Play offers children the opportunity to try out new ways of relating to the physical and social world. Through a range of encounters they can develop their imagination and skills, without incurring the material consequences of similar activities enacted ‘for real’. It is an essential and often joyful part of child development, and glum is the adult who does not retain some playfulness. It is a laboratory where children can develop different strategies to cope with the practical tasks of daily living and integrate themselves into a social network. Aberrant patterns of play may indicate a variety of difficulties and disorders in development, and may often provide important clues as to the problem. For example, a gross lack of imagination and rigid stereotyped play are found in children with autism; violent play with underdeveloped elaboration of emotional states is characteristic of children with conduct problems; repeated re-enactment of a single disturbing scene may be seen in children with post-traumatic stress disorder; and a disturbed pattern of emotional relationships is often exhibited in the doll play of children with attachment problems. As well as providing clues to the nature of a child's difficulties, play often offers an opportunity to engage with the child, and can provide a main avenue for therapeutic work, particularly with younger children who are not adept at talking about emotions and relationships.

In this and subsequent issues, we shall be publishing a number of commissioned reviews exploring children's play from a number of perspectives. Anthony Pellegrini and Peter Smith start us off with a review of the development of play and its forms and functions. As well as covering the structure of play including fantasy and pretend elements, the authors go on to consider its benefits for the child, and include a rather novel approach of attempting a cost-benefit analysis. Then Peter Blatchford reviews the state of play in schools. Here the importance of a time for the child to develop peer relationships and friendships away from the watchful gaze of adults is stressed, not only from a theoretical viewpoint, but from the practical standpoint of how much supervision should be given in the playground. In future numbers of the Review, we will publish an anthropological perspective by Allison James, a child psychotherapist's view by Anne Alvarez and Asha Phillips, and a review of the importance of drama in play and therapy by Peter Slade. At all times we would welcome your reactions, agreements, and disagreements, plus comments on what you think has been left out. Please do write to the Review office.

In the first part of the Forum on Play, in Volume 3, Number 2, an overview of the functions of play was provided by David Pellegrini and Peter Smith, and the importance of play in the school playground was emphasised by Peter Blatchford.

In this, the second part of our forum, Anne Alvarez and Asha Phillips start us off with a masterly exposition of the importance of play in a clinical therapeutic relationship. They show how analytic thinking about play has developed, and add in a wider understanding from developmental psychology. They give vivid examples of what can happen during therapeutic sessions, and propose that if a secure relationship can be established, the child will then be safe to explore alternative ways of feeling and being, free of fear.

Allison James then brings us an anthropological perspective on play. With examples, she develops the argument that children's play is not merely a re-enactment of adult values and rules. Rather, successful play with other children is a finely tuned ‘act’ that requires sensitive attunement in order to follow the niceties of the rules and meanings that govern situations. These are complex and differ according to the context the child is in, but are specific to the child's own world and not merely generated by adults.

Finally, Peter Slade offers us a uniquely personal view of how he has used play in drama therapy with children. Reading it enables us to glimpse ways of thinking spanning his 50 years of experience.

To give a practitioner's perspective, we invited Ann Cattanach to comment on the first two reviews in the forum and Margaret Hunter to comment on the three reviews in this issue. However, if any of these reviews or commentaries sparks off opinions, reminiscences, or experiences, please write to the Editors, so they can be shared with the readership.

A review of the psychological, psychiatric, and social science literature revealed that parentification and role-reversal are terms that are used extensively, often without precise definition, although the implication is almost invariably that the process is pathogenic. An organismic rather than mechanistic view of the situation might suggest that, as is so often the case, whether the effects are adverse or not depends on a multitude of other factors. The final outcome for any individual can only be judged at the end of his or her life-span and the judgement will be largely subjective.

The concept of dyslexia can be confusing to clinicians who encounter children with severe reading difficulties within their day-to-day practice, given the problems of definition. Usually, such reading difficulties are accompanied by emotional and/or behavioural adjustment problems, or more widespread problems at school, hence the child's referral into child mental health services. Understanding the nature of the reading difficulty offers the prospect of prioritising treatment alternatives. For instance, if a child has a specific reading difficulty that has resulted in much teasing at school, and high levels of parental disapproval, he/she may then manifest symptoms of anxiety that will in turn further hamper the acquisition of reading skills. Remedial teaching, albeit accompanied by work with parents to foster an understanding of their child's difficulties, becomes an urgent priority. Alternatively, it is possible to envisage a situation in which an emotionally abused child is too distressed to acquire reading skills commensurate with their cognitive potential. With the latter child, the underlying causes of their presenting reading difficulty are emotional in origin rather than reflecting a core difficulty or abnormality in their cognitive processing. Although remedial reading may well be necessary at some stage, the clinician should first concentrate on alleviating the abuse. These are, of course, extreme examples and children rarely present in such a clear-cut way. Nonetheless, it is important for the clinician to know whether there is a group of children with meaningfully divergent reading difficulties, such that they can be characterised as having a specific reading retardation. If there are such children, how would they be identified and distinguished from those readers regarded simply as generally poor readers; what is the prognosis for such children; and what remediation would be appropriate and helpful?

