A Critical Reframing of Play in Relation to Indigenous Children in Canada

Abstract

In this paper, we explore the implications of applying critical perspectives to the play occupations of Indigenous children in Canada, and of reframing play as an occupational determinant of health. First we consider the normalizing construction of play in early child development. We then apply critical perspectives to discuss the implications of reframing play as an occupational determinant by exploring how Indigenous children's play can be shaped by broader historical, political and socio-economic structures that may otherwise remain obscured. We propose that a critical reframing of play as an occupational determinant of health may be important in fostering health equity for Indigenous children.

Keywords:

• Occupational determinant of health
• Health equity
• Early child development and intervention
• Aboriginal populations
• Indigenous people

Critical theoretical perspectives generate insights on occupations and occupational injustices by challenging tacit assumptions and exposing the complex ways in which they are shaped by, and situated within, systemic relations of power and historical, political and socio-economic structures (Hocking, 2012; Laliberte Rudman, 2012, 2013). Critical theoretical perspectives, however, continue to have a minimal presence in the fields of early child development (ECD),¹ occupational therapy, and occupational science. Whilst there has been some work in these fields on critiquing the hegemony of Western spheres of knowledge, only a relatively small number of ECD (Dahlberg, Moss, & Pence, 2006; Viruru, 2007) and occupation focused theorists internationally (Hammell & Iwama, 2012; Hocking, 2012; Laliberte Rudman, 2013) have drawn oncritical perspectives.

In this paper, we explore the implications of applying critical theoretical perspectives to taken-for-granted assumptions, discourses, and practices in relation to ECD and play in the context of Indigenous children. Our theorizing on play draws primarily on Western postcolonial feminist scholarship (Collins, 2009; hooks, 2000; Mohanty, 2003). As an analytical framework, postcolonial feminism integrates concepts from critical, feminist, postcolonial and intersectional theories, and has the capacity to promote more complex, historicized, contextualized, and nuanced understandings of play. Taking up postcolonial feminism as a critical analytical lens involves recognizing and generating new knowledge from the perspectives and lived experiences of people who experience varying forms of social exclusion, marginalization, and social injustices; these perspectives are considered to be central to the social construction of knowledge, knowledge production, and praxis-oriented inquiry (Anderson, 2004; Browne, Smye, & Varcoe, 2007).

Our analysis is also informed by postcolonial Indigenous knowledge which, as a related but distinct endeavor, emerged “from the inability of Eurocentric theory to deal with the complexities of colonialism and its assumptions” (Battiste, 2000a, p. xix). This perspective calls for complex and transformative strategies in order to better understand and address Indigenous peoples' varied experiences and circumstances related to multiple and intersecting forms of colonization, racism, gendered inequities, and other forms of oppression and marginalization (Battiste, 2000a; Battiste, 2008). As noted by Battiste (2000b), a Mi'kmaq scholar, “Indigenous thinkers use the term ‘postcolonial’ to describe a symbolic strategy for shaping a desirable future, not an existing reality” (p. xix). Thus the ‘post’ in postcolonial does not imply that we have moved beyond inequitable social and power relations; rather that new forms of inequities continue to emerge (Ashcroft, Griffiths, & Tiffin, 2007).

Critical theorizing on play contests a culturalist discourse² in which understandings of play in the context of Indigenous families and children are centred on how this occupation is influenced primarily by local beliefs, values, behaviours and customs. The primary author's research, clinical experiences and professional partnerships with Indigenous families, communities and ECD organizations in British Columbia (Gerlach, 2007, 2008) support our contention that culturally-specific information provides only part of the picture. Early childhood and play in Indigenous families must also be understood in relation to past and ongoing contexts of colonization; this is particularly pertinent in Canada, the United States, New Zealand and Australia.

Currently there remains a distinct lack of Indigenous knowledge and scholarship in relation to this childhood occupation in Canada and internationally. Our intent in writing this paper is not to attempt to represent how play is perceived and experienced by the extremely diverse groups of First Nations, Métis, and Inuit families that live in very different geographical contexts across Canada. Rather, in drawing on critical theoretical perspectives, we aim to promote a more complex analysis of play that moves beyond the notion of culturally-specific information to take into account the ways in which historical, political and socioeconomic conditions influence Indigenous children's play.

From an occupational science perspective, children's participation in meaningful play experiences and opportunities are essential to their individual and collective health and well-being (Durocher, Rappolt, & Gibson, 2013). We suggest that reframing play as an occupational determinant of health not only draws attention to the health benefits of play but also contests the normalizing construction of play and foregrounds how this occupation can be shaped by broader historical, political, and socio-economic structures within society. This has yet to be explored in the occupational science literature, and could contribute significantly to occupational therapy where there is a pervasive use of play in early intervention.

