Experiences in Physical Education with Bardet-Biedl Syndrome: An Interpretative Phenomenological Analysis Case Study

By Katherine Holland, Justin A. Haegele, Xihe Zhu, and Ellie Brady

Katherine Holland is a doctoral student in the Department of Human Movement Sciences at Old Dominion University in Norfolk, Virginia.

Justin A. Haegele, PhD, CAPE, is an assistant professor in the Department of Human Movement Sciences at Old Dominion University in Norfolk, Virginia.

Xihe Zhu, PhD, is an associate professor in the Department of Human Movement Sciences at Old Dominion University in Norfolk, Virginia.

Ellie Brady is a graduate student in the Department of Human Movement Sciences at Old Dominion University in Norfolk, Virginia.

Abstract

The purpose of this study was to examine physical education (PE) experiences from the perspective of an adult with Bardet-Biedl syndrome. An interpretative phenomenological analysis (IPA) research approach was used, and one male (age 32) with Bardet-Biedl syndrome acted as the participant. Sources of data included a semi-structured, audiotaped telephone interview and reflective interview notes. The interview was transcribed verbatim and data were analyzed thematically using a two-step approach informed by the IPA. Three themes emerged from the data: (a) “We were pretty much good friends”: The teacher’s influence, (b) “You’re different, must destroy”: Bullying and negative peer interactions, and (c) “I could never see the damn thing coming”: Inappropriate and inaccessible activities. These themes provide unique insights into how an individual with Bardet-Biedl syndrome experienced PE. Generally, the participant recalled negative experiences with regards to peer interaction and an inability to participate, but positive memories of one physical educator.

Keywords

Visual impairment, adapted physical education, blindness, inclusion

 

The Individuals with Disabilities Education Act (IDEA) (2004) mandates that all children with disabilities in the United States (US) receive instruction in physical education as a part of a free and appropriate public education. IDEA (2004) defines physical education as the “development of physical and motor fitness, fundamental movement skills and patterns, skills in aquatics, dance, and individual and group games and sports (including intramural and lifetime sports).” According to the Society of Health and Physical Educators (SHAPE America, 2013), the goal of physical education is to produce physically literate individuals that have the ability, confidence, and desire to be active throughout the lifespan.

Youth with visual impairments tend to experience unique obstacles that may influence them to not fully engage in physical education classes. For example, research examining the perceptions of individuals with visual impairments toward physical education has found that teachers are central to the quality of experiences (Haegele, Zhu, & Davis, 2017), and a lack of training on how to promote physical education activities for students with visual impairments can be a detriment to engagement in activities (Stuart, et al., 2006). In addition, research by Haegele and Kirk (2018) has identified that individuals with visual impairments often feel as though their physical education experiences were not rigorous enough because teachers had lower expectations for them than for their sighted peers. In instances like this, students without visual impairments tend to be encouraged to participate competitively, whereas those with visual impairments are often cast aside or given an alternative task by the physical education teacher (Haegele & Kirk, 2018).

While teachers are central to the quality of experiences in physical education, studies have demonstrated that peer relationships also inform the meaning that persons with visual impairments ascribe to their physical education experiences (Haegele & Zhu, 2017). Unfortunately, it is known that many students with visual impairments experience negative peer interactions during their time in physical education (Haegele & Kirk, 2018; Haegele & Zhu, 2017). Haegele and Zhu (2017) revealed that these interactions occur most commonly during integrated activities at the middle school level. These instances are typified by students having difficulty “fitting in” and feeling like a “burden” to their peers. Similarly, research has revealed that students with visual impairments tend to experience instances of bullying, including peers making negative comments specifically about their eyes or visual impairments (de Schipper, et al., 2017; Haegele & Kirk, 2018).  

