PLAY

DEFINITION

Play is an activity in which anyone is engaged for enjoyment without considering its end results

CHARACTERISTICS OF PLAY

 Self-directed
 Self-selected
 Open-ended
 Voluntary
 Enjoyable
 Flexing
 Motivating
 Individual or group

Advantage/Benefits of Play

1. Sensorimotor Development: Sensorimotor activity is a major component of play at all ages. It has the
following benefits:
It serves as outlet for extra energy.
It helps in muscle development.
It gives the child a chance to learn body control.
It helps the child develop hand and eye co-ordination.
It helps children to learn increasingly complex and co-ordinated activities such as race, games, roller
skating, bicycle riding, etc
.
2. Intellectual Development
Through play children learn about colors, shapes, sizes, textures, etc.
Play helps children to develop an understanding of abstract concepts and spatial relationships such as up,
down, under, over, etc.
Play helps children to differentiate between fantasy and reality.
It helps in language development

3. Social Development
Play helps children in socialization.
Through play they learn to make friends and get along with others.
Play gives children a chance to learn to be a good sport—a good loser or winner.
It helps children learn the acceptable standards and norms of the society.
It helps children in learning to take responsibility of their actions.

4. Creativity
Play encourages creativity in children.
Play gives children an opportunity to experiment and try out their ideas through all the available things
like clay, clothes, etc.

5. Therapeutic Value
 Play provides a way to get rid of anger, fear, jealousy and grief.
It is a means for release of stress and tension.
It increases appetite. It leads to healthful sleep.
Through play, children are able to communicate their needs, fears and desires that they are unable to
express with their limited language skills.

6. Moral development
Learns which behavior is acceptable or not
Understands importance of taking turns and honesty
Recognizes importance of team work

CLASSIFICATION OF TOYS

[Link] of Play According to Level of Social Participation

Unoccupied play: In the early months of infancy, from birth to about three months, the child remains busy in
unoccupied play. Children make random movements with no clear purpose, but this is the initial form of playing
with least social involvement.

Solitary play: From three to 18 months, babies will spend maximum time playing on their own. During solitary
play. children engage in playing with own toys and they may not seem to notice other children sitting or playing
nearby. They are exploring their world by watching, grabbing and rattling objects. Solitary play begins in infancy
and is continued in toddlers.

Onlooker play: Onlooker play happens most often during the toddler hood. In this type of play, the child watches
other children play. Children learn how to relate to others and learning language. Although children may ask
questions to other children, there is no effort to join the play.

Parallel play: From the age of 18 months to two years, children begin to play alongside other children without any
interaction. This is called parallel play. They start showing their need of being with other children of their own age.
They are observant of others and may copy how others are playing but seldom interact with them. They are
playing. beside them rather than with them. Parallel play is usually found with toddlers, although it happens in any
age group.

Associative play: Preschoolers demonstrate more interest in other children than the toys. Child socializes with
other children. This play is often referred to as "loosely organized play."
Through associative play, preschooler learns the do's and don'ts of getting along with others.
Associative play teaches the art of sharing, encourages language development, problem-solving skills and
cooperation..

Cooperative play: It is common in preschool and school age children. As their social and emotional development
matures, children play cooperatively with others. Their play has an organized structure and children will
communicate with each other as they work together toward a common goal

2. Types of Play According to Cognitive Involvement

Functional/practice play: When children run, jump, and play games such as hide and seek and tag, they engage in
physical play. Physical play offers a chance for children to exercise and develop muscle strength
Constructive play: In this type of play, children create things.
Constructive play starts in infancy and gains complexity as the child grows.
This type of play starts with the baby putting things in his/her mouth to feel and taste.
Constructive play enables children to explore objects and discover patterns.
Children gain pride when accomplishing a task during constructive play

Dramatic/pretend play: Children learn to try new roles and situations, experiment with languages and emotions
with pretend play.
Children learn to imagine and create beyond their world.
They assume adult roles and learn to think in abstract methods.
Children stretch their imaginations and use new words and numbers to express concepts, dreams and
history thus improving language, vocabulary and memory abilities

Games with rules: When children move front & self-centered world to an understanding of the importance of
social contracts and rules, they begin to play games with rules.
It is usually played by more than one person and to common before 4 years of age.
In these, children accept predetermined rules to play games such as card game and various sports.
Games with rules teach children the concept that life has rules that everyone must follow,

SELECTION OF TOYS

While selecting toys for children, parents should keep in mind the following:
1. Toys should not have sharp edges that can cut.
2. Toys should not have sharp points that can puncture.
3. Toys should not have propelling parts that can injure eyes.
4. Toys should not have small parts that children can swallow or inhale. For children under 3 years of age, any toy
or part of toy that is smaller than 1.25 inches in diameter and 2.25 inches in depth is dangerous and should not be
given.
5. For infants avoid toys with strings that are 7 inches or longer, since they may cause strangulation.
6. Toys that produce excessive noise should be avoided as they can cause hearing loss
7. Select toys that are light enough and will not cause any harm even if they fall on the child.
8. Make sure that materials used in toys are non-toxic.
9. For all children less than 8 years, avoid electric toys.
10. Select toys that are durable enough to survive rough handling by children.
11. Avoid toys made up of glass. Children must be taught about correct use of toys. Also they must be instructed
about maintenance and storage of their toys

PLAY THERAPY

DEFINITION
It can be defined as a technique whereby the child's natural means of expression, i.e. play, is used as a therapeutic
method to assist him/her in coping with emotional stress or trauma.

