Playtime for Children With Cognitive Delays

Medically Reviewed by Louise Chang, MD on October 14, 2010
From the WebMD Archives

Play is such a natural part of childhood. Sometimes we forget that it's not always just fun and games. It’s also crucial to promoting healthy development and maintaining strong parent-child bonds. Child specialists say this is equally true for children with cognitive delays, which can arise from genetic abnormalities, problems in the nervous system, or developmental disorders.

WebMD consulted the experts about how you can effectively direct your child’s play if he or she has any type of cognitive delays.

Understand What Play Is

As parents, you should understand the role of play in your children's lives. Stephanie Pratola, a registered play therapist and clinical psychologist in Salem, Va., states that play helps children form attachments. As one of the ways that children actively communicate with others, "it's their way of relating. It helps to build the relationship," which is a process that may need specialized attention for children with cognitive delays.

Focus on What Your Child Can Do and What She Does Well

''Rather than focusing on the deficits of your child, focus on the strengths," says Kat Davitt, a certified child life specialist at the Cook Children's Medical Center in Fort Worth, Texas. She stresses how parents should pay attention to what their children can do and what activities make them happy.

Davitt notes that even if your child has cognitive delays, her play will most likely resemble that of a typically developing child. As a result of socializing difficulties, children who are autistic may sometimes be the exception. Nevertheless, playful activities are equally important for their development as for any other child.

Determine Your Child's Preferences

Pratola states that even young children have preferences when it comes to play. You just have to figure them out and follow your child’s lead.

Pratola states that it’s important to decode what kind of stimulation is most engaging for your child. Some children like soft, fuzzy, stuffed animals, while others will find hard plastic balls more appealing. Some children may respond to noisy play, while others may recoil and prefer the quiet. She encourages parents to step back and watch your children’s expressions in order to make the distinction.

Likewise, Davitt states that it’s important for parents to be aware and accepting of the fact that their children with cognitive challenges may continue playing with toys that are recommended for a lower age range.

Be in the Moment

Although you may expect your child’s play to work toward some noticeable goal, to achieve something that's measureable, Pratola persuades the parents of children with cognitive delays to think of playtime differently.

"Real play is not goal oriented," she says. Rather, "you present the child with an opportunity and follow their lead for what they want to learn.” From here cognitive development and other benefits will follow. Your goal, as the parent, should be to foster your relationship with your child and to make sure that you both are enjoying the other’s company. In order to do so, you may find it helpful to present yourself in fun mode, rather than wearing your strict parent’s cap.

To make play time successful, Pratola says you should also set aside specific time for playing. Make it a priority. Easier said than done, but it's important.

Enlist the Help of Your Child's Therapists

Cognitive delays span a broad variety of difficulties, and children's personalities can differ greatly. So it's a good idea to consult with your child's physical therapist, speech therapist, occupational therapist, and any other experts who are helping and guiding your child's development. Ask them for guidance on specific activities that you can do at home.

While focusing on the fun, it's also important to know the rationale behind some of the suggestions that experts may make for the playful activities that you can enjoy with your child.

Here are some of the reasons for certain expert suggestions, for the best activities for children with cognitive delays in different age groups.

Play Tips: Newborn to Age 1

Pratola states that sensory motor play is beneficial at this young age. These activities will involve body play, like tickling, along with lots of close face to face interaction and eye contact. Be sure to play games that feel good to your child and that include tactile elements, like making a game out of giving your baby belly rubs.

Trish Cox, a certified child life specialist and social worker at the Portsmouth School District in New Hampshire, states that at this age mobiles are also very important for healthy development, because they engage children’s visual senses. She suggests lullabies, rattles, and toys with different sounds -- even toys or books with distinct smells, in order to engage all your child’s senses.

''Offer a mirror so the child can look at himself,” Cox suggests. Consider a play mat so he can spend time on the floor in different positions.

Play Tips: Ages 1 to 3

Sensory play should continue from the first through the third birthday, advises Pratola. You can add imaginative role play, which combines pretend and imitation. "It's laying the groundwork for using play as a way to learn things.” Provide your child with items that she can pretend with, such as toy kitchen sets or baby dolls.

Also, when your child begins potty training, it may benefit you both to get a baby doll that your child can put on a miniature potty. This will make potty training fun, while giving your child a model for the lesson.

Let your child manipulate toys as much as possible at this stage, Cox states. Building blocks are ideal. Let your child build them up and knock them down, and repeat the activity as much as she likes. ''All kids really need that repetition and mastery over the toy.”

By ages 1 to 3, you can also start adding structure to your child’s playtime, Davitt says. “Kids with cognitive delays benefit from structure even more than other kids.” So, for instance, you might tell your child that as soon as she wakes up in the morning, she will have breakfast and get to listen to a short story every morning.

Play Tips: Ages 3 to 6

At age 3 and above, a child’s imagination grows stronger, says Pratola. Therefore, she encourages parents to continue encouraging their children to participate in role-playing activities.

These years are the perfect time to add expressive activities to your child’s playtime, such as arts and crafts. You want your child with cognitive delays to enjoy the same kind of coloring and painting experiences as other children, Pratola emphasizes. But,you may need to adapt the materials to suit your child’s need, like swapping out crayons for finger paints.

During these years children are learning to play well with each other. So doing puzzles may be a good option, Cox says, making sure they are learning to take turns with you or their playmates.

Since children in this age range may be starting school or preschool programs, Davitt encourages parents to remember the fatigue factor. "If they’ve had to be 'on' all day at school the play when they get home might have to be more relaxed."

Be sure to support their school activities at home, asking both teachers and therapists for advice on the best ways to do so. If your child, for instance, needs help learning how to dress himself, you might offer him a doll and ask him to dress it – not in a graded or performance-focused way, but in a fun way.

Show Sources


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

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

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

WebMD Medical Reference: "Recognizing Developmental Delays."

Ginsburg, K. Pediatrics, January 2007; vol 119: pp 182-91.

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