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Introduction: Making Leisure Matter:
Multi-Tiered Framework Guiding Leisure Participation
Tier 3: Individual Leisure Coaching
Tier 2: Targeted Leisure Groups
Tier 1: Universal Leisure Promotion

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Introduction
Multi-Tiered Framework Guiding Leisure Participation
(Tier 3) Individual Leisure Coaching
(Tier 2) Targeted Leisure Groups
(Tier 1) Universal Leisure Promotion

Downloadable Materials

The following materials provide summary information about Making Leisure Matter.

Summary sheet: Multi-tiered Leisure Pyramid (1 page)Individual OT Leisure Coaching Process (2 pages)Check it Out! Leisure Video Clips!

Video #1: Kelson’s Story.Individual leisure coaching with David Weiss (OT), helped Kelson successfully play adapted sports despite his disability and behavioral challenges. Watch him experience joy during soccer practice and hear what his mother has to say about the benefits! (3 min.)

Video #2: Dori’s Story.Meet Dori. Despite her developmental disability, she is a successful competitive swimmer and experiences joy in this pursuit. Hear what her parents and occupational therapist (Mary Louise Kennedy) have to say about the benefits. (4 min.)

Video #3: Game Break Group. Watch 2 OTs lead an after-school leisure group in a clinic setting with children who have a range of developmental disabilities (ADHD, autism) and mental health challenges (anxiety). Listen to what a young boy, mother and OT say about the social and emotional benefits of the group!

Consider this …

Ultimately, leisure provides life with deeper meaning, opportunities for enjoyment, and connection with others and the world around them. It contributes to identity and self-efficacy and provides a way to cope with lifes challenges.22

Introduction

Vision Statement

All children and youth have a right to participate in and enjoy healthy hobbies and interests in inclusive school and community settings.

This initiative is all about ‘making leisure matter’ for all children and youth!

Leisurecan be thought of as any out-of-school activity that is of personal interest to a young person. Examples include: sports, arts & crafts, games, music & theatre, outdoor activities, etc. Our aim is to help all youth explore, identify, and participate in healthy hobbies and interests.

Why isleisure important?
The activities we engage in help define who we are, where we have been, and where we are going. We want to hear children say things like ‘I love to draw’ or ‘I love basketball’ or ‘I love to do puzzles’.So, ask the question, “What do you like to do for fun after school?” and take an interest.

Benefits:Youth who engage in one or more structured leisure activities after school do better social, emotionally, and academically. Specifically, participation in out-of-school structured leisure activities is associated with improvements in:

academic achievement1
personal development (identity and skill development, development of hobbies & interests, development of initiative)2
interpersonal development (social skills and friendships)2,3
development of beginning work skills (time management, persistence, following directions)4
social and emotional development (managing feelings, controlling impulses, improved self-esteem)3

The purpose of the Making Leisure Matter initiative is to:
1. Educate school personnel, youth workers, and parents about the physical and mental health benefits of out-of-school leisure participation; and
2. Promote leisure participation within a multi-tiered frameworkat the universal, targeted, and individualized levels.

When people learn to enjoy complex occupations that provide challenges corresponding to their skills, they are more likely to develop innate abilities, experience a positive self-esteem, and be happier over-all.5WHAT is leisure? Expand

Leisure refers to activities pursued during không lấy phí time that are personally meaningful and enjoyable.6,7,8 Opportunities to explore a variety of activities is important so that youth can identify their strengths and interests. As children try out different activities they can eventually choose the ones they would like to continue. Ones leisure interests reveal what makes a person unique and should be pointed out and celebrated.

Structured leisure activities (or organized) are associated with regular participation schedules, direction by one or more adult, rule-guided interaction, an emphasis on skill, and performance that requires sustained active attention and the provision of feedback. Higher social complexity involving peer cooperation, tư vấn from family members, and guidance from adult role models is also associated with structured leisure activities.

Unstructured leisure activities are generally spontaneous, occur without formal rules and adult direction, and include few opportunities for skill development (eg. watching television, listening to music, going out to eat, and hanging out with friends).

Which is better? Although children and youth need opportunities for both structured and unstructured leisure, research consistently shows a positive relationship between participation in structured leisure and positive youth development for building strengths and flourishing.1,9,10

Remember that leisure activities come in many forms, such as:

Sports (basketball, soccer, volleyball, football, track and field sports)
Outdoor sports (archery, rock climbing, hiking, camping, walking)
Art (painting, pottery, drawing)
Crafts (needlework, knitting, decoupage, woodworking, mosaics, paper crafts)
Music (playing an instrument, listening to music, singing, drumming circles)
Games (board games, card games, Legos, puzzles)
Mindfulness, martial arts, exercise (yoga, lifting weights, karate)
Reading for pleasure

Who’s at-risk of leisure deprivation? Expand

The home, school, and community environments may either tư vấn or undermine youths participation in leisure activities. Resources such as parks, organized sports, community programs, and competent adults to oversee the activities is essential.

