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"This is a bad dog, you know...": constructing shared meanings during sibling pretend play.

The construction of shared meanings in play, pretense enactment, internal state language, and sibling relationship quality were investigated in 40 kindergarteners with an older (M age = 7.10 years) or younger (M age = 3.6 years) sibling. Dyadic strategies to construct shared meanings (e.g., extensions, building on) were positively associated with frequency of pretense and internal state language. Developmental differences indicated that older dyads used more shared meaning strategies, whereas younger dyads engaged in non-maintenance behaviors (i.e., disruptions to flow of play). Furthermore, firstborn kindergarteners used more non-maintenance behaviors, whereas second-born kindergarteners extended partner's ideas. Findings highlight the sibling relationship as a context for illuminating social understanding and relationship dynamics during pretend play.

Age Factors↗

Mental ability, symbolic play and receptive and expressive language of young children with Down's syndrome.

The relationship between measures of mental ability, symbolic play and expressive and receptive language was investigated in a sample of 73 children with Down's syndrome (mean CA 48.9 months, range 19-90 months; mean MA 30.4 months, range 13-73 months). Language delay became increasingly apparent with age, and more so in boys than girls. There was no significant difference between mental ages derived from standard ability tests and corresponding age equivalent scores of the Lowe and Costello symbolic play test. A developmental progression of play similar to that seen in non-handicapped groups was found. However, it is suggested that the use of a more detailed scoring system would be informative.

Child↗

A case of functional urinary retention: the use of family play therapy.

This case presents a technique for doing family therapy in families with young children. In family play therapy, the entire family plays together, allowing full participation of even the youngest children in the therapeutic process. Standard family therapy interventions in the latter part of each session make use of family interaction patterns and unconscious processes revealed during the earlier play. In the case presented here, the technique was successfully applied to a family with a 3-year-old son who had functional urinary retention. This case also provided an opportunity for interdisciplinary collaboration between the separate Child and Family Services at a major teaching hospital.

Adult↗

Clinical observations of play of hospitalized suicidal children.

This paper emphasizes the usefulness of play observation for diagnosis, treatment, and understanding suicidal behavior of children. Predictive indicators of play for potential suicidal behavior are themes of separation and loss, repetition of dangerous and reckless behavior, misuse and destruction of toys, and repetitive acting out of omnipotent fantasies. The selection of a suicidal method is partly derived from unconscious motivations that are illustrated in play themes. This study revealed a characteristic suicidal technique of latency age children seems to be jumping from heights.

Acting Out↗

Developing pretend play in children with autism: a case study.

A classroom-based intervention study aimed to explore whether it was possible to teach children with autism and additional learning difficulties to use symbolic pretend play. Five children with autism were involved in a 4 month intervention that used structure, affect and repetition. The intervention progressively faded out the structuring over three phases. All the children were able to use some symbolic acts within play. The study suggests that some of the symbolic play was not the result of replicating previously modelled examples but was spontaneous and novel.

Affect↗

Social skills assessment of children with autism in free-play situations.

Poor social functioning and limited play are characteristic of children with autism. Increasingly, education for children with autism is provided within mainstream settings, but given their particular difficulties, the adequate provision of educational services in such settings is challenging. This study presents observational data of the play behaviour and social interaction patterns of 10 children with autism in mainstream kindergartens and primary school playgrounds. The target children differed significantly in terms of their play and social interactions from typically developing children in the same settings. The adequacy of the provision of services for children with autism in mainstream provision is discussed.

Adaptation, Psychological↗

Play dough as an educational tool for visualization of complicated cerebral aneurysm anatomy.

BACKGROUND: Imagination of the three-dimensional (3D) structure of cerebral vascular lesions using two-dimensional (2D) angiograms is one of the skills that neurosurgical residents should achieve during their training. Although ongoing progress in computer software and digital imaging systems has facilitated viewing and interpretation of cerebral angiograms enormously, these facilities are not always available. METHODS: We have presented the use of play dough as an adjunct to the teaching armamentarium for training in visualization of cerebral aneurysms in some cases. RESULTS: The advantages of play dough are low cost, availability and simplicity of use, being more efficient and realistic in training the less experienced resident in comparison with the simple drawings and even angiographic views from different angles without the need for computers and similar equipment. The disadvantages include the psychological resistance of residents to the use of something in surgical training that usually is considered to be a toy, and not being as clean as drawings or computerized images. CONCLUSION: Although technology and computerized software using the patients' own imaging data seems likely to become more advanced in the future, use of play dough in some complicated cerebral aneurysm cases may be helpful in 3D reconstruction of the real situation.

Attitude of Health Personnel↗

Mental play in Gilles de la Tourette's syndrome and obsessive-compulsive disorder.

