Paradigm Of Play Development

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Throughout this paper I will be discussing the paradigm of play development. Play development is the focus of development throughout the life span of an individual. It focuses on processes of social, emotional, physical, language and social constraints within the child’s life. In the research paper I have correlated play as development to a child within the healthcare setting. One will also learn about two theorists that are linked to development, Parten and Piaget. I have also included an example of therapeutic activities that can promote healthy development to a child within the healthcare setting. Lastly, I have discussed the importance of child life in this scenario and how they can also promote development for all stages throughout an individual’s life span.


Regardless of a child’s circumstances while they under healthcare, play is powerful for children. While working towards a degree in child life I expect to be asked a number of times from professionals and parents why play is so important for a child in a traumatic situation. Play can be seen as a difficult and trying task to some when viewing it in a health care setting. For children, play is an essential everyday task such as work is to an adult. ‘[…] play is an arena in healthcare settings where children can exert power, create a sense of comfort, familiarity, and safety, express thoughts and feelings, and make choices” (Thompson, 2018, p. 231). There are four different paradigms that play is defined by. The four paradigms of play are enjoyment, development, learning, and therapy. Within this research paper, I will be examining the effects and importance of play in development. Children today are said to lead very sedative lifestyles, which relate to not a great deal of playtime. (Bidzan-Bluma, & Lipowska, 2018) Children should spend as much time as they can engage in physical activity. I know this is not always the case for a child in the healthcare setting, but as child life specialists it is important to find ways to offer playtime for our patients. (Bidzan-Bluma, & Lipowska, 2018)

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What is a Paradigm?

According to the lecture conducted in week fives presentation, a paradigm is a,

The philosophical and theoretical framework of a scientific school or discipline within which theories, laws and generalizations and the experiments performed in support of them are formulated. (Lecture Week 5)

There are several different types of paradigms that surround play and offer different insights into the importance of play. For example, the different paradigms of play are, play as enjoyment, play as development, play as learning and play as therapy. There are also expanded forms of play such as play as flow, comfort, and hope. (Lecture Week 5)

Importance of Play in Healthcare

‘Feelings such as fear, anguish, anxiety, and stress are caused by the hospitalization of the child, and the use of play aims to minimize the trauma caused by this process, seeking to provide physical and emotional improvement” (Da Silva, 2018, p. 3485). When a child is in a stressful situation it is important for them to have an opportunity to release stress and use their imagination and creativity. For children play is a normal, everyday functionality of life. When a child is then taken from general life and put into a healthcare setting the question of whether or not they will be able to or have the ability to play. Play helps children to express emotions, have a sense of control and allows for a sense of normalcy. (Jones, 2018, p. 303) For children, the ability to experience play is crucial to growth and development. However, when the child is now faced with a diagnosis and has to be in a healthcare setting the ability to play changes. It is important for professionals in the healthcare setting to understand the need for play to be normalized within this setting. There are many different ways that play can be achieved in the healthcare setting. For example, Jones (2018), talks about using medical equipment for children to learn about what is happening to them as well as be able to play with the same tools on a cloth doll or other resource. Hospitalization can be very scary for children, which can put off a great deal of stress. Not only is it a stressful time, but it can also be threatening. It is during this time that coping and putting the child at ease is the most important. (Li et al., 2016) It is at this time that play in the hospital should be used as intervention an education as well as to promote development. (Li et al., 2016)

Theorists in Play as Development

Parten’s Theory of Play

Parten was a childhood developmentalist. Parten developed four levels of play, solitary play, parallel play, associative play, and cooperative play. (Thompson, 2018, p. 234) Solitary play is nonsocial, unoccupied behavior. This is when the child spends time playing alone while uninterested in others around them. The age of the child at this stage of play is typically under three years of age. (Thompson, 2018, p. 234) The second stage is parallel play. This stage is when children start to play near others, but not with others. During this stage children around the age of three years old find themselves playing independently, but with similar toys as the other children around them. (Thompson, 2018, p. 234) The third stage is associative play. At this time children experience interaction with others without organization or cooperation towards each other. The last stage is the social stage or cooperative play. Older preschool children and younger elementary school children partake in cooperative play. Cooperative play is when the child can be inclusive and demonstrate group activity. (Thompson, 2018, p. 235)

