Children's play-work occupation continuum: Play-based occupational therapy, play therapy and playwork.

Introduction: Occupational therapists often use play-based approaches to facilitate children's occupational development and promote participation, for example, play-based occupational therapy, play therapy and playwork. However, where does play occupation fit, within these adult-guided play-based approaches in occupational therapy? Purpose: To examine and discuss the play-work occupation continuum of children to inform occupational therapy practice. Key Issues: Children's play occupations are free-selected, unstructured, internally-controlled, spontaneous and intrinsically-motivated. Yet, occupational therapists often utilize play as a therapeutic modality to support occupational development for occupations other than play. This use of play represents play-based work occupations as they are structured, externally-controlled, adult-guided, goal-focused and extrinsically-motivated. Play occupations then move from being authentic free-play to adult-guided play-based work occupations for children. Implications: When working with children and families, occupational therapists need to balance the use of self-selected, unstructured play occupations with the application of adult-guided, structured, goal-focused play-based work occupations.