Play and friendships with other children

So far, the discussion has focused on children’s relationships with adults, their parents, carers and other significant adults in the family. Children’s relationships with other children also play a very important role in their development, as the ability to get on with others in the same age group is clearly relevant to children’s progress in school, in taking part in social activities in their communi­ties and later in making their way in adult society.

Playing with others begins early

Researchers in child development have noted that typically developing babies are interested in one another from as early as 2 months of age[TODO: references 2]. Babies can get excited by the sight of other infants and they will stare at one another with evi­dent interest. By 6 to 9 months of age, babies will attempt to get the attention of other babies. By this age, they will smile and babble at other babies, some­times initiating and sometimes responding. By 9-12 months of age, typically developing babies will begin to imitate each other. There is no published research on the early social interest of babies with Down syndrome in other babies, but we have observed examples of social interest and communication in babies as, in the course of their work, they often have groups of similar age children together. A couple of examples will illustrate their observations. Some years ago, while making a video on early language development, one of the authors observed a 10 month old girl with Down syn­drome working hard to get the attention of a 3 year old in the room. The baby made ‘calling noises’ to try to get the older child’s attention, and when the older child stopped what she was doing and looked at the baby, the baby cooed with pleasure. The older child looked and away went back to her play and the baby started over again - calling and then cooing when she had succeeded and the child looked at her.

Recently, one of the authors observed an 8 month old girl with Down syndrome learn a motor action in a few minutes by watching and then copying a 9 month old boy with Down syndrome. At the start of this encounter she was shaking two rattles independently, one in each hand, but was not able to copy an adult model of banging two similar rattles together in front of her chest (in the mid-line). The little boy was able to copy banging his rattles together as soon as the adult started this movement. The little girl watched him intently for a minute or two and then began to successfully copy him. These examples both indicated that babies with Down syndrome can have age-appropriate social interactive skills at this age and are very tuned into gaining one-to-one attention from both adults and other children.

Playing ‘alongside’

Children’s ability to benefit from play with other children develops further in the second year. Play interactions get longer and more complex and sequences of imitation indicate that toddlers are aware, at least on some level, of the intent of others consistent with their emerging ‘theory of mind’. Their ability to copy each other (‘you do it, I do it, you do it’) reveals their developing turn-taking abilities. These very simple abilities to share meaning, be aware of other’s inten­tions, and take on reciprocal roles probably lay the groundwork for coordi­nated play. At this stage, children are often described as playing alongside one another and sometimes, this is not seen as social play; but, in fact, it is clear that children are learning from each other at this stage.

Playing together

In establishing play routines in which children begin to play together in the sense of sharing a game or building a construction together, language certainly helps. Indeed, children who speak more clearly, and communicate their ideas better in preschool years will have an easier time in starting play with other children and keeping play going. There is also a link with cognitive develop-ment as the ability to plan and to remember will influence children’s abilities in developing longer sequences of play. Children with Down syndrome are going to be disadvantaged as a result of their language and cognitive delays but their social strengths and ability to imitate need to be remembered, as well as the important fact that they usually understand more than they can communicate. Typical 3 and 4 year olds are able to understand the needs of a playmate with developmental delays, and to play with them, especially when in an environ­ment where the adults are providing sensitive role models and encouraging this support by other children. Children with Down syndrome may be just as interested in other children as typically developing children but they will take a little longer to develop their play.

More complex games

Play develops to more complex games and pretend games by school age. Typically developing children move first to games involving co-operative play with one partner in their second and third years and will be 4 to 5 years of age before games can involve 3 or more children who can co-ordinate what they are doing.

Social experience is important

Experience is important and there is evidence from research that greater expe­rience in adult-supervised play-groups is linked to more complex peer interac­tions among all toddlers and preschoolers. Research into the effects of child care settings report a variety of outcomes but the important factor seems to be the quality of the child care. Children who have experienced high quality child care are more competent in relating to their peers in preschool and school.

Familiar play mates, early friends

Playing with the same children regularly helps, as research shows that toddlers find it easier to play with the children they play with often - they show their most mature play when playing with someone they know well. When children play together regularly, they make friendships from the toddler stage that have been shown to last into school years. Studies suggest that children who are friends persist in solving disputes and play for longer. More peer experience is good for learning to manage emotions and get on with others. Friends are more likely to try to stick it out, resolve the conflict, negotiate, compromise and continue to play. In the authors’ experience, this is equally true for children with Down syn­drome. The friends that they make at preschool continue to be their friends and to support them when they move into school. The children in their classes are often very tuned in to their strengths and to their needs, and can sometimes be better at understanding and supporting them than the adults around them! Children are very good at seeing the child first and not the disability - they see Johnny or Lizzie - they do not see ‘a child with Down syndrome’ in the way adults often do. It is important to talk to children with Down syndrome about emotions and to teach them the words for emotions as there is some evidence that, because of their language delay, parents talk less about emotions[79,80]. Studies of the peer relationships and play of children with Down syndrome and other developmental delays suggest that they gain many of the same benefits from play and social experience as other children[79-85].

Ability, age and play

Children of similar abilities and skills are able to develop play together, but children also learn a great deal from playing with older children and younger children, including brothers and sisters. Playing with an older child provides new ideas for developing and extending play and playing with a younger child provides the chance to learn how to adapt and to assist that child in play. Researchers have looked at the play of children with developmental delays in inclusive mainstream playgroup/preschool settings and compared this with special settings for disabled children. The studies show that during free play, interactions with other children as well as the quality of cognitive play, particu­larly more constructive play, improved considerably in an inclusive setting. The benefits probably come from having more active and more imaginative play partners to copy even if children are at the stage of playing alongside rather than with other children.

