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Play Assessment Norms

 

Symbolic Play and Symbolic Gesture

            Symbolic play and symbolic gesture provide a window into the cognitive problem-solving of children who cannot communicate through language.  Observing how children interact with the objects in the environment and people can tell us a great deal about the cognitive readiness of the child for mastering language targets.  An excellent way to establish targets for intervention is to observe the symbolic play and symbolic gesture of the child.

Symbolic Play is highly related to symbolic gesture. 

    • Cognitive development, as measured by symbolic play skills, was found to be highly related to gesture age on the MacArthur Communicative Development Inventory. 

 

Relationship between Symbolic Play, Self-Help and Situation Comprehension on the Minnesota Child Development Inventory:

    • The symbolic play scale has been shown to have a strong relationship with the development of prelinguistic gestures (Carey, 1995), a measure of self-help (Coulter, 1995), comprehension-conceptualization (Coulter, 1995) and situation-comprehension (Coulter, 1995) on the Minnesota Child Development Inventory and a criterion reference teacher checklist of symbolic play in preschool (Coulter, 1995) and the Westby Play Scale (Coulter, 1995). 

     

Symbolic Play has significant and strong relationships with Gestures Produced, Words Produced, Phrases Understood and Words Understood on the MacArthur Communicative Development Inventory:  Words and Gestures

    • Additionally, this measure has a strong relationship with gestures produced, words understood, phrases understood and words produced on the MacArthur CDI (Day, 1995).  Both Minnesota Child Development Inventory (MCDI) and the MacArthur Communicative Development Inventory (CDI) have very strong relationships with the Sequenced Inventory of Communicative Development (SICD) and the Mean Length of Utterance (MLU).
    • Relationships between play and symbolic gesture have been observed in children with automatic/rote development.  Parent questionnaires, such as the MacArthur Communicative Development (CDI) have been used to investigate the interrelationship of symbolic gesture and language through a connectionist perspective. 

 

Symbolic Play relationships with language development with typically developing children. Several of these relationships have been demonstrated in the development of typically developing children (Bates, Camaioni and Volterra, 1975; Snyder, 1978; Harding and Golinkoff, 1979; Miller, Chapman, Branston and Reichle, 1980; Smolak, 1982; Gopnik and Melzoff, 1986; Tomasello and Farrar, 1984; McCune-Nicolich, 1981; Shore, 1986; Shore, O'Connell, and Bates, 1984).

    • The Symbolic Play Quotient (SPQ) is not intended to be an intelligence quotient nor does the author make any claims that the quotient is a predictor of later language skills. 
    • During the birth through three year age period, there is, however, an extremely high relationship between symbolic play skills and language skills. 
    • There is evidence for a very strong parallel relationship so that observation of symbolic play can be a mirror into the child’s understanding of concepts important to language development when the child has a significant hearing loss.
    • Symbolic play development could be a crucial element at this stage level because it allows an investigation of non-verbal variables which are not as affected by hearing loss but have a strong relationship with language targets.  
    • Regardless of the intelligence level of the child, a lack of synchrony between language skills and symbolic play skills may later impede the child's ability to reach his/her intellectual potential.

     

Symbolic Play Inventory and strong relationships with vocabulary development among infants and toddlers who are deaf or hard of hearing: 

  • Those children who were identified at birth and had quotients above 80 on the Play Assessment Questionnaire (PAQ) were the most likely to be close to their hearing peers in language skills, for all degree of hearing loss from mild through severe hearing impairments (Carey, 1995).  
    • This same relationship between age of identification, cognitive and language skills was found in a study of 150 children with hearing loss (Yoshinaga-Itano, Sedey, Coulter & Mehl, 1998).
    • Normative data on developmental levels of symbolic play can help the intervention provider determine whether language and symbolic play development are similar. 
      • The provider can determine how similar the child is to other children with significant hearing loss and to children with normal hearing. 
      • The intervention provider can examine the individual skills of the child and determine what language aspects are most likely to be learned quickly. 
      • The developmental scores represent the range of scores obtained from the Colorado population of over 350 children. 
      • Using these graphs, the intervention provider is able to determine how any individual child compares with a normative sample of children with mild through profound hearing lossa

       

 

Play Assessment Questionnaire:  Spontaneous


Total Group

 

Early Identified

 

Late Identified

Mild/Moderate Hearing Loss


Moderate-Severe/Severe Hearing Loss


Profound Hearing Loss

 

Play Assessment Questionnaire:  Spontaneous and Imitated


Total Group


Early Identified


Late Identified


Mild/Moderate Hearing Loss

Moderate-Severe/Severe Hearing Loss

 

