Background: Perhaps no other demographic group in the history of the United States has undergone such a significant transformation in the past several decades as that of our children. Societal trends have dramatically altered the nature of play and the way children interact with their environment. These trends have included a significant decrease in outdoor recreation, an increased dependence on electronic media, and the conceptual emergence of "time poverty." Consequently, childhood obesity and type 2 diabetes rates are skyrocketing because of the preponderance of sedentary lifestyles, and children are experiencing poor social skill development, less problem-solving abilities, and a marked increase in depression. For children with disabilities, such as spinal cord injuries (SCIs), these issues are even more significant. With a traumatic injury, the need for play and its therapeutic value becomes more important and yet is harder to attain. Methods: Literature review. Findings: In a study examining recreation involvement for 66 children and adolescents with SCI, the top 5 activities were all sedentary in nature, involving little to no social interaction and conducted indoors. Listening to music, reading, computer, video games, and television viewing are the top recreation activities for children and adolescents with SCI. In addition, data collected in 2005 on "participation in organized community activities" for the pediatric SCI population found 203 of 326 patients reported no participation in sports, clubs, or youth centers after injury/diagnosis. An astonishing 62% reported no organized activity at a time when participation in adult-supervised structured activities for able-bodied children is at an all-time high. Given these statistics, it is imperative that pediatric health care professionals understand societal trends and how they affect the SCI population. Making meaningful connections between these trends and the impact they have on children and adolescents with SCI will provide the theoretical framework for future solutions.
