Interactive Play
for Children
with Autism
BY
Diana Seach
MA, BA (Hons) Psychology, Cert. Ed
INTRODUCTION
We all have a unique way of understanding the world in which we live and all our
experiences and actions create an emotional response in us that reflects how we
relate to others. For someone with autism this could mean that they behave in ways
that others do not understand and their learning and adaptations to people can be
significantly affected. We can meet the child in their world by sharing in their
experiences, through activities that are meaningful to them and in ways that allow
the child to take some control over the interactions they make. For those of us who
live and work with children who have autism, our aim is to make them feel secure, to
find ways of motivating them to want to communicate and to help them achieve
skills which let them know who they are as a very special individual.
“Birds fly, fish swim and children play”
Dr G. Landreth
Making sense of the world is an enormous task for young children and yet it is
something that a baby begins to do as soon as they are born. Through exploration
and interaction the child is assimilating experiences so that he or she can gain a
greater knowledge of themselves within their world. This sensory exploration is the
basis for all play activities that the child engages in either with a carer or by
themselves. Children become active learners through play. It enhances their
emotional, physical, social and intellectual well being and can therefore be a highly
motivating way of working with children who have autism.
PLAY IN CHILDREN WITH AUTISM
Through activity, manipulation of objects and interaction, play helps children to
make connections by creating meaning from their experiences and this is
inextricably linked to the child’s social, emotional and cognitive development. For
children with autism their immediate environment, far from being something that
they might want to explore, presents numerous difficulties and they can so easily
feel overwhelmed by events around them.
This is one reason why children with
autism will be seen in solitary play with an activity or an object being used in a
repetitive way, as it helps them to organise and learn about their environment in the
same way that play does for any young infant.
Both play and these stimulating behaviours are serving the same purpose. They are
enabling the child to explore objects at a sensory and kinaesthetic level, they are
motivating and pleasurable, they allow the child to have some control over what they
are doing and more importantly the child is engaged in something that they are
enjoying.
Observations of play in children with autism frequently identify it as lacking in
spontaneity and creativity, ritualistic and isolated and as such this undermines the
role that it is having for the child. Sherratt (1998) has highlighted how developing
imaginative play skills in children with autism helps to overcome some of the core
difficulties experienced by children with autism particularly in developing symbolic
understanding and flexibility in the thinking processes.
In my experience children with autism are taking notice of the world around them
and they do interpret this into their play activities. Children with autism love to line
things up. In our homes and neighbourhoods this is not an unusual phenomenon.
On the contrary, society has devised ways of creating order just so that we can
function in our every day lives such as, bus queues, car parks, houses and
supermarket isles.
Lining up cars, play people, sticks or indeed any toy that grabs
the attention of the child gives them an opportunity to create patterns and shapes, to
develop an understanding of space and in addition to all of these, opportunities to
extend fine motor and observational skills. Play, whatever form it takes, needs to be
encouraged and supported by adults.
At the home of a young child with autism, his mother had explained that recently he
had started to line up all his toys again. My play session with Liam soon got
underway as I watched him put all the cars and trucks that he had in lines on the
carpet. “It’s Sainsbury’s car park” he told me. Well after that it seemed perfectly
alright to line up the cars and we continued most of our play session with cars going
in and out of the barrier he made with Lego blocks. He then built a Sainsbury with
Lego blocks. His play was repetitive but there was also an element of fun included
when he wanted cars to go through the ‘Exit Only’ barrier. I wasn’t going to stop
him lining things up. I encouraged it and from that he developed his play, using
language and creativity, based on his own experiences of going to the supermarket. I
just joined in with his story.
PLAY AND EMOTIONAL DEVELOPMENT
Developmentally, play begins with the early interactions between an adult and the
young infant as a sensory experience involving touch, sounds and movement. All of
these are synchronized to enhance the social connection and communication
between the caregiver and child. It becomes a shared experience based on mutual
enjoyment that is reciprocated through actions and expressions (Nind and Hewett,
1995).
