Symbolic play in autistic, Down's, and normal children of equivalent mental age

Playing to Pretend or "Pretending" to Play: Play in Children with Autism Spectrum Disorder

Children diagnosed with autism spectrum disorder (ASD) exhibit early delays and deficits in play. In infancy, they engage in unusual exploratory behaviors with toys. As toddlers, they are slow to develop functional play, and in preschool some children with ASD fail to develop symbolic play despite having the necessary cognitive and language skills. Furthermore, when children with ASD are engaged in play, they demonstrate less playfulness. This article reviews the literature on the characteristics of exploratory, functional, and symbolic/pretend play in children with ASD and possible reasons for their unusual patterns of play development. Increased quantity and quality of play are frequent therapeutic goals for children with ASD. If play interventions are to be successful, it is critical that speech-language pathologists have an adequate assessment of children's play skills. Several frameworks and tools appropriate for assessing play in typical children and children with ASD are described.

Symbolic Play among Children with Autism Spectrum Disorder: A Scoping Review

Symbolic play is considered an early indicator in the diagnosis of autism spectrum disorder (ASD) and its assessment. The objective of this study was to analyze the difficulties in symbolic play experienced by children with ASD and to determine the existence of differences in symbolic play among children with ASD, children with other neurodevelopmental disorders and children with typical development. A scoping review was carried out in the Web of Science (WoS), Scopus, ERIC, and PsycInfo databases, following the extension for scoping reviews of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The number of papers included in the review was 22. The results confirm that children with ASD have greater difficulties with symbolic play than children with other neurodevelopmental disorders and children with typical development, even when controlling for their verbal age. Difficulties are greater in situations of free or spontaneous play. Results evidenced that the absence or deficiency in the symbolic play can serve as an early indicator of ASD between the first and second year of life, the developmental moment in which this type of play begins.

Referent selection in children with Autism Spectrum Condition and intellectual disabilities: Do social cues affect word-to-object or word-to-location mappings?

BACKGROUND

There is conflicting evidence regarding whether children with Autism Spectrum Condition (ASC) and intellectual disabilities (ID) follow social pragmatic cues such as a speaker's eye gaze or pointing towards a novel object to assist mapping a new word onto a new object (e.g. fast mapping).

AIMS

We test fast mapping from a speaker's gaze and pointing towards objects in children with ASC and ID with varying chronological and receptive language ages compared with receptive language matched groups of typically developing (TD) children.

METHODS AND PROCEDURE

Across eight trials, a speaker gazed and/or pointed towards one out of two objects while saying a new word. Pointing was either 'referential' (with intention), or 'incidental' (without obvious intention). To investigate whether children formed more robust word-to-object links rather than associative word-to-location ones, we reversed the original location of the objects in half of the test trials.

OUTCOMES AND RESULTS

Children with ASC were as successful as TD children using social cues to form word-to-object mappings. Surprisingly, children with ID did not fast map from referential pointing, or when objects changed location.

CONCLUSIONS AND IMPLICATIONS

Children with ID may use different processes to facilitate word learning compared to TD children and even children with ASC.

Fidget Spinner Ingestions in Children-A Problem that Spun Out of Nowhere

The Consumer Product Safety Risk Management System's injury and potential injury database records 13 cases of fidget spinner ingestion since 2016. In addition to a database query, we report 3 additional cases of fidget spinner ingestion to describe patient presentations and subsequent management strategies.

Theory of mind predominantly associated with the quality, not quantity, of pretend play in children with autism spectrum disorder

This study aimed to clarify the relationships between theory of mind and pretend play in children with autism spectrum disorder, using refined assessments of theory of mind and pretend play while controlling for autistic behaviors and verbal comprehension. A total of 92 children with autism spectrum disorder aged 4-10 years were enrolled. In two visits, the children were assessed with the Theory of Mind Task Battery, the Child-Initiated Pretend Play Assessment, the Childhood Autism Rating Scale, and the Verbal Comprehension Index of the Wechsler Intelligence Scales, respectively, for their theory of mind, pretend play performance, autistic behaviors, and verbal comprehension. The hierarchical regression models showed that in addition to the contributions of the autistic behaviors and verbal comprehension scores, the theory of mind scores positively predicted (p < 0.001) the elaborateness scores of pretend play in the conventional imaginative and symbolic play contexts, respectively, accounting for an additional 8.1 and 18.5% of the variance, but did not predict the scores for number of object substitutions or imitated actions. The findings demonstrate that theory of mind has a predominant role in the quality, not the quantity, of pretend play of children with autism spectrum disorder, when the children's autistic behaviors and verbal comprehension are considered. This study fills a gap in the previous literature and provides information useful for clinicians and researchers on the relationships between theory of mind and pretend play in children with autism spectrum disorder.

