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Sarah Zimmerman, OTD, OTR/L

Saint Louis University

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Objectives

Understand the role of occupational therapists in promoting play
Understand barriers to access to play for children with disabilities
Learn about the Switched-Adapted Toys program and its impact at Saint Louis University
Explore how to start a Switched chapter
Adapt a toy!

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Role of OT in Play

OTs are skilled at completing activity analysis and adapting contexts and materials to promote play.

Person

• Promoting development, improving physical, sensory, social, cognitive skills related to play

• Just-right challenge of play

Environment

• Modifying the environment to promote play indoors and outdoors

• Advocating for play

Object

• Helping parents and teachers select developmentally appropriate toys

• Modifying/adapting toys to increase participation

OTs are skilled at performing task analyses and can be instrumental in choosing or creating assistive technology devices, seating options, or computer access. Our perspective can ensure that items are meaningful, functional, and promote independence using a strengths-based approach.

Relevant quotes from the textbook (CH 11):

Create a slide related to role of OT in play (use textbook as source)

Play is the arena for the development of sensory integration, physical abilities, cognitive and language skills, and interpersonal relationships (Mary Reilly, 1974)

OTs consider the physical environment, cultural context, temporal context, virtual context, on play. OTs also consider play deprivation. Adapting and Modifying Play Contexts and Materials.

In using play as a tool, the occupational therapist completes an activity analysis and determines that a specific skill may be developed by engaging in play activities or with a certain toy.

In some instances, occupational therapists working to facilitate engagement in play or leisure must merely make it available and support it as a priority.

occupational therapist to understand, assess, and intervene to promote play and playfulness.

These include that play is self-chosen or at least self-directed, it is intrinsically motivated and done for its own sake, is guided by rules that may be managed creatively, is imaginative, and occurs in a relatively stress-free state but active state of mind. Other authors would add that play is pleasurable, meaningful, and occurs with an attitude of playfulness

Through play, she believed, children learned skills and developed interests that later affected choices and success in work and leisure. Reilley proposed that play was the arena for the development of sensory integration, physical abilities, cognitive and language skills, and interpersonal relationships.

The playful children showed flexibility and spontaneity in their play and in social interactions, curiosity, imagination, creativity, joy, the ability to take charge of situations, the ability to build on and change the flow of play, and total absorption

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Access to Play

Traditional play is often difficult for children with disabilities to access

Barriers to Play:

Switched-adapted electronic toys cost up to 9 times as much as the original, non-adapted toys (Rasmussen et al., 2023)
Insurance does not reimburse for switch-adapted toys

Lack of access to play: delayed development,; limited endurance and movement, impaired attention span, initiative, and curiosity, limited resourcefulness and creativity, increased anxiety (O’Brien & Kuhaneck, 2020).

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Switched Adapted Toys: Mizzou

Founded in 2018 by Dana Chloe, PT, DPT, PCS, Rachel Hughes PT, DPT, and Eric Chole.

Partnered with Pascal’s Pals a nonprofit that provides toys to children undergoing hospital stays in mid-Missouri.

The mission is to put smiles on the faces of children and comfort in the hearts of their families in times of need. “We hold firm to the belief that health and happiness go hand in hand,” (Pascale’s Pals, 2019).

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Why bring it to SLU?

Interprofessional Collaboration: The SLU SWITCHED chapter allows occupational, physical, and speech therapy students to work together to build the toys. Sharing between disciplines builds knowledge and skills through interprofessional collaboration.

Meeting a Community Need: Many children with medically complex disabilities lack access to toys when compared with peers. SWITCHED adapts toys so that they are switch-activated, and opportunities for play, participation, and skill development are provided for all children. The project addresses needs in the community by providing toys to disabled children so that they can play with greater autonomy. This echoes the SLU Jesuit value of serving marginalized populations.

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Funding

The SLU SWITCHED chapter provides opportunities for occupational, physical, and speech therapy students to adapt toys for children with disabilities.

These toys and switches will be distributed at no cost to children and their families through partnerships with local organizations.

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Year 1 (2023-24)

Rotary Club Grant for tools and toys
Hosted first interprofessional build day for SLU students
Learned to switch-adapt toys from no prior knowledge
Distributed toys to St. Louis ARC Capable Kids Program
Barrier was switch cost (switches for $60+ and not all worked…)

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Year 2 (2024-25)

1818 Community Engagement Grant
Renewed grant from Rotary Club
Community partners

SLU Center for Additive Manufacturing for 3D-printed switches
St. Louis ARC Capable Kids Program

Distribution Day

Ranken Jordan Pediatric Hospital - provided switches for Huddy Buddy Bag program

Interprofessional workshop for SLU OT, PT, and SLP students
Additional build day: Interprofessional workshop for 19 practitioners from St. Louis region

ARC Capable Kids Distribution Day

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Year 3 (2025-26)

Received grant from Rotary Club
Continued interprofessional build day for students, distribution day with ARC, and practitioner build day for community partners
Future plan of additional parent build day this spring
Future plan of STEM day activity for high school students at Christian Friends of New Americans program

Image from student build day

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Benefits of SLU Switched Program

Leadership opportunities for Occupational therapy graduate students
Hands-on learning opportunities
Interprofessional learning opportunities between OT. PT, SLP
Critical thinking, problem solving, learning through doing
Giving back to community partners
Promoting occupational justice through access to play

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How to start Switched

Access the Switched website at https://www.switchedtoys.org/pages/switch-chapters
Go to “Our Mission” tab
Select “Switched Chapters”
Press “Start a Switched Chapter”

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Let’s Build!

Ball Popper

DJ Bouncing Beats

Coco the Monkey

Youtube:

Can my 9 year old switch adapt the Playschool Busy Ball Popper

Youtube:

Switch Adapted Fisher-Price DJ Bounding Beats for Inclusive Play

Youtube:

Switch Adapted Plush Toys

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References

O’Brien, J., & Kuhaneck, H. (2020). Case-Smith’s occupational therapy for children and adolescents (8th ed., pp. 412–447). Elsevier.

Pascale’s Pals. (2019). Pascale’s Pals. https://www.pascalespals.org/who-we-are

Rasmussen, K. M., Chole, D. M., Hughes, R., Threlkeld, K., & Janes, W. E. (2023). Caregiver‐reported impact of access to switch‐adapted toys on play for children with complex medical conditions. Child: Care, Health and Development. https://doi.org/10.1111/cch.13106

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