Play and Autism

contents

Introduction 3
Interview with Professor Melanie Nind 4
Research Articles Reviewed 11
1. Alone and in a Group: Ethnographic Research on Autistic Children’s Play 11
2. Mothers’ Reports of Play Dates and Observation of School Playground Behaviour of 13
Children having High-functioning Autism Spectrum Disorders
3. Description of a Mother's Play Guidance for her Child with Autism in the Process of 15
Playing by the Rules
4. Inclusion in Play: A Case Study of a Child with Autism in an Inclusive Nursery 18
5. Parents as Play Date Facilitators for Preschoolers with Autism 20
6. Picture Me Playing: Increasing Pretend Play Dialogue of Children with Autism 22
Spectrum Disorders
7. Qualities of Symbolic Play among Children With Autism: A Social-Development 24
Perspective
8. Relationships between the Responsiveness of Fathers and Mothers and the Object Play 26
Skills of Children with Autism Spectrum Disorders
9. e Role of High-Level Play as a Predictor of Social Functioning 27
10. e Impact of the Advancing Social-communication And Play (ASAP) Intervention 29
11. Symbolic Play of Preschoolers with Severe Communication Impairments with Autism 30
and Other Developmental Delays: More Similarities than Differences
12. e Relation between Social Engagement and Pretend Play in Autism 31
13. Play and Communication in Children with Autism Spectrum Disorder: 32
A Framework for Early Intervention

Conclusion 34
 3

Introduction

This is the ninth Research Bulletin produced by

Middletown Centre for Autism. The aim of the
Centre’s Research Bulletin Series is to provide
accessible summaries of relevant peer-reviewed
research articles. The current Bulletin contains 13
summaries of articles related to play and autism,
and commences with an interview with Professor
Melanie Nind.

Melanie Nind BEd, Phd is Professor of Education at the University of Southampton. Her particular areas of
interest and expertise lie in the fields of interactive and inclusive pedagogy, and inclusive research methods.
She also maintains a keen interest in inclusion, and gender, sexuality and disability rights issues within a broad
social justice framework, but is best known for her work on Intensive Interaction. She is editor of the
International Journal of Research and Method in Education and on the international advisory or editorial boards
for the Journal of Research in Special Educational Needs, European Journal of Special Needs Education, British
Journal of Learning Disabilities and Disability and Society.

Melanie began her teaching career in special schools as a teacher of students with severe and complex learning
difficulties and autism. She has also worked in further education where she has coordinated support for
students with learning difficulties and disabilities. In higher education she has worked as an Associate
Research Fellow in the Centre for Autism Studies at the University of Hertfordshire, as a Senior Lecturer in
Special Education at Oxford Brookes University, and at e Open University developing and teaching
undergraduate and postgraduate distance learning courses in inclusive education. She has been researching for
three decades and is currently a co-director of the ESRC National Centre for Research Methods.

Please note that the views represented in this document do not necessarily reflect the views of Middletown Centre for
Autism. Reviewers have, where possible, used the original language of the article which may differ from UK and
Ireland usage and the usage of a range of terminologies for autism.
4

AN INTERVIEW WITH MELANIE NIND

Melanie Nind,
Professor of Education,
University of Southampton

1. What do educators mean by play and play skills or behaviours; it is about being playful in a
why is it important? variety of ways, shaped by sociocultural contexts and
everyday settings as well as individual dispositions. It
As educators, when we talk about play we tend to be is important in its own right and it is important for
referring to an activity we see as integral to children’s well-being and for their learning, for what
childhood and to learning. Particularly in Western it offers in supporting children’s social
Europe and Northern America, we are steeped in connectedness. Yet there are not right and wrong
cultures in which play is seen as a “good thing”, not ways to play. If we are celebrating play we need to
just in and of itself, but for fostering children’s celebrate the ways in which all children play and
development. Even within these cultures, educators have a concept of it that is expansive and inclusive.
are not a homogenous group, of course, and the
sector we work in and the kind of training we have 2. Why do children with autism have
undergone is likely to influence just what it is we difficulties with some types of play?
mean by play. Early childhood educators, for How do children display/communicate this
instance, are often highly committed to play as the difficulty?
business of young children – their work – but also
what comes naturally to them. Tony Booth and Children with autism have difficulties with some
colleagues (2006) sum this up in the Index for types of play when a normative framework is
Inclusion (Early Years) when they assert that young applied. ese difficulties can be continuously
children are experts at play and that it is through exposed by a research tradition in which the play of
their play experiences that they learn. children with autism has been compared with that of
matched, non-disabled peers. Here, so-called play
Play has long been at the heart of early education, skills are assessed in what is presented as objective
valued for being the way that children make sense of tests of play with a focus on those areas of play that
the world, get to know and enjoy it, and feel that are perceived to be lacking: joint attention and
they belong. Being included in play is about being comprehending pretence in particular. Diana Seach
included in the social world of childhood. ere are (2007) has argued that cognitive developmental
many examples of champions of early childhood theories have played a part in building up this deficit
education seeking to protect the place of play in the orientation. ese research and theoretical
early years, where trends toward more formalised approaches have inevitably orientated educators
curricula have put this under threat. Special towards focusing on children’s deficits rather than
educators, by comparison, often have a view of play their strengths, which has led to the preoccupation
in which the instrumental value dominates over the with therapeutic intervention to improve or
intrinsic qualities of play, and in which certain kinds normalise their play skills. Ironically, at the same
of play are valued over others. us, rather than a time children with autism are often placed in
play-based curriculum one is more likely to find play educational environments with structured, adult-led
therapies and interventions designed to teach or philosophies that provide them with fewer
enhance the play skills of children with autism and opportunities to just play, without the holistic
various impairments, not so much to enable the approach that would be enabling.
child’s entitlement to play but as a vehicle to
achieving other goals. is perspective has recently At the level of individual play interactions, children
come under considerable criticism within disability with autism sometimes do not play their part as
studies because it positions the play of the disabled expected and as a result they may not stimulate
child as flawed or lacking; Dan Goodley and playful interactions in others. ere is, then, an
Katherine Runswick-Cole (2010) and Jenene Burke interaction between what children with autism bring
(2012), for instance, offer powerful challenges. and what the adults (or even other children around
them) bring, making play feel like an area of
My own view is that play is more than a collection of
 5

difficulty. Assessments of play skills or playfulness research that adult intervention programmes may
can turn this fluid situation into more of a problem actually reduce or impoverish children’s play with
than it is, but play-based assessment does not have to each other, and the act of intervening in or removing
act in this way. It can also be used to get to know individual children from naturally occurring peer
children as people with preferences and personalities play is not, as I see it, the way to teach play.
that vary as their play contexts vary. I prefer to see a
focus on supporting children’s right to play through I would encourage educators to focus on the
focusing on the whole child in the context of the opportunities for play that they offer and their role
whole curriculum, rather than focusing on within these. We can certainly plan for play. We can
remedying particular difficulties. When we observe go back to the sensible argument that what is needed
carefully we can see that in some environments is a balance of the teaching and learning suited to all
children with autism have an ability to play that children (common pedagogy), that suited to children
challenges assumptions of deficits. I would not wish with specific/impairment-related difficulties (specific
to negate the difficulties of individual children, pedagogy), and that suited to the unique individual
merely put them into a context in which we can view (individual pedagogy). is focuses us first on what
them with a different lens. children on the autistic spectrum share with all
children, including (as Rita Jordon would remind us)
3. Does this have an impact on their the need to be emotionally engaged in learning,
development? hence the regular play opportunities. But it also
prompts us to consider where they might need
For me, as educators we cannot ignore the educative something extra. is means tuning in to the child
potential of play; the potential for fostering and to what we can do to assist, while retaining as far
development in all children. is does not mean that as possible the spontaneity and intrinsic pleasure of
the best way forward is to find out what is broken in play. Teaching play must not equate to taking over
a child’s play repertoire and fix it. It means that we the play agenda and seizing control from the child.
need to provide children with rich and varied play
environments that work for them. It means that we 5. How can practitioners and parents
need to observe so that we can value the play that unlock the motivation for play and move
does happen and the contexts that foster this. It learning forward? Are there key strategies?
means that the adults in those play environments
need to be skilled supporters and mediators of play, It follows from everything I have already said that
and sometimes play partners. In all these ways play motivation for play needs to come from following
can have the positive impact on children’s the child’s lead. We need to create settings in which
development that we know it can have. being playful is irresistible, and keep an open mind
about what form that play might take. Once we have
4. Can children and young people with created carefully considered contexts for play we
autism be taught to play? need to allow children to be active meaning-makers
within those contexts, often intervening as little as
is may depend on your model of teaching and possible in the flow of children’s playful interactions.
learning. When I think about this I do not have in Supporting the motivation to play can mean being
mind telling a child how something is done, or some non-directive and optimally facilitative, with support
elaborate training programme to model and reinforce being most effective when adults follow the lead
distinct skills and behaviours. I have in mind the given by children, enabling them to enjoy
educator’s role in creating an environment in which participating in an activity they show an interest in,
learning happens - often the outcome of a good mix and avoiding styles of interaction in which we
of ethos, human and physical resources, activities dominate. Based on fieldwork in which one child
and support. Fani eodorou found in her doctoral with autism was observed being optimally supported
6

