Developed and presented by:

Erin Lash, MA, CCC-SLP

and
Patricia McCoy, MA, CCC-SLP

WV Autism Training Center at Marshall University

PLAY AND AUTISM

1
 10/2010

ABOUT THE WEST VIRGINIA AUTISM

TRAINING CENTER

 The WV Autism Training Center was established

in 1983 by the West Virginia Legislature, through
the efforts of parents of children with Autism.

 Anyone, regardless of age, who has a primary

diagnosis of Autism, Asperger’s Disorder, or
PDD-NOS and who lives in West Virginia can
apply for services.

WV Autism Training Center FF-PBS

3
 WV Autism Training Center FF-PBS 10/2010

OVERVIEW OF WV-ATC SERVICES

 Lending library for registered clients

 In-service training and workshops
 College coursework
 Family Focus Positive Behavior Support program
 Resource referral
 Family Coaching sessions
 College Program for Students with Asperger’s Disorder
 Autism Mentor training

 Website: www.marshall.edu/coe/atc

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WHAT IS PLAY?
• Play is the universal language of childhood.

• It is through play that children learn to

interact, relate to peers and establish friendships.

• Play is a learning process, a social process and an

emotional process.

5
DEVELOPMENT OF PLAY

• A child’s play progresses through a number

of developmental stages (Boucher, 1999):
• Sensory motor play
• Exploratory and manipulative play
• Physical play
• Social play
• Pretend play

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TYPES OF PLAY

• Solitary: Does not require sharing

space, materials, or interaction
• Parallel: Along others, may or may not involve
observing
• Cooperative: Share a common activity and work
toward a common goal
• Unstructured: Group activity that has no
predicablilty
• Pretend: Pretending an object is something else
• Social : Involves social interaction in a group, 7
SOCIAL QUALITIES OF CHILDREN WITH
AUTISM
• Children with autism may exhibit the
following:
– Unusual eye gaze
– Difficulty shifting attention
– Lack of joint attention
– Weak imitation skills
– Ritualized object use
– Avoid peer interactions and/or no response to
social initiations from peers
8
HOW PLAY DIFFERS IN AUTISM

• The DSM-IV diagnostic criteria for

autism includes
“a lack of varied, spontaneous make-
believe play or social imitative play
appropriate to the developmental
level”
as one of the indicators of autism.

9
 HOW PLAY DIFFERS IN AUTISM (CONT.)
• Some children with autism do not give any
indication that they want to play with other
children; this may indicate that they prefer to
play alone or it may be that they do not have
the social or communicative skills to seek out
play interactions with others.
• Solitary play in children with autism is often
accompanied by a strong resistance to those
who attempt to participate or disrupt their
patterns or rituals.

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HOW PLAY DIFFERS IN AUTISM (CONT.)
• The play skills of children with autism serve
as a window into what they understand.

• Toys and objects may be used in a rote or

inflexible way.

• The repetitiveness of play is indicative of a

limited understanding of how to use the toy
appropriately.
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HOW PLAY DIFFERS IN AUTISM (CONT.)
• An informal survey of the play activity preferences
of 100 children with autism revealed the following
popular responses (Quill, 1997):

• Using a computer
• Watching videos
• Looking at books
• Completing puzzles
• Using fine motor manipulatives
• Playing physical games

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 Playground
0%

40%

Solitary Play
60% Parallel Play
Interacting

*
BLOCKS

Blocks Area

0%

34%

Solitary Play
Parallel Play
66%
Interacting
WHY TEACH CHILDREN WITH AUTISM HOW
TO PLAY?

• Teaching children with autism to play with

peers is vital for their social success.

• For the child with autism, maximizing their

ability to observe the social behavior of
others and to share toys and materials is a
critical beginning.

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WHY TEACH CHILDREN WITH AUTISM HOW TO
PLAY? (CONT.)

• Allows practice of newly acquired skills in a safe

and supportive environment.

• A lack of play skills can contribute to the social

isolation.

• Play allows them to connect feelings and thoughts

with events.

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WHY TEACH CHILDREN WITH AUTISM HOW
TO PLAY? (CONT.)

• Children with autism may have difficulty expressing

their thoughts and feelings.

• Play allows children to connect feelings and

thoughts with events to enable them to express
emotions. (develop cause and effect thinking for
emotions)

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• Research has shown:
• that the predictability of interactions with adults
serves to increase the communicative
effectiveness of children with autism.
• peers are less likely to adapt their communication
styles. (Although peers can be taught to adapt
their behavior to be play partners for children with
autism.)
• during peer play sessions, the social
responsiveness of children with autism improved
when they were able to predict the sequence of
events involved in the play activity.

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JOINT ATTENTION (JA) AND PLAY

• Joint Attention (JA): sharing moments are

crucial for language development, academic
learning, and preliteracy development.

• Play is an excellent time for SLP’s to focus

on the development of JA.

