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PLAY AND CHILDREN WITH DISABILITIES

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Title: PLAY AND CHILDREN WITH DISABILITIES


1
PLAY AND CHILDREN WITH DISABILITIES

2
PLAY AND CHILDREN WITH DISABILITIES
  • Children with disabilities may engage in play
    differently than their peers without
    disabilities. Consequently, quality of play
    depends on the following
  • The disability or combination of disabling
    factors.
  • The opportunity for play.
  • The accessibility of toys.
  • A modified play environment.
  • The presence of peers and adults to facilitate
    and encourage play.
  • Disabilities can be classified in terms of the
    following
  • Intellectual impairment, physical disabilities,
    and emotional disorders (Rubin, Fein
    Vanderberg, 1983)
  • Developmental and developmental delay.
  • Children at risk for development (children who
    can become disabled without intervention).

3
THE NATURE OF DISABLITIES
  • PHYSICAL DISABILITIES
  • Children with Physical Disabilities can have
  • Hearing impairment. Depending on type of
    malfunction to the ear or nerves, impairment may
    range from mild to severe temporary or
    permanent.
  • Visual impairment. Variation in range of
    impairment due to premature birth, injury, or
    medical causes.
  • Motor impairment. Variations range from physical
    restrictions of limbs, hand, trunk control,
    mobility, and strength. Generally caused by
  • Spina Bifida
  • Cerebral Palsy
  • Muscular Dystrophy

4
Spina Bifida
  • Develops when spinal cord is not fully developed
    and has an opening that impedes protection of the
    cord.
  • Significant impairment causes
  • Loss of bowel and bladder control
  • Bone Deformities
  • Motor Impairment
  • Paralysis
  • Hydrocephalus.
  • A condition in which spinal fluids collects in
    the brain. If left untreated can result in
    retardation and seizures. Condition commonly
    treated by surgically implanting a tube into
    brain which allows fluid to drain and blood to
    circulate properly.

5
Cerebral Palsy
  • Most common type of orthopedic impairment leading
    to a neuromuscular disability.
  • Results from injury to brain before or during
    birth.
  • Children (mild to moderate) are able to walk and
    use other motor movements with some awkwardness
    however, children (severe) often have other
    disabilities (mental retardation and have little
    or no mobility).
  • Muscular Dystrophy
  • Results in progressive degeneration of the
    voluntary muscle of the arms and legs.
  • Symptoms (can appear in children as young a 3
    years of age)
  • Appearance of awkwardness
  • Walking on tiptoes
  • Severe curvature of the spine
  • Other postural abnormalities
  • Although there can be periods of remission,
    gradually the child loses the ability to walk and
    early death is possible.

6
AT- RISK CHILDREN
  • At-risk Children. Childrens experience with
    Biological or Environmental factors that may
    result in developmental delays or disabilities.
  • Biological Risk Factors
  • Children have biological history that can result
    in later developmental problems
  • Children at-risk include
  • Premature babies.
  • Children born to mothers who have German measles
    while pregnant or complications during labor.
  • Low birth weight babies.
  • Children who accidentally ingest toxic substance
    during infancy and toddlers years.
  • Environmental Risk Factors
  • Can be at risk because of the environment in
    which they lived before and after birth.
  • These risk factors result from the mothers living
    in substandard or deprived environments.
  • Early identification of at-risk child is
    essential so that intervention earlier on can be
    provided.

7
DEVELOPEMNTAL DELAYS
  • COGNITIVE DELAY
  • Child with cognitive or mental retardation is
    unable to use thinking skills to the level that
    is characteristic of normal development.
  • A child with Downs Syndrome experiences cognitive
    delays that result in mental retardation
  • ADHD
  • Language Delay
  • Difficulty in articulating or expressing
    language. Speech deficit that limits
    verbalization, such as stuttering or inability to
    utter sounds correctly.
  • Immature use of language.
  • Limited vocabulary.

8
Emotional and Behavioral Disorders
  • Exhibit deviation from age appropriate behavior
    that can cause them to be very aggressive or very
    withdrawn. Leading to behavioral problems such
    as
  • Aggression.
  • Academic disability.
  • Anxiety.
  • Depression.
  • Behavioral deviation can be caused by
  • Psychological causes Bereavement due to loss of
    a parent through divorce or death.
  • Environmental causes Parenting methods of child
    management, Teacher management strategies.
  • Psychological causes Genetic factors.

