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Introduction: This study explored the extent to which an interactive computer play system, Bootle Blast, supports motor learning in a clinical context and examined clinicians' perceptions of their therapeutic role in the system's use as an intervention tool. Methods: In this observational sequential explanatory mixed methods study, five children with cerebral palsy [mean age 9.4 years (SD, 0.5), Gross Motor Function Classification System Levels I-III] used Bootle Blast during a single videorecorded therapy session with their treating clinicians (physical therapists, occupational therapists, and therapy assistants). Children played one Bootle Blast mini game independently (without clinician involvement) before clinicians carried out therapy sessions with the game as per usual care. The type and extent of motor learning strategies (MLS) delivered by Bootle Blast and clinicians were rated from video recordings by a trained assessor using the 22-item Motor Learning Strategies Rating Instrument. Semi-structured interviews with clinicians were conducted to gain insights into MLS use and clinicians' perceived role during Bootle Blast use. Interviews were audio recorded, transcribed verbatim, and analyzed independently by two researchers using thematic analysis. Quantitative and qualitative data were merged and reported using narrative and joint display approaches. Results: Bootle Blast provided eight MLS, with clinicians adding or enhancing another eight. Four themes reflected clinicians' perspectives: (1) Bootle Blast disguises therapy as play, (2) clinicians give Bootle Blast the human touch; (3) home use of Bootle Blast is promising; and (4) Bootle Blast is not always the right fit but some shortcomings could be addressed. Agreement was found for nine MLS and disagreement for four MLS when quantitative and qualitative findings were merged. Discussion: Bootle Blast delivers several MLS as part of game play and clinicians can enhance and provide additional MLS to suit the child's needs/abilities. Further game refinements that were identified in this study may optimize its clinical use. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore the efficacy of sandplay therapy in intervening social communication deficits in children with autism spectrum disorders (ASD), and whether this efficacy is influenced by the age of the children and the dosage of sandplay therapy intervention.MethodsFollowing the PICOS principle, randomized controlled trials (RCTs) related to sandplay therapy for social communication deficits in ASD children were retrieved from seven databases: PubMed, WOS, The Cochrane Library, Embase, CNKI, Wanfang, and VIP, from the inception of each database to November 10, 2023. Two experimenters independently conducted study screening and excluded studies with concomitant diseases, incomplete data, unextractable data, and non-randomized controlled trials. The PEDro scale was used for methodological quality assessment, and the GRADEprofiler method was employed to evaluate the quality of evidence. Stata17 software was used for meta-analysis, subgroup analysis, sensitivity analysis, and publication bias testing. The standardized mean difference (SMD) and 95% confidence interval (CI) were used as the effect statistics.ResultsA total of 12 RCTs (791 cases) were included. Sandplay therapy had a positive impact on the social communication deficits of ASD children [SMD = −1.42, 95%CI (−1.79, −1.04), P

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects individuals’ ability to regulate their attention, impulses, and activity levels. It is commonly diagnosed in childhood but can persist into adolescence and adulthood. Children with such type of disorder are having copious problems related to social skills. Understanding these core symptoms is crucial in recognising and addressing the challenges faced by children with ADHD. Hence, some interventions has to be introduced in the form of a play toolkit, which has a significant effect on ADHD children’s prosocial behaviour and empathy. This play toolkit includes two components: play therapy and doodle therapy. Using play-based activities to enhance social skills, emotional regulation, problem-solving, and cooperation skills in a supportive and engaging environment is essential. Utilising creative activities like drawing, colouring, and art-based projects to facilitate self-expression, communication, and emotional understanding can indirectly improve social interactions. By incorporating these interventions into a comprehensive treatment plan, nurses and healthcare professionals can help children with ADHD develop essential social skills, improve their relationships with peers and adults, and enhance their overall well-being.

Copyright of Journal of Pediatric Emergency & Intensive Care Medicine / Çocuk Acil ve Voğun Bakım Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects individuals' ability to regulate their attention, impulses, and activity levels. It is commonly diagnosed in childhood but can persist into adolescence and adulthood. Children with such type of disorder are having copious problems related to social skills. Understanding these core symptoms is crucial in recognising and addressing the challenges faced by children with ADHD. Hence, some interventions has to be introduced in the form of a play toolkit, which has a significant effect on ADHD children's prosocial behaviour and empathy. This play toolkit includes two components: play therapy and doodle therapy. Using play-based activities to enhance social skills, emotional regulation, problem-solving, and cooperation skills in a supportive and engaging environment is essential. Utilising creative activities like drawing, colouring, and art-based projects to facilitate self-expression, communication, and emotional understanding can indirectly improve social interactions. By incorporating these interventions into a comprehensive treatment plan, nurses and healthcare professionals can help children with ADHD develop essential social skills, improve their relationships with peers and adults, and enhance their overall well-being. [ABSTRACT FROM AUTHOR]