As play between the adult and child develops it serves to build on
establishing those positive emotions and relationships.
“Play develops creativity, intellectual competence, emotional strength
and stability, and feelings of joy and pleasure. The
habit of being happy”.
Piers and Landau
For children with autism, those early interactive skills can be significantly impaired,
not because of an inability by the caregivers to engage with the child but because the
child is unable to grasp those social signals such as eye contact, facial expressions
and playfulness and reciprocate these with an adult. In that sensory play stage when
a young infant is exploring through touch and sounds they learn what gives pleasure
or discomfort and an inability to form an attachment will have a profound effect on
the child’s emotional development. As a consequence, children with autism struggle
with their ability to develop a sense of self, and become increasingly more
emotionally detached from those around them.
Craig sat passively in the corner of the room. Occasionally he looked up but most of
his attention was on the green ball that he held in his right hand. He liked to suck it
and watch the dribble on the surface of the ball as he turned it around, or sometimes
he held it up to his right eye, twisted it about and made ‘happy sounds’ with what he
was seeing.
Craig sat like this for twenty minutes before an adult came up to him
and attempted to take the ball away so that he could be taken to another activity.
For Craig his play activity provided a safe place for him. He was absorbed in an
activity and motivated by the sensory experience.
He was also relaxed and his
concentration lead him to begin to use his voice as he found pleasure in what he was
doing. In 1983 Bruner wrote, “ Play under the control of the player gives the child his
first and most crucial opportunity to have the courage to think, to talk and perhaps
even to be himself.” Sharing in the child’s play experiences draws the adult into the
child’s social world. Together with an acceptance of what the child is doing, trust
and mutual enjoyment become the cornerstones of the child’s emotional and social
development.
“How a child relates to us tells us much about their inner world”
Jon Clements
Developing an empathetic relationship doesn’t just depend on a child learning to
recognise the emotional states of others. It isn’t that children with autism do not
have empathy but that without interaction they have no means of expressing it
(Williams, 1998). With the adult supporting and nurturing the child’s emotions the
child has a far greater opportunity to develop self awareness. Becoming more open
to ones own emotions enables us to read the feelings of others. Both interactive play
and drama within play situations provide valuable opportunities for allowing this to
take place and the child with autism can learn to recognise their own and others
emotions through gestures, tone of voice and facial expressions.
Gradually as the child recognises that their actions are accepted, so the awareness
of self enables him or her to develop greater independence and a motivation to
interact in positive ways with his or her environment. Play can and should be used to
bring about changes in the child’s emotional growth and consequently in all areas of
functioning.
ENCOURAGING INTERACTION AND COMMUNICATION
The potential for developing interaction between a child and significant other
people in his or her life lies in recognising that individual’s uniqueness. The need to
communicate is innate but how this is achieved will vary between individuals because
it is dependent on how they feel about themselves, each other and their current
situation.
Failure to communicate effectively with another person is not uniquely
autistic but to establish communication and understanding between two people with
different experiences and perspectives does involve developing a common language
(Sinclair 1988).
This principle lies behind the s m i l e approach.
It disregards many of the
assumptions made about the disordered world of autism and instead emphasises
that human interaction begins with the mutual acceptance of a way of being. Since
play is a natural medium of self expression it becomes the tool through which a child
can develop greater self realisation and from this learn to relate more effectively with
others (Axline 1989).
The s m i l e approach aims to develop Social skills and Motivation by letting the
child Initiate Learning so that they Enjoy interacting with another person.
Furthermore a smile signifies that universal expression of pleasure and fun, it is the
first gesture an infant gives to another when they recognise them as a significant
other person and it can have a profound effect on changing the physiological
wellbeing of an individual.
