classification of toys : in a library for children with mental handicaps

MENTAL HANDICAP VOL. 12 DECEMBER 1984

CLASSIFICATION OF TOYS

in a library for children with mental handicaps

Charlotte Green Penny Bebbington

SUMMARY. This article describes and evaluates a flexible system for cataloguing toys in a community based toy library for children with mental handicaps. The toys are allocated into eight major categories according to psychological function.

Introduction The Psychology Department at the Manor Hospital, Epsom

undertook to set up a toy library as part of a developing community service for disadvantaged children living at home, whose mental handicaps ranged from a mild to a severe degree. The toys were to be used in parental home teaching programmes under the guidance of either specialist community nurses or psychologists. Therefore, neither the children nor the parents selected the toys, but people with appropriate professional backgrounds who were familiar with a system in which toys were catalogued according to psychological function.

The logic behind the scheme The rationale behind the system is that toys should be

classified according to the cognitive function that they develop, rather than according to their superficial content. The toy library is therefore arranged quite differently from most toy catalogues, where items are classified according to age or superficial content. It was considered that selecting toys for children with mental handicaps using age as a guide was misleading and possibly depressing. What was needed was guidance, not in terms of age but in terms of difficulty.

The method behind the scheme Starting with the basic idea that the system should be based on

psychological function, the main categories had to be decided. These are: primary sensory stimulation, communication and expression, construction, and discrimination. (Some major areas, such as financial and spatial constraints had to be omitted because of mobility.) Each category is given its own colour to aid the location of toys within the category both in the cupboard and in the card index. In addition to being numerically coded, each toy and each toy card is colour labelled. All that has to be done when a toy is borrowed, is to sign and date the appropriate card and transfer it from the index box to another box. When the toy is returned, this is marked on the card and the card and toy are put back.

The main categories chosen were so large it was necessary to subdivide them according to psychological functions. For example, discrimination was split into visual and non-visual areas. The visual area was further divided according to whether the discrimination was by shape, size, or colour; and then the non-visual according to whether the discrimination was auditory, tactile, kinaesthetic, or mixed.

To continue with the example of visual discrimination by shape, size, or colour, which in terms of play largely means matching or sorting, a four column coding system was introduced, so that toys serving a common psychological function could be grouped together, and also so that the psychological differences between toys could be readily appreciated.

Continuing visual discrimination as an example, the four column coding operates as follows: Column 1: defines the toy within the category of visual discrimination

by shape, size, or colour; Column 2: refers to the prime purpose of the toy and defines whether it

is primarily for matching or for sorting; Column 3: refers to whether the matching and/or sorting is based

predominantly on colour or shape; Column 4: identifies each toy.

The essentials of this method have been applied to all toys in the library. The scheme is given in detail, so that those who want to do so can use it.

Evaluation of the scheme The scheme is not intended to be a definitive fixed system but

cah be adapted according to need. As it stands, it is heavily loaded towards discrimination. Should this cease to suit the library the catalogue would have to be expanded to include, perhaps, new categories in the area of ability. It is quite likely that toy libraries serving people with mainly one type of handicap, such as visual handicap or cerebral palsy, would want to specialise in certain categories of toys and would therefore need to refine the coding system for those areas.

There is a danger that the coding system could become so refined that it would be difficult to understand. Even as it is presented here, many non-psychologist professionals prefer to have the system explained to them. As a result much potential cross-referencing has been avoided to reduce possible confusion, but anyone who wished to develop cross-referencing could easily build this in through colour coding.

The scheme has been found most useful in guiding the professional workers using the library to clarify their goals, hence fulfilling a useful training function. Furthermore, the logic of the scheme has also had a most beneficial effect upon the organisation of the toy cupboards themselves, through imposing a structure.

Another advantage is that the coding system enables an at a glance check to find out which categories are short of toys. Funds can then be spent in a rational manner and, if sufficient, can enable the toy library to add a new area, the cataloguing scheme being flexible enough to accommodate it.

Acknowledgement

Psychologist, for her help and advice. Thanks are expressed to Ms. Jean Robertson, Top Grade

CHARLOTTE GREEN and PENNY BEBBINGTON are Clinical Psychologists based at the Manor Hospital, Epsom, and working for Mid-Surrey Health Authority.

146 @ 1984 British Institute of Mental Handicap


Cataloguing scheme

PRIMARY SENSORY STIMULATION - colour code orange Column 1: is always 0 and defines the toy as involving primary sensory stimulation. Column 2: refers to the primary mode of stimulation -

1 = visual stimulation 2 = tactile stimulation 3 = auditorystimulation 4 = stimulation towards mobility 5 = toys where specific actions have built-in reinforcement in one or more of the above modes 6 = toys providing stimulation in several of the above categories.

Column 3: identifies each toy.