Research about physical education for individuals with visual impairment has grown in recent years (de Schipper et al., 2017; Haegele & Kirk, 2018; Haegele & Zhu, 2017), however studies pertaining to individuals with specific conditions that cause visual impairment, such as Bardet-Biedl syndrome (BBS), are uncommon. Affecting approximately 1 in 100,000 individuals in North America, BBS is a genetic disorder that affects a broad range of body systems (Kerr, 2016). BBS evolves slowly and often remains undiagnosed until late childhood or early adulthood, as polydactyly, or having more than five fingers or toes on one limb, is often the only observable feature at birth. Common symptoms include digit anomalies, genital and kidney malformation/malfunction, obesity, and intellectual disability (Kerr, 2016). In addition, visual impairment resulting from rod-cone dystrophy is considered among the most common and noticeable symptoms of those with BBS (Beales et al., 1999). Vision loss among those with BBS begins with a decrease in night vision and deterioration is rapid, with most persons with BBS becoming legally blind in their mid-teens (Beales et al., 1999).

Individuals with BBS have characteristics that are unique to individuals with other disabilities, including those with visual impairments with other etiologies. To successfully teach individuals with BBS in the physical education setting, we must first understand how they experience instruction. By providing a voice to persons with BBS to describe their physical education experiences, more insight can be gained into how they experience lessons as well as salient features that contribute to the meaning they ascribe to these experiences (Coates, 2011; Haegele & Sutherland, 2015). Thus, the purpose of this interpretative phenomenological analysis (IPA) case study was to examine physical education experiences from the perspective of an adult with BBS.

Methods

Research Approach

To examine how an individual with BBS experienced physical education, this study employed an IPA case-study approach. IPA is a qualitative research approach that aims to understand the subjective meaning that individual participants ascribe to events or experiences (Smith & Osborn, 2008). This research approach is idiographic in nature, and focuses specifically on understanding each individual person’s embodied and situated relationship with their experiences (Smith, et al., 2009). The idiographic nature of IPA makes this research approach particularly relevant for case study analyses. IPA is also strongly influenced by phenomenology, in that it is concerned with each individual’s experiences rather than objective descriptions of events, and hermeneutics, in that it is the researchers aim to understand what participants are explaining when exploring the meaningfulness of their experiences (Smith & Osborn, 2008). Case study designs, which typically focus specifically on a single case, seek to understand complex social phenomena while retaining the holistic and meaningful particularities of real-life circumstances (Yin, 2003). According to Fade (2004), “the case-study approach to IPA can be used to develop an in-depth description of just one individual’s experience, where this seems appropriate” (p. 648). Because of the utility of the IPA case-study approach in understanding individuals’ complex experiences while retaining holistic and meaningful particularities from an embodied perspective, it was deemed an appropriate research approach for the current study.

Participant

The participant recruited for this study was part of a participant recruitment procedure for another study focusing on physical education experiences of individuals with visual impairments. For the larger study, participants were purposefully recruited through an electronic call, distributed by email through a registry of individuals with visual impairments who are interested in participating in research. Recruitment was based on the following criteria: (a) the individual must be at least 18 but less than 35 years of age, (b) the individual must self-identify as having a visual impairment during their K-12 education, and (c) the individual must be willing to complete an interview for 60-90 minutes. This age range was selected to ensure that the participant had concluded their K-12 physical education (Haegele & Zhu, 2017) and would be able to reflect on memories of their experience. Interested potential participants were asked to email the researcher to express interest and were screened through a questionnaire to ensure that they met the pre-specified eligibility criteria.

After receiving the screening questionnaire from Winston (a pseudonym), he was asked if he would be interested in participating in a case study focusing specifically on an individual with BBS. After agreeing to participate verbally, Winston provided written informed consent, formalizing his participation. The Institutional Review Board at the university affiliation of the authors reviewed and approved the study protocols.

Winston.

Winston was 32 years old at the time of the interview and identified himself as a white male. His visual impairment was caused by macular dystrophy, which is a component of his broader BBS diagnosis. Winston was born with 20/20 vision that got progressively worse as he aged, decreasing below 20/200 (legal blindness) in his early teens. Winston attended public schools at the elementary, middle, and high school levels in a rural town in the Northeastern region of the United States. Winston participated in integrated physical education classes with his sighted peers, using a cane for orientation and mobility purposes as his eyesight worsened. In middle school he occasionally received support in physical education from his teacher for students with visual impairments (TVI). Winston had some difficulty with fine motor tasks due to decreased dexterity in his hands. In addition to macular dystrophy and limited dexterity, weight gain and obesity are common symptoms of BBS. Winston recalls having been overweight during his years in public schools, weighing 210 pounds in the sixth grade and over 300 pounds in high school. Winston’s visual impairment, weight status, and difficulty with fine motor tasks presented unique challenges throughout his school-based physical education experience.

