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Belonging through Sport Participation for Disabled Youths: A Scoping Review

Belonging through Sport Participation for Disabled Youths: A Scoping Review. Winnie Zhao, Kirtana Thirumal, Rebecca Renwick, Denise Dubois University of Toronto, Department of Occupational Science and Occupational Therapy. Abstract

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Belonging through Sport Participation for Disabled Youths: A Scoping Review

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  1. Belonging through Sport Participation for Disabled Youths: A Scoping Review Winnie Zhao, Kirtana Thirumal, Rebecca Renwick, Denise Dubois University of Toronto, Department of Occupational Science and Occupational Therapy Abstract Introduction. Belonging is central to how young adults with intellectual and developmental disabilities (IDD) experience inclusion in community life1.Across a range of disabled and non-disabled populations, belonging has been broadly understood to be facilitated by sport participation, which has therapeutic benefits in rehabilitative contexts. Yet belonging has been only partially conceptualized and superficially studied. Further, although literature on sport participation and belonging encompasses various populations, significant gaps in knowledge remain about young adults aged 18-36 with IDD. Objectives. The findings of this scoping review will describe and characterize how belonging has been conceptualized in the literature examining sport participation for young adults with IDD. Methods. The most up-to-date and rigorous methodological standards 2,3 guided this scoping review. With the support of a research librarian with specific knowledge of rehabilitation, a search of five key scientific databases identified relevant literature (1988 - 2018). Two independent reviewers screened titles, abstracts, and full texts for inclusion. After each selection stage, reviewers compared, discussed, and agreed on articles to include and exclude (e.g. duplicates, full text unavailable, non-IDD population, no sport participation, no belonging-related concepts). Then, study, sample, and construct (e.g., belonging, sport participation) characteristics were extracted, charted, and categorized. Results. A total of 17 497 potentially relevant articles were identified from the initial search. After completing all levels of screening, a final total of 39 articles were included for this review. A number of concepts related to belonging were identified and organized based on the Belonging Framework1: social relationships (n=35), finding a good fit (n=19), negotiating meaningful roles (n=8), and interacting with similar people (n=6). The words “belonging” and “belong” were used in eleven studies, yet none of these studies defined belonging or described it in depth. The most common concepts related to belonging were socialization (n=33), self-statements (e.g. self-concept, self-esteem) (n=26), engagement (n=23), enjoyment (n=19), inclusion (n=18), and acceptance (n=17). Conclusions. This scoping review systematically synthesized how belonging was conceptualized within the research literature about young adults with IDD in sport. Gaps in the current understanding of belonging were identified and encourage future studies to define belonging more fully. Outcomes of this review highlighted a priority area for OT roles in programmatic interventions for this population. Conclusions Methods A scoping review was identified as the most appropriate approach to comprehensively review the literature on sport participation and belonging for young adults with IDD. This approach uses systematic search, selection, and extraction methods to synthesize the available information in an area of interest. This study design was selected over a systematic review, as our primary goal was not to assess the quality of articles or the effectiveness of interventions, but to reveal the breadth of this particular area of research. The scoping review protocol was informed by the framework outlined by Arksey and O’Malley 2, the Joanna Briggs scoping review methodology 17, and updated scoping review methods and report clarifications as reported by Colquhoun et al. 3. These authors suggest that scoping reviews are a helpful starting point to: extend the understanding of constructs of interest, assess the need to conduct a full systematic review, and identify existing gaps in the current extent of the research 18. Search Strategy In collaboration with a University of Toronto librarian in September 2018, search terms were established by the research team and grouped into four concepts of interest: (a) belonging; (b) sport participation; (c) IDD; and (d) youth, adolescent, young adults, and adults. Articles were gathered from September and December 2018 through multiple search methods. An initial literature search of six large electronic databases (Medline, PsycInfo, CINAHL, Sociological Abstracts, and SPORTDiscus) was conducted to offer a multidisciplinary outlook of the available literature. Only research articles published between 1988 and 2018 were included because the SO (a primary provider of sport participation opportunities for individuals with IDD) was officially recognized by the IOC in 1988 10. Search lines were established, and search terms were truncated and exploded according to specific databases. A hand-search was then conducted to gather novel pertinent articles. The initial search was completed in December 2018 and yielded 17 497 titles.   This scoping review aimed to synthesize and describe the literature relating to the concept of belonging through sport participation for young adults with IDD, using the Belonging Framework defined by Renwick and colleagues (2019). 17 497 studies published from 1988 to 2018 were examined and a total of 39 studies met the inclusion criteria for the final review. Conceptualizations of Belonging Concepts related to all four subcomponents of the Belonging Framework emerged within the included literature (see Figure 2). The most prevalent themes relating to belonging subcomponents were socialization (n=33), self-statements (n=26), and engagement (n=23). • Summary of belonging findings • Only two studies examined all four aspects of belonging in sufficient capacities. Findings from these two articles demonstrate that organized sport may facilitate all aspects of belonging in individuals with IDD. Although the majority of selected studies did not explore all four processes of belonging, it is possible that this is due to a conceptual misunderstanding of belonging for people with IDD. • The findings of this review indicate that belonging is not a well-researched concept in the literature. • Our results suggest that in the context of sport, there is ambiguity between the definitions of the four subcomponents of belonging. • Study Selection • Following article collection, screening criteria and definitions of variables of interest were established. IDD included learning disabilities, neurodevelopmental disorders, developmental delays, cognitive disabilities, and specific disorders, such as ASD and Down’s Syndrome. The age range of 18-35 years was important as support and services for individuals with IDD typically terminate after they turn 18 years old 19. Sport participation was defined by the ICF framework as “engaging in competitive and informal or formally organized games or athletic events, performed alone or in a group” 12. The conceptualization of belonging determined by Renwick and colleagues 1 was used, outlining four clear processes: (1) interacting with similar people, (2) negotiating meaningful roles, (3) having social relationships, and (4) finding a good fit. • Inclusion criteria. Retrieved articles were included in the current study if they: (i) reported on primary data or were a scoping or systematic review; (ii) included the experiences of individuals with IDD with any of our ages of interest (18-35 years old); (iii) sufficiently described the experience of individual(s) with IDD in sport, as defined by the ICF; and (iv) reported on any concepts or constructs related to belonging and its subcomponents. • Exclusion criteria. Articles were excluded if: (i) the study focused on only individuals with physical disabilities, mental illnesses, or other disorders not related to IDD; (ii) the study focused on physical or cognitive outcomes (e.g. physical fitness, academic performance, etc.) and did not describe any psychosocial factors related to sport participation; and (iii) there was insufficient information on the sport participation experience. • Microsoft Excel was used to organize relevant articles and conduct the screening process. Study selection (Figure 1) was completed at the title level in January 2018, at the abstract level in February 2019, and at the full-text level in March 2019.  Each selection process was performed individually by two reviewers, who met after each level of screening to compare and discuss results. • Charting the Data and Reporting Results • Data from selected articles were extracted and organized into a charting framework using Microsoft Excel, to provide an overview of belonging as experienced through different sport participation roles in individuals with IDD. The following categories of information were extracted from each document: publication date, researcher characteristics, sample population characteristics, research methods and approach, sport, and belonging/related concepts.   • Data was synthesized in a descriptive manner for each study, and quantitatively integrated across studies based on specific characteristics such as sample population, sport participation, study design, and concepts relating to belonging. Other trends The most common study respondent was a combination of individuals with IDD and their parents and/or support staff, suggesting that the majority of data available is not exclusively from the perspectives of youths with IDD Only one article in this breadth of research originated from an OT background, revealing a role for future OT research. OT relevance Occupational therapists have recognized the value of sport-based therapies in rehabilitative practices and also understand the role of occupational engagement in overall well-being. The findings of this review have synthesized the knowledge in terms of how belonging is experienced through sport in individuals with IDD and offers insight into valuable information for development of clinical strategies and tools. Findings also identified concepts that promote occupational engagement, such as motivation and achievement, that are facilitated sport. Recognizing this, clinicians can use sport-based therapies to foster engagement in social relationships and encourage finding a good fit, to enable increased occupational engagement. Introduction Intellectual and developmental disabilities (IDD) IDDare a heterogeneous group of disorders that involve difficulties in several domains including learning, problem solving, behaviour, and language4. These issues adversely affect their ability to participate in daily occupations that promote self-care, productivity, and leisure 5. In recent years, there has been a movement to increase the occupational opportunities and engagement for this population.   Belonging Through occupation, individuals with IDD can also experience a sense of belonging. Belonging is a core dimension of social inclusion for individuals with disabilities 6. While the ‘sense of belonging’ has been explored in the literature regarding individuals with IDD, there is no clear consensus on the definition of this term 7. Belonging is a construct that is inherently subjective in nature, and thus requires consideration of the individual to gain an accurate understanding of the experience 8. Renwick and colleagues (2019) developed a theoretical framework for belonging involving four processes, as it is experienced by individuals with IDD (Figure 1). These four processes facilitate the experience of belonging during occupational engagement in various community activities including school, employment, and sport. Sport Sport plays a valuable role in connecting individuals through a shared life experience. Sport has evolved to enhance opportunities for marginalized populations, including individuals with IDD. Established in 1968, the Special Olympics (SO) has been the primary provider of sport participation opportunities for athletes with IDD 9. Since then, an array of sport programs and recreational activities have become readily available for individuals with IDD of all ability levels 11.  The International Classification of Functioning, Disability, and Health (ICF) 12 defines sport as “engaging in competitive and informal or formally organized games or athletic events, performed alone or in a group”. Sport is considered to be a meaningful occupation to many, and has increasingly been used as a rehabilitative tool in therapeutic practice 13, 14 due to its physical and psychosocial benefits 15, 16. Despite the common belief that sport purports a sense of belonging, this concept has been minimally researched in the literature focusing on sport participation in individuals with IDD. Based on the conceptualization of belonging proposed by Renwick and colleagues 1, sport appears to have a unique opportunity to promote the four aspects of belonging in individuals with IDD. There is currently a paucity of knowledge surrounding the effect of sport on belonging for young adults with IDD. The intersecting area of sport participation, belonging, and IDD is important to understand as it has significant implications for occupational therapy practice and the development of future sport programs for this population. Further, no systematic or scoping review of sport participation for individuals with IDD has focused on the psychosocial benefits, related to belonging. • Research gaps and future directions • Expand to other countries • Young adult age group exclusively • OT perspective • Define belonging • Create a comprehensive Belonging Framework Results A total of 17 497 potentially relevant articles were identified from the initial search. After completing all levels of screening, a final total of 39 articles were included for this review. • Limitations • While this scoping review provided key knowledge about the sense of belonging through sport participation for individuals with IDD, there are several limitations to these findings. • Language the included studies were limited to articles written in English • Study respondents  Eighteen of the included studies had combined respondents • Population description Many of the included articles did not explain how the diagnosis of their IDD participants was established. • Despite these limitations, this is the first study to date to examine the literature relating to belonging in sport for individuals with IDD. The current findings provide a solid foundation for future research in this topic area. This scoping review demonstrates the role that sport plays in promoting a sense of belonging for individuals with IDD. The current literature portrays sport as an enjoyable and motivating occupation that allows individuals with IDD to experience several positive outcomes related to belonging including inclusion, engagement, acceptance, and perception of self (e.g. ‘self-competence’, ‘self-identity’, ‘self-esteem’). Engaging in social relationships, a subcomponent in the Belonging Framework by Renwick et al. (2019), has been identified as a major avenue through which the sense of belonging occurs in sport. However, the current Belonging Framework as proposed by Renwick et al. (2019) requires some refinement to clarify the distinctions between each subcomponent. This review contributes important knowledge that can inform the use of sport as an occupational strategy for individuals with IDD. Stakeholders including OTs, policy makers, and researchers will benefit from applying these findings to their respective fields to promote the community inclusion and engagement of individuals with IDD. Study Respondents Study Approach Data Collection Country of Origin Figure 1. Belonging Framework1. Acknowledgements Department of Occupational Science and Occupational Therapy and the Quality of Life Research Unit lab at the University of Toronto References Renwick, R., DuBois, D., Cowen, J., Cameron, D., Schormans, A. F., & Rose, N. (2019). Voices of youths on engagement in community life: a theoretical framework of belonging. Disability & Society, 0(0), 1–27. https://doi.org/10.1080/09687599.2019.1583551 Arksey, H., & O’Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616 Colquhoun, H. L., Jesus, T. S., O’Brien, K. K., Tricco, A. C., Chui, A., Zarin, W., … Straus, S. (2017). Study protocol for a scoping review on rehabilitation scoping reviews. Clinical Rehabilitation, 31(9), 1249–1256. https://doi.org/10.1177/0269215516688514 CDC. (2015, February 12). Key Findings: Developmental Disabilities Prevalence Trends | CDC. Retrieved May 21, 2019, from Centers for Disease Control and Prevention website: https://www.cdc.gov/ncbddd/developmentaldisabilities/features/birthdefects-dd-keyfindings.html NICHD. (2018). Intellectual and Developmental Disabilities. Retrieved May 20, 2019, from NIH Fact Sheets website: https://www.report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=100 Hall, S. A. (2009). The social inclusion of people with disabilities: a qualitative meta-analysis. Journal of Ethnographic & Qualitative Research, 3(3). Mahar, A. L., Cobigo, V., & Stuart, H. (2013). Conceptualizing belonging. Disability and Rehabilitation, 35(12), 1026–1032. https://doi.org/10.3109/09638288.2012.717584 Walmsley, J., Strnadová, I., & Johnson, K. (2018). The added value of inclusive research. Journal of Applied Research in Intellectual Disabilities, 31(5), 751–759. Požėrienė, J., Adomaitienė, R., Ostasevičienė, V., Rėklaitienė, D., & Kragnienė, I. (2008). Sport participation motivation of athletes with intellectual disabilities. Education. Physical Training. Sport, 70(3). Special Olympics. (2018). Recognition and Growth Around the World. Retrieved September 18, 2018, from Special Olympics website: https://www.specialolympics.org/about/history/recognition-and-growth-around-the-world Harada, C. M., & Siperstein, G. N. (2ICF. (2017). Sports. Retrieved May 21, 2019, from ICF Browser website: http://apps.who.int/classifications/icfbrowser/ 009). The sport experience of athletes with intellectual disabilities: A national survey of Special Olympics athletes and their families. Adapted Physical Activity Quarterly, 26(1), 68–85. DePauw, K. P., & Gavron, S. J. (2005). Disability sport. Human Kinetics. Lufi, D., & Parish-Plass, J. (2011). Sport-based group therapy program for boys with ADHD or with other behavioral disorders. Child & Family Behavior Therapy, 33(3), 217–230. Donaldson, S. J., & Ronan, K. R. (2006). The effects of sports participation on young adolescents’ emotional well-being. Adolescence, 41(162), 369–389. McVeigh, S. A., Hitzig, S. L., & Craven, B. C. (2009). Influence of sport participation on community integration and quality of life: a comparison between sport participants and non-sport participants with spinal cord injury. The Journal of Spinal Cord Medicine, 32(2), 115–124. Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 13(3), 141–146. Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: advancing the methodology. Implementation Science, 5(1), 69. Stewart, D., Stavness, C., King, G., Antle, B., & Law, M. (2006). A Critical Appraisal of Literature Reviews About the Transition to Adulthood for Youth with Disabilities. Physical & Occupational Therapy In Pediatrics, 26(4), 5–24. https://doi.org/10.1080/J006v26n04_02 Objective This scoping review aimed to describe and characterize the research studies (1988-2018) that focuses on sport participation and belonging of young adults (18-35 years old) with intellectual and developmental disabilities (IDD) in order to clarify current conceptualizations for sport participant and belonging for this population. Figure 6. Frequency of belonging subcomponents in selected articles (left). Data on number of subcomponents examined in each article (right). Figure 3. Study characteristics of selected articles (n=39). Figure 2. Study selection flowchart. Figure 4. Participant characteristics of selected articles (n=39). Figure 5. Sport characteristics of selected articles (n=39).