This paper is organized into three sections. First, we provide an overview of Indigenous peoples in Canada and Indigenous children's experiences of health and health inequities. Second, we examine the normalizing construction of play in early childhood. Third, we explore a critical reframing of play as an occupational determinant of health in the context of Indigenous children, including how this central occupation of childhood can be shaped by intersecting historical, political and socio-economic structural factors.

The ideas discussed in this paper are driven by the interests of the first author (Gerlach), an early intervention occupational therapist who has been working with and learning from Indigenous families and Indigenous ECD colleagues in British Columbia, Canada for many years, and who is undertaking doctoral research to explore how health equity for Indigenous children is promoted through an Indigenous-led ECD program in British Columbia. In her clinical work, she considered herself fortunate to be free of constraints often associated with dominant ECD institutions as she was hired directly by an Indigenous organization to provide early intervention occupational therapy. From her growing awareness of critical theoretical perspectives, she realized that whilst she was not necessarily in the ‘master's house’, as she was less constrained by the policies of a mainstream child development agency, she was using the ‘master's tools’ (Lorde, 1984) as the taken-for-granted institutions of ‘early child development’ and ‘occupational therapy’ shaped and constrained her clinical reasoning and practices.

In the introductory section, we provide some contextual information on Indigenous peoples in Canada, and the health and well-being of Indigenous children including the prevalence of health inequities.

Indigenous Peoples in Canada

There are over 370 million Indigenous peoples living worldwide, in countries on every continent (Gracey & King, 2009). In this paper, ‘Indigenous peoples’ refers to people who self-identify as descendants of the original inhabitants of the land now called Canada (Stout & Downey, 2006). There are an estimated 1.4 million Indigenous peoples in Canada, who self-identify as First Nations, Métis and Inuit peoples, and who make up 4.3% of the total population (Statistics Canada, 2013). Indigenous families represent a fast growing, and youthful population, with the majority of families living in urban areas (Statistics Canada, 2008).

Whilst it is important to recognize the enormous diversity within and between Indigenous peoples and Indigenous knowledges,³ there are some commonalities that collectively inform a foundational referent for more localized forms of knowledge (Little Bear, 2000). A shared and central underpinning of many Indigenous philosophies, for example, is a relational understanding of people, spirituality, and the natural world as interdependent and cyclical (Little Bear, 2000). Indigenous knowledge is most often grounded in local contexts, communities and histories, and therefore is inclusive of multiple sets of knowledge in any one nation, community or society (Battiste, 2008). The transmission of Indigenous ways of knowing and being in the world, as they foster a sense of cultural identity and continuity, are increasingly recognized as a vital Indigenous determinant of individual and collective health and well-being across the life course (Chandler & Lalonde, 1998, 2008; Reading & Wien, 2009).

Many Indigenous peoples in Canada and in other national contexts share a common history of colonization. Colonization has been defined as “a process that includes geographic incursion, socio-cultural dislocation, the establishment of external political control and economic dispossession, the provision of low-level social services and ultimately, the creation of ideological formulations around race and skin color that position the colonizer at a higher evolution level than the colonized” (Kelm, 1998, p. 123). Colonization, as manifested in patriarchal and colonial relations between Indigenous peoples and the State, systemic racism and discrimination, economic and political marginalization and lack of self-determination, intersects in multiple and complex ways with other fundamental determinants of health, including education, employment, housing and food security, to adversely influence the health and well-being of Indigenous families, communities and Nations, and the children who are born and raised within them (Adelson, 2005; Greenwood & de Leeuw, 2012).

Colonization has had a relentless focus on Indigenous children (de Leeuw, 2009). State sanctioned residential schools, which operated in Canada between the mid-1800s until as late as 1996, have been described as “the core of the damage, beyond all the other mechanisms cleverly fashioned to subjugate, assimilate, and annihilate” (Armstrong, 1996, p. x). During this period, it is estimated that 100,000 Indigenous children aged 4 to 18 were forced to attend residential schools as part of the Canadian government's assimilation plan (Royal Commission on Aboriginal Peoples, 1996b). Many of the children who attended residential schools were physically punished, emotionally traumatized, sexually abused, and denied the opportunity of having healthy and loving relationships with siblings, parents, and extended family (Fournier & Crey, 1997; Haig-Brown, 1988; Royal Commission on Aboriginal Peoples, 1996a). Children were also denied the use of their traditional language, customs, diet and tribal way of life, and indoctrinated into a system based on British industrial schools (Fournier & Crey, 1997; Haig-Brown, 1988).

