08:45am Monday 24 February 2020

Rutgers Professors Enlist Play to Help Children Cope with Chronic Illness, ADHD

By Lisa Intrabartola
We should take child’s play more seriously.

Rutgers Professors Enlist Play to Help Children Cope with Chronic Illness, ADHD That’s the message from two Rutgers professors whose research has found that play is an invaluable educational resource and emotional outlet for children, including those dealing with serious illness or struggling socially because of developmental disorders.

Credit: Michael Zhang
Play encourages problem-solving and decision-making skills while helping children build relationships and explore ideas.

Cindy Dell Clark likens imaginative play to a muscle: without exercising it, we could lose the mental flexibility required to wrap our heads around life’s hardships.

“We’re all going to confront things that stress us. We can’t protect our children from the world,” said Dell Clark, a visiting associate professor of anthropology at Rutgers-Camden. “What we can do is give them the space within their imagination to help them grapple with its difficulties.”

While all children can benefit from imaginative play, the research outlined in Dell Clark’s book In Sickness and in Play (Rutgers University Press, 2003) found that ill children – including those attending camps for youth with diabetes and asthma – use it as coping mechanism.

“Take, for example, a send up of “Three Little Pigs” written by a group of asthmatic children for their end-of-camp production. In this rewrite, the Big Bad Wolf was stricken with such a severe case of asthma that he required a lung transplant. The spoof momentarily stripped all scariness from the one-time huffer-and-puffer – and their illness.

“They were rolling in the aisles,” said Dell Clark of the children’s response. “The worst part of asthma is it’s smothering. It’s terrifying. And they made a laughing stock out of the very things that are difficult for them to handle.”

Despite the many benefits of unstructured play, children have lost an average of nine hours of free playtime a week since the 1970s.

Aside from taking some of the sting out of living with illness, Dell Clark contends that such play within a peer group creates a culture that can foster acceptance of their disease and treatments – perhaps with better results than adults lecturing about the biomedical nature of their condition.

Such camaraderie typically evades children with ADHD, says Linda Reddy an associate professor of psychology at Rutgers and director of the Child ADHD and ADHD-Related Disorders Clinic in Piscataway.

Most children with ADHD tend not to fair well with traditional social skills. “Many have difficulties making and maintaining friendships due to their inattention, impulsivity, or hyperactivity.”

Some have difficulties during preschool and daycare and, as a result, have fewer invitations for play dates and birthday parties,” said Reddy who recalled tearful parents’ tales of being excluded from family functions because of their children’s behaviors. “So the isolation for the children and even the parents can be quite significant.”

Seeking to reduce this painful ostracizing and improve classroom success rates for children with ADHD and their families, Reddy founded the Child ADHD Multimodal Program (CAMP) while teaching at Farleigh Dickenson University. CAMP is a 10-week training program for 4- to 8-year-old children that uses group play interventions to teach self control and social skills to ADHD children, their parents, and educators. Reddy’s new book, Group Play Interventions for Children: Strategies for Teaching Prosocial Skills, soon to be published by the American Psychological Association Press, is based on that research. The program, which integrates cognitive and behavioral techniques into group play, teaches children skills, such as asking for help or helping others.

Reddy and Dell Clark recommend that all children be allowed to enjoy unfettered and unscheduled play.  But that precious playtime is being threatened. According to a Gannett News Service article, children have lost an average of nine hours of free playtime a week since the 1970s. And when given the opportunity to engage in recreational activities, they are usually adult-led and adult-supervised.

In addition to its obvious physical benefits, play encourages problem-solving and decision-making skills, and helps children build relationships and explore ideas.

Play also allows children to act out a new way of thinking about the real world.

That’s because imaginative play employs liminality, said Dell Clark, which in anthropological terms means a space that is betwixt and between the normal boundaries of reality.

That liminality allows a mother to call a syringe “a zebra” that gives “kisses” to her diabetic son each time he needs insulin. And it’s what gives that child permission to stomp on the “bad” zebra – instead of his mother – after each shot. Role play, imaginary friends, and other free-form play can help any child reconfigure life’s pressures and to cope with agility, Dell Clark said.

“Play is a self-soother, like a teddy,” she said. “This is a way to have a whole place in your mind called transitional space. It’s not a way of separating from reality, but a way to find solace, while remaking what hardships mean or imply.”

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