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Table 5 Solutions regarding participation in the playground for children with PD

From: Barriers, facilitators and solutions for active inclusive play for children with a physical disability in the Netherlands: a qualitative study

Emotional barrier vs. Physical barrier General inclusion Role of professional
Parents need to be coached and empowered to help them overcome social/emotional barriers. (pro, par) More education to abolish the stigma of children with disabilities in society.(pro) Professionals need to educate parents and close associates about the importance of play. (pro, par)
Role models, like paralympic athletes, can inspire the child. (pro) All playgrounds need to be adapted for physical accessibility. (pro) Involve parents in the therapy. (pro)
Support parents in letting go and allowing children to try and experience for themselves. (pro, par) Increased general inclusion, inclusive education, and inclusive daycare. (pro, par) Interventions need to be long-term before the behavioral change takes place. (pro)
Introduce a playmate, within their network or from a volunteer project. Parents and/or child go together with another family, another child without disabilities, or an ambulatory companion. (pro) Increased general acceptance of children with a disability. (pro) Therapy at the functional location. (pro)
Safe environment with regards to traffic, equipment, and shelter. (pro, par) Health professionals and teachers need to be made competent in play and inclusion. (pro, par) Intervention playing outside needs to start around the age of 2 years. (pro)
Parents need to be made aware that participation in play is not a physical problem but mostly a social problem. (par) A therapist could make parents competent in stimulating inclusive play. (par) Cluster information about inclusive play, for example in an app. (pro)
Organize so that parents of children with disabilities meet often, share experiences about play, and inspire each other. (pro) Increased support for children in inclusive education, like ambulatory companions. (pro) Support parents to take responsibility. (pro)
Teach the child his or her own capabilities and boundaries and increase self-esteem. (pro) The playground should be a challenging environment. (pro, par) All professionals have a role in stimulating play and inclusion. (pro)
Show parents what the possibilities are by involving them in therapy and during play weekends, play courses/workshops. (pro, par) Structurally organized activities, like inclusive playground sports. (pro, par) Professionals need to be all-round. (pro)
Support and coach parents with mourning and acceptance. (pro) The network around the parents and child needs to be involved and needs to know how to play with and support the child during outside play. (pro) Professionals need to be made aware of their role in stimulating play and inclusion. (pro)
Reduce care burden. (pro) Playground close to home. (pro, par) Increase cooperation in multidisciplinary teams. (pro, par)
Children enroll with a group from special education for a play activity, therefore not being the only child with disabilities. (pro) Behavioral change towards children with disabilities encouraged by advertisements and education that reach the whole society. (pro, par) Education takes place during regular visits to the professional and during play weekends, play courses/workshops. (pro)
Wheelchair skills training. (pro) Wheelchairs for other children to play with. (par) Professionals can suggest play as a therapy goal. (pro)
Social skills training. (pro, par) Parents give education in the neighborhood about their child. (pro) Professionals should focus more in therapy on participation at home, at school, or in the neighborhood. (pro, par)
Help parents to find a way of playing that stimulates the intrinsic motivation of the child. (pro) Courses about inclusive play in education, for children and teachers. (pro, par)  
  1. Pro Professionals, Par Parents