Introduction: playing, as an activity inherent to childhood, enables the child to acquire new knowledge about the world and to come across their own individuality expressing the world that is meaningful to him. The child's temporality composes his existence and drives him in the search for authentic existence. Objective: To describe the child's temporality during the stages of bonding and stopping playing in dramatic therapeutic play sessions. Method: phenomenological study in the light of the Heideggerian philosophical framework, with 12 children, aged between three and 11 years. For data collection, phenomenological interviews were conducted, mediated by the dramatic therapeutic toy. Results: the following thematic axis emerged: - The child's play time: being open. Conclusion: play reveals existential aspects of the child in chronological time and it fosters the sharing of new possibilities of relationship, in a free way, with the world. However, playing time might be elastic and negotiable according to individual need, so that all the expressions of the child becoming in their facticity during play would be considered. Therefore, regardless of the way and time they play, this study highlights the importance of respecting the child's existence at that moment. [ABSTRACT FROM AUTHOR]

This study aimed to compare the impact of child-centered play therapy and story therapy on parent - child interaction, impulsive behaviors, and anxiety in preschoolers diagnosed with hyperactivity disorder in Tehran. The research followed a semi-experimental design, employing pre-test and post-test assessments with a control group. The study's target population encompassed all preschool children, with 45 participants randomly selected and assigned to either of the two experimental groups or the control group (each group consisting of 15 individuals). Data collection involved the use of Barratt Anxiety and Impulsiveness questionnaire, Spence Children's Anxiety Scale, and Pianta Parent Relationship Scale (CPRS). Data analysis utilized the analysis of covariance test. The findings revealed that both child -centered therapy and story therapy significantly impacted parent -child interaction, impulsive behaviors and anxiety in preschoolers with hyperactivity disorder in Tehran. Consequently, these interventions led to increased parent-child interaction and a decrease in impulsive behaviors and anxiety. Furthermore, the results demonstrated that child-centered therapy was more effective than story therapy in enhancing parent-child interaction and reducing impulsive behaviors and anxiety in preschool children with hyperactivity disorder. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has further intensified the substantial demand for psychological treatment for children. However, in Brazil and various other nations, there is a lack of resources and evidence-based treatments focused on child mental health. Given this scenario, an evaluation of the efficacy of a pilot psychosocial group approach called "Operative Play Group" (OPG) was conducted within a public health service. This model aims not only to promote mental health but also to enhance equity through recognizing the social determinants of health. To measure behavioral problems, an analysis grounded in the principle of Intent-to-Treat was employed. However, this analysis did not demonstrate the effectiveness of the intervention. Nevertheless, through comprehensive research of cases, it was found that the program positively impacted the internalizing issues observed in children. The OPG model presents a distinctive feature as it stands out as one of the few methods incorporating dance. Dance can foster the expression of emotions and expand bodily perception. The findings of this study suggest the feasibility and relevance of utilizing body movement and dance as practical components in psychosocial interventions.

Background: Individuals with Avoidant/Restrictive Food Intake Disorder (ARFID) experience restrictive or highly selective eating problems that interfere with growth and development. Despite the increasing number of referrals for ARFID, no evidence-based treatments exist. This compilation of case composites describes a novel manualized treatment, Psychoeducational and Motivational Treatment (PMT) for children with ARFID, focusing on exploring motivation to change eating behaviors. This approach is based on motivational non-directive psychotherapy models, psychoeducational interventions, and the usefulness of play to support psychotherapeutic learning in school-age children. Case Presentations: Three cases of children with ARFID treated using PMT are presented: a 7-year-old, a 10-year-old, and a 12-year-old. These cases illustrate how a clinician delivers PMT interventions in the context of developmental abilities and common comorbidities associated with ARFID. Conclusion: PMT is a promising therapy for ARFID in school-age children. Challenges and strategies are discussed, including ways to address obstacles such as young age, comorbidities, and use of the virtual environment. [ABSTRACT FROM AUTHOR]

