Effects of three play conditions on separation anxiety in young children

Pretend play as abstraction: Implications for early development and beyond

Humans are the only species that engages in sustained, complex pretend play. As pretend play is practically ubiquitous across cultures, it might support or afford a context for developmental advances during the juvenile period that have implications for functioning in adulthood. Early in development, learning to separate our thoughts from reality is practiced in pretend play and is associated with changes not just in cognition, but in emotional and social domains as well. Specifically, pretend play affords opportunities to engage in abstractions that could support abilities such as perspective-taking, emotion recognition and regulation, and cooperation and negotiation in childhood. In turn, the abstraction skills promoted by early pretend play might underlie creativity, innovation, and our capacity to feel empathy and moral obligation to others in later childhood and adulthood. In fact, because pretend play affords sharing our abstractions with others, it might be an early context for behaviors that ultimately promote the shared abstractions of human culture itself.

Child Adjustment During COVID-19: The Role of Economic Hardship, Caregiver Stress, and Pandemic Play

The coronavirus disease 2019 (COVID-19) led to many lifestyle changes and economic hardships for families with young children. Previous research on risk and resilience highlights that children's adjustment to family hardships is influenced by caregiver stress, but individual child behaviors and characteristics may protect children from negative outcomes. Interestingly, many children have been reported to incorporate COVID-19 themes in their pretend play. Theory suggests children may do so to cope with pandemic-related stress, but no empirical studies have explored this possibility. The purpose of this study was to understand the process by which COVID-19 economic hardships experienced by a family were related to children's emotional well-being and development and to investigate how this process may vary as a function of children's engagement in pandemic-related pretend play. Caregivers (N = 99; mostly high earning families) of preschoolers ages 3-6 years (51% girls, 82% White) living in the United States participated in an online survey at two time points during the pandemic. Result revealed that COVID-19 economic hardships were related to increased caregiver stress, which, in turn, was associated with children's emotional distress and poorer self-regulation. However, engaging in pandemic-related pretend play appeared to protect children's well-being by weakening the adverse association between caregivers' stress and children's emotional distress. Thus, addressing caregiver stress levels and allowing children an outlet to cope with challenges through pretend play could have crucial protective effects on early development and well-being during times of crisis.

Just Playing … is it Time Wasted?

Occupational therapists may embark on play therapy as part of an intervention package in child psychiatry. This article examines the effectiveness of play therapy with children who have experienced emotional deprivation. Even though emotional deprivation is seldom the primary reason for referral, it may underpin the behavioural difficulties with which the children present. One important aspect of emotional deprivation appears to be the disruption of early dose relationships and, traditionally, the damage caused by this has been considered irreversible. Consequently, the possibility of children deriving benefit from play therapy and the lack of clarity about emotional deprivation are examined.

Research that sheds light on this discussion is considered and, finally, the ways in which occupational therapists might contribute to this body of research are suggested.

Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety

Anxiety disorders are the most common mental health disorder among children and adolescents. We examined 111 treatment outcome studies testing 204 treatment conditions for child and adolescent anxiety published between 1967 and mid-2013. Studies were selected for inclusion in this review using the PracticeWise Evidence-Based Services database. Using guidelines identified by this journal (Southam-Gerow & Prinstein, 2014), studies were included if they were conducted with children and/or adolescents (ages 1-19) with anxiety and/or avoidance problems. In addition to reviewing the strength of the evidence, the review also examined indicators of effectiveness, common practices across treatment families, and mediators and moderators of treatment outcome. Six treatments reached well-established status for child and adolescent anxiety, 8 were identified as probably efficacious, 2 were identified as possibly efficacious, 6 treatments were deemed experimental, and 8 treatments of questionable efficacy emerged. Findings from this review suggest substantial support for cognitive-behavioral therapy (CBT) as an effective and appropriate first-line treatment for youth with anxiety disorders. Several other treatment approaches emerged as probably efficacious that are not primarily CBT based, suggesting that there are alternative evidence-based treatments that practitioners can turn to for children and adolescents who do not respond well to CBT. The review concludes with a discussion of treatments that improve functioning in addition to reducing symptoms, common practices derived from evidence-based treatments, mediators and moderators of treatment outcomes, recommendations for best practice, and suggestions for future research.

