here is no standardized definition of play, but it is generally understood as participating in a range of "spontaneous, pleasurable, rewarding, and voluntary" activities. Play relieves stress, supports childhood development, improves socialization, and facilitates family bonding. Conversely, isolation and loneliness due to social exclusion are linked to poorer mental health and wellbeing outcomes, and are predictors of depression and anxiety for young people.
Play is clearly critical for children’s wellbeing, but not all children have access to play opportunities. Children with disabilities are especially excluded from opportunities for play and socialization, and this marginalization is more pronounced in low– and middle–income countries (LMICs). A recent analysis of data from 38 LMICs, for example, demonstrated that in comparison with their peers without disabilities, children with disabilities aged 2–4 years old had 9% fewer opportunities for play. Similarly, a 2019 systematic review concluded that children with disabilities reported feelings of profound isolation from their peers.
How are children with disabilities excluded from play?
Children and adolescents with disabilities are an extremely diverse group, yet across the world they experience similar barriers when trying to access play and recreation. These barriers operate at multiple, interconnected levels including the individual, community, and environmental. Socioeconomic conditions and a lack of formal disability–related support services (such as respite care, accessible transport, housing, and inclusive education) in low–resource settings deepen the exclusion of children with disabilities in LMICs.
In LMICs, most children with disabilities receive support and care primarily from their own families. However, parents or other primary caregivers may feel inadequately equipped to play with their children because access to reliable information about childhood disability, and how to play in age– and disability–responsive ways, is extremely limited in low–resource settings. Insufficient access to knowledgeable health and allied professionals contributes to parental insecurity about how best to play and communicate with their children.
In addition, the scrutiny of surrounding communities makes it hard for parents to feel comfortable in public playing with or letting their children play independently with others. This is especially the case for children with developmental delays or intellectual disabilities who may have difficulty communicating in ways that are familiar to their parents and peers. Parental expectations and concerns about their child's acceptance by peers may thus limit the child’s opportunities to play.
Children with disabilities often have limited access to outdoor play spaces or are excluded by inaccessible recreational environments. In Trafford’s recent qualitative study from South Africa, for example, low–income mothers of children with various disabilities talked repeatedly about the inaccessibility of playgrounds. Even if they were able to get their children to a local park, the equipment had not been built with their needs, or the safety of their children, in mind.
Play is not trivial
Despite the intersecting exclusions referenced above, numerous international conventions and guidelines affirm the right of children to leisure and play, and situate these rights as equal to other needs. The United Nations (UN) Convention on the Rights of the Child (CRC) enshrines the right to play and interact with people in their community. Furthermore, the Nurturing Care Framework (NCF) establishes the importance of connection with primary caregivers in the earliest years of a child’s life. Article 26 of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) also mandates that children with disabilities be provided access to play and participation in sports.
In LMIC settings, however, where the vast majority of the world’s estimated 240 million children with disabilities live, the right to play appears to have been deprioritized. This may be partly because issues of basic survival are far from resolved and can seem more urgent than play. Additionally, the deep stigma and discrimination still associated with disabilities fuels misconceptions and a lack of understanding of the strengths and capabilities of children with disabilities.
But calls for improving access to play for children with disabilities need not displace advocacy for improved basic living conditions, because these goals are complementary.
How to improve access to play for children with disabilities
A holistic systems approach would facilitate more opportunities for children with disabilities to play in ways that are stimulating for them. Empowering families with accurate information and disability–sensitive training can address stigmatizing beliefs and help parents to understand different manifestations of play as well as how to keep their children safe while playing. In parallel, creative efforts to reduce stigma and increase community engagement by challenging societal perceptions about childhood disability should continue. These initiatives should be informed by an understanding of what play means and why it matters to children with disabilities in LMICs. Additionally, government policies and infrastructure should prioritize accessibility and inclusivity.
Access to age–appropriate play and recreation is an often neglected but critical aspect of improving the wellbeing of children with disabilities.
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Equitable access to play critical for children with disabilities
Photo by Robert Norton on Unsplash.
