ArticlePDF Available

The Importance of Pretend Play in Child Development: An Occupational Therapy Perspective

Authors:

Abstract and Figures

Play is a complex behaviour and is defined as being more internally than externally motivated, transcending reality as well as reflecting reality, controlled by the player, involving more attention to process than product, safe, usually fun, unpredictable, pleasurable and spontaneous and involving non-obligatory active engagement (Bundy 1997, Stewart et al 1991). Pretend play, which occurs between the ages of 18 months and 6 years, reflects these qualities of play. Using the World Health Organisation's classification of body functions and structures, activities and participation (ICIDH-2, WHO 1999), this paper outlines the skills that are essential for pretend play ability and asserts that if there are any impairments in these skills the child experiences a reduced ability to pretend play. This leads to possible participation restrictions in the child's life, such as difficulties in fulfilling usual social roles. Cognitive, social and emotional skills are presented as having the biggest impact on pretend play development, while the motor and sensorimotor skills that enable the child to manipulate objects in the environment are presented as being of secondary importance. Two models are offered which illustrate the importance of pretend play to child development and the sequence of play development. The paper concludes by recommending that occupational therapists address and reduce the participation restrictions that some children experience in learning and social situations by enabling a child to increase activity in pretend play.
Content may be subject to copyright.
A preview of the PDF is not available
... There is no consensus on how play is defined, however, several authors defined play to have similar essential components: intrinsic motivation, controlled by the player, spontaneous, fun, non-obligatory, suspended from reality and focusing on the process rather than on the product (Stagnitti & Unsworth, 2000;Skard & Bundy, 2008;Moore & Lynch, 2018b). This is further reflected by how OTs define play as an occupation. ...
... For example, DeGangi, Wietlisbach, Goodin, and Scheiner (1993) found that the use of child-initiated play and therapist-directed structured program to improve developmental competencies have their own strengths. Nevertheless, non-directive, child-initiated and child-directed play-based approaches can support child development such as in pretend play (Stagnitti & Unsworth, 2000) or when used in a program wherein the OT assumes a directive approach at the beginning and becomes less directive as the child's play skills improve (Stagnitti, Connor & Sheppard, 2012). Utilizing the child's preference and response, may be a basis for the therapeutic experiences using play, such as the techniques involved in Ayres' Sensory Integration (Smith Roley, Mailloux, Kuhaneck & Glennon, 2007). ...
Article
There is limited information on the use of non-directive, child-initiated and child-directed play in occupational therapy. Play as an occupation characterized by internal control, intrinsic motivation, suspension from reality, and engaged in with focus on the process rather than the product necessitates child-centeredness with initiation and direction led by the child. This research aims to determine whether Filipino occupational therapists’ (OTs) attitudes, knowledge, and behavior are consistent with the principles of child-centered practice. A secondary analysis of a previous online survey was conducted. Purposive sampling and snow-balling techniques were used to select and recruit participants. Data were analyzed using descriptive statistics. A total of 91 OTs participated in the study. Results of the study indicate OTs generally are child-centered in their attitude & behavior. However, responses to certain items under attitude (children need to be given correct answers to questions and children tend to make right decisions) and behavior (abilities to facilitate decision making and responsibility in children and to facilitate spontaneity and creativity during play) indicate some reservations with the approach. The current attitude, knowledge and behavior of Filipino occupational therapists indicate alignment with child-centered principles but with reservations. This may affect how play is utilized in practice.
... Interestingly, developmental psychology has shown that children rely on two additional features: 1) imaginative play and 2) social situatedness. On the one hand, imaginative play allows children to imagine and target goals that they did not encounter previously; by substituting an object with another for example (Lewis et al., 1992;Stagnitti & Unsworth, 2000). The IMAGINE approach attempts to leverage this feature in IMRL by using language to imagine new goals (Colas et al., 2020a). ...
