The Importance of Play for Parents of Hospitalized Children

The Importance of Play for Parents of Hospitalized Children

Mauro Brembilla (Studio Dialoghi – Studio di Psicologia, Pedagogia e Formazione, Italy), Yagmur Ozturk (University of Trento, Italy), and Teresa Del Bianco (Centre for Brain and Cognitive Development, Birkbeck University of London, UK)
DOI: 10.4018/978-1-6684-5068-0.ch009
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Parenting is the practice of caring and nurturing of offspring from birth to financial independence and entails taking care of offspring throughout developmental stages that are highly differentiated in terms of needs and skills: infancy, toddlerhood, childhood, and adolescence. Throughout all these stages of development, parents and children face challenges equally. Parental stress can impact both individuals and family relationships. For instance, the hospitalisation can be stressful for both children and their parents who may experience anxiety and depression. Play may help parents handle these challenges. This chapter focuses on parenting, parental stress, and the importance of play for children and parents, with specific attention to the hospital context.
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Parenting is the practice of caring and nurturing of offspring from birth to financial independence, and entails taking care of offspring throughout developmental stages that are highly differentiated in terms of needs and skills - infancy, toddlerhood, childhood and adolescence. Parenting regulates most of children’s interactions with the environment and helps to shape the child’s adaptation, therefore playing a significant role in shaping the child's mental health (Bornstein, 2013). During the sensorimotor stage (birth to about two years; Piaget, 1973), children go through a period of dramatic physical growth and learning, and they continuously make new discoveries about how the world works (Piaget, 1973). Parenting a newborn sets the start of parents’ responsibilities and requires high levels of dedication. Caregivers may spontaneously call parenting an infant “24/7” job because the infant totally depends on parents for survival (Bornstein, 2002). Human babies are born highly dependent on their parents (for example, a high proportion of infants need parental presence to fall asleep and parents manage the infant’s good nutrition, either by breastfeeding or complementary feeding). Moreover, a parent’s presence in their infant’s life from birth is essential to create a strong emotional bond that shapes the way an infant interacts with caregivers and others as they mature (Bowlby, 1969). Taken together, infants need constant attention and contact with their parents because they are unable to look after themselves.

Next, the parenting of toddlers, which refers to the period bridging infancy and early childhood, has its own demands. Parental support, guidance, and structure help the child navigate the toddler period (Edwards & Liu, 2002). In terms of parenting, the transition from infancy into early childhood, known as toddlerhood, can be described as entering a new world with unique challenges and milestones associated with particular developmental changes, such as the acquisition of language, walking and trying to foster their independence as autonomy seeking. During this stage, children begin to engage in symbolic play and learn to manipulate symbols, however they do not yet understand concrete logic (Piaget, 1973).

Toddlerhood is a period of developmental plasticity in children including rapid progress in all domains of development (e.g., cognitive and emotional development), as shown by the emergence of new behaviors and capabilities such as autonomy from parents and emotional regulation (Edwards & Liu, 2002). This new world encompassing the transition from infancy to toddlerhood presents a normative and universal challenge for parenting (Knoche, Sheridan, Clarke, Edwards, Marvin, Cline, & Kupzyk, 2012). Externalizing behaviors, such as oppositional and aggressive behaviors, are fairly common during toddlerhood (Keenan, & Shaw, 1994; Van Zeijl, Mesman, Stolk, Alink, Van IJzendoorn, Bakermans-Kranenburg, Juffer, & Koot, 2006; Yaman, Mesman, Van Ijzendoorn, & Bakermans-Kranenburg, 2010). Several strategies exist to deal with these challenges, including the self-perception of parenting that plays an important role when dealing with the difficulties in toddlerhood (Pope-Edwards and Liu, 2002). Parents’ perception of their own parenting can include several possible characteristics such as feeling of competence, engagement and enjoyment of caregiving relationship, and ability to balance parenting with other roles in life (Bornstein et al., 2003; Delvecchio, Di Riso, & Salcuni, 2016). Overall, the toddler stage is filled with new experiences, despite the challenges for children and their parents.

After toddlerhood, parents of children between ages of 5 and 12 years, referred to as middle childhood, face challenges arising from both maturational changes and social factors. We may consider middle childhood as one of the most vital periods for child development (Coll & Szalacha, 2004; Howie, Lukacs, Pastor, Reuben, & Mendola, 2010). According to Piaget, at this age children enter their third stage of cognitive development - termed the concrete operational stage - and start improving their logical skills, thinking symbolically about the world, making improvements in short term and long term memory (Piaget, 1973). Indeed, development of logical thought characterizes this period (Piaget, 1973). Erik Erikson stressed the importance of middle childhood as a time when children move from the network of closest family members into a wider social context that strongly influences their development as they learn to cooperate with their peers and adults (Erikson, 1973). In summary, children experience various dramatic biological, psychological, and social changes (Collins, 1984; Eccles, 1999; Howie, Lukacs, Pastor, Reuben, & Mendola, 2010). Children begin valuing friendships and become more involved in activities. They develop new capabilities and receive roles and responsibilities within their families and communities (Collins, 1984). Vygotsky believed that external factors (such as culture) and people (such as parents, caregivers, and peers) play a significant role in the development (Vygotsky, 1978).

During middle childhood, many changes occur within the family, such as the child becoming more independent, able to care for himself/herself and capable of contributing responsibilities at home. Children's cognitive, emotional and social transitions change their behavior towards parents, making parenting during middle childhood unique in its own way (Collins, Madsen, & Susman-Stillman, 2002). These adaptations including distinctive transformations of human development not only affect concurrent wellbeing of children, but have significant implications later in life (Collins, Madsen, & Susman-Stillman, 2002). Then, the child’s transformation from middle school into adolescence introduces new issues and concerns into family functioning that brings a new equilibrium in the parent-child relationship (Steinberg & Silk, 2002).

Taken together, in all stages of development, parents face various challenging situations as much as children face. It seems that there is a reciprocal influence between parents and child: the dynamic of child development affects parenting, and parenting influences child development. All these changes during development, in turn, affect the ways in which parents treat the child. However, it is also important to note that parenting is multidimensional and for responding to the varied needs of their children in all stages of development, parents develop both depth and breadth of knowledge, ranging from being aware of developmental milestones and norms that help in keeping children safe and healthy to understanding the role of others such as educators, social workers, institutions etc (Breiner, Ford, Gadsden & National Academies of Sciences, Engineering, and Medicine, 2016). This parenting knowledge can help children develop successfully.

Key Terms in this Chapter

Play: Activity for the purpose of enjoyment and recreation.

Depression: A state of melancholy and inaction due to persistent low mood.

Parenting: The process of raising children and providing them with protection and care.

Hospitalization: The period of confinement in a hospital to receive treatment.

Play Specialists: A professional with a background in psychology or pedagogical sciences who provides hospitalized or at-home inpatient children with structured play programs.

Intervention: The act or process of planned action carried out by experts to achieve an outcome.

Anxiety: A feeling of worry experienced with or without challenging situations, that can lead to impoverished mental health.

Parenting Stress: The distress parents experience with lower emotional well-being.

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