Playing Program for Child Development and Parenting

Overseen By Lola Halperin, EdD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Yeshiva University

Disqualifiers: Sensory deficit, Psychiatric disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

10 Participants Needed

Trial Summary

What is the purpose of this trial?

This project aims to assess the feasibility of an intervention program consisting of parent online group sessions in addition to guided individual play session between parent, child, and occupational therapy student (OTS) or an occupational therapist (OT). The investigators speculate that the Promoting Health Through Play Opportunities program will be effective in improving: 1. Parent ability to support their child's playfulness as measured during 15-minute video-recorded joint play activity at home using the Parent/Caregiver Support of Childre Playfulness \[PC-SCP\]. 2. Child's playfulness behavior as measured during 15-minute video-recorded joint play activity at home using the Test of Playfulness \[ToP\]. 3. Child's psychological adjustment as measured by the Strength and Difficulties Questionnaire \[SDQ\]. 4. Parent's perception and satisfaction from their involvement in the program as measured through open-ended questions.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Playing Playfully to Overcome Adversity?

Research shows that therapeutic play can help children behave more appropriately for their age, reduce anxiety, and improve cooperation during stressful situations like hospitalization. This suggests that play-based treatments can be effective in helping children overcome adversity. ^{1 2 3 4 5}

Is the Playing Program for Child Development and Parenting safe for children?

The research suggests that play activities, including risky outdoor play, generally have positive effects on children's health and development, though they can also be associated with injuries. Programs like Sit Down and Play have been found to be feasible and beneficial in promoting positive parenting behaviors, with no specific safety concerns reported. ^{6 7 8 9 10}

How is the Playing Playfully to Overcome Adversity treatment different from other treatments for child development and parenting?

The Playing Playfully to Overcome Adversity treatment is unique because it uses play and playfulness to help children build resilience and cope with stress, focusing on spontaneous free play that is directed by the children themselves. This approach contrasts with more structured interventions, emphasizing adaptability, control, and emotional balance through play, which is not typically found in other parenting programs. ^{11 12 13 14 15}

Eligibility Criteria

This trial is for parents and their children. It's designed to help improve parenting skills and child development through a program that includes online group sessions for parents, as well as play sessions involving the parent, child, and an occupational therapy professional.

Inclusion Criteria

Enrolled in Head Start pre-school program within New York greater area

For the Spanish speaking group, parent must be fluent in the Spanish language

Parent-child dyads

Exclusion Criteria

I have a hearing or vision problem that makes it hard for me to join online programs.

Parents with psychiatric or behavioral disorders that affect their ability to participate in a group-based intervention

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Parents participate in five 45-minute online group sessions and one 30-minute online guided play session with their child and an occupational therapist or student

6 weeks

Follow-up

Participants are monitored for improvements in parent and child outcomes through assessments and interviews

6 weeks

Treatment Details

Interventions

• Playing Playfully to Overcome Adversity

Trial Overview The 'Promoting Health Through Play' program is being tested to see if it can enhance parent support of their child's playfulness, boost the child's playful behavior, improve psychological adjustment in kids, and increase parental satisfaction with their involvement.

Participant Groups

Group I: Promoting Health Through Play Spanish version Experimental Treatment 1 Intervention

Parent online group sessions- Spanish version consisting of five 45-minute-long parent group online sessions. In addition, each parent-child dyad will receive, one 30-minute-long online guided play session with OTS/OT.

Group II: Promoting Health Through Play English version Experimental Treatment 1 Intervention

Parent online group sessions- English version consisting of five 45-minute-long parent group online sessions. In addition, each parent-child dyad will receive, one 30-minute-long online guided play session with OTS/OT.

Who Is Running the Clinical Trial?

Yeshiva University

Lead Sponsor

Trials

13

Recruited

2,600+

Head Start

Collaborator

Trials

1

Recruited

10+

Findings from Research

Therapeutic play was effective in helping children aged 3 to 5 years who were recently hospitalized to behave in ways that are typical for their age group.

The children demonstrated signs of adaptation and increased ego strength, suggesting that therapeutic play can support emotional and psychological resilience in young hospitalized patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[The effect of the use of therapeutic play by the pediatric nurse on the behavior of recently hospitalized children]. Ribeiro, CA.[2019]

A play-based psychosocial intervention delivered by psychology trainees significantly reduced parental stress during their child's hospitalization, with only 5% of parents feeling stressed about their child's illness after the intervention.