Preprint
Full-text available
In the quest for autonomous agents learning open-ended repertoires of skills, most works take a Piagetian perspective: learning trajectories are the results of interactions between developmental agents and their physical environment. The Vygotskian perspective, on the other hand, emphasizes the centrality of the socio-cultural environment: higher cognitive functions emerge from transmissions of socio-cultural processes internalized by the agent. This paper argues that both perspectives could be coupled within the learning of autotelic agents to foster their skill acquisition. To this end, we make two contributions: 1) a novel social interaction protocol called Help Me Explore (HME), where autotelic agents can benefit from both individual and socially guided exploration. In social episodes, a social partner suggests goals at the frontier of the learning agent knowledge. In autotelic episodes, agents can either learn to master their own discovered goals or autonomously rehearse failed social goals; 2) GANGSTR, a graph-based autotelic agent for manipulation domains capable of decomposing goals into sequences of intermediate sub-goals. We show that when learning within HME, GANGSTR overcomes its individual learning limits by mastering the most complex configurations (e.g. stacks of 5 blocks) with only few social interventions.
... The skills learned during playing will have an important function for that child throughout life. While playing games, they learn to deal with difficulties, mutual respect, and sharing early [2][3][4][5]. Playing, which has so many functions, is a right for children in a sense and it must be supported [6,7]. ...
Article
Full-text available
The concepts of games and toys have a very important role in children's lives. It contributes to the development of cognitive, motor, psychosocial, emotional, and linguistic skills. It also plays a key role in raising self-confident, creative, and happy children. Therefore, attention should be paid to the concepts of games and toys, which are so important for the child to be a part of society as a healthy individual at every stage of his development. On the other hand, providing playgrounds where children can play comfortably and safely are essential in reducing the risk of accidents related to toys. All health-care components, especially pediatricians and family physicians, should take an active role in ensuring that these play processes, which are the most beautiful parts of childhood, are healthy and safe.
... This study constitutes the first Spanish validation of the JSE-HPS scale in occupational therapy students. This internationally known scale has been used in numerous research studies to analyze the level of empathy of university students from different health professions, such as medicine, nursing, pharmacy, or physiotherapy [12,42,43]. The process of cultural adaptation carried out in this study followed a specific methodology, including being analyzed in detail by bilingual translators, in addition to having several differentiated phases of blinded analysis. ...
Article
Full-text available
Background In occupational therapy, empathy is a fundamental concept and has a positive impact on health and quality of care outcomes for patients. It is a basic and essential concept that should prevail in the training of occupational therapy students. The aim of this study is to validate and cross-culturally adapt the Jefferson Medical Empathy Scale, version for health professionals (JSE-HPS) in a sample of Spanish university students of occupational therapy. Methods A cross-sectional descriptive study was conducted between 2019 and 2020. A convenience sample was selected, consisting of 221 students from the four courses of the Occupational Therapy degree at the Universidad Rey Juan Carlos during the 2019–20 academic year. Each of the participants voluntarily and anonymously completed a sociodemographic data sheet (including age and sex), in addition to the following assessment scales: JSE-HPS and the Interpersonal Reactivity Index (IRI). Results A culturally adapted version of the JSE-HPS that guarantees conceptual and grammatical equivalence specific to the study population was obtained. The psychometric analysis of the translated version showed a Cronbach coefficient α of 0.786. The test-retest reliability analysis showed an intraclass correlation coefficient of 0.90 (95% CI = 0.86–0.93, p < 0.0001). Confirmatory factor analysis (CFA) showed positive results (χ ² = 269.095, df = 167, p < 0.001, Confirmatory Fit Index [CFI] = 0.90, Root Mean Square Error of Approximation [RMSEA] = 0.04). Conclusion The cultural adaptation and psychometric results suggest that the Spanish version of the JSE-HPS is a valid and reliable way to evaluate the empathic ability of occupational therapy students.
... In relation of cognitive skills development, children with ASD in this study also has been reported to be more interested in playing and showed and expansion of play skills including initiating pretend play. Children with ASD were not commonly reported to engage in pretend play often (Jarrold, 2003;Lee et al., 2016;Stagnitti & Unsworth, 2000). This could be due to children's experience of leading the play and with parents joining them, increase the playfulness of the play for children. ...
