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PubMed2006

Joint attention and symbolic play in young children with autism: a randomized controlled intervention study.

BACKGROUND: Delays and deficits in joint attention and symbolic play constitute two important developmental problems in young children with autism. These areas of deficit have been well studied in autism but have rarely been the focus of treatment efforts (see Kasari, Freeman, & Paparella, 2001). In this study, we examine the efficacy of targeted interventions of joint attention and symbolic play. METHODS: Participants were 58 children with autism aged 3 and 4 years (46 boys). Children were randomized to a joint attention intervention, a symbolic play intervention, or control group. Interventions were conducted 30 minutes daily for 5-6 weeks. Both structured assessments of joint attention and play skills and mother-child interactions were collected pre and post intervention by independent assessors. RESULTS: Results indicate that both intervention groups improved significantly over the control group on certain behaviors. Children in the joint attention intervention initiated significantly more showing and responsiveness to joint attention on the structured joint attention assessment and more child-initiated joint attention in the mother-child interaction. The children in the play group showed more diverse types of symbolic play in interaction with their mothers and higher play levels on both the play assessment and in interaction with their mothers. CONCLUSIONS: This randomized controlled trial provides promising data on the specificity and generalizability of joint attention and play interventions for young children with autism. Future studies need to examine the long-term effects of these early interventions on children's development.

Adult↗
PubMedDate not supplied

The play and language behavior of mothers with and without dyslexia and its association to their toddlers' language development.

The play and language behavior of mothers with (n = 49) and without (n = 49) specific reading disabilities (RD) was investigated during play with their 14-month-old children. The contribution of maternal behavior to the language development of their children was examined. The children's receptive and expressive language skills were assessed longitudinally at 14, 18, and 30 months, using the MacArthur Communicative Development Inventories and the Reynell Developmental Language Scales. Children with and without familial risk for RD did not differ from each other in any play or language measures at these ages. No group differences were found for mothers' manifestations of nonsymbolic play and language. However, the typically reading (TR) mothers produced significantly more symbolic play and language in play interactions with their child than did the mothers with RD. The correspondence between mother-child symbolic play and maternal play-related language was also higher for the TR group than it was for the RD group. The mothers' symbolic play did not show any relation to their children's language development, but their expressions of symbolic language did show a relationship. The mothers' child-directed symbolic language contributed significantly toward the comprehension skills of 14- and 18-month-olds in the RD group. This association, however, was lower at 30 months, at which point it was reliably present for the first time in the TR group.

Child Language↗
PubMed2000

Negative correlates of computer game play in adolescents.

There is some concern that playing computer games may be associated with social isolation, lowered self-esteem, and aggression among adolescents. Measures of these variables were included in a questionnaire completed by 204 year eight students at a North London comprehensive school. Principal components analysis of a scale to assess needs fulfilled by game play provided some support for the notion of 'electronic friendship' among boys, but there was no evidence that game play leads to social isolation. Play was not linked to self-esteem in girls, but a negative relationship was obtained between self-esteem and frequency of play in boys. However, self-esteem was not associated with total exposure to game play. Aggression scores were not related to the number of games with aggressive content named among three favourite games, but they were positively correlated with total exposure to game play. A multiple regression analysis revealed that sex and total game play exposure each accounted for a significant but small amount of the variance in aggression scores. The positive correlation between playing computer games and aggression provides some justification for further investigation of the causal hypothesis, and possible methodologies are discussed.

Adolescent↗
PubMed1987

Independent and social play among profoundly mentally retarded adults: training, maintenance, generalization, and long-term follow-up.

Play skills were taught to eight profoundly mentally retarded adults in two interrelated experiments. In Experiment 1, a multiple baseline across subjects design was used to assess the efficacy of verbal and physical prompts on independent play. In Experiment 2, the same subjects and experimental procedures were used to develop social play. Verbal prompting and graduated physical guidance procedures were found to be effective in substantially increasing independent play in Experiment 1 and social play in Experiment 2. Positive changes were also observed in collateral behaviors. Inappropriate play decreased slightly and stereotypy decreased to very low levels. Social interaction increased substantially in Experiment 2 when social play was targeted but little change was observed in Experiment 1 when only independent play was targeted. Treatment gains were maintained for 26 weeks in Experiment 1 and 10 weeks in Experiment 2. In addition, the treatment gains were generalized across subjects and settings in Experiment 2. Finally, regular follow-up checks showed that independent and social play remained in the repertoire of the subjects for 12 months following the termination of programmed maintenance.

