Skip to main content
SpringerLink
Log in

Examining Effective Intervention Strategies in a Play-Based Program for Children with Prader-Willi Syndrome

  • ORIGINAL ARTICLE
  • Published:
Journal of Developmental and Physical Disabilities Aims and scope Submit manuscript

Abstract

Background: Children with Prader-Willi Syndrome (PWS) display impaired pretend play abilities, reflective of broader social-cognitive challenges. Pretend play interventions for children with PWS demonstrate preliminary efficacy for improving cognitive and affective processes in play. It is unknown which specific intervention strategies, such as prompting, summarization, and modeling, most effectively improve these skills. The present study examined the effectiveness of different interventionist strategies on eliciting child behaviors within pretend play intervention sessions. Methods: Participants included 21 children (ages 6–12) with PWS who participated in a pretend play intervention. Recorded intervention sessions were coded for interventionist strategies and child pretend play skills. By pairing each interventionist strategy with the immediately following child behavior, it was possible to discern the frequency of how often certain intervention strategies immediately preceded various child pretend play skills. Results: All intervention strategies were followed by child pretend play over 50% of the time. Interventionist summarizing/reflection and modeling most often preceded child pretend play, as well as specific skills of imagination and organization. Prompting, followed by modeling, most often preceded affect expression. Conclusions: Interventionist strategies of summarization and modeling may most effectively facilitate pretend play. Prompts for emotions may be more effective to elicit affect expression, potentially due to social-cognitive difficulties inherent in PWS. Children with developmental differences may benefit from adults who engage in play as a partner, rather than direct the play, to help the child stay on-task and learn target behaviors. This insight may strengthen future efforts to support socioemotional skills through pretend play.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Angulo, M. A., Butler, M. G., & amp; Cataletto, M. E. (2015). Prader-Willi syndrome: A review of clinical, genetic, and endocrine findings. Journal of Endocrinological Investigation, 38(12), 1249–1263. https://doi.org/10.1007/s40618-015-0312-9

  • Bergen, D. (2002). The role of pretend play in children’s cognitive development. Early Childhood Research & Practice, 4(1), n1.

  • Barton, E. E., & Wolery, M. (2008). Teaching pretend play to Children with Disabilities: A review of the literature. Topics in Early Childhood Special Education, 28(2), 109–125. https://doi.org/10.1177/0271121408318799

    Article  Google Scholar 

  • Bertamini, G., Bentenuto, A., Perzolli, S., Paolizzi, E., Furlanello, C., & Venuti, P. (2021). Quantifying the child–therapist Interaction in ASD intervention: An observational coding system. Brain Sciences, 11(3), 366. https://doi.org/10.3390/brainsci11030366

    Article  PubMed  PubMed Central  Google Scholar 

  • Bohonowych, J., Miller, J., McCandless, S. E., & Strong, T. V. (2019). The global Prader–Willi Syndrome Registry: Development, Launch, and early demographics. Genes, 10(9), 713. https://doi.org/10.3390/genes10090713

    Article  PubMed  PubMed Central  Google Scholar 

  • Caixàs, A., Blanco-Hinojo, L., Pujol, J., Deus, J., Giménez-Palop, O., Torrents-Rodas, D., Coronas, R., Novell, R., & Esteba-Castillo, S. (2021). Altered gesture imitation and brain anatomy in adult Prader–Willi Syndrome Patients. Journal of the International Neuropsychological Society, 27(10), 1024–1036. https://doi.org/10.1017/S1355617721000060

    Article  PubMed  Google Scholar 

  • Cassidy, S. B., Schwartz, S., Miller, J. L., & Driscoll, D. J. (2012). Prader-Willi syndrome. Genetics in Medicine: Official Journal of the American College of Medical Genetics, 14(1), 10–26. https://doi.org/10.1038/gim.0b013e31822bead0

    Article  PubMed  Google Scholar 

  • Chang, Y. C., Shih, W., Landa, R., Kaiser, A., & Kasari, C. (2018). Symbolic play in School-Aged minimally verbal children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 48(5), 1436–1445. https://doi.org/10.1007/s10803-017-3388-6

    Article  PubMed  Google Scholar 

  • Davidson, D., & Stagnitti, K. (2021). The process of learn to play therapy with parent–child dyads with children who have autism spectrum disorder. Australian Occupational Therapy Journal, 68(5), 419–433. https://doi.org/10.1111/1440-1630.12751

    Article  PubMed  Google Scholar 

  • Descheemaeker, M. J., Govers, V., Vermeulen, P., & Fryns, J. P. (2006). Pervasive developmental disorders in Prader–Willi syndrome: The Leuven experience in 59 subjects and controls. American Journal of Medical Genetics Part A, 140A(11), 1136–1142. https://doi.org/10.1002/ajmg.a.31235

