Watching your child grow and develop is a rewarding, remarkable experience. Yet it can be fraught with anxiety. How do you know if your child is reaching all the right milestones? When should you get a cute quirk in their behaviour looked at?
Many parents ponder the question of whether their child is shy or whether their shyness is a sign of autism. That’s because the line between the two can be blurry – some of the behaviours are very similar.
For example, a shy child may avoid eye contact, hide behind their parents or not join in at playgroup or in social settings. Likewise, a child with autism may not speak, look at other people or play with their peers. Both shy children and those with autism may appear quieter and more reserved than other children and may find it harder to make friends.
What is autism?
Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Scientists do not know yet exactly what causes these differences for most people with ASD. However, some people with ASD have a known difference, such as a genetic condition. There are multiple causes of ASD, although most are not yet known.
There is often nothing about how people with ASD look that sets them apart from other people, but they may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.
A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.
ASD begins before the age of 3 and lasts throughout a person’s life, although symptoms may improve over time. Some children with ASD show hints of future problems within the first few months of life. In others, symptoms may not show up until 24 months or later. Some children with an ASD seem to develop normally until around 18 to 24 months of age, and then they stop gaining new skills, or they lose the skills they once had. Studies have shown that one third to half of parents of children with an ASD noticed a problem before their child’s first birthday, and nearly 80%–90% saw problems by 24 months of age.
What Autistic Play Looks Like
While it is typical for toddlers to engage in solitary play from time to time, most graduate quickly to “parallel” play during which more than one child is engaged in the same activity at the same time (two children colouring in the same colouring book, for example).2 By the time they are two or three, most children are playing together, sharing an activity or interacting in order to achieve a goal.
Autistic toddlers often get “stuck” in the earliest types of solitary play or engage in activities that have no apparent meaning or purpose.
Here are some scenarios that may sound familiar to parents with young children or toddlers on the spectrum:
- A child stands in the yard and tosses leaves, sand, or dirt into the air over and over again
- A child completes the same puzzle over and over again in the same way
- A child stacks objects in the same pattern and either knocks them down or becomes upset if someone else knocks them down
- A child lines up toys in the same order over and over again with no apparent meaning to the chosen order
As children with autism grow older, their skills improve. Those children with the ability to learn the rules of game-playing often do so. When that happens, however, their behaviours are still a bit different from those of other children. For example, they may:
- Become so rule-bound that they are unable to cope with necessary changes to the number of players, size of playing field, etc.
- Find it impossible to share games with other children (video games can become a solitary obsession)
- Become extremely focused on a peripheral aspect of a game (collecting football statistics without actually following or playing the game of football)
Why Is Play So Tough for Children with Autism?
Why is it that children with autism play differently? Most are facing some daunting challenges which stand between them and typical social communication. Among these challenges are:
- Lack of Imitation Skills: Typically-developing children watch how others play with toys and imitate them. For example, a typically developing child might choose to line up blocks one next to the other the first time they play with them. But as soon as the typically developing child sees others build with the blocks, he will imitate that behaviour. A child with autism may not even notice that others are playing with blocks at all and is very unlikely to observe others’ behaviour and then intuitively begin to imitate that behaviour.
- Lack of Symbolic Play Skills: Symbolic play is just another term for pretend play, and by the age of three, most children have developed fairly sophisticated tools for engaging in symbolic play both alone and with others. They may use toys exactly as they’re designed—playing “house” with a pretend kitchen and eating plastic food. Or they may make up their creative pretend play, turning a box into a fortress or a stuffed animal into a talking playmate.
Children with autism rarely develop symbolic play skills without help. They may enjoy placing engines on a track, but they’re unlikely to enact scenes, make sound effects, or otherwise pretend with toy trains unless they are actively taught and encouraged to do so. Even when they do engage in symbolic play, they may repeat the same scenarios over and over again using the same words and even the same tone of voice.
- Lack of Social Communication Skills: In order to be successful in pretend play and imitation, typically developing children actively seek out engagement and communication, and quickly learn how to “read” the intentions of other people. Children with autism tend to be self-absorbed and have little desire or ability to communicate or engage with playmates. Peers may see this behaviour as hurtful (“he’s ignoring me!”) or may ignore the autistic child. In some cases, autistic children are bullied, scorned, or ostracized.
