C e r e b ra l Pa l s y 9 - P l a y, To y s a n d L e i s u r e A c t i v i t i e s informative leaflet intended to families of Children and Teens Program © Centre de réadaptation Estrie, 2008 Cerebral Palsy - Play, Toys and Leisure Activities Section 1 - T h e s t i m u l a t i o n o f p l a y f o r a c h i l d with cerebral palsy1 Some children with cerebral palsy have a limited ability to explore and discover their environment. This has an impact on the games they play and their development, in turn affecting their ability to learn. Through play, your child lays the foundation on which other skills will develop. Each child is unique, with his or her own strengths and difficulties. That’s why it is important to stimulate her, to help and encourage her so as to maximize her abilities and reduce the impact of her limitations. Like a game, a child develops in stages, at his own unique speed. How should I play with my child? The choice of toys, the child’s position and how you help will all be important in helping your child to play. Play should not be something planned, a “work session”. Rather than putting play on a schedule, make it a normal part of daily activities. For example, give your child tasks that she is capable of doing alongside you in your own work. Have your child take part in dusting, preparing meals (mixing a cake, making cookies with cookie-cutters), etc. To encourage participation, give your child two choices and set aside the one not chosen. If he loses concentration, don’t insist. This way you will keep him interested and he will want to continue trying. Encourage your child to explore by handling objects slowly and repeatedly. Take her hand or put your hand on hers and help her discover the objects she is holding. Play along with her, then take turns. Make sure you don’t help too much. Sometimes, helping your child to overcome difficulties can lead to being overly directive, suggesting for example that she place the little block on the big one, turn the lid instead of pulling on it. Don’t be afraid to let her solve problems by herself. Quite soon enough, she will ask for help when she needs it. Try to understand what your child is trying to do, and only help when she is genuinely in difficulty. Do things with her instead of for her. 1- This section of the Booklet is based on the book Le modèle ludique written by Francine Ferland (1994). See the bibliography at the end p. 11 page 2 Cerebral Palsy - Play, Toys and Leisure Activities Wo u l d y o u l i k e t o p l a y … Your child needs to play, it’s his main occupation! Playing is how your child experiences pleasure, discovery, mastery, creativity and selfexpression (Ferland, 2003). Through play, your child will learn, explore, experiment, imitate, exercise. He will develop his motor skills, his senses and perception, his ability to communicate and his social, intellectual and emotional skills. Motor skills Place your child in the right position so he can look at the toys, touch them with his hands and bring them to his mouth. Have him take objects of different shapes and drop them into a container. Change the position of play regularly so he can explore different ways of moving. Place the toy where he can reach it. Encourage him to be active and to move in every position he can maintain. (See Booklet 3 – Basic Principles, and Booklet 4 – Motor Skills and Movement.) Senses and perception We all know the senses of sight, hearing, taste, smell and touch. Through them, your child perceives sensations from the world around him, observing its features of colour, shape, size and so on. As well, when your child moves there are other senses that give him additional information, perceptions about the movements of his body and the position of his body in space. It may be that your child enjoys stimulation and uses it to learn. Alternately, he may find sensory information hard to take, or misinterpret it. In the latter case, sensations may not be enough to alert him and get his attention (for ex.: doesn’t cry when he hurts himself, stuffs his mouth when eating); or sensations may be felt too intensely (for ex.: sensitivity to clothes touching his body, to noise or certain smells, lumps in a purée, motion in a car). In these situations, pay attention to his reactions. page 3 Cerebral Palsy - Play, Toys and Leisure Activities Some examples of activities to stimulate the senses Vision 8 8 8 8 8 8 8 8 Present objects for your child to look at, and encourage her to take her time looking at them. Set up a mobile over her bed. Slowly move a stimulating object in front of her face. Move it from left to right, up and down, to encourage her to follow it with her eyes. Change the intensity of the lighting. Change the position of her bed relative to the window in her room. Use contrasting colours (black/white). Present objects against a contrasting background so they will be more visible. Use fluorescent colours. Choose colourful toys. Limit the number of toys if they seem to be