Patient Presentation
A 9-month-old male comes to clinic for his health supervision visit. His mother says, “I know that he needs to play but I’m not sure what type of toys to buy him.”The past medical history shows a former 35-week premature infant who is developmentally appropriate for his chronological age.
The pertinent physical exam reveals a healthy infant with normal growth parameters.
The diagnosis of a healthy child is made and appropriate health supervision and anticipatory guidance is given. His mother is told that he will like brightly colored rubber and soft items that he can easily grasp, mouth and throw. Items which make noise or even light up are also appropriate for his age.
She is also told that having him near people will be good for him and that all of his toys should be checked for safety.
Discussion
Play is children’s work. It is the core of their daily existance and is the stimulant for their emotional, social, physical and cognitive growth. Play is children’s scientific approach to acquiring and understanding knowledge. It is one of the most powerful teaching tools for them in the early years.
Learning takes place with every experience. It occurs when the child is ready to understand all by himself just what is happending.
Children play with many kinds of specially produced materials called toys, but toys are only one part of the total environment which also includes people, imagination and real materials.
Play:
- Uses a child’s energy
- Creates an environment for imagination
- Develops physical and mental skills
- Develops acceptable social traits including individuality
- Releases emotions
- Provides pleasure
- Reaffirms values and attitudes of others in the environment
Remember for child it is the process, not the product that is important. It doesn’t really matter that he used 5 colors of paint that are now all a muddy brown picture. He learned from the painting. Or, it matters that he is matching the colors on the board game, not that he wins the game.
It is the process not the product.
The learning process is simple:
The same principles apply for choosing toys for children with disabilities. The National Lekotek Center has resources for choosing toys for children of all abilities (see To Learn More below).
Toys by Developmental Stage
Infants – birth to walking
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Developmentally, the infant:
- Has a beginning awareness of the world, senses, feelings and other people
- Believes all things revolve around him – his needs and care
- Needs to learn to trust in the new environment – his view of the world is built as the child finds security in having his needs met
- Uses his mouth to explore much of the world
- Is different from every other child. All children need food, sleep, cuddling, cleaning, talking and interesting stimulation, but each child needs these to different degrees
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Toy types and examples
- Simple, safe materials
- Bright colors
- Moveable or dangly objects – ball, mobile (if out of reach)
- Rattles and toys which make noise – keys
- Rubber and soft items – dolls
- Materials which attract light – unbreakable mirror
-
Rationale for the toy types
- Everything in the surroundings is new and therefore attractive to the child
- He explores with all his senses
- He needs to reach out and find what his interactions do to the world – action begets reaction
- Few purchased toys are needed. The child entertains himself from stimulating forces in the environment
- Being near and able to see and hear others is important. A crib or seat near people allows the child to have stimulating interactions with people and the simple materials within his limited reach
Toddler
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Developmentally, the toddler is:
- Expanding his world through the increased ability to move on his own and get what he wants through actions and speech
- Still believing often that all things revolve around him
- Enjoying being around other children but plays mainly by self
- Finding it difficult to share
- Easily distracted from one activity to another
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Toy types and examples
- Push and pull rolling toys
- Real materials – boxes, spoons, food
- Bright colors
- Shapes
- Climbing and locomotion toys – ride-on wheeled toy
- Containers – tissue box, bucket, cup
- Water toys – sprinklers, watering can, funnel
- Sand toys – funnel, plastic cups, sifters
- Transportation toys – push truck, fire engine
- Books
- Animals and dolls
- Musical and rhythm toys – rattle, tamborine, whistle
- Art materials
- Dramatic play – dress up clothes
- Sensory objects – shaving cream, pinecone, snow
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Rationale for the toy types
- Usually he explores the world without fear
- Still he puts many things in mouth
- Developing large muscle skills rapidly
- Materials should be geared to his size because he will try everything
- He gathers everything so containers and items to collect and carry from one location to another are important
- Unlimited curiosity
- Imitates much of what he sees and will reproduce it with materials on hand
- May need several of the same or similar items available as he has problems sharing
Preschooler
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Developmentally, the preschooler is
- Rapidly developing in all areas including physical, social, emotional and cognitive
- Seeing things in only one way
- Finding it hard to carry concepts from one experience to another
- Exploring the world with others than just by himself
- Molding his individuality
- Learning differences are important
- Learning by doing or seeing rather than just hearing
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Toy types and examples
