The Children’s Hospital Handicapped Sports Program

from Caring For Our Future, Fall 2003

By Wendy Larsen, MHS

When it began in 1968, The Children’s Hospital Handicapped Sports Program (TCH HSP) was the first and only ski program in the United States for children with disabilities. Today there are many such programs across the nation.

The idea for the ski program took shape in 1967 through the efforts of the staff at The Children’s Hospital Amputee Clinic and William Stanek, MD, who was the chief orthopedist for the clinic at that time. Dr. Stanek and Col. Paul Brown, MD, an orthopedist at Fitzsimons Army Hospital , were both interested in the idea of involving individuals with amputations in such outdoor activities as skiing. Stanek and Brown found that they shared similar aspirations for connecting amputees with the sport. As a result, they collaborated to form an innovative ski program, combining a group of Vietnam veterans convalescing at Fitzsimons with young amputees from Children’s.

In 1967, former U.S. Olympic ski team coach Willy Schaeffler was director of the ski school at Arapahoe Basin . He was approached by Stanek and Brown about the possibility of teaching people with amputations to ski at Arapahoe Basin . Schaeffler was receptive to the idea, and the patients were invited to begin the ski program the following year. The facilities at Arapahoe Basin were offered at no charge, and the first class was held in January 1968. Duane Messner, MD, an orthopedist at Children’s who took on the role of medical director for the fledgling program, and Willie Williams, RN, a former nurse at Children’s who was designated program coordinator, joined Stanek in the venture. Messner, Williams and 15 children from The Children’s Hospital Amputee Clinic participated that first year, along with dedicated instructors and volunteers, and the “Three Track Ski Club” was born – named for the three tracks left in the snow from two outriggers and one ski.

Although the participating vets lost limbs to land mines or in war and the children lost theirs to congenital conditions, cancer and childhood trauma, the psychosocial impact of amputation on the veterans and the children was similar in many respects. An early program volunteer, Virginia McMurtry, remembers: “The children were in awe of the Vietnam heroes. And the vets were in awe of the children. They thought that if a child could learn to ski, they could too. And of course, the children wanted to be as courageous as the veterans. In the end, both learned self-sufficiency and experienced success. And the rest of us were rewarded by being with them. We caught their spirit.”

In 1969, George Engel, Director of the Winter Park Ski School , was approached about the possibility of moving The Children’s Hospital’s Three Track Ski Club to Winter Park . With the assistance of Hal O’Leary, an instructor at Winter Park , the program was moved there in 1970. O’Leary volunteered to coordinate the program, and Engel provided instructors, lessons and equipment free of charge. Under O’Leary’s wizardry and inexhaustible energy, the program has seen considerable growth over the past three decades. In 1974, Carol Page, physical therapist, the current director of TCH HSP, integrated a group of children with neurological impairments into the Winter Park-based program. This collaboration sparked the name change from the Three Track Ski Club to the Handicapped Ski Program (HSP) and helped steer HSP’s scope of service to the diversity it represents today.

This year marks O’Leary’s 33rd in participating with the HSP. During this time, O’Leary also developed the world-renowned National Sports Center for the Disabled (NSCD) at Winter Park . This effort was based on his initial exposure to the young skiers he taught from The Children’s Hospital. The NSCD is now the largest program of its kind in the world, and O’Leary and his staff provide education and training related to adaptive skiing on an international basis. For an article celebrating HSP’s 20th year, O’Leary said: “The Children’s Hospital set the precedent in the world of the disabled. One child told me, ‘I only feel disabled at the bottom of the hill when I take my skis off.’” The Children’s Hospital HSP remains an active component of the overall ski program presently offered by the NSCD.

Currently, an average of 65 children from The Children’s Hospital with a wide variety of physical disabilities ski for several weekends each winter with the NSCD at Winter Park . The attendees reflect the diversity of adaptive skiing styles and techniques that exist today. To better clarify skiing techniques, TCH HSP categorizes skiers into one of two styles: “upright/stand” skiing and “sit” skiing.

In general, upright skiers are individuals who ski on two skis and may or may not use poles, three-track (one ski with two outriggers), or four-track (two skis with two outriggers). An outrigger is a forearm crutch with a ski tip mounted on a rocker base, used to enhance the skier’s balance and control. There are a variety of individualized adaptations that may be used in upright skiing styles. Upright skiers generally are assigned to one instructor. Children with mild to moderate cerebral palsy, brain injury, amputations, mild spina bifida and hemiparesis are typically upright skiers. As a rule, HSP skiers in this category are between 8 to 18 years of age.

Sit-skiers use a ski device with a bucket-type seating system. Sit-skiers use a bi-ski (with two skis attached to the bottom) or a mono-ski (one ski attached to the bottom). All sit-skiers begin with the instructor controlling the skier with a tether. The tether can be removed once the sit-skier is “tested” to be safe and independent using a mono-ski. Short outriggers are typically used by sit-skiers. Sit-skiers in the HSP are usually assigned to two instructors. Children with spinal-cord injuries between the ages of 12 and 18 with severe cerebral palsy or spina bifida, quadraparesis and degenerative types of conditions are characteristically HSP sit-skiers.

