How to Encourage Play During Treatment

Movement during play for sick children can be especially beneficial.

Navigating treatment for any health condition, particularly for children, presents immense challenges. The sterile environment, the discomfort of procedures, and the emotional toll can strip away the very essence of childhood: play. Yet, play isn’t merely a distraction; it’s a vital, often underestimated, therapeutic tool that fosters healing, coping, and development. This guide provides a definitive, in-depth, and actionable framework for encouraging play during treatment, offering practical strategies and concrete examples to transform the treatment experience.

The Power of Play in Healing

Before diving into the “how,” it’s crucial to acknowledge the profound impact of play during illness. Play acts as a powerful antidote to stress and anxiety, promoting emotional regulation and providing a sense of control in an otherwise uncontrollable situation. It can reduce the perception of pain, improve cooperation with medical procedures, and accelerate recovery by boosting mood and engaging the body’s natural healing mechanisms. Furthermore, play maintains a sense of normalcy, fostering social connections and preserving developmental milestones that might otherwise be stalled. Our focus here is to equip caregivers and healthcare professionals with the tools to harness this power effectively.

Creating a Play-Conducive Environment: More Than Just Toys

The physical and emotional environment profoundly influences a child’s willingness to engage in play. It’s not enough to simply provide toys; the space itself needs to invite and facilitate play.

1. Optimizing the Physical Space:

• Declutter and Organize: A chaotic environment is overwhelming. Regularly declutter the immediate treatment area, whether it’s a hospital room or a designated home treatment zone. Organize toys and materials in clear, accessible containers. For example, use clear plastic bins for LEGOs, art supplies, or small animal figures, labeling them with pictures for non-readers.

• Personalize the Space: Allowing a child to personalize their immediate surroundings fosters a sense of ownership and comfort.

  • Example: If a child is undergoing chemotherapy infusions in a hospital room for several hours, help them hang up drawings, photos of family and pets, or even a small, favorite blanket or pillow. Consider portable, adhesive-backed wallpaper borders with their favorite characters that can be easily removed.
• Ensure Safety and Hygiene: This is paramount, especially in a medical setting. All play items must be easily cleanable and regularly sanitized.
  • Example: Opt for hard plastic toys over plush ones in high-germ environments. Provide sanitizing wipes for children to “clean” their toys before and after play, making it part of the play routine rather than a chore. Avoid small, choking-hazard toys for very young children or those with compromised motor skills.
• Optimize Lighting and Sound: Harsh fluorescent lights and constant beeping can be disorienting.
  • Example: Bring in a small, portable lamp with a warm light for a more comforting ambiance. If permitted, play calming instrumental music or nature sounds quietly in the background, or offer noise-canceling headphones for moments of intense treatment, allowing for focused play without auditory distractions.
• Create Defined Play Zones (Even Small Ones): Even within a small hospital room, designate a “play corner.”
  • Example: Use a colorful rug or a large, soft blanket to visually delineate a play space on the floor. A small, foldable table and chairs can create a dedicated art or puzzle station. This helps the child mentally separate “treatment time” from “play time.”

2. Cultivating an Emotional Atmosphere of Permission and Support:

• Model Playfulness: Children are incredibly attuned to adult energy. If you seem stressed or hesitant, they will mirror that.
  • Example: Instead of just handing a child a puzzle, sit down and say, “Wow, look at all these pieces! Which one do you think goes here?” and genuinely engage. Laugh, make silly sounds, and show enthusiasm.
• Validate Emotions Without Guilt-Tripping: Acknowledge their feelings about treatment but gently redirect to play as a coping mechanism.
  • Example: If a child says, “I hate this IV!” respond with, “I know it’s really hard, and it’s okay to feel that way. How about we build the tallest tower ever with these blocks while we wait?” Avoid phrases like, “Don’t be sad, just play.”
• Empower Choice and Control: Illness often strips children of autonomy. Play can restore it.
  • Example: Instead of asking, “Do you want to play?” which can be met with a “no,” offer specific choices: “Do you want to play with the cars or draw a picture?” Let them choose the game, the role, or the activity. Even simple choices, like “Which color crayon first?” can be empowering.
• Prioritize Play in the Schedule: Integrate play into the daily routine, just like medication or meals.
  • Example: After a particularly challenging procedure, schedule 15-20 minutes of uninterrupted free play. Announce it beforehand: “Okay, we have 15 minutes of quiet time now, and then it’s superhero building time!” This gives them something to look forward to and a sense of predictability.
• Involve Siblings and Peers (When Appropriate): Familiar faces can normalize the environment and make play more inviting.
  • Example: If a sibling visits, facilitate a board game or a joint art project. Ensure siblings understand the importance of play for their ill brother or sister and how they can participate. For older children, arrange virtual playdates with friends if in-person visits aren’t possible.

