- Adapted Physical Education
Adapted physical education is a sub-discipline of
physical education. It is an individualized program created for students who require a specially designed program for more than 30 days. The program involves physical fitness, motor fitness, fundamental motor skills and patterns, aquatics skills, dance skills, individual, group games, and sports (including lifetime sports). For people with disabilities, adapted physical education provides safe, personally satisfying, and successful experiences related to physical activity, rather than a sedentary alternative program. Adapted Physical Education is a direct service, not a related service.
Students who receive services
Students who qualify for adapted physical education include people with disabilities as specified in the
Individuals with Disabilities Education Act(IDEA). This includes children who have mental retardation, deafness or other hearing impairment, speech or language impairment, blindness or other impairment, serious emotional disturbance, orthopedic impairment, autism, traumatic brain injury, a learning disability, multiple disabilities or other health impairments that require special educationor related services.
Infants and toddlers who need early intervention services because of
developmental delaysin cognitive, physical, communication, social, emotional or adaptive development can also qualify for adapted physical education. The state can chose to include infants and toddlers who are under three-years old who are “at risk” for experiencing a developmental delay if early intervention services are not provided.
Students who qualify under section 504 of the
Rehabilitation Act of 1973can also receive adapted physical education. In section 504, a person with a disability is anyone who has a physical or mental impairment that limits one or more major life activities, has a record of impairment, or is regarded as having an impairment.
A fourth group of students who might qualify for adapted physical education are students who are recuperating from injuries, accidents, recovering from noncommunicable diseases, are overweight, have low skills levels, or have low levels of physical fitness. This group is not covered by legislation, but a school district can decide to develop a plan to meet these students’ physical education needs.
Adapted physical education serves people of all ages.
There are four basic ways to adapt or modify any activity for a student with a disability. By adapting any area or multiple areas, a student will have more success in class and the teacher will be able to provide a better learning experience for the student. The four modification areas are:
1) Equipment – easiest area to modify, options are almost unlimited. Objects should vary in size, shape, color, weight, and texture. Equipment should represent the present skill level of a student. A student with a visual impairment should use a brightly colored ball or other object during a striking unit. For some students, especially students with autism, it is important to have equipment which can be weight-bearing. Some students will need to wear backpacks to help with the stimulation process.
2) Environment – limiting play area when movement capabilities are limited or restricted. Having a designated area for equipment when the activity is done (usually behind a mat) so students are not distracted during instruction or during the next activity. Having a certain area in the gymnasium, for students who have autism, helps if they need time to relax. Lighting and sound also play a vital role in the environmental setting for students with autism. Students with autism can observe minute changes which may be extremely distracting.
3) Instructions – permitting the substitution or interchange of game and/or activity duties by determining positions in games that work with the abilities of the student. Using a variety of different instructional strategies such as verbal, visual, guided discovery and peer teaching are great ways to adapt instruction in APE. Using a variety of instructional strategies can give the students the opportunity to start learning on their own and to become more independent. Picture books are also very important in terms of instruction. Some students need to hear and see what they are supposed to do throughout the day. Students rely heavily on picture books and are thrown off if activities do not occur how they should.
4) Rules – rule changes will help to equalize competition. Rules can also be modified to challenge different skill levels within an APE class. If a student with a disability is in an inclusion class, adapting and modifying rules is important for the students' success. Changing rules for a game in an inclusion class can also help a student with a disability become more involved. For example, during game play the team scores one point if the student with a disability is not involved in the scoring process, two points if they help score the point. Another example for rule modification to create success for a student with a disability would be to give them extra attempt at a skill where general students have only a limited number of attempts, i.e. strikes in baseball.
Another option for modification can be time; providing extra time or allowing a student additional rest.In each area a number of changes can be made for almost any activity.
APE teachers do not need to reinvent the wheel when looking for activities or games for students with disabilities. APE teachers can take activities used in general physical education and modify or adapt these activities for students with disabilities. If the APE teacher makes the proper modifications, the inclusion or APE experience for the student with a disability and the students without disabilities will be more enjoyable and productive. Making these modifications will hopefully increase practice time and success in an inclusion or APE setting.
Equipment such as
standing framesand other assistive technologycan make the environment more inclusive for children who ambulate with a wheelchair.