The intervention was well-received, with 90-96% of parents feeling respected and understood, indicating that such programs can enhance child-parent interactions and improve the overall hospital experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and feasibility testing of a play-based psychosocial intervention for reduced patient stress in a pediatric care setting: experiences from Pakistan. Rasheed, MA., Bharuchi, V., Mughis, W., et al.[2021]

Therapeutic play, in the form of an interactive puppet show, significantly reduced anxiety and increased cooperation in preschool children before surgery, as evidenced by lower blood pressure and pulse rates during a stressful injection compared to a control group.

Children who participated in therapeutic play also showed quicker recovery indicators, such as faster bladder voiding after surgery and lower stress-related behavior scores after hospital discharge, highlighting its efficacy in managing stress during hospitalization.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Therapeutic play for hospitalized preschoolers in Lebanon. Zahr, LK.[2015]

This study highlights the importance of assessing 'playfulness' in children, which refers to their approach and attitude during play, rather than just focusing on motor skills, as traditionally done in occupational therapy.

By comparing four children who received targeted occupational therapy interventions to improve play behaviors with four who did not, the study provides valuable insights for therapists to design effective treatments aimed at enhancing playfulness in children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Occupational Therapy on a Child's Playfulness. O'Brien, J., Coker, P., Lynn, R., et al.[2022]

The therapeutic play/play therapy (TP/PT) program significantly reduced post-operative pain in children, as evidenced by decreasing pain scores measured with the Wong-Baker Faces Pain Rating Scale.

Parents' anxiety levels also significantly decreased after the TP/PT program, indicating that the therapy not only helps children but also alleviates parental anxiety during the post-operative period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reducing Children's Pain and Parents' Anxiety in the Postoperative Period: A Therapeutic Model in Turkish Sample. Yayan, EH., Zengin, M., Düken, ME., et al.[2021]

Risky outdoor play is linked to positive health outcomes in children, including increased physical activity and improved social behaviors, despite concerns about safety and injury.

The systematic review of 21 studies suggests that promoting risky outdoor play is beneficial for healthy child development, highlighting the need for more high-quality research and encouraging policies that support such play opportunities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review. Brussoni, M., Gibbons, R., Gray, C., et al.[2022]

In a study involving 53 pediatric patients aged 4-11, unstructured play significantly reduced urinary cortisol levels, a marker of stress, in children aged 7-11 during hospitalization for respiratory diseases.

The effectiveness of play as a coping strategy was less pronounced in younger children (4-7 years old), suggesting that age and cognitive engagement play a crucial role in how children utilize play to cope with stress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of play activities on hospitalized children's stress: a randomized clinical trial. Potasz, C., De Varela, MJ., De Carvalho, LC., et al.[2015]

A randomized controlled trial involving 501 mothers of children aged 6-12 years is being conducted to evaluate the effectiveness of a digital tool and in-person workshop designed to increase mothers' tolerance of risk in their children's play.

The primary outcome of the study is to measure changes in risk tolerance using the Tolerance of Risk in Play Scale, with secondary outcomes focusing on self-reported behavior change goals, aiming to shift parental perceptions and promote children's opportunities for risky play.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Go Play Outside! Effects of a risk-reframing tool on mothers' tolerance for, and parenting practices associated with, children's risky play: study protocol for a randomized controlled trial. Brussoni, M., Ishikawa, T., Han, C., et al.[2019]

A quality improvement initiative using the Practicing Safety toolkit significantly increased screening rates for child abuse and neglect risk factors, with assessments for maternal depression and child development rising from 0% to over 50% post-implementation.

Resource provision related to child development issues improved over time and was maintained for 1.5 years, demonstrating the effectiveness of integrating standardized assessments into electronic health records in urban practices serving low-income children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child Abuse and Neglect Risk Assessment: Quality Improvement in a Primary Care Setting. Chung, EK., Gubernick, RS., LaNoue, M., et al.[2020]

The Sit Down and Play (SDP) program, implemented in a primary care setting, showed significant improvements in parenting practices related to child development among 30 caregivers of infants aged 6-12 months over a 1-month period.

