Now more than ever, parents, families and caregivers have been faced with stress and lack of resources when it comes to caring for their children — especially for children who have delays in development. The limitations and impact of the COVID-19 pandemic will likely be with us for a long time, but it is important to help our children grow and develop in the best ways possible.

Occupational therapists address all functional aspects of life. Many times, when people don’t know what occupational therapy is, they will ask, “Do you help people find jobs?” While we do that sometimes, we see everything that people do as an occupation. For example, a person may knit as a hobby; so we view that as an occupation. Every time someone gets dressed in the morning, they are engaging in an occupation. For children, play is a primary occupation that is so important and gives way for the development of motor skills, language and cognition.>

This article will discuss ways to facilitate age-appropriate play and encourage exploration of new ways of play for children with trisomy 21.

Ways we can facilitate play can be something as simple as changing the inflection in our voice, having a continuous dialogue with our children or playing with a toy in different ways.

Play is ever changing

First and foremost, play is going to look different at every age. When working with children with T21, it is important not to focus on when play stages are “supposed to happen.” It’s more important to know how to progress play. Think about how a child interacts with a ball. Initially, an infant would just look at a ball. Then the infant will reach for or swat the ball, hold it in their hands, then progress to dropping the ball in a bucket or rolling it to a parent when prompted.

Play starts as an independent activity and becomes more interactive. For example, a child may be content playing with a ball by themselves, then they may start to play with the ball while sitting next to another child to then becoming more socially engaged and tossing a ball back and forth or playing a higher level game with the ball, such as basketball or kickball.

Just in these examples you can see how play is so important to motor (reaching for a ball, holding a ball with two hands, throwing a ball, kicking a ball, etc.) and cognition (becoming aware of the ball, being able to pay attention to the ball for long enough to constructively play with it, looking for a ball in a toy chest, putting two steps together to play like dribbling then throwing the ball, etc.).

Tying in language development

It is easy to incorporate language development during play. You can facilitate verbalizations or language development by narrating what you are doing.

For example, you could say: “This is the green ball.” “Do you want the green ball or yellow ball?” “Ready, set, …” and let the child verbalize the next word, “go!”

Tips to maximize play

If you feel your child is beginning to plateau or needs a lot of toys to stay occupied, they may need a little help. Ways you can redirect play so your child gets the most out of it are:

  • Have the child sit on a stool if they are able to better define a spot where they play and don’t become distracted by crawling again or moving to another toy quickly. This may have to start with a short amount of time, then progress to longer periods.
  • To help with attention, sit directly in front of your child and talk to them while you play. For example, say: “Oh, what’s this? You found the ball! Now push it down the ramp. Great job!”
  • Provide a lot of positive reinforcement when a child does play with a toy the way you are directing them to. “Yay, good job putting the ball in the bucket!”
  • To limit throwing behaviors, physically and verbally redirect. For example, if a child goes to throw a ball to the side without interacting with it, guide their hand back in front of them and facilitate having them put it where you want them to. Say, “No throw. We put the ball in” while you do it.
  • To help provide language the child can use to communicate with you, provide them the cues. For example, your child has been playing with this ball for a while and you notice they are starting to lose interest. Say, “It looks like you are feeling all done with the ball. Are you feeling all done?” This is a great time to incorporate simple sign language with verbalizations. Make sure to wait for a response. If you don’t get one, help them with hand-over-hand sign language and say it at the same time.

Play is kids’ occupation!

Play is so important for many different parts of development, which is why we consider it their occupation. It is amazing how something so natural and simple can lead to so many development milestones.

Play can be hard for parents to facilitate, especially since your role is different than someone like a therapist. Remember to be patient with yourselves, just as you are patient with your child.

This article is just an introduction to play, so you begin to think about something so typical as something much more important. Here are a few additional resources on development of play you may find helpful:

  • A journal article outlining parents play with children with Down syndrome
  • Tips from the American Occupations Therapy Association
  • Helping kids with disabilities learn to play (download to read the full article) 

Contributed by: Anne L. Borema, MS, OTR/L

Categories: Trisomy 21

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