What makes playgroups therapeutic? A scoping review to identify the active ingredients of therapeutic and supported playgroups

Setting the Stage for Play: Exploring the Relationship Between Play Type and Positive Caregiving Strategies During Therapeutic Playgroup

IMPORTANCE

Although play and positive caregiving strategies have been associated with child well-being, little is known about the relationship between play type and strategies used by caregivers in early childhood.

OBJECTIVE

To investigate whether a relationship exists between play type and positive caregiving strategies.

DESIGN

Exploratory correlational nonexperimental design.

SETTING

Early childhood center.

PARTICIPANTS

A convenience sample that included 60 observations of 14 caregivers during a therapeutic playgroup with 14 children with and without disabilities ages 15 mo to 3 yr (4 fathers, 3 mothers, 1 nanny, and 6 female early childhood teachers; age range = 30-39 yr). The caregivers were Black (n = 1; 7.1%), Hispanic (n = 5; 35.7%), and White (n = 8; 57.1%).

OUTCOMES AND MEASURES

Positive caregiving strategies were scored using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes.

RESULTS

Results revealed no significant correlations between play type and positive caregiving strategy. There was a positive, significant correlation between caregiving strategies (affection, responsiveness, encouragement, teaching, and total; rpbs = .767-.970, n = 58, p = .001). The play type and caregiver type variables did not predict total positive caregiving strategies, F(2, 57) = 2.147, p = .126. One variable, caregiver type, added statistical significance to the prediction (p = .045).

CONCLUSIONS AND RELEVANCE

The findings show no relationship between play type and positive caregiving strategy. Consideration of the types of caregivers participating in a therapeutic playgroup and their roles and use of positive strategies during play is worthy of further investigation. Plain-Language Summary: This study explored how parent and teacher caregivers supported children (both with and without disabilities) during a therapeutic playgroup at an early childhood center. Therapeutic playgroups are a special type of group play in which a trained professional helps guide play activities to support participation. The researchers wanted to see whether there was a connection between the type of play the children engaged in and how the adult caregivers interacted with them. The surprising finding was that there was no link between play type and how caregivers interacted. However, the caregivers often used positive strategies with the children, regardless of the play activity. Interestingly, type of caregiver (parent, teacher) seemed to make a slight difference in how they interacted with the children during playtime. Overall, this study suggests that more research is needed to understand how the types of play activities and objects might influence caregiver interactions during group play.

What are the active ingredients of 'arts in health' activities? Development of the INgredients iN ArTs in hEalth (INNATE) Framework

Background: There is a scarcity of research concerning what it is about arts engagement that may activate causal mechanisms leading to effects on health and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be relevant to specific contexts and types of art forms. The aim of this study was to carry out a comprehensive mapping of potential active ingredients, construct a shared language, and propose a framework and toolkit to support the design, implementation, and evaluation of arts in health activities. Methods: Drawing upon Rapid Appraisal techniques and collaborating with 64 participants working in arts in health, we engaged in a three-phase process: 1) scoping review to inform the development of an initial framework; 2) consultation on the initial framework; and 3) analysis and construction of the INNATE framework. Results: The study identified 139 potential active ingredients within the overarching categories of  project, people, and  contexts.  Project components relate directly to the content of the arts activity itself, intrinsic to what the activity is. The  people category denotes how people interact through engagement with the activity and who is involved in this interaction, including activity facilitation.  Contexts relates to the activity setting comprising the aggregate of place(s), things, and surroundings. Aligning with complexity science, ingredients may interconnect or feed into one another to prompt mechanisms, and may not be experienced as distinct by participants. Conclusions: Our mapping exercise is the most extensive to date. In relation to arts in health activities, the INNATE framework can support with: design and implementation, such as co-producing an intervention to meet the needs of a particular population; evaluation, such as facilitating the comparison of different interventions and their efficacy; and replication, scalability, and sustainability through enabling detailed reporting and articulation of what an arts in health activity entails.

What are the active ingredients of ‘arts in health’ activities? Development of the INgredients iN ArTs in hEalth (INNATE) Framework

Background: There is a scarcity of research concerning what it is about arts engagement that may activate causal mechanisms leading to effects on health and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be relevant to specific contexts and types of art forms. The aim of this study was to carry out a comprehensive mapping of potential active ingredients, construct a shared language, and propose a framework and toolkit to support the design, implementation, and evaluation of arts in health activities.