Whos at-risk of limited leisure participation?

Children and youth with disabilities.11, 12 There may not be community-based programs that know how to include children with disabilities. Parents may not know how to find inclusive leisure activities for their child.

Children and youth living in low-income environments may have less access to leisure pursuits due to availability, affordability, and lack of transportation.13,14 Most structured leisure activities (organized sports, dance lessons, and Scouts) require some sort of transportation and fee for participation.

Youth experiencing mental health challenges (e.g. depression) and peer rejection are at higher risk of boredom and leisure deprivation.15

School providers and parents need to pay close attention to these at-risk groups and implement some of the Tier 1, 2, and 3 strategies outlined below.

Multi-Tiered Framework Guiding Leisure Participation

Applying a multi-tiered framework to address leisure expands our efforts beyond individual services to considering the benefits of small group interventions and universal whole school and community initiatives.6

The three major tiers of leisure promotion include:
Tier 3: Individual Leisure Coaching for children and youth who have no leisure interests or who are deprived of opportunities to participate in leisure. Individualized intervention focuses on leisure coaching with the young person and family in order to foster successful leisure participation.
Tier 2: Targeted Prevention efforts focus on reducing the occurrence of leisure deprivation by providing services such as small group interventions for youth at-risk (e.g. children with disabilities, social challenges, or those living in poverty).
Tier 1: Universal Whole School or Community-Based Strategies for promoting healthy leisure participation in all children and youth with and without leisure deficits. Leisure promotion emphasizes competence enhancement as well as environmental modifications to tư vấn leisure participation.

Key Approaches for Promoting Leisure Participation

Based on current literature on promoting enjoyable leisure, it is important to foster exploration and participation in a variety of structured activities within natural settings. A number of intervention approaches guide the Making Leisure Matter initiative and are described below.

Focus on STRENGTHS: All young people possess a unique combination of strengths, struggles, interests, personality traits, and passions.16 Research has shown that youth who participate in a higher number of community-based after-school activities, report having a higher number of personal and interpersonal strengths. Assisting youth to develop leisure interests that enhance and showcase their strengths is an important strategy for deepening strengths over time.16 If a young person likes to help people, for example, volunteering with older adults might be a good fit. Strengths to tune into include: humor, friendliness, persistence, athleticism, and creativity to name a few. As adults working with children and youth, make a point to help them notice, value and use their strengths in their everyday lives.

Embed PLAYFULNESS:When promoting leisure, it is important to embed playful interactions to communicate having fun together. Playfulness, such as joking or using humor, can be used to diffuse tension and to move beyond resistance to participate. It can be powerful in building relationships between adults and youth. 7 It is also important to recognize and encourage a young persons playfulness by explicitly pointing it out as an important character strength to both the young person and parents. For example, Max has a great sense of humor. He makes us all laugh which adds to our fun and wanting to spend time together!

Apply ENVIRONMENT-FOCUSED SERVICES:This refers to intervention focusing on modifying environmental conditions and activity demands to foster leisure participation rather than focusing primarily on improving the young persons component skills. For example, in order to decrease the activity demands of independent performance during a dance class, a peer buddy (e.g. a child with higher skills and positive social interaction) may dance alongside a child with autism to provide the needed environmental supports (e.g. verbal and physical prompts) for successful participation. It is important to consider how changes in the physical, sensory, or social environment can improve participation.

Provide LEISURE COACHING:The coaching process combines the use of emotional tư vấn and encouragement, information exchange, and a structured process of planning for and participating in chosen activities. Details on leisure coaching is described under Tier 3 services.

(Tier 3) Individual Leisure Coaching

For children and youth who have little or no leisure participation, individual leisure coaching may be effective.
Evaluation: First, identify who may need leisure coaching by evaluating the young persons leisure participation.
Leisure Coaching: Then, use the leisure coaching process to foster the development of healthy hobbies and interests!
Success stories demonstrating leisure coaching outcomes in school and clinic settings are also provided.Details provided below!

Leisure Evaluation Expand

Evaluation: An informal evaluation of leisure participation, opportunities, and barriers can be completed by an occupational therapy practitioner (OTP) or other school personnel (e.g. physical therapist, PE teacher) with expertise in physical and mental health. This information can easily be obtained with informal conversations using open-ended questions such as, what do you do for fun after school and on weekends?, tell me about a typical weekend, what are your favorite hobbies and interests?, what new leisure activity would are you like to learn and do? Such informal interviews with the young person are critical for gaining their perspectives. Interviewing the parents is also helpful to gain their insights about their childs leisure experiences and interests as well as their needs for assistance.

Although parents may have a sense of their adolescents interests, it is important to talk individually with the young person to gain their views. For example, when an occupational therapist used an interest inventory with pictures, a young girl with Down syndrome and intellectual impairment pointed to pictures of softball and camping. Her parents exclaimed, We never knew she was interested in these activities!. Based on this evaluation, the occupational therapist worked with the parents and young girl to find a local softball team and provided informal coaching to foster successful participation. The parents were excited to have their daughter be a part of a team and experience joy and success in participating.