Psychotherapies for the youth have resulted from the confluence of 3 major disciplines: adult psychology and psychiatry, developmental neurology and pediatrics, and developmental psychology and ethology. Since their humble origins in the psychoanalytically oriented play therapy and the related theories in the pre-War Germany, over more than a century, they have embraced diverse theoretical views that include but not limited to the integration of developmental issues, evolution of the child guidance movement, and the various influences of institutional and social policies. Such a rich journey has eventually resulted in evidence-based practices (EBPs)—powerful interventions for children and families for complex behavioral problems. In this chapter, we attempt to trace the blooming field of youth psychotherapies in their historical contexts, provide an account of the existing gaps of knowledge, briefly narrate the modern-day developments, mostly regarding the multimodal/eclectic treatment aspects and finally, given their rapid growth, we speculate about their (positive) future. Child and adolescent therapies have progressed considerably, as reflected in the number of controlled studies, their methodological quality, and identification of evidence-based treatments. Despite the methodological difficulties in outcome studies, the field has witnessed major advances regarding the efficacy of selected treatments in child and adolescent psychotherapy and good quality meta-analyses do suggest that 75% of children and young people who attend therapy benefit from it. However, despite the comforting data related to efficacy, major challenges still remain, especially in regard to patient engagement and dropout rates, gap in knowledge about what works and why it works, cultural sensitivity, and data of cost- effectiveness—just to quote a few. Several key areas have been neglected in research, such as the mechanisms of change, the moderators of treatment outcome, and the generalizability of the research findings to the clinical practice arena—this has greatly limited what we know about treatment and partly explains the relative lack of personalized psychotherapies and scarcity in their dissemination/generalization despite the documented evidence on their efficacy. Tailoring treatment more specifically to each patient may be necessary to reduce this nonresponsiveness and dropping outs, as one treatment does not fit all. This necessitates the need for eclecticism—to combine youth psychotherapies with other modes of treatments, such as medications, neuromodulation interventions, and Yoga and mindfulness-based cognitive therapy. Future practice for treatment of mental health conditions in the youth will likely adapt to this huge need for development of eclectic modalities and also reflect cost effectiveness and cultural sensitivity to an increasingly diverse population. [ABSTRACT FROM AUTHOR]

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Aims: Promoting social adjustment can improve the developmental skills of preschool children. Therefore, the present study aimed to determine the effectiveness of play therapy based on cognitive-behavioral on social adjustment of preschool children. Instrument & Methods: The quasi-experimental research method was pretest and posttest with a control group with a follow-up period. The statistical population included all preschool children (5 to 6 years) in Bojnourd in the academic year 2019-2020 that 40 people were selected by convenience sampling method and were randomly divided into experimental and control groups. The experimental group underwent cognitive-behavioral play therapy training in 12 sessions of 90 minutes; but the control group did not receive any training. The social adjustment questionnaire was administered to the subjects before and after the training. Data were analyzed using repeated measures analysis of variance test at the significance level of 0.05 with SPSS software version 24. Findings: The results showed that play therapy based on cognitive-behavioral was effective in improving social adjustment of preschool children (p

Background and Objective: Emotion regulation and separation anxiety are some of the problems faced by elementary-school students. This study aimed to investigate the effectiveness of cognitive-behavioral play therapy (CBPT) on emotion regulation and separation anxiety of elementary-school children in Isfahan. Methods: This quasi-experimental study was conducted using a pretest-posttest design with a control group. The statistical population included all male elementary-school students in Isfahan, Iran in 2020. Using the convenience sampling method, 30 students were selected and divided into experimental and control groups (n= 15 per group). The experimental group underwent eight sessions (one 30-minute group session per week) of CBPT, while the control group received no intervention. The research tools included the Cognitive Emotion Regulation Questionnaire (CERQ) and the Separation Anxiety Assessment Scale-Parent version (SAAS-P). Data were analyzed using the analysis of covariance in SPSS 22 software. Findings: The participants included 30 elementary-school students, aged 9.12±1.35 years old. The mean ± SD of the post-test scores of emotion regulation and separation anxiety in the CBPT group was 58.26±1.96 and 45.26±1.08 and was 52.26±1.96 and 76.33±2.67 for the control group. The results indicated that CBPT improved emotion regulation and reduced separation anxiety in elementary-school students (P= 0.001). Conclusion: It can thus be concluded that play therapy with a cognitive-behavioral approach can mitigate anxiety and improve emotion regulation in elementary-school students. [ABSTRACT FROM AUTHOR]

Copyright of Ümraniye Pediatri Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Gaming is a natural process for the child, and with the play therapy technique used in this process, opportunities are offered to the child to express their problems and emotions by playing. Play therapy is used in many studies with children. The number of studies conducted on the effectiveness of play therapy in Turkey is increasing with each passing day. In this study, experimental graduate studies related to the play therapy education program from the past to the present (1987-2020) were examined and the results were brought together. A total number of 38 master's and 8 doctoral studies were reached in the YÖK (Council of Higher Education) thesis center related to the subject, but only 7 studies in accordance with the inclusion criteria were analyzed with meta-analysis method. While examining the postgraduate studies, care was taken toward the existence of an experimental and control group in which play therapy was applied. The studies in which play therapy was applied to the experimental group but not the control group were included in this study. In order to calculate the effect sizes, average (X), standard deviation (SS) and sample size (N) values from master's theses were processed in the Excel program. Later, CMA (Comprehensive Meta Analysis) statistical program was used for the analysis required for the study, "Hedges's g" was used to calculate the effect size and the Excel program was used for the collection-processing of the data. As a result of the research, it was found that the effect size of play therapy on children's behaviors has an excellent effect size. It was concluded that 5 of the studies included in the study were excellently effective, 1 was moderately effective, and 1 was broadly effective. These limited studies provide information that play therapy has a positive effect on children. [ABSTRACT FROM AUTHOR]