Examples TOY Easigrip ball Multicoloured cloth ball with bell inside

CODING 02A* MD**

*The Easigrip ball has A as its identification letter as it is the first toy in the category 02. **The multicoloured cloth ball has D as its identification letter as it is the fourth toy in the category 06.

COMMUNICATION AND EXPRESSION - colour code green Column 1: Column 2:

is always 1 and defines the toy as primarily for developing symbolic processes. refers to the main purpose of the book (if it is one): 0 = toys (expanded in next column) 1 = books with clear pictures of everyday objects 2 = books with clear pictures of everyday experiences that the child will be able to understand verbally and later to talk about himself 3 = books where the child participates by matching actions to verbal content 4 = books illustrating basic concepts such as size and shape 5 = books specifically planned for learning programmes based on perception, memory, and sequencing. refers to toys stimulating symbolic processes through the understanding and expression of language and through the manipulation of ideas in specific situations: 0 = abook 1 = toys stimulating the understanding and expression of language 2 = toys stimulating the manipulation of ideas in specific situations.

Column 3:


Examples TOY Hand puppet Dolls’ house and furniture

EYE-HAND COORDINATION - colour code white Column 1: Column 2:

is always 2 and defines the toy as being primarily useful for the development of coordination. refers to the main movement ability involved in the use of the toy: 1 = fitting 2 = stacking 3 = threading 4 = screwing, turning, and wrist movements 5 = hammering 6 = toys combining several of the above abilities.


Examples TOY Hammer and pegs Screwing rod

CODING lOlE 102B

CODING 25A 24G

CONSTRUCTION - colour code white

Column 1: Column 2:

Toys in this section involve eye-hand coordination as well as providing opportunities for the child to make creative associations. is always 3 and defines the toy’s major use as construction. refers to how far the child is free to develop his own plans (unstructured toys) or how far the child has to follow a pre-determined plan (structured toys): 1 = unstructured toys

refers to ease of connection, for example, putting two parts together: 1 = toys where the parts need to be put on top of, or alongside, each other, for example, wooden blocks 2 = toys where the parts need to be pushed together with a gross motor movement, for example, Sucklebricks 3 = toys where the parts need to be pushed together with a precise movement, for example, Leg0 and Duplo 4 = toys involving the screwing or fUring together of parts which may look very different.

2 = StNCtWed toys. Column 3:


Examples TOY Assorted bricks Leg0

CODING 311B 313D

@ 1984 British institute of Mental Handicap 1 47


DISCRIMINATION The ability to comDare and contrast underlies much of cognition. There is, therefore, a very wide range of toys in this section which

has been diiided into visual and non-visual categories.

VISUAL (by shape, size, andor colour) - colour code yellow

difficult items like snap, lotto, and dominoes. Sorting toys, insets, and jigsaws also come within this category. Visual matching and sorting

Column 1: Column 2:

In practice this often means discrimination by picture or pattern and involves matching toys which are very simple, and more

is always 4 and defines the toy as for matching or sorting. refers to the prime purpose of the toy, that is, matching or sorting: 1 = primarilyamatching toy 2 = primarily a sorting toy 3 = could be used equally well for either. refers to whether the matching and/or sorting includes colour or shape: 1 = colour 2 = shape 3 = could be used equally well for either.

Column 3:

Column 4: identities each toy.

Examples TOY Colour matching balloon game - - Postbox Picture dominoes

CODING 41 1C 422F 413A

Insets

While there is some developmental overlap between insets and jigsaws, insets are usually introduced fwst.

Column 1: is always 5 and defines the toy as an inset. Column 2: refers to knobs:

1 = noknob 2 = smallknobs 3 = big knobs.

refers to how the pieces are arranged in the tray: 1 = discrete or separate pieces 2 = adjacent or touching pieces 3 = interlocking pieces.

Insets are like jigsaws in many ways ut differ in that (1) the pieces fit into a tray or frame which is part of the toy; and (2) t pieces do not usually interlock.

Column 3:

Column 4: identifies each toy. Examples TOY CODING Bear picture: 6 adjacent pieces with no knobs Assorted vehicles: 11 separate pieces with small knobs

512A 521D

Jig=” Thm type of toy probably covers the widest developmental range.

Column 1: Column 2:

is always 6 and defines the toy as a jigsaw. refers to the number of pieces: 1 = 1-6 pieces 2 = 7-13 pieces 3 = 14-20 pieces. refers to the size of the pieces: 1 = large 2 = medium 3 = small.

Column 3:


Examples TOY Sunflower jigsaw: 4 medium pieces Farmyard floor jigsaw: 16 large pieces

CODING 612E 631A

Numbers and letters

other categories. This section features toys and games that can be used to teach formal aspects of numbers and letters. Column 1: is always 7 and defines the toy as for teaching the formal aspects of numbers and letters. Column 2: refers to the precise purpose of the toy:

1 = numbers 2 = letters 3 = mixed numbers and letters. refers to the degree of difficulty: 1 = toys or games involving single letters or numbers 1-20 2 = toys or games where letters are combined to form small words and numbers are manipulated.