Interest Checklists: Consider using an informal leisure inventory or interest checklist as a part of your evaluation. Here are some easy-to-use options:
Child interests activity checklist1For parents to do with therapist.
When I Grow Up: Interest Survey2 This is kid-friendly.
Interest Survey UK (adapted version)3 Picture version to be completed with child.

1Dunst, C. J., Raab, M., & Trivette, C. M. (2013). Child interests activity checklist. In C. J. Dunst & M. Raab (2013). Checklist and guidelines for identifying young childrens interests. Everyday Child Language Learning Tools, Number 3.
2 Career Wonders (2011). SD Dept. of Labor and Regulation
3 McCormack, A. (năm trước). Interest Survey UK (adapted version)About Leisure Coaching Expand

The focus of Leisure Coaching is to help all children and youth explore, select and participate in extracurricular leisure activities in order to develop enjoyable hobbies and interests. Originally developed and implemented by OT practitioners, Leisure Coaching can be provided individually with a young person and family, within a small group context, or at a school-wide level. Other school personnel might want to serve as a leisure coach, such as PE teacher, art or music teacher, or other adults passionate about leisure promotion.

The Leisure Coach serves as an:
Educator, sharing information about the health benefits of participation in enjoyable hobbies and interests with children/youth, families and school personnel;
Facilitator of the change process, by working collaboratively with youth to help them explore and participate in enjoyable leisure activities; and
Advocate of inclusive leisure participation, by promoting involvement in integrated school and community-sponsored extracurricular activities.

Leisure Coaching provides:
Emotional Support and encouragement is provided to build trust and help the youth and family explore and pursue leisure participation. The leisure coach uses: listening, empathy, reframing abilities, guiding and encouraging
Information exchange with the youth and family. The leisure coach shares information about the health benefits of leisure participation. Child/youth shares information about potential leisure interests. Family shares information about available resources (financial, transportation, time, etc.) and values related to leisure participation.
Structured process involving identifying interests, exploring options, and planning for and engaging in the leisure activity (see OT Leisure Coaching process). This process often involves: activity analysis, problem-solving and scaffolding the experience; advocating for the child/youth/family; and therapeutic use of self to enable successful participation.

Leisure Coaching: 6 Steps to Success! Expand

6 Steps in Leisure Coaching
1. Start the conversation about the importance of leisure. Meet with child/youth and parents and educate them about the health benefits of participation in meaningful hobbies and interest during out-of- school time. Obtain parental buy-in and tư vấn. Begin to develop a trusting relationship.
2. Interest Inventory: Spark an interest. Complete an interest inventory with child/youth; provide education about a variety of creative arts, sports, and nature- based activities; help child/youth prioritize list of interests; share with caregivers.1,2,3
3. Explore school or community-sponsored options. Explore options for participation using the Internet based on the family resources; engage the child/youth and family in this process as much as possible. Know your community and venues for inclusive participation!
4. Make a match and a plan. Discuss school and/or community-sponsored options for participation with the child/youth and caregivers; plan for registration and entry into the activity. Contact the program instructor/coach (if necessary) to discuss relevant information regarding the child/youths strengths and needs related to accommodations and successful participation.
5. Just do it! Child/youth participates in the activity. Coaching is provided to foster success only as much as needed (e.g. adapting entry into the activity, modifying the environment, coaching and tư vấn to instructor/coach, etc.).
6. Occupational reflection and future plans. Following participation, talk with the child/youth and caregivers (separately) about the experience. Explore likes? Dislikes? Foster ongoing exploration and participation in a variety of healthy hobbies and interests.

Download the 2-page OT Leisure Coaching Information Brief

1Dunst, C. J., Raab, M., & Trivette, C. M. (2013). Child interests activity checklist. In C. J. Dunst & M. Raab (2013). Checklist and guidelines for identifying young childrens interests. Everyday Child Language Learning Tools, Number 3.
2 Career Wonders (2011). When I Grow UP: Interest Survey. SD Dept. of Labor and Regulation
3 McCormack, A. (năm trước). Interest Survey UK (adapted version)Success Story: School-based Leisure Coaching Expand

Why address leisure in schools?
First, ‘it’s the LAW’! In schools, its critical to be aware of how the Individuals With Disabilities Education Act (IDEA) (Pub. L. 108446) supports services that promote play and leisure in natural contexts throughout the day. IDEA mandates that schools must provide nonacademic and extracurricular services and activities in the manner necessary to afford students with disabilities an equal opportunity for participation in those services and activities (See Section 300. Nonacademic Services). These services and activities may include athletics, recreational activities, special interest clubs, and recess activities. Second, schools must ensure that each student with a disability participates with non-disabled peers in the extracurricular services and activities to the maximum extent possible (least restrictive environment). Further, supplementary aids and services deemed necessary by the IEP team need to be provided to help students participate in nonacademic settings.

