Feedback from our blogs revealed that nannies value tips and advice to help them in their work, so in this issue we bring a question-and-answer session with Dr Debby Watson focusing on playfulness and children with complex needs
Dr Debby Watson is a researcher with special interest in playfulness and children with profound and complex impairments. She recently completed her PhD study and is supporting the Case for Play inquiry launched by deaf-blind charity Sense into the provision of play opportunities for children aged 0-5 with multiple needs, in England and Wales.
What is playfulness?
Playfulness is one of those things that is really hard to define, but unmistakable when you see or feel it. In children with complex and profound needs, it can be a bit harder to spot because of physical, communication and sensory impairments, but it is definitely there. Often, it’s a case of knowing a child really well and being able to recognise their particular expression of playfulness.
I would say that playfulness in children with complex needs involves several elements: a lift in mood; physical signs; increased awareness; increased motivation and a sense of fun and humour being present.
Why is playfulness so important for children with complex needs?
Although it is also really difficult to say definitively why playfulness is important, in my research there has been strong evidence that it may increase well-being, arousal, communication and responsiveness; make the child feel good and have fun without being judged; help with development; enable the child to be connected to others and may also have educational benefits such as transferring skills, increasing concentration, creative thinking and potentially helping children to entertain themselves.
Above all, though, I think that playfulness helps to make children become excited and have fun. In that state, other things such as the motivation to reach out or make sounds will follow.
What are the barriers to playfulness?
It is remarkable that children with complex needs are playful at all considering the enormous barriers to playfulness that they have. To me, it shows just how fundamentally important playfulness is, because it survives barriers such as feeling unwell, being uncomfortable and being misunderstood – in addition to all the more obvious barriers such as not being able to get up and run around, or not being able to hear or see well.
Adult participants in my PhD study in playfulness and children with profound and complex impairments generally agreed that physical impairments were not the main barriers to playfulness. Instead they felt that poor attitudes, low expectations and difficulties with communication (for the child and the person interacting with them) were more significant.
To me, it’s important to look at barriers and supports on three levels if we want to encourage playfulness: within the child we need to be aware of the child’s preferences, character, communication style and impairments and how these things interact. Around the child, it’s important th think about attributes in supporters that enable receptiveness to, and messages for, playfulness and to pay attention to physical and psychological issues such as positioning, allowing time, reducing stress.
It is also vital to spend time preparing for playfulness and focusing on keeping it going. Beyond the child with profound and multiple learning disabilities (PMLD), it is essential that there is a permissive environment (psychological and physical), where playfulness is encouraged.
My personal plea to care professionals is to talk to the family about encouraging playfulness really early on when a child is identified as having an impairment. Playfulness for this group of children doesn’t need to be ‘special’ with specialist toys or training; it needs to be as natural and as fun as possible, just encouraged for its own sake, not so that a box on an assessment form can be ticked. Siblings and other children are really good at it and we could learn a lot from them.
How can we support children with complex needs to be playful?
In lot’s of ways! However, many of them will be very individual to a particular child.
During my PhD research, I looked carefully at what sort of attributes people need to encourage playfulness and the top three things were: knowing and understanding the child well, with trust between the ‘play partners’ being established; being able to model playfulness and being willing to be silly and playful oneself; and being patient and persistent, not giving up easily if there seems to be little response, but willing to try different things out.
Finally, it’s really important to ‘tune in’ to a child and go along with the child’s choices as this can work well in encouraging playfulness.
Playfulness is such an important aspect of all our lives, but for children with complex needs it can get lost in a world of assessments, health scares and exhausted carers. I hope that by promoting playfulness as a vital aspect of life through my research and involvement with the Case for Play it will go some way to putting it higher up the list of priorities. After all, it’s not as it’s not fun!
About the ‘Case for Play’ inquiry
Sense has supported and campaigned for people with multiple impairments for the last 60 years. The charity ran a public inquiry into the provision of play opportunities for children aged 0-5 with multiple needs in England and Wales.
The inquiry aimed to help lift the lid on the barriers that are preventing children with multiple needs from enjoying play activities, and potentially holding back their development. The evidence submitted to the inquiry formed the basis of a report setting out recommendations for national and local government and organisations that provide play opportunities.