Play activities of normal and hospitalized child of all age group

AMRITA A.SASSISTANT PROFESSOR

play is language of the children , toys are their words

INTRODUCTION

• Play therapy is a vital opportunities that is given to the child to act out his feeling , problems , fears, feeling of loneliness and hatred

• Play therapy is important tool to manage stress

• It is critical to childhood development

FUNCTION OF PLAY

• Provides diversion and recreation• Encourage emotional expression , help safe

release of anger • Provide sense of security • Helps reducing stress and feeling of home

sickness

Function contd..

• Provide expressive ideas for curative outlets

• Provide the sense of independence and opportunity to make choices

• Encourage interaction and positive attitude towards others

Just as the adult works , the child plays, this is the business of the childhood……….

CATEGORIES OF PLAY

Physical play

Expressive play

Manipulative play

Dramatic play

Familiarization play

Symbolic play

Surrogate play

Creative play

others

Physical play

CATEGORIES OF PLAY

• Physical play• Includes jumping , running, playing hide and

seek• Provide exercise and essential in development• Seen commonly in toddlers , preschooler

children

Expressive play

Expressive play

• Expressive play• Provide children to express feeling through

play materials

• Includes watercolors , finger paints

Manipulative play

Manipulative play

Seen in infants• Manipulate the environment, people around

them• Ex, drop a toy and wait for the parent to pick it

up , clean it and returning it back to the infant and then they drop it again

• This brings parents and the infant together in the game

Symbolic play

Symbolic play

Symbolically express the child’s feeling• Uses this play to learn , to reinforce and alter

the painful experience• Ex, a child from abusive family may act as the

mother , loves , care and cuddles the doll • Or, same child can act as the abusive mother

by screaming and beating the doll

Familiarization play

Familiarization play

Seen during hospitalization• Child hold materials and explore • Useful in preparing the child for fearful

procedures and surgery• Ex, playing with dummy syringe , stethoscope

Dramatic play

Dramatic play

• During hospitalization• Child will act out the situation that they

suspect will happen to them or have witnessed

• May be therapeutic for the child in the hospital

Creative play

Creative play

If the child is too angry or fearful to act out feeling through dramatic play

• Be able to draw pictures that expresses their feeling and emotions

• For example, a child before going for chemotherapy draws a picture regarding self mutilation, pain etc

Surrogate play

Surrogate play

Seen during hospitalization• For the child who is ill and cannot play,

another child or parents will act as a surrogate

• Watching them play is stimulating for the child

others

• Other games • Like board games , card games • Played by school age children as these

children learn to play by rules and to take turns

PLAY THERAPY AND DEVELOPMENT

• Through the play child develops , learns and ultimately maturates , it encourages emotional and social development

Physical developmentIntellectual development

Moral development

Creative development

Therapeutic development

Social development

Play helps in…..

Physical development

• Develops physical and intellectual abilities• Infants and young children – develop tactile,

visual, sensory, auditory development through playing with rattle , balls

• Toddlers and preschooler – enjoys climbing trees and exploring the environment

• School age child – enjoys more complex forms like skating cycling etc

Intellectual development

• Learn different shapes, sizes , colors , textures , numbers and name of the object

• Learn language ability by speaking with others

• Understand real world from unreal

Moral development

• Learn moral values from parents , teachers and other adults

• Show honesty , integrity , sportsmanship while playing

• Learn to take responsibility of their own action

Creative development

• Shows creativity through playing with clay , fingers paint

• Plays with different objects like representing wooden boxes houses, blocks train etc

• if Parents are urging children to play with only one kind of toy ,they are hampering the child’s sense of creativity

Therapeutic development

• Provides release of stress and tension of all age groups

• For ex , a child is disturbed by the arrival of a new sibling may assume the role of the mother in the play and care for the doll while mother is caring for the baby

Therapeutic development contd..

• child may assume the role of adult to lessen the stress

• For ex , school age child may act as the doctor or nurse

• Express feeling in threatening environment

Social development

• Social and emotional development is enhance through play

• Develop social relationship while playing in group

types

Unoccupied play

Solitary play

Onlooker play

Parallel play

Associative play

Types of play

• Unoccupied play• No play in real sense • Lowest form of social

involvement• Child may move around

randomly , crawling under the table , climbing the tree , follow another person or just stand alone

Solitary play

• Independent play

• does not acknowledge what others are doing

• Pre toddlers and toddlers engage in this type of play

Onlooker play• Child watches others play

but does not become engaged in their play

• may sit or stand near the children playing

• Different from unoccupied play as in this play the child is interested in the other children activity

