Journal of Occupational Therapy, Schools, & Early

Intervention

ISSN: 1941-1243 (Print) 1941-1251 (Online) Journal homepage: http://www.tandfonline.com/loi/wjot20

The importance of play

Olga Nestor & Christy Szczech Moser

To cite this article: Olga Nestor & Christy Szczech Moser (2018): The importance of play, Journal
of Occupational Therapy, Schools, & Early Intervention, DOI: 10.1080/19411243.2018.1472861

To link to this article: https://doi.org/10.1080/19411243.2018.1472861

Published online: 31 May 2018.

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JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION
https://doi.org/10.1080/19411243.2018.1472861

The importance of play

Olga Nestor, OTD, OTR/L and Christy Szczech Moser, PhD., OTR/L, FAOTA
Occupational Therapy Department, Concordia University Wisconsin, Mequon, WI, USA

ABSTRACT KEYWORDS
This review will explore the importance of play and its impact on the Play; importance of play;
health and well-being of children of all ages. Evidence that supports occupational therapy; play
the importance of play will be highlighted. Additional resources will evaluations
be provided to assist parents, caregivers, and professionals on how to
utilize play strategies in the everyday experiences of children.

Play is often referred to when describing an action of a child, however, play is an activity
that can and should follow us into adulthood. Play is defined by Parham and Fazio
(2008) as:
any spontaneous or organized activity that provides enjoyment, entertainment, amusement or
diversion. It is an attitude or mode of experience that involves intrinsic motivation, emphasis
on process rather than product and internal rather than external control and an ‘as if’ or
pretend element. It takes place in a safe, non-threatening environment with social sanctions
(p.448).

As noted in the Declaration of the Rights of the Child (1959), the United Nations has
promoted the entitlements of children (which includes the right of each child to play). As
play is such an integral part of a child’s life, we decided to dedicate this Reviews, Tools, and
Resources submission to exploring the importance of play and the role we can take as
occupational therapists in ensuring each child’s ability to play. We will share research
findings, helpful techniques to engage children in playful activities, and resources that
address the importance of play. We hope you find this information beneficial and that you
will be able to utilize it in your current practice.
When looking through an occupational therapist lens, play itself is therapeutic in
nature. It encompasses individuality, skill building, cognitive reasoning, self-expression,
and skill mastery. Play is a child’s occupation where the child can experience flow and
participate in a meaningful and personal experience. We will start with a variety of
research studies that have explored the many facets of play.

Research findings
This first group of articles will highlight research that included children from birth and
their engagement in playful activities.
Case-Smith, J., & Kuhaneck, H. M. (2008). Play preferences of typically developing
children and children with developmental delays between ages 3 and 7 years. Occupational

CONTACT Christy Szczech Moser Christine.Moser@cuw.edu

© 2018 Taylor & Francis
2 O. NESTOR AND C. S. MOSER

Therapy Journal of Research, 28(1), 19-29. Retrieved from http://search.proquest.com.cuw.

ezproxy.switchinc.org/docview/220301651?accountid=10249
The purpose of this study was to examine play preferences of children. The authors
considered gender differences, age groups, and children with and without developmental
delays (n = 166). The authors found that same age, different gender, typically developing
peers preferred similar activities such as drawing, dolls/action figures, and then video
games. Children with developmental delays preferred rough and tumble play and toy
exploration.
Fabrizi, S., & Hubbell, K. (2017). The role of occupational therapy in promoting
playfulness, parent competence, and social participation in earl childhood playgroups: A
pretest posttest design. Journal of Occupational Therapy, Schools, & Early Intervention, 10
(4), 346-365.
Fabrizi and Hubbell explore the impact of community-based playgroups, looking at
both child and parent outcomes. As an occupational therapist you may want to consider
implementing a similar type of playgroup in your own community utilizing the findings
from this study.
Fabrizi, S. E., Ito, M. A., & Winston, K. (2016). Effect of occupational therapy–led
playgroups in early intervention on child playfulness and caregiver responsiveness: A
repeated-measures design. American Journal of Occupational Therapy, 70(2),
7002220020. Retrieved from http://dx.doi.org/10.5014/ajot.2016.017012
The purpose of this study was to examine the effects of an OT led community
playgroup on playfulness of children with special needs and the responsiveness of their
caregivers. The researchers found that there was a positive impact on the children’s
playfulness. However, less change was noted in the care givers’ responses.
Graham, N. E., Truman, J., & Holgate, H. (2015). Parents’ understanding of play for
children with cerebral palsy. American Journal of Occupational Therapy, 69(3),
6903220050. http://dx.doi.org/10.5014/ajot.2015.015263
The purpose of this study was to explore parents’ (n = 7) understanding of how their
child with severe cerebral palsy plays. Graham and Truman also explored parents’ under-
standing of how play is used as a therapeutic tool within therapy and home programs. It
was found that through an in-depth examination, the parents had a complex under-
standing of the importance of play and its uses in therapy.
Hofferth, S. L. (2009) Media use vs. work and play in middle childhood. Social
Indicators Research, 93(1), 127-129. Retrieved from doi:http://dx.doi.org.cuw.ezproxy.
switchinc.org/10.1007/s11205-008-9414-5
The purpose of this study was to examine the hypothesis of media displacement (which
postulates that media displaces reading, studying, physical activity and play activities). The
results demonstrated an increase in media (computers, video games, and television)
decreases the amount of time children spend reading, studying, outdoor activities, playing,
and sleep.
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 3

