PURPOSE: The purpose of this study was to investigate the current level of accessibility of playgrounds in Omaha, Nebraska, for children with disabilities and to create and implement the Playground Accessibility Checklist.

RATIONALE: Play at the playground is important for children to build life skills; however, the majority of playgrounds do not meet the needs of children with disabilities. Playground modification and design is an emerging area of occupational therapy (OT) practice. At the time of this study, occupational therapists were not involved in playground modification or creation in Omaha.

DESIGN: This study used an exploratory sequential three-phase mixed-methods research design.

PARTICIPANTS: Four playground experts were interviewed in Phase 1 and included the City of Omaha Department of Parks and Recreation construction supervisor, a playground vendor, the founder of AllPlay Foundation (an accessible playground foundation based in Omaha, NE), and a pediatric occupational therapist. One girl and 1 boy with disabilities (ages 5 and 9 yr) and 3 parents were included in the Phase I focus group. Phase 2 participants included 4 of the researchers involved in this study. Phase 3 participants included 3 pediatric occupational therapists and 3 OT students.

METHOD: Data collection included four qualitative guided interviews, a focus group, and the quantitative Playground Accessibility Checklist. The Playground Accessibility Checklist was created by integrating Phase 1 themes with the Americans With Disabilities Act (ADA) and the Occupational Therapy Practice Framework: Domain and Process (3rd ed.; American Occupational Therapy Association, 2014) and was modified on the basis of feedback from practitioners.

ANALYSIS: The constant comparative method was used to analyze data gathered in Phase 1. Data collected in Phases 2 and 3 were analyzed using descriptive statistics.

RESULTS: Five themes were identified in Phase 1 and included playground features and environmental space demands, playground development and improvement, role of OT, regulation guidelines, and safety. These themes illustrated persistent environmental barriers that limited children’s ability to access playgrounds and engage in play. Two playgrounds (one designated accessible, one inaccessible) were assigned by the City of Omaha and were assessed using the Playground Accessibility Checklist. These playgrounds received respective accessibility scores of 30.99 (accessible) and 15.88 (not fully accessible), consistent with designations from the City of Omaha. Results indicate that lack of safe, appropriate, and accessible playground structures limit participation for all children.

DISCUSSION: Additional research to assess the 155 remaining playgrounds in Omaha, NE, is needed to standardize the Playground Accessibility Checklist. Further interprofessional collaboration with the City of Omaha and its residents in designing and modifying age-appropriate accessible playgrounds is warranted. Continued research should be completed to better understand and define the role of OT in increasing playground accessibility. Playground experts and families interviewed all recognized the value that OT may add to the process.

IMPACT STATEMENT: Skills outlined by the Framework align with the ADA for the creation and modification of accessible playgrounds. These attributes are unique to OT and, in conjunction with current findings, will support a leadership role in developing and modifying playgrounds to increase accessibility.

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. http://dx.doi.org/10.5014/ajot.2014.682006