1. Introduction

In the multidisciplinary play literature, parents have been identified as the main social environment where child’s play evolves and develops, especially in the early years of child’s life [1-4]. As a result, a number of parent-child play studies have begun to evolve from various disciplines and under several theoretical perspectives which provide play literature with knowledge for many aspects of parental play attitudes and behaviors. The focus of these studies include parental play attitudes, behaviors and interactions, and their contribution on child’s play and other areas of development, differences and similarities between mothers and fathers’ play styles, influence of parental cultural beliefs and socioeconomic background as well as child’s age, gender and development on parental play [5-18]. Although the above studies have provided play literature with valuable knowledge regarding parental play engagement, they can be criticized for giving a fragmented or incomplete view of it, related to the discipline’s area of concern or the researcher’s area of interest. For instance, anthropology has studied parental play beliefs and behaviors from a cultural and a macro-system perspective sacrificing individual preferences and attributions, while sociology has related parents’ play behaviors to parents’ socioeconomic status. On the other hand, many psychological studies focus on parental play behaviors because of their contribution to child’s play and other areas of development. Finally, most of the above studies have studied play in laboratory rather in naturalistic settings [19, 20].

In occupational therapy, play is one of the major areas of occupations in which an individual engages in throughout his/her life, especially during childhood [21]. Under the occupational perspective, individuals are considered as occupational beings who constantly engage in occupations. Occupations refer to all activities of human doing, being, becoming and belonging that unfold through time and space, have purpose, meaning and perceived utility for the individual, and maintain and promote health [21, 23, 24].

Under this perspective, parental play engagement is considered as an everyday occupational experience of parents that unfolds or develops in the life of a person who becomes a parent through the everyday co-occupational play transactions of parents with their children. Co-occupations are considered the most highly interactive types of occupation, and refer to the purposeful and meaningful occupations that two or more individuals share or are reciprocally engaged in [25-32]. Co-occupations have a transactional nature that refers to the extending experience of a single person to encompass others as well as the social, physical and cultural context [33,34]. Although co-occupations are frequently accompanied with face-to-face interactions, shared physicality, emotionality, intentionality, or meaning, these elements are not always required [27].

In occupational science studies on parental play explore this occupational experience of parents’ daily life in the natural setting in which it occurs and in the context of the everyday co-occupation of parent-child play. In these studies parental play consists the primary unit of concern, since it is considered not only as the social environment in which child’s play occurs but as an everyday occupational experience in the here and now of parents’ life [35]. These studies make use of the existing interdisciplinary knowledge about play and adopt a multidisciplinary perspective in approaching it. The uniqueness of these studies is reflected in the integration of all the pieces together in order to facilitate the emergence of the knowledge that parental engagement in parent-child play co-occupation includes [36]. These studies aim to explore the observable and phenomenological aspects of parental play engagement and to disclose information regarding the “how, what, when, where and why” parents engage in play with their child [19, 27, 29, 30, 34, 37-44].

The findings of these studies have disclosed valuable information regarding the observable and phenomenological aspects of parental play occupational engagement. Concerning the observable aspects of parental play, Primeau studied the orchestration of work and play in family daily life and identified that parents employed strategies of segregation and inclusion in order to orchestrate the play with their children into their daily life. In strategies of segregation, parent-child play occurs as a separate activity from parental household or other tasks whereas in strategies of inclusion parent-child play is embedded in the parent’s everyday tasks as when the parent, while doing the dishes, engages playfully his/her child in the task. She further introduced the term occupational scaffolding to name the parental processes of structuring and supporting the activity so that the child could perform as much of it as possible [43]. On a similar vein, Pierce studying the maternal contribution on the home play environment, disclosed the behind-the-scenes work done by mothers as they create play opportunities for their infants and toddlers. These invisible tasks include selecting commercial toys and household objects for play, positioning infants for play, maintaining and making play objects available, furnishing the home with child care equipment, controlling infant access to the spaces of the home, and monitoring for safety [27]. Pierce’s findings contribute to our knowledge regarding the ways that developmental opportunities for play of infants and toddlers are created, maintained and managed in their homes.

Pizur-Barnekow et al. investigating the play styles used by mothers of 3-4 months old infants during two short mother-infant play episodes, disclosed that mothers of very young infants during the co-occupations of mother-infant play, exhibit attention-supporting play for the longest duration of play time, less time in attention-directing strategies and even less in control play. The study also revealed that mothers’ attention-supporting play increases during the second play episode, a result that suggests that co-occupational engagement is fluid and dynamic [42].

Regarding the phenomenological aspects of parental play occupation, studies have shown that socio-cultural context including values, beliefs, customs, rapid social changes, parents’ finances, the family’s neighborhood or parents’ relationships with broader family and friends, as well as the importance that activities hold for mothers or the work of mothers, impact parental attitudes and behaviors towards their own and their child’s play and result in the amount of time they spent in play with their child, the way they create their child’s home play environment or the encouragement or not of their child’s play [19, 33, 37, 45, 46, 27, 47]. Finally, Downs revealed that parents of children with disability view the sharing of leisure routines in their family as a way to create opportunities for moments of happiness, normalcy and moments of control of one’s life and environment. These perspectives reveal the contribution of shared leisure occupations to the maintenance of health and well-being of parents who cope with the responsibility of caring for a child with disability [48].

1.1. Justification of the Study

The above studies although bring in light some issues of the unexplored parental play engagement, each has studied parts of this phenomenon such as its orchestration in family life, or the ways mothers create their home play environment, the play behaviors mothers exhibit during play with their infants, the mothering perspectives, or the influence of socio-cultural beliefs on parental play attitudes and behaviors. Additionally, most of the studies include mothers as the main participants or explore the phenomenon in families with a child with disability. There has been found no study in occupational therapy and science that explores the whole phenomenon of parental play as it naturally occurs in the daily life of the family. Therefore, the question of what constitutes parental play occupational engagement still remains unanswered, living many aspects of it unexplored and salient such as what are the types of play parents play with their child, when and where does the parent-child play naturally occur, what play spaces and opportunities parents create for their child, how do parents think about their own play with their child or their child’s play. The shortage of comprehensive knowledge on parental play leaves pediatric occupational therapists working in family-centered play practice without a framework on which to base their home family-centered play-based interventions [37, 41]. The results of the present study are considered to increase occupational science’s knowledge on this important occupational experience in parents’ life but also to inform occupational therapy family-centered pediatric play practice on the parental and family play facets that occupational therapists need to consider in order to develop their home play-based treatment programs [49].

2. Methodology

A qualitative research design, using a phenomenological approach was chosen for an in depth exploration and insight of everyday parental play engagement. Phenomenological research designs focus on the lived experiences and perspectives as told by the individual, explore human phenomena within the natural setting in which they occur and provide a wide variety of qualitative data, in the form of words or observations that reflect the subjective and personal experiences of people under study [50].

2.1. Sampling Procedures and Participants

Two families participated in the study that were recruited through a convenience sampling procedure. Family A consisted of the 38 years old father, the 41 years old mother and their 26 months old son. Father was working as a teacher in a special school and mother was an occupational therapist working in a community hospital. The father, at the time of the study was doing his Master of Philosophy in Special Education and the mother her Master of Science in Occupational Therapy. The mother came from USA but since her marriage, 6 years prior to the study, she had moved to London. Their son was born and lived in London and according to parents was normally developing. Family B consisted of the 39 years old father, the 39 years old mother and their 24 months old daughter. The father worked in Software Engineering and had a degree in History and Philosophy of Science. The mother was working as an occupational therapist in a community pediatric hospital and she was doing her Master of Science in Occupational Therapy, Pediatrics. They came from England, lived and worked in London. Children in both families spent their weekdays with a child minder.