9
A. Autism
  • Children with autism experience severe emotional
    disturbance. Noticeable as early as 2½ years of
    age.
  • More common in boys than girls and is believed to
    be a biological problem that occurs during
    prenatal stages of development.
  • Behavior exhibited includes
  • Head banging.
  • Extremely delayed expressive language.
  • Echolalia speech.
  • Stereotypical body movements.
  • Children with Autism
  • Can seem to be insensitive to sound and events
    around them.
  • Have difficulty in socially interacting with
    others.
  • Fail to recognize that outside world is different
    from self.
  • Often experience mental retardation as well.

10
(B) Abused Neglected Children
  • Children can be abused emotionally, physically,
    sexually, and through neglect. Frequently
    children who are abused experience more than one
    form of abuse.
  • Abused children are aggressive and use
    inappropriate social behavior they are equally
    likely to be withdrawn and passive.
  • Aggressive children can be
  • Disruptive.
  • Antisocial.
  • Children who have been sexually abused might use
    inappropriate sexual behavior in social
    interaction with peers.
  • Physically abused children might wear clothing
    that is seasonally inappropriate to cover signs
    of abuse.
  • Neglected children might be dressed
    inappropriately or in dirty clothes. Generally,
    because they have received minimal care and
    supervision.

11
Children with Multiple disabilities
  • Children with disabilities frequently have
    combination of conditions.
  • Example. Children with visual impairments can
    also have hearing impairments, mental retardation
    with unusual and hearing impairments.
  • Cognitive delay or mental retardation can have
    language delay or communication disorder.
  • Behavior disorder can also experience language
    abnormalities or cognitive delay.
  • It is important to understand the nature of
    disabilities in order to understand how these
    conditions and variations from normal development
    affect how children play.
  • Easier to understand the limitation of children
    with physical disability and how their play is
    affected than children with behavior or mental
    disabilities.
  • Providing play opportunity is more challenging in
    case of multiple disabilities.

12
DISABILITIES AND PLAY
  • It is difficult to study the play of children
    with disabilities.
  • Handicapping condition involves a wide range of
    disabilities, therefore it can be difficult to
    determine the cause of play differences.
  • Studies are flawed because they have failed to
    separate the developmental differences from
    differences caused by disabling condition.
  • 3) Different researchers from different
    profession might be studying play for different
    purpose and with different results.
  • 4) Some researches are conducted with individual
    children and do not consider the effect of peer
    relationship or behavior in a group setting.

13
Children With Visual Impairments
  • CHARACTERISTICS OF PLAY
  • Troster and Bambring (1994) summarized
    significant difference between the play of
    sighted children and blind children. Blind
    children do the following
  • Explore their surrounding and the objects in
    their surrounds less often.
  • As infants and preschoolers, frequently engage in
    solitary play that is repetitive and stereotyped.
  • Exhibit less spontaneous play far more than
    sighted children, they have to be taught how to
    play.
  • Do not or only rarely imitate the routine
    activities of the caregiver.
  • Play less frequently with stuffed animals and
    dolls and rarely engage in animism.
  • Play less frequently with peers and usually
    direct their play towards adults.
  • Exhibit clear delay in the development of
    symbolic play and role play.
  • Engage in play that contains fewer aggressive
    elements.
  • Children with visual impairments often have
    developmental delays in other domains of
    development that could easily affect their play
    skills.
  • Overprotection or fear of danger might result in
    limited attempts to engage in play.

14
  • Tend to ask more questions of adults in an effort
    to further their understanding of the
    environment.
  • Have obstacles interpreting nonverbal
    communication that can impede interacting with
    sighted children
  • Differences in cognitive play i.e., use hands,
    feet and other parts of the body in object kind
    of plays.
  • Lack of interest in exploring toys in the
    environment might be due to lack of experience
    and tendency to be more interested in their
    bodies than the environment.
  • Presiler Palmer (1989) found them to be more
    interested in environmental elements that opened
    and closed e.g., doors.

