Evaluation of a cognitive play intervention in children with profound multiple disabilities at a children’s home in South Africa
Summary
Purpose: This research was designed to evaluate the effectiveness of a cognitive play intervention (CPI) on improving cognitive play performances of children with moderate to severe disabilities in Sizanani Children’s Home in South Africa. Additionally, it has been investigated if children with varying functional abilities (social, cognitive and physical) profit differently of the intervention and if the effect of CPI is moderated by the effect of one of the parallel programs, Conductive Education (CE) or Multi-Sensory-Storytelling (MSST). Method: The research has been conducted in a single-case-experimental design with multiple interventions. Thirty children participated in CPI. In a 6-week period, the children received two play sessions per week from the childcare workers. The level of cognitive play performance has been assessed by means of the ‘Play Observation Scale’ (POS). Part of the research group also took part in either one or both of the parallel programs (CE and MSST). The effectiveness of the Conductive Education (CE) has been determined by means of the ‘Goal Attainment Scale’ (GAS), the level of gross and fine motor skills with the ‘Fine and Gross Motor Scale’ (FGMS). The level of social responsiveness before and after the MSST program has been measured with the ‘Social Responsiveness Scale’ (SRS). Results: The cognitive play intervention shows a significant effect on cognitive play performance. The cognitive play abilities of the residents in Sizanani Children’s Home improved more during CPI than during the MSST-intervention or the baseline period. It has been established that children starting the intervention with a lower level of cognitive play progress to a greater extent than those already starting on a higher level. The level of motor functioning or social responsiveness does not moderate the effectiveness of CPI on cognitive play performances. Neither is the effectiveness of CPI moderated by the effect of one of the parallel programs (CE and MSST). Conclusion: The cognitive play intervention, as implemented in Sizanani Children’s Home and conducted by the childcare workers, contributes to the cognitive development of the children and young adults. Participating in the CPI has a positive effect on the cognitive play performance, especially for those whose play abilities are not much developed yet. It can be concluded that the intervention is suitable for all children regardless of their motor or social functioning and gives the residents an opportunity to profit from the valuable effects that play has on the cognitive development.