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Purpose:The Australian National Disability Insurance Scheme (NDIS) will provide people with individual funding with which to purchase services such as therapy from private providers. This study developed a framework to support rural private therapists to meet the anticipated increase in demand. Method:The study consisted of three stages utilizing focus groups, interviews and an online expert panel. Participants included private therapists delivering services in rural New South Wales (n = 28), disability service users (n = 9) and key representatives from a range of relevant consumer and service organizations (n = 16). We conducted a thematic analysis of focus groups and interview data and developed a draft framework which was subsequently refined based on feedback from stakeholders. Results:The framework highlights the need for a ‘rural-proofed’ policy context in which service users, therapists and communities engage collaboratively in a therapy pathway. This collaborative engagement is supported by enablers, including networks, resources and processes which are influenced by the drivers of time, cost, opportunity and motivation. Conclusions:The framework identifies factors that will facilitate delivery of high-quality, sustainable, individualized private therapy services for people with a disability in rural Australia under the NDIS and emphasizes the need to reconceptualize the nature of private therapy service delivery.Implications for RehabilitationRural private therapists need upskilling to work with individuals with disability who have individual funding such as that provided by the Australian National Disability Insurance Scheme.Therapists working in rural communities need to consider alternative ways of delivering therapy to individuals with disability beyond the traditional one-on-one therapy models.Rural private therapists need support to work collaboratively with individuals with disability and the local community.Rural private therapists should harness locally available and broader networks, resources and processes to meet the needs and goals of individuals with disability. [ABSTRACT FROM PUBLISHER]

Parents are often concerned about managing risks for their children, particularly in the context of disability. This paper reports qualitative findings from an intervention study and examines how parents of children with developmental disabilities (mainly autism) manage risks during play. Interviews (n = 17) highlighted parents' fears about their child's safety, which were often exacerbated by concerns about the child's (lack of) cognitive and intellectual capabilities to 'appropriately' negotiate harms. Outdoor play and play that involved other children were reported as particularly challenging. In these contexts, parents described how they would intervene and redirect play activities to avoid any emergent physical, emotional and social harms. The social aspects of risk and disability gave way to adult-mediated and controlled forms of play. We conclude by considering opportunities to support the full inclusion of children with disabilities and their rights to play. Play is an important aspect of all children's health and development Children with disabilities often experience fewer opportunities to engage in play Parents responses to 'risk-taking' in their children's play help understand the barriers to play for children with a disability Social aspects of play are particularly challenging for parents of a child with disability Developing socially inclusive contexts is important to enhance all children's opportunities to play. [ABSTRACT FROM AUTHOR]

Introduction: Children with disabilities often experience unsupportive environments that restrict their play opportunities and inclusion on the school playground. This exclusion can perpetuate inequities for children with disabilities, with lifelong implications. The Sydney Playground Project uses a simple, innovative intervention consisting of placing recycled materials on the playground and engaging parents and educators in risk reframing sessions to create increased playground choice, control, independence and inclusion for all children. Methods: The purpose of this study was to learn from participants about the utility of the intervention for promoting choice and control among children with disability on the school playground. Data included evaluative interviews with 27 school staff (teaching assistants, teachers, therapists, school leadership) across five participating schools after completing of the intervention. Analysis was thematic and explored prominent ideas first within schools, and then between schools. Results: Prior to the intervention, participating school staff focused on active supervision to support play and student needs. During the intervention, school staff experienced role shift and confusion as they allowed the children increased independence while using the recycled materials and learned to navigate how much independence to give the children. Children engaged in increased imaginative and social play, and school staff adopted higher expectations of children's capabilities. Conclusion: Interventions such as the Sydney Playground Project that collaboratively shift adult perceptions to focus on the capabilities of children with disabilities and increase the supportiveness of the physical environment have great promise in increasing play choice and inclusion on the school playground. [ABSTRACT FROM AUTHOR]

The academy should be a welcoming environment for people with disability. Across Australia, however, there is a current shortage of programmes supporting people with disability to develop their careers as researchers. This article critically investigates current practice and experiences concerning universities and the employment and career development of people with disability as advised by the literature, and how this practice aligns with the lived experiences of several of our authors. Our review of the literature utilising Scopus, PsycINFO and ProQuest databases found a deficiency of research attention on this topic, with only 16 relevant articles identified. This paucity of literary evidence has been augmented in the article by personal stories shared by four of its authors. By focusing on evidence-based measures with potential to support disability employment and career pathways throughout universities in Australia and elsewhere, this article challenges leaders to address ableism and to advance a more inclusive academy. [ABSTRACT FROM AUTHOR]

