This document discusses the use of play therapy for children with disabilities. It defines play therapy as using play as a child's natural means of self-expression. Play therapy can help children process feelings, improve psychological well-being, and develop optimally. The document also outlines how play affects brain development by improving learning, memory, stress response and more. It describes different play therapy approaches and techniques that can be modified to meet the specific needs of children with disabilities, such as adjusting materials, settings and including parents/caregivers. The goal is to help children with disabilities develop a positive self-image and sense of competence through play.

1. USING PLAY THERAPY FOR
CHILDREN WITH
DISABILITIES
Hemangi Narvekar
Clinical Psychologist

2. PLAY THERAPY
• Play Therapy is based upon the fact that play is the child’s
natural medium of self expression. It is an opportunity for the
child to ‘play out’ his/her feelings and problems just as adults
talk out their difficulties.(Axline Virginia)
• Play therapy is the systematic use of a theoretical model to
establish an interpersonal process where in trained play
therapist use the therapeutic powers of play to help clients
prevent or resolve psychological difficulties and achieve optimal
growth and development. (Association for Play Therapy Board,
March 1997)

3. PROCESSES IN PLAY

4. EFFECTS ON BRAIN STRUCTURE AND
FUNCTIONING
• Play is found to have both direct and indirect effects on brain structure and functioning.
• Play leads to changes at the molecular (epigenetic), cellular (neuronal connectivity), and
behavioral levels (socioemotional and executive functioning skills) that promote learning
and adaptive and/or prosocial behavior.
• Play activates norepinephrine, which facilitates learning at synapses and improves brain
plasticity.
• Play also usually enhances curiosity which facilitates memory and learning (Gruber, et.
Al., 2014).

5. EFFECTS ON BRAIN STRUCTURE AND
FUNCTIONING
• High amounts of play are associated with low levels of cortisol, suggesting either that play reduces stress or
that unstressed animals play more (Wang, S., & Aamodt, S. 2011).
• Play, especially when accompanied by nurturing caregiving, may indirectly affect brain functioning by
modulating or buffering adversity and by reducing toxic stress.
• Other benefits of play include improvements in executive functioning, language, early math skills
(numerosity and spatial concepts), social development, peer relations, physical development and health, and
enhanced sense of agency (Kinchin, J., & O’Connor, 2017).
• Pankseppj (2007) suggested that play deprivation is associated with the increasing prevalence of attention-
deficit/hyperactivity disorder.

6. FUNCTIONS
OF PLAY
In the child therapy literature, four broad functions of play
emerge as important in therapy.
1. Play is a natural form of expression in children.
2. The child also uses this language of play to communicate with
the therapist.
3. Play is as a vehicle for the occurrence of insight and working
through.
4. Play in therapy is that of providing opportunities to practice
with a variety of ideas, behaviors, interpersonal behaviors, and
verbal expressions.

7. MECHANISMS OF CHANGE IN THERAPY
Expression, Catharsis and Labeling of Feelings
Corrective Emotional Experience
Insight, Re-Experiencing, and Working Through
Problem-Solving Techniques and Coping Strategies
Object Relations, Internal Representations and Interpersonal
Development

8. PLAY THERAPY APPROACHES
Directive Approach
The therapist assumes responsibility for
guidance and interpretation of the play
interactions
Non Directive Approach
The therapist tend to leave the
responsibility and direction of the
therapeutic process to the
child
(Rasmussen & Cunnigham, 1995)

9. Play
Therapy
Directive
Cognitive
Behavioral
Therapy
Gestalt
Therapy
Developmental
Therapy
Trauma
Focused
Therapy
Non
Directive
Client
Centered
Therapy
Psychoanalytic
Therapy
Jungian
Therapy

10. APPROACHES FOR DISABILITY
THE "I AM"
Deals with emotional adjustment
and helps the child to develop
positive self-esteem, personal
competency, and self-reliance
THE "I CAN“
Deals with physical
activity and is related
to feelings of
competence and
control of
circumstances

11. Modifications for Children with Disabilities
Procedural Modifications
Material Modifications
Settings Modifications

12. Procedural Modifications
Inclusion of a Treatment Team
Incorporation of Parents and
Caregivers
CHILD

13. Material Modifications
To provide an appropriate play therapy environment for a
child with a disability the following factors must be taken into
consideration:
1. Specific Disability
2. Physical Accommodation
3. Material Modifications or Adaptive Toys
4. Developmental Level
5. Experiences that may be unique to a child with a
disability

14. Settings Modifications
• Plenty of Space
• Proper Lighting
• Sign Language
• Accessible

15. OTHER
MODIFICATION
S
1. Simplifying the Activity
2. Using Child Preferences
3. Peer Support
4. Invisible Support

17. REFERENCES
• Carmichael, K. D. (1993). Play Therapy For Children With Disabilities. Alabama: The University of Alabama.
• Lorenz, D. C. (2008). Can I Play? Using Play Therapy for Children and Adolescents With Disabilities. VISTAS
online.
• Russ, S. W. (2004). Play In Child Development And Psychotherapy. New Jersey: Lawrence Erlbaum Associates,
Inc.
• Yogman, M., Garner, A., Hutchinson, J., Hirsh-Pasek, K., Golinkoff, R. M. (2018). The Power of Play: A Pediatric
Role in Enhancing Development in Young Children. Committee On Psychosocial Aspects Of Child and Family
Health and Council On Communications And Media. DOI: 10.1542/peds.2018-2058