2.2. Data Collection Methods and Procedures

Semi-structured interviews with each parent, observational methods, questionnaires, and play diaries were used for the collection of information from both families. Additionally, the researcher kept a reflective diary throughout the whole study. The data were collected within one week period and the researcher visited twice each family’s house.

Four semi-structured, face-to-face interviews of 45-60 minutes were conducted by the researcher with each of the parents of both families. Interviews were chosen as the primary method of this study in order to elicit information on parental experiences and thinking regarding their engagement in the co-occupation of parent-child play. The interviews were based on open-ended questions and focused on four main issues: a) parental experiences, behaviors and feelings regarding their engagement in and for the play of their child, b) parental experiences, behaviors and thinking regarding the orchestration of their play with their child in the everyday family routine, c) parental beliefs, concerns and thinking about their own play with their child and their child’s play. The parents were provided with the themes of the interviews during the first visit of the researcher and the interviews took place during the second visit. All interviews were audio taped.

The issues of the interview were based on the research interest of this study and on the themes of parental play engagement that evolved from a free and informal discussion of the researcher with the parents of an English family. The refinement of the themes as well as the interview skills of the researcher were the focus of four pilot interviews the researcher undertook prior to the study with four one-child families (child around the age of two) who also met the educational inclusion criterion of the study. The findings of the pilot interviews revealed that pre handing the issues of the interview facilitated the reflection of parents on their behaviors and thinking, thus improving their readiness for the interview. Additionally, the pilot study disclosed that parents were clearer in their attitudes if questions about events precede attitude questions. These findings were further elaborated in the study. After the researcher had transcribed the information collected from the interviews, she posted the transcriptions to the parents for member checking purposes.

Two observational methods were used in the study for the collection of information regarding the home play environment and the ways parents played with their child. Observation is an essential data collection method for understanding human phenomena as it both provides the researcher with direct first-hand naturally occurring experience and reduces the artificiality of other methods by supplementing verbal reports [51]. The observation of the home play was conducted during the first visit of the researcher and was centered to: a) the types of toys, play materials or play equipment existed in each house, b) the distribution of toys in the rooms of the house and c) their locations or positions.

Information on the way parents play with their child was collected through video recording the natural occurrences of play episodes between each of the parents and his/her child. A portable video camera was provided and placed in the living room of each family’s house during the first visit of the researcher. Living room was chosen because, as parents reported, it was the most likely room for the co-occupation of parent-child play to occur. Parents were instructed to turn on the camera themselves and record naturally occurring 15 minutes play episodes with their child. This observational method was chosen as the most effective and least intrusive way to capture the everyday parent-child play occurrences compared to researcher’s participant observation. Pierce argues that video recording, as a data collection method, provides occupational science research with great potential for the study of occupation in all its contextual complexity since it captures everyday activities and interactions of humans with the social, physical and temporal context in their natural settings. Furthermore, it gives the opportunity to the researcher to microanalyze the behaviors of people under study (language, non verbal communication, affective and emotion) [52].

A weekly play chart was also provided for completion to the parents of each family during the first visit. The purpose of this chart was to collect information on the “what”, “where” and “when” the parents play with their child. The weekly play chart was structured in such a way so as to offer information about the daily play occurrences on an hourly base. The play chart was returned completed to the researcher during her second visit.

2.3. Interpretation of the Data

The researcher of this study based her interpretation mainly on the data coming from the interviews and used the information from the videos, observations, play charts and field journal to supplement and/or confirm the emerging ideas or assumptions. A cross case analysis strategy was used because of its capability to reveal a deep understanding and explanation of a phenomenon by examination of differences and similarities across the two families. This strategy was thought to lead not only to the formulation of more general categories that might exist across the cases but also to the description of the conditions under which these categories were most likely to occur [53]. The researcher grouped together the classified and condensed information from each of the parents to a meta-matrix from which the themes or categories emerged.

3. Findings of the Study

The findings of the study reveal that parental play engagement includes four main themes:

■ Parental orchestration of the parent-child play in the everyday family life

■ Parental play behaviors

■ Parental contribution to the creation of the home play environment

■ Parental play perspectives [54].

The above four themes of parental play will be presented in the following sections.

3.1. Parental Orchestration of the Parent-child Play in the Everyday Family Life

The orchestration of parent-child play in the everyday life of a dual earner’s family was one of the main themes that parents brought in their interviews and was found to be a complicated family issue that consists of the followings:

- factors interfering with the parental engagement in play with their child

- parental orchestration of parent-child play

- temporal patterns of parent-child play.

Factors interfering with the parental engagement in play with their child

Parents reported that their engagement in play with their child was dependent on time constraints, psychological constraints and on the importance parents attribute to play in relation to other activities of their daily life. Regarding time constraints, the busy daily lives of parents composed of tight schedules and filled with personal and professional commitments, attached to the multidimensional roles of parents, decrease their available time to play with their child. Phrases like “it depends really on time” or “we have quite busy lives and tight routines” came up when parents described the time allocated to play with their child.

More specifically, the parents of the study reported a conflicting interrelationship between parents’ completion of housework routines, work commitments and/or personal arrangements and the parental engagement in play. One of the mothers described this conflicting interrelationship as follows “Not everything stops for Rosa (child). You know we have quite busy lives. We can’t spend the whole week in complete disorder at home. I often have to work at home, we often go out and meet friends, so these things will limit us in being able to stop and play with her”. The above words indicate that work obligations, housework tasks, as well as parents’ needs to socialize with friends might take precedence over the play with their child.

However, it was evident in parents’ words that work tasks, household and personal commitments do not always and for all the parents interfere with their engagement in play with the child. For example, with regards to work tasks, one of the fathers articulated that he “would definitely not stop” his work in order to play with his daughter in contrast to his wife who described that she “would stop very easily” her work to play with her daughter. With regards to household chores, three of the four parents stated that they “usually do not definitely stop or not stop the household chores to play with the child” with the exception of one father who reported that he would always be engaged, in some way, in play with his son or even “change the menu for having time to play with my son”.

It is apparent from the above statements that for some activities, parents have predetermined their decisions on how to act (whether they will engage in their child’s play or not). These predetermined decisions are further speculated to relate to how important parents perceive their work, personal and/or household commitments are in relation to the play with their child. For example for the father who would always be engaged in play with his son instead of doing household chores, or the mother who would definitely stopped her work to play with her daughter, the play with their child seems most important than their work or household tasks. However, there are other situations in which parents are not consistent in the way they will react such as in the case of engaging in household chores or in child’s play. In these cases, their decision seems to depend on the situational circumstances.

Additionally, parents reported both their own and their child’s psychological dispositional constraints to interfere with their engagement in play with the child. One of the mothers reported about the effect of her mood in her engagement in her son’s play “when I am depressed or tired or cranky, I am less likely to play with him and if I play, my whole heart is not in it”. However, a difference was found between fathers’ and mothers’ dispositional effects on their engagement in play with their child. According to the findings, fathers’ negative mood was reported, in contrast to mothers, to positively relate with their engagement in play with their child. One of the fathers described his tendency to play with his daughter when is in a bad mood “to be quite honest, if I am in a bad mood, I am more likely to play with her”.

