Outdoor Play Decisions by Caregivers of Children with Disabilities: a Systematic Review of Qualitative Studies
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Outdoor play offers children vast benefits for development and well-being. However, children with developmental disabilities participate less in outdoor play than their typical peers. Typically, adults make decisions about children’s play routines, especially for children with developmental disabilities. The purpose of this systematic review was to synthesize the results from qualitative studies on decision making processes of caregivers around outdoor play in children with developmental disabilities using ecocultural theory. Studies addressing decision making of parents, teachers, and other caregivers of primary school-aged children with developmental disabilities relating to outdoor play were searched in CINHAL, Medline, Web of Science, ERIC, Scopus, PsycINFO, and SocINDEX from 1990 to May 2015. Eleven predominately qualitative studies met the inclusion criteria. The CASP quality of reporting quality checklist was used to evaluate the transparency of reporting for included studies. An ecocultural framework was used for thematic analysis and synthesis. Results showed caregivers, families, schools, and communities consider many factors when deciding about when, where, how, and if outdoor play occurs. Factors comprised: motivation for participation in outdoor play; social and built environments; familial and school considerations including time and finances; caregivers’ awareness of opportunities; and child considerations such as their skills, health, and interests. A dynamic interaction exists between and within the ecocultural environment of a child with developmental disabilities to determine decision outcomes in outdoor play. Consequently, to increase the opportunities for benefits associated with outdoor play, each ecocultural layer must be targeted.
KeywordsParent Teacher Kid Thematic analysis Qualitative synthesis
Compliance with Ethical Standards
An Australian Research Council Discovery Grant (number DP140101792) obtained by AB for the Sydney Playground Project (Levelling the Playing Field: Starting with the School Playground), made possible the PhD scholarship of JS.
This article does not contain any studies with human participants or animals performed by any of the authors.
Conflicts of Interest
The authors have no competing interests to report.
- Anaby, D., Hand, C., Bradley, L., DiRezze, B., Forhan, M., DiGiacomo, A., & Law, M. (2013). The effect of the environment on participation of children and youth with disabilities: a scoping review. Disability and Rehabilitation, 35, 1589–1598. doi: 10.3109/09638288.2012.748840.CrossRefPubMedGoogle Scholar
- Australian Institute of Health and Welfare (AIHW). (2004). Children with disabilities in Australia. AIHW cat. no. DIS 38. Canberra: AIHW.Google Scholar
- Bloemen, M., Verschuren, O., van Mechelen, C., Borst, H. E., de Leeuw, A. J., van der Hoef, M., & de Groot, J. F. (2015). Personal and environmental factors to consider when aiming to improve participation in physical activity in children with Spina Bifida: a qualitative study. BMC Neurology, 15, 11. doi: 10.1186/s12883-015-0265-9.CrossRefPubMedPubMedCentralGoogle Scholar
- Bronfenbrenner, U. (1979). The ecology of human development: experiments in nature and design. Cambridge, MA: Harvard University Press.Google Scholar
- Brussoni, M., Gibbons, R., Gray, C., Ishikawa, T., Sandseter, E., Bienenstock, A., et al. (2015). What is the relationship between risky outdoor play and health in children? A systematic review. International Journal of Environmental Research and Public Health, 12, 6423–6454. doi: 10.3390/ijerph120606423.CrossRefPubMedPubMedCentralGoogle Scholar
- Bult, M. K., Verschuren, O., Jongmans, M. J., Lindeman, E., & Ketelaar, M. (2011). What influences participation in leisure activities of children and youth with physical disabilities? A systematic review. Research in Developmental Disabilities, 32, 1521–1529. doi: 10.1016/j.ridd.2011.01.045.CrossRefPubMedGoogle Scholar
