Benefits of Teaching Play Skills to Children

Introduction

 Language development is a process that begins early in human life and supports a child’s capabilities to communicate and express their wants and desires. Subsequently, insufficient language skills for early childhood has numerous consequences including: finding problem-solving challenging, inability to communicate, difficulty with social interactions, and an increase likelihood for rejection by peers (Craig-Unkefer & Kaiser, 2002). The most natural context for learning language is through play (Levy, 1984). Play is a space children can learn new language skills and refine the language they currently have (Torr & Pham, 2016; Athanasiou, 2007) by providing children with opportunities for social interaction and social communication (Bloom, 1993; Lifter & Bloom, 1989, 1998; Piaget, 1952). Play allows them to develop cognition, social competence, academic achievement and positive peer relationships (Conner, Kelly-Vance, Ryalls, & Friehe, 2014).

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 Researchers have found that early intervention yields greater play and language skills in the mature preschool years (Craig-Unkefer & Kaiser, 2002, 2003; Mallory, Kelly-Vance, & Ryalls, 2010; Sualy, Yount, Kelly-Vance, & Ryalls, 2011). Since play gives children a chance to engage their emerging cognitive and language capabilities, it can be used for children struggling in these areas. Kelly-Vance and Ryalls developed the Play Assessment and Intervention System (PLAIS) in 2005, since then studies have repeatedly shown to improve the overall level of play in children as well as increasing language skills (Mallory, Kelly-Vance, & Ryalls, 2010; Sualy, Yount, Kelly-Vance, & Ryalls, 2011; Conner, Kelly-Vance, & Ryalls, 2014; Cordel, Kelly-Vance, & Ryalls, 2017). Less research has been conducted regarding how teaching play skills to young children in a Head Start program could improve their language skills.

 In the following sections, play and language interventions will be described in order to present readers with enough information and detail regarding the need for the current study. The proposed study will examine if teaching play skills to children via the PLAIS system, will increase their play skills, and if teaching play skills to children at a Head Start will increase their language skills more than those who don’t receive the play skills intervention.

Development of Play Skills

 For play interventions to be effective at improving play, a strong understanding and knowledge base of play is vital (Casby, 2003; Lifter & Bloom, 1998; Rossetti, 2001).

Developmental theorists (Vygotsky, 1966; Werner & Kaplan, 1963) have shown an interest in play, although, much contemporary work on this subject, has been based on the work of Piaget (1951). Piaget believed that play progressed in ordered stages over the first four years of life beginning at sensorimotor and evolving to representational play. For example, play behavior begins with a child exploring and manipulating toys and eventually develops into more symbolic (i.e. pretend, imaginative or representational) play as the child matures (Anthanasiou, 2007). Many studies have supported this documentation of play progression from exploration to pretend play (Belsky & Most, 1981; Elder & Pederson, 1978; Fenson, 1984; Fenson & Ramsay, 1980; Lyytinen, 1991; McCune-Nicolich, 1981; Parten, 1932; Tamis-LeMonda & Bornstein, 1994). Piaget’s explanation of what constitutes “play” is the basis of the play skill definitions used in the proposed study’s assessment measure and will be described and labeled in further detail. 

 The first type of play used in the PLAIS is exploratory play. As the most basic type of play, infants and young children seem naturally motivated to engage in their environment through exploration. This is when a child manipulates an object, for example: shaking a rattle, rolling a ball, bangs an object, or presses buttons, to become familiar with their surroundings (Cordel, 2017; Kelly-Vance & Ryalls, 2014). The shift from exploratory play to symbolic or pretend play is the most significant in a child’s play development (Belsky & Most, 1981).  As a child matures, they progress to simple pretend play which is the second stage of the PLAIS system. This involves a child using an object to act out every day actions. For example, the child eats from an empty spoon or uses a cardboard box as a house. If a child puts two or more different simple pretend play acts together, this is complex pretend play. If a child pretends to make dinner or to go to the doctor’s office, they are combining simple pretend steps (i.e. driving to the doctor, sitting on the table, checking heartbeat), to create a more advanced play skill. Since children progress in play skills that correlate to their development, play is easily utilized as an assessment tool to measure behavioral, social, cognitive, and emotional development of children (Cordel, 2017; Kelly-Vance & Ryalls, 2014) Although play continues to increase in complexity, not all children develop typically. 

