The therapeutic power of play: examining the play of young children with leukaemia.

BACKGROUND The therapeutic function of play has been investigated in relation to recognized stressors such as hospitalization, illness and medical treatments for ill children. While medical treatments in the past 30 years have improved survival rates, children's psychological experiences and quality of life during and after their illness have received limited attention. OBJECTIVE The present study investigated the therapeutic effects of play on 3- to 5-year-old children with leukaemia compared with a control group of healthy children. METHOD The participants with leukaemia (n = 11) were from the external oncology clinic of an urban children's hospital; control children (n = 11) attended a day care centre. Measures included children's experience of stress, social and cognitive play behaviours, and daily mood. RESULTS A series of manova revealed that the children with leukaemia, compared with the control children, engaged in (a) significantly fewer total play behaviours, and in particular less (b) parallel, (c) group and (d) dramatic play. Pearson correlations revealed significant relationships between reports of 'being happy' and play only for children with leukaemia. Quantitative and qualitative analyses revealed a pattern of repetitive play activities week after week for children with leukaemia, but not controls. DISCUSSION Findings are discussed in light of the theoretical and practical implications for children undergoing treatment for leukaemia.

[1]  James F. Christie,et al.  The Effects of Play Period Duration on Children's Play Patterns Patterns , 1988 .

[2]  D. Tegano,et al.  Length of Activity Periods and Play Behaviors of Preschool Children , 1991 .

[3]  M. Kayes Making Sense of It: The Role of Play in Assisting Children Requiring Extensive Hospitalization To Understand and Cope with Their Illness, Its Treatment and Their Hospital Experience. , 1991 .

[4]  Kenneth H. Rubin,et al.  Free-Play Behaviors in Preschool and Kindergarten Children. , 1978 .

[5]  P. Mcgrath Findings on the impact of treatment for childhood acute lymphoblastic leukaemia on family relationships , 2001 .

[6]  A. Freud The Role of Bodily Illness in the Mental Life of Children , 1952 .

[7]  Robert Wälder The Psychoanalytic Theory of Play , 1933 .

[8]  M. Klein The psychoanalytic play technique. , 1955, The American journal of orthopsychiatry.

[9]  L. Barnett,et al.  Research note: young children's resolution of distress through play. , 1984, Journal of child psychology and psychiatry, and allied disciplines.

[10]  L. Chandler The source of stress inventory , 1981 .

[11]  B. Compas,et al.  Coping with stress during childhood and adolescence. , 1987, Psychological bulletin.

[12]  C. Eiser Long-term Consequences of Childhood Cancer , 1998 .

[13]  Gilmore Jb The role of anxiety and cognitive factors in children's play behavior. , 1966, Child development.

[14]  D. Meichenbaum,et al.  The work of worrying in children undergoing surgery , 1979, Journal of abnormal child psychology.

[15]  Primary and secondary control among children undergoing medical procedures: Adjustment as a function of coping style. , 1994 .

[16]  J. Bruner Nature and uses of immaturity. , 1972 .

[17]  M. Rutter Prevention of children's psychosocial disorders: myth and substance. , 1982, Pediatrics.

[18]  C. Eiser,et al.  Issues in measuring quality of life in childhood cancer: measures, proxies, and parental mental health. , 2001, Journal of child psychology and psychiatry, and allied disciplines.

[19]  S. Russ,et al.  Play as a predictor of coping and distress in children during invasive dental procedure , 1996 .

[20]  J. Varni,et al.  Stress, social support and negative Affectivity in children with newly diagnosed cancer: a prospective transactional analysis , 1997, Psycho-oncology.

[21]  L. Barnett,et al.  Play, pleasure, and pain: The reduction of anxiety through play , 1981 .

[22]  H. Levin,et al.  The research uses of doll play. , 1962, Psychological bulletin.

[23]  M. A. Adams,et al.  A hospital play program: helping children with serious illness. , 1976, The American journal of orthopsychiatry.

[24]  G. Fein Pretend play in childhood: An integrative review. , 1981 .

[25]  F. F. Worchel,et al.  The psychosocial impact of play on hospitalized children. , 1989, Journal of pediatric psychology.

[26]  A. Mendelsohn,et al.  Psychotherapy with hospitalized children with leukaemia: Is it possible? , 1990 .