  2. Abstract Introduction. Belonging is central to how young adults with intellectual and developmental disabilities (IDD) experience inclusion in community life1. Across a range of disabled and non-disabled populations (e.g., Olympic and Paralympic athletes; war veterans), belonging has been broadly understood to be facilitated by sport participation, which has therapeutic benefits in rehabilitative contexts. Yet belonging has been only partially conceptualized and superficially studied. Further, although literature on sport participation and belonging encompasses various populations, significant gaps in knowledge remain about young adults aged 18-36 with IDD. Objectives. The findings of this scoping review describe and characterize how belonging has been conceptualized in the literature examining sport participation for young adults with IDD. Methods. The most up-to-date and rigorous methodological standards 2, 3 guided this scoping review. With the support of a research librarian with specific knowledge of rehabilitation, a search of five key scientific databases (MEDLINE, CINAHL, PsycINFO, SPORTDiscus, & Sociological Abstracts) identified relevant literature (1988 - 2018). Two independent reviewers screened citations and abstracts for inclusion. After each selection stage, reviewers compared, discussed, and agreed on articles to include and exclude (e.g. duplicates, full text unavailable, non-IDD population, no sport participation, no belonging-related concepts). Then, study, sample, and construct (e.g., belonging, sport participation) characteristics were extracted, charted, and categorized. Results. A total of 17 497 potentially relevant articles were identified from the initial search. After completing all levels of screening, a final total of 39 articles were included for this review. A number of concepts related to belonging were identified and organized based on the Belonging Framework1: social relationships (n=35), finding a good fit (n=19), negotiating meaningful roles (n=8), and interacting with similar people (n=6). The words “belonging” and “belong” were used in eleven studies, yet none of these studies defined belonging or described it in depth. Two studies had findings reflecting all four processes of belonging, suggesting that organized sport can facilitate belonging fully in individuals with IDD. The most common concepts related to belonging among these studies were socialization (n=33), self-statements (e.g. self-concept, self-esteem) (n=26), engagement (n=23), enjoyment (n=19), inclusion (n=18), and acceptance (n=17). Conclusions. Scoping review findings: (i) systematically synthesized how belonging and sport participation are conceptualized within the research literature about young adults with IDD; (ii) identify gaps in current knowledge; and (iii) highlight priority areas for future OT roles and research.

