ARTICLE: The Playful Relationship by Debby Watson

Father playing with daughter on sofa

People with profound impairments are not often discussed in terms of their playfulness. In fact, I’m still shocked by how few books and articles in this area even mention play, as I believe play is an important key to enriching the life of someone who has few means of expressing themselves and unlocking their character, strengths and preferences. I have come to this conclusion following a long relationship with children with profound impairments, both in residential social work and research, which a few years ago left me feeling a bit jaded. We seemed to be finding out a lot about what was wrong with services and the struggles that families had. Although these are important aspects, I wanted to do research with a positive slant, something that could potentially go some way to improving the lives of profoundly disabled children.

A ‘tipping point’ for me occurred when I was co-researching with some young disabled people and one of them expressed surprise that a non-verbal child who we were observing was playing very joyful tricks on his teaching assistant. It seemed very sad that even other young disabled people were surprised by playfulness and when I was offered the chance to carry out funded, doctoral research, it didn’t take long to work out what my subject would be. By studying how to encourage playfulness, I also hoped to find out how important play is for people with profound impairments and the people around them. Although playfulness is hard to define, it is easily recognised and can be  a reasonably straightforward ‘way in’ to interacting with people who may seem closed off from the world. By focussing on such a positive aspect of children’s lives, I hoped for positive outcomes!

In this blog, I will briefly focus on three aspects that I believe are important when thinking about encouraging playfulness:

  • Observation
  • Attitudes
  • Environment  


Observation was the methodology that was open to me with this group of children and it also was a key way for myself and others to really understand a child’s playfulness. I devised an observation schedule which I used to take minute-by-minute notes of: time, context, communication and appearance, posture, mannerisms, influence and activity. Although challenging and not attempted for longer than an hour at a time, these observations bore some precious fruit in that they allowed me to focus entirely on the child: what made the child ‘light up’, what the people around them were doing when this happened and what the child looked like when they were playful. These discoveries were really important when I was considering the differences and similarities between what I was told about a child and what they actually did. For example, I was told that one child was not interested in interacting with other children and yet my observations showed that he actually took great pains to move towards particular children. Several adult professional and family participants told me that they would like to have more time to observe children but that other constraints got in the way of this. The Play Passport that I developed with families and professionals over the course of the research could be a possible short cut to understanding a child’s playfulness if it has been thoughtfully completed by someone who knows the child well. The Play Passport can be downloaded here.


It became clear that playfulness is almost entirely developed within a relationship with others This is crucial for people with profound impairments who are so dependent on others. Although it was evident that children with profound impairments are playful, and playful for a considerable amount of their time, the greater need for support is where children with profound impairments differ from non-disabled children. I initially had some very naïve thoughts about how profoundly disabled children, if left alone to play and not interfered with all the time, would somehow become involved in playful activities without adult intervention. This may be true for non-disabled children but children with profound impairments really need support and encouragement within a trusting relationship in order to express playfulness. The type of support needed may be practical or emotional. However, if the willingness or opportunity to see disabled children as playful is not there, they may lead very impoverished lives as a result.

My research showed that levels of playfulness varied considerably between home and school for some of the children. This clearly wasn’t to do with their impairment, but to do with the people around them. Interestingly, where communication and relationships between different settings was good, then the levels of playfulness were much more consistent, showing that differences were not inevitable. 

In order to engage a child in playful activities, a great deal of effort has to be made but the rewards are considerable and the process equally valuable. My research showed that the person interacting does not need to have any special training or qualifications, but does need perseverance, flexibility, authenticity, creativity and the willingness to be silly! Having said this, some participants also thought it was useful to have some idea of developmental psychology and play pedagogy, in order to overcome some ‘brick walls’ and have appropriate expectations about play. For example, some children may not be at the developmental stage to be able to engage in play with peers and effort may be better placed in encouraging one-to-one playful activities with an adult or older child. It became clear in the research that the more actively involved the child was in playful activities (see ‘Categories of Playful Activities Below’), the more ‘strengths’ such as the ability to make choices the child showed. It may be a bold claim, but I believe that without the starting point of positive attitudes, these higher levels of engagement in active play and subsequent strengths may be less likely to occur.


The environment, both emotional and physical is really important in order for playfulness to thrive. A participant summed this up nicely when she said:

‘It is an environmental context which is absolutely crucial. If we don’t give people permission, if we don’t say, ‘it’s alright’. If the culture says, you know, ‘you’re being silly, stop it’. So whether you’ve got that is important. It’s inherent in all the disability stuff that you’ve got this mixture of what the person brings and what the environment brings. I think that’s the same for playfulness as well. You could have the most playful person in the world, but in the wrong environment it doesn’t come out and vice versa. So you can bring out playfulness in people who aren’t very playful by putting them in the right contexts.’

A conducive emotional environment may involve reducing anxiety in the child by explaining what is happening, tuning into their mood and making sure that practical and medical issues are taken care of, so that the emotional ‘space’ for playfulness is there – easier said than done! However difficult, by knowing a child well and actively encouraging playfulness, a conducive emotional environment may reap rewards for all concerned. A joyful interaction, even if brief, can mean so much to those involved and can be the launch pad to all kinds of other ‘breakthrough’ moments.