For throwing and catching balls it will be helpful to use a variety of balls. For throwing and shooting at a target smaller balls work best. For striking, kicking, and catching, bigger balls will create more success for students. These include yarn balls that do not bounce away and are easy to catch because students can grab onto the yarn. Wiffle balls are recommended because they are lightweight. Beach balls are useful because they are large and soft to catch. Giving the students the option of which ball to choose allows them the opportunity to create their own level of skill development. If a student seems to be struggling with a certain ball or a certain ball is not challenging enough, just suggest a different ball that you would like to see them try to use. For students with visual impairments, use multicolored balls and balls with bells in them that make sound as they roll. Placing a ball in a plastic grocery bag, placing a bell inside of a balloon, and attaching bells to student's shoes are simple ways to accommodate students with visual impairments.A catapult works great for students who may have cerebral palsy or limb limitations during throwing and aiming activities. This can help involve the students in activities they may have been limited in. Catapults are also great for arm and hand strength development for students who have cerebral palsy or limited mobility of their arms and hands.
For kicking a variety of balls can also be used to benefit the students. For students who ambulate with a wheelchair, large balls bigger than soccer balls will be helpful. For students with cerebral palsy, a stationary ball can be used.
ADAPT-A-BAG:Adapted Phyiscal Education (APE) teachers are always on the go and may be pressed for time to adapt an activity during APE, this is why it is important to develop or make an adapt-a-bag for these circumstances. An adapt-a-bag, is a bag an APE teacher can bring to each of his or her teaching areas, which can help modify or adapt an activity for a variety of disabilities. Some simple items to put in an adapt-a-bag are duck tape, velcro, string, dry erase board, bells (jinggling bells inside a balloon), shiny objects, pvc pipe (large and small - one for guide line and one for ramp),plastic shopping bag, and straws. Other objects which may cost little money are blinking balls, bubbles, bubble wrap, horns,jinggling bells inside a balloon, beep balls, and stimulating balls. It is important to remember there can never be too many items in an adapt-a-bag. House hold items are great for making modifications in APE, it is important to always be looking and searching for items which can be put into an adapt-a-bag.
Along with these adaptations it is important to understand the individual's disability. For instance if a student has a Vestibular disability they may need an object that is easier to track. A balloon or a larger ball would be a great adaptation for this student. These students may also be very unstable, so something as simple as a mat beneath them while performing an activity could be a valuable adaptation.
Some tips for an individual with Spina Bifida could be adapting activities that can be played with the use of crutches, braces, or wheel chares. The use of a helmet may also be necessary in case the student has a shunt. This will help to prevent further head injuries. This may also be done with the use of a soft foam ball or balloons, but be sure the student is not allergic to latex, because this is a common problem with individual with this disability. Individuals with Spina Bifida do make great athletes, so it is important to modify and develop an assortment of games and activities for these individuals. These individuals can become very mobile and skilled in wheelchairs, so introducing these individuals to games such as tennis, basketball, and even racquetball can be great for this skill development and also social interaction in the community.
Some suggestions for an individual with CP or Cerebral Palsy are to do more stretching exercises. The disease causes their muscles to have tendency to become very tight so a slow stretch can be helpful to reduce the tone. You can also work on body positioning, and strength exercises to help the student gain enough strength to support their own body weight.
Individuals with a visual impairment may be more successful in a well-lit room. It may also help to keep objects in a routine place so they can become accustomed to knowing were they are. The use of audio devices in equipment and different textured equipment may also be very beneficial. Using of guidelines, and brightly colored boundaries can also help these individuals to be more successful in the physical education setting.Some safety concerns for these individual would be to let them were protective goggles and keep the floor clear of any tripping hazards.
Individuals with a hearing impairment may need to use a guide in class. It is also important to keep their learning environment free of excessive noise to include music while giving instruction. They may need a shorter more direct instruction when it comes to activities. Visual indicators are also more important for these students to understand the beginning and end of game play. Students with a hearing impairment also tend to perform better in small groups and understand better if the instructor speaks clearly.
Individuals with Muscular Dystrophy may tire quickly, are almost always in a wheel chair. Lifetime activities these individuals can perform in their chair can be beneficial to them. Activities that involve breathing practices can also be beneficial for these students. Remember these students will be losing strength increasingly as they grow older.