Lifter, K., Foster-Sanda, S., Arzamarski, C., Briesch, J., & McClure, E. (2011). Overview
of play: Its uses and importance in early intervention/early childhood special education.
Infants and Young Children, 24(3), 225. Retrieved from http://search.proquest.com.cuw.
ezproxy.switchinc.org/docview/878642411?accountid=10249
The authors highlight the theoretical research and policy background that explains
what is known about the development of children’s play as well as play in the early
intervention/early childhood special education area, assessments, interventions, and cur-
riculum relating to play.
Lifter, K., Mason, E. J., & Barton, E. E. (2011). Children’s play: Where we have been and
where we could go. Journal of Early Intervention, 33(4), 281-297. Retrieved from https://
search.proquest.com/docview/921333593?accountid=143111
The importance of play as an intervention for children with disabilities is reviewed. The
authors present an argument that play is absent from public law PL 99–457, and that
integrating the behavior and constructivist perspectives are necessary to clarify what play
is and how it is used.
Miller, L. J., Schoen, S., Camarata, S., McConkey, J., Kanics, I., Valdez, A., & Hampton,
S. (2017). Play in natural environments: A pilot study quantifying the behavior of children
on playground equipment. Journal of Occupational Therapy, Schools, & Early Intervention,
10(3). 213-231.
A very interesting exploration of the utilization of specific pieces of playground equip-
ment and its therapeutic impact on children.
Miller, E., & Kuhaneck, H. (2008). Children’s perceptions of play experiences and play
preferences: A qualitative study. The American Journal of Occupational Therapy, 62(4),
407-15. Retrieved from http://search.proquest.com.cuw.ezproxy.switchinc.org/docview/
231970776?accountid=10249
The purpose of the study was to examine children’s (n = 10) perception of play, what
play means to children and the reason for their play choices. The authors found that
children preferred to play with others, they enjoyed social games with rules, playing
computer games with peers, and playing with same age/gender individuals as themselves.
Miller and Kuhaneck also discovered that participants preferred to participate in activities
that matched their ability and level of difficulty in order to achieve success.
Stagnitti, K., & Unsworth, C. (2000). The importance of pretend play in child devel-
opment: An occupational therapy perspective. British Journal of Occupational Therapy, 63
(3), 121-127.
The authors explored the importance of play through an occupational therapy lens. The
authors discuss the importance of play and occupational therapy skills necessary for
pretend play and issues which impair participation in play. The therapist is able to assess
the child’s cognitive, social, emotional, and motor skills to determine impairments in the
child’s ability to participate in play. It is imperative for occupational therapists to identify,
address, and reduce participation restrictions in order for children to participate as fully as
possible in pretend play.
4 O. NESTOR AND C. S. MOSER

