Are Intervention Programs Inadvertently Damaging Development Through “Therapeutic” Use of Toys?
PLAY AND THE IMPAIRED CHILD
“Play is a spontaneous act that involves interaction with objects or people in a pleasurable manner. It occurs across all environments and can be goal directed or free flowing” (Fewell, 1986). “Play includes an element of enjoyment, something that is done for fun… If it’s not fun, it’s not really play” (Musslewhite, 1986, p.26). While this occurs naturally for most non-impaired children, the disabled child’s difficulties or delays in self-direction and motivation often are inappropriately responded to by professionals who utilize intervention strategies that incorporate overly structured teacher-directed experiences. These experiences are mistitled “play” therapies and inhibit spontaneity, self-exploration and an internal focus of control.
As special educators we need to understand the role of play in psychological development and learning. Unless the well-documented information about the importance of play is incorporated into our “therapeutic” interventions, we risk the likelihood that these children indeed will be “handicapped;” we risk the possibility that our activities are actually more damaging than helpful. The greatest handicap is not the lack of a limb, muscle control, vision or hearing, but the loss of spontaneity and joy in discovery and learning and of the positive self-image, generated by a sense of mastery and competency.
Appropriate play experiences are child-directed and enhance self-esteem, socialization, communication, a sense of mastery and motor and concept development. A single play experience should incorporate all of these components versus tasks that are designed to focus on limited, specified concepts and skills. “Children’s learning does not occur in narrowly defined subject areas; their development and learning are integrated. Any activity that stimulates one dimension of development and learning affects other dimensions as well” (Bredekamp, 1987, p.3). “Teaching to the test” or intervention strategies that are rigidly copied from developmental checklists and assessment tools do not encourage spontaneous play and thus do not address the learning style and emotional needs of young children. And, most important, they place the fragile, burgeoning self-esteem and self-motivation of the impaired child at risk.
FSIP MODEL RATIONALE
Facilitated spontaneous interactional play (FSIP) is the model utilized in Braille Institute’s Child Development Services program. FSIP was developed for use with visually impaired infants and grew out of our concern that emotional development often is ignored or misunderstood in current intervention models While admittedly the title is stilted and academic, the goal of the strategy is to engage children in appropriate play experiences that facilitate development in all domains and promote autonomy, competency and a sense of joy in discovery and learning.
Although concept development is woven into the play experience, it is not the primary purpose of the activity. When an intervention is geared solely to the teaching of a concept, not only will the child be unable to generalize, he also will be put at risk by the factors previously noted. A child who has had colors drilled through a rigid teacher-directed activity will not readily transfer the concept to other projects in his world. A child who is engaged in an adult-directed object permanence task by being repeatedly requested to lift up a cloth covering a block will not integrate the concept and broadly understand it within the context of his whole cognitive and psychological being. He will not spontaneously open a kitchen cupboard to find the missing pots and pans to play with or master separation experiences with his parents.
Blind children often have a lesser degree of motivation to explore the environment because vision provides such a profound impetus to learn about the things we see. The sighted infant has the opportunity for constant visual input that entices him to reach out and explore objects and people. This action provides continual incidental learning experiences that exponentially build on his concept development and desire to explore. Thus play often needs to be facilitated for a blind child by an adult.
Facilitated play is the creation of the opportunity, the setting up of the environment. Appropriate facilitation of play is effected by continual observation and assessment of the child and continual adaptation by the adult in response to the child. The initial assessment provides the basis for the activity; however, ongoing assessments based on observation during play are essential and provide the information by which the adult modulates his interactions in response to the dynamic behaviors of the child.
Assessment includes establishing the following information about the child:
1. Communication Cues – How does the child tell you what he needs, is interested in or has an aversion to? The cues can be vocalizations, changes in body posture, minuscule muscle movements or twitches. Keen observations are essential, especially with multi-handicapped children.
2. Temperament and Pacing – Is the child slow to warm up? easily agitated? Does the child need additional response time because of motor or sensory limitations? Has the child just awakened or eaten?
3. Developmental Level – What are the areas of competency and of delay?
4. Preferred Sensory Modality – Does the child prefer tactile, auditory or visual experiences?
5. Preferred Interactions – Are there favorite games or play activities that can be expanded?
6. Preferred Play Objects and Mode of Play – Can a transitional object or significant toy be incorporated into the interaction? How does the child like to play?
