- A Brief Explanation of Discrete Trial Training
- Supporting Students with Asperger's Syndrome Who Present Behavioral Challenges
- Applied Behavior Analysis: A Focus on Outcomes
- A Challenge to Reframe our Thinking About Behavior
- Concerning Consequences: What Do I Do When...?
- Consequences, Behavior, and My Birds
- Don't Forget About Self Management
- Ever Had a Crisis Kind of Day?
- Movement Difference: A Closer Look at the Possibilities
- Movement Differences Among Some People with Autism: an Impetus to Re-Examine Behavioral Issues
- Observing Behavior Using A-B-C Data
- Positive Behavior Supports Creating Meaningful Life Options for People with ASD
- Ten Steps Towards Supporting Appropriate Behavior
- The Challenge of Combining Competing Input in the Classroom
- "Your Attitude Just Might Be My Biggest Barrier"
- Applied Behavior Analysis: The Role of Task Analysis and Chaining
- Tips for Choosing a Provider for Applied Behavior Analysis (ABA)
- What to Consider When Looking for a Qualified ABA Provider
- “If They Could Only Tell Me What They Are Thinking.” The Need for Augmentative Communication for Individuals with Autism Spectrum Disorders
- Assessment Day: Questions About the Communication Development of Your Young Child with an Autism Spectrum Disorder
- Aiding Comprehension of Individuals with Autism Spectrum Disorders During One-on-One Interactions
- Can Social Pragmatic Skills Be Tested?
- Comprehension of the Message: Important Considerations for Following Directions
- First Steps and the Journey to a Diagnosis of ASD for a Child under Three
- Functional Categories of Delayed Echolalia
- Functional Categories of Immediate Echolalia
- Initial Guidelines for Developing a Communication Intervention Plan for Individuals with Autism Spectrum Disorders and Significant Limitations in Communication Ability
- Long and Short Term Strategies for Reducing Specific Repetitive Questions
- Successfully Using PECS with Children with ASD
- Meeting the Challenge of Social Pragmatics with Students on the Autism Spectrum
- Opportunity to Communicate: A Crucial Aspect of Fostering Communication Development
- Reading with Your School-Age Child: Building Vocabulary One Word at a Time
- Social Communication and Language Characteristics Associated with High Functioning, Verbal Children and Adults with ASD
- The 21st Century Speech Language Pathologist and Integrated Services in Classrooms
- The High Functioning Person with an Autism Spectrum Disorder: A "Tourist" in His Native Country
- The Role of the School Speech Language Pathologist and the Student with Autism
- Using a Visual Support to Enhance WH Question
- Visual Resources for Enhancing Communication for Persons with Autism Spectrum Disorders and Other Disabilities
- Visual Schedules and Choice Boards: Avoid Misinterpretation of their Primary Functions
- Visual Supports: Sources for Symbols for Receptive and Expressive Communication
- What is the Picture Exchange Communication System or PECS?
- Articles - Communication
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- PICO - A Decision Making Tool For Selecting Apps
- Helping Your Child to Develop Communication Skills
- Evidence-Based Practices for Effective Communication and Social Intervention
- Important Predictors
- The Use of Technology in Treatment of Autism Spectrum Disorders
- Collaborative Teaming
- Educational Programming
- Academic Supports for College Students with an Autism Spectrum Disorder
- Advice from Adults with Autism Spectrum Disorder to Teachers Regarding Literacy Instruction
- Advice for Peer Tutors
- Applying the Ziggurat and CAPS Model in Your School District
- Aspects of Support for Learning
- A Young Adult's Guide to Deep Breathing as a Relaxation Technique: A Personalized Fact Sheet
- Can Schedule Usage Training Include Elements of Literacy Instruction?
- Clean Up Your Act! Creating an Organized Classroom Environment for Students on the Spectrum.
- Change is Good! Supporting Students on the Autism Spectrum when Introducing Novelty
- Classroom Choreography: The Art of Scheduling Staff and Students
- Creating a Circle of Support
- Complexities of Instructional Support
- Critical Features of Early Intervention: Merging Best Practices
- Developing Long Term Relationships Between School and Parents
- Early Intervention for Young Children on the Autism spectrum: Parent’s Perspective
- Educating Students with Autism: Are There Differences in Placement?
