Inability to focus, demonstrate self-control over impulsive behaviors (may act without considering the outcome), short attention span, or excessive activity (Adhvaryu et al., 2022). Some common characteristics of individuals with ADHD include, but are not limited to, difficulty following instructions, often daydreaming and not being able to focus their attention to complete simple tasks, having difficulty taking turns and maintaining relationships with others, and demonstrating poor motor skills, which may limit growth and development (Adhvaryu et al., 2022; Centers for Disease Control and Prevention, 2022).

Tips for working with children with ADHD:

• Get to know the child. Know their signs of frustration and how to reengage them in the activity.

• Always remain calm and have patience when interacting with children.

• Keep directions short and simple using "First-Then" language.

  • • Example: First, hit the ball, then run to first base.

• Use and refer to a visual schedule to keep children on task.

• Consistent praise of the child for their attempts and other positives.

• Establishing and maintaining eye contact while communicating will ensure they receive the message.

• Redirect challenging behavior to the task they are performing.

• Take a movement break during downtime or while waiting for an activity.   

(Adhvaryu et al., 2022; Charkalis, 2021)

Individuals with ASD can experience deficits in executive functioning, social communication, motor learning, sensory modulation, and behavioral comorbidities such as restricted, repetitive patterns of behavior, interests, or activities, ranging from mild to severe (Ruggeri et al., 2019). Individuals with ASD typically experience challenges in social situations; they tend to withdraw and not want to participate. Decreased participation limits exposure and interaction with the world and may cause delays in their gross motor functions, fine motor functioning, and coordination (Ruggeri et al., 2019).

Tips for working with children with ASD:

• Use fewer words when communicating.

• Give extra time for them to process what is said.

• Check in frequently to see if they comprehend.

• Use visual rather than verbal instruction to decrease distractions. 

• Depending on the severity of ASD symptoms, frequent verbal and physical redirection may be necessary.

• Ask if they need assistance before assisting.

• Encourage interaction with peers.

• Ask parents if they have any sensory or specific needs, such as noise-canceling headphones or sunglasses.

•  If the individual is misbehaving them if they need to take a rest break or a movement break.

• Model what you want to teach your child so they can imitate the task. 

• Keep a close eye on children on the spectrum; sometimes, they have short attention spans and can wander/elope.

(Ruggeri et al., 2019; Stewart, 2023)

Cerebral palsy is a collective term for several clinical conditions resulting from damage to the developing brain (Yamamoto, 2017). CP is the most common motor disability among children (Yamamoto, 2017). The symptoms of CP can vary from mild to severe and differ from person to person depending on the severity and location of damage to the brain (CDC, 2018a). CP typically impacts balance, coordination, muscular tone, posture, and mobility. Uncontrollable movements, intellectual impairments, seizures, vision, hearing, or speech deficits, spine abnormalities, or joint issues can also affect individuals with CP (CDC, 2018a; Yamamoto, 2017). CP is not a progressive condition; however, the symptoms that affect the individual often change over time (Yamamoto, 2017).

Tips for working with children with CP:

• Provide frequent encouragement when performing tasks.

• If you are unable to understand the individual, be patient and ask them to repeat themselves.

• Allow the individual extra time to perform the task.

• If the individual is having difficulty with a task, ask if they need assistance and how you can help.

• If the individual is demonstrating involuntary movements or frequent unwanted movements:

  • • • Ask if you can provide them with stability/balance by having them hold on to your arm or hands.

      • Ask the individual if they need to take a rest break.

• Never force any type of movement. 

(CDC, 2018a; Yamamoto, 2017)

DS is a lifelong condition where an individual is born with an extra chromosome (CDC, 2021; Mayo Clinic, 2018). This extra chromosome changes how the body and brain develop and may cause cognitive and physical challenges for the individual (CDC, 2021; Mayo Clinic, 2018). Many individuals with DS have secondary health conditions such as hearing loss, sleep apnea, immune disorders, obesity, and heart defects (CDC, 2021; Mayo Clinic, 2018). Individuals with DS share distinct features, including a flattened face, upward-slanting eyes, a short neck, a protruding tongue, poor muscle tone, and excessive flexibility (CDC, 2021; Mayo Clinic, 2018). Individuals with DS may have challenges with language, attention, developmental delays, and short-term and long-term memory (CDC, 2021; Harbach et al., 2020; Mayo Clinic, 2018).

Tips for working with children with down syndrome:

• Avoid stretching due to joint laxity.

• Allow the individual extra time to perform a task or express themselves.

• Use visual aids to assist if an individual who cannot understand verbal instructions.

• Allow the individual rest breaks to avoid overexertion.

• Provide the individual with encouragement and praise.

• Communication is important. When instructing individuals with down syndrome, use fewer words and direct instructions such as 2-3 step instructions.

• Before speaking to individuals with down syndrome, make sure to establish eye contact and gain their attention.

• Encourage social interactions with peers.