Tanner, K., Hand, B. N., O’Toole, G., & Lane, A. E. (2015). Effectiveness of interven-
tions to improve social participation, play, leisure, and restricted and repetitive behaviors
in people with autism spectrum disorder: A systematic review. American Journal of
Occupational Therapy, 69(5), 6905180010. Retrieved from http://dx.doi.org/10.5014/ajot.
2015.017806
A systematic review was completed to examine interventions that could potentially
address the difficulties that people with autism experience with social participation, play,
and leisure activities. Restricting repetitive movement behaviors that interfere with occu-
pational performance were also examined. The authors identified well supported inter-
ventions to improve social communication and social skills which are within the scope of
occupational therapy.
Watts, T., Stagnitti, K., & Brown, T. (2014). Relationship between play and sensory
processing: A systematic review. The American Journal of Occupational Therapy, 68(2),
e37-46. Retrieved from http://search.proquest.com.cuw.ezproxy.switchinc.org/docview/
1509022602?accountid=10249
The authors reviewed eight articles with the purpose of answering research questions
regarding play preferences, delayed levels of play, and measurement and response to play
and sensory processing. The implications to practice that were noted by the authors were
guiding therapy focus and treatment interventions based on evidence based practice.

Adolescents
The following studies included older children and include the impact of electronic
gaming.
Adachi, P. J., C., & Willoughby, T. (2013). More than just fun and games: The long-
itudinal relationships between strategic video games, self-reported problem solving skills,
and academic grades. Journal of Youth and Adolescence, 42(7), 1041-52. doi:http://dx.doi.
org.cuw.ezproxy.switchinc.org/10.1007/s10964-013-9913-9
This study is one of the first to discover a relationship between strategic (not fast paced)
video game play and self-reported problem solving skills. The authors found that there is a
positive indirect relationship between video game playing and academic grades. The
authors found that four high school years of playing strategic video games enhanced
adolescents’ self-reported problem solving skills. An increase of academic grades was also
noted (n = 1,492 students).
Adachi, P. J., C., & Willoughby, T. (2014). It’s not how much you play, but how much
you enjoy the game: The longitudinal associations between adolescents’ self-esteem and
the frequency versus enjoyment of involvement in sports. Journal of Youth and
Adolescence, 43(1), 137-45. doi:http://dx.doi.org.cuw.ezproxy.switchinc.org/10.1007/
s10964-013-9988-3
The authors explored two questions:
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 5

(1) Does self-esteem predict frequency of involvement in sports over time or does
frequency of involvement in sports predict self-esteem over time?
(2) Is there an association between the enjoyment of sports and self-esteem over time?

The authors concluded that self-esteem predicted the frequency of involvement in sports
over time, while the frequency of involvement in sports did not predict self-esteem over
time. They also found that the enjoyment of sports predicted self-esteem over time
(n = 1,492).
Adachi, P. J., C., & Willoughby, T. (2016). Does playing sports video games predict
increased involvement in real-life sports over several years among older adolescents and
emerging adults? Journal of Youth and Adolescence, 45(2), 391-401. doi:http://dx.doi.org.
cuw.ezproxy.switchinc.org/10.1007/s10964-015-0312-2
Two goals were examined in Adachi and Willoughby (2016). First, is there a long-term
association between sports video games and involvement in real life sports among older
adolescents and young adults, and second, is self-esteem an underlying component to this
association? They found a long-term predictive effect of sport video game play on
involvement in real life sports among older adolescents and young adults. In addition,
they found that self-esteem was a component through which sport video games play
predicted involvement in real life play over time (n = 1,132).
Bower, J. M., & Carroll, A. (2015). Benefits of getting hooked on sports or the arts:
Examining the connectedness of youth who participate in sport and creative arts activities.
International Journal of Child and Adolescent Health, 8(2), 169-178. Retrieved from http://
search.proquest.com.cuw.ezproxy.switchinc.org/docview/1706179361?accountid=10249
This research study compared 12–17 year olds who participated in extracurricular
activities in which they received awards for achievement, held leadership positions,
awareness of self, and were mindful of the needs of others and those who did not
participate in extracurricular activities. There were significant differences in self-
awareness and social responsibility between the two groups. However, there were no
differences found in connectedness to family, school, peers, or participation in antisocial
activities due to the lack of extracurricular activities (n = 107).
Fredricks, J. A. (2012). Extracurricular participation and academic outcomes: Testing
over-scheduling hypothesis. Journal of Youth and Adolescence, 41(3), 295-306. doi:http://
dx.doi.org/10.1007/s10964-011-9704-0
This study used a prior study and examined the association between the number of
extracurricular activities 10th grade students participated in and the time spent in each
activity. The results suggested that the 10th graders who participated in the study tended
to have better grades, higher test scores, increased educational expectations, and educa-
tional status despite their involvement in 2–3 extracurricular activities which took up to
5 h per week.
Guèvremont, A., MA, Findlay, L., & Kohen, D., (2014). Organized extracurricular
activities: Are in-school and out-of-school activities associated with different outcomes
6 O. NESTOR AND C. S. MOSER

