Effects of a school-based physical activity intervention on children with intellectual disability: a cluster randomized trial

Background: Children living with disability have poorer health outcomes than their typically developing peers. They are less physically active and at increased risk of chronic disease. Teacher-led, whole-of-school physical activity interventions are promising levers for population-level change, but are seldom tested among children with disability. We aimed to evaluate the effect of a blended teacher-professional learning program (online and in-person) on fundamental movement skills (FMS) and physical activity among children with intellectual disability. Methods: In this cluster randomized clinical trial, we randomized 20 government-funded primary schools, including 238 consenting students (Grades 2–5; aged 8–11 years at baseline). Ten schools received the blended teacher-professional learning intervention and 10 were assigned as waitlist controls. The professional learning was designed to support teachers as they implemented a whole-of-school intervention designed to enhance FMS and increase physical activity levels. The school-based intervention was mostly online learning, followed by lesson observations and site visits from project staff. Blinded assessors measured FMS competency using the Test of Gross Motor Development-3. Secondary outcomes were self-concept, enjoyment, wellbeing, 300-yard run time, and accelerometer-measured physical activity. Results: We found no significant group-by-time effects for the primary outcome (FMS competency: b = 1.07 [95% CI -3.70, 5.84], p =.658) or any secondary outcomes. Conclusions: A school-based intervention did not improve FMS competency or physical activity in children with intellectual disability. Results may be attenuated by the COVID-19 pandemic. Alternatively, low intensity teacher-professional learning interventions may not be enough to improve FMS or physical activity among children with intellectual disability.