AN INTERVIEW WITH MELANIE NIND

by very skilled practitioners, we concluded that make the best play partners for each other - that they
adults helpfully adopt roles as supporters or can create and sustain mutual interest that is rich and
mediators of play or as active play partners. undirected. e accompanying argument is that the
Supporting play is likely to mean enabling it to shared interest is usually more authentic than when
happen and observing, perhaps offering an adults attempt to establish mutual play with
occasional commentary to children’s activity, but children. We can act as a play partner and
encouraging familiar playful rituals in which children simultaneously and intuitively model how to play,
gain confidence. A mediating role is more but to perform these roles we need to let go of some
purposefully interventionist, yet still intervening no of our other roles, particularly “being in charge”.
more than is needed; most often this will be in the
face of real or potential breakdown in playful Being social is something I aspire to for all children.
exchanges or to provide minimal, timely assistance. If that necessitates adults being play partners rather
As supporting, possibly mediating adults we need to than other children, then we are still opening up the
make ourselves available to children - in quiet social world, and we may have a vital role to play
proximity to their play - ready to be drawn in as a here. rough social play we come to enjoy spending
resource if needed. Sometimes the play will be with time together, making sense of things together, and
us, when we need to take on the role of active play so playing with other children is central to children’s
partner. In this case we need to learn to read social inclusion. I would work hard to facilitate this,
children’s cues and intentions, however idiosyncratic, starting with creating social play opportunities.
and support the establishment of reciprocity and
mutual fun. We have to relax into play and genuinely 7. How does the regulation of sensory
enjoy it. We need to act with spontaneity, but retain input influence play scenarios and
our ability to reflect, in the moment, on how to engagement?
optimise play interactions. All of this is helped
enormously by supportive cultures where there is an We are sensory beings and play is a sensory
ethos of valuing play and playfulness. experience. For some children with autism typical
play environments like playgrounds and paddling
6. Should we support and modify solitary pools can be overwhelming on the senses and
play to encourage inclusion with their thereby interfere with play. We need to get to know
peers? children and what environments suit them best.
Play-based assessment can even be a means for
If we value the social world then obviously we want getting to know them holistically and to know what
to open it up to all children, to foster their inclusion they can do in what optimally supportive social
in social activities and playful interactions. is is situations. Toni Linder’s (1993) transdisciplinary
best helped by creating the right environment and play-based assessment, which involves a team
adopting the roles I have described. We might want observing the child in unstructured and structured
to create situations in which play is happening play, in play with other children and with parents,
alongside children with autism, coaxing them in, or and in various environments, can shed light on the
we might need to be their play partners ourselves sensory features that are facilitative or detrimental to
sometimes. is might be separate to children’s play. Understanding children’s responses to the
solitary play, or it might mean joining in with their sensory world can inform our planning for play.
solitary play. I would not use the language of Phoebe Caldwell & Jane Horwood (2008) are good
modifying play as it creates all the wrong on this theme in relation to those individuals with
expectations, and it devalues the child and whatever autism who experience sensory distress. ey
the play activity is that is important to them. recommend combining the approaches of Intensive
Interaction and Sensory Integration, thus bringing
I am largely convinced by the argument that children together tuning in to the whole person and
awareness of sensory overload.
 7

8. The advent of technology is potentially a Caldwell, P. and Horwood, J. (2008).

motivating means of play engagement for Using Intensive Interaction and Sensory Integration: A
Handbook for ose who Support People with Severe
the child with autism. It has its benefits, but Autistic Spectrum Disorder. London: Jessica Kingsley.
does it also have disadvantages?
Goodley, D. and Runswick-Cole, K. (2010).
is is not something I have much experience of Emancipating Play: Dis/abled Children,
Development and Deconstruction.
myself. e technology I am wed to is the video Disability and Society, 25, p. 499-512.
camera and the role video can play in helping us to
reflect on play interactions and our own role in Jordan, R. (2007) Social Inclusion and the education
them. Beyond that, the answer I could give, based on of children with Autism Spectrum Disorder
what I do know, is that if some form of technology is (Unpublished). A speech at International European
Congress 1 September 2007.
what is interesting and engaging for a child with
autism, then we would be foolish to ignore its Lewis, A. and Norwich, B. (2005). Special Teaching
potential for playfulness and play interactions. I also for Special Children? Pedagogies for Inclusion.
know that there is enthusiasm for the potential of the Maidenhead: Open University Press.
technology of virtual reality to offer a vehicle for
Linder, T. W. (1993). Transdisciplinary Play-Based
children with autism to engage in simulations of Assessment: A Functional Approach to Working with
real-world social situations and learn about them Young Children. Baltimore: Paul H. Brookes
without being threatened by them. us a child Publishing Co.
might engage in virtual play with virtual children in
a controlled way, learning about the social while Nind, M., Flewitt, R. and eodorou, F. (in press).
Play and Inclusion, In: Cologon, K. (ed.)
avoiding the social! ere might be potential for real A Good Start: Inclusion in the Early Years. Oxford:
children playing collaboratively in this way, and there Oxford University Press.
might be motivating elements. My colleague at
Southampton, Sarah Parsons, has research experience Nind, M. and Hewett, D. (2005). Access to
of this, but she also warns of over-optimism Communication: Developing the Basics of
Communication with People with Severe Learning
regarding the role virtual environments are as yet Difficulties through Intensive Interaction.
able to play in supporting real-world, especially non- (2nd edn). London: David Fulton.
rule-bound, social abilities (Parsons & Cobb, 2011).
My own view is that there is plenty of potential in Parsons, S. and Cobb, S. (2011). State-of-the-art of
the ready availability of everyday children, adults and Virtual Reality Technologies for Children
on the Autism Spectrum. European Journal of Special
social situations, and that we have the ability to Needs Education, 26 (3), p. 355-366.
make play safe and motivating without the need for
such technology. We need to be careful not to Seach, D. (2007). Interactive Play for Children with
disempower ourselves, or to de-value the human Autism. London: Routledge.
resource of the children in our classrooms, families
eodorou, F. and Nind, M. (2010). Inclusion in
and neighbourhoods. Play: A Case Study of a Child with Autism in an
Inclusive Nursery. Journal of Research in Special
Bibliography Educational Needs, 10 (2), p. 99-106.

Booth, T., Ainscow, M. and Kingston, D. (2006). Trevarthen, C., Aitken, K., Papoudi, D. and Robarts,
Index for Inclusion: Developing Play, Learning and J. (1996). Children with Autism: Diagnosis and
Participation in Early Years and Childcare. Bristol: Interventions to Meet their Needs. London: David
Centre for Studies on Inclusive Education (CSIE). Fulton.