  3. Introduction Intellectual and developmental disabilities (IDD).IDDare a heterogeneous group of disorders that involve difficulties in several domains including learning, problem solving, behaviour, and language4. These issues adversely affect their ability to participate in daily occupations that promote self-care, productivity, and leisure 5. In recent years, there has been a movement to increase the occupational opportunities and engagement for this population.   Belonging. Through occupation, individuals with IDD can also experience a sense of belonging. Belonging is a core dimension of social inclusion for individuals with disabilities 6. While the ‘sense of belonging’ has been explored in the literature regarding individuals with IDD, there is no clear consensus on the definition of this term 7. Belonging is a construct that is inherently subjective in nature, and thus requires consideration of the individual to gain an accurate understanding of the experience 8. Renwick and colleagues (2019) developed a theoretical framework for belonging involving four processes, as it is experienced by individuals with IDD: (a) interacting with similar people, (b) negotiating meaningful roles in the community, (c) engaging in social relationships, and (d) finding a good fit - navigating norms and expectations. These four processes facilitate the experience of belonging during occupational engagement in various community activities including school, employment, and sport. Sport. Sport plays a valuable role in connecting individuals through a shared life experience. Sport has evolved to enhance opportunities for marginalized populations, including individuals with IDD. Established in 1968, the Special Olympics (SO) has been the primary provider of sport participation opportunities for athletes with IDD 9. In 1988, the SO movement was officially recognized by the International Olympic Committee, solidifying its influence in the sport world 10. Since then, an array of sport programs and recreational activities have become readily available for individuals with IDD of all ability levels 11.  The International Classification of Functioning, Disability, and Health (ICF) 12 defines sport as “engaging in competitive and informal or formally organized games or athletic events, performed alone or in a group”. Sport is considered to be a meaningful occupation to many, and has increasingly been used as a rehabilitative tool in therapeutic practice 13, 14 due to its physical and psychosocial benefits 15, 16. Despite the common belief that sport purports a sense of belonging, this concept has been minimally researched in the literature focusing on sport participation in individuals with IDD. Based on the conceptualization of belonging proposed by Renwick and colleagues 1, sport appears to have a unique opportunity to promote the four aspects of belonging in individuals with IDD. There is currently a paucity of knowledge surrounding the effect of sport on belonging for young adults with IDD. The intersecting area of sport participation, belonging, and IDD is important to understand as it has significant implications for occupational therapy practice and the development of future sport programs for this population. Further, no systematic or scoping review of sport participation for individuals with IDD has focused on the psychosocial benefits, related to belonging. The intersection of sport participation, belonging, and IDD is an important area to understand as it has significant implications for occupational therapy practice and the development of future sport programs for this population. Thus, this scoping review aimed to describe the current research available on sport participation and belonging for youths (18-35 years) with IDD. Guided by the conceptual framework of belonging proposed by Renwick and colleagues 1, a secondary aim was to clarify current understandings of belonging within the sport participation literature for this population.

  4. Objective This scoping review aimed to describe and characterize the research studies (1988-2018) that focuses on sport participation and belonging of young adults (18-35 years old) with intellectual and developmental disabilities (IDD) in order to clarify current conceptualizations for sport participant and belonging for this population.