for Canadian youth? The Journal of School Health, 84(5), 317. Retrieved from http://
search.proquest.com.cuw.ezproxy.switchinc.org/docview/1518116371?accountid=10249
The authors examined if children with disabilities are motivated by participating in
similar activities as their nondisabled peers or is their participation changed by having a
disability. The authors also investigated how person and environmental factors influence
successful participation of children with disabilities. The authors of this article weave their
research with applicable theory to illustrate a complete occupational therapy picture. The
subjects in the study identified four important aspects in participating in common
activities: having fun, feeling successful, doing things independently, and doing and
being with others. The authors concluded that children with disabilities enjoy the same
activities as their nondisabled peers.

Children who are hospitalized

Relieving anxiety, negative emotions and suffering that accompany children who are
hospitalized is the aim of many professionals around the globe. Play has proven to reduce
anxiety, negative emotions, lower blood pressure, lower pulse rates, and increase coopera-
tion during painful injections during a hospital stay. Here are a few examples of how play
impacts children’s health and well-being.
Burns-Nader, S., & Hernandez-Reif, M. (2016). Facilitating play for hospitalized chil-
dren through child life services. Children's Health Care, 45(1), 1-21. doi:10.1080/
02739615.2014.948161
The authors reviewed literature on play which examined the role of a child life
specialist who addressed the psychosocial care of hospitalized children. Areas which this
article address include play and coping in hospitalized children, common types of play
used by child life specialists, normative play, medical play, and therapeutic play, the use of
play by others providing psychological care for hospitalized children.
Li, W. H. C., Kwan, J. O., Ka, Y. H., & Blondi Ming, C. K. (2016). Play interventions to
reduce anxiety and negative emotions in hospitalized children. BMC Pediatrics, 16(36).
Retrieved from https://bmcpediatr.biomedcentral.com/track/pdf/10.1186/s12887-016-
0570-5?site=bmcpediatr.biomedcentral.com
The purpose of this study was to examine the effectiveness of play interventions as a
means of reducing anxiety and negative emotions in children who are hospitalized in
China. The researchers used a control group of 150 children who received regular
treatment and 154 children who received hospital play interventions. The authors found
that children who received play interventions experienced less anxiety and negative
emotions than the group who received only regular medical treatment.
Lina, K. Z. (1998). Therapeutic play for hospitalized preschoolers in Lebanon. Pediatric
Nursing, 24(5), 449-54. Retrieved from http://search.proquest.com.cuw.ezproxy.switchinc.
org/docview/199418496?accountid=10249
The purpose of this study was to examine if using therapeutic play one day before
surgery would impact children physiologically and behaviorally during a stressful hospital
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 7

procedure in a Lebanon hospital. The authors found that the 50 children who received
therapeutic play demonstrated less anxiety, more cooperation, lower blood pressure and
pulse rates during painful injections. Differences were also noted on the post hospitaliza-
tion questionnaire between children who received intervention and the children in the
control group.
Silva, S., Santos, M. A., Floriano, C. F., Damião, E. C., Campos, F., & Rossato, L. M.
(2017). Influence of therapeutic play on the anxiety of hospitalized school-age children:
Clinical trial. Revista Brasileira De Enfermagem, 70(6), 1244-1249. doi:10.1590/0034-7167-
2016-0353
The purpose of this study was to examine the effects of dramatic therapeutic play on
the anxiety levels of 28 hospitalized school age children in Sao Paulo, Brazil. The control
group received their regular treatment in the hospital. The results of the study demon-
strated no significant differences in anxiety from the control group who did not receive
dramatic therapeutic play.