Piaget’s Theory of Play

Like Parten’s, Piaget divided his theories of play as development into four stages. The first stage of development is the functional play stage that occurs during the first two years of life. Within this stage, children learn to manipulate objects through repetitive actions. (Thompson, 2018, p. 235) The second stage is the constructive play stage. This stage focuses on goal-directed activities. (Thompson, 2018, p. 235) Within this stage, children start to construct real-life models using objects such as play dough for example. The third stage is dramatic or sociodramatic play. During this stage, the child starts to imaginary roles, interact with other children and use objects to expand their imagination and creativity. (Thomson, 2018, p. 236) The last stage is the Games-With-Rules stage. This is where children have the ability to follow a set of rules in a group and start to enjoy playing games with others. “Through game playing, children learn how to most fully cooperate, resolve conflicts, and express themselves to others” (Moravcik & Nolte, 2013; Piaget, 1950 as cited by Thompson, 2018, p. 236).

Cognitive Development

All throughout life play has an impact on an individual’s cognitive development. Even though adolescents and adulthood play stimulates development. Throughout life play influences youthfulness, physiological maturity, and experiences. (Ahmad et al., 2016, p. 72) “According to Santrock (2005), play exercises offer numerous open doors for controlling, investigating and honing and are hence profoundly suggested as road for cultivating the intellectual skills of youthful kids’ (Ahmad et al., 2018, p. 72). Play offers the ability to explore one’s imagination and gives children an opportunity to use problem-solving and decision-making. Learning these skills at a young age enhances a child’s cognitive development and gives them life long skills. Play allows for a connection to reality. For example, play enforces feelings, interaction, the use of senses and imagery. (Ahmad et al., 2016, p. 73)

Self-Expression & Self-Esteem

Play is not only board games, video games, dolls, and paint. Play is a way for children to discover who they are as individuals. Play does not only affect cognitive development, but it also affects emotional and physical development. There are several forms of development that Hart and Rollins (2011) focus their therapeutic activities on. For example, there are activities for the development of self-expression, development of self-esteem, body image and aspects of humor. All of these different aspects are important components of child development. When thinking about a child in a healthcare setting, particularly a hospital, I believe that self-expression and self-esteem are two of the most beneficial to the child.

Self-expression is how a person identifies their individuality. This is where an individual can use their creativity to promote their personality, communication abilities, hairstyle, clothing, art, and their own beliefs. It is important for people to be able to find that there are passionate about and learn to express their individuality however they feel comfortable. (Hart & Rollins, 2011, p. 23) In the healthcare setting self-expression is a way for people to express themselves in a place that they may not feel always feel the most like themselves.

Self-esteem is an emotional feeling that reflects how an individual feels about oneself. “A child with a strong sense of self-esteem is more likely to have the confidence to develop new coping mechanisms, make positive adjustments to change, and capably handle stress” (Hart & Rollins, 2011, p. 45). A child’s development of self-esteem is influenced by one’s environment. Some examples of environmental influences include what age-appropriate tools are available to them and significant others around them. (Hart & Rollins, 2011, p. 46)

Stages of Play Development

Self-esteem and self-expression affect development differently for each stage of growth. As both individualities are discovered during development, Thompson (2018) discusses the different attributes play development has on these same stages of maturity. Thompson (2018) distinguishes the paradigm of play development through infants and toddlers, preschoolers, school-age children, and adolescents. Infants and toddlers primary form of play is exploration and observation. (Thompson, 2018, p. 236) During the first year of life, children will start to reach for objects, use motor skills such as mouthing and shaking as well as grasping objects such as fingers and toys. (Thompson, 2018, p. 236) For infants in critical healthcare instances, they are often times confined to a crib, but it is still important at this stage to encourage sensorimotor skills. When thinking about toddlers it is very important for health care professionals to allow for playtime as it encourages children to learn the manipulation of toys. Health care providers should also be educated on what toys are beneficial for each age group as well. It is important to know that an infant is going to benefit from a rattle or something with lights and sounds where a toddler will need something interactional that offers stimulation. (Thompson, 2018, p. 236-237)