Preschool period is a period when children start to get to know the environment and gain basic vital skills thanks to their developing cognitive, social, physical and emotional skills. During this period, when the child tries to get to know himself/herself and to control the environment, psychopathological results may occur from time to time. It is seen that the play therapies are getting more and more widespread with the addition of the game, which is the most important occupation of the child, to the treatment stages of the problems experienced in this period. Play therapies are defined as a therapy method in which children’s psychosocial problems are treated using the healing power of the game. The most preferred age group for play therapies that can be applied in different age groups such as baby, child, and adolescent is the 3-12 age range. Thus, it is aimed to improve the problem-solving skills of the children and to be reach their psychological well-being with the play therapy techniques prepared considering their current developmental periods. In addition to the above, play therapies are used in the treatment of many psychological disorders. In the current review article, the effectiveness of play therapy on disorders such as depression, attention deficit hyperactivity disorder, childhood period traumas, anxiety disorders, behavioral disorders, autism and learning disability that are common in pre-school period were evaluated in the pre-school period, and then it was concluded that play therapy was effective in the treatment of all disorders examined, especially behavioral disorders and depression.

Background: Childhood cancer is a grueling event that can affect the lives of patients and their parents both psychologically and physically. Playing is a way to reduce this problem in children with cancer. Objectives: The aim of this study was to evaluate the effectiveness of individual play therapy on hope, adjustment and pain response of hospitalized children with cancer. Methods: This quasi-experimental study was performed among 30 children with cancer aged 8 to 12 years. Subjects were randomly divided into experimental and control groups. In the experimental group, individual play therapy intervention was performed for two months (10 sessions). The study instruments included: Snyder’s Hope Scale, Pediatric Pain Response Questionnaire (Walker et al.), and Dokhanchi’s Adjustment Questionnaire (1998). In order to analyze the data, repeated measures analysis and Bonferroni post hoc test were performed in SPSS, version 16. Results: In this study, the mean age of participants in the experimental and control groups was 9.36±1.68 and 10.1±1.98 years, respectively. The results of this study showed that the difference between the three evaluation stages in all variables, except the post-test with the follow-up of hope variable, was significant in the experimental group (p≥0.001). But no significant difference was observed between the three evaluation stages in the control group (p≤0.001). Conclusion: It seems that play therapy intervention has an effect on the research variables. Given that the research was conducted on a small sample in a hospital, it is suggested that similar research be conducted to increase the external validity of the present study.

Aims: Promoting social adjustment can improve the developmental skills of preschool children. Therefore, the present study aimed to determine the effectiveness of play therapy based on cognitive-behavioral on social adjustment of preschool children. Instrument & Method: The quasi-experimental research method was pretest and posttest with a control group with a follow-up period. The statistical population included all preschool children (5 to 6 years) in Bojnourd in the academic year 2019-2020 that 40 people were selected by convenience sampling method and were randomly divided into experimental and control groups. The experimental group underwent cognitive-behavioral play therapy training in 12 sessions of 90 minutes; but the control group did not receive any training. The social adjustment questionnaire was administered to the subjects before and after the training. Data were analyzed using repeated measures analysis of variance test at the significance level of 0.05 with SPSS software version 24. Findings: The results showed that play therapy based on cognitive-behavioral was effective in improving social adjustment of preschool children (p<0.05). And the results continued in the follow-up period (p<0.05). Conclusions: Teaching play therapy based on cognitive-behavioral to preschool children can be an effective step in promoting their social adjustment. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This systematic review aims to examine the effect of therapeutic play methods on hospitalized children in Turkey. Methods: Medline/PubMed, ScienceDirect, YÖK (higher education institution) National Thesis Center, Ovid, Web of Science, Wiley Online Library, Turkey Clinics, and Google Academic databases were searched for relevant data from 2009–2019 using the keywords therapeutic play, play therapy, child, and pediatrics. Ultimately, 36 studies published in English and Turkish conducted in 2006–2018, which reported the impact of game methods and whose full text can be reached, were included herein. The Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 guideline and Patient, Intervention, Comparison, Outcomes, Study Design model were used in analyzing the studies. Results: Among the studies included herein, 25 were randomized controlled trials, seven were semi-experimental studies, two were qualitative and quantitative mixed pattern studies, one was a semi-experimental and cross-sectional study, and one was a case–control study. Our findings showed that distraction cards have been the most frequently used therapeutic game method, with durations varying between 3 min and 1 h depending on the attempt, and that therapeutic play has mostly been utilized during the bloodletting process. Moreover, our results revealed that therapeutic play generally reduces pain, anxiety, and fear and increases the child's adaptation to the hospital environment. Conclusion: The present review showed that therapeutic play among hospitalized children in Turkey was effective in relieving pain and anxiety and helped them adapt to the hospital environment. These results suggest that therapeutic play may aid medical personnel during painful procedures and throughout the hospitalization process.