- Establishing Long Term Goals: What Are We Hoping to Achieve
- For General Education Teachers: Helpful Questions to Ask About Students with ASD
- Get Engaged: Designing Instructional Activities to Help Students Stay On-Task
- "Ham It Up and Get It Cookin!!" Thoughts From Dr. Greenspan
- Home-School Communication
- "I Can Do It Myself!" Using Work Systems to Build Independence in Students with Autism Spectrum Disorders
- “I Wake Up for MY Dream!” Personal Futures Planning Circles of Support, MAPS and PATH
- Life After High School...So Now What
- Literacy Resources
- Lovaas Revisited: Should We Have Ever Left?
- Making the Most of Morning Meeting
- Motivating Students Who Have Autism Spectrum Disorders
- Moving from Preschool to Kindergarten: Planning for a Successful Transition and New Relationships
- Peer Support Programs
- Promoting the Educational Success of Students with Autism: The Role of the Parent-Staff Relationship
- Planning for Successful Transitions Across Grade Levels
- Practical Steps to Writing Individualized Education Program (IEP) Goals: And Writing Them Well
- Practical Recommendations for Utilizing a Range of Instructional Approaches in General Education Settings
- Recognizing Different Types of Readers with ASD
- Reframing Our Thinking and Getting to Know the Child
- Restricted Repertoires in Autism and What We Can Do About It
- School Cultures that Support Students Across the Autism Spectrum
- Service Learning: Something to Think About
- Supporting Staff Using Coaching Model
- Supporting Students with Asperger's Syndrome
- Teaching Students Who Are Low-Functioning: Who Are They and What Should We Teach?
- Theory of Mind in Autism: Development, Implications, and Intervention
- There is No Place Called Inclusion
- The Road to Post-Secondary Education: Questions to Consider
- Tips for Teaching High-Functioning People with Autism
- Tips to Consider When Including a Student with ASD in Art, Music, or Physical Education
- Transition: Preparing for a Lifetime
- Transition to Middle School
- Transition Time: Helping Individuals on the Autism Spectrum Move Successfully from One Activity to Another
- Understanding the Design and Power of a Personal Schedule
- Using Visual Schedules: A Guide for Parents
- Who Are We Working for Anyway? Avoiding Personal Agendas at Meetings to Better Support Individuals Across the Autism Spectrum
- Structured Teaching Strategies: A Series
- Growing Up Together
- How to Open A Combination Lock/Locker
- Supporting Youth with Autism Spectrum Disorders Through Postsecondary Transition
- Curriculum Materials and Programs for Individuals on the Autism Spectrum
- Implementation and Effectiveness of Using Video Self-Modeling with Students with ASD
- Video Self-Modeling How To and Examples
- Advocates: Qualities to Look for and Choosing the Correct One for YOU
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- Finding or Starting a Support Group
- Making the Most of the Holidays for Your Family and Your Son/Daughter on the Autism Spectrum
- Selected Bibliography for Families of People within the Autism Spectrum
- Selected National Resources for Information on Autism Spectrum Disorders
- Selected Resources for Understanding and Supporting Siblings
- Setting the Stage for Parent-Professional Collaboration
- Siblings Perspectives: Some Guidelines for Parents
- What About the Dads?