distracting her. Hearing 8 8 8 8 8 8 8 Limit the sources of noise in the room. Make sure you have your child’s attention when you speak to him. Speak slowly and simply. Your tone of voice, your gestures and expressions are all perceived by your child. Dance to different types of music. Imitate animal sounds. Change your tone of voice: talk like a robot, a mouse, a lion... Sing songs and nursery rhymes. Make up a new nursery rhyme to a familiar tune, using a handful of simple, familiar words. Add a few gestures to go with your song. Repeat it often. If you always sing the same song at bath time, your child will expect it and respond. Taste Whenever you can, have your child taste different foods. This way she will be more open to new things. page 4 Cerebral Palsy - Play, Toys and Leisure Activities Smell 8 At meal times, have your child smell the different foods. 8 Look for toys that have a scent, like balls and pens. 8 Lightly spray her favourite teddy bear with perfume. Touch 8 8 8 Movement 8 8 8 Rock your child. Put him in a swing (models with a high seat back provide better support). Dance with your child in your arms to various types of music. Vary temperatures and textures: hot and cold, rough and soft, wet and dry, etc. Have your child play in water, in sand; touch different fabrics, different foods (whipped cream, cookie dough), etc. Give your child massages. If your child doesn’t seem to enjoy being touched, start with a less sensitive part of the body, such as the back, arms or legs. Firm pressure may be tolerated more easily than light caressing. Bodily perception 8 Do activities in a swimming pool. o Engage in horseplay. o Take your child’s hands or feet and tap them together. page 5 Cerebral Palsy - Play, Toys and Leisure Activities Communication and sociability Play helps your child learn that there are things he can communicate and people he can communicate with. Play can be practised alone or with others, both children and adults. The skills required for life in society (sharing, listening, working together, etc.) can all be developed by simply playing. Play will also help him to develop language and vocabulary (see Booklet 5 - Communication). Intellectual skills Your child learns, understands her environment and develops her ability to think and use language, all by having fun. When she experiments and tries things out, she acquires knowledge that helps hr solve problems, pay attention, make connections and develop her memory. Some examples of games to play with your child: 8 Hide your face and ask her to find you; hide an object under a blanket and ask her find to it. 8 Offer hr toys that have wheels to turn, buttons to push (a toy that does something or an activity centre). 8 Encourage her to: pull a string to start a music box playing; strike an object such as a xylophone; roll a toy with wheels; kick a ball or hit it with her hands; pull a toy car on a string; look at picture books; imitate the sounds of things and animal calls; empty and fill containers; stack up blocks, put one on top, on the bottom, on the side; associate shapes and images; copy drawings and build things with blocks. Emotional skills Play is an opportunity to initiate actions, express feelings (joy, sorrow, anger, etc.) and develop self-esteem. page 6 Cerebral Palsy - Play, Toys and Leisure Activities Section 2 – What toys to choose and how to adapt them Many toys on the market may be perfect for your child’s needs. Your choice should be based on what she herself enjoys and her physical and intellectual abilities. A game that is too difficult will be frustrating, while a game that is too easy will be quickly rejected. Pay attention to the size of toys. Which one is easier to handle depends on the skills of your unique child: sometimes it’s a larger toy, sometimes a smaller one. Toys can be borrowed from certain libraries, so your child can try them out before you buy. Toys that are on the market can be adapted by you so they suit your child’s needs even better. Some suggestions for toys Balls Every child loves balls! Their size, texture, colour and weight can all play into what you choose. Keep in mind that a foam ball is easier to handle and doesn’t hurt. Large beach balls can be great for children who are weaker on one side than the other, since the size of the ball encourages them to use both hands. The same skills can also be stimulated with a hanging ball, small balls or a bean bag. Blocks Large wood blocks can be used for building things or to play pairing games. Adding Velcro can make stacking them easier. Music Music is stimulating, especially when it’s his own! A bottle filled with dried beans, or a bracelet of bells on his wrist or ankle become fun musical instruments. Puzzles Choose puzzles with peg tops on the pieces, which are easier to pick up. page 7 Cerebral Palsy - Play, Toys and Leisure Activities Some suggestions for adapting toysSome suggestions for adapting toys 8 8 8 8 8 8 8 8 8 8 8 8 page 28 Velcro and suction cups are a