- Indoor-outdoor physical equipment – swing, ball
- Building and construction materials – blocks
- Locomotion and transportation
- Books
- Compact discs, tapes, movies
- Animals and dolls
- Music and rhythm equipment
- Simple board games – Candy Land®, Uncle Wiggly®, HI HO Cherry-O!®
- Manipulative materials – shells, stickers, coins, paperclips
- Special interest items
- Sensory materials
- Materials for conceptual stimulation of math, art, science and language – cards, magnetic letters or numbers
- Dramatic play
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Rationale for the toy types
- Continued development of large and small muscles
- Continued curiosity of the world
- Can struggle with all the new information, but learns its meaning through “playing it” into reality
- Experiments with language
- Familiar objects continue to be familiar play toys
- Unstructured materials encourage experimentation; structured materials reinforce necessary concepts
- Future interests are taking form
- Values and attitudes of adults are important
- Emotions are developing, toys that help their expression are necessary
School Ager
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Developmentally, the school ager is:
- Discovering the causes and mechanisms of the world through fantasy
- Further defining specific interests
- Having peers take on new meaning and importance
- Having rules and social acceptance mark his life
- Gaining competency through his experiences, abilities and knowledge
- Having more conflicts arise between peer confirmity and individuality
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Toy types and examples
- Games
- Sports equipment
- Musical instruments
- Books, magazines, newspapers
- Radios, compact discs, tapes
- Arts and crafts
- Working replicas of real things – play make-up
- Specific experimental materials for science, math, language
- Models or materials that can be built – model cars
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Rationale for the toy types
- Child is developing a strong sense of realism and self-criticism and needs direction and constructive choices
- Understands concepts and begins to apply their meaning to new materials and skills
- Group interaction and acceptance of rules to make things ‘work’ captures his interests
- Wants to be independent and responsible
- More complex materials that develop and perfect skills are valuable
- New stimulation may be needed to keep interests alive
- Many toys are no longer artifical replicas but are real materials signifiying interests and the child’s personality
Learning Point
Toys do not have to be expensive. Some of the best items are free because they are packaging or would be discarded from the home.
Toys should be safe for the child at each age and developmental level, and play should be appropraitely supervised, especially anything with small parts or is sharp. Children can and should learn to take care of their toys and help the family by picking up their toys with supervision and the help of adults and older children.
Children will be messy when they are playing and need to be allowed to be messy. Putting an inexpensive shower curtain under a work area and using an old shirt as a cover-up over the child’s clothes can keep the mess to a minimum. The shower curtain is also a good place for older children to play on with small toys as the curtain can be easily folded up if a small child comes into the room.
Suggestions for an Art/Writing Box
- Paper for writing/drawing- all colors, sizes, textures
- Paper for cutting up – magazines, cardboard, greeting cards
- Paper for mimicking – envelopes, forms, checkbook registers
- Writing instruments – markers, crayons, pencils, pens, window markers
- Paint – fingerpaint, watercolors, school paint
- Tape
- Glue, gluesticks or paste
- Scissors
Suggestions for an “Art Center” or the “Big Box of Junk” as many parents call it
- Blocks – wooden, plastic, boxes
- Cans – coffee cans, oatmeal boxes, juice cans
- Foil
- Foil pie tins
- Kitchen utensils – egg beaters, measuring spoons, metal cups, wood spoons, cookie cutters
- Old clothes and hats
- Keys
- Plastic bottles and cups
- Cotton tippped swabs
- Cotton balls
- Ribbons
- Thread spools
- Wood scraps
- Buttons
- Beads
- Yarn
- String
- Fabric scraps
- Bottle caps
- Corks
- Plastic garden containers
- Cardboard tubes – from toilet paper, paper towels
Other manipulatives for children to play with
- Shaving cream
- Pipe cleaners
- Pom Poms
- Stamping – stamp pads, bingo markers
- Straws
- Popsicle sticks
- Napkins
- Food – gelatin, pudding, macaroni, small marshmallows
- Nature items – rocks, sticks, pinecones, leaves, flowers, feathers, nut shells, sand, water, seeds
- Toothpicks
- Paperclips
- Coins
Questions for Further Discussion
1. Where can parents get information about toy safety recalls?
2. What should parents consider when allowing children to play with computer games?
3. What is the American Academy of Pediatrics recommendation for the ages and amount of time children should view television and/or use computers and videogames?
Related Cases
- Symptom/Presentation
- Specialty
- Age
To Learn More
To view pediatric review articles on this topic from the past year check PubMed.
Information prescriptions for patients can be found at Pediatric Common Questions, Quick Answers for this topic: Toy Safety.
To view current news articles on this topic check Google News.
Hauser P. Toys a Guide for Selection. Child Care Coordinating Council of Detroit, Michigan (Handout, no date available).
National Lekotek Center. Top 10 Tips for Choosing Toys.
Available from the Internet at http://www.lekotek.org/resources/informationontoys/tentips.html (cited 6/7/05).
Author
Donna M. D’Alessandro, MD
Associate Professor of Pediatrics, Children’s Hospital of Iowa
Date
August 8, 2005