- When Your Child is Diagnosed with an Autism Spectrum Disorder
- What to Do If You Suspect Your Son/Daughter Might Have an Autism Spectrum Disorder
- For Parents: Preparing for the School Year
- Self Help/Medical
- Teaching a Young Man to Shave
- An Introduction to Possible Biomedical Causes and Treatments for Autism Spectrum Disorders
- The "M" Word
- Mealtime and Children on the Autism Spectrum: Beyond Picky, Fussy, and Fads
- Good Night, Sleep Tight, and Don’t Let the Bed Bugs Bite:
- Taking Your Son/Daughter with an Autism Spectrum Disorder to the Dentist
- Teaching a Young Woman to Shave
- Anxiety and Panic Struggles
- Anxiety and Autism Spectrum Disorders
- Having THE Talk with Your Child with ASD
- General Information
- Assessment Processes for Autism Spectrum Disorders: Purpose and Procedures
- Autism Awareness Month: Facts and Tips for Working with Individuals on the Autism Spectrum
- Diagnostic Criteria for Autism Spectrum Disorder
- Diagnostic Criteria for Social (Pragmatic) Communication Disorder
- Disability Information for Someone who has an Autism Spectrum Disorder: A Customized Example
- Getting Started: Introducing Your Child to His or Her Diagnosis of Autism or Asperger Syndrome
- Increasing Incidence of Autism Spectrum Disorders Continues in Indiana
- Standardized Tests and Students with an Autism Spectrum Disorder
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- What’s in a Name: Our Only Label Should Be Our Name: Avoiding the Stereotypes
- For Physicians: Diagnosing Autism Spectrum Disorders and Working with Schools
- Behavioral Issues and the Use of Social Stories
- How to “Lose the Training Wheels:” A New Way to Teach Bicycle Riding
- Living in Fear: Anxiety in Adolescents with Autism Spectrum Disorders
- Local Community Resources to Enhance Activities
- Making (and Keeping) Friends: A Model for Social Skills Instruction
- Making Camps Accessible for All
- Play in the Lives of Young Children with Autism
- Play Time: An Examination Of Play Intervention Strategies for Children with Autism Spectrum Disorders
- Social Activity Groups: Another Approach for Helping to Bridge the Friendship Gap
- Teaching Social Skills through Theatre
- The Collective Outcomes of School-Based Social Skill Interventions for Children on the Autism Spectrum
- The Value of Movement Activities for Young Children
- We All Need Exercise
- Finding a Friend in School
- Bullying and Students on the Autism Spectrum
- Incorporating Typical Peers Into the Social Learning of Children with Autism Spectrum Disorders
- Articles by Temple Grandin
- An Inside View of Autism
- Choosing the Right Job for People with Autism or Asperger's Syndrome
- Evaluating the Effects of Medication
- Genius May Be an Abnormality: Educating Students with Asperger's Syndrome, or High Functioning Autism
- Making the Transition from the World of School into the World of Work
- Social Problems: Understanding Emotions and Developing Talents
- Teaching Tips for Children and Adults with Autism
Play Time: An Examination Of Play Intervention Strategies for Children with Autism Spectrum Disorders
Contributed by Johanna Lantz
There is no question that play is an integral part of child development. Through play, children learn social skills such as sharing, cooperation and turn-taking. Social language is learned, self-esteem is built, and friendships are formed during recreational activities with peers. Play encourages cognitive enrichment, emotional growth, and influences personality development. It offers a means of exploring various societal roles and rules, and provides time to practice finding solutions to problems. Creativity and imagination are fostered through play. For typically developing children, engaging in pleasurable, imaginative and socially interactive activity is a natural part of life. In contrast, many children with autism spectrum disorders do not play in a manner that is beneficial to development. Skill deficits and interfering problem behaviors often inhibit productive play in children with autism spectrum disorders; consequently, this crucial aspect of development should be a target for early intervention. Pamela Wolfberg’s Integrated Play Groups (IPG) and Stanley Greenspan’s Floor Time are two intervention strategies that are intended to increase developmentally beneficial play in children with autism spectrum disorders. This article will discuss IPG and Floor Time, and will examine research that has investigated the efficacy of these models.
Play Characteristics of Children with Autism Spectrum Disorders
Wolfberg (1995) defines play as an activity that is pleasurable, intrinsically motivated, flexible, non-literal, voluntary, and involves active engagement. In contrast, children with autism spectrum disorders often engage in inflexible, repetitive play patterns and may not exhibit symbolic or pretend behavior. Individuals with this disorder tend to view the world as concrete and literal; consequently, they may have difficulty with abstract concepts and imaginative behavior. Children with autism spectrum disorders may also display deficits in sequencing and motor planning. As a result of these deficits, they may not develop play scripts or understand the scripts of other children. Play in children with autism spectrum disorders is often solitary. Several factors contribute to the lack of social play. First, individuals with autism have communication deficits. They may not understand the language or social cues of peers, or have the ability to express their feelings effectively with others. Second, children with autism spectrum disorders may not understand that others have their own unique thoughts and feelings. This lack of understanding limits reciprocity in relationships. Third, it is common for individuals with this disability to have restricted and unusual interests, so they may be resistant to explore new play themes with others. Finally, peers may exclude children with autism spectrum disorders or may not understand how to effectively engage them in play. In summary, factors inhibiting social play in children with autism spectrum disorders include the following: communication deficits; difficulty understanding the feelings of others; restricted and unusual interests; and peer exclusion.
