1. Symbolic Play Behaviors and its Relationship with Language and Cognition in Typically Developing Children. Presented by, Devika M R, AIISH,Mysore

2. INTRODUCTION  Play is defined as any voluntary activity engaged for the enjoyment it gives without consideration of the end result (Piaget, 1962).  It combines both action and thought (Tassoni & Hucker, 2005).

3. Features of Play PLAY Natural to children Spontaneous Voluntary Chosen by children Designed by children Initiated by children

4. Importance of Play Importance of Play Play as a Platform Social interaction Emotional Motor Cognitive Language

5.  Symbolic play (12-36 mths) A type of play which involves acting out a concept as perceived by the performer. It contains rule based play without written lines and with few props. A type of play which involves acting out a concept as perceived by the performer. It contains rule based play without written lines and with few props. This type of play includes This type of play includes a. Pretentious play b. Representational play c. Enactive play

6. Symbolic play development  Develops in an orderly and predictable manner (Piaget, 1962; Mc Cune- Nicolich, 1977; Watson & Fischer, 1977; Bretherton, 1984). (Piaget, 1962; Mc Cune- Nicolich, 1977; Watson & Fischer, 1977; Bretherton, 1984).

7. Significance of symbolic play Significance of symbolic play  Provides the children with a creative outlet, where they have the power to create a fantasy world.  Important indicator of a child’s increasing cognitive competence.  Important indicator of a child’s increasing cognitive competence.  Provides a window on the child’s developing knowledge of scripts or event representations.  Temporally corresponds to aspects of early language and contributes to language development (Paula, 1983).

8. Relationship between symbolic play and language development Relationship between symbolic play and language development  Language development and symbolic play tend to proceed in parallel and there is an association between the two.  The manipulation of symbols seen in symbolic play and representational abilities is related to the development of language (Bates, Benigni, Camaioni & Volterra, 1979)

9. Figure 1: Hierarchy of symbolic play development and its relationship with language development (Mc Cune,1995)

10. NEED FOR THE STUDY NEED FOR THE STUDY  Very few studies have examined children in the age group of 2-3 years.  It is important to find what identifying features of a child’s diagnosis puts him/her at risk for demonstrating less sophisticated play behaviors.  Observation and assessment of play reveals about the developmental status.  Play also provides a functional baseline of the child’s developmental level of language and may provide additional direction for early intervention efforts.

11.  However, in the Indian scenario, there are very limited studies relating symbolic play to language development. Moreover, there are no standardized tests for the assessment of symbolic play. Hence there is a pressing need to conduct such studies. Hence there is a pressing need to conduct such studies.

12.   To investigate the symbolic play behaviors in typically developing children   To examine whether symbolic play development corresponds with the language development and cognitive development.   To examine whether symbolic play development corresponds more with the receptive language development or expressive language development

13. METHOD

14. SUBJECTS SUBJECTS 10 SUBJECTS 5subjects (24-30 months) 5subjects (30-36 months) 2-3 yrs

15. Age range Age range 1) 24- 30 months- 5 participants 2) 30-36 months- 5 participants  These subjects were matched for gender, age range, socio economic status and child care history.

16. Tools used: Tools used: Three-Dimensional Language Acquisition Test (3D-LAT) (Geetha Harlekhar, 1986)   The assessment checklist for play skills (Swapna, Jayaram, Prema & Geetha, in progress)   Assessment checklist for cognitive skills (Swapna, Jayaram, Prema, Geetha, in progress )

17.  WHO Ten-question disability screening checklist (Singhi, Kumar, Malhi & Kumar, 2007) was used to rule out any disability.  Ethical procedures was used to select the participants.