In 1990, Congress passed the Individuals with Disabilities Education Act (IDEA), in order to make significant alterations to the Education of All Handicapped Act of 1975. For example, IDEA redefined the purpose and process of the Individualized Education Plan (IEP). One significant change to the IEP was a newly required transition statement, which was to be developed no later than a student's 16th birthday (Modell & Megginson, 2001).
Transition is the successful movement from a student in school to a productive, quality, and meaningful adult life. Effective transition is based on the individuals' needs, and consists of coordinated activities in the following areas: Education, Career, Community, Communication, Social Interaction, Recreation and Leisure. (Not every transition program will be the same; it is dependent upon the individual. Transition, as defined by IDEA 1997, is “…a coordinated set of activities for a student, designed within an outcome-oriented process which promotes movement form school to post-school activities, including postsecondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation. (IDEA, 1997, Section 602.30) Furthermore, according to federal legislation, students 14 years and older are required to attain planning methods provided by the Adapted Physical Education Transition Model (Strategies for Success Trnasition, 2003, 98). All methods provide greater opportunity for students to transition into a more productive, and meaningful adult life.
Given their ever-expanding role, adapted physical educators must pay attention to this issue. As adapted physical educators it is important to provide students with experiences and resources during their time in an educational setting so the students have a better chance of staying physically active during and after the transition period. Expanding and exploring students ideas and knowledge about phyiscal activity is essential for success outside of the education setting.
Transition in adapted physical education helps students with disabilities move towards community involvement through healthy and independent lifestyles. The first crucial element in a successful transition is for the student’s IEP team to have a well developed and defined vision based on the students strengths, needs, and preferences. (Savage, 2005, 46)
It is essential for transition to be part of the school’s curriculum. Without transitioning a student into real life situations he or she may have a difficult time taking part in some of the lifetime activities they learned throughout their time in school and thus have a more
sedentary lifestyleleading to more health risks and issues. By putting transitioning into a schools curriculum it will increase the overall learning experience for students in adapted physical education. The curriculum for APE in the school setting should focus on developing the students' fitness, motor skills, sport skills, social-skill training, community adjustment, and take part in a recreation and leisure survey. During the transition period more focus should be put on fitness, sport, disability sport, friendships, community participation, and recreation and leisure(Modell & Megginson, 2001). If more focus is put in the curriculum during the years students with disabilities are in the school, the smoother the transition process with go.
Transitioning prepares students for life outside of school. Participation and experiences in leisure activities provides opportunities for skill and competency development needed to successfully participate in a variety of activities upon leaving school (Modell & Megginson, 2001, 45). As an adapted physical educator it is important to talk with the family and find some physical activities the family enjoys so you can help your student learn the knowledge and skills to particiapte with their family. Leisure activities may include, but are not limited to, the following:
*Track and Field
While teaching students leisure activities, it is criticial to provide information of appropriate facilities. Community clubs, organizations, and parks provide many opportunities for students to remain active. Many community resources have programs specifically designed for individuals with disabilities. The adapted physical education teacher should be familiar with these programs and utilize them as a regular part of the students' transition program. The APE teacher should also stress functional transition skills, such as the proper use of fitness equipment or how to use an electronic identification card to sign in at a fitness center. Individuals with disabilies who have greater access to, and actively participate in recreation and leisure activities are more satisfied with their lives (Harner & Heal, 1993). In addition, when engaged in recreation and leisure activities, opportunities of success in communities increases for individuals with disabilities (Modell & Megginson, 2001, 45).
Transition related to the adapted physical education curricular area focuses on most of the previously listed areas. Students will not only learn how to do an activity, but the progressive skills it takes to have the opportunity to complete the activity in a community based setting. Such skills can include the following:
*Finding the information about the activity
*Finding time of operation for places
*Figuring out transportation
*Know how to perform the activity independently
*Finding a way to fit the activity into the individual's weekly schedule.
These all include social interaction and various means of communication. Students will need to be taught many skills beyond the normal adapted physical education curriculum in order to achieve lifetime physical activity.
Some ideas for the student to find what interests him/her to help with transition 4-5 years prior to graduation:
* Take a community education class.
* Attend events to learn spectator or audience member skills.
* Learn how to plan recreation and leisure activities (where, when, cost, transportation).
* Establish exercise routines.
* Join a club or an organization in your community.
3 years prior to graduation:
* Explore new ways to use your free time.
