Play for children with complex needs

Post date: 
Monday, 14 September 2015
A girl with complex needs playing on a swing

Sarah Holton shares her favourite play ideas from RNIB’s guide to Working with complex needs.

Why is play so important? 

Children at the earliest developmental levels learn through play – by doing, and by trial and error. They find out what effect they can have on the world and build their self-image:  "This is me; this is what I can do!" Without this knowledge, it isn't easy to learn from others or appreciate what's in another person's mind:  "This is what she wants me to do." 

To learn from instruction, a child needs personal experiences to relate back to. Most importantly, children like playing and like learning.  

Questions to consider 

  • Do I give sufficient time to make their own discoveries?
  • Have I created a safe space for them to play?
  • Do I truly observe and pick up on their learning style?
  • What senses does the child use predominantly in play?
  • What developmental level is the child working at?
  • What preferences does the child show for sound, texture or movement?
  • How do I support the child's play without interfering?
  • Do I communicate my understanding in a way that the child can make sense of? 

Make it fun

The ultimate aim is for children to enjoy themselves. Play encourages children to think for themselves, to learn that they are individual, important, and can make things happen. 

If we don't provide play experiences, a child may think that nothing happens in their world, unless an adult is there to provide it for them. 

Obstacles to play

For children with complex needs, the greatest obstacle to play can be a vision impairment or visual processing difficulties

Children with little or no vision know less about what's out there to explore, and may not be attracted by the interesting colours and shapes that motivate a child with vision. It's also harder for them to share their interest with someone else and communicate about objects (joint attention) through the conventional visual channels – by looking at the object and looking at a playing partner to see how they are playing with the same thing, and reacting together. 

Other obstacles might include: 

  • other physical, learning or sensory disabilities
  • levels of stress and anxiety
  • medication, pain or fatigue.

These factors may vary depending on time and circumstance. As someone who knows the child well, you will know how to create a play environment that minimises these obstacles. Playing should be fun not hard. 

Give enough time 

Vision gives a child a lot of information about an object or activity very quickly and lets us scan other toys, activities or people to play with. With impaired vision choices and understanding may be slower. Touch, smell and hearing may not give a child such an instant understanding of the toy, activity or process. Simple descriptions help some children exploring a new object by touch. 

Give huge amounts of time for children to relax, familiarise, repeat, explore, process and attend to the activity or toy near them. 

Get the play space right 

Many children prefer a lot of space around them, so that they can feel in control of that space. They may feel anxious about other people acting in an unpredictable fashion close by. Others feel more confident in a confined space, so that they know exactly how that space is defined. Feeling comfy and safe are crucial. 

The Little Room by Lilli Nielsen is widely used and adapted as a play space for children with complex needs. See our Learning through play in the early years guide for more information on Little Rooms.

Offer interesting playthings

Everyday objects are often rewarding for children with complex needs to explore. While push-button toys that play music and other sounds may give pleasure and teach cause and effect, once the toy has been mastered little further learning is involved. So what to offer next?  

One option is creating a treasure basket with everyday things, such as a wooden spoon, sponge, saucepan or toothbrush?  

For more ideas read our leaflet on choosing toys in the Parents’ section

Respect different play styles 

Children with vision impairment are building the same concepts as other children, but may have very different ways of doing this. 

Body-centred play

What does this toy do to me (not what does this toy do?) 

Sound and timing 

Sounds, rhythm and timing may be important aspects of play and exploration. So just as you’d offer a sighted child many different objects and colours to look at and play with, make sure you provide variety in their play soundscape.

Movement

Moving is playing! Many children with vision impairment play with movement alone. Learning how their body feels and changes in space – light and heavy, tense and relaxed, high and low – are concepts usually learnt with vision. These need to be experienced directly through movement. Big-movement play like jumping, rocking, sliding and swinging are to be encouraged.

Using hands to explore

Many children with vision impairment and complex needs dislike using their hands and some develop fear and resistance to touching new things. 

So very little is gained by sitting children with a vision impairment and complex needs at a table and expecting them to play with their hands. Far more can be achieved by allowing them to approach the world in whichever way suits them best, observing their preferences and creating an environment that supports their developmental needs and preferred means of exploration. 

Sarah Holton is RNIB Children and Young People’s Officer, (Complex Needs)

Our thanks to Mary Lee, formerly Principal Teacher at the Royal Blind School in Edinburgh who wrote the developing play section of our guide to working with children who have complex needs.

Sense public inquiry into play 

The UK deafblind charity, Sense, is running a public inquiry into access to play opportunities for children aged 0-5 with multiple needs.

The inquiry will explore whether barriers exist to children with multiple needs accessing play, and what is working well.  Sense will use the evidence from the inquiry to produce a report and campaign for changes to take place.  

Parents and professional can help out by completing Sense’s play survey online. All the information you provide will be fully anonymised. If you would prefer to talk through your experiences on the phone, please get in touch at [email protected]

Professionals can respond in writing to Sense's call for evidence or attend a play roundtable discussion event at Sense HQ. They will be running a session for professionals and academics on Thursday 29 October 2015 and a session for play practitioners on Thursday 19 November 2015

You can find out more about the play inquiry, including other ways you can get involved, on the Sense website or by emailing [email protected].

More resources

You can download the Working with complex needs guide from our Education Professionals web pages

Read more about creating a distraction free environment for children with cerebral visual impairment and profound and multiple learning disabilities.

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