Preschool period is a period when children start to get to know the environment and gain basic vital skills thanks to their developing cognitive, social, physical and emotional skills. During this period, when the child tries to get to know himself/herself and to control the environment, psychopathological results may occur from time to time. It is seen that the play therapies are getting more and more widespread with the addition of the game, which is the most important occupation of the child, to the treatment stages of the problems experienced in this period. Play therapies are defined as a therapy method in which children's psychosocial problems are treated using the healing power of the game. The most preferred age group for play therapies that can be applied in different age groups such as baby, child, and adolescent is the 3-12 age range. Thus, it is aimed to improve the problem-solving skills of the children and to be reach their psychological well-being with the play therapy techniques prepared considering their current developmental periods. In addition to the above, play therapies are used in the treatment of many psychological disorders. In the current review article, the effectiveness of play therapy on disorders such as depression, attention deficit hyperactivity disorder, childhood period traumas, anxiety disorders, behavioral disorders, autism and learning disability that are common in pre-school period were evaluated in the pre-school period, and then it was concluded that play therapy was effective in the treatment of all disorders examined, especially behavioral disorders and depression. [ABSTRACT FROM AUTHOR]

Background and Objective: Play therapy provides an opportunity for children with disabilities to experience and learn new skills. The aim of this study was to evaluate the effectiveness of play therapy in improving the adaptive skills of children with physicalmotor disability (PMD). Methods: The method of the present study was quasi-experimental using pre-test and post-test design with control group. The statistical population of this study included all 6-8-year-old PMD children referred to Behesht Occupational Therapy Clinic in Isfahan in the first half of 2020. According to the inclusion criteria, 30 children were selected through convenience method and randomly divided into two groups of 15 ones as the experimental and control groups. The Lambert Adaptive Behavior Scale was used to collect the data. Finally, the data were analyzed by one-way covariance test using SPSS 21. Findings: These findings showed that there was a significant difference between the pretest and post-test in adaptive skills in the experimental group (F=72.8; P=0.01). This difference was not found in control group (170.7±10.06; 171.3±10.6; P>0.05). Conclusion: According to the results, play therapy helps the children to learn the adaptive skills; therefore, it is suggested that the play therapy, in addition to conventional treatment methods, could be used for these children in rehabilitation centers to establish a happy and creative environment. [ABSTRACT FROM AUTHOR]

Purpose: Child participation in type 1 diabetes (T1D) self‐care is needed in developing countries due to a lack of resources, especially during the school day. This pilot study evaluated the feasibility of a therapeutic play intervention (ITP) versus standard education (SE) on the ability of children with T1D to correctly perform insulin injection technique. Design and Methods: Children with T1D (7–12 years) were recruited at two diabetes clinics in Brazil and randomized to ITP or SE. Registered nurses received protocol training to deliver the intervention and perform data collection. ITP group received an education that included a story about a child with T1D who self‐injects insulin at school; SE group received routine clinic‐based education. Preintervention, children were video‐recorded giving insulin injections to a doll; postintervention, children were rerecorded giving the doll an injection. The research team reviewed the videos and assessed the injection technique using validated checklists. Parents reported children's self‐injection practices at baseline and 30 days. Results: Children (N = 20, 40% male) were 9.6 ± 1.3 years old and had T1D for 3.6 ± 2.3 years; HbA1c was 9.1 ± 2.0%; 20% of ITP and 50% of SE children used syringes (vs. pens) for injections. At baseline, 80% of both groups knew how to self‐inject; most were taught by a parent/relative. Injection technique scores were low in both groups; ITP group increased their scores significantly postintervention. Practices of self‐injection did not change in either group after 30 days. Practice Implications: The play‐based intervention appeared to improve the injection technique in the short‐term. Pilot findings support the development of a larger trial to evaluate the effectiveness of ITP on educating children on insulin injections. [ABSTRACT FROM AUTHOR]

