Children with Intellectual Impairments (page 2)
Up until the later years of the 1960s, there existed, even among professionals, a serious misconception about the play of children with intellectual impairments. This was the assumption that such children do not play, either because they do not want to or because they do not need to (McConkey, 1985). Fortunately, this belief has been changing gradually over the past 20 years.
Why, when it has become increasingly clear to modern child development professionals that play is an essential ingredient in the lives of children, has the play of the child with an intellectual impairment been ignored? In part, it is because the emphasis of those professionals who work with such children has been on intellectual and educational enrichment; their efforts have been characterized by a decidedly remedial focus rather than an appreciation of basic patterns of child development displayed by children in this special population (McConkey, 1985; Quinn & Rubin, 1984).
The capacity for play of children with intellectual deficits has been underestimated because much of the research on the subject has emphasized differences between those who perform at an average intellectual level and those whose performance is below average. In highlighting the ways in which able and mentally impaired children differed in their play, researchers often failed to emphasize the fact that, the differences notwithstanding, children with cognitive deficiencies do indeed play
Throughout the years there have appeared surprisingly few studies of the uses of toys in free play by children who are mentally impaired. The findings from these studies are that (1) children who are intellectually impaired seem to prefer what might be thought of as structured materials, such as puzzles and jacks, while normal children of the same mental age prefer open-ended materials (e.g., art supplies) that allow them to be creative and imaginative (Horne & Philleo, 1942), and (2) children who are mentally disabled are less likely than children who are able to combine objects appropriately in play (Tilton & Ottinger, 1964; Weiner & Weiner, 1974). Tilton and Ottinger (1964) discovered, for example, that normal children will bring objects together in play, as when they build with blocks, combine cups with saucers, or screw nuts into bolts. Children with disabilities are less likely to do so and instead engage in much nonspecific touching of their toys.
How can one interpret the observed differences in the object play of children of different intellectual abilities? It is difficult to do so, both because there are so few studies and because such studies typically contain methodological flaws. Accurate measures of group differences were difficult to obtain in all three studies because in none were there attempts to distinguish between exploratory behavior and play (Quinn & Rubin, 1984). Since the children were observed only in their first session with the toys, the greater amount of nonspecific touching by the group with cognitive deficits may have indicated only that they were less familiar with the materials. It is possible too that children with deficits need more time than able children to learn how to play and how to use toys; after the novelty of the toys had worn off, both groups might have played with them in similar ways. Interestingly enough, in another study, in which children were observed across extended play periods, object play differences between groups differing in intellectual ability failed to appear at all (Hulme & Lunzer, 1966).
Symbolic, or make-believe, play emerges during the second year of life as children acquire the ability to represent the world mentally to themselves. The normal pattern is of a gradual developmental progression into the world of make-believe. But what can be said about the make-believe play of children with cognitive delays? Three main conclusions can be drawn.
First, symbolic play has been observed consistently in such children; there is no evidence that intellectual impairment prevents children from engaging in imaginative acts of make-believe (Casby & Ruder, 1983; Cunningham, Glenn, Wilkinson, & Sloper, 1985; Hellendoorn & Hoekman, 1992; Hill & McCune-Nicolich, 1981; Jeffree & McConkey, 1976; Li, 1985; Wing, Gould, Yeates, & Brierly, 1977).
Second, mental age is a better predictor of the onset of symbolic play than is chronological age; thus, symbolic play typically appears later in intellectually impaired children than in those whose intellectual development is normal. For example, Wing, Gould, Yeates, and Brierly (1977) examined the symbolic play of 108 severely mentally retarded children who ranged in age from 5 to 14 years. Symbolic play was found, but it did not occur before the children had attained a mental age of 20 months. This mental age is approximately the same as the age at which able children begin to become involved in make-believe.
The third conclusion pertains to the fact that symbolic play does not appear suddenly; its onset is gradual, and there seems to be a series of stages through which children progress (Cunningham, Glenn, Wilkinson, & Sloper, 1985; Hill & McCune-Nicolich, 1981; Jeffree & McConkey, 1985). While the stage progression seems to be identical in children at all levels of intellectual ability, children with impairments lag behind able children and are less likely to reach the most sophisticated levels.
As an illustration of evidence in support of this third conclusion, Li (1985) compared the play of 25 children diagnosed as mildly mentally retarded, aged five to seven years, with a matched group of able children. All were given a sand tray and a variety of miniature life toys, such as people, animals, houses, vehicles, signs, trees, and fences, and told to "build something and tell a story about it." After five minutes, if a child had not yet begun to build, he or she would be asked, "What are you making?"
Four levels of make-believe play were identified, with each representing refinements of, and elaborations upon, the preceding ones. The simplest was object-related symbolic play, in which children played out one pretend action sequence, either alone or with a particular toy (e.g., "The soldier's shooting" or"It goes choo-choo"). Next came the level of play with a scene: the child decides in advance on an idea for the play and creates a scene around that idea (e.g., "This is a farm"). There followed the level of play with a theme, in which the play was characterized by a central preplanned theme or action sequence; one child's theme was "making a city in winnter," for example, and all of the play materials were then integrated into this theme. Finally, there was play with a story, which consisted of (1) imaginative play with (2) a sustained theme throughout, and (3) verbalization about the story.
Li (1985) discovered that, not unexpectedly, almost all of the children with intellectual impairments engaged in some forms of symbolic play, but differences appeared in the levels at which the able and the intellectually impaired children were found. For example, approximately half of the able five-year-olds were at the highest levels (themes and stories), but none of the mentally retarded five-year-olds played at those levels. By contrast, only 15 percent of the able five-year-olds played at the first level, while 55 percent of the disabled children engaged in object-related symbolic play.
In conclusion, it seems that children of all intellectual levels involve themselves in functional play with objects, and children at all levels engage in make-believe play. While the research tends to emphasize group differences, the overwhelming impression is one of similarity. That is, it appears that children of different intellectual levels are not qualitatively different in their attitudes toward, and their approaches to play. Those with impairments are simply delayed, but can play as other children do if groups are equated in terms of mental rather than chronological age.
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