- Lack of Joint Attention Skills: Joint attention skills are the skills we use when we attend to something with another person. We use joint attention skills when we share a game, look at a puzzle together, or otherwise think and work in a pair or group. People with autism often have impaired joint attention skills. While these skills can be taught, they may never develop on their own.
Types of play skills for children with an autism spectrum disorder
Young children engage in six main types of play, which develop in stages. Children with autism spectrum disorder (ASD) might need extra help at each stage.
This is when children explore objects and toys, rather than playing with them – for example, feeling a teddy bear, mouthing a block or looking at a doll’s hands. At this stage of play, children are learning about their world through different shapes, colours, sizes and textures.
You can help your child with ASD by modelling this type of play and by encouraging your child to explore objects around them. For example, you could encourage your child to splash water in the bath and rub soap between their fingers.
This is when children play with toys that need an action to produce the desired result – for example, pressing a button to play music, or winding up a jack-in-the-box. This type of play teaches children that their actions have effects and gives them a sense of control in their play.
Your child with ASD might learn to operate toys independently, through exploratory play, or you might need to show your child how. Praising your child when they do the right action will encourage them to keep doing it. It will also encourage your child to interact with other toys in a cause-and-effect way as well.
This is also a good opportunity to teach your child how to ask you for help and to play by taking turns. For example, you could take turns pressing a button to make something pop up and take turns pushing it back down again.
Toy play (or ‘functional’ play)
This is learning how to play with and uses toys in the way they were designed – for example, pushing a toy car, bringing a toy phone to the ear, or throwing a ball.
If this is an area of challenge for your child with ASD, the following ideas might help:
- Sit in front of your child, so your child can look at you, communicate with you, and see what you’re doing. This also makes it easier to engage your child in play.
- Offer two or three toys your child enjoys. This gives your child a choice but doesn’t overwhelm your child.
- Join in with what your child is doing, rather than trying to guide play. You can start by copying what your child is doing, then add to the activity. For example, if your child is spinning the wheels of a car, you could spin them too. Then turn the car the right way up and run it along the floor saying, ‘Brrm, brrm’. Or if your child likes opening and closing doors on toys, start with this and then add toy figures walking in the doors.
- Encourage your child to play if your child doesn’t copy you. You could do this by saying, ‘Your turn to drive the car’, taking your child’s hand and placing it on the car, then moving it across the floor together.
- Reward your child. Use praise and positive feedback like ‘You’ve built a big tower. Good job!’ You could also add other rewards, like a couple of turns of blowing bubbles.
- Knowing when to stop or change is also important, so look out for signs of boredom or lack of interest.
- Show your child short videos of people playing. This can give your child ideas of what to do with those toys.
- Look out for signs that your child is getting bored or losing interest – knowing when to stop or change is important.
This is when children build or make things. It involves working towards a goal or product – for example, completing a jigsaw puzzle, making a tower out of blocks, or drawing a picture.
Some children with ASD might have delays in this area of play, whereas others will progress much like typically developing children. Sometimes children with ASD excel at a skill like completing jigsaws, building Lego or drawing.
You can encourage constructive play by showing your child what to do. For example, you could try building a tower with blocks to show your child how to do it, or you could use pictures or photographs that show how to build a tower.
This is rough-and-tumble play, running around, and other physical play that provides whole-body exercise and helps your child develop gross motor skills.
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This is when children pretend and use their imaginations during play. Examples of this type of play include pretending to feed a teddy bear, dressing up as a superhero, pretending to be driving the car, or pretending the couch is a sailing boat.
Pretend play happens later in development – usually around two years of age in typically developing children. It’s the most sophisticated form of play.
Pretend play is particularly important for developing the skills needed for social relationships, language and communication. This type of play is often delayed in children with ASD, but many children with ASD can and do ultimately develop pretend play.
There are lots of simple, everyday pretend actions your child can learn to use in pretend play, like driving a car, riding a horse or banging a drum.