great way to make certain toys more stable. If a toy has to be wound up, you can make the handle bigger to make it easier to turn. Handles can be enlarged by wrapping them in terry cloth. This makes it easier for your child to grip the toy. Magnetic toys can also make certain activities easier. Look for them in stores, or adapt toys you already have by applying pieces of selfadhesive magnetic tape. Place a non-slip mat underneath the toy. If toys keep falling on the floor, hang them where your child can reach them or sew them to a cushion. A toy that is hard to hold or too small can be attached to a stick. If it is too light or tips too easily, it can be glued or screwed onto a larger base. Use elastic bands or bands of stretch terry to help your child retain things in his hand. For example, after placing the band around his hand, slip the object through so that it is held in his palm, as shown in the illustration. Many toys on the market are designed to be easy to pick up and use, such as finger crayons for drawing and T-ball stands for playing baseball. Some companies sell toys that are already adapted. Computers and other electronic toys can encourage learning. A swing with a high seat back can support your child when sitting. For a child in a wheelchair, a raised sandbox can be easier to get into. Cerebral Palsy - Play, Toys and Leisure Activities From ordinary stuff to extraordinary games Remember that Christmas when a child got a great big present, but spent all her time playing with... the box! We often forget that children can amuse themselves with next to nothing. In every home, there are many objects with which a child can happily play and learn. Some of the most fun ones are in a place that is wonderful to explore: the kitchen cupboards! A simple plastic container with a cover can be something extraordinary for your child. Roll the container toward your child so she follows it with her eyes, then have her push it back to you. To make it more interesting, put some dried beans in the container. The gentle sounds will get her attention even more. Another idea is to use empty plastic bottles for bowling. 8 Spoons and pots and pans are terrific fun for picking up, making noise and pretending. 8 Playing in pudding is an exciting sensation for little ones. 8 A simple sheet of paper, rolled into a ball with something hidden inside, can be very intriguing. 8 A home offers all sorts of learning activities for the everyday responsibilities of life. Such activities can also give a child a little more independence. For example, a child can have fun by: 8 8 8 8 8 organizing the family’s shoes and socks in pairs and by colour; picking up and putting away her toys; carrying an object from one place to another; wiping up little spills; brushing off a corner of the table. page 9 Cerebral Palsy - Play, Toys and Leisure Activities Section 3 - L e i s u r e a c t i v i t i e s a s a f a m i l y a n d with friends Personal and family obligations take up a good part of your time with your child. To maintain balance in your lives, it is important to devote some of your time to leisure activities, be they cultural, sports, tourism or nature outings. In doing so you will meet your child’s needs for relaxation, rest and entertainment. It is also an opportunity to stimulate your child’s development, meet people and other children, and encourage him to participate in society. Some suggestions for leisure activities 8 8 8 8 8 8 8 Practise activities as a family. Many activities can be adapted so your child can do them too, or at least be with you (for example, add a child seat or a trailer to your bicycle). Play outside: in the grass, in the sand, in the snow (hiding, rolling in it, sliding), etc. Take your child for a ride in a wagon or a sleigh. Many municipal parks have outdoor play modules; join your child in the fun. Find out what’s offered at your local community and recreation centres (crafts, toddler activities, swimming (free swimming or swimming lessons). Be on the lookout for upcoming cultural events and family outings in your neighbourhood. Use Booklet 14 – Resources, to find organizations that offer activities suitable for children. Think of leisure activities as a way to enjoy being with your child while at the same giving her positive experiences that will help her gain confidence and develop self-esteem. page 10 Cerebral Palsy - Play, Toys and Leisure Activities Bibliography FERLAND Francine, (1994), Le modèle ludique. Le jeu, l’enfant avec déficience physique et l’ergothérapie, Montréal, Les presses de l’Université de Montréal, 114 p. BEAULIEU Julie et Line CHARRON (2004, J’apprends en jouant : le développement du jeune de 0-2 ans, Québec, IRDPQ, 35 p. (lecture notes) Pe r s o n a l N o t e s page 11 w w w. c e n t r e d e r e a d a p t a t i o n e s t r i e . o r g Centre de réadaptation Estrie 300 King Street East, Suite 200 Sherbrooke QC J1G 1B1 T: 819-346-8411 F: 819-346-4580
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