Play for OT Intervention

1. Play for OT Intervention 薛卉君老師

2. What is play? • Play has been identified as one of the primary occupations in which people engaged. • Any spontaneous or organized activity that provides enjoyment, entertainment, amusement or diversion；an attitude or mode of experience that involves intrinsic motivation, emphasis on process rather than product and internal rather external control. • Two sides of play: the science of play, where play is a critical aspect of human development that deserve serious study • The art of play：the child and the OT are players, where there is joy, pleasure, and freedom.

3. Play theories • Clark et al, 1991 Play can be viewed through these substrates of occupation: 1. As activities having certain characteristics ( i.e., its form, including activities, characteristics, and products) 2. As a developmental phenomenon contributing to a child’s development and enculturation (i.e., its function, including purposes, process, and experience) 3. As an experience or a state of mind (i.e., its meaning, including what motivates or satisfied the child) • As any other activity, takes place within context, which denotes the individual’s environments and the personal, physical, and social elements of each environment. • Children’s play activities change over time and reflect their development (Bergen, 1988)

4. Play theory (1) ：Forms of play • Sensory-motor and exploratory play :predominate in infancy as infants develop mastery over their own bodies and learn the effect of their actions upon objects and people in the environment. This form peaks in the second year of life, then declines. --Children continue to use this form of play when they learn new skills. Exploratory play begins in infancy, and by then end of the first year, infants actively explore their surroundings, demonstrate a beginning understanding of cause and effect, and are interested in how things work. In the second year, play centers around combining objects and learning their meaning. Children begin to classify objects and develop purpose in their actions.

5. Play theory (1) ：Forms of play • Constructive play: has identifiable outcomes and predominates during the preschool years as practice. The form of play remains high during middle childhood and adolescence but becomes more abstract. It may develop into arts and crafts.

6. Play theory (1) ：Forms of play • Symbolic play and pretend: develop at the end of the first year and through the second, peaking at around 5 years of age and develop into dramatic and social dramatic play. During the middle childhood, symbolic play and fantasy play are seen in the mental games, secret clubs, and daydreaming, and in language play such as riddles or secret codes. TV, computer games, and movies are also ways of indulging in fantasy play.

7. Play theory (1) ：Forms of play • Social play begins very early in infants, and by the age of 3, children engaged in complex social games. Children use role play to learn about social systems and cultural norms. --four types of roles seen in group play(1)functional roles: pretending to be a doctor (2)Relational roles: pretending to be mother and baby (3)Character roles: from TV and movies (4)Roles with no identifiable identity. --This form of play predominates during the school age years. Games with rules teach children to take turns and to initiate, maintain, and end social interactions.

8. Play theory (1) ：Forms of play • Adolescents are concerned with autonomy and being socialized into adult roles. This is a period of transition as obligations, time available for play, changes and refinements of interests, family and peer pressures all affect teen activity. • The largest single activity of adolescents was socialization. Second was television, and third, sports, games, hobbies, reading, and music.

9. Play theory (1) ：Another way to look at the Form of play • Characteristics of play: (1)Expresses intrinsic motivation and self direction (2)Focuses on means rather on ends (3)Organism centered rather than object centered (4)Noninstrumental /symbolic (5)Shows freedom from externally imposed rules (6)Reveals active engagement in the activity

10. Play Theory (2):Function of play: or how play influences adaptation. • Processes, experiences, and purposes of play. • 3 ways to consider play and development: (1)Play reflects development (2)Play reinforces development (3)Play is an instrument of developmental change.

11. Play Theory (3):Meaning of play：quality of the experience or to a person’s state of mind • Bundy : qualities of playfulness as a person’s intrinsic motivation, internal control, and the ability to suspend reality. • Knox: The playful children showed flexibility and spontaneity in their play and social interactions, curiosity, imagination, creativity, joy, the ability to take charge of situations, the ability to build on and change the flow of play, and total absorption.

12. Play assessment Four types: • Skills in a particular skill area, i.e.: materials, play settings….etc. • Developmental competencies: cognitive, social-emotional, language, physical, and motor development. • The ways a child plays, including playfulness and play style( reflects the child’s experiences). Play history and Play scales may be included. • narratives

13. Constraints to play • hospital experiences • Physical disability • Cognitive impairment • Sensory impairment • Difficulty in Sensory integration • Children with Autism

14. Play in intervention • Play as a modality( developmental, functional, and sensory integrative approach). • Play as an intervention goal • Facilitating playfulness • Adaptations • Parent education and training

15. Knox Preschool Play Scale --Space management --Material management --pretense/ symbolic --social participation

16. Case studies and practices • Play assessment (through Knox Preschool Play Scale and DIR stages for different children) • “Play” is as a modality of OT intervention. • “Play” is also a goal( or goals) of OT intervention. • Education to parents through playing with their children.