Do coaches need knowledge of impairment to coach people with disability?

How much impairment specific knowledge do you need to coach an athlete with a disability?

It's a good question. An interesting question. One that has come up time and time again over the years.

Generally speaking there seems to be two sides in the schools of thought. On the one hand there are those people who think that it is not necessary to have any knowledge of impairment to coach an athlete with a disability. On the other hand there are those that say you must have knowledge about impairment to coach an athlete with a disability.

But extremes of thought rarely paint the whole picture! Our goal in this article is to help you think about the issues involved the best we can, rather than us trying to give you an answer.

Let's start by making a generalisation that we can be pretty confident is correct.

"Generally, the higher the level of impairment, the more likely it is that knowledge of impairment is necessary."

There is a relationship between the level of athlete impairment and the required knowledge a coach may need to coach that athlete. 

For example, say the athlete has cerebral palsy approximate to Paralympic classification of C7 or C8. This level of impairment is not high. The athlete is generally independent, perhaps has some issues with balance and strength but the impairment does not significantly impact on technique with respect to running or swimming.

The coach needs to know about running or swimming technique but not about cerebral palsy. Issues of balance and strength are concerns of all coaches regardless of the presence of impairment. The coach needs to know their sport and any idiosyncracies associated with the athletes performance of a skill can be understood by talking to the athlete. The rest is pure coaching.

But, and this is where it gets interesting, can the same be said for athletes with an equivalent classification of say, C5 or C4. Is there a point where knowledge of impairment is actually useful, above and beyond, pure knowledge of the sport and coaching?

There are a number of factors at play here that need to be considered.

The impact of the impairment on the performance of the task

This is critical to the whole discussion. Again, and somewhat unfortunately, it is not as simple as saying that 'knowledge of impairment is necessary where it impacts on performance'. This is because it is often hard to differentiate between what is good coaching knowledge and what is necessary knowledge of impairment.

What do we mean by that exactly?

Well, let's take the example again of an athlete with cerebral palsy roughly equivalent to a classification of C5, performing a throwing activity such as shot putt. A good coach will know about throwing technique; about issues to do with strength, flexibility, power-to-weight ratios, body rotation and issues to do with rest, hydration and motivation. They know about individualised coaching programs and routines. So is knowledge of impairment - the condition of cerebral palsy, per se, relevant?

Sarah Milner considers confidence in coaching is very important to this:

"They (coaches) are concerned that they do not have enough knowledge about specific impairments. To overcome this we need to support their development and help them recognize that a good coach differentiates and develops their athletes according to their ability - confidence is key here."

So is it 'confidence' and good coaching the key? Does understanding the impairment really help in the coaching situation and 'speed up' the coaching process or is it useful as a confidence booster? We'll let you think about that one!

The goals of your coaching program

Is the goal of your coaching program performance or participation? There are plenty of grass roots coaches who simply want to see more people participating in their sport. Sure, they want to see their athletes improve. But, fundamentally, they aim to get more people involved in a safe and enjoyable way.

There are also plenty of coaches whose primary goals are performance based. They are interested in setting targets, improving performance and in competition. It makes a big difference if you are a participation based coach or a performance based coach. Of course, you can be both too.

One group you have may be participation focused, another group performance focused. If you are looking to shave 0.5 seconds off a 200 metres race for your athlete with cerebral palsy you need to know a lot more detail, such as, degrees of spasticity that impact on running gait and how messages are transferred through neurone activity from the brain. Knowing a few things about the etiology of cerebral palsy could help in this situation. Similarly, if you are training an athlete with autism it may be good to know a different communication strategies and about how environments may impact on learning patterns for people with autism.

If you are participation focused then knowing about the impairment is less important as your goals are more about fun, involvement and enjoyment.

Again, you can still argue that even for performance based coaches it's not really necessary to know anything about the 'general' impairment as each athlete is different and will bring their own unique characteristics to the sport, as all athletes do. Similar to the relationship between level of impairment and required knowledge, there appears to be a relationship between performance level and required knowledge of impairment.

Pete Edwards, a national Boccia coach in the UK, illustrates this very well:

"I have learnt that getting to know the athletes as individuals first helps with the coaching. I don't think about the impairment (although I am aware of it) until the athletes make that move to wanting to go up the athlete pathway."

