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PubMed1991

Measuring symbolic play style in infancy: a methodological approach.

Researchers have examined symbolic play style as a qualitative variable distinguishing two groups of children: patterners and dramatists. We have conceptualized style not as a typology of children but as reflecting dimensions of difference between children which are amenable to quantitative analysis. For the construct of style to be invoked, it must be measurable by many variables, it must be observable over time, and it ought to be demonstrably independent of general developmental level. Fifteen boys and 15 girls were each seen twice, once at 21 months of age and again 6 weeks later. The Session 2 pattern of correlations among hypothesized dramatist measures was not entirely consistent with that observed at Session 1; however, three measures, narrative vocalizations, spontaneous play, and elicited-appropriate play were primary dramatist measures at both sessions.

Female↗
PubMed1997

In the land of counterpane. Travels in the realm of play.

Using illustrations from the treatment of a three-year-old girl, a case is made that imaginative play between therapist and young child is not only a legitimate but often a preferable medium for therapeutic intervention. The displacement and magical thinking characteristic of the child's play are seen as creative and developmentally appropriate modes of thought, rather than as primarily defensive. By making her person available to be played with, the therapist facilitates a rich intersubjective exchange which permits the child to explore otherwise anxiety-provoking feelings, roles, and relationships.

Child, Preschool↗
PubMed1980

Documenting the value of supervised play in a pediatric ambulatory care clinic.

This study tested the hypothesis that supervision of play in a pediatric ambulatory clinic would increase positive resonses and decrease negative responses in outpatients. During the control week, children played unsupervised in the unaltered clinic waiting area; selected behaviors were recorded then and during the experimental week, in which changes introduced in the clinical environment facilitated supervised play. Significant increases in positive responses and significant decreases in negative responses were noted during the experimental week (X2=474.4; p. <. 001.). A second study demonstrated that significant changes were not caused by environment alteration alone. The resultant outpatient program and its benefits are described.

Child↗
PubMedDate not supplied

Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study.

This paper presents the results of a clinical trial of a virtual reality play-based intervention. The results of three single case studies are presented. The virtual reality intervention used the Mandala Gesture Xtreme technology. It was applied to three school-aged children with cerebral palsy. A pre-test-post-test design was used. The relevant outcome of interest was self-efficacy as measured with the Canadian Occupational Performance Measure (COPM). Group scores on the COPM indicated clinically significant changes in self-efficacy for all children. Two of the participants demonstrated the greatest changes in both perceived performance abilities and satisfaction with performance with respect to task specific domain areas. Qualitative comments from the participants revealed a high degree of motivation, interest, pleasure, and opportunity for engagement in play, activities not previously engaged in. Overall, this pilot study suggests the viability of a virtual reality play-based intervention as part of the rehabilitation process for children with cerebral palsy. These results form the basis of a larger scale randomized clinical trial.

Cerebral Palsy↗
PubMed1991

Play and energy regulation in mammals.

Analysis of ecological constraints on juvenile mammals suggests that energy expended in play behavior does not reduce fitness, but actually increases it. When viewed as a promoter of adaptive energy loss, play can be considered an antipredator strategy. In addition, it may balance a low-protein diet in favor of growth, as well as increase resistance to pathogens and to cold exposure. These short-term benefits result from activation of the sympathetic nervous system (SNS), which is hypothesized to occur during play. SNS activation increases heat production in brown adipose tissue. The energy-regulation approach generates many predictions that are supported in the literature, and others that can be empirically tested.

Adaptation, Physiological↗
PubMed1980

Pediatric intensive care unit patients. Effects of play intervention on behavior.

The effects of a 20-min play intervention by a child life teacher on two observed behaviors were investigated in Pediatric Intensive Care Unit (PICU) patients at the Johns Hopkins Hospital Children's Center. Eleven subjects, ranging in age from 2--13 years, were observed using a Preintervention--Intervention--Postintervention design with a 3-min time sampling technique to measure the change occurring when structured play activities were introduced into the PICU environment. Significant positive changes were noted between Preintervention and Intervention in (1) affect and (2) interaction with materials. In the Postintervention period, these behaviors fell close to Preintervention levels, suggesting that the positive changes were not maintained in the absence of the Intervention condition. The results indicate that while play intervention in the PICU environment can have beneficial effects on patient's behavior, the effects of such intervention are short-lived. These data hold important implications for the staffing requirements needed to provide opportunities for the positive behavior changes to occur.