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• To be effective learners, children with
autism need to find meaning in everyday
interactions.

• Teaching the three “R’s” will be a

challenge if the child with autism finds
no meaning in them.

*
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• Classroom teachers may not be
familiar with the prerequisite skills for
the development of preliteracy skills.

• The SLP’s role may be to reframe their

thinking of these precursor skills to
include teaching joint attention and
play skills

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WHEN TEACHING JOINT ATTENTION THE SLP
SHOULD:
• Use preferred objects/toys
• Take the child’s lead in the play interaction
• Pay attention and comment on what the child
is doing
• Make your presence more obvious. Choose
to do things you know he will find interesting
to attract his attention.

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• If he is standing in front of you with a
toy, react as if he is showing it to you.
Show interest and talk about it.

• Draw attention by putting word or picture

with the object/toy.

• Use the same word or phrase

consistently

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SUMMARY: TEACHING JOINT ATTENTION
• Imitate what the child is doing with the toy.
• Take the toy, comment on it, and wait for
them to reach for it.
• Use toys that need help such as placing a
favorite item in a container with a tight lid.
• Interact with toys at eye level so that the
child can shift their gaze between the toy and
your face.

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 WHY DOES IT MATTER?

• Play is an important part of language and

social development.

• It is through play that children learn to

see things from another person’s point of
view.

• They also learn

negotiation, collaboration, and
cooperation 25
WHY? (CONT.)

 May increase fluidity of thought

 May reduce conceptual fragmentation

 May assist in reducing repetitive and rigid

behaviors
 May encourage communication development
 Sherratt and Peter (2002)

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PLAY AND SPEECH THERAPY
• Observing/evaluating play skills is an important part
of the initial assessment phase.

• Play can be one way we implement therapy.

• Play is a skill itself and a natural activity for

children.

• Play is a representation of the child’s language

abilities. (If a child has no play abilities then his
entire language system may be affected.)
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ASHA POSITION STATEMENT
 Roles and Responsibilities of Speech-Language
Pathologists include:
• Addressing: joint attention, shared
enjoyment, social reciprocity in nonverbal and
verbal interactions, mutually satisfying play and
peer interaction, comprehension of other’s
intentions, and emotional regulation.

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SLP’S ROLE (CONTINUED)

 Critical in supporting the individual, the

environment, and the communication partner
to maximize opportunities for interaction in
order to overcome barriers that would lead to
ever-decreasing opportunities and social
isolation if left unmitigated.

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DELIVERY MODELS
 Should lead to increased active engagement
 Should build independence in natural learning
environments
 Should facilitate peer-mediated learning
 Should provide services that are connected with
functional and meaningful outcomes

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EBP COMPENDIUM GUIDELINES
 Six kinds of interventions should have
priority:
• Functional, spontaneous communication
• Social instruction
• Teaching of play skills
• Other instruction aimed at goals for cognitive
development
• Interventions to address problem behaviors
• Functional academic skills

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AND FINALLY…..

 SLP’s should provide pull-out services ONLY

when:
• Repeated opportunities do not occur in natural learning
environments
• Working on functional skills in more focused
environments
• MUST insure that any pull-out services are tied to
meaningful, functional outcomes and incorporate
activities that relate to natural learning environments.

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WHAT LANGUAGE SKILLS DO WE EXPECT TO DEVELOP
THROUGH PLAY?

• Attention getting
• Imitation
• Expressing emotions
• Negotiating
• Commenting
• Group play

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HOW DO WE START?
FIRST STEPS

• The general strategies include:

• Observing
• Waiting

• Listening

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FIRST STEPS (CONT)

• Observing

– Paying close attention to the child’s interests

– (Children with autism may have novel, out of the

ordinary interests.)

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FIRST STEPS (CONT)

• Waiting

– Wait for the child to initiate and giving time to

communicate

– (children with autism may not initiate

communication or social interactions. )

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FIRST STEPS (CONT)

• Listening

– Paying close attention to what the child

communicates so we can offer an appropriate
response
– When we listen, we communicate to the child
that what they have to say is important.
– (For the child with autism, this is an important building
block in promoting social connectedness and language
development.)

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REMEMBER..

• Play in children with autism is often over

taken by their need for sameness.
• Their play can become a repetitive activity
which blocks out social interactions and
opportunities for language development.

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SENSORY/EXPLORATORY PLAY

• Involves the child manipulating

objects for visual, auditory, touch or
taste experiences or stimulation.

• May get “stuck" in this stage of

play.

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SENSORY/EXPLORATORY PLAY

• Strategies to expand the child’s play:

– Help him focus not only on the toy but on

also on you (hold the toy close to your
face, imitate his actions/sounds)
– Encourage social interactions with physical
games (peek-boo, horsey rides, etc.)