Data Collection

Data was collected for this study through a semi-structured phone interview and reflective interview notes. The participant completed a one-to-one audiotaped interview with the second author that lasted 48 minutes. The telephone interview was used, consistent with previous research examining experiences of individuals with visual impairments (Haegele & Zhu, 2017), to allow for a cost-effective participant recruitment across North America. The interviewer opened the interview by reminding the participant of the purpose of the study and exposing his positionality by identifying himself as a: (a) Caucasian male without a disability, (b) former adapted physical education teacher, and (c) research faculty member who trains physical educators. The interview followed a semi-structured interview guide, which included broadly worded questions informed by the IPA research approach. The interview guide was adopted from work by Haegele et al. (2018), who developed and obtained content validity for the guide. The guide was subsequently adapted for the purposes of this study, acting as a checklist during the interview while allowing the interview to proceed flexibly and the interviewee to dictate the order of discussed topics (Smith, 2017). Questions were designed to facilitate a conversational tone and focused on the individual’s experiences in physical education as a person with BBS. Sample questions included: (a) Can you tell me what your experiences with your peers were like when you were in physical education? (b) Do you think having a visual impairment influenced how you experienced physical education? and (c) Can you describe what your experiences in physical education were like while you were in school?

A second source of data were collected in the form of reflective interview notes. During and immediately following the interview, the second author recorded notes that included reflections on the ease and tone of the conversation, initial feelings about what the participant had said, any items that stuck out as particularly meaningful, and preliminary thoughts on potential themes (Smith & Sparkes, 2017). Completing this process allowed the interviewer to identify any potential personal biases that may have affected the interview process and the subsequent interpretation of the interview.

Data Treatment and Analysis

Upon completion of the data collection process, the fourth author transcribed the audio-recorded interview verbatim. The transcription process provided a semantic record of the interview and included every word spoken by both the interviewer and interviewee (Smith et al., 2009). Given that the aim of IPA is to specifically interpret the content of the interview (Smith et al., 2009), any information unrelated to the content, as well as non-verbal utterances and pauses, were not recorded.

Once the transcription process was complete, the first author conducted a two-step thematic analysis inspired by IPA. The goal of this process was to capture and display results in the form of Winston’s embodied experiences in physical education (Smith et al., 2009). First, the lead author (i.e., the analyst) read and reread the transcript many times to develop familiarity with the interview content (Smith, 2017). While doing so, the analyst noted items of interest and began to insert early interpretative commentary through descriptive and exploratory comments. Second, the analyst reduced the transcript, reflective interview notes, and descriptive and exploratory comments into emergent themes (Smith et al., 2009). The objective of this step was to create concise statements of important findings in the data in the form of various comments attached to the pieces of transcript. These themes reflected not only the participant’s original words but also the analysts’ interpretation (Smith et al., 2009). Emergent themes were then reviewed by the authorship team to ensure that the findings were in line with the purpose and research approach of the study. Agreed-upon themes were presented as results and discussed concurrently.

Quality Assessment

The researchers followed four principles for assessing the quality of qualitative research as presented by Yardley (2000) and recommended by Smith and colleagues (2009) for use in IPA studies. The four principles were: (a) sensitivity to context, (b) commitment and rigor, (c) transparency and coherence, and (d) impact and importance. The interviewer addressed sensitivity to context by openly describing his positionality as a researcher to uncover any potential bias in the interview. Additionally, an abundance of verbatim transcript extracts was presented in the results to allow the reader to check interpretations (Smith et al., 2009). Commitment and rigor were addressed in two ways: (a) the utilization of an interview guide that was inspired by the research approach that upheld the focus of the study, and (b) the interviewer closely attended to what the interviewee was saying and had an appreciation for the interactional nature of interviews during data collection (Smith et al., 2009; Yardley, 2000). The researchers explicitly described the interview, data treatment, and analysis protocols to the participant as well as identifying positionality, potential biases, and reflexivity, supporting transparency and coherence (Yardley, 2000). Yardley (2000) explains that the impact and importance of qualitative research lies in the authors’ ability to communicate the content as such to the reader. Thus, the final principle will be determined by those consuming this research.  