Play Interventions

 When play development is atypical, it may be addressed through intervention. A significant amount of research has concentrated on the effect of play on young children’s development.  Play interventions use various techniques to increase instances of children engaging in play behaviors. To increase a child’s play skills, modeling and facilitating play has been incorporated into play interventions and have proven to be effective (Mallory et al., 2010; Sualy et al., 2011).

 The importance of modeling in child development has long been recognized. Bandura’s (1977) social learning theory proposes children learn by watching others model various behaviors. Modeling is defined as a demonstration of specific desired behaviors to one or more observers (Rivera & Smith, 1997; Vaughn, Kim, Morris Sloan, Hughes, Elbaum, & Sridhar, 2003). An example of modelingmay include demonstrating a pretend multi-step playact to the child, such as pretending to be in a doctor’s office. Fenson and Ramsay (1981) found that the use of modeling increased more advanced play than play sessions exclusive of modeling. Similarly, Vaughn et al. (2003) found that social skill interventions including modeling and play-related activities resulted in an increase in positive social outcomes in children with disabilities. This suggests that including modeling in play skill interventions can increase social learning during play.

 Another method used to increase play skills is facilitation. Facilitation refers to a set of skills utilized by the interventionist to reflecting content of the child’s play, provide positive behavior praise, and reflect feelings (Giordano, Landreth, & Jones, 2005). Keren, Feldman, Namdari-Weinbaum, Spitzer, and Tyano (2005) conducted a study focusing on parents’ facilitative play style associated with their child’s level of symbolic play. They found that the parents’ facilitative style elicited an increase in the child’s symbolic play, suggesting that actions that reinforce, praise, or acknowledge positive child behavior may be associated with increased instances of child symbolic play.  In another study by Sualy, Yount, Kelly-Vance, and Ryalls, (2011) the interventionists were trained to ask questions, make comments, and reflective statements about the child’s play. To facilitate complex levels of play, Sualy et al. promoted and encouraged more complex levels of play by asking questions such as “What do you think the baby needs? Is she hungry?” (pp. 112). The results found that the participants play behavior complexity increased after the play intervention was implemented. Many aspects of the intervention could have benefitted the children, but the use of modeling and facilitating from the interventionist could have allowed them to better imitate those behaviors and act them out on their own.

  The Play in Early Childhood Evaluation System (PIECES) is the observational assessment piece of the PLAIS (Kelly-Vance & Ryalls, 2005), and serves as a tool to measure children’s play skills. The PIECES is completed in the child’s natural environment and involves the child engaged in free play (alone or with peers) while the observer codes for specific play behaviors. Another part of the PLAIS is the Child Learning in Play System (CLIPS) which serves as the intervention. CLIPS can be designed to focus on specific play skill deficits identified by the PIECES and is effective at increasing play skills and social skills through direct teaching (Kelly-Vance & Ryalls, 2014). Some research examining PLAIS has looked at whether play skills can be taught to different groups of children in order to enhance skill development. For example, Cordel, Kelly-Vance, and Ryalls (2017) used the PLAIS to teach play skills to children with behavioral problems. The study incorporated prompting, modeling, direct teaching, and provided positive reinforcement for socially acceptable play behaviors. The results of this study suggest play interventions that incorporate direct teaching of play skills, provide positive feedback, and include promoting and modeling by the interventionist can be successful in improving play skills for children with challenging behaviors.

 Not only can the PLAIS be implemented on children with challenging behaviors, the teaching of play skills has also shown to improve children’s social skills, cognitive skills, and language skills (Mallory, Kelly-Vance, & Ryalls, 2010; Sualy, Yount, Kelly-Vance, & Ryalls, 2011; Conner, Kelly-Vance, & Ryalls, 2014; Cordel, Kelly-Vance, & Ryalls, 2017). The next section will describe how play interventions impact language skills and will provide information regarding the reason for the proposed study. 

Play and Language Interventions

 At young ages, play and language development parallel one another and are equally reinforcing (McCune, 1995; Singer, 1994). Piaget (1962) believed that in order to reach symbolic play, a higher level of play, the development of language and object permanence are essential. This suggests that play interventions that incorporate a language component could aid in not only improving play skills, but also language development. Research on play interventions have shown to increase language skills. For example, Craig-Unkefer and Kaiser (2002) created a play intervention to promote social interaction for children at-risk for language problems. Results showed that, after the intervention, the children’s play behaviors were more complex. As for language development, all participants increased their statements, responses, comments, yes or no questions, and clarification and action requests. They also increased their vocabulary and conversations skills (Craig-Unkefer & Kaiser, 2002).