The Health and Well-being of Indigenous Children in Canada

Although many Indigenous peoples' daily lives continue to be influenced in different ways by past and current colonial policies and practices, many families and communities are thriving and looking to meet the challenges of a fast-growing population of young children who will shape their future. Raising healthy children is key to the work being undertaken to restore and revitalize Indigenous family and community supports and networks (Castellano, 2002). This includes longstanding advocacy by Indigenous families and ECD leaders for the right to design and deliver community-based programs and services that care for, teach and support the health and well-being of Indigenous infants and young children (Blackstock, Bruyere, & Moreau, 2006; First Nations Early Childhood Development Council, 2011). ECD programs and services⁴ that are anchored in local Indigenous knowledge are increasingly recognized for supporting Indigenous infants and young children to have the best start in life (First Nations Early Childhood Development Council, 2011; Greenwood, de Leeuw, & Fraser, 2007). In many communities, Indigenous ECD programs are also increasingly recognized as critical sites for cultural rejuvenation, language revitalization, and community (re)building (First Nations Early Childhood Development Council, 2011; McIvor, 2005).

Indigenous scholars in Canada have conceptualized health in early childhood as “a state of being, involving multiple perspectives and dynamic mechanisms that systematically promote wellbeing” and “where all children are able to reach their potential” (Blackstock et al., 2006, p. 4). Despite the significant strengths within Indigenous families and communities, international concerns continue to center on the high proportion of Indigenous children whose early development, well-being and potential are constrained by the down-stream effects of an inequitable distribution of social determinants and resources (Canadian UNICEF Committee, 2010; de Leeuw & Greenwood, 2011). It has been suggested that improving Indigenous children's early development and health requires a radical shift that is responsive to families' lived realities and the multiple ways in which they are adversely impacted by social determinants that stem from socioeconomic, historical, and political structures that make up the fabric of Canadian society (Greenwood & de Leeuw, 2012; Priest, Mackean, Davis, Waters, & Briggs, 2012).

Whilst mindful of the limitations of the available data on Indigenous children's health and the propensity for health statistics to perpetuate a deficit-orientated and de-contexualized discourse, some statistical information is provided here in order to draw attention to the serious and unjust burden of health inequities and social suffering experienced by Indigenous infants and young children in Canada. Indigenous children remain significantly less healthy than other children in Canada on virtually every measure of health and quality of life, and for many Indigenous children health equity remains out of reach (Ball, 2008; Postl, Cook, & Moffatt, 2010). For example, the average rate of infant mortality is 4 infant deaths per 1,000 live births in the province of BC (Office of the Provincial Health Officer, 2009). For Indigenous infants living on reserves, the rate increases to 5-6 deaths per 1,000 live births; this rate doubles to 10 deaths per 1,000 live births for infants living off reserve and is more likely to be attributable to preventable causes such as sudden infant death syndrome, infections, and other external causes compared to non-Indigenous infants (Office of the Provincial Health Officer, 2009). Health statistics that are directly attributable to the down-stream effects of having many Indigenous children growing up in poverty include a significantly higher prevalence of respiratory problems, including bronchitis and tuberculosis, childhood obesity and diabetes, and accidental injury and death (Office of the Provincial Health Officer, 2009; Public Health Agency of Canada, 2001, 2011; Saylor, 2004).

The World Health Organization (2008) defined health equity as the absence of systematic and remediable differences in one or more aspects of health across socially, economically, or demographically defined populations or population groups. Health equities are closely connected to the distribution of power and wealth within a society, and the social conditions in which people grow and live. Thus the overburden of poor health and quality of life in Indigenous children's early years results from a complex interplay of factors that includes their social identities and historical positioning within a colonial state, and the influence of multiple and intersecting social determinants that are rooted in broader historical, political, and socio-economic structural inequities (Greenwood & de Leeuw, 2012; Greenwood et al., 2007). From this perspective, the persistent and pervasive poor health outcomes experienced by Indigenous children are viewed as health inequities as they are closely connected to the inequitable distribution of power and resources within the ongoing colonial landscape of contemporary Canadian society (Bryant, Raphael, & Rioux, 2010; World Health Organization, 2008).

The Normalizing Construction of Play in Early Childhood

In the following section of this paper, we examine how the occupation of play in early childhood reproduces a normative agenda that is embedded within and sustained through prevailing ECD discourses. Foucault (1972) conceived discourse as “anything but immaterial” as they “systematically form the objects of which they speak” (p. 49). Discourses are both a product and important instrument of power as they transmit and reproduce power (Foucault, 1972).

