Advances in Physical Education
2013. Vol.3, No.4, 187-189
Published Online November 2013 in SciRes (
Open Access 187
Adaptive Behaviour and Paddle Tennis:
A Case Study of Down’s Syndrome
Ricardo De la Vega1, Roberto Ruíz2, Maria De la Rocha3,4,
Jesús Onrubia4, Oswaldo Rivera1
1Department of Physic al Education, Sports and Human Motricity,
Autonomous University o f Madrid, Madrid, Sp ai n
2Department of Evolutionary and Educational Psychology,
Autonomous University o f Madrid, Madrid, Sp ai n
3Vicalvaro’s Health Center, Madrid Health Center, Madrid, Spain
4Sport and Physical Activity, Disability and Social Integration,
Autonomous University o f Madrid, Madrid, Sp ai n
Received September 19th, 2013; revised October 19th, 2013; accepted October 26th, 2013
Copyright © 2013 Ricardo De la Vega et al. This is an open access article distributed under the Creative Com-
mons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, pro-
vided the original work is p roperly cited.
Adaptive behaviour is one of the key elements to diagnose intellectual disability. In addition, these be-
haviors are crucial in order to operate on the daily life. As a population with a high risk of developing a
sedentary lifestyle, adapted physical activity programs for people and children with intellectual disability
are needed. Therefore the aim of this study is to assess the influence of adapted paddle tennis intervention
program on the adaptive behaviour of a child with Down’s syndrome. In a case study of child with
Down’s syndrome (male, Caucasian, age = 4.5 years), he participated on a paddle tennis program with a
length of 12 weeks. The child’s parents assessed the adaptive behaviour before and after the program
through the Adapted Behaviour Scale (ABS-S:2). Obtained data showed that three domains presented a
positive increasing. Parents reported that physical development increased from 19 to 23.5, and this in-
crease was corroborated by the instructor (post score = 23.8). Moreover, language development increases
from 18.5 to 28 (parents). The paddle tennis instructor perceived an increase in speaking abilities after the
program. The self-management domain also showed an increase from 8 to 17. The adapted paddle tennis
program is suitable for promoting physical activity and for improving adaptive behaviour in children with
intellectual disabilities.
Keywords: Adaptive Behaviour; Paddle Tennis; Down’s Syndrome; Physical Activity
The American Association on Intellectual and Developmen-
tal Disabilities (2002) establishes that the diagnosis of disability
is composed of two elements: the intellectual functioning and
the adaptive behaviour. In this sense, the person’s intellectual
coefficient (IQ) did not diagnose an intellectual disability
unless the assessment of the adaptive behavior is included, and
this perspective is known as the functioning model of intellec-
tual disability. Adaptive behaviour is defined as the compound
of conceptual, social and practical abilities which a person
learned in order to effectively operate on his daily life (Luck-
asson et al., 2002). These abilities are crucial for the person’s
integration and general functioning (Goldberg, Dill, Shin, &
Nhan, 2009) and close related with the person’s adaptation to
the daily life. As consequence, differences on the adaptive be-
haviour represent a major impediment to lead an independent
life (Soenen, Van Berckelaer-Onnes, & Scholte, 2009). It is
considered that these impediments are manifested early in the
person’s life and persist throughout life unless the child par-
ticipates in an intervention program (Chadwick, Cuddy, Kusel,
& Taylor, 2005). Intervention programs based on the IQ per-
pective are static, limiting in this way a possible improvement.
Contrary, the adaptive behaviour could increase as the result of
an intervention program.
