Planning a Play-Based Therapy Session

momanddoll

The big laminate-top kidney tables that many of us have in our school-based “speech rooms” are a great place to run through flashcards, worksheets, read and map stories, answer questions, and teach brand new skills. However, unlike infant–toddler SLPs, for whom playing on the floor is standard, school-based SLPs often overlook opportunities for such play-based therapy.

With play-based therapy, you can really capture a child’s attention and make memories that will extend beyond the therapy session. These memorable moments support learning and retention, and are essential when treatment sessions are infrequent.

Play is flexible, non-literal, episodic and process-oriented. During play, the child is actively engaged and intrinsically motivated. True play has no extrinsic goals, but we sacrifice some of that to ensure that target skills are practiced. When designing play-based lessons, the less you deviate from true play, the better. Here’s how:

Required targets

The first step of planning a play-based therapy session is to select targets to teach. Next, you’ll identify a way to require those targets during play. Start with the lesson, not with the toy or game! You may think in terms of how to give access to something the child wants following skill demonstration. This “something” can be toys, food, parts of a whole (for example, puzzle piece, song phrase, portion of a motor sequence), social interaction, or a funny or amusing consequence. You’ll also have suggested targets that are encouraged but not required. This is because requiring target demonstration at too high a frequency quickly turns the play session into drill-based “work” and begins to peel away the benefits of playful learning.

Example: “Sleepy Sue,” target = /s/-initial words. Let the student choose dolls for each of you. Make your doll’s name “Sue.” Explain that Sue has a pesky tendency to fall asleep (*insert snoring*). When she dozes off, the child’s job is to wake her up by saying, “Sue! …Sue!” You assist with correct articulation, then commence with doll play until Sue falls asleep again. In a short period of play, the word “Sue” will be required many times, but you may also model things Sue and her dolly friends like to do, like sew, sing, or sit—targets that will be suggested but not required.

Memorable episode

The more episodic and story-like your play-based session is, the better. This is because associated events scaffold memories. Later that day, if a child can’t tell mom “what I did in speech today,” you aren’t reaping the benefit of repeated recall. Consider the “Sleepy Sue” example above—the more related the activities that Sue and her doll friends do, the better. It’s too easy to *think* you’re using playful learning, when in reality you’ve set up a nonassociative work–reward–work–reward structure (as with many games).

Memorable targets

In addition to the play episode being memorable, it’s perhaps even more important that the targets be memorable. I’ve used “Sleepy Sue” with a five-year-old who called me out the next session because I accidentally called Sue, “Sam.”And that was great! But a lot of kids wouldn’t remember that target, just like they won’t likely remember many of the target words in a series of flashcards. So I’ve also had “Sleepy Sue” do a cooking episode.

Example: “Sue Makes Soup,”target = /s/-initial words. Sue loves to cook, and the student can help Sue by choosing the ingredients for her soup. The child can add salsa, sausage, seeds, soy sauce, syrup, sour cream, and such. Of these targets, some can be the real thing! And how much fun is it to put real salt or real seeds in the soup bowl? “Salt” and “seeds” can be your required targets, and you hold the shakers until the student needs them. The student may even take some of the “targets” home to show dad. The other words may be required or suggested targets, depending on the student.

Play-based learning can be done with children of any age. What would play-based learning look like for a fifth grader? Start by considering how fifth graders play with one another (for example, talking about their favorite TV show), and design from there. Play-based learning is also excellent for students with autism—check out this article and this one. Whatever the child’s age or skills, always ask yourself—“Could we be playing with this?”


Meredith Poore Harold, PhD, CCC-SLP,
is a speech–language pathologist and independent scholar in Kansas City, Missouri. She works primarily with infant-toddler and elementary-aged children, and provides resources for parents and clinicians at www.meredithharold.com.