Adolescent↗
PubMed1984

Examining the reliability and validity of the Play History.

Few occupational therapy tools exist that evaluate play totally and systematically. The purpose of this study was to examine the Play History Interview and establish its value as a scientific clinical tool. The parents of 15 disabled and 15 nondisabled children between the ages of 1 and 7 1/2 years were interviewed about their children's play behaviors using the Play History Interview. Children were rated on an ordinal scale according to the criteria outlined on the Play History Chart and Taxonomy for Diagnosis. Interrater and test-retest reliabilities were determined by two independent raters. The scores from the Play History and Minnesota Child Development Inventory were correlated to examine concurrent validity of the Play History. Content validity was studied via a literature review. Significant results suggest that the Play History is a reliable and valid interview in occupational therapy for assessing children's play behavior.

Child↗
PubMed1993

Assessment of play and leisure: delineation of the problem.

This paper discusses current perspectives on play and leisure and proposes that if play and leisure are to be accepted as viable occupations, then (a) valid and reliable measures of play must be developed, (b) interventions must be examined for inclusion of the elements of play, and (c) the promotion of play and leisure must be an explicit goal of occupational therapy intervention. Existing tools used by occupational therapists to assess clients' play and leisure are evaluated for the aspects of play and leisure they address and the aspects they fail to address. An argument is presented for the need for an assessment of playfulness, rather than of play or leisure activities. A preliminary model for the development of such an assessment is proposed.

Humans↗
PubMedDate not supplied

Play in Mayan children.

OBJECTIVE: The purpose of this study was to describe the characteristics of play activities and playfulness in a group of Mayan children in southern Belize. METHOD: This qualitative study involved participant observation in the daily occupations of 20 children from five Mayan families over a 2-week period. Analysis of the field notes, using open and closed coding, revealed themes specific to customs of child rearing, play activities, and playfulness. FINDINGS: The primacy of adult work is a major cultural principle that influences Mayan children's daily occupations. Parents did not encourage play but permitted play if it did not interfere with work. Children found ways to integrate play activities and playfulness into their daily occupations. CONCLUSION: The statement, "play is a child's major occupation," may not be a universally held belief. Parental values and customs of child rearing should be considered in order to provide culturally sensitive and relevant services.

Adolescent↗
PubMedDate not supplied

[Changes in the galvanic skin reaction and speech parameters of 8- to 9-year-old children during play].

Changes of parameters of the speech signal (fundamental frequency, Ef, and evaluation of the frequency of the first formant, n(0)) were compared to the skin galvanic (SGR) reaction shifts in 8-9 years old children during playing computer games under different conditions: 1) playing using the child's own strategy; 2) that under the conditions of time deficits; 3) that with minimization of errors. In each playing situation a child had 3 trials. Parameter SGR-1 reflected SGR amplitude changes depending on a trial number, SGR-2 reflected those depending on the beginning, the middle, of the end of a battle with an enemy. At playing under the conditions of time deficits there was an increase of emotional stress and that of the number of negative emotional reactions of children being accompanied by worsening of playing activity parameters. Ef and SGR-2 were mostly expressed in comparison to other playing situations. The greatest changes of n(0) and SGR-1 were observed at playing with child's own strategy. Emotional stress in the latter situation was minimal, number of positive emotional reactions was comparable to that in the third playing situation, and negative emotional reactions were absent. The data obtained point to the structural change of motivation at complicating the situation (at playing with time deficits).

Acoustic Stimulation↗
PubMed1996

Fair-play rules and injury reduction in ice hockey.

OBJECTIVE: To determine the rate, type, and severity of injuries incurred and penalties assessed during the qualifying fair-play (points for playing without excessive penalties) and championship "regular" rules (winner advances) portions of a 1994 Junior Gold ice hockey tournament. DESIGN: A prospective evaluation of injuries by certified athletic trainers at the tournament site. SETTING: A community-organized, 3-day, 31-game tournament in Minnesota. PARTICIPANTS: Two hundred seventy-three male players, younger than 20 years and in high school. MEASUREMENTS/MAIN RESULTS: Injuries were recorded by an on-site certified athletic trainer, and the penalties were tallied from the score sheets. The injury rates for the total number of injuries were 26.4 injuries per 1000 athlete exposures and 273.8 injuries per 1000 player hours. When only notable injuries (concussion, facial laceration, or moderate level of severity and above) were considered, the injury rates were 10 per 1000 athlete exposures and 103.9 per 1000 player hours. The ratio of notable fair-play to notable regular-rules injuries was 1:4.8. The number of penalties assessed per game averaged 7.1 penalties during fair-play rules and 13 penalties during the regular-rules competition. Penalties related to rough play and injury occurred four times more frequently during games with regular rules than those with fair-play rules. CONCLUSIONS: The fair-play concept can reduce injury rates, penalty rates, and severity of penalties and should be considered for ice hockey at all levels of play. The fair-play concept could be applied to other contact sports to reduce injury rates and rules infractions.

