Outdoor Play and Sun Safety

Outdoor learning contributes positively to foundational STEM skills. However, children are at high risk of suffering sun burn from overexposure to UV radiation. Following are several recommendations for supporting sun safety and helping children with disabilities benefit from outdoor play.

Sarah Pedonti's headshot
By Sarah Pedonti

Ph.D. candidate in Applied Developmental Psychology and Special Education at the University of North Carolina at Chapel Hill’s School of Education

About the author: Sarah Pedonti, M.Ed., is a Ph.D. candidate in Applied Developmental Psychology and Special Education at the University of North Carolina at Chapel Hill’s School of Education. Her research focuses on early reading and language interventions for young children with or at risk for developmental language disorders. She has worked in varied settings serving young children with disabilities, including Early Head Start, Head Start, North Carolina Pre-K (co-located within a Title I Engineering Magnet Elementary School), NC State’s Engineering Place Summer Programs, and the Office of Head Start’s National Center on Early Childhood, Development, Teaching, & Learning (NCECDTL)

Outdoor learning  is important for helping young children with and without disabilities to regulate attention (Szczytko et al., 2018) and improve learning engagement (Norwood et al., 2019) and contributes positively to foundational STEM skills such as spatial working memory (e.g. remembering the position of cards during a game of memory; Schutte et al., 2015). Yet, there may be hurdles to safe participation in outdoor learning for some children with disabilities, including sensory hypersensitivities which may cause difficulty with safety precautions such as sunscreen. 

Sunscreen use is important: one in five U.S. citizens will be diagnosed with skin cancer in their lifetime (Guy et al., 2015). Although children are at low risk for developing skin cancer in childhood, sun safety behaviors in childhood can prevent the overexposure to UV rays which are responsible for skin cancers in later adulthood (Autier et al., 1994a,b). A childhood history of severe sunburn significantly raises one’s lifetime chance of developing skin cancer (Iannacone et al., 2012; US Department of Health & Human Services, 2014). Some children with disabilities may be particularly at risk for severe sunburn due to genetic skin conditions such as ichthyosis or Ehler-Danos syndrome, or due to developmental disabilities such as autism (Kanellis, 2020). Some children with autism and other developmental disabilities may display sensory hypersensitivity (Baranak et al., 2007) to “light” tactile experiences like sunscreen application (Baranek & Berkson, 1994; Quinde-Zlibut et al., 2020). Sensory (e.g., autism) or physiological (e.g., icthyosis or similar dermatological disorders with acutely sensitive skin) difficulties associated with sunscreen application can make outdoor summer activity difficult for families. Following are several recommendations for supporting sun safety and helping children with disabilities benefit from outdoor play and to understand the scientific rationale for sun protection:

Universal:

  • Limit outdoor time to morning and late afternoon hours outside peak sun exposure when possible.
  • Reapply every 90-120 minutes- even “waterproof” sunscreens need reapplication, and will need so even more frequently if you’re in the water (FDA, 2019)
  • Seek the shade! Use a sun-tent or umbrella at the beach, and use playgrounds that have shady spaces under trees or sun sails.
  • Don’t forget the hat! 13% of all skin cancers occur on the scalp. (Prodinger et al., 2018)

Individualized:

Most of all, have FUN! Outdoor learning supports children with disabilities to learn, participate with their peers, and benefit cognitively from STEM experiences that occur outdoors. Sun safety precautions can protect children from future risk of skin cancer while encouraging their present-day learning!

