The types of physical activities children with visual impairment participate in and the reasons why

Values and beliefs

Parents discussed that a key motivator for engaging and choosing activities for their child was based on their own childhoods, ‘my husband and I are really sport[s] people and always played all sorts of things growing up so that’s . . . what we wanted for them too’. Many of the values and beliefs that parents held were not related to their child’s VI but were beliefs they held for all of their children. These core values and beliefs meant that, ‘sport it’s just something that we put up there’ and prioritize for all of their children. Parents also valued the social opportunities in physical activities, ‘I met a lot of my long-term friends through sport . . . so that’s kind of what we thought for him as well’. Participating in physical activities also allowed children to develop valuable life lessons, with a parent commenting:

with all the bad stuff happening nowadays, you got to keep kids in sport, keeps them out of trouble. It is my firm belief that in a club, good community with family and friends around you then hopefully that will alleviate any bad eggs and being influenced by bad eggs as well.

These beliefs continued across multiple families, with one parent noting:

. . . you learn to lose which is a big problem with current kids, they don’t know to fail which is my big thing, you have to learn to fail, you learn how to be part of a team, you learn your role in a team. Sport just gives them friendships, yeah it is just one of those things it just gives you so much.

Parents hoped that early engagement in activities would instill these values and beliefs in their children:

I think it is great to take direction from other people, great to be part of a team, actually being physical you know getting into that routine of being physical when you are young, I think helps you as you get older.

This was similarly noted by a parent from a different family:

. . . sport teaches you a lot of things. In a team environment it teaches you how to operate in a team, how to work with other people, how to manage those different personalities . . . it also teaches you how to lose, how to win gracefully, how to be a good sport. And it teaches you respect and commitment, you have to turn up to training, you have to turn up to the actual thing.

Although the parents’ values and beliefs were consistent for all of their children regardless of diagnosis of VI or not, many parents discussed seeking specific physical activities for their child with VI to assist them to overcome a limitation they experienced.

Desired outcomes

Parents often sought activities which they felt would be able to improve their child’s functioning in areas of perceived difficulties. Parents noted that due to their child’s VI they had less confidence, decreased general physical development, and more difficulties with social interactions. Most commonly, it was parents who had other children without VI who were particularly attentive to these differences and sought ways to help their child develop along the same path as their siblings: ‘I just wanted him to do it because I think I thought it might give him . . . you know . . . he wanted to be like his big brother . . . it might give him his self-confidence’. Multiple parents noted that due to their child’s VI they had difficulties with making friends and therefore sought physical activities as a way to increase social opportunities ‘it was mainly for the social side of things . . . because obviously he finds things a little bit more difficult making friends and things like that’ and ‘we did it as a sport that she could be involved in and also, at the time giving her social opportunities with people that were seeing similar struggles to those she was having’. Children with VI, whose parents reported the above findings, sought Goalball and judo to assist with social skills but also as the child was interested in those activities. The aspiration for their child to be confident and gain social opportunities was the most commonly desired outcome. Other desired outcomes included physical development, ‘I was actually originally thinking of for strength, and you know I was hoping she would like it too, but it was more the therapy side of it’. Parents could also encourage their children with VI to participate in activities by modelling participation.

Modelling

Parents who modelled participating in physical activities and maintaining a healthy lifestyle believed this was important in encouraging their child to participate. At times this was reflective of their participation in their younger years, we ‘also did athletics because his older brother and sister did it but again that’s because (DAD) and I did it I suppose, a lot of kids do what their parents do’. Other parents of younger children would note they would bring their children to watch their games, and encourage them to participate where possible, ‘we go and watch (DAD) so yeah, they enjoy it like being able to get out there and go out on the oval at quarter-time’. However, some parents found that the need to balance duties as a parent, employment and other activities meant they were not always able to sustain their engagement in physical activities. In these cases, some parents tried to maintain an active lifestyle:

we were always taking them to the beach and throwing balls to them and I mean, I just find that parents nowadays are so busy they don’t do some of the basics with kids, like go to the park and throw a ball with them, stuff, like it doesn’t have to be have to go to this class or have to go to dancing, and you got to go here and we were very big both (DAD) and I, in natural play, like go to the playground play, throw a ball, go down to the river and kayak, swim at the beach.

Modelling a physically active lifestyle reflected parents who valued being active and structured life to facilitate their child’s participation in physical activities. The presence of positive parent factors was noted as influential in not only what activities children participated in but also the attitude in which children approached their participation. When choosing physical activities, it was found that parents were attentive to their child’s interests and capacity to engage in physical activities.