Adolescent↗
PubMed1987

A longitudinal study comparing responses of hearing-impaired infants to pure tones using visual reinforcement and play audiometry.

A group of hearing-impaired infants, originally identified using visual reinforcement audiometry (VRA), were followed until they could be tested using more conventional play audiometry. Minimum response levels using VRA on this hearing-impaired population were highly consistent with measurements obtained later by play audiometry. Statistical analysis shows no significant differences between the two approaches. Test results obtained after the child's second birthday using conventional play audiometry were sufficiently similar to the earlier results obtained by VRA to validate the early test findings. VRA information can be obtained during a period of time when the child is too young to give behavioral information in another way. Use of the VRA test method can specifically define a hearing-impaired infant's minimum response levels so that definite recommendations can be made for auditory management.

Audiometry↗
PubMed1991

Nonverbal play interaction between hearing mothers and young deaf children.

The following preliminary study assessed the nonverbal play interactions of two hearing mothers and their profoundly hearing-impaired infants using a nonverbal coding scheme adapted from descriptors used by Fein (1979) and Bruner (1975a,b). The goal also was to describe the nonverbal components of their interactions during play relative to normally hearing mother-child dyads. More specifically, the goal was to determine if the behavioral patterns exhibited by the hearing mothers and their hearing-impaired children were consistent with patterns that have been reported for verbal components of play interactions. The nature of the behavioral patterns were in agreement with much of the previous literature on verbal and social interactions between hearing mothers and hearing-impaired children, but some notable differences were observed.

Behavior↗
PubMed1990

Sexualized doll play among young children: implications for the use of anatomical dolls in sexual abuse evaluations.

The use of anatomical dolls in sexual abuse evaluations remains controversial because of concerns that the dolls induce normal, nonabused children to act out in sexual ways that are likely to be misinterpreted as evidence of sexual abuse. This study examines the incidence of explicit sexual doll play in a large, demographically diverse sample of 2- to 5-year-olds. The 6% incidence of demonstrations of apparent sexual intercourse found in this sample compared favorably with the rate of less than 2% across prior studies of anatomical doll play among presumably nonabused children. However, higher rates of explicit sexual play were associated with being older, poor, black, and somewhat with being male, with over 20% of some subgroups of children displaying such behavior. These results are interpreted as evidence that anatomical dolls are not overly suggestive to young, sexually naive children, but are useful in assessing sexual knowledge and exposure to sexual intercourse.

Child Abuse, Sexual↗
PubMed2000

Acute effects of cocaine on play behaviour of rats.

Play behaviours are exhibited by many mammalian species. The similarity of such behaviour across children, non-human primates and rats makes it an especially appropriate target for the investigation of drug- or toxicant-induced disruption. In this study the acute effects of cocaine on play behaviour in male and female Sprague-Dawley rats was assessed. Same-sex dyads of rats (postnatal day 35-36) were separated 24 h prior to testing. On the following day, one or both rats of the dyad were injected with the same dose of cocaine (0, 2.5, 5.0 or 20.00 mg/kg). Thirty minutes later the rats were placed together and, after 5 min of habituation, the frequency of pins and crawl-overs were measured for each subject. In dyads in which both rats were treated, crawl-overs and pinning behaviour were decreased by 20 mg/kg cocaine. In dyads in which only one rat was treated, there was marginal effect of cocaine treatment on pinning frequency, while crawl-overs were unaffected. Pinning frequency was not sexually dimorphic in either type of dyad; however, crawl-overs were more frequently exhibited by females in dyads in which only one rat was treated. Thus, pinning behaviour in juvenile rats appears somewhat more sensitive to cocaine-induced disruption than crawl-over behaviours. Additionally, the presence of an untreated rat appears to attenuate the play-disrupting effects of cocaine on pinning frequency.

