Inclusive Play Design with Occupational + Physical Therapists

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by Carol Henry, PLA, ASLA, REFP

The movement toward inclusive play environments is gaining momentum and it’s a welcome and exciting development in modern playground design. Last month I and two of my colleagues at Design Concepts attended the Play for All! seminar in Denver. The gathering included landscape architects, parks professionals, parent advocates, play equipment developers, and occupational and physical therapists (OT/PT's). The group of diverse experts represents the next generation of play design.

Three Steps to Nowhere

Place a second set of handrails at children's height to increase accessibility.

Place a second set of handrails at children's height to increase accessibility.

As one OT spoke about a problem she called the “three steps to nowhere” I was reminded how beautifully the different worlds of landscape architecture and OT/PT converge. 

The issue was that of OT/PT patients getting bored and frustrated with the "three steps to nowhere" often used in indoor clinical settings.

In an outdoor play environment, these same “three steps” are not repetitive work, but steps that lead to fun and adventure—and the reward of play.

 

Therapeutic Requirements Meet Joyful Fun

The therapeutic benefits of a double slide are maximized by the childlike desire to "Do it again!"

The therapeutic benefits of a double slide are maximized by the childlike desire to "Do it again!"

The therapeutic aims of OT/PT can be achieved naturally for children in an accessible, inclusive playground. I give several examples below from playgrounds I have designed recently in Washington: Meadow Crest playground in Renton, and Inspiration Playground in Bellevue.

OT/PTs need movements that improve vestibular (position and movement in relation to gravity) and proprioceptive (joint and muscle sensation, equilibrium, and the relative position of one’s own body). Landscape architects provide play activities that kids love: rocking, swinging, spinning, rolling, balance, and climbing.

OT/PT's need activities that improve gross motor skills; we include play structures with wheels, buttons, and levers, plus all manner of climbing activities. They need activities that improve fine motor skills; we include chalk boards or sand. They need a place to rest after activities have challenged their patients; we provide shaded tables and a fun spot for snack time. 

OT/PT's need activities that encourage repetitive use and ease of therapist assistance, routes that allow wheelchair accommodation, and surfacing that works for all abilities. We provide a double slide on which children and caregivers can go down at the same time (a moment of shared non-verbal communication reinforced by movement and fun). We design the slide with stairs near the exit and multiple access points (a transfer station and short set of stairs, up a climbing wall, or a sidewalk ramp behind the climbing wall) to include all possible abilities.

OT/PTs work to improve children’s verbal and nonverbal communication development; we know that play provides natural social interactions, both verbal or non-verbal—and it’s fun!

Playgrounds Provide Natural Graduated Challenges

Graduated balancing challenges are natural additions to playgrounds.

Graduated balancing challenges are natural additions to playgrounds.

Including elements of increasing challenges can give children a reason to work on their skills. Each level of difficulty in a play environment is a subtle raise in the game.

For example, balancing can begin with walking painted lines on the ground. When that skill is mastered, children can graduate to a simple balance beam, either with or without handrails. Next they can step from log to log, which requires balance and navigation skills. A wobbly bridge can teach balance correction. Each new step is a victory for the child, always encouraged by the natural motivation of outdoor play.

Stairs can first be just a transfer station with hand-holds, transitioning to a ladder, then up to a rope climber or climbing wall. Increasing the level of challenges as skills develop is natural on a playground where younger children instinctively want to do what the “big kids” are doing.  This is actually a therapeutic benefit itself. Some children have challenges planning their next steps, so the desire to play throughout the whole playground provides a natural incentive to improve this skill.

 

When to Include OT/PTs in the Design of Accessible and Inclusive Play Environements

Smooth surfaces and inclusive play structures mean the play area is accessible to all children.

Smooth surfaces and inclusive play structures mean the play area is accessible to all children.

Especially in a play environment that will be used by OT/PT’s, a preliminary meeting at the beginning of the design process allows time to discuss important questions. Which skills are difficult to teach inside? What activities will best reinforce skills? What are the most commonly needed skill areas?

Discussions during the planning process can incorporate the skills OT/PT's need to teach, and landscape architects can show which types of activities may be best achieved through play.

Near the end of the design process, reviewing the plans with an OT or PT will help evaluate if the design provides maximum opportunity for skill growth and engagement. It will also highlight any opportunities that are being overlooked while there is still time to modify the design.

Better Design Through Collaboration

The different worlds of landscape architecture and OT/PT can blend and improve when both professionals share their knowledge and expertise. Both are striving to give children opportunities to play joyfully, and learning from one another's strengths and knowledge will turn a good space into a great space. One of the speakers at the Play for All! seminar commented, “Our goal isn’t normalcy, it’s joy.” Well said.

The inclusivity of rolling down a hill. These children are rolling down a synthetic turf hill; almost all kids can do it, regardless of muscle control, and the synthetic turf allows ease of access to the top of the hill.

The inclusivity of rolling down a hill. These children are rolling down a synthetic turf hill; almost all kids can do it, regardless of muscle control, and the synthetic turf allows ease of access to the top of the hill.

How to Find an Occupational or Physical Therapist

The services of local school districts are available regardless of whether your child attends the local school. Schools often have specialists that visit on a regular schedule, and they may have additional resources to recommend.

Local children's hospitals or rehabilitation centers, pediatricians and doctors should all be able to give recommendations. Other parents can share their experiences, and many communities have websites or Facebook pages with information and gatherings. Also, the American Physical Therapy Association and American Occupational Therapy Association have information on numerous topics as well as services and specialties available.


This blog is part of a three-part series by Design Concepts on inclusive play environments. See The Play Brigade: Advocate for Inclusive Play by Roger Burkart. Inclusive Play in Colorado: Where Can It Happen? by Lisa Langer will be coming soon.

The Play for All! conference in Denver was sponsored by the STAR Institute and Landscape Structures.