YouTube videos
Several YouTube videos can be found supporting the importance of play. Here are a few
examples:
Children Speaking Out on the Importance of Play.
www.youtube.com/watch?v=sby38BbLZuY
Children in this YouTube video talk to adults about the importance of play and why
they feel they need more of it.
The Importance of Play by John Cohn
https://youtu.be/I-NT1-BdOvI
John Cohn discusses the importance of bringing play to your occupation and having a
playful spirit. Involving play as an occupation or a career leads to increased creativity and
production.
The Decline of Play
https://www.youtube.com/watch?v=Bg-GEzM7iTk
Peter Gray discusses play being nature’s means for humans to acquire skills that they
need to develop into successful adulthood. He discusses the decline of play since the 1950’s
and the increase of childhood mental illness and suicide rates.
The Power of Play
https://www.youtube.com/watch?v=uMP8h7fPpoY
Charlie tells his story of his journey to life burnout and anxiety and his way out
through adding daily play.
Children’s Occupational Therapy-The OT Practice
https://www.youtube.com/watch?v=1DksYb6NBAw
8 O. NESTOR AND C. S. MOSER

An amazing example of how occupational therapists are promoting the importance of

play!
Using Switches to Adapt Toys and Technology
https://www.youtube.com/watch?v=-We84cxubCY
Holly Cohn is an occupational therapist who has formed an organization which adapts
technology for clients who due to their disability are not able to fully participate in their
occupation.
How to Make a Switch Adapted Toy
https://www.youtube.com/watch?v=iy06198hDd4
Learn how to adapt battery operated toys through this step-by-step video.

Blogs
A popular way to share information is through a blog. Here are just a few examples you
might find interesting.
Playful Matters
http://playfulmatters.net/
This is a blog by a parent named Amie. Her blog makes connections between play,
creativity, and sensory integration. She offers many activities which incorporates all three
of the above mentioned strategies to play.
The Empowered Educator
http://www.theempowerededucatoronline.com/2015/05/my-guide-to-the-best-early-
years-and-play-based-learning-blogs.html
This blog is a resource to early years, play based learning blogs.
The Play At Home Mom
http://www.playathomemomllc.com/
This is an educational blog with many play based activities and categories for
exploration.
15 Amazing Activity Blogs
http://www.funathomewithkids.com/2013/06/15-amazing-kid-activity-blogs.html
This is a resource blog which lists educational activities which are creative and play
based.

Websites
As you can imagine, there are hundreds of websites associated with the concept of play.
Here are a few sites for you to explore.
The National Association for the Education of Young Children
http://www.naeyc.org/play
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 9

This website offers information for parents and also includes research based informa-
tion that all therapists should find helpful in their quest to infuse play into their therapy
sessions.
The Association for Play Therapy
http://www.a4pt.org/?page=PlayTherapyPub
This is a professional website which offers scholarly articles, books, and other resources
for the play therapist.
National Lekotek Center
http://www.lekotek.org/
Lekotek is a nonprofit organization. Check out their website to review the selection of
amenities they provide with the goal of enhancing the lives of children through a variety of
play-based activities and toys.
Able Play
http://www.ableplay.org/
Awesome resource to find appropriate toys for children with disabilities. Able Play is
also referenced on the Lekotek website.
Pathways: Importance of Play in Children’s Development.
https://pathways.org/news/articles/importance-of-play-in-childrens-development/
Great source to learn about play development.
Literacy Trust: 10 Reasons Why Play is Important. National Literacy Trust. https://
literacytrust.org.uk/resources/10-reasons-why-play-important/
Check out the bilingual tips provided on this website!
Why Play is Important
http://raisingchildren.net.au/articles/why_play_is_important.html
Australian parenting website, filled with great information.
Parenting Magazine: The Importance of Play.
https://www.parents.com
Click on the link and search the term “play” to be directed to a host of topics related to
play!
Bright Horizons. The importance of play for school-aged children.
https://www.brighthorizons.com/programs/baby-care
Spend some time exploring this website to find an array of play ideas.
Play England. Why play is important.
www.playengland.org.uk
An international perspective on play that offers an array of ideas on what constitutes
play.
Make time to play. Adolescent play.
10 O. NESTOR AND C. S. MOSER

