Cognition Mediates Playfulness Development in Early Childhood: A Longitudinal Study of Typically Developing Children

Amiya Waldman-Levi, Anita Bundy, Dana Shai

Research output: Contribution to journalArticlepeer-review


Importance: Play, children’s central occupation, and playfulness, its behavioral manifestation, are the foci of occupational therapy intervention. However, information about the development of playfulness behavior and the role of cognitive function is limited. Objective: To explore the development of playfulness and its relation to cognitive functioning from infancy to toddlerhood. Design: Longitudinal study with data collected at ages 6 mo, 18 mo, and 24 mo. Setting: Laboratory (age 6 mo) and home (ages 12 and 18 mo). Participants: Eighty-six typically developing children drawn from a convenience sample of 109 low-risk families of middle to upper socioeconomic status. Measures: The Mullen Scales of Early Learning (MSEL) to assess cognitive functioning and the Test of Playfulness (ToP) to assess children’s playfulness. Results: ToP scores were significantly higher at age 24 mo than at age 6 mo, t(88) 5 –60.30, p < .001, 95% confidence interval (CI) [–1.47, –1.38]. Correlation analysis revealed that the more playful the infant was at age 6 mo, the higher their cognitive functioning was at age 18 mo and the more playful they were at age 24 mo. Toddlers with higher cognitive performance at age 18 mo demonstrated more playful behavior at age 24 mo (b 5 0.120, SE 5 0.05, 95% CI [0.0377, –0.2276]). Conclusions and Relevance: Children’s playfulness is evident as early as age 6 mo and continues to develop through toddlerhood, depending on their cognitive growth. Occupational therapists play a key role in working with families with young children, promoting cognitive development to further the development of playfulness behaviors. What This Article Adds: Understanding the development of playfulness and exploring its relationship with cognitive functioning in typically developing children fills important gaps in occupational therapy knowledge and contributes to delivery of early intervention, especially when cognition or playfulness are at risk. Our findings confirmed that cognitive functioning contributes to the development of playfulness.

Original languageEnglish
Article number7605205020
JournalAmerican Journal of Occupational Therapy
Issue number5
StatePublished - Sep 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022 Authors. All rights reserved.


  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cognition
  • Early Intervention, Educational
  • Humans
  • Infant
  • Longitudinal Studies
  • Occupational Therapy
  • Play and Playthings
  • Young Adult

ASJC Scopus subject areas

  • Occupational Therapy


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