The authors examine the historical framework within which child psychotherapists have used play. They discuss developments in theory and technique influenced by advances in psychoanalytic thinking, child development studies, and clinical work with severely deprived and disturbed patients.

Child and adolescent deliberate self-harm is a common problem faced by medical services. In 1982 the Royal College of Psychiatrists recommended that certain guidelines be followed in all cases of child and adolescent self-harm. This paper examines to what extent these guidelines are being incorporated into child and adolescent self-harm policies in the West Midlands region. The implications of the findings are discussed for young people and the NHS Trusts who treat them.

In this review we consider the nature and possible developmental functions of three forms of play: pretend, social, and locomotor. Play is defined in terms of dispositional and contextual criteria. First, the frequency of occurrence of each form of play across the period of childhood is documented. Developmental function of play is conceptualised in terms of immediate or deferred beneficial consequences. Four strategies for examining developmental function are reviewed: arguments from design, correlational analyses, experimental enrichment and deprivation, and cost-benefit analyses. Whereas most theories of play implicitly assume that during childhood it occurs frequently and has benefits deferred until adulthood, we suggest that some benefits of play are immediate.

In recent years, limitations of the discrepancy definition of specific reading difficulties have led researchers to propose that dyslexia is best described as a core phonological deficit. With studies of the normal development of reading as a backdrop, this paper reviews the phonological processing deficit hypothesis of dyslexia. The extant evidence suggests that phonological difficulties in dyslexia persist throughout development from the preschool years into adulthood, despite compensation of reading deficits. Moreover, individual differences in the behavioural manifestation of dyslexia are consistent with differences in the severity of underlying phonological difficulties. Implications for the early identification of dyslexia and for interventions to prevent reading failure are discussed.

This paper offers a critical assessment and some illustrations of an anthropological approach to the study of children's play. It argues that universal definitions of play are problematic and that therefore attention should be paid to the local definitions of play operative in any culture. This includes, importantly, the meanings that children attribute to and generate through their play. Drawing on ethnographic fieldwork the paper illustrates just one aspect of children's play: the different ways in which play facilitates power relations to be articulated, upheld, and challenged. In this sense play is revealed to be far from a frivolous activity. Instead, it is a serious medium through which children conduct their social affairs.

This paper concentrates on children's play during school breaktimes. Though neglected by researchers, it is one of the few occasions when children can play and interact in a relatively safe environment, free of adult control. The paper reports on a recent programme of research at the University of London Institute of Education. There are signs that the prevalence of a negative view about breaktime in schools is leading to more deliberate management and supervision of breaktimes, and a reduction in duration. Breaktime can be a time when aggression, teasing, and bullying take place, but this paper also reviews positive aspects of peer relations and games at breaktime, including opportunities for friendship development, social competence, and peer culture. An important challenge facing schools is achieving a balance between control over pupil behaviour, while facilitating pupil independence and social development.

This study set out to evaluate the treatment of 52 consecutive referrals to a Child and Family Centre. Mothers of referred children were interviewed before treatment and again 3 to 4 months later. The interview investigated the children's behaviour problems, their mothers' mental health and life quality, their attitudes and expectations of treatment, and their satisfaction with the treatment. Significant improvements were observed in children's behaviour problems, mothers' mental health, and some areas of the mothers' life quality. A significant correlation between the children's behaviour problems and their mothers' mental health was observed.

We argue against defining dyslexia as requiring by definition the presence of demonstrable phonological difficulty, and also against defining it in relation to exclusion criteria. Instead, we suggest that what matters is evaluating any child's set of reading subskills against age-related norms for those subskills. We also argue that in considering the causes of reading difficulty it is essential to distinguish between proximal cause (some abnormality in the information-processing system that the child is using to read) and distal cause (the reason for this system being abnormal). The same proximal cause (e.g. poor phonic knowledge) can be the product of different distal causes in different children (e.g. the distal cause might be constitutional, environmental, or educational).

