Infants age range?
Infant play type?
Infant stressors?
- 0 to 1 year
- solitary
- separation anxiety by 6 months
- realize they are separate beings
- can identify primary caregivers
Infant Stress reduction
encourage parents to stay, hold, meet basic needs
Infant Therapeutic Play
-less than 3 years don’t understand enough about why they are in the hospital to benefit from therapeutic play
How to establish rapport with infants
Quiet soothing gentle tones, smile
Toddler age range?
Toddler play type?
Toddler stressors?
- 1 to 3 years
- parallel
- separation anxiety
- disruption of routine
- loss of control (confined/limited)
- age group most at risk for stressful experience
- cries if parent leaves
- frightened if forced to lie supine
Toddler stress reduction
- allow exploration but keep safe
- routine and rituals important
- dolls, toys from home
- simple explanations for 3 years old
Toddler Therapeutic Play
-less than 3 years don’t understand enough about why they are in the hospital to benefit from therapeutic play
Establishing rapport with toddlers
Patience especially when they want to do their own thing
Preschooler age range?
Preschooler play type?
Preschooler stressors?
- 3 to 6 years
- associative
- fear: separation, bodily injury, mutilation, dark, being alone, ghosts
- magical thinking
- view illness as punishment
- cries if parent leaves
- frightened if forced to lie supine
- associates pain with punishment
Preschooler Stress Reduction
- encourage parental involvement
- simple explanations
- clear up misinterpretations
- safe versions of medical equipment for play, draw, paint
Preschooler Therapeutic Play
- dolls
- hospital equipment to deal with fear of bodily harm
- crayons and coloring books
- animal therapy
Establishing rapport with preschoolers
Patience especially when they want to do their own thing
School age range?
School age play type?
School age stressors?
- 6 to 12 years
- cooperative
- loss of control
- fear of death
- fear painful procedures
- loneliness
- boredom
- withdrawal
- frustration
- tries to act brave
- may try to postpone an event
- hostility
School age stress reduction
- privacy
- anatomically correct models/dolls
- drawing
- encourage school work
- hobbies
- friend visits
School age Therapeutic play
- anatomically correct dolls
- collect and organize objects (bandage, cast, tooth)
- books “curious George goes to the hospital”
Establishing rapport with school age children
involve in discussion, respect privacy.
Adolescent age range?
Adolescent play type?
Adolescent stressors?
- 12 and over
- “hang out”
- fears: separation from peers
- fear of altered body image
- rejection
- uncooperativeness
- fear
- anxiety
- overconfidence
- may capitalize on gains from pain
- boredom
- withdrawal
Adolescent stress reduction
- privacy
- participation in decision making
- friend visits
Adolescents Therapeutic play
- talk with friends by telephone
- have friends visit
- computer
- playroom
- “teen time” (movies, pizza party, video games)
Establishing rapport with adolescents
involve in discussion, respect privacy.
Object permanence
8-12 mths
-looks for parent to leave or when object is dropped
Transductive reasoning, magical thinking, animism
4-7 yrs
Stranger anxiety
8-12 mths
-can start at 6 months and up to 2 years
Egocentric behavior
2-4 years
