The Impact of Occupational Therapy on a Child's Playfulness

Abstract

The constant changing health care system has made it imperative for occupational therapists (OTs) to examine the effectiveness of treatment interventions with children. Few studies exist examining play as the desired outcome of the intervention. Previous studies in occupational therapy (OT) have focused on the motor aspects of play in children (Anderson, Hinojosa & Strauch, 1987; Florey, 1981; Morrison, Bundy, & Fisher, 1991). In these studies, the researchers hypothesize that improving motor skills will improve play skills in children. OTs frequently evaluate play using the Preschool Play Scale (PPS) (Bledsoe & Shephard, 1982; Knox, 1997) which provides a developmental age for play skills. Therapists also use developmental assessments designed to examine the skills used during play (Bundy, 1991). Skills used in play are important but fail to look at a child's approach or attitude during play. A child's approach to activities of play is termed "playfulness" (Bundy, 1997). The Test of Playfulness (TOP) (Bundy, 1997) was developed to measure this construct. The TOP provides information that can assist therapists working with children in designing measurable playfulness goals. This study examined the playfulness of four children who received OT intervention specifically designed to improve play behaviors in comparison to four children who did not receive this intervention. The results provide therapists with information and insight for treating children with play deficits. This information will help therapists design effective treatment to increase playfulness in children.

A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive

“…The findings from this study support recommendations of the importance of providing long-term early childhood intervention programs for children with HIV living in challenging socioeconomic circumstances in South Africa [10, 14, 38, 39]. Preparing children for schooling through an early childhood play-based intervention will provide children with more opportunity to practice, learn, and develop through play [3, 23, 32]. As play is deemed the main occupation of childhood and described as a determinant of health and well-being [3], the play needs of children with HIV should be brought to the forefront in this area of research.…”

Does Playfulness Change over Time? A Preliminary Look Using the Test of Playfulness

“…Yet these studies indicate that playfulness skills may change over time and with intervention. O'Brien et al (2000) found changes in the playfulness scores of children diagnosed with autism after 3-months. However, there were many confounding variables to this study.…”

“…These results indicate that programming may have an impact on playfulness skills of children. O'Brien et al, (2000) reported changes in playfulness scores (per ToP) in children with autism. Four children were assigned to a control group and 4 children were assigned to an intervention group.…”

Efficacy of a Crisis Intervention in Improving Mother–Child Interaction and Children’s Play Functioning

“…The framework of the FI-OP and playroom programs included eight 30-min sessions, with an interval of 4 days to 1 wk between sessions. Because both interventions took place at the shelters, we selected the number of sessions on the basis of previous intervention studies (e.g., O'Brien et al, 2000;Okimoto et al, 2000;Wadsby, Sydsjö, & Svedin, 2001) and the crisis philosophy of intervention in shelters for abused women. The decision to conduct 30-min sessions was in accordance with the expected attention span of children ages 1-5 yr.…”

“…The literature includes several studies describing interventions focused on improving mother-child interaction (e.g., DeGarmo, Patterson, & Forgatch, 2004;Windham et al, 2004;Wolfe et al, 2003). Other studies have focused on improving children's play functioning (Bell, Lyne, & Kolvin, 1989;O'Brien et al, 2000). Only Okimoto, Bundy, and Hanzlik (2000) emphasized improving both; however, their sample did not include domestic violence survivors, who have special needs.…”