• If an individual is struggling with an activity, focus on where they are having difficulty and break down the tasks into manageable units.

(CDC, 2021; Harbach et al., 2020; Mayo Clinic, 2018)

Hearing loss is the inability to hear in one or both ears, entirely or partially, and may be present from birth or later in life (CDC, 2018b). Speech, language, and social skills may be affected in individuals with a hearing impairment, especially earlier in life (CDC, 2018b). When communicating with others, individuals with an impairment may utilize lip reading, sign language, interpreters, or assistive technology devices like hearing aids or cochlear implants (CDC, 2018b).

Tips for working with children with hearing loss:

• Establish hand gestures or simple hand communication.

• Have a written outline of the activities in advance.

• When speaking to individuals with hearing loss, always face the person, even if an interpreter is being used, speak at an average pace, and use short sentences so they can read your lips.

• Pair the individual with a peer or volunteer to assist and keep them safe.

• Use visuals aids.

• Use modeling when providing instructions.

• Contact the YMCA to see if an interpreter is available.

• Learn some basic sign language to communicate with the individual.

• Use a communication device to facilitate communication.

(CDC, 2018b; Leitschuh, 2021)

MD is a category of conditions that interfere with the building of healthy muscle and leads to gradual muscle loss and weakening (Mayo Clinic, 2020; Messina & Vita, 2018; Valle et al., 2016). Depending on the type of MD, the signs and symptoms can appear as early as early childhood and progress at different rates (Mayo Clinic, 2020; Messina & Vita, 2018; Valle et al., 2016). Complications include difficulty walking, using arms to complete daily tasks, limited mobility due to shortening of tendons or muscles, difficulty breathing, a curved spine, heart problems, and swallowing problems (Mayo Clinic, 2020; Messina & Vita, 2018; Valle et al., 2016). Since MD is progressive, the symptoms will eventually worsen as time goes on, and individuals may need to rely on wheelchairs to move around their environment (Valle et al., 2016). However, being proactive and engaging in physical activity can help slow this process down (Messina & Vita, 2018; Valle et al., 2016).

Tips for working with children with MD:

• Stretching helps keep the joints flexible and functional for as long as possible.

• If the individual is in pain stop the activity immediately.

• Take frequent rest breaks as needed and avoid high-impact and prolonged activities.

• If the individual is having difficulty performing a task, ask them if they need assistance.

• If the individual is using a wheelchair, it is important to maintain proper body position and alignment to reduce additional pain.

(Messina & Vita, 2018; Valle et al., 2016)

 SB is a condition that affects the spine, occurs within the first 28 days of pregnancy, and is usually apparent at birth (CDC, 2018c). It is a type of neural tube defect that occurs when the neural tube does not close all the way leaving the spinal cord exposed to injury (CDC, 2018c; Spina Bifida Association of America, 2023). SB can cause damage to the nerves responsible for sensory and muscles in the abdomen, pelvis, and leg regions (Spina Bifida Association of America, 2023). The severity can range from mild to severe depending on the location and size of the spine opening and if the spinal cord or surrounding nerves are affected (CDC, 2018c; Spina Bifida Association of America, 2023).

Tips for working with children with SB:

• Start slow and allow the individual extra time to perform the task. 

• Have the individual maintain proper posture when performing movements.

• Many individuals with SB may be allergic to latex. Make sure there are latex-free alternatives to any equipment used.

• Individuals with SB may lose control of their bowel and bladder. Make sure to have them use the restroom before engaging in physical activity. When in doubt, ask if they need to use the restroom.

• Some individuals with SB may have a shunt to assist them with drainage of excess fluids. It is important to not cause any trauma to the shunt or tubing. 

• Some individuals with SB may have difficulty regulating their body temperature. It is important for them: 

  • • • To wear appropriate clothing

      • Keep cool with a water spray or a fan

      • Ask if the individual needs to take a rest break.

(CDC, 2018c; National Center on Health, Physical Activity and Disability, n.d.; Spina Bifida Association of America, 2023)

Vision impairment results from various factors such as injury, disease, or a congenital condition (Cleveland Clinic, 2023). Vision impairments can range from mild to complete blindness (Cleveland Clinic, 2023). Blindness refers to having lost all or most of one's vision (Cleveland Clinic, 2023). These visual impairments can put children at risk for delayed motor milestones, language development, and emotional, social, and cognitive growth (Cleveland Clinic, 2023).

Tips for working with children with a vision impairment:

• Use assistive technology such as a beep baseball when hitting and fielding.

• Use a guide rope to help the individual advance the bases.

• Use a sound device on the bases to help the individual advance the bases.

• Use verbal cues such as "swing" to assist the batter.

• Have the individual use a cane or service animal to help them go around the bases.

• Provide detailed verbal instructions if the individual is unable to see demonstrations visually.

• Provide physical assistance if the individual requests it.

(Cleveland Clinic, 2023)