Results and Discussion

The following three themes emerged from the interview transcript: (a) “We were pretty much good friends”: The teacher’s influence; (b) “You’re different, must destroy”: Bullying and negative peer interactions; and (c) “I could never see the damn thing coming”: Inappropriate and inaccessible activities. These themes will be described with verbatim narrative examples and interpreted within the context of the current literature below.  

“We Were Pretty Much Good Friends”: The Teacher’s Influence

Teachers are considered central to the quality of student experiences in integrated physical education because they have the ability to ensure that students have meaningful learning experiences (Block & Obrusnikova, 2007; Haegele, Zhu, & Davis, 2017), such as those attended by Winston. Winston recalled attending physical education with his sighted peers, but receiving only intermittent support from a TVI and no support from an adapted physical education professional. Consistent with previous research examining experiences of persons with visual impairment (Haegele & Zhu, 2017), Winston had challenging experiences with his physical education teachers. Specifically, he described his middle school physical education teacher as a “space shot,” and suggested that this teacher did not provide modifications or accommodations and interacted with him in a very limited capacity. In addition, he recalled an inconsistency in expectations from his middle school physical education teacher, where “sometimes he would treat me the same as the other kids, sometimes he would be kind of riding me a little bit because I wasn’t able to keep up with some of the activities, and sometimes he would just ignore me.” Winston attributed his inability to keep up during physical education to the weight, vision, and dexterity limitations that he experienced due to his having BBS. Disappointingly, Winston’s experiences with inconsistent expectations is well-aligned with previous literature that has depicted similar instances among students with visual impairments (Haegele et al., 2018). At times when his physical education teacher ignored him, Winston remembered his TVI stepping in to intervene. When reflecting on the support he received he identified help being offered when “she [TVI] noticed that I was being left to sit in a corner.” Winston’s overall feelings toward his middle school physical educator were not overtly negative, but rather took a more neutral tone. He summarized: “I think sometimes he didn’t always quite realize that if you throw something at me I might not be able to catch it or stuff like that. But overall, I don’t think he was like, ‘Ah! Ew! Blind person!’ or anything like that.”

In contrast, positive experiences with physical education teachers can help students enjoy and look forward to physical activity opportunities (Block & Obrusnikova, 2007). Winston recalled positive memories of his experiences in high school physical education and credits those memories to the relationship that he had with one of his high school physical educators, describing the two of them as “good friends.” Winston recalled feeling as though his high school physical education teacher valued Winston’s participation with his peers and spent time “trying to take the stuff that would be really visual and find a way to make it work so that I wasn’t singled out or anything,” and also spent time with him during class during “free-time” activities. Winston fondly recalled his teacher joining him on the field to hit golf balls, calling it his most positive memory from his physical education career. Previous research by Fitzgerald (2005) has highlighted that students with disabilities find physical education enjoyable when they have positive interactions with teachers who they perceive to be thoughtful and considerate of the students’ needs. It is clear, based on Winston’s narrative, that these feelings were present when describing his high school physical educator.

“You’re Different, Must Destroy”: Bullying and Negative Peer Interactions

Although Winton recalled having some peers that were kind and helped him participate during physical education, his memories of peer interactions were mostly negative. Mostly, he noted accounts of verbal and physical bullying that were informed by perceptions of inability that existed due to his visible characteristics of BBS (i.e., weight gain and vision loss). Winston recalled that while some kids bullied him, “most of the other kids kind of ignored me and did their own thing.” Unfortunately, trends in current research show that bullying is generally a part of life for most individuals with visual impairments (Danes-Staples et al., 2013), including during physical education classes (de Schipper et al., 2017; Haegele & Kirk, 2018). Winston specifically recalled feeling targeted for his weight and his visual impairment (characteristics of his BBS diagnosis), and often simply because his peers wanted to make him angry. For example, he recalled being the victim of “pantsing” (i.e., peers pulling his pants down in public spaces) during elementary school and reported feeling like some of his peers “just absolutely had it out for me. Either because they thought it was funny to bully me or just basically ‘oh well you’re different, must destroy’ or whatever.” Because Winston fit the archetypal characteristics of individuals who are victims of bullying, often socially isolated and perceived as “different” than their peers (Kueny & Zirkel, 2012), it is not surprising to learn that he experienced these types of negative social interactions during physical education. 