A theoretical approach to the deficits in infantile autism

Deficits specific to the syndrome of infantile autism appear in imitation, emotion sharing, theory of mind, pragmatics of communication, and symbolic play. Current competing theories of Hobson and of Baron-Cohen, Frith, and associates account for some, but not all, of these specific deficits. The present article suggests that early social capacities involving imitation, emotion sharing, and theory of mind are primarily and specifically deficient in autism. Further, these three capacities involve forming and coordinating social representations of self and other at increasingly complex levels via representational processes that extract patterns of similarity between self and other. Stern's theory of interpersonal development is offered as a continuous model for understanding the development and deficits of the autistic child and as a means for integrating competing theories about the primary deficits in autism. Finally, the article suggests a neuropsychological model of interpersonal coordination involving prefrontal cortex and executive function capacities that is consistent with the social deficits observed in autism.

Theory of Mind Deficit is Associated with Pretend Play Performance, but not Playfulness, in Children with Autism Spectrum Disorder

Objective/Background

This study aimed to examine the relationships of theory of mind (ToM) to both pretend play and playfulness in children with autism spectrum disorder (ASD).

Methods

Twenty children with ASD aged between 3 years and 7.11 years were assessed with the ToM test, and then placed in a free play condition and a pretend play condition to assess pretend play and playfulness with the Child-Initiated Pretend Play Assessment and Test of Playfulness, respectively. In addition, the children's symptom severities of ASD and verbal abilities were also assessed with the Childhood Autism Rating Scale (CARS) and Receptive and Expressive Vocabulary Test—second edition, respectively.

Results

The results of the regression analysis confirmed that ToM significantly predicted pretend play variables, namely, Number of Object Substitutions (R² = .158, p = .002) and Number of Imitated Actions (R² = .175, p = .001), but not playfulness. The CARS score was a significant predictor of the Percentage of Elaborate Pretend Play Actions of pretend play (R² = .075, p = .034), as well as the internal control (R² = .125, p = .006) and framing (R² = .071, p = .039) variables of playfulness.

Conclusion

The findings support the idea that children with ASD who have better ToM might be able to develop better pretend play, but not better playfulness, which might be more strongly related to their autistic severity.

Mother-Child Play: A Comparison of Autism Spectrum Disorder, Down Syndrome, and Typical Development

The purpose of the present study was to analyze mother-child collaborative play in children with Autism Spectrum Disorders (ASD) compared to children with Down Syndrome (DS) and typical developing children (TD). Children with ASD are often described as having deficient play skills, particularly in the symbolic domain. Caregivers’ involvement in child play activities increases the structural complexity of playing in both typically developing children and children with disabilities. Participants included 75 mothers and their children with ASD (n = 25), with down syndrome (n = 25) and with typical development (n = 25). Mother–child play sessions were analyzed using a coding system for exploratory and symbolic play. Results indicated that children with ASD showed more exploratory play compared to children in the other groups. No significant differences emerged between the three groups for child symbolic play or for mother play. These findings are discussed in relation to the debate about functional and symbolic play in children with ASD and in relation to the importance of setting and age for play assessment.

Play Behaviors of Young Children with Autism

Autism has been shown to be associated with deficits in play behavior. The play behaviors of children with autism indicate that they tend to have severe deficits in play, both with toys and with regard to social behaviors. A consistent finding in the literature has been that both symbolic play and symbolic language are areas in which children with autism show specific impairments. Interventions to promote the play behaviors of these children have involved the use of either nonhandicapped or disabled peers, the use of specific instructions or verbal and physical prompts, highly structured one-to-one interactions involving adults and peers, or manipulation of the setting. Although different intervention techniques have been successful in promoting play behaviors, there is some concern about lasting effects after the intervention.