15
  • Adults should not only provide a variety of real
    objects for play but also assist children in the
    symbolic use of the objects.
  • Toys should be selected to encourage symbolic
    representation e.g., dolls wooden trucks.
  • Adults can provide experience with objects ,
    which sighted children can acquire automatically.
  • Adults can support play by providing the
    opportunity to explore in a safe familiar
    environments.
  • Partially sighted children need opportunities for
    motor play so that they can develop the same
    abilities as their sighted peers.
  • Adults can assist children in becoming autonomous
    and independent in play. Assist them in
    developing social interaction with other
    children.
  • Guide them to use more imagination and fantasy so
    their play can be enhanced with sighted peers.
  • To encourage interaction with sighted peers, to
    start with include one peer and then gradually
    increase to more.
  • Teachers can help sighted children to understand
    the nature of visual impairments and encourage
    them to play with visually impaired children.

16
Children with Hearing Impairments
  • Characteristics of Play
  • Children with hearing impairments are less
    affected in their play than children with usual
    impairments.
  • There is delay in language, which results in less
    interest in make-believe play or fantasy play
    than hearing peers.
  • Engage less often in socio-dramatic play.
  • Use less symbolism of objects than children with
    normal hearing ability
  • Social interaction with hearing children can be
    facilitated by using sign language or by lip
    reading.
  • According to Parten(1932) parallel play can be
    observed more often in the self contained setting
    for hearing impaired children.
  • Associative play more common in integrated
    setting in a study conducted by Esposito
    Koorland (1989).

17
Children with Motor Impairments
  • Characteristics of Play
  • Complex because there are many kinds of motor
    impairments and severity varies from child to
    child.
  • The most significant limitation is in play that
    involves physical activity.
  • Indoor play is least affected because some of the
    activities do not require gross motor skills.
  • By using wheel chairs and other physical
    assistance devices, children with mobility
    problems can be included in games and other play
    activities with minimum adaptations.
  • Unless other disabling conditions, social
    interactions are affected only to extent that
    children without disabilities are guided in
    accepting the childs limitation and can modify
    their play to include the child.

18
  • Positioning Equipment Is equipment that can
    provide support and proper positioning that
    permits children to carry out daily self care
    activities and engage in play, e.g. car seats,
    prone standers, stroller, toilet seat.
  • Equipment permits the child with weak muscle
    support to be placed in setting position and also
    provide mobility for some children or at a
    minimum makes it possible for children to use
    their hands to play with objects.
  • Lack of mobility or limitations in mobility makes
    it difficult for the child to participate in
    outdoor play with peers who are not disabled.
  • The environment should be made accessible to
    children with motor impairment.
  • An issue in school settings is inclusion of
    children with motor impairments in sports and
    other physical activities with their peers who
    are not disabled.

19
The Role of Adults
  • The American with Disabilities Act ensures the
    rights of people with disabilities to be
    encompassed in all aspects of community life,
    including participation in physical activities
    and integrated settings.
  • Teachers, physical education coaches and sports
    leaders must find ways to adapt and accommodate
    to provide support on an individual basis.
  • Remove barriers to participation in physical
    activities.
  • Burkour (1998) suggests the following to include
    children with disabilities in youth sports
  • Skill assessment/task analysis clearly identify
    all of the physical, sensory, learning,
    communication, socialization skills needed to be
    successful.
  • Focus on maximizing abilities utilize
    individual strengths.
  • Ask everyone for accommodation ideas the child,
    family, teachers, therapists, and other children
    should be asked to come up with most unobtrusive
    adaptations.

20
Characteristics of Play
  • Play of at-risk children can be described in
    terms of sensor-motor practice play, symbolic
    play and social play.
  • The play of sensor-motor play of at-risk children
    develops similar to that of non-risk, but if play
    indicates differences, it can give early
    indications of a possible delay or handicapping
    condition
  • Ex. Narrow range of sensorimotor activities might
    be found to be unusually impaired or autistic or
    have motor impairment.
  • Level of symbolic play with play objects is
    affected in sensory impaired, mentally retarded
    and autistic children who show less ability to
    use complex transformations in their play.
  • Interactive adult-child social play routines can
    be impaired in children with reversal, motor,
    cognitive, or emotional impairments.
  • Children born to teenage mothers can have delays
    in social play because the mothers may have fewer
    social support systems, and are less
    knowledgeable about parenting.
  • Children who develop poor social interactions
    with adults may also experience delays and
    distortions in social play interactions with
    peers.

