Play in Children With Autism Spectrum Disorder: Development and Characteristics

Introduction

Play’s evaluation allows us to enter the child’s world. In fact, the observation of play skills is useful to have information about both the child's cognitive development and to explore the child's affective and social domains (Frost, Wortham, Reifel, 2008). During play, children have the chance to develop not only motor skills but also cognitive and social skills (Bornstein, 2007; Tamis-LeMonda & Bornstein, 1996). In addition to this, play provides a motivating environment for child learning so that child performance happens in a pleasant and functional context. Play is universal, in fact, cross-cultural studies demonstrated similarities in play developmental trajectory among different cultures (Drewes, 2005). Advanced levels of play are associated with greater cognitive and language development, and for this, by observing play interaction it is possible to have access to the child's developmental level in the first years of life. Further, given the social nature of play, its observation is fundamental to detect aspects of caregiver-child interaction. To sum up, play contributes to the child's psychophysical development, it constitutes an opportunity for socialization and learning, increases agility and intelligence, and has an important educational function in strengthening mental functions (Frost et al., 2008). The first aim of the current chapter is to outline the play developmental trajectory of children, starting from simple exploratory activities to a higher level of symbolization (more details concerning the phases are discussed in the next section).

In recent years, developmental trajectories of children with typical development have been deeply investigated, however, the characteristics of play in children with Autism Spectrum Disorder (ASD) have not yet been fully explored, although significant differences are highlighted (Sigman &Ungerer, 1984; Williams, Reddy, Costall, 2001; Hobson, Lee, Hobson, 2009). ASD is a neurodevelopmental disorder characterized by social communication deficits and restricted, repetitive behaviors (APA, 2013). Differences in the play of children with ASD seem to appear during the first year of life and then remain in the next phases of child development. Children with ASD show less spontaneous, less frequent, and limited symbolic play, and show fewer extended sequences of symbolic play compared to typically developing children or children with intellectual disabilities (Blanc, Adrien, Roux & Barthèlèmy, 2005; Jarrold, Boucher & Smith, 1996, Rutherford & Rogers, 2003). Another peculiar characteristic of play of children with ASD is linked to possible alterations in the sensoriality domain. For this, children may undertake unusual actions or activities with objects, and stay focused on only some parts of an object. For example, children with ASD can play and stay focused on the car's heels instead of playing with the whole object. Objects tend to be used more as a source of sensory stimulation rather than for their functional use (Van Bercelaer-Onnes, 2003).

In this chapter, the authors aim to outline the state of the art of the literature considering play and children with ASD. An additional goal of the current chapter is to outline the state of the art in dyadic play between caregivers and their children with ASD. Research in this field is also helpful in adequately involving caregivers for children with ASD in order to experience situations characterized by fixed routine and stability. These children can have a hard time when sudden changes happen in their life and this may cause frustration, especially if not anticipated. In this sense, the caregiver can represent a stable figure for the child in different situations (Schaaf, Toth-Cohen, Johnson, Outten, & Benevides, 2011; Thompson & Tielsch-Goddard, 2014). Considering this, it is important to specify that when mothers and fathers are considered, these are discussed in terms of their role instead of their gender in line with a free-gender stereotypes perspective. In fact, the literature underlines that families with lesbian mothers and gay fathers are similar to heterosexual families in their family functioning and child development (Baiocco et al., 2015). In line with this, some literature warns against an assumed overlap of caregiving role and parent gender and stresses the need to consider these factors independently, also in heterosexual two-parent families (Carone & Lingiardi, 2022; Golombok, Mellish, Jennings, Casey, Tasker & Lamb, 2014). Specifically, one study underlines that adoptive gay fathers are similar to the traditional paternal role more focused on physical and social play with more involvement in physical care and emotional support and a less didactic role (Feugè, Cossette, Cyr & Julien, 2019).