Effectiveness of Play Therapy in enhancing Social skills in Intellectually Disabled Children by

• Azka Tauqeer Asjad

Abstract

The present study was targeted to measure the effectiveness of play therapy in enhancing social skills in pre-diagnosed intellectually disabled children of mild and moderate level. The research was comprised of ten intellectually disabled children of mild and moderate level of ages 5-15 from Army Special Education Academy Rawalpindi. Social skills were considered as dependent variable, whereas play therapy as independent variable in this study. The method of this research was quasi, pretest-posttest type with an experimental and control group. Social Skills Checklist (Heather Thomas, 2013) was administered in pretest and posttest. It was hypothesized that play therapy on experimental group will be effective as it will produce significant positive results in enhancing social skills as compared to the control group. The analysis included paired sample t-test and findings were presented in tabulated form. The current study will help in understanding the use of play therapy to facilitate children with intellectual disability and it will bridge the gap between the mental health needs of exceptional children and the available services.

Play therapy is a therapeutic process between the client and the therapist where the therapist uses play as a therapeutic intervention for solving the child’s emotional and social difficulties and for incorporating required skills and appropriate behavior (Association for Play Therapy). Play therapy acts as a mode of communication between the therapist and the child. This method is based on the assumption that play is a way of children making contact with their environment. Play therapy is to children what counseling and psychotherapy is to adults. Young children express themselves comfortably through play when they cannot through meaningful conversation. Therefore, play is an indirect way for therapists to understand and alter children’s perceptions, cognitions, and behaviors.

Intellectual disability stands for impairments in overall mental abilities which affects adaptive functioning skills of three multiple domains or areas that arise during the passage of children’s development. Limitations should be present in comparison to other peoples of the same age, gender, and social-cultural upbringing. These individuals show difficulties perceiving and assimilating new informa­tion, learning new things quickly and completely, applying knowledge and skills to solve new problems, thinking imaginatively and flexibly, and responding swiftly and correctly. The criteria identify three domains of adaptive function­ing i.e. conceptual, social, and practical. Individuals with intellectual disability should show impair­ment in at least one domain. The first one is conceptual domain that includes skills in language, reading, writing, mathematics, reasoning, knowledge and the ability to learn and remember information and skills. The second domain is social skills which includes interpersonal communication skills, empathy rules following, social adjustment, understanding others, making and maintaining friends. The last domain is Practical skills and it includes activities of daily living skills including personal care safety, home activities, school/work skills recreational activities and using money. (DSM V)

In the case of children with intellectual disability, thorough training is required to integrate appropriate social behavior. If the intellectually disabled children are provided the opportunity to socialize with others during childhood, they will achieve social competency. Therefore training should be started very early (NIMH, 1990). Social development is multidimensional processes through which children gain competencies and the required social behavior that enable them to function in a social environment appropriately, in a way that is favorable to their welfare and to that of others as well. Social skills have been described in various terms. Eisenberg and Harris (1984) have defined it as developmentally related abilities that lead towards achieving the optimal level of social competence. According to Charon (1986), social skills are a composition of skills that enables us to interact, socialize and develop relationships with others. They are comprised of both verbal and non-verbal types of communication.

According to American Psychological School Association (2012), schools are a source of enhancing and developing social skills. According to them, social skills stand for the acceptable set of behavior and etiquettes to behave and interact in the society and to refrain from the negative behaviors unacceptable in the community as a byproduct of these positive influences and interactions. If there are services provided in school environment where concern is focused by the counselor on the social skills and interpersonal development of the students, it can also boost the academic performance (McClelland, Morrison, & Holmes, 2000). If the children achieved meaningful and positive interpersonal relationships in the elementary years i.e. 6-12 ages; they will have the ability to face the challenges of adolescence and perform much better in their social and academic lives (Feldman, 2014).

Wlkinson and Carter (1982), author of the Social Skills Training Manual; included social behaviors which are: greeting behaviors such as hand shaking; smiling; hugging; saying: “Hi”; in communicating with others, maintaining eye contact and be at a reasonable distance. Inappropriate social behavior of intellectually disabled children may be due to their incorrect perception about their social environment and situations. They may be facing difficulties in understanding and identifying social relationships, misguiding others feelings and inability to understand the required social rules conformity. They may also be unable to understand different manners and ways of communicating with peers, adults and family (Kronick, 1983).

Children express themselves freely in play therapy because it is a condition which does not lead to any serious consequences although it is fun and joyful. It helps the child in forgetting the frightening world and it provides a safe environment where risk can be taken and there can be no rules or social conformity and the child is independent from the real world (Skynner & Cleese 1983:298).

