Intervention
Normalizing Play -
Familiarizing the environment, providing a sense of normalcy, making the hospital
more normal with parental presence, items from home, artwork, photos, preparation and
education of medical sights
- Preschoolers benefit from this type of play the most
Developmental Play -
Basic mechanism for learning and refining developmental skills; ensures children
have the fundamentals in place for their cognitive, physical, social and emotional growth;
promotes supportive, therapeutic relationships; age appropriate activities and materials meant
to maintain developmental milestones
- hand eye coordination toys, tracking toys, blocks, building toys, puzzles, push & pull toys
Healthcare/Medical Play -
Gives children an opportunity to freely explore, manipulate, & play with medical
equipment; eliminate common misconceptions and fears, play through the
experience/procedure; integrate, practice, and "brainstorm" coping skills; can reduce emotion
distress and help them cope with medical experiences as well as anxiety and anticipatory
stress, more cooperative
- Non-directed: adult follow child's lead
Therapeutic Play -
Play techniques are used to understand the child's thoughts and feelings and to
promote communication; prevent physiological injury and facilitate emotional and physical
well-being, and support normative development
This type of play aims to:
- meet children ongoing developmental needs
- help children cope with unfamiliar hospital environment
- increase children's understanding of their hospitalization and treatment
- promote a sense of control, mastery, and positive self concept
- facilitate self-expression
- help children cope with separation and deprivation
Child-Directed Play -
Child has greatest degree of control over situation, event, or other players; one on
one interaction between CCLS & child, the child directs the play session.
- no time controls, objects/themes chosen to meet individual interest, pretense, fantasy,
voluntary
Relationship Building Play -
Engaging in the child's "favorite" things, understand the child better in terms of
personality, demonstrates to the child that they can trust you
- Lots of time spent playing, talking, listening and interacting with you also helps the child
learn key life skills, like communicating, thinking, solving problems, moving and being with
other children and grown-ups
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,Mastery Play -
To gain mastery appropriate with developmental stage and fears of the hospital
Examples:
- 9yo scared/anxious of MRI playing through experience with doll and MRI scanner,
mastering the experience
Play for Assessment -
Child's natural mode of communication and education, play allows them to explore
concepts that may be unfamiliar or scary, therefore, allowing them to share misconceptions
and fears for assessment
- Play as assessment also provides a mode for developmental assessment by applying
"typically developing" play theories to the hospitalized child
Expressive Play -
Enabling children to express feelings and energy in an acceptable, pleasurable, and
physical manner
Educative Play -
Teaching children about certain topics through play, can be medical play with a
medical doll to teach about their bodies - or, choosing appropriate play opportunities to
promote optimal development while hospitalized; such as playing board games with a school
age child or choosing vocabulary words as a distraction method during a procedure
When is Normative Play Appropriate? -
When the child is medically stable, chronic patient, long admissions, preschool age
benefits the most, even short term patients (setting a positive stage for future admissions)
- No urgent medical needs, normalizing play may be prescribed to promote optimal
development while hospitalized, increase familiarity, and lessen trauma
- Particularly helpful for children who are anxious and or struggling to cope with
hospitalization
- Could even be considered as having family photos present in the room - many modalities
Parten's Types of Play: Onlooker -
Children are not actively involved in the play, but rather their attention/focus is on
the play activities of others; consciously observing other's play
Parten's Types of Play: Solitary -
Children engaging in play alone with no efforts to engage with others or invite them
into play, seemingly content with this behavior
Parten's Types of Play: Unoccupied -
Children demonstrating this behavior seem not to be playing but watching instead,
whatever strikes them as interesting
- random movements that infants make with no clear purpose is the beginning of play
Parten's Types of Play: Cooperative -
Children playing in a group, developing play roles and theme, developing a goal
Parten's Types of Play: Associative -
2|Page
, Children interacting with one another while engaged in a common activity with no
shared goal
Parten's Types of Play: Parallel -
Children play in the same area with like materials side by side but no attempt is
made to alter the play of others
Structured Play -
Governed by rules; present specific challenges and goals; can still be exploratory and
creative
- children in healthcare settings to obtain mastery with objects & rules associated with
healthcare experience
Piaget and Smilanksy - Classification of Play Types -
Piaget (1962):
- practice play
- symbolic play
- games with rules
Smilansky (1968):
- functional (adding constructive, refining "practice play')
- dramatic (symbolic)
- retained games with rules
Dramatic Play -
Children's creation of scenes when they play "pretend", imitating real life situations
- spontaneous & guided role play that focuses on health care & can include medical
equipment, effective after a procedure
- SYMBOLIC
Functional Play -
Simple, repetitive motor movements, with or without objects
Games with Rules -
Acceptance of prearranged rules and adjustments to these rules
- board game rules or rules of play roles dramatic play
Piaget and Vygotsky - Influence on Play -
Piaget's (1962) cognitive theory and Vygotsky's (1978) socio-cognitive theory added
other dimensions in understanding function of play
- Piaget: play is the way younger children abstract or assimilate experiences into their
existing schema or internal cognitive structures
- Vygotsky: added that play is a process that advances learning (scaffolding, zone of proximal
development)
Definition of Play -
Play must be:
- voluntary
- internally motivated
- pleasurable, relaxed
- "as if" or pretense present
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Normalizing Play -
Familiarizing the environment, providing a sense of normalcy, making the hospital
more normal with parental presence, items from home, artwork, photos, preparation and
education of medical sights
- Preschoolers benefit from this type of play the most
Developmental Play -
Basic mechanism for learning and refining developmental skills; ensures children
have the fundamentals in place for their cognitive, physical, social and emotional growth;
promotes supportive, therapeutic relationships; age appropriate activities and materials meant
to maintain developmental milestones
- hand eye coordination toys, tracking toys, blocks, building toys, puzzles, push & pull toys
Healthcare/Medical Play -
Gives children an opportunity to freely explore, manipulate, & play with medical
equipment; eliminate common misconceptions and fears, play through the
experience/procedure; integrate, practice, and "brainstorm" coping skills; can reduce emotion
distress and help them cope with medical experiences as well as anxiety and anticipatory
stress, more cooperative
- Non-directed: adult follow child's lead
Therapeutic Play -
Play techniques are used to understand the child's thoughts and feelings and to
promote communication; prevent physiological injury and facilitate emotional and physical
well-being, and support normative development
This type of play aims to:
- meet children ongoing developmental needs
- help children cope with unfamiliar hospital environment
- increase children's understanding of their hospitalization and treatment
- promote a sense of control, mastery, and positive self concept
- facilitate self-expression
- help children cope with separation and deprivation
Child-Directed Play -
Child has greatest degree of control over situation, event, or other players; one on
one interaction between CCLS & child, the child directs the play session.