What to do? Make a habit of discussing students’ leisure participation at meetings (IEP, parent-teacher, etc.). Share information about IDEA and student’s right to have accommodations and supports needed to participate. Embed leisure coaching within therapy services (e.g. OT and OTA, PT and PTA). Most leisure activities help develop skills (gross motor, fine motor, social) and, as such, can address IEP goals.

Success Story: Kelson. David Weiss, OTR/L is a therapist at the Positive Education Programs (PEP) Prentiss Autism Center for children and youth who demonstrate severe and challenging behaviors and have other complex developmental disabilities. He provided OT Leisure Coaching for Kelson, a 14 y.o. with autism, anxiety, and limited leisure participation. David was able to help Kelson participate in community-based adapted football and soccer. His mother indicates that p.articipation has helped him be more focused and patient in working toward a goal and learning that if he can control himself, he is able to participate. that he looks forward to football and that it makes him happy. David Weiss, OTR/L indicates that Kelsons participation in adaptive football gives him an opportunity to practice the skills learned in school (e.g. self-regulation and calming strategies, motor skills). He adds that when Kelson participates in football, hes joyful, laughing and smiling which contributes to his positive mental health. Because Kelsons experience with adapted football was so successful, Sonia enrolled him in an adapted soccer program in the Spring. View a short video of Kelson playing soccer.

Read about more Tier 3 Success Stories here. (2-page table)

Success Story: Clinic-based Leisure Coaching Expand

Outpatient, after-school therapy services:It is not uncommon that some children and youth with disabilities receive additional therapy services after-school in clinic settings. Oftentimes, these services are individual, 1:1 therapy. In năm trước, after becoming a part of Every Moment Counts leisure initiative, occupational therapists at the Cleveland Clinic Pediatric Outpatient Services decided that it was time to promote leisure participation in more intentional ways. Mary Lou Kennedy, OTR/L and Jenny Negrey, MOT, OTR/L committed to providing both individual and group services focusing on leisure participation, social skills, friendship, and positive mental health. An example of an individual leisure coaching success story is described below.

Success Story: Dori, a 13 y.o. with mitochondrial disease, has been receiving outpatient OT and PT at The Cleveland Clinic since she was an infant. Her challenges include limitations in physical strength and coordination, gross motor development, and social participation. Strengths include perseverance and her love of swimming.

Dori participated in individual adapted aquatics lessons since she was five years old with her OT instructor, Mary Lou Kennedy, OTR/L. Because Dori struggled with self-esteem in groups and difficulty making friends, Mary Lou felt that she would benefit from being a part of a swim team, both socially and emotionally. Although Mary Lou found a local Paralympics swim team and had parental tư vấn, Dori was reluctant to joining. Mary Lou convinced Dori to observe a swim practice. Once Dori was there, she was decided to join. She swims 3X/week and completes in meets. Her circle of friends has expanded. Dori gained strength and coordination as a result of the increased amount of swimming per week which, in turn, decreased her need for OT and PT services to monthly consultation. View a short video of Dori.

(Tier 2) Targeted Leisure Groups

Targeted services emphasize both the prevention leisure deprivation due to risk factors (e.g. disability, mental health challenges, poverty) as well as the promotion of a variety of healthy and meaningful leisure interests.13

Leisure Groups can be an important strategy for fostering hobbies and interests in at-risk youth. Within small groups, youth can be exposed to a range of potential leisure activities giving them a change to try something new, identify hidden strengths, and develop new interests. There is strong evidence to tư vấn activity-based groups for enhancing childrens social participation and mental health.21 By doing together, activity-based groups help youth work together in a cooperative manner, experience group cohesion, and build friendships.

Schools: Groups Fostering Leisure Participation Expand

Why address leisure participation in school? It’s the LAW! The Individuals With Disabilities Education Act (IDEA) (Pub. L. 108446) supports services that promote play and leisure in natural contexts throughout the day. IDEA mandates that schools must provide nonacademic and extracurricular services and activities in the manner necessary to afford students with disabilities an equal opportunity for participation in those services and activities (See Section 300. Nonacademic Services). These services and activities may include athletics, recreational activities, special interest clubs, and recess activities. Also, schools must ensure that each student with a disability participates with non-disabled peers in the extracurricular services and activities to the maximum extent possible (least restrictive environment). Further, supplementary aids and services deemed necessary by the IEP team need to be provided to help students participate in nonacademic settings.

School personnel need to promote leisure participation during recess and after-school. For example, small groups that integrate both students with and without disabilities can be offered during recess to enhance play, leisure, and social participation. Such recess groups, despite occurring over a short amount of time, can be effective in exposing youth to games (e.g. card games, board games, four square) or simple crafts (e.g. making friendship bracelets), building friendships, and reducing bullying.

