Play.

 “If play is the vehicle by which individuals become masters of environments, then play should be among the most powerful of therapeutic tools” –Bundy (1991) 

Play is the primary occupation of children, it is important that everyone understand the need for play activities during the early stages for children diagnosed with Autism.  Play activities assist in achieving developmental milestones across all stages of play and support development across all domains.

Advantages of early play skills for children with Autism:

Cognitive: improves attention span, early object use, symbolic and representation play, imitation, problem solving, discrimination, one to one interaction, sequencing and drawing ability.

Social Emotional: improves temperament, mastery motivation, social interaction with parent and peers, dramatic play, humour and social conventions.

Communication and Language: improves on pragmatics of stages, range of meaning, functions, discourse skills, imitation/ echolalia, sound production system, semantic and syntactic understanding in verbal expression, comprehension of language and oral skills.

Sensorimotor: improves on muscle tone, strength, endurance, reactions to sensory input from environment, play mobility, motor planning, prehension (grasping) and manipulation.

Play and the Child with ASD.

Play can present challenges for those involved in educating young children with Autism, since difficulties in developing play skills characterise Autism in the Early Years. 

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Categories of Play and the Child with ASD:

While there are various conceptualisations of play, Aistear characterises the following key forms of play in early childhood:

Exploratory/Sensory play: using physical skills and sensations to learn about materials and their properties, what they feel like and what can be done with them.

Children with autism can sometimes get ‘stuck’ here. At this stage, be sure to encourage variation in play and make yourself noticed. Help the child focus not only on the toys/items, but on people and faces. Encourage social interactions with physical game such as peek-a-boo.

Begin to teach imitation through reciprocal imitation strategies, which involves imitating the child, describing the actions, and then modelling action for the child to imitate and providing prompting as necessary.

Functional/Constructive play: the manipulation of objects and materials to build or create something using natural or manufactured materials such as blocks, playdough, junk and collage materials, sand and water. Involves creating, recognising and solving problems.

Some children with Autism will excel with these types of constructive or manipulative toys, particularly with activities that are very visual and have concrete beginning and ends such as puzzles, shape sorters or Mr. Potato Head.

However, some children will need additional support such as visual structures, or activities broken down into more achievable steps. For example, you may need to teach the child to create block structures from a visual model/template, or form playdough to match a playdough mat. Or you might break these activities into very small, more achievable steps and gradually build. You could present Mr. Potato Head assembled with only the ear missing, and then after he can do that, with the ear and nose missing and so on. 

Creative play: using open-ended materials such as art materials and natural materials in ways that encourage fluency, flexibility, originality imagination, embellishment and making novel connections.

While children with Autism may readily learn to create structures or projects from visual models and templates, they often have more difficulty with creative play. For many of these children, play can be very routine or repetitive. For example, they may become masters at following visual models or building ‘taught’ structures, but not be able to generate novel block structures or creative figures from play-dough.

To encourage more creative play, try to avoid letting the child establish rigid patterns with particular materials or toys. Interact with the child and model variations in play.

You may need initially to teach through repetition or use of visual models, but if so, use several models and fade over time.

Pretend, fantasy and socio-dramatic play: includes role play, pretending with objects, pretend actions and situations, persistence within the imaginary play frame to create a play episode or event. When it involves interaction and verbal communication with one or more play partners regarding the play event it is termed socio-dramatic play (Monighan & Nourot, 2006). 

Some children may respond well to an adult modelling varied actions with preferred material. However, for some children with Autism, you will need to be quite deliberate and thoughtful about how you teach pretend play.

This might involve progressively working through the pretend play stages as defined by Weitzman and Greenberg, 2002, beginning first with simple actions on self (pretending to eat, drink, sleep), and then on toys or others (pretending to feed a doll).

Next, you might target a series of actions in a familiar routine (making dinner, getting ready for bed), less familiar routines (going to the doctor), and then imaginary themes with peers (pirates or ballerinas).

Physical locomotor play: activities that involve all kinds of physical movement for their own sake and enjoyment. In this type of play a range of fine or gross motor skills are practised and mastered.

Language or word play: unrehearsed and spontaneous manipulation of sounds, and words often with rhythmic and repetitive elements. As children get older, this kind of play often incorporates rhyme, word play and humour. 

Moving from Solitary Play to Social Play.

Working towards cooperative and social play for the young child with Autism will often require having to teach component skills or behaviours which might develop more naturally for other peers.

The following graphic demonstrates considerations and how you might progress play for a young child with Autism with very limited engagement and social interest.