Supporting Outdoor Play: A Practical and Evidence-Based Approach

Annual Conference of the American Occupational Therapy Association

April 27,2006

Linn Wakeford, M.S., OTR/L

Dr. Petra Kern, MT-BVM, MT-BC

The Setting…

  • Frank Porter Graham Child Care Program
  • Inclusive
  • Serves ages 6 weeks to 5 years
  • Serves 65-75 children, total
  • Approximately 1/3 of the children have identified special needs
  • IEP/IFSP teams include OT, PT, Speech, Special Ed, parents, teachers
  • Therapy services provided using an integrated model and collaborative consultative approaches

The context

  • Children spend at least an hour a day on the playground
  • Teachers take breaks during outdoor play, reducing the number of adults on the playground
  • The playground is often seen as a venue for free play, and alternative or additional activities occurred intermittently

Our playground

  • Is a large open fenced area, with two smaller fenced partitions for a “special activities area” and an infant/ toddler playground. There are two large trees, with benches around them. There are two sandbox areas, the larger of which is home to a climbing structure (rope ladder, tunnel, monkey bars, and 2 slides), and the Music Hut. The Music Hut is a large wooden platform with a variety of percussion instruments attached. Other musical elements (e.g., kettle drums) are placed in other locations on the playground as well. There is a bike path for trikes, wagons and other riding toys. There is also a wooden playhouse, big plastic building blocks, and picnic-style tables available. A wide sidewalk area marks the boundary between the playground and the building, and at one end there is a child-sized basketball hoop. Two preschool classrooms and an infant room have doors that open directly onto this sidewalk area and the playground.

What we observed about children…

  • Children with identified disabilities may, indeed, require more support on the playground than children without disabilities, BUT
  • The existence of a “diagnosis” does not necessarily mean that outdoor play will be difficult, AND
  • There are children without identified disabilities who have difficulty with physical or social components of outdoor play, AND
  • All children (with disabilities or without) need novelty and appropriate challenges to sustain engagement in activities, including outdoor play

Our conclusions…

  • There are a number of children, with disabilities and without, for whom outdoor play is difficult, because the physical and social environment of the playground does not match their abilities, interests or needs.
  • Cultural influences create expectations about outdoor play, but these don’t always match with the experiences or expectations of the child
  • Temporal aspects of outdoor play may also influence participation. These may include the length of time children are on the playground, the pace at which active outdoor play occurs, and the loosely structured nature of outdoor play, in which structure and routine may be minimal.

What we observed about the adults…

  • Adult participation varies greatly and is dependent on many factors, one of which is how many other adults are there…
  • When there are more adults on the playground, their participation becomes more “custodial” and “supervisory” rather than as co-constructers of play (in large part because they begin to interact with one another, rather than the children)
  • This allows children to enjoy that free play element they enjoy, but also results in missed opportunities to support the participation or inclusion of children who need some help…

Our conclusions…

  • Adults must, first and foremost, provide a safe environment for play, and playground supervision is a key role for adults
  • Adults need structure and support in order to provide structure and support on the playground
  • Adults need novelty and appropriate challenges
  • Adults need opportunities to interact with other adults

So…

  • We looked at existing research and other pertinent literature
  • We began discussions about how to engage individual children, and all children, in more purposeful play on the playground
  • The staff adopted a center-wide goal related to supporting outdoor play and formed a Playground Committee

What we know about Playgrounds…

  • Playground time is important in learning and social development
  • Playground time should be part of the overall curriculum
  • Outdoor environments offer different learning, play and social opportunities than do indoor environments
  • There is a "free choice" element to outdoor play that children value
  • What we know about Playgrounds…
  • It is important for the environment to afford a variety of play opportunities and those need to target different developmental levels
  • Children with disabilities require more adult support than children without disabilities in order to participate in play and social interactions on the playground

