Lighthouse Project

Providing Occupational Therapy Services
for Individuals with Unique Learning Needs
  Cultural and Historical
   


Cultural and Historical Perspective of Play
By Rondalyn V. Whitney, MOT, OTR/L

"It is clear that play, or possessing the characteristic of playfulness, is a primary aspect of health and wellness Concomitant to this, the role of occupational therapy practitioners, in part, is to restore the value and power of play in the lives of individuals and in society."
-Charlotte Brasic Royeen, PhD, OTR, FAOTA

Play develops language, motor skills, mental thought, ability to work out psychic challenges, master the environment and reflects the child’s culture. Play has an organizing effect on human behavior. (Royeen, 1997).

Play is defined best, I think, by Caillois, "One plays only if and when one wishes to.". (1961, p. 7).

The current social context of play is a sad affair. Kindergarten is no longer the garden in which children can play. Play is no longer valued as a worthwhile and important part of a child’s academic, social, and cultural development in America. We have begun to emphasize academics at earlier ages with the intention that we assure the life time success of our children. Research has clearly indicated that play is the foundation of creative thinking, socialization, sensorimotor skill development and role acquisition. (Royeen).

Play is how a child learns to learn. Play enables the child to understand and find meaning in their world, to develop ways to cope with life’s tasks, to develop mastery in certain skills. Play supports the development of self-confidence and self-competence and helps a child relate to herself, to others and to the world that which she feels and sees, and times in which she is ready to learn.

In the 60’s kindergarten was a place to explore with your neighborhood friends. Play was creative and free spirited. Now, kindergarten is a business, a thriving business if we look at all the Gymboree, Primary Plus, and other private kindergartens across the country. Play is the work of childhood and yet has been devalued in most academic settings. Recesses have been shortened or discontinued and are often "removed" as punishment when a child can’t sit still and listen. Lunch hours are staggered so that all children can use the picnic benches in many elementary schools in California as a way to deal with over-crowding. By the time a child eats (no socializing, no sharing, move along) they have time to go to the bathroom and then maybe time to play for 5 or 10 minutes before returning to the classroom for an afternoon without recess. Is it any surprise that children are struggling to make friends, develop social skills, and have adequate motor skills?

Children at the age of 3 are being asked to sit in small chairs and attend to a group leader as they give out instructions to the 6, 12, or 30 children. Developmentally, we are asking too much of young nervous systems, not yet ready to process information in that way.

Play is more than an unsophisticated use of unstructured time. Children spend much of their early years as a means of developing, practicing, and gaining mastery over social behaviors, motor skills, cognitive capacities, and other skills needed throughout life. (Schaaf, Burke, 1997). "A child’s nervous system is in constant interaction with the environment, continuously sorting, registering, and processing information about what is thought to be interesting and boring, good and bad, pleasant and unpleasant. (p. 81). During play, and as a result of play, changes occur in the nervous system that enhance growth, maturation, and organization of the nervous system which supports the individual to interact with their environment in more meaningful and complex ways. Play nourishes the nervous system, providing essential sensory stimuli that helps it grow additional neural connections, resulting in both functional and structural changes to the brain. The stimuli allows the individual to make more adaptive responses in their environment. This enhanced capacity of the nervous system allows the child to interact with the environment in more complex ways and to develop more sophisticated strategies to deal with new challenges." -(Schaaf, Burke).

Features that promote and inhibit play

Knox (1974) and Michelman (1974) have described factors in the environment that either produce or inhibit play.

Promote:

  • An environment that permits movement and exploration

  • Availability of objects

  • Availability of persons and pets

  • Freedom from stress

  • Provision of novelty

  • Opportunities for repetition

  • Opportunities to make choices

Factors that inhibit play

  • External purpose or constraints

  • Self-consciousness

  • Too much novelty

  • Limiting choices by stereotyping

  • Too much challenge

  • Over-competition.
and finally,
  • neither overstimulate or understimulate the capabilities of the child.

Historical Context of the incidence of Nonverbal Learning Disorder: A Proposed Theory

"What did you do at lunch time today?"
"I walked around a tree"
"What? Didn’t you look weird doing that?" "I don’t know but I was listening to two boys tell jokes and feeling the tree roots. The roots stick up out of the ground and are all knotted and it feels really good on my feet so I do that a lot of walking around that tree at recess because it feels so good. Is that too weird?"
"No, that’s cool. I want to walk around that tree now too."
- conversation at bedtime, Zac W. March 15, 2000

Once thought to be rare, NLD is now thought to be as prevalent as dyslexia. Estimates place NLD occurrence between 1 in 1000 to 1 in 50, suggesting that one child in every classroom has NLD. Dr. Kathryn Stewart has worked extensively with children with neurocognitive disorders such as Asperger’s and NLD in the Berkley California area. In her presentation at the 4th annual NLD symposium (1999) Dr. Stewart suggests NLD occurs less frequently than language based learning disorders and is predicted to be 10% of those with learning disabilities or about 1% of the general population. Therefore, for every 100 students in a grade level (assuming there are 30 students in 3 classrooms) one child would be expected to have some degree of impairment significant enough to meet the diagnostic criteria of NLD. Unlike language based disorders, NLD appears to equally affect males and females.