Most children have some understanding of quantity long before they are ready to learn what numbers represent. Toys for the former purpose can be found in

Column 3:


Examples TOY CODING Number jigsaw: numbers link with objects, 20 pieces Picture word dominoes: match the object to the word

711D 722B

1 48 @ 1984 British Institute of Mental Handicap


NON-VISUAL (auditory, tactile, kinaesthetic, mixed)

Column 1: is always 8. Column 2:

Toy libraries serving clients with sensory handicaps will need to develop a more sophisticated coding for this section.

refers to the mode of stimulation: 1 = auditory 2 = tactile 3 = kinaesthetic 4 = where the mode of stimulation is mixed. refers to the potential number of comparisons: 1 = up to 2 comparisons 2 = 3 - 5 comparisons.

Column 3:

Column 4: identifies each toy. Example TOY Xylophone Sand letters

CODING 812G 832C

Nocturnal enuresis in hosnital: -~

I- -.- -~~ - some cost and training considerations

Extent of the problem This study is based on information gained from a mental

handicap hospital in the north of England during 1982/83. Of 262 men, women, and children resident in the hospital, 57 were described as frequently nocturnally enuretic, and 43 as occasionally nocturnally enuretic (standardised ward assessments).

Staggeringly, therefore, more than one person in five resident in the hospital (21.7 per cent) frequently wet the bed, or would have done so were it not for the practice of “padding” with commercial incontinence pads. Some 40 residents were “padded” each night.

Equally staggering is the fact that over 38 per cent of residents suffered the inconvenience, and personal and social embarrassment, of bedwetting to varing degrees.

Some training considerations In this article “training considerations” refers to employing

training programmes designed to teach nocturnal continence, using existing staff resources.

Of the 57 people described as frequently nocturnally enuretic, 25 were non-ambulant and also frequently diurnally enuretic. While at least some could use commodes and bed pans with help, any training programme would require intensive staff input. The whole of this group was therefore exdudect from initial consideration for night time continence programmes.

This left 32 of the people described as frequently nocturnally enuretic (12.2 per cent of the total population), who could be considered trainable, by virtue of being ambulant andor having demonstrated bladder control during the day, as well as the 43 people who had been described as occasionally nocturnally enuretic.

On this basis, 75 per cent of the people originally described as frequently or occasionally nocturnally enuretic, were considered to be capable of attaining nocturnal continence.

Details of proven approaches to achieve this aim are beyond the scope of this study, but may still be described briefly. Firstly, it is worth commenting on primary and secondary nocturnal enuresis. The distinction is between a primary case of nocturnal enuresis, where control of nocturnal micturition has never been demonstrated, and one of secondary nocturnal enuresis, where nocturnal continence has been demonstrated, usually for at least six months, prior to the onset of regular bedwetting.

While such a distinction has, perhaps, less validity when applied to a group of people with mental handicap who have been institutionalised it is still seen by many workers in mental

Kevin Kitching

handicap as a useful indicator of the outcome of a training programme. This belief, however, is not borne out in practice. “Primary” and “secondary” nocturnal enuresis seem to be examples of the need to use diagnostic terminology, but to date these terms have not been proved to have any prognostic validity (Doleys, 1977).

The most widespread “clinical procedure” used with people who are severely and profoundly mentally handicapped and nocturnally enuretic is the use of the “bell and pad” method. This consists of placing electrodes (usually carefully fashioned metallic gauze pads) in the bed. The passage of urine completes a weak electric circuit between the pads, causing an alarm to sound and alerting trainer and trainee to the fact that micturition has taken place. Readers interested in the learning processes involved in this procedure, which have been the subject of some argument since 1938 when Mowrer and Mowrer first described its use, would do well to read Doleys (1977). Those more interested in the “how” of the procedure, and some interesting points about prevention of relapse, would do well to read Smith (1981).

Other approaches have included “Dry bed training”, an intensive approach with several component elements (see Azrin, Sneed, and FOXX, 1974; Bollard and Nettlebeck, 19811.

An approach with which many night nurses in mental handicap hospitals will identify was described by Philip Barker in 1979. This basically involved identifying a patient’s “peak wetting time”, and then waking the patient and sending him to the toilet. This procedure was quite successful. Interestingly, it was more successful when combined with elements of “restitution”- the patient being required to correct errors, that is, remake a wet bed, and with elements of “positive practice” - the patient, after making the bed, was required to lie in it and then practise visiting the toilet.

The cost of the problem The intention of this study was to gain some indication of the

financial cost of nocturnal enuresis in a mental handicap hospital, as well as to identify by how much that cost might be realistically reduced by means of nocturnal continence training.

KEVIN KITCHING wrote this article whilst working as a Charge Nurse at Lightwood House, Sheffield .

0 1984 British Institute of Mental Handicap 1 49

classification of toys : in a library for children with mental handicaps

Documents