One of the common pathologies associated with intellectual
disability is Down’s syndrome. This syndrome results from a
chromosomal abnormality in which a person’ cell nucleons
present 47 chromosomes instead of 46; and the exceeded
chromosome belongs to the 21st pair. This genetic despair
brings out modifications on the development and functioning of
organs and systems. These modifications are manifested during
prenatal and postnatal stages. The central nervous system CNS
is one of the most common affected systems. Especially, brain
and cerebellum are affected, and for this reason in a constant
way, a person with Down’s syndrome presents, in a variable
level, intellectual disability and psychomotor deficiencies. Es-
pecially, Down’s syndrome genetic alteration is close related
with deficiencies in the orthopedic and cardiovascular systems
(Sanyer, 2006). Children with Down’s syndrome have had little
participation in leisure and sport activities. In addition, their
main leisure activities are mainly sedentary and solitary (Oates,
Bebbington, Bourke, Girdler, & Leonard, 2011). Furthermore,
their interpersonal relations with other children are restricted. It
has been reported that children with Down’s syndrome have a
few number of friends (D’Haem, 2008). With an approximate
incidence of one of 650 - 1000 births, they are a population
with a high risk of developing a sedentary lifestyle, and conse-
quently a higher risk to being obese (De, Small, & Baur, 2008).
Individuals with intellectual and developmental disabilities, as
Down’s syndrome, are in need of effective physical fitness
training programs (Lotan, Yalon-Chamovitz, & Weiss, 2009).
Some limitations for practicing sports highlighted by Sanyer
(2006) in children with Down’s syndrome are the need to in-
volve health and sport sciences professionals in the manage-
ment and care of people with intellectual disability (D’Haem,
2008). Therefore, an adapted paddle tennis program, monitored
by qualified personnel, could be highly beneficial. Regular
physical activity improves the cardiovascular and muscle func-
tion. Additionally, physical activity also appears to decrease
depression, and enhance feelings of well-being (Franklin,
Whaley, & Howley, 2000). The objective of the present study
was to describe the effect of an organized adapted paddle tennis
program on the adaptive behaviour of a child with DS.
Participated in the study a child with Down’s syndrome
named Carlos (male), age (4.5 years), race (Caucasian). Carlos
lives with his parents, and did not have any experience practic-
ing paddle tennis or physical activity. We contact with Carlos’
parents through de Adapted Paddle Tennis School (Madrid,
Spain) which is part of the official schools of the Paddle for All
Association. Parents and the paddle tennis’ instructor voluntary
participated and provided informed consent. This study was
approved by the ethical committee of the Paddle for All Asso-
We used the Spanish version (García, 2001) of the Adaptive
Behaviour Scale (ABS-S:2; Lambert, Nihira, & Leland, 1993).
The scale is based on the performance of people with intellec-
tual disability with ages range from 3 to 69 years. The scale
assesses and describes the adaptive behaviour, obtaining a pro-
file with eight domains: Independent functioning, Physical
development, Language development, Numbers and time, Do-
mestic activity, Self-direction, Responsibility, and Socialization.
This instrument allowed us to identify behaviour strengths and
deficiencies. Moreover, it facilitates to assess the person’ pro-
gress while participating in an intervention program (Hardiman,
Guerin, & Fitzsimons, 2009). The ABS-S:2 has a reliability
coefficient of 0.96 (Medina, 2010). The ABS-S:2 scale is com-
pound of two parts, the first to assess the adaptive behaviour,
and a second to assess the maladaptive behaviour, in our study
we focused on the first part, data obtained from the second part
will not be used, neither in a further study.
Using the ABS-S:2, the parents assessed Carlos before and
after the intervention program. Parents were interviewed by the
research staff in order to obtain information related to Carlos.
Separately, each parent completed the scale. The paddle tennis
instructor was interviewed at the end on the intervention to
obtain information of Carlos related to his physical and techni-
cal issues, his behaviour during the sessions, and the interaction
with him before and after the program.
The intervention consisted on 12 adapted paddle tennis
classes (one each week) during the months of April to June of
2012. The class duration was 45 minutes and consisted on three
stages, first the warm-up, second the paddle tennis drills and
technique, and third the feedback and leisure part. This struc-
ture focus on satisfy the needs of physical activity and well-
being issues.
To assess the intervention program effect on the adaptive be-
haviour we desc ribe the data obtained with the ABS-S:2. De scri-
ptive data of the ABS-S:2 domains are presented in Table 1.
In general, the results showed that Carlos presented deficien-
cies in the adaptive behaviour domains, some of these deficien-
cies are major ones, as in the case of Independent Functioning.