18. PROCEDURE

19. Phase 1: Investigation of symbolic play behaviours Phase 2:Assessment of language and cognitive skills.

20.   PHASE - 1

21. TWO PLAY SITUATIONS FREE PLAYSTRUCTURED PLAY STANDARD TOY SETS BASKET-ABASKET-B TWO PLAY SESSIONS

22. FREE PLAY FREE PLAY BASKET -A BASKET-B BASKET -A BASKET-B -two small human figures -small plastic animals -one baby doll, a brush -a comb, kitchen set -chair, table, cot, -a spoon, a cup and saucer -furniture set -large bus -small auto -plate -knife ** blocks and sticks -two small blankets, -two little doll house figures -small plastic farm animals -two baby dolls, - stuffed bear -stuffed rabbit - baby bottle - spoon, a plate - brush -pillow - blocks, - jar lid, -quilt **sticks *The two basket design is planned in order to examine test-retest reliability of play behavior

23. STRUCTURED PLAY   Set 1: doll, baby bottle, quilt, stick   Set 2: stuffed bear, brush, blanket, stick.   Set 3: two small human figures, horse, soap, block   Set 4: lorry, doll, screwdriver, two blocks, stick.   *A stick or a block as an item to be transformed

24. These toys have been selected on the basis of literature support (Rescorla and Goosens, 1992) with suitable modifications for Indian context. These toys have been selected on the basis of literature support (Rescorla and Goosens, 1992) with suitable modifications for Indian context.

25. FIRST SESSION

26. Free play with basket A Free play with basket A Basket -A 10 Min. duration *The mother was seated in the room but was asked not to intervene in the child’s play.

27. Structured play with toy sets Structured play with toy sets STRUCTURED PLAY 4 SETS OF TOYS 5 Min. DURATION Set 1: doll, baby bottle, quilt, stick Set 2: stuffed bear, brush, blanket, stick. Set 3: two small human figures, horse, soap, block Set 4: lorry, doll, screwdriver, two blocks, stick. *A stick or a block as an item to be transformed

28. SECOND SESSION The second session was recorded a week after the initial visit. The second session was recorded a week after the initial visit.

29. Free play with basket B: Free play with basket B: 10 Min. Duration Basket -B The same procedure as in session 1 will be carried out.

30. Structured play with toy sets TOY SETS INSTRUCTIONS MODELLING

31.  All these sessions mentioned above were videotaped.

32. PHASE-2

33. Three-Dimensional Language Acquisition Test (3D-LAT) (Geetha Harlekhar, 1986) Assessment checklist for cognitive skills (Swapna, Jayaram, Prema, Geetha, in progress).

34. Analysis  Data coding for free play: Various types of play behaviors exhibited during free play with basket A & B were coded from the videotape for frequency of the specified play behaviour. Various types of play behaviors exhibited during free play with basket A & B were coded from the videotape for frequency of the specified play behaviour. It was marked in the tally sheet and documented descriptively. It was marked in the tally sheet and documented descriptively.

35.  The coding categories include  A variety of o non-pretend behaviors such as  Grouping  Manipulation  Wandering and social interaction.  Three basic categories of functional and/or pretend play  Functional conventional,  Functional to self, and  Functional to other.  Two types of elaborate or advanced play  Symbolism sub classified into three types.  Sequences sub classified into four types

36. Data coding for structured play Data coding for structured play  Scoring:  Spontaneous occurrence of a desired behavior in session 1- 3  Occurrence of a desired behavior in response to instruction in session 2- 2  Occurrence of a desired behavior following modeling in session 2- 1  Non occurrence of a desired behavior in session 1 or 2- 0  Maximum score that can be obtained: 5 (Spontaneous display in session 1 and display response to instruction in session 2)

37.   RESULTS AND DISCUSSION

38. Aggregate of free play behaviors overall (A+B) and by individual baskets A and B). BehaviorsBasketsScores/Frequency of response across all subjects Scores/Frequency of response in 2 – 2.6 yrs Scores/Frequ ency of response in 2.6 – 3 yrs Unoccupied A + B1147 Manipulation A + B823646 Grouping A + B481731 Social A + B17710