Strategic Play Facilitation: Tailoring Activities to Needs

Effective play during treatment isn’t about random activities; it’s about thoughtful selection and adaptation based on the child’s age, developmental stage, energy levels, and specific medical needs.

1. Adapting Play for Energy Levels and Physical Limitations:

• Low Energy/Sedentary Play:
  • Description: For children experiencing fatigue, nausea, or pain, active play is impossible. Focus on activities that require minimal physical exertion but still engage their minds and creativity.

  • Concrete Examples:

    • Storytelling/Audiobooks: Read aloud from favorite books or play engaging audio stories. Encourage the child to imagine the scenes, ask questions about the characters, or even create their own ending.

    • Art and Craft Kits: Provide pre-packaged kits for drawing, coloring books, sticker mosaics, scratch art, or simple origami. These require fine motor skills but no strenuous movement.

    • Puzzles and Logic Games: Jigsaw puzzles (appropriate piece count), Sudoku for older children, word searches, crosswords, or simple brain-teaser apps on a tablet.

    • Building with Large, Lightweight Blocks: Soft foam blocks or magnetic tiles can be manipulated from a bed or chair with minimal effort, allowing for creative construction.

    • Virtual Reality (VR) Experiences (Supervised): For older children, some VR experiences offer calming, immersive environments (e.g., exploring virtual worlds, meditative scenes) that can distract from discomfort without physical movement.

• Moderate Energy/Semi-Active Play:

  • Description: For children with fluctuating energy or those recovering but still limited, activities that involve some movement or focused attention but aren’t exhaustive are ideal.

  • Concrete Examples:

    • Board Games/Card Games: Classic board games (Candyland, Chutes and Ladders), card games (Go Fish, Uno), or even simple role-playing games like “I Spy” or charades adapted for seated play.

    • Puppet Shows: Use hand puppets or even socks decorated as puppets to create stories. This encourages imaginative play and vocal expression with minimal physical effort.

    • Light Building Projects: LEGOs, K’nex, or Lincoln Logs can be built on a tray table or bedside. Encourage building structures related to their interests (e.g., a hospital for their teddy bear, a spaceship to escape).

    • Gentle Movement Games: “Simon Says” with modified movements (e.g., “Simon says touch your nose”), stretching exercises disguised as animal movements (e.g., “be a tall giraffe”), or gentle ball tossing if space and condition allow.

• Higher Energy/Active Play (When Permitted):

  • Description: For children who are feeling better and have medical clearance, incorporating more active play is crucial for physical and emotional well-being. This can be adapted even within confined spaces.

  • Concrete Examples:

    • “Hospital Olympics”: Design a series of simple, playful physical challenges within the room or a designated play area.
      • Example: “Bedside Basketball” (crumpled paper into a wastebasket), “Hallway Hopscotch” (using tape on the floor), “Pillow Stack Race” (stacking pillows as quickly as possible).
    • Dance Parties: Put on their favorite music and encourage free-form dancing. Even seated dancing can be energetic.

    • Gross Motor Skill Games: Large building blocks they can rearrange, soft balls for gentle throwing and catching, or even just marching in place to music.

    • Imaginative Movement Play: “Let’s be a bird flying,” “Let’s be a robot walking,” encouraging them to act out scenarios with full-body movement.