 Similarly, Sualy, Yount, Kelly-Vance, and Ryalls, (2011) questioned whether children with verified language delays play differently than their typical developing peers. The PLAIS was used to see if children with a verified language delay show an increase in play skills through a play intervention. Results showed that five of the six children improved their play level
after the intervention compared to their pretest. These results show the play intervention effectively increased play skills in young children (Sualy et al., 2011).

 Finally, Conner, Kelly-Vance, Ryalls and Friehe (2014) used the PLAIS to assess and enhance language development and play skills for 2-year-old children. This study asked how a short intervention including reading a story then modeling the play skill could make a significant impact on language development and play skills. Before implementation of the intervention began, the PIECES assessment, Preschool Language Scale (PLS), and a Vocabulary Assessment was given to each participant by the researcher. The PLS was given to determine current language and communication skills (Zimmerman & Castilleja, 2005). Both assessments were incorporated in the pre-and posttest assessment as well as a follow-up assessment one month after the conclusion of the intervention (Conner et al., 2014). 

 The CLIPS intervention was administered two times a week to the intervention group. The researcher began the session by reading a book that related to the theme of the play intervention. Once the story was over, the researcher introduced and modeled how to play with the toy set that resembled the story. The participants were given 5 minutes to play with the toy set while the researcher encouraged pretend play and provided praise throughout the session (Craig-Unkefer & Kaiser, 2002). Results from this study indicated that most of the participants in the intervention group improved the amount of time spent engaged in pretend play according to the PIECES. As for language development, all children in the intervention group increased their scores on both language measures.

 The PLAIS has been used to increase the language skills of children who have been identified with a language delay (Sualy et al., 2011) as well as children who are at the most progressive age for language development, two years old (Conner at el., 2014). Less research has been done using the PLAIS on children who come from a low socioeconomic background to improve language skills.

Current Study

 The present study reflects the methodology applied by Conner at el., (2014) which examined the effectiveness of play interventions on language development in children. Storytelling will continue to be a part of the intervention since storytelling has shown to improve language development (Colmar, 2011; Vaughn et al., 2003). Thus, the present study will incorporate prompting, free play, and modeling of play behaviors into the intervention. Research in this area lacks diversity in participants (Conner et al., 2014; Sualy et al., 2011). Many different studies have shown that family SES is a large predictor of children’s academic skills at school entry through high school (Hoff, 2013). Hart and Risley (1995) found that at three years of age, low SES children know half as many words as their same age peers in a higher SES home. Therefore, this study will focus on improving young children in a Head Start program play and language skills. This will be done by comparing pretest and posttest scores for an intervention group and a comparison group on a play and a language measure.

Method

Participants

 For this study, children from a national Head Start program located in the Midwest will be recruited. A total of ten participants ages 3 or 4 years will be included in this study. The participants will be from a Head Start preschool classroom. Children at varying levels of play and language skill will be used in this study therefore, play level and language ability will not be assessed in selection for participants. The study will aim to measure the participants improvements of their play and language skills regardless of their levels before the play intervention. The participants will be broken into two groups: the intervention group and the comparison group.

Setting

 The intervention and data collection will take place at a Head Start preschool classroom. Head Start is a federally funded preschool program that began in 1964 and started as a key component of President Lyndon Johnson’s War on Poverty (Lamy, 2013). Head Start strives to be a high-quality early childhood program that utilizes research-based, well-designed curricula with a primary focus on developmental domains across content areas. This program offers education, health, nutrition, family support and disability services to children up to age five and their families who qualify. A Head Start preschool classroom is divided into two separate classes. One class takes place in the morning and one in the afternoon. Each session lasts for three hours and consists of the same teachers for both sessions. For the proposed study, all participants will be from the same preschool classroom.

Measures

 Play Assessment and Intervention Scale. The PLAIS is a system that measures play skills through observation which then can be used for intervention development. The Play in Early Childhood Evaluation System (PIECES) is used as the assessment component that measures play skills through a 30-minute observation of a child engaging in free play. Once the observation period is complete, the PIECES coding scheme is used to identify play behaviors into three types of play: exploratory, simple pretend, and complex pretend. The scale rates children’s behavior on a 13-point scale, lower scores reflect exploratory behavior, while higher scores are used to indicate the most advanced form of play the child can perform. The CLIPS is the next part of the PLAIS system and is the intervention used to increase pretend play and decrease exploratory play if the CLIPS is used with a play intervention. Materials needed for this intervention include toys and books used for play. Inter-rater reliability for the PLAIS is moderate to high, while test-retest reliability is moderate (r = .48). The PLAIS and the Bayley Scales of Infant Development (BSID-II) were compared to evaluate concurrent validity. They showed to be significantly correlated, with the PLAIS resulting in scores that are slightly higher than the BSID-II (Kelly-Vance, Needelman, Troia, & Ryalls, 1999).