Burke, J. (2012). Some Kids Climb Up; Some Kids

Climb Down: Culturally Constructed
Play-Worlds of Children with Impairments.
Disability & Society, 27 (7), p. 965-981.
 11

Research Paper

Alone and in a Group: Ethnographic Research on Autistic

Children’s Play

RESEARCH AIMS ■ Imitation, re-enacting the play of adults rather

than peers
is research aimed to study the social interaction
and play of children with autism, and the role of the ■ Simple functional play, with the preferred toy
adult in developing play skills. e researchers of choice being a car
expected the children with autism to encounter
significant challenges in: ■ Imaginative play. Although the children used the
toys in what appeared to be imaginative play
■ Learning how to play and socialise with their scenarios, some may have been re-enactments
peers from previous experience, playing in a manner
■ Entering the play arena that follows a story.
■ Listening and catering to others
■ Arousing and maintaining the interest of others Group Play
■ Ending the play.
ere appeared to be differences between playing
e uses of play as a learning tool in both academic together, creative action, cooperation, interaction
and social fields were also highlighted by the and directing the action. e children who had
researchers. greater language skills were more able to interact
with their peers. One child tended to be dominant,
RESEARCH METHOD controlling the play, with the others following
imaginative play in such situations.
Forty-five children (11 girls and 34 boys) with
autism in 11 groups were observed, with Television, video, music video, computer or the Play
documented written notes and videotapes, in Station were all popular forms of introducing shared
organised and free play situations. activity. e children also engaged in rough-and-
tumble play scenarios, appearing to enjoy them, but
■ Twelve children were under 6 years of age it became apparent that the children with autism had
■ Eighteen were between 6 and 11 years difficulty discriminating when this moved to
■ Fifteen were aged between 12 and 16 years. inappropriate and harmful behaviour.

e study addressed the question, “How do children IMPLICATIONS FOR PRACTICE

with autism play?” and sought to answer this (by the authors)
through analysis of the lone and group play activities
of children with autism. ■ If there is a route to open the social world of
children with autism, then teachers, parents and
RESEARCH FINDINGS allied health professionals need access to methods
to support the child on an individualised basis.
Lone Play
■ When children with autism are playing, we must
In the majority of situations, the children with be aware that there may be a logical pattern or
story to the play and that the child may be
autism played alone without paying attention to
deriving some form of comfort. e child may
other children and engaged in: also engage at particular times within the re-
■ Sensomotoric practice play, manipulating and enactment, which could be opportunities for new
arranging items learning.
12

■ As the child frequently re-enacts the play of an Full Reference

adult, a structured approach, with a script
designed to support social interaction, can be Kangas, S., Määttä, K. and Uusiautti, S. (2011).
used to develop opportunities for group Alone and in a Group: Ethnographic
activities. Research on Autistic Children’s Play. International
Journal of Play, 1 (1), p. 37-50.
■ Adults and peers may be used to teach more
complicated play skills, yet focused repetition
and practice will be needed to allow the child to
master the skill.

■ Use the motivator of television, video, music

video, computer or the Play Station to initiate
group play experiences, as the children actually
supported one another as they discussed and
guided the play.

■ Vigilance is needed when children engage in

rough-and-tumble play, as the children may not
be able to see or interpret how another is feeling,
when this is then changing to play that is hurting
another. However, as rough-and-tumble play
appears to be appealing and important for
children with autism, the children may need to
be specifically taught a safe place and safe way of
engagement.

■ Children with autism will engage in functional

play during unstructured times, yet the
development to symbolic functional play may be
dependent on cognitive and communication
skills.

■ e children’s play may be controlled by their

compulsion for repetition, sensory needs and
personal interest, refelective of lone sensomotoric
rather than group play activities. Having said
that, novelty or the introduction of a motivator
can interrupt lone play for engagement in a
group activity. Having a memorable experience
seems crucial for encouraging play progression.
 13

Research Paper cont.

Mothers’ Reports of Play Dates and Observation of School

Playground Behaviour of Children having High-functioning Autism
Spectrum Disorders
RESEARCH AIMS children with autism who had more play dates in their
home tended to engage for longer time in mutual
Children with Asperger’s syndrome or high- behaviours such as offering of objects, conversing and
functioning autism have been observed to initiate joint attention. Importantly, they also received more
and reciprocate peer interactions much less positive responses to their overtures from peers.
frequently than peer-matched children with
developmental disabilities. Play dates, which are Results revealed that the frequency of play dates was
popular in our society among neurotypical children, most important in predicting joint engagement and
are thought to be an important contributing factor positive responses to overtures from peers, and these
to the formation and maintenance of friendships. relationships remained highly significant even after
e current study set out to assess the relationship accounting for other demographic, general social and
between play date frequency and amount of conflict, cognitive variables, including verbal IQ.
with peer interaction observed on the school
playground. It was hypothesised that children with It is noteworthy that the most important contribution
autism who experienced less conflict and more of play dates to the development of friendship was their
frequent play dates would have more friends at persistence rather than their quality; it would appear
school and this would be reflected in more positive from these results that even play dates that were
peer interaction in the playground. characterised by higher levels of conflict and lower
quality of interactions still fostered more interaction in
the playground.
RESEARCH METHOD

Twenty-seven boys and four girls and their families IMPLICATIONS FOR PRACTICE
participated in the study. Twenty-nine of the (by the authors)
participants were in mainstream education and two
were in special education placements. Increasing the frequency and quality of play dates for
children with autism may be an important outcome of
Parents were asked to complete the Autism Spectrum school-based social skills training and may result in the
Screening Questionnaire, the Social Skills formation and maintenance of best friendships. is is
Responsiveness Scale, the Quality of Play important as authors have found that where a child
Questionnaire and the Conflict Scale. Children’s with autism has a “best friendship” with a neurotypical
interactions were also observed in playground child, the friendship has been found to be more durable
situations and their behaviour was coded to allow for and stable and both children have been found to
quantitative analysis. display higher levels of goal-oriented social behaviours
and positive affect.

RESEARCH FINDINGS Additionally, friends in mixed dyads were more

responsive to one another, showed higher levels of
e hypothesis that children with less conflict and positive social orientation and cohesion, and
more frequent play dates would have more positive demonstrated a more complex level of coordinated play
peer interaction in the playground was partially that those in non-mixed dyads.
confirmed. e frequency of play dates, but not
conflict on play dates, was related to rates of peer As a consequences of these findings, it seems crucial
interactions in the playground. It was also found that that parents are supported by the professionals working
14

with their child to organise play dates that are held

outside of the school day.

Full Reference

Frankel, F. D., Gorospe, C. M., Chang, Y. and Sugar,

C. A. (2011). Mothers’ Reports of Play
Dates and Observation of School Playground
Behaviour of Children having High-functioning
Autism Spectrum Disorders. Journal of Child
Psychology and Psychiatry, 52, p. 571-579.
 15

Research Paper cont.

A Description of a Mother's Play Guidance for her Child with Autism

in the Process of Playing by the Rules

RESEARCH AIMS RESEARCH FINDINGS

e purpose of this study was to provide a In order to examine the interactions of the mother
description of the strategies employed by a mother of with her child, the mother created a group of five
a child with autism during games activities with people for her child to play hide-and-seek, tag, and
typically developing peers, to help support the child other games with. e game of hide-and-seek, for
with necessary social skills. example, was played in a park near the child’s home.
Video recordings of the game were examined. e
analysis of the recordings showed that the mother used
RESEARCH METHOD
13 verbal and seven non-verbal communication
strategies during the game (Figure 1). How the mother
is was a qualitative single-subject case study. e
used the strategies was as important as the kind and
participants were a mother and her nine-year-old son
frequency of the strategies.
with autism, one brother, and three typically
developing peers. e participants were determined
e methods by which the mother used these strategies
via a purposeful sampling technique.
are explained under the headings of:
e study was carried out in the family home and at
the children’s park. e researcher took part in the Mother’s contribution
study as “participant observer”. e mother gave the e mother determined the child’s play preferences
researcher the role of “teacher”. e brother was and play initiations, made environmental
instructed to participate in the playgroup as a play arrangements, guided the participation process,
partner, in the same way as the peers and the child found playmates and invited them to play.
with autism.

