Play Occupation

• ‘A subjective experience of joy and fun, that comes from engaging in freely chosen, intrinsically motivated, self-directed meaningful occupations; play transactions take place between the child and the environment (including the virtual); play is about the process of engagement rather than the product.'¹ 
• Play is the central domain for occupational therapy practitioners working with children with disabilities and their families.¹ 
• Historically, play was used for purposes such as diversion, development of skills, or remediation.² 
• Play is important for children’s health, development, and wellbeing.³ 
• Play can be a means to achieving developmental goals but also a central occupation.¹ 
• Play can be active or passive (observation).
• Play is for play’s sake or child-initiated free-play.⁴ 

Measurement Tools

• Play History (Takata, 1974)
• Knox Playscale (Knox, 1974)
• Test of Playfulness (Skard and Bundy, 2008)

Challenges of Promoting Play in Practice

• A greater emphasis on scientific and measurable approaches due to a shift to a biomedical model of practice from external pressure on the profession.^5 6 
  • The focus tends to be on body function and impairment rather than participation in play.⁷ 
• Concerns about attitudes towards play in therapy practice⁸ 
• Barriers in service delivery models
• Lack of knowledge
• Limited access to play assessments
• Lack of training
• Reimbursement issues⁹ 
• Difficulties in implementing play-centered interventions.¹⁰ 
• Lack of education, e.g., post-professional OT courses on learning about play.¹¹ 
• Many have called for the profession to embrace occupations such as play as the basis of practice.¹² 

1. Lynch, H., & Moore, A. (2016). Play as an occupation in occupational therapy.[↩][↩][↩]
2. Knox, S.H. (2010), “Play”, in Case-Smith, J. and O’Brien, J.C. (Eds), Occupational Therapy for Children, Elsevier, Missouri, pp. 540-554.[↩]
3. Lester S and Russell W (2010) Children’s right to play - an examination of the importance of play in the lives of children worldwide. Working paper in early childhood no 57. The Hague, The Netherlands, Bernard van Leer Foundaiton.[↩]
4. Lynch H and Moore A (2016) Play as an occupation in occupational therapy. British Journal of Occupational Therapy 79(9):519–520.[↩]
5. Jackson, J. (1998), “The value of occupation as core treatment: Sandy’s experience”, American Journal of Occupational Therapy, Vol. 52 No. 6, pp. 466-473.[↩]
6. Kielhofner, G. and Burke, J.P. (1977), “Occupational therapy after 60 years: an account of changing identity and knowledge”, American Journal of Occupational Therapy, Vol. 31, pp. 675-689.[↩]
7. Saleh M, Korner-Bitensky N, Snider L, et al. (2008) Actual vs. best practices for young children with cerebral palsy: A survey of paediatric occupational therapists and physical therapists in Quebec, Canada. Developmental Neurorehabilitation 11(1):60–80.[↩]
8. Couch, K., Dietz, J. and Kanny, E. (1998), “The role of play in pediatric occupational therapy”, American Journal of Occupational Therapy, Vol. 52 No. 2, pp. 111-117.[↩]
9. Miller-Kuhaneck H, Tanta K, Coombs A, et al. (2013) A survey of pediatric occupational therapists’ use of play. Journal of Occupational Therapy, Schools and Early Intervention 6(3): 213–227.[↩]
10. Rodger S, Brown T, Brown A, et al. (2006) A comparison of paediatric occupational therapy university program curricula in New Zealand, Australia and Canada. Physical & Occupational Therapy in Pediatrics 26(1–2): 153–180.[↩]
11. Lynch, H., Prellwitz, M., Schulze, C., & Moore, A. H. (2018). The state of play in children’s occupational therapy: A comparison between Ireland, Sweden and Switzerland. British Journal of Occupational Therapy, 81(1), 42-50.[↩]
12. Wilcock, A.A. (2005), “Occupational science: bridging occupation and health”, Canadian Journal of Occupational Therapy, Vol. 72 No. 1, pp. 5-12.[↩]