The Uses and Effectiveness of Occupational Therapy Physical Activity Interventions in Young Children with Developmental Disabilities: A Systematic Review.

BACKGROUND: Physical activity (PA) is often used to support the development of young children (<5 years) with disabilities. The effectiveness of PA as an occupational therapy (OT) treatment approach in this population has not yet been systematically examined. AIMS: This research aimed to explore the uses and effectiveness of OT PA interventions on developmental indicators in young children with developmental disabilities. METHODS: A systematic review of peer-reviewed publications (from 2000 onward) across six electronic databases was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to assess study quality. Narrative synthesis (vote counting and structured reporting of effects) was employed to summarize the findings. RESULTS: Eight studies with heterogenous interventions were included. Evidence demonstrated positive trends of participation in the PA interventions on physical, cognitive, and social-emotional indicators, with significance varying. There was no association between interventions and communication indicators or negative effects related to participation in the interventions. Overall, the studies were low-quality when judged by GRADE. CONCLUSIONS: PA may be a promising avenue for OT interventions among young children with developmental disabilities. Rigorous research is needed to determine the magnitude of effect PA has on developmental indicators.

Physical Activity Among Young Children With Disabilities: A Systematic Review.

Physical activity (PA) in the early years is foundational for growth and development and associated with numerous health benefits. However, the prevalence of PA participation among the pediatric population with disabilities is less clear. This systematic review aimed to synthesize the existing literature on PA levels of young children (0-5.99 years) with disabilities. Empirical quantitative studies were collected from seven databases and reference hand searching; 21 studies were included in the review. PA levels varied widely based on disability type and measurement strategies, but overall, PA levels were low. Future research should address the underrepresentation of measurement and reporting of the PA levels of young children with disabilities.

A scoping Review of Tools to Evaluate Existing Playgrounds for Inclusivity of Children with Disabilities.

Introduction: Children with disabilities may be unable engage playground spaces due to barriers exacerbating exclusion. Therefore, clarity on how to evaluate existing playgrounds for inclusivity of children with disabilities is required. Methods: A scoping review was undertaken to explore auditing tools. Results: Fourteen white and grey literature resources were identified. The term "inclusion" was operationalized differently across tools, primarily focusing on physical accessibility. Characteristics of the tools were synthesized into 13 inclusive design recommendations for playgrounds. Two tools showed promise, evaluating 12/13 recommendations. Discussion: The results of this review provide guidance on existing tools for evaluating playgrounds for inclusion for community stakeholders and researchers. Systematic Review Registration: https://osf.io/rycmj.

Playground Inclusivity for Children With a Disability: Protocol for a Scoping Review.

BACKGROUND: Although playgrounds are designed to promote outdoor play, children with disabilities may be unable to engage in these spaces due to intrinsic and extrinsic factors. Previous research has examined inclusive/accessible playground design when developing new playgrounds; however, it is unclear if there is a best-practice tool for evaluating the inclusivity of existing playground structures. OBJECTIVE: A scoping review of both peer-reviewed and grey literature will be employed to explore evaluation tools for playground inclusivity, to enable the participation of children with disabilities. METHODS: The conduct of this study will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A search for peer-reviewed research studies will be conducted in the following electronic databases: MEDLINE, Scopus, CINAHL, and Embase. Grey literature will be examined via a three-step process: (1) a search in the Canadian Health Research Collection Database; (2) a targeted Google search; and (3) reference list searching. Titles, abstracts, keywords, and full texts of identified studies will be independently screened for inclusion by two reviewers. A synthesis of included articles will describe the publication and auditing tool details. A summary of the findings will highlight the types of playgrounds measured, types of disability considered, measures of inclusion used, and psychometric properties. RESULTS: Database searches for peer-reviewed articles were completed in December 2021. A total of 1471 unique records were returned after the removal of 559 duplicate records. Full texts of 167 studies meeting eligibility criteria will be reviewed. The peer-reviewed research search will guide the grey literature search. The scoping review is planned for completion in 2022. CONCLUSIONS: A rigorous search of the literature will determine the availability of tools for evaluating existing playground structures for the inclusivity of children with disabilities. The results will inform recommendations on tool applications, and applicable knowledge translation activities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37312.

Exploring the Effect of Perceptions on Children's Physical Activity in Varying Geographic Contexts: Using a Structural Equation Modelling Approach to Examine a Cross-Sectional Dataset.

Most Canadian children are not meeting the recommended 60 min of moderate-to-vigorous physical activity per day. Research suggests that children's perceptions of their environment have an influence on their physical activity behaviours, but there is a lack of generalizability among previous work. The purpose of this study was to assess the mediating effect of children's perceptions of barriers to physical activity on the relationship between their environments and their level of moderate-to-vigorous physical activity (measured with accelerometers). Structural equation modelling stratified by gender was used to assess the research objective in a sample of 546 participants aged 8⁻14 years old from Northwestern and Southwestern Ontario, Canada. In both models stratified by gender, perceptions of barriers did not significantly mediate the relationship between urbanicity and physical activity. Independent of all other factors, there was no significant relationship between urbanicity and physical activity in girls, but there was in boys. These results offer insight into potential processes by which perceptions impact physical activity and provide initial information to further our understanding of the behavioural aspects of physical activity through multiple levels of analysis. Researchers must continue to improve efforts for quantifying the experience of children's daily activity contexts.

Context Matters: Examining children's perceived barriers to physical activity across varying Canadian environments.

Children's perceptions of their environment have been associated with their physical activity (PA) levels, however a better understanding of the formation of perceptions within different contexts is needed. This will help to inform decision making related to physical inactivity trends in Canadian children. We examined socio-ecological factors influencing children's perceptions of barriers to PA in Ontario, Canada. Binary logistic regression models measured the relationship between perceptions of barriers and PA for 892 children in Ontario. At the intrapersonal level, girls reported the most barriers to PA. Interpersonally, children whose mother was employed reported the most barriers. At the physical environment level, children in urban and suburban neighbourhoods of large cities, and rural areas reported the most barriers, differing relative to population size. The major contribution of this paper is a new perspective of environmental influences on children's perceptions of PA, using an urbanicity spectrum, and highlighting place specific needs of Canadian children.