21
The Role of Adults
  • Children found to be at risk for development or a
    disability are generally served through
    interventions to enhance development and minimize
    the risk of handicapping conditions.
  • Services might be provided directly with the
    child, indirectly through parents and other adult
    caregivers or both.
  • In case of child who has an early diagnosis of a
    disabling condition, both the child and care
    giving adults receive intervention services.
    Parent also receives help in how to enhance the
    childs development and to compensate for
    limiting physical or mental conditions
  • In case of children who are at risk for
    environmental causes, such as those whose mothers
    exposed them to drugs or alcohol during prenatal
    stage, decisions have to be made about
    appropriate environment for the child whether
    the mother can provide a healthy environment.
  • Children might be served in a foster home or
    placed with a relative.
  • Care giver at risk for environmental causes also
    needs intervention service and support if they
    are to engage in appropriate adult-child
    interaction to meet the childs needs.
  • Play has a significant role for development in at
    risk children.
  • Provider of intervention services needs to
    include play in the curriculum for children at
    risk for delay as well as children with diagnosed
    disabilities.
  • Parents and other care givers at home need to
    know how to use play with children and how to
    enhance the childs ability to play.
  • Childs need to play and purpose for play should
    be the major focus for play activities.

22
Developmental Delay
  • Children with Cognitive Delay Mental
    Retardation
  • Characteristics of play
  • Literature on play of children with cognitive
    delay is limited when compared to other types of
    disabilities
  • Reasons
  • Research has been done with individual children
    and limited to the study of their play with
    objects.
  • Most of the research done is medical in nature.
  • Research results have been inaccurate in that the
    researchers seemed to be unaware of the nature of
    the early development that includes individual
    differences in rate of development in children
    without developmental delays.

23
Findings
  • Play of children with cognitive delay is less
    sophisticated and more functional than play of
    children with cognitive delay and requires more
    structure (Beckman Kohl, 1987 Mindes, 1982
    Weiner, Tilton Ottinger, 1969).
  • Play of children with cognitive delay is similar
    to that of children without cognitive delay and
    is developmentally appropriate (Switzky, Ludwig
    Haywood, 1979 Weiner Weiner, 1974).
  • Differences in findings might be because of lack
    of control for toy familiarity in some studies
    and the differences in context for the studies
    (Malone Stoneman, 1990 Rubin Quinn, 1984).
  • When equated with mental age, children with
    cognitive disabilities do not differ from normal
    children in some characteristics of play.
  • Nor do they differ in their preference from
    unstructured activities vs. structured
    activities.
  • Prefer child centered or child initiated
    activities to adult-directed activities.

24
The Role of Adults
  • Adults use play with intervention with children
    with cognitive delay as an assessment tool to
    identify specific delays that need intervention.
  • As a strategy, that can be used in intervention
    programs.
  • The Value of social play between adults and
    infants and toddles is also valuable for children
    with cognitive delay or mental retardation.
  • Techniques used with children with cognitive
    delay are adapted to use a range from very
    directive to playful strategies.
  • Strategies are both taught to parents and used by
    care givers in intervention programs and they are
    taught to be playful and responsive to their
    children.
  • Modeling by adults is used to demonstrate
    symbolic play roles, with more structured
    coaching used for children who are severely
    impaired.

25
  • It is natural for adults to be more directive in
    play with children with cognitive delay than with
    non-delayed peers.
  • Integration of skills teaching into play
    sometimes can improve play and development.
  • Free play can also facilitate development
    especially when adapted toys and play
    environments facilitate social interaction
    between children.
  • The challenge for adult provider of intervention
    for children with cognitive delay or mental
    retardation is to affirm the childs ability and
    interest in engaging in play.

26
CHILDREN WITH LANGUAGE DELAY AND COMMUNICATION
DISORDERS
  • CHARATERISTICS OF PLAY
  • Children with speech impairments did engage in
    make-believe play, but occurred less often and
    was of less mature level of play than play of
    children without speech delays.
  • Children with language impairments are capable of
    engaging in object substitutions and object
    transformations.
  • They exhibit symbolic play less frequently than
    their peers with typical language development.
  • Language- impaired children use less complexity
    in their play activities as they grow older.
  • Children with communication disorder in group
    settings interact more with adults than peers,
    are less likely to respond to peer initiation for
    play , and tend to ignored more often by peers.

