This study describes a longitudinal design (following subjects described in Rutherford & Rogers [2003, Journal of Autism and Developmental Disorder, 33, 289-302]) to test for predictors of pretend play competence in a group of children with autism. We tested the hypothesis that developmental change in pretend play performance can be predicted by earlier measures of either executive function, intersubjectivity, imitation, or general development. Participants at the time of follow-up testing were 28 children with autistic disorder (mean chronological age (CA) 57.6 months), 18 children with other developmental disorders (mean CA 59.0 months), and 27 typically developing children (mean CA 30.1 months). Children with autism were profoundly delayed given both competence (prompted) measures as well as performance (spontaneous) measures. Joint attention at time 1 strongly and uniquely predicted pretend play development.

A variety of techniques grounded in behavioral psychology, and more specifically in applied behavior analysis, have been established to increase and improve play skills in children with autistic spectrum disorders. This article introduces a set of efficacious methods, which range from highly structured techniques to more naturalistic strategies. It focuses on object play as other authors in the issue discuss social play in greater depth. Behavioral techniques that are reviewed include: discrete trial training, use of stereotyped behaviors to increase play skills, pivotal response training, reciprocal imitation training, differential reinforcement of appropriate behavior, in vivo modeling and play scripts, and video modeling. A discussion of expanding behavior techniques to teach more complex play as well as training in varied environments is also presented. References are provided to allow the reader to obtain more in-depth information about each technique.

The article reviews the empirical evidence relating to the development of early solitary object and parent-infant play in typical infants and children diagnosed with autism. Whilst, collectively, the findings indicate that there may be both qualitative and quantitative differences in the early play of children with autism, relative to that of other children, it is also clear that significant gaps exist in our current knowledge. It is proposed that longitudinal studies, which make a detailed examination of the form and developmental trajectory of early play, are needed if we are to devise the most effective content, design and outcome measures for intervention programmes using play as a therapeutic medium.

The article reports the results of a pilot study comparing traditional behavioural approaches and natural play interventions for young children with autism over a 10 week period. Two matched groups of eight young children with autism participated. Using a crossover design, children in both groups showed positive gains in compliance, attending, play and communication with their therapists and parents. Improvements in attending and compliance were higher following the behavioural condition compared with the natural play condition. Seven participants had reduced autism scores after the intervention. The findings suggest that behavioural and play approaches affect behaviour in different ways and that autistic symptomatology of young children may be amenable to treatment. The discussion focuses on the active ingredients of treatments and the need to base efficacy research on well-planned treatment comparisons.

This study compared the effect of structured play (SP) and facilitated play (FP) in promoting spontaneity and responsiveness in communication and play behaviors in children with autism. SP is characterized by the use of mass practice trials under the instruction of the experimenter while FP incorporated incidental teaching with multiple exemplars. Eight preschoolers participated in a crossover design of both play conditions. Gains in appropriate communication and play were observed across both treatments. Respondent communicative acts occurred more frequently across all participants during SP compared with FP. The preliminary results indicate an interaction between the mental age of the child and the teaching paradigm used. The need to match treatment goals and specific methods of the play intervention to the skill profile of participants is discussed.

We hypothesized that the difficulties of the child with autism originate from disorders of organization and regulation of actions according to environmental changes. Autism impoverishes general mental representation skills, which are the basis of symbolic play and the development of communication. Twenty-one children with autism were compared with 14 children with global intellectual impairment and 15 matched typically developing children, on both regulation of play activities and communication development. Regulation of play was very disordered in children with autism, with breaking off, dissociation and instability of actions. However, in directed play their actions were more structured and corresponded to a better developmental level. In addition, dysregulation was associated with delayed, heterogeneous development of communication skills. The results of this study are in line with our hypotheses and emphasize the role of symbolic play in differential diagnosis and the value of therapies based on regulation processes and symbolic play.

To teach play skills, first of all we want to assess the developmental level of the child, see what he is able to do and then build on it.

The purpose of the present study was to examine the effects of participation in an integrated play group on the joint attention, symbolic play and language behavior of two young boys with autism. Two 6-year-old twin brothers participated in this study, along with three typically developing girls, ages 5, 9 and 11. A multiple baseline design was used with three phases: no intervention, intervention with adult coaching, and intervention without adult coaching. After being trained, the three typically developing children implemented the integrated play group techniques in 30 minute weekly play group sessions for over 16 weeks. Results indicate that participation in the integrated play group produced dramatic increases in shared attention to objects, symbolic play acts, and verbal utterances on the part of the participants with autism. These increases were maintained when adult support was withdrawn. Implications of these findings for inclusion of children with autism are discussed.

