Playtime for Children With Physical Disabilities

From the WebMD Archives

Playing is crucial to healthy development and for building strong parent-child bonds. It's equally important if your child has a physical disability, such as a hearing impairment, vision difficulties or blindness, muscular dystrophy, and so on.

WebMD consulted child life specialists and experts to help you find guidance about playing with your physically disabled child. Here you’ll find their tips on play and age-specific suggestions for physically disabled children, from newborns to age 6.

What Is the Purpose of Playing?

Playing helps children learn, but in a relaxed and fun environment.

According to Stephanie Pratola, PhD, a registered play therapist and clinical psychologist in Salem, Va., playing also helps to form important attachments. So it’s important for you to play with your child often in order to improve your relationship and help him cope with his physical challenges.

Think "Inclusion" and "Adaptation"

Don't automatically rule out play activities due to your child's physical disability. ''Any sort of play material can be adapted," says Sara Doschadis, a certified child life specialist at Monroe Carell Jr. Children's Hospital at Vanderbilt in Nashville, Tenn. For instance, a handle on a paintbrush can be extended to help a child with below-average hand coordination. A basketball hoop can be lowered to accommodate a child in a wheelchair. A table height can also be changed to accommodate a wheelchair. Your child's physical or occupational therapist can help you with suggestions for play adaptation.

Resist the urge to jump in right away and help your physically challenged child manipulate a toy, Pratola says. "You have to coach parents when to hang back and let the kid struggle with the toy. There's a fine line ... you have to learn what that is."

On the other hand, she says, you don't want to let your child's frustration with the toy be so overwhelming it's not fun anymore. “[Let] the play be theirs, so that they feel ownership. ... Help them overcome obstacles without doing it for them."

Tap Into Your Child's Imagination

Pratola remembers a child with a spinal cord injury who came to her for help with recovery. ''Play was so important to her," she says. "In her imagination she could do anything." While in real life, the little girl was paralyzed, in playing, the figure she identified with was very active, Pratola says, always running or jumping.

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Be in the Moment

When parents play with their children, they tend to think they should be working toward a goal or something measurable. But Pratola persuades parents to think of play differently. Instead of focusing on a goal, simply give your child an opportunity for play. Follow your child’s lead for what they want to play, which is basically what they want to learn. And just enjoy the time together, she says.

Enlist the Help of Your Child's Therapists

Consult with your child's physical, occupational, or speech therapist, or other experts on her team. And get input on what kinds of playing might be appropriate for your child.

Ask your child’s therapist which toy catalogues they would suggest and adapted toys they like and why. With a little research you may also discover that your community has a toy-lending library in operation.

Physical challenges span a broad variety of difficulties, and you should be sure to take your child’s own likes, dislikes, and preferences into account as well.

Play Tips: Newborn to Age 1

From birth to 1 year of age, it's crucial to let your child spend a healthy amount time out of their crib, says Doschadis.

Have rattles, mirrors, lights, and other stimulating toys on hand. "With physical disabilities, your child may need assistant in movement," she says. "He may need help turning over."

Focus on sensory play, says Kat Davitt, a certified child life specialist at Cook Children's Medical Center in Fort Worth, Texas. Consider tactile blankets, which are made from a variety of materials, some that may crunch, others that may pop, and so on.

Play peek-a-boo for visual stimulation, or play with a rattle to include identifiable sounds in your child’s playtime.

Play Tips: Ages 1 to 3

Doschadis says that at age 1, play can begin taking place in different environments, such as in the water, in the sand, or as close as on the front lawn.

Offer your physically challenged child every opportunity that would be presented to a typically developing child at the same age, she says. You can begin incorporating large, soft balls in your child’s playtime. And keep in mind that adaptation for most materials and toys is usually possible to suit your child’s individual needs.

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Movement is especially important in this age range, as children learn to crawl, stand, and walk, says Davitt. Try dancing to music, using just the upper body if your child's physical challenges make lower body movement difficult.

At this stage, your goal as a parent is to help your child feel more mobile and have access to his surroundings, says Trish Cox, a certified child life specialist and social worker who is an adjunct professor of child life at the University of New Hampshire, Durham, and an educational consultant for Portsmouth School District in New Hampshire.

Play Tips: Ages 3 to 6

Introduce board games that are age appropriate for this particular stage, Doschadis suggests. And audio books are often beneficial for children in this age range, as well.

Between ages 3 and 6, children become much more social, yearning to be with other children and make friends. So you can bring other children into your child’s regular play sessions. But be prepared for questions from your child’s playmates about why he is moving differently, Davitt says.

Give simple, age-appropriate answers to these kind of questions, she suggests. And as your child gets older, he can provide the answers to his playmates himself.

WebMD Feature Reviewed by Louise Chang, MD on October 14, 2010

Sources

SOURCES:

Trish Cox, certified child life specialist, social worker, professor of child life, University of New Hampshire, Durham; educational consultant, Portsmouth School District, New Hampshire.

Kat Davitt, certified child life specialist, Cook Children's Medical Center, Fort Worth, Texas.

Stephanie Pratola, PhD, registered play therapist, clinical psychologist, Salem, Va.

Ginsburg, K. Pediatrics, January 2007; vol 119: pp 182-191.

Sara Doschadis, certified child life specialist, Monroe  Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tenn.

WebMD: "Recognizing Developmental Delays in Children."

© 2010 WebMD, LLC. All rights reserved.

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