39. Free Play Analysis BehaviorsBasketsScores/Frequency of response across all subjects Scores/Frequency of response in 2 – 2.6 yrs Scores/Frequ ency of response in 2.6 – 3 yrs Functional/ Conventional A + B1265175 Functional to Self A + B361422 Functional to Other A + B863551 Sequence ABCD A + B451530

40. Free Play Analysis BehaviorsBasketsScores/Frequency of response across all subjects Scores/Frequency of response in 2 – 2.6 yrs Scores/Frequ ency of response in 2.6 – 3 yrs Symbol ABC A B19910 A + B291316 Verbal Symbol ABC A B A + B523

41. Table 2: Mean number of targeted responses in structured play: session I vs. structured play: session II - instruction/modeling) across subjects

42. Mean weighted scores of different play behaviours during structured play across sets.

43. Relationship of Play With Language and Cognition 3D - LATAssessment Checklist RLAELACLAPACA RLA-.655.623.420.421 ELA.665-.702* p=.05.612.639 CLA.623.702 p=.05.749* p=.05.778* PA.420.612.749*-.835** 0.005 *p <.05 level, **p <.01 level, Receptive Language Age, ELA – Expressive Language Age, CLA –Cognitive Language Age, PA –Play Age, CA- Cognitive Age.

44. Correlation between Receptive Language, Expressive Language and Cognitive Language TestRR SquareAdjusted R Square STD Error of Estimate Cognition Checklist 0.8350.6980.6551.92665

45. IMPLICATIONS OF THE STUDY  It is expected that the findings of the study will provide an insight into the relationship between the symbolic play skills and language development children.  It is expected that the findings of the study will provide an insight into the relationship between the symbolic play skills and language development children. It will help us to refine our understanding of both normative and atypical symbolic development. The study has important implication for early childhood assessment and intervention alsoEarly identification

46.   The findings of such research might contribute to theories of language development as well as assist clinicians and public planners in designing accurate screening procedures.   Further research -study can be undertaken in different other age groups by incorporating more number of subjects in each age group.

47.   A longitudinal study of children also could throw light into the pattern of changes that occur with respect to the skills and their temporal correspondences in the various developmental stages.   The results may reveal the use of structured play assessment as a valid, clinical tool for differential diagnosis of various communication disorders.

48. REFERENCES  Bretherton, I. (1984) Representing the social world in symbolic play: Reality and fantasy. In I. Bretherton (Ed), Symbolic play- The development of social understanding. Orlando, FL:Academic Press.  Brown, J. (1975). Symbolic play in normal and language impaired children. Paper presented at the American Speech- Language- Hearing- Association Annual Convention, Washington, DC.  Bates, E., Benigni, L., Bretherton. I.,Camaioni, L.,& Volterra, V.(1979).The emergence of symbols:cognition and communcation in infancy. New York:Academic Press.  Chick Hsia Yu Kitty (2000) ‘Correlation between symbolic play and language in normal developing Cantonese speaking children.’ Dissertation submitted as a part of partial fulfillment for the bachelor of science, speech and hearing sciences. University of Honk kong.

49.  Cooper, J., Moodley, M., & Reynell, J. (1978) Helping language development: A developmental program with children with early language handicaps. St. Martin’s Press.  Geetha Harlekhar (1986) ‘Three dimensional language acquisition test (3D-LAT)’ unpublished dissertation, speech and hearing. Mysore university  Lovell, K., Hoyle, H., & Siddell, M.Q.(1968). A study of some aspects of the play and language of the young children with delayed speech. Journal of Child Psychology and Psychiatry, 9, 41-50.  Lombardino.L., Stein J., Kricos P., & Wolf, M.(1986). Play diversity and structural relationship in the play and language of language impaired and language-normal preschoolers. Preliminary data. Journal of Communication Disorders, 19, 475-489.  Lyytinen,P.,Laakso.M.(1997).Language and symbolic play in toddlers. Journal of Behavioural Development, 21(2),289-302.  Mc Cune-Nicolich, L. (1977). Beyond sensorimotor intelligence: Assessment of symbolic maturity through analysis of pretend play. Merrill Palmer Quarterly, 243(2), 89-101. Michael,W.C.(2003) Developmental Assessment of Play: A Model for Early Intervention Communication Disorders Quarterly 24:175-183.  Nelson, K. (1986). Event Knowledge: Structure and function in development. Hillsdale, NJ: Lawrence Erlbaum.