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SENSORY/EXPLORATORY PLAY

• Communication goals may

include:

– Paying attention to objects and people

– Shared play
– Imitation
– Understand words in simple routines

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 NONFUNCTIONAL PLAY

• Using a toy/object in an
unconventional way such as lining up
objects, banging blocks instead of
building.

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NONFUNCTIONAL PLAY

• Strategies to expand the child’s

play:

– Join in the interaction to promote

proximity tolerance
– Repeating the play routines with the
same words so the child with autism
learns to understand them in a familiar
context
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NONFUNCTIONAL PLAY

• Communication goals may

include:

– Attending to people
– Imitating actions

– Turn taking

– Following simple directions

44
FUNCTIONAL/CONSTRUCTIVE PLAY

• Child demonstrates purposeful, appropriate

use of toys and common objects. ( using a
shape sorter, rolling a ball, building a block
tower)

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FUNCTIONAL/CONSTRUCTIVE PLAY

• Strategies to expand the child’s

play:
– Introducing him to a range of toys
– Sustain his attention with back and forth
games
– Show him how to vary and extend play
actions (fill truck with animals, push
them around, dump them out)

46
FUNCTIONAL/CONSTRUCTIVE PLAY

• Communication goals may

include:

– Imitating words
– Following verbal directions

– Making requests
(signs/pictures/words)

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POTENTIAL THERAPY GOALS
 To intentionally interact and communicate for a variety of
reasons.

 To communicate using words, gestures, eye-gaze, facial

expressions, and/or body language.

 Expand his/her play repertoire.

 To imitate others in actions, words, and prosody.

 To play and interact with others for increasing periods of

time.
.

48
POTENTIAL THERAPY GOALS (CONT)
 Appropriately initiate social interactions with
peers and adults.

 Respond to the social initiation of others in

appropriate ways.

 Request items or actions during play.

 Develop an expanding interest in a variety of

toys or objects.

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OBJECTIVES

 Managing Attention:
• Shift attention between people, activities, and
toys
• Pay attention to routine changes
• Increasing awareness of a play partner
• Awareness of, and interest in, playful social
interaction.

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OBJECTIVES (CONT)

 Communication:
• Understand and use a set of important
words and phrases (scripted language)
• Understand pictures as representing
activities, emotions, or people.
• Follows 1-2 step directives during play.

• Initiate and maintain a conversation with

others during play.

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OBJECTIVES (CONT)

 Understand and use nonverbal cues

 Understand “yes” and “no” as meaning
different things at different times
 Protest with words, gestures, or tone of voice

 Request with words, gestures, or tone of

voice.
 Understand, follow, or describe the steps for
completing a play activity.

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OBJECTIVES (CONT)

 Call to others
 Greet others

 Say “bye bye”

 Request help

 Direct others’ behaviors with words

 Communicate the desire to end an activity in

an appropriate way

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OBJECTIVES (CONT)

 Comprehend and follow verbal directions

 Complain with words

 Remember with words

 Plan with words

 Communicate playfulness with facial

expression, gesture, eye gaze, or voice

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OBJECTIVES (CONT)

 Emotional Regulation
• To stay emotionally regulated when others
say “NO”
• To stay emotionally regulated with the
unexpected happens
• To persist when appropriate

• To not persist when appropriate

• To recognize and name facial expressions

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OBJECTIVES (CONT)

 To use words and other forms of

communication to calm self down
 To join in play activities with playfulness

 Respond to the social initiations of peers.

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OBJECTIVES (CONT)

 Initiation and Making Choices

• Make a choice between two appropriate
options
• To initiate games with actions, words, or
pictures
• To discuss and choose between two
options

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OBJECTIVES (CONT)

 Cooperation:
• To follow routines within games and activities
• To communicate the desire to end an activity
• To take turns
• To move with others/in response to others

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OBJECTIVES (CONT)

 Play:
• To use toys in an intended way
• To use toys in a variety of ways
• To follow routines within games or activities
• To add new ideas to play, as inspired
• To join into play activities

59
WHAT RESOURCES DO I NEED?
• Play activities that are useful for building play skills
include (Quill, 2000):

• Exploratory toy and activities (e.g. cause-effect

toys, bubbles)
• Physical toys and activities (e.g. bicycles, playground)
• Manipulative toys (e.g. puzzles, pegs)
• Constructive toys (e.g. blocks)

60
WHAT RESOURCES DO I NEED? (CONT.)

 Arts and Crafts (e.g. playdoh, paints)

 Literacy activities

 Music activities

 Games (e.g. board games)

 Social games (e.g. Hide-and-Seek)

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RESOURCES (CONT.)

• It is important that your child’s interests are

taken into consideration when deciding what
toys and activities to use as you design and
implement the play skills program.

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WHAT ABOUT MATERIALS?

 Children with autism have a wide range of

interests, likes, and dislikes
 At what level of Play is the child functioning?
What are peers playing?
 THROW out the flashcards…Bring out the
games!

