A second Look at the Play of Young Children with Disabilities • Michelle Buchanan and Tricia Giovacco Johnson The authors investigate the nature of child play for young children with disabilities using two different research models—the traditional psychoeducational research paradigm and the more recent interdisciplinary approach of the childhood studies paradigm. They base their discussion on a research study of toddlers with disabili- ties, and they review the history of the scholarship on the issue. In considering such matters as voice, agency, identity, and equity, which are typically concerns of the more recent paradigm, they find that the need young children with disabilities have for all kinds of play has been misrepresented by the more traditional approach. In fact, when viewed from the perspective of childhood studies, play appears to be as necessary to the quality of daily life for young children with disabilities as it does for all young children. The authors advocate the same right to play for children with disabilities granted to other children by society in general, a right acknowledged and codified in the United Nations Convention on the Rights of the Child. t his article examines two different research paradigms applied to under- standing the play of young children with disabilities. Research on the play of three toddlers at home with their mothers provides a setting for a discussion of the contributions of each of these paradigms. We begin with a brief overview of the history of ways that researchers have approached the study of the play of young children with disabilities and the role of play in early intervention. Then we turn to the two paradigms to interpret findings from a study of the home play of toddlers with disabilities. In the first interpretation of findings, we use the historically common ap- proach to the research, a paradigm rooted in developmental psychology and early childhood special education. Throughout this article, we use the term psychoeducational research paradigm to refer to this type of interpretation. This paradigm encompasses learning processes and developmental outcomes for young children based on a variety of theoretical frameworks, including cogni- tive, developmental, social, and educational learning theories; sociocultural © 2009 by the Board of Trustees of the University of Illinois AmJP 02_1 text.indd 41 7/14/09 2:42:37 PM 42 AmeRICAn JouRnAL oF PLAY  •  Summer 2009 theories; and behavioral learning principles. Research using this paradigm has often informed the assessment of a child’s disabilities, the kind of education he or she receives, and the need for early intervention. Next, we take a second look at the study of toddlers with disabilities through the lens of a more recent childhood studies paradigm. Childhood studies is a relatively new interdisciplinary field dedicated to improving the quality of childhood. The study of the everyday worlds of children is grounded in re- lations between people as individuals and as groups. Adopting sociological perspectives, childhood studies researchers view children as active agents in constructing their own lives and identities in relationships with others. In or- der to demonstrate what this childhood studies paradigm contributes to our understanding of the play of young children with disabilities, we use this new approach to examine the same data from the toddler study. This alternative perspective emphasizes social and political discourses and considers matters commonly found in them—voice, agency, identity, and equity—as fundamental to understanding the complexities of play. Our intention is to illustrate ways that both models enrich and deepen our understanding of child play and de- velopmental difference. Historical overview: understanding the Play of Young Children with Disabilities and the Role of Play in early Intervention Young children with disabilities are a heterogeneous group composed of unique individuals with the same varieties of personalities, abilities, values, and pref- erences found in the general population of children. Speaking of the play of young children with disabilities as a population, therefore, is as problematic as speaking of the play of young children as a whole. The ways in which research- ers view disability as a condition of childhood drive the questions they ask in their study of play. The traditional approaches to psychological and educational studies of children with disabilities look at the impact of the disability on play development, at adult and peer interactions and relationships in play, and at the effects of a variety of physical and social interventions for facilitating and supporting play development. Although psychologists and educators deem play central to the lives of chil- dren, they have neglected, until relatively recently, the play of young children AmJP 02_1 text.indd 42 7/14/09 2:42:37 PM Play of Young Children with Disabilities 43 with disabilities. Prior to the 1980s, scant research existed on the play of young children with disabilities, and the few available studies were so methodologi- cally flawed that psychologists John Quinn and Kenneth H. Rubin described the literature as “a veritable case of ‘The Emperor’s New Clothes.’”1 Of the studies Quinn and Rubin reviewed that were conducted prior to the mid-1980s, most failed to control for the effects of the play setting or for the children’s familiarity with