3. Play Therapy Must Follow the Neurobiological
Sequence of Development To support recovery, play therapy must replicate the normal developmental progression of experiences, beginning at the lowest disorganized brain region for optimal outcome (Perry & Dobson, 2013). Play therapy is often regressive as absent, abnormal, or incomplete early experiences must be successfully accomplished (neurologically This “bottom up” approach is essential since each brain region must interpret, integrate, and consolidate information for use at successive levels of brain function, as development and treatment are hierarchical processes (Perry, 2001). Incoming impulses must be properly processed, organized, and integrated if other brain regions are to use the information effectively. This means play therapy is frequently a “bottom-up” healing process (Gaskill & Perry, 2017). Matching the child’s age when the trauma occurred to the onset of symptoms can help identify disorganized brain regions and a starting point of play therapy. Play Therapy intervention strategies must impact the brain region affected by the traumatic experience. Strategies failing to do this will be much less successful (Gaskill & Perry, 2017).
4. Play Therapy Begins at the Child’s Functional Age Under normal circumstances, each developmental step in neuronal milestones. Unfortunately, trauma impedes the expected sequence of development, resulting in neurological functioning below the
or immature development in one or more developmental domains on the brain region or regions negatively affected by the traumatic experiences. For this reason, play therapy must begin at the child’s functional age and not their chronological age (Gaskill & Perry, 2017). Progress in play therapy is based on successful mastery of each consecutive stage (development should be viewed as a progression of increasingly complex neurological connections and organization). Play therapy must begin at the last successful stage, regardless of age, and progresses based on mastery of successive stage. Assessment of a child’s current functional age may be aided by conversations with adults familiar with the child, direct observation of the child, and/or use of developmental surveys to help identify the child’s functional capacity. Teachers, parents, or others familiar with the child can be rich resources of information. Child-Directed methods of assessment and observation in play therapy also provide valuable information quite naturally, as a child typically gravitates to play consistent with child’s functional age is an excellent guide for teachers, parents, and therapists creating an effective therapeutic web or therapeutic social support system (Gaskill & Perry, 2017).
The play therapist must
communicate in a form, style, or modality recognized by the brain region targeted for change.
A child’s favored communication medium during play is strongly tied to the functional age of the child (the brain region actively developing) and a critical determinate of treatment success. Each brain region responds to a unique “language” of sensory input consistent with brain development and functional age. Contrary to popular thought, not all brain regions respond equally well to the spoken word. The play therapist must communicate in a form, style, or modality recognized by the brain region targeted for change. It is critical to recall brain regions are Lower brain regions (brainstem and diencephalon, prominent during and movement stimulation, generally at heart rate or some harmonic of heart rate. The limbic system is sensitive to warm relational experiences including verbal and non-verbal communication (the primary mode of communication from the 2nd to 4th years). Finally, the cortex responds to spoken language, concepts, logic, and facts used conceptually to understand and solve problems from grade school through adulthood. It is important to be mindful that scaffolding (building supports to ensure success when addressing underdeveloped or disorganized abilities) is an extremely helpful teaching and therapeutic technique.
6 | PLAYTHERAPY | June 2022 |
www.a4pt.org
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