The Use of Play in Speech and Occupational Therapy
Sensory Processing Disorder and speech impairment affect millions of children in the United States. Sensory Processing Disorder (SPD) affects a child’s development leading to difficulties with “detecting, modulating, interpreting, and/or organizing sensory stimuli” (Miller, Nielsen & Schoen, 2012, p.804). Furthermore, these children may find it difficult to self-regulate their behavior. Speech impairment is typically described as speech sound disorders (SSD), which involves a child having difficulties with communicating or correctly producing their native language (Brumbaugh, Smit, Nippold & Marinellie, 2013). Brumbaugh et al. (2013) also found that these children were likely to develop a poor self-image which provides even more incentive to find effective therapies. Furthermore, children with SPD and SSD are likely to have other behavioral disorders such as Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD) (Carr, Agnihotri, & Keightley, 2010; Cheung & Siu, 2009).
Occupational therapy is often used to treat SPD and speech therapy for SSD. Occupational therapists may employ treatments such as sensory integration approach or Sensory Integrative Treatment Protocol, which has been found to have promising results increasing sensory integration in children (Case-Smith & Bryan, 1999; Paul et al. 2003). Speech therapists use play therapy as it has been proven effective in helping children improve their speech as well as helping children with autism (who tend to be seen in speech therapy) learn to interact with other children (Danger & Landreth, 2005). The interactive activities used in play therapy have been shown to improve multiple behavioral disorders, including SPD. This was the motivation behind creating an interactive game for children to play while in therapy sessions. Although there have been proven tasks and activities that help children improve upon their developmental delays from their behavioral disorder, there has been little research on a formal game that can be used in therapy.
After researching and brainstorming, the interactive game developed in this project became known as Hands Up, Speak Up! The inspiration for the game was Cranium, an entertaining, but interactive board game. Melissa Quinn, teacher in a specialty classroom, and Nancy Koppl, speech therapist, were used as consultants for the game and allowed the children in their classrooms at C.L. Smith elementary school be used in the pilot of the game. Ms. Koppl recommended the use of the 80% rule as a main goal of the game, as this rule encourages learning and builds a child’s confidence. The 80% rule states that children should complete the task correctly 80% of the time; if the child is under then the task should be made easier, if the child is over then task should be made more difficult. The target audience for the interactive game was elementary school students in speech or occupational therapy with multiple behavioral disorders (SPD, SSD, ASD, etc).
The game consists of five sections: Act Up, Build Up, Speak Up, Hands Up, and Community, which are all aimed to benefit children in speech or occupational therapy. During the pilot of the game, which consisted of four rounds, one of the creators played the game with the children while the other observed. The 12 children ranged from first to fourth grade and were all apart of Ms. Quinn’s specialty classroom. Modifications made to the game after the pilot were the addition of a game master (a therapist or trained adult who could provide help during the game and scaffold the tasks to fit the child’s needs) and beginning the game with a Community game for increased engagement. After these modifications were made, a second pilot was conducted and demonstrated these changes to be helpful in increasing interest and engagement. In the future, it would be noteworthy research to assess if Hands Up, Speak Up! holds statistical value in improving children’s fine motor skills, gross motor skills, articulation, or expressive vocabulary.