 

References

Autier, P., Doré, J. ‐F, Schifflers, E., Cesarini, J. ‐P, Bollaerts, A., Koelmel, K. F., Gefeller, O., Liabeuf, A., Lejeune, F., Lienard, D., Joarlette, M., Chemaly, P., & Kleeberg, U. R. (1995). Melanoma and use of sunscreens: An EORTC case‐control study in Germany, Belgium and France. International Journal of Cancer, 61(6), 749–755. https://doi.org/10.1002/ijc.2910610602

Boyd, B. A., Baranek, G. T., Sideris, J., Poe, M. D., Watson, L. R., Patten, E., & Miller, H. (2010). Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Research, 3(2), 78–87. https://doi.org/10.1002/aur.124

Baranek, G., Boyd, B., Poe, M., David, F., & Watson, L. (2007). Hyperresponsive sensory patterns in young children with autism, developmental delay, and typical development. American Journal on Mental Retardation, 112(4), 233–245. https://doi.org/10.1352/0895-8017(2007)112

Baranek, G. T., & Berkson, G. (1994). Tactile defensiveness in children with developmental disabilities: Responsiveness and habituation. Journal of Autism and Developmental Disorders, 24(4), 457–471. https://doi.org/10.1007/BF02172128

Food and Drug Administration (2019) Sunscreen: How to Protect your Skin. https://www.fda.gov/drugs/understanding-over-counter-medicines/sunscreen-how-help-protect-your-skin-sun#infants

Guy, G.P., Machlin S., Ekwueme, D.U., & Yabroff, K.R. (2015) Prevalence and costs of skin cancer treatment in the US, 2002–2006 and 2007–2011. American Journal of Preventative Medicine, 48(8) 183–7.

Iannacone, M. R., Wang, W., Stockwell, H. G., O’Rourke, K., Giuliano, A. R., Sondak, V. K., Messina, J. L., Roetzheim, R. G., Cherpelis, B. S., Fenske, N. A., & Rollison, D. E. (2012). Patterns and timing of sunlight exposure and risk of basal cell and squamous cell carcinomas of the skin - a case-control study. BMC Cancer, 12(1), 1–11. https://doi.org/10.1186/1471-2407-12-417

Kanellis, V. G. (2020). Barriers to sun safety in autism spectrum disorder. In Biophysical Reviews (Vol. 12, Issue 4, pp. 791–792). Springer. https://doi.org/10.1007/s12551-020-00732-2

Norwood, M.F., Lakhani, A., Fullagar, S., Maujean, A., Downes, M., Byrne, J., Stewart, A., Barber, B., Kendall, E., (2019). A narrative and systematic review of the behavioural, cognitive and emotional effects of passive nature exposure on young people: Evidence for prescribing change. Landscape and Urban Planning, 189, 71-79.

Prodinger, C. M., Koller, J., & Laimer, M. (2018). Scalp tumors. Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 16(6), 730–753. https://doi.org/10.1111/ddg.13546

Schutte, A. R., Torquati, J. C., & Beattie, H. L. (2017). Impact of Urban Nature on Executive Functioning in Early and Middle Childhood. Environment and Behavior, 49(1), 3–30. https://doi.org/10.1177/0013916515603095

Szczytko, R., Carrier, S.J., Stevenson, K.T., (2018). Impacts of outdoor environmental education on teacher reports of attention, behavior, and learning outcomes for students with emotional, cognitive, and behavioral disabilities. Frontiers in Psychology, 3

Tripp, M., Herrmann, N., Parcel, G., Chamberlain, R., & Gritz, E. (2000). Sun protection is fun! A skin cancer prevention program for preschools. Journal of School Health, 70(10), 395–401. https://doi.org/10.1111/josh.2000.70.issue-10

Quinde-Zlibut, J. M., Okitondo, C. D., Williams, Z. J., Weitlauf, A., Mash, L. E., Heflin, B. H., Woodward, N. D., & Cascio, C. J. (2020). Elevated thresholds for light touch in children with autism reflect more conservative perceptual decision-making rather than a sensory deficit. Frontiers in Human Neuroscience, 14, 122. https://doi.org/10.3389/fnhum.2020.00122

US Department of Health & Human Services. (2014) The Surgeon General’s Call to Action to Prevent Skin Cancer. Washington, DC: US Dept of Health and Human Services, Office of the Surgeon General.

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Comments

  • You can apply sunscreen with a big makeup brush. My kids like this for the face because then I can be more careful around the eyes. 

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