Play is a primary occupation of childhood and an important contributor to healthy development. The United Nations High Commission for Human Rights acknowledges play as being the right of every child.  The American Academy of Pediatrics recommends that children play or exercise outside for 30-60 minutes a day.  Despite this recommendation, a study of nearly 9,000 preschool children found that almost half of them don’t go outside even once per day. 
Outdoor play encourages physical movement and social and emotional interactions. It fosters thinking and creativity. The quality of outdoor play activities depend upon children being able to experience and to be in an environment that is safe, inclusive, engaging, fun, spontaneous, and arouses curiosity and creativity. When children play outside they can learn to enjoy their own company, take turns and listen to the perspective of others, create and follow and break rules, understand the consequences of their actions, take risks, learn, role play, challenge themselves, problem solve, move, and have fun. Arguably, what happens in outdoor play and exploration is equally as important as classroom learning. To deprive any child of opportunities to be outside and in nature is simply wrong.
When all children—regardless of ability levels, social, or cultural backgrounds—participate by having opportunities to feel included, experience control in what they choose to do, and to find goal-oriented meaning and purpose in all types of outdoor play activities, there is a strong likelihood that their quality of life will improve. Outdoor environments designed to meet the needs of all children at their level is key to ensuring their worth, value, and meaning. This specifically refers to universally designed outdoor spaces that establish children as equals, no matter if children need or choose to sit or stand, to walk or wheel through, to watch or to do, to be alone or to be with peers. Children who feel welcome, safe, and able to participate in an outdoor space are more likely to thrive, feel good about themselves, and follow a more healthy and well-rounded developmental trajectory.
Traditionally, children’s outdoor space design has been the domain of landscape architects, with limited consultation from allied health or education professionals. There is room in the proverbial sandbox to move from solo to interdisciplinary practice. In particular, the knowledge bases of occupational therapy and landscape architecture can be blended to design universal and inclusive outdoor spaces that maximize engagement. Occupational therapy practitioners understand human structure and function and how to adapt environments and eliminate barriers to participation. Landscape architects understand how to creatively plan and design traditional outdoor environments and restore environments disturbed by human or natural forces. An interdisciplinary design process can lead to universal and inclusive designed outdoor spaces that put children at the center of doing what they need and want to do.
A universal and inclusive outdoor space is planned and designed for all, regardless of age or ability. It considers usability by holistically integrating easy to use, convenient, and safe features that promote participation in play. The most usable outdoor environments embrace diversity, are equitable, and intuitive. They provide ease of access to, near, and around all built and natural elements, accommodate parallel and cooperative play for all children, and encourage social interaction.  Universal design makes it easy for children to manipulate all components of the playspace. For instance, raised sand tables with ample surrounding space provide access for sitting and standing users. Incorporating various shovels, scoops, rakes, and other implements enables all children to manipulate the sand. This same sand table could be sited next to an at grade sandbox, where a transfer deck offers the choice to stay in a wheelchair and play at the sand table and/or transfer to the larger sandbox.  It is equitable and flexible by incorporating features that allow children to choose which sand area to play in.
Working as a team to create universal and inclusive outdoor spaces that welcome diversity; balance options for risk with safety and choice; are easy to use and provide opportunities for multi-sensory, creative, and imaginative social play experiences; and are easy to understand embraces the heart of inclusive interdisciplinary outdoor space design. And who better to be recipients of such spaces than children?
 World Health Organization. (2002). Towards a Common Language for Functioning, Disability and Health (ICF).
 American Academy of Pediatrics (2007). Position Statement. Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity.
 Tandon, P., Zhou, C., & Christakis, D.A. (2012). Frequency of parent-supervised outdoor play of US preschool-aged children. Archives of Pediatric and Adolescent Medicine, 116(8), 707-712.
 Wagenfeld, A. Young. D., & Westley, M. (2014, July 14), Let’s ALL play. OT Practice, 19(16), 7-11.
by Amy Wagenfeld, PhD, OTR/L, SCEM, CAPS, Affiliate ASLA, assistant professor in the Occupational Therapy Department at Rush University and Principal of designcOnsulTation, an organization that specializes in therapeutic and universal design consultation services. She is co-author, with landscape architect Daniel Winterbottom, FASLA, of Therapeutic Gardens: Design for Healing Spaces, published in 2015 by Timber Press.