    Article  Google Scholar 

  • Dimitropoulos, A., Ferranti, A., & Lemler, M. (2013a). Expressive and receptive language in Prader–Willi syndrome: Report on genetic subtype differences. Journal of Communication Disorders, 46(2), 193–201. https://doi.org/10.1016/j.jcomdis.2012.12.001

    Article  PubMed  Google Scholar 

  • Dimitropoulos, A., Ho, A., & Feldman, B. (2013b). Social responsiveness and competence in Prader-Willi Syndrome: Direct comparison to Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 43(1), 103–113. https://doi.org/10.1007/s10803-012-1547-3

    Article  PubMed  Google Scholar 

  • Dimitropoulos, A., Ho, A. Y., Klaiman, C., Koenig, K., & Schultz, R. T. (2009). A comparison of behavioral and emotional characteristics in children with Autism, Prader-Willi Syndrome, and Williams Syndrome. Journal of Mental Health Research in Intellectual Disabilities, 2(3), 220–243. https://doi.org/10.1080/19315860903052204

    Article  Google Scholar 

  • Dimitropoulos, A., Zyga, O., Doernberg, E., & Russ, S. W. (2021). Show me what happens next: Preliminary efficacy of a remote play-based intervention for children with Prader-Willi syndrome. Research in Developmental Disabilities, 108, 103820. https://doi.org/10.1016/j.ridd.2020.103820

    Article  PubMed  Google Scholar 

  • Dimitropoulos, A., Zyga, O., & Russ, S. (2017). Evaluating the feasibility of a play-based telehealth intervention program for children with Prader–Willi Syndrome. Journal of Autism and Developmental Disorders, 47(9), 2814–2825. https://doi.org/10.1007/s10803-017-3196-z

    Article  PubMed  Google Scholar 

  • Driscoll, D. J., Miller, J. L., Schwartz, S., & Cassidy, S. B. (2017). Prader-willi syndrome. GeneReviews®[Internet].

  • Dykens, E. M., Cassidy, S. B., & King, B. H. (1999). Maladaptive behavior differences in Prader-Willi syndrome due to paternal deletion versus maternal uniparental disomy. American Journal on Mental Retardation, 104(1), 67–77.

    Article  PubMed  Google Scholar 

  • Dykens, E. M., Lee, E., & Roof, E. (2011). Prader–Willi syndrome and autism spectrum disorders: An evolving story. Journal of Neurodevelopmental Disorders, 3(3), 225–237. https://doi.org/10.1007/s11689-011-9092-5

    Article  PubMed  PubMed Central  Google Scholar 

  • Feldman, B. H., & Dimitropoulos, A. (2014). Face discrimination skills in Prader-Willi Syndrome and Autism Spectrum Disorder. Journal of Mental Health Research in Intellectual Disabilities, 7(3), 264–285. https://doi.org/10.1080/19315864.2013.857744

    Article  Google Scholar 

  • Foti, F., Menghini, D., Orlandi, E., Rufini, C., Crinò, A., Spera, S., Vicari, S., Petrosini, L., & Mandolesi, L. (2015). Learning by observation and learning by doing in Prader-Willi syndrome. Journal of Neurodevelopmental Disorders, 7(1), 6. https://doi.org/10.1186/s11689-015-9102-0

    Article  PubMed  PubMed Central  Google Scholar 

  • Funderburk, B. W., & Eyberg, S. (2011). Parent–Child Interaction Therapy. 22.

  • Hoffmann, J. D. (2016). Intervening without interfering: Supporting the imaginative play of elementary school girls. The International Journal of Creativity & Problem Solving, 26(1), 85–105.

    Google Scholar 

  • Hoffmann, J., & Russ, S. (2012). Pretend play, creativity, and emotion regulation in children. Psychology of Aesthetics Creativity and the Arts, 6(2), 175–184. https://doi.org/10.1037/a0026299

    Article  Google Scholar 

  • Holland, A., Whittington, J., & Hinton, E. (2003). The paradox of Prader-Willi syndrome: A genetic model of starvation. THE LANCET, 362, 4.

    Article  Google Scholar 

  • Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611–620. https://doi.org/10.1111/j.1469-7610.2005.01567.x

    Article  PubMed  Google Scholar 

  • Lang, R., O’Reilly, M., Rispoli, M., Shogren, K., & Machalicek, W. (2009). Review of Interventions to Increase Functional and Symbolic Play in Children with Autism. 13.

  • Lifter, K., & Bloom, L. (1989). Object knowledge and the emergence of language. Infant Behavior and Development, 12(4), 395–423.

  • Lifter, K., Foster-Sanda, S., Arzamarski, C., Briesch, J., & McClure, E. (2011). Overview of play: Its uses and importance in early intervention/early childhood special education. Infants & Young Children, 24(3), 225–245.

  • Lillard, A. S. (1993). Pretend play skills and the child’s theory of mind. Child development, 64(2), 348–371.