Our goals

  • To support inclusion (group membership and social participation)
  • To support independence, engagement and social participation of all the children on the playground
  • To provide specific supports related to outdoor play for individual children with special needs
  • To create an outdoor play environment that is fun, and emotionally and physically safe

So we needed outdoor play opportunities that…

  • Offer novelty and new, but appropriate, challenges
  • Can be adapted so that any child can participate
  • Can be offered within the realm of “free choice” on the playground (i.e., kids can come and go relatively freely)
  • Focus and structure a part of playground time for both children and adults
  • Don’t require involvement of all adults
  • Allow us to attend to individual and group needs simultaneously

Occupational Therapy Perspectives

  • Play is the primary occupation of children, and this includes outdoor play
  • Outdoor play spaces are “natural environments”
  • For young children, adults are co-constructors of play, either in providing direct support and ideas or by engineering the environment to support play
  • Outdoor play occurs as a transaction among the child, the specific activity, and the social and physical environment
  • The child’s ability to engage successfully in outdoor play is influenced by what the playspace offers and the child’s ability to use those affordances
  • The meaning that outdoor play has for the child also influences participation, and the child’s experiences of the playground are unique to the interaction of that child and the playground setting
  • Physical, social, cultural, temporal and personal contexts may influence outdoor play

Performance

Assessment of Outdoor Play

Individual:

  • Child performance in context
  • Motivation, interest
  • Knowledge, understanding
  • Abilities
  • Activity Demands and supports
  • Performance habits and patterns
  • Context: social, physical, temporal, cultural

Population

  • Variety of play
  • Activity demands/supports
  • Types of play (active, imaginary, constructive, themes, etc.)
  • Flow of proximity and social interactions during play
  • Length of engagement
  • Adult presence and roles
  • Child-led play
  • Inclusion/exclusion criteria
  • Responses to novelty
  • Contextual influences

Music Therapy Perspectives

  • Uses music and/or musical elements therapeutically to address physical, emotional, cognitive, behavioral, and/or social functioning
  • Music therapy provides a unique variety in musical experiences in an intentional and developmentally appropriate manner
  • Relationships (adult/child, child/child, music/participants) are structured and adapted through the elements of music to create a positive environment and set the occasion for successful growth
  • Music provides a predictable time-oriented and reality oriented structure while offering opportunities for participation at one’s own level of function and ability
  • Music stimulates all the senses and involves the child at many levels
  • Music is highly motivating, yet can also have a calming and relaxing effect
  • Assessment and Intervention
  • Serve children with and without special needs
  • Assess children’s current level of functioning
  • Tailor musical activities to accomplish individual goals and objectives as determined on the IFSP/IEP
  • Provide services in the child’s natural environment
  • Share expertise and train team members in use of music therapy strategies and techniques to implement interventions
  • Evaluate interventions and provide documentation

Intervention ideas

Goal:To create an outdoor play environment that is fun, and emotionally and physically safe

  • Zone or “tag-team” models of supervision
  • Action cards
  • Define supervision duties
  • Identifie particular safety aspects
  • Include ideas for simple individual or small group activity
  • Identifie location for corresponding materials
  • Describe maintenance and clean-up procedures
  • Located on the playground in the different zones

Goal: Toprovide specific supports related to outdoor play for individual children withspecial needs

  • Idea books
  • Social Stories
  • Peer-mediated or peer-supported strategies
  • Direct teaching
  • Music therapy interventions

Case Example: Outdoor Play for Justin

Concerns (expressed by both parents and FPG teachers and therapists)

  • variety of play (prefers simple play in sandbox and sitting on bench under tree)
  • persistence (engagement in any single purposeful activity < 5 minutes)
  • peer interactions (observes but does not participate in play with peers)

Goals

  • Increase variety in outdoor play activities
  • Increase length of engagement in purposeful outdoor play activities
  • Increase frequency and duration of play with peers on playground

Child factors

  • diagnosed with high functioning autism
  • likes books
  • comfortable with familiar adults, but not very interactive with peers
  • pragmatic language good
  • cognitive skills good
  • sensory processing issues (praxis, low arousal)

