Can You See Us Play? Observing Inclusive Outdoor Play Behaviour Among Children With and Without Disabilities: A Mixed Methods Study

BACKGROUND: Outdoor play is essential for children's development. However, children with disabilities face barriers in outdoor play. In the Netherlands, there are limited opportunities for children with and without disabilities to play together. While previous research examined the perspectives of parents, professionals and children regarding inclusive outdoor play, little is known about actual outdoor play behaviour. This exploratory study uses observational research to investigate how children with and without disabilities engage in outdoor play together. METHODS: We used a mixed-methods approach: quantitative assessments using the Test of Playfulness (ToP) and the Test of Environmental Supportiveness (TOES) were combined with qualitative observations focused on inclusive outdoor play, conducted during six outdoor play sessions at inclusive playgrounds. Children with and without disabilities aged 4-12 years (n = 63) were selected through purposive sampling. RESULTS: Quantitative analysis revealed that boys and children with disabilities scored significantly lower on the ToP, indicating reduced playfulness. Gender was also significantly associated with TOES scores, with boys scoring lower, indicating less environmental support for play. Qualitative observations identified six key themes influencing inclusivity in outdoor play behaviour: (1) variety of play types, (2) getting to know each other, (3) making contact, (4) interaction while playing together, (5) influence of the social environment and (6) influence of the physical environment. CONCLUSIONS: This study highlights the diversity in playfulness skills and environmental support observed among children with and without disabilities. It emphasizes the role of social interactions, peer relationships and environmental factors in shaping inclusive play behaviour. These findings underscore the importance of both social and physical aspects to promote inclusive outdoor play. By integrating these insights, the study provides guidance for paediatric rehabilitation professionals, whose role in facilitating inclusive play and overcoming barriers is essential to create outdoor play opportunities for all children.