63
MATERIALS MAY INCLUDE:

 General categories might include:

• Visually stimulating or interesting
 bubbles,puzzles, Legos, shapes, cars, trucks, little
people, “noisy” toys, things that move, play
sets, computer programs….
• Books
 Pop-ups,touch
books, puzzle, activity, word, coloring, theme
character (Thomas the Train, Disney, Blues
Clues, Spongebob)

64
MATERIALS MAY INCLUDE:

• Physical activity toys:

 Trampoline, sandbox, swing, slide, rocking horse, ride
or bounce on toys, jungle gym, hula hoop…..
 Social games: Follow the leader, Duck-duck-
goose, Red light-Green light, Twister, Hide and
Seek, Mother May I?, Charades, Animal
charades, Ring toss, bowling
games, horseshoes, bean bag toss……

65
MATERIALS MAY INCLUDE:

• Singing and dancing games

Wheels on the bus, pat-a-cake, Itsy Bitsy Spider, hokey-
pokey, Pop goes the Weasel (the more repetition, the
better)
• Games
 Candyland, Connect4, card games, Lotto, matching
games, Chutes and Ladders….
 BOARDGAMES encourage social and cooperative
play, turn taking…..and so much more

66
THE PEER BUDDY SYSTEM

 .To use the peer buddy

system:
 Recruit a child to be the
peer buddy.
 Give the peer buddy
direction as to how long
they should stay with the
child with autism (e.g. until
the timer rings, for entire
play period etc.)
 Let the peer buddy know
what you expect him/her to
do with the child with
autism (i.e. take turns, play
with things together etc.)
 Staff will wander the room
during playtime to
encourage the student to
play with his buddy and to
offer praise for appropriate
play.

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THE PEER BUDDY SYSTEM
 The peer buddy system can be reinforced through
the use of tangible rewards such as stickers. If the
child with autism stays with his buddy for the
allotted amount of time he and his buddy will
receive a reward. Additionally, staff can set up a
“buddy” table. The “buddy” table will consist of
items/activities that are reinforcing to the child with
autism. The child must find a friend to play at the
table with in order to gain access to the
items/activities

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MEET ZACHARY

A case study

69
SEVERAL INITIAL PARENTAL CONCERNS

 Making friends
 Vocalizing at school

 Screaming, crying, upset

 A lot of “drama” when upset

 Doesn’t associate with others at

school
“There, but alone”
 SEVERAL PARENTAL “HOPES”

 Become more “a part” of school

 Relating more to teachers and students

 Finding a “friend”

 Become involved in a community

activity
 31-03-2012

TEACHING NEW SKILLS: STRATIGIES

 SOCIAL SKILLS
 Observations in after-school care to identify peers as
playmates
 Collect baseline data for spontaneous verbal interactions
with peers and adults
 Suggestions to after-school caregivers to encourage peer
interactions
 Play dates scheduled at home

 Facilitated play sessions conducted at after-school care

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 31-03-2012

BASELINE DATA
SPONTANEOUS VERBAL INTERACTIONS
 Observations conducted on 3 occasions
 Baseline data collected on greetings, spontaneous
interactions with peers, interactions with adult
caregivers, and ease of transitions

 Settings
 Gym, snack time, computer time, playground

 Observations recorded for sixteen, 15-

minute periods

73
 31-03-2012

Observational Baseline Data

20

18

16

14
Spontaneous Interactions

12

10

0
15-1 15-2 15-3 15-4 15-5 15-6 15-7 15-8 15-9 15-10 15-11 15-12 15-13 15-14 15-15 15-16
15-Minute Periods

74
 31-03-2012

BASELINE DATA-INTERPRETATION

 Verbal interactions with peers and adults

ranged from 0 to 20 per given period
 Total interactions: 45 in 240 minutes

 Average spontaneous social verbalization=

2.8 per 15-minute period
 Several peers were identified as potential
“playmates”

75
 31-03-2012

INTERVENTION

 Two facilitated play sessions were

initiated, with Zack and another peer.
 Activities were selected to encourage verbal
interactions.
 Education Specialist (SLP) encouraged
verbal reciprocity by teaching and modeling
during these sessions.

76
 31-03-2012

Independent and Directed Play Interactions

90

80

70

60
Interactions

50

40
Directed play

30

20

10

0
15-1 15-2 15-3 15-4 15-5 15-6 15-7 15-8 15-9 15-10 15-11 15-12 15-13 15-14 15-15 15-16 15-17 15-18 15-19 15-20 15-21
15 Minute Period

77
 31-03-2012

INTERPRETATION OF DIRECTED PLAY DATA

 Zack’s verbal interactions with a peer and

facilitator were recorded
 Total number of verbal interactions: 290 over
six, 15-minute segments
 The number of interactions ranged from 18-
78 per period
 Average number per 15 minute period=48