Haegele and Zhu (2017) noted that middle school tends to be reported as the most common time for individuals with visual impairments to experience bullying during physical education. Congruently, Winston recalled that during middle school, one particular peer regularly targeted him with bullying behaviors. He noted that “there was this one kid in my middle school years who just was after me. So, I was convinced he was the spawn of Satan or something because he absolutely had it out for me.” Winston recalled multiple occasions when this student chased him around, took his belongings from him, and verbally insulted him.

One repercussion of negative peer relationships for Winston during middle school was being targeted during activities, such as dodgeball, where his vision as well as other characteristics of BBS made it difficult for him to move out of the way of oncoming balls. Winston also cited a difficulty with emotional regulation as a potential cause of the bullying while in middle school. He noted that “primarily I think it was just trying to get a reaction from me. One of the other things, I don’t know if it’s a me thing or a BBS thing because I’ve also noticed this to a small extent with other folks, is emotional control.” It appears that Winston believed that his bullies provoked him during physical education for entertainment, although it was clearly not entertaining for him. Winston’s narratives provide an example of how differences and vulnerabilities, associated with BBS, being put on display can influence negative peer relationships during physical education (Kueny & Zirkel, 2012).

“I Could Never See the Damn Thing Coming”: Inappropriate and Inaccessible Activities

Being asked to participate in physical education activities that are not adapted or modified to meet the needs of students with disabilities can have detrimental effects (Bredahl, 2013). For example, Goodwin and Watkinson (2000) suggest that when students with disabilities are asked to participate in activities that are not adapted for their needs, perceptions of students with disabilities as being unable to participate are fostered. Winston’s experiences in physical education aligned well with previous research, where a lack of access to appropriate and accessible activities was evident. For example, when discussing rope climbing, Winston described the “deep, deep bubble of frustration” that he felt each time he failed to successfully scale the rope, which he thought may have been a result of his weight and dexterity limitations, characteristics of his BBS diagnosis:

I was never able to do that no matter how hard I tried. I don’t know if that was because of the weight or because my upper body strength wasn’t so good or if I just didn’t have the dexterity needed to climb the stupid thing but every time I would try and try and try and I could never get on the stupid thing… Deep, deep bubble of frustration. Like why can’t I do this? I’m pretty strong, I should be able to do this. Even if I can’t get my feet on those stupid knots I should at least be able to pull myself up.

Like feelings previously reported by other persons with disabilities (Haegele & Zhu, 2017), Winston described feelings of frustration with not being able to perform activities. These types of feelings can lead to the student themselves questioning their ability to perform (Bredahl, 2013) and withdrawal from future physical activities (Haegele & Zhu, 2017). Winston’s experiences deviated from these results however, in that rather than a decrease in his participation, he recalls that he “would try and try and try.”  

Of the activities he participated in during physical education, Winston recalled dodgeball to be the most challenging due to his BBS characteristics of increased weight and vision loss, and aforementioned experiences as a target for bullying. Dodgeball is an elimination-style game that involves two teams throwing balls at each other with the objective of hitting an opponent and removing them from the game. In recent years, dodgeball has been added to a list of activities that are inappropriate and no longer considered best practice for physical education due to a high risk for physical harm (Rovegno & Bandhauer, 2016). Winston recalled both the physical and emotional impact of dodgeball on his physical education experiences: 

I always remember them throwing almost as hard as if they were shooting it out of a gun or something. It always hurt because I would get hit occasionally just because I couldn’t dodge very well. And because I could never see the damn thing coming until it was too late.

