Background: Playgrounds facilitate important opportunities for growth and development during childhood. These experiences are not afforded to children with disabilities due to environmental and societal barriers despite ADA regulations. The objective of this systematic review is to dentify and synthesize existing research on the relationship between key areas of development and accessible play settings for children aged 3-12 with disabilities, and provide occupational therapy practitioners (OTPs) with a body of evidence to inform evidence-based interventions and utilize in advocating for occupational justice. Methods: The following databases were searched on January 30, 2021: Academic Search Complete/EBSCO, CINAHL/EBSCO, Education Research Complete/EBSCO, ERIC, OTSeeker, and PubMed. Study Selection and Data Collection: This systematic review was conducted using PRISMA guidelines. Included studies were peer-reviewed, included children with disabilities aged 3-12, in an accessible play setting, and had outcomes related to areas of childhood development. Validated tools were used to determine risk of bias and quality of evidence. Results: Nine articles met inclusion criteria. This included one Level IIIB matched case-control study, four Level IV cross-sectional studies, three Level V qualitative studies, and one mixed-methods study with both Level IV and Level V evidence. Social participation, play participation, and motor skill development were negatively impacted in 8 of 9 studies despite playgrounds being labeled accessible. Conclusion: Children with disabilities have decreased engagement in activities that provide opportunities for play, social participation, and motor skill development. OTPs should address occupational injustice in the playground setting through developing programs to combat stigma, engaging in policy and playground design, and conducting longitudinal cohort studies. Through addressing play accessibility, OTPs could significantly reduce instances of play inequity. Creating interdisciplinary teams to address accessible playground design locally would allow OTPs the opportunity to make a lasting impact for the children in their community.
Samantha Rosenthal, PhD, MPH
OTD - Occupational Therapy Doctorate
Zawadzki, Anna; Gately, Kelsey; Mosley, Alyssia; Badua, Alyssamarie; Swanberg, Jennifer; and Rosenthal, Samantha, "Occupational Injustice and the Right to Play: A Systematic Review of Accessible Playgrounds for Children with Disabilities" (2023). Student Research Design & Innovation Symposium. 23.