Sunday, March 27, 2011

Pretend Play and Autism


The absence of pretend play skills is an indicator of autism.

Many developmental models talk about the importance of pretend play in healthy development

Pretend play in my opinion is one of the developmental milestones that simply cannot be skipped over

In the Floortime sense its an entire developmental level

Some Speech Language Person say that Pretend Play is essential to the development of proper language ( as language and pretend-play both harness symbolic thinking ) and one cannot come without the other

I had mentioned R's play therapist in a prior post and my friend Tanya asked me to provide some more detail on Pretend play and I thought it may be useful knowledge for all of us here and I in turn asked Ms Gypsi to give a short description of  pretend play

Ms Gypsi is one of our absolute favorite people. She has known R since he was 3-when he had just started with the school system. She is extremely intelligent  has 7+ years working with young  kids on the Spectrum. 

An additional gift that she has is a super understanding of Spectrum folks as she is an Aspie herself

Each summer we try to address one important thing for R . Earlier we used to try and get ESY but we figured out that it was actually better for R to not have ESY and instead learn an important skill

Last summer we addressed Pretend Play and Ms Gypsi started to work with R last summer and he can actually play with toys now. 

Here is her interview from the fabulous Ms Gypsi Leigh

1. What is pretend play ?

As I see it, there are two different types of pretend play.

The first is direct object pretend play. I have a car and I am pretending it is a real car. I make engine and horn noises, I pretend I'm driving the car and that the car is just like my real car.

The second type is a more abstract pretend play. For example, I have a cardboard box and I pretend that it is a car. It has none of the features of a car; I have to use my imagination and stretch it a bit to see this box as a car. Both types of pretend play are valuable and important.

2. Why is play important for spectrum kids ? Why is it difficult for kids on the spectrum to develop these skills ?

Children on the Autism Spectrum tend to think in concrete terms, making it hard to understand things like jokes, puns, sarcasm and playing pretend.

While this is not true for every child on the Spectrum, it is true for many.

As a result, these kiddos need just a little extra help to see HOW to play in a pretend way.

Using the car toy as an example again, our kiddos might be more interested in the object itself—the color, any letters on the car, the wheels and how they turn—than in the fact that it is a car and can be played with as if it were a real car.

Play is extremely important for many reasons.

One, is because that is how children communicate and learn to negotiate with other children—through play. Playing together is the basis for all social communication and skills. If a child doesn’t know how to play, and therefore how to play with another child, then that child is at a negative for navigating the social waters with other children.

Two is that playing with the appropriate toys (imaginative toys, not battery operated toys that entertain and do all the playing for you) teaches a variety of skills without a child knowing it. Turn-taking is learned through play. Social scenarios are learned through play. Fine and gross motor skills are honed through play.

Third, as a child learns to play appropriately with toys, he or she looks more typical to other children. Should that be a number one priority? No. But, as an educator, my goal is help a student be as similar to typical children as possible, so that he or she will be able to develop social relationships with typical peers. When thinking of it that way, it does become very important.

Lastly, but probably most importantly is that appropriate pretend toy play turns into an opportunity for appropriate play with others, thereby increasing the opportunity for social interaction. This is especially important for interaction with parents and siblings. Tossing a ball back and forth gives a chance for eye contact as the ball is thrown. Play food and cooking gives an opportunity for verbal interaction about the food. Building with blocks give a chance to a conversation about what is being built.

3. How do you teach pretend play ? Can you give some examples

As is expected, it’s never easy for a child with Autism to rewire how he or she thinks about playing and to begin with it is often a challenge and rather painful to the kiddo.

R, for example, was interested in the dollhouse people, but he wanted to hold them and look at them. He did NOT want me to tell him how to play with them. At this point, one treads very carefully.

We’re not here to break a child , we’re here to mold and shape the child

The most important thing to do first, is to show just how darn fun it is.

When I start with a new toy or a new play routine, I am going to am be as overly enthusiastic and energetic about how fantastically marvelously fun this is as I can without seeming phony.

And, because I happen to love what I do, it’s pretty easy to have a great time!!

 For example, I would sit by R, with one of the dollhouse dolls in my hands, and have a great time taking her up the dollhouse steps. “Up, up, up, up!” I would say in an animated, happy voice.

Some example of the props that Gypsi uses in our house to teach pretend play

R's dollhouse

R's little people Village


After doing it several times, if he wasn’t yet watching I would say, “hey, R, watch me!” and do it again.

If I still couldn’t get him to watch, I would gently say, “hey, R, it’s my turn for the dolls,” take his dolls and then ask him to watch.

After he watched, I would say, “your turn!” and give him my doll and guide his hand to take her up the stairs, verbalizing the “ups” for him.

Then I would give him his dolls back and back off of him for a few minutes, while I “played” by myself, still being very animated and using simple verbal phrases as I played.

Then we’d repeat it. This would go for fifteen minutes, then the timer would go off, I would show him the schedule and let him know we were all done at the dollhouse and what area we were going to play with next.

