The Importance of Play
Board games… It’s an essential for any Occupational Therapy Clinic, and might be found in your house. Board games are essential for learning without a syllabus. As we approach the unknown with how our upcoming school year will be, we can encourage good habits that keep our children engaged and learning in a manageable way. As I watch all the children of my family clutching to their iPads, board games may sound a little old fashioned, but you may be surprised to see how much fun they have with it! It’ll probably bring back some childhood memories for you as well!
Recently, I’ve been spending more time indoors with family due to the quarantine, and it’s hard to get creative at times. That’s what I love about board games, there’s enough color and entertainment that keeps kids occupied and off the tablets. I’ll go through three classic board games and tell you how to adapt for certain ages and to adapt for age gaps between kids. Most games have the age appropriate label, which is a good indicator, you can adapt for younger ages at times with different techniques.
Scrabble
The age listed for this game is 8+, but children start learning to spell around 6 years old. This game is especially helpful to support that learning especially if an adult is present they can give cues or assist for the child to participate. Kids as young as 3-4 can help a parent put the words on the board for them by directing the child to put cued letters on the appropriate spaces. That could help the young ones with following one step tasks and fine motor skills. For the older kids, it would work on spelling, literacy and critical thinking to get the most points. Also, for younger kids (6+), you can cue them to do simple math to figure out the word scores. The great thing about scrabble is that you can play with 2-4 players, so even if it’s an only child household, they can participate with a parent.
Monopoly
The age listed for this is 8+ as well, but it can be adapted many ways for younger kiddos. This past weekend I was playing with my 5 year old nephew, the family included him in the game by letting him sort the money, and hand the money to the banker for players. It may be a small part, but it’s participation nonetheless! So for the babies of the family, they can help with sorting money by color, throwing dice, and helping with placement of the figurine on the appropriate box (with pointing and coaching from an adult/older child). This game does involve a good deal of reading and critical thinking for those that are older, and as most of us know- it can go on, and on. It also comes with learning some of the frustrations of pretty real-life stresses. Paying rent, having to pay taxes every (year) round, and critical thinking for how you’ll get ahead. If you’re playing with an older child above 8, I recommend making them the banker so that it challenges them a little more with math skills.
Connect Four
This is a classic that I’ve used in practice with ALL ages. I’m talking about 2 year olds to 100 year olds. It’s easy to set up, there are different ways of using it, and it’s strategic for older people, but simple enough for kids as well. For the young ones, at about 12-15 months kids can pick up the discs and use explorative play. By about 2 years old, kids can start picking up the discs and place them into slots as a game. At about 18 months, they can do it by color. As for kids that are younger than about 7, they will be able to imitate or copy an adults strategy for playing Connect Four, but according to Piaget (a developmental psychologist) - those skills to understand rules, apply them, and using logic does not develop until about 7. These skills are important once they get to that age, to encourage games like this. But before then, they will need coaching and explanations for different game tasks.
Quick Understanding of Play Development:
Exploratory Play (0-2 years old) - Exactly how it sounds, they explore the properties and effects of actions an objects and people, usually mostly with parents/caregivers
Symbolic Play (2-4 years old) - Experiences where the child formulates, tests, classifies and tweaks ideas, feelings, and actions. Associated with language development, not exactly playing with children just yet, becoming more cooperative over time.
Creative Play (4-7 years old) - This is when children start to cooperate in peer groups, they explore actions on multiple objects. They start to refine skills in play experiences with sensory, motor, cognitive, and social play.
Games (7-12 years old) - This is when games with rules really come into play. Social interaction, competition are big in this stage, as well as making friends as a validation of play items and performance.
A Video Game for ADHD?
After hearing about a new FDA approved prescription video game for ADHD, I had to read the research myself to believe it. At first thought, it seemed counterproductive to me. How can something that typically has been known to be a distractor help ADHD? Don’t get me wrong, technology has its pros, such as increased productivity for the workplace, convenience of shopping from home, even working from home thanks to COVID but it still makes me question the effectiveness of a video game to improve your attention.
In today’s day and age, technology is such a large part of our lives. Screen time on our phones increase, and our threshold for the amount of “multitasking” for the first hour of our work day has drastically increased over the past 20 years. Below is part of the research study that I found. I hope you find this useful!
ADHD is a widely known diagnosis that children struggle with, it accounts for about 5% of US children, and is the most commonly diagnosed pediatric mental health disorder. As we learn more about mental health in the US, we want to find the safest treatment - especially for children who are still developing and growing. Medication has it’s side-effects, and has short-term efficacy. I was especially surprised to hear that the trials used for pharmacological efficacy for ADHD typically used parent rated or clinician rated symptom measures! This means the research to back these drugs used for ADHD are mostly based on the parent or clinicians subjective opinion. Having alternate methods outside of pharmacological intervention is important, especially if it has limited improvements that become outweighed by side effects.
Participants: 8-12 years old with ADHD, No Medication even if regularly taken, 348 kids
About the Study Design: Randomized, Double-Blind, Parallel-group, Controlled Trial
The video game trial would be an alternative method that would be engaging, but also reduces adverse effects (negative side effects). The novel digital therapeutic. AKL-T01 (Akili Interactive Labs, Boston, MA, USA), was made to engage children with ADHD but also targets attentional control to improve completion of tasks and shift attention more efficiently between tasks. What makes this trial unique to research for the ADHD population, is that it uses objective cognitive assessments to measure outcomes. So, findings are not based on a parent or clinician opinion of the results, but tests administered to the child. The trial showed significant improvement in attention-related measures with children that used the video game AKL-T01, compared to the group that did not. It also reduces negative side effects for the child. The only reported adverse effects included 7% of children using AKL-T01 were frustration and headache, versus 40-60% of children in trials of commonly used stimulant medications (which has a lengthy list depending on the medication). Specifically, trials done for stimulant medications don't have research on the functional improvement on a validated measure that this study has. There definitely needs more research done to see the long term effects of this video game, but it’s a novel treatment technique that may be safer and more accessible to families in the future.
References
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Kollins SH, DeLoss DJ, et al. A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomized controlled trial. Lancet Digital Health 2020: Volume 2, Issue 4, E168-e178.
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