Playfulness in Children with Traumatic Brain Injury

Abstract

The sequelae of paediatric traumatic brain injury (TBI) are well documented as being permanent and pervasive. The impact, however, on how a child approaches the childhood occupation of play, termed 'playfulness,' has been neglected. This prospective analysis of difference study used the Test of Playfulness to compare the playfulness of eight children aged 3-13 years diagnosed with moderate to severe TBI to an age-matched control group. Using Rasch analysis, the TBI group did demonstrate the behaviour of playfulness, but to a significantly lower extent than the control group (Wilcoxon matched-pairs signed-ranks (T(8) = 0, p= .012). The findings suggest that playfulness is negatively impacted by TBI, and that strategies to legitimise and optimise playfulness be incorporated into therapy practice for this population.

Key Words:

• Pediatrics
• brain injury
• rehabilitation
• play
• playfulness

Additional information

Notes on contributors

Patricia A Mortenson

Michael Lepp, PT, is in private practice, Associate Instructor of the Upledger Institute, and Clinical Instructor, Case Western Reserve University School of Dentistry, Cleveland, OH.

Marie McKenzie, MS, OTR, is in private practice. She was Coordinator of Occupational Therapy at Scottish Rite Hospital at the time of this study.

Heather Miller, MS, OTR/L, is currently employed by Madison County Educational Service Center, providing therapy services to the county's pre-schools. This research was completed in partial fulfillment of the requirements of an MS degree at Ohio State University.

Linda Viscardis, BA, is Team Leader and Community Development Worker, Peterborough Family Enrichment Centre. She is Co-Founder of P.R.O.S.P.E.C.T.S., a support and advocacy group for families who have children with special needs.

Debra Stewart, BSc, OT(C), is Occupational Therapist, Erinoak, Serving Young People with Physical Disabilities, Mississauga, ON, and Clinical Lecturer, School of Rehabilitation Science, McMaster University.

Janette McDougall, MA, was Project Coordinator

Kip Husted, BEd, was a parent representative on the study team.

Aviva Yochman, MA, OTR, was a student in the School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel at the time of this study.

Imelda Burgman, MA OTR/L BCP, completed her MA in Movement Sciences at Teachers College, Columbia University, and was an Occupational Therapist at The Shield Institute, Bronx, NY. She is currently Lecturer, Habilitation, School of Community Health, Faculty of Health Studies, Charles Sturt University, Albury, N.S.W., Australia.

Barbara J. Steva, OTWL, BCP, is Occupational Therapist, University of New England Community Occupational Therapy Clinic, Saco, ME. She was Director of Occupational Therapy and Therapeutic Recreation, Franciscan Children's Hospital and Rehabilitation Center, Boston, MA, when this work was completed.

Mary-Ann L. Fulks, MSc, OT(C), is Occupational Therapist, Vancouver Community Mental Health Service and Clinical Assistant Professor, School of Rehabilitation Sciences, University of British Columbia. This study was completed in partial fulfillment of a Master of Science degree.

Laura Zawacki, MS, PT, PCS, currently practices Pediatric Physical Therapy in the Chicago metropolitan area.

Judy T. Jennings holds a Certificate in PT and an MA in Special Education and has 25 years of experience as a PT working with children from infancy to high school.

Nicholas S. Payne, PhD, recently retired from 40 years of experience in statistics and data analysis at Proctor & Gamble, Cincinnati, OH. He was recently Research Fellow in Data Analysis, clarifying the needs of mothers and babies.

At the time of this study, Marianne Kratochvil, MA, was a social worker at the Glenrose Rehabilitation Hospital, Edmonton, Alberta. She has since retired.