The Integrated Play Group Model
The Integrated Play Group Model, which is based on Vygotsky’s social constructivist theory, aims to improve the social and symbolic play skills of children with autism spectrum disorders ages 3 to 11. In addition to addressing skill deficits, the IPG model also emphasizes developing the intrinsic desire to play. According to Wolfberg and Schuler (1993), in the IPG model, “Play development is fostered by physically arranging the environment to bring about the most competent forms of play, and by guiding participation within these environments while capitalizing upon child initiations.” It is important to differentiate between social skills training which involves direct skill instruction, and IPG which provides a support system for a childs’ initiations.
Integrated play groups contain guides, expert players, and novice players. Guides are adults who have training in IPG and experience working with individuals with autism spectrum disorders. The play group guides use various methods of assessment to determine how to best coordinate play activities to maximize the social and cognitive development of the participants. The expert players are socially competent peers, and the novice players include children with autism spectrum disorders at any level of functioning. The groups are comprised of three to five children with a higher ratio of expert to novice players. The IPG model is based on the concept of guided participation. The guide adjusts the amount of support given during the play group sessions according to the needs of the children, and builds on the interests and abilities of the group members. Initially, the guide directs the play activity. As the children become more capable of creating play themes, initiating interactions and setting up play events, the guide fades support until no direct guidance is provided. Transitions are often challenging for children with autism. Consistency in schedule and routine are important components of the IPG model because they help participants anticipate future events. The same groups meet regularly in natural settings, two to three times a week for 30-60 minutes. Opening and closing rituals are utilized and visual cues provide additional support. Materials such as constructive and sociodramatic toys are selected to encourage interaction and imaginative play.
Wolfberg and Schuler (1993) examined the efficacy of the IPG model. The researchers were interested in determining if the model would increase the functional and symbolic use of objects and social play of individuals with autism. In addition, they investigated whether qualitative improvements in play skills would generalize to different settings. The researchers conducted three play groups in a public school setting for 30 minutes two times a week for four months. Each group contained two novice players and three expert players. Data were collected on three of the novice players with autism. The results indicated that all participants with autism engaged in a greater percentage of functional and symbolic toy use and social play after the IPG intervention. Parent and teacher interviews revealed that qualitative play improvements were evident in a variety of settings. This research is promising; however, the results are somewhat limited by the small sample size and lack of a control group. More research should be conducted on the IPG model.
The Floor Time Model
Greenspan’s Floor Time offers another play intervention for preschool age children with autism spectrum disorders. The Floor Time model focuses on developing relationships and affect. Interventions are designed according to the child’s developmental level and individual characteristics. Greenspan explains that although affective engagement such as showing pleasure, sharing emotions, and reciprocating interactions is secondary to the primary symptoms of autism (e.g., cognitive deficits), affect and relationships are more amenable to intervention. Greenspan believes that through affective interaction, children with autism will concurrently experience cognitive and emotional growth.
Floor Time is child directed and adult supported. It provides an opportunity to transform perseverative play into more meaningful and developmentally beneficial behavior, and works to expand the play themes of children with autism spectrum disorders. At the same time, it is designed to help the child develop relationships with others. Floor Time involves five steps:
- The adult observes the child playing in order to determine how to approach him/her.
- The adult approaches the child and joins the activity while trying to match the child’s emotional tone.
- The child directs the action and the adult follows the child’s lead.
- The adult expands on the child’s chosen play theme without being intrusive.
- When a child builds on the adult’s input, the child “closes the circle of communication” and starts a new circle.
It is crucial that the adult does not use Floor Time as a time to teach a particular skill. It is also important to remember that the child is the leader of the activity.
Floor Time can be used to change perseverative behavior. For example, if a child is fixated on lining up blocks, the adult joins in and adds blocks to the child’s line. Then the adult may place a block perpendicular and start the line going in a different direction. When the child continues the new line, he/she has “closed the circle of communication.” Some suggestions for Floor Time include inserting obstacles into play and helping the child problem-solve. If a child has very limited play themes, it may be helpful to use sensory toys (e.g., sand tables, shaving cream, bubbles) or use popular characters that the child enjoys to gain attention.
