Elizabeth Bing, PhD Clinical Psychologist Play is the primary childhood occupation (Case-Smith & Miller Kuhanek, 2008) Play is an indication of developmental level (Sparling, Walker, & Singdahlsen, 1984) Play has been linked to growth in memory, self control, symbol identification, oral language, and increased academic & literacy abilities Leong & Bodrova, (2005). Play skills have been linked to language in typically developing children (Lewis, Boucher, Lupton, & Watson, 2000) Reciprocal interaction between language and play (Sigman & McGovern, 2000) Play skills are important in the development of social competence (Stone & LaGreca, 1986) by allowing children to explore social roles and rules (Sroufe, Cooper, & DeHart, 1996) Although typically developing children naturally engage in play, children with autism do not engage in play activities that stimulate their development (Lantz, Nelson, & Loftin, 2004). Primary goal: developing social competence ◦ Improving reciprocity in social interactions ◦ Boundaries and limits ◦ Cooperation ◦ Communication (reciprocal language/pragmatic language) Additional Goals: ◦ Developing a sense of mastery, positive self-esteem ◦ Improvement of positive affect through absorption in activities ◦ Developmental: cognitive, speech/language, fine/gross motor, functional leisure skills Particular ASD diagnosis Age/developmental level Cognitive functioning Speech/language abilities Gross/fine motor abilities Sensory issues Play skills & level of play: solitary, parallel, imaginative Associated mental health issues: mood instability, behavioral issues, oppositionality, anxiety, depression, low self-esteem Interview parents Observe the child with and without parents Read school records Read Evaluation Team Reports Read mental health records Goals Current Status Desired Outcome Client: Luke Rogers Date: 4/20/10 Play Therapy Goals Goal Current Status Desired outcome Improve social competence Controlling; rigid Improvements in reciprocity Improve oppositionality Tends to resist outside intervention Accepts intervention Improve play behaviors Controlling & rigid in play Improve ability to observe incorporate play behaviors of therapist Client: Annie Walker Date: 10/28/10 Play Therapy Goals Goals Current Status Desired Outcome Improve social competence Problems in reciprocity, eye contact Improvements in reciprocal play, improved eye contact Improve play skills Client has limited play behaviors Improve variety of play behaviors Improve communication/social language Client has limited verbal skills Improvements in receptive/expressive language during play 1) Nondirective Play (Landreth): child- directed, observing, tracking, reflecting feelings 2) Semi-Structured Play 3) Directive or Structured Play Use of Scaffolding in semi- structured/directive Blend the techniques to address goals that you have selected Scaffolding is a concept originated in Vygotsky’s work, although he never used the term Definition: interactional support and the process by which adults mediate a child’s attempts to take on new learning has come to be termed “scaffolding.” Scaffolding represents the helpful interactions between adult and child that enable the child to do something beyond his or her independent efforts. A scaffold is a temporary framework that is put up for support and access to meaning and taken away as needed when the child secures control of success with a task. Cazden (1983) defined a scaffold as “a temporary framework for construction in progress”. For example, parents seem to know intuitively how to scaffold their children’s attempts at negotiating meaning through oral language. The construction of a scaffold occurs at a time where the child may not be able to articulate or explore learning independently. The scaffolds provided by the tutor do not change the nature or difficulty level of the task; instead, the scaffolds provided allow the student to successfully complete the task. Involves the use of prompts: Verbal Point Touch Physical (partial to full) Physical assistance to build a block tower that matches the child’s ability to stack, provision of the most minimal assistance necessary to provide for a successful stack. Pointing to game board spaces during counting for a child who does not understand one-to-one correspondence enough to move their game piece. Minimal verbal prompts or models to encourage a child to label the name of the toy with which he is playing Partial assistance in opening or manipulating toys when fine motor skills are not sufficient to play successfully. Providing a child with a social model for how to take turns while playing, encouraging them to look and listen to what you are doing as well as their own activity. Providing a verbal cue regarding social skills – “friends play with the ball together” to encourage this understanding Select toys based on the child Basic ideas: ◦ Blocks ◦ Sand ◦ Small dolls & dollhouse ◦ Simple games ◦ Board games ◦ Toy animals ◦ Drawing tools ◦ Clay or playdough ◦ Manipulative/sensory toys for younger ages/developmental levels Follow the child: watch and listen ◦ Be a good observer ◦ Look at strengths and weaknesses ◦ Look for a chance to intervene with structure ◦ Take it one level up (scaffolding) ◦ Observe the effects of your intervention and respond accordingly What Goals will this address? Know your limits and boundaries ◦ Enforce them consistently ◦ Enforce them compassionately What goals will this address? Pace Your Interventions and interactions ◦ Watch for opportunities to introduce new/different interventions or tasks ◦ Make communications important, interesting, and salient ◦ Observe the child & how he/she is responding and change your behavior accordingly What Goals will this address? Exhibit positive coping skills when there are difficulties or adverse reactions ◦ Encourage a change of task ◦ Make a task easier ◦ Assist in distracting the child ◦ Be positive in your verbalizations & interactions What goals will this address? Have the child finish a product successfully to encourage mastery, however small ◦ Encourage finishing a block tower ◦ Encourage completing a drawing ◦ Encourage finishing a game or stopping at a designated point What goals will this address? Provide positive reinforcement ◦ Praise improvements for achievements ◦ With verbal children, verbally identify their improvements ◦ Use judiciously, not constantly What goals will this address? What goals did I address? What improvements did I observe? Were any new goals identified?