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Playfulness in children with an acquired brain injury : a preliminary study Mortenson, Patricia Anne

Abstract

The sequelae of paediatric traumatic brain injury have been well documented in the literature, and include permanent and pervasive impairments of varying severity that impact cognitive, physical, language, social and behavioural functioning, and the ability to participate in home and school activities. While children with similar disabilities have been identified as having play deficits, the impact of traumatic brain injury on play, and in particular, a child's playfulness and ability to approach play, have not yet been investigated. Play is thought to be important as it contributes to meaning and quality of life, provides opportunities for skill development and serves as the primary occupation of childhood. This prospective analysis of differences study compared the 'playfulness' of eight children aged 3 to 13 years diagnosed with a moderate to severe traumatic brain injury to an age-matched control group of eight typically developing children. The Test of Playfulness (Bundy, 2000) was used to measure playfulness. Rasch analysis was used to transform the raw scores to interval data, with scores from both groups demonstrating "goodness of fit" and conformity to the Rasch model. A significant difference between the matched scores was demonstrated using a Wilcoxon matched-pairs signed-ranks T test (T(8)=0,p=.012). The conclusions of this study are that within this small sample, the playfulness of children with TBI was significantly less than that of their age-matched peers. Although the small sample size presents generalizability limitations, this finding provides valuable insight about a vital aspect of childhood occupational performance that until now has not been considered for children with moderate to severe TBI. Implications for broadening the present scope of research and rehabilitation to include play performance for children with TBI are discussed.

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