Implementation of Learn to Play Therapy for Children in Special Schools.

This study looked at a play therapy program for 38 children with intellectual disabilities and autism in special schools. Children participated in weekly 1-hour play sessions with occupational therapists for 7 months. After the program, children showed improvements in their pretend play, language skills, social skills, and school performance. The results suggest that helping children develop better play skills can lead to improvements in other important areas of development.

This pre-post intervention study evaluated Learn to Play Therapy in four Victorian special schools with 38 children (mean age 5.7 years) diagnosed with intellectual disability, autism, and global developmental delay. The 7-month program involved weekly 1-hour sessions led by occupational therapists focusing on child-centered pretend play development. Significant improvements were observed in pretend play skills (p=.03), sentence recall (p=.02), social skills (p=.022), and academic competence (p=.012). The intervention showed particularly large effects on narrative skills (d=2.72).

Follow-up analyses revealed that baseline play abilities predicted various developmental outcomes, suggesting play skills may be foundational for broader developmental gains in children with intellectual disabilities.

Learn to Play Therapy shows promise for improving multiple developmental domains in children with intellectual disabilities in special school settings. The intervention's child-centered approach and focus on pretend play may offer a feasible model for occupational therapists working in educational environments to support comprehensive development.

Single-group pre-post design without control group limits causal inferences. Sample included mixed diagnoses making intervention effects for specific conditions unclear. No information provided about follow-up duration or long-term maintenance of gains.

Play is the primary occupation in childhood and fundamental to occupational therapy practice. To evaluate a play intervention in special school settings. Pre- and postinvolvement of a 7-mo play program. Four special schools in Victoria, Australia, for children with IQs < 70.

Thirty-eight children with diagnoses including intellectual disability, autism, and global developmental delay, 7 teachers, 2 speech pathologists, and 2 occupational therapists. Learn to Play Therapy for 1 hr per week over a 7-mo period. Pre-post outcome measures included children's pretend play skills, language, social skills, emotional regulation, and academic competence. Mean age of 38 children (15 girls and 23 boys) at baseline was 5 yr 7 mo (SD = 0.46 yr).

Results showed significant changes in children's pretend play (p = .03), ability to recall sentences (p = .02), social skills (p = .022), and academic competence (p = .012). Learn to Play had a large effect on children's narrative skills (d = 2.72). At follow-up, object substitution at baseline influenced expressive language (p < .001), narrative mean language utterance (MLU; p = .015), social skills (p < .001), and academic competence (p < .001); elaborate play at baseline plus time influenced social skills (p < .001); and elaborate play at baseline influenced narrative MLU (p =. 016), sentence recall (p = .009), and academic competence (p = .001). Embedding pretend play within practice positively influenced children's language, narrative, social, and academic skills.

Plain-Language Summary: This study adds to the limited research on play-based therapy programs in special school settings for children with an IQ of less than 70. Children participated in Learn to Play Therapy, during which an occupational therapist, who has observed and assessed the child's play and understands the child's play abilities, played beside the child. Learn to Play Therapy is a child-centered therapy that is used to increase a child's ability to self-initiate and enjoy pretend play. The positive impacts of supporting the children's pretend play ability were highlighted by increases in their pretend play, language, social skills, academic competence, and narrative language after participating in Learn to Play Therapy in their special schools.