The results of a study co-authored by Dr. Amiya Waldman-Levi, clinical associate professor in the Occupational Therapy Doctorate program, revealed that the more playful infants were at 6 months, the higher their cognitive functioning at 18 months.

By Dave DeFusco

Dr. Amiya Waldman-Levi, clinical associate professor in the Katz School’s Occupational Therapy Doctorate program, has been awarded the 2022 Cordelia Myers AJOT Best Article Award for her study linking the development of playfulness in infants to the cognitive functioning of toddlers.

She and her co-authors Dr. Dana Shai, principal investigator of the research and a professor at the Academic College Tel Aviv Yaffo, and Dr. Anita Bundy, department head in occupational therapy at Colorado State University, will receive the award in April from the American Journal of Occupational Therapy at the AOTA INSPIRE 2023 conference in Kansas City.

In the study, the researchers showed that children’s playfulness is evident as early as 6 months and continues to develop through 24 months, depending on cognitive growth. The results were based on the examination of 86 children from middle- to upper-income families.

“Understanding the development of playfulness and exploring its relationship with cognitive functioning in typically developing children fills important gaps in pediatric practitioners’ knowledge,” said Dr. Waldman-Levi. “It will prompt health care providers to intervene earlier when a child’s cognition or playfulness is at risk.”

The Cordelia Myers AJOT Best Article Award is presented every year to recognize a high-impact, high-quality research study published in the American Journal of Occupational Therapy that reflects the publication’s mission. The editor issued Dr. Waldman-Levi a certificate for her “tireless effort and valuable contribution as a reviewer for the American Journal of Occupational Therapy.”

In the article, “Cognition Mediates Playfulness Development in Early Childhood: A Longitudinal Study of Typically Developing Children,” the researchers explained how they used the Mullen Scales of Early Learning (MSEL) to assess cognitive functioning and the Test of Playfulness (ToP) for children at 6 months, 18 months and 24 months.

The results revealed that the more playful infants were at 6 months, the higher their cognitive functioning at 18 months, which then led to more playful behavior at 24 months.

At 6 months, infants can provide clear cues to caregivers about their needs through eye contact, facial expressions, and their ability to reach for objects and engage in play. They are also emotionally developed enough to play next to their caregiver, and can roll, reach, grasp objects and hold attention for about five to seven minutes.

“All of these development milestones allowed us to look at how they play,” said Dr. Waldman-Levi. “We observed infants and children playing by themselves and with others, and then we compared what we observed to a set of criteria. We also looked at behaviors, such as how they manipulated objects and how they transitioned from one play activity to another.”

Dr. Waldman-Levi said pediatric clinicians, occupational therapists and child psychologists will be able to use the results of their study to guide their evaluations and intervention planning. Children who engage in limited play because of a lack of mobility, resources and access to childcare and play spaces are at risk for cognitive developmental delays. Similarly, children with known cognitive impairments will also benefit from increased play opportunities at home and in daycare.

“Ultimately,” she said, “we want clinicians to consider the intersection of play and cognition in a child’s development as they assess and intervene.”