Additionally, the findings of this study demonstrated an interrelationship between the child’s psychological disposition and the parental willingness to play with the child. More specifically, a happy, flexible and willing to play child has more possibility of attracting his/her parents to engage in play episodes with him/her. One of the mothers explained, “You know there are days that he(son) is unhappy about anything; he has to fight about everything; he wants to play with something else with what I am doing. Those days I am less likely to be patient and play with him”. The above statements further imply the bi-directional contribution of both parents and their child to the co-construction of the everyday occurrences of parent-child play.

Parental orchestration of parent-child play

Parents, in order to balance their household, self-maintenance, child caring, personal arrangements and work commitments with the play with their child, resort to a number of perplexing and innovative strategies of planning and composing these activities in their everyday lives. These strategies reflect an artistic way that parents plan and compose their daily itinerary. These strategies include:

a) sharing the play with their child with their partner

b) incorporating the play with their child into their daily tasks

c) playing with their child at the same time they are engaged in their own tasks

d) playing with their child at intervals from their own tasks

e) timing their own activities with the play with their child.

The “sharing the play with their partner” strategy refers to the allocation of play and daily tasks between the parents. This means that parents arrange their activities so as one of the parents to complete the housework while the other parent takes over the play with their child. One mother reported “the weekdays, Monday through Thursday, and the days I go to a parenting class or meet a friend, my husband usually does the bath and bed play with him”.

During the “incorporation of parental play with the child into the daily tasks of parents” strategy, the parents embed the play with their child in their housework and/or caretaking activities. Parents mention in their interviews and document in their play charts to play with their child at the same time they bath, feed or dress the child or engage their child in everyday household chores like cooking or doing the dishes, setting the table, making the bed. One of the mothers reported “we also play while I am cooking and washing up; he will come and join me in the cooking or washing or whatever. So it is not really playing with a toy but is playing with the cooking and washing”.

The strategy of “parental play at the same time that parents are engaged in another task” usually refers to the playful verbal interaction between parents doing a household task and their child who is playing with something. Parents play with their child and continue their task. The verbal interaction’s content is usually the child’s play. The following play recorded scene reflects this type of orchestration strategy demonstrated by the father:

Father and child are in the kitchen. The father is cleaning the table and the child is playing with a monkey mask and is talking playfully to daddy about that mask. In a particular moment, the child puts the mask on the face of a donkey toy. During the play of the child, the father although he does not stop cleaning the table, is paying attention to his daughter play and is talking playfully to her. He changes his voice and he starts singing “monkey face on the donkey, donkey face on the monkey”.

The strategy of “parental play at intervals”, refers to parents stopping their tasks, joining their child’s play for a few minutes and returning to their tasks. This strategy of orchestration usually occurred when the parent was asked to help the child’s play or when the child is asking for parents’ attention. Finally, the “timing their own activities with the play with their child” strategy refers to parental engagement in play with their child that occurs at times that parents have arranged to remain free from their tasks, by arranging their tasks at times when the child is not around e.g. sleeping. One of the fathers described “I will arrange to read a book late at night when she is asleep. During the days I much prefer to play with her and arrange those things at night or time them with her nap at noon”.

The above range of parental orchestration strategies of sharing, incorporating, playing simultaneously with another task, playing at intervals and timing, reflects an artistic way through which parents plan and compose their daily itinerary. The artistic quality of this orchestration lies in both the harmonic occurrences of parent-child play and in the fulfillment of parental commitments or needs. It could be further argued that parental orchestration strategies resolve the situational conflicts parents face when they have to complete their household, caretaking, personal or job requirements and play with their child, and serve as a way of maintaining the balance of the work and play with their child, in their lives.

Temporal patterns of parent-child play

Although the occurrences of parent child play were difficult to be clearly established due to their vulnerability to the previously discussed interfering factors, the use of parental orchestration strategies resulted in the establishment of particular times that parent-child play was most likely to occur. During the working days, evening time, bath and bed time were reported as the most likely hours that parent-child play was happening. The early morning of the weekdays was reported as the least likely time that parents engage in play with their child due to their tight routines. One of the mothers reported “Because our routines are pretty tight in the morning we do not have time to play. Some kind of play takes place in the evening, during Rosa’s tea time or in her teatime and bedtime”. In contrast, the parental engagement in play with their child dramatically increases during the non-working days of parents. More specifically, play charts revealed that parent-child play co-occupation manifests itself during the wakening hours, breakfast and after breakfast time, in late morning, in evening time and in the usual bath and bed time. One of the mothers stated “Everything we do during the weekend is sort of keeping her occupied in play”.

The identification of the times that parent-child play is most likely to occur further suggests a temporal pattern of parent-child play co-occupation which includes repeated play episodes at specific times of the working and non-working days.

3.2. Parental Play Behaviors

Two main features were identified to be associated with the parental play behaviors: the patterns of parental play behaviors and the types of parental play.

Patterns of parental play behaviors

Six patterns of behavior were identified to be used by parents during the play transactions with their child. These patterns include leading, scaffolding, responding, talking, approving and controlling behaviors. Τhe “leading behaviors” concerned with whether or not the parents drive the course of play activity either by introducing toys or by suggesting play actions to the child. The findings revealed that although parents introduce toys or suggest play actions, they do not force their child to play with those toys or in those ways respectively. The parental stance regarding their leading behaviors reflected an attitude of suggesting rather than leading their child’s play. Adopting this attitude, parents were found to adjust their behaviors during the course of parent-child play according to the child’s play wishes or interests. One of the fathers reported “If I am taking something to her and she is not interested in it, I won’t play with that; I will just put it down; simple as that”. The following recorded play scene reflects the number of adjustments in maternal behavior in order for her to comply with her child’s play lead and wishes.

Mother and child are in the living room. Mother asks the child “Do you want to play with the farm or the train?”. The child answers “Farm”. Then the mother goes to the basket, where the toys are kept and is looking for the farm. As she is looking the child says “train, train”. The mother asks “you want the train now?”. The child answers “train, house, train, house. Then the mother says “alright the train and the house”. She leaves this basket and goes and gets another one. She looks for the train and the house in the new basket. The basket is full of toys and the child picks up a push car and starts playing with the car. The mother stops looking for the train and the house, takes a similar car and starts pushing it by saying “cho! cho!” After they have played for a while, the child remembers the train and the house and starts asking “train, train, house”. The mother stops playing with the car and starts looking for the train and the house in the basket again.

Parental rearing beliefs were further reported to contribute to parents’ leading behaviors. One of the fathers reported “I am not one of the fathers that will force her play and channel her behavior into my own patterns; I want her to have choices in her play”. Therefore, the children of those two families appeared to be the leaders of the play. However, mothers were found to have a tendency to lead more than fathers their child’s play by introducing and/or suggesting toys to their child. Mothers attributed their tendency to suggest more toys to educational purposes and to their proneness to get more engrossed and/or excited during the play with their child. One of the mothers reported “Many times I let him take the lead in play, but I also do suggest things, like when we are in the pool, I say “do you want to play humpty-dumpty?, because I want him to learn to swim”. The other mother reported “Some days I let her take the lead; other days I take the lead because I want to show her a new activity or toy or we have fun with something”. Consequently, mothers engaged in more types of play activities with their child than fathers did, who seem to be happy with one play activity, unless their child was bored. In the video-recordings mothers engage with their child in more than twice as many play activities as the fathers did. However, the mothers of both families finally comply with their child’s wish if the child is unwilling to play with the proposed toy. One of the mothers described “I think sometimes I try to lead; I suggest things that he is not ready or excited about; it does not work, so I give it up and follow his lead again”.