It is clear that Winston was targeted by peers during games like dodgeball, a game that is considered inappropriate for utilization in physical education (Rovegno & Bandhauer, 2016). When he refused to continue his participation in dodgeball, Winston was instructed to engage in cardiovascular exercises using a StairMaster^® rather than being active with his peers. Being excluded from activities during physical education because they are either inaccessible or inappropriate is omnipresent in research examining physical education experiences among persons with disabilities (Goodwin & Watkinson, 2000; Haegele & Sutherland, 2015). Winston recalled “hating” this non-inclusionary option, and actually preferred participating in inappropriate activities like dodgeball to being left out of activities. Interestingly, although it is well known that engaging in inappropriate activities is challenging for those with disabilities in physical education, Winston’s perspective highlights how powerful exclusionary experiences are in informing negative perceptions toward physical education.

Implications for Practice

Winston’s experiences in physical education provide insight into the challenges that students with disabilities, and specifically BBS, can face during their time in K-12 PE. Three implications for practitioners stood out when reviewing his narratives. First, Winston’s descriptions of his middle school physical education teacher, in contrast to those of his high school physical education teacher, emphasize the need for teachers to avoid segregated or exclusionary practices. When Winston felt as though an effort was made to include him in class activities, he had a positive perspective toward his teacher, and more favorable feelings toward physical education. Second, teachers should utilize appropriate instructional practices. Winston’s most challenging experiences in physical education occurred while his class participated in a dodgeball game. In recent years, dodgeball has become widely accepted as an inappropriate physical education activity due to the elimination style of play and high risk for injury (Rovegno & Bandhauer, 2016). Teachers should seek out information regarding instructional best practices in physical education and plan their curriculum accordingly. Lastly, teachers must be diligent in their supervision of social interactions and their interventions during occurrences of bullying behavior. Winston, like many students with disabilities, experienced both verbal and physical bullying during his K-12 physical education experience. Teachers should strive to create an atmosphere that is emotionally safe for all students and ensure that adequate supervision is provided so that incidents similar to Winston’s “pantsing” experience are not replicated.  

Limitations and Conclusions

Several limitations must be addressed in this study. First, the data collection process called for a retrospective recalling of experiences, which due to the constantly changing landscape of physical education, may have influenced the quality of the data (Haegele et al., 2017). Additionally, the semi-structured interview was held over the telephone, which may have diluted the intimacy of the interaction (Haegele & Zhu, 2017) as there was an inability to observe body language or facial expressions in addition to the recorded information (Goodwin & Staples, 2005). Lastly, the experiences described in this study are of just one participant. Due to the low-incidence nature of BBS, the information garnered from one participant was deemed valuable. However, Winston’s experiences may not be inherently transferable to all individuals with BBS.

The purpose of this case study was to examine physical education experiences from the perspective of an adult with BBS. Using an IPA approach, researchers discovered three themes that reflected the participant’s experiences in physical education. Each of the three themes provide unique insight into how individuals with vision loss due to, and along with additional symptoms from, BBS experience physical education. Generally, our participant recalled negative experiences with regards to peer interaction and an inability to participate, but positive memories of one physical educator that was motivated to ensure he felt included. This suggests that the experiences of individuals with BBS in physical education might be similar to those with visual impairments stemming from other causes. To our knowledge, however, this is the first study to examine the experiences of individuals with BBS in physical education. This study used a convenience sample of one participant, and further phenomenological research might pursue additional individuals with BBS to compare the results with those from this study.

References

Beales P.L,, Elcioglu N., Woolf A.S., Parker, D., & Flinter, F.A. (1999)  New criteria for improved diagnosis of Bardet-Biedl syndrome: results of a population survey. Journal of Medical Genetics, 36(6), 437-446. http://dx.doi.org/10.1136/jmg.36.6.437

Block, M. E., & Obrusnikova, I. (2007). Inclusion in physical education: A review of the literature from 1995-2005. Adapted Physical Activity Quarterly, 24(2), 103-124. https://doi.org/10.1123/apaq.24.2.103

Bredahl, A. M. (2013). Sitting and watching the others being active: The experienced difficulties in PE when having a disability. Adapted Physical Activity Quarterly, 30(1), 40-58. https://doi.org/10.1123/apaq.30.1.40

Coates, J. (2011). Physically fit or physically literate? How children with special educational needs understand physical education. European Physical Education Review, 17(2), 167-181.

