Making Meaning through Play: Psychoanalytic Intervention in a Pre-School Child with Global Developmental Delay

Pub Date : 2021-01-01 DOI:10.1080/00797308.2020.1859278
Suzanne Donner
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Abstract

ABSTRACT Global developmental delay (GDD) is defined as significant delay in two or more developmental domains, including motor, speech and language, cognition, social/personal and activities of daily living. The prevalence of GDD is estimated to be 1–3% of children below 5 years of age, yet the child psychiatric and psychoanalytic literature is very limited as to effective treatment modalities for pre-school children with severe and/or multiple developmental delays. For these impacted children, the treatments are often highly fragmented with multiple providers typically prioritizing their own objectives with potential results, from the child’s and the parents’ point of view, of uncoordinated, confusing, challenging and anxiety-producing experiences. This case report, describing the first 2 ½ years of the psychoanalytic treatment of a 3 ½ year old girl with global developmental delay, proposes that, in the treatment of such pre-school children, a psychoanalytic play therapy model with multiple visits per week effectively can: (i) focus on and address the child’s developmental and emotional state as a whole; (ii) provide a safe, stable and containing developmental object relationship for the child to use effectively in their developmental process to build internal psychic structure; (iii) significantly decrease anxiety and oppositional or negative behaviors by verbally linking words and co-created meaning to difficult feelings, problems and memories and thereby provide the child with tools to understand and govern their own emotions and behaviors and finally (iv) help the larger system of parents and allied professionals organize the clinical data, prioritize goals and shift technique to consider the child’s mental states.
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通过游戏创造意义:精神分析干预学龄前儿童整体发育迟缓
摘要全球发育迟缓(GDD)是指在运动、言语和语言、认知、社交/个人和日常生活活动等两个或多个发育领域出现的显著迟缓。GDD的患病率估计为5岁以下儿童的1-3%,但儿童精神病学和精神分析文献对患有严重和/或多重发育迟缓的学龄前儿童的有效治疗方式非常有限。对于这些受影响的儿童,治疗往往是高度分散的,多个提供者通常会优先考虑他们自己的目标,从儿童和父母的角度来看,可能会产生不协调、混乱、具有挑战性和产生焦虑的经历。该病例报告描述了一名患有全球发育迟缓的3岁半女孩接受心理分析治疗的前2年半,提出在治疗此类学龄前儿童时,每周多次就诊的心理分析游戏治疗模式可以有效地:(i)关注并解决儿童的整体发育和情绪状态;(ii)为儿童提供一种安全、稳定和包容的发展对象关系,使其在发展过程中有效地利用这种关系来建立内部心理结构;(iii)通过将单词和共同创造的意义与困难的感觉、问题和记忆口头联系起来,显著减少焦虑和对立或消极行为,从而为孩子提供理解和控制自己情绪和行为的工具,最后(iv)帮助更大的父母和相关专业人员系统组织临床数据,根据孩子的心理状态,确定目标的优先顺序并转换技巧。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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