  5. Method A scoping review was identified as the most appropriate approach to comprehensively review the literature on sport participation and belonging for young adults with IDD. This approach uses systematic search, selection, and extraction methods to synthesize the available information in an area of interest. This study design was selected over a systematic review, as our primary goal was not to assess the quality of articles or the effectiveness of interventions, but to reveal the breadth of this particular area of research. The scoping review protocol was informed by the framework outlined by Arksey and O’Malley 2, the Joanna Briggs scoping review methodology 17, and updated scoping review methods and report clarifications as reported by Colquhoun et al. 3. These authors suggest that scoping reviews are a helpful starting point to: extend the understanding of constructs of interest, assess the need to conduct a full systematic review, and identify existing gaps in the current extent of the research 18. Search Strategy In collaboration with a University of Toronto librarian in September 2018, search terms were established by the research team and grouped into four concepts of interest: • Belonging • Sport participation • IDD • Youth, adolescent, young adults, and adults Articles were gathered from September and December 2018 through multiple search methods. An initial literature search of six large electronic databases (Medline, PsycInfo, CINAHL, Sociological Abstracts, and SPORTDiscus) was conducted to offer a multidisciplinary outlook of the available literature. Only research articles published between 1988 and 2018 were included because the SO (a primary provider of sport participation opportunities for individuals with IDD) was officially recognized by the IOC in 1988 10. Search lines were established, and search terms were truncated and exploded according to specific databases. A hand-search was then conducted to gather novel pertinent articles. The initial search was completed in December 2018 and yielded 17 497 titles.  

  6. Method Study Selection Following article collection, screening criteria and definitions of variables of interest were established. IDD included learning disabilities, neurodevelopmental disorders, developmental delays, cognitive disabilities, and specific disorders, such as ASD and Down’s Syndrome. The age range of 18-35 years was important as support and services for individuals with IDD typically terminate after they turn 18 years old 19. Sport participation was defined by the ICF framework as “engaging in competitive and informal or formally organized games or athletic events, performed alone or in a group” 12. The conceptualization of belonging determined by Renwick and colleagues 1 was used, outlining four clear processes: (1) interacting with similar people, (2) negotiating meaningful roles, (3) having social relationships, and (4) finding a good fit. Inclusion criteria. Retrieved articles were included in the current study if they: (i) reported on primary data or were a scoping or systematic review; (ii) included the experiences of individuals with IDD with any of our ages of interest (18-35 years old); (iii) sufficiently described the experience of individual(s) with IDD in sport, as defined by the ICF; and (iv) reported on any concepts or constructs related to belonging and its subcomponents. Exclusion criteria. Articles were excluded if: (i) the study focused on only individuals with physical disabilities, mental illnesses, or other disorders not related to IDD; (ii) the study focused on physical or cognitive outcomes (e.g. physical fitness, academic performance, etc.) and did not describe any psychosocial factors related to sport participation; and (iii) there was insufficient information on the sport participation experience. Microsoft Excel was used to organize relevant articles and conduct the screening process. Study selection (Figure 1) was completed at the title level in January 2018, at the abstract level in February 2019, and at the full-text level in March 2019.  Each selection process was performed individually by two reviewers, who met after each level of screening to compare and discuss results. Charting the Data and Reporting Results Data from selected articles were extracted and organized into a charting framework using Microsoft Excel, to provide an overview of belonging as experienced through different sport participation roles in individuals with IDD. The following categories of information were extracted from each document: publication date, researcher characteristics, sample population characteristics, research methods and approach, sport, and belonging/related concepts. Data was synthesized in a descriptive manner for each study, and quantitatively integrated across studies based on specific characteristics such as sample population, sport participation, study design, and concepts relating to belonging.

  7. Results Country of Origin Study Approach Study Respondents Data Collection 3b) 3a) A total of 17 497 potentially relevant articles were identified from the initial search. After completing all levels of screening, a final total of 39 articles were included for this review. Study Characteristics • Publication Date: The selected articles were published between 1993 and 2018. The majority of articles were published in 2016 (n=5) and 2017 (n=5). • Country of Origin (Figure 3a): Studies were conducted in the USA (n= 17), Canada (n= 7), Australia (n= 5), and UK (n= 5). Remaining articles originated from countries such as Republic of Ireland, Italy, and Israel. • Research Background: Psychology/Psychiatry (n= 9), Exercise & Sport Science/Physical Education (n= 7), and Human Kinetics/Kinesiology (n= 5). Only one study applied an Occupational Therapy perspective. • Study Approach (Figure 3b): Study designs were qualitative (n= 21), quantitative descriptive (n=7), mixed methods (n=7), quantitative experimental (n=3), and reviews (n=1) • Study Respondents (Figure 3c): The overall population of interest in all the included studies was individuals with IDD. Most studies had combined respondents (e.g. child with IDD and their parent) (n=18). The remaining studies had individuals with IDD only (n=15), parents (n=3), coaches/support workers/volunteers (n=2), research studies (n=1) • Data collection (Figure 3d): Individual semi-structured interviews (n=16), surveys/questionnaires (n=10), combination of methods (n=10), group interviews (n=2), literature searches (n=1) 3d) 3c)

  8. Results 4a) Participant Characteristics • Population of interest (Figure 4a): Studies included individuals with varying intellectual/developmental disability labels. Common labels included ‘intellectual disabilities’ (n= 14), specified heterogeneous samples of IDD (e.g., combination of Down Syndrome and Cerebral Palsy (CP)) (n=9), Down Syndrome (n=5), Autism Spectrum Disorder (ASD) (n=2), ‘developmental disabilities’ (n= 2), Attention Deficit Hyperactivity Disorder (ADHD) (n= 1), and CP (n= 1). Five articles did not specify the disability or diagnosis of their sample, and used terms such as ‘Special Olympics athletes’. • Age range (Figure 4b): To be included studies had to have at least one individual within the young adult age category (18-35). Thirteen of the studies included individuals aged 18 and younger, fourteen studies included ages 35 and older (n=14), and six studies included individuals across the lifespan (i.e., both younger than age 18 and older than age 35). Only two studies included participants with ages exclusively within our target range of 18-35 years old. 4b)