Athletic Injuries↗
PubMed1994

Effects of alpha-2 adrenoceptor antagonists on rough-and-tumble play in juvenile rats: evidence for a site of action independent of non-adrenoceptor imidazoline binding sites.

The pharmacological specificity of alpha-2 adrenoceptor involvement in the modulation of rough-and-tumble play behavior was assessed in juvenile rats. The alpha-2 adrenoceptor antagonists idazoxan and RX821002 both increased the frequency of pinning in individually housed rats that were given a brief opportunity to play. Dorsal contacts, a measure of play solicitation, were not consistently affected by these compounds. Since RX821002 shows little affinity for non-adrenoceptor imidazoline binding sites, it is likely that the facilitation of play following administration of these two compounds is due to blockade of alpha-2 receptors. The effect of RX821002 and idazoxan is unlikely to be an artifact associated with using rats that are reared in isolation, as RX821002 also increased pinning, as well as dorsal contacts, in group-housed rats that were isolated for a short period (4h) before the play session. The alpha-1 adrenoceptor antagonist prazosin, which also binds to alpha-2B receptors, reduced the frequency of both pinning and dorsal contacts. There was a strong trend for St 587, a centrally active alpha-1 agonist, to attenuate the effect of prazosin on play. While this leaves open the possibility that prazosin may be reducing play through alpha-1 blockade, antagonist activity at alpha-2B receptors cannot be ruled out. From these data, we conclude that the facilitation of play following idazoxan and RX821002 is likely due to blockade of alpha-2A adrenoceptors. These findings add further support for a specific role of alpha-adrenoceptors in the modulation of playfulness in the juvenile rat.

Adrenergic alpha-2 Receptor Antagonists↗
PubMed1983

Olfactory bulbectomy and play fighting in juvenile rats.

To determine the influence on play fighting of inputs to the brain that arise in or course through the olfactory bulbs juvenile male and female rats were bilaterally bulbectomized at 23 or 24 days of age. The frequency of play fighting and play initiation was observed in tests conducted in the home cage. Bulbectomy did not affect the frequency of play fighting or play initiation by males, but slightly increased the frequency of play fighting without altering play initiation in females. Since peripheral anosmia has only modest effects on play fighting, neither the chemosensory nor the modulatory influences of the olfactory bulbs on limbic system activity appear to be especially important in the control of play by juvenile rats.

Aggression↗
PubMed1997

The neurobiology of social play behavior in rats.

Social play behavior is one of the earliest forms of non-mother-directed social behavior appearing in ontogeny in mammalian species. During the last century, there has been a lot of debate on the significance of social play behavior, but behavioral studies have indicated that social play behavior is a separate and relevant category of behavior. The present review provides a comprehensive survey of studies on the neurobiology of social play behavior. Evidence is presented that opioid and dopamine systems play a role in the reward aspect of social play behavior. The role of cholinergic, noradrenergic and opioid systems in attentional processes underlying the generation of social play behavior and the involvement of androgens in the sexual differentiation of social play behavior in rats is summarized. It is concluded that there is not only behavioral, but also neurobiological evidence to suggest that social play behavior represents a separate category of behavior, instead of a precursor for adult social, sexual or aggressive behavior.

Animals↗
PubMed1999

Evaluation of a Role-Play Learning Exercise in an Ambulatory Clinic Setting.