The “scaffolding behaviors” of the parents include the facilitative and/or helping behaviors that parents exhibit when their child is experiencing difficulty to accomplish a desired play activity. These behaviors have the purpose to provide assistance and scaffold upon which the child can manage the play activity in hand. One of the mothers described that behavior “At this stage, when they are toddlers and they are kind of between baby and child; he is the scientist and I am the scientist’s assistance. He is investigating the world and you are there to help him set up his experiment but he is in charge on how he wants to conduct his experiment”. The following play scene reflects the scaffolding behaviors one farther exhibited during the play with his daughter.

Leon is playing with her daughter Rosa with her push and pull cars. She is trying to press the button of a push car. She does not manage it and the father takes the car, presses the button downwards and says “you have to do it like that” (modeling behavior on the toy in combination with offering suggestion). He then gives back the toy to her and says” come on, you do it. Push your hand hard like that” and he models to her how to put her hand and to what direction to press. She then tries to push the car by positioning her hand as her father demonstrated and she finally manages to do it.

Parents reported to employ scaffolding behaviors more in constructive play activities that require mature hand manipulation than in pretend or imaginative play. One of the mothers reported “I will show to her construction toys, you know building bricks, building little villages”. Additionally, parents described that they don’t scaffold immediately they realize the difficulty of the child to perform a play activity. They provide their child with time to explore the activity and challenge his/her own play skills. One of the fathers depicted “I don’t immediately help her; I want her to learn to explore”.

The scaffolding behaviors of the parents included:

■ Offering suggestions to the child of how to perform a play task

■ Pointing at specific parts of a toy that the child needs to manipulate

■ Modeling the appropriate play behavior to the child

■ Simplifying the task by breaking its steps

■ Taking over at times that child is unable to perform the task

■ Manipulating the play environment in order to facilitate their child’s play performance

The videos disclosed that parents used more than one scaffolding behaviors during a play episode with their child and that each parent exhibited one scaffolding behavior more than others. For example one of the mothers exhibited more the “offering suggestions” and proceeded to the other scaffolding behaviors when she felt that the “offering suggestions” did not work. On the other hand, her husband used more the “modeling” or “taking over” behaviors. However, these behaviors were exhibited only during the 15 minutes of play recorded episodes, therefore they could not be generalized for all the types of play episodes.

Parents exhibited high responsiveness to the child’s communicative verbal and non-verbal messages. One of the mothers described the purposes of her “responsive behaviors” “I am trying to understand what her perspective is, to pay attention to what her reactions are and to respond to that”. The identified parental responsive behaviors include:

■ Paying attention to what the child is trying to communicate by asking him/her questions

■ Talking to their child about the content of his/her communication message

■ Showing their feelings about what the child is communicating

■ Play acting in the way the child wants them to do by the message s/he sends to them

The “talking behaviors” refer to the constant verbal stimulation that parents provide their child with. The parents kept repeating the child’s words or completing the sentences or phrases the child was trying to say. It appeared like the parents were trying to keep their child in verbal track with them and with what is happening. An example of a talking behavior of a father is presented in the following recorded episode.

“Father is in the kitchen with his daughter who is playing with a monkey mask. The child wears the mask on the face of a toy donkey. Father who is looking the play scene says “you put the monkey face on the donkey”.

The content of parental talking behaviors included:

■ Their child’s play behaviors and feelings

■ Their own behaviors and feelings

■ Their child’s play intentions

■ Their own play intentions

■ Information relevant to their play

■ Explanations relevant to their play

Parents exhibited a great amount of “approving” their child’s play behaviors or achievements. They showed their approval and encouragement either by producing vocalizations like “wow” or “that’s very good”, “good girl”. An example of parental approving and encouraging behaviors are presented in the following recorded scene.

Father and her daughter are engaged in a drawing activity. The child is supposed to have drawn a whale. She turns to her father and exclamates “Big wale, look big wale”. Father enthusiastically says to her “Big wale! Wow that’s amazing!”.

In all the above communicative behaviors (responding, talking, approving), parents changed the style and structure of their linguistic behavior into more childish, playful and simpler utterances so as their spoken language to match with their child’s level of understanding or linguistic style. One of the fathers described these alterations “I will explain to her in the simplest terms what might happen, like “it will heart your finger” or “it will burn you” or “very, very hot”, she knows what hot and cold is. So I usually make use of words that she understands”.

Finally, the “controlling behaviors” that parents exhibited refer to the parental direct interferences in the course of child’s play. The parents reported that, under specific circumstances, they attempt to regulate their child’s play by exhibiting domineering behaviors or setting limits to their child’s play, mainly for educating or safety reasons. These circumstances include:

■ The child’s engagement in play activities with objects, toys or materials that can become dangerous (knives, glasses, sharp objects, chemical liquids, televisions, computers)

■ The child’s violent or destructive behavior towards the parents, other children, objects or furniture

■ The child’s messiness without any preliminary control of the environment

■ The child’s engagement in play when s/he has to eat, sleep or get dressed

One of the fathers described “I am not happy with her play with the television because she has pulled it down twice and it’s bloody heavy; it could kill her”. One of the mothers described her attempt to discipline his son “I would control his play when he breaks the rules; when he shows violent behavior towards other children, pets or furniture”. Regarding the interference of play in the accomplishment of child’s self care activities or sleep, parents most concerns were described around child’s sleep. One of the fathers described about his controlling behaviors during bed time “I don’t mind her to play up until the point she is meant to be sleeping. There is play before she goes to bed, but when I say good night, I see you tomorrow morning, that is!! You go to sleep”. The mother of the other family reported “I don’t want him to play when it is nap time”.

Parents exhibited a repertoire of controlling behaviors including inductive as well as power assertive behaviors. However, parents made more use of inductive controlling behaviors, unless their child did not comply with their wish. It was in those cases, that parents exhibited the more assertive behaviors. The parental controlling behaviors in the sequence they were relinquished included:

■ Distracting their child’s attention suggesting another play activity or toy

■ Drawing verbally the child’s attention to the inappropriate behavior

■ Giving firm directions to the child

■ Moving a toy away from the child

■ Ending a play activity they are engaged in with the child

■ Excluding the child from the room

The parents of the study expressed a large amount of awareness about the purposes, frequencies, characters as well as of the consequences of their controlling behaviors to their child. One of the mothers said about her controlling behaviors. “I can also be domineering sometimes and that is not bad as long as you are aware of when you do it or why you do it; so you do not do it all the time, I set limits to her play when I think she is in danger or when I want to teach her that she has to be safe and she should not hurt other people”. Additionally, parents reported their rearing beliefs to undergird their type of controlling behaviors. For example one of the fathers reported “I would never hit her, for me hitting is punishment; for me it is you have lost it; it is your luck of self-control; it is just not on”. Similarly, the father of the other family explained “I don’t want to say no to him all the time; I don’t want to be over”.

An interesting feature of parental controlling behaviors was the “session” that parents gave to their child after they had relinquished the most assertive behaviors such as taking the toy away from the child such as taking the toy away from the child or excluding the child from the room. Considering that these behaviors usually bring negative effects to the child’s emotional state, the parents in order to calm their child and bring back the climate of playfulness, gave a “session” as they called it that included close physical contact with the child, cuddles, hugs and kisses.