Once your child can do some pretend actions, you can develop their imaginative and pretend play skills by breaking the pretend play activity into steps. You can also use written or picture instructions to help your child understand what to do. You might want to make it funny – for example, try using a hairbrush instead of a spoon to feed a teddy bear. You can also encourage your child to join in with a fun game of ‘let’s pretend’.
This type of play also includes role-playing. You can encourage role-play by taking your child’s favourite story and getting your child and others to act it out. You can give the children costumes and suggest changes to the characters’ voices and gestures. By slowly introducing new themes and gradually changing parts of the play, you can guide your child towards independent, creative, dramatic play.
Social play skills for children with an autism spectrum disorder
Along with the six types of play above, there is social play – the ability to play with others.
Social play also follows developmental stages, but playing with others can be particularly challenging for children with autism spectrum disorder (ASD). You can help your child by noting what stage of social play your child is at and by providing opportunities, support and encouragement for them to progress to the next one. The stages are outlined below.
Note that even as children develop through the stages of social play, they’re likely to want to spend time playing by themselves as well as playing alongside others. It’s OK if your child wants to play alone some of the time.
Playing alone (solitary play)
This is when children play alone and independently when they don’t try to get close to other children and don’t pay attention to what others are doing.
For children with ASD, you can encourage solitary play skills by starting with activities that have a clear goal and end. Keep the play short, to begin with, so your child can finish the activity quickly and feel successful. For example, you might choose a simple jigsaw puzzle.
Playing alongside (parallel play)
Children at this stage of play start to play alongside other children and might use the same or similar toys as those around them.
You can promote play in this stage by encouraging your child with ASD to play at an activity − like trains − on their own but alongside other children. You can encourage your child to imitate the other children’s play while your child is playing on their own.
Playing and sharing with others (associative play)
In this stage of play, children interact with other children – giving, taking and sharing play materials. This usually starts at around three years of age in typically developing children.
You can help your child with ASD learn skills for associative play by encouraging your child to swap things while still playing on their own – for example, swapping bikes, trikes or scooters when cycling or scooting with other children.
Playing and cooperating (cooperative play)
Playing cooperatively with others includes playing games with rules, making up rules, and working together on something, like building a cubby house or making a sandcastle. Cooperative play can become quite complex and involves communication skills.
Many of the social rules in this stage of play can be difficult for children with ASD to understand. You can help your child by using clear instructions to simplify the rules of games. For example, ‘First, you hide somewhere in the house. Then Sam counts to 10. Then Sam comes to find you. When Sam finds you, it’s your turn to count while Sam hides’.
It can also help to explain the rules using pictures or Social Stories™. Making games more visual can also help – for example, you can mark the person who is ‘it’ with a special hat.
Encouraging play with others for children with an autism spectrum disorder
Once your child with autism spectrum disorder (ASD) has a range of play skills or is beginning to play with and take notice of other children, you can help your child learn how to interact and play with others.
Simple games are a good way to build social interaction in play as well as turn-taking skills. Games like peekaboo, pat-a-cake and ring-o-roses are all social. Playing interactive games like snap or memory with cards can also be helpful because they’re structured and have a defined end.
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Here are some other ideas to get your child interacting and playing with others:
- Use playdates or visits with friends or family whose children are around the same age as your child. You could also ask your child’s siblings or cousins to help with showing your child how to play games, take turns and so on.
- Teach your child how to join in. Again, siblings, friends and cousins might be able to show your child how it’s done.
- If other children ignore your child, watch carefully and see whether you can work out why. Does your child need help to learn and work on a skill? You could speak to your child’s school, preschool or early intervention teacher if you’re not sure. Early childhood workers have lots of skills for helping children learn to play together.
Parents, therapists, or teachers can apply all of these techniques, and all have the potential to be helpful. None, however, comes with any guarantee; while some children with autism do develop solid play skills, others find the challenge too great. For most parents, the best way to get started is with the involvement and help of a trained therapist who can provide coaching and support.
If your child receives an autism diagnosis, treatment will begin immediately. You’ll work with your child’s doctors and the school district to map out a treatment plan, so your child’s outlook is a success.