A new phenomenon, found only in Gilles de la Tourette (GTS) patients, and which we have called 'mental play', is described. It was compared with the phenomenon of counting, which occurred in both GTS and obsessive-compulsive patients. In the GTS patients both mental play and counting were best characterised as playful impulsions. In contrast to the GTS patients, the counting of the obsessive-compulsive patients was in line with their obsessive-compulsive behaviour. These findings suggest that repetitive symptoms in GTS patients, even when they share superficial similarities with obsessive-compulsive symptoms, should not be diagnosed automatically as obsessive-compulsive.

Adolescent↗

Does rational role-play enhance the outcome of exposure therapy in dysmorphophobia? A case study.

BACKGROUND: Dysmorphophobia may improve after a variety or combination of treatments, but which elements of a treatment are useful is usually not certain. METHOD: In a single out-patient case study rational role-play ('paradoxical discourse') was added to exposure plus cognitive restructuring (CR) for a dysmorphic delusion study comprised of 20-minute sessions one week apart. RESULTS: Previous exposure plus attempted CR had improved anxiety, phobias, work and social leisure, but not dysmorphic belief. Added brief rational role-play was followed by resolution of the dysmorphic belief. All measures remained much improved at 18-month follow-up. CONCLUSIONS: Rational role-play deserves a controlled trial in dysmorphophobia and other problems and exploration of its mechanism of action.

Adult↗

Sex steroids and human behavior: prenatal androgen exposure and sex-typical play behavior in children.

Gonadal hormones, particularly androgens, direct certain aspects of brain development and exert permanent influences on sex-typical behavior in nonhuman mammals. Androgens also influence human behavioral development, with the most convincing evidence coming from studies of sex-typical play. Girls exposed to unusually high levels of androgens prenatally, because they have the genetic disorder, congenital adrenal hyperplasia (CAH), show increased preferences for toys and activities usually preferred by boys, and for male playmates, and decreased preferences for toys and activities usually preferred by girls. Normal variability in androgen prenatally also has been related to subsequent sex-typed play behavior in girls, and nonhuman primates have been observed to show sex-typed preferences for human toys. These findings suggest that androgen during early development influences childhood play behavior in humans at least in part by altering brain development.

Androgens↗

The role of play in a pediatric bone marrow transplantation unit.

This article examines the function of play in the care of children who have undergone bone marrow transplantation. The serious nature of the children's illnesses, the rigors of treatment, and the restrictions posed by the environment make the provision of quality play a challenging endeavor. It is clear that the child's play behavior varies with the stage of the transplant procedure. Each phase of the process is a unique condition posing its own set of problems and solutions. Familiarity with these stage-related behaviors may assist health care professionals in working optimally with these patients.

Bone Marrow Transplantation↗

Fluid and rigid boundaries of paranoid and nonparanoid schizophrenics on a role-playing task.

The concepts of fluid and rigid boundaries were assessed in an improvisational role-playing task in an attempt to differentiate paranoid from nonparanoid schizophrenics. Thirty-one schizophrenic patients divided into paranoid, intermediate, and nonparanoid groups were given an improvisational role-playing task. The resulting scenes were analyzed by Fluid Boundary and Rigid Boundary scales, which were developed on the basis of specific aspects of the physical and verbal representations of characters, objects, and settings. The hypothesis that variations in the disruption or emphasis of representational boundaries differentiate paranoid and nonparanoid symptomatology received support. Paranoid schizophrenics scored higher on the Rigid Boundary scale, i.e erecting and/or exaggerating physical and interpersonal boundaries; and nonparanoid schizophrenics scored higher on Fluid Boundary scale, i.e. showing fused and fluid representations of characters, objects, and settings. Improvisational role-playing seems to hold promise as a medium with diagnostic value.

Adolescent↗

Behavioral observation of children during play therapy: preliminary development of a research instrument.

There is a need for a measure of children's playroom behavior to assess areas of functioning relevant to diagnosis, therapy process, and outcome, as discussed in clinical literature. This study concerned the development of a Play Therapy Observational Instrument designed to meet criteria specified as necessary for such a measure. Two nonclinicians were trained in the observation and scoring of 31 child behaviors. The observations were made on video tapes and transcripts of ongoing play therapy sessions. Results indicated that 13 of the behaviors were scored with a high level of interjudge reliability. These reliable scores formed three statistically valid and theoretically meaningful subscales: emotional discomfort, use of fantasy play as a coping method, and the quality of the child's interaction with the therapist. Children's scale scores were sufficiently stable within sessions and across two therapy sessions to indicate that they reflected individual differences. Relationships between scales were assessed and discussed in the light of theoretical controversies. Implications for future research were discussed.

Adaptation, Psychological↗

Effects of perinatal exposure to bisphenol A on play behavior of female and male juvenile rats.