Understanding the athlete perspective

This is an interesting one! There is a strong argument that to be an effective coach you must have an understanding of what it is like to be an athlete. It is often said that the best coaches are former athletes. The argument goes that being an athlete, particularly at the higher levels, gives coaches an insight and empathy that is not possible to have if you have not 'been there and done that'! Of course, the counter argument is that there are plenty of successful coaches that have not played their sport at a high level. There is more to coaching than understanding the athlete perspective and it is possible, through experience and training, to gain that understanding anyway.

But, is it necessary to have an understanding of the lived experience of disability, or at least an in depth knowledge of the condition, to coach an athlete with disability? Danny Miles makes a very strong point:

"As a totally blind athlete and coach (futsal, cricket, tennis and goalball), I would very strongly suggest that the best coaches in disability sport are those who have first-hand professional (and preferably personal) experience of the impairments in which they ply their trade."

Danny goes on to give an excellent example:

"How can somebody who is sighted fully appreciate the perception of movement (or lack of) possessed by athletes who have been blind from birth and who have subsequently never been able to observe the posture of professional sportspeople? How does somebody with no experience of communicating in non-visual terms deal with the complexities of explaining concepts like field of vision or the importance of minute angles to somebody with tunnel vision?”

If it is not possible, then the only effective coaches for athletes with particular impairments would be coaches with similar impairments. Which, would be highly restrictive and unrealistic! And could the same be said for coaching athletes with physical disability as opposed to athletes with vision impairment? Is it also dependent on the performance level of the athlete and coach education and experience? Good coaches 'know their players' and develop two-way player-coach learning environments, as Mike Nolan, a Football Coach points out:

"If players have ownership of and input into their practice the coach can develop their understanding and knowledge. Teaching and learning should be a two way flow.”

You can see a picture emerging here. That required knowledge of impairment is dependent on a range of issues that are context specific. Let's have a look at one final issue that is important in this debate.

Duty of care and safety

All coaches have a duty of care to ensure the safety of their athletes. This duty of care is embedded in Coaches Codes of Conduct and policies around the world. Is knowledge of impairment necessary to ensure safety? Unfortunately, again, there is no straightforward answer. In the majority of circumstances the coach will be made aware of any aspects of the impairment that impact on safety. This is important and should be part of the regular communication that takes place at the start of any coaching program.

It is easy to find online 'contraindications for physical activity' for people with disability. Here, you'll find information on a wide range of conditions from atlantoaxial instability to cataracts. These are lists of why people with disability should not do certain types of physical activity. Now, while these are important for obvious safety reasons, is it even more important to apply a common sense approach to this type of information.

In all circumstances it is the reasonable duty of care to assume that the coach will know about the aspects of impairment that might compromise the safety of athletes. But it is easy to make assumptions and misinterpret this type of information when it is taken out of context. For example, not all people with Down Syndrome have atlantoaxial instability. And not all people with atlantoaxial instability should be excluded from physical activity. It depends on the requirements of the activity and the potential pressure on the neck and spine. The common sense approach is to understand fully the impact of the activity on the individual - this can be achieved by talking to the athlete, the parents, the support workers etc. It is not common sense to exclude someone based on a blanket 'contraindication'.

Coach education and training

From the mid 1990's through to about 2002 Australia had a national coaching accreditation scheme specifically for people that wanted to coach athletes with disabilities. The Coaching Athletes with Disabilities (CAD) Scheme was a world leading program with some highly developed resources. You could undertake a generic Level 1 Coaching Athletes with Disabilities course, a Coaching Wheelchair Athletes course, a Coaching Athletes with Vision Impairments course etc.

Then, around 2002 a review was done on the Scheme. In short, as a result of the review the CAD accreditation program was abandoned and work commenced on ensuring that all generic coaching courses included information and material about coaching athletes with disabilities.

A core reason for abandoning the CAD accreditation Scheme was that it 'badged' a small army of grass roots coaches as experts in disability sport. This army became the 'gatekeepers' of inclusion which made it far too easy for other coaches to abdicate their responsibility to coach athletes with disabilities - the reason being that they didn't have to coach athletes with disability because they were not accredited and had not undertaken the course. This was not a good outcome.

The lesson learnt from that experience was that there was nothing wrong with the materials and course content, but it was pitched at the wrong level.

This goes back to the issues raised so far in this article. There is a danger in saying that grass roots, participation based, coaches need knowledge of impairment to coach athletes with disabilities because this provides an easy reason not to get involved in the first place. All coaches should be willing and able to coach athletes with disabilities, so education and training programs at that level should always include appropriate information and resources around inclusion.

However, at what point does knowledge of impairment become a factor in the coaching environment? Answers on a postcard please!