Parents further reported that the above parental play behaviors related both to their rearing beliefs and personality style and to their child’s behavior and developmental level. One of the fathers described the interrelationship of his rearing and personality style to his behavioral approach during his play with his daughter “I am not one of the fathers that will force her play and channel her behavior into my own patterns. I want her to have choices in her play. For example, if I am taking something to her and she does not want it, I will put it down simple as that”. He further pointed “I will never hit her. For me hitting is not punishment. For me is you have lost it. It is your luck of self-control; it is just not on”. The parents’ rearing style identified in the study was one of flexibility, permissiveness, provision of conversational opportunities and of a stimulating play environment. The influence of the child’s developmental level and behavior on the parental play behaviors is reflected in the following words of a mother “It is very easy to play with him. I don’t have any problems with little kids, but when they get older, I start to feel less comfortable; I can’t quite figure out what I am supposed to do. But with little kids I have a great time, I don’t have any problem at all”.

In general, parental play behaviors reflected a child-centered stance in which parents stimulated but did not lead their child’s play, provided scaffold to their child at times the child was exhibiting difficulties, continuously talked to their child about the “here’ and “now” of their play, highly responded to their child’s verbal and non-verbal communication messages, consistently encouraged their child’s play attempts and actions and finally regulated their child’s antisocial or unsafe play behavior through the use of inductive discipline techniques and under a highly empathic atmosphere. One of the mother described this child-centered stance as follows: “There is a book by Penelope Linch called: “Your baby and child” in which she gives a lot of advice on how to bring up your child; she says “at this stage, when they are toddlers, and they are kind of between baby and child he is the scientist and you are the scientist’s assistant. He is investigating the world and you are there to help him set up his experiment but he is in charge of how he wants to conduct his experiment, and I found that a useful analogy and I do try to do it in that way”.

Types of parental play

The findings indicate that parents engaged in various types of play activities with their child during their daily play interactions. These types of play activities include pretend play, rough-and-tumble play, educational play, constructive play, verbally interactive play. Parents enacted roles or feelings, created playful situations with the toys such as building towers or houses, played with educational concepts like letters and numbers, chased and were chased by their children, sang, danced and laughed with their children. The parents appeared to have “good time” when played with their children.

However, findings demonstrated that the engrossment and frequency of parental engagement in each of the above types of play were related to the extent that each parent valued the different types of play and to gender issues. The value that parents placed to each of the identified types of play was further reported to be related to the educational background and socioeconomic status of the parents. This means that parents engaged more often and appeared more engrossed in types of play that they valued most, had a familiarity with through their educational, professional or personal experience and/or were valued most among the people of their social class. One of the mothers described the impact of her social status on the type of play she engages with her daughter, “I think the virtues of being very middle class is what we know about educating and we do learning play quite naturally; so you know we play with numbers and letters, we count and pick out colours”. The mother of the second family (both parents had an educational background in education and were familiar with the educational aspects of child development) described her preference to educational play as follows, “I like to encourage books because it is really important for his learning; so we read books every night at bedtime; we read books before he has a nap; I bring books with me when we wait in the doctor’s office. I want him to learn”. In contrast, the father of the first family, having an educational background in History and Philosophy of science and personal experience in play acting in theatre or films, valued mostly imaginative play and showed a frequency and engrossment in imaginative and/or pretend play episodes with his daughter. He reported “I sort of play with her more with creative toys, that she can play out roles; like the play mobile things; like people and farm sets; that she can come up with stories and develop her fantasy. I think fantasy is what distinguishes human beings from other animals and it is something that it is suppressed very quickly in our lives”.

Differences were found between the types of play activities that fathers and mothers were engaged in. For example, the father in family B reported a dislike for the puzzles or for the “kind of activity things”. More specifically he described “I hate puzzles, I am not really a puzzle person; so I less often engage in puzzle play with her. Usually Nataly (his wife) does this type of activity play with her”. Mothers engaged more in singing nursery rhymes, and educational play than fathers did, and reported less engagement in rough-and-tumble play. One mother described “My husband does more rough and tumble play than I do”.

3.3. Parental Contribution to the Creation of the Home Play Environment

The contribution of parents to the creation of home play environment was found to include the types of toys parents purchase for their child and their toy selection criteria, the distribution of those toys to the rooms of the house, and their beliefs regarding the accessibility and the availability of the home play spaces.

Regarding the type of toys, parents reported to be that main responsible for the types of toys found in the houses. One of the fathers described “I suppose I do direct her play in a certain extent by the things I buy for her”. The findings indicate that parents purchase for their child’s or their own play with their child age-appropriate, relevant to their own and their child’s play preferences, non-expensive, safe, well made, educational, both gender-assigned and attractive toys. One of the mothers described her toy selection criteria as follows, “Things that are of the right age group and also relevant to his preferences. Again, safe and attractive; things that can not fall apart easily. I also buy for him toys that I think they are going to help his development”. All the parents reported concerns regarding the cost of the toys. One of the fathers described “I am not going to spend lots of money for toys; especially for toys that do nothing, are plastic or are very limited”. Regarding the gender-assigned toys, one of the mothers described “I try to have equal access to the traditional boy staff and the traditional girl staff”. The safety and quality of the toys constituted main considerations of the parents. One mother reported I wouldn’t buy her anything that can become dangerous; and anything that becomes dangerous as a result of being broken; I would throw away”. Finally, regarding the influence of parental toy preferences on the purchased toys, one of the mothers reported “I go on for toys that I particularly like; it might be because they are endearing, fascinating and they appeal to me or because I know they are going to help her development”.

Parents of both families reported a high value for the creative versus passive toys and their misgivings regarding the violent toys. Parents think that constructive and creative toys such as farm sets, train sets, Lego constructions, animals, miniature play people contribute to the child’s mental, social and imagination development. One of the mothers articulated “I like him to play with imaginative and constructive toys where he can role-play and build-up little stories or things; because they help his social and mental development; you know being engaged with his mind and body into play, in contrast to sitting down and watching TV, which he might enjoy but he is very passive”. Regarding violent toys like guns, swords, soldiers, although both families reported negative attitudes, the purchase of them or not was found to relate to whether parents wanted to impose their attitudes to their child. Therefore, the parents of one family do not purchase those toys and describe “Carl and I both do not like the violent staff, the guns and the swords and all of that stuff. I would rather he does not have here any guns; he does not have any violent toys at all. That is the only thing I would say no; because I think predominant social attitude about violence is far too accepting and I do not approve of it. I approve of nonviolent ways of living”. In contrast parents of the other family reported that they would buy those toys if their daughter wished to play with them by saying “My personal feeling is that I don’t like games that are kind of war play but I do not have a ruling about she (daughter) not playing with these toys. I do not think I would stop her from having guns or things like that. So my feelings are that she can play with all those things but it’s about how we as parents, explain our misgivings about those toys. As she gets bigger, I think I will discuss those things with her; but as I say, if she wants to play with those toys I would not stop her”.

The types and the amount of toys parents provide their child were reported to be associated with the educational, professional and economic background of parents. One of the mothers described “My experience and knowledge about the toys, because of my job and education, certainly influence me on the sorts of toys I buy for her; for example I know what is good for her development or what will interest her to play with. She is lucky she comes from a family where we can afford to buy her toys; she is extremely well off for lots of things”.

