The Schön-Klinik is an internationally recognised, highly specialised hospital in the heart of Chiemgau in Upper Bavaria. The main focus is on the spinal column and scoliosis centre as well as neurosurgery and epilepsy surgery. Its paediatric specialist centres for paediatric orthopaedics and neuro-paediatrics, neurological rehabilitation and epileptology are both national and international leaders. Furthermore, the neuro-paediatric specialist centre is one of the largest in the German-speaking area. Children with a wide range of neurological diseases are cared for here. The association Silberstreifen e.V. promotes and supports the little patients in the field of neuro-paediatrics. On a voluntary and donation basis, the association helps to support the families quickly and unbureaucratically.
Playgrounds are places where children meet. It is here where the children spend time with their friends. Playgrounds encourage play and are full of challenges and adventures (Prellwitz & Skär, 2007). However, for children with disabilities, access to playgrounds or the usability of playground equipment is often limited or impossible due to physical barriers (Prellwitz & Tamm, 2000; Prellwitz & Skär, 2007; Ripat & Becker, 2012; Moore & Lynch, 2015). Children with disabilities are thus deprived of opportunities to play and participate in playful activities. This includes being able to move, engage in free play on a regular basis and interact together with their peers. Therefore it is important to create opportunities for children with disabilities which help them to engage in games with other children (Birkner, Eitel & Menek 2019). To meet this need, occupational therapists Corinna Eitel (Schön Klinik Vogtareuth, Department of Neuropaediatrics) and her former fellow students Lisa Birkner and Lale Menek developed a concept for the design of an inclusive and barrier-free playground on the outdoor grounds of the Schön Klinik in their Bachelor's thesis "The way to play - an inclusive playground design". The work was awarded the Science Prize of the Leben pur (pure life) Foundation in 2019.
The concept developed in the context of the Bachelor's thesis is being realised by an interdisciplinary working group in the project "Simply Play! " The working group consists of occupational therapists (Hessenauer & Eitel), an educator (Dobler), building management (Wurzer) and clinic development (Karl). The association Silberstreifen e.V. (Kuhn) and the renowned landscape architecture office Köppel in Mühldorf am Inn, with its experienced senior head Lothar Köppel, continuously support the team.
Due to the internationality, ethnic origin, religion, world view, sexual identity, social status, affectedness and abilities of the children, inclusion combined with accessibility is the basis for the overall playground project.
From a holistic point of view, the planning requirement was to create an inclusive, playable therapy space. Free and supervised play with and without assistance was to be made possible. The fact that the young patients depend on walking aids, rollators and wheelchairs that are adapted to user sizes, also had to be taken into account in the planning.
The results of the bachelor thesis "The way to play - an inclusive playground design" served as the basis for the planning. In an explorative study, 47 participants (children, parents, therapists, educators and nurses in neuro-paediatrics) were asked about their experiences of using playgrounds as well as about their wishes (Birkner, Eitel & Menek, 2019). The data collected, information from the literature, five expert interviews and the scientific assessments of the authors formed the basis for the design of the barrier-free and inclusive playground. The following are some examples from the survey forms:
Desired play elements: slides, swings, climbing equipment, sandbox, carousel, seesaws and trampoline were primarily requested. However, the wishes also focused on play with water and sand, independent play and transfer possibilities, barrier-free play with accessibility and reachability, assistance offers, wheelchair suitability, ball games.
Wishes for well-being: joint play, independent play, play with water, play successes, swings.
What materials do the children like to play with in the playground? Water, sand, stones, wood, plants, earth. Less desired were plastic, ropes, sand toys, metal and vessels.
And what should not be missing at an inclusive and barrier-free playground? First and foremost: a barrier-free sandbox, swings and slides, shaded areas, climbing frames, accessible play levels, paths, accessibility and transfer options (adapters). Further additions (enumeration without rating): playground equipment suitable for wheelchairs, seesaws, hiding places, play areas, stones, seating, sanitary facilities, rest areas, playhouse, high-contrast design, challenges, hammocks, joint play, success, relaxation, opportunities for physical activity, auditory offers, space offers.
All wishes were then evaluated and a list of priorities was compiled for further planning by taking into account the strengths and weaknesses of the study.
Suggestions for overcoming barriers and challenges on playgrounds
Adaptation of the environment > Accessibility e.g. access to the playground and playground equipment as well as barrier-free ground, fall protection.
Adaptation of accessibility >Different accesses, e.g. via ramps, smaller distances between rungs, easier access to playground equipment.
Adaptation of usability > Holding options and fixation aids on play equipment, seating aids, adapters horizontally and vertically, transfer options.
In order to constantly and sustainably implement accessibility and usability on the inclusive playground, Design for All with the 7 principles of the Center of Universal Design should be applied to the development of the playground.