The participants in the research that I carried out had several things to say about the physical environment and its ability to encourage playfulness:

  • Attention needs to be paid to positioning so that good eye contact can be maintained and the child is comfortable
  • The child needs to have some control over their environment (for example, being able to reach out to other children or to a toy/ipad, etc.)
  • The use of natural objects and outdoor spaces can be very rewarding
  • Adaptation to scale may be needed, so that a small area such as a cardboard box could be adapted for the child to lie in
  • If a child seems to respond well to an area or activity, go there often to see what happens
  • The environment should neither be overly structured or too chaotic, a happy medium is needed in order to be flexible
  • Attention needs to be paid to sensory issues such as light, heat and noise and can be enhanced with water, lights, music, smells, etc.
  • It may be useful to make different areas to move between that create different ‘moods’
  • Some physical preparation for play may be needed such as massaging of hands or feet

In addition, several participants talked of the value of having a ‘mixed’ environment, where more physically able children are able to model play and interact with those who are less able to move around.

In summary, playfulness may not be very obvious in children with profound impairments, but it is clearly observable in virtually all children when the time is taken to really look. It may be fleeting, it may fluctuate and it may be difficult to describe, but once seen, the joy of playfulness is never forgotten! I hope that this has given you an appetite to focus on the potential of playfulness to transform relationships with children and adults with profound impairments. Happy playing!

Dr Debby Watson, PhD

The themes of disability and play have followed me throughout my working life. My first job after qualifying as a social worker was with disabled children in a residential setting, followed by work with adults with dementia. I later became a research fellow at the Norah Fry Centre for Disability Studies, working mostly on projects involving disabled children, their families and carers. In 2014 I completed a doctoral study on playfulness and children with PMLD at the University of Bristol, developing a Play Passport for people with PMLD. I now work on a freelance basis and am semi-retired. Playfulness remains a major part of my life as I volunteer with a charity that provides a play site for disabled children in Gloucestershire and I have two young grandchildren. I can be contacted by email: [email protected] 

Download a pdf of The Play Passport


Categories of Playful Activities for Children with PMLD

‘Active’ items

  1. The child is actively touching or feeling something, maybe with support from an adult
  2. The child is involved physically in an activity by, for example, bouncing on a trampoline, going on a swing or going down a slide
  3. Joking/humour/slapstick. The child is deliberately being funny by, for example, dropping something or making funny faces
  4. The child is engaged with something in an ‘appropriate’ way, i.e. they are using an iPad or sending balls down a chute
  5. Making a sound. The child is either operating a device or musical instrument or making sounds by banging or using voice
  6. Interaction with adult. The child is actively engaged in an interaction, either verbal or physical, with an adult
  7. Interaction with other child/ren. The child is actively engaged in an interaction, either verbal or physical, with sibling/s, a child or children
  8. Interaction with adult/s and child/ren. The child is actively engaged in an interaction, either verbal or physical, with adult/s and child/ren
  9. Anticipation of event/game/activity. The child is excited/aroused by the anticipation of something that is about to happen

‘Passive’ items

  1. Sensory experience. The child is being supported to touch, smell or feel something
  2. The child is being cuddled, stroked, massaged or moved to a new position
  3. Joking/humour/slapstick. The child is watching or has observed something funny
  4. The child is listening to something that they do not have control of
  5. Watching/looking (at object, toy, TV, iPad, etc.). The child is watching or looking at something, without exploring it physically
  6. Watching/looking at adult/s. The child is watching or looking at adult/s but is not actively engaged with them
  7. Watching/looking at children. The child is watching or looking at child/ren but is not actively engaged with them
  8. Watching/looking at adult/s and child/ren. The child is watching or looking at adult/s and child/ren but is not actively engaged with them

‘Neutral’ item

Unknown stimulus. It is not clear what is exciting/arousing the child

 Debby’s Publications

D Watson (2020) Crossing the wobbly bridge: an inclusive approach to researching playfulness and children with PMLD in Belonging for individuals with Profound and Multiple Learning Difficulties: Pushing the boundaries of inclusion Nind, M. and Strnadova, I. (eds) London: Routledge

D Watson, A Jones, H Potter (2018) Expressive Eyebrows and Beautiful Bubbles: Playfulness and Children with Profound Impairments. The Palgrave Handbook of Disabled Children’s Childhood Studies, pp177-190 Edited by K. Runswick-Cole, T. Curran and K. Liddiard. Palgrave: London

D Watson (2015) ‘Go-getters’ and ‘clever little cookies’: a multi-method study of playfulness in children with profound and multiple learning disabilities (PMLD) Thesis: University of Bristol

D Watson (2015) Turning to playfulness: findings from a study on playfulness and children with profound impairments. The SLD Experience 73 (1),18-23

D Watson, M Corke (2015) Supporting playfulness in learners with SLD/PMLD. The Routledge Companion to Severe, Profound and Multiple Learning Difficulties edited by Penny Lacey, Rob Ashdown, Phyllis Jones, Hazel Lawson, Michele Pipe. London: Routledge

Watson, D. (2015) Playfulness and children with profound impairments: Lighting the fire! Special, July 2015

Watson, D. (2015) ‘Go-getters’ and ‘clever little cookies’: findings from a multi-method study on playfulness and children with PMLD. PMLD Link Vol 26 Issue 79 pp 7-9

Watson, D. (2013) Playfulness and children with PMLD: Going beyond the statutory to reach the child. PMLD Link 25 (2) Issue 75 pp. 8-9