An investigation of the quality of pretend play ability in children with cerebral palsy.

Background: Cerebral palsy (CP) describes a group of permanent disorders in the development of movement and posture due to non-progressive disturbances during foetal or infant brain development that can result in activity limitations, including engagement in pretend play.

Methods: Twenty children aged four to seven years with spastic CP participated in this descriptive qualitative study. The Child-Initiated Pretend Play Assessment (ChIPPA) clinical observations were analysed from five categories: Time, Interaction with the examiner, Imitation, Theme and Story.

Results: Seventy per cent (70%) of the children completed the assessment (Time), and 90% of children interacted socially with the examiner during the play (Interaction with the examiner). All children initiated their pretend play without requiring examiner demonstration (Imitation). Sixty per cent (60%) of the children were appropriate to their stage of development for Theme. Finally, 60% of the children set up a scenario, but did not develop a narrative (Story).

Conclusion: Qualitative aspects of the children's pretend play performance were satisfactory, showing typical play indicators in all the categories, except for 'Story'. 'Story' represents more complexity in a child's pretend play ability. Therefore, a play intervention is suggested to stimulate and expand the pretend play ability of preschool children with CP.