Data were collected using field notes, interviews,

audio- and videotape recording during normal
interactions between the mother and her child.
Figure 1

Verbal communication strategies Non-verbal communication strategies

Giving instruction Physical prompting

Whispering Modelling
Asking question Gestural prompting
Making explanation Making eye contact
Reminding Touching
Approving Waiting
Verbal prompting Using gestures and mimics
Self-talk
Encouraging
Comical action
Giving feedback
Rewarding
16

Mother monitoring play initiations and the ■ Play guidance.

preferences of her child. e mother played with her son to help him take
Once the mother knew her child’s play preferences, part in the game. She gave him reminders to help
games were planned accordingly. e mother also him focus and to complete tasks in the game.
used what the child liked to do as a reward, in this
case playing computer games and cycling. Mother’s contribution in making her child
participate in a “play by the rules” game
e mother initially played with the child alone to Hide-and-seek is a game with five aspects: starting
monitor play initiations in the hide-and-seek game. the game, counting out, hiding, being “it” and
When it was apparent that the child was not meeting ending the game. e mother’s guidance process in
the tasks of the game, the mother invited the child’s these aspects, the strategies she used to make her
brother to participate in the game. She then hid with child participate in the game and the child’s
the child and jointly tried to find his brother. A few participation process are explained through the
days after the first hide-and-seek game the mother descriptions below.
played the game again in her home, helping her
child to find the other children when he was “it”. Starting the game activities.
At the beginning of the game the mother wanted the
Environmental arrangements. children to gather in the playground and greet each
e mother used the slide unit in the park for the other. She guided them in planning the game and
children’s hide-and-seek game. e street lamp remembering the rules. To assist the child in the
located near the playground was chosen as the home greeting aspect, the mother attracted her child’s
base. attention by touching him and asking him the
question, “Did you say hello to your friends?” to
Finding playmates and inviting them to the remind him to greet his friends.
game.
e mother found the friends to play with her child Counting out and choosing “it”.
and invited them to play the game. e children were gathered around. e mother
chose one of the other children to count out. e
Mother’s process of guided participation. child sang out a counting-out song whilst pointing
e mother participated and guided the children. to each child. When the child with autism was “it”
is process of guided participation can be examined the mother pulled her child to her chest (touching),
under the following three headings: getting his attention and making him wait. After the
other children told him he was “it” his mother
■ Social communication guidance. explained he was “it” and directed him towards the
By participating in the game the mother guided home base using physical prompts.
her child’s initial interaction with his peers,
responded to the subsequent interactions and Hiding.
helped sustain his interaction. e child’s activities consisted of finding a place to
hide, waiting in that place, controlling home base
■ Scaffolding interactions. and tagging home base. For example, when the child
e child was supported by his mother according had to hide the mother told her son that they had to
to his needs. rough giving instructions, acting hide. e child waited and looked at his mother. e
as a model and providing verbal assistance, the mother then grabbed his arm and walked with him
child’s initiations increased and the mother behind the trees. e child crouched down when she
withdrew her support; however, she never carried touched his shoulders and pointed for him to sit. She
out any independent application. also gave him verbal instructions to hide quietly by
whispering, and then asked him to verify whether he
understood what they were doing.
 17

Research Paper cont.

Being “it”. interaction strategies in this guidance process. In

When it was her child’s turn to count out, the doing so she contributes to the process of
mother used a sign clue to get him to close his eyes participation in the games by the child with autism
and reminded him to count by saying “one”. When and in the child’s social interaction with his peers.
he had completed his counting his mother attracted
his attention by grabbing the child’s right shoulder IMPLICATIONS FOR PRACTICE
(touching) and saying “let’s seek now” (giving (by the authors)
instruction). When the child went in the wrong
direction, his mother called out his name to get his If adopting the integrated playgroups model the
attention, then called him near her by giving research highlights that:
instruction.
■ It is important before starting to engage in play
Ending the game of hide-and-seek. the abilities and interests of the child should be
In the process of ending the game, planning the observed and interpreted. e play environment
activities of another game and saying goodbye were and play materials should be prepared, and
friends found and invited to play.
carried out. e child’s mother grabbed his shoulder
from behind and leaned slightly towards him. e ■ Skills should be taught in natural environments
mother reminded the child to say goodbye by asking that are full of peers who have social capabilities
him the question “Did you say goodbye?” e and where children often display difficulties in
mother also helped to make plans for arranging social skills, such as in the home, at school and in
another appointment for the day after. After the social areas.
child had said goodbye the mother gave her approval
by saying “Ok, let’s go”. She waved at the other ■ Playgroups should consist of familiar children,
children (modelling). siblings, at least three people, at most five people,
and there should be more peers who have social
competences in the group as this has been shown
An examination of the video recordings revealed that to help children with autism to improve their
the sequence of how the mother took part in play social skills.
activities with her child showed similarities to that of
the integrated playgroups model. In this study no ■ e role of the adult should be to determine
instructions were given to the mother. e child with what the child can do independently and offer
autism and the mother have no educational guidance to assist the child to participate in an
experience about the integrated playgroups model. It activity that the child cannot do independently.
is thought that this model could be an easily e adult should then act as a support to assist
the child’s performance in the play activity.
applicable one.
■ e authors also recognise that in future research,
is research was not aimed at observing the increase a child’s acquisition of play skills with the
in the participation rate of the child at play or the guidance of the mother could be examined by
usage of verbal expression. e gradual withdrawal of carrying out experimental studies. Further
the mother’s guidance in the play and going back to research could also examine the interactions of
verbal guidance while counting and being the person the children in the playgroup with each other
who looks for others hiding in the game can be using qualitative research methods.
interpreted as a way of increasing the child’s
participation in play. A child with autism can learn Full Reference
how to play games.
Ökcun, M. C. and Akçin, N. (2012). A Description
of a Mother’s Play Guidance for her Child with
e data examined in this study revealed that a Autism in the Process of Playing by the Rules.
mother having a child with autism acts as a guide Journal of Research in Special Educational Needs, 12
during games and uses verbal and non-verbal (2), p. 96-106.
18

Inclusion in Play: A Case Study of a Child with Autism in an Inclusive

Nursery

RESEARCH AIMS ■ Teacher as mediator – intervening in the face of

potential misunderstanding or exclusion.
is ethnographic case study aimed to understand
and describe the play of a child with autism in a ■ Teacher as active play partner – acting as a role
naturalistic early years setting. It discusses the play model while engaged in the play scenario. e
interaction of a child and the strategies adopted by skilled exponent can be both playmate and
her teachers to facilitate her successful inclusion. e facilitator.
authors hold the view that the promotion of play as a
vehicle for social interaction and learning is central IMPLICATIONS FOR PRACTICE
to support teachers to provide for successful (by the authors)
inclusion and the subsequent benefits for all in this
classroom environment. Teachers must plan their ■ When a child wishes to engage in an interaction
practice to ensure the inclusion of children with with a peer, he/she may not have the necessary
autism. skills and in such an instance an adult should
provide the child with autism with the necessary
vocabulary and commentary.
RESEARCH METHOD
■ e adult can motivate, engage and maintain
e study was conducted in an early years setting attention by modelling the acceptable format of
that aims to meet the educational needs of 50 the play using the appropriate pedagogical
children between the ages of three and five years, interactions and framing. Children with autism
coming from a diverse range of ethnic backgrounds rely on the adult to provide the opportunities
in an urban setting. e focus was a girl with autism and the resources to enhance interactions and
described as being intelligent, computer-wise and learning.
having a keen interest in the character “omas the
Tank Engine”. Data derived from field and video ■ Without over-interference the adult may have to
observations, field notes of brief jottings, direct explain the expectation of the play scenario on an
quotations and episodes of dialogue and interviews individual basis to the child with autism. If
were collected in week-long blocks across a six- he/she does not know the rules of the play,
month period. e study observed the child with he/she cannot be expected to learn them without
autism and her play but did not compare the child to specific guidance.
her typically developing peers.
■ Such explanations must also be carried out in a
RESEARCH FINDINGS timely fashion to ensure that others do not
become frustrated when the child with autism
e case study concluded that teachers attempting to does not comply with the rules and expectations
ensure successful inclusion facilitated the child by of the play.
operating in three distinct capacities:
■ Children with autism learn from observing,
■ Teacher as supporter - supporting the children’s modelling and interacting with their peers.
play by modelling cooperative involvement However, teachers may have to teach the
rudiments of the play activities to ensure
whilst offering occasional commentary. To aid understanding and inclusion. is direct
inclusion, the teacher asks the child a direct involvement can lead to sustained attention,
question and gives her a role within the play. more shared experiences, and greater
 19

Research Paper cont.

opportunities for learning and cognitive

development.

■ Teachers have the opportunity to teach

appropriate interactions with consideration and
cooperation when immersed in the play
situation.