March 29, 2024
Children and adolescents with disabilities are an extremely diverse group, yet across the world they experience similar barriers when trying to access play and recreation—crucial elements of wellbeing and mental heath, write Zara Trafford, Xanthe Hunt, and Tracey Smythe.
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here is no standardized definition of play, but it is generally understood as participating in a range of "spontaneous, pleasurable, rewarding, and voluntary" activities. Play relieves stress, supports childhood development, improves socialization, and facilitates family bonding. Conversely, isolation and loneliness due to social exclusion are linked to poorer mental health and wellbeing outcomes, and are predictors of depression and anxiety for young people.
Play is clearly critical for children’s wellbeing, but not all children have access to play opportunities. Children with disabilities are especially excluded from opportunities for play and socialization, and this marginalization is more pronounced in low– and middle–income countries (LMICs). A recent analysis of data from 38 LMICs, for example, demonstrated that in comparison with their peers without disabilities, children with disabilities aged 2–4 years old had 9% fewer opportunities for play. Similarly, a 2019 systematic review concluded that children with disabilities reported feelings of profound isolation from their peers.
How are children with disabilities excluded from play?
Children and adolescents with disabilities are an extremely diverse group, yet across the world they experience similar barriers when trying to access play and recreation. These barriers operate at multiple, interconnected levels including the individual, community, and environmental. Socioeconomic conditions and a lack of formal disability–related support services (such as respite care, accessible transport, housing, and inclusive education) in low–resource settings deepen the exclusion of children with disabilities in LMICs.
In LMICs, most children with disabilities receive support and care primarily from their own families. However, parents or other primary caregivers may feel inadequately equipped to play with their children because access to reliable information about childhood disability, and how to play in age– and disability–responsive ways, is extremely limited in low–resource settings. Insufficient access to knowledgeable health and allied professionals contributes to parental insecurity about how best to play and communicate with their children.
In addition, the scrutiny of surrounding communities makes it hard for parents to feel comfortable in public playing with or letting their children play independently with others. This is especially the case for children with developmental delays or intellectual disabilities who may have difficulty communicating in ways that are familiar to their parents and peers. Parental expectations and concerns about their child's acceptance by peers may thus limit the child’s opportunities to play.
Children with disabilities often have limited access to outdoor play spaces or are excluded by inaccessible recreational environments. In Trafford’s recent qualitative study from South Africa, for example, low–income mothers of children with various disabilities talked repeatedly about the inaccessibility of playgrounds. Even if they were able to get their children to a local park, the equipment had not been built with their needs, or the safety of their children, in mind.
Play is not trivial
Despite the intersecting exclusions referenced above, numerous international conventions and guidelines affirm the right of children to leisure and play, and situate these rights as equal to other needs. The United Nations (UN) Convention on the Rights of the Child (CRC) enshrines the right to play and interact with people in their community. Furthermore, the Nurturing Care Framework (NCF) establishes the importance of connection with primary caregivers in the earliest years of a child’s life. Article 26 of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) also mandates that children with disabilities be provided access to play and participation in sports.
In LMIC settings, however, where the vast majority of the world’s estimated 240 million children with disabilities live, the right to play appears to have been deprioritized. This may be partly because issues of basic survival are far from resolved and can seem more urgent than play. Additionally, the deep stigma and discrimination still associated with disabilities fuels misconceptions and a lack of understanding of the strengths and capabilities of children with disabilities.
But calls for improving access to play for children with disabilities need not displace advocacy for improved basic living conditions, because these goals are complementary.
How to improve access to play for children with disabilities
A holistic systems approach would facilitate more opportunities for children with disabilities to play in ways that are stimulating for them. Empowering families with accurate information and disability–sensitive training can address stigmatizing beliefs and help parents to understand different manifestations of play as well as how to keep their children safe while playing. In parallel, creative efforts to reduce stigma and increase community engagement by challenging societal perceptions about childhood disability should continue. These initiatives should be informed by an understanding of what play means and why it matters to children with disabilities in LMICs. Additionally, government policies and infrastructure should prioritize accessibility and inclusivity.
Access to age–appropriate play and recreation is an often neglected but critical aspect of improving the wellbeing of children with disabilities.