• Less frequently observed in children

Parallel play

• Child play with same toys as used by children nearby

• Child play alongside but not with others

• Preschooler engages in this type of play

Associative play

• Interaction occurs between children

• Learn to follow other children “borrow” and “ lending “ toys among other children

• typical in school age

children

Cooperative play

• Play by dramatizing a real life situation like “playing house “ or “doctor patient”

• There are leaders and followers in this group

• Typical of older preschool children

CHARACTERSTICS OF PLAY ACCORDING TO THE AGE

• Infants • Engages in social effective play• For ex , adults talk to infant while cuddling

and in response the infant smiles or imitate adult behavior

Contd…

• Infants and young children• Engages in sense pleasure play • For ex , play with a various colors , textures ,

shapes • Learn the movements of their bodies like

walking , rocking and bouncing

Contd…

• Infants also engages in skill play• In this a activity that is carried out repeatedly

until it is learned• Skills learned through imitation like games of

pee – ka-boo etc

Contd..

• Preschooler and schooler children engages in imitative and dramatic play

• In which they imitate adult activity• For ex , a child may imitate adults by making a

phone using a toy phone

Contd..

• Later preschooler children engages in formal type of play

• Like ring – a – rosy• School age children will be more interested in

hobbies • Like playing more complex games monopoly ,

puzzles etc

Contd...

• Adolescence engages in imaginative play• Like girls imagine themselves as a beautiful

heroines and boys thinks themselves a man.

AGE APPROPRIATE TOYS FOR CHILDREN

• Infancy• From 0 to 5 months

Place a crib mobile within infant reachPacifier for suckingLarge bright pictures on the crib wallsProvide multicoloured fuzzy toys that infant

can not swallow

Contd..

• From 5 to 8 monthsHarder toys with movable partsProvide complex soft cuddly toysProvide different texture of food for infant to

feelProvide floating toys for bathing

Contd..

• From 8 to 10 monthsShow large pictures in the bookPlays pee ka booVocalizes sounds like bye Place infant in jumper seat to encourage

standing and jumping

Contd..

• From 10 to 12 months• Place infant in walker and encourage letting go• Provide crayons for drawing• Encourage infant to push a chair

Contd..

• Toddler ( from 2 to 3 year)

• Motor play – push pull toys, pedal walker, small car, block play

• Creative play-manipulation of sand, mud or clay as well as use of crayons and finger paints

• Dramatic play-enjoys playing with dolls and household items

• Quiet play-singing simple songs, simple dancing to the music

Contd..

• Preschooler ( from 3 to 5 year)• Preschooler runs, climb • Boys and girls play dolls house imitating others

adults in the house

Contd..

• 3 year old• Enjoys nursery rhymes• Plays with dolls house , dolls bed , tea set• 4 and 5 year old• Plays dolls house by wearing mother’s heels , old

dress and puts on make up• Enjoys playing with simple puzzles• Runs and jump• Listening and reading stories

Contd..

• School age child• Plays more complex games like football,

cricket• Have same gender friends

SELECTING A SAFE TOY FOR A CHILD

• according to child’s age , interest, Environment, abilities as well as safety.

• read the labels for age and safety recommendation

• According to their abilities for example, shooting games or electrical games are not advised for young children.

Contd..

• Plays should teach new skills• should be checked to see they are non toxic,

inflammable ,sturdy, easy to keep clean and safe.

• Toys should not have sharp edges, sharp points that can puncture

• No propelled toys that can injure eyes for ex ,missile or weapons.

Contd..

• No part of the toys should be swallowed or inhaled

• No excessive noise that can damage the hearing of the children

• No elements that can causes burn are used for ex, cooking toys

• No toxic paints or other toxic materials are used . Parents should check the labels

SUITABLE TOYS DURING HOSPITALIZATION

• Small children needs the comfort and reassurance of familiar things such as stuffed toys that child can hugs for comfort and takes to bed at night.

• Large number of toys often confuse and frustrate the child.

Role Of Nurse

• should carefully observe the play of children can determine needs , concerns , and feelings that cannot be put into words.

• Nurses must protect children if their play becomes too aggressive and guide them into less destructive types of play activities

Contd..

• Understand child social and emotional condition

• Orient to the hospital• Reinforce and encourage question• Discuss the way parents participate in the care• Assess and discuss family support , make

referral

RESEARCH ABSTRACT

• Study conducted by D ’Antonio (1984) states that through therapeutic play nurses working with young hospitalized child can ascertain both effects hospitalization and illness had on the child and also enhance the emotional growth.