Objective: To know the perception of nursing professionals about the use of therapeutic plays in children's hospitalization. Methods: This is a descriptive research with a qualitative approach carried out with 18 nursing professionals who work in a pediatric unit of a teaching hospital in southern Brazil. Data were collected through semi-structured interviews, based on a predefined script that combines open and closed questions, whose analysis was thematic. Results: Two categories were elaborated: Knowledge about therapeutic play; Use of distraction strategies or therapeutic play in child care. Most participants showed to have a simplified understanding about the therapeutic play, ignoring its applicability and functions, associating it with recreation and attributing its practice to occupational therapy professionals, not using it in their daily work. However, they use distraction techniques to provide greater comfort to the child during a hospitalization. Conclusion: It is believed that the development of standard operating produces regarding the use of therapeutic plays in the care of hospitalized children can contribute to minimizing the negative effects of children's hospitalization. [ABSTRACT FROM AUTHOR]

Background: Mentally retarded influences social skills and adaptive behavior in children. That leads to social and communication impairment and adjusting social problem. Therefore, this research investigates the influence of puppet play therapy on adaptive behavior and social skills in male children with mentally retarded. Methods: This study is a quasi-experimental study with pre and post-tests. 30 mentally retarded male children selected through the criteria from Noreslam School of Varamin County in 2016-2017. They were assigned randomly to the control and intervention groups. The intervention group received puppet play therapy for eight treatment sessions (25 minutes for each session, twice a week). The research instruments were Vineland Social Maturity Scales and Adaptive Behavior Index of Limbert (ABIC). Statistical analysis conducted by analysis of covariance. Results: Findings indicated that the mean’s scores of six subscales of adaptive behavior including violent and disruptive behavior (F= 2.61, p= 0.007), antisocial behavior (F= 3.41, p=0.016), rebellious behavior (F= 2.41, p= 0.011), untrustworthy behavior (F= 8.20, p= 0.008), stereotyped behavior (F= 0.87, p= 0.039), unacceptable of eccentric habit (F= 5.51, p= 0.026), and in Vineland social maturity (F= 1.09, p= 0.305) after intervention, in research groups were significantly difference. In addition, the results of variance indicated that there is not a significant difference between withdrawal behavior (F= 0.93, p= 0.34), inappropriate social behavior (F=4.23, p= 0.069), unacceptable vocal habits (F= 4.77, p= 0.078), hyperactive tendencies (F= 1.55, p= 0.223), and psychological disturbance (F=3.69, p = 0.065), five subscales of adaptive behavior. Conclusions: Puppet play therapy improves adaptive behavior and social skills in children with mentally retarded. Hence, it is necessary to utilize it in order to decrease social skills deficits and promote social adjustment in children with mentally retarded.

Objective: This systematic review aims to examine the effect of therapeutic play methods on hospitalized children in Turkey. Methods: Medline/PubMed, ScienceDirect, YÖK (higher education institution) National Thesis Center, Ovid, Web of Science, Wiley Online Library, Turkey Clinics, and Google Academic databases were searched for relevant data from 2009-2019 using the keywords therapeutic play, play therapy, child, and pediatrics. Ultimately, 36 studies published in English and Turkish conducted in 2006-2018, which reported the impact of game methods and whose full text can be reached, were included herein. The Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 guideline and Patient, Intervention, Comparison, Outcomes, Study Design model were used in analyzing the studies. Results: Among the studies included herein, 25 were randomized controlled trials, seven were semi-experimental studies, two were qualitative and quantitative mixed pattern studies, one was a semi-experimental and cross-sectional study, and one was a case-control study. Our findings showed that distraction cards have been the most frequently used therapeutic game method, with durations varying between 3 min and 1 h depending on the attempt, and that therapeutic play has mostly been utilized during the bloodletting process. Moreover, our results revealed that therapeutic play generally reduces pain, anxiety, and fear and increases the child's adaptation to the hospital environment. Conclusion: The present review showed that therapeutic play among hospitalized children in Turkey was effective in relieving pain and anxiety and helped them adapt to the hospital environment. These results suggest that therapeutic play may aid medical personnel during painful procedures and throughout the hospitalization process. [ABSTRACT FROM AUTHOR]