27
  • THE ROLE OF ADULTS
  • Children with language impairments benefit from
    playing in integrated settings.
  • They can be taught, how to communicate and
    interact with other children.
  • Adults working with children with language delays
    and disorders need to be skilled in ho to provide
    language intervention within play.
  • Adults can serve as a facilitator of
    communication between children at play without
    directing the play activities.
  • Can encourage the child with language delay to
    use verbalization and model appropriate language.
  • Modeling of language in socio-dramatic play can
    also guide the child with language delay in how
    to engage in more sophisticated play.

28
CHILDREN WITH AUTISM
  • CHARACTERISTIC OF PLAY
  • Autistic children's pattern of development is
    distorted.
  • Play patterns of these children are also
    different from children with other types of
    disabilities.
  • Autistic children do not generally engage in
    symbolic play.
  • They lack make- believe in their play because
    they lack basic representational skills.
  • They lack in symbolic play because of
  • Lack of motivation.
  • Poor social context.
  • Level of repetitive language skills.
  • Lack peer interaction in play.
  • Autistic children tend to engage in repetitive
    and stereotyped manipulation in toy and object
    play.
  • They are less likely to use toys appropriately or
    engage in complex toy play.
  • Few autistic children play similarly to children
    with cognitive delay and normal children.

29
  • THE ROLE OF ADULTS
  • New intervention strategies are used which are
    more child oriented and focus in planned
    environments and opportunity to play wit peers in
    a group.
  • According to Wolf-berg Schulers Integrated
    play Group Model, The play opportunities should
    have eight components
  • Natural Integrated Settings.
  • Well- Designed Play Space.
  • Selection of Play Materials.
  • A consistent Schedule Routine.
  • Balanced Play Group.
  • Focus on Child Competence.
  • Guided Participation.
  • Full Immersion in Play.

30
Abused Neglected Children
  • Characteristics of Play
  • There are some indicators that abused and
    neglected children play differently from their
    peers, who are not experienced in abuse.
  • Type of abuse can also affect play behavior
    differently.
  • A study comparing abused children with control
    group found the following differences (Hughes,
    1998)
  • Abused children played in less mature ways both
    socially and cognitively.
  • Engaged in less play overall.
  • Involved in themselves, and less often in group
    and parallel play.
  • Used the play materials in less imaginative and
    more stereotyped ways.
  • Fantasy themes are more imitative and less
    creative.
  • They repeatedly played out domestic scenes.

31
  • Sexually abused children had an absence of
    fantasy play suggesting a need to occupy the
    present.
  • Sexually abused children have been found to be
    more passive, but they are not necessarily
    antisocial or negative.
  • Sexually abused children are more focused on
    sexual features of anatomically correct dolls.
  • Play themes of physically abused children were
    more action oriented to include fights, wars, and
    sudden disasters.
  • Physically abused children tend to be disruptive
    and uncommunicative and are antisocial.
  • Their play is characterized as fantasy,
    aggressive and chaotic.

32
Role of Adults
  • Teachers role would seem to be to guide children
    in ways to play appropriately and expanding
    socio-dramatic play to include many types of
    themes.
  • Teacher needs to be aware of the differences in
    play behavior and alert to the possibility that
    the child had been experiencing abuse.
  • THE ROLE OF THE ENVIRONMENT
  • Influences of Inclusion Classrooms in Childrens
    Play
  • A major goad of intervention programs is to help
    children with disabilities develop social
    competence.
  • Social interaction is seen as a way for children
    with disabilities to overcome long delay and to
    acquire developmental skills.
  • Social play is also perceived to benefit children
    who involved themselves with less complex form of
    play as a result of a disability.

33
  • Children with disabilities are not as involved or
    accepted as children who are developing
    typically. Also they receive initial
    opportunities for social play less often and have
    fewer reciprocal friendships and less involved in
    higher levels of social play.
  • Children with typical development have positive
    attitudes towards children with disabilities.
  • Peer mediated activities in inclusion classrooms
    were found to
  • Increase peer interaction.
  • Children with disability benefited both
    academically and socially.
  • Children with disabilities can benefit from
    inclusion in mixed age classroom. They achieved
    more sophistication in play with toys in mixed
    age classrooms.
  • Teachers attitude in inclusion classroom can
    have an effect on successful social
    relationships. Teachers with positive attitudes
    have a positive effect on para-professional time
    and direct time with children with disabilities,
    and the social competence of children without
    disabilities.
  • Teachers training can be a factor, as can be
    specific teaching behaviors that are supportive
    of play.

