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Play activities of normal and hospitalized child of all age group
AMRITA A.SASSISTANT PROFESSOR
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play is language of the children , toys are their words
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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
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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
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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
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Just as the adult works , the child plays, this is the business of the childhood……….
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CATEGORIES OF PLAY
Physical play
Expressive play
Manipulative play
Dramatic play
Familiarization play
Symbolic play
Surrogate play
Creative play
others
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Physical play
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CATEGORIES OF PLAY
• Physical play• Includes jumping , running, playing hide and
seek• Provide exercise and essential in development• Seen commonly in toddlers , preschooler
children
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Expressive play
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Expressive play
• Expressive play• Provide children to express feeling through
play materials
• Includes watercolors , finger paints
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Manipulative play
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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
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Symbolic play
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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
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Familiarization play
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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
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Dramatic play
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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
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Creative play
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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
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Surrogate play
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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
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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
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PLAY THERAPY AND DEVELOPMENT
• Through the play child develops , learns and ultimately maturates , it encourages emotional and social development
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Physical developmentIntellectual development
Moral development
Creative development
Therapeutic development
Social development
Play helps in…..
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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
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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
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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
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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
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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
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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
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Social development
• Social and emotional development is enhance through play
• Develop social relationship while playing in group
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types
Unoccupied play
Solitary play
Onlooker play
Parallel play
Associative play
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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
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Solitary play
• Independent play
• does not acknowledge what others are doing
• Pre toddlers and toddlers engage in this type of play
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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
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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
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Associative play
• Interaction occurs between children
• Learn to follow other children “borrow” and “ lending “ toys among other children
• typical in school age
children
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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
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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
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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
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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
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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
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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
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Contd...
• Adolescence engages in imaginative play• Like girls imagine themselves as a beautiful
heroines and boys thinks themselves a man.
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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
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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
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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
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Contd..
• From 10 to 12 months• Place infant in walker and encourage letting go• Provide crayons for drawing• Encourage infant to push a chair
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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
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Contd..
• Preschooler ( from 3 to 5 year)• Preschooler runs, climb • Boys and girls play dolls house imitating others
adults in the house
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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
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Contd..
• School age child• Plays more complex games like football,
cricket• Have same gender friends
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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.
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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.
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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
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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.
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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
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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
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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.
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