Prevailing ECD and intervention discourses reflect various perspectives of early childhood, including an economic ‘human capital’ approach (Siddiqi, Hertzman, Irwin, & Hertzman, 2011); a biodevelopmental approach (Shonkoff, 2012), and more recently, a human rights approach (Tobin, 2006). However, they share a common goal of supporting children's early years based on the belief that this is a sensitive period of human development that can influence health and well-being across the life course (Hertzman, 2010; Shonkoff, 2012). Silently embedded within prevailing ECD discourses is the largely unquestioned assumption that these approaches are universal and can be generalized across all child populations (Niles, Byers, & Krueger, 2008; Soto & Swadener, 2002). A tacit conceptual ‘norm’, that all children progress through defined developmental ages and stages, is problematic when it is applied universally through ECD theories and intervention for all children, irrespective of their socio-cultural or historical contexts (Penn, 2008; Rogoff, 2003; Woodhead, 2011).

The ways in which early human development is constructed as ‘childhood’ is “neither a natural nor universal feature of human groups but appears as a specific structural and cultural component of many societies” and is historically specific (Prout & James, 1997, p. 8). Critical early childhood theorists have noted that the construction of ‘early childhood’ occurred in the same historical period as colonization of most parts of the non-Western world and served a similar purpose (Cannella & Viruru, 2004; Dahlberg et al., 2006). Thus “in the same way that geographical realities were created to serve the interests of imperial capitalist powers” a ‘sacred Western lens’ of childhood was created (Canella & Viruru, 2004, p. 4). Described as “another of colonialism's truths that permit no questioning” (Viruru, 2005, p. 16), the construction of childhood represents and reproduces an essentialized⁵ perspective that privileges white, European, Christian ‘norms’ (Dahlberg et al., 2006; Pacini-Ketchabaw, 2010). Thus, hegemonic ECD knowledge represents and reproduces a normative agenda that fails to recognize the diverse socio-cultural, geographical, or historical contexts in which many children live and experience play (Dahlberg et al., 2006; Pacini-Ketchabaw, 2010). This hegemonic stance is imposed relatively uncritically for all children ‘for their own good’ and is tacitly reproduced through prevailing ECD discourse and intervention practices, state priorities, and funding policies (Dahlberg et al., 2006; Viruru, 2005).

In Western societies, play is considered uniquely important for children, as it is considered to have both intrinsic value as an enjoyable occupation, and extrinsic value, supporting learning and healthy development (Goodley & Runswick-Cole, 2010; Woodhead & Oates, 2013). Play has been described as a ‘cherished part of childhood’ (Ginsburg, 2007), ‘a universal human right’ (UNICEF, n.d.; Woodhead & Oates, 2013) and essential to children's optimal development and well-being (Case-Smith & O'Brien, 2010).

Prevailing discourses on play in ECD and occupational therapy, underpinned by assumptions that play is universal and necessary for promoting development, are largely derived from research involving White, middle-class children (Bazyk, Stalnaker, Llerena, Ekleman, & Bazyk, 2003). In early intervention occupational therapy, play is frequently used as a therapeutic technique for evaluation and intervention undertaken with children who are at risk for, or who have, developmental differences or disabilities (Case-Smith & O'Brien, 2010). Occupational therapists routinely attend to how children participate in play, evaluate children's development using play-based occupations, and adapt play activities to promote development and independence (Case-Smith & O'Brien, 2010; Parham & Fazio, 1997).

Western scholarship that has contributed towards a primarily culturalist discourse on childhood occupation has highlighted how play can be shaped by diverse child rearing practices, family structures, parental values, beliefs and expectations related to childhood, and local geographical contexts (Bazyk et al., 2003; Dender & Stagnitti, 2011; Rogoff, 2003). However, in drawing on critical perspectives, we assert that children's play has been largely defined, categorized, and decontextualized by adults from primarily a White, middle-class, and urban perspective. It may therefore be more accurate to reframe much of what is taken for granted as ‘play’ as ‘Western play’ (Bazyk et al., 2003; Fleer, 1996). There remains a distinct gap in the literature on Indigenous children's play in Canada, and internationally, that is generated through Indigenous methodologies and grounded in Indigenous ways of knowing and doing.