The parents made accessible all the toys for their child and they place them either in boxes on the floor or in the lowest shelves of bookshelves or they hang them in nets on the wall in reachable for the child heights. The only non-accessible play materials are the art play materials like play-dough or finger paints which were kept in non-reachable for the child shelves. The parents reported concerns for these materials due to the messiness they cause to the rooms or the child which in turn increases the cleaning housework for the parents. The parents needed to take preliminary control of the environment before the child gets engaged in those play activities.

The distribution of the toys to the various rooms was made according to the topography of the different types of child’s or family’s play. Therefore, squeezing, pouring or other toys, used in bath play, were kept in the bathroom whereas books, tapes with tape recorders, dolls, fluffy and cuddly toys, sound producing toys and some constructive or household toys were found in the child’s bedroom since they were used during bed or before bed play and during the early morning play. However, the greatest number of toys was found in the living room where the family spends most of their day and parent-child play mostly occurs. Toys were not detected in the parents’ bedroom and in spare bedrooms or the offices of the houses of both families. Finally, toys like sand pools, water pools, baskets with shovels were kept in the garden since the messy play or the type of child’s play that needs space takes place in the garden. Nevertheless many easy-to-carry toys were found all over the house, something that implies that toys although they have their main locations in the house, during the day they are moved following the parents’ and child’s play movements in the home space.

Regarding the availability of the home play spaces, the findings of the study demonstrated that there is a strong relationship between the child’s safety and messiness, and the establishment of the place where the child’s play is permitted or not. Consequently, the parents did not allow their child to play unsupervised in the bathroom and garden due to the existence of acid liquids and hot water, as well as dangerous objects and messy staff respectively. Additionally, parents hold negative beliefs about their child’s play in the neighborhood due to safety reasons. Finally, garden play was permitted in both families to occur mostly in summertime than in wintertime due to the weather changes that effects the clothes worn, thus increases the amount the clothes for cleaning.

3.4. Parental Play Perspectives

The perspectives that parents of this study hold for play included both perspectives for their child’s play and their own engagement in their child’s play. Regarding the perspectives for their child’s play, the findings indicated that parents acknowledge child’s play as a healthy, natural, needed, and prevalent experience in the two-year-old life, as an important experience for child’s learning and emotional state, and as a link between their world and their child’s world. One of the mothers described the prevalence of play in her daughter’s life as follows “She seeks to do it generally all the time; everything is play for her; even if something does not start as play, it turns out to be play”. Additionally, parents identified child’s play as “a massive learning process about life” meaning the learning of concepts, roles, habits and social rules as well as the development of various areas in a child’s life such as imagination, language and manipulation skills. One of the fathers described “Through play she plays out roles like mummy and daddy roles and she plays over and over things that she sees in the television; she learns how people interact and inter-react; she learns about relationships”. Regarding the emotional effect of play on their child, parents acknowledge that play is a pleasurable experience for their child which offers fun, relaxation or excitement or a general positive attitude about life. One of the fathers reported “Play has a calming effect on her as well as an exciting effect in her”. Interestingly, parents viewed child’s play as the context where their child’s understanding and development uncover. One of the mothers articulated “It is exciting for me to watch my little girl develop ideas and to listen to the things that have become familiar to her; I find it fascinating to watch her play because all of her understanding of the world uncovers”.

The parental perspectives regarding their own engagement in the child’s play included both positive and negative attitudes. The positive ones reflect that parental engagement in play with their child is an experience of fun, joy, relaxation from life’s troubles and for some parents as a way to regain their lost playfulness. One of the fathers described “It is a good therapy; an unwinding session for me after the high pressures at work; playing with him (son) gives me an excuse for playing that I do not have when he is not present; it is like having an excuse to go and see “101 Dalmatians”. One of the mothers described “Playing with him helps keeping my attitude to life more positive, increases my playfulness and might change my depressed feelings”.

The negative attitudes were reported only from mothers who in contrast to fathers reported that play is not always a pleasurable activity for them and that it could be felt sometimes as a negative experience. The negative maternal play experiences were reported to be a result of time and energy demands that play requires from them. One of the mothers described “It is tiring play-acting all of the time and giving her (daughter) that sort of attention. Sometimes I have a wonderful time with her, other times I feel myself to force a positive attitude to her because I am tired and I just want to stop for a minute or I need some time out”. The other mother reported “Sometimes playing with him (son) might be a chore, especially at times that I am tired or my mind is in something else; sometimes can be annoying if I don’t have the resources to do it”.

Finally, all the parents reported that playing with their child at this age was very easy for them. One of the fathers stated “I do not have any problem to play with her. I have only logistical problems”. Cone mothers reported concerns regarding her ability to play with his son at older ages “It is very easy to play with him now, I do not have any problem with little kids; but as they get older, I start to feel less comfortable; I can not quite figure out what I am supposed to do. But with little kids I have a great time”.

4. Discussion of the Findings

The findings of this small scale qualitative research study revealed that the parental engagement in parent-child play occupation consists of four main features: a) orchestration of parent-child play within the daily family life, b) parental play behaviors, c) parental contribution in the creation of home play environment and d) parental perspectives regarding the play of their child and their own play with their child. Many of the emerged issues on the above features can provide occupational therapists reasoning with valuable knowledge to consider when they plan their play-based assessment and intervention programs for each family. For example, the findings indicate that pediatric occupational therapists should collect information on the realities of the family life, explore the factors that interfere with the parental play engagement, the temporal patterns (if any) of parent-child play, the behaviors parents exhibit during the parent-child play co-occupation, the types of play each parent mostly values, the type of toys they provide their child with, their concerns regarding their child’s play, and finally the parental perspectives regarding their own and their child’s engagement in play. Without implementing information on the above issues in the home play-based programs, occupational therapists would fail to address the problems that have meaning for both the child and his/her family given the context of their lives [49].

Orchestration of parent-child play

The findings on the orchestration of parent-child play co-occupation in family daily life contribute to occupational science’s and therapy’s knowledge regarding the factors that interfere with parental engagement in play, the orchestration strategies parents employ in order to play with their child, the forms that this engagement might take as well as the temporal patterns through which parental engagement in child’s play is repeated.

Consistent with the literature, the findings of this study highlighted that on a daily basis, parents of dual earners’ families face conflicting demands and needs in order to accomplish the various occupations of their life such as paid and unpaid work, housework, child care tasks, personal and social activities [41, 55-59]. More specifically, studies have shown that work, household or social parental needs might take precedence over child’s play [55, 60], depending on their importance in relation to child’s play [40, 46]. Within this busy daily life context, parental occupational choices are either predetermined and consistent or situational and inconsistent. The predetermined and consistent occupational choices that some parents reported e.g. between work and play or play and housework, support the individualistic perspective of occupation, meaning that the occurrences of parent-child play co-occupation is merely a result of parental decisions. On the other hand, the situational and inconsistent parental occupational choices support the transactional perspective of the occurrences of parent-child play co-occupations. The transactional perspective was supported by the interference of parents’ and child’s psychological disposition on parental willingness to play with the child or the situational importance of parental tasks in relation to play with their child. According to this transactional perspective, the occurrences of the co-occupation of parent-child play emerge out of the ongoing transactions among the ever-changing parents with the ever-changing child, the ever-changing parent-child context and the ever-changing circumstances of every day demands or commitments [33, 34, 61].

