What is play therapy, and how do I do it?
If your child is on THE SPECTRUM or delayed in other ways, you’ve probably heard of “play therapy” by now. Play therapy became popular in the 80s and 90s as professionals found out that getting down on the carpet with their autistic-type 2yr olds, and engaging them, actually made progress. You’d think this would be obvious, but it wasn’t something that the professional community had necessarily thought of before—at least, not given at regular doses like “therapy.” Before that, professionals were… well, professional. They sat in chairs and had nice offices with toys, but they administered tests, tried verbal exercises, and had children do activities mostly in chairs and desks. Not exactly the comfort and freedom a child is used to.
Early Intervention is essentially “play therapy,” often mixed with speech therapy. A trained special ed person comes to your house and plays with your little guy for about an hour. She has a bag of toys with her and knows what’s she’s doing, but it is essentially play to engage your child with his or her weaknesses right where s/he’s most comfortable… on the living room carpet. Genius, right!
Well, the good news is you can do play therapy yourself too. If you suspect your child is having developmental problems, if you know they do, or if they don’t but you’re just looking for some more educational time with them, play therapy is a great option.
For the bible on the subject, check out Stanley Greenspan’s book (http://www.amazon.com/Engaging-Autism-Floortime-Approach-Communicate/dp/0738210943/ref=sr_1_1?ie=UTF8&s=books&qid=1250945781&sr=1-1 ). But if you don’t have time for that kind of thing, here’s basically what you need to do. (For ages 0-5).
1) Pick a space and time to do it. Mostly for you so you’ll stick with it, but also because the routine will minister to your child if they are hostile to the idea at first. Most kids love one-on-one time, but some don’t! Make sure it’s a nice comfortable place with space to play. Also make sure it’s not a naturally grumpy time for your child.
2) Set aside some special toys for the time. You don’t have to spend a fortune at Toys R Us, but do consider getting some things that will make the playtime special and familiar. And imaginative since that is usually an area most playtime kids have trouble with. Sometimes this means just some props that you think of using a dozen different ways (i.e. a paper towel tube). Sometimes this is a favorite toy that a child will love going back to (i.e. a little Bob the Builder set or Dora figures). There is merit in some of those toy companies like Imaginarium and Alex that make educational toys for kids, but use your own judgment. (Try not to pick anything too complicated or messy, which will discourage you or your child from wanting to do it again!)
Also, check out a book like Jane Oberlander’s “Slow and Steady, Get Me Ready” (http://www.amazon.com/Slow-Steady-Get-Me-Ready/dp/159160236X/ref=sr_1_1?ie=UTF8&s=books&qid=1250945678&sr=8-1 ) Her book is based on daily different activities you can do with ordinary household items. You can incorporate a couple of these into your routine and change them out as necessary. Love it, love it.
3) Start with about 10 minutes for a reluctant child and work up to about an hour. Start a couple times per week (i.e. MWF) and work up to every day (or even twice a day) depending on the severity of your child’s diagnosis. Think of it like little doses of preschool. It is the concentrated attention regularly that constitutes “therapy” just like at a real therapist’s office.
4) Ok, just start playing with your child. Bring out one toy and set them in front of it, to see what they’ll do. This is child-guided play where you facilitate. Don’t jump in with your whole script and ideas. You’re “peering” here. And you’re building off what your child does.
It helps to have some goals in mind before you start, so know whether your focus is going to be physical, emotional/social, imaginative, language, memory, etc. Your child may have a combination of goals, but try to target no more than two in a session. When your child gets frustrated with a toy or can’t use it, then try another. Don’t go through your props like you’re trying to please the child’s whims, but don’t exasperate them either. You’re going to eventually spend time with everything you’ve got, so do some stretching.
5) Engage their attention. Play therapy is especially good for children with social, emotional, attention, and empathy problems. They may not recognize or want you there in their space, and that’s fine. That’s part of the therapy. What you want to do is engage them, or sometimes gently confront them, especially if they are autism spectrum. If they jump their little horse up and down, you jump yours up and down near them. If they get stuck spinning wheels, you crash your little car into them (gently) saying “Vroom vroom!” Try to get them out of their world and into yours. If they’re verbal but hostile to you, or turn away, aim for the gentle but stubborn approach. It helps to do this in a room where you can close the door so they can’t run away. Make sure you hide other toys too, so they can focus on you and the props you have chosen.
6) Use toys vicariously, to get them to verbalize their experience. If they don’t talk, this might be one of your main goals: to get them to “talk” with their pieces. There are some ways to play with toys if your child is having trouble with language or imagination that I have listed in other posts on speech. This is the first level of play therapy, to get them to be verbal. (i.e. please keep in mind that age-appropriate speech varies widely, and you shouldn’t be making speech a huge goal if your child is under two.)
The second level of play therapy occurs when your child becomes (or is already) verbal. Now you want to use their toys as “counselors” or “mouthpieces.” Don’t talk to them directly, use your piece. Get them to talk back with their piece. Kids will tell you all kinds of things if you let them talk through their pieces, about all kinds of things that upset them. You can also teach all kinds of things through your pieces that they wouldn’t listen to you, their mom, about. Now the playtime isn’t a teaching time, it’s an understanding time. But a good therapist DOES use toy “mouthpieces” therapeutically, say to discuss the toilet or a source of a bad dream, etc. Use your imagination. Keep it pretend and in the realm of playing a game. And if you’re going to teach or talk about something, stick to one theme per session so the child doesn’t feel lectured.
Hooray! You’re a play therapist!