Play as a means of governance

Critical disability theorists have described the prevailing use of play in early intervention contexts as a “means of governance, surveillance and control of disabled children and their families normalcy” (Goodley & Runswick-Cole, 2010, p. 504). In the context of Indigenous peoples, surveillance has been described as a powerful strategy of colonization as “it implies a viewer with an elevated vantage point” who has the power to define and objectify the colonized subject “in a way that fixes its identity in relation to the surveyor” (Ashcroft et al., 2007, p. 226). For Indigenous mothers, play as an act of ‘governance and surveillance’ can be viewed as particularly problematic, given Canada's residential school history and the ongoing state surveillance of Indigenous parents and children through contemporary child welfare services⁶ (Cull, 2006; Denison, Varcoe, & Browne, 2013). The perpetuation of state power through mechanisms of surveillance and intervention in Indigenous children's lives is structured through enduring patriarchal and racialized⁷ discourses that silently reproduce historically-rooted and enduring assumptions of Indigenous children as ‘at risk’ (Cull, 2006; Denison et al., 2013).

Racializing discourses that define, categorize and mange Indigenous children as ‘at risk’ have become embedded in the normative fabric of Canadian society, and legitimize and perpetuate state surveillance and intervention in the lives of these children. Black feminist scholar Patricia Hill Collins (2009) noted that dominant groups maintain their power by creating “a popular system of ‘commonsense’ ideas that support their right to rule,” which may be so pervasive that “it is difficult to conceptualize alternatives to them, let alone ways of resisting the social practices that they justify” (p. 302).

We question how racializing discourses and patriarchal relations of surveillance between the state and Indigenous mothers are, albeit unknowingly, perpetuated through and manifested in how play has been constructed in prevailing ECD and intervention discourses as a technique for the normative evaluation of Indigenous children's development and the quality of parent-child relationships. We are concerned that acontextual and normative understandings of play run the risk (often unknowingly) of perpetuating normative comparisons and judgments of Indigenous children as ‘at risk’ and Indigenous mothers as negligent. Furthermore, ethnocentric developmental and biomedical understandings of play that are complicit in a silent agenda of hetero-normativity not only erase children's socio-cultural and historical positioning (Rogoff, 2003), but also the impact of social factors and structures on their early years and their health and well-being (Bryant et al., 2010). This hegemonic epistemology has become integral to everyday and ‘common sense’ understandings of play in ECD and early intervention occupational therapy. Less attention has been given to how play is influenced by broader factors and contexts, and subsequently there is a lack of research in this area. In the following section of this paper, we explore the implications of reframing play from a critical occupational science perspective as an occupational determinant of health in the context of Indigenous children.

A Critical Reframing of Play as an Occupational Determinant of Health for Indigenous Children

In considering the play of Indigenous children from a critical occupational science perspective, we argue that historical, political, and socio-economic structures create occupational injustices when they prevent children from participating fully and freely in meaningful play as a health-promoting occupation of early childhood. An occupational justice perspective highlights the unique nature of an individual's occupational needs, routines, and potential, and the relationship between occupation and the socio-emotional and physical aspects of health and well-being (Stadnyk, Townsend, & Wilcock, 2010). Occupational injustice is believed to occur when individuals are either prevented from participating in occupations, or have occupations imposed on them that are unlikely to be of benefit (Stadnyk et al., 2010).

A critical reframing of play as an occupational determinant of health draws attention to how occupational injustices involving this childhood occupation can stem from factors that are rooted in broader social structures that are beyond a parent's immediate control. We propose that a critical reframing of play as an occupational determinant of health highlights how Indigenous children's opportunities and experiences to participate in meaningful play can be shaped by historical, political and socio-economic structural inequities. A critical reframing of play also contests the dominant discourse about Indigenous motherhood in which mother-child, play-based interactions and play opportunities within a home are understood to be a mother's choice and judged against normative standards. This critical reframing is aligned with the call within the occupational science literature for more critical analyses of the prevailing assumption of individualism in relation to occupation, and how occupational experiences and opportunities, particularly for people who continue to experience marginalization, are shaped by broader structural forces within societies (Laliberte Rudman, 2013; Hocking & Whiteford, 2012).

It is important to recognize, however, that reframing play as an occupational determinant of health perpetuates the use of the ‘master's tools,’ as discussions draw on and reproduce dominant concepts and ideology. This situation is compounded by the absence of knowledge on play in early child development, occupational therapy and occupational science from the perspectives of Indigenous families and children.

In the following section of this paper, we use the Canadian context to explore play as an occupational determinant of health and examine how this occupation in the context of Indigenous families and their children can be profoundly shaped by historical, political and socio-economic structures. Whilst these are presented separately, we perceive these structural factors and processes as intersecting in multiple and complex ways to shape Indigenous children's play within their families and communities.