  9. Results 5a) Sport Characteristics • Organization (Figure 5a): More than a third of the selected studies (n= 17) focused on organized sport run through by Special Olympics (SO). Fifteen studies also examined other organized community-based sports participation. Three articles investigated organized sport events (i.e. Paralympics Games, World Cerebral Palsy Championships, and a power wheelchair soccer tournament), and one article focused on school-based sport participation. Four articles did not specify the nature of the organized sports in which the participants engaged. • Sport focus (Figure 5b): Regarding the types of sports examined, few studies focused on a single sport (n= 5). The majority of studies examined a combination of at least two different sports (n= 25), while nine studies did not specify the types of sport. Of all sports discussed within the articles, the most common were swimming (n= 17), bowling (including lawn bowling and 10-pin bowling) (n= 15), athletics (including cross-country running, track and field, and triathlon) (n= 10), soccer (including soccer and power wheelchair soccer) (n= 9), and basketball (n= 9). A total of 38 different sports were included in the articles. 5b)

  10. Results 6a) Belonging • Two of the studies included in this scoping review described all four components of the Belonging Framework as outlined by Renwick et al. (2019) - engaging in social relationships, finding a good fit - navigating norms and expectations, negotiating meaningful roles in the community, and interacting with similar people. Several articles had results that reflected more than one of the subcomponents (Figure 6a). • The common outcomes of the studies focused on: engaging in social relationships (n=35) and finding a good fit (n=19) (Figure 6b). • The words “belonging” and “belong” were used in eleven studies, yet none of these studies defined belonging or described it in depth. • The most common concepts related to belonging were socialization (n=33), self-statements (i.e. concepts related to the individual’s perception of themselves, such as ‘self-esteem’ and ‘self-identity’) (n=26), engagement (n=23), enjoyment (n=19), inclusion (n=18), and acceptance (n=17). 6b)

  11. Discussion This scoping review aimed to synthesize and describe the literature relating to the concept of belonging through sport participation for young adults with IDD, using the Belonging Framework defined by Renwick and colleagues (2019). 17 497 studies published from 1988 to 2018 were examined and a total of 39 studies met the inclusion criteria for the final review. Conceptualizations of Belonging Concepts related to all four subcomponents of the Belonging Framework emerged within the included literature (see Figure 2). The most prevalent themes relating to belonging subcomponents were socialization (n=33), self-statements (n=26), and engagement (n=23). Engaging in social relationships (n=35): • Most commonly cited subcomponent of belonging in this review • Related concepts: socialization (i.e. ‘social network’, ‘social skills’, ‘social support’) and friendship (i.e. ‘peers’, ‘camaraderie’) • Socialization opportunities occurred between many stakeholders in the sport experience including other athletes, coaches, family, spectators, and support staff at facilities. • Among articles examining this subcomponent, the term ‘belonging’ was only used in five of these articles • These findings demonstrate that ‘belonging’ as a concept is not currently well-conceptualized in the literature pertaining to engaging in social relationships. • These findings indicate that the social aspects of sport play a major role in the sense of belonging of individuals with IDD. Sports provide a natural environment for individuals with IDD to socialize with others over a common interest. In turn, social relationships with others motivate individuals with IDD to continue participating in sport. The social benefits of sport also enhance aspects of daily life including productivity and leisure activities. Finding a good fit - navigating norms and expectations (n=19): • Acknowledgement of their own skill sets and establishing well-balanced support systems on their sports teams were key contributors to finding a good fit • Nineteen articles described concepts related to this category. • Related concepts: self-statements and ‘achievement’.   • Among articles examining this subcomponent, the term ‘belonging’ was used in only eight of these articles • These findings suggest that finding a good fit is an important aspect of belonging in sport for individuals with IDD. However, it is not often recognized as related to ‘belonging’ in the current literature, but rather as concepts such as ‘inclusion’ and ‘acceptance’. Negotiating meaningful roles in the community (n=8): • Results indicated that sport facilitated the acquisition of meaningful roles, such as being a ‘helper’, within a team or organization. Acknowledgement and recognition from teammates and others for their athletic efforts strengthened the meaningfulness and importance of sport • Among articles examining this subcomponent, eight articles described concepts related to this category. • Related concepts: ‘purpose’, ‘focus’, ‘achievement’ • This review reveals that organized sport offers unique opportunities to foster and define meaningful roles for individuals with IDD, which appear to strengthen their sense of purpose and achievement. Yet only few studies touched on this aspect of belonging.    Interacting with similar people (n=6): • Findings suggested that sport offers the opportunity to interact with others with similar interests, characteristics, and experiences. • Related terms: ‘socialization’ and ‘peer’. However, many of these terms are also related to the social relationships subcomponent. • The results of this review demonstrate that interacting with similar people is a component of belonging that is reported by both individuals with IDD and their parents. However, in terms of motivation for sport participation, individuals with IDD focus more on socialization in general while their parents cite similarities with peers

