Sunday, June 02, 2002
Play therapy boosts HIV children Staff at a major African hospital are using play therapy to help mothers and their children to cope with HIV. Occupational therapists at Groote Schuur Hospital in Cape Town, South Africa, discovered that many children with HIV had developmental problems. While some of these difficulties could be attributed to the disease, staff believed that much of it was due to a lack of bonding between mother and child. The mothers don't know what to do to get the child to interact with their environment They found that mothers with HIV had distanced themselves from their offspring, almost in preparation for the child's death. This meant that in many cases the children had never been taught or encouraged developmentally, for instance they could not crawl or sit. Toy therapy To tackle the problem, therapists play with the children. This, they say, shows mothers how to interact and develop a relationship with their children. Elelwani Ramogondo, an occupational therapist at Groote Schuur Hospital, said the children's problems were often complex. "Almost all of them would be developmentally delayed and more often than not it was gross motor development that was behind. "So milestones like sitting, rolling even, sometimes even lifting their head up from the floor wouldn't happen at the time that it should." Speaking on the BBC World Service programme Health Matters, she said: "Because with HIV having turned into Aids, a big thing that gets affected is endurance. "It could be because of respiratory difficulties, not breathing sufficiently to give the circulation the oxygen that muscles need, illnesses like diarrhoea and a whole lot of things." But she added: "The mothers don't know what to do to get the child to interact with their environment." Ms Ramogondo said showing mothers how to interact with their children had proved helpful. "They start watching me interacting with the child. It's almost like role modelling for them and the first thing is, you know, she's taking interest in her child in a different way." Lack of bond She said the lack of a bond was understandable. "A lot of it was because they were also dealing with the possibility of this child moving on and dying in a couple of years. "How do you begin to bond with someone that will leave you, almost certainly?" She added: "And also the burden of guilt. Thinking you might probably have been the one that causes so much distress for your child. It really paralyses you." Ms Ramogondo said the scheme had resulted in visible improvements in many children. Whereas many children had been unable to walk at the beginning of the treatment, many now ran into the clinic. She said: "They walk from the time that they realise that they're nearing the clinic, leaving the mother behind and starting to run because they know there are toys at the other end."