Danes-Staples, E., Lieberman, L. J., Ratcliff, J., & Rounds, K. (2013). Bullying experiences of individuals with visual impairment: The mitigating role of sport participation. Journal of Sport Behavior, 36(4), 365-386.

de Schipper, T., Lieberman, L.J., & Moody, B. (2017). “Kids like me, we go lightly on the head”: Experiences of children with a visual impairment on the physical self-concept. British Journal of Visual Impairment, 35(1), 55-68. https://doi.org/10.1177/0264619616678651

Fade, S. (2004). Using interpretative phenomenological analysis for public health nutrition and dietetic research: A practical guide. Proceedings of the Nutrition Society, 63(4), 647-653. https://doi.org/10.1079/PNS2004398

Fitzgerald, H. (2005). Still feeling like a spare piece of luggage? Embodied experiences of (dis) ability in physical education and school sport. Physical Education & Sport Pedagogy, 10(1), 41-59.

Goodwin, D. L., & Staples, K. (2005). The meaning of summer camp experiences to youths with disabilities. Adapted Physical Activity Quarterly, 22(2), 160-178. https://doi.org/10.1123/apaq.22.2.160

Goodwin, D. L., & Watkinson, E. J. (2000). Inclusive physical education from the perspective of students with physical disabilities. Adapted Physical Activity Quarterly, 17(2), 144-160. https://doi.org/10.1123/apaq.17.2.144

Haegele, J. A., & Kirk, T. N. (2018). Experiences in physical education: Exploring the intersection of visual impairment and maleness. Adapted Physical Activity Quarterly, 35(2), 196-213. https://doi.org/10.1123/apaq.2017-0132

Haegele, J. A., & Sutherland, S. (2015). Perspectives of students with disabilities toward physical education: A qualitative inquiry review. Quest, 67(3), 255-273. https://doi.org/10.1080/00336297.2015.1050118

Haegele, J. A., Zhu, X., & Davis, S. (2017). The meaning of physical education and sport among elite athletes with visual impairments. European Physical Education Review, 23(4), 375-391. https://doi.org/10.1177/1356336X16650122

Haegele, J. A., & Zhu, X. (2017). Experiences of individuals with visual impairments in integrated physical education: A retrospective study. Research Quarterly for Exercise and Sport, 88(4), 425-435. https://doi.org/10.1080/02701367.2017.1346781

Individuals with Disabilities Education Act, 20 U.S.C. § 1400 (2004)

Kerr, E. N. (2016). Exploration of the cognitive, adaptive and behavioral functioning of patients affected with Bardet-Biedl syndrome. Clinical Genetics, 89(4), 426-433. https://doi.org/10.1111/cge.12614

Kueny, M.T., & Zirkel, P.A. (2012). An analysis of school anti-bullying laws in the United States. Middle School Journal, 43(4), 22-31. https://doi.org/10.1080/00940771.2012.11461817

Rovegno, I. & Bandhauer, D. (2016). Elementary physical education. Jones & Bartlett Publishers.

SHAPE America. (2013). National standards for K-12 physical education. Reston, VA.

Smith, B., & Sparkes, A. C. (2017). Interviews. In B. Smith & A. C. Sparkes (Eds.), Routledge handbook of qualitative research in sport and exercise (pp. 103-123). Routledge.

Smith, J. A. (2017). Interpretative phenomenological analysis. In B. Smith & A. C. Sparkes (Eds), Routledge handbook of qualitative research in sport and exercise (pp.219-229). Routledge.

Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretive phenomenological analysis: Theory, method, and research. Sage.

Stuart, M.E., Lieberman, L., & Hand, K.E. (2006). Beliefs about physical activity among children who are visually impaired and their parents. Journal of Visual Impairment & Blindness, 100(4), 223-234. https://doi.org/10.1177/0145482X0610000405

Smith, J. A., & Osborn, M. (2008). Interpretative phenomenological analysis. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (pp. 54-80). London, UK: Sage.

Yardley, L. (2000). Dilemmas in qualitative health research. Psychology & Health, 15(2), 215-228. https://doi.org/10.1080/08870440008400302

Yin, R. K. (2003) Case Study Research: Design and Methods. First edition. Sage.

The Journal of Blindness Innovation and Research is copyright (c) 2020 to the National Federation of the Blind.