Background. Children with disabilities are particularly vulnerable to participation restrictions resulting from the interactions between children and their physical and social environments. Purpose. The purpose of this study was to gain a better understanding of how children with disabilities view their participation in out-of-school-time (OST) activities in a range of environmental settings. Methods. A case-study design was used to examine six children's views on their OST activities using the Children's Assessment of Participation and Enjoyment (CAPE), photographs of their OST activity settings, and semi-structured interviews. Findings. CAPE results indicated that the children participated most often in recreational activities. Through the use of photographs and interviews, four major themes emerged that emphasized a deep interconnection between childhood activities and settings. Implications. This unique pilot study contributes to developing an understanding for occupational therapists about how children with disabilities view their participation, their activity environments, and how photographs can be used to engage children in research.