Association for Behavior Analysis International

Play is one of the core deficits of children with autism. Impairments in play impact communication and language, cognition, and social and emotional interactions. Appropriate independent and sociodramatic play skills are critical to the development of social skills. Children who do not learn to play may miss out on opportunities for social interactions due to observable differences in their play. Increasing appropriate play has been shown to increase language skills while decreasing stereotopy and other problem behaviors. Play is an integral part of the development of typically developing children and should be an emphasis in behavioral intervention for children with autism. The ACI Play Protocol incorporates a systematic approach to teaching preschool-aged children appropriate play skills and language. Play components, which include appropriate play with figures (dolls/stuffed animals), adults, and peers are taught using individualized treatment packages. Specific skills included abstract play with and without objects, rotating between play schemes, combining items from 2 or more play schemes, initiating, responding and expanding on current play targets.

There is a connection between high quality play and cognitive competence, language acquisition, and proficiencies in social abilities for individuals with autism. Wolery, 2002, states more appropriate intervention strategies are identified through assessment of play. Interventions to increase one aspect of play for children with autism have been the focus in the field of behavior analysis. Studies have utilized a variety of interventions (antecedent manipulations, system of least prompts, video modeling) to increase the complexity of functional play, decrease stereotopy, or engage in pretend play schemes. Play should be a separate domain and used as the primary emphasis in assessing and program development for children with autism (Lifter, K. 2011). Learning the play activities and corresponding vocalizations of typical peers identifies developmentally appropriate programming for individuals with autism. The purpose of this study was to assess the pretend play skills of typically developing preschool-age children, ages 2 -5. Typically developing boys and girls were video-taped playing in a designated play room with 15 play schemes (e.g. ice cream shop, camping) engaging in independent and sociodramatic play opportunities. Researchers coded the play using a specified developmental play sequence to identify the play actions and vocalizations across the age spans.

Research identifies a number of complex stages in the typical developmental sequence of play (e.g. pretend-self, single scheme sequences). Teaching children diagnosed with autism appropriate play skills requires isolating the individual components within each stage of play to acquire, maintain and generalize the target skill. Deficits in play are linked to poor social relationships, limited expressive language and high rates of stereotypic behavior. The purpose of this study was to utilize the developmental sequence of play and evaluate the effectiveness of teaching a series of 9 components encompassing the first developmental stage of play. Least-to-most prompting was used to teach single play actions and vocalizations to 3 male children diagnosed with autism, ages 3-5. All 3 children were taught play actions to self, to figures, and acting as the figures across 3 categories; familiar (e.g. brush hair), observed (e.g. hold phone to ear), and community (e.g. give baby a shot). Abstract play, responding and initiating exchanges with peers were also targeted throughout the 9 components. A multiple baseline across participants was conducted. The outcome of this study demonstrated the efficacy of the 9 teaching components as steps to teach all 3 children single play actions with corresponding vocalizations.

Children with autism are often able to emit functional play skills under contrived circumstances, supporting that the deficit in spontaneous play is due to the acquisition, rather than the production of play. Individuals diagnosed with autism commonly engage in perseverative and stereotypic play. The purpose of this study was to utilize the developmental sequence of play and evaluate the effectiveness of using a systematic approach delineated into 9 teachable components. Individualized treatment packages incorporated the use of behavioral interventions including priming, script fading, or video modeling. Each participant was taught 7 play actions and corresponding vocalizations including responding, initiating, and expanding play while rotating and combining play schemes. A multiple baseline across participants study was conducted with 3 males diagnosed with autism, ages 5, 5 and 6. The outcome of this study demonstrated the efficacy of the 9 teachable components (independent play, active figure play and play with peers) from the developmental sequence of play to teach a chain of 7 actions and corresponding vocalizations to all 3 participants.