Intervention strategies

  • Direct “how -to” teaching on playground (repetition, rehearsal, frequent opportunities) for specific activities, at school and home (fade adult support)
  • Use of peers as models for activities
  • Direct teaching and rehearsal of language (scripts) to initiate/enter and sustain short periods of play with peers (fade adult support)
  • Playground Ideas book (baggie book with photos of activities and friends)
  • Daily implementation of choosing activity and a friend from playground book (with “down time” allowed)
  • Peer-mediation: coaching peer to participate in use of Idea book to select activity
  • Time-delays and fading prompts to use Idea book

Outcomes

  • Asks teacher for Idea book
  • Responds quickly to teacher prompts to use book when not engaged
  • Chooses activities and peers promptly
  • Can successfully participate in all familiar playground activities
  • Initiates asking peer to play with him with minimal verbal prompting
  • Sustains engagement in most playground activities for 7-10 minutes
  • serves as a peer buddy for another child with autism in Music Hut

Case Study: Outdoor Play for Phillip

Playground Interaction Project

  • In childcare programs children spend large blocks of time in outdoor play
  • Playgrounds are a challenging setting for young children with autism
  • Characteristics of autism often result in lack of peer interaction
  • Predictable play routines and play activities supporting the children’s interests and strengths need to be identified and established.

Aim of the Playground Intervention

  • to increase peer interaction of young children with autism on the playground
  • to design a motivating and supportive playground
  • to design an intervention including educational/therapeutic strategies and goals
  • to implement the intervention in daily routines
  • to evaluate the effects of the intervention.

Participants

  • Four boys with autism (n=4)
  • Diagnostic tools: PEP-R; ADOS; Vineland
  • Children with and without disabilities, age 2-5 years
  • Eight formal peer helpers (n=8)
  • Teachers (n=6)

Collaborative Consultative Strategy

  • Define the problem together
  • Identify goals for intervention
  • Plan intervention together
  • Music Therapist provides training on the use of therapeutic strategies
  • Consult and support during implementation
  • Engage in follow-up.

Music Hut

Unique Song

  • Individualization
  • Song matches the child's personality musically
  • Emphasizes the child’s strengths
  • Structure and predictable routine
  • Form
  • Lyrics
  • IEP goals and objectives
  • Name peers
  • Improve communication skills
  • Understand turn taking
  • Improve choice making
  • Learn appropriate body contact

Phillip’s Groove!

A

I want to play the_____with you.

I want to play the_____with you.

I want to play the_____with you, come on this is what we do.

2x B

It’s_____turn to keep the groove to sing and play and make us move.

It’s_____turn to keep the groove to sing and play and make us move.

Goal: To support inclusion (group membership and social participation)

Goal: To support independence, engagement and social participation of all the children on the playground

Prop boxes

  • Contain materials and directions needed for play around a particular theme, as well as ways to adapt the activity and safety precautions, as needed
  • Firefighters
  • Hunt for Buried Treasure
  • Fishing
  • Baby dolls
  • Etc…

Activities!

The following slides present some of the activities we have done on our playground, and include some of the goals and reasoning that contributed to our activity choices and design. However, our ultimate goal in these activities is to allow all the children to participate and to have a sense of agency, group membership, and most of all…sheer pleasure!

Beach Party!

We can all dig for Buried Treasure! (See activity sheet)
Provides experiences in

  • Peer interaction (proximity play to cooperative play)
  • Persistence
  • Problem-solving
  • Tool use
  • Sensory play

We can all dress up!

  • Children made “grass skirts” from green paper, and leis and sunglasses were made available. A mirror from one of the preschool classrooms was taken to the playground, so the children could see themselves dressed up!

Provides experiences in:

  • Social interaction
  • Communication (requesting, commenting, etc.)
  • Dressing
  • Movement
  • Basic concepts (colors, size, shape, match, compare)

We can all dance!