* Identify supports needed to participate in activities of interest.
2 years prior to graduation:
* Try additional recreation and leisure activities.
1 year prior to graduation:
* Continue to take part in activities of interest.
1-2 years after graduation:
* Join and participate in adult recreation activities. (Auxter, Pyfer & Huettig, 2005, 97).
The process of transition can work very well with students, however this process does not happen overnight. Students will need the appropriate amount of time to learn all of the necessary skills. Transition services become a part of a student's education at the age of 14 or 16 depending on the school district and continue until the student is 22 years of age. At this time, an Individual Transition Plan is developed with goals and objectives written in person first language, specific to the individual student to ensure their abilities to function in the community when they graduate. The members involved in developing the Individual Transition Plan should be the IEP team members. The IEP team members should have the following questions in mind:
1. What interests or hobbies do the students and his or her family enjoy doing?
2. What knowledge and competencies does the student need in order to move from school-based to community based living in their particular community.
3. What knowledge and prior experience does the student already have?
4. What knowledge and experience will the student need to be successful?
5. What will the student's living situation be like after high school?
6. Will the student be employed in the area? Will working interfere with recreation/leisure time? If so, how will the student stay active?
As is true in most aspects of adapted physical education, the skills practiced during the transition process tend to be most successful when the students have an opportunity to contribute to the decision making process. Also, providing sufficient amounts of repeated trials will drastically improve the students' level of success.
Making a Leisure Transition Plan (LTP) is a great way to help and aid an individual with a disability during the transition process. The purpose of the LTP is to develop the student's ability to select and participate in activities in the community during his or her free time. Specialists from the APE field must be aware of physical recreation opportunities available in the community; determine the student's activity interests, preferences, and needs: and then include these activities in the student's physical education curricula and LTP. Here is an example of a LTP(Krueger & DiRocoo, 2000):
Transition Goal #1 Cindy will increase her awareness and use of public transportation.
Cindy will meet with a representative from Valley Transit to discuss bus routes.
Cindy will experience getting on and off a bus with the use of a lift, while in her wheelchair.
Cindy will verbally demonstrate her understanding of the proper way to anchor a wheelchair inside the bus.
Cindy will map out a schedule to and from a destination (field trip), identifying bus routes, departure, and arrival times. Cindy will use Valley Transit as a means of transportation for a field trip.
Cindy will meet with a representative of Medi-Vans to receive information on rules and regulations, cost, and how to schedule trips.
Cindy will experience getting in and out of a Medi-Van while in her wheelchair.
Cindy will receive information to share with her parents on the procedure for obtaining an ADA card (use with Medi-Van).
Cindy will call to schedule transportation for a field trip using Medi-Vans.
Cindy will travel on a field trip using Medi-Vans for transportation.
Cindy will meet with a representative from Valley Cabs to discuss how to schedule trips.
Cindy will schedule transportation for a field trip with Valley Cabs.
Cindy will use Valley Cab as a means of transportation for a field trip.
Transition Goal #2 Cindy will increase her awareness of federal legislation (ADA and IDEA).
Transition Activities Cindy will do searches on the internet to locate five sites that give information on federal (disability) legislation, then print the first page of each to put in her transition portfolio for future reference.
Cindy will locate "ADA Accessibility Guidelines For Buildings and Facilities" on the internet, then print the Table of Contents to put in transition portfolio for future reference.
Cindy will locate three accessibility guidelines in ADA, record minimum requirements/measurements, and then check to see if her school building is in compliance.
Cindy wilt locate three advocacy sites (for persons with disabilities) on the internet, print a document from each relating to federal legislation, and study and dictate a summary of each on audio tape. Cindy will share this audiotape with her parents.
Transition Goal #3 Cindy will plan and take field trips into the community to visit sites that offer physical activities that she has indicated are of interest to her. She will observe or participate in these activities while on the field trip. Cindy will evaluate each experience.
Transition Activities Cindy will identify locations and activities she would like to explore in the community.
Cindy will discuss with the APE specialist and/or community resource person what preparations and arrangements need to be made prior to going on the field trip (i.e. time schedules, transportation, clothing, equipment, accommodations/adaptations, and money).
Cindy will make arrangements for the field trip with the APE specialist and/ or community resource personnel.