An Approach for Enhancing the Symbolic, Communicative, and Interpersonal Functioning of Young Children with Autism or Severe Emotional Handicaps

An intervention approach emphasizing development of symbolic thought, communication, and interpersonal relationships was Implemented with 26 children (ages 2 through 6) who had infantile autism, pervasive developmental disorder, or severe emotional handicaps. The main intervention strategy was the use of play in all its interpersonal, cognitive, and structural variety, imbedded in a reactive language environment. Over a six- to eight-month intervention period, the children demonstrated significant changes in several targeted developmental areas, including cognition, perceptual/fine motor, social/ emotional, and language skills. The cognitive complexity of their play skills increased significantly in areas of symbolic complexity, symbolic agent, and symbolic substitutions. Additionally, significant improvement in the communicative and interpersonal characteristics of their play was found. These changes support the efficacy of this approach with young autistic and severely emotionally handicapped children when the children's needs for high levels of structure, intensity, and consistency are met.

Structural and Affective Dimensions of Play Development in Young Children with Down Syndrome

A comparative developmental approach was undertaken to study the play development of young children with Down syndrome and non-handicapped children during the transition from sensorimotor to representational functioning. Age-related trends in the structure of object and social play development as well as interrelationships among play maturity, cognitive functioning, and affective-social dimensions of play behaviour were considered. Although children with Down syndrome were significantly delayed in the maturity of their object and social play when compared to normal agemates, the quantity and complexity of play behaviour did not differ significantly from that of cognitively comparable non-retarded children. For both groups of children, similar developmental trends in play development were observed. Simple manipulative object play declined linearly in prevalence, whereas decontextualised symbolic play and structured social turntaking games showed a reverse trend. Despite significant differences in certain aspects of social play and interactive behaviour between groups, similar patterns of correlations among children's overall cognitive functioning and their play maturity, affective dimensions of play (quality of exploration, play engagement, positive affect), and social interactive behaviours (e.g. initiating) were observed in all children. Results attest to the coherence of play development and the organisation of symbolic behaviour during early childhood for children with Down syndrome. Implications for the use of play as a potential tool for intervention and assessment are discussed.

A Review of Research into Pretend Play in Autism

Autism is currently diagnosed, in part at least, on the basis of problems in imagination. The article reviews the empirical evidence of difficulties in pretend play in autism, and focuses in particular on individuals’ ability to engage in pretence in free play conditions, to produce pretence in more structured situations, and to make sense of pretend actions carried out by another person. These data suggest that individuals with autism have a marked difficulty in producing pretend play, but one that is reduced by providing substantial structure to the play situation or by testing comprehension of pretence. The implications of these findings for theories of pretend play in autism, in terms of an inability to conceive of non-literal situations, a difficulty in imposing a pretend usage on an object, or a failure to gain a benefit from engaging in pretend play, are discussed.

Assessment of pretend play in Prader-Willi syndrome: a direct comparison to autism spectrum disorder

Children with Prader-Willi syndrome (PWS) are at risk for autism spectrum disorder (ASD), including pervasive social deficits. While play impairments in ASD are well documented, play abilities in PWS have not been evaluated. Fourteen children with PWS and ten children with ASD were administered the Autism Diagnostic Observation Schedule (ADOS) (Lord et al. in Autism Diagnostic Observation Schedule manual. Western Psychological Services, Los Angeles, 2006) as part of a larger project. A modified Affect in Play Scale (APS; Russ in Play in child development and psychotherapy: toward empirically supported practice. Lawrence Erlbaum Associates Publishers, Mahwah, 2004; Pretend play in childhood: foundation of adult creativity. APA Books, Washington, 2014) was used to score ADOS play activities. Results indicate both groups scored below normative data on measures of imagination, organization, and affective expression during individual play. In addition, the inclusion of a play partner in both groups increased all scaled scores on the APS. These findings suggest children with PWS show impaired pretend play abilities similar to ASD. Further research is warranted and should focus on constructing and validating programs aimed at improving symbolic and functional play abilities within these populations.