Firstly, there is need to establish a safe environment where the child understands
that what they do in that place is mutually accepted and that the boundaries it
provides are firmly reassuring. It is important that the person who is with the child
does not see him or herself as the one in control but as the facilitator or mediator,
allowing the child to initiate what will happen in the session. S m i l e focuses on
developing parents’ skills to enhance the interaction between them and their child
but this approach can also be implemented by other significant people in the child’s
life with whom they are learning to interact with. It doesn’t always have to be an
adult working as a mediator with the child since a sibling or an older peer could also
fit this role. The important thing is that whilst the child is initiating what they are
doing, there is much greater scope for them to be spontaneous. The facilitator
merely supports that spontaneity by imitating or joining in with that activity to the
extent that the child then feels that his or her actions are acceptable. This approach
emphasises ‘creative learning together’ which implies that both the child with autism
and their mediator or facilitator are working to find a mutually enjoyable
environment in which to interact.
“Children learn so much through play because
it takes place in a positive emotional climate.”
Long and Fogell
The range of toys which are used will be based on where the children’s interest lie
at a particular time and it should be remembered that a ‘toy’ to a child can mean
anything which they find fascinating or comforting. When the Kaufman’s began
working with their child in this way they were banging saucepan lids on the floor!
(Kaufman 1994).
Other toys can be introduced at a later stage as the child’s
interests change and develop. These can include functional toys that the child may
use in role play situations, toys which encourage manipulation and fine motor skills
or toys which can be used in pretend play.
The child needs to recognise the
facilitator as part of that environment with whom they are also ‘allowed’ to interact
with and in turn the facilitator has to be willing to engage in playful activities with
the child that are not necessarily based around a specific task or activity. Once that
trust has been established the child with autism will be motivated to interact, not
just with the objects around him or her but with the person they are with as well. At
the core of all communication is the motivational desire to want to interact.
Harry was a very passive, non verbal child and rarely initiated interaction with others.
He did enjoy bouncing on the large, coloured balls in the play room so was taken
there regularly.
Harry was wary of loud noises so I would sing “ Harry loves
bouncing, bouncing, bouncing, Harry loves bouncing up and down” and eventually
this led to him giving me eye contact and smiling. We would then play a game when
I would stop bouncing him on the ball and wait for him to initiate what would
happen next. When he looked at me we would bounce again. After just a few
sessions, when I stopped bouncing him he would look at me and say “go again”
which I repeated and so he continued bouncing on the ball. He used language in this
context but not in others because here, not only was he enjoying what he was doing,
but he enjoyed the interaction and wanted to use language.
Jon Sinclair, a person with autism describes that as a child it wasn’t that he couldn’t
talk or wouldn’t talk, but he didn’t know what talking was for. Many approaches for
teaching communication are based on developing linguistic competence and use
behavioural approaches to encourage learning. Interactions often taken place in very
structured settings in which there is an element of control over what will happen,
with rewards (food) used as a motivation to encourage children to perform a
particular communicative task. Rather, the focus should be on where the child is
within that communicative process. For there to be a shared language the starting
point has to be shared interaction leading to social understanding.
“The reward for communicating is communicating”
Nind and Hewitt
It is not that the child with autism doesn’t want to socially interact but doesn’t know
how to want to. We have to help them create the wanting and we do this initially by
developing a common understanding of a way of being which is more effective when
it is child-led. Valuing the presence of another and feeling emotionally comfortable
within the environment has to be at the core of developing communication and
reciprocal interaction before embarking on language acquisition.
PLAY AND LEARNING
“Children have a real understanding only of that
which they invent themselves and each time we try to
teach them something too quickly we keep them
from reinventing it themselves.”
Piaget
Play is a spontaneous and active process through which the child gains knowledge
of him or herself and the world and play that is decided upon by the child will have
much more meaning. For the child with autism, the challenge is not about learning
to cope with new experiences but how they consolidate these experiences in order to
learn. When this occurs through play he or she is likely to be much more motivated
to interact with a wider range of objects and to broaden these skills to more social
play experiences.
