This Podcast is brought to you by the GOSH Learning Academy.
SA: Hello and welcome to a brand new series on GOSHpods - PlayPods. The play team are an indispensable part of the MDT at both Great Ormond Street Hospital and in children's wards across the country. We're very lucky at GOSH that we have a play team that's been around for almost 50 years and is entirely funded by the GOSH charity. Play is vital for promoting wellbeing in babies, children, young people, and their families. It offers a safe outlet for big emotions, a space to feel grounded and it can act as a means of understanding and navigating the complicated and scary world of healthcare.
In this four episode series we're going to explore the power of play and the role of the play team at Great Ormond Street Hospital.
I'm Dr. Sarah Ahmed, a paediatric registrar, and the current digital learning education fellow here at GOSH, and in every episode I'll be talking to members of the play team.
In today's episode, we're going to be talking about normalizing and developmental play.
SA: Hello everyone. It's wonderful to have you all here with me today. I'm really excited for our conversation. Can we possibly start with a round of introductions? So who wants to go first?
CM: I'll go first. My name is Claudia and I'm a health play specialist on Caterpillar outpatients.
AC: Hello, I'm Amy. I'm a play worker on Fox and Robin World.
JA: Hey, I'm Jodie. I'm the Playworker on Squirrel Ward.
SA: Oh, it's wonderful to have you all here today. So we normally start with these podcasts with some learning outcomes. So what would you like people to get out of listening to today's podcast?
CM: I think that at the end of this podcast, what we want people to take away is an understanding of what normalizing and developmental play is and its benefits for the child, young people and their families. Also to extend people's understanding of how we deliver normalizing and developmental play within our roles.
SA: Amazing. So like you said, this is all about normalizing and developmental play, which are terms that I suspect people aren't too familiar with. So what is normalizing and developmental play?
AC: So the normalizing play is providing children and young people with familiar play resources such as games and arts and crafts. Normalizing play provides a sense of normality and safety for children and young people whilst in hospital. It can make the hospital feel less scary and more like home.
Developmental play is about planning and providing activities for children and young people to help them reach targets and milestones. We often work together with physios and OTs to use play to help children reach their targets. Due to being in hospital, our children and young people are often working towards their own goals rather than focusing on expected milestones.
SA: Fantastic. That all sounds really interesting and so important as well. And just an aspect of your role in the play team that I didn't really understand before we started doing this. Can you tell us a little bit more, maybe provide us with some examples of normalizing and developmental play?
JA: So you might think that play in hospital is limited. There are a few, but within reason we can provide a huge variety of activities. This could be anything from messy play, cooking, sensory play, crafts, or playing with small world figures. I could talk probably for hours about the things that we get up to in the hospital, but here are a few of our favourite examples.
AC: Tie dye is such a popular activity, it's simple and effective. Our young people enjoy to tie dye because it's fun and it allows them to be creative. We can tie dye all sorts of things, like socks, t shirts and pillowcases. One of my patients turned a pin case into a bandana. She really was proud of this and she loved showing all the staff.
CM: Another, you know, activity is board games. And I had a patient on my ward who was quite reluctant to engage with play to start with, but at some point he accepted to play and he chose to play Monopoly. So his father, who was with him, played with us too. And we would sometimes play the same game over and over for days because Monopoly can be a quite long game. So after, after a while, you know, this young person wanted to play board games from his home country, which was Nigeria. So, so his dad went to a Nigerian shop and he brought some games that are played in Nigeria such as Whot! which is a game, a game cards like UNO, and Ayo, which is like a new strategic game. So bringing this familiar activity into an unfamiliar world helped to reduce his anxiety and also aiding with relaxation. But most of all, it improved our communication and our relationship developed so much through play.
JA: Talking of board games, I had a young person recently who was amazing at IT, but he also loved board games. So having been inspired by a colleague who made a renal version of Dobble, we decided to make Squabble. This was a Dobble based on Squirrel Ward. So the cards had items like bedpans, masks and even a little poo emoji because we're a gastro ward. This project opened up a space to talk to this young person and it just really tapped into his specific interests. It actually kept us busy for weeks, it was great.
SA: That sounds fantastic.
JA: And then thinking about developmental play, up on Squirrel Ward I do lots of work with babies. If it's medically safe to my mission and my ultimate goal is to get those babies out of bed as much as possible. We want to provide them with opportunities that are similar to what they'd have at home, so that means tummy time, learning to sit up, and showing parents that despite all these medical devices, we can still play. Developmental play can be about parental empowerment and supporting their attachment during what can be a really difficult time. It is very special when a baby takes their first steps or they sit up for the first time at the hospital and we can be part of that.
SA: That’s wonderful.
AC: One of the most popular activities in the hospital is syringe painting. My patients have to be isolated in their rooms so when we did syringe painting, we had to use a bed sheet to cover the walls. I reminded the young person to be careful of the white walls, but as soon as I said that, she did it with such force, she had the paint everywhere. She found this hilarious and it was lovely to see her relax and enjoy herself.