78
 31-03-2012

POST INTERVENTION DATA

 Structured play sessions continued in the

after-school care setting on a monthly basis
 Chosen activities encouraged reciprocity (ie:
Go Fish, Candyland, Simple Object
Bingo, Memory, etc)
 The facilitator faded modeling and teaching

79
 31-03-2012
Facilitated Play with Peers

50

45

40

35
Verbal Interactionss

30

25

20

15

10

0
Christmas 1/19/2009 1/19/2009 1/19/2009 2/18/2009 2/18/2009 2/18/2009 4/15/2009 4/15/2009 4/15/2009 5/6/2009 5/6/2009 5/6/2009
Break
15 Min. Period

80
 31-03-2012

POST INTERVENTION DATA INTERPRETATION

 Zack’s independent verbal interactions were

recorded over twelve, 15-minute periods
(total time = 3 hours)
 Verbal interactions with a selected peer
ranged from 17 to 46 per period (total = 369
interactions in 180 minutes)
 Average responses = 31 spontaneous
interactions per 15-minute period

81
 31-03-2012

DATA SUMMARY
 Baseline observational data collection:
spontaneous verbalizations = 19% of
observed time
 Following play interventions: spontaneous
verbalizations= 49% of observed time
 Responses following intervention:
 appeared age appropriate
 included both conversational reciprocity and
turn-taking while playing a two-person game

82
 31-03-2012

TEACHING NEW SKILLS

STRATEGIES

 COMMUNICATION
 Team members modeled greetings and used
verbal prompts to encourage responses
 A social story was used to enable Zack to tell
others that he was hurt or in pain
 Eye-contact was addressed during directed play
interventions, in the classroom, and at home
 A social story was used to ask for help, and use
words to express “I don’t know”

83
 31-03-2012

QUALITY OF LIFE

 After school care-givers encouraged

cooperative play in various settings
 Spends more time away from
computers, preferring locations where
peers gather
 Enjoys encouraging peers in a game of
“chase”
 Older children taught him to “shoot hoops”

84
 31-03-2012

QUALITY OF LIFE (CONT.)

 At School
 Enjoys being a “helper” in the classroom
 Follows a routine with little assistance or teaching
 Is demonstrating improved problem solving skills
 More responsive and helpful at school
 Communicating verbally with teachers and peers

 Home and Community

 Play dates continue at home
 More comfortable in the community
 Enjoys having peers and others around him
 Parents notice fewer “meltdowns”

85
 QUALITY OF LIFE (CONT.)

 Home and Community (cont.)

 Telling
others when he is hurt, allowing
them to “look”

*Successfully played T-Ball during the Spring

of FFPBS
 Interacted with peers during practice, and on
the field
 Mother was ecstatic when several boys were
playing in the dirt: “I had to take a picture! I
dare anyone to find the boy with Autism!”
ADDITIONAL INTERVENTION STRATEGIES
• If your child has a limited repertoire of interests, observe
what does interest the child and begin with activities and
items that have the same visual, auditory, tactile or
movement feedback.
• Specifically, a child who likes watching movement may
relate to activities that provide the same type of feedback
such as playing with a ball or bean bag toss.

87
INTERVENTION STRATEGIES
• A visual support will be beneficial to help the child
with autism understand the play activity.

• The visual support may also be used as a cue for

transition.

88
INTERVENTION STRATEGIES

89
COOPERATIVE PLAY INTERVENTION
STRATEGIES
• When facilitating cooperative play, it is
important to remember to begin with adult-
child play dynamic and then bring in one child
to the play session, with the adult serving as
the facilitator.

90
COOPERATIVE PLAY INTERVENTION STRATEGIES
(CONT.)
• Select activities in which the children share a common
activity and work toward a common goal.
• Select activities that are motivating and reinforcing to the
child with autism.
• Select activities that do not require direct observation.
• Select activities that emphasize nonverbal responses and
limit the requirements for verbal interaction.

91
COOPERATIVE PLAY INTERVENTION STRATEGIES
(CONT.)
• Examples:
• Two children share a bin of blocks and take
turns building a tower.
• Two children play with play dough using a
play dough press or cookie cutter. When one
child has pressed or cut his play dough, then
he gives it to the other child.

92
PLANNING FOR SOCIAL PLAY INTERVENTION

• When planning for social play intervention, play

should focus on activities that are mutually enjoyed
by the child and others.
• The child with autism should understand what to
DO before being placed in the social play situation.
(Use priming, a social story, practice with an adult
before the actual situation.)

93
INTERVENTION STRATEGIES FOR SOCIAL
PLAY INTERACTIONS
• Where to begin:
– Identify the social behaviors that are most important to
the play situation.
– The communication messages should mirror the
messages of the same-age peers: For example, the
typically developing 4 year-old may not say, “John, would
you like to play with me?” Instead they may say, “Come
on!” or “Look here.”
– Use a social script to teach what to say.