This article presents exploratory research on the feasibility of non-directive play therapy for children with autism. Video recordings of 16 sessions of play therapy with a 6-year-old boy with severe autism were analysed qualitatively and quantitatively. The study concluded that this child was able to enter into a therapeutic relationship and demonstrated attachment behaviour towards the therapist. Key areas of improvement were in the child's development of autonomy and pretend play, while ritualistic behaviours showed only mild improvement. Changes in therapy were concurrent with the changes reported by the boy's mother at home of increased independence and empathy. One implication of this preliminary research is that non-directive play therapy may enhance and accelerate emotional/social development of children with severe autism. More research is urgently needed; non-directive play therapy and behavioural treatments may complement one another to provide an overall treatment plan for children with severe autism.

First, the stages of development observed in Nonverbal Thinking, Communication, Imitation, and Play are described. Second, sample activities have also been included of teaching techniques that can be adapted to these different developmental levels.

Individuals with autism can be taught to pass theory of mind tasks and thus it is teachable. Also, early intervention enables social impairments be improved.

Research has shown that for young children with autism, sensory motor play dominates beyond the verbal mental age, at which it normally declines in infants without autism.

It is well established that the play and language skills of children with autism are impaired. The article considers the relation- ship between these developments in typically developing children and children with autism. First, the evidence for a relationship between these two areas in typically developing children is reviewed. Despite many methodological differences between studies, this evidence supports a relationship, with specific developments emerging first in play and subsequently in language. Second, evidence for a relationship between play and language in children with autism is reviewed. From published and some previously unpublished data it is concluded that if there is a relationship between play and language in children with autism it is weak, if it exists at all. Finally, the implications of these findings are discussed and it is suggested that any relationship between play and language may be mediated by how children and their parents interact when they are playing.

This is a personal account of the play behaviors of an individual who has autism as remembered by himself and his mother. Jean-Paul Bovee explains the activities that were enjoyable for him and which were his play, although they were unusual and may not fit the typical definition of play. His mother, Dr Julie A. Donnelly, tells of her attempts to involve Jean-Paul in typical play and how important play is as a bridge to social skills and involvement with peers. Jean-Paul concludes that his play is a part of the unique individual he has become.

Autism is currently diagnosed, in part at least, on the basis of problems in imagination. The article reviews the empirical evidence of difficulties in pretend play in autism, and focuses in particular on individuals' ability to engage in pretence in free play conditions, to produce pretence in more structured situations, and to make sense of pretend actions carried out by another person. These data suggest that individuals with autism have a marked difficulty in producing pretend play, but one that is reduced by providing substantial structure to the play situation or by testing comprehension of pretence. The implications of these findings for theories of pretend play in autism, in terms of an inability to conceive of non-literal situations, a difficulty in imposing a pretend usage on an object, or a failure to gain a benefit from engaging in pretend play, are discussed.

The article considers the nature of the presumed social play deficit in autistic spectrum disorders (ASDs). The nature of play and its typical development is outlined and discussed in relation to play development in ASDs. It is suggested that social play is a confluence of two strands of development that are affected in autism: social and emotional development, and the cognitive development of play. It is shown that social play develops in a transactional way and in ASDs initial social difficulties prevent the development of social interaction, with its role in eliciting and enriching spontaneous play. At the same time, cognitive and affective difficulties prevent the play of children with autism developing to the extent of attracting other children and being of a complexity from which social play might develop. This cycle of impoverished play opportunities for children with ASDs may be broken through direct teaching and there are encouraging models of teaching social play with some success.

The article focuses on integrated play groups (IPGs) as a model to support children with ASD in play with typically developing peers/siblings, and its recent adoption with children in a home and school setting in Taiwan. The first part provides a brief overview of the IPG model and its essential features. The second part reports on a pilot investigation that combined quantitative and qualitative methods to examine the effects of participation in IPGs on the symbolic and social play of two early elementary-aged children with autism. Preliminary findings suggest that each child made notable gains in reciprocal social interaction and symbolic/pretend play while participating in play groups. Implications are discussed in terms of play's role in enhancing socialization, imagination and peer cultural inclusion.

The relationship between symbolic play and other domains, such as degree of autistic symptomatology, nonverbal cognitive ability, receptive language, expressive language, and social development, was investigated. The assessment files of 101 children with Autism Spectrum Disorder were studied. Nonverbal cognitive ability and expressive language were both significantly and uniquely related to symbolic play, although receptive language was not. Autistic symptomatology ceased to be significantly related to symbolic play when controlling for two or more other variables. Social development was related to symbolic play in those children with high nonverbal cognitive ability but not those with low nonverbal cognitive ability. The diagnostic and treatment implications of these results are discussed.

Play becomes meaningful for children with autism when it has an inherent interest value for the individual or when its value is enhanced through the exaggerated enthusiasm of other players.

Functional play was encouraged by these training programmes. Moreover, there is some evidence that it produced more change in the group receiving training using photographs of self and that the changes made by this group continued over time.