Using Augmented Reality to Elicit Pretend Play for Children with Autism

Children with autism spectrum condition (ASC) suffer from deficits or developmental delays in symbolic thinking. In particular, they are often found lacking in pretend play during early childhood. Researchers believe that they encounter difficulty in generating and maintaining mental representation of pretense coupled with the immediate reality. We have developed an interactive system that explores the potential of Augmented Reality (AR) technology to visually conceptualize the representation of pretense within an open-ended play environment. Results from an empirical study involving children with ASC aged 4 to 7 demonstrated a significant improvement of pretend play in terms of frequency, duration and relevance using the AR system in comparison to a non computer-assisted situation. We investigated individual differences, skill transfer, system usability and limitations of the proposed AR system. We discuss design guidelines for future AR systems for children with ASC and other pervasive developmental disorders.

Parent-child interactions in autism: characteristics of play

Although the literature on parent-child interactions in young children with autism has examined dyadic style, synchrony, and sustained engagement, the examination of parental skill in sustaining and developing play skills themselves has not been targeted. This study examined the extent to which parents of young children with autism match and scaffold their child's play. Sixteen dyads of parents and their children with autism participated in this study along with 16 matched dyads of typically developing children. Both groups were administered a structured play assessment and were observed during a 10-min free play situation. Strategies of play were examined and results revealed that parents of children with autism initiated more play schemes and suggested and commanded play acts more than parents of typical children. They also responded to their child's play acts more often with a higher level play act, while parents of typical children matched/expanded their responses to their child. Parent imitation was also related to longer sequences of play. The findings can guide further research and play intervention for parents.

The Effect of Teaching PECS to a Child With Autism on Verbal Behaviour, Play, and Social Functioning

The Picture Exchange Communication System (PECS) is a widely used intervention strategy designed to teach communication skills to children with developmental delays, including autism. The Picture Exchange Communication System incorporates the teaching of mand initiations that are thought to be pivotal response behaviours, and have been demonstrated to lead to generalised improvements in other nontargeted behaviours. The aim of the present study was to assess the acquisition of PECS with a 3-year-old boy with autism using the established PECS training program, and to evaluate concomitant changes in spoken language, social–communicative behaviours, and functional play. Results indicated that the participant rapidly acquired the criterion behaviours for Phases 1 to 3 of the PECS program. Although PECS exchanges were rarely observed in the generalisation settings, clear increases were evident in verbal mands and other initiations in both home and kindergarten generalisation settings. Increases in spoken vocabulary and in the length of comprehensible spoken utterances in free-play were observed as were gains in time spent in developmentally appropriate play. Implications of these results and directions for future research are discussed.

A theoretical approach to the deficits in infantile autism

Deficits specific to the syndrome of infantile autism appear in imitation, emotion sharing, theory of mind, pragmatics of communication, and symbolic play. Current competing theories of Hobson and of Baron-Cohen, Frith, and associates account for some, but not all, of these specific deficits. The present article suggests that early social capacities involving imitation, emotion sharing, and theory of mind are primarily and specifically deficient in autism. Further, these three capacities involve forming and coordinating social representations of self and other at increasingly complex levels via representational processes that extract patterns of similarity between self and other. Stern's theory of interpersonal development is offered as a continuous model for understanding the development and deficits of the autistic child and as a means for integrating competing theories about the primary deficits in autism. Finally, the article suggests a neuropsychological model of interpersonal coordination involving prefrontal cortex and executive function capacities that is consistent with the social deficits observed in autism.

A longitudinal study of pretend play in autism

This study describes a longitudinal design (following subjects described in Rutherford & Rogers [2003, Journal of Autism and Developmental Disorder, 33, 289-302]) to test for predictors of pretend play competence in a group of children with autism. We tested the hypothesis that developmental change in pretend play performance can be predicted by earlier measures of either executive function, intersubjectivity, imitation, or general development. Participants at the time of follow-up testing were 28 children with autistic disorder (mean chronological age (CA) 57.6 months), 18 children with other developmental disorders (mean CA 59.0 months), and 27 typically developing children (mean CA 30.1 months). Children with autism were profoundly delayed given both competence (prompted) measures as well as performance (spontaneous) measures. Joint attention at time 1 strongly and uniquely predicted pretend play development.

