This is the conclusion to a two-part series on Appropriate Play. Before continuing, please make sure you’ve read Part I.
Play as a tool
For the sake of argument, I will be discussing the benefits of symbolic play as it would pertain to a person who is living in society and thus, would have some motivation, however begrudging, to participate in said society.
Let’s go back to the components of play. Child-led, intrinsic motivation, immersive, spontaneous, and enjoyable. Allee-Herndon and Sherron thoroughly described play as an educational tool in their 2020 paper. They describe a classroom environment that brings up images of Montessori, with stations full of various materials and objects with set themes, such as arts and crafts, sociodramatic play, books, etc. These stations allow for guided play, which exists in a happy medium between unstructured play, which has little to no expected responses or setup, and direct instruction which has specific expected responses and is highly contrived.
The classroom setup allows for all of the components of play to be present while a trained adult is immersed along with them, ready to take advantage of the learning opportunities that arise. This shouldn’t be completely foreign to the behavior analyst, of course. This is basically just natural environment teaching (NET). You’re probably thinking Koegel & Koegel (2006) and their description of Pivotal Response Training (PRT). Other practitioners may be thinking Play Therapy, where child-led play is used by trained professionals to work through psychological and developmental difficulties (Allee-Herndon et al., 2019).
Allee-Herndon et al. cites counseling research describing play as the universal first language for children. If you are looking at play development as a continuum, many autistic children would be at the beginning of that continuum. Instead of seeing this in a pathologizing way though, see it as a method of communicating with that autistic child in a way both of you will understand. That mutual understanding is crucial for getting to know the child (you know, what pairing is supposed to be) as well as learning to communicate with them in a way that makes sense to them, rather than trying to force them to communicate in the way that makes the most sense to you.
It should be their world, not yours.
However, the American Academy of Pediatrics cautioned in 2007 that, when play is controlled by adults, the children tend to resign to the adult’s choices and rules, and lose some of the benefits of completely child-led play, such as learning to work in groups, and exploring issues and situations relevant to them. This is a big issue that comes up when neurotypical parents attempt to play with their children, especially their autistic children (Ginsburg, 2007). I’ve witnessed this with many parents while working with them on how to play with their kids. There’s this desperation to see some semblance of “normal” play come out. It becomes less about joining their child in their world, and more a series of demands that quickly sucks the fun out of the activity and ultimately punishes the child’s behavior of playing with their parents (Ginsburg, 2007; Lowry, 2016).
This is not necessarily because the parents aren’t accepting their child for who they are and are inherently ableist. Sure, that’s the case sometimes, but I would argue that the majority stems from misinformation fed to them about what play is and should be, and what skills are important. Parents come in with an expectation, based on their own learning histories, of what play looks like as well as what skills their child supposedly needs to be happy and healthy. Plus, they have likely seen the typical education environment available for pretty much all kids, with or without disabilities. Teachers are usually directing the student’s actions, or therapists are running discrete trials. Either way, the result is a demand-heavy activity focused on eliciting “normal” behavior.
The goal is a happy medium– emphasis on happy
Purposeful, guided play follows the child’s lead, with the adult interjecting based on the path the child carves. The play is more reciprocal, as the adult will interact through language and modeling rather than dictating the child’s next action. Especially when there are set goals in mind, learning can take place while still allowing the child autonomy and choice (Allee-Herndon & Sherron, 2020). In applying this practice to autistic children, you find opportunities to also understand how that specific child learns best– important since how that child learns best may not be how you are most used to teaching. Because it’s also related to the child’s interest and they have the freedom to be themselves, motivation will be high. Giving this level of control to the child is also helpful when interacting with those with anxiety or who have experienced trauma, both of which are high co-morbidities in the autistic population.
It is possible to teach meaningful skills without pressure to conform to pointless expectations that don’t actually benefit the person directly.
Once you’ve worked with a child in this way for a while, you will also start to see opportunities for that child to be successful in school, rather than depending on restrictive settings for the rest of their lives. That is, how can the school accommodate the child rather than demanding only the other way around?
Stating the obvious
What I found especially striking was the amount of research that had to be done to determine that autistic kids are more likely to be motivated to play when that play involves things they’re interested in. ABA is especially bad about this. Baker, Koegel, and Koegel explored teaching autistic kids to interact with their non-disabled peers in 1998. The paper pulled from research showing that incorporating autistic kid’s obsessions into their reinforcers made them much more motivated to perform tasks.
Imagine pathologizing disabilities so hard that you need to research whether having a shared interest with another human being makes you more likely to want to interact with them.