Learning in ambulatory settings can be aided by teaching activities which do not slow the pace of the clinic. In this study, simulated-parent role-play scripts were developed for use with students prior to seeing actual patients. During the learning exercise, a faculty member role-played various parents, a medical student role-played the physician while another student observed. Students were randomly assigned to either the Treatment Group (participated in role-play exercise) or Control Group (did not participate). Sixteen Treatment Group students completed approximately 20 role-play cases on the first day of the Pediatrics clerkship. Both Treatment and Control Group students were then individually assessed one to two days later using two role-play cases by an examiner blinded to the students' experimental status. Student performance was scored on three criteria: history taking, differential diagnosis, and correct diagnosis. The Treatment Group achieved higher scores than the Control Group for history taking, but not for differential diagnosis or correct diagnosis. Role-play learning exercises can be used to improve student history taking in an ambulatory clinic prior to seeing actual patients. Potential use of role-play cases as a screening exam to exempt some students from the role-play learning exercise is discussed.

Journal Article↗
PubMed2001

Return to play after cervical spine injury.

STUDY DESIGN: A questionnaire survey was mailed to members of the Cervical Spine Research Society, the Herodiuus Sports Medicine Society, and to members of the authors' Department of Orthopaedics. OBJECTIVES: The purpose of our study was to evaluate what influence, if any, factors such as published guidelines, type of sport of the patient, number of years in practice, subspecialty interest, and sports participation of the respondent held in the "return to play" decision-making process after a cervical spine injury. SUMMARY OF BACKGROUND DATA: The consequences of cervical spine injury are potentially catastrophic, and return to play decisions in athletes with a history of neck injury can be agonizing. Although recent publications have addressed some of the concerns regarding cervical spine injuries in the athletic population, many questions remain unanswered. Factors such as published guidelines, type of sport of the patient, number of years in practice, subspecialty interest, and sports participation of the respondent have all been suggested as having a possible role in return to play decisions. METHODS: Representative radiographs and case histories of 10 athletes who had sustained neck injury were mailed to 346 physicians. For each case physicians selected every type of play (of six categories) that they felt comfortable recommending. Type of play was divided into six categories: Type 1, collision sports; Type 2, contact sports; Type 3, noncontact, high velocity sports; Type 4, noncontact, repetitive load sports (e.g., running); Type 5, noncontact, low impact sports; Type 6, no sports. In addition, demographic data regarding board certification, subspecialty interest, number of years in practice, use of guidelines in return to play decisions, and personal participation in sports were queried from all respondents. Statistical analysis was completed with Statview (Berkeley, CA). Basic descriptive statistics, chi2, and ANOVA were used where appropriate. RESULTS: Three hundred forty-six questionnaires were mailed and 113 were returned (response rate 32.7%). One hundred ten (97%) of the respondents who completed the questionnaire were board certified. Seventy-five were subspecialists in spine, 22 were subspecialists in sportsmedicine, and 13 reported interests in both sports medicine and spine. Use of Published Guidelines. Although 49% of respondents reported using guidelines in decision-making, the use of guidelines was statistically significant in only one case (P = 0.04). Hierarchy of Risk. In general, those physicians who participated in the study followed the hierarchy of risk that we established in this study (Type 1 [collision sports; highest level of risk] through Type 6 [no sports; lowest level of risk]). Twelve (10.6%) respondents, however, deviated from it in one or more cases. Years in Practice. In three cases there was a statistically significant association between the number of years a physician was in practice and the type of play selected (P < 0.05). In each case a lower level of play tended to be recommended by more senior physicians. Subspecialty Interest. In three cases those respondents with a spine subspecialty interest recommended returned to a higher level of play (P < 0.05). CONCLUSIONS: There is no consensus on the postinjury management of many cervical spine-injured patients. Further research, education, and discussion on this topic are needed.

Adolescent↗
PubMed2000

Comparative analyses of the role of postnatal development on the expression of play fighting.

Whether it is that animals are young so that they can play, or whether it is that they play because they are young, play should be more prevalent in species that have a greater degree of postnatal development. This hypothesis is tested by comparative analyses within two mammalian orders (primates and muroid rodents) using independent contrasts. This technique can account for the relative degree of relatedness among the species. For both orders, the complexity or prevalence of play fighting is compared to the degree of prenatal development (neonatal weight/adult weight). In addition, the prevalence of play in primates is compared to prenatal brain development (neonatal brain weight/adult brain weight). Significant negative regressions show that 30% of the variance in the distribution of play in the rodents is accounted for by the degree of prenatal development of body size, and 60% of the variance in play in the primates is accounted for by prenatal brain growth. The findings are thus consistent with the prediction. Species with a greater proportion of their growth occurring postnatally play more and have more complex play than do species with more of their growth occurring prenatally.