Caregivers reported high satisfaction with the program, highlighting the importance of play and noticing positive changes in their children, suggesting that SDP is a feasible intervention that could enhance parenting behaviors during pediatric visits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sit Down and Play: A Preventive Primary Care-Based Program To Enhance Parenting Practices. Shah, R., DeFrino, D., Kim, Y., et al.[2022]

The Play Nicely program effectively increased the comfort level of pediatric residents and medical students in counseling parents about positive parenting strategies, as evidenced by pre- and posttraining questionnaire results.

Participants also showed a significant increase in parenting knowledge and a decrease in positive attitudes toward spanking, indicating a shift towards more supportive parenting practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changing Health Care Professionals' Attitudes Toward Spanking. Burkhart, K., Knox, M., Hunter, K.[2017]

The Play Nicely program effectively reduced positive attitudes toward spanking among 33 caregivers of children aged 2 to 5 years, indicating its potential to promote positive parenting practices.

This brief intervention is particularly beneficial in socioeconomically disadvantaged populations and can be implemented in group settings, making it a practical tool for addressing childhood aggression and preventing adverse experiences related to spanking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Decreasing Caregivers' Positive Attitudes Toward Spanking. Burkhart, K., Knox, M., Hunter, K., et al.[2019]

The 'Play Nicely Program: The Healthy Discipline Handbook' was successfully translated and culturally adapted for use in Brazil, involving a comprehensive process with four translators and seven expert judges.

The program achieved high content validity, with 100% adequate assessments from experts and 89.5% from the target population, indicating it is suitable for parents, teachers, and healthcare professionals in Brazil.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Translation, cross-cultural adaptation and validity study of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil. Begui, JR., Scholer, S., Polita, NB., et al.[2023]

Child life programs play a crucial role in pediatric care by addressing the emotional and psychological needs of hospitalized children, helping them cope with stress through therapeutic play and communication.

These programs not only promote optimal development and prepare children for medical procedures but also foster family involvement, which is essential for the child's overall well-being during hospitalization.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child life services. [2014]

Play and playfulness are crucial for enhancing children's ability to cope with stress and adversity, helping them develop adaptive responses in a safe environment.

Spontaneous free play, guided by children's perspectives, fosters essential skills like adaptability, resilience, and emotional balance, which are foundational for lifelong social and emotional health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Seeking Balance in Motion: The Role of Spontaneous Free Play in Promoting Social and Emotional Health in Early Childhood Care and Education. Hewes, J.[2020]

References

1. Brazil pubmed.ncbi.nlm.nih.gov

[The effect of the use of therapeutic play by the pediatric nurse on the behavior of recently hospitalized children]. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Development and feasibility testing of a play-based psychosocial intervention for reduced patient stress in a pediatric care setting: experiences from Pakistan. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Therapeutic play for hospitalized preschoolers in Lebanon. [2015]

4. England pubmed.ncbi.nlm.nih.gov

The Impact of Occupational Therapy on a Child's Playfulness. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Reducing Children's Pain and Parents' Anxiety in the Postoperative Period: A Therapeutic Model in Turkish Sample. [2021]

6. Switzerland pubmed.ncbi.nlm.nih.gov

What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Effect of play activities on hospitalized children's stress: a randomized clinical trial. [2015]

8. England pubmed.ncbi.nlm.nih.gov

Go Play Outside! Effects of a risk-reframing tool on mothers' tolerance for, and parenting practices associated with, children's risky play: study protocol for a randomized controlled trial. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Child Abuse and Neglect Risk Assessment: Quality Improvement in a Primary Care Setting. [2020]

10. United States pubmed.ncbi.nlm.nih.gov

Sit Down and Play: A Preventive Primary Care-Based Program To Enhance Parenting Practices. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Changing Health Care Professionals' Attitudes Toward Spanking. [2017]

12. United States pubmed.ncbi.nlm.nih.gov

Decreasing Caregivers' Positive Attitudes Toward Spanking. [2019]

13. Brazil pubmed.ncbi.nlm.nih.gov

Translation, cross-cultural adaptation and validity study of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil. [2023]

14. United States pubmed.ncbi.nlm.nih.gov

Child life services. [2014]

15. Switzerland pubmed.ncbi.nlm.nih.gov

Seeking Balance in Motion: The Role of Spontaneous Free Play in Promoting Social and Emotional Health in Early Childhood Care and Education. [2020]