■ e use of a collaborative and supportive

curriculum framework assisted the teacher and
other staff members to include, and the child to
be included.

■ e strategies used by the setting were supportive

of all of the children, all-inclusive, contextually
and culturally appropriate, and not seen as
explicitly “autism-specific” approaches – good
practice can be just that, good practice.

Full Reference

eodorou, F. and Nind, M. (2010). Inclusion in

Play: A Case Study of a Child with Autism in an
Inclusive Nursery. Journal of Research in Special
Educational Needs, 10 (2), p. 99-106.
20

Parents as Play Date Facilitators for Preschoolers with Autism

RESEARCH AIMS interactions between their children with autism and

their typically developing peers. Play dates occurred
Although most social play interventions have been in each family’s home across a variety of natural play
designed and implemented in school settings, settings. Materials for the play dates varied according
research suggests that typically developing children to the interests of the children and the play date
often invite friends to play at home. To date there activity. Materials were supplied by the parent except
has been little research to examine the home play for a few special toys that were provided by the
date as a potential intervention context for children researcher.
with autism.
To prepare for implementation, each parent received
e aims of this study were to assess the effectiveness instructions on how to host a contextually supported
of parent-implemented contextually supported play play date that involved:
dates.
■ Mutually reinforcing activities – activities that
were motivating to both the child with autism
RESEARCH METHOD and the peer.

Two boys with autism, their mothers and two ■ Cooperative arrangements – activities that
playmates were recruited for the study through an encouraged the participation of both children,
agency providing early intervention services to i.e. coaching child-child interactions only as
children with autism. Children with autism were needed.
included in the study if they:
e primary dependent variable measured in this
■ Were aged between four and six years with a study was the percentage of 30-second intervals
diagnosis of autism from a medical professional during which the children with autism engaged in
synchronous reciprocal interactions (SRIs) for the
■ Were able to understand English as their first majority (i.e. at least 16 seconds) of the interval. An
language and had a receptive language age SRI began when a child made a verbal statement or
equivalent of at least three years question, eye contact, facial expression or
gesture/action that was directed toward the other
■ Were engaged primarily in parallel play with child and was related to engagement in a joint
peers activity. If the child with autism was prompted by
the parent to make any of these, the subsequent SRI
■ Were able to remain independently engaged with was not counted. An SRI ended as soon as either
preferred play activities for at least 10 minutes at child stopped participating in a cooperative motor
a time act (e.g. one child pulling his hand off a spoon when
two children were stirring together).
■ Had access to a regular peer play partner who
was no more than three years younger or older Secondary measures included affect ratings for the
and had no identified social, cognitive or children with and without autism and parents, plus a
behavioural problems measure of social validity completed by the parents
immediately following completion of the study and
one year later. In addition, a follow-up survey related
■ Had a parent who agreed to the time to parents’ use of the key play date strategies.
commitment required for play date facilitator
training. Children with autism were excluded Two independent reversal designs were used to
if they engaged in serious peer-directed problem demonstrate functional relationships between parent-
behaviour in peer play situations. implemented, contextually supported play dates and
an increase in synchronous reciprocal interactions in
e two parents were taught how to design both participants.
cooperative play arrangements to facilitate social All sessions were videotaped for data collection. A
 21

Research Paper cont.

research assistant (RA) who was blind to the IMPLICATIONS FOR PRACTICE
condition she was coding was enlisted to observe the (by the authors)
videotapes and record occurrences of the target
behaviours. e RA was provided with a scoring Each approach to play is best suited to children with
manual containing operational definitions of autism with specific skills profiles; however, there is
examples and non-examples of target behaviours, little information available to inform decisions
and a scoring protocol. Training was provided until regarding this. Parents in the study found that using
the RA achieved 90% accuracy over three practice motivating material, avoiding distracting stimuli,
play date activities that were not part of the study. providing only one of each item so the children
e data were coded and scored from all videotaped needed to share, and preparing materials in advance
sessions. Videotapes were also reviewed to examine all helped with implementing this type of
the parents’ ability to implement the intervention intervention.
accurately. For each activity, a checklist was used to
evaluate the parents’ use of the 10 strategies that e authors of the approach examined in the present
were presented during training. Each strategy was study recognise that it is more appropriate for the
scored as either correct or incorrect for each play date home setting that involves only a few children and is
session. supported by parents. It is the first time a study
involved teaching parents to conduct contextually
RESEARCH FINDINGS supported play dates and to use preschool children
with autism and young school-aged children as
e results of this study suggest that teaching partners. Future research is therefore required to
parents/caregivers to support social play in their explore the effectiveness of this intervention across a
homes is both feasible and desirable. ere was a variety of settings and across a more varied group of
steady increase in the number of implementation individuals.
strategies used by both parents. Activities for both
children increased during this phase and there was an A limitation to this study is that the sample size was
immediate and dramatic increase in synchronous small involving participants with distinctive
reciprocal interactions (SRIs) for both children. characteristics. Future research would also be needed
Supplemental measures also indicated improvements to replicate the training procedures with many
in child affect and an increase in the number of different types of parents and with children of
social invitations (e.g. sleepovers, birthday parties) varying ages, backgrounds and abilities, and to
received by the children with autism over a one-year examine the relative effectiveness of various
follow-up period. approaches for supporting children with autism of
various ages and abilities.
Upon completion of the study both parents rated
their confidence in their ability to plan and execute is study did not anticipate the importance of
play date strategies as very high. ey also felt that parent-to-peer prompting during the intervention
their children’s ability to participate in play dates had and therefore did not assess the frequency of parent
increased. Approximately one year after the prompts across the videotapes. Future research
intervention ended, none of the social validity scores should include a specific measure of this component
had changed dramatically. Both parents continued to to determine its importance as part of the overall
rate the strategies as useful, displayed confidence in training aspect of the study.
their ability to use them and continued to host play
dates using the strategies they had been taught. e Full Reference
results therefore suggest that parents can learn skills
to become skilled play date facilitators within their Jull, S. and Mirenda, P. (2010). Parents as Play Date
own homes within a reasonable length of time. Facilitators for Preschoolers with Autism.
Journal of Positive Behaviour Interventions, 13(1),
p. 17-30.
22

Picture Me Playing: Increasing Pretend Play Dialogue of Children

with Autism Spectrum Disorders

RESEARCH AIMS and 2 females). Prearranged schedules and roles were

in place prior to the intervention for this study.
is study examined the effectiveness of the Picture
Me Playing intervention for increasing the play Prior to the baseline observations, a toy survey was
dialogue (PD) of preschool children with autism completed by caregivers of each child in order to
during pretend play opportunities with typical peers. choose materials that were of equal familiarity and
skill to each child. e Picture Me Playing story was
Picture Me Playing is a pictorially enhanced, script- only used during the intervention and was not
based intervention targeting character role play available to the participants during data collection.
through a narrative vignette.
Baseline measures were taken for all the participants
e following research questions were investigated: divided into the two groups of six. One group was
randomly selected to receive the intervention during
1. Would the intervention group exhibit greater the first condition. e second group served as the
gains in PD than the comparison group? comparison group.
2. After both groups received the intervention
Data were collected in a quiet office within the
would the participants demonstrate increases
in their ability to produce PD with peers centre on two separate days, to limit the influence of
while playing with the trained toy? a participant’s individual mood on a given day. Adult
prompting was not permitted with the exception of
3. Would the participants demonstrate increases ending problematic or dangerous behaviour. Each
in scripted as well as unscripted utterances? interaction was video recorded and timed with a
stopwatch. In the baseline and intervention phases,
the children were given the opportunity to interact
RESEARCH METHOD with the target toy (castle set) during two five-
minute sessions occurring on separate days.
e study was conducted at a private comprehensive Different peers were utilised to avoid the possibility
treatment centre for children with autism. Twelve that a particularly engaging or inhibiting peer might
children were selected and parental permission given. skew the performance of an individual child. e
Children were aged between 55 months and 75 peers participating in data collection also served as
months and had a diagnosis of autism or pervasive the peers participating in the group intervention and
developmental disorder - not otherwise specified each child participated in data collection with at least
(PDDNOS). e children were all able to follow one same-sex peer. Data from only two play sessions
group-directed instructions as well as comply with were added together, resulting in the amount of PD
and attend to group activities. Eight typically exhibited by each participant.
developing peers, four from each classroom, also
took part in the study but were not targeted or Transcriptions were coded in order to determine
assessed. ey simply acted as communicative whether participants would directly repeat the
partners. scripted utterances or if increases would be noted in
novel, unscripted utterances.
Attendees from two of the preschool classrooms were
assigned to comparison and intervention groups Social validity questionnaires were distributed to
based on which class they attended. Each group participating families. Respondents were asked to
consisted of 6 children with ASD (five males and one rate play skills on a three-point scale. Additional
female) and four typically developing peers (2 males
 23