How the legacies of the residential school system shape play within Indigenous families and communities

For over 100 years of Canada's recent history, multiple generations of Indigenous children's play opportunities and experiences were severely constrained through the residential school system. During this era of Canadian history, Indigenous childhood was structured and controlled by the state through enforced attendance at residential schools that were intended to assimilate Indigenous children into White society (Fournier & Crey, 1997). This assimilation process denied Indigenous children the freedom and experience of playing with, and developing relationships through meaningful play with their friends, siblings and families in their own languages; playing in ways that reflected their families' beliefs, values and local knowledge, and playing on their land and traditional territory. In residential schools, the freedom to participate in meaningful play was replaced with imposed occupations focused on children's future roles as menial workers in a White settler society (Fiske, 2009; Fournier & Crey, 1997). Occupations were gendered and confined to specific areas: “Outdoor spaces were masculine; boys worked in fields and carried out routine tasks in barns and other buildings. Indoors was a female space; in the infirmary, kitchen and sewing rooms, girls learned their gendered roles through the embodiment of domestic tasks” (Fiske, 2009, pp. 148-149).

Child rearing practices in many Indigenous families in Canada have been significantly shaped by the intergenerational impact of the residential school system (Gerlach, 2008; Irvine, 2009). For many Indigenous families, parental responses to the intergenerational trauma of the residential school system have been framed in relation to ‘disrupted attachment’ relationships with their children (Haskell & Randall, 2009). Disruption in parent-infant attachment as a result of intergenerational trauma from the residential school system can be manifested in a mother or father not knowing how to interact, engage, and bond with their children through play or by being playful as a result of their own childhood experiences. Thus we propose that Indigenous children's play experiences within their homes may be shaped by intergenerational occupational injustices as parents' own lack of participation in childhood play experiences are transferred forward to the next generation.

We contend that framing play as an occupational determinant of health in the context of Indigenous children in Canada highlights how this determinant can be rooted in and shaped by historical and socio-political factors that do not affect non-Indigenous children. Normative assumptions about parent-infant play, and play within Indigenous families, can increase the likelihood that parents are blamed and shamed as disinterested in, or even neglectful of, their children. Furthermore, that early intervention play-based strategies lack relevancy or efficacy as they are based on the assumption that all parents know how to play and be playful with their children. Reframing play as an occupational determinant in the context of Indigenous children may therefore disrupt and contest implicit racialized discourses about Indigenous mothers, and provoke a more critical and trauma-informed approach to how play is conceptualized and used in early intervention.

Rather than being influenced by any one factor, we view Indigenous children's access to the health benefits of play as being shaped by a complex intersection of social factors and structures. In the following section we highlight the impact of a neoliberal discourse of school readiness and socio-economic structures.

How neoliberal discourses of ‘school readiness’ shape play in Indigenous children's early years

A neoliberal⁸ prioritization on ‘school readiness’ has had a pervasive impact on shaping early childhood and the nature of ECD and early intervention practices. Prevailing discourses that privilege play as ‘child's work’ have been criticized for aligning with a neoliberal agenda of school readiness and the appropriation of early childhood as a time to prepare for future productivity in the workforce (Ginsburg, 2007). An agenda of school readiness objectifies children as ‘human capital’ and early childhood as a critical period of opportunity or risk for future adult productivity and national economic growth and stability (Goodley & Runswick-Cole, 2010).

Whilst we share these concerns about the prioritization of school readiness for all children, we are concerned that the prioritization of play occupations that focus on developing literacy, numeracy and the English language is a more insidious and pervasive form of colonization as Indigenous children are primarily viewed as human capital for the economic health of the state. Government agencies increasingly mandate and prioritize school readiness in their funding requirements for Indigenous ECD programs (Ball & Le Mar, 2011). School readiness has also become a central feature of early intervention occupational therapy as therapists' expertise in children's fine-motor development, for example, is often translated into play-based therapeutic activities aimed at promoting early literacy skills that support an agenda of school readiness.

As previously noted, Canada has a long history of colonization centred on the assimilation of Indigenous children for the benefit of the state (de Leeuw, 2009). ECD and early intervention programs that privilege school readiness in the context of Indigenous children risk perpetuating the role of the state in containing and shaping their early play experiences. Research in British Columbia suggests that whilst Indigenous families and ECD providers view early education as key to alleviating poverty in their communities, they are also concerned that externally designed school readiness programs and the current narrow focus on early literacy, numeracy, and English language skills pre-empts the underlying philosophy of Indigenous ECD programs that includes a focus on cultural rejuvenation, self-determination and a broad perspective of health and well-being (Ball & Le Mar, 2011). The privileging of school readiness in Indigenous ECD settings risks that Indigenous children lack access to early childhood occupational experiences that promote the intergenerational transmission of ancestral knowledge and language, and support the development of a greater sense of cultural identity and pride (Ball & Le Mar, 2011; Greenwood et al., 2007).

