Play and Speech Therapy in Schools: Toward a Model of Interprofessional Collaborative Practice

Play and Speech Therapy in Schools: Toward a Model of Interprofessional Collaborative Practice

Suzan E. Weishof (International School of Hamburg, Germany)
DOI: 10.4018/978-1-5225-2224-9.ch017
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Research over the past eight decades has demonstrated strong correlations between the development of play and the development of language in young children. Play and speech therapists share a common child-centered, play-based approach to therapeutic interventions. The growing trend of service delivery within the school setting, along with professional ethical requirements, has led to the necessity of play therapists, speech therapists, teachers, and parents to work collaboratively in promoting holistic, comprehensive intervention plans that serve children's best interests. Based on the healthcare field's model of interprofessional collaborative practice, the purpose of this chapter is to define areas of common practice among speech and play therapists and to propose a model of interprofessional collaborative practice within a school-based context.
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The Connection Between Play And Language Development

The child does not, in the first instance, communicate with his fellow beings in order to share thoughts and reflections; he does so in order to play. (Jean Piaget, 1959, p. 27)

The substantial body of research in the field of play and language has firmly established an incontrovertible connection between play and the acquisition of language in children’s development. As early as 1933, Vygotsky described symbolic play as the critical “pivot” that allows children to develop symbolic speech. Martin (1981, p. 49) described play as “an essential precursor to language,” and Formaad (1974, p. xii) posited that “play is powerfully at work in the growth process of the child and is related most closely to the motivation and exercise of speech.” Since the 1970s, the substantial body of research outcomes derived from both the play therapy and speech and language pathology fields has highlighted the relationship of symbolic play to children’s acquisition of receptive and expressive language, and how these two areas of child development appear to be inextricably intertwined.

Both play and language are symbolic in nature; in play, a child uses one object to represent another (a stick becomes a car), and in language, sounds and words represent internal meanings relating to the real world. McCune (1995, p.198) described this burgeoning cognitive function of the child as mental representation—the “internal component that supports the expression of meaning in various modalities.” Mental representation is the ability of the child to understand that an object (termed a signifier) can represent an object that is not present (the signified). In an example provided by Leslie (1987), a child’s perception that “this is a banana” illustrates the normal representational system. However, when a child can “decouple” this perception from its literal meaning and make the cognitive leap to the pretend perception that “this banana is a telephone,” one begins to see the observable behavior found in symbolic play. The development of a child’s capacity for mental representation is theorized to be a direct contributor to both language acquisition as well as the development of symbolic play.

Play and language both advance through well-defined stages of ever-increasing complexity. Piaget (1962) outlined the seven levels of symbolic play development (beginning at approximately 16-20 months of age):

  • 1.

    Enactive Representation: A child shows understanding through gesture (i.e., shaking the hand as if it is holding a rattle).

  • 2.

    Symbolic Schema: A child pretends to engage in normal activities (i.e., using an empty cup to pretend he/she is drinking).

  • 3.

    Single Schema: A child pretends an object engages in normal activities (i.e., covering a truck with a blanket and putting it “to sleep”) or the child pretends to engage in normal activities of others or other objects (i.e., pretending to be a dog).

  • 4.

    Single Schema Combinations: A child plays at only one action, but expands it to various objects or people (i.e., feeding dolls and stuffed animals).

  • 5.

    Multi-Schema Combinations: A child plays at more than one action (i.e., feeding the stuffed dog, then brushing its hair, then putting it to sleep).

  • 6.

    Planned Single Schema Symbolic Play: A child plans the play activity (level 4) in advance.

  • 7.

    Combinations with Planned Elements: A child plans multi-schema play sequences that tend toward realistic scenes.

Bowen (1998) explained how Roger Brown’s (1973) stages of syntactic and morphological development (expressive language) similarly delineates the sequence in which children learn and use grammatical structures (from approximately 15-52 months of age):

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