Why all of a sudden are there so many cases of NLD? Again, no one knows but several theories make sense. For example, the theory of genetics. Many children with NLD have parents who have some pieces of the NLD symptom criteria. Maybe mom has trouble with visual-spatial organizational skills, say at 20% impairment and dad has difficulty with peer relations at 50% impairment along with some mild deficits in visual-spatial-organization (say 15%) and then they pass on those weaknesses, little Sammy has 50% impairment of in peer relations and 35% deficits in visual-spatial-organization.. Of course, more research is needed to quantify the genetic component but many clinicians report, anecdotally, that parents and children are easily paired in waiting rooms. Or, to quote one clinician, "The genetic component always reveals itself".

The theory of environmental toxins, effects of working with computers, later life pregnancies in career oriented men and women, and our stressed lifestyles have all been proposed as possible causes of increased incidents of learning problems in our children.

But the theory that makes the most sense to me, as an occupational therapist, is to look at the changes in our society, our lifestyles and changes in our family dynamics. To take a historical perspective, 30 years ago if a child was born with, say, a 50% deficit in motor skills and had a 95% strength in verbal skills that was a large enough gap that today, we may call it NLD. However, the lifestyles 30 years ago demanded children play inventively. They ran and rode bikes from morning till sundown. They explored in the woods and climbed trees for hours. They played hop-scotch, jacks, and stick ball immediately after school and on the weekends. They played with a small circle of friends who lived within walking or bike riding distances from their homes. Parents didn’t have two cars, typically, and children were left to play with friends who were in walking or riding distance. Peer circles remained fairly stable over many years as there was not a great deal of moving around. The academic demands were simple, concrete and expectations were pretty clear. Recesses were long (20 – 30 minutes) and occurred twice a day and lunch was an extended period. Children climbed trees, monkey bars, played on teeter-totters and swings. The amount of visual, proprioceptive, vestibular and tactile experience was profound and pervasive. The amount of social skill development was exceptional as well. The opportunity to devour information was low. A family may travel to the local library on Saturdays but they didn’t have access to much of the world, and certainly not at the click of a mouse or the push of a remote’s button as it flew over 65 channels on television. Extended families were the norm, neighbors felt free to intrude into a gang of rowdy children and many caregivers were around to coach children on appropriate ways of behaving. Play was unstructured. Academic requirements began in first grade and maybe, at age 5, in kindergarten or Headstart.

In the 90’s and now in the 00’s (the Millenium O’s my son calls this decade) we require children as young as 3 to sit in a circle of 20 other children and attend to one adult. We expect them to follow directions, to draw pictures according to the assignment. We read to our children early and celebrate when they begin to read at age 3. We put a pencil into the hands of a 4 year old and encourage them to write their ABC’s. It’s not enough to learn the alphabet these days but children need to learn how to respond to a two dimensional visual prompt on a computer when Grover (from Sesame Street) holds up a number. We keep our children inside because it is not safe to let them roam the community and play. They ride bikes, when they do, on our 5 foot long driveways where we can see them. If they are in a structured academic pre-school, they don’t have the opportunity to pull pans from the shelf, bang them, and learn visual organizational skills of replacing silverware in a drawer that got pulled out, again, during routine exploration.

This is all not to say that preschool is causing NLD and other learning disorders. But it seems important to look at that child who is born with 50% motor and 95% verbal skills. Thirty years ago, the 50% motor skills developed to say, 70 or 80% due to every day life and the demands and opportunities available to the child and they were completely functional. The 95% verbal skills set the child up for success in school and since the school provided structured, predictable assignments, for the most part, the child succeeded. Now, in the year 2000, we have children who increase their rote knowledge daily. Born with a 90% strength in verbal skills and other strengths associate with NLD such as a rote memory for facts, these children can surf the internet and acquire vast amounts of factual information. They can become experts in bats, or trains, or Pokemon through an environment enriched with technology, books, magazines aimed at children, and television. However, they have less opportunities to engage in casual social interactions or motor skill development. Play dates are arranged weeks in advance to accommodate busy schedules. Children spend hours learning factual information. The gap between performance (motor skills) and verbal widens rather than shrinks. By the time a child enters school, they have vast knowledge but impoverished skills in moving their hands together in simple tasks. A child with a 50% deficit in motor skills has now regressed to 40% while simultaneously their verbal skills have increased to 99%. This gap, indicative of NLD, has grown to the point of being disabling to a child.

