Development of the trauma play scale: An observation-based assessment of the impact of trauma on play therapy behaviors of young children.

Abstract

Literature suggests that traumatized children exhibit a type of play that is distinct from the play behaviors of other children (Terr, 1983). The purpose of this study was the development of an instrument designed to detect differences in the play therapy behaviors of children with a history of trauma versus children with no known history of trauma.The study consisted of two phases; the instrument development and pilot study phases. The researcher followed Hill's (1991) guidelines for instrument development. The scale was designed so that raters could rate a child's behavior, via videotaped play therapy sessions, at five minute intervals. The scale consisted of the following domains: Intense Play, Repetitive Play, Play Disruptions, Avoidant Play Behavior, and Negative Affect. The Average Trauma Play Scale Score is an average of scores across these domains.During the pilot study phase, the researcher evaluated the scale in terms of reliability, face validity, and discriminant validity. Subjects were twelve children; six had a history of trauma and six had no known trauma history. Five trained raters rated eight consecutive videotaped play therapy sessions for each participant. One-way and repeated measures analysis of variance statistics, including effect sizes, were used to detect differences between the groups.Percentage agreement and correlational estimates of interrater reliability suggest that raters are able to acheive consensus and consistency in their ratings. Quantitative and qualitative feedback from experts in the field of play therapy provide strong support for the face validity of the scale. Statistical analyses indicate that the Trauma Play Scale has a high degree of discriminant validity. Traumatized children scored higher on the Trauma Play Scale than nontraumatized children, as expected. Effect size estimates indicate strong relationships between participants' trauma history status and their Average Trauma Play Scale scores. In post-hoc analyses, the Repetitive Play Domain was omitted from the aggregate score; this analysis uncovered statistically significant differences between the two groups.ii

Development of the Trauma Play Scale: Comparison of children manifesting a history of interpersonal trauma with a normative sample.

“…Trauma affects children holistically (Findling, 2004). The effects of trauma can permeate all areas of healthy childhood development and negatively impact the lives of children in the present and in the future.…”

“…To address these issues, the Trauma Play Scale (TPS), an observationbased assessment designed to measure play behaviors of children as they engage in play therapy, was developed and a pilot study was conducted to assess its psychometric properties (Findling, et al, 2006). In this study, play behaviors of clinically referred children in play therapy with a history of interpersonal trauma were compared with play behaviors of clinically referred children in play therapy with no known history of interpersonal trauma.…”

“…Findling (2004) identified two major impediments to the empirical study of play behaviors of traumatized children:…”

“…CCPT is a therapeutic approach to working with children that is responsive to the developmental needs of children (Axline, 1969;Bratton & Ray, 2002;Findling, et al, 2006;Gallagher, Leavitt, & Kimmel, 1995;Guerney, 1983;Sweeney, 1997;Terr, 1981), providing significant opportunities for growth, mastery and healing (Bratton, et al, 2008).…”

“…The role and potential of play in the diagnosis and treatment of children who have been traumatized has received support in recent years (Findling, Bratton, & Henson, 2006;Gil, 1998;1989;Terr, 1991). Terr (1983) found that children who have experienced trauma exhibit distinct play behaviors which she termed as posttraumatic play.…”