Play Specialist-Based Intervention in the COVID-19 Era: Crisis and Opportunities of Change – An Experience From Italy

Play Specialist-Based Intervention in the COVID-19 Era: Crisis and Opportunities of Change – An Experience From Italy

Giulia Perasso, Giulia Boldrini, Alice Maggiore, Chiara Allegri, Gloria Camurati
DOI: 10.4018/978-1-7998-7275-7.ch021
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Abstract

The present chapter provides insights about the play specialist-based intervention for children with a wide range of pathologies. Telematic adaptations of pedagogical interventions are needed in order to overcome the obstacles given by pandemic emergency and social isolation. The chapter offers a literature review around the role of the play specialist, providing definitions, historical evolution, and outcomes on children's wellbeing. Plus, results from a research around parental wellbeing after the telematic play specialist-based adaptation are displayed and discussed. Finally, qualitative outcomes from parent and educator interviews over the telematic intervention are presented.
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Introduction

The Negative Impact of Covid-19 Restrictions on Italian Families: Could the Implementation of Online Play Specialist Strategies Make a Difference?

On the first day of March 2020, the World Health Organization declared the status of pandemic. Since then, Covid-19’s outbreak has reshaped the routines of families and children all over the world. In Italy, restrictions began on February 23, 2020, to prevent the virus from spreading into other regions from the area of Codogno (Lombardy, northern Italy) where the first case italian case of Coronavirus was detected. Although the lockdown of Codogno, the virus rapidly spread across Italy until the Government declared the status of national lockdown on March 11, 2020. The strategies to face pandemics have brought restrictions on mobility, socialization, and behavior among adults, adolescents, and children (see Italian Government, 2020). More specifically, cinemas, theaters, cultural centers, sport-centers, shops not selling staple goods, and schools were closed.

Moreover, authorities are still imposing social distancing and home working to stop the contagion (Lazzerini & Putoto, 2020) since Italy is severely suffering from the Covid-19 pandemic. As literature stressed out, Italian families were affected by children’s irritability, regressive behaviors, and problems in managing pre-existing behavioral, psychological, and physical difficulties (Pisano et al., 2020). Plus, homeworking negatively impacted parenting as working mothers and fathers, daily struggling to fulfill their professional responsibilities, reported problems to manage their sons at home (Colizzi et al., 2020; de Girolamo et al., 2020).

By closing or reducing the time-schedule, Italian schools have redesigned the learning process and children and adolescents' social experience. School closure represents a disruption in youngsters' learning trajectories, while remote education challenges both students and teachers (Daniel, 2020). However, the lack of data about the long-term effects of remote education makes it premature to determine whether it is positively or negatively impacting students' learning processes (Zimmerman, 2020). The literature highlights that this change may be harmful to children and adolescents with clinical conditions (e.g., autism, special educational needs) and mental health issues since it disrupts the structured routine guaranteed by school for learning and socialization (Bozkurt et al., 2020; Bozkurt & Sharma, 2020a; Lee, 2020). Lacking a school routine is also associated with a higher risk of weight gain in children and adolescents (Rundle et al., 2020). Plus, the online environment is becoming the primary source of socialization for most children and adolescents - often navigating without adults' supervision - with a higher risk of developing problematic internet use patterns (De Miranda et al., 2020; Dong et al., 2020). As stressed out by Bozkurt and Sharma (2020b), the concept of ‘normality’ has been reshaped in individuals’ daily life: smart-working and remote education are now part of the human’s routine, that can be defined as ‘the new normal’ and will have a long-term impact on the new generations.

Overall, according to previous studies over the impact of the SARS epidemic (2002-2004) and contemporary research over Covid-19 pandemic, depression, stress, irritability, anxiety, PTSD symptoms are direct consequences of quarantine isolation across different age-ranges (Courtney et al., 2020; Hawryluck et al., 2004; Liu et al., 2012).

