Abstract
A repeated measures single subject design was used to examine the effectiveness of a joint play approach embedded in professional practice, in supporting pretend play for autistic children. Seven autistic children, aged 5–8 years, with a placement within a specialist educational provision, and who demonstrated restricted play, participated in weekly sessions using the Playboxes approach over a period of 3 months. Pre- and post-approach pretend play abilities were assessed using the Symbolic Play Test and the Test of Pretend Play. Every child gained increased age-equivalent scores on the Test of Pretend Play, ranging from + 8 to + 30 months. Pretend Play abilities can support developmental outcomes and incorporation of this approach into regular practice could be of value for autistic children.
Highlights
Autistic children have been reported to show a particular reduced involvement in symbolic play, and limited spontaneous imaginative creativity in pretence (Beyer & Gammeltoft, 2000; Hobson et al, 2013; Janert, 2000; Jarrold et al, 1993; Kasari et al, 2010; Rutherford et al, 2007; Wilson et al, 2017)
It can be seen that for most children pre- and postapproach scores on the Symbolic Play Test (SPT) were near the uppermost score for this test (36 months), and showed little movement, which could be due to the ceiling effect
To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The evidence from this small-scale study using independent standardized measures of pre and post change indicates the effectiveness of the Playboxes approach in supporting the development and use of pretend play abilities in autistic children, and that these abilities can be supported
Summary
Autistic children have been reported to show a particular reduced involvement in symbolic play, and limited spontaneous imaginative creativity in pretence (Beyer & Gammeltoft, 2000; Hobson et al, 2013; Janert, 2000; Jarrold et al, 1993; Kasari et al, 2010; Rutherford et al, 2007; Wilson et al, 2017). Studies in which autistic children are supported to become engaged in play activities by, for example, trained professional adult or parent play partners, structured and semi-structured play situations, and peer support, in homes, nurseries, schools and clinical environments, report positive developments in joint attention and pretend play abilities (Hobson et al, 2013; Kasari et al, 2006, 2010; Kossyvaki & Papoudi, 2016; Lawton & Kasari, 2012; O’Connor & Stagnitti, 2011; Sherrat, 2002; Wolfberg, 1999; Zercher et al, 2001), and in language, cognitive abilities and friendships (Chang et al, 2018; Dykstra et al, 2012; Kasari et al, 2012; Stagnitti et al, 2012; Weider & Greenspan, 2003) Such findings can be argued to indicate that the processes underpinning pretend play abilities are able to be supported through engaged interaction, and that lack of demonstration of pretence in play for autistic children does not reflect altered imaginative processes underlying pretence, or an absence of potential (Hobson et al, 2013; Jarrold, 2003; Jarrold et al, 1996; Kasari et al, 2013; Sherratt, 2002). While play-based interventions are reported to support playful engaged interactions for young children on the autism spectrum, Kossyvaki and Papoudi (2016) report that the design of the majority of studies in their review of play interventions in schools was found to be less than strong, with, for example, outcome variables lacking precise description. Kasari et al (2013), reviewing such methodological limitations in studies of children’s play, stress the need for rigorous testing of pretence abilities. Thomson and Goldstein (2019) highlight the variability and range of play behaviours and understandings within pretend play emphasising the need for clarity and precision of description in measuring specific pretense behaviours, and Pierucci et al (2015) indicate the need within research for concordant assessment approaches of pretence
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