Choice

Almost all parents considered their child’s interest and choices, when selecting physical activities for their child with VI. Swimming was the exception to this, with parents stating that ‘swimming is an important thing for us . . . it was a no-brainer . . . they started as babies swimming’ and ‘I just think that living in Australia swimming is important, it is a given’. When looking at other physical activities, the child’s choice was considered alongside the parent’s views. Older children discussed being able to exercise their choice through school sport electives, access to extra-curricular activities (through school), or independently access community areas such as local parks and teams. The interplay between parents’ factors and child’s choice is demonstrated through parents noting ‘we have a strong desire to get him into sport, but it has to be a personal decision’, and other parents stating, ‘I mean I give them their choice and I know what I would prefer them to do but it is up to them’. By considering their child’s choice parents noted reduced resistance to participating in physical activities: ‘I wanted him to be physical and he likes that, and he enjoys that, and he likes to be social . . . and I like to put him in things with his friends’ and ‘just wanted to get them into something . . . they (children with VI) go for anything that interests them’. Children’s interest and therefore choice was commonly linked to social factors. Children with VI often chose activities that their siblings or friends were doing, ‘my brother and sister just did it, so I thought I tried it and it was really fun’, and ‘I first picked soccer because . . . heaps of my friends were doing it’. Parents corroborated this view noting that their child chose activities, ‘because his brother and sister did it and he would come and watch so he just wanted to do it’. This desire for social connections was valuable in facilitating ongoing engagement. Findings showed that when children were younger, parents would seek out activities that ‘l think they might be interested in and go with that’. Parents of younger children noted that sometimes they felt the child’s choice was not possible due to other factors such as routine ‘they just get exhausted by the end of the week’, and practicality ‘we steered him away from that . . . it just didn’t seem like a safe idea’. This could be viewed as an ‘ableist’ view with parents enforcing their beliefs about their child’s capacities and influencing engagement in activities even before the child had attempted the activity. However, as children got older and their choices were perhaps more reflective of practical activities, choice was more of a deciding factor. The variation in the role of ‘choice’ is perhaps due to the presence of the VI itself. Parents noted that younger children did not always have an accurate understanding of their visual limitations and some parents felt this led them to choices which were not consistent with positive early experiences, ‘she would get frustrated you know in herself . . . because she couldn’t find them because she couldn’t see them in the water so that was . . . the reasons I took her out of that swimming’.

Disability

Both children and parents noted that the presence of VI and on occasion other co-occurring disabilities heavily influenced their choice of activities. Depending on the cause of VI, the impact on choice varied. For example, VI caused by conditions such as albinism, cataract removal, or bilateral colobomas meant parents often guided children towards indoor activities or environments conducive to reduced glare, ‘I can see swimming is an easier sport for them because there is less vision involved’, and ‘I do get worried about the vision stuff like with the cycling and stuff’. Parents also noted that VI which caused difficulties with tracking movements meant they guided children towards activities which did not involve small balls or fast-moving people or objects ‘there are certain sports like anything with a fast-moving ball is probably something that she is not going to be successful at’. This was repeated with other parents stating, ‘we sort of steered him away from that (cricket) . . . you know because of the small ball’. There were also safety considerations noted for children whose VI meant an increased risk of physical injury, such as those with a diagnosis of X-linked Juvenile Retinoschisis, or Hermansky-Pudlak Syndrome (HPS). This reduced engagement in ‘contact’ activities such as rugby or football, with parents noting ‘we have to be very careful with him because it is contact and with his head . . . we will have to quit at the end of this year because it is getting too dangerous’, and ‘because with HPS there is problems with bleed outs in the lower intestines . . . it’s quite dangerous . . . so they have stopped doing that’. These concerns regarding safety were at times strong enough to override the parents’ motivators and the child’s choice. One parent guided their child to dance for this reason; ‘because it is just a matter of remembering the routine and she has a very good memory, and the choice is well suited to her ability and her skill set’. Parents also guided their children to activities where they felt their child was more likely to succeed ‘I try to get him into things where he would only be competing against things like his own time, like the running and cycling’. Older children with VI considered their own vision limitations when making their choices, noting: ‘I have other opportunities like athletics and swimming where I don’t have to worry about things hitting my face’ and ‘sometimes because if you can’t see it (ball) . . . so that is why I like doing dancing and swimming because there is no ball’. However, parents of younger children with VI commonly noted their child had asked for activities they did not feel were suitable; ‘except that SON VI wants to do tennis which I am bit opposed to just with the vision’ and ‘hand-eye coordination is not his strong point in any way and to be honest I can’t think of a worse spot than tennis’. As previously commented, the parents’ perceptions of the child’s capacities could represent an ‘ableist’ view, in which parents reduced opportunities based on their perspective of the child.

Some parents noted limitations outside of their child’s vision which influenced whether their child engaged in particular physical activities. Children experienced a range of co-occurring disabilities from related conditions to the VI including cortical VI as a result of acquired brain injury, congenital toxoplasmosis, and ataxia telangiectasia and unrelated disabilities such as learning difficulties, autism, renal disease, osteopenia, seizures, global developmental delay, and cerebral palsy. When discussing the biggest barrier to commencing physical activities one parent commented: ‘his behaviour, definitely his behaviour’ which was primarily due to a co-occurring diagnosis of Autism. Co-occurring disabilities which impacted physical development such as Developmental Coordination Disorder could also influence choice: ‘you know he had very poor balance and spatial awareness’. Some children were heavily influenced by limitations outside of their VI, however for others it did not significantly influence their participation. The degree of influence was closely related to whether the child was potentially at risk of injury as a result of their difficulties (vision or other). Families revealed a pattern where risks to safety overrode the child’s choice, and parents’ values and beliefs. However, in cases where the VI and/or co-occurring disability did not indicate a significant physical risk, then the child was still able participate. Parents were able to overcome their fear of perceived minor risk of injury to provide their child with the opportunities and experiences they could get from engagement; ‘when he came home and said he wanted to do tennis, it was like ok how are we going to make tennis work’. Outside of the child and parents’ factors, there was commonly an external factor which assisted the children with VI getting involved in a physical activity.