Animals↗
PubMedDate not supplied

Playing with fire: images of fire on toy packaging.

Despite prevention efforts designed to teach children that fire is not a toy, each year hundreds of children, primarily male, are injured while playing with fire. Mass-produced toys and games shape children's behaviors, and the fire images on toy packaging may send the message that fire is fun rather than dangerous. The purpose of this study was to determine the frequency of male fire-related injuries at our burn center and to investigate the use of fire images in toy packaging. An aisle-by-aisle search was conducted at a national toy store. Toys with fire images on their packaging were identified. Target gender and the setting in which the fire was displayed also were recorded. Only toys with clearly visible flames on their packaging were included. We reviewed our TRACS database from April 1997 to May 1999 for fire-related injuries to children admitted to our institution as a result of playing with fire. Review of toy stores revealed 404 toys with packaging containing fire images. Of these, 97% (393 of 404) were targeted to males. Video games were the leading category of flame-related packaging (208 of 404), followed by toy car/truck displays (84 of 404). Packaging for girls' toys had safe and contained settings, whereas boys' toys used settings that were uncontrolled and associated with speed and weapons. A total of 59 children, 52 males and 7 females, with a mean age of 10 +/- 0.6 years and mean TBSA burn of 12.3 +/- 2.1% were admitted to our facility with fire-related injuries during the study interval. Children imitate life with toys and use play to experiment with new behavior. Boys are receiving a powerful, consistent message from images of fire on toy packaging. These advertisements may help to contribute to the higher incidence of fire-related injuries in boys.

Accident Prevention↗
PubMedDate not supplied

Use of play materials in treating a severely handicapped child.

A 4-year-old boy with a physical handicap severe enough to preclude his manipulating materials, participated in a play intervention designed to help him to deal with some of his limitations. His skill in communicating to the therapist and in utilizing vicarious experiences allowed him to participate fully and successfully in therapy, although several modifications had to be made in the usual play procedures. The basic techniques of play therapy may therefore be of use to other motorically handicapped children who are capable of verbalizing and fantasizing. During the course of the therapy, this child also evidenced some unusual perceptions of the world. The lack of opportunity to have the customary sensorimotor experiences had apparently delayed his development of object permanence. This finding is consistent with Piaget's theory, which emphasized early motoric behaviours as prerequisites to later intellectual operations.

Child, Preschool↗
PubMed1990

Role-playing as a method in nursing research.

This report describes a way in which role-playing can be applied in nursing research. The questions investigated were how much the memory capacity is influenced by different methods of providing information, and in what manner objective and comprehensive information about a disease with all its possible consequences is experienced by the recipient. To elucidate these questions, 48 healthy persons imagined that they had a chronic disease. The study was arranged as a 2 x 2 factorial design, the factors being group information versus individual information about the disease, and provision of the whole information at once versus division of the information into three parts separated by 15 minutes. The information was given orally and a structured interview was consequently conducted. After 1 week the subjects were telephoned and were asked to tell the investigator what they remembered about the disease. The results showed that the amount and type of information recalled was not affected by the way in which it was given. The information in itself, however, had the effect of making the subjects calmer. Several parallels between the results of the role-playing study and observations in patients demonstrate that role-playing provides useful knowledge and should be applied to a greater extent in nursing research.

Adult↗
PubMed2006

Do students develop better motivational interviewing skills through role-play with standardised patients or with student colleagues?