Research Paper cont.

questions required the respondent to agree or IMPLICATIONS FOR PRACTICE

disagree on a scale of whether they had observed (by the authors)
behavioural changes in the children.
is research highlighted a number of implications
RESEARCH FINDINGS for practice:

Results of this study indicate that the Picture Me ■ Peers are a critical component of research
Playing intervention was effective for increasing the focusing on child-to-child interaction. is study
PD of the children with autism during interactive provided some evidence for the effectiveness of an
integrated playgroup. ere is no need to
play activities with typically developing peers. specifically train peers to prompt or cue children
Significant differences were displayed between the with autism.
intervention and comparison groups and for the
within-subjects comparisons following introduction ■ It is essential to provide specific and direct
of the intervention to the comparison group. instruction, even scripted dialogue, to children
Participants were able to generalise the increased with autism; it is just as important to provide
levels of PD to a novel toy. A significant 60% of the intervention in the natural environment during
meaningful communicative interactions.
post-intervention PD was coded as unscripted, novel
utterances, indicating that the children were not ■ e Picture Me Playing intervention, because of
strictly following the scripts provided. Overall the its visual strategy, could be incorporated as an
participants demonstrated high levels of appropriate independent learning centre in a preschool
dialogue across the study and reduced the level of classroom.
inappropriate utterances by 4% after participating in
■ Results of the study are limited due to the small
the intervention.
sample size and the lack of random group
structure. Ideally, an additional generalisation
With regard to the children’s ability to maintain their condition should be implemented to mirror the
level of PD with an untrained toy, post-intervention baseline condition. us, baseline to
data were compared to generalisation data in order to generalisation comparisons from this study
evaluate whether there was a reduction in PD should be interpreted with caution. Emphasis in
between the trained and untrained toys when this study is, however, more appropriately placed
on comparisons between post-intervention and
scripted utterances were not provided. Results generalisation data. Future research could repeat
indicated no significant difference, demonstrating and extend these findings using both older and
that the level of PD was maintained from younger participants, and children with lower
intervention to generalisation. verbal ability.

Results of this study are consistent with previous Full Reference

studies indicating that children with autism can
increase pretend play behaviours following Murdock, L. C. and Hobbs, J. Q. (2011). Picture Me
intervention. e Picture Me Playing intervention Playing: Increasing Pretend Play Dialogue of Children with
allowed children to engage in high levels of pretend Autism Spectrum Disorders. Journal of Autism and
play with no adult prompting, and to maintain the Developmental Disorders, 41, p. 870-878.
learned skill when only provided with a basic play
structure.
24

Qualities of Symbolic Play among Children With Autism:

A Social-Development Perspective

RESEARCH AIMS ■ Self-awareness

is study’s aim was to determine if children with ■ Investment in symbolic meanings
autism engaged in less playful pretend play. is ■ Creativity
involves self-conscious awareness of pretending, and
the symbolic representation of the materials ■ Fun.
provided. It hoped to gain insight into the nature of
the play amongst children by paying close attention RESEARCH FINDINGS
to those qualities of symbolic representational play
that might derive from and reflect specific aspects of e study found that the playful pretend play of
children with autism, in both the spontaneous and
social engagement. e assumption made at the modelled interaction, was distinctive due to
beginning of the research was that children with difficulties in the lack of awareness of self in creating
autism display a limited capacity for creative meanings, investment in symbolic meanings,
symbolic play. creativity and fun, which may be deemed as essential
and reflective of normative social and creative play
RESEARCH METHODS development.

Children with autism demonstrated relative

e study tested pretend play activities in 16 boys competence and ability with the mechanics of
with autism between the ages of 7:1 and 13:9 years, pretend play, yet experienced difficulty with the
and 16 children (11 boys and 5 girls) between the expression of this playfulness. Children with autism
ages of 7:10 and 12:3 years who did not have autism, matched their peers in terms of inventing imaginary
but did have a learning difficulty or a developmental objects, making one item represent another and
flexibility in using the play objects. e children
delay. All children were matched through verbal with autism appeared to engage more confidently
ability ascertained using the British Picture and creatively when the play had been modelled,
Vocabulary Scales (BPVS). particularly when using the toys for more than one
purpose, and to illustrate the playfulness that can be
e children were tested individually and this was achieved.
videotaped for future reference and rating by an
independent clinician, who was not given any insight IMPLICATIONS FOR PRACTICE
into diagnosis, through two play scenarios: Doll (by the authors)
Condition and School Condition. e test consisted
of: ■ Children with autism can play and can engage in
1. Play without modelling – spontaneous play symbolic play activities. ey may simply be less
with the instruction, “Use these things to emotionally expressive, and may be so in a
make up a story” manner that is difficult to recognise.

2. Modelled play, with the tester describing all ■ We may not realise what exactly is at the heart of
of his actions. their pretend play experience. erefore close
attention must be given to the child’s expression
of motivation and engagement in an array of play
e tester commented, encouraged and talked with opportunities and situations.
the children, yet did not participate in the play. e
children’s interactions were then rated in the six areas ■ Children with autism have difficulty with overt,
of: easily recognised means of self-expression, the use
■ Attribution of symbolic meaning to play objects of verbal and non-verbal communication, and
practitioners may have to look for more subtle
■ Potential for flexible use of objects indicators. We cannot categorically state from
 25

Research Paper cont.

observation whether the child is discriminating

through his or her facial or bodily expressions.

■ As the child with autism experiences difficulty

reading his or her own self-expression, he or she
may have difficulty discerning the enjoyment and
engagement of another, which may influence the
development of perspective taking and
interpersonal engagement.

■ Modelling play may be a suitable introduction to

an activity for children with autism and may
allow them to see a range of functions for
particular toys and resources.

■ e fun experienced by a child with autism may

also be indicated in an unusual manner. As
practitioners, we may have to look more closely
to see if the child is having a positive experience.

■ As practitioners, we must foster creativity in

symbolic play by offering opportunities for joint
engagement and negotiation with a range of
partners.

■ More research is needed in the full curricular area

and leisure activity of play across other age ranges
and developmental levels. is study asserts that
the researchers have much still to learn on the
quality of the child with autism’s play.

Full Reference

Hobson, R. P., Lee, A. and Hobson, J. A. (2008).

Qualities of Symbolic Play among Children With
Autism: A Social-Development Perspective. Journal
of Autism and Developmental Disorders, 39, p. 12-22.
26

Relationships between the Responsiveness of Fathers and Mothers and

the Object Play Skills of Children with Autism Spectrum Disorders
RESEARCH AIMS in a higher level of object play. ere was a
particularly strong correlation in play interactions
■ To research differences in levels of object play with fathers. ere are a number of interpretations of
demonstrated by children engaged in both free this finding:
play and play with their mothers and fathers
■ Fathers’ use of responsive play behaviours may
■ To investigate concurrent relationships between stimulate more frequent child play at the
the levels of object play demonstrated by children symbolic level
with autism and the verbal and play
responsiveness of their mothers and fathers. ■ Fathers may use more responsive play behaviours
with their children who can engage in symbolic
levels of play
RESEARCH METHOD
■ Fathers do not use as many responsive play
behaviours if their children engage only in lower-
Parents confirmed their child’s diagnosis of autism
level object play
and completed demographic questionnaires. In
addition, assessments were completed regarding non- ■ Fathers’ responsive behaviours may encourage
verbal quotients as well as receptive and expressive more symbolic child play, especially for children
language skill levels. Subsequently three 15-minute who are developmentally ready to engage in
free play observations involving mother and child, symbolic-level play.
father and child and free play were conducted and
However, there is no evidence in this study to
analysed. suggest whether fathers’ responsive play fosters child
symbolic play, or vice versa, or both.