94
SOCIAL SCRIPTS

Social Scripts: Social scripts are similar to Social

Stories; however, an actual script is developed
for a specific social situation (it is specific to the
child and the social situation). Use of social
scripts also readily helps in role playing these
various social situations with
peers, puppets, etc.

95
INTERVENTION STRATEGIES FOR SOCIAL
PLAY INTERACTIONS
• Example: A child has difficulty asking peers
if he can join in their "ball-tag" game at
recess. He will run into the group, take the
ball and then run away. The script would
read:
– Zachary - “I want to play"
– Guys - “O.K., Zach, wait for your turn."
– Zachary - "O.K.”

96
SUMMARY
• Children with autism have deficits in play skills that impact
their social and communication skills, their cognitive and
emotional development, and their imagination and creativity.
• For children with autism, play skill development cannot be
left to chance. Play skills must be taught like any other skill.
• Play skills objectives should be part of IFSP and IEP
development and a data collection system should be in
place to assess improvement (or lack of) in these skills.

97
SOME TIPS TO GET STARTED
• Assess your child’s level of play development
• Structure your environment to support play opportunities
• Prepare materials/toys needed to engage in a variety of play activities
• Develop needed supports such as visual cues, scripts, labels
• Use multiple, short sessions throughout the child’s day to address
specific play skills (Always try to stop the session before the child
becomes tired or loses interest)
• Play activities should always stop on a positive note
• Get on the child’s level (physically and mentally!)
• HAVE FUN!

* The possibilities are endless! Just imagine…

98
 From Steps to Independence, fourth edition. Copyright 2004 by Paul H. Brookes Publishing Co., Inc. all rights reserved

Play Skills Checklist

This checklist contains some of the skills involved in many types of play. Place a check in the
column to the right of each skill that best indicates your child’s current performance level.

Does Does with Does Does

Not Much Help with alone
Do Some
Help
CATEGORYA:
BASIC PLAY SKILLS
Pays attention to someone speaking
Pays attention to music
Grasps or holds large toys or objects
Grasps or holds crayons or pencils
Pushes, pulls and turns toys
Names toys and objects used for play
Names body parts
Plays simple hide and seek games
Follows directions: gives or takes toys
Follows directions: opens and closes lids or doors
Follows directions: lines up toys on table
Follows directions” carries toys from place to place
Sits alone for up to five minutes
Imitates gestures

99
 Play Skills Rating Scale: Sample Checklist

 Child’s Name: ________________________________ Observation Date:____________________
 Child’s Age:_______________________________ Observation time:____________________
 Observed by: _______________________________ Location:__________________________

 Circle the number which most closely describes the child’s play skills during this observation.

 (Circle One)
 Never Always

 Appears to enjoy interacting with peers. 1 2 3 4 5
 Able to enter play groups successfully. 1 2 3 4 5
 Uses peers’ names 1 2 3 4 5
 Communicates effectively with peers 1 2 3 4 5
 Able to lead play effectively 1 2 3 4 5
 Able to follow directions of others 1 2 3 4 5
 Able to share materials appropriately 1 2 3 4 5
 Able to solve social problems appropriately 1 2 3 4 5
 Able to get attention from other children 1 2 3 4 5
 Is accepted into play groups 1 2 3 4 5
 Plays with a variety of children 1 2 3 4 5
 Sought out by other children 1 2 3 4 5
 Able to choose play activity 1 2 3 4 5
 Appears engaged, involved 1 2 3 4 5
 Play is appropriately complex 1 2 3 4 5
 Shows enjoyment 1 2 3 4 5
 Adds to play, has ideas about activity 1 2 3 4 5
 Is creative in play 1 2 3 4 5
 Appears comfortable with play 1 2 3 4 5
 Interacts with make believe activities 1 2 3 4 5
 Shows interest in different activities 1 2 3 4 5
 Sustains play for appropriate period 1 2 3 4 5


100
OUR ROLE
• Understand the relationship between
language development, social skill
development, and play
• Consider more inclusive (“Push in”) services
• Help build independence in natural learning
environments
• Provide services that encourage functional
and meaningful outcomes

101
STRATEGIES DO PAY OFF
Baseline/Intervention Data for Peer Interaction During Play

33

35

30

25

20

15
6
10

0
Baseline Intervention
A PICTURE’S WORTH…

103
 REFERENCES
• Beyer, J., & Gammeltoft, L., (2000). Autism and Play.
London: Jessica Kingsley Publishers.

• Bolick,T. (2003). Play as a Strategy for Interaction and

Coping. Autism/Asperger’s Digest, July-August, 12-14.

• Norris, J, & Hoffman, P (1990). Language Intervention

within Naturalistic Environments. Language, Speech, and
Hearing Services in the schools, Vol. 21, pg 72-84

104
REFERENCES (CONT.)
• Pei, C. (2000). Developing Play Skills in Pre-
Schoolers. ARC Newsletter, 3(4), 5-9.

o Quill, K.A., (2000). Do-Watch-Listen-Say. Baltimore:

Paul H. Brookes Publishing Co.

