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

The Effectiveness of Visual Pedagogy for Toothbrushing in Children with Autism Spectrum Disorder

Objectives

The aim of this study was to evaluate toothbrushing effectiveness in children with mild and moderate levels of severity of autism spectrum disorder (ASD) after using visual pedagogy.

Materials and Methods

This quasi-experimental study was carried out with 30 children with ASD aged 5-17 years; 21 had mild ASD and 9 had moderate ASD. Informed consent and the subject's demographic information were obtained from caregivers. All subjects were then asked to show their toothbrushing practices, which were recorded by video. The toothbrushing ability, toothbrushing cooperation, and plaque index were evaluated before the study and at 2 weeks, 4 weeks, 3 months, and 6 months after visual pedagogy had been used. Results were analyzed by the Friedman test, Pearson's chi-square test, Fisher's exact test, and Mann‒Whitney U test.

Results

Toothbrushing ability was significantly improved at all periods of follow-up. Toothbrushing cooperation and the dental plaque index were significantly better than before the study at 4 weeks, 3 months, and 6 months of follow-up. The toothbrushing ability of subjects with mild ASD was significantly better than that of subjects with moderate ASD at 4 weeks and 6 months of follow-up. The toothbrushing cooperation of the mild group was significantly better than that of the moderate group at 2 weeks, 4 weeks, and 3 months. There was no statistically significant reduction in the plaque index between the two groups.

Conclusion

Visual pedagogy is useful for improving toothbrushing effectiveness in children with mild or moderate severity ASD. However, children with moderate severity ASD take longer to improve.

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.

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.

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.