RESEARCH FINDINGS IMPLICATIONS FOR PRACTICE

(by the authors)
Children were found to engage in more relational
is research indicates that object play skills may
play (stacking objects, sorting objects and “put increase play development and have long-term
in”/“take out” type activities) in play with their benefits for joint attention and language
mothers than in either free play or in play with their development for young children with autism.
fathers. is suggests that the play interactions with Targeting parental responsiveness to children’s play
mothers mirror the quality of play interactions of may be a useful intervention strategy for young
mothers and typically developing children. However, children with autism.
children with autism fail to develop functional and
Full Reference
symbolic (higher levels) of object play in comparison
to typically developing peers and doing so is linked Flippin, M. and Watson, L. R. (2011). Relationships
to better developmental outcomes. erefore, between the Responsiveness of Fathers and Mothers
targeting higher levels of play may be particularly and the Object Play Skills of Children with Autism
important for play intervention delivered by mothers Spectrum Disorders. Journal of Early Intervention,
of children with autism. 33, p. 220-234.

e study found a strong connection between parent

verbal responsiveness and higher levels of object play
for children with autism. For both parents the use of
verbal responses was linked with their child engaging
 27

Research Paper cont.

The Role of High-Level Play as a Predictor of Social Functioning

RESEARCH AIMS engaging in conversation. e children with autism

scored significantly lower than the DLD group in
It is established that children with autism engage less both of these areas. Rule-bound game playing and
in imaginative play than their typically developing successfully participating in a conversation both
peers. require the child to have an understanding of turn-
taking, and this may be impaired in children with
e research aimed to examine the play and social autism.
abilities of high functioning children with a
diagnosis of autism (HFA) and compare these Another interesting finding was in the area of overall
abilities with those of a group of children with a social rating. As expected, the children with autism
diagnosis of developmental language disorder scored significantly lower than their DLD peers in
(DLD). It was hypothesised that the children with a the early part of the play session. However, as the
diagnosis of high functioning autism would produce play session continued the children with autism
less developed forms of play than their DLD peers. became more socially engaged and the differences
became non-significant by the end of the encounter.
RESEARCH METHODS is appears to be correlated with the degree of
direction by the adult, and it would appear that
e sample consisted of 30 children with a diagnosis social engagement of the children with autism
of high functioning autism and 33 age- (7-9 years) increased as the adult became more directive and
and gender-matched peers. involved.

e children were observed and videoed over a 25- e final notable finding was a relationship between
minute period, during which they were presented play and social functioning; the authors report play
with a puzzle box. eir play was observed for 10 to be a significant predictor of social function. e
minutes with this and then in a 15-minute researchers suggest that play could be a useful
unstructured play session with an unfamiliar adult. method of increasing or improving the quality of
e adult was non-directive for the first five minutes social functioning.
of the play session but then became increasingly
directive to elicit age-appropriate play. IMPLICATIONS FOR PRACTICE
(by the authors)
e child’s play and social functioning was then
coded from the 25-minute video. e research has a number of useful points for
practitioners:
RESEARCH FINDINGS
■ ere tends to be a relationship between social
engagement and play; professionals working with
e children with autism demonstrated impaired
younger children can use play as a way of
play skills and there were differences between the engaging the child and for addressing any social
groups in the area of symbolic play, functional play impairment.
and in overall play. None of these differences was
significant and the researchers concluded that neither ■ e research indicated that the child’s initial
the children with autism nor their DLD peers were social difficulty decreased with the amount of
engaging in this kind of play at a high level. engagement from the adult involved in directing
the play. is suggests that guided one-to-one
engagement may be a useful way of working with
e significant differences between the groups were children who have impairments in play and
in the areas of engaging in rule-based play and social interactions.
28

■ e relationship between play and social

engagement requires much more teasing out; the
research addressed only those children said to be
highly functioning, within a narrow age frame
and within a relatively small sample. Future
research with a larger and more representative
sample size could focus in on mapping the
broader correlations and potential causations
between social engagement and play.

Full Reference

Manning, M. and Wainwright, L. (2010). e Role of

High-Level Play as a Predictor of Social Functioning.
Journal of Autism and Developmental Disorders, 40,
p. 523-533.
 29

Research Paper cont.

The Impact of the Advancing Social-communication And Play

(ASAP) Intervention
RESEARCH AIMS (ANOVA) on the pre- and post-intervention data
indicated that all three children had significant
is research aimed to determine the impact of the increases in their social communication and play
Advancing Social-communication And Play behaviours.
intervention (ASAP) on the play skills of three
children with an average age of 4.2 years. All of the IMPLICATIONS FOR PRACTICE
children presented with limited and impaired (by the authors)
language skills and identified needs in social
communication and play. e ASAP was an effective intervention to increase
social communication and play for this small group
RESEARCH METHODS of children. e findings were variable across one-to-
one and group settings.
e ASAP intervention is designed to target social
communication and play of children with autism in e research supports the use of this programme and
a preschool setting. e intervention targets 20 practitioners may find it a useful tool for guiding
social-communication objectives across the areas of individualised plans for children to assist the
social interaction, requesting and joint attention, and development of their social communication and play
21 play objectives across the areas of exploratory, skills. It is worth noting that the intervention was
relational, functional and symbolic play. most effective in a one-to-one setting and
practitioners should consider the need to work
Following assessment to determine the level of individually with children prior to implementing
intervention, ASAP is delivered on a one-to-one basis group work. A final observation is that the research
for 40 minutes once a week, and daily in 10-15- was conducted on a very small group of children, all
minute group instruction sessions to promote of whom were being educated in an autism-specific
generalisation. e success of the programme is classroom, and these factors might impact on the
judged by the frequency of spontaneous social results.
communication or play, specifically three
unprompted occurrences of targeted behaviours in Full Reference
one day.
Dykstra, J., Boyd, B., Watson, L., Crais, E. and
e children were then observed in the school setting Baranek, G. (2012). e Impact of the Advancing
and their social communication and play behaviours Social-Communication and Play Intervention on
were recorded and coded. Preschoolers with Autism Spectrum Disorder.
Autism, 16 (1), p. 27-44.

RESEARCH FINDINGS

All of the children demonstrated increases in both

social communication and pretend play following
the full implementation of the ASAP programme.
For the single case design data, the strongest
increases were observed during one-to-one settings.
However, they were also observable in group settings,
but these increases were more variable. For social
validity, the results of an analysis of variance
30

Symbolic Play of Preschoolers with Severe Communication

Impairments with Autism and Other Developmental Delays:
More Similarities than Differences
RESEARCH AIMS RESEARCH FINDINGS

Research into the symbolic play of children with e research findings indicated no significant
autism in comparison to developmentally delayed differences between the two groups of children in
peers has been equivocal. e majority of research levels of play or in expressed interest in playing with
confirms that children with autism have difficulties different toys. e groups were similar in their
with symbolic play and also limited functional play. emergence and mastery of symbolic play, although
Children with autism demonstrated less interest in this was the least observed type of play for all of the
dolls and shorter play sequences than children with children. e diversity and functional symbolic play
Down’s syndrome. was not significantly impaired in the children with
autism in comparison to their developmentally
e researchers also highlight the relationship delayed peers. e most common type of play across
between symbolic play, language and cognitive skills. both the groups was functional play, and a few of the
Relationships have been identified between word children across both groups engaged in low levels of
usage and symbolic play, and also later language symbolic play.
development and levels of symbolic play.
e researchers’ second hypothesis, that there would
e researchers aimed to determine the differences, if be correlations between play, language and
any, between a group of children with autism and a cognition, was supported. ere were high
group of children with developmental delay in correlations between play, language and cognitive
symbolic play. ey hypothesised that the children measures indicating that play is commensurate with
with autism would present with more limited these measures
symbolic play.
IMPLICATIONS FOR PRACTICE
ey also wanted to determine the relationship, if
any, between measures of play and non-verbal and Although the researchers’ hypotheses were not all
communication measures. ey hypothesised that borne out by the research findings, the research does
measures of cognitive ability and communication have some useful elements for current practitioners.
would be congruent with measures of play. e importance of play in children across
developmental abilities is worthy of note. ose
RESEARCH METHOD living and working with children with autism and
other developmental delays should note the
e sample consisted of 35 children with autism and importance of play in their lives and promote play
38 children with developmental delay. e average and play opportunities with children.
age was 49.5 months. All of the children had a
diagnosed learning difficulty as well as Working on play skills may also have a positive
communication impairments. impact on the future development of language, and
the researchers confirm that there is a relationship
e researchers used the Developmental Play between play and current and future language and
Assessment, which measures play ability over eight cognitive abilities.
levels and 15 categories. e children were observed
in play situations, and their engagement in play was Full Reference
measured and coded by observers.
iemann-Bourque, K., Brady, N. and Fleming, K.
e children were also assessed for their cognitive (2012). Symbolic Play of Preschoolers with Severe
and language abilities using a standardised measure Communication Impairments with Autism and
of learning for preschoolers. Other Developmental Delays: More Similarities than
Differences. Journal of Autism and Developmental
Disorders, 42, p. 863-873.
 31