TYPES OF PLAY THERAPY

1. Individual versus Group Play Therapy:
In this type, the play therapist's attention is focused on one child only, to help him solve his problems.
 Some children do not respond well with individual play therapy as their problems are of such a nature,
e.g. shyness, where Individual Play therapy might be difficult. For such children Group Play Therapy is
used where other children are utilized to draw the child out of his problems

[Link] or Free versus Controlled or Situational Play Therapy:

In spontaneous play therapy, the child is free to decide what toys he wants to play with, the mode of play,
expression of emotions and interaction with play therapists and those around him.
This form of therapy is very useful in aggressive children.
This form of therapy gives the child a chance to reflect his conflicts through the characters that he plays in
given play situation.

3. Structured versus Unstructured Play Therapy:

In Structured Play Therapy planned situations are used to obtain information about child's behavior.
In unstructured play therapy no situation is set and no plans are followed, the child is left free to play.

4. Directive versus Non-directive Play Therapy:

In Directive play therapy, the play therapist sets directions for the child to play. The play therapist makes
suggestions and interpretations of the child's words and actions.
In non-directive play therapy, the child receives no directions from the therapist. The child is allowed to
play according to his own wish

PROBLEMS DURING FEEDING

Regurgitation-
 It occurs as backward flowing of feeds from stomach along with swallowed.
 Management: The infant should be placed on right side after feeding and burping should be
done by proper technique to remove the swallowed air.
During feeding precautions to be taken to prevent excessive intake of air.
The baby should not feed when crying.
Vomiting
 Vomiting may occur due to overfeeding, excessive swallowing of air, prolonged burping or may
be due to pathological conditions like gastroenteritis or intestinal obstruction, etc.
 Management: The baby should be observed carefully to detect the cause.
Faulty pathological condition should be detected by specific investigations and management to
be done accordingly.

Suckling and Swallowing Difficulties-

 Some neonates have suckling problem in first few days after birth. It may be nomal in the
process of adapting the breastfeeding technique. But the prolonged problem may be due to
congenital malformations like cleft palate, cleft lip, large tongue, nasopharyngeal obstruction
etc.
 This problem may be related to some conditions of the breast like cracked nipple, retracted
nipple, big nipple, breast engorgement and breast abscess.
  Management: Careful assessment of the cause and specific management should be done
quickly to prevent further complications and poor prognosis.

Fever
 Fever, drowsiness, lethargy and refusal of feed are common in neonates in first 3 to 4 days of
life.
 It can be due to inadequate feeding or may be due to infections.
 Management: The cause to be find out by details history and thorough examination.
Mother should be advised to give breastfeeding frequently with patience to manage the
dehydration.
Antibiotics may be needed to treat the associated infection.
Hygienic measures and adequate warmth to be maintained.

Excessive Crying
 Excessive crying of the infant is usually related to hunger. It may be due to wet napkin, thirst,
chilling, need for mothering, abdominal colic or any discomfort.
 The infant may cry towards late afternoon or evening, especially in first three months of age
and can be termed as ‘three months colic’ or ‘evening colic’. It may be due to excessive
intestinal activity.
 Management: Mother should be made aware about the adequacy of breastfeeding and
appropriate technique of it.
Mother should take care of own diet to promote breast milk secretion.
Other causes of crying should be detected and appropriate measures to be taken.
Mild antispasmodic therapy and prone position may help the infants to get relieve of the
problem.

Underfeeding
 Low breast milk production and early introduction of artificial feeding with highly diluted
formula feed due to ignorance and economical problem are important causes of underfeeding
and failure of weight gain.
 The infant may present with irritability, excessive crying and hunger.
 Management: Mother should be instructed to take measures for increasing breast milk
production and appropriate technique of breastfeeding.
Mother should offer both breasts at a feed and several times each.
Feeding to be given frequently and longer, day and night, at least 10 to 12 times per day. Bottle
feeding should be stopped.
Locally available galactogogues or home-remedies to be used to increase milk secretion.

Overfeeding
 Some baby may have overfeeding which result in infantile obesity, excessive vomiting, fatty
diarrhea, excessive crying, abdominal discomfort and emotional problem.
 Management: Mother and family members should be made aware about the problem.
Required and calculated amount of feeds to be recommended according to the expected weight
of the particular age of the child.
Mother may need regular guidance from the health workers regarding infant feeding.