  • Lionti, T., Reid, S. M., White, S. M., & Rowell, M. M. (2015). A population‐based profile of 160 Australians with Prader‐Willi syndrome: Trends in diagnosis, birth prevalence and birth characteristics. American Journal of Medical Genetics Part A, 167(2), 371–378.

  • Meehl, P. E., & Rosen, A. (1955). Antecedent probability and the efficiency of psychometric signs, patterns, or cutting scores. Psychological bulletin, 52(3), 194.

  • Malone, M. (2009). Patterns of home- and classroom-based toy play of preschoolers with and without intellectual disabilities. International Journal of Disability Development and Education, 56(4), 333–347.

    Article  Google Scholar 

  • Matthews, W. S. (1977). Modes of transformation in the initiation of fantasy play. Developmental Psychology, 13(3), 212.

  • Moore, M., & Russ, S. W. (2006). Pretend Play as a Resource for Children: Implications for Pediatricians and Health Professionals. 27(3), 12.

  • Moore, M., & Russ, S. W. (2008). Follow-up of a pretend play intervention: Effects on play, creativity, and emotional processes in children. Creativity Research Journal, 20(4), 427–436.

    Article  Google Scholar 

  • Power, T. J., & Radcliffe, J. (1989). The relationship of play behavior to cognitive ability in developmentally disabled preschoolers. Journal of Autism and Developmental Disorders, Vol. 19, 97–107. https://doi.org/10.1007/BF02212721

    Article  Google Scholar 

  • Riguet, C. B., Taylor, N. D., Benaroya, S., & Klein, L. S. (1981). Symbolic play in autistic, down’s, and normal children of equivalent mental age. Journal of Autism and Developmental Disorders, Vol. 11, 439–448. https://doi.org/10.1007/BF01531618

    Article  Google Scholar 

  • Russ, S. W. (2014). Pretend play in childhood: Foundation of adult creativity. American Psychological Association.

  • Russ, S. W. (2004). Play in Child Development and Psychotherapy: Toward Empirically Supported Practice. Routledge.

  • Trawick-Smith, J., & Dziurgot, T. (2011). Good-fit’ teacher–child play interactions and the subsequent autonomous play of preschool children. Early Childhood Research Quarterly, 26(1), 110–123. https://doi.org/10.1016/j.ecresq.2010.04.005

    Article  Google Scholar 

  • Vetter, J. A. (2018). Parent-child Interaction Therapy for Autism Spectrum and Attention-Deficit/Hyperactivity Disorders: A review of the literature. Child and Family Behavior Therapy, 40(3), 204–232. https://doi.org/10.1080/07317107.2018.1487740. Scopus.

    Article  Google Scholar 

  • Wallace, C. E., & Russ, S. W. (2015). Pretend play, divergent thinking, and math achievement in girls: A longitudinal study. Psychology of Aesthetics, Creativity, and the Arts, 9(3), 296.

  • Whittington, J., & Holland, A. (2017). Cognition in people with Prader-Willi syndrome: Insights into genetic influences on cognitive and social development. Neuroscience & Biobehavioral Reviews, 72, 153–167. https://doi.org/10.1016/j.neubiorev.2016.09.013

    Article  Google Scholar 

  • Zyga, O., Russ, S., Ievers-Landis, C. E., & Dimitropoulos, A. (2015). Assessment of pretend play in Prader–Willi Syndrome: A direct comparison to Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45(4), 975–987. https://doi.org/10.1007/s10803-014-2252-1

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Thank you to the Foundation for Prader-Willi Syndrome Research and the Prader-Willi Syndrome Association for their support of this work and to all the families who participated in the PRETEND program, without whom this research would not be possible. We would also like to thank lab members who assisted with the project: Ellen Doernberg, Morgan Hyun, Katelyn Furgason, Molly Easly, Michelle Chu, Lydia Dorr, Sophia Lee, Toyin Olabode, and Benjamin Kruger.

Author information

Authors and Affiliations

  1. Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road, Cleveland, OH, 44106, USA

    Rachel A. Gordon, Sandra W. Russ & Anastasia Dimitropoulos

Authors
  1. Rachel A. Gordon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sandra W. Russ
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anastasia Dimitropoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Data collection and analysis was performed by Rachel A. Gordon. The first draft of the manuscript was written by Rachel A. Gordon and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rachel A. Gordon.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments. The study was approved by the Institutional Review Board of Case Western Reserve University.

Informed Consent

Informed consent was obtained from the parents/guardians for the study.

Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gordon, R.A., Russ, S.W. & Dimitropoulos, A. Examining Effective Intervention Strategies in a Play-Based Program for Children with Prader-Willi Syndrome. J Dev Phys Disabil 36, 511–533 (2024). https://doi.org/10.1007/s10882-023-09920-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10882-023-09920-w

Keywords

Search

Navigation