playthings. Other studies did not control for the subjects’ chronological age, nature, and degree of their developmental differences. Quinn and Rubin faulted other studies for failing to account for differences in the developmental age of research participants and for differences in gender, intervention history, socioeconomic status, and cultural background. Often, the number of subjects included in such studies was small. The studies also used inappropriate statistical procedures in data analysis. Quinn and Rubin noted that, most seriously, the researchers apparently lacked an understanding of the typical developmental progression of play in early childhood. For example, researchers mixed and equated simple, repetitive, exploratory, and manipulative play with sophisticated symbolic play episodes in their analysis of play behavior.2 Prominent play scholar Brian Sutton-Smith described the literature on the play of children with disabilities as a closed book not worthy of the serious attention of researchers. Having to take into account so many defects vitiated any interest in the study of a behavior that seemed to be of little educational value.3 In a chapter reviewing the empirical basis for play in early intervention published in 1988, Rebecca R. Fewell and Ruth A. Kaminski articulated the need for research on the play of young children with disabilities. At the same time, other leaders in the field of early intervention, such as Toni W. Linder, began making a case for using play for assessment and intervention in supporting the development of young children with disabilities. The result was an increase in the number of studies on the play of young children with disabilities and in the quality of research during the 1990s.4 Psychologists and educators began to explore the development of play in young children with disabilities; the impact of specific disabilities on play; parent-child interaction in play; play as a me- diator for learning, social interaction, and peer relationships; the effectiveness of interventions in teaching play skills; and contextual variables, such as the settings and toys, that influenced play. The interest of practitioners in the use of play as a context for assessment and intervention and as a vehicle for successful inclusion in early care and education settings intensified in the 1990s. Findings from psychoeducational AmJP 02_1 text.indd 43 7/14/09 2:42:37 PM 44 AmeRICAn JouRnAL oF PLAY  •  Summer 2009 research were—and continue to be—used by early interventionists to develop behavioral and relationship-based interventions to impact specific behaviors that support or hinder children’s functioning in community-care and educa- tion settings. This is particularly true in the study of play and intervention for children with autism because these children often lack the typical play behaviors that serve as a medium for cognitive development and as the “glue” for social interaction with other children. During this same time period, the field of early childhood special education began to blend several perspectives from social and constructivist developmental theories with behavioral learning theory, which contributed to a significant evolu- tion in research and practice. Diane Bricker, a scholar in the field of early child- hood special education, revolutionized the field by introducing Activity-Based Intervention as a child-initiated, naturalistic, transactional, or relationship-based approach to intervention. In this approach, Bricker encouraged practitioners to focus early intervention on supporting the learning and development of young children with disabilities in the social contexts of everyday activities such as child-care routines, child-chosen play activities and adult-planned activities. The Activity-Based Intervention approach was founded on the work of sociohistorical theorists such as Lev Vygotsky, on developmental theories such as those of Dante Cicchetti and Donald J.Cohen, on the cognitive theory of Jean Piaget, on John Dewey’s philosophy of education, and on the principles of behavioral learning. Bricker’s approach to intervention emphasized learning in the context of daily routines, including child-preferred activities, and, as a result, elevated the status of exploration and play in early intervention.5 Drawing on similar theoretical perspectives in the 1990s, Linder intro- duced Play-Based Assessment and Intervention and brought child-initiated play center stage in assessment and intervention. This popular approach to intervention promoted play as a medium for cognitive development and other areas of development such as communication, motor, and social interaction in young children with disabilities. Linder’s work provided specific and practical strategies for assessing play development and for intervening to facilitate the development of play skills as an aspect of cognitive development.6 Recently, interventions emerging from clinical mental-health disciplines have grown in popularity. These early intervention practices rely on adult-child, relationship-based play activities to support healthy development. Drawing on a substantial history of infant and early childhood mental-health research and practice, Stanley Greenspan and Serena Wieder introduced a developmental AmJP 02_1 text.indd 44 7/14/09 2:42:37 PM Play of Young Children with Disabilities 45 biopsychosocial model as a framework for comprehensive assessment and in- tervention