After completing the adapted paddle tennis program Carlos
obtained a score of 61 from a maximal of 119. Physical devel-
opment showed an increase after the intervention from 19 to
23.5, with a maximum domain score of 24. This is a prosperous
result for the intervention program, due to the increase in this
domain which can be presented as a Carlos’ strength. This in-
crease on the physical development was confirmed by observa-
tions performed by the research staff and with the information
obtained with the instructor. In addition, other domain to con-
sider was the Language development, results showed an im-
provement before the intervention, with an increase from 18.5
to 28. This improvement was confirmed by the instructor.
Self-direction domain also improves from 8 to 17 (maximum
score of 23), which can be considered as other adaptive behav-
iour strength.
From a practical point of view the adapted paddle tennis
program had an effect on Carlos’ adaptive behaviour. These
effective results allowed us to consider this type of intervention
as a viable option to promote the sport practice in a population
characterized by a sedentary lifestyle. Results of the ABS-S:2
scale offered a general view of the strengths and deficiencies of
Table 1.
Domains scores of the adaptive behaviour scale ABS-S:2, descriptive
statistics mean scores pre-post intervention and maximum domains
ABS-S:2 Domains Prea Posta Max*
I: Independent funtioning 48.5 61 119
II: Physical develompment 19 23.5 24
IV: Language development 18.5 28 43
V: Numbers and time 4 5.5 14
VI: Domestic activities 3.5 5 23
VIII: Self-direction 8 17 23
IX: Respon sability 2.5 5.5 10
X: Socialization 8.5 8 26
Note: aMean scores from parents’ assessment; *Maximun score per doma i n .
Open Access
Open Access 189
a person’s abilities to effectively conduct his daily life. The
objective of this study was to describe, as a pilot study, the
effect of an adapted paddle tennis program on the adaptive
behaviour of a child with Down’s syndrome. Due to Carlos’
young age, just one year above the minimum age of the scale,
the obtained domain scores are majorly low, showing deficien-
cies on these behaviors (Goldberg, Dill, Shin, & Nhan, 2009).
Nevertheless, results related to Physical development showed
an improvement after the program, accordingly to the increased
scores, and this domain can be considered as a child’ strength.
Being a sport related intervention, specifically paddle tennis, is
not surprising that the physical development improves before
the program. Moreover, the scores of this domain obtained
before the intervention were higher. Our results allowed us to
suggest that this sport based programs can be integrated into the
leisure activities of children with Down’s syndrome. In refer-
ence to language development, we considered that the program
allows the children to interact with other people outside their
family. In addition, this interaction improves the language
abilities, and this issue is relevant if we consider that children
with Down’ syndrome have a low number of friends, and
mostly perform solo activities (Oates et al., 2011). As a sport
based program it is possible to fight against the sedentary life-
style of this population and helps them to obtain the benefits of
the sport practice (De, Small, & Baur, 2008). The program in-
cluded three stages, and as an adapted program it included im-
portant issues as participation, social support and self-reward-
ing (D’Haem, 2008). Due to the need to satisfy the demand of
practicing physical activity (Lotan, Yalon-Chamovitz, & Weiss,
2009), the program is feasible and suitable to fight against chil-
dren’ sedentary lifestyle. Moreover, as an intervention program
adapted to the intellectual disability population, the program
offers the service of qualified personnel. Contrary to a general
paddle tennis class, our pilot intervention focuses on satisfying
the needs of the persons with intellectual disability, especially
at early ages. Although it was a short length intervention, only
12 sessions, we observed improvements in the adaptive behav-
ior, and further studies which use a longer length intervention
are needed. The adaptive behaviour research allows using a
case study methodology. Contrary to the IQ classification ap-
proach, which is static, the adaptive behaviour allows us to
identify strengths and deficiencies along a wide range of do-
mains. Nonetheless, it will be interesting for further research to
analyze the effect of the adapted paddle tennis classes with a
larger group of participants.
