When I completed graduate school and decided that I was going to work with children, I often was asked “What does an occupational therapist do with children?  What is a child’s occupation?” According to AOTA (American Occupational Therapy Association) an occupation is any meaningful everyday activity.  For a child, this can include playing, learning, sleeping, and resting, interacting with friends, getting dressed, and other daily activities.

Since I prefer to work with the younger population (birth – 3 years), most of my practice focuses on assisting children in developing the necessary play skills that will later promote participation in learning.  So in honor of Teddy Bear Picnic Day (think of pretend play), I thought I would talk for a minute about the developmental stages of play.  I promise that I won’t get too technical – although I could discuss this topic for hours!

Depending upon which theory of practice you choose to follow, there are various different stages of play. Although different theorists have different labels for various stages, when you actually look into it, they are all addressing the same thing.  It’s like a to-ma-to/to-mah-to situation.  You say it one way, I say it another, but we are both talking about the same thing.

I am going to address play from an occupational therapy point of view, and point out some of the critical developmental stages we pediatric OTs look for as your child grows from birth to 3 years of age.

  • Exploratory Play (Birth – 12 months)
    • Sensorimotor play – children engage in activities through manipulation of body or objects in order to explore their sensory characteristics (e.g. mouthing a block, shaking a rattle, banging a toy)
    • Functional play – children begin to use toys according to their functional purpose (e.g. cause and effect toys; if I push the button, the music will play)
  • Relational Play (12 months – 24 months)
    • Relational play – children engage in simple pretend play directed toward themselves (e.g. pretending to eat or pretending to sleep)
    • Functional play – children demonstrate imitative play from an immediate model (e.g. if adult stirs spoon in bowl, child stirs spoon in bowl)
    • Gross Motor play – children roll, crawl, and walk to explore all spaces in the room – children enjoy sensory experiences of gross motor play (e.g. swinging, climbing, running)
    • Social play – children begin to notice peers, watch other children and demonstrate parallel play (where children play next to each other, but do not interact with each other in play scheme)
    • Pretend/Symbolic play – children make inanimate objects perform actions (e.g. doll eats food, hugs people) – children pretend that objects are real or that an object symbolizes another object (e.g. ball becomes an apple, block becomes bar of soap)
  • Symbolic/Imaginary Play (2-3 years)
    • Symbolic play – children engage in longer sequences of play (e.g. feeding baby doll extends into taking baby doll for a walk, bathing baby doll, putting baby doll to sleep) – children begin to play out dramatic scenes with stuffed animals or dolls
    • Constructive play – children engage in completing puzzles, or drawing
    • Gross Motor play – children enjoy rough-housing and making messes – jumping and rough-and-tumble play begins to emerge
    • Social play – parallel play dominates and toward the end of this year, children begin to slowly interact with other children around them, sharing, taking turns, etc.

So I know that is a lot of information.  To be honest, it’s really just the tip of the iceberg when it comes to play. But it is fascinating to watch a child move through these developmental stages and begin to play in new ways. One of my favorite stages occurs when a child really enters the Functional Play stage and begins to look at objects in a whole new way. Suddenly they are not just putting coins into the treasure chest slot, but they are studying how the coin enters the treasure chest, where it goes when they push it, and, if the toy makes sounds, at what point in this process does the music play.

I’m a bit of a nerd when it comes to this topic.  You should see me with my daughter. I get so excited witnessing her move through the play stages. She recently turned 2 and all of a sudden she is ‘taking care’ of all of her dolls. They all eat together, they all sit and watch her engage in play activities, and when she determines they are sleepy, she finds a washcloth or some other “covering”, places it over the doll so they can go “night-night”, and finds a “bed” for them. I could honestly watch her play for hours and never get bored.

What was your favorite stage of play?