Risks for the quality of the relationship between parents and children are also worth noticing. Economic insecurity, lack of leisure time, low perceived social support are all consequences of Covid-19 restrictions and risk factors for parental burnout syndrome (Lindström et al. 2011; Sorkkila & Aunola, 2020). Parental burnout consists of emotional and physical fatigue related to the parent's role, which leads to considering interacting with the child as no more enjoyable, less engaging, and perceive a massive emotional distancing, psychosomatic complaints, and depressive symptoms (Roskam et al., 2017). Parental burnout is also a predictor of children's neglect and maltreatment, an issue that needs to be appropriately addressed with preventive interventions (Mikolajczak et al., 2018).

During the Covid-19 months (i.e., from March 2020 national lockdown to present), parents have to spend more time alone at home with their children since: (a) school's timetable is reduced, (b) parents are often recommended to work from home, (c) grandparents, aunts and uncles, and babysitters are less engaged in family routine given the possibility of a mutual contagion. Defining barriers within the family house between workspaces and children-spaces can be very challenging, depending on variables associated with the family socioeconomic status (e.g., the house's dimensions, the number of rooms, the number of gardens). In this framework, parents of children in clinical conditions are more at risk of developing burnout because the caregiver’s physical and psychological strain can become massive (e.g., autism, disabilities, intellectual disabilities, cancer, ADHD) (Arafa & Lamlom, 2020; Weiss, 2002). These data underline the importance of professionals' intervention to support children with physical or psychological frailty during the Covid-19 era, providing them with a constant routine for learning and socialization activities. This chapter proposes implementing an online adaptation of the Play Specialist intervention model, addressing at ameliorating diverse aspects of the family life experiencing psychosocial difficulties.

Key Terms in this Chapter

Telematic(s): This term refers to the branch of information technology that allows transmitting information from remote, dealing with the long-distance (e.g., through the internet).

Play Specialist: The Play Specialist is a professional with an educational background in psychology or pedagogical sciences who provides hospitalized or at home inpatient children with structured play programs. In the UK, the Play Specialist is called and certified as “Healthcare Play Specialist”, while in the US this role is labeled as “Certified Child Life Specialist”. This professionalism has not been institutionally recognized yet in many countries (e.g., Italy).

Conduct Problems or Disorders (Children): Persistent and repetitive behavioral and emotional patterns of children and adolescents. Conduct problems lead to difficulties in respecting rules and interacting with peers in a socially acceptable way. Disobeying rules, cheating, destroying others’ possessions, and physically harassing others are relevant examples of conduct problems that can also be called ‘Externalizing Behaviors’.

Pandemic: A disease that spreads across the world (e.g., COVID-19), provoking global emergency, and government interventions. The term needs to be distinguished from epidemic, which refers to a disease spreading in a circumscribed community in a specific time range.

Anxiety: Emotional status experienced by children and adults, provoked by overwhelming concerns, and accompanied by increased arousal and blood pressure. When persisting and intense, anxiety can turn into anxiety disorders that may negatively impact on the individual’s health, social life, and daily routines.

Perceived Social Support: The term refers to how much a person perceives his/her social system as supportive in terms of emotional, informational, companionship, and tangible resources. Thus, the construct reflects how much a person perceives that he/she can rely on his/her social network in need of assistance. The primary sources of social support are family, friends, coworkers, pets, etc.

Parental Burnout: Parental burnout consists of emotional and physical fatigue related to parenting. Parental burnout leads mothers and fathers to consider the interaction with the child as no more enjoyable, less engaging than before, with massive emotional distancing, psychosomatic complaints, and depressive symptoms. Parental burnout can predict children's neglect and maltreatment.

Depression: Depression consists of a persistent feeling of sadness, accompanied by a lack of interest in activities previously perceived as enjoyable. Depression can cause sleep, concentration, and appetite issues, and persistent tiredness. It can affect people’s normal functioning with long-term effects. Depression can be caused by social, psychological, and biological factors, and it can be treated with psychopharmacological intervention and psychotherapy.

Emotional Problems (Children): During development, humans can encounter difficulties in emotion regulation, materialized as anger, guilt, anxiety, despair, sadness, depression, sleeping problems, appetite problems, psychosomatic complaints.

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