In higher vertebrates, estrogen can exert an organizational effect on sexually dimorphic areas of the central nervous system (CNS) during the perinatal phase of development. The possibility that estrogenic pollutants may mimic estrogen action on the CNS during development and produce long-lasting or irreversible effects is an issue of great concern. Bisphenol A (BPA), a compound widely used in the food industry and in dentistry, has proven estrogenic actions. To study its potential developmental effects on behavior, we gave female Sprague-Dawley rats 40 microg/kg/day BPA from conception to weaning postnatal day 21 and 400 microg/kg/day BPA from gestation day 14 to postnatal day 6. After exposure, we studied social behavior in a play situation in juvenile male and female offspring. The attempt to use play behavior to study the effects of BPA yielded some interesting results. We observed an early action of BPA on several behavioral categories in both males and females. In particular we observed a masculinization of female behavior in two behavioral categories (play with females and sociosexual exploration), an effect probably mediated by the estrogenic activity of BPA in the CNS. These long-lasting effects of BPA could have important consequences at individual and population levels.

Administration, Oral↗

Play behavior and communication between deaf and hard of hearing children and their hearing peers in an integrated preschool.

Sixty preschoolers (30 deaf and hard of hearing, 30 hearing) were observed in their integrated school during "centers" and outdoor play. Half the children experienced auditory communication and half total communication modes of communication. All children had known their classmates for six months to three years. It was found that all children preferred to play and communicate with same-hearing status children, however 63% of all children communicated with children of other-hearing status. Amounts of social play and communication differed somewhat between the two communication environments, and context of interaction was related to the behavior and communication of children who were deaf and hard of hearing. Implications are discussed for the education of young children who are deaf and hard of hearing--specifically that educational and social benefits accrue to those who are integrated throughout the school day (across context) and have access to hearing classmates and classmates who are deaf and hard of hearing.

Child, Preschool↗

Development of a behavior analytically derived alcohol-specific role-play assessment instrument.

Social learning theory postulates that chronic alcohol abusers may have deficits in ability to cope with stressful situations, and these deficits may be associated with relapse after treatment. Attempts to study the hypothesized deficits have been hampered by methodological problems. Therefore, a behavior analytic procedure was used to develop 10 categories of situations based on over 600 drinking situations elicited from alcoholics. Role plays were developed for each of these categories, and samples of alcoholics in treatment were asked to respond as if they were trying not to drink. Videotaped responses were behaviorally rated by trained judges for skill and anxiety, and subjects completed self-report ratings of urge to drink, anxiety, difficulty and skill after each role play. Good interrater reliabilities and internal consistency were found across three samples of alcoholics, with virtually no gender differences. Previous and current investigations show the validity and utility of this instrument. The Alcohol Specific Role Play Test therefore shows promise as a means of assessing alcoholics' reactions to high-risk situations.

Adaptation, Psychological↗

An evaluation of two procedures for training skills to prevent gun play in children.

OBJECTIVE: Unintentional firearm injuries threaten the safety of children in the United States. Despite the occurrence of these injuries, few studies have evaluated the effectiveness of child-based programs designed to teach children gun-safety skills. This study compared 2 programs that were designed to reduce gun play in preschool children. METHODS: A between-groups no-treatment control design was used. Children were randomly assigned to either 1 of 2 firearm-injury prevention programs or a no-treatment control condition. Participant recruitment, training, and data collection occurred in preschools and children's homes located in a midwestern city with a population of approximately 80,000. Thirty-one 4- and 5-year-old children participated in the study. The effectiveness of the National Rifle Association's Eddie Eagle GunSafe Program and a behavioral skills training program using instruction, modeling, rehearsal, and feedback was evaluated. Children were issued 0 to 3 ratings on the basis of their ability to say correctly the safety message and similar ratings on the basis of observations of their ability to perform correctly the skills in the classroom and when placed in a realistic simulation. RESULTS: Both programs were effective for teaching children to reproduce verbally the gun-safety message. The behavioral skills training program but not the Eddie Eagle GunSafe Program was effective for teaching children to perform gun-safety skills during a supervised role play, but the skills were not used when the children were assessed via real-life (in situ) assessments. CONCLUSIONS: Existing programs are insufficient for teaching gun-safety skills to children. Programs that use active learning strategies (modeling, rehearsal, and feedback) are more effective for teaching gun-safety skills as assessed by supervised role plays but still failed to teach the children to use the skills outside the context of the training session. More research is needed to determine the most effective way to promote the use of the skills outside the training session.

Child Behavior↗

[Playing in hospital: addition to nursing care].

Playing is one of the essential activities for the physical, emotional and social development to the child. Although the recognized importance of this activity, during the hospitalization process it is little value, so it is not find out between the foreseen therapeutic actions that are preview. The goal of this paper is discuss the theory and practice principles to subsidize the utilization of play in the aid to the hospitalization children. The empiric data collection was realized through the participant observation of 11 children who were intern in a pediatric unit of a teaching hospital of State of São Paulo up country. We identify that the act to play has repercussions in the child, nurse and hospital. To the child it is not obstruct the development; help it in the understanding about what is occurring with itself and discharge fear, tension, anxiety and frustration; promote satisfaction, funny and spontaneity and allows it transforms experiences that should support inactive in active discharge. To the nurse it is a tool of intervention and a way of communication, that allows detect the uniqueness of each child. Related to the hospital, change the current view that is only a pain and suffering place.

Child↗