000). On the basis of these data, we can conclude that
inactivity in physical education class as well as during free time is related to age.
Activity counts for most of the participants were below the moderate to vigorous
activity levels believed necessary to improve health-related fitness (National Associa-
tion for Sport and Physical Education, 2004). The activities of the participants in the
study included a large number of minutes classified as static no movement and sta-
tionary limb movement. More than half of the sample had mean physical activity these
Volume 36, Number 1, Spring 2004 43
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TABLE 1. Scores of Children With Visual Impairments (N= 19) on Children’s
Physical Activity Form (CPAF) and Social Engagement
Social
Vision CPAF score engagementa
Participant Gender/Age level (per minute) (%) Activity
1 M/15 yrs. Low 85.59 25.29 Games and sports
2 F/10 yrs. Low 156 17.49 Games and sports
3 F/ 10 yrs. Blind 114.1 7.89 Dance
4 F/17 yrs. High 92.47 26.63 Games and sports
5 M/ 18 yrs. High 106.15 5.2 Recreational
sports
6 M/8 yrs. Low 145.52 10.87 Fundamental
movement
7 F/ 13 yrs. High 128.53 27.28 Fundamental
movement
8 M/13 yrs. High 134.57 4.86 Fundamental
movement
9 F/6 yrs. Low 137.78 0 Fundamental
movement
10 M/12 yrs. High 114.54 38.84 Recreational
sports
11 M/14 yrs. Blind 86.05 10 Recreational
sports
12 F/16 yrs. High 94.5 32.87 Recreational
sports
13 F/12 yrs. Blind 94.84 3.95 Recreational
sports
14 M/11 yrs. High 183.71 8.08 Games and sports
15 M/17 yrs. High 95.33 3.9 Recreational
sports
16 F/11 yrs. High 146.89 26.13 Games and sports
17 F/15 yrs. High 90.73 36.45 Recreational
sports
18 F/12 yrs. High 132.5 23.41 Dance
19 M/9 yrs High 128.41 1.62 Recreational
sports
aSocial engagements were interactive and noninteractive engagements with both peers
and adults.
counts that fell below scores that would indicate that any limb movement occurred dur-
ing the entire interval. Further, only one of the participants averaged physical activity
counts in physical education class that were at or above a value indicating slow trunk-
movement. These data supprt the notion that regardless of curricular offerig, many of
these young people stayed in one place for the most part and engaged in some pur-
poseful limb movement. Absent was the large muscle activity needed to elevate the
heart and receive health-related benefits from physical education (National Association
for Sport and Physical Education, 2004).
The results show no significant relationships between level of vision and social
engagement in physical education classes. This finding is different from previous stud-
ies conducted in other settings that found significant relationships between levels of
vision and social engagement (D’Allura, 2002; Resnick, Fries, & Verbrugge, 1997;
Zanandra, 1998). It may be that these participants in a structured setting are acting in
accordance with rules of engagement for learning environments that may include pay-
ing more attention to teacher feedback and learning outcomes rather than social inter-
actions. This leaves in question what types of physical education instruction have the
potential to address social goals in children with disabilities. Undoubtedly, the structure
of the lesson and the nature of the activities offered play a role in social engagement.
For the current sample, bowling and other recreational sports did not yield any sig-
nificant differences in social engagement from other more traditional sport activities.
Given the low percentage of engagement found for all activity types, teaching style and
other organizational patterns of the lesson need to be studied to determine if physical
education offers comparable socialization opportunities for all children with visual
impairments regardless of level of vision.
Fundamental movement and scooter activities demonstrated the highest mean phys-
ical activity counts while yielding the lowest mean social engagement scores. This
makes sense in that children engaged in parallel play experiences would move more
and socialize less. Interaction is perhaps less important in these individual activities
where learners are moving from one place to another. This indicates that some code-
pendence should exist between physical activity offerings and social outcomes.
The findings did not indicate a dependence of physical activity scores on curricula
offerings (Table 2). This is of concern given the wide range of activities presented.
Conceptually, a child engaged in games or sports should have significantly higher
activity counts than a child who is bowling or doing other more stationary activities
such as archery or horseshoes. This was not the case in this limited sample and indi-
cates that inactivity may be chronic in physical education for some children with visu-
al impairments.
In summarizing engagement and physical activity found in this small sample of chil-
dren educated in special school setting, it is hard to refute the social deficits believed
to exist in younger children with visual impairments (Parsons, 1986; Zanandra, 1998)
and the inactivity believed to be especially prevalent in individuals with visual impair-
ments (Longmuir & Bar-Or, 2000). Of the 12 students with engagement percentages
below 25%, 10 of them were between the ages of 6 and 14 years (Table 1). Low phys-
ical activity counts coupled with a general lack of engagement is supported in these
values. Specifically, the lack of moderate to vigorous physical activity reflected in
these data are of concern for program planners and may indicate a need for curricular
Volume 36, Number 1, Spring 2004 45
revision as well as concentrated efforts during individualized education program com-
mittee meetings to target both social and movement opportunities for some children
with visual impairments.
A final point of consideration is the nature of the setting where we studied the partici-
pants. The specialized school may offer less opportunity for children with visual impair-
ments to engage with peers without disabilities who may have an edge in social and motor
skills. For this reason, children with visual impairments who have the ability to engage
socially and in traditional sport offerings may have less opportunity to find highly skilled
playing partners and friends of similar interests. It is possible that an inclusive environ-
ment would yield different findings, ones in which children similar to these move more
and engage at higher levels. However, more studies are needed to determine if setting is a
determinant of social or activity patterns in individuals with visual impairments.
Recommendations
More studies involving higher numbers of participants and specialized and inclusive
school settings are needed before any conclusions can be made about physical education
and social engagement for all children with visual impairments. The present observations
have implications in designing specific interventions to promote physical activity in
youth with visual impairments. New studies should investigate how instructional proce-
dures can focus on social and movement opportunities within activities. Clearly, one bas-
ketball lesson can differ from another depending on how children are organized and the
nature of the activity provided. An additional recommendation is to expand to other struc-
tured physical activity settings such as youth sports to determine the current status of
activity counts and social engagement in these after school programs. Finally, the impact
of physical education instruction on lifelong learning and on moving needs to be studied
with children with visual impairments.
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TABLE 2. Mean Scores of Children With Visual Impairments (N= 19) on Chil-
dren’s Physical Activity Form (CPAF) and Social Engagements During Various
Physical Activities
Social
Activity CPAF score engagementa(%)
Games and sports n= 5 132.95 20.78
Recreational sports n= 8 101.32 16.52
Dance n= 2 123.3 15.65
Fundamental movement/scooter n= 4 136.6 10.88
aSocial engagements were interactive and noninteractive engagements with both peers
and adults.
Summary
The purpose of this study was to identify the relationships between physical activi-
ty and social engagement pattern in students with visual impairments. We found no
relationship in the children we studied. Further, our study of the association of curric-
ular offering with physical activity levels indicated low activity levels across curricular
offerings. Finally, age was the only determinant for physical activity in the individuals
with visual impairments studied. More research is required to identify other factors that
might stimulate increased physical activity and social engagement in individuals with
visual impairments in structured physical education settings.
Note
1. Low vision and high vision are the categories used by the school for the blind. They
would not release vision scores or other information on the etiology of the impairments of the
participants.
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