By Dave DeFusco 

For many people, play is simply something children do for fun, but for Tina Weisman, an adjunct professor in the Katz School’s Occupational Therapy Doctorate and a pediatric occupational therapist with more than four decades of experience, play is one of the most important ways children learn about themselves and the world around them.

Speaking on the Assistive Technology Today podcast episode, “Play Is Powerful: How Positioning Unlocks Learning,” Weisman explained how adaptive play, proper positioning and assistive technology can help children with physical disabilities develop skills, independence and confidence.

“Play is our child’s first occupation that’s really meaningful,” said Weisman. “It’s the earliest way a child begins to learn that they do have impact on their environment. They learn social skills, sensory motor skills and cognitive skills.”

Throughout her career, Weisman has worked primarily with children who have severe motor impairments, including cerebral palsy. Early in her career, she collaborated with Steven Kanor and the team at Enabling Devices to develop adaptive toys and equipment that help children participate more fully in play. That experience, she said, helped shape her professional philosophy.

“We would come up with project ideas and design ideas that would facilitate play and adaptive play,” she said, “and enhance our children’s ability to participate in the most meaningful occupation of play and to interact with each other, their siblings and the world.”

One challenge many children with significant physical disabilities face is that much of the world comes to them rather than the other way around. Parents, siblings and caregivers often bring toys, activities and experiences directly to the child because mobility can be difficult. As a result, children may miss opportunities to discover how their own actions can influence their surroundings.

“They don’t really have the opportunity to master their environments and gain agency in being able to have something influenced in their environment through their movement, through their intentional desire to play or create play,” said Weisman.

Adaptive toys and switches can help change that. When a child activates a toy and immediately sees or hears a response, they begin learning an important lesson: their actions matter.

“I hit this and something happens. I can do this and something happens,” she said. “Not only do we have the cause and effect and the cognitive development, but we have a concept of mastery.”

Those moments can have benefits that extend far beyond the child. “You see the world engaging even more with them,” she said. “You see the siblings or the other caregivers start to get more engaged.”

Weisman recalled working with a child who learned to use an adaptive toy. The toy became the child’s favorite activity, giving the child an opportunity for independent play and providing a much-needed break for the mother.

“The mom was able to have a cup of coffee and have this child play with this toy, interact with the toy with pure delight,” shw said.

A major theme of the podcast was that access involves much more than simply touching a switch. “Access means they hit the target, but there’s so much more to it,” said Weisman. “You have to be able to hit your desired switch. You have to be able to release or stop or hit it within the desired timing and then repeat it and do it again and not get fatigued.”

Developing those skills takes practice and repetition. Children need opportunities to use switches and other assistive technologies in different environments and positions so they can become efficient and comfortable.

“We have to think about it as motor efficiency,” said Weisman. “How do they generalize this skill so that motor efficiency starts to transfer into higher cognitive or mobility tasks?”

Positioning is a critical part of that process. Before therapists think about where to place a communication device or switch, they first need to ensure that the child is properly supported.

“You’re starting not at the device,” said Weisman. “You’re starting at the pelvis and making sure before you look at anything external that that child has the proper alignment so that they could have distal efficiency.”

Weisman said she's excited about advances in artificial intelligence, robotics and assistive technology; however, she believes technology should always support human independence.

“My caveat is always to make sure that the human is still the one with the intent,” she said.