Conceptual clarification of the playful engagement in social interaction of preschool-aged children with autism spectrum disorder (ASD)

Children with autism spectrum disorder (ASD) demonstrate limited playfulness. Their difficulty engaging in meaningful interaction with others renders playful engagement in social interactions a challenge. Although little direct evidence exists regarding the promotion of these children’s playful engagement, links can be established with many traits cited in play and social interaction studies. This paper presents the results of a conceptual clarification exercise regarding the key behaviours associated with the construct of playful engagement in preschool-aged children with ASD. Behaviours were identified based on hallmark deficits in early social interactions and play of children with ASD. The analysis revealed the following behaviours: positive affect, engagement, imitation, joint attention, initiation of social interaction, social responsiveness, flexibility, child’s laughter in funny situations and giving and reading non-verbal cues. In conclusion, a conceptually coherent stage has been set for exploring the literature regarding interventions to promote the playful engagement of preschool-aged children with ASD.     

"I'm glad I'm not young anymore"

The author, a physician in late middle age reflects on his own medical career, the aging of those who have taught him and also of those whom he has taught. He describes the sense of ennui and déjà vu. The things that seemed important as a younger doctor seem less important. He has adopted a different paradigm and has come to see that both playfulness and integrity are essential ingredients for health. As a sailor, he more keenly appreciates the struggles our patients and colleagues have with illness and draws an analog between sailing and life.     

The creative role of playfulness in development

Abstract

This paper explores how two children of different ages, races and backgrounds were helped in their development through a creative use of play. It reflects on play as an interpersonal phenomenon and also on its significance in relation to a specific aspect of it: playfulness. There is a kind of joyful joined up play between mother and child which promotes growth and healthy development. This paper investigates how, in this sort of play, important maternal functions take place and how a relationship between container and contained can generate – as Bion conceptualised it – mental growth.     

Playfulness in Children with Traumatic Brain Injury

The sequelae of paediatric traumatic brain injury (TBI) are well documented as being permanent and pervasive. The impact, however, on how a child approaches the childhood occupation of play, termed 'playfulness,' has been neglected. This prospective analysis of difference study used the Test of Playfulness to compare the playfulness of eight children aged 3-13 years diagnosed with moderate to severe TBI to an age-matched control group. Using Rasch analysis, the TBI group did demonstrate the behaviour of playfulness, but to a significantly lower extent than the control group (Wilcoxon matched-pairs signed-ranks (T(8) = 0, p= .012). The findings suggest that playfulness is negatively impacted by TBI, and that strategies to legitimise and optimise playfulness be incorporated into therapy practice for this population.     

The Frog and Toad stories of Arnold Lobel: a psychoanalytic perspective

Arnold Lobel (1933–1987) was an American author and illustrator of picture books for children. Unlike his contemporary, Maurice Sendak, Lobel spoke little about his own work. Perhaps for this reason and perhaps because of the muted nature of Lobel’s style, his books have not received wider critical attention, particularly from those looking at the intersection of psychoanalysis and children’s literature. But Lobel’s later work, most notably his series of four books about Frog and Toad, warrant closer examination. Lobel was always clear that the best children’s books ‘strike deep’ and that ‘underneath there is something much more’. While never losing their playful quality, the Frog and Toad stories engage both child and adult readers at a more profound level. This deeper level of engagement owes much to the psychoanalytic ideas that are embodied throughout. Reference primarily to D.W. Winnicott will be made and the relationship between children’s literature, in particular the picture book, and psychoanalysis will be considered. After exploring Lobel’s background, influences and style, attention will be given to the many and varied roles that Frog and Toad may represent. A close reading of three stories will be used to illustrate the psychoanalytic ideas that may lie ‘underneath’.     

Preliminary Efficacy of a Friendly Constraint-Induced Therapy (Friendly-CIT) Program on Motor and Psychosocial Outcomes in Children with Cerebral Palsy

Aims: Constraint-induced therapy (CIT) is effective, but concerns have been repeatedly raised regarding the generalizability, feasibility, and potentially intrusive nature of restraining a child's unimpaired upper limb. We examined the feasibility and efficacy of friendly-CIT, which uses home-based model, a caregiver-determined schedule, and gentle restraint, in children with cerebral palsy. Methods: In a one-group pre-post intervention trial, 15 children (median of age = 8 years, 4 months) participated in 8 weeks of friendly-CIT (36 hours). Motor and psychosocial outcomes were investigated. Results: Participants showed significant improvement on the manual dexterity subtest of the Bruininks-Oseretsky Test of Motor Proficiency (p = 0.004); the how often (p = 0.01) and how well (p = 0.02) scales of the Revised Pediatric Motor Activity Log; and the functional skills score on the Chinese version of the Pediatric Evaluation of Disability Inventory (p = 0.002). For psychosocial outcomes, children with CP consistently demonstrated high engagement and increased playfulness (p < 0.0001) during the 8-week intervention. Parents showed no change in stress status and high satisfaction with friendly-CIT. Conclusion: Friendly-CIT is feasible and promising for improving a child's motor and psychosocial outcomes without increasing parental stress.     

A Taxonomy of Playfulness for use in Occupational Therapy

Occupational therapy intervention requires the active involvement of clients for beneficial effects on their health to occur. Clients may be reluctant to participate in selected activities, however. Focussing on a play context, consideration is given to facilitating client motivation to engage in play activity. A taxonomy of playfulness is presented and its application in practice discussed.     

Interventions to promote the playful engagement in social interaction of preschool-aged children with autism spectrum disorder (ASD): a scoping study

ABSTRACT

Children with autism spectrum disorder (ASD) experience significant difficulties engaging in meaningful play. Although enabling their playful engagement in social interactions is an important objective, little is known about which interventions effectively promote it. The aim of this was study to conduct a scoping study to map the breadth and summarize the research evidence regarding interventions that promote the playful engagement of preschool-aged children with ASD with adult play partners. Arksey and O’Malley’s (2005) methodological framework for scoping studies was used. Literature from January 2000–December 2015 was included. The results of this study revealed a considerable number and variety of strategies as well as intervention approaches that are coherent with the promotion of playful engagement. The conceptually based approach used allowed the integration of the literature from different perspectives. The results provide specific guidance to therapists and parents on strategies that may be embedded in their daily interactions with these children.     

Caregivers' playfulness and infants' emotional stress during transitional time

The purpose of this study is to explore the playfulness of the teachers of infants and its relations to infants' emotional distress during the transitional time at a child care centre. The study used a qualitative case study. Two infant caregivers in a university-based child care centre participated in this study. For the three-month research period, observations, interviews, ongoing conversations, email exchanges and field notes were used as data sources. The findings revealed that the infant caregivers' playfulness appeared in a wide range of verbal and non-verbal behaviours, gestures and expressions. Also, the caregivers' playfulness helped to alleviate infants' emotional distress and made smooth transitions to new experiences. The study suggests playfulness is a constructive way for infants to build up the relationship between infants and teachers.