Kelsey A. Gately, BA, is OTD Student, Department of Occupational Therapy, Johnson & Wales University, Providence, RI;
Anna H. Zawadzki, BS, is OTD Student, Department of Occupational Therapy, Johnson & Wales University, Providence, RI.
Am J Occup Ther. 2023 Mar 1;77(2). doi: 10.5014/ajot.2023.050035.
Playgrounds facilitate important opportunities for growth and development during childhood. Despite accessibility regulations, these experiences are not afforded to children with disabilities as a result of environmental and societal barriers.
To identify and synthesize existing research on the relationship between key areas of development and accessible play settings for children with disabilities to inform evidence-based interventions and advocacy work.
The following databases were searched on January 30, 2021: Academic Search Complete/EBSCO, CINAHL/EBSCO, Education Research Complete/EBSCO, ERIC, OTseeker, and PubMed.
This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were peer-reviewed, included children with disabilities ages 3 to 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.
Nine articles met inclusion criteria: 1 Level 3b matched case-control study, 4 Level 4 cross-sectional studies, 3 Level 5 qualitative studies, and 1 mixed-methods study with Levels 4 and 5 evidence. Eight of 9 studies reported that social participation, play participation, and motor skills development were negatively affected despite playgrounds being labeled accessible.
Children with disabilities have decreased engagement in activities that provide opportunities for play, social participation, and motor skills development. Practitioners should address occupational injustice in the playground setting by engaging in program development, policy, and playground design to reduce stigma and increase accessibility. What This Article Adds: By addressing play accessibility, occupational therapy practitioners could significantly reduce instances of play inequity. Creating interdisciplinary teams to address accessible playground design locally would allow occupational therapy practitioners the opportunity to make a lasting impact for the children in their community.
操场为儿童提供了重要的成长和发展机会。尽管有可达性法规，但由于环境和社会障碍，残疾儿童无法获得这些体验。
确定并综合现有研究，探讨残疾儿童关键发展领域与无障碍游戏环境之间的关系，为循证干预和倡导工作提供信息。
于 2021 年 1 月 30 日在以下数据库中进行了搜索：Academic Search Complete/EBSCO、CINAHL/EBSCO、Education Research Complete/EBSCO、ERIC、OTseeker 和 PubMed。
本系统评价采用系统评价和荟萃分析报告的首选项目进行。研究为同行评审，包括在无障碍游戏环境中 3 至 12 岁的残疾儿童，并且与儿童发展领域的结果相关。使用经过验证的工具来确定偏倚风险和证据质量。
9 篇文章符合纳入标准：1 项 3b 级匹配病例对照研究、4 项 4 级横断面研究、3 项 5 级定性研究和 1 项具有 4 级和 5 级证据的混合方法研究。尽管操场被标记为无障碍，但其中 8 项研究报告称，社会参与度、游戏参与度和运动技能发展受到负面影响。
残疾儿童参与提供游戏、社会参与和运动技能发展机会的活动减少。从业者应通过参与方案制定、政策制定和操场设计来解决操场上的职业不公正问题，以减少污名化并提高可达性。本文的添加内容：通过解决游戏的可达性问题，职业治疗师可以大大减少游戏不公平的情况。在当地组建跨学科团队来解决无障碍操场设计问题，可以让职业治疗师有机会为他们所在社区的儿童产生持久的影响。
