The Autism Society Event and Education Recordings Archive

Play is a lifelong activity that begins at birth and continues to evolve throughout our life span (Yawkey & Silvern, 1977). Play serves a crucial function in our social, emotional, cognitive, language, and cultural development (Baren-Cohen, 1987; Wolfberg, 1999; Mastrangelo, 2009). It also augments creative thinking, creates rapport and cultivates trust, helps develop critical thinking, and alleviates stress (Baines & Slutsky, 2009). It is also important to try and understand the development of play and how it has been defined according to popular theorists in the field. A deeper understanding of these theories and how they relate to play in children with autism will help us better understand the difficulties children face in play and what intervention methods might be best to use.  “Paucity of play is a distinct characteristic of autism, one not easily disentangled from social, cognitive, and affective aspects of the disorder” (Wolfberg, 1999, p. 2).  Wolfberg (1999) also wrote that children with autism face a significant amount of problems pretending and organizing social activity with other children. Discovering the types of problems children with autism face when playing is a considerable challenge for researchers, family members, professionals, and practitioners (Wolfberg, 1999). Unraveling these problems will helps us better understand the issues surrounding play and autism. It will also assist in identifying the interventions that would be most beneficial towards helping children with autism cope with these difficulties.

Learning Objectives Explained:

1.  Identify and describe the basic components of play according to the theories of Jean Piaget and Lev Vygotsky and how they relate to children with Autism.

a. Jean Piaget has been a significant contributor to the theory of child development and his developmental model continues to be used in contemporary research and in understanding the development of play in children (Casby, 2003). According to Piaget (1962) play evolves through various related stages and the development of this skill correlates with the development of intelligence. According to Piaget (1962) children’s play can be classified into 3 different types; practice play, symbolic play, and games with rules.  Piaget also states that at any age or cognitive level of development after the age of two children will engage in types of creative and constructional play. 

 i. Children follow three stages of play in Piaget’s theory; practice play, symbolic phase, and playing games with rules. By taking the characteristics of autism into consideration it is evident children would most struggle with Piaget’s second and third stages of play. Piaget’s first stage, practice play, is similar to functional play. Children do not yet create symbols and can engage in sensory motor type tasks. According to Baron-Cohen (1987) children with autism do not relatively show deficits in functional or reality play. Furthermore, children also demonstrate an abundance of sensory motor play over any other types of play. Piaget’s symbolic stage most similarly represents the symbolic play often described through out this review. Research studies repeatedly show that children with autism struggle with playing symbolically (Baron-Cohen, 1987, Stahmer, 1995, Lang et al, 2009).  Children would also have a difficult time with Piaget’s third phase of playing games with rules. Autism affects a child’s ability to socialize and communicate (American Psychiatric Association, 2000, p. 75). These difficulties make playing with others and following the rules of other children problematic.  According to Piaget children cannot progress to the next stage without having mastered the previous stages.  Therefore, in Piagetian theory many children with this disability would be incapable of reaching the final play stage as they would struggle mastering the first two stages and be unable to fully develop the ability to play games with rules.

b. Lev Vygotsky views play as a social means of development. Through play children are able to better understand the customs and norms relevant to their culture (Vygtosky, 1978).  Furthermore, play allows children to better understand their social environment and develop their cooperative play skills important for future functioning and development (Wolfberg, 1999). According to Vygotsky (1978), while play is not a dominant feature of childhood, it is a leading factor in development. Play transitions from emerging in children as imaginary situations to rules in the development of play.  Play also causes internal transformations in a child and helps children cope with changes in needs and consciousness (Vygotsky, 1978). 

 i. When considering Vygotsy’s perspectives, children with autism would be unsuccessful at developing play skills according to his proposed theories. Autism affects a child’s ability to engage in peer and social relationships (Thomas & Smith, 2003). It also prevents a child from engaging in the social activity necessary to gain shared meanings of values and skills relevant to Vygotsky’s theory. His theory also stresses the importance of play for the development of social skills and for a child to better understand his/her culture. When taking his theory into consideration, a child with autism’s lack of ability to engage in play would inhibit their social and emotional development. Children would not achieve maturation of skills as typically developing peers who engage in various types of play interactions daily.  Autism would also make it difficult for a child to engage in make believe and pretend play, which Vygotsky considers crucial for social and cognitive competence. Since lack of symbolic play is a characteristic of autism, Vygtostky’s theory suggests that some children with ASD would not be able to access this vital developmental play phase and acquire social and cognitive competence.

