Abstract
Play is recognised in occupational therapy as a central domain of childhood and an essential focus in working with children with disabilities and their families. Although there are different definitions of play and no consensus on naming different play forms, the evidence of its importance for health, development and well-being is consistently documented (Lester and Russell, 2010). Particularly from birth to eight years, play is known to be the window into the child’s development. So it is not surprising that occupational therapists use play primarily as a means to achieving other developmental goals. However, this results in play being typically overlooked as an aim of intervention – so are we in reality ignoring play as a central occupation in the child’s world?
To explore this question, we need to define play occupation: or ‘play … undertaken for its own sake’ (United Nations Committee on the Rights of the Child, 2013). Play is a subjective experience of joy and fun, that comes from engaging in freely chosen, intrinsically motivated, self-directed meaningful occupations; play transactions take place between the child and the environment (including the virtual); play is about the process of engagement rather than the product. Engagement may be low intensity and can involve daydreaming or watching others play. Equally, it may be high intensity; for example, rough-and-tumble play. Core attributes of participation are evident in play occupation: to take part, to feel included, to have choice over what to take part in and to achieve a meaningful goal (Hoogsteen and Woodgate, 2010). However, participation can be amended to include ‘taking part’ through being an observer of the play event, and achieving a goal as about process rather than the product of the play event.
Play occupation is the driver of learning in early childhood; hence in educational settings (for example, preschool), learning is typically play based. This means that the child leads while the adult scaffolds play. However, by middle childhood play occupation is less central and learning now takes the form of structured education: play evolves into leisure pursuits that take place in residual time (Sellar and Stanley, 2010). And while leisure is also experienced as fun and intrinsically motivated, it is less central to learning.
So by this definition, play is different to leisure, yet they are often used interchangeably in occupational therapy. Perhaps this explains a lack of focus on play occupation: it is viewed as an occupation done in residual time. Play as a primary occupation should imply that priority is given to enabling play: that is, not simply to teach play skills or practise play activities in therapy clinics, but to design context-focused interventions that focus on play, playfulness and participation. Occupational therapy researchers have already begun to promote newer ways to enable play participation through designing community play environments (for example, Moore and Lynch, 2015). Context-based approaches are showing promise as effective ways to address participation, through focusing on changing the activity or environment instead of the child (for example, Law et al., 2011). However, another challenge is that traditional tools for assessing play focus more on skills than play occupation. Further research is needed to establish a child-centred perspective on play preferences and play participation, so that ‘play for play’s sake’ is not overlooked. Few studies have engaged children in researching play occupations, and we need to develop more child-centred studies to analyse play form, function and meaning in young children so that we can develop assessment tools that are able to more accurately capture play occupation in context.
To reconnect with play occupation, we can be guided by the General Comment (United Nations Committee on the Rights of the Child, 2013) that highlights issues of play deprivation in children, including those with disabilities, and urges its member states to take play seriously. It sets objectives that we are challenged to adopt, including giving the child protected time to play, avoiding over-structured organised activities that take over from play, and providing safe, accessible and usable play environments. Occupational therapists have significant and valuable contributions to make to enabling participation in play, and we need to embrace it as occupation: play as an aim, play as a right, and play for participation.