Cindy will fill out a critique form after each community experience. Critique will address accessibility, effectiveness of accommodations/adaptations, atmosphere of community setting (i.e. friendly, helpful), and personal reactions on enjoyment and possible future participation.
Many of the activities done in adapted physical education are also done in competition. As part of transitioning to life after school an adapted physical education teacher can let the students know about athletic competitions and associations for the activities done in adapted physical education. Some organizations include: the National Beep Baseball Association, the National Disability Sports Alliance (NDSA), Special Olympics International (SOI), the American Wheelchair Bowling Association (AWBA), the United States Association of Blind Athletes (USABA), and the Disabled Sports USA (DSUSA). These and other organizations like them can also introduce the students to new activities such as beep baseball, which is a baseball game played by individuals with visual impairments and others using blindfolds. As the name suggests they use a ball that beeps as well as bases that beep. These organizations and competitions can help students get interested in an activity that will keep them active for a lifetime.
People who may be involved in a student's Individual Transition Plan:
"Direct Service Providers"
* Special Educators
* Hospital/Homebound Instructors
* Instuctors in Instiutions and other settings
* Adapted Physical Educators
* General Physical Educators
* Vision, Orientation and Mobility Specialists"Related Service Providers"
* Counseling Services
* Medical Diagnostic Servce Personnel
* Occupational, Speech, Recreation and Physical Therapists
* Parent Counselors and Trainers
* Rehabilition Counselors
* Assistive Technology Service Personnel
* School Health Service Personnel
* Social Workers
* Transportation Specialists
* Transition Service Personnel (Auxter, Pyfer & Huettig, 2005, 103-12).
Advocacy for TransitionWith respect to transition, adapted physical educators should first and foremost advocate that their own involvement in the post-school transition process be indicated on their students' Individualized Education Program (IEP) (Modell & Megginson, 2001). Some other areas in transition which should be brought to the attention of administrators and community officials are implementing ways in which physical activity sites can become more accessible, advocating that students with disabilities be able to participate in the entire continuum of sports programs (integrate and segregated) sponsored by the school and community; and helping parents rally for appropriate community recreation and sport opportunities for their children with disabilities (Modell & Megginson, 2001).
Barriers to Transition
• Transportation: Transportation can become a problem during transition. Many students who have a disability cannot drive a car, so it is important to teach students, during their educational process, other means of transportation. This may mean teaching students routines on how to use the city bus system, or finding a group to car pool with, or even finding an older adult who may not mind picking up a student when they are going to the local YMCA.
• Money: Many fitness clubs are increasing prices for membership and with increasing gas prices it may be difficult for students with disabilities to afford a membership somewhere and have the means of getting there if they are not within walking distance.
• Planning: For many students with disabilities planning a trip to the YMCA or any facility will be difficult task. In school their schedule was planned for them and they didn't have to worry about how and when things were going to happen. As a result, planning is one of the biggest barriers to transition. Students with disabilities may need to be taught what to wear, what transportation to use, how to set up plans with friends, and how to figure out how much money they may need.
• Lack of programs: There may be a lack of programs in a community, who have the knowledge and ability to assist individuals with disabilities. This may mean individuals with disabilities may have to participate in programs with individuals without disabilities. This may help with the socialization aspect of development, but may limit their practice and participation time. The individual may also be intimadated by the other individuals, which may push them away from that activity or program.
• Lack of Support i.e: school, organizations, public, families...
• Staff/ employee knowledge i.e: at local businesses, teacher assistants
• Strange “New” places
• Lack of Motivation: Students with a disability have received motivation by teachers, paraprofessionals, and classmates during their education process. When their education process is done these individuals may not be there to motivate and push them to become physically active. Finding out activities and sports during the education process which the student enjoys participating in can help intrisically motivate these students when they are in the transition period.
• Limited Community Recreation Activities
Overcoming Barriers and Improving a Transition Program.
Many times teachers don't know how to help students tranition from high school. There are many barriers students face once out of high school. However, there are things teachers, parents, and students can do to ensure their ability to function in the community when leaving the school setting. A big barrier is the knowlegde of parents. A good way to help them is to hold parent workshops. Not only are they able to talk with other parents, but also learn about different ways they can help their child tranistion into the community. Another thing that can be helpful is to have parent mentors. Parents who have already had their child graduate can mentor a parent whose child hasn't graduated yet. Another mentoring option is to have students who have graduated mentor a student who hasn't graduated yet. This gives them a companion and a responsibility and a feeling of importance in another childs life. Activity newsletters are also wonderful tools for parents and students to receive information about different activities and programs that go on in the community for them to get involved in.
