Karen Stagnitti is the founder of "Learn to Play Therapy". The aim of the program is to build the spontaneous play ability of children. Learn to Play emphasizes pretend play, as it is considered the most advanced and sophisticated form of play. This type of play significantly influences language development (especially narrative language), social interaction, and the emotional processing of a child's experiences. (2,3)

The play skills targeted in Learn to Play Therapy include the ability to spontaneously initiate play, logically sequence play actions, use objects as symbols (such as object substitution), engage with a doll or teddy bear as a separate character, integrate play into a script, participate in role play, and interact socially through play. (2,3)

Pretend play takes place when children imagine something. Pretend play is unique and requires complex skills:

• children use objects as something else (box is a castle)

• children give properties to objects (babydoll is sick)

• children pretend objects exist where they are not (big fish)

Pretend play is linked with language development, narrative language, abstract thought, logical thoughts, social interaction with peers, social and emotional wellbeing, creativity and ability to play with others. (2)

Learn to Play Program has developed play assessments and they are designed for different age groups. Pretend Play Enjoyment Developmental Checklist is an informal assessment of a child's ability to engage in pretend play.

During the Learn to Play sessions, the therapist is focused on:

• modeling the play (therapist play with the toys)

• repetition with variation (therapist sticks to the one play activity)

• tracking (talking about) the play

• challenging the child (therapist gradually introduces more complex pretend play)

Some children who join Learn to Play Program experience reduced language ability, they can not use the language to express emotions or communicate through narrative. By facilitating a child's ability to spontaneously engage in pretend play, children increase their ability of self-expression, both verbally and non-verbally. As children are playing with figurines, they are exploring their feelings and playing out scenarios which parallel their life experiences. This helps them to find a solution to a problem. Direct teaching is used in the Learn to Play program when the therapist uses instruction, modelling, guided practice or positive reinforcement during the play. Emotional engagement of the child is vital for the Learn to Play program to be successful.

There was a case study where a child underwent Learn to Play Therapy and she was able to shorten the gap between her results and her peers in literacy, math, social competence and self-regulation. (4)

Learn to Play Therapy also helps children to reduce anxiety around playing with other children, because learning how to pretend in play helps to understand what other children are doing in their play. (3,4)