Based on research conducted as part of the Sydney Playground Project, this paper provides an exploratory investigation of the perspectives of girls relating to the ideal school playground experience, and whether their perspectives are influenced by a loose-parts playground intervention. The focus is on the play behaviours of 22 girls aged 8-10 years, from the perspective that school playgrounds are generally designed in ways that are more suited to the play behaviours of boys. The research is based on a qualitative analysis of children's drawings, interviews and focus groups, exploring meanings associated with desired play experiences. Findings indicate that girls' views of the ideal school playground are influenced by the geographies of the spaces they play in, and that girls highly valued changes provided by a loose-parts intervention. [ABSTRACT FROM AUTHOR]

Our aims were to examine the efficacy of a new observational instrument ‘System for Observing Outdoor Play’ for detecting changes in outdoor play and chart the use of recycled and repurposed materials in the school playground during the course of an intervention to increase outdoor play. Children from one Sydney primary school were observed (N = 111; 5–12 years) using an observational instrument developed as part of the Sydney Playground Project. Data on types of activities and frequencies were collected at baseline and seven times during intervention. Use of intervention materials was consistently high and associated with increases in play-related activities (40–77%), while inactive pursuits decreased (52–31%), on average. The observational instrument proved efficacious in tracking changes in play. Modification of the school playground environment by introducing loose parts changed children’s play-related behaviour; the variety of activities increased, including construction and creative play. Physical inactivity decreased. Recycled materials can increase children’s creative, social and physical play. [ABSTRACT FROM PUBLISHER]

ABSTRACT BACKGROUND We assessed the effectiveness of a simple intervention for increasing children's physical activity, play, perceived competence/social acceptance, and social skills. METHODS A cluster-randomized controlled trial was conducted, in which schools were the clusters. Twelve Sydney (Australia) primary schools were randomly allocated to intervention or control conditions, with 226 children (5-7 years old) selected randomly to participate. Data were collected at baseline and after 13 weeks. The intervention consisted of introducing recycled materials without an obvious play purpose into school playgrounds and a risk-reframing workshop for parents and teachers. RESULTS Children from the intervention schools increased physical activity and reduced sedentary time while control schools decreased physical activity and increased sedentary time. The intervention yielded increases in total accelerometer counts (β = 9350 counts, 95% CI 3490-1522, p = .002), minutes of moderate/vigorous physical activity (MVPA) (β = 1.8 min, 95% CI 0.52-3.12, p = .006), and reductions in sedentary time (β = −2.1 min, 95% CI −3.77-(−0.51), p = .01). Although the changes in time spent in play and nonplay were not statistically different (p = .08) the effect size (d = .27) indicates clinical significance. CONCLUSIONS This intervention was effective for increasing MVPA during recess and demonstrated capacity to improve play opportunities in school playgrounds. [ABSTRACT FROM AUTHOR]

Recent theoretical debates highlight the competing risk logics and varying rationalities mobilised in response to dangers and approaches to risk management. Yet the concept of uncertainty, and how it informs perceived risks, is relatively less well understood. Debates of this kind are illuminated in contexts where risks are managed as part of everyday practice. The school setting provides an example of a context in which risks are continuously negotiated amidst dominant protectionist concerns about children’s well-being and safety. Such protectionist concerns are particularly pronounced for children with disabilities, as assumptions about limited capabilities complicate and structure the everyday play experiences for children. Drawing on findings from the Sydney Playground Project, in this article we aim to unpack the felt discomfort experienced by school staff in their responses to uncertain moments in children’s play. We report qualitative data collected from two schools between October 2014 and September 2015 using video observations of children’s play and teachers’ responses to an online Tolerance of Risk in Play Scale. Our findings point to the competing logics and forms of sense-making operationalised by teachers to manage the unknown. Our analysis explored the ways in which risk strategies were (re)framed by school staff and such reframing explained their action (or inaction) in the playground and how these were underpinned by concerns about professional accountabilities. Their responses located risks within the child with disabilities, rather than the play activity itself. Another approach to uncertainty can be achieved by mobilising a discourse of trust in which ‘letting-go’ offers children opportunities to reflexively engage in risk-taking. [ABSTRACT FROM AUTHOR]

Background: Providing children and adults with opportunities to engage in manageable risk taking may be a stepping stone toward closing the gap in life conditions currently experienced by young people with disabilities. We aim to demonstrate the effectiveness of a simple, innovative program for 1) changing the way parents and teachers view manageable risk-taking for children with disabilities and 2) increasing the level of responsibility that children take for their own actions, as seen on the school playground.Methods/design: We will employ a cluster repeated measures trial with six Sydney-area primary-school-based programs for children with disabilities. The intervention comprises two arms. 1) Risk-reframing--teachers and parents will participate together in small group intervention sessions focusing on the benefits of manageable risk-taking; 2) Introduction of play materials--materials without a defined purpose and facilitative of social cooperation will be introduced to the school playground for children to use at all break times. A control period will be undertaken first for two school terms, followed by two terms of the intervention period. Outcome measures will include playground observations, The Coping Inventory, qualitative field notes, and The Tolerance of Risk in Play Scale.Discussion: New national programs, such as Australia's National Disability Insurance Scheme, will place increasing demands on young people with disabilities to assume responsibility for difficult decisions regarding procuring services. Innovative approaches, commencing early in life, are required to prepare young people and their carers for this level of responsibility. This research offers innovative intervention strategies for promoting autonomy in children with disabilities and their carers.Trial Registration: Australian and New Zealand Clinical Trials Registration Number ACTRN12614000549628 (registered 22/5/2014). [ABSTRACT FROM AUTHOR]