- Bundy, A., Wyver, S., Beetham, K. S., Ragen, J., Naughton, G., Tranter, P., et al. (2015). The Sydney playground project- levelling the playing field: a cluster trial of a primary school-based intervention aiming to promote manageable risk-taking in children with disability. BMC Public Health, 15, 1125. doi: 10.1186/s12889-015-2452-4.CrossRefPubMedPubMedCentralGoogle Scholar
- Campbell, R., Pound, P., Pope, C., Britten, N., Pill, R., Morgan, M., & Donovan, J. (2003). Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care. Social Science and Medicine, 56(4), 671–684. doi: 10.1016/S0277-9536(02)00064-3.CrossRefPubMedGoogle Scholar
- Children’s Play Council (1998). The new charter for children’s play. Book. London: The Children’s Society.Google Scholar
- Colver, A., Thyen, U., Arnaud, C., Beckung, E., Fauconnier, J., Marcelli, M., et al. (2012). Association between participation in life situations of children with cerebral palsy and their physical, social, and attitudinal environment: a cross-sectional multicenter European study. Archives of Physical Medicine and Rehabilitation, 93, 2154–2164. doi: 10.1016/j.apmr.2012.07.011.CrossRefPubMedGoogle Scholar
- Creswell, J. (2007). Qualitative inquiry and research design: Choosing among five approaches (2nd ed.). Thousand Oaks, California: Sage Publications Inc..Google Scholar
- Critical Appraisal Skills Programme. (2014). CASP Checklists. http://www.casp-uk.net/
- Dixon-Woods, M., Sutton, A., Shaw, R., Miller, T., Smith, J., Young, B., et al. (2007). Appraising qualitative research for inclusion in systematic reviews: a quantitative and qualitative comparison of three methods. Journal of Health Services Research & Policy, 12, 42–47 %U http://jhsrp.rsmjournals.com/cgi/content/. doi: 10.1258/135581907779497486
- Downs, S. J., Boddy, L. M., Knowles, Z. R., Fairclough, S. J., & Stratton, G. (2013). Exploring opportunities available and perceived barriers to physical activity engagement in children and young people with Down syndrome. European Journal of Special Needs Education, 28, 270–287. doi: 10.1080/08856257.2013.768453.CrossRefGoogle Scholar
- Downs, S. J., Knowles, Z. R., Fairclough, S. J., Heffernan, N., Whitehead, S., Halliwell, S., & Boddy, L. M. (2014). Exploring teachers’ perceptions on physical activity engagement for children and young people with intellectual disabilities. European Journal of Special Needs Education, 29, 402–414. doi: 10.1080/08856257.2014.906979.CrossRefGoogle Scholar
- Ginsburg, K., American Academy of Pediatrics Committee on Communications, & American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health (2007). The importance of play in promoting healthy child development and maintaining strong parent-child bonds. American Academy of Pediatrics, 119, 182–191.Google Scholar
- Hossein Memari, A., Panahi, N., Ranjbar, E., Moshayedi, P., Shafiei, M., Kordi, R., & Ziaee, V. (2015). Children with Autism Spectrum Disorder and Patterns of Participation in Daily Physical and Play Activities. Neurology Research International, 1–7. doi: 10.1155/2015/531906.
- King, G., Law, M., King, S., Rosenbaum, P., Kertoy, M. K., & Young, N. L. (2003). A conceptual model of the factors affecting the recreation and leisure participation of children with disabilities. Physical & Occupational Therapy in Pediatrics, 23, 63–90. doi: 10.1300/J006v23n01_05.CrossRefGoogle Scholar
- King, G., Law, M., Hanna, S., King, S., Hurley, P., Rosenbaum, P., et al. (2006). Predictors of the Leisure and Recreation Participation of Children With Physical Disabilities: A Structural Equation Modeling Analysis. Children's Health Care, 35, 209–234. doi: 10.1207/s15326888chc3503_2.CrossRefGoogle Scholar
- King, G., Law, M., Hurley, P., Petrenchik, T., & Schwellnus, H. (2010). A Developmental Comparison of the Out-of-school Recreation and Leisure Activity Participation of Boys and Girls With and Without Physical Disabilities. International Journal of Disability, Development and Education, 57, 77–107. doi: 10.1080/10349120903537988.CrossRefGoogle Scholar
- Law, M., Finkelman, S., Hurley, P., Rosenbaum, P., King, S., King, G., & Hanna, S. (2004). Participation of children with physical disabilities: relationships with diagnosis, physical function, and demographic variables. Scandinavian Journal of Occupational Therapy, 11, 156–162. doi: 10.1080/11038120410020755.CrossRefGoogle Scholar