Play is not any artificial environment created by the therapist or experimenter; instead it is child’s natural world where they could be free from obstacles of daily life charades. Office of the United Nations High Commissioner for Human Rights states that play is an undeniable right for every child in 1989. The American Academy of Pediatrics published a white paper to commemorate the significance of play for the healthy growth and development of the children (Ginsberg, 2007).

Play therapy provides a safe, nurturing and comfortable environment where children play out what they have experienced, their reactions and feelings about those experiences, what they need in their lives, and how they feel about themselves. Play is also use to teach new skills to the client. Therefore it is a complete therapeutic process. Play therapy is the most effective way as it makes the child feel safer. It is a place which is completely safe, a place where the child is accepted as the person he is. It is an active process where the child is allowed to be creative, make mistakes and be himself. Play is a mode of embracing new information and making it part of their personalities.

Social Skills and Play Therapy

Social skills stand for the ways which the child could in order to relate with others, to make new friends, to express their needs. It makes the child understand his boundaries, others feelings and needs and he learn cooperation. For the social skills to be developed completely, the child has to understand and be familiar with multiple actions and behaviors and be aware about the consequences.

As stated by Landreth (2001), all children can gain positive behaviors and influences by engaging in a controlled play therapy where they are given the chance to exercise their social skills. Group play therapy could also benefit the child in refining new skills, accepting their social self and their peers, identifying their social capabilities and in achieving self-control (Landreth et al., 2005). Counseling provided at elementary level in the school setting help children in learning of new skills as well as in becoming aware and responsive of their customs, values and priorities (Gladding, 2011). Working along a small group who are experiencing the same difficulties enhance the abilities of students to work out their social, psychological and emotional challenges (Campbell & Bowman, 1993).

Functional skills are important for the intellectual disabled children to learn in the educational process as unlike to normal children who could adopt the required behaviors and skills through observation of their environment and daily experience. The curriculum of intellectually disabled children is planned by keeping in the view the importance of teaching daily life skills. Even the basic things such as putting nuts and bolts together are practiced by the children. The intellectual disabled children require direct training in specific activities and tasks lo learn generalization and to perform the tasks more regularly and easily (Narayan & Kutty, 1998).

Teaching the age appropriate social skills helps the child in acquiring the skills compulsory for living independently in the social community. The program for teaching such skills differs from the regular academic curriculum and it maximizes the self-esteem, independence and competence in daily life of the children (Heward, 2006).

It is stated that a small group intervention can contribute positively in the process of developing social skills (Kayler & Sherman, 2009). Group interventions provide the opportunity to develop and sustain relationships as well as enhance the personal characteristics that could influence accomplishment. It is a multidimensional, effective and efficient method of teaching new behaviors and skills (Akos & Milsom, 2007).

Theories of Intellectual Disability

The intellectual disabled also progress through the same cognitive developmental stages defined by Piaget as their peers (Zigler, 1969). The only difference is that their cognitive stages develop much slower and their cognitive abilities cannot be compared with a non-disabled individual. An intellectual disabled individual cannot reach the mature level of cognitive functioning at any point. According to the various studies, intellectual disabled individuals will perform poor on cognitive tasks as compared to the control group of same mental age level. It was known was “mental-age lag” phenomena (Spitz, 1982).

According to developmental theorists, children suffering from intellectual disability also experience the similar information restructuring as explained by Piaget, but their process is much slower as compared to the normal children. According to Anderson, Children with intellectual disability have slower speed of processing and this is the reason that they could understand information in chunks as compared to information in whole. The individuals with intellectual disability, whether they are children or adult, they will face deficits in intellectual abilities and knowledge processing in comparison to the individuals with same mental age. It means that intellectual disability has an enduring and lasting effect which cannot be reversed.

The consequences of intellectual disability may differ from person to person as different abilities level present in people without any such difficulty. Approximately 90% of the intellectual disabled are at mild level and they only differ from normal population as they are much slower in learning new set of skills and information. Rest of the 10% will have complications in daily functioning and social skills (Gallagher et al., 2000). If they are diagnosed in early years and a proper individual educational plan is formulated according to their specific needs; they can become a supportive and contributing member of the society.

Children with intellectual disability have the capability to learn things in the same 12 learning techniques as other normal children do, but due to their labeling and exclusion from normal education, they are often failed to see as learners. This is the lead reason which cause low literacy level in intellectual disabled population. The researcher conducted a meta-analysis of the researches on intellectual disability and learning in special education and only one of the research results pointed out that special education proved useful for children with intellectual disabilities. In the other researches, learning at home and normal institutions also seemed to benefit the intellectual disabled (Jackson, 1994).