Aim Play is vital to children's development, health and resilience. Play modulates cognitive, emotional and social well-being. Children constitute approximately half of all humanitarian refugee entrants resettled in Australia. Refugee children are commonly victims and witnesses of war and persecution, living across resource-poor environs during transit. Little is known about the effects of refugee migration on play. This study explores how refugee children engaged in play pre-migration (in their home country) and post-migration (Australia). Methods Refugee children attending the Refugee Health Clinic of a tertiary children's hospital were invited to complete a qualitative descriptive study of play. The children were asked to draw how they played pre- and post-migration. Drawings were analysed for (i) the presence of play; (ii) location of play; and (iii) drawing detail. Results Nineteen refugee children were recruited (mean age 8.5 years ± standard deviation 6.4 months). Significantly fewer children drew play pre- versus post-migration (11/19, 58% vs. 18/19, 95% P < 0.03). Girls had greater comparative changes in play with migration (pre: 2/8, 25% vs. post: 7/8, 87%, P = 0.06), trending to significance. Of those children who drew play, almost all drew playing outside (pre-migration: 10/11, 90.9%; post-migration: 17/18, 94.4%). Drawings showed equivalent detail pre- and post-migration. Conclusion Resettled refugee children, especially girls, demonstrated limited play pre-migration, with higher levels of engagement post-resettlement. Facilitating opportunities for variety of play may strengthen positive resettlement outcomes for children and parents. Larger longitudinal studies examining play in refugee children and associations with physical, development and psychological well-being are warranted. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

developmental psychiatry/mental health international child health general paediatrics Community

descriptive research refugee Australia human sex difference Refugees controlled study priority journal pediatric hospital qualitative research psychological well being Humans migrant psychology Adolescent cognitive development male Emigrants and Immigrants female preschool child pilot study Child, Preschool drawing tertiary care center child psychiatry Article play migration posttraumatic stress disorder Stress Disorders, Post-Traumatic recreation Play and Playthings psychosocial development Child Development Child