Despite some disagreements among the respective authors, the previous two articles contain many thoughtful recommendations about how to conceptualise reading disability. My reactions will be organised around two issues: the role of intelligence in understanding reading disability and the implications that recent work on subtypes has for the phonological core deficit model.

There is a growing concern about behaviour, violence, and moral attitudes. The following is an outline of the link between home and school and what might be done to encourage early-learning conditions; also there are warnings about how delinquency might start. There is the author's original description of the two main forms of play and of how to establish more constructive attitudes through Social Drama, particularly in Senior Schools. In dealing with delinquents, there is explanation of emotional ‘Experience without Sin’. Conclusions are based on nearly 70 years of careful observation of thousands of children.

Non-attendance for first outpatient appointments at Child Mental Health Clinics is a common problem affecting efficient use of resources, as well as staff morale. This study demonstrates that requiring families to confirm that they want an appointment, in order to receive one, significantly improves the attendance rate for first appointments, compared to two other commonly used procedures: a reminder letter before the appointment is sent, and a standard appointment letter. Furthermore, this procedure did not appear to reduce accessibility to the service.

Interpersonal psychotherapy for adolescents (IPT-A) is a short-term treatment for adolescents with major depression. Unlike most supportive, expressive forms of psychotherapy that are often used to treat depressed adolescents and are not standardised, IPT-A has a treatment manual available (Mufson et al., 1993) and specific training is required for the therapist. Unfortunately, there is no training centre yet in the U.K., although several groups, including ours, are developing expertise in IPT-A. This paper discusses the role of IPT-A, outlines the structure of sessions, and offers an analysis of the differences between this and other therapies.

Peers have both positive and negative influences on children; therefore, considerable attention has focused on assessing peer relationships and friendships through childhood and adolescence. The present article provides an overview of the main methods of assessing peer relationships. The adaptive nature of children's peer relations has been assessed through four main methodologies: (1) asking the children themselves about elements of peer relations and friendships; (2) asking children about their perceptions of others within the peer group; (3) asking adults (i.e. parents and teachers) about the peer relations skills of children in their care; and (4) directly observing children during interactions with peers. Each of these approaches is described, with attention to relative strengths and weaknesses and their suitability for assessing peer relations in early childhood, middle childhood, and adolescence.

Pellegrini and Smith (1998) have provided a challenging review of the forms and possible functions of play during childhood, and Blatchford's (1998) paper on children's play reports a programme of research about the nature of play at school breaktimes that seems to be the sort of research that Pellegrini and Smith recommend in their conclusion, calling for more descriptive studies of children's play. When considering the nature and possible functioning of play during childhood Pellegrini and Smith explore general definitional issues. They suggest that play theorists such as Piaget and Vygotsky considered that play was the way that children learnt skills necessary for successful functioning in adulthood. Perhaps this is a simple way to express, for example, Vygotsky's (1978) descriptions of play in ‘The Role of Play in Development’ in Mind in society. Vygotsky states that in play a child creates an imaginary situation; that play is the place where a child spontaneously makes use of his ability to separate meaning from an object without knowing he is doing it. The creation of an imaginary situation is the first manifestation of the child's emancipation from situational constraints and the primary paradox of play is that the child operates with an alienated meaning in a real situation. Vygotsky may be describing an important skill for successful functioning in adulthood, but it is also an important function in childhood.

Snowling and Coltheart and Jackson provide an excellent overview of the contemporary cognitive and linguistic approach to the description and definition of dyslexia. Both contributors consider dyslexia to be a disorder of written language. Snowling focuses on the origins of the difficulty in a central ‘phonological deficit’. Coltheart and Jackson emphasise the internal modular structure of the reading and spelling systems, suggesting that different components may be impaired in different individuals, resulting in distinctive (phonological and surface) patterns of dyslexia. Both conclude that future research might focus on implications for effective programmes of treatment.

This review examines some of the definitional issues of attention and the related constructs of working memory and executive control. Measurement approaches to two attention elements, inattention and impulsivity, which are relevant to the diagnosis of attention deficit hyperactivity disorder, are also explored. Features of Stroop and Stroop-like tasks, continuous performance tests, and assessment paradigms that have a volitional or motivational aspect, such as delay of gratification, are highlighted. The conclusions emphasise the multidimensional nature of attentional constructs and the care that must be taken when attempting to measure a single attentional element.