It is no surprise to me that interventions in the areas of movement, social relationships, and visual-perceptual development are the areas that provide the most success. It is a surprise to me that as a society we haven’t stopped to examine the consequences of enriching part of our children’s minds but leaving the body and spirit impoverished. (Note: As a parent of a child with NLD, and as therapist, I too am guilty of providing all the books my son wanted but not challenging him to move and explore his world, to get to know his body as it moved in space and time and to understand the environment more kinesthetically.) It certainly seems to me that environmental changes, viewed from a historical perspective, must be considered when exploring the "causes" of nonverbal learning disorders.

Taxonomy for Learning
When we begin to explore the methods for determining successful interventions for non-language based learning disorders, a taxonomic system is helpful to understand and identify useful goals and in writing precise objectives. It identifies relative difficulties of tasks and aids us in determining the sequence of learning. Taxonomy refers to the arrangement or laws of classification. Bloom’s taxonomy offers hierarchical steps in the cognitive domain of learning and includes (in order to least complex to more complex) knowledge, comprehension, application, analysis, synthesis and evaluation. The hierarchical steps in the psychomotor domain proposed by Simpson (1972) offers the classification of behavioral objectives: perception (being aware of objects) , set (being reading for response), guided response (imitating the performance or another or learning through repetition) mechanism (responding to the demands of a situation with confidence) Complex overt response (performing without hesitating with coordinated muscle control) Adaptation (altering basic motor responses to enact demands of new situations) and last, Origination (Creating new motor acts or ways of manipulating materials). One of Bloom’s associates, Krathwohl, developed a classification system for classifying the affective domain (1964). This includes receiving (being aware of phenomena, being willing to direct and control attention), Responding (complying with a suggestion, being willing to respond) Valuing (accepting a value as a belief), Organizing (conceptualizing a value and organizing a value system into an ordered relationships) and characterization of internally consistent value system (acting with consistency in accordance with values that are integrated into a total philosophy or world view).

We need to be cognicent of our interventions to make sure we are develop the whole child, not just the child’s ability to write a paragraph or to fill out a page of math problems but that they can organize their work, that they can appreciate the valuing of others, that they can adapt to changes in the environment and that they can experience love from and for others.

Summary "Mom, I didn’t get all my homework done, I got most of it and I understand fractions now. A "B" average is okay in our family, right? As long as I’m happy and did my best? Our family doesn’t value A’s right mom?"

"I know you can do A level work. What our family values is that you did your best and that we have made time to play as well as to learn. You had time to go for a swim with your new friend, read the Hobbit while you snuggled with Dad and our family really liked that trip to Baskin Robbins for an ice cream treat after dinner. THAT is what is more important than an "A" average in fourth grade to our family."
-conversation at our kitchen table, March 18, 2000

When children are not allowed free play, are forced into strict educational situations early, before they are neurologically prepared, breakdowns in learning can occur. Children need time to be playful, to move their bodies to walk around and around and around a tree because it feels good on their feet. Our world, our society, has begun to deprive our children, to neglect parts of them. With the best of intentions, we have attempted to enrich their lives by enriching their minds. But the body and the mind and the spirit are inseparable. We can no longer afford to risk the balance of a life by over-emphasizing education, academics and rote learning. We need to honor the importance of emotions, the creative act of "do-nothing time" and the return ourselves to a time that honors the whole child. We cannot afford another explosion of a disorder so potentially disabling as NLD. We have worked for years to understand the cause of childhood dis-ease of learning. I frequently say, the children who have come to this earth with NLD have come to teach us something. I pray we learn it – that we learn to honor their honest, kindhearted attempts to teach us that there is more to live than knowing all the facts on Jeapordy or Who Wants To Be a Millionaire or on the National Stat-9 tests. We need to raise individuals who are at peace with themselves, who know how to care, how to play and how to bring their unique gifts to our future. In fact, the future depends on it.

References: Caillois, R (1961) Man, play and games. New York; The Free Press.

Chandler, B (1997) Introduction The Essence of Play. Bethesda, MD AOTA

Knox, S (1974) A play scale. in M. Reilly (Ed.) Play as Exploratory Learning Beverly Hills, CA: Sage

Drathwohl, D.R. et al. A Taxonomy of Educational Objectives. Handbook II: Affective Domain. New York: David McKay

Royeen, C.B. (1997) Play as Occupation and as an Indicator of Health In The Essence of Play. Bethesda, MD AOTA

Schaaf, R, Burke, J (1997) What Happens When We Play? A Neurodevelopmental Explanation In The Essence of Play. Bethesda, MD AOTA



 
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