(1) Wide usability,
(2) Flexibility in use,
(3) Simple and intuitive handling,
(4) Sensory information,
(5) Error tolerance,
(6) Low physical effort,
(7) Size and space for accessibility, accessibility and use
It should be emphasised that wishes for physical activity games were in the foreground.
Implementation / Planning / Realisation
In the following design concept, an attempt was made to implement the results of the bachelor thesis to a large extent in a project-related manner, as far as the spatial and financial conditions allowed.
For the available, enclosed area within the hospital grounds, a reorganisation in the form of a building block-like functional concept was created.
The functional areas were networked with a barrier-free guidance system.
In particular, the texture, colour, contrasts and structure of the rollable ground were used for this purpose.
In the existing building, the existing vegetation areas and trees were integrated as framing, playable and functional areas with shade.
A physical activity and game area with a mineral water play area was assigned to the play terrace area.
The main play area is to be a barrier-free climbing slide combination parallel to the site boundary. To save space, a closed, transparent, playable back wall of the multi-storey playhouse combination forms the enclosure of the play area.
The special construction made of natural robinia wood is accessible to wheelchair users via a ramp at a height of approx. 2.50 metres.
With adapters made of hand and foot installations that provide support, as well as optical equipment, the various entrances and exits can be played on without barriers.
Facilities for sensory activities and therapy, as well as retreat areas, are planned in the resulting protected play areas.
The economical and design-oriented minimalist multifunctional play element can fulfil many wishes and requirements in a confined space in its elongated appearance.
Resting and seating areas accompany the organically coloured, water-permeable pathways, linking them to the other functional areas.
The contact-oriented multiple swings with special swing seats for children with multiple disabilities offer opportunities for movement play. High-contrast floor adapters with wheels provide barrier-free and therapy-friendly access to the activity options.
It is possible to use the wheelchair on the adjacent ground trampoline, which can be used by everyone, via a ramp-like entry aid.
Standard constructions were not desired due to the therapeutic requirements and play wishes for the functional sand play area.
With sustainably reused large stone pavers, different play heights were created, with and without single or double wheelchair-accessible play tables, which were optimally adapted to the differentiated play heights due to the depth of the sand.
Lying boards connect the play levels, which can also be used as mini-slides. A recycled sun sail protects the majority of the raised, barrier-free play areas from sun radiation.
Play niches, storage areas and lockable material boxes for mobile sand toys and play vehicles have been cleverly integrated into the design.
A wheelchair-accessible play bridge spatially and functionally divides the overall sand play area with special fine-grained, mouldable play sands.
For the creation of an additional space for wheelchair-accessible table games such as table tennis, a gate relocation is planned in the access area, which was originally intended as a fire brigade access. This was no longer required due to the new functional planning. These former areas could now be used for additional play spaces and play equipment and be allocated to the areas of the desired or explored inclusive, barrier-free play opportunities.
With regard to realisation, mainly for financial reasons, the construction was subdivided into two interrelated construction phases which were and still will be realised in 2021 and 2022. The technical inspection agency TÜV-Süd was commissioned for the safety inspection and did not find any deficiencies in the assessment for safe use.
Due to the preparatory bachelor's thesis, the active participation of the therapists, the sponsors, the support association and the professional management, as well as the professional planning and supervision, the first construction phase could be completed on schedule with a very ambitious timeline.
By consistently applying the contents of the newly updated Standard DIN 18034-1:2020 "Playgrounds and open spaces for play", which the bachelor thesis scientifically confirmed, it was possible to create play areas in terms of planning and construction that fully take into account inclusion and accessibility.
Everyone is already looking forward to the second construction phase, which will hopefully fulfil all further wishes.
Birkner L., Menek L., Eitel C. (2021) The way to play - Spielplatzentwurf für ein Klinik-Außengelände für Kinder zwischen 1,5 und 14 Jahren (playground design for an outdoor clinic area for children between 1.5 and 14 years). In: ergoscience 16 (1): 3-11.
Prellwitz, M., & Skär, L. (2007). Usability of playgrounds for children with different abilities. Occupational Therapy International, 14(3), 144-155.
Prellwitz, M., & Tamm, M. (2000). How Children with Restricted Mobility Perceive their School Environment. Scandinavian Journal Of Occupational Therapy, 7(4), 165- 173. doi:10.1080/110381200300008706.
Ripat, J., & Becker, P. (2012). Playground Usability: What Do Playground Users Say? Occupational Therapy International, 19 (3), 144-153. doi:10.1002/oti.1331.
The members of the working group (Birkner, Eitel & Menek) of the bachelor thesis of "The way to play- an inclusive playground design" continue to act as consultants on the topic of inclusive playground and expectations, wishes and needs of the target groups.
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