Success Story: Recess Groups. An occupational therapy practitioner (Teri LaGuardia, MOT, OTR/L) indicated the importance of looking for the open doors for providing needed services. At two separate IEP meetings, concerns about the students struggles with anxiety, making friends, and being bullied were discussed. Based on this awareness and the principals tư vấn, the therapist developed a group called Friendship and Activity Detectives which was offered one day per week for eight weeks during recess targeting students who struggled as well as non-disabled peer mentors. The groups focused on playing games, leisure exploration, friendship promotion, and social and emotional learning. Because the groups were so successful in helping the students have fun and make friends, the principal supported continued implementation.

Success Story: HOPE Groups (after-school community setting) Expand

HOPE Groups (Healthy Occupations for Positive Emotions)
Low income urban youth are at-risk of occupational deprivation in the area of leisure due to lack of family and financial resources. One way to meet the structured leisure and social and emotional needs of this population is through university-led service learning programs (e.g. OT or recreation therapy).

The Occupational Therapy Groups for HOPE (Healthy Occupations for Positive Emotions), embedded in an after-school program in Cleveland, Ohio, were developed to address the leisure, mental health, and social participation needs of low-income urban youth. Developed by Susan Bazyk, PhD, OTR/L, the HOPE groups have been offered by Cleveland State University (CSU) occupational therapy students since 2004.20

The HOPE Group Curriculum: The integration of knowledge about group process, leisure participation, social and emotional learning (SEL), mental health literacy, and positive behavioral interventions and supports (PBS) provide the foundation for the 8-week HOPE groups. Graduate OT students co-plan and facilitate the weekly groups, with 6 to 10 youth ages 6-14 years.

The groups promote:
Participation in Meaningful Leisure Occupations: The HOPE groups expose youth to a variety of structured leisure activities. Examples include: games, drumming, horticulture, and arts and crafts. Activities are selected with the goal of exposing them to new activities and the development of new hobbies and interests.
Social and Emotional Learning (SEL) Activities: SEL activities are embedded into each of the groups and focus on the development of social competencies (e.g., understanding the relationship among feelings, thoughts, and behaviors; empathy), friendship skills, conflict resolution skills, and anger management skills. The social-emotional aspects of the group session help youth recognize their emotions, think about their feelings and how one should act, and regulate their behavior based on thoughtful decision-making.
Group Process: Research suggests that children who demonstrate personal or social difficulties benefit more from small groups that provide a supportive environment and an opportunity to develop positive relationships with caring adults than those who receive individual interventions. Through doing together, the HOPE groups foster peer interaction and team work leading to a sense of group cohesion.
Positive Behavioral Interventions and Supports (PBIS): PBIS promotes the use of proactive strategies to prevent problem behavior by altering a situation before problems escalate, and to concurrently teach appropriate alternatives Examples of strategies embedded during the HOPE groups included clearly communicating group rules and creating a warm and positive group environment.
Mental health literacy: Youth learn about positive mental health (feeling good, doing well, coping with challenges) and strategies for managing stress. By participating in various leisure activities, they learn first-hand the relationship between enjoyable occupations and feeling good emotionally.

Organization of the Group Sessions
Group sessions are structured into three segments: conversation time, project activity, and closure. Conversation time focuses on introducing the social-emotional theme for the session, setting the emotional tone, and promoting group cohesion. The project activity is considered the heart of the group because it exposes the children to activities that may develop into long-term interests and allows them to practice the social-emotional skill introduced during conversation time. Examples of projects and activities include making greeting cards using rubber stamping, crocheting scarves, mosaic projects, and doing yoga. The activities focus on exposing children to structured leisure to promote the development of healthy hobbies. Closure involves revisiting the SEL theme and occupational reflection an opportunity to think about the influence of activity on emotional and physical health.

Research outcomes: Becoming Hooked on Doing
A phenomenology study, using a combination of in-depth interviews and participant observations, explored the meaning of the group participation from the youths perspective. Findings revealed that the youth perceive the groups to be fun because of engagement in novel and challenging projects and talking about feelings within a supportive group context. Participation in creative leisure occupations that allow for choice transforms moodyouth experience happiness and forget their problems (occupational function). The children enjoy the projects and activities and express wanting to do more. Children are often heard saying what are we going to do today? or I wish you could come every day. They become hooked on doing and experience firsthand the power of occupationthat participating in creative occupations fosters positive feelings. In addition, as the weeks pass, the youth begin to interact as a cohesive groupsharing materials and praising each others accomplishments. Youth also indicated that they enjoy being able to talk about their feelings.