Disagreements can be positive

During the preschool years, play is not always smooth as children find shar­ing and co-operating difficult. Some disagreements and aggressive behav­iours often occur as children begin to play together, peaking between 2 and 3 years and then declining. Aggressive behaviours at this age, such as pushing or snatching toys are common and parents need to be reassured that most chil­dren showing a bit of aggression at two years do not continue to be aggressive; in fact, they may be more socially outgoing, and try to play with more children as they get older. It is possible that the experience of conflict can be positive as children then learn to negotiate, compromise, share and to take turns.

Popularity

However, if children do continue to be aggressive in their play at 5 years and older, then they tend to become unpopular with other children and not chosen as playmates. Particularly shy and submissive children are also at risk of being unpopular.

How do parents help?

Children’s sense of security matters

Children who are experiencing secure and loving relationships at home are well prepared to develop good relationships with other children outside their homes. Secure emotional attachment is associated with social competence for toddlers and preschoolers and predicts popularity and friendships in school and preschool. Insecure attachment seems to limit children’s social compe­tence - and it can lead to patterns of hostile, angry, and aggressive behaviours when with other children or to whiney, easily frustrated behaviour. There is thought to be a link here with children’s developing ideas of themselves. Early attachment experiences may affect the ideas they develop about themselves and others (so called inner working models of relationships). Angry children who feel unloved and unlovable not surprisingly make poor playmates, as do ‘whiney’ easily frustrated children.

Parenting styles

Research also suggests links between children’s social behaviour with other children and parenting styles. A parenting style which combines warmth, love and security with clear and consistent control (called authoritative parenting) provides the best foundation for children’s social development and achieve­ment. These parents tend to talk to their children, explaining the reasons for rules as they encourage appropriate behaviour. Parenting styles that are too disciplinarian and controlling or too permissive and indulgent or too overpro­tective, are not so successful. Consistency is really important and this is dis­cussed further in the final section on behaviour. The keys to good parenting are exactly the same for children with Down syndrome.

Providing opportunities

Parents can do many things to support children, and parents with more socially successful children tend to give them many play opportunities. They believe that helping their children to play well with others is part of their role, therefore they supervise their children’s play, explain why some behav­iours are acceptable and others are not, and model ‘good’ behaviour. One useful strategy is to comment on and praise the ‘good’ behaviour of any child who is playing ‘well’. Parents of socially competent children believe that chil­dren learn how to behave and they do not blame problems on their children’s temperaments, though they do make appropriate allowances for factors which lead to problems such as being too tired, letting them play too long, or being in too large a group.

Brothers and sisters

Much of the discussion in this section has talked about the benefits of being with other children in general, including brothers and sisters. However, broth­ers and sisters often play a very important and unique role in the lives of chil­dren with disabilities. All children learn from brothers and sisters - especially in these preschool years. Babies and toddlers usually want to be like their older sibling and copy their play, behaviour and language. In these sibling relationships, all children will experience jealousy at times, will compete for parents’ attention and have to learn to share. They can learn the necessary give and take of relationships at home and this will help them when they go to school and preschool settings[TODO: references 86]. Most children find the arrival of a younger brother or sister quite hard to manage - sometimes they feel pleased with the new arrival but at other times angry and jealous about losing the full attention of their parents. Children with Down syndrome are just the same - some are placid and do not show jealousy while others can be quite upset and take time to adjust. They will adjust more quickly if parents can make sure they still have some special quality time and attention when the new arrival is asleep or in someone else’s arms. They need to know they are still loved as much as they were before the new baby arrived.

How do teachers and carers help?

Teachers and carers will be successful if they show the same warmth, consist­ency and ‘good’ parenting approaches outlined above. In addition, they are in the very powerful position of being able to offer group play situations. Children with Down syndrome are often at a disadvantage as they have less advanced play skills and language but teachers and carers can help by selecting toys and materials that encourage social interaction, designing activities that enhance social interaction and actively enlisting the assistance of more skilled children.

Quality support makes a difference

For toddlers, social play is demanding and easily disrupted. Toddlers are easily distracted and play with another child is not easy to maintain. The way that adults structure play environments for toddlers makes a difference to how much and how well they play together. For example: a) organising the play areas and toys to encourage children to be near each other and communicate - such as putting a two seater couch in the book area, having two seater cars, and placing children opposite each other at the sand or water tray to encourage eye-contact and communication;

2. providing activities that encourage shared play and co-operation - such as providing duplicate sets of toys at the sand and water tray so that children can imitate each other, providing a range of toys for different developmen­tal skill levels an area so that a number of children can join in the play at their own level, providing house corners and dressing up corners;

3. using verbal supports such as, inviting a child to join a group and sug­gest a role for the child - “Anne would like to be a nurse, can you show her what the nurse is doing in your game”, explaining a behaviour to the other children - “I think Freddy is telling you to put the red block on next”, or suggesting ways to include such as, “can you pass Jenny the scissors - she might like you to help her with the glue when she has cut her shape”

4. praising children for social behaviours, “you worked well together on that computer game, Lenny and Max”, “you shared your toys really nicely, Sarah”.

There are training programmes to teach staff in preschool settings to use strat­egies like these to ensure that all children are socially included and learn how to get on effectively with one another. One of the best known is Learning language and loving it: a guide to promoting children’s social, language and literacy develop­mentinearlychildhoodsetting - see the resources list for details. Research studies have shown that training staff on this programme does increase their support­ing behaviours and does increase the amount of communication between chil­dren with disabilities and the other children in preschool settings.