• Wolfberg, P., (2003). Peer Play and the Autism

Spectrum. Kansas: Autism Asperger Publishing
Co.

105
REFERENCES AND SOURCES (CONT)
• American Speech-Language-Hearing Association
(Position statement, Compendium)

• www.centerforcreativeplay.org

• www.playsteps.com

• http://sites.google.com/site/autismgames/home (Tahirih
Bushey, MS CCC-SLP)
• Toys R Us (Toy Guide for “Differently Abled Children”)
• www.mousetrial.com

106
ADDITIONAL RESOURCES

 www,asha.org/Publications/leader/2005/0509
27.htm
 www.autisminternetmodules.org (OCALI)

 www.centerforautism.com

 www.fraser.org/tip_sheets/play_skills. PDF

 www.teacch.com

 Westby, Carol.(1991) Symbolic Play Scale,

107
A SCENARIO: WHAT CAN I DO?

• Adam loves toy trucks and cars. He also

appears interested in blocks.

• When Adam plays, he holds up the car or

truck and studies the wheels.

• He will build a 3 block tower with prompts.

108
ADAM (THROUGH THE STAGES)

• Sensory-motor (exploratory) play

– Manipulate your own car, turn the wheels, look at
different aspects, open the doors, close the
doors, push the car.

109
ADAM (THROUGH THE STAGES)
 Build a tower with blocks, build a bridge.
 Sort the blocks into piles (color, shape).
 Build a building.
 Put the car on or in the building.
 Push the car fast.
 Make the car stop.

110
ADAM

• Representational/exploratory play
– Make a road and bridge. Drive the car over the
bridge
– Send the car over the edge of the table. Push
the car (with “zoom zoom”)
– Crash the two cars together (add crashing
noises)
– Make a ramp. Push the car over the ramp.

111
ADAM PLAYS

• Build a garage with blocks. Park the car in

the garage. Put gas in the car. Drive the car
away.

• Add people. Have them drive the car. Stand

on the car, crash the car.

112
ADAM PLAYS

• Build a house with blocks. Build a chair in

the house. Build a car with blocks. Have
people stand on the house, walk over the
bridge. Fall off the bridge. Slide down the
bridge.
• The car goes in the garage. Does donuts in
the driveway.

113
PRETENDING

• Use the real item (i.e.: real telephone)

• Use a pretend item as a representation (i.e.:
toy telephone)
• Use a “substitute” item (i.e.: a block)
• Omit props

114
ADAM PRETENDS

• A block becomes a car.

• Add an action hero. “Superman” lifts the
car, throws the car, stops the car. Turns it
into a spaceship. Takes the spaceship car to
Krypton.
• 2 chairs become a car. Where are you
going? Drive the car. Hit a bump, Ouch! Go
to the doctor.

115
ADAM PRETENDS

• Advance to “play sets” and “action figures

• Build a garage, add a truck. The car has a
flat tire (Oh no!) Tow the car to the garage.
Put it “up” on the elevator. Take it down
• Drive the car to school. Get out, go to
school, back in the car.

116
PRETEND PLAY (CONT)

• The car becomes a fire truck. Goes to an

accident. Goes to the house (a cardboard
box?), puts out a fire.
• Back to the firehouse. Firemen put up
hoses, slide down the pole, fix dinner, wash
the fire truck….
• The scenario is endless….just imagine!

117
DESIGNING PLAY AREAS
• Size
• Provide enough space for the children to move
freely
• Avoid large open spaces as they can inhibit
social interactions and allow for the child with
autism to wander off and become segregated.

118
DESIGNING PLAY AREAS (CONT.)
• Boundaries

• Play areas should have clearly defined boundaries with

partitions on at least three sides of the area.
• Each play area should be marked with pictures, symbols
and/or words showing what the area is for (block
area, book area, housekeeping, arts and crafts, etc.)

119
DESIGNING PLAY AREAS (CONT.)
• Organization:

• Materials are accessible, visible, labeled and

logically arranged
• Shelves and containers are labeled with
words, pictures/symbols or a combination of the
two.

120
DESIGNING PLAY AREAS (CONT.)
• Limit Distractions:

• Avoid clutter with play materials, be selective.

• Limit toys that contain multiple pieces.

121
PLANNING FOR INTERVENTION
• Play skill intervention should be planned and
progressive.
• Target one skill at a time.
• Build from simple to complex.

• Social play activities range in complexity according to

social, language and communication features of the
situation.

122
PLANNING FOR INTERVENTION (CONT.)
• The easiest play activities are comprised of the
following components:
– Closed ended:
• Closed ended play activities involve toys and
materials being used in a specific way, utilizing a fixed
sequence of steps.

123
PLANNING FOR INTERVENTION (CONT.)
– Examples of closed-ended activities can
include:
• books,
• physical games with a sequence such as hop scotch
or musical chairs
• puzzles,
• board games
• art projects with a pre-determined final product.