Regarding the interference of child’s psychological disposition on the occurrences of parent-child play co-occupation, a similar finding has been reported in Larson’s study where mothers described the child’s level of stress, contentment and self-sufficiency to affect maternal decision to complete their household tasks or to address the child’s request for attention [40]. In the present study mothers’ willingness for play is negatively influenced by mother’s bad mood or tiredness, whereas fathers’ bad mood is positively related to their willingness to play with their child. This finding might further suggest either the asynchrony of biological rhythms [62, 63] among young children and their mothers or the numerous daily demands of working mothers of preschool-aged children [37, 45]. The negative psychological disposition makes the mothers of the study either to not play with their child or to drag in play in contrast to fathers who experience a positive transformation when they engage in play with their child.

The orchestration strategies parents employ in order to manage to play with their child in their busy daily lives, have been documented in previous research studies, such as the “sharing responsibilities and opportunities between parents” strategy which has been associated with non-traditional families, with a harmonious marital relationship and with parental feelings of balance [37, 40, 59, 60, 64, 65]. The strategies of “incorporating the play with their child into their daily tasks” and “playing with their child in the same time they are engaged in their own tasks” have been reported as “strategies of inclusion” in Primeau’s study [43] or as “enfolding occupations” in Segal’s study [65]. These two strategies move our conceptualization of parent-child play occupation beyond the clearly defined or bounded play activities since the simultaneous mixing of concepts, objects and functions of theoretically different activities (play, household and child caring) supports the assumption of occupational scientists that it is usual for occupations to be “nested” or “embedded” within other occupations or to occur simultaneously [66-68]. These findings support the concurrency of parent-child play co-occupation with other parental occupations and reflect the complexity of everyday parental occupational engagements. Finally, the strategies of “playing with their child at intervals from their own tasks” and “timing their own activities with the play with their child” seem similar with the “process of segregation” that was used by the parents of Primeau’s study [43], the “planning/organizing strategy” incorporated by mothers in Larson’s study [41], the “temporal unfolding” adaptive strategy of mothers of children with ADHD in Segal’s study [65], and the “allocating strategy” used by parents in the study of Wada et al. [60]. All the above strategies could become useful guidelines for occupational therapists’ consultation in families that seek advice in how to increase their playful interactions with their child without losing track of their everyday tasks or personal arrangements.

Parental orchestration strategies resulted in the creation of temporal patterns of parent-child play co-occupation. These patterns are congruent with the literature and other studies that highlight that family’s leisure activities are anchored to weekends and parts of evening hours since parents’ work is the zeitgeber (time giver) that structures family schedules [43, 62]. Considering the positive influence of family routines on family’s member health and well-being and the understudied routines of families with typically developing children [69], the temporal routines of parent-child play co-occupation that were found in this study can be considered for their contribution to family’ health and well-being.

Parental Play Behaviors

Bearing in mind that parent-child play is a co-created occupation between parents and their children [34], and that only one occupational science’s studies has examined the parental play behaviors [42], the disclosure of the parental play behaviors contribute greatly to our knowledge regarding the doing aspect of parental play engagement and the parental role in this complex and reciprocal shared occupational experience. More specifically, the findings disclose the types of scaffold that parents provide their child with, the content of parents’ talking and responsive behaviors, the types of controlling behaviors, the circumstances under which the parents exhibited them as well as the order in which they were displayed, the adjustments parent made in their play behaviors as well as the differences between mothers’ and fathers’ play behaviors or the factors that parents reported to contribute to the behaviors they exhibited. In general, parents were found to actively participated in complementary and reciprocal joint play with their child, to respect their child’s right for play, to suggest but also to comply with their child’s play leads and preferences, to offer scaffold to the child when needed, and, finally to create a playful climate highly responsive, interactive and encouraging for their child’s play engagement. The parents were also found to exhibit spontaneous, creative, joyful and engrossed engagement in all the types of child’s play.

Although many of the identified parental play behaviors have been extensively investigated in play literature mainly for their contribution to child’s areas of development [70-80], the researcher felt that this child-centered play approach that parents demonstrated contributed to the mutuality and fluidity of parent-child play transactions. Indeed, play literature, consistent with the interpretation of the researcher, has identified the above parental play behavioral approach as a child-centered approach which and has associated this approach with higher levels of parent-child mutuality during play [81]. More specifically, literature indicates that children are more engaged in child-driven and unstructured play activities and engage their parents more positively in their play [74], that intersubjectivity, the extent to which an interactive partner can “read” the mind of another, affects the coordination of fluidity, and execution of joint action sequences from the seemingly routine ones to more improvisational or playful [83], and that talking parental behaviors create opportunities for meanings to be negotiated and open windows for children to understand their experience but also the mothers to learn their children as well. In a similar vein, although parental scaffolding behaviors have been reported by others to contribute to the development of the child’s play or other areas’ of occupational development [84, 85, 43], the researcher of this study felt that behaviors of occupational scaffolding might also contribute to the flow and continuation of parent-child play co-occupation, at least in times of difficulty.

Another feature of the findings that the researcher associated it with the mutuality and the flow of parent-child play co-occupation was the behavioral adjustments parents exhibited during the course of play with their child in order to coordinate themselves with their child’s play interests, difficulties and/or the child’s developmental play, cognitive or linguistic level. Indeed, Lawlor analyzing the parent-child-sister play interaction in a hospital hallway, while the child was inpatient, highlights that each actor in this coordinated play action makes adjustments, based on the interactive partner, that reveal qualities of interrelatedness that could be called attunement, synchrony, co-regulation, mutuality or reciprocity [34]. Additionally, these adjustments provide strong evidence for the impact of child’s behaviors, capabilities, psychological disposition, interests, and play level on parental play behaviors and parental chosen types of play. This finding has been also highlighted in interdisciplinary play literature [74, 86] and supports occupational science’s current belief that in the parent-child play co-occupation, each individual shapes the function of the other through an ongoing transactional experience during which the two parties are not interact as separate forms, but they move through one another as co-constituted entities [34, 87-90]. Therefore, parents in this study continuously transformed their child’s behavior at play through their leading, scaffolding, talking, approving, responding and controlling behaviors, while at the same time their own behaviors at play were transformed by their child’s developmental capabilities and play interests. Under this perspective, the functional coordination between parents and child’s elements is considered to facilitate and perpetuate the chunks of joint attention, and the flow and harmony of parent-child play co-occupation by contributing to its complementarity and shared meaning.

The above play behavioral approach was associated with parents’ rearing style which was further related to the educational background of parents. The parenting style of the parents of this study was one of flexibility, permissiveness, provision of conversational opportunities and of a stimulating play environment. Indeed literature suggests that parents of middle-class families, with high socioeconomic status promote child’s autonomy and independence and provide their child with increased early verbal stimulation, in contrast to children of lower socioeconomic families, experience low levels of talk from both mothers and fathers [80, 91, 92]. This relationship might give explanations to the emerged parental child-centered play approach, since the families of the study had middle-class status and the parents had also an educational background in fields relevant to child development and education.

Finally, the types of play that parents play with their child complement to occupational science’s knowledge regarding the form of parent-child play by suggesting that in families with a toddler it can take the form of pretend, learning, rough-and-tumble, constructive and verbally interacting play. Mothers in this study were found to value and engage in different types of play from fathers, a finding that is congruent with previous research findings where mothers’ engagement in educational, interactive and object play was a natural process for them, whereas fathers were more likely to engage in rough-and-tumble and “physical play” with their child [16, 93, 94, 95]. Additionally, the finding that each parent bring his/her play preferences or the play activities they are familiar with, in the play transactions with the child is consistent with the findings of Bonsall’s study where fathers of a child with a disability incorporated their interest into the emerged family’s play or leisure occupations, suggesting thereof that individual interests and abilities can be molded to fit within a family context [84].