 Observable Speech-Language Skills. The Observable Speech-Language Skills is a criterion referenced tool used to assess receptive and expressive language skills in children ages birth to 5 years of age. This relatively new measure was developed as a supplementary screening tool to the PLAIS by Coufal and DeVeney (n.d./2017). Due to the recency of the scale’s development, reliability and validity information is not available. The proposed study will contribute to the scale’s validation and Interrater reliability will be tested in the Spring of 2019. This measure was used over other language scales because extending the PLAIS system to encompass a language measure will aide in using the PLAIS for a full evaluation in early childhood. This measure is designed to be used during the 30-minute free play observation that is necessary for the PIECES assessment and can be done by anyone conducting the assessment. The observer is looking for whether the child has a specific language skill. For example, asking simple questions such as “What’s that?” or understanding opposite concepts (e.g. big/little). Depending on the child’s age, a specific language skill is identified and the observer will mark whether the child engages in that skill.

Procedure

 Informed consent forms and demographic forms will be filled out before the beginning of the study by the participants’ parents/guardians. The PIECES will be administered by the researcher to each participant to determine their level of play skills. In addition, the Observable Speech-Language Skills will be administered simultaneously with the PIECES scale to determine the participants current language development. The PIECES will involve a 30-minute period of free play time in the main room of the child care center. Each target participant is attended by two extra participants to ensure the play time feels natural and the target participant is not playing alone.

 The study itself will take place over an 8-week period, twice each week preferably in the morning. The study will take place in a distraction-free room in the Head Start preschool classroom. A checklist will be developed to ensure treatment integrity and correct implementation of the intervention procedures. During the intervention phases, the researcher and the five participants will be videotaped for the researcher future coding of play and language skills. Each intervention phase will be given its own theme. These themes will be picked by the researcher along with a book and play sets that coincide with the play theme. Examples of themes could be a “kitchen/restaurant” or a “house” theme.

 The PIECES intervention will begin with the experimenter reading the book that correlates with the chosen theme to the participants. When the story is finished, the researcher will introduce the toy set that relates to the story. The researcher will model and describe how to play with the toys (Craig-Unkefer & Kaiser, 2002).

 Once the researcher is finished introducing the toy set to the participants, the participants are allowed five minutes of free time to play with the toy set. During this time, the researcher will facilitate the participants’ play. When the five minutes expire, the researcher will give the participants an additional five minutes to play with the toy set. The researcher will observe, with no direct facilitation. At the end of the session, the researcher reviews the book and play behaviors that took place. The researcher will also follow-up with the overall theme of the story and play set. 

 One-month follow-up assessments using the PIECES and the Observable Speech-language Skills will be given to the five participants to establish if the effects were sustained. 

Data Analysis & Inter-rater Agreement

 Researchers will examine each participant separately for an increase in the level of play skills and language skills compared to the beginning of the intervention. Inter-rater agreement will be utilized to ensure accurate coding of play. A colleague will be trained on the PLAIS system, as well as the Observable Speech-Language Skills prior to the study. Both the researcher and colleague will code for pre-test and post-test play observation periods.

Discussion

 The presented study will examine the effectiveness of the CLIPS intervention in improving language and play skills for children in a Head Start. Previous studies involving play interventions to improve language skills have included children with a language delay as well as younger participants. Additionally, these studies have incorporated different language assessments in order to measure language skills. The presented study will use older preschool children from a low SES background and use a new language measure to assess for language skills that is created to compliment the PLAIS. Once the intervention is completed, the study hopes to find an increase in language and play skills as well as provide validation and reliability for the Observable Speech Language Skill measure. As previously stated, the participants are from low SES households which research has shown children know half as many words as children from higher SES households at age three. Therefore, the study is also hoping to see if the intervention group’s language skills has increase more than the control group’s language skills.

 Play is a critical part of a child’s everyday life and interventions including play have been shown to increase skills in many areas of the child’s development (Cordel et el., 2017; Sualy et al., 2011; Conner et al., 2014; Kelly-Vance & Ryalls, 2005).

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