- no time controls, objects/themes chosen to meet individual interest, pretense, fantasy,
voluntary
Relationship Building Play -
Engaging in the child's "favorite" things, understand the child better in terms of
personality, demonstrates to the child that they can trust you
- Lots of time spent playing, talking, listening and interacting with you also helps the child
learn key life skills, like communicating, thinking, solving problems, moving and being with
other children and grown-ups
1|Page
,Mastery Play -
To gain mastery appropriate with developmental stage and fears of the hospital
Examples:
- 9yo scared/anxious of MRI playing through experience with doll and MRI scanner,
mastering the experience
Play for Assessment -
Child's natural mode of communication and education, play allows them to explore
concepts that may be unfamiliar or scary, therefore, allowing them to share misconceptions
and fears for assessment
- Play as assessment also provides a mode for developmental assessment by applying
"typically developing" play theories to the hospitalized child
Expressive Play -
Enabling children to express feelings and energy in an acceptable, pleasurable, and
physical manner
Educative Play -
Teaching children about certain topics through play, can be medical play with a
medical doll to teach about their bodies - or, choosing appropriate play opportunities to
promote optimal development while hospitalized; such as playing board games with a school
age child or choosing vocabulary words as a distraction method during a procedure
When is Normative Play Appropriate? -
When the child is medically stable, chronic patient, long admissions, preschool age
benefits the most, even short term patients (setting a positive stage for future admissions)
- No urgent medical needs, normalizing play may be prescribed to promote optimal
development while hospitalized, increase familiarity, and lessen trauma
- Particularly helpful for children who are anxious and or struggling to cope with
hospitalization
- Could even be considered as having family photos present in the room - many modalities
Parten's Types of Play: Onlooker -
Children are not actively involved in the play, but rather their attention/focus is on
the play activities of others; consciously observing other's play
Parten's Types of Play: Solitary -
Children engaging in play alone with no efforts to engage with others or invite them
into play, seemingly content with this behavior
Parten's Types of Play: Unoccupied -
Children demonstrating this behavior seem not to be playing but watching instead,
whatever strikes them as interesting
- random movements that infants make with no clear purpose is the beginning of play
Parten's Types of Play: Cooperative -
Children playing in a group, developing play roles and theme, developing a goal
Parten's Types of Play: Associative -
2|Page
, Children interacting with one another while engaged in a common activity with no
shared goal
Parten's Types of Play: Parallel -
Children play in the same area with like materials side by side but no attempt is
made to alter the play of others
Structured Play -
Governed by rules; present specific challenges and goals; can still be exploratory and
creative
- children in healthcare settings to obtain mastery with objects & rules associated with
healthcare experience
Piaget and Smilanksy - Classification of Play Types -
Piaget (1962):
- practice play
- symbolic play
- games with rules
Smilansky (1968):
- functional (adding constructive, refining "practice play')
- dramatic (symbolic)
- retained games with rules
Dramatic Play -
Children's creation of scenes when they play "pretend", imitating real life situations
- spontaneous & guided role play that focuses on health care & can include medical
equipment, effective after a procedure
- SYMBOLIC
Functional Play -
Simple, repetitive motor movements, with or without objects
Games with Rules -
Acceptance of prearranged rules and adjustments to these rules
- board game rules or rules of play roles dramatic play
Piaget and Vygotsky - Influence on Play -
Piaget's (1962) cognitive theory and Vygotsky's (1978) socio-cognitive theory added
other dimensions in understanding function of play
- Piaget: play is the way younger children abstract or assimilate experiences into their
existing schema or internal cognitive structures
- Vygotsky: added that play is a process that advances learning (scaffolding, zone of proximal
development)
Definition of Play -
Play must be:
- voluntary
- internally motivated
- pleasurable, relaxed
- "as if" or pretense present
3|Page