34
Adapted Play Environments
  • Environments that serve a large number of
    children must include modifications for all types
    of disabilities.
  • The environment needs to be predictable so that
    they can play with confidence
  • The American with Disabilities Act (ADA) aims to
    ensure that people with disabilities have access
    to employment, public accommodation, commercial
    facilities, government services, transportation,
    and telecommunications.
  • Regulatory Negotiation Committee on Accessibility
    Guidelines for Play Facilities are as follows
  • Be based on childrens anthropometric dimensions
    and other resource information.
  • Be base on children with disabilities using a
    variety of assistive devices.
  • Provide opportunity of use by children who have a
    variety of abilities.
  • Support social interaction and encourage
    integration.
  • Create challenges, not barriers.
  • Provide advisory information to assist designers,
    operators, and owners, to effectively incorporate
    access into their designs. Information should be
    in an understandable format.

35
Components of Play Environments
  • Ground level Components
  • Are different types of play components that can
    be entered and exited at ground level (e.g.
    swings, climbers, spring rockers).
  • Recommendation suggests that children with
    disabilities have a choice of at least one of
    each different type of play components.
  • Ground component should equal to 50 of total
    number of elevated play components.
  • Elevated Play Components
  • Are part of a composite play structure and are
    entered above or below grade, e.g., slides,
    climbers, and activity panel.
  • At least 50 of all elevated play components be
    accessible to children with disabilities.
  • Accessible Routes
  • Guidelines require that pathways be constructed
    of a material that is suitable for wheelchair and
    other mobile aids.
  • At least one Accessible route be provided within
    the boundary of the playground and connect
    accessible play components including entry and
    exit points.
  • Ramps, Decks Stationary Bridges
  • Access to elevated play components is provided
    through use of ramps, decks and stationary
    bridges.

36
THE ROLE OF TECHNOLOGY
  • ASSISTIVE TECHNOLOGY
  • Technological advances in recent years have
    enhanced the possibilities for children with
    disabilities to be able to communicate,
    participate and engage in play with their peers.
  • These assistive devices are provided as the
    result of an evaluation of the technological
    needs of individual children and selection of the
    most appropriate devices that can be acquired or
    devised.
  • ADAPTED TOYS
  • Assistive technology can be used to adapt toys
    for children with disabilities.
  • Specially designed switches, control units,
    battery devices adapters and mounting system can
    be used with available toys to make them
    interesting and accessible.
  • Battery powered toys can be adapted for
    external switch control so the child can control
    the on and off operation of the toy.
  • Switch control adaptation can be used for battery
    powered kitchen appliances, and action toys.
  • Games can also be adapted with a control switch.

37
CREATIVITY PLAY
  • Assistive technology makes it possible for
    children with some types of disabilities to
    engage in creative activities.
  • Types of adaptation makes it possible for
    children with disability to enjoy creative play.
  • With careful planning, children with disabilities
    can be encouraged to engage in creative
    activities.
  • PLAY - BASED ASSESMENT
  • Understanding play variations resulting from
    disabling conditions can be helpful in
    understanding their needs for intervention.
  • The appearance of or a delay in the play behavior
    can also be used to assess children.
  • Earlier identification of children with delay or
    disabilities traditionally was done through
    standardized assessment.
  • Recently play-based assessment with children with
    disabilities has gained popularity.

38
  • There are three approaches to play observations
    which are being currently used. These are
  • Nonstructured Assessment
  • Purpose is to identify all behaviors that
    occur during a play session.
  • Spontaneous play is observed in
    nonstructured play assessment.
  • Play may be initiated by either the child or
    the caregiver.
  • Structured Assessment
  • Focus on a previously designed set of play
    behavior.
  • Procedure are established, as are the toys
    to used.
  • Techniques employed by adults to initiate
    the play activities.
  • 3. Tran disciplinary Assessments
  • Included a team of evaluators who observe
    the child at a play concurrently.
  • Each member of the team observes a
    different domain of developmental or for a
    different purpose.
  • Observation are generally structured.
  • May include planned adult interaction.

39
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  • 5 Powderhouse Lane
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  • Bringing Out the Best. Research Press.
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