Anyway, Baker et al. (1998) demonstrated that when games and activities involved their subjects’ special interests (determined by informal observation of the children and asking the children’s teachers and caretakers, never the children themselves), that the autistic children were very likely to be motivated to engage with those activities. Furthermore, the non-disabled peers were motivated to engage with the autistic children, since the activities involved mutual interests. The typical peers also perceived their autistic peers’ “obsessions” in a positive rather than a negative light. That is, they would say things like “____ is the smartest kid in school! He knows all the states!” etc.
Other baffling results included more positive affect in both groups, and autistic children spontaneously choosing to engage with their nondisabled peers.
All of the components of play were present, and it led to autistic children being accepted by their peers. Thus, play skills benefitted the autistic children by allowing them to fit in and be less likely to be seen as weird. (Some sarcasm there)
The problem lies with the non-disabled community
After picking apart research across multiple fields, it is true that some forms of play do serve meaningful results for all learners. Social interaction also benefits those who wish to interact, even if on the most minimal levels. There is an innate need for human contact, especially if said human is going to be existing in human society. Motivation to interact, however, can be quickly punished from infancy if that interaction doesn’t meet the expectations of the typical person they are interacting with. ABA perpetuates this because Lovaas set the foundations for it; thus, all of our goals are focused more on making children appear normal rather than what is actually necessary for development.
The only problem with autistic play is ableism
Education and psychology are also guilty of this to a degree, but are still more focused on increasing children’s ability to gain new skills, as opposed to what those specific skills are. That means that objective research on the kind of play that would benefit autistics is available, it’s just currently only available outside of ABA. Still, it should be easy enough to apply this research to ABA practice, it just depends on your own skills and willingness. If your training focused on understanding the science of learning, this should be no problem. If your training focused on how to make disabled people appear more normal though, this is likely going to be a challenge for you. Of course, if your training was just on how to make disabled people appear normal, your training was not in ABA, your training was just in ableism. Go back to school.
Sorry not sorry.
Once you standardize play, it ceases to be play
For any benefit to come from play, the goals must exclude ableism of any kind. Play must be completely child-led, and you need to let go of any expectations of what play “should” look like or that appearing normal is necessary. Your goals will need to stray away from the ABLLS-R and VB-MAPP which, especially if your training was less than adequate, will be tricky. Specific goals, targets, and measurements will get tricky too, especially if you are used to a discrete trial format, but it’s very doable if you are thinking behavior analytically. Remember, play need only be child-led, intrinsically motivated, immersive, spontaneous, and enjoyable.
When you are willing to meet and join the child where they are, when you aim to make accommodation the norm in society rather than the “burdensome” exception, meaningful learning will happen.
Generalization and Maintenance
Now, let’s talk about integration with non-disabled society. Our practices, yes all related fields, have been hinging for far too long on creating a monolith out of child development and learning. We place all of the responsibility on the disabled person to make themselves as comfortable for the nondisabled people around them as possible. We have been unwilling to put forth any extra effort to the contrary because it’s “hard” and, let’s face it, we’re the ones with the perspective-taking problem.
A lot of the ways autistic kids play are identical to the way typical kids play, it just looks weird to the typical, ableist outsider. That’s what really needs to change: Not the way it looks when autistic kids play, but how we see it. The same excuse is brought up again and again though, regardless of the myriad of research showing its harmful effects: We can’t change the rest of the world, so we might as well change them.
Except we can change the world’s attitudes. We just have to be willing to make the effort.
Allow me to introduce you to The Nora Project.
Putting the focus on non-disabled behavior
The Nora Project was co-founded by Lauren Schrero, mother of Nora, a little girl with disabilities who was about to enter school. Nora’s family and support system realized that, in order for Nora to make friends with her typical peers, her peers needed to understand disabilities, not the other way around. The project is focused on training teachers and other practitioners to teach empathy and understanding to their students. The program covers all levels from preschool through high school, and it’s been incredibly effective. Their reports indicate that an average of 90% of students show increases in empathy and understanding towards disabled classmates and an overall ability to understand the importance of accommodation in society.
If you haven’t petitioned your school to incorporate the Nora Project into their curriculum, visit their website to learn more, then drop everything and make that petition.
Tl;dr, what’s the point?
When answering the question “are play skills important, and if so, what kind?” the answer is hidden across nearly every field that pertains to child development. Each individual practitioner, not even the field they practice in, has their own definition of what play is. As such, to determine if play is important depends on how play is defined. Determining what kinds of play are important depends on what the goals are.
For our purposes here, we must first establish the right goals and the wrong goals. Right goals: Allowing the individual to benefit in ways that are meaningful specifically to them, and reaching developmental levels necessary for living in the society in which the individual chooses to live. Wrong goals: Anything that forces the person to sacrifice healthy behaviors for the purpose of comfort to non-disabled people around them.
