As many individuals now spend a large proportion of their time in virtual worlds, what is the value of real space in the 21st century? And for children especially, what are the dimensions of a physical area or expanse that promote health and well-being, support learning and development, and encourage play and creativity? In reviewing the literature over the past few decades, there are a few seminal papers. Notably, Wade and Ellis1 manipulated playgrounds to explore the play of children in two environments. One came with a large amount of apparatus to promote physical activity (climbing frames, cargo nets, hollow tubes, etc.); another equipped with only a steel horse, and small wooden beam and cylinder. Using heart rate telemetry and observations, the findings showed that group size (numbers of children) provoked greater physical activity than the highly-equipped environment, once the initial novelty of the equipment had ceased. A more recent study considered the nature of playground equipment and risk exposure and impact on physical activity and play.2 The materials utilized in the intervention schools were moveable, low-cost, and/or recycled, such as car tyres, Styrofoam boxes, or milk crates. Items were chosen to encourage cooperation and multi-purpose play through challenging, creative, and/or sensory experiences. New materials were added every 3 weeks to maintain novelty. Children in the intervention schools were found to engage in approximately 12% more moderate to vigorous physical activity, measured via accelerometers, with indications of sustained benefits at 2 years. Extending the concept of playgrounds to the natural environment, access to nature, particularly green spaces (grass, trees, parks, forests, etc.) and blue spaces (lakes, rivers, coastal water, etc.) has been associated with better mental health.3 The wonders and beauty of nature are difficult to quantify, but include unexpected pleasures such as coming upon a strip of daffodils (as in Wordsworth's poem I wandered lonely as a cloud 1807) or hearing birdsong whilst smelling spring blossom. These multi-sensory experiences do not necessarily require physical activity, but only space and time in which to appreciate the surroundings. In this respect an investigation of the leisure activities of children with cerebral palsy showed that going for a walk or a hike were recreational activities in which more than 50% participated.4 While most participants in this study had more mild movement restrictions and/or were independently ambulatory, why should those without independent mobility not also enjoy access to the natural environment? These studies highlight some interesting points with respect to the use of open spaces and the freedom for children with disabilities to explore these spontaneously. Moveable items in playgrounds and outdoor activities in natural environments are commonly considered as risky due to more unpredictable usage and hazards.2 Safety-conscious societies may thus inadvertently be contributing to increased risks to health and well-being by limiting these experiences. Our efforts to design spaces to encourage participation and engagement could in fact constrain countless aspects of spontaneity and limit creative play and enjoyment of various spaces. There are opportunities to exploit nature's potential for enjoyment and creativity, alongside enhancement of play and physical activity for young people with more restricted mobility. A recommendation is therefore made to include a sixth ‘F’ word in child disability interventions:5 freedom. This includes the freedom to choose, freedom to be, and freedom to enjoy the moment. Initiating occasions to engage with nature and allow participation in open environments with unstructured activities may be more difficult to orchestrate for children and young people with disabilities and their families, but this should not stop us from trying. The design of virtual spaces that recreate the multi-sensory and emotional experiences of nature will be more of a challenge.
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