124
PLANNING FOR INTERVENTION (CONT.)
• The easiest play activities are comprised of the following
components:

– Utilize limited toys and materials

– Involve one partner
– Separate toys and materials for each child
– Sharing, turn taking or waiting is not required
– Listening and language are not required.

125
PLANNING FOR INTERVENTION
• The most complex play activities are comprised of the
following components (these are the most difficult for
children with autism):

– Open ended:
 involve toys and materials that are used in a
variety of ways.
 no sequence of steps or no pre-determined
outcome or ending
 sequence of events and the outcomes are
determined by the participants

126
EXAMPLES OF OPEN-ENDED TOYS

 Examples of open-ended activities

include:

 playing in a sandbox
 playing dress up
– Lego's/blocks
– action figures/dolls
– any type of manipulative

127
PARALLEL PLAY WITH OPEN ENDED
TOYS
• Promoting parallel play with open ended
toys can be accomplished by giving each
child a colored mat on which to build with
Lego’s.
• The children have their defined building
spaces but the Lego blocks are shared
between the children.

128
LEGO TABLE

• The Lego Table serves as an effective tool to

promote both parallel play and interactive
play. The general play space is defined with
enough room for each child to have his/her
own comfort area for play.

129
PARALLEL PLAY INTERVENTION
STRATEGIES
• The first goal should be to support the child in
sharing physical space with peers. Specifically, the
child has his/her own set of materials and plays in
proximity to peers.

130
PARALLEL PLAY INTERVENTION
STRATEGIES (CONT.)
• Set up similar materials in the same play
space.
• Choose materials and activities that naturally
lend themselves to parallel play such as
water tables, action figures, toy cars.

131
PARALLEL PLAY INTERVENTION STRATEGIES
(CONT.)
• Select activities that allow the child to play
independently with his own set of materials.
• Select activities that do not require direct
observation.
• Select items/activities that are motivating to
the child with autism.

132
PARALLEL PLAY INTERVENTION
STRATEGIES (CONT.)
• Examples:
– Each child has a place at the table defined with a
placemat or tray and a container of puzzle
pieces.
– Each child has his own road rug and set of cars.

133
COOPERATIVE PLAY AND THE BLOCKS AREA

• When facilitating cooperative play strategies, select

activities in which the children share a common activity
and work toward a common goal such as building a
structure with blocks.
• Example:
– Two children take blocks from labeled shelves
and build a block structure on a tray that is
labeled with both of their names.

134
COOPERATIVE PLAY IN THE ART AREA

• The classroom area can also serve to

facilitate cooperative play by having the
child with autism and a partner work to
complete a project.
• Example:
– Creating a collage using a large piece of
paper and various art materials such as
glitter, buttons, feathers.

135
COOPERATIVE PLAY IN THE WATER TABLE
• Example:
– Place a water wheel in the empty water table; set six cups of
water nest to it.
– One child stands by the water table and gives the cup of water to
the child with autism.
– The child with autism dumps the water over the water wheel.
– Play continues until all of the cups have been used; the children
switch places and use another six cups of water. (This activity can
also be solidified for turn taking and exchange of roles to occur
after every cup of water.)

136
COOPERATIVE PLAY IN UNSTRUCTURED
GROUPS AT THE WATER TABLE

• Example:
– Place a bucket in each corner of the water
table; fill the table with plastic fish.
– Each child uses his own fishnet to scoop
fish into one of the buckets.

137
SETTING THE STAGE FOR SOCIAL
PLAY IN THE HOUSE AREA
• Completely organize the kitchen area.
Have all the items in clearly marked bins.
• Make sure all items are accessible to the
children.
• Limit the number of children in the House
Corner.

138
FACILITATING PLAY IN THE HOUSE AREA

• The teacher as the play facilitator:

– Enter the play area as an observer.
– Comment and ask questions about what
you see happening.
– This area is first and foremost a place for
children to play and interact with each
other.
– As you facilitate play, avoid dominating
the conversation.

139
FACILITATING PLAY IN THE HOUSE
CORNER (CONT.)

• Example:
– Set up a grocery store with every item clearly
labeled.
– The adult says to the child “working” at the cash
register, “I need some food for my house can you
help me?”
– Once the child offers help, the adult can incorporate
another peer by saying, “My friend needs some
food. Can you help him, too?”

140
INCORPORATING INTERESTS IN THE
HOUSE AREA

• A child with autism who is interested in

numbers could be motivated to participate in
the House Area by offering items such as cash
registers and toy phones with the adult
facilitating and encouraging peer interaction.

141
INCORPORATING INTERESTS IN THE
HOUSE AREA (CONT.)

• If your child with autism is more interested in

books than exploring other learning
centers, incorporate books specific to the
theme of the center. This is an example of
incorporating books into the House Area:

142