Methods: Drawing upon Rapid Appraisal techniques and collaborating with 64 participants working in arts in health, we engaged in a three-phase process: 1) scoping review to inform the development of an initial framework; 2) consultation on the initial framework; and 3) analysis and construction of the INNATE framework.

Results: The study identified 139 potential active ingredients within the overarching categories of  project, people, and  contexts.  Project components relate directly to the content of the arts activity itself, intrinsic to what the activity is. The  people category denotes how people interact through engagement with the activity and who is involved in this interaction, including activity facilitation.  Contexts relates to the activity setting comprising the aggregate of place(s), things, and surroundings. Aligning with complexity science, ingredients may interconnect or feed into one another to prompt mechanisms, and may not be experienced as distinct by participants.

Conclusions: Our mapping exercise is the most extensive to date. In relation to arts in health activities, the INNATE framework can support with: design and implementation, such as co-producing an intervention to meet the needs of a particular population; evaluation, such as facilitating the comparison of different interventions and their efficacy; and replication, scalability, and sustainability through enabling detailed reporting and articulation of what an arts in health activity entails.

The parenting occupations and purposes conceptual framework: A scoping review of 'doing' parenting

INTRODUCTION

Parenting is a valued, common and challenging adult role. Many parents, including some living with disability or difficult social circumstances, experience barriers to fulfilling their parenting roles. Yet, occupational therapy involvement in parenting is rarely documented. Current understandings about 'doing' parenting lack cohesion and are dispersed in occupational therapy literature. This study aims to map and synthesise occupational therapy literature on 'doing' parenting to describe the state of the existing knowledge base, and develop a conceptual framework of parenting occupations as portrayed in occupational therapy literature.

METHODS

A scoping review was conducted. Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science were searched on 28 October 2019 and updated on 18 February 2021. Journal articles and book chapters were screened for eligibility. Included texts' publication characteristics, methodological characteristics, and areas of focus were summarised. Interpretive content analysis was conducted.

RESULTS

From 5945 unique records, 105 texts were included. These discussed general parenting, parents with disabilities, and parenting in challenging social situations. Most texts focussed on mothers caring for young children in Western cultural contexts. The analysis culminated in the development of a conceptual framework: the Parenting Occupations and Purposes (POP) Framework. This comprises 10 interrelated areas of parenting occupations, which are performed for the purposes of addressing the child's basic, developmental and social needs. Parenting occupations were also found to be influenced by additional, underlying occupations that build parenting capacity - Continuous Parental Development (CPD) occupations.

CONCLUSION

These findings provide an overview of current occupational therapy conceptualisations of parenting. Unlike most of the existing literature on parenting, the POP Framework is parent-centric rather than child-centric. More research on parenting occupations is needed, especially with more diverse representation (fathers, ages of children, parental disability and sociocultural background). Further research is required to examine the POP Framework's usefulness in guiding research and practice, particularly among parents with diverse characteristics.

The Power of Playgroups: Key components of supported and therapeutic playgroups from the perspective of parents

INTRODUCTION

Playgroups are community-based programs for children and families aiming to improve child outcomes, enhance family and community networks and increase parenting capacity. Despite the prevalence of playgroups in Australian communities there is a lack of research clearly articulating the key components of playgroups, specifically from the perspective of parents attending these groups. This study aimed to identify the key components of supported and therapeutic playgroups impacting on perceived effectiveness from the perspective of parents with a child with a developmental delay and/or disability.

METHODS

This study explored the experiences of 23 parents attending supported or therapeutic playgroups using a qualitative interpretive phenomenological approach. Data were collected through three focus groups and seven individual interviews and analysed using Colaizzi's (1978) qualitative method of data analysis.

RESULTS

Findings indicated playgroup components that most strongly impacted on perceived effectiveness were feeling accepted; providing opportunities for child development, socialisation and enjoyment; and enhancing parental knowledge and skills. Findings reinforced the importance of family centred practice and facilitating peer support for families of children with developmental delay and/or disability.

CONCLUSION

Supported and therapeutic playgroups emerged as a valuable model for parents of children with developmental delays and/or disabilities but require an interplay of specific facilitator, parent and child characteristics to be effective. This study contributes to the understanding of key components of successful supported and therapeutic playgroup models, highlighting the importance of engaging consumers in developing evidence-based meaningful interventions for children with developmental delay and/or disabilities and their families.