Learning Through Play with Cerebral Palsy


Original Editor - Roelie Wolting
Top Contributors - Michelle Lee, Kim Jackson, Shaimaa Eldib, Laura Ritchie, Naomi O'Reilly, Admin, Rachael Lowe, Simisola Ajeyalemi, Jess Bell and Olajumoke Ogunleye


 Introduction 

The information on this page has developed for you from the expert work of Roelie Wolting alongside the Enablement Cerebral Palsy Project and Handicap International Group.

Learning Through Play 

Play is an important part of any child's development. It is an activity that makes a child/person happy and is enjoyable so that they want to do it again. Play is one of the most important ways that children develop mentally, socially and physically. It gives a chance for a child to practice doing activities in their own way so that the child can be successful, as the child grows the way of playing changes. The sequence in which play develops is the same for all children, whatever their abilities or handicaps.

Sequence of Play

Here are the sequences of play:

1. Playing alone (till 1 year): At first the child will play with his body and then will gradually begin to reach out to things he sees nearby and play with them. She will not be interested in other children or anything they are doing but she will like other people playing with him/her.
2.  Watching others play (1,5 -2 years): The child will stop with what she is doing and watch other children who are playing nearby. But she will not join them in their activities. She likes to repeat things many many times.
3. Playing next to others but not with other children (2-3 years): From a distance it can look as if they are playing together, but in fact there is no direct communicationg between the children and they are all playing their own games. The child will hate to share toys with others.
   
4. Beginning to play with others (3-4 years): The child will begin to play and share toys with others. They will talk to each other about the game in progress, but the game has no specific shape or rules.
5. Cooperating with others in play (about 5 years, when they start school): The child will play structured games with other children, taking turns and using rules. Rules for games become very important at this stage.

Here are some examples of some games and what children learn from them:

Game	Learning
Peekaboo	Taking turns, learning something is not visible but it still exists , collaboration
Hide and Seek	Counting, waiting, taking turns, collaboration, gross motor, balance, body perception, memory, muscle strengthening, building vocabulary
Playing father and mother	Moving around (gross motor), fine motor, balance, vocabulary, memory, imitation, imagination, memory, communication, listening
Playing with ball	Fine motor, planning, eye hand coordination, balance, gross motor, distance, fast – slow, hard – soft, patience, solve problems, learning to comply with rules (if e.g. football), cause and effect
Chess	Fine motor, eye hand coordination, planning, problem solving, taking turns, patience, cause and effect

Play and Physical Development

Play is one of the ways that children learn to move from sitting, to crawling, and then to standing, and walking; they learn balance and coordination. The child learns to manipulate and handle objects and learn that objects are not part of their body; they first learn to hold objects and then to move them. Later they learn to use their eyes and hands at the same time. At the same time as learning to use the hands the child will be using mental abilities to learn about subjects; and develop imagination and creativity (a comb can be a comb but also an aeroplane or a car).

Play and Social Skills

The child learns social skills through playing with others. Young children usually only think of themselves and in play they can learn basic ideas of sharing and what others want and need. The child will learn through talking, exploring possibilities and learning to express own ideas.
The child will learn to cooperate with friends; the ability to work together with others is important.  Through playing the child will experience the joy of winning – and learn to cope with losing.

Play and Emotional Development 

Often children will use games to work through the things that frighten or worry them. They play out the roles and by doing this come to terms with their difficulties. e.g. a child who goes to the hospital often plays afterwards “hospital”, or “doctor”, or “nurse”. This may help to cope with the frightening experience. They also learn adult roles: children often play ‘father and mother’, teacher, etc. They also invent games to show skills like building houses or playing to cook.

Therapeutic Play

Often children will use games to work through the things that frighten or worry them. They play out the roles and by doing this come to terms with their difficulties e.g. a child who goes to the hospital often plays afterwards “hospital”, or “doctor”, or “nurse”. This may help to cope with the frightening experience. They also learn adult roles: children often play ‘father and mother’, teacher, etc. They also invent games to show skills like building houses or playing to cook.
Therapeutic play is:

• Using play to help disabled children learn mental, social and physical skills and abilities
• Using rehab goals to adapt exercises into play activities
• Often includes a component of competition against self or others

Therapeutic play can be harder to design than simple exercises as it takes more analysis and creativity. It needs to be challenging but at the same time the child needs to experience positive result and fun. The play should be adjusted according to the physical and the mental abilities of the child.

A paediatric therapist/fieldworker should always adapt exercises into play activities. This may be more difficult but is also more rewarding.

Turning therapy into play example:

A  therapy session for a child of 4 years (mental age) needs to encorporate walking in the parallel bars. The child has cerebral palsy and needs both hands to hold to walk in the parallel bar. Here are some examples of how to make this boring task fun for the child:

The child is 4 years old, so making puzzles (with 5 – 20 pieces) can be encorporated. Have two chairs at each side of the parallel bar. Put all pieces of the puzzle on one chair. The child has to bring piece for piece at the other child and making their the puzzle. When finishes talk about the puzzle, praise the child etc. Maybe the child can put a piece of the puzzle in his trouserpocket, or tie something around his arm or neck to carry from one side to the other. You also can use: blocks and build a tower or a house; stones and make a house