Article
Full-text available
Play is important for children’s development and used as teaching and learning tool for children. Children’s skills including physical, emotion, social and cognitive are potentially to develop that could transform children into their full potential. Play is effective in supporting children’s development and learning when it is child-directed and focuses on play as the main aim with development and learning as the by-product. Children with Autism Spectrum Disorder (ASD) faced multifaceted challenges and resulted in receiving little benefit from play. This qualitative study through in-depth semi-structured interviews explores parents of children with ASD’s perspectives about child-led play for children with ASD. Analysis of the interviews found that children with ASD were able to engage in child-led play activities at home and showed positive outcomes in their play, social, language and communication skills as well as their prosocial behaviour. Although positive outcomes have been shown, interpretation of the findings should be cautionary due to limited representation of the data for Malaysian population and can be further improved with varied and more participants. Various source of data to be analysed are recommended to increase sensitivity of the finding interpretation.
... Reliability for each factor was carried out by calculating this coefficient for the items with respect to the global score and the other coefficient for the items of each domain with respect to its value. Cronbach's alpha values >0.70 were considered acceptable to guarantee the internal consistency of the questionnaire [31]. ...
Article
Full-text available
Play is essential in childhood, allowing for a positive trend in development and learning. Health professionals need useful tools to assess it, especially in the case of children with neurodevelopmental disorders. The aim of this study was to validate and cross-culturally adapt the My Child's Play questionnaire and to find out if this instrument allows us to differentiate the play of children with neurodevelopmental disorders from the play of children with neurotypical development. A total of 594 parents completed the questionnaire. A confirmatory factor analysis was conducted, which showed a similar structure to the English version: (1) executive functions; (2) environmental context; (3) play characteristics; and (4) play preferences and interpersonal interactions. The reliability of the analysis was high, both for the whole questionnaire and for the factors it comprises. The results provide evidence of the potential usefulness of the My Child's Play questionnaire for determining play needs and difficulties of children; moreover, this tool can also be used to plan intervention programs according to the needs of each child and family.
... The skills learned during playing will have an important function for that child throughout life. While playing games, they learn to deal with difficulties, mutual respect, and sharing early [2][3][4][5]. Playing, which has so many functions, is a right for children in a sense and it must be supported [6,7]. ...
Article
The concepts of games and toys have a very important role in children's lives. It contributes to the development of cognitive, motor, psychosocial, emotional, and linguistic skills. It also plays a key role in raising self-confident, creative, and happy children. Therefore, attention should be paid to the concepts of games and toys, which are so important for the child to be a part of society as a healthy individual at every stage of his development. On the other hand, providing playgrounds where children can play comfortably and safely are essential in reducing the risk of accidents related to toys. All health-care components, especially pediatricians and family physicians, should take an active role in ensuring that these play processes, which are the most beautiful parts of childhood, are healthy and safe.
Article
Introduction This study compares the self-initiated pretend play abilities of preschool-aged children with an acquired brain injury, with the self-initiated pretend play ability of their neurotypical peers. Method A non-experimental group comparison was conducted between 22 preschool-aged neurotypical children (M = 52.8 months, SD = 7.1 months) and 21 children with an acquired brain injury (ABI, M = 50.5 months, SD = 11.9 months), who had been discharged from inpatient rehabilitation and who were able to engage in a play session. The children were assessed individually using the Child-Initiated Pretend Play Assessment (ChIPPA). Results The children with an ABI had significantly lower scores in pretend play ability than their neurotypical peers as measured by the percentage of elaborate play actions in both the conventional (P < .000) and symbolic (P < .000) sections of the ChIPPA, as well as the number of object substitutions (P < .000). The children with an ABI completed significantly less of the play time required compared with their neurotypical peers (P = .001); 66% could not play for the required time. There was no significant difference in the ChIPPA scores of the children with an ABI injured before and after the age of 18 months, nor between children with a severe or moderate injury. Conclusion The quality and the quantity of pretend play of preschool-aged children with an ABI are significantly below that of their neurotypical peers. Assessment of pretend play ability and direct intervention in ABI rehabilitation by occupational therapists is essential to enable children with an ABI to participate in pretend play and garner the developmental benefit this affords.
