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van Engelen L1,2, Boonzaaijer M1,2, Ebbers M1,2, van der Put I3, Bloemen MAT1,2
1HU University of Applied Sciences Utrecht, Master Program Physiotherapy, Specialisation Paediatric Physiotherapy, Utrecht, Netherlands, 2HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre for Healthy and Sustainable Living, Utrecht, Netherlands, 3De Speeltuinbende Foundation, Experience Experts and Independent Consultancies on Inclusive Play, Arnhem, Netherlands
Background: Children with physical disabilities are less physically active than typically developing peers. The most important contributor to physical activity is outside play for primary school-aged children and should be part of the life of all children. However, children with disabilities experience multiple barriers regarding participation in playgrounds. De Speeltuinbende (the Playground gang) is a foundation and a community of children with and without disabilities and their parents and advices in accessibility of playgrounds and inclusive play. Despite several improvements of the physical accessibility of Dutch playgrounds, participation of children with disabilities did not increase.
Purpose: The purpose of this study was to explore facilitators, barriers and solutions that influence participation of children with disabilities in Dutch outdoor playgrounds from both a parental and professional's perspective.
Methods: This study has a descriptive qualitative design. Purposive sampling was used to include parents from children with several physical disabilities and ages between 2-12 years and professionals with different levels of experience and various professions. Twelve semi-structured interviews with parents and five focus groups with professionals (n=25) working with children with disabilities (such as pediatric physical therapists) were conducted and transcribed verbatim. To assure data saturation, we performed three member check meetings (n=21). Two independent researchers analyzed the data using an inductive thematic approach, in case of no consensus a third researcher was consulted. Barriers, facilitators and solutions were coded and themes were constructed using the modified Physical Activity for person with a Disability model as a background scheme (adjusted PAD-model). Critical peer review sessions were established to avoid bias.
Results: Similar barriers, facilitators and solutions were mentioned by parents and professionals and observed for all domains of the modified PAD-model. The most important environmental factor was that the Dutch community is not inclusive yet. People often find it difficult to interact with children with disabilities, making participation and inclusiveness a challenge. The most important personal factors were physical and social problems that were experienced when children with disabilities wanted to join outdoor play. Interestingly, parents and professionals believed that the social barrier was far more important than the physical barrier. Two additional themes were emphasized upon from the professional's perspective, namely to introduce children with disabilities to the playground at a young age and the role of professionals in facilitating active inclusive play.
Conclusion(s): According to both parents and professionals, the most important barrier for outdoor active play is that children with disabilities do not join typically developing peers because of social problems. To overcome these problems, professionals should take an active role in empowering children with disabilities and their parents. Furthermore, it is important to introduce outdoor active play at a young age, so it becomes part of normal daily life. In addition, a change in the mindset of typically developing peers and their parents seems essential to achieve true inclusive active play.
Implications: Social-emotional aspects such as social skills and empowerment of both children and parents should be part of pediatric physical therapy interventions.
Keywords: Children with disabilities, Inclusive active play, Pediatric Physical Therapy
Funding acknowledgements: na
Purpose: The purpose of this study was to explore facilitators, barriers and solutions that influence participation of children with disabilities in Dutch outdoor playgrounds from both a parental and professional's perspective.
Methods: This study has a descriptive qualitative design. Purposive sampling was used to include parents from children with several physical disabilities and ages between 2-12 years and professionals with different levels of experience and various professions. Twelve semi-structured interviews with parents and five focus groups with professionals (n=25) working with children with disabilities (such as pediatric physical therapists) were conducted and transcribed verbatim. To assure data saturation, we performed three member check meetings (n=21). Two independent researchers analyzed the data using an inductive thematic approach, in case of no consensus a third researcher was consulted. Barriers, facilitators and solutions were coded and themes were constructed using the modified Physical Activity for person with a Disability model as a background scheme (adjusted PAD-model). Critical peer review sessions were established to avoid bias.
Results: Similar barriers, facilitators and solutions were mentioned by parents and professionals and observed for all domains of the modified PAD-model. The most important environmental factor was that the Dutch community is not inclusive yet. People often find it difficult to interact with children with disabilities, making participation and inclusiveness a challenge. The most important personal factors were physical and social problems that were experienced when children with disabilities wanted to join outdoor play. Interestingly, parents and professionals believed that the social barrier was far more important than the physical barrier. Two additional themes were emphasized upon from the professional's perspective, namely to introduce children with disabilities to the playground at a young age and the role of professionals in facilitating active inclusive play.
Conclusion(s): According to both parents and professionals, the most important barrier for outdoor active play is that children with disabilities do not join typically developing peers because of social problems. To overcome these problems, professionals should take an active role in empowering children with disabilities and their parents. Furthermore, it is important to introduce outdoor active play at a young age, so it becomes part of normal daily life. In addition, a change in the mindset of typically developing peers and their parents seems essential to achieve true inclusive active play.
Implications: Social-emotional aspects such as social skills and empowerment of both children and parents should be part of pediatric physical therapy interventions.
Keywords: Children with disabilities, Inclusive active play, Pediatric Physical Therapy
Funding acknowledgements: na
Topic: Paediatrics; Disability & rehabilitation
Ethics approval required: No
Institution: HU Univeristy of Applied Sciences Utrecht
Ethics committee: Medical Ethical Screening committee
Reason not required: The study used interviews with no emotional burden
All authors, affiliations and abstracts have been published as submitted.
