Child's play: an assessment parameter

1 Nov 2003

We are so used to seeing children and infants play that we tend to overlook its importance. How often do we hear the phrase 'it’s child’s play'? Any busy active baby demonstrates that it is anything but simple and straightforward. Play is the child’s daily work and part of their development. While it is easy to understand that children play for pleasure, they may also use play to act out the struggles they face on a daily basis (Winnicott, 1964), and make life real and meaningful.

Through play, children can learn to deal with and feel in control of real experiences, fears as well as aggression. There is a great drive to persevere to a real and desired end, to overcome difficulties and to concentrate on the matter in hand. Play is therefore a powerful and expressive tool by which we, as clinicians, can assess, engage, intervene and understand children’s daily struggles.

What constitutes play?

Babies come into the world with a general readiness to engage socially (Murray, Andrews, 2001). The baby begins to discover its environment and capabilities by touch, taste, sight, hearing, smell and movement. Play is not something parents generally need to worry about 'learning' or 'teaching' their baby. Any interaction between the child and the outside world may be deemed play.

A child or baby that is engrossed in something usually gets absorbed intensely in what they are doing. Opportunities for play behaviour enable the child to seek levels of stimulation that lead to cognitive behaviour, or to avoid or cope with unpleasant stressful situations. Play may be as simple as the infant following a mother’s face as she turns away to pick something up or reaching out to touch a rattle shown to him/her.

Focusing and paying attention to toys and people as well as everyday objects, is the basis of understanding the broader world. Providing an object for the baby’s viewing, seeing if he/she can follow it, or reaching out to grasp it, is all play that is aiding the infant’s cognition. The infant using his/her voice to babble is 'playing' with the sounds he/she produces. Our talking back to him/her, imitating, gives meaning and engages him/her in play. Play is the infant’s tool, and when we relate to the infant with play that is thoughtfully about him/her, the infant has a sense of being 'met' and this conveys a message to him/her (Thomson-Salo et al, 1999).

Young children may play out their anxiety and new experiences through play. The infant or young child, struggling with unpleasant feeding experiences (e.g. excessive vomiting) may respond by only feeding while distracted by toys, or 'switch off' and stare at an object to help him/her 'get through' the experience. Alternately they may 'play' with the breast or bottle before they settle in to the feed. Expecting them to feed 'properly' may impinge on their way of developing confidence about the coming feed. By being in control of what goes in may make it easier to take in more.

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