Can the cognitive level of play in disabled youth be improved by structured play therapy?

Abstract

Background: The effectiveness of a Cognitive Object Play Intervention (COPI) was examined in a sample of 32 disabled children and (young) adults of a residential children's home and its accompanying day care centres in South-Africa. COPI intends to improve the cognitive level of play through structured scaffolding techniques. Method: Progress in play was examined during the intervention period as well as by means of a generalization test where an untrained object set without support was given. Maintenance effects were studied both 5 weeks and 9 months later. Additionally, it was examined if COPI’s effectiveness depended on the participant’s initial level of cognitive play. Finally, the integrity of the therapy and the relation between elements of the intervention and growth in play performance were examined. Results: During the training the participants showed an increase in independent play and a decrease in support needed. After 10 COPI sessions participants showed an improvement on the generalization test, while participants in the control-group did not. These effects were maintained over a 5-week period as well as over a period of 9 months. Further analysis revealed that effects were more positive for participants with a lower initial level of play performance. The therapy in general was given as intended for more than half of the time and variation in integrity did not predict cognitive growth. Conclusions: Findings suggest that COPI is a useful intervention method for improving play skills of disabled youth. Implications for further research are discussed.