Play should be child-led and meaningful to them. Learning, especially early learning, should be based on play as much as possible. We as practitioners should be better trained in guided play and finding ways to teach skills based on where the child leads us. We need to be paying more attention to what is meaningful to each specific autistc child, rather than constantly comparing them to their typical peers.
Stop pathologizing their every freaking move. Appearing normal is overrated and harmful.
The more advanced the skills involved in play, the more advanced skills can be taught. That being said, play is not the only way to teach and has its limits, especially as children grow and their interests change. Prerequisite skills are going to be necessary for some types of play to be beneficial, but we need to be looking outside the box. Play, teaching methods, goals, all of it needs to be meaningful to the autistic person we’re supporting, and we need to be changing the definition of what skills are truly essential for living. Normalizing accomodation and teaching better understanding and interaction skills to non-disabled children will need to come first, followed by looking outside of our tiny insular field for answers. Then, and only then, will we be qualified to talk about how autistics play.
Resources
Allee-Herndon, K.A., Killingsworth-Roberts, S., Hu, B., Clark, M.H., & Steward, M. (2020). Let’s Talk Play! Exploring the Possible Benefits of Play-Based Pedagogy on Language and Literacy Learning in Two Title I Kindergarten Classrooms. Early Childhood Education Journal, January https://doi.org/10.1007/s10643-020-01141-6.
Allee-Herndon, K.A., Dillman, D., & Killingsworth-Roberts, S. (2019). Putting Play in its Place: Presenting a Continuum to Decrease Mental Health Referrals and Increase Purposeful Play in Classrooms. International Journal of Play, https://doi.org/10.1080/21594937.2019.1643993.
Allee-Herndon, K.A. & Killingsworth-Roberts, S. (2020). The Power of Purposeful Play in Primary Grades: Adjusting Pedagogy to Children’s Needs and Academic Gains. Journal of Education, 1-10, https://DOI.org/10.1177/0022057420903272
Alexander, M. (2018, Jan, 23). Creating Inclusive Play Spaces: Place to Start. Play Radical. https://playradical.com/2018/01/23/creating-inclusive-play-spaces-a-place-to-start/
Baker, M.J., Koegel, R. L., Koegel, L. K. (1998). Increasing the Social Behavior of Young Children with Autism Using their Obsessive Behaviors. Journal of the Association for the Severely Handicapped, Vol 23(4), 300-308.
Coplan, R.J., Schnieder, B.H., Matheson, A., & Graham, A. (2010). ‘Play Skills’ for Shy Children: Development and a Social Skills Facilitated Play Early Intervention Program for Extremely Inhibited Preschoolers. Infant and Child Development, 19, 223-227. https://doi.org/10.1002/icd.668.
Ginsburg, K. R. (2007). The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds. American Academy of Pediatrics. https://docs.google.com/document/d/1Tc3I2GKvR9nIjbZJIqUdiESmW0PrVHwDOAg4ssPM6Ns/edit
Hatzenbuhler, E.G., Molteni, J.D., Axe, J.B. (2019). Increasing Play Skills in Children with Autism Spectrum Disorder via Peer-Mediated Matrix Training. Education and Treatment of Children, Vol. 24(3), 295-320.
Jung, S. & Sainato, D.M. (2013) Teaching Play Skills to Young Children with Autism. Journal of Intellectual and Developmental Disability, Vol. 38(1), 74-90.
Koegel, R.L., & Koegel, L.K. (2006). Pivotal response treatments for autism: Communication, social, & academic development. Paul H Brookes Publishing.
Lee, G.T., Feng, H., Xu, S., & Jin, S. (2019). Increasing “Object Substitution” Symbolic Play in Young Children with Autism Spectrum Disorders. Behavior Modification, Vol. 43(1), 82-114. DOI: 10.1177/0145445517739276
Lowry, L. (2016). Play & Autism: More Evidence for Following the Child’s Lead. The Hanen Centre. https://www.hanen.org/MyHanen/Resource-Centre/Articles/Research/Play—Autism–More-evidence-for-following-the-chi.aspx
Stahmer, A.C. & Schriebman, L. (1992). Teaching Children with Autism Appropriate Play in Unsupervised Environments Using Self-Management Treatment Package. Journal of Applied Behavior Analysis, Vol. 25(2), 447-459.
The Nora Project. https://thenoraproject.ngo/
Thorp, D.M., Stahmer, A.C., & Schriebman, L. (1995). Effects of Sociodramatic Play on Children with Autism. Journal of Autism and Developmental Disorders, Vol. 25(3), 265-282.