www.maketime2play.co.uk/fun-forever/adolescents/
Consider this website when looking for play strategies for adolescents. Continue to
explore the website to find play strategies for all ages of children.
Health of Children-Forum. Play- stages, definitions, descriptions, common problems.
www.healthofchildren.com/P/Play.html
Check out this amazing site to find play defined by categories. Functions of play are
also well defined.
Pacer Center
http://www.pacer.org/?gclid=CjwKCAiA47DTBRAUEiwA4luU2bVueaEuvv_
7O3selTdixXDNwquRO5UKVcd6E18SJw-iyW2uwA7P5hoCAcAQAvD_BwE
The Pacer Center offers an array of information on play from a parent’s role in helping
children learn to play to summer camp opportunities for children with disabilities.
Therapeutic Play Activities for Children https://www.yourtherapysource.com/product/
therapeutic-play-activities-children/
This downloadable book offers 100 activities with printable worksheets for you to share
with family and caregivers. Created by a parent with a child with special needs and a
physical therapist, activities are presented in a parent-friendly manner. Some examples
from the book are offered as a free download! Entire document is under $25.00.

Books
A plethora of books on various aspects of play can be found through various online
sources. The following are just a few examples of books we thought you might find helpful
to broaden your knowledge of play.

Book recommendations for parents

Brown, S. & Vaughn, C. (2009). Play: How it shapes the brain, opens the imagination and
invigorates the soul. New York, NY: Penguin Publisher.
The authors offer may be interesting perspectives about play, including their insights on
rough and tumble play, neural connections, video game addictions, and creativity and
innovation. Brown and Vaughn also present a brief history of play, and reinforce the
notion that play is not just for children!
Masi, W., & Cohen Leiderman, R. (Eds.). (2006). The parent’s guide to play. Buffalo,
NY: Firefly Books.
The editors of this book have compiled a host of playful activities to engage young
children in. The book is divided into sections covering activities for babies to preschoolers
Moor, J. (2008). Playing, laughing and learning with children on the autism spectrum: A
practical resource of play ideas for parents and careers. (2nd ed.). London, UK: Kingsly
Publishers.
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 11

A wonderful resource for parents with children on the autism spectrum.

Pancoast, C. (2013). Why play? The role of play in early childhood development.
CreateSpace Independent Publishing Platform.
The author describes various types of play, and offers numerous suggestions on how
parents can engage their children in playful activities
Windell, J. (2012). The everything child psychology and development book: A compre-
hensive resource on how children think, learn, and play- from the final months leading up to
birth to their adolescent years. Avon, MA: Adams Media.
If you want a comprehensive review of the development of play concepts, and how
children think and learn, this is the book for you! Twenty chapters cover all aspects of
development with an entire chapter dedicated just to play.

Books for professionals to explore

As occupational therapists, the following books by leaders in our field may be of interest
to you
Frolek Clark, G., & Chandler, B.E. (2013). Best practices for occupational therapy in
schools. Bethesda, MD: AOTA Press.
The authors include a chapter on play in this extensive book on school based occupa-
tional therapy highlighting the importance of play within the educational environment.
They also cover federal mandates such as the Americans with Disabilities Act of 1990,
Section 504 of the Rehabilitation Act of 1973, and Title IX of the Education Amendment
of 1972. The chapter also covers the best practices on play within an educational setting
and how play, recess, and leisure enhance participation in school
Frolek Clark, G., & Kingsley, K. (2013). Occupational therapy practice guidelines for
early childhood: Birth through 5 years. Bethesda, MD: AOTA Press.
A book all therapists who work with young children should be familiar with. The
authors emphasize the importance of play, reminding us of the numerous merits of play
such as “the development of motor, social communication, cognitive, and self-care skills.”
(Frolek and Kingsley, 2013, p. 24)
Parham, L.D., & Fazio, L. (2008). Play in occupational therapy for children (2nd ed.).
St. Louis, MO: Elsevier.
Leaders in the field of occupational therapy, Parham and Fazio continue their exploration
of play in this second edition of their play text. Inviting leaders in pediatric practice, topics
such as play, leisure, and social participation in the educational setting, assessment of play,
fantasy play, and integrating children with disabilities into family play are highlighted.