Early communication development and intervention for children with autism

Autism is a neurodevelopmental disorder defined by impairments in social and communication development, accompanied by stereotyped patterns of behavior and interest. The focus of this paper is on the early development of communication in autism, and early intervention for impairments in communication associated with this disorder. An overview of components of communication is provided. Communication characteristics that are diagnostic of autism are summarized, with consideration of the overlap between social and communication impairment, particularly for children with autism functioning at the prelinguistic level. Early communication development and predictors of communication functioning in autism are examined, based on a review of prospective and retrospective studies. The focus of the discussion then turns to intervention. Consideration is given to the rationale for beginning intervention as early in life as possible for children with autism. Implications of motor, imitation, and play deficits for communication-based intervention are examined. Finally, issues related to the design and delivery of intervention for young children with autism are presented, along with a review of the major early intervention approaches for autism.

Symbolic Play in Children with Autism Spectrum Disorder

The relationship between symbolic play and other domains, such as degree of autistic symptomatology, nonverbal cognitive ability, receptive language, expressive language, and social development, was investigated. The assessment files of 101 children with Autism Spectrum Disorder were studied. Nonverbal cognitive ability and expressive language were both significantly and uniquely related to symbolic play, although receptive language was not. Autistic symptomatology ceased to be significantly related to symbolic play when controlling for two or more other variables. Social development was related to symbolic play in those children with high nonverbal cognitive ability but not those with low nonverbal cognitive ability. The diagnostic and treatment implications of these results are discussed.

Taking a closer look at functional play in children with autism

Research evidence indicates that children with autism may experience problems with functional play, in addition to their well-documented deficits in symbolic play. However, as a result of the tendency of previous studies to group all functional play into a single category, the precise nature and extent of this deficit remains unclear. The present study undertook a more refined analysis of such play, subtyping the functional acts into various categories, in terms of the developmental progression suggested by research with typical infants. The functional play of children with autism was compared to that of developmentally matched children with Down syndrome and typical infants. Although there were no group differences in overall measures of the proportion of total play time spent in functional play and in the number of functional acts performed, a closer analysis of the composition of this play did reveal striking, qualitative differences. The functional play of the autism group was less elaborated, less varied, and less integrated than that of the controls. The implications of these findings are explored in relation to current theoretical models of autism and in relation to the role of other people in mediating the appropriate use of objects.

Spontaneous play in children with autism: a reappraisal

Much controversy remains regarding the ability of children with autism to engage in spontaneous play. In this study children with autism, Down syndrome and typical development with verbal mental ages of approximately 2 years were assessed for play abilities at three data points. Even in this group of children with autism, who had relatively low verbal mental ages, symbolic play skills were not totally absent. However, it was possible to distinguish their pattern of play behaviors from the other two groups. Consequentially, it is argued that there are unusual features in early spontaneous play in children with autism and these atypical patterns are not restricted to their difficulties in the production of symbolic play. Such differences in early spontaneous play raise interesting questions about the etiology of autism, the direction of future research, and the theoretical models that can account for the condition.

Motor imitation in young children with autism: what's the object?

Two studies investigated the nature of motor imitation in young children with autism. Study 1 compared different types of motor imitation in 18 autistic children, 18 children with developmental delay, and 18 normally developing children. Results revealed weaker imitation skills for the autistic group, though all groups demonstrated a similar pattern of performance across different imitation domains. Imitation of body movements was more difficult than imitation of actions with objects, and imitation of nonmeaningful actions was more difficult than imitation of meaningful actions. Study 2 investigated concurrent and predictive relations between imitation and other developmental skills within a sample of 26 two-year-old children with autism. Results suggested that imitation of body movements and imitation of actions with objects represent independent dimensions. Imitation of body movements was concurrently and predictively associated with expressive language skills, and imitation of actions with objects was concurrently associated with play skills. Improvements in both motor imitation domains occurred over a 1-year period.

Imitation of pretend play acts by children with autism and Down syndrome

Although there has recently been considerable research interest in the difficulties that children with autism have engaging in pretend play, little attention has been paid to the ability of these children to imitate pretend play acts. Furthermore, suggestions that children with Down syndrome have relatively advanced abilities in pretend play have not been accompanied by an examination of their capacity to imitate pretend play. Three groups of children: autistic, Down syndrome, and normally developing were studied for their capacity to imitate single pretend acts and a series of pretend acts that formed scripts. While the children with autism were surprisingly better than the other two groups on the single-scheme task, they demonstrated specific difficulties on the multischeme task. Results are discussed in relation to current theories of autism and the notion of imitation.