References:
Bazyk, S. (2006). Creating occupation-based social skills groups in after-school care. Occupational Therapy Practice, 11, 13-18.
Bazyk, S., & Bazyk, J. (2009). The meaning of occupational therapy groups for low-income youth: A phenomenological study. The American Journal of Occupational Therapy, 6, 69-80.Success Story: Clinic-based leisure groups Expand

Outpatient, after-school therapy services: It is not uncommon that some children and youth with disabilities receive additional therapy services after-school in clinic settings. Oftentimes, these services are individual, 1:1 therapy. In năm trước, after becoming a part of Every Moment Counts leisure initiative, occupational therapists at the Cleveland Clinic Pediatric Outpatient Services decided that it was time to promote leisure participation in more intentional ways. Mary Lou Kennedy, OTR/L and Jenny Negrey, MOT, OTR/L committed to providing both individual and group services focusing on leisure participation, social skills, friendship, and positive mental health.

Given that youth with disabilities are at greater risk of leisure deprivation and being bullied, developing and providing occupation-based groups is an important service delivery option for outpatient clinic settings. Participation in groups provides opportunities to develop friendships. Having high-quality friendships, or at least one best friend, can help prevent youth from being a victim of bullying. Offering a range of leisure groups as a way to expose youth to a variety of structured leisure (games, art, horticulture) can also provide opportunities to address performance goals such as fine motor skills, self-regulation, and sensory processing.13

Success Story: At Cleveland Clinics Outpatient Services, Jenny Negrey, MOT, OTR/L, noted that most of the youth on her caseload reported having few friends, limited leisure pursuits (with most being unstructured video gaming), and anxiety. With the realization that individual therapy sessions limit the ability to foster social interaction and friendship skills, Jenny and colleagues developed and implemented several theme-based leisure groups targeting at-risk youth and exposing them to a variety of activities. The first group, co-led with Julie Jesinski, MOT, OTR/L, focused on playing games and targeting youth on their caseloads with limited leisure participation, friendship challenges, and families with limited financial resources. Each week, a small group of seven youth learned and played one trò chơi (e.g. Uno, dominoes, Pictionary, Trivial Pursuits). Families received an information sheet each week about the trò chơi at home. During the group, pro-social skills such as turn-taking, how to be a good friend, and how to win or lose gracefully were reinforced. Not only did the youth enjoy and benefit from participation, parents recognized the value of participating in leisure activities and making friends. As a result of this groups success, the therapists developed other leisure groups focusing on art (Young Artists), horticulture (Green Thumbs Up), yoga (Mindful Movements), and hobby exploration (Positive Pursuits). Watch a short video of the Game Break group to hear what Jenny and a young participant and mother have to say about it.

(Tier 1) Universal Leisure Promotion

It is critical that parents and school personnel be made aware of the multiple benefits of structured leisure for their children that participation in self-selected structured leisure provides positive opportunities for fostering health, identity work, and life skill development. Developing an awareness of the school and communities extracurricular activities is important so that school providers can foster exploration and participation for all youth with and without challenges. Being knowledgeable about community leisure is useful for actively advocating for inclusive participation another important aspect of the therapists role. Read about these success stories!

Universal leisure promotion strategies Expand

At the universal level, school and community providers (OT, SLP, recreation therapists, PT, PE teachers) can make a point to know about school and community sponsored leisure activities. This information can be powerful in helping youth and families explore options and participate.

Consider completing a Leisure Environmental Scan. Identify where youth with and without disabilities can participate in a range of leisure activities including: sports, arts, theatre, music, and outdoor nature. Try and find out whether the program is open to including children and youth with special needs. Document a list of places and contact information in whatever form that allows you to add to and revise the information (e.g. googleform).

Consider compiling the information and sharing it with parents and youth at school or community events. For example, a list of community activities can be shared at a table during parent-teacher night or at a PTA meeting. The most important ‘take away’ is to simply ‘Make Leisure Matter’ in your daily conversations with children/youth, school personnel, and parents/caregivers. Remember, youth who have at least one healthy out-of-school leisure activity do better socially, emotionally, and academically.

Success Story: Cleveland Municipal School District (CMSD) Eileen Dixson, MS, OTR/L completed a leisure environmental scan of low-cost activities requiring little or no transportation for the children and families. Most of the families have limited finances and transportation, so Eileen identified neighborhood activities that were feasible in terms of cost and that could be accessed by bus or on foot. She listed the activities on a handout as well as a neighborhood map which had push-pins identifying the community program.

Communities tend to be ‘rich’ in activities to do in places like libraries, recreation centers, and even churches.

Be informed and be a leisure advocate!

Success Story: Whole School Strategies for Promoting Leisure Expand

Success Story: Special Olympics and Walking & Running Club

David Weiss, OTR/L, an OT at the Positive Education Program (PEP) Prentiss Autism Center, which is an alternative school for students with autism and significant developmental and emotional disabilities. A majority of the students have one or more co-morbid mental health challenges (e.g. anxiety, depression, severe behavioral disorders). Because the school did not offer any extracurricular sports or leisure activities, with the tư vấn of the schools principal, David developed a number of whole school leisure promotion initiatives over the past 7 years. David is an advocate for social justice and inclusive leisure participation, for working collaboratively with all school personnel and families, and for making leisure an integral part of the schools curriculum throughout the day.