All participants in the ski program must have a functional level that allows for program participation away from home for a 12-hour day, including up to five hours spent on the bus each session. In addition, skiers should be essentially independent in using the bathroom, feeding, taking medications and transferring during the day.

The HSP mission statement says: “The intent of The Children’s Hospital Handicapped Sports Program is to provide resources and programs for children with physical disabilities that influence their ability to participate in organized recreational activities. Focusing on abilities, the ultimate goal is to promote skills that lead to a lifelong awareness of the role of leisure in maintaining a healthy lifestyle.” The goals and objectives of the HSP include using an individual approach to equipment needs and instructional techniques, coordinating recreational skiing experiences for children with physical disabilities that promote independent participation in the sport, and encouraging the development of greater self-esteem and confidence through physical achievement that will promote future participation in a recreational lifestyle with peers and family members.

The Children’s Hospital Handicapped Sports Program is maintained by three part-time paid staff members based at TCH. Page is the program director and has maintained a singular commitment to the program since 1974. Page also functions as a physical therapist for the Rehabilitation Department at the hospital. Wendy Larsen, MHS, is the activity coordinator and brings a background in therapeutic recreation to the ski program. Jane Fellerman has training in special education and provides administrative assistance to program operations. In addition to these paid staff members, Frank Chang, MD, an orthopedic surgeon at The Children’s Hospital, volunteers his time as the medical director for the ski program. As of 2002, Chang has provided HSP with 20 years of guidance related to orthopedic issues, triage in the event of injuries, and overall good humor and encouragement on the mountain. Chang also has archived much of the HSP’s history by videotaping the program participants over the many years of his involvement.

A recent addition to TCH HSP’s volunteer staff has been Jim Carollo, PhD, PE, who is the director of the Center for Gait and Movement Analysis (CGMA) at The Children’s Hospital. This state-of-the art gait analysis laboratory provides information about the interaction of body segments in motion, the forces that result from limb segment interaction and the muscle activity that initiates it. Building on technology first developed for the elite athlete, gait and movement analysis is able to present objective, computerized, measurable, reliable and reproducible data on how the body moves in space. Carollo has been a ski instructor with HSP since 2000 and has incorporated the expertise and technical intervention offered through the CGMA into his role. The gait lab and its technology have been made available to TCH HSP and NSCD staff members for educational and analytical purposes related to posture and movement during skiing.

Primary financial support for TCH HSP comes from fundraising efforts organized by Friends of Children’s Handicapped Sports Program (CHSP), a chapter of the Association of Volunteers at TCH. Friends of CHSP is dedicated to raising funds for the sports program. A variety of events are sponsored and supported by this group throughout the year. These events help raise funds for all aspects of administrative and programmatic functions of HSP. This fundraising is especially critical in view of rising organizational costs (e.g., transportation, contractual services at Winter Park NSCD, equipment rental/purchase) each season.

Participation fees for the children vary according to activity. Financial assistance and scholarships are available to families with an identified need. Annually, approximately 15 percent to 20 percent of the total fees for ski program participation are funded by scholarships and financial assistance.

Although skiing remains HSP’s largest organized activity, the program offers year-round involvement in other sports for children with physical disabilities.  Between summer programming and winter skiing, nearly 100 children and their families take advantage of what this unique program has to offer each year.

If you know of a child who would be appropriate for participation in HSP, ask the potential participant (or family members) to send a letter to the TCH HSP office stating his or her interest in the program. Include the child’s age (both chronological and developmental), abilities, mobility, diagnosis/medical condition and any previous leisure-time experience. Further information from physicians and therapists may be requested to determine if the child can safely and actively participate in the program.

If you are interested in becoming one of the approximately 50 volunteer ski instructors each ski season, you will need to qualify for instruction by attending special training clinics through the National Sports Center for the Disabled at Winter Park. You also must successfully complete one dry-land session and six on-the-mountain training sessions at Winter Park before beginning instruction with an HSP skier. All NSCD/HSP volunteers are required by Winter Park Resort to teach 10 ski days each season. Adult volunteers also are needed in many other aspects of the program. Training requirements vary according to activity. Potential HSP volunteers are asked to submit a letter to the HSP office stating their interest and experience relative to a particular activity.

To contact the HSP office, call 720-777-6590.

References

O’Leary, Hal, (1989). Bold Tracks: Skiing for the Disabled. Evergreen, CO: Cordillera Press, Inc.

The Children’s Hospital Handicapped Sports Program: More Than 20 Years of Love, Sweat and Cheers, (1988). The Children’s Hospital Impact Magazine, Denver, CO.