    • Outdoor Play (if allowed and safe): Even a short walk in a hospital garden or a park can be incredibly beneficial. Focus on simple activities like collecting leaves, observing nature, or gentle swings.

2. Leveraging Different Types of Play for Therapeutic Benefit:

• Medical Play:

  • Description: This involves using play to help children understand, process, and cope with medical procedures and their illness. It demystifies the unknown and provides a sense of control.

  • Concrete Examples:

    • Doll/Teddy Bear Doctor Kit: Provide a toy doctor’s kit with band-aids, syringes (without needles), stethoscopes, and allow the child to “treat” their dolls or stuffed animals.

    • Role-Playing Medical Scenarios: Encourage the child to be the doctor, nurse, or patient. This allows them to express fears and concerns in a safe, imaginative space.

    • Drawing or Painting Medical Scenes: Ask them to draw what happens during an IV insertion, or how they feel before/after a procedure. This can reveal anxieties they can’t articulate verbally.

    • Explaining Equipment Through Play: Let them touch and explore safe medical equipment (e.g., an empty IV bag, a blood pressure cuff) on their toys or even themselves, explaining its purpose in simple terms.

• Creative and Expressive Play:

  • Description: Activities that allow children to express emotions, thoughts, and experiences non-verbally, fostering emotional release and self-expression.

  • Concrete Examples:

    • Art Therapy: Provide a wide range of art supplies (paints, clay, markers, glitter) and encourage free expression. “Draw how you feel right now,” or “Paint a picture of your favorite place.” Don’t judge the outcome; focus on the process.

    • Music and Movement: Play instruments (toy drums, shakers) or simply listen to music. Encourage singing, humming, or creating rhythms to externalize feelings.

    • Dramatic Play/Puppetry: Create scenarios where they can explore different roles and emotions. For example, a puppet who is scared of a shot, or a brave knight battling an illness.

    • Journaling/Story Writing: For older children, provide a notebook and encourage them to write stories, poems, or simply journal their thoughts and feelings.

• Cognitive Play:

  • Description: Activities that stimulate critical thinking, problem-solving, memory, and learning, helping to maintain cognitive development during periods of disrupted schooling.

  • Concrete Examples:

    • Educational Games/Apps: Age-appropriate apps that focus on math, reading, science, or logic. Many educational apps are designed to be engaging and fun.

    • Building Sets with Instructions: LEGO kits, K’nex, or even model airplane kits (for older children) that require following step-by-step instructions.

    • Memory Games: Matching cards, “Simon Says” (for remembering sequences), or simple quizzes about their favorite topics.

    • Science Experiments (Simple and Safe): Small, contained science kits like growing crystals, making slime, or creating a mini-volcano with baking soda and vinegar (with proper supervision and safety measures).

• Social Play:

  • Description: Facilitating interactions with others, which is vital for emotional well-being and preventing feelings of isolation.

  • Concrete Examples:

    • Board Games/Card Games with Others: Play with siblings, parents, or child life specialists. This encourages turn-taking, cooperation, and friendly competition.

    • Collaborative Art Projects: Work on a large drawing together, or each contribute a piece to a larger mosaic.

    • Role-Playing Scenarios: Create a “restaurant” where the child takes orders and “serves” the family, or a “school” where they are the teacher.

    • Virtual Playdates: Use video calls to allow children to play games, share stories, or simply chat with friends and family who cannot visit in person.

Overcoming Common Obstacles

Encouraging play during treatment is not without its challenges. Anticipating and addressing these obstacles proactively is key to success.

1. Addressing Fatigue and Low Energy:

• Short, Frequent Bursts: Instead of aiming for long play sessions, offer multiple short bursts of play throughout the day (5-10 minutes each).

• Passive Engagement: Sometimes, just being present and observing others play is enough. Don’t force active participation.

  • Example: If a child is too tired to play with cars, sit next to them and narrate a story about the cars you are moving.
• Rest-Play Balance: Emphasize the importance of rest. Frame play as a fun break, not an obligation.

• Identify Peak Energy Times: Observe when the child generally has more energy (e.g., in the morning before medication, after a nap) and schedule play during those windows.