- Law, M., Petrenchik, T., King, G., & Hurley, P. (2007). Perceived Environmental Barriers to Recreational, Community, and School Participation for Children and Youth With Physical Disabilities. Archives of Physical Medicine and Rehabilitation, 88, 1636–1642. doi: 10.1016/j.apmr.2007.07.035.CrossRefPubMedGoogle Scholar
- Law, M., Darrah, J., Pollock, N., Wilson, B., Russell, D. J., Walter, S. D., et al. (2011). Focus on function: a cluster, randomized controlled trial comparing child- versus context-focused intervention for young children with cerebral palsy. Developmental Medicine and Child Neurology, 53, 621–629. doi: 10.1111/j.1469-8749.2011.03962.x.CrossRefPubMedPubMedCentralGoogle Scholar
- Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. a., et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Annals of Internal Medicine, 151, W-65. doi: 10.1371/journal.pmed.1000100.CrossRefGoogle Scholar
- Llewellyn, G. (2012). Ecocultural theory: Everyday cultures of children. In S. Lane & A. Bundy (Eds.), Kids can be kids (pp. 180–193). Philadelphia, PA: F.A. Davis Company.Google Scholar
- Mactavish, J., & Schleien, S. (1998). Playing together growing together: Parent’s perspectives on the benefits of family recreation in families that include children with a developmental disability. Therapeutic Recreation Journal, 32, 207–230.Google Scholar
- Mactavish, J., & Schleien, S. (2004). Re-injecting spontaneity and balance in family life: parents’ perspectives on recreation in families that include children with developmental disability. Journal of intellectual disability research: JIDR, 48, 123–141. doi: 10.1111/j.1365-2788.2004.00502.x.CrossRefPubMedGoogle Scholar
- Office of the United Nations High Commissioner for Human Rights. (1990). Convention on the Rights of the Child. Convention on the rights of the child: General Assembly Resolution 44/25 of 20 November 1989. doi: 10.3126/jnps.v29i1.1601
- Palisano, R. J., Kang, L.-J., Chiarello, L. A., Orlin, M., Oeffinger, D., & Maggs, J. (2009). Social and community participation of children and youth with cerebral palsy is associated with age and gross motor function classification. Physical Therapy, 89, 1304–1314. doi: 10.2522/ptj.20090162.CrossRefPubMedGoogle Scholar
- Prellwitz, M., & Tamm, M. (1999). Attitudes of key persons to accessibility problems in playgrounds for children with restricted mobility: a study in a medium-sized municipality in northern Sweden. Scandinavian Journal of Occupational Therapy, 6, 166–173. doi: 10.1080/110381299443645.CrossRefGoogle Scholar
- Rosenbaum, P., & Stewart, D. (2004). The World Health Organization International Classification of Functioning, Disability, and Health: A Model to Guide Clinical Thinking, Practice and Research in the Field of Cerebral Palsy. Seminars in Pediatric Neurology, 11, 5–10. doi: 10.1016/j.spen.2004.01.002.CrossRefPubMedGoogle Scholar
- Shields, N., & Synnot, A. (2016). Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study. BMC Pediatrics, 1–10. doi: 10.1186/s12887-016-0544-7.
- Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8. doi: 10.1186/1471-2288-8-45.
- Thompson, D., & Emira, M. (2011). “They say every child matters, but they don”t’: an investigation into parental and carer perceptions of access to leisure facilities and respite care for children and young people with Autistic Spectrum Disorder (ASD) or Attention Deficit, Hyperactivity D. Disability & Society, 26, 65–78. doi: 10.1080/09687599.2011.529667.CrossRefGoogle Scholar
- Weisner, T. S. (2002). Ecocultural understanding of children’s developmental pathways. Human Development, 45, 275–281. doi: 10.1159/000064989.
- Williams, K., MacDermott, S., Ridley, G., Glasson, E., & Wray, J. (2008). The Prevalence of Autism in Australia: Can it be Establisher from Existing Data? Journal of Paediatrics and Child Health 44, 504–510. file://localhost/Volumes/Volume_2/ZoteroLib_LV/library/Papers/2006/MacDermott/Australian Advisory Board on ASD 2006 MacDermott.pdfGoogle Scholar
- Wilson, D. (2014). Incorporating group selection into the adaptionist program: A case study involving human decision making. In J. Simpson & D. Kenrick (Eds.), Evolutionary social psychology (pp. 345–387). Mahawah, NJ: Psychology Press.Google Scholar
- World Health Organization (2001). International classification of functioning, disability and health. Geneva: World Health Organization.Google Scholar