planning for children with developmental delays and/or mental- health issues. Greenspan, a specialist in the field of infant mental health, and Wieder are credited for connecting developmental disabilities with infant and early childhood mental health in the developmental, individual-differences, relationship-based (DIR) model for intervention planning. This model requires specialists to use the very play activities a child initiates to encourage his or her own emotional, cognitive, and adaptive development.7 The research and development of these and other approaches to intervention have validated the importance of play for young children with disabilities both as behavior highly preferred by the children themselves and as behavior that pro- vides a means for learning, development, assessment, and intervention. Currently, early intervention practitioners from a number of disciplines embrace this view of play. For example, Anita Bundy, an occupational therapist, advocates teaching play to young children with disabilities by building on their existing abilities and capitalizing on the motivating nature of play to support development.8 Beginning in the 1980s, scholars applied sociological perspectives to the study of childhood, and the childhood studies paradigm emerged in the social sciences. Those following the new paradigm critiqued the social and power rela- tions used to construct and situate “children” as a group with minority status, controlled and monitored by adults. Berry Mayall, a specialist in childhood studies, echoed other scholars in his historical analysis of the social construc- tion of children as a group believed to need adult protection and preparation for adulthood.9 He proposed that constructions of childhood have historically placed children in a group viewed to be immature and rife with problems that need fixing. This subgroup of children who are developmentally different from adults seems to need interventions because of the problems created by their difference but also because they become the “others” that we adults struggle to understand. The childhood studies paradigm, instead of viewing developmental difference as problematic, sees this difference as just one more manifestation of diversity. The study of children using the childhood studies paradigm exam- ines the quality of a child’s life, a child’s agency, a child’s identity, and a child’s equity in comparison to the lives of other children and adults. Inquiry into the play of young children from the perspective of childhood studies challenges the “grand narratives” of development and normative perspectives and seeks to understand the phenomenon of play itself for children with multiple and diverse identities. Investigations using this paradigm emphasize the meaning AmJP 02_1 text.indd 45 7/14/09 2:42:38 PM 46 AmeRICAn JouRnAL oF PLAY  •  Summer 2009 of play for the players and play’s contribution to the quality of the child’s ex- perience.10 This research paradigm has rarely been applied to the study of the play of young children with developmental differences. In this article, we summarize the findings of a study of the home play of toddlers with disabilities first from a psychoeducational perspective. Then we take a second look at the same data set from a childhood studies perspective. We choose this toddler study, conducted in the 1990s, because it provides a rich data set including natural observation and the voices of participants, lending itself to the diverse perspectives addressed in both research paradigms. We demonstrate the value and distinctly unique purposes of each paradigm for advancing our understanding of play and developmental difference. the Home Play of three toddlers with Disabilities: A multiple Case study Michelle Buchanan conducted a qualitative study of the play of three toddlers ranging in age from thirty to thirty-two months in their homes. The toddlers were chosen specifically because each had distinctly different characteristics that contributed to their identification as disabled or developmentally delayed. The study was designed to view each child as an individual player bringing his or her own unique abilities to their play activities.11 It is important to note that the three toddlers chosen certainly do not represent all toddlers with disabilities. Instead, the study intended to explore the development of play behavior in three young children in their own homes, in other words, under the physical and social contexts in which they play naturally. Three major questions guided the research. What is the nature of toddler and mother-toddler play as it hap- pens spontaneously in the home? In what physical and social contexts does play happen? How do mothers participate in their children’s play, and what do they think about it? The mothers of the toddlers were Caucasian, middle class, and married. All of them had at least a high school education. The toddlers were identified with disabilities shortly after birth, and all had similar intervention histories and services. Each toddler received early childhood special education, speech therapy, and occupational and/or physical therapy. All three attended play groups for several hours a day, two or three days per week during the study. At other times, they were at home or out in the community with their mothers. One toddler, Victoria (thirty months old), was diagnosed with Down syndrome; AmJP 02_1 text.indd 46 