Accessibility of Childcare Services for Children With Disabilities Aged 0 to 5 Years: A Scoping Review of Promising Solutions.
François Routhier, Josiane Lettre, Maude Lemieux and 24 others
PMID 40347172WHAT IT FOUND
Childcare accessibility research focuses almost entirely on social support and autism, leaving physical environment changes and other disabilities largely unexamined.
Most solutions combine multiple interventions, so specific component effects remain unclear. Clinicians should advocate for broader research into environmental adaptations and non-autism populations.
Key findings
01The vast majority of included studies focused on children with autism, limiting generalisability to other disabilities.
02When multiple solutions were implemented in the same study, it was not possible to isolate which specific solution caused the observed outcome.
03Very few studies documented physical environment changes, and no studies covered staff attitudes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The search strategy did not include the term 'accessibility', relying instead on broader concepts, which may have missed relevant studies. The list of disability keywords was not exhaustive, potentially missing children with less common diagnoses. Most included studies focused on autism, so findings may not apply to children with other disabilities. Studies involving only healthcare services (e.g., catheterisation, feeding tubes) were excluded, meaning the review does not address accessibility barriers for medically complex children. The review did not search grey literature, which may contain practical initiatives not published in journals. Because many studies combined multiple interventions, it is impossible to determine which specific component was responsible for the outcomes.
Declared interests
The text does not report any conflicts of interest or funding sources for the review itself.
The easy way to misread this
Do not interpret the documented 'promising solutions' as evidence that any single intervention works in isolation. Most studies combined multiple strategies, such as assistive devices with staff training, so the review cannot tell you which part of the package actually made the difference.