Special Olympics: In năm ngoái, David developed an official school-wide Special Olympics program. He collaborated with the adaptive physical education teacher to embed sports training into the curriculum including basketball, football, soccer, cheerleading, and running. All students participate either in a sporting sự kiện or in making signs and materials for the parade. All families have opportunities to participate and attend the annual games and parade. This program has been so successful and enjoyable, that it has become a part of annual activities and the school culture.

Walking and Running Marathon Program: Autistic adolescents are less likely to be physically active leading to greater risk for other health problems such as overweight and obesity, diabetes, and poor physical endurance. In năm nay, the walking/running club was initiated as a simple strategy to foster more movement throughout the day.

Why promote walking and running at school? Walking and running has little associated cost, can be done individually or as a group, and uses the strengths of people with autism (e.g. thrive on structure, routine, and repetition). Many physical and emotional benefits are associated with walking and/or running such as decreasing anxiety and depression, elevating mood, and increasing physical fitness.

How? The walking club is built into the schools schedule after lunch for 30 minutes. The Walking/Running Marathon Program became an extension of the walking club.
Running Marathon Program. Developed by David and implemented with two others (Robert Zachary, Teacher at PEP and Doug Bletcher, Autism Personal Coach). Students participate in 2-3 training sessions per week for 2-3 months as a part of their school day. Trainings involve stretching, race etiquette, socializing with peers, and tracking miles). Students have a goal of completing 25 miles and participate in a practice race before completing a community race (from 1.2 miles to 26.2 mile marathon distance). The race is attended by family and friends. Students that complete community race, earn medal, shirt, không lấy phí pair of running shoes, celebration banquet.

Marathon Program participation has grown from 3 students in năm nay to 15 students in 2019.

Benefits: Leisure participation has results in numerous benefits for both the youth and families. Students demonstrate less aggressive behavior and improved self-regulation and social interactions with peers and adults. Students develop new friends and have opportunities to develop leadership skills. Parent are happy, proud, and more confident about their youths ability to engage in healthy leisure pursuits at school and in the community.

Zacharys success: Zachary is an adolescent with autism who struggles with prolonged engagement, sensory defensiveness, and verbal communication. He has participated in the Marathon Program for three years as well as Special Olympics and the schools football, soccer, and basketball competitions. Participation has resulted in improvements in affect, communication, and staying engaged in activities. He has completed six 5k races, two 10 k races, and a half marathon. In 2019, he received a Gold and Silver Medal in the Special Olympics Ohio Summer Games. Zacharys parents are thrilled about his success. Zachary is passionate about running and his parents, extended family, and friends enjoy going to see him race. Participation in running is an established and enjoyable leisure occupation for Zachary and his parents. It has resulted in improved mental and physical health and quality of life.

Success Story: Community-Based Leisure Expand

There are a number of ways in which therapists and other school providers can promote leisure participation in inclusive community settings. Research has shown that the more youth with disabilities participate in meaningful community-based activities, the more strengths they develop.22

Here are two success stories involving the work of Maria Llerena, OTR/L – offering services at a local recreation center and bringing community recreation providers into school settings.

Success Story #1: KIDnections Group, LLC
The KIDnections Group, LLC was developed by therapists (OT, SLP, ABA)1 with the purpose of offering cooking groups at a local recreation center and targeting children and youth with autism (thekidnectionsgroup). Parents enjoy being able to drop their son or daughter off at a recreation center to engage in group activities under the skilled facilitation of therapists. Based on demand and parent feedback,The KIDnections Groups expanded to include other leisure activities (e.g. crafts, legos, games) and peers without disabilities. The benefits of this type of program is that the therapists do not have the added expenses of paying for clinic space and parents may prefer to have their youth participate at a recreation center instead of an out-patient clinic.

Success Story #2: Bring community leisure programs into school
Creative occupational therapy practitioners find ways to make leisure promotion an integral part of their everyday work. For example, Maria Llerena, OTR/L brought community-based leisure programs in as guest presenters at an autism school (Achievement Centers for Children). The therapists found that an overwhelming number of community programs (e.g. martial arts, ballet, theater) wanted to include youth with disabilities and/or mental health challenges. Leaders from various community programs come in as guests to talk about their program, perform demonstrations, and involve students in sample activities. These mini-sessions provide students with an opportunity try out a variety of leisure activities in order to spark an interest and pursue community-based participation. The programs also provided written materials to parents about their specific program schedule and registration information.