This paper reports the results of risk reframing, an intervention to offer parents and educators a context for building new and complex perceptions of risk in children’s outdoor free play. Our objective was to alter these adults’ perceptions of risk to increase the sustainability of an innovative child-centred playground intervention. Qualitative data in the form of audio-recordings of risk-reframing sessions, brief participant evaluations and field notes kept by project staff were collected and either transcribed in their entirety or summarised in brief written reports. These data were subjected to constant comparative analysis to identify emergent themes. Results suggest that educators and parents benefit from opportunities to share risk perceptions and discuss the costs and benefits for offering outdoor free play to children to achieve their common goals for children: health, happiness and resilience. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the effects of an innovative school-based intervention for increasing physical activity. METHODS: 226 children (5-7years old) randomly selected from 12 Australian primary schools were recruited to a cluster randomised trial with schools randomly allocated to intervention or control conditions. The 13-week intervention comprised: (1) altering the school playground by introducing loose materials and (2) a teacher-parent intervention exploring perceptions of risk associated with children's free play. The primary outcomes were total accelerometer counts and moderate-vigorous physical activity during break times. Testing took place in Sydney, 2009-2010. RESULTS: 221 participants were tested at baseline. Mixed-effect multilevel regression revealed a small but significant increase from the intervention on total counts (9400 counts, 95% CI 3.5-15.2, p=0.002) and minutes of MVPA (1.8min, 95% CI 0.5-3.1, p=0.006); and a decrease in sedentary activity (2.1min, 95% CI 0.5-3.8, p=0.01) during break times. We retested children in one intervention school after 2years; they maintained the gains. CONCLUSIONS: Capturing children's intrinsic motivations to play while simultaneously helping adults reconsider views of free play as risky provided increases in physical activity during break times. Using accelerometry as the sole measure of physical activity may underestimate the effect. Trial registration: ACTRN12611000089932. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of an innovative school-based intervention for increasing physical activity. Methods: 226 children (5–7 years old) randomly selected from 12 Australian primary schools were recruited to a cluster randomised trial with schools randomly allocated to intervention or control conditions. The 13-week intervention comprised: (1) altering the school playground by introducing loose materials and (2) a teacher–parent intervention exploring perceptions of risk associated with children's free play. The primary outcomes were total accelerometer counts and moderate–vigorous physical activity during break times. Testing took place in Sydney, 2009–2010. Results: 221 participants were tested at baseline. Mixed-effect multilevel regression revealed a small but significant increase from the intervention on total counts (9400 counts, 95% CI 3.5−15.2, p=0.002) and minutes of MVPA (1.8 min, 95% CI 0.5–3.1, p=0.006); and a decrease in sedentary activity (2.1 min, 95% CI 0.5–3.8, p=0.01) during break times. We retested children in one intervention school after 2 years; they maintained the gains. Conclusions: Capturing children's intrinsic motivations to play while simultaneously helping adults reconsider views of free play as risky provided increases in physical activity during break times. Using accelerometry as the sole measure of physical activity may underestimate the effect. Trial registration: ACTRN12611000089932. [Copyright &y& Elsevier]

School playgrounds offer everyday opportunities for physically active and social play that combats obesity, develops skills, and promotes well-being. However, teachers' fear of the legal consequences of injury can elicit over-zealous risk reduction with the result that playgrounds lack challenge, and the potential benefits of play become limited. In this research, we trialled a simple, cost-effective strategy to encourage children to be more active and social on a school playground. Over 11 weeks, we made available materials with no fixed purpose (e.g. car tires, boxes) to a playground of children aged five to seven. Accelerometers showed children became significantly more active. Interviews with teachers suggested children also became more social, creative, and resilient. However, despite no incidence of injuries, teachers perceived an increased risk and encountered dilemmas regarding duty of care. We conclude that future interventions should address issues of 'surplus safety' at individual, school, system, and policy levels. [ABSTRACT FROM AUTHOR]

Background: In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills.Methods/design: This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment.Discussion: These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health.Trial Registration: Australian and New Zealand Clinical Trials Registration Number ACTRN12611000089932. [ABSTRACT FROM AUTHOR]