Assessment and Intervention of Play

Question 1

5 most agreed upon characteristics of human play

Answer 1

1.) self-chosen and self-directed
2.) intrinsically motivated
3.) guided by mental rules, but the rules leave room for creativity
4.) imaginative
5.) conducted in an alert, active, but relatively non-stressed frame of mind

Question 2

An early aspect of OT

Answer 2

• work, play, rest, and sleep as the 4 rhythms that shape human organization
• one of the first playgrounds established at Hull House
• toys have been considered important treatment tools since the 1950s
• play as the arena for the development of sensory integration, physical abilities, cognitive, and language skills, and interpersonal relationships

Question 3

Play as an occupation

Answer 3

• form
• function
• meaning
• context

Question 4

Form

Answer 4

• specific types of play
• games, building and construction, social play, pretend play, sensorimotor play, dramatic play, team sports, and digital play
• developmental nature of play
• changes in the preferences of children of different ages

Question 5

Function

Answer 5

• where most of the areas of research are going on now
• how it serves the person and impacts health and well-being
• most research related to the role of physical play on health
• more recently, researchers have considered play on overall well-being and mental health, especially as free play is being replaced with structured play and technology in youth

Question 6

Meaning

Answer 6

• the person’s state of mind and the value the play experience has for the individual
• the “why” of play
• per kids’ report, why do they play? it’s fun!

Question 7

Context

Answer 7

• physical environments
• social environments
• cultural environments
• temporal
• virtual environments

Question 8

Physical environments of play

Answer 8

• spaces = indoors, outdoors, home play spaces, natural environments
• access to toys

Question 9

Social environments of play

Answer 9

• individuals available for play
• adults, siblings, teachers, children

Question 10

Temporal environments of play

Answer 10

• time use and participation
• play versus enrichment activities or watching television

Question 11

Virtual environments of play

Answer 11

• physical and social
• overreliance on screens has changed the type of play
• increased passivity and reliance on others for entertainment

Question 12

Roles of OT with play (PEO Model)

Answer 12

Person:
- promoting development, improving physical, sensory, social, and cognitive skills related to play
- just-right challenge of play
Environment:
- modifying the environment to promote play indoors and outdoors
- recess promotion
- advocating for play
Object:
- helping parents and teachers select toys
- modifying/adapting toys to increase participation

Question 13

Assessment

Answer 13

• play is considered a child’s major occupation by OTs, few routinely evaluate
• barriers include lack of education of play assessments, lack of time, issues with role boundaries and funding
• play/leisure must be made a priority through discussion with children, teens, families, and team members
• play is how we connect with others, how we form the foundations for friendship
• it is critical for positive mental health
• should be part of every OT assessment
• gives input into helping the child to participate in meaningful activities
• helps understand physical, cognitive, social, imagination, independence, and coping mechanisms

Question 14

Non-standardized assessments of play

Answer 14

• ask the child about play, activities, leisure (what does the child like to do? not like to do? > gives insight into skills that we might want to explore on)
• observe the child playing
• ideally in the natural environment and with others
• note how physical, sensory, cognitive, and social skills impact play

Question 15

Occupational profile

Answer 15

• What does the child like to play?
• Favorite toys/games?
• Active play/quiet play?
• Who does the child like to play with?
• What does the child like to play with at home?
• What does the child play at school?
• What does the child play inside? Outside?
• What types of physical play, pretend play, fine motor play, social play, and virtual play?

Question 16

Test question

Answer 16

Are standardized tests of play common? NO

Question 17

Test of Playfulness , Version 4 (ToP)

Answer 17

• formal assessment
• measures the play of children between 6 months and 18 years
• based on observation of the child’s free play inside and outside
• measures on a 4-point scale elements of playfulness related to intrinsic motivation, internal control, freedom to suspend reality, and framing (the ability to give and read cues)

Question 18

Knox Preschool Play Scale

Answer 18

• ages 0-6
• observed inside/outside environment
  4 dimensions of play observed:
• space management = gross motor and interests
• material management = manipulation, construction, purpose, attention
• pre-tense symbolic = imitation and dramatization
• participation = type, cooperation, communication, and language

Question 19

Performance skills related to play

Answer 19

• fine motor skills
• gross motor skills
• sensory modulation
• executive function
• confidence
• social skills
• coping skills (winning/losing)
• risk/resilience
• creativity
• problem solving

Question 20

Use of play in OT

Answer 20

• play as a tool
• play is used to develop a specific skill that has been identified as a weakness
• work on developing a specific skill utilizing a toy
• play as a reward
• play is used as a reward after tasks are complete
• play as a primary occupation

Question 21

Facilitating playfulness

Answer 21

• attitude
• body language
• speech
• model playfulness
• imaginary play
• fun
• shared control and decision making

Question 22

Tiered framework guiding play and leisure (Every Moment Counts)

Answer 22

Tier 3 = play for children, individual leisure coaching for older youth
Tier 2 = target leisure groups for youth at risk for decreased participation
Tier 1 = universal play and leisure promotion for all youth

Question 23

Addressing play with Tier 3

Answer 23

• activity analysis of play (motor, social, sensory, cognitive) to address underlying weaknesses
• educate about the benefits of leisure on health and well-being
• use individual coaching strategies to help identify potential interests, explore options, and participate successfully

Question 24

Addressing play with Tier 2

Answer 24

• be aware of youth who may be at risk for limited play including youth with disabilities, mental health issues, sensory issues, social differences, obesity, and social conditions (poverty and foster care)
• provide small leisure groups during recess or after school to expose youth to potential activities and participation

Question 25

Addressing play with Tier 1

Answer 25

- work with children's museums to develop accessible spaces - advocate for recess in schools, play spaces, and accessible play spaces - educate youth, families, and school providers about the mental and physical benefits of play and structured leisure - help develop school-wide initiatives (such as Refreshing Recess) - help develop school-wide inclusive activities

Question 26

Every Moment Counts Programs

Answer 26

- Refreshing Recess - Leisure

Question 27

Play looks different from person to person

Answer 27

- consider culture, family dynamics, and neurodiversity - we know autistic children engage more in sensory-based play, tend to base play scripts on experiences and memories, and engage in social play differently than non-autistic children - consider the child's interests and manner of self-directed play (ex: lining up the trains can be interpereted as play to them) - consider if you are asking a child to complete a "fun" activity or engaging them in a play