Cultural identity and continuity are increasingly recognized as fundamental determinants of health for Indigenous peoples, with implications for their health and well-being across their life course (Chandler & Lalonde, 1998; Greenwood & de Leeuw, 2012). Research suggests that Indigenous parents believe that having a sense of cultural and spiritual identity helps their children overcome the challenges they are likely to face from living in a colonial society (Ball, 2012, p. 289). Thus, culturally meaningful occupations, that is occupations that connect Indigenous children with their history, land, language and ancestral knowledge, represent occupations that are highly valued and essential for Indigenous children's long term health and well-being. This is aligned with a longstanding call by Indigenous leaders in Canada for self-governance over the funding, design and delivery of ECD programs in their communities, so that the nature of Indigenous early childhood is no longer constrained by state-sanctioned programming that is a requirement of funding (Blackstock et al., 2006; First Nations Early Childhood Development Council, 2011).

We propose that the subjugation of Indigenous knowledge in ECD programs, in pursuit of a broader political agenda of promoting human capital and state growth, may be viewed as an occupational injustice as Indigenous children are denied their right to fully participate in culturally meaningful occupations. Skill development in early literacy and numeracy are important, however, we propose that taking up a broader and more critical perspectives of play as an occupational determinant of health highlights the socio-cultural nature of this occupation. Further, such a perspective can support ECD and early intervention professionals to recognize their responsibility to broaden their thinking beyond a Western perspective so that their use of play is more informed and respectful of Indigenous families and communities knowledge and self-identified priorities.

How socio-economic inequities shape play within Indigenous families and communities

Taking up a critical perspective of play as an occupational determinant of health also draws attention to how Indigenous children's early play experiences and opportunities intersect with socio-economic determinants that are rooted in how Canadian society is structured. From this perspective, we believe that play as an occupational determinant of health is adversely impacted through gendered, classed, and racializing discrimination that is embedded in neoliberal modes of governance that inform the distribution of social and economic resources through public policies.

Neoliberal social and welfare policies that defer “responsibility from the public/macro-scale to the private/micro- or family scale” (Gurstein & Vilches, 2011, p. 226) create conditions of extreme vulnerability for the increasing number of Indigenous lone mothers in caring for themselves and their children. Raising children as single mothers living on incomes that are often below poverty levels increases the vulnerability for both the mother and her children in ways that are not only unacknowledged but actually increased through current social and welfare policies (Gurstein & Vilches, 2011; Russell, 2011). Whilst it is recognized that economic structures create a disproportionate distribution of adverse social determinants, such as unsafe and inadequate housing and food shortages, their impact on play as an occupational determinant of health in early childhood has yet to be considered.

As Milteer and Ginsburg (2012) asserted, “although lower-income parents may have the same desires for their children to succeed and reach their full potential as do parents with greater economic and social assets,” (p. 208) their efforts may through necessity be more focused on ensuring their family's survival. When families experience food and housing insecurity, making sure that their children have active and creative play opportunities both inside and outside of their home may not be a choice (Milteer & Ginsburg, 2012). Thus, socio-economic and political structures, particularly as they intersect with Indigenous mothers' historical positioning in Canadian society, may result in children having inequitable access to meaningful play opportunities and experiences compared to non-Indigenous and middle-class families. “Because play holds so many benefits, including fostering connection between parents and children, less play may be an added, although rarely mentioned, risk of poverty” (Milteer & Ginsburg, 2012, p. 208).

We contend that reframing play as an occupational determinant of health draws much needed attention to how Indigenous children's play experiences and opportunities can be influenced by their parents' socio-economic circumstances and their access to other social determinants. In taking a more critical stance, supporting parent-infant play and playfulness needs to take into account and be responsive to a family's socio-economic circumstances and how this may be influencing their resourcefulness and agency in relation to their children's play. Otherwise, play as a technique of ECD evaluation and intervention may fail to be meaningful or effective for children and families who are living with social disadvantages rooted in structural inequities.

