Chapter reviews latest research on health benefits of walking for those with disabilities

In a chapter to be published next year, we argue that walking is the best way for people with developmental disabilities to achieve important goals related to health and happiness, despite significant policy barriers

While many people find that getting and staying healthy and happy is a struggle, many of those caring for people with developmental disabilities find this to be an even greater challenge. What does research tell us about the extent of the problem, about possible solutions, and about policies that might create barriers to implementing these solutions? An invitation to contribute a chapter to the latest edition of the Handbook of Autism and Pervasive Developmental Disorders created an opportunity to collect answers to these questions regarding people with Intellectual / Developmental Disabilities and/or Autism (IDD/A) that could potentially reach a wide audience of academics and clinicians. We were especially excited because the Handbook is perhaps the most influential reference work in the field of Autism since first published more than 30 years ago.

So what did we learn? Research clearly supports conclusions and recommendations in several areas. For example, there is a general agreement regarding the amount and type of physical activity needed to get healthy, with consensus-based guidelines published by the US Department of Health (US DOH) generally echoed by other national and international guidelines. A number of studies have also confirmed that people with IDD/A struggle to get and stay healthy, and specifically to meet the goals established by the US DOH guidelines. Another review by the National Clearinghouse for Autism Education and Practice (NCAEP) also confirmed that exercise is an evidence-based practice for addressing other behavioral and education goals, like reducing problem behaviors and improving academic skills.

It is also clear that there are important gaps. Many different types of physical activities have been studied in those with IDD/A, but these have not always included specific measures to confirm the health benefits, and only a small number of these studies involved adults. People with more significant disabilities appear more likely to fall short of recommended levels of physical activity, but many of the studies intentionally or unintentionally exclude this group despite their higher risk. While many would agree that health is directly associated with happiness, few studies have explored the relationship between health and quality of life amongst those with IDD/A. These gaps make it more difficult for researchers to argue for more funding to address these important questions, or for educators and clinicians to get grants to explore solutions.

The chapter explored how walking might fill these gaps, especially for adults with more significant levels of IDD/A like Margot. The amount of walking needed to meet US DOH physical activity guidelines is well understood, and several studies have explored ways to increase walking among adults with IDD/A. Compared to other forms of exercise, there are relatively few barriers to walking every day. I used the example of our walks with Margot to illustrate the potential.

The rest of our chapter explored some of the policy implications and barriers, discussed in greater detail in a parallel post in Kennett Ability Network. In sum, a program of daily walks is one of the least complex to implement: in most cases, all you need is a Direct Care Professional (DSP) and an easy path to walk to get started. Longstanding problems with the recruitment and retention of DSPs remain the principle barrier, problems traced to policies that have chronically underfunded DSPs. And the stakes could not be higher; the state share of waivers that support programs for about 40 000 adults with IDD/A represents about 5% of the entire Pennsylvania budget.... and these costs will only grow if we cannot help adults like Margot get healthy.