1Maria Llerena, OTR/L, Jamie Hughes, MA, CCC/SLP, Elizabeth Radachi, BCaBAReferences1 Larson, R. W. (2000). Toward a psychology of positive youth development. American Psychologist, 55, 170-183.
2 Dworkin, J. B., Larson, R., & Hansen, D. (2003). Adolescents’ accounts of growth experiences in youth activities. Journal of Youth and Adolescence, 32, 17-26.
3 Mahoney, J. L., & Stattin, H. (2000). Leisure activities and adolescent antisocial behavior: The role of structure and social context. Journal of Adolescence, 23, 113-127.
4 Bazyk, S. (2005). Exploring the development of meaningful work for children and youth in Western contexts. WORK: A Journal of Prevention, Assessment, & Rehabilitation, 24, 11-20.
5 Csikszentmihalyi, M. (1993). Activity and happiness: Towards a science of occupation. Occupational Science: nước Australia, 1, 3842.
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7 Passmore, A., & French, D. (2001). Development and administration of a measure to assess adolescents participation in leisure activities. Adolescence, 36, 67-75.
8 Zhang, S., Shi, R., Liu, X., & Miao, D. (năm trước). Passion for leisure activity, presence of meaning, and search for meaning: The mediating role of emotion. Social Indicators Research, 115(3), 1123-1135. psycnet.apa/doi/10.1007/s11205-013-0260-8
9 Fredricks, J. A., & Eccles, J. S. (2006). Is extracurricular participation associated with beneficial outcomes? Concurrent and longitudinal relations. Developmental Psychology, 42(4), 698-713. psycnet.apa/doi/10.1037/0012-1649.42.4.698
10 Leversen, I., Danielsen, A. G., Birkeland, M. S., & Oddrun, S. (2012). Basic psychological need satisfaction in leisure activities and adolescents life satisfaction. Journal of Youth and Adolescence, 41, 1588-1599. doe:10.1007/s1094-012-9776-5
11 Law, M., Finkelman, S., Hurley, P., Rosenbaum, P., King, S., et al. (2004). Participation of children with physical disabilities: Relationships with diagnosis, physical function, and demographic variables. Scandinavian Journal of Occupational Therapy, 11, 156-162.
12 Law, M., Anaby, D., Imms, C., Teplicky, R., & Turner, L. (năm ngoái). Improving the participation of youth with physical disabilities in community activities: An interrupted time series design. Australian Occupational Therapy Journal, 62(2), 105115. doi/10.1111/1440-1630.12177
13 Bazyk, S. (2011). Enduring challenges and situational stressors during the school years: Risk reduction and competence enhancement. In S. Bazyk (Ed.), Mental health promotion, prevention, and intervention with children and youth: A guiding framework for occupational therapy (pp. 119-139). AOTA Press.
14 Farnworth, L. (1999). Time use and leisure occupations of young offenders. The American Journal of Occupational Therapy, 54(3), 315-325. doi/10.5014/ajot.54.3.315
15 Spaeth, M., Weichold, K., & Silbereisen, R. K. (năm ngoái). The development of leisure boredom in early adolescence: Predictors and longitudinal associations with delinquency and depression. Developmental Psychology, 51(10), 1380-1394. psycnet.apa/doi/10.1037/a0039480
16 Carter, E. W., Boehm, T. L., Biggs, E. E., Annandale, N. H., Taylor, C. E., Loock, A. K., & Liu, R. Y. (năm ngoái). Known for my strengths: Positive traits of transition-age youth with intellectual disability and/or Autism. Research and Practice for Persons with Severe Disabilities, 40(2), 101-119. doi/10.1177/1540796915592158
17 Proyer, R. T., & Tandler, N. (2020). An update on the study of playfulness in adolescents: Its relationship with academic performance, well-being, anxiety, and roles in bulling-type-situations. Social Psychology of Education, 23, 73-99. doi/10.1007/s11218-019-09526-1
18 Anaby, D. R., Law, M. C., Majnemer, A.,& Feldman, D. (năm nay). Opening doors to participation of youth with physical disabilities: An intervention study. Canadian Journal of Occupational Therapy, 83(2), 83‐90. doi:10.1177/0008417415608653
19 Bazyk, S., & Winne, R. (2013). A multi-tiered approach to addressing the mental health issues surrounding obesity in children and youth. Occupational Therapy in Health Care, 27, 84-98.
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21 Bazyk, S. & Arbesman, M. (2013). Occupational Therapy Practice Guideline for Mental Health Promotion, Prevention, and Intervention for Children and Youth. Bethesda, MD: AOTA Press.
22 Powrie, B., Copley, J., Turpin, M., Ziviani, J., & Kolehmainen, N. (2020). The meaning of leisure to children and young people with significant physical disabilities: Implications for optimizing participation. British Journal of Occupational Therapy, 83(2), 67-77. doi/10.1177%2F0308022619879077Jump to a Section

Introduction: Making Leisure Matter:
Multi-Tiered Framework Guiding Leisure Participation
Tier 3: Individual Leisure Coaching
Tier 2: Targeted Leisure Groups
Tier 1: Universal Leisure Promotion

Downloadable Materials

The following materials provide summary information about Making Leisure Matter.

Summary sheet: Multi-tiered Leisure Pyramid (1 page)Individual OT Leisure Coaching Process (2 pages)Check it Out! Leisure Video Clips!

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