The present study does have a number of limitations. The
case study approach, which can be considered for studying
adaptive behavior, is not as accurate in order to study the effect
of adapted sports and physical activity on intellectual disabili-
ties. However, having a participant that didn’t have any previ-
ous paddle experience was adequate for our purpose. The lack
of comparisons with other children, with or without intellectual
disabilities is also a limitation. Future research may therefore be
warranted by comparing what differences, if any, the practice
of physical activity of adapted sports plays in the adaptive be-
havior on larger groups. Furthermore, it would be interesting to
consider the effect of adapted paddle tennis during a longer
period of time or with more frequent sessions, instead of just
one week.
The adapted paddle tennis classes are positive not just to im-
prove the physical and psychomotor skills, but also to be served
as an interactive space for leisure.
This research has been subsidized by the Fundación Repsol,
through the “Adaptive Behaviour and a Paddle Tennis: a case
study of Down’s syndrome” project (Fundación Deporte Joven,
Consejo Superior de Deportes (CSD), Asociación Padelparato-
dos (ASPADO), Universidad Autónoma de Madrid (UAM).
American Association on Metal Retardation (2002). What is intellectual
Chadwick, O., Cuddy, M., Kusel, Y., & Taylor, E. (2005). Handicaps
and the development of skills between childhood and early adoles-
cence in young people with severe intellectual disabilities. Journal of
Intellectual Disabilities Research, 49, 877-888.
D’Haem, J. (2008). Special at school but lonely at home: an alternative
friendship group for adolescents with Down syndrome. Downs Syn-
drome Research and Practice, 12, 107-111.
De, S., Small, J., & Baur, L. (2008). Overweight and obesity among
children with developmental disabilities. Journal of Intellectual De-
velopmental Disability, 33, 43-47.
Franklin, B. A., Whaley, M. H., & Howley, E. T. (2000). ACSM’s
guidelines for exercise testing and prescription (6th ed.). Phila-
delphia: Lippincott Will iam s & Wilkins.
García, M. (2001). Las personas con retraso mental y su diagnóstico:
Traducción, adaptación y valoración de la Escala de Conducta
Adaptativa ABS S:2 y del método de Evaluación de las “Áreas de
Habilidades Adaptativas AAA”. Ph.D. Thesis, Burgos: Burgos Uni-
Goldberg, M. R., Dill, C. A., Shin, J. Y., & Nhan, N. V. (2009). Reli-
ability and validity of the Vietnamese Vineland Adaptive Behavior
Scales with preschool-age children. Research in Development Dis-
abilities, 30, 592-602.
Hardiman, S., Guerin, S., & Fitzsimons, E. (2009). A comparison of the
social competence of children with moderate intellectual disability in
inclusive versus segregated school settings. Research in Develop-
ment Disabilities, 30, 397-407.
Lambert, N., Nihira, K., & Leland, H. (1993). Adaptive Behavior
Scales-school: Second edition. ABS-S.2. Austin: PRO-ED, American
Association on Mental Retardation.
Lotan, M., Yalon-Chamovitz, S., & Weiss, P. (2009). Improving
physical fitness of individuals with intellectual and developmental
disability through a Virtual Reality Intervention Program. Research
in Development Disabilities, 30, 229-239.
Luckasson, R., Borthwick-Duffy, S., Buntix, W., Coulter, D., Craig, E.,
Reeve, A., et al. (2002). Manual retardation, Definition, Classifi-
cation and Systems of supports (10th ed.). Washington: American
Association on Mental Retardation.
Medina, M. (2010). Evaluación de la Conducta Adaptativa de las
Personas con Discapacidad Intelectual. Valoración y Usos de la
Escala ABS-RC: 2. Ph.D. Thesis, Burgos: Burgos University.
Oates, A., Bebbington, A., Bourke, J., Girdler, S., & Leonard, H.
(2011). Leisure participation for school-aged children with Down
syndrome. Disability and Rehabilitation, 33, 1880-1889.
Sanyer, O. (2006). Down syndrome and sport participation. Current
Sports Medicine Reports, 5, 315-318.
Soenen, S., Van Berckelaer-Onnes, I., & Scholte, E. (2009). Patterns of
intellectual, adaptive and behavioral functioning in individuals with
mild mental retardation. Research in Development Disabilities, 30,