Teaching symbolic play skills to children with autism using pivotal response training

Used Pivotal Response Training (PRT) to teach 7 children with autism to engage in symbolic play behaviors. Symbolic play, complexity of play behavior, and creativity of play were assessed. In addition, generalization measures were obtained across settings, toys, and play partners. Interaction with the play partners and comparison with typical controls were also examined. Results indicated that children with autism rarely exhibited symbolic play before training or after a control condition. After specific symbolic play training using PRT, all of the children learned to perform complex and creative symbolic play actions at levels similar to that of language-matched typical controls. In most cases the children generalized their play to new toys, environments, and play partners and continued to engage in symbolic play behavior after a 3-month follow-up period. In addition, interaction skills improved after training. Treatment implications for these findings are discussed.

Executive function deficits and the pretend play of children with autism: a research note

The failure to produce pretend play seen in autism may arise from executive deficits associated with the syndrome. This experiment investigated the ability of children with autism to use various objects in pretence, the prediction being that they would have particular difficulty using props with a clear function (e.g. a pencil) to perform a different pretend function (e.g. to act as a toothbrush). However, children with autism were as likely as controls to select a prop with an inappropriate function from amongst other, nonfunctional props, suggesting that executive deficits of this particular kind cannot readily explain an absence of pretend play in autism.

An observational study of humor in autism and Down syndrome

Investigated examples of naturalistic humor in a group of 6 young children with autism and 6 age- and language-matched children with Down syndrome, who were videotaped while interacting with their mothers in bimonthly 1-hour sessions over the course of 1 year. Humor episodes were analyzed on three dimensions: cognitive developmental, social, and intentionality. The autistic children produced significantly less humor overall and less humor involving nonverbal incongruity. The only jokes in the study were told by 2 of the children with Down syndrome. Results indicate that while children with autism can produce and appreciate humor to a limited extent in a naturalistic setting, they do so at a significantly reduced level compared to matched controls. Findings are discussed in relation to the social-cognitive deficits in autistic children, which are among the primary characteristics of the syndrome.

Comprehension of pretense in children with autism

In an attempt to tap underlying competencies, the ability of children with autism to comprehend pretend acts carried out by an experimenter was compared with that shown by controls. These acts consisted of the pouring of a pretend substance from an appropriate container onto a target figure. There was no significant difference in the groups' ability to identify the pretend substance involved, to predict the pretend outcome of the actions, or to reflect on the pretend nature of the episodes. However, the performance of controls on these latter two tasks was surprisingly poor, limiting the implications that might be drawn from the observed absence of group differences in comprehension abilities.

Symbolic play in autism: a review

Experimental research into the symbolic play of autistic children is reviewed in an attempt to outline the nature of their deficit in this area. While many studies can be criticized on methodological grounds, there is good evidence for an impairment in the spontaneous symbolic play of autistic children, an impairment that appears to extend to cover spontaneous functional play also. However studies that have investigated elicited and instructed play have indicated that autistic children may have a capacity for symbolic play that they do not spontaneously exhibit. The implications of these findings for various hypotheses concerning a symbolic play deficit in autism are considered and directions for future research are outlined.

Autism by another name? Semantic and pragmatic impairments in children

The literature on children with language disorders that are characterized by semantic and pragmatic impairments is reviewed and the conclusion is drawn that some of these conditions may stem from the same fundamental cognitive and interpersonal difficulties that are found in early childhood autism. A summary is presented of recent relevant research and theory in the field of autism and suggestions are offered on how these ideas might be applied to children showing semantic and pragmatic difficulties.

A comparative study of autistic subjects' performance at two levels of visual and cognitive perspective taking

This study extended previous investigations of autistic subjects' perspective-taking abilities through a within-subjects contrast between two levels each of both visual and cognitive problems with stringent controls against guessing. When compared with normal and mentally retarded subjects', the autistic group's performance supported Baron-Cohen's (1988) hypothesis of a selective deficit for cognitive perspective taking among autistic subjects. Both levels of visual perspective taking demonstrated virtually unimpaired performance for autistic subjects with no significant difference between them and control groups. On the cognitive perspective-taking tasks, however, the performance of the three groups was significantly different, with the vast majority of autistic subjects unable to do even the most basic level of this task. Possible explanations and educational implications were discussed.