7/14/09 2:42:38 PM Play of Young Children with Disabilities 47 another, Corey (thirty-two months), with cerebral palsy; and the third toddler, Elizabeth (thirty months), with developmental delays and a metabolic disor- der that sapped her energy at various times of the day. Victoria used gestures, sounds, and facial expressions to communicate; Corey used these same means and sign language; and, at the time of the study, Elizabeth was learning to use picture communication. The toddlers were videotaped at home for a total of six hours each. Videotape captured 215 play episodes among the three toddlers. Researchers defined a play episode as a continuous stretch of play with an object or set of objects (like a ball or a set of farm animal figures) or a stretch of play related to a central theme (like a tea party or a chase-and-run game). Short breaks from play of less than one minute were considered just digressions if the child returned to the play activ- ity. In an analysis of the episodes, Buchanan found that the toddlers engaged in play both independently and with their mothers during all daily routines in the home. Buchanan noted the kind of play (like dressing a doll) and the type of play (like pretend play) for each episode, when and where the play occurred (such as before breakfast in the living room), and whether a child played alone or with the mother. If a child played with the mother, the researcher noted who initiated the play and how the mother participated. These observations provided the first layer of narrative in the descriptive research report. Next, each of the three mothers was interviewed while she watched the videotape of her toddler at play, and these interviews provided a second layer of narrative for the report. Mothers were asked to describe their toddlers’ play and their own motives and intentions in participating (or not participating) in the play. Their responses were recorded along with the other thoughts and judgments the mothers expressed. The result was a detailed description of the types and kinds of play, of the physical and social contexts in which the play occurred, and of the ways the mothers participated in the children’s play. The mothers’ perspectives, including the ways they thought about and valued their children’s play, provided a critical social context for play in the home. Psychoeducational Interpretation of Findings: A First Look From a psychoeducational perspective, the research and findings address com- mon interests of psychologists and educators in the study of play development and the impact of disability on types and kinds of play. The study also exam- AmJP 02_1 text.indd 47 7/14/09 2:42:38 PM 48 AmeRICAn JouRnAL oF PLAY  •  Summer 2009 ines mother-child interaction in play and mothers’ perspectives on the play of their children. Therapists and clinicians find this information particularly useful for child assessment and for devising parent/professional partnerships in intervention planning. There is vast literature on the structural and functional features of play at various stages of a child’s development. Four types of play are typical of young- sters transitioning from late infancy to toddlerhood. They include exploratory and manipulative play, functional or relational play, social play routines, and pretend play.12 In early infancy, play takes the form of visual, auditory, tactile, and kinesthetic object exploration and manipulation followed by object play in which children begin to use playthings in conventional ways. Between the ages of eighteen and thirty-six months, the symbolic use of playthings emerges and becomes increasingly elaborate. A child’s first symbolic acts are inspired by the properties of objects (as when a child pretends to drink from an empty cup). Later acts of pretending are decontextualized, and a child transforms one object into another (such as pretending a block is a car). Children in infancy and toddlerhood also develop ritual social play that involves coordinated and reciprocal interaction (peek-a-boo and chasing-and-hiding games). Toddlers in this study used these forms of play to engage in the physical and social environment in many of the same ways as their more typically developing peers. Each of the three toddlers engaged in exploration of household spaces and items of interest (such as cupboards with pots, pans, and food items; items on shelves and tables; and stashes of toys). Their explorations led to manipula- tive play with items and playthings including inspecting objects visually and tactilely, shaking them, mouthing them, throwing them, and tinkering with them. All of the children engaged in functional play: they used playthings in conventional ways; they pushed and threw balls; they fed baby dolls and stuffed animals; and they pushed buttons on a tape recorder to activate a recording. All three shared common social play routines with their mothers—tickling and chasing games, like “I’m gonna get you!” or other routines that generated excitement, surprise, and laughter. Pretending for the toddlers consisted of simple pretend play with the self as a referent (as in pretending to eat from a wooden spoon) to more complex pretending involving planning and acting out a sequence of actions related to a theme (as in pretending to have a tea party with several participants). The toddlers differed in the frequency and in the amount of time they spent engaged in various kinds of