Article
EDUCATORS AND OCCUPATIONAL THERAPISTS regard play as a primary occupation of childhood, which in the case of children with special needs has not been well studied. The aim of this descriptive study was to observe the free-play behaviour of children with special needs in both special education and mainstream education settings. The Revised Preschool Play Scale and Lunzer Scale of Organisation of Play Behaviour were used to observe and record short play samples of 12 children with special needs, aged 48 to 84 months, in both educational settings. Results suggest that developmental play skills remained constant between the two settings. This study highlights the strong developmental foundations provided by play as well as advocating for the importance of play assessment in school-based therapy.
Chapter
Indice: 1. Definizioni di gioco 2. Tipologie di gioco nella letteratura 3. La necessità di una tassonomia condivisa per supportare il gioco inclusivo 4. Una tassonomia condivisa del gioco: la proposta dell’Azione COST LUDI 5. Gioco e sviluppo
Article
This paper considers the narrative function of children's play by focusing on interwoven elements of story, imagination, and visual expression. It is argued that both story and play are important features of children's lives. When children engage in storytelling they are participating in a form of play which brings into account both their knowledge of the world and their knowledge of narrative conventions. Context is seen as an important factor in shaping and constraining the stories children tell. The paper concludes that storytelling has the potential to enhance literacy and, therefore, children's oral storytelling in classrooms needs to be encircled.
Book
Focused on the importance of play in evaluating and treating children with disabilities, Play in Occupational Therapy for Children, 2nd Edition presents play theories and assessments along with the theories and assessments reached from research conducted by occupational therapists and occupational scientists. This edition also includes five new chapters that reflect the latest developments in the areas of autism, play assessment, play for institutionalized toddlers, school-based play, and play and assistive technology in an early intervention program to provide you with the most up-to-date information available. Case Studies highlighted in special boxes provide snapshots of real-life situations and solutions to help you apply key concepts in the clinical setting. Clinical trials and outcome studies emphasize evidence-based practice. Key Terms, Chapter Objectives, and Review Questions help you assess and evaluate what youve learned. A clean two-color format highlights learning points to emphasize important concepts. Additional Evolve Resources include video clips for clinical assessment, web links, references, and assessment forms found in the book provide you with additional learning tools.
Article
The Preschool Play Scale and Preschool Play Materials Preference Inventory were administered to 66 pre-school-age boys (35 normal, 31 iwth sensory integrative [SI] dysfucntion). Data were analyzed descriptively. The results demonstrated that (a) normal pre-school-age boys and pre-school-age boys sith SI dysfunctin did not differ with regard to play preference; (b) pre-school-age boys with SI dysfunction scored significantly lower than did their normal peers on three of the four dimensions of the play scale; (c) there was no relationship between play preference and performance for the boys with SI dysfunction and only a moderate relationship for the normal boys. Furthermore, none of the scores of the normal preschoolers fell into the category of high preference, low performance in any area of play, whereas 9% of the scores of the boys with SI dysfunction were associated with this type of play deficit. A greater percentage of scores (22%) of the boys with SI dysfunction fell into the category of low preference, low performance in given play categories; only 4% of the scores of the normal boys fell into this category. Clinical implications and recommendations for further study of play deficits are discussed.
Article
This article offers the opinion that the use of non-directive play therapy is not in itself a sufficient theory for working within child psychiatry. The authors suggest that the added understanding of analytical theory be applied to non-directive play therapy and, combined with the skills of an occupational therapist, will provide a unique style of working. The article does not set out to describe the work of occupational therapists within child, adolescent and family psychiatry, which will be the subject of another paper.
Article
Unless a therapist has a good grasp of the sequence of normal play development, he/she is unable either to assess a child's current developmental level accurately or to suggest play activities which are appropriate for the child. The study of play is complex and only two of the main categories of play can be discussed here, each from babyhood to school age. It is not only children with impairments who are disadvantaged developmentally and a brief mention of social class related differences in play behaviour is made. The article also looks critically at the quality of play research in its comparison of old and new developmental inventories.