Parental contribution to the creation of the home play environment

According to occupational science, situational contextual factors such as the physical space, the objects or the materials used in occupations greatly influence the actors’ occupational engagement [67, 89, 96]. Therefore, the findings of the present study regarding the contribution of parents to the creation of the home play environment extent our existing knowledge regarding the physical and material aspects of parent-child play co-occupational engagement. These aspects include the types of toys parents provide their family with, the ways parents distribute the toys to the rooms inside or outside the house and the home spaces where the parent-child play engagement usually occurs or child’s play usually occurs.

Consistent with the mothers in Pierce’s [27] and in Larson’s study [41], the parents of the present study buy developmentally appropriate for their child, attractive for their child and themselves, educational, both gender-assigned, safe and well made toys. Parents reported their educational background, socioeconomic status as well as their wider social environment to influence the types and the amount of toys they provided their child. This finding supports Dickie et al statement that each of the above decisions are shaped by one’s situation, cultural values and beliefs, finances, the nature’s of one’s neighborhood and relationships with family and friends [33]. Although the type of toys parents provide their child with, have been studied in the play literature mainly for their contribution to child’s play or gender role development [27, 97], the interesting feature of the findings is that the parents move their thoughts beyond the educational element of the toys to encompass characteristics such as toy attractiveness, developmental suitability, safety and pleasantness. Parents reported these characteristics as essential for their own and their child’s play engrossed engagement. Indeed, interdisciplinary research has shown that attractive, age-appropriate and mutually enjoyable for mothers and toddlers, toys elicit positive and joyful interactions, and enhance parent-child communication and positive maternal affect. In contrast, the provision of less interesting toys elicits more negative maternal affect [16, 74, 81, 82, 98, 99].

With regards to the accessibility of the toys and the availability of the home play spaces, the parents of this study, as the mothers of higher socioeconomic status in Pierce’s study, reported safety and messiness concerns [27]. As a consequence, they kept almost all of the toys accessible for their child apart from art play materials due to the messiness they cause if the child plays with them unsupervised, and restricted their children from playing in garden, bathroom and neighborhood due to safety reasons. Safety parental concerns have been reported in play literature mainly for the mediation of children’s active play [100].

The findings regarding the allocation of the toys further indicate that the space matrix of the parent-child play co-occupation or child’s play contributes to the distribution of the relevant playthings or toys. This signifies that in each room of the house there is a matching of the types of the parent-child play co-occupation or child’s play occupation occurring in that room, with the occupational materials utilized in those types of play. The interrelationship between the play space-matrix and the occupational play objects/materials provides evidence for the ergonomic way that human beings create and construct their everyday environments so as to save time and energy in their everyday busy lives.

Additionally, the movement of child’s and parent-child’s play from outdoors (garden) to indoors (home) and vice versa, following the seasonal changes, supports Moore’s argument about the seasonal cycles of occupations. More specifically, Moore discusses the change in-groups and activity that move around in synchrony with the seasons and weather [101]. This movement of parent-child play further emphasizes the changes that the form of parent-child play co-occupation might undergo during the different periods of the year.

Parental Play Perspectives

The parental play perspectives about their own and their child’s play, contribute to occupational science’s and therapy’s knowledge regarding the health-promoting and health-compromising effects of parent-child play co-occupation for both parents and their child. The health promoting effects of parental engagement in play such as relaxation, joy and playfulness have been reported by Cohen’s study who described that during parent-child play, the good time is not experienced only from children but also from their parents who find the opportunity to act again like children [102]. In the co-occupation of parent-child play rather parents and children experience a mutual enjoyment during this transactional experience. This finding has been more recently reported in Downs’ study on leisure routines of parents of children with disability [48]. One of the study’s findings was that the sharing of leisure occupations creates moments of happiness and well-being. This finding might provide evidence regarding the ways that parent-child play co-occupation promote parental health and well-being, an overarching belief of occupational therapy [21].

The health compromising effects of the engagement in parent-child play co-occupation were mentioned only by mothers and include the time and energy demands that play co-occupation requires from them. This finding implies that mothers have fewer time and energy resources for pleasurable experiences with their child than fathers, which in turn might suggest that life demands for mothers might be higher or might be experienced as higher. Therefore, for mothers of this study the play with their child was not perceived always as a pleasurable and health-promoting experience especially when time or energy constraints interfere.

The parental recognition of play as a healthy, natural and needed experience in a child’s life moves beyond the functionalist view of play which recognizes it only for its contribution to the child’s development [103] and supports occupational therapy’s theoretical construct that play is an active ingredient of a healthy life in the here and now [35]. Indeed, occupational science’s studies on family occupations indicate that parent-child play co-occupation provide opportunities for sharing, learning and being together [104] and facilitate relationships among the members of the family [84]. The consideration of play as a link between parents’ and child’s world has been also reported by interdisciplinary play studies which support that the relaxed and joyful interaction between parents and their child during play, allows parents to pay better attention, to “listen” and understand their child’ needs in a different and more productive way, to see the world through their child’s eyes, contributing therefore to stronger emotional connections [79, 105-108].

The understanding of parental play perspectives was one of the essential features of parental play since it framed their particular engagement and gave meaning to it. It seems that the everyday struggles of parents to find time to play with their child, the employment of a child-centered play approach and the provision of an enriched, safe and accessible play environment can be justified and explained after the disclosure of the parental play perspectives. The relationship between parental play attitudes and parental play behaviors has been emphasized in previous research studies in which parental attitudes were proposed as determinants of parental play behaviors [12, 19, 109]. Additionally, the disclosure of the above parental play perspectives draws light on the meaning that parent-child play co-occupation and their child’s play occupation hold for the parents, therefore justifies the existence of play co-occupation in their lives. This assumption is consistent with Trombly’s statement that only meaningful occupations remain in a person’s life repertoire [110].

5. Conclusions

This research study revealed that the parental engagement in the co-occupation of parent-child play consists of four main features: the orchestration of parent-child play in the everyday family life, the parental play behaviors, the parental contribution to the creation of the home play environment and the parental play perspectives. The emerged issues are considered to contribute to occupational science’s and therapy’s knowledge regarding the parental engagement in the co-occupation of parent-child play. As a consequence, this knowledge is thought to provide occupational therapists reasoning with valuable information to use in their family-centered play-based area of practice.

However, two of the most important limitations of this study were the inclusion of a very limited sample (two families) and the relevant with child development and education, educational and professional background of the parents. This signifies the impact of parental background on the emerged qualities of parental play engagement and perspectives and further implies that the findings of the study cannot be generalized or might be comparable only to families with analogous educational and socioeconomic status.

Therefore, further studies on the emerged features of parental engagement and perspectives are proposed with the purpose of elaborating and refining the present issues and of providing a more holistic picture of it e.g. in families with similar or different socioeconomic background, in families with children with disabilities or families with more than one child or with children of different ages. Given the lack of occupational therapy’s assessments on parental play, the results from those studies might possibly result in the development of an assessment tool for occupational therapists on parental play co-occupational engagement.

This article presents a recent review of the findings of an original study designed to explore parental engagement in play with their child, that was completed as part of the MSc program of the researcher.