By Brianna Stampler, M.S., CCC-SLP
Play is not all fun and games.
Did you know that people who do not engage in play during childhood are likely to exhibit significant deficits in social, emotional, and development skills? Research shows that play deprivation during early childhood is linked to increased depression and anxiety, feelings of isolation and decreased self-confidence, and limited resilience and self-control in later years. Play in early years has a substantial impact on the skillset, character, and overall success of every human (and even other species, too).
Play is not an innate skill that babies are born with! Just like any other skill, play needs to be learned- either from teaching or self-discovery. There are many different types and levels of play. They include the following (with associated ages):
- Unoccupied Play (0-3 months)
- Independent/ Solitary Play (0-2 years)
- Onlooker/ Spectator Play (2 years)
- Parallel Play (2-3 years)
- Associative Play (2-3 years)
- Cooperative/ Social Play (4-6)
- Other Types of Play:
- Competitive Play
- Constructive Play
- Dramatic/ Fantasy Play
- Physical Play
- Symbolic Play
What does play have to do with communication?
First off, let’s define “communication”. The American Speech-Language-Hearing Association (ASHA) defines communication as such: “Communication is the active process of exchanging information and ideas. Communication involves both understanding and expression. Forms of expression may include personalized movements, gestures, objects, vocalizations, verbalizations, signs, pictures, symbols, printed words, and output from augmentative and alternative (AAC) devices. When individuals communicate effectively, they are able to express needs, wants, feelings, and preferences that others can understand.”
In the Speech-Language Pathology world, we separate communication skills into multiple different areas; one of these service delivery areas of communication is “language”. Language can be divided into three categories- pragmatic, receptive, and expressive. Let’s break those down quickly:
- Pragmatic Language is the functional exchange of communication between partners (e.g., turn taking in verbal and non-verbal exchanges, understanding/responding to/displaying emotions, self-regulating and co-regulating, joint attending, engaging in play with others)
- Receptive Language is any information an individual receives (e.g., understanding directives, identifying vocabulary and actions, comprehending question words)
- Expressive Language is how an individual conveys himself/herself (e.g., request/protest/comment, describing items, answering questions appropriately, formulating sentences)
As a pediatric Speech-Language Pathologist (SLP), my job is to assist neurodiverse children in increasing functional communication skills. The traditional route promotes children sitting in a chair at a desk; maybe this is to try to get “the most trials” or possibly because it has always been done this way. However, my experience and research has supported a completely different method of treatment- communication development through play. It is my duty to meet a child at his/her level and to engage each client in the most naturalistic way- within their preferred play.
Clinicians understand therapy within a “Continuum of Naturalness” in which there are three distinct treatment styles. At the one end of this continuum, therapy is clinician-directed; it can be very structured and drill based. The middle of this spectrum includes a hybrid approach, in which therapists try to repeat targets in a more naturalistic way; however, it continues to be very structured and rigid. The third and least restrictive therapy style is child-centered and client led. This type of therapy shapes a child’s preferred settings, games, and ideas into functional communication development opportunities. I choose to take on the child-led therapy option, and I have seen the power of play.
There are many evidence-based therapy methods that encourage development of skills through play. I frequently implement techniques from the Greenspan DIR/Floortime model, the Hanen Early Language Program, and the PLAY Project Model. Each of these models of treatment encourage child-led play. Children with language disorders benefit greatly from learning through play. In fact, early assessment of communication skills is through observation of play. Play is the first sign of true, intentional communication.
How can I practically apply play into my child’s life?
The beauty of targeting skills within play is that you do not need to have an elaborate plan. You get to follow the child and shape that preferred play into beautiful communication opportunities. It is a time to get creative.
You can use one single object in SO many different ways. Let me give you some examples of how I can use bubbles to target receptive, expressive, and pragmatic language skills:
You can play with your child during your “Activities of Daily Living” (ADLs). These include mealtime, play time, dress time, bath time, driving, shopping, and more. Here are some practical and easy techniques to implement wherever you are:
- Narration of play: describe what you are doing and seeing. This helps children understand identification and labeling of nouns (e.g., food, body parts, clothing, animals, toys, objects, places), verbs (e.g., past/present/future actions), adjectives (e.g., color, size, shape, weight, texture), and basic concepts (e.g., spatial terms, quantities, qualities, temporal terms, social-emotional terms). Here are some examples:
- Mealtime: “Your chicken, French fries, and broccoli smell so delicious. Your chicken is dinosaur shaped and brown. I think they might be crunchy. Your fries are yellow and crunchy. They might be really hot, so don’t forget to blow on them before you eat. I love broccoli. It’s green and crunchy. It kind of looks like a small tree. That’s so silly. Let’s see if your dinosaur nuggets can eat the broccoli” (and pretend play that out).
- Dress time: “I really like this red shirt you chose today. It has a cool monkey on it. Is that monkey dancing? Show me how you dance! Can you put your shirt on your foot?! NO, that’s so silly. Can you put it on your belly?! NO, that’s so silly. Can you put it over your head? That’s a good choice.
- Play time: “Are we playing with the cars and ramp today? That looks like a lot of fun. I’m choosing the blue car. What color are you choosing? My car is going so fast, what about yours? Oh my goodness, my car is on my head, where is your car? Can your car go under the ramp? Can it go behind you? AHHH my car turned into a phone… hello? Is this Mickey Mouse? Okay… bye… see you later.”
- Building of predictable and anticipatory routines: repeat the same routines with the same verbiage to build a predictable pattern for your child to understand and “fill in the blank”. The more anticipation built before the target word, the more fun children seem to have. I love a “ready-set- (wait…) GO” routine across multiple different play tasks.
- Withholding techniques: withhold preferred items in the play routines for the child to label, request, protest, etc… While withholding, sometimes I will use these two techniques:
- Playful sabotage: I will block a door, key hold, coin slot, or the like during a play routine and “sabotage” the environment to elicit a response from the kiddo (e.g., move please, excuse me, beep beep). Pretend items are stuck or broken and you need help from the child.
- Creative stupidity: pretend play and make objects into something novel (e.g., a popsicle stick becomes a see-saw, then a phone, then a rocket, then a brush). When I child points to or requests something, grab the wrong item. Act like you don’t know how to use objects or play games and let them explain.
- Wait time: after you give the child any demand (e.g., asking a question, giving a command, eliciting a choice, etc…), allow time for the child to respond. The rule of thumb is 7 seconds… and then more.
- Carryover and generalization: This is probably the most important technique. Skills can only be obtained if they are practiced and repeated. This has to be the case every day. Consistency is key!
If your child is struggling with meeting developmental norms, just know that you can start helping today through play!
My name is Bri Stampler. I have been a Speech-Language Pathologist for 4 years, and I absolutely love it. I primarily work with children with Autism and early intervention kiddos. I love entering the unique worlds of each of my clients, understanding and tapping into his/her preferences, and treating each friend holistically and appropriately. I feel overly blessed every day to do what I do. My love for this profession increases every day. I continue to learn nonstop. I am excited to continue to pursue this passion and help treat my babies with exceptional and special needs.