Play is spontaneous when the initial impetus for the activity comes from the child. The role of the professional is to respond to the cues of the child, determine what is pleasurable for him and assess his competencies. Play is no longer fun and will not generate additional spontaneous curiosity if the child is unable to engage competently. If the child is frustrated and not able to master a game, the impetus toward future play is interrupted. Play can occur with any materials, situations, or persons. Thus the facilitation of spontaneous play begins with whatever the child is already involved in. The professional needs to blend in with the experience of the child and not alter it abruptly. Goals for motor, language or cognitive development must be incorporated into the ongoing activity. New activities or toys may be introduced gradually if the child is respectfully enticed to explore new things.
The issue of spontaneity is crucial, essential to the development of self-trust and a sense of mastery. Unless the infant begins to feel that his actions result in responses that are pleasurable and enhance his significant relationships, the primary task of infant development, “trust vs. mistrust” (Erikson, 1963), is not realized. Brazelton’s (1969) work eloquently demonstrates the delicate balance in infant relationships and the need for respectfully modulated adult responses that are based on the cues of the baby. It is another illustration of the spontaneity issue, and a primary consideration in the FSIP mode.
Visually impaired and multi-handicapped infants commonly need to have adults involved in their activities because they often have difficulty staying focused on a game and sustaining their play. The relationships between infant and adult can act as a motivator if the relationship is respectful and based on the factors outlined in facilitated play. The adult can expand on the experience and enhance learning and mastery through verbal feedback.
Since visually impaired children often are delayed in the development of affective responses such as smiling, laughing, and eye contact, the adult must be keenly aware of other minuscule cues. Adult responses to these infant-initiated cues validate the child’s involvement and self-worth and provide additional enticement for the child to engage with others. This results in the development of trusting relationships with significant others.
It is the adult’s responsibility, not the infant’s, to modulate her behavior to the temperament and need of the infant. “For any person to establish a mutual relationship with another person, it is essential that the two people share some type of common understanding. Young children are not capable of adjusting to adults as a basis for establishing a relationship with them. Consequently the quality of the relationship. . . is primarily dependent upon the adult adjusting downward to the child’s level. . . and is compatible with the child’s level of functioning. The quality of the play will be enhanced such that it will likely have maximum impact on the child’s rate of development” (Mahony & Powell, 1984, p.40).
PLAY INTERACTION OUTLINE
1. Adult observes child for preferred activities by noting body movement, smiles, vocalizations, eye contact and minuscule changes in behavior or position.
2. Adult considers social, vestibular and tactile events as possible play interactions.
3. Adult modifies her interactions and movements to fit the temperamental style and pacing of the child.
4. Adult provides opportunities for child to choose from a variety of activities and notes aforementioned behaviors to determine child’s preference.
5. Adult mediates play interaction by using appropriate language to interpret the experience (e.g., comments on the child’s actions, expands the child’s vocalizations and repeats key words or phrases).
6. Adult recognizes child’s attempts and intent and facilitates child’s successful completion of tasks by providing support, shared attention and close physical proximity. Clapping and verbal reinforcers such as “good boy” or “good play” are not relevant and thus not appropriate.
7. Adult provides stimulating opportunities for the child to use self-initiated repetition to practice and experience feelings of autonomy and success.
8. Adult recognizes that children learn from trial and error.
9. Adult offers assistance when and if necessary, based on the above ongoing observations and assessments.
As special educators we risk the possibility of inadvertently interrupting rather than promoting the child’s development through our intervention strategies. We need to reassess our models and ensure that the approaches used encourage spontaneous play that is respectful of the child’s temperamental style, competencies and preferences.
The use of toys alone does not accomplish this goal. Our play experiences should facilitate development in all areas and promote autonomy, mastery and a sense of joy in discovery and learning. When language, motor and concept skills are separated, and learning tasks are adult-initiated and highly structured, we risk the greatest damage of all. We are in danger of creating an individual who is truly handicapped – one who is dependent and rigid and who suffers from low self-esteem.
Brazelton, T.B. Infants and Mothers: Differences in Development. New York: Dell, 1969.
Bredekamp, S., ed. Developmentally Appropriate Practice in Early Childhood Programs Serving Children from Birth Through Age Eight. Washington, D.C.: NAEYC, 1987.
Erikson, E. Childhood and Society. New York: Norton, 1963.
Fewell, R. Presentation at the Council for Exceptional Children, Division of Early Childhood Conference, Louisville, KY, 1986.
Mahoney, G., and Powell, A. The Transactional Intervention Program: Preliminary Teachers Guide. Woodhaven, MI: T.O.T.E. Woodhaven School District, 1984.
Musselwhite, C. Adaptive Play for Special Needs Children. San Diego, CA: College Hill Press, 1986.
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