Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Health Sciences


Rehabilitation Sciences

First Advisor

Dr. Patrick Kitzman

Second Advisor

Dr. Carl Mattacola


The purpose of this research was to explore and describe the relationship among the child, family, home environment, and pretend play of children with motor disabilities. The environment is a powerful force in early child development. This research is based on Bronfennbrenner’s ecological theory of development and the ubiquitous role of play in all domains of development. Children with motor disabilities may lack exploration of the environment and as a consequence demonstrate deficits in play. Play was measured in 32 children with motor disabilities aged 24.8 to 61.3 months with a mean age of 33.7 (SD 9.3) months. Children demonstrated mild to moderate motor disabilities based on the Gross Motor Function Classification System. The prevalent motor disabilities were cerebral palsy, genetic disorders, delayed development, and myelomeningocele. The questions addressed were what combination of child and family variables will predict play ability in a child with motor disability and do the learning materials in the home or levels of maternal or paternal education affect play ability in children with motor disabilities.

Two studies were conducted to establish reliability with the Test of Pretend Play (ToPP) and to determine if children with delayed development would exhibit a delay. One study was done to establish reliability for the Fluharty-2.

The results of the main study demonstrated a significant positive correlation between ToPP scores and the learning material subscale (LMS) scores of the Home Observation for Measurement of the Environment Inventory and maternal education. The LMS scores were significantly correlated with family income, maternal and paternal education. The ToPP scores were not significantly correlated to income or paternal education. Age of the child was significantly positively correlated with ToPP scores and the LMS scores. Fifty-three percent of the children exhibited delays in play. The child’s age and the maternal level of education accounted for 60% of the variance in ToPP scores. Children with cerebral palsy and myelomeningocele appear to be at greater risk for pretend play delays than children with developmental delay and genetic disorders. More research is needed to further elucidate the role of play in children with motor disabilities.