JA: Now, if you've ever stayed on my ward, you'll know that one of my favourite things is to get children and families out to the park. I have to say, not all of the children and young people here can leave the hospital, but when they are well enough, we make a huge effort to get them outside as much as we can. We've got a really nice park near the hospital and it's quite a good sneaky way of getting children to do their physio activities. I've seen a lot of children and young people reach goals that they didn't think they could at the park and do things that they used to do that like when they were at home.
I recently had a young person who thought that she couldn't climb the slide. She'd kind of lost a lot of her confidence recently since she'd been unwell, but I said to her, if I've been down that slide before, you definitely can. So together we did. And she was so proud of herself and it was lovely to see and when we got back to the hospital, we told her mom and she was just in tears because she also didn't really realize that she was going to be able to get back to those activities that she used to be able to do. So that was a really special moment.
CM: I have another example. So, I was doing my apprenticeship, I had a patient who loved arts and craft and she decorated her whole cubicle with her artwork. It was everywhere, every wall. She said to me that it looked so nice she didn't want to go home anymore. And her mom said, please don't say that.
SA: Oh, it's so wonderful hearing all of your stories and it just sounds so, so empowering. So sometimes you might have kids who are a bit older, a bit younger, who might have learning difficulties. How do you adapt what you're doing for each individual child?
JA: So as we've probably mentioned, we have children and young people all the way from zero to 18 years old in the hospital. So that means we've got to be super flexible and always adapting our sessions. We don't always know much about children when they arrive, so we tend to focus on information gathering. So when we first meet a child or young person, we're trying to seek out things like, what are they interested in? What ability are they working at? If a patient's non verbal, we might use their main carer to help kind of get to know them a bit better. Or that child might use their preferred communication tool, such as a choosing board, to show us their play preferences.
All of our sessions are child led, so despite their age, gender, or ability, we encourage the child to tell us what they enjoy, and we provide sessions based on this, as best we can, anyway. Many patients at Great Ormond Street Hospital will have additional needs. This could be a learning disability, a visual or hearing impairment, or a combination of these, and this is referred to as a multisensory impairment. This shouldn't be a barrier to play, though. We take time to find out what they enjoy at home, and we adapt accordingly. If a child has a specific need, such as a visual impairment, our play might take form of sensory play. So we might explore different objects, we might do singing. I can't promise it's good singing, but we'll do singing. Or engage in sensory stories. My favourite sensory story is “We're Going On A Bear Hunt”. So throughout that story, each different part has a sensory element to it. So I'm sure you all know that story well. So if you think about the swishy swashy grass, we use a green pom pom for that. I've got a little spray bottle for the water. And then my favourite part is using chocolate frosting for the squelchy mud.
We've also got some specialist resources around the hospital like switch operated toys. The bubble machine on my ward is definitely a favourite.
CM: In the international and private care department, we might face a language barrier but you'd be surprised how play seems to have its own language and the child or a young person can still engage with play. An example is that we can play games that require very little spoken language like, for example, Connect 4, Jenga, UNO. So during these games like, we might use a lot of body language and facial expressions to communicate the rules and and everything.
SA: It really does sound like play is just completely universal. So you talked a little bit earlier about working closely with physios and OTs. Can you tell us a little bit more about who the play team works with and what some of the wider benefits are of this kind of normalizing and developmental play?
CM: Yeah, you know, GOSH is a big place, we don't work as an isolated team. We work closely with OTs, with nurses, physios, music therapists, psychologists, speech and language therapists, and also the school. We, we have weekly psychosocial and goal setting meetings where we can identify specific areas of the patient's need, so we can work together to to aid their recovery process with the help of play. So collaborative working can reduce a child's fears and increase their engagement with services.
SA: I think the work that the play team does is so important, but you can't be everywhere all the time. Are there any ways that other professionals can incorporate some of these aspects that we've been talking about to help them with their patients?
AC: Play is a language children and young people understand, so all staff can use this to help build a relationship with them. Taking the time just to get to know their hobbies or interests might be a really good way to make a more friendly environment and show the child or young person that you want to get to know them as a person, not just a patient.
By just saying, I love your Paw Patrol blanket can straight away make you seem less scary.
SA: I really hope that people who can listen to this can take away some of what you've been talking about. So just to summarize everything that we've been talking about, what would be your takeaway learning points?
CM: I think that what we hope you can take away from today's chat is, is that play has a major role in helping children and young people during their admissions. And that play can help them have the best possible experience in, in an environment that can be challenging. You know, play is always possible.
SA: I think that's a really lovely sentiment to end on, that play is always possible. Amy, Claudia, Jodie, thank you so very much for talking with me today.
CM: Thank you, Sarah.
JA: Thanks.
AC: Thanks.
SA: Thank you for listening to this episode of GOSHpods PlayPods. You can find out more about the play team at their Instagram page @GOSHPlayTeam. We would love to get your feedback on the podcast and any ideas you may have for future episodes. You can find a link to the feedback page in the episode description or email us at
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We hope you enjoy this episode and we'll see you next time. Goodbye.