The Relation between Social Engagement and Pretend Play in

Autism
RESEARCH AIMS e correlation between individual differences in
communication/social interaction impairment on
To study the individual differences in social the ADOS and playful pretence scores on the ToPP
interaction and communication, symbolic play, and was only significant for the children with autism.
language among children diagnosed with autism, e most severe cases of communication and social
autistic spectrum disorder (ASD) and those with a interaction disorder were correlated with those more
developmental disorder (DD). severely impaired in playful pretence skills.

RESEARCH METHODS Children with autism tend to show impairment in

playful pretence skills even when they have the
ree groups of children between 2.11 years and 9.8 mechanics of symbolic play and when other qualities
years with a verbal mental age (VMA) of at least 15 of play, as matched by the ToPP, are similar.
months were all tested on the Autism Diagnostic
Oberservational Schedule-General (ADOS-G) and Impairments in social communication skills are
the Test of Pretend Play (ToPP). associated with limitations in play quality even when
formal play skills (assessed by the ToPP) are
e groups were divided as follows: accounted for.

■ Children with a previous clinical diagnosis of e play of children with autism may be
autism confirmed on the ADOS fundamentally different from that of other children.
■ Children with ASD who had received a diagnosis e social communicative nature of the play of
of social communication disorder and met some
of the criteria for autism typically developing children is founded upon
engagement with other people and the world. ere
■ Children with DD. is a mechanical component to the symbolic play
displayed by children with autism. e lack of
e hypothesis was that children with autism would playfulness may be an indicator of how social
display a relative absence of play features and that communication skills contribute to the nature of
this reflects their underlying social-developmental symbolic play in typical children.“ey are tell-tale
impairment. signs that the child is engaged in a…grounded process of
symbolic meaning-making that seems relatively limited
among children with autism.”
RESEARCH FINDINGS
Full Reference
On the composite measure of playfulness on the
ToPP, children with autism were given significantly Hobson, A., Hobson, R., Malik, S., Bargiot,K. and
lower scores across the items (e.g. investment, Calo, S. (2013). e Relation between
creativity and fun) than participants with DD. Social Engagement and Pretend Play in Autism.
British Journal of Developmental Psychology, 31,
Across the three groups, the degree of children’s p. 114-127.
communication/social interaction impairments on
the ADOS was associated with lower scores for
playful pretence. is indicates that social
communication impairments explained some of the
variance in quality of playful pretence, beyond the
ability to play as assessed.
32

Play and Communication in Children with Autism Spectrum

Disorder: A Framework for Early Intervention
RESEARCH AIMS play. However, greater research is needed to
determine if the influence is greater between the
is review of concurrent and longitundal studies association of non-verbal intentional communication
found an association between object play and increasing symbolic play or if symbolic play leads to
intentional communication in children with autism, greater non-verbal intentional communication.
with the authors stating that a theoretical framework
is needed as a means of devising a model for Associations were found between non-verbal
conceptualising intervention involving play and intentional communication and symbolic play as
communication in children with autism. e review well as a correlation between expressive language and
found four questions to be addressed: symbolic play. e authors have suggested that in
order to develop symbolic play, particularly as it has
1. Is there a positive association between object its roots in the social context, the child must be
play and intentional communication in afforded a range of opportunities whereby he or she
young children with autism? is interacting with and becoming aware of people,
objects and actions in his or her environment, as a
2. Are there positive associations between means of assimilating the information. It is assumed
specific categories of object play (i.e. non- by the authors that through such repeated
symbolic and symbolic play) and intentional interactions, the child’s attention to all within his or
communication (i.e. non-verbal intentional her environment will support development.
communication and expressive language)
within the population with autism? IMPLICATIONS FOR PRACTICE
(by the authors)
3. Is the relationship among these aspects of
development significant and even after ■ In order to develop expressive language with
controlling for other probable explanations children with autism, the authors claim that
for the relationship? there is a pathway to follow, with play as the
medium to deliver development.
4. For those with autism, is there evidence that
this association is causal, and if so, in what ■ Acquiring and achieving fluency within each area
direction? of non-symbolic play, non-verbal intentional
communication, symbolic play, and eventually
RESEARCH METHOD expressive language are interrelated and
interdependent. With each aspect, the educator
Meta-analytic and narrative reviews were conducted must build towards acquisition and
to examine the association between object play and generalisation until fluency is achieved.
intentional communication, with a range of
inclusionary and exclusionary criteria set. Twelve ■ At the beginning, the child with autism may
reports were finally identified as examining the need a stepping-stones approach before full
association between the two and in relation to engagement in a joint action routine, a
children with autism. foundational interaction pattern or framework,
can be established. For example, this may include
RESEARCH FINDINGS building from “peek-a-boo” and “pat-a-cake”, to
getting used to an interactive reciprocal game
Ten of the identified studies reported concurrent with an adult, to eventually partaking in a joint
associations between intentional communication and object-based play in a social environment. e
object play in children with autism while five reciprocity attained through play is a forerunner
examined longitudinal associations, with several for the reciprocity needed for expressive
reporting both concurrent and longitudinal communication.
correlations. Findings included a suggestion that an
increase in object play causes an increase in non- ■ Choice of play objects and actions must be
verbal intentional communication, and that such an individualised to meet each child’s stage of play
increase in turn can cause an increase in symbolic development while cognisance is given to
 33

chronological age. e level of social

communication skills of each child must also be
attained as a means of informing the goal and
content of the play offered. e play can then be
differentiated as the child develops, with the
objects having more than one function. is
diversity can be supportive of the child’s
opportunity to develop greater language and
engagement.

■ Opportunities to practice newly acquired non-

symbolic play skills are thought to lead to
fluency, which may result in generalisation of
play actions across context. Use of generalised
play actions can increase non-symbolic play
skills, which can be supportive of turn-taking, a
skill many children with autism find difficult. As
non-symbolic play is generalised, non-verbal
intentional communication is introduced, and
with this change comes learning.

■ is practice and communication development

grows to include non-verbal intentional
communication; once fluency is established, the
child’s symbolic play skills can evolve and with
this their expressive language.

■ is format of building on already attained skills

will form the basis of other intervention planning
and implementation to maximise functional use
of skills and ultimately to optimise
developmental and lifelong outcomes.

Full Reference
Lieberman, R. G. and Yoder, P. (2012). Play and
Communication in Children with Autism Spectrum
Disorder: A Framework for Early Intervention.
Journal of Early Intervention, 34, p. 82-103.
34

CONCLUSION

The quotation “The work of the child is

play” is generally attributed to Jean
Piaget; this current Research Bulletin
certainly provides evidence of this.

e articles summarised demonstrate the importance

of play in the social and communicative
development of the child.

Using novel and enjoyable media such as computers,

music or TV can promote group play and address
the child with autism’s preference for playing alone.
However, the child with autism may not have the
social skills to understand the boundaries of rough-
and-tumble play, and group play should be
monitored.

Both parents and teachers have a role in promoting

and facilitating play skills, and also in supporting the
maintenance of play once initiated. e promotion
of play skills should be recognised as an opportunity
to foster not just play but also social and
communication skills.

e Centre’s tenth Research Bulletin is on the area of

Autism and Inclusion, comments on current
Bulletins and suggestions for future Bulletins are
always welcome; please contact
[email protected]
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