Animals↗
PubMedDate not supplied

Short-term responsiveness of manual thoracic end-play assessment to spinal manipulation: a randomized controlled trial of construct validity.

OBJECTIVE: To evaluate the short-term responsiveness of rotatory thoracic end-play assessment to spinal manipulation and, thereby, motion palpation construct validity. DESIGN: Prospective, single-blind, randomized, controlled trial (randomized blocks design). SETTING: Laboratory, Center for Technique Research. PARTICIPANTS: Sixty first-year chiropractic college student volunteers; seventy-three possible candidates were screened. INTERVENTIONS: The treatment group received manual high-velocity, low-amplitude rotatory manipulation. The control group received no intervention to minimize nonspecific effects of sham treatment. MAIN OUTCOME MEASURES: End-play response, defined as the change from restricted to normal end play immediately after intervention. Responsiveness, defined as the percentage of the end-play response attributable to spinal manipulation: relative response attributable to the maneuver, RRAM = (treatment group response--control group response)/treatment group response. RESULTS: Ten percent of the tests were positive for restriction of end play in left or right rotation from T3-T4 to T12-L1; the average rate was 2.1 restrictions per subject (SD = 1.4). End-play response was 60% in the treatment group, in contrast to the 37% response in the control group (z = 1.86, p = .04). More than a third of the response in the treatment group was attributable to spinal manipulation (RRAM = 39%). For one examiner, RRAM = 51%. Mild symptomatology did not affect responsiveness. CONCLUSIONS: The data suggest a moderate short-term responsiveness of rotatory thoracic end-play restriction to spinal manipulation, hence it has utility as a posttreatment evaluative test. This study was the first to use an external standard (manipulation) to demonstrate that segmental end-play restriction changes, hence end-play restriction itself, are detectable in human subjects with manual palpation by chiropractors. Further research is required to determine the generalizability of the study findings.

Adult↗
PubMed2005

Play assessment for group settings: a pilot study to construct an assessment tool.

The Play Assessment for Group Setting (PAGS) was constructed to measure children's play performance. The study was undertaken with 93 children aged from 2 to 8 years to examine whether the items of the PAGS construct a unidimensional scale that can be used to measure children's play ability. The internal scale validity and the person response validity of the PAGS were investigated by examining the goodness-of-fit of the play items and children's play performance to the many-faceted Rasch model for the PAGS. In total, 46 of the 51 play items demonstrated acceptable goodness-of-fit. Of the 93 children, 90.3% demonstrated acceptable goodness-of-fit on the scale of play items. Overall, the results support both the scale and person response validity for the PAGS, as well as providing preliminary evidence that the PAGS can be used for a more detailed evaluation of children's abilities in play performance within natural day-care contexts. Further research is needed to examine other aspects of the validity and reliability of the PAGS measures.

Attitude↗
PubMed1997

Factors parents use in selecting play spaces for young children.

BACKGROUND: The amount of time children spend in play spaces (ie, physical locations that are appropriate for children's physical activity) near their homes is correlated with their level of physical activity. OBJECTIVE: To examine factors used in parents' decisions about the selection of play spaces for their children. SUBJECTS: Parents (primarily mothers) of 178 Mexican American and 122 white children who were a mean age of 4.9 years old at the first measurement. MEASURES: In individual interviews, parents rated 24 factors on their importance in selecting for their children a play space that is away from their home or yard. Decision factors were rated from 1 (ie, not important at all) to 5 (ie, very important). RESULTS: The most important factors, with ratings ranging from 4.8 to 4.2, were safety and availability of toilets, drinking water, lighting, and shade. Mexican American parents rated 8 of 24 items significantly higher than did white parents, including lighted at night, organized activities, play supplies, and drinking water. White parents rated 5 of 24 items significantly higher than did Mexican American parents, including distance from home, cost of admission, and child's friends go there. The rated importance of 7 of 24 items increased during 1 year, including play supplies, drinking water, distance from home, and parents' friends or relatives go there. CONCLUSIONS: These results indicate that parents can identify factors they use in selecting places for their young children to play, and selection factors differ somewhat by ethnicity or socioeconomic status. Further studies are needed to determine whether improvements on the most important selection factors might be effective in increasing the use of play spaces by children and their parents. Clinicians may be able to use the most highly rated decision factors to help parents assess the acceptability of play spaces in their areas.

Adult↗