Occupational Therapy -> Play

Play

Play is an important occupation for children to provide learning, development, and joy. Play is activity engaged in by people across the lifespan providing fun, entertainment and enjoyment. Play can be completed individually or with others. Pediatric occupational therapists often focus on play as an intervention and a goal to promote learning, skill development, social participation, and regulation.

Minor focus areas

Skilled interventions

  • Play-Based Therapy

    Play-Based Therapy leverages the natural medium of play to facilitate developmental growth in children. This approach is particularly effective for young children, as it integrates learning with fun and creativity. Through imaginative play, constructive play, and interactive games, children enhance their cognitive, social, and motor skills. The therapy is individualized, allowing children to explore and learn at their own pace, while therapists guide and support their developmental journey in a nurturing environment.

    Therapeutic Activities Include:
    • Imaginative Play: Encouraging role-play and storytelling to enhance creativity and language skills.
    • Constructive Play: Building with blocks or other materials to develop fine motor skills and spatial awareness.
    • Interactive Games: Playing turn-taking games to improve social interaction and patience.
    These interventions are tailored to each child's unique needs and are designed to be engaging and developmentally appropriate, promoting overall growth and independence.

  • Visual Schedule

    Visual Schedules help individuals visualize the sequence of upcoming activities, providing a clear structure that can be followed throughout the day. This intervention is particularly effective in supporting transitions between activities, which can be challenging for some individuals. The schedules can be customized to include specific tasks, events, or routines, tailored to the user’s personal, educational, or therapeutic needs.

    The therapeutic use of Visual Schedules involves initially working with the individual to understand their typical day and identifying key activities that need structuring. The therapist then creates a schedule using appropriate symbols or pictures that the individual can easily recognize and understand. The schedule is placed in a prominent location, and the individual is taught how to refer to it throughout the day.

    Training with the Visual Schedule includes teaching the individual to check off or remove each completed activity, which reinforces a sense of accomplishment and control over their environment. This practice not only helps improve focus and organization but also supports emotional regulation by providing predictable and clear expectations.

