Can Autistic Child Pretend Play?

Can Autistic Child Pretend Play?

Children with autism spectrum disorders (ASD) are delayed in their ability to produce pretend play compared to typically developing children and children with language matched peers with learning disabilities. This is probably due to a combination of difficulties with generating ideas and self-initiated actions required for pretend play and lack of understanding of how others might act when they use these skills in social settings.

Generativity Problems

Children impacted by autism are not capable of producing spontaneously produced pretend play because they struggle to generate new ideas or actions that are needed for their own play. This is because their imagination is hampered by a lack of symbolic and abstract thinking abilities, as well as the social skills that would allow them to understand what others are doing when they pretend.

To help improve these skills, clinicians may consider teaching joint attention skills, such as the pointing gesture to highlight an object, and alternating eye contact to check if another person is also interested in that object. These skills can facilitate the development of a sense of being in charge of one’s own behavior, which is known to contribute to an internal experience of playfulness.

Playfulness Variables

The study examined the relation between pretend play and several playfulness variables, including interest in toys, familiarity with toys, and reciprocal interaction with toys. It found that, whereas interest in and familiarity with presented toys were not significantly related to observed pretend play, they did predict a higher number of acts of OS. This finding suggests that, for a child with ASD, interests in and familiarity with toys may play a role in initiating the initial activities of spontaneous pretend.

This could be because, like a TD child, they already have a personal interest in a particular toy and an understanding of its typical functions. Hence, they are more likely to engage in spontaneous pretend by trying out novel uses for that toy (e.g., slamming it against the floor as an imitation of hitting things).

However, this relationship was not significant when comparing children with ASD to a TD child. This is probably because the relationship between verbal mental age and pretend is not a factor for children with ASD, as it is for TD.

Communication Deficits & Autistic Severity:

Finally, the results showed that, in addition to being related to the number of acts of OS, interest in toys also influenced the amount of APP and IO that children with ASD produced in the observed spontaneous pretend play. This interaction effect was larger than the effects of reciprocal interaction or restrictive repetitive behaviors, suggesting that developmental delays in communication, but not reciprocal interaction or restricted repetitive behaviors, might be a contributing factor to the occurrence of different subtypes of pretend among a child with ASD.

These findings suggest that a child with ASD who does not have good ToM will have difficulty with their ability to perform pretend play, but not with their inclination to engage in playful behaviors. Occupational therapists, clinicians, and parents should assist children with ASD to develop their ToM so they can perform better in pretend play. They should also encourage them to play freely and in a social way with their friends, as this will strengthen their sense of internal control and facilitate their playfulness.