  12. Discussion Summary of belonging findings Only two studies examined all four aspects of belonging in sufficient capacities. Findings from these two articles demonstrate that organized sport may facilitate all aspects of belonging in individuals with IDD. Although the majority of selected studies did not explore all four processes of belonging, it is possible that this is due to a conceptual misunderstanding of belonging for people with IDD. Discrepancies in the definition of belonging and in the outcomes/concepts which authors believe best reflect belonging have resulted in an incomplete understanding of the experience of athletes with IDD. The findings of this review demonstrate a gap in the current knowledge of understanding the experience of belonging as it relates to individuals with IDD. Overall, the findings of this review indicate that belonging is not a well-researched concept in the literature. The belonging model developed by Renwick and colleagues (2019) aimed to outline specific aspects of belonging as it relates to the experiences of individuals with IDD. This framework was used in the current scoping review to map findings of the available literature in the intersecting area of sport, belonging, and IDD. Results demonstrated that all aspects of belonging were recognized in the literature in various capacities, however there was difficulty separating certain concepts into well-defined subcomponents of the model. For example, the concept of ‘achievement’ fell into both the processes of finding a good fit and negotiating meaningful roles. When ‘achievement’ was described in the context of establishing a successful balance between skill set and other supports, the concept resounded well with finding a good fit. However, ‘achievement’ was also described when receiving acknowledgement and recognition from others for their efforts on the team, and corresponded appropriately to negotiating meaningful roles. Our results suggest that in the context of sport, there is ambiguity between the definitions of the four subcomponents of belonging. Similar findings were interpreted as falling under different subcomponents, based on the context in which they were examined. The Belonging Framework offered a structured approach to organize the breadth of knowledge in the available literature. Although findings did not match discretely within each aspect of the model, this may be a result of the assortment of methodological approaches (e.g. structured questionnaires vs narrative summaries) or the various beliefs of which outcomes best reflect belonging. Nevertheless, it appears that the experience of belonging for individuals with IDD through sport participation is shaped by the interplay between all four branches of belonging.

  13. Discussion Other trends • The most common study respondent was a combination of individuals with IDD and their parents and/or support staff, suggesting that the majority of data available is not exclusively from the perspectives of youths with IDD • Only one article in this breadth of research originated from an OT background, revealing a role for future OT research. OT relevance Sport has consistently been considered a meaningful occupation for many individuals of various populations. Occupational therapists have recognized the value of sport-based therapies in rehabilitative practices and also understand the role of occupational engagement in overall well-being. The findings of this review have synthesized the knowledge in terms of how belonging is experienced through sport in individuals with IDD and offers insight into valuable information for development of clinical strategies and tools. This scoping review indicated that the social aspect of belonging was the most represented subcomponent, followed by navigating norms and expectations. Findings also identified concepts that promote occupational engagement, such as motivation and achievement, that are facilitated sport. Recognizing this, clinicians can use sport-based therapies to foster engagement in social relationships and encourage finding a good fit, to enable increased occupational engagement.

  14. Discussion Research gaps and future directions Expand to other countries  The findings of this review identified a number of pertinent gaps in the literature. This review revealed that the current literature on sport and belonging in individuals with IDD is predominantly from the perspectives of those living in developed countries (i.e. USA, Canada, Australia). Thus, it is important to consider the experiences of sport participation and belonging in other countries based on varying cultural and environmental contexts, and that these perspectives are unaccounted for in the current research. Young adult age group exclusively  Although this review aimed to examine the literature on young adults (18-35 years old), most studies included participants <18 years old and/or >35 years old. Only two studies had participants exclusively in the range of 18-35 years old. This represents a significant gap in the literature for individuals with IDD amidst their challenging transition to adulthood given the significant decrease in supports and services after age 18 (Stewart et al., 2009). Future research that focuses on individuals with IDD in the young adult age group may inform policy and service provision to promote lifelong occupational engagement. OT perspective  Only one study used an OT perspective to examine belonging through sport participation. Given that sport is an occupation and belonging can be shaped by occupational engagement, OTs are well placed to offer a unique and holistic approach to this area of research. Future studies from an OT background would be beneficial to establish additional evidence for prospective clinical practice and program planning for individuals with IDD. Define belonging  The current review revealed the paucity of articles exploring all four proponents of belonging. Future research should aim to include and examine all four proponents of belonging in the context of sport to provide a comprehensive understanding of the experience of belonging for athletes with IDD. As the majority of past research has failed to fully define and incorporate all relevant aspects of belonging for this population, there is still a gap in our understanding of this area. It will also be important to clarify the means through which these four belonging components are actualized through sport participation in individuals with IDD. Create a comprehensive Belonging Framework  In our exploration of the concept of belonging, several recurring concepts were identified in the included literature. The most common of these concepts were socialization, self-statements, engagement, inclusion, and acceptance. Their relation to the concept of belonging may be important to explore as a future direction for research related to the conceptualization a comprehensive Belonging Framework. Renwick and colleagues’ (2019) Belonging Framework provides a good starting point off which to develop a comprehensive understanding of ‘belonging’ in relation to individuals with IDD. Future research on sport and belonging should aim to: (i) define the concept of belonging more fully (e.g., perhaps by applying the Belonging Framework); (ii) consider a range of and access to sport participation (e.g. organized team and individual sports) across a variety of environments (e.g. structured and non-structured sport); and (iii) explore how belonging through sport may influence other areas of community participation and occupational engagement.