Profound Hearing Loss

 

 

Symbolic Play and traditional tests of performance intelligence

  • Cognitive development is difficult to measure in children between birth and six years of age, particularly within a population of children who have significant hearing loss.  Clinical experience with the Bayley Infant Scales of Mental Development has shown that scores tend to decrease with age because of the emphasis upon language skills as the child ages and the inability to separate language from performance intelligence skills.
  • Additionally, the Bayley scales do not have a strong relationship with the development of language skills either at the infant/toddler level or as a predictor of later language skills in the deaf and hard of hearing population.  Boyle (1977) stated that this test may be used for hearing-impaired children but is more appropriate for children functioning in the average range of intelligence.  Sullivan & Vernon (1979) reported that results indicate the student's current performance but that the test is not appropriate as a prediction of later ability for children with hearing loss.  Further, typically the Bayley Mental Scale is administered with a number of items omitted by examiners because they are inappropriate items for deaf and hard of hearing children since they require hearing. According to the test manual, omission of items will invalidate test scores (Bradley-Johnson & Evans, 1991; Bayley, 1969).  Because of these factors, it is extremely difficult to translate performance on the Bayley Scales to intervention goals and strategies.
  • Nonverbal indicators of skills related to the development of word knowledge. Traditional means of measuring cognitive potential through performance intelligence scores from standardized tests indicate that the distribution for children with hearing loss is comparable to the distribution of hearing students, but with a slightly lower mean than 100, indicating that these skills are less affected by language delay caused by hearing loss
  • Thus, it is important to also measure cognitive abilities that are not significantly affected by hearing loss and language development.  A comparison of the symbolic play, the performance intelligence measures and language development will provide the professional and families an avenue for predicting the child’s intellectual potential.  However, the fact that the performance intelligence skills remain within a normal range, even though language skills of many deaf and hard of hearing students become significantly delayed indicate that the potential for age-appropriate language exists and it becomes the responsibility of the educational system to develop techniques capable of closing the gap between cognitive and language skills.  Perhaps the most important role of symbolic play development is that it can be used as a means of designing curricular goals.

Using Assessments To Determine Teaching Goals

Assessment

  •  Based on the information presented, the author makes the following recommendations.
    • Assessments of the D/HH infant/toddler’s symbolic play should be made to determine cognitive readiness for linguistic milestones.  Parent/facilitators can promote development of symbolic play through modeling of the next step.  The Play Assessment Questionnaire (Calhoun, 1987; Yoshinaga-Itano, 1994), The Symbolic Play Test (Lowe & Costello, 1976); the Play Assessment Scale (Fewell, 1984) can be used with the infant/toddler.  The Transdisciplinary Play Assessment (Linder, 1990) is a criterion reference play assessment technique designed to identify appropriate intervention strategies.
    • Measures of non-verbal cognitive skills that are unaffected by language development are important to provide further indication of a child’s intellectual potential.  The Bayley Mental Scales (Bayley, 1969) and the Minnesota Child Development Inventory (MCDI) Ireton, 1972, 1994), particularly the Situation-Comprehension and the Self-Help subscales can be used as indices of general intelligence.
    • A comparison between symbolic play, other non-verbal cognitive measures and language development can provide information about the effectiveness of intervention.  Comparisons between the Play Assessment Questionnaire, the MacArthur Communicative Development Inventory (CDI), the Expressive Language and Comprehension-Conceptual subscales of the Minnesota Child Development Inventory (1972) can provide information about the parallel domains.  

Intervention

  •  Utilizing either the McCune-Nicolich developmental continuum or the Snyder (1994) adaptation of levels of play from the Play Assessment Questionnaire, the developmental appropriateness of the play should be evaluated.  If the child has delays in symbolic play development that are greater than development in other non-verbal areas, the intervention provider may wish to determine whether the child is able to develop at a more rapid rate through the use of scaffolding techniques.  Several steps of instruction can be followed. 
      • Identify the next instructional level of play.
      • Make sure that the child has the opportunity to demonstrate this level of play through play opportunities with the appropriate toys and objects.  Toys and objects that do not have symbolic characteristics should be made available to the child (blocks that can become imaginary cars, people).  These might include blocks or play doh because these play objects can be made into anything symbolic.
      • Model the instructional level of play for the child.
      • Reinforce the child’s imitation of this play model through social reinforcement.
      • Allow the child to explore extensions of this play and to demonstrate understanding.
      • Using appropriate narration the parent can supply the child with the language appropriate to the play situation.
      • The parent can expand and extend the play behavior of the child.  For example, if the child lines up cars but not in any particular category, the parent might line the cars up by color, size or shape.