Preschooler’s attention to play is based on Paget’s preoperational stage in which play is an assimilative function. (Thompson, 2018, p. 237) It is a time that allows for children to use make-believe and real-life roles as a way to express themselves. “Preschoolers have the task of learning initiative without too much guilt” (Hart & Rollins, 2011, p. 46). When in the healthcare setting ages 3-5 can be the most curious of what is going on around them. This is a time where professionals, such as child life, can introduce manipulatives to better explain to the child what may be occurring to and inside of their bodies. For example, we can introduce doctor’s kits for them to practice on dolls or dinosaurs with. (Jones, 2018, p. 304 Table, 1) During this stage of life, children are consistently imitating real-life experiences and channeling them into their own version using coping mechanisms. (Thompson, 2018, p. 238)

School-age children are between the ages of six and twelve. During this stage, children start to think more clearly and orderly which allows for a more realistic sense of play. Often times this is when children will play games that incorporate rules and groups. This is a time when children start to develop a need for acceptance by others. This can be a challenging period if the child is in a healthcare setting. Children at this stage do not want to be seen as different which in return can lead to being teased at school that can then hinder an individual’s self-esteem. (Hart & Rollins, 2011, p. 47) As the child gets to the later ages of ‘school-aged,’ 8-12 years of age they tend to look at themselves and start to learn judgment. It is critical that healthcare professionals are educated in ways of coping to help school-aged children in this stage of life.

Adolescent’s ranges from ages eighteen to twenty. Play as an adolescent is typically seen as doodling, drawing, daydreaming and sports. During this time adolescents are trying to find their identity. Play at this time of life is when adolescents discover play development through the Internet, video games, music and hanging out with friends. (Thompson, 2018, p. 240) At this stage of life, body image becomes a factor, which in return affects individuals self-esteem. (Hart & Rollins, 2011, p. 47)

Activities in Healthcare

For children in healthcare, it is important to provide ways, as professionals, to allow those children to seek out their individual strengths and accomplishments. One way to do this is to provide activities for those children to accomplish throughout their stay. Hart and Rollins (2011) give numerous amounts of activities that one can perform to help promote all different stages of development. Within each chapter are different activities that focus on the different ages and abilities of the children. One activity that I particularly like is depicted in chapter 6 called the doctor-bag collage. Within this activity, individuals have the opportunity to cut out paper versions of medical equipment to then glue into their doctor-bag collage. This activity is primarily directed towards preschool and school-aged children. I believe that this activity gives the children an opportunity to take control of their illness and gain an understanding of the tools being used around them daily. “Play has long been regarded as a vital element in the normal growth and development of children and is widely used in many Western countries to alleviate the stress experienced by pediatric patients and their families during hospitalization’ (Li et al., 2016).

Child Life

“Play provides child life specialists rare opportunities to understand children’s worlds and allows a flow of communication when other forms of interpersonal connection are difficult or impossible” (Thompson, 2018, p. 260). As a child life specialist play is where it all started. Therapeutic play is important to optimize development, promote relaxation and divert attention from what is happening around them. (LECTURE) Being a child life specialist allows for the opportunity to offer patients the chance to continue their play development while still being in a traumatic situation.

‘One of the roles of child life specialists is to think of play as a developmental process that proceeds through stages that are linked to, yet separate from, the areas of cognitive, social, emotional, physical, language and gender role development’ (Thompson, 2018, p. 234). Being a child life specialist it is important to focus on our patients’ development throughout their time in the hospital. Along with a multitude of other tasks a child life specialist has to complete a day-to-day basis, one, in particular, is helping the child with play. Physical play allows for cognitive development, a way for a child to experience cultural norms and discover their own world. (Ahmad, et al., 2016, p. 73) Overall play serves a great deal of importance for socialization for the child, allows for stress relief and creativity. (Da Silva et al., 201         


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