Introduction: Children with cancer need psychological treatment to increase their quality of life along with medical treatments. Accordingly, the aim of this study was to determine the comparing the effectiveness of cognitive-behavioral art-play therapy group and the cognitive-behavioral story therapy on health related quality of life among children with cancer. Materials and Methods: The research method was semi-experimental, and research design was three groups with two stages (pre-test and post-test design). From statistical population of 8-12 years old children with cancer in Amir Hospital (Shiraz city, Iran) in the Summer of 2018, 36 children were selected and then randomly assigned in two therapeutic groups (each group with 12 cases) and a control group (with 12 cases). Children Health related Quality of Life Scale (KiD-KINDL-Bullinger & Ravens-Sieberer, 1998) was used to measure the dependent variable in the pretest and post-test. The group of cognitive-behavioral art-play therapy and cognitive-behavioral story therapy received 12 sessions of treatment. The data were analyzed using multivariate analysis of covariance. Results: The results showed that there was a significant difference between cognitive-behavioral art-play therapy and cognitive-behavioral story therapy with the control group in health related quality of life (P<0.001) and their components. However, there was no significant difference between cognitive-behavioral art-play therapy and cognitive-behavioral story therapy in increasing the health related quality of life in children with cancer (P>0.05). Conclusion: It is suggested that cognitive-behavioral story therapy and cognitive-behavioral art-play therapy should be used in educational and therapeutic environments to promote the level of health related quality of life for children with cancer. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the effect of a new therapeutic model (a therapeutic play/play therapy (TP/PT) program) on alleviating pain in children receiving inpatient treatment in paediatric surgery units and parents' anxiety levels in the post-operative period. The study was designed as a semi-experimental model using the TP/PT program. Four measurements (pre-test, two interim tests and post-test) for children and two measurements (pre-test and post-test) for parents were performed. The data were collected using the Child and Parent Information Form, the Wong-Baker Faces Pain (WBFP) Rating Scale and the State-Trait Anxiety Inventory (STAI). The mean pain score for children after TP/PT decreased in each measurement, and a significant difference was found between these measurements. The mean state anxiety score for parents significantly decreased after the TP/PT program, and a statistically significant difference was found between these measurements (p = 0.000). This study determined that the post-operative TP/PT program was an effective method to reduce acute post-operative pain in children. Parental anxiety levels were found to correlate with levels of pre- and post-operative pain in children. The findings of this study provide a basis for using a new therapeutic model that is easy to apply and effective for reducing children's pain and parents' anxiety. • Postoperative pain is a serious problem for children after surgery. • Parent anxiety is correlated with child pain. • Therapeutic play/play therapy program was an effective method to reduce the acute postoperative pain in children. • Parental anxiety levels decreased with decreasing children's pain levels. [ABSTRACT FROM AUTHOR]

This systematic review examines the literature on the effectiveness of child-centered play therapy (CCPT) for youths who have experienced traumatic events. Two independent reviewers conducted the search procedures, as well as all data extraction and coding. Seven peer-reviewed articles reporting treatment outcomes were included in the review. As the focus of the review was on CCPT, treatment methods were similar across the seven articles (e.g., use of similar materials). There was also some consistency in findings regarding outcomes related to internalizing problems, self-concept, and self-competence. However, there was significant variability in the outcome measures used to evaluate effects, as well as limitations regarding the study methods that impact the overall conclusions regarding the use of CCPT to treat children that have experienced traumatic events. Treatment recommendations and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

Process evaluations provide insight into the implementation of complex interventions. This study is a process evaluation for the implementation of a parent-led physical activity intervention at home with youth with a rare neurodevelopmental disorder (Prader-Willi syndrome, PWS) and youth with non-syndromal obesity (NSO). Participants included 42 youth with PWS (10.9 ± 2.5 y; 24M: 18F) and 65 youth with NSO (9.8 ± 1.1 y; 34M: 31F), assigned to an intervention or a delayed intervention group. The 24-week intervention included parent training, receiving equipment and a pre-planned curriculum with playground games and interactive console-based games. We evaluated intervention implementation fidelity, dose (reported physical activity minutes), acceptability (perceived difficulty and enjoyment of the planned activities) and contextual factors (facilitators and barriers). Overall, 68.2% of participants (immediate and delayed intervention groups) completed ≥70% of the planned physical activity sessions. The average length of the sessions was 44 ± 23 and ≥49 ± 22 min for playground and console-based games, respectively. Most activities were more difficult for those with PWS than those with NSO. Common barriers to implementation included scheduling and the child's motivation, and facilitators included features of the curriculum and social support. This intervention modality (home-based, delivered by parents) appears suitable for families with children with and without neurodevelopmental disorders. Trial Registration NCT02058342. Registered 6 February 2014 retrospectively registered. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to assess the efficacy of a childcare-based intervention in increasing child physical activity by allowing children unrestricted access to outdoor areas for free-play when structured activity is not taking place. A randomized controlled trial was conducted in six childcare services. Intervention services provided children unrestricted access outdoors for active free-play, while control services provided their usual scheduled periods of outdoor play. Consent was obtained from 231 children. Child moderate to vigorous activity (MVPA), the primary trial outcome, was assessed via accelerometer at baseline and 3 months post baseline. Intervention effects were examined using Generalised Linear Mixed Models. Controlling for child age, gender and baseline outcome measure, at follow-up there were no significant differences between groups in minutes of MVPA in-care (mean difference: 4.85; 95% CI: −3.96, 13.66; P = 0.28), proportion of wear time in-care spent in MVPA (mean difference: 1.52%; 95% CI: −0.50, 3.53; P = 0.14) or total physical activity in-care (mean difference in counts per minute: 23.18; 95% CI: −4.26, 50.61; P = 0.10), nor on measures of child cognition (P = 0.45–0.91). It was concluded that interventions addressing multiple aspects of the childcare and home environment might provide the greatest potential to improve child physical activity. [ABSTRACT FROM AUTHOR]