Sensorimotor and action development in autistic children from infancy to early childhood

Home movies of eight normal children and eight children later diagnosed as autistic were analysed according to development in sensorimotor and action competencies. The age range covered was from 4 to 42 months of age. From the beginning of the second year of life, the timing and sequence of developmental gains in normal and autistic children show striking differences. One year later the development of the autistic children seems to be not only delayed, but qualitatively different with respect to the more challenging kinds of action outcomes. This is particularly noticeable for action outcomes involving mental representations of the intended outcome.

Training nonverbal and verbal play skills to mentally retarded and autistic children

Two mentally retarded boys with autism and one mentally retarded girl with Down syndrome were taught to initiate and play a ball game with an adult confederate. The program targeted both nonverbal responses related to the actual execution of the ball game as well as verbal responses for play initiation and providing compliments for the confederate's behavior. Training sessions provided ample practice in all aspects of the game from initiation to termination through use of brief play cycles. Instruction was provided using a combination of physical and verbal prompts as well as reinforcement and time-out. All three children learned the game and by the study's completion executed multiple play cycles each session. The implications of combining play and social skills training in programming for developmentally handicapped children are discussed.

Do autistic children differ from retarded and normal children in Piagetian sensorimotor functioning?

Piagetian sensorimotor functioning of 10 autistic, 10 retarded, and 10 normal children, closely matched on mental age, was assessed with the Dunst revision of the Uzgiris and Hunt scales of infant psychological development. The three groups showed no significant differences in overall performance or specific subtest performance as revealed by estimated developmental ages, number of failed items, and Piagetian stage levels. These findings, which are contrary to previous reports of early sensorimotor deficits specific to autism, suggest that the long-term cognitive deficits in autism are more in symbolic thinking, which does not emerge until the end of the sensorimotor period.

The relationship of play behavior to cognitive ability in developmentally disabled preschoolers

The relationship of play behavior to cognitive functioning in preschool developmentally disabled children was studied by comparing performance on Lowe and Costello's Symbolic Play Test (SPT) with that on the Bayley Scales and Stanford-Binet Scale. Subjects were 247 children referred for evaluation to a hospital-based child development clinic. Subjects were classified as mildly retarded, moderately retarded, atypical, borderline, and language disordered. Correlations between the Bayley/Binet and SPT for the whole sample were significant and in the low to moderate range. Correlations between cognitive and play measures for each clinical group were in the low to moderate range, except for atypical children where the correlations were negligible. The retarded and borderline groups achieved similar mental ages on the Bayley/Binet and SPT, but the language-disordered and atypical groups demonstrated marked differences in their Bayley/Binet and SPT functioning. Implications for using the SPT in clinical practice were discussed.

Peer versus adult models and autistic children's learning: acquisition, generalization, and maintenance

This study compared the effectiveness of a peer model and an adult model in teaching an expressive language task to four autistic boys. A BCBC design, counterbalanced across subjects, was used. After training criterion was reached, generalization of responding to an extratherapy school setting and to the home was measured. Thirteen weekly maintenance probes were conducted after training in each condition. Results indicated that all children learned through observing the peer and adult models and that few consistent differences occurred across the two conditions. The degree of generalization and maintenance of responding was consistently high in both conditions. The relation of these data to the modeling literature on autistic children and implications for developing educational programs for autistic children are discussed.

Nonverbal communication and play correlates of language development in autistic children

The aim of this study was to determine the social and cognitive correlates of language acquisition in autistic children. Functional and symbolic play skills were shown to be associated with language abilities in a sample of young autistic children (mean CA 54.5 months), thereby replicating previous findings. Certain types of nonverbal communication skills were also shown to be significant correlates of language development in this group of autistic children. These involved the ability to use gestures to coordinate visual attention between social partners with respect to objects or events. The play and nonverbal communication variables were not significantly correlated, suggesting that these variables reflect independent psychological factors associated with language development in young autistic children.