Use of TechnologyWith the development of new and improved technology with physical educaiton and especially adapted physical education it is important for the APE teacher to know and understand different ways to implement technology for a successful transitional period for his or her students. APE teachers can develop an updated website regarding a fitness workout plan, in which students, who may need to stay at home half of the day, can download and follow at home with a sibling or parents. Video files can also be used to demonstrate proper technique, and appropriate music for aerobic activities could be downloaded as well. With technology growing and becoming better each day, APE teachers need to continue to grow as professionals and try to use this to benefit and enhance their students physical development.
Adapted physical education teachers are not only required to teach students with disabilities how to stay and become physically active, but also how, when and where. APE teachers are responsible for recognizing and teaching students with disabilities how to overcome the barriers for transition. In order to achieve this APE teachers need to concentrate on activities in the community that promote a physically active lifestyle while enhancing the health and wellness of students with disabilities (Krueger, DiRocco, Felix, 2000, pg 222). Upon graduation, students with disabilities should know how to plan their activity, perform their activity and become personally responsible for participating in recreational activities on a regular basis.
University Partnerships for Transition:
* Creates Friendships.
* Introduce students to transportation system.
* Provide students with an opportunity to use facilities not available at high school level.
* Provides education for both university students and students with disabilities.
* Great stepping stone into the transition process
Anchorage School District (2005). http://www.asd.k12.ak.us/depts/APE/adaptations/ Retrieved May 9, 2006.
Winnick, Joseph, P. (2005). Adapted Physical Education and Sport, Fourth Edition. Champaign, IL: Human Kinetics.
California State Council on Adapted Physical Education (2000). http://www.sc-ape.org/Guidelines-Index.htm/ Retrieved April 12, 2008.
Folsom-Meek, Sherry L., Ruth J. Nearing, and Renae E. Bock. "Transitioning Children, Youths, and Young Adults with Disabilities." JOPERD 3 (2007): 38-45.
Savage, R. 2005. The Great Leap Forward: Transition into the adult World. Preventing School Failure. Summer 2005. Vol. 49, (4) Pg. 46.
Modell, S. J., & Megginson, N. L. (February 2001). Life After School: A Transition Model for Adapted Physical Educators. "JOPERD, 72"(2), 45-48.
Harner, C., & Heal, L. (1993). The Multifaceted Lifestyle Satisfaction Scale (MLSS): Psychometric Properties of an Interview Schedule for Assessing Personal Satisfaction of Adults with Limited Intelligence. "Research in Developmental Disabilities, 14," 221-236.
Strategies for Success Transition. (January 2003). "Adapted Physical Activity Quartely, 20"(1), 98.
Visual aids found on http://www.campabilities.org/tvic-index.htm
Krueger, Deborah L., DiRocco, Patrick., Felix, Manny. (2000). Obstacles Adapted Physical Education Specialists Encounter When Developing Transition Plans. "Adapted Physical Education Quarterly", Vol 17, pg 222-236.
Auxter, David, Pyfer, Jean, Huettig, Carol. (2005). Principles and Methods of Adapted Physical Education and Recreation. Boston, MA: McGraw Hill.
Hawaii Early Learning Profile (HELP) retrieved on April 10, 2008 http://www.vort.com/profb3.htm
United Cerebral Palsy Research Fact Sheets retrieved on April 12, 2008 http://www.ucpa.org/ucp-generalsub.cfm
retrieved on April 12, 2008 www.scope.org.uk
Muscular Dystrophy information retrieved on April 10, 2008 http://twu.edu/inspire/Fact-Sheets/muscdys.htm
Modell, Scott J., & Megginson, Nancy L. (2001). Life After School: A Transition Model for Adapted Physical Educators. JOPERD. 72(2), 45-48.
Krueger, Deborah L., & DiRocco , Patrick (2000). Obstacles Adapted Physical Education Specialists Encounter When Developing Transition Plans. APAQ. 17, 15. http://web.ebscohost.com/ehost/detail?vid=1&hid=120&sid=045e7655-60b9-4237-8cd6-49f0dd2547eb%40sessionmgr109
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