Conclusion

Indigenous children experience a disproportionate amount of unjust and potentially preventable health inequities. In working towards addressing Indigenous children's health inequities, we are calling for a more critical analysis of play as an occupational determinant of their health and well-being. This requires that ECD and early intervention professionals move beyond how play is currently constructed within prevailing discourses and taken up in their routine practices. Reframing play as an occupational determinant of health may support questioning of taken-for-granted assumptions and routine practices surrounding Indigenous children's play that risk inadvertently and silently perpetuating a normalizing and colonizing agenda that includes the surveillance of Indigenous mothers and racialized discourses of Indigenous children as at risk. A critical reframing of play may also serve to generate a more nuanced, contextually-tailored and trauma-informed discourse on how to support play opportunities for Indigenous children in their homes and in ECD and intervention programs.

Taking up critical perspectives of play as an occupational determinant of health requires that Indigenous families and children's play is understood within the context of broader historical, political, and socio-economic structure, that are largely beyond the control of individual families, and which can intersect in complex ways to become embodied in the lived realities of Indigenous children's play interactions, opportunities and experiences. Thus, positioning play as an occupational determinant of health may be an important element in fostering health equity as it requires practices to become more attentive and responsive to the complex ways in which Indigenous children's play and the benefits derived from this occupation are shaped by families' socio-historical and political location within Canadian society. We believe that addressing Indigenous children's health inequities may require macro- and micro-levels of intervention to foster meaningful early play experiences and opportunities, and structural changes that can foster children's equitable access to the potential health promoting benefits of play.

Finally, we conclude that enacting the critical potential of occupational science requires theoretical perspectives that deepen and broaden our understanding of the complexities of occupations and the ways in which they are shaped by people's social identities as they interact with broader contextual and structural factors (Laliberte Rudman, 2013). As an analytical framework, postcolonial feminism draws occupational scientists' attention to the ways in which gender, racialization, socio-economic status, and historical positioning intersect simultaneously to shape peoples' material existence. From this perspective, individual experiences are linked with broader social and structural forces and contexts in order to generate knowledge that can contribute towards addressing injustices and inequities (Anderson, 2004). Thus, framing occupation from a critical postcolonial feminist perspective brings a moral obligation to move beyond descriptions and narratives, and to address Indigenous peoples' experiences of occupational marginalization and injustice. This will require research that is undertaken by, or with, Indigenous scholars and community research partners so that knowledge production is grounded in the lived experiences and perspectives of families and children who have been historically silenced and contributes in a meaningful way towards transformative social action.

Notes

1. We use the term ‘early child development’ to refer to a broad range of scholarship that is focused on the period of human development from 0-5 years. Increasing evidence suggests that this is a critical period for early intervention, particularly for children who have developmental differences or who are living with social disadvantages, in order to promote their health and well-being across their life course (Milteer & Ginsburg, 2012, p. 208).

2. By ‘culturalist discourses’ we are referring to the complex practices and ideologies that conflate culture with ethnicity as the primary analytical lens for understanding presumed differences about various groups of people. In the context of Indigenous peoples, culturalism is complicit in a colonial discourse of ‘Othering’ (Browne & Varcoe, 2006).

3. Battiste and Henderson (2000) identified the features common to Indigenous knowledge, including: (1) knowledge of and belief in unseen powers in the ecosystem; (2) knowledge that all things in the ecosystem are dependent on each other; (3) knowledge that reality is structured according to most of the linguistic concepts by which Indigenous (people) describe it; (4) knowledge that personal relationships reinforce the bond between persons, communities and ecosystems; (5) knowledge that sacred traditions and persons who know these traditions are responsible for teaching “morals” and “ethics” to practitioners, who are then given responsibility for this specialized knowledge and its dissemination (p. 42).

4. Indigenous ECD programs and services may include childcare/daycare centres, part-time preschools, home visiting programs, outreach programs, adult and tot drop-in programs, Head Start programs, and programs based in community centres.

5. Colonial discourses promoted essentialism “to create the idea of the inferiority of the colonial subject and to exercise hegemonic control over them through control of the dominant modes of public and private representation” (Ashcroft et al., 2007, p. 73).

6. There are now more Indigenous children in ‘state care’ than at the peak of the residential school system (Blackstock, 2011).

7. Racialization refers to a process of attributing social, economic, and cultural differences to race. Racialization may be conscious and deliberate (an act of racism that discriminates openly) or unconscious and unintended. It “takes its power from everyday actions and attitudes and from institutionalized policies and practices that marginalize individuals and collectives on the basis of presumed biological, physical, or genetic differences” (Browne, Smye, & Varcoe, 2005, p. 21).

8. Neoliberalism is a political ideology grounded in a fundamental philosophy of contemporary capitalism, in which people are constructed by their labour power, and illness is significant for one's inability to work or participate in consumerism (Bryant et al., 2010).