OBJECTIVE: Smoking is the leading cause of preventable death in the USA and reducing the number of smokers by 50% is among the goals of the Healthy People 2010 initiative. Despite its importance, few medical students receive formal training in smoking cessation counselling. Motivational interviewing is a patient-centred, but directive, method of counselling that has been found to be more effective than giving brief advice for motivating smokers to quit. We wanted to determine whether using standardised patients to teach this skill to Year 3 medical students would be more effective than using student role-plays. METHODS: We conducted a randomised, controlled trial of 93 Year 3 family medicine clerkship students at our medical school between July 2003 and July 2004. The control group (n=46) practised motivational interviewing with one another and the intervention group (n=47) practised with standardised patients trained in motivational interviewing for smoking cessation. At the end of the study all the students conducted an interview with a different standardised patient that was videotaped. The primary outcome was analysis by a trained masked evaluator of the quality of a final videotaped interview using the motivational interviewing treatment integrity code (MITI), which assesses the quality of the interview according to 6 different criteria. RESULTS: There was no significant difference between the control and intervention groups in the final analyses of the interviews. CONCLUSIONS: According to MITI scores, standardised patient role-plays are similar in effectiveness to student role-plays when teaching basic motivational interviewing skills for smoking cessation to Year 3 medical students.

Adult↗
PubMed2006

Modified symbolic play test for Oriental children.

BACKGROUND: Symbolic play test (SPT) is a simple test for screening preverbal language in children. This test had been validated in English-speaking children. However, the toys may not be useful for other cultures such as Orientals like Chinese, Japanese, Koreans or Thais as they use chopsticks and bowls as eating utensils rather than spoon, fork or knife. The aim of this study was to find a set of miniature toys suitable for children of Oriental ethnic origin in order to get a reliable language test. METHODS: Altogether 140 children were recruited into this study. This included 62 control children and 78 with idiopathic developmental delay. The original SPT was applied together with an additional set of miniature toys appropriate for Oriental culture (i.e. modified version of SPT) by modifying play items in situations 3 and 4 to suit the Chinese culture. The authors replaced the knife, fork and plate with chopsticks and bowl in situation 3 and replaced the tractor and trailer with train carts in situation 4. For the ease of comparison, the authors segregated the age groups with the same age range as the original English-based SPT: less than 20 months (N= 11); 21-30 months (N= 45); 31-40 months (N= 43); 41-50 months (N= 21), and more than 50 months (N= 4). RESULTS: The mean scores of the cohort was higher (14.83) with the modified version of SPT than when the original SPT was used (13.64). A statistically significant increase in the mean score in situation 3 (3.67-3.24 = 0.43), situation 4 (3.76-3.36 = 0.40) and the overall score (14.83-13.64 = 1.19) was obtained when the modified SPT was used instead of the original SPT (all with P < 0.001). CONCLUSION: The authors recommend replacing play items like spoon, knife, fork and plate with Oriental culture-based items like chopsticks and bowl for the modified SPT (Oriental version). Users of the test should have a set of toy train carts available to supplement the tractor and trailer as these toys were not commonly seen in real life for Oriental children. The authors hope that the modified SPT can be used reliably to assess for preverbal ability of Oriental children, especially Chinese children.

Asian People↗
PubMed1997

The creative potential of play and regression in analytical training: a personal reflection.

The seminar group can serve as a framework in which to meet the fear generated during training. The group can become a maddening environment, but on occasions when it is experienced by the trainee as good enough, it can act like a playgroup which facilitates development. Experiences in the group can be viewed from the perspectives of group dynamics or of transference phenomena which embody regression. When this regression enables scope for play it can serve in the interests of ego development in the process of discovering the sort of analyst the trainee is becoming as the training unfolds. During play aspects of oneself can merge, then differentiate again. They can have different meanings at the same time. The rational and emotional, the adult and the childlike are all given a place in play.

Adult↗
PubMedDate not supplied

Development of self-recognition, personal pronoun use, and pretend play during the 2nd year.

This study examined the relation of visual self-recognition to personal pronoun use and pretend play. For a longitudinal sample (N=66) at the ages when self-recognition was emerging (15, 18, and 21 months), self-recognition was related to personal pronoun use and pretend play such that children showing self-recognition used more personal pronouns and demonstrated more advanced pretend play than did children not showing self-recognition. The finding of a relation among these measures provides additional evidence that in the middle of the 2nd year of life a metarepresentation of self emerges in the human child.

Child Language↗