Reference links

  • Occupational Therapy Practice Guidelines For Children and Youth Ages 5–21 Years 2
    research.aota.org     Author: Cahill and Beisbier - Collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes as guided by the evidence. Activity- and Occupation-Based Interventions to Support Activities of Daily Living, Instrumental Activities of Daily Living, Play and Leisure, and Rest and Sleep -Parent, school, and community involvement should be supported throughout the course of intervention, and pediatric services should be provided in the natural context of the child’s or youth’s routine and environments. -Engagement in daily occupations should remain the central focus of goals and intervention. Practitioners should use manualized programs that have clear activity- and occupation-based strategies as opposed to those that are solely focused on performance skills or client factors. -Practitioners should collaborate with clients and caregivers to establish meaningful occupation-based and achievable goals and use intentional strategies to maintain a collaborative relationship throughout the therapy process. -Consistent caregiver training and instruction should be provided to promote carryover, and the power of the caregiver to effect change and support the child should be emphasized. -Practitioners should follow up with children, parents, and teachers and provide ongoing coaching and feedback on performance. They should provide opportunities for collaborative problem solving and model strategies for ongoing problem solving in the home and community as new challenges arise. -Skills-based interventions should incorporate peer, family member, and practitioner interaction. -Small-group service delivery methods provide an opportunity for increased motivation and modeling. -Practitioners should explore interactive technology interventions, especially with clients with ASD and ADHD. The use of technology can be coupled with skills training and other evidence-based interventions. -The evaluation and occupational profile should include consideration of the quality of rest and sleep. -Rest and sleep should be addressed to enhance health and well-being and increase performance and participation in meaningful occupations. Activity- and Occupation-Based Interventions to Improve Mental Health, Positive Behavior, and Social Participation -Activity- and occupation-based interventions should be implemented to address the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. -Practitioners should use group service delivery models when providing intervention to children and youth with or at risk for mental health concerns. -Sports activities should be used to develop social interaction skills. -Practitioners should incorporate meditation practices and blogging when attempting to foster positive feelings about self in children and youth. -Manualized yoga programs or less structured yoga games and poses should be used when addressing the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Activity- and Occupation-Based Interventions to Improve Learning, Academic Achievement, and Successful Participation in School -Practitioners should incorporate peer support, such as peer tutoring and peer-mediated interventions, into occupational therapy interventions and provide services in typical school environments to promote social participation and academic performance. -Practitioners should emphasize the use of activity- and occupation-based approaches to improve learning, academic achievement, and successful participation in school. -Therapeutic practice should be favored over sensorimotor approaches for the development and remediation of handwriting and literacy skills and performance. -Weighted vests should be used with caution. Citation: Susan M. Cahill, Stephanie Beisbier; Occupational Therapy Practice Guidelines for Children and Youth Ages 5–21 Years. Am J Occup Ther July/August 2020, Vol. 74(4), 7404397010p1–7404397010p48. doi: https://doi.org/10.5014/ajot.2020.744001
  • Variables Related to Successful School-Based Practice 1
    www.nbcot.org     Author: Case-Smith, Jane.  - Three themes were identified: "Finding the key" described a procedural reasoning process in which the participants searched for the underlying reasons for each student's behaviors and performance. "The whole child" emphasized the importance of the student's psychosocial core and described the therapist's use of interactive and conditional reasoning to form supportive relationships with their students. Because each participant valued the student's vision of a new self, she was able to help the student achieve new social roles and improved self-esteem. "Whose success is this?" told of the importance of a cohesive team, which included the parents, to the child's success. The child's achievement of important life goals and success as a student seemed to be the result of a team effort to which occupational therapy contributed.
  • Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation For Children and Youth: A Systematic Review 2
    research.aota.org     Author: Cahill, Egan and Seber - Productive occupations and life skills, sports, and yoga addressed mental health, positive behavior, and social participation for children and youth with and at risk for mental health concerns. Moderate-strength evidence suggests that yoga can be used to address mental health, positive behavior, and social participation of children and youth. Low- to moderate-strength evidence suggests that productive occupations and life skills training can be used to address mental health, positive behavior, and social participation. Moderate-strength evidence supports the use of play and creative arts. Activity- and occupation-based interventions should be implemented to address the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Practitioners should use group service delivery models when providing intervention to children and youth with or at risk for mental health concerns. Sports activities should be used to develop social interaction skills. Practitioners should incorporate meditation practices and blogging when attempting to foster positive feelings about self in children and youth. Manualized yoga programs or less structured yoga games and poses should be used when addressing the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Citation: Susan M. Cahill, Brad E. Egan, Joanna Seber; Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation for Children and Youth: A Systematic Review. Am J Occup Ther March/April 2020, Vol. 74(2), 7402180020p1–7402180020p28. doi: https://doi.org/10.5014/ajot.2020.038687
  • Scope of Occupational Therapy Services For Individuals With Autism Spectrum Disorder Across the Life Course 1