  15. Discussion Limitations While this scoping review provided key knowledge about the sense of belonging through sport participation for individuals with IDD, there are several limitations to these findings. Language First, the included studies were limited to articles written in English. Some papers that were promising at the abstract review stage were not available in full-text English language format. Further exploration of the pertinent research being conducted internationally may contribute to our understanding of sport experiences for individuals with IDD in different cultural contexts. Study respondents  Another limitation of this review was related to participants in the studies. Eighteen of the included studies had combined respondents (i.e. individuals with IDD and other stakeholders, such as their parents, siblings, and coaches). Some studies had parents act as proxy reporters for their children, while other studies asked stakeholders to provide their perspective on the individual with IDD. Findings from these studies may not be fully representative of the thoughts and beliefs of individuals with IDD, as the opinions of others may differ from the perspectives of the individuals themselves. Population description The population of interest described in the studies represents another limitation of this review. Many of the included articles did not explain how the diagnosis of their IDD participants was established. Of the studies that provided a description for how diagnosis was made, the majority were self- or parent- reported. Further, some studies examined individuals with disabilities, but did not specify whether the IDD participants were included in their sample. Given the inclusion of these articles in the review, the findings may not be representative of individuals with IDD. Despite these limitations, this is the first study to date to examine the literature relating to belonging in sport for individuals with IDD. The current findings provide a solid foundation for future research in this topic area.

  16. Conclusions This scoping review demonstrates the role that sport plays in promoting a sense of belonging for individuals with IDD. The current literature portrays sport as an enjoyable and motivating occupation that allows individuals with IDD to experience several positive outcomes related to belonging including inclusion, engagement, acceptance, and perception of self (e.g. ‘self-competence’, ‘self-identity’, ‘self-esteem’). Engaging in social relationships, a subcomponent in the Belonging Framework by Renwick et al. (2019), has been identified as a major avenue through which the sense of belonging occurs in sport. However, the current Belonging Framework as proposed by Renwick et al. (2019) requires some refinement to clarify the distinctions between each subcomponent. This review contributes important knowledge that can inform the use of sport as an occupational strategy for individuals with IDD. Stakeholders including OTs, policy makers, and researchers will benefit from applying these findings to their respective fields to promote the community inclusion and engagement of individuals with IDD.

  17. References • Renwick, R., DuBois, D., Cowen, J., Cameron, D., Schormans, A. F., & Rose, N. (2019). Voices of youths on engagement in community life: a theoretical framework of belonging. Disability & Society, 0(0), 1–27. https://doi.org/10.1080/09687599.2019.1583551 • Arksey, H., & O’Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616 • Colquhoun, H. L., Jesus, T. S., O’Brien, K. K., Tricco, A. C., Chui, A., Zarin, W., … Straus, S. (2017). Study protocol for a scoping review on rehabilitation scoping reviews. Clinical Rehabilitation, 31(9), 1249–1256. https://doi.org/10.1177/0269215516688514 • CDC. (2015, February 12). Key Findings: Developmental Disabilities Prevalence Trends | CDC. Retrieved May 21, 2019, from Centers for Disease Control and Prevention website: https://www.cdc.gov/ncbddd/developmentaldisabilities/features/birthdefects-dd-keyfindings.html • NICHD. (2018). Intellectual and Developmental Disabilities. Retrieved May 20, 2019, from NIH Fact Sheets website: https://www.report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=100 • Hall, S. A. (2009). The social inclusion of people with disabilities: a qualitative meta-analysis. Journal of Ethnographic & Qualitative Research, 3(3). • Mahar, A. L., Cobigo, V., & Stuart, H. (2013). Conceptualizing belonging. Disability and Rehabilitation, 35(12), 1026–1032. https://doi.org/10.3109/09638288.2012.717584 • Walmsley, J., Strnadová, I., & Johnson, K. (2018). The added value of inclusive research. Journal of Applied Research in Intellectual Disabilities, 31(5), 751–759. • Požėrienė, J., Adomaitienė, R., Ostasevičienė, V., Rėklaitienė, D., & Kragnienė, I. (2008). Sport participation motivation of athletes with intellectual disabilities. Education. Physical Training. Sport, 70(3). • Special Olympics. (2018). Recognition and Growth Around the World. Retrieved September 18, 2018, from Special Olympics website: https://www.specialolympics.org/about/history/recognition-and-growth-around-the-world • Harada, C. M., & Siperstein, G. N. (2009). The sport experience of athletes with intellectual disabilities: A national survey of Special Olympics athletes and their families. Adapted Physical Activity Quarterly, 26(1), 68–85. • ICF. (2017). Sports. Retrieved May 21, 2019, from ICF Browser website: http://apps.who.int/classifications/icfbrowser/ • DePauw, K. P., & Gavron, S. J. (2005). Disability sport. Human Kinetics. • Lufi, D., & Parish-Plass, J. (2011). Sport-based group therapy program for boys with ADHD or with other behavioral disorders. Child & Family Behavior Therapy, 33(3), 217–230. • Donaldson, S. J., & Ronan, K. R. (2006). The effects of sports participation on young adolescents’ emotional well-being. Adolescence, 41(162), 369–389. • McVeigh, S. A., Hitzig, S. L., & Craven, B. C. (2009). Influence of sport participation on community integration and quality of life: a comparison between sport participants and non-sport participants with spinal cord injury. The Journal of Spinal Cord Medicine, 32(2), 115–124. • Peters, M. D., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 13(3), 141–146. • Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: advancing the methodology. Implementation Science, 5(1), 69. • Stewart, D., Stavness, C., King, G., Antle, B., & Law, M. (2006). A Critical Appraisal of Literature Reviews About the Transition to Adulthood for Youth with Disabilities. Physical & Occupational Therapy In Pediatrics, 26(4), 5–24. https://doi.org/10.1080/J006v26n04_02

  18. Acknowledgements Department of Occupational Science and Occupational Therapy and the Quality of Life Research Unit lab at the University of Toronto

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