play, reflecting their preferences and abilities. For example, Elizabeth, the child with a metabolic disorder, had very little energy AmJP 02_1 text.indd 48 7/14/09 2:42:38 PM Play of Young Children with Disabilities 49 prior to mealtimes and did not play much prior to eating. Even though she was fully rested, she lay on the couch while her mother made breakfast, and she softly kicked her legs and sucked her thumb. After breakfast, she began explor- ing and playing. Corey, the toddler with cerebral palsy and significant motor impairments, explored and manipulated his physical environment by rolling from one place to another and grasping objects of interest. His mother talked about his preference for play that incorporated symbols, such as number games and word play: “Corey did not laugh until he was a year old. The first things he laughed at were the numbers going backwards on the microwave oven. Words were also funny to him. He laughs when he hears words like ‘acidophilous’ or ‘tapioca.’ So we sing and act out songs like ‘One-Two, Buckle my Shoe.’ Play with numbers and words really tickle his funny bone.” Corey’s play took on a unique form: instead of acting out his thinking in pretend play, he used sign language and gestures understood by his mother to request that she sing about things or events on his mind. He was delighted when she sang, signed, and acted out the events he requested. He actively joined his mother in signing along with the words of the songs. In an interview, his mother reported that this singing and signing was a primary mode of play for her and her son: If you can’t move around and act out typical imaginative play situations and you can’t tell others what you are pretending because you don’t have the signs for it, then your pretending is going to be limited. So other kids pretend to be the postman . . . and we sing about the post office; he loves the post office. We go to the post office, and we sing about what we do there. And when we go shopping, we make up songs about what we do in the store and what we have done in the past and who we go shopping with. Corey’s play gave insight into how he used his abilities in unique ways to engage in symbolic and song play as a substitute for typical pretend play. Researchers conducting laboratory studies of mother-child play have often concluded that mothers of children with disabilities are more controlling and di- recting in their play with their children than mothers of more typically developing children.13 Contrary to previous findings, mothers in this toddler play study were observed responding to their children’s play initiations, following their children’s leads in play, and intentionally scaffolding play to support their children’s own play goals. Elizabeth’s mother stated, “I follow her initiative. I try to formulate AmJP 02_1 text.indd 49 7/14/09 2:42:38 PM 50 AmeRICAn JouRnAL oF PLAY  •  Summer 2009 games around what she is already doing or what she seems interested in. So I try to make her play a natural extension of what she is doing.” These mothers participated in their children’s play in notably similar ways. In following their children’s leads, they helped their children when necessary, demonstrated new behaviors, elaborated on their children’s play, bumped up levels of play, commented on play, and enriched the play with relevant infor- mation. Mothers spoke of being selective in attending to their children’s play. They were more likely to comment on and participate in new play activities than in play that was familiar and well established. Victoria’s mother described this: “Yeah, when Victoria does new things, that’s when I really jump in and interact, go along with it, help her with it, whatever it is she is exploring. . . . Whatever door she is opening, I help her either go through it or find out what she wants to do with the open door.” Social, communicative, and motor development; energy level; and child- and health-care needs all directly impacted the play of these children. They were, however, active and enthusiastic players, and their mothers nurtured and acted deliberately to support their children’s individual preferences for play. These findings can be especially useful for interventionists who wish to support children’s functioning in everyday routines in the home. By learning about fa- miliar play in the home and ways mothers support play, interventionists better understand how to support children’s play in early care and education settings. This is valuable information, and more research within this paradigm is needed. As this research shows, psychoeducational studies contribute understanding and substantially inform practice in early intervention. Some other important perspectives, however, are not addressed in this paradigm. Childhood studies Interpretation of Findings: A second Look An alternative paradigm for interpreting the findings of this study follows lines of inquiry from childhood studies. Childhood studies advocates take critical aim at the normative narratives of child development and at the preoccupation with developmental futures. Childhood studies specialists replace the normative nar- ratives with the examination of children’s multiple and diverse identities and with the primacy of their own experiences as the essence of the inquiry.14 We now interpret the findings from the same toddler play data set presented above giving AmJP 02_1 text.indd 50 7/14/09 2:42:39 PM