  • Beach music played on a CD player contributed greatly to the “Party”

Provides experiences in

  • Movement/rhythm
  • Listening
  • Peer interactions
  • Vocalizing

Playing the Limbo game!

  • A bamboo pole was used to play limbo, with really no rules about how you get underneath it. Children could be held, pushed in wheelchairs, or move of their accord to play, and some children chose to watch and cheer for others rather than do it themselves.

Provides experience in

  • Movement/body awareness
  • Turn taking
  • Cheering!
  • Giving directions
  • Making choices
  • Problem-solving

Italian Café!

We can all add “toppings” to “pizza”!

  • A round table was covered with brown butcher paper, and a “crust” line and a few veggies were drawn on to give the idea. Markers, both adapted and not, were provided, and physical assistance was provided as needed.

Provides experience in:

  • Creativity
  • Drawing (developing interest or skill)
  • Sharing ideas (about what toppings to put on, etc.)
  • Playing near or with peers

Buying and serving lemonade

  • Our plain wooden playhouse was covered on one side with red paper, with a hole cut out for the window. An “Italian café” sign was put at the top, and a “menu” poster next to the window. A large cooler of lemonade was inside the playhouse, along with small paper cups. Fake paper $1 bills were provided. Children took turns buying and selling lemonade to each other.
    Provides experiences in:
  • Communication
  • Negotiating (some cups of lemonade cost $10!)
  • Working together
  • Manipulative skills and coordination

Drinking lemonade!

  • Social interaction
  • Using a cup
  • Group membership
  • Language (requesting, commenting)
  • Sensorimotor experience

Dancing (to Italian music played on CD player)

  • Movement
  • Sound
  • Social interaction

Blumen! (Flowers!)

Making our flowers…

  • Children made flower “masks” by cutting out different colored flower petals from construction paper and stapling them around the edge of a yellow paper plate that had the center cut out of it (for their faces)

Provides experiences in:

  • Making choices
  • Using tools
  • Sharing ideas
  • Asking for help

Wearing our flowers…

  • Expressing individuality
  • Sharing ideas
  • Showing off!

Singing and dancing…as flowers!

  • Petra wrote an original song about flowers, and the children could sing along, dance with their flower faces or colored scarves, or help Petra play her guitar!

Ocean Life!

Building an Ocean Drum and Sea Animal Jingles

  • Children made ocean drums by putting small colored beads in a translucent blue plastic plate, putting another plate on top (bottoms of plates to the outside), and sealing the edges with blue duct tape. When you move the “drum” it makes a sound like ocean waves! The “jingles” were made with pre-cut wooden sea animal shapes (available at craft stores). The children colored them in, then holes were drilled so that pipe cleaners could be inserted, and jingle bells attached. Children that were able to do so, and wanted to, were assisted to use the drill.

Provides experiences in:

  • Creating
  • Making choices
  • Exploring different sounds
  • Sharing ideas
  • Tool use

Playing with the instruments!

  • After the instruments were finished, we all sat in a circle on an ocean blue tarp, and sang some songs about the ocean and used our instruments. Then we got out a parachute, through the jingle instruments in, and pretended to be ocean waves!

Provides experiences in:

  • Exploring sounds
  • Play with peers
  • Sharing
  • Cooperating
  • Motor coordination

Painting…!

  • Our plain wooden playhouse was covered on all four sides with butcher paper, and we “painted the house!” A variety of types of brushes and markers were provided, physical assistance was offered as needed, and children with difficulty making choices or communicating were provided with both opportunities and supports (to choose colors, give ideas to their friends, etc.)

Painting…to music!

  • We called this activity “Musical Muslin Masterpiece.” A length of plain cotton muslin fabric was hung on a low fence, and children painted while listening to Wynton Marsalis! Brushes and paint containers were adapted for greatest accessibility, and other supports were offered. Some chose to use hands instead, and all efforts were attended to and praised!

Car Wash!