Greenspan and Wieder reviewed the charts of 200 children diagnosed with autism spectrum disorders, and found that most children who received Floor Time intervention for at least two years made significant improvement in all areas of development. All children in the study received two to five hours of Floor Time interaction at home in addition to comprehensive services such as speech therapy, occupational therapy, and special or general education services. The researchers claimed that 58% of the participants made “good to outstanding” progress, which they defined as making significant improvements in affect, social behavior, cognitive skills, symbolic play, and creative behavior. In addition, the “good to outstanding” children no longer engaged in avoidant, self-stimulatory, or perseverative behavior. According to the authors, all of the children in the “good to outstanding” group were no longer considered autistic according to the Childhood Autism Rating Scale (CARS); however, these findings need to be replicated by other researchers not involved in the development of Floor Time. Twenty-five percent of the children were defined as having made “medium” progress. These children made affective improvements and gains in gestural communication, but they still evidenced significant delays in symbolic language and play. The “medium” group no longer engaged in self-stimulatory, avoidant, perseverative behavior. The researchers reported that 17% of the children were considered to have “ongoing difficulties.” These children made little or no improvement in affect, symbolic ability, attention, or avoidant behavior. The researchers added that most children in the “ongoing difficulty” group presented more extreme autistic symptomology when first evaluated.
The results of the chart analysis are impressive, but should be interpreted with caution. Due to sample limitations, the results only apply to the children used in the study. More research needs to be conducted with a larger and more diverse population, and by researchers other than the creators of Floor Time. In addition, a controlled scientific study would provide more definitive information on the efficacy of Floor Time intervention. However, the results of the chart review indicate that some children with autism are capable of symbolic thought, and they can make significant improvements in social relationships and affect.
Play is a voluntary activity and is differentiated from social skills training in which specific skills are systematically taught. In the IPG and Floor Time models, skills are learned indirectly through guidance and interactions with others. Both the IPG model and Floor Time are based on child initiations that are supported by adults.
The IPG and Floor Time models have strengths and weaknesses. The primary advantage of both models is that they allow children with autism spectrum disorders the opportunity to explore relationships with others on their own terms without the imposition of adult demands. One disadvantage of the IPG model is that it requires regular participation from at least two typically developing peers, an appropriate setting, and trained guides to facilitate the group. This may be difficult to organize without the cooperation of a school or community group. Some disadvantages of the Floor Time model are that it does not address social interaction with peers, and there is little information on generalization of skills to other situations and settings. More research on the efficacy of IPG and Floor Time needs to be conducted by individuals who have not been involved in the development of the models. Although a few limitations exist, both intervention strategies have merit and deserve further investigation. As with any intervention, individual differences and desired outcomes need to be considered when deciding what method to use and progress needs to be regularly evaluated.
Through play, children learn a variety of skills that are fundamental to development. Many children with autism spectrum disorders have skill deficits and interfering problem behaviors that hinder developmentally beneficial play. Integrated Play Groups and Floor Time are two early intervention strategies that aim to improve qualitative play skills in young children with autism spectrum disorders. In both models, direct instruction is not provided; rather, adults provide support to child initiated interactions. The research available supports the effectiveness of the IPG and Floor Time models; however, inadequate samples and other methodological issues limit the utility of the studies. Early intervention efforts typically focus on the development of communication skills, social skills training, and the reduction of problem behaviors through direct instruction. Often a child with an autism spectrum disorder has a day filled with constant demands from adults, which when compared to the expectations placed on typically developing children, seems unnatural and developmentally inappropriate. It is proposed that skill deficits addressed through child directed and adult supported play become a standard component of early intervention practice.
Suggested Readings and Websites
Greenspan, S. I., & Weider, S. (1998). The Child with Special Needs: Encouraging Intellectual and Emotional Growth. Reading, MA: Addison-Wesley.
Greenspan, S. I., & Wieder, S. Developmental patterns and outcomes in infants and children with disorders in relating and communicating: A Chart Review of 200 Cases of Children with Autistic Spectrum
Diagnoses. World Wide Web: www.icdl.com
Integrated Play Groups: http://www.wolfberg.com/.
Wolfberg, P. J. (1999). Play and Imagination in Children with Autism. New York, NY: Teachers College Press - Columbia University.
Wolfberg, P. J. (1995). Enhancing children’s play. In K. A. Quill (Ed.), Teaching Children with Autism: Strategies to Enhance Communication and Socialization (pp. 193-218). Albany, NY: Delmar Publishers.
Wolfberg, P. J., & Schuler, A. L. (1993). Integrated play groups: A model for promoting the social and cognitive dimensions of play in children with autism. Journal of Autism and Developmental Disorders, 23, 467-489.
Lantz, J. (2001). Play time: An examination of play intervention strategies for children with autism spectrum disorders. The Reporter, 6(3), 1-7, 24.