With the release of our play guideline for OTs, we are privileged that Dr Naomi Graham, a children's OT and member of our play guideline development group, has volunteered a guest blog about the importance of play.
Dr Graham is a children’s occupational therapist and the Founder & CEO of Growing Hope, a charity providing free therapy for children and young people with additional needs and their families – in partnership with local churches across the UK.
Naomi loved being a part of the play guideline development group in order to help champion play in occupational therapy.
Play is an essential part of my role as a children’s occupational therapist. The play guideline backs this up, providing a summary of research around the importance of play for children and ways in which we can champion play in our practice.
I often say to people ‘I love my job, I get to spend lots of my day playing!’
It can involve things like crawling around on the floor pretending to be a bear or a crab, creating an obstacle course with pretend lasers I have to avoid, or popping bubbles and creating play opportunities with messy play. A brilliant OT once said to me that families should look at your therapy sessions and think you’re just playing.
Play is a primary occupation for children. It’s through play that we enable opportunities for learning, engagement, motivation, social interaction and development of social skills. As I play with children at Growing Hope, I spend time explaining out loud to parents why we are playing in a particular way and what it is that we’re working on. Being a part of the play guideline development group with RCOT enabled me to learn and share with other OT’s who are passionate about play.
I promote play for play's sake, as well as demonstrating to parents how therapy goals do not need to be considered as work, but can be a part of everyday play.
I spent time videoing and interviewing children who have cerebral palsy as part of my PhD. During these interviews children talked to me about their experience of playing and engaging in play in different ways. Despite their high levels of physical disability, which meant they needed physical support and facilitation, not one child talked about not being able to play. This opened my eyes to the importance of play from the perspective of the player which is something we discuss in the guideline.
Whilst I’m working with a child I am always trying to understand each child’s experience of play. I promote play for plays sake, as well as demonstrating to parents how therapy goals do not need to be considered as work, but can be a part of everyday play. For example, we often talk about playing games at bath time with shaving foam on the side of the bath to practice drawing car tracks and patterns in the foam to support letter formations and handwriting development.
I love the moments that I have in clinic where the opportunity to play leads to break through in a therapy session.
Aaron*, a three year old boy who I’ve worked with recently, has experienced trauma and is currently non-verbal, he seeks out a lot of movement activities and both his mum and his nursery were struggling to cope with his outbursts. Aaron spent his first four occupational therapy sessions screaming, throwing toys and becoming upset because he did not want to follow instructions. We’d been trying to work out what would best support Aaron to feel safe and to be able to join in. For his fifth session we decided to try something totally different. We reduced the amount of equipment and toys in the room and I agreed with Mum that we wouldn’t talk, but we’d base our session on following Aaron’s lead. This play focused, child led, and intensive interaction approach was transformative for Aaron. He was able to calmly enter the room and engaged actively in play and interaction with both me and his mum. For the first time in a long time, Aaron led a play sequence with his mum, making silly faces at her which she then was able to copy. It was a joy to see the impact of play for Aaron in the way it enabled him to re-connect with his mum and safely explore the room.
The more children are able to play as part of working towards their therapy goals the more this is incorporated into their day to day life with their families.
The play guideline provides an extensive literature review and recommendations which occupational therapists can discover and put into practice. It highlights areas in which we can consider the importance of play as well as areas in which more research is needed. As a children’s occupational therapist, play is a bread and butter part of our work – this guideline provides a basis which backs up and informs this.
*Pseudonyms have been used in this blog.
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Our sincere thanks to Dr Naomi Graham for her insight and thanks again to the amazing work of all those who contributed to our play guidelines.