2.  Examine play development of typical children

a. The names used to describe and differentiate the types of play children participate in have evolved to meet the needs of contemporary times. Some of these types of play will sound similar to the types described by previous theorists. The types of play children engage in are listed below:

i.     Pretend or Symbolic Play

ii.     Functional Play

iii.     Cooperative Play

3. Analyze how the characteristics of Autism affect the development of play stages and skills.

a. Children on the autism spectrum demonstrate substantial delays in the development of play skills (Baron-Cohen, 1987). The fundamental characteristics of autism include the presence of “markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interests” (American Psychiatric Association, 2000, p.70).  Delays or abnormal functioning in children’s symbolic or imaginative play are also defining characteristics of ASD (Baron-Cohen, 1987, Charman & Baron-Cohen, 1997).

 i. Social interaction and play help in the development of play skills for typical peers, however children with ASD exhibit great difficulty with developing appropriate peer and social relationships with peers their age (Thomas & Smith 2003, Prendeville, Prelock, & Unwin, 2006). Autism affects a child’s social or emotional reciprocity and causes “a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people” (American Psychiatric Association, 2000, p. 75).

ii. Proficient communication skills are essential for any child, including children with autism, to learn how to be social partners and engage with others (Wolfberg & Schuler, 1993). However, difficulties in communication skills are one of the defining premises of Autism Spectrum Disorder (Wolfberg, 1999). ASD affects their ability to communicate appropriately with others and his/her environment, and sustain a conversation with others. Communication is also impaired due to repetitive or stereotyped use of words and language, often referred to as echolalia (Wolfberg, 1999). A child’s impairment in communication deters typical peers and children with autism to engage in naturally occurring social situations.

 iii. According to the DSM-IV (2000) the third of the other central categories that define ASD includes repetitive and stereotyped patterns of behaviors, activities, and interests. This makes it difficult for a child to engage in pretend or symbolic play, and social imitative play appropriate to their developmental level. The repetitive and stereotypical behaviors often observed in children can greatly effect the development of play and their ability to learn various skills as observed in various studies (Baker, Koegel, & Koegel, 1998; Lang, et. al, 2010; Rowland & Schweigert 2008).

4. Identify, synthesize, and compare various play interventions for children with Autism. 

a. The following are types of play interventions often used for children with autism and documented in research studies. The way various research studies use them with children vary from case to case. The poster will present how they can be used to help children acquire play skills and the results of the studies using these interventions.  The poster will also present the benefits and drawbacks of using the following interventions and the implications discussed n research studies.   

i.Play Scripts

ii. Integrated Play Groups

iii. Video Modeling 

iv. Pivotal Response Training (PRT)

v.  The Developmental, Individual-Difference, Relationship Based Model (DIR)

Best Practices and Advancement:

1. Although research on play and autism began over 20 years ago with studies conducted by researchers such as Baron-Cohen (1987), much more needs to be done to understand what interventions would best help children.

a. While a handful of play intervention studies exist, what is less available is how successful these interventions are in relation to one another.

b. Interventions do not all focus on every single type of play. A majority of the interventions focus on symbolic play and/or increasing social skills in children.  A single intervention does not seek to improve all forms of play types.

2. It is also important to try and decipher which interventions are most feasible to conduct on a daily basis at home and in the school environment.

a. The feasibility and how much training is involved to implement interventions presented in a school, community or home environment is unclear in the interventions reviewed.

3. Less play research is available of children in naturalistic settings

a. It is crucial for future studies to identify how to modify controlled research studies in large scales and how to generalize these studies to the home, school, and community setting.

4. Autism is a spectrum disorder and children on the spectrum can greatly vary in their social, emotional, cognitive, and functional disabilities.

a. There are less interventions and research available on how to work to improve play skills in children who are severely autistic and have less language or communicative abilities.

5. Implementing play interventions with peers has had a small role in treating and education children with autism (Wolfberg, 1999).

a. Further research needs to focus on how to target this skill in a structured, routine, and consistent basis and how to include this in a child’s home and school treatment plan.

6. Each child’s needs must be considered when choosing which intervention to implement.

7. Autism should not be a barrier for children from accessing play and more research should focus on how to allow all children to learn how to play and acquire social and cognitive competence        through play skills

 *Reference List is Available and can be emailed as an attachment if needed.