Assessments
While several standardized evaluations include components of play, the following assess-
ments focus specifically on play
12 O. NESTOR AND C. S. MOSER

Bundy, A. (2001). Test of playfulness manual. Boulder, CO: Colorado State University.
Assesses playfulness in children ages 6 months to 18 years of age when playfulness has
been identified as a challenge.
Bundy, A. C. (2001). Test of Environmental Supportiveness (TOES). Fort Collins, CO:
Colorado State University, Department of Occupational therapy.
This assessment will help determine which aspects of the environment influence the
players’ motivation to play. It is given with the Test of Playfulness. Information gained
through the administration of this test will help the therapist understand what aspects of
the child’s environment facilitate and motivate or restrict play.
Henry, A. (2000). Pediatric Interest Profiles: Surveys of play for children and adolescents,
kid play profile, preteen play profile, adolescent leisure interest profile. Thorofare, NJ:
Therapy Skill Builders.
This profile actually is available in three parts, the Kids Play Profile, Preteen Play Profile
and the Adolescent Profile. The profile examines the play and leisure interests of individuals.
Knox, S. (2008). Development and current use of the Knox Preschool Play Scale. In L.
Parham & L. Fazio (Eds.). Play in occupational therapy for children (2nd ed.). (pp. 55-70),
St. Louis, MO: Mosby.
This assessment was initially created by Knox in the late 1960’s and continues to be a
well-respected play assessment.

American occupational therapy resources

The following resources are just a few examples of information available through the
American Occupational Therapy Association. Members have a wealth of materials at their
fingertips to assist them in incorporating play into their treatment sessions and providing
helpful information to parents, teachers, and caregivers.
TIPS for living life to its fullest: Learning through play.
https://www.aota.org/~/media/Corporate/Files/AboutOT/consumers/Youth/Play/
Learning%20Through%20Play%20tip%20sheet.pdf
This tip sheet identifies what families can do to facilitate play with their children, what
the occupational therapist’s role is in facilitating play and recommendations for play ideas
which range from infancy through adolescents.
TIPS for living life to its fullest: Building play skills for healthy children and families.
https://www.aota.org/~/media/Corporate/Files/AboutOT/consumers/Youth/Play/
Building%2Play%20Skills%20Tip%20Sheet%20Final.pdf
This tip sheet describes the different developmental stages ranging from infancy
through high school and suggests age appropriate play activities for each stage.
Let’s all play! Designing universal and inclusive play spaces.
https://www.aota.org/Publications-News/otp/Archive/2014/7-14-14/Lets-All-Play.
aspxpy
 JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 13

This article reviews the importance of universal inclusive space for individuals with
disabilities. Universal inclusive play spaces provide opportunities for all individuals to
access playgrounds in order to support both directed and self-directed play. Universal
playgrounds are safe for all, are wheelchair accessible, integrate sensory features and
include raised items such as sand tables and interactive items.
Recess and play are vital to children’s mental wellness.
https://www.aota.org/Publications-News/ForTheMedia/PressReleases/2013/050713-
Recess.aspx
Occupational therapy plays a significant role in promoting physical, social and mental
health prevention. OT advocates for promoting recess for children which promotes increased
mood and attention as well as stronger academic performance and pro-social behavior.
Moreno, S. A., & Pelham-Foster, S. (2017). Online resource guides: Facilitating return
to play and leisure activities. OT Practice, 22(18), 14–17.
After a life altering event that results in a prolonged hospital stay there is often disruption in
treasured occupations and relationships. This may cause a change in occupational identities.
When in the hospital, the focus of rehabilitation is on self-cares and preparing the client for
discharge. Little time is left for preparing the client and family for new meaningful occupa-
tions. The authors of this article formed an online magazine which connects families with
outside accessible play and leisure programs for clients and their families. The authors give a
brief overview on how to set up community resources for your clients.

Conclusion
While there are certainly more examples of play materials available, we hope the refer-
ences provided here will help foster your desire to learn more about the role of OT in
promoting playful experiences for all children. As occupational therapists we can provide
parents and caregivers with the tools they need to successfully play with their children of
all ability levels.

References
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American Occupational Therapy Association. (2013). Recess and play are vital to children’s mental
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American Occupational Therapy Association. (2014). TIPS for living life to its fullest: Learning
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Able Play. (n.d.). Retrieved from http://www.ableplay.org/
14 O. NESTOR AND C. S. MOSER

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