    research.aota.org     Author: Copyright © 2015 By the American Occupational Therapy Association, Inc. The American Journal of Occupational Therapy, 2015, Vol. 69(Supplement_3), 6913410054p1–6913410054p12. - Occupational Therapy practitioners work collaboratively with individuals on the autism spectrum, their families, OTHER PROFESSIONALS, organizations, and community members in multiple contexts to advocate for and provide a range of needed resources and services that support individuals' ability to participate fully in life (Case-Smith & Ambersman, 2008; Kuhaneck, Madonna, Novak, & Pearson, 2015; Tanner Hand, O'Toole, & Lane, 2015; Watling & Hauer, 2015a; Weaver, 2015). According to a study conducted by the Interactive Autism Network (2011), occupational therapy ranks second to speech-language pathology as the most frequently provided service for individuals with autism throughout the United States.
  • Nurturing Care For Early Childhood Development 1
    cdn.who.int     Author: World Health Organization - Your loving care as a parent is what a child needs to be healthy, wellnourished and safe. • Communicate early and often, starting even before your baby is born. It will help you build a warm and loving relationship. • Make time to play with your child and engage them in your daily chores. You will help your child to learn, be happy and thrive. • Remember that feeding times are periods of learning and love – talk to your child while feeding and make eye to eye contact. • If you feel sad and unable to respond joyfully to your child, seek help from your health care provider.
  • Why Do the Children (Pretend) Play? 1
    ctheory.sitehost.iu.edu     Author: Angeline S. Lillard - Pretend play appears to be an evolved behavior because it is universal and appears on a set schedule. However, no specific functions have been determined for pretend play and empirical tests for its functions in humans are elusive. Yet animal play fighting can serve as an analog, as both activities involve as-if, metacommunicative signaling and symbolism. In the rat and some other animals, adaptive functions of play fighting include assisting social behavior and emotion regulation. Research is presented suggesting that pretend play might serve similar functions for humans.
  • Learning Through Play 0
    www.aota.org     Author: AOTA - AOTA Tip sheet about the occupation of play. Sensory rich play, manipulative play, imaginative and pretend play, and the just right challenge
  • Occupation- and Activity-Based Interventions to Improve Performance of Activities of Daily Living, Play, and Leisure For Children and Youth Ages 5 to 21: A Systematic Review 2
    research.aota.org     Author: Laverdure and Beisbier - Strong evidence indicates that engagement in occupations and activities, practice within and across environments, and coaching and feedback improve participation and performance in ADLs and functional mobility. Moderate evidence supports the use of collaborative goal setting, modeling, and guided participation in play and leisure. Moderate evidence also supports technological interventions for ADL, play, and leisure performance. Collaborating with clients and caregivers on the development of goals and intervention plans Providing caregiver training in the implementation, carryover, and transfer of occupation- and activity-based interventions in meaningful contexts Providing training and feedback to support client initiation of and engagement in occupational tasks and routines Embedding occupation- and activity-based interventions in natural routines, contexts, and environments and with naturally occurring social partners (e.g., caregivers, peers) Guiding and structuring occupation- and activity-based intervention and considering the use of technology (e.g., video modeling, virtual reality, and video game training interventions) to support and reinforce occupational participation and performance Instructing caregivers in the structured practice and provision of coaching and feedback on ADL skills in home and community settings. Citation: Patricia Laverdure, Stephanie Beisbier; Occupation- and Activity-Based Interventions to Improve Performance of Activities of Daily Living, Play, and Leisure for Children and Youth Ages 5 to 21: A Systematic Review. Am J Occup Ther January/February 2021, Vol. 75(1), 7501205050p1–7501205050p24. doi: https://doi.org/10.5014/ajot.2021.039560
  • Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review 2
    research.aota.org     Author: Schaaf, Dumont, Arbesman, & May-Benson - The evidence is strong that ASI intervention demonstrates positive outcomes for improving individually generated goals of functioning and participation as measured by Goal Attainment Scaling (GAS) for children with autism. Moderate evidence supported improvements in impairment-level outcomes of improvement in autistic behaviors and skills-based outcomes of reduction in caregiver assistance with self-care activities Citation: Roseann C. Schaaf, Rachel L. Dumont, Marian Arbesman, Teresa A. May-Benson; Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review. Am J Occup Ther January/February 2018, Vol. 72(1), 7201190010p1–7201190010p10. doi: https://doi.org/10.5014/ajot.2018.028431
  • Intervention Strategies For Anxiety In Children: A Summary of the Evidence 2
    research.aota.org     Author: Handojo, Hsu-Nazzal, Kabbani, Swinth, Tomlin, and Brubaker - Treatment of Anxiety in Children. Interventions include cognitive–behavioral strategies, occupation-based and child-centered play interventions, yoga, and music. These may improve functional performance and participation. Social skills and the ability to build high-quality friendships effectively supplement anxiety interventions. Citation: Nina Handojo, Christine Hsu-Nazzal, Nadia Kabbani, Yvonne Swinth, George Tomlin, Kristen Brubaker; Intervention Strategies for Anxiety in Children: A Summary of the Evidence. Am J Occup Ther July 2017, Vol. 71(4_Supplement_1), 7111520273p1. doi: https://doi.org/10.5014/ajot.2017.71S1-PO1052
  • Nurturing Care For Early Childhood Development 1
    www.who.int     Author: World Health Organization - Your loving care as a parent is what a child needs to be healthy, wellnourished and safe. • Communicate early and often, starting even before your baby is born. It will help you build a warm and loving relationship. • Make time to play with your child and engage them in your daily chores. You will help your child to learn, be happy and thrive. • Remember that feeding times are periods of learning and love – talk to your child while feeding and make eye-to-eye contact. • If you feel sad and unable to respond joyfully to your child, seek help from your health care provider

Activity List(s)

Visual Schedule Cards