Assessment of brief interventions for nighttime fears in preschool children

Nighttime fears (NF) and sleep problems continue to be major problems in clinical services. The aim was to assess the effects of two brief interventions on NF, and related sleep problems and parental fear-reducing behaviors in children. One hundred and four children aged 4-6 years with significant NF were randomly assigned into two intervention groups: the Huggy-Puppy intervention (HPI), which is based on providing children a puppy doll with a request to take care of the doll, and a revised version (HPI-r) which is based on providing the same doll with a cover story that the doll will serve as a protector. At baseline, the domains of NF, behavior problems, and sleep disruptions were assessed. Data were collected from parents and children using objective and subjective measures. The effects of the interventions were assessed by comparing four time points: baseline, first week of intervention, 1 month, and 6 months after initial intervention time. A waiting list comparison group (WL) was used as spontaneous recovery comparison group. Both interventions significantly reduced NF with similar impact. The improvement after 1 month was significantly higher than in the WL group. Furthermore, both interventions significantly reduced parental fear management behaviors and children's sleep problems. Finally, the reduction in NF and parental fear management strategies were maintained 6 months post-treatment.

CONCLUSIONS

Relatively simple and cost-effective doll interventions can reduce NF and their associated sleep problems. Further research is needed to implement these interventions for other anxiety disorders in childhood.

Empirically tested psychotherapies for youth internalizing and externalizing problems and disorders

This article is a review of specific psychotherapies that have been supported in clinical trials. Treatments that showed significant effects in studies published over a period of 4 decades were identified, with the goal of complementing the overall picture of treatment benefit provided in narrative reviews and meta-analyses with a detailing of the specific interventions that have shown significant effects. The article focuses on treatments for four broad clusters of problems and disorders that account for a very large proportion of youth mental health referrals: anxiety, depression, attention-deficit/hyperactivity, and conduct.

Considering the clinical utility of performance-based measures of childhood anxiety

Examines general issues regarding the clinical utility of performance-based measures and specifically considers the utility of performance measures relevant to childhood anxiety and fear. First, we discuss the limitations of questionnaire and interview measures of childhood anxiety and the ways in which performance-based measures may compensate for or augment the use of such measures. Second, we review the major groups of performance-based measures that are potentially relevant to childhood anxiety and discuss evidence regarding their reliability and validity. Third, in the context of a general discussion of the various ways in which an assessment procedure may have clinical utility, we discuss the extent to which the performance-based techniques reviewed possess utility. Although many of these measures show promise of one or more types of clinical utility, none currently possess sufficient documented utility to warrant their dissemination for clinical use. We conclude by recommending directions for future research to demonstrate and improve the utility of such measures.

The use of child-centered play therapy and filial therapy with Head Start families: a brief report

Play therapy and filial therapy show promise as effective ways to provide direct services to Head Start, addressing the needs of the children, the families, and the Head Start teachers and staff. This paper examines the utility of play and filial therapies for the Head Start population, presents a systemic explanation for the benefit of filial therapy, and provides a case example for illustration.

Play, creativity, and adaptive functioning: implications for play interventions

Discussed the importance of play in creative problem solving and its implications for play interventions. Theory and research in the areas of play and creative cognitive processes and play and creative affective processes are reviewed. Play has been associated with the development of creative problem solving. Creative problem solving is thought to be a resource for everyday coping and adjustment. Play intervention studies that investigate the effects of specific aspects of play on specific criteria would be appropriate for the creative problem-solving and coping area. A systematic program integrating laboratory research on play and creativity, research on play techniques, and play intervention with specific populations is needed.

What's real in children's fantasy play?: fantasy play across the transition to becoming a sibling

This study examined children's fantasy enactments during the critical life transition of becoming a sibling to determine the degree to which the thematic content of fantasy play reflects children's realistic concerns. Thirty 3-5-year-old children played with their best friend at two pre- and three post-birth intervals. Mothers kept diary records of children's concerns, worries, and events they were excited about during 3-day periods surrounding the five play sessions. Raters then evaluated the degree to which the thematic content of the fantasy play was consistent with their concerns as reported by mothers. Overall, little convergence was apparent between the themes of fantasy play and children's perceived concerns. However, a modest relationship was found between acting out positive concerns in play and sibling relationship quality. Although these results lend limited support for the notion that children's concerns are reflected in the content of their spontaneous play, they do suggest that 'playing it out' is beneficial for children.

Group play therapy. Using an interaction model with delayed regressed behaviors in children

This article gives an overview of individual play therapy and relates the concepts of individual play therapy to group play therapy. A new model of group play therapy, an interactional model, is introduced. The article provides basic guidelines for beginning play therapists. An actual group is described and specific interventions for problems are suggested.