Measuring the Effectiveness of Occupational Therapist–Led Playgroups in Early Intervention

This study investigated the effectiveness of a community playgroup on the playfulness of children ages 15 mo–3 yr and the sensitivity and responsiveness of their caregiver. We examined two research questions: Is an occupational therapist–led community playgroup effective in increasing the playfulness of children ages 15 mo–3 yr enrolled in early intervention? Is the occupational therapist–led community playgroup effective in modifying the sensitivity/responsiveness of the caregiver?

Play is context dependent and takes on many forms unique to the individual.

A playful attitude can influence how a child approaches new opportunities for participation. Playgroups are one way that occupational therapists can provide young children with special needs and their caregivers an opportunity to participate in play with other children out in the community. There is a need to determine the effectiveness of occupational therapist–led playgroups to provide scientifically based interventions to families during early intervention.

A pretest–posttest, repeated-measures design was used to evaluate 8 child–caregiver dyads participating in a 2-mo community playgroup. Families receiving early intervention services were contacted to participate in the study. Child participants were 5 boys and 3 girls with a mean age of 26 mo.

The children had diagnoses of developmental delay (n = 3), autism (n = 3), or Down syndrome (n = 2). The Test of Playfulness measured playfulness based on 30 items on a 4-point scale reflecting the extent, intensity, or skill of a child in free play. The sensitivity and responsiveness subscale adopted from the National Institute of Child Health and Human Development caregiver rating assessment rated the caregiver on a 7-point scale, from 1 (very low) to 7 (very high). Data were collected from the 8 dyads by unobtrusive video recording for 15 min of free play at Weeks 1 (T1), 5 (T2), 13 (T3), and 17 (T4).

A one-way, within-subjects, repeated-measures analysis of variance (ANOVA) was performed for child playfulness and caregiver sensitivity and responsiveness. Four pairwise comparisons were made: T1 with T4 (overall changes), T1 with T2 (standard of care early intervention), T2 with T3 (playgroup intervention), and T3 with T4 (sustainability).

A repeated-measures ANOVA demonstrated participation in the playgroup significantly increased child playfulness (p < .01, h _p ² = .89). Analysis did not detect a significant change in caregiver sensitivity or responsiveness.

Results suggest that children enrolled in early intervention benefit from participation in a community playgroup. Caregivers who chose to participate in the study were rated as highly responsive, and this was maintained. The physical and social play environment can be used to support and encourage playful behaviors through use of high-quality, age-appropriate, and engaging play objects as well as additional opportunities for children to engage with peers.

Community playgroups led by occupational therapists are effective in increasing outcomes such as the playfulness of the child and may help transition families from play at home to play in the community. The playgroup is a type of occupational therapy intervention in which to effectively implement strategies such as modeling playful behaviors, adapting the environment for developmental and social play, and coaching the caregiver.

This proposal describes translational research that provides initial support for expansion of the role and services of the occupational therapist in early intervention, with potential to influence policy and practice. These findings suggest occupational therapist practitioners can include community playgroups as part of comprehensive early intervention services.