Strategies for inclusion in play among children with physical disabilities in childcare centers: an integrative review

Phys Occup Ther Pediatr. 2014 Nov;34(4):404-23. doi: 10.3109/01942638.2014.904470. Epub 2014 Apr 8.


The purpose of this integrative review was to examine strategies that facilitate inclusion in play among children with physical disabilities in childcare centers. Nine databases were systematically searched for peer reviewed empirical studies investigating inclusion strategies for play in childcare settings among preschoolers with physical disabilities. Nine studies met the inclusion criteria and were appraised using the McMaster Critical Review Forms. The inclusion approaches identified were grouped into relevant strategies during analysis. Two main strategies were identified: role of the adult facilitator and environmental factors. substrategies within the role of the adult facilitator included: customize approach for specific child's needs; adult facilitator self-awareness of presence; prompting and praise; and promote fairness, equity, and play interaction. Substrategies within the environmental factors included: physical setting; type of toys; and type of play activity. The findings suggest play inclusion strategies in the childcare environment. Therapists are encouraged to apply inclusion strategies to improve play opportunities for children with disabilities, but future research is necessary to confirm the effectiveness of these strategies using higher quality study designs.

Keywords: Childcare; inclusion; physical disability; play; preschoolers.

Publication types

  • Review

MeSH terms

  • Child
  • Child Day Care Centers / methods*
  • Disabled Children*
  • Environment Design*
  • Faculty
  • Humans
  • Play and Playthings*
  • Professional Role
  • Social Facilitation