I didn’t try to throw in a lot all at once.

Master one thing—taking the doll up the stairs—then add in another. This would be an example of the first type of pretend play I mentioned.

He has come so far, from just holding the dolls, to being able to tell me the dolls are shopping or sleeping or other activities.

In addition to the actual play, because his verbal expressive language is still limited, one of my main concerns was giving him appropriate phrases to use as we played, but not overwhelming him with a lot of extra verbiage. When a doll went down the slide, I would say and excited “WHEE!” or “That’s FUN!”. When a car crashed, I would say “OH NO!” or “LOOK OUT!”.

Simple appropriate phrases, that he can take an use when playing or in daily life. We’ve noticed that he has taken these phrases and done just that!

Another example, and one of the more abstract type of play, is teaching a variety of ways to use blocks.

When R and I first started playing with the large cardboard blocks, he was comfortable stacking them, but that was the extent of his repertoire and pushing him to new activities made him very nervous.

As I did with the dollhouse, we proceeded very slowly, with me showing it as a lot of fun.

We would first stack and then I would knock them over, in very exaggerated language, “uh, uh, uh, uh OH!!” and would laugh and tickle him and we would laugh together.

As he began to find that fun, he would build, knock down, and request a tickle, so that the experience of building and knocking down was very positive to him, because it finished up with a preferred activity, a tickle.

Using his love of musical instruments, I showed him to pretend the blocks were drums.

Later I brought cars into the block area and we made a road of blocks.

After that, I added tools to “build” with the blocks. We also built animals and letters out of blocks. All of it done gradually, first doing the activity he had become comfortable with and then the new activity, then back the comfortable one with lots of verbal and tickle reinforcement (as well as bubbles and preferred treats) along the way.

Now, as you know, he builds a giraffe by himself, as well as roads, houses and other things, and plays with these blocks appropriately without needing to be prompted to play.
Our children on the Spectrum are capable of doing so much, and pretend play is one of these things.

It just is going to take them a little bit longer (sometimes a whole lot longer) than it will other children, because it doesn’t come naturally to the way their brain is wired. Patience, continuity, practice and reinforcement—those are the keys.


Anonymous said...

Great practical tips! Thanks for sharing. I'll be linking to this on FB for my friends. ~Ellen

Donna Aumann Cooper said...

Great post! I remember Jonathan long long ago, with no imagination or pretend skills. He would line things up or spin them. But, as we worked with him, he began to blossom. He's grown into a very imaginative young man! I used to wonder why he did not like Legos. Then it dawned on me...all he could see was a BRICK. He could not visualize it as a car or house or ???. I bought a young child's game that had cards. You had to pick a block as you moved your minifig around the board, and then build what your card had on it. It clicked! Not only are these bricks, but they can be anything!!
Now he loves Legos. He delights in showing me his creations. Anyway, great post and wonderful advice.

Lyndsey said...

Thanks for the information, Gypsi! You're so great at what you do! :)

Anonymous said...

This is such a helpful post! We are planning to apply for ESY, but now you've got me thinking about other options... Thanks!

Patty O. said...

What a great post! Thanks for sharing. I will try to use some of these suggestions with my son.

Rachel said...

So glad you shared this!

#1 - Her hair ROCKS!

#2 - I wish I'd had someone work with me like that when I was a kid. Scholastics do not begin to compare to social interaction.

#3 - Only because I adore my horse, "breaking" one can actually seem an inappropriate word. Teaching them new tools and to let them learn to enjoy human interaction... that's my idea of "breaking" them :)

#4 - It's no wonder R has learned so much and loves to engage like he does - with these kind of loving people in his life.

Floortime Lite Mama said...

thank you guys so much for your lovely comments
Rach I removed the "breaking" wording - sorry about that
Miss Gypsi is a true animal lover - forever rescuing strays - and one of the kindest people I know and I know she was simply using it as a phrase

Rachel said...

K - you are so sweet! And I am sorry I made you regret that phrase - though how it was used was perfectly appropriate because of the common perception of how horses are broken (forced to become useful)...

You and Ms. Gypsi are beautiful souls and I don't doubt for a moment what was intended to be conveyed.

Please accept my apologies and my silliness in posting that!

Li said...

Great post! Miss Gypsi looks and sounds awesome. R is lucky to have her.

Can't wait to try some of this with my own kiddo. He's pretty good at the first type of imaginative play but we need to work on the more abstract form.

I totally agree about the link to language. We recently had a language leap and it's been accompanied by a leap in imaginative play.

Anonymous said...

great post. Ethan loved Ms Gypsi!

Þorgerður said...

Spontaneous language and ideas in play makes sense that the two have to come together..I have an inkling that this is stalling our progress... so thank you for the reminder... a great post as always :)

Dr. Uffda said...

I couldn't agree more. I even take the opportunity with teenagers on the spectrum to go back and practice this important skill if it hasn't already been honed... its just one of those things that opens the mind in a really important way. Great post!

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