Exploratory, Functional, and Symbolic Play Behaviors of Toddlers with Autism Spectrum Disorders

Introduction: Although there is a general convergence of research which indicates that children with autism spectrum disorders (ASD) have deficits in play behavior, substantial gaps remain in our knowledge of play in children with ASD. Areas in need of more investigation include research focusing on very early development of play skills in children with ASD, study of the type or types of play impaired in children with ASD, examination of how individual variation in play relates to the three diagnostic domains of ASD, and study of the underlying theories that may account for play differences observed in this population. Method: This prospective study examined play behavior in children between 18 and 24 months of age who were later diagnosed with ASD (n=48). These children were matched with groups of children with developmental delay (DD) in whom ASD had been ruled out (n=25) and children with typical development (TD; n=48). Precise measures of proportion and rate of exploratory, combinatorial, and functional and symbolic play actions were obtained through systematic observation of Behavior Samples from the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 2002). Results: Children with ASD demonstrated significantly higher proportions of exploratory play behavior than children in the TD group, but not the DD group. Children in the ASD group also demonstrated significantly lower proportions and rates of functional and symbolic play behavior than children in the TD group. In the ASD group, functional play behaviors were significantly related to concurrent social communication skills and repetitive movements, as well as nonverbal development assessed at the time of the third birthday. In addition, exploratory play in the ASD group was significantly related to concurrent symbolic skills and repetitive movements, as well as social affect scores at age three. Discussion: The results add important information to the play literature in ASD about the type of play deficits found in very early development and their relationship to other diagnostic domains central to ASD. The results have important implications for improving early identification of play deficits in this population.