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Background: Childhood cancers are fatal diseases which cause intense stress and traumatic situations for the ones who experience those diseases. This kind of an emotionally hard life may create some hardships for developing self-concept. The aim of the study is to put forth the self-exposure of a school-age child by using plays. Materials and Methods: Six play sessions had been carried out in June-August 2011. As a searching pattern, interpretive case study method was used. The research consisted of six children with cancer, aged between 9 and 12 years. The research was conducted in a public hospital in children oncology service. Results: The assessment of data was realized in two stages. The first one was examining the data; the other stage was the content analysis that has been constructed after the play sessions as "Nursing Intervention: Play Model." In the newly formed model, nine themes had been found: (a) expressing good memories, (b) control, (c) problem-solving ability, (d) relations, (e) aggressive behaviors, (f) regression, (g) good-bad, (h) trauma, and (i) anxiety. Conclusions: The self-concept of the school-age child needs to be supported. It has been submitted that the themes can be supportive for the prospective nursing models concerning child′s self-exposure. It has been suggested that the themes produced by "Nursing Intervention: Play Model" can be used while planning, implementation, and assessment of the nursing care.

Background and Objectives: With regard to the prevalence of Oppositional-Defiant Disorder in children and converting to the other disorders, if left untreated, this research aims to investigate the effectiveness of group play therapy on oppositional-defiant disorder symptoms among children. Materials and Methods: This study is interventional and quasi-experimental research. In this study based on cluster sampling method, 30 participants were selected and randomly assigned to the experimental and control groups. The tools discussed here included Child Behavior Checklist (CBCL), Raven's Progressive Matrixes, Teacher Report Form (TRF) as well as a clinical interview with parents. Play therapy was provided weekly by group for the participants, in sixty-minute eight sessions. Participants were assessed in three stages of pre- interference post- interference and after two month intervals from completing sessions. SPSS18 and multi-variables covariance analysis method were used for analyzing data. Results: The results obtained by Mancova analysis showed that there was a significant decrease in oppositional defiant-disorder symptoms in comparison with control group reporting by parents and teacher (P < 0.001). In addition, the results indicated the same effect after two months. Conclusions: The results indicated the efficiency of group play therapy on decrease of oppositional defiant disorder symptoms among children. Accordingly using this treatment method on children was recommended to the therapists.

Objective: verify how the parents and/or legal caregivers of hospitalized children perceive playing as a dimension of Nursing care. Method: qualitative, descriptive, exploratory and prospective study, using theme/category-based analysis. A semistructured interview was held at a Children’s Hospital of reference in the State of Amazonas in January 2016. The participants were 22 parents between 18 and 50 years of age. The thematic categories “Meaning of play and playing”, “Importance of the toy during playing practice for hospitalized children” and “Care while playing” emerged from the analysis. Results: the parents acknowledged the importance of playing during the care process in pediatric contexts, but did not envisage the activity as part of the professionals’ care plan, so that the child’s singularity can be fully respected in that sense. Conclusion: the professionals need qualification and awareness raising to use play in their care practice.

Aim: The study aims to determine the effect of pre-intervention training provided through therapeutic play on reducing the anxiety of pediatric oncology patients during peripheral catheterization. Materials and Method: This experimental study was conducted between September 2012 and March 2013. The study included 40 children (20 in the control group and 20 in the experimental group) who were receiving treatment for hematological-oncological diseases in the Pediatric Hematology and Oncology Units of Istanbul University, Istanbul Faculty of Medicine and Cerrahpasa Faculty of Medicine, and in the Department of Pediatrics of the American Hospital. The children were randomly allocated into the experiment and control groups. The children were asked to complete an Information Form before the peripheral catheterization. The intervention was explained to the experimental group through therapeutic play. The data obtained through the State-Trait Anxiety Inventory for Children (STAIC) after the peripheral catheterization were analyzed using the Statistical Package for Social Science (SPSS) 21 package for Windows. Findings: It was found that the mean trait anxiety scores were similar and remained moderate in the experimental and control groups; that there wasn’t any statistically difference between the groups (p<0.05); and that the mean state anxiety score of the experimental group was lower than that of the control group (Control: 43.40 ± 5.42, Experimental: 31.50 ± 4.73) and this difference was statistically significant (p<0.001). The state anxiety level was found to be reduced in all children – regardless of the variables – with the training provided through therapeutic play. Conclusion: Children provided training with therapeutic play before the intervention can reduce their anxiety during procedures, such as peripheral catheterization. The use of therapeutic play made widespread in health institutions will decrease both pain and suffering in children. [ABSTRACT FROM AUTHOR]