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Lisa Black

Pediatricians can work with families whose children with chronic conditions or medical complexity would benefit from recreation or sports

Children with disabilities should be encouraged to participate in sports, recreation and physical activities that best suit their preferences and abilities, with help from pediatricians who can offer guidance, reassurance and resources.

The American Academy of Pediatrics describes the benefits of physical activity for every child and ways to overcome historic barriers within an updated comprehensive clinical report, “Promoting the Participation of Children and Adolescents With Disabilities in Sports, Recreation, and Physical Activity.”

The report, published in the December 2021 Pediatrics (published online Dec. 1), focuses on the inclusion of children based on their strengths and abilities, pivoting away from more conservative approaches that centered on a child’s disability. The report’s underlying messages are consistent with the AAP’s emphasis on equity and inclusion goals for all children.

“We know that movement and activity offer so many benefits, but sometimes – perhaps out of an overabundance of caution -- we overlook options available for our children with medical conditions or disabilities,” said Paul S. Carbone, MD, FAAP, lead author of the report, written by the AAP Council on

Children with Disabilities and the AAP Council on Sports Medicine and Fitness.

“As pediatricians, we can create ‘physical activity prescriptions’ for children with disabilities and offer practical suggestions on identifying what would be the best fit for the individual child within their community. Taking part in a recreational sport or activity gives children a sense of achievement and chance to improve not only physical health, but skill levels, creativity, friendships and quality of life.”

Nearly 1 in 5 U.S. children have a special health care need, ranging from chronic conditions to those with medical complexity or cognitive, behavioral, or emotional conditions.

The report identifies barriers to participation in sports and physical activity, including the child’s functional limitations, negative self-perceptions, high cost, lack of accessible facilities, lack of nearby facilities or programs, and lack of providers with adaptive recreation expertise. Many individuals with disabilities are still, to a large extent, socially segregated and experience negative societal stereotypes and low performance expectations, providing them with limited opportunities for participation in group-based physical activities.

The AAP recommends, in part, that pediatricians:

  • Assess a child’s motor development, physical literacy, and physical activity levels at all wellness visits and discuss physical activity benefits and goals with children and their families.
  • Encourage parents to be physically active and encourage inclusion of children with disabilities in family recreational activities. The pediatrician can help caregivers recognize, identify, and address barriers to participation at the individual, family, community and societal levels.
  • Partner with interdisciplinary team members to develop “physical activity prescriptions” that can be incorporated within the electronic medical record.
  • Use a sports preparticipation form to promote the documentation of relevant medical issues that can be shared with therapeutic recreation programs, schools, and coaches.
  • Work with school districts and other community partners to identify and develop activities for children that focus on inclusion.

“Pediatricians can help families and children balance the benefits of participation with the potential risks,” said Claire LeBlanc, MD, FAAP, an author of the report. “It’s no longer acceptable to play it safe or assume children with disabilities ‘can’t do that.’ We want all children to experience the challenges and joys of participating in some form of recreation.”


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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