2. Managing Pain and Discomfort:

• Distraction as a Tool: Use engaging play as a powerful distraction during painful procedures.

  • Example: During a blood draw, have the child focus on blowing bubbles, watching a captivating video, or listening to a funny story.
• Comfort Measures During Play: Ensure the child is physically comfortable while playing. Use extra pillows, adjust bed positions, or offer warm blankets.

• Pain-Informed Play Choices: Avoid activities that exacerbate pain. If moving arms causes discomfort, choose activities that focus on listening or quiet observation.

• Acknowledge and Validate: “I know this hurts, and it’s okay to feel that. Let’s try to focus on this amazing story while we wait for the pain to ease.”

3. Dealing with Emotional Resistance and Behavioral Challenges:

• Patience and Persistence: Some days, a child simply won’t want to play. Respect their boundaries and try again later. Don’t take it personally.

• Offer Choices, Not Demands: “Would you like to build with blocks or listen to music?” is more effective than “You need to play now.”

• Connect Play to Their Interests: If they love superheroes, find superhero-themed games or art supplies.

• Process Emotions Through Play: If a child is angry, provide opportunities for safe expression through play (e.g., pounding play dough, drawing angry pictures, smashing soft blocks).

• Involve Child Life Specialists: These professionals are trained to use play therapeutically and can offer tailored strategies and support.

• Positive Reinforcement: Praise effort and engagement, not just outcomes. “I love how you focused on that puzzle!” or “You did a great job trying that new game.”

4. Addressing Sterility and Infection Control:

• Hospital Policies: Always adhere strictly to hospital infection control protocols.

• Sanitizable Toys: Prioritize toys that can be easily wiped down with disinfectant. Many hospitals have lists of approved toys.

• Individual Play Kits: Create a personal play kit for the child with items that are theirs alone and can be regularly cleaned or disposed of.

• Hand Hygiene: Emphasize and model rigorous hand washing for both child and caregiver before and after play.

• “Show and Tell” Through Barriers: If a child cannot touch an item due to infection risk, describe it vividly or show pictures.

The Role of Caregivers and Healthcare Professionals

Encouraging play during treatment is a collaborative effort.

For Parents and Guardians:

• Be the Play Partner: Don’t just provide the toys; get down on their level and play with them. Your presence and engagement are invaluable.

• Advocate for Play: Don’t hesitate to discuss the importance of play with the medical team. Ask about designated play areas, child life services, and ways to integrate play into their routine.

• Be Flexible and Adaptable: Your child’s energy and mood will fluctuate. Be prepared to shift gears and offer different types of play.

• Celebrate Small Victories: Acknowledge any engagement in play, no matter how brief.

• Prioritize Your Own Well-being: You can’t pour from an empty cup. Take breaks when you need them so you can be fully present for your child.

For Healthcare Professionals:

• Integrate Play into Care Plans: Recognize play as a vital component of holistic care, not just an optional activity.

• Refer to Child Life Specialists: These experts are invaluable in facilitating therapeutic play and preparing children for procedures.

• Create Child-Friendly Environments: Advocate for dedicated playrooms, colorful decor, and accessible play materials in treatment areas.

• Use Play as a Communication Tool: Observe how children play to gain insights into their emotional state and understanding of their illness.

• Educate Families: Explain the benefits of play and provide practical tips for encouraging it at home and in the hospital.

• Be a Playful Presence: Even a brief moment of shared laughter or a silly comment can humanize the medical experience.

Conclusion

Encouraging play during treatment is more than a diversion; it is a fundamental act of care that empowers children to cope, heal, and continue to develop amidst challenging circumstances. By creating supportive environments, strategically facilitating diverse play experiences, and proactively addressing obstacles, we can transform the arduous journey of treatment into one where joy, resilience, and hope continue to thrive. The laughter, the imaginative worlds, and the simple act of play become powerful medicines in their own right, reminding children that even in the face of illness, their spirit of childhood remains vibrant and strong. Prioritize play, and you prioritize healing.