51. Appendix I List of play behaviors coded during free play List of play behaviors coded during free play Non pretend behaviors Non pretend behaviors  Wandering/unoccupied – Behaviours not involving any active interaction with objects or individuals in the room.  Manipulation/handling- Involves child’s visual and kinesthetic exploration and manipulation of toys.  Grouping: Placing two or more like objects together in a group, line or stack.

52. Functional/pretend play Functional/pretend play  Functional conventional (Presymbolic scheme): Behaviours indicating that child knows the functionally appropriate use of an object.  Functional to self (Autosymbolic scheme): Functionally appropriate use of an object on oneself.  Functional to other (Decentered symbolic games): Involves performance of a pretend action upon a recipient other than self.

53. Elaborate/advanced play Elaborate/advanced play  Symbolism Type A: Substitution of one object for another. Using objects in a manner different from its intended functional use.  Symbolism type B: Pretending to use an absent object, creating an absent person, or referring to an absent substance.  Symbolism Type C: Animating the doll or animal as an independent and active agent.

54.  Sequence Type A: Two or more consecutive but different actions, one or more which is functional conventional.  Sequence Type B: Same recipients (two or more consecutive and) but different actions.  Sequence type C: Two or more recipients /( two or more consecutive and) same actions.  Sequence Type D: Two or more recipients/(two or more consecutive but ) different actions.

55. Verbalized elaborate/advanced play Verbalized elaborate/advanced play  Verbal Transformation: Verbal substitution of one object for another.  Verbal creation of object: Verbally creating an absent person or object by referring to it.  Verbal animation: Verbally creating action, animating an object or toy with no accompanying action.

56. Social interaction Social interaction  Child initiated social games: Play behaviour involving an adult in the room without functional or symbolic use of an object.  Child-initiated social interaction: Active or verbal non- play behaviour initiated by the child and directed by an adult.

58.  It will help us to refine our understanding of both normative and atypical symbolic development and to clarify issues in developmental difference the disordered population.  This study will also lead to strengthening of the fact that in children with language disorders, it is necessary to consider assessments of symbolic play and nonverbal ability along with expressive and receptive language, which will help speech- language pathologists to arrive at an accurate and appropriate diagnosis.

59. Mean number of targeted responses in structured play (session I) vs. structured play (session II - instruction/modeling) across two age groups. (30-36mths)

60. Mean number of targeted responses in structured play (session I) vs. structured play (session II - instruction/modeling) across two age groups. Mean number of targeted responses in structured play (session I) vs. structured play (session II - instruction/modeling) across two age groups. (24-30 mths)

61. Symbolic Play Development ( Patterson and Westby, 1998) AGE PROPS PROPS THEMES THEMESORGANIZATION ROLES ROLES LANGUAGE DURING PLAY 18 months Uses one realistic object at a time Familiar everyday activities in which child is active participant Short, isolated Autosymbolic pretend Language used to get and maintain toys and seek assistance. 22 months Uses two realistic objects at a time Familiar activities that care givers do. Combines two related toys or performs actions on two people Acts on dolls and others. Occasional comment on toy or action 24 months Uses several realistic objects Multischeme combinations of steps. Talks to doll briefly: describes doll’s actions. 3 years Sequence of multischeme events, brief role play with peers. Talks to doll in response to doll’s actions. Comment on what they have done or what they will do next. 4years Imaginary props Familiar fantasy things. Planned play events. Handles 2 or more dolls in complementary roles. Uses language to plan and narrate the story line