Clearly children are motivated by things that interest them and this has to be the
starting point for learning new skills. Rather than see the obsessive behaviours and
topics as barriers to learning, by nurturing their interests these can be used to
encourage interaction. A child interested in banging bricks together can be shown
that the bricks can be built into a tower and then knocking them down and building
them up can develop their anticipation and interaction. In the same way, the
development of pretence and symbolic play in children with autism begins with the
child’s fascination with particular objects and ideas from their own experiences.
With a group of children we would sing a song and as the child’s name was sung
they were given a coloured scarf.
Initially Darren was uncertain about the scarf
touching him but gradually tolerated the scarf over his head.
We would share a
game of ‘peek- a –boo’ which he enjoyed and he would give me eye contact and
smile. On one occasion when we were playing this game another child stood up and
let the scarf drop to the floor and called it a “parachute”. Then the other children,
including Darren, stood up and they were all dropping them to the floor making
“parachutes”. This was the beginning of symbol representation for Darren. He then
tried to role up the scarf and threw it and then pulled it along the floor like a snake.
Although Darren had no language he was beginning to use pretence in his play.
Play initiated by the child results in them being able to have a choice, to have
ownership of the play situation and develop their autonomy. The role for adults is to
value and respect the child’s ideas and interests so that learning through exploration
and experience develops.
The playful activities of children provide us with a valuable insight into how the
child is thinking and feeling and when the adult engages in a narrative with the child
so the child is ‘freed’ to use language as well, to represent their play.
Interactive play is still dependent on structure in terms of where it will take place,
the expectations of what will happen there and the timing and pace of the
interaction. It involves an understanding that any attempt at communication will be
rewarded and is gently reassuring even when the child’s behaviour reflects the
difficulties they are having with communication. Eye contact should not be expected
but celebrated when it does happen and in the same way games and activities can
build in turn taking with a planned pause to encourage the child to react.
Rarely in play will children express aspects of disturbed behaviour since they are
engaged in an emotionally positive activity that is self-motivating. Some children
with autism may engage in behaviours, such as screaming, spitting or self injury
which significantly affect their interactions with their environment and people around
them. Whilst in a play situation these behaviours may not be appropriate, the child
will need to be given time and support to recognise alternatives. Making loud noises
with an instrument may produce the same effect as screaming, playing with water
may be a distraction from spitting and rough and tumble games and sensory
materials can be used to reduce self injury or attacks on others. A great deal of
patience is required in the relationship, as is a great emphasis on having fun.
In the context of the school these two aspects of teaching and learning, that of
patience and fun, may well be overlooked in favour of ensuring access to the
curriculum via structured activities. Since play must be regarded as a tool for
learning, then both play and learning will need to be carefully planned so that
progress is assured. In young children play should not be seen as a separate activity
from work but an integral aspect of learning and experiencing their world and since
it has its own intrinsic rewards it cannot necessarily be quantified.
A definition of the curriculum is ‘ everything children do, see, hear or feel in their setting,
both planned and unplanned - and that includes play.’
DfEE
In the home environment, as in the school setting, play activities should be seen as
opportunities for developing a range of adaptive skills so that the child feels more
able to cope with the social experiences and expectations which they have to deal
with on a daily basis.
CONCLUSION
Invariably the play skills of children with autism are viewed as either nonexistent or
developmentally delayed and in this paper I have wanted to emphasise the role of
play in developing communication and social interaction as well as supporting the
individuals’ sense of well being and their intellectual development. In play, children
cannot fail because in that situation, as in any other, they are always doing the best
they can at that particular moment.
“ it is true that we cannot know in advance what any child
will accomplish, but we must not decide in advance all
of the things a child will never achieve.”
Raun Kaufman
The potential for learning through play should not be underestimated, particularly in
children with autism where, because of the emphasis on play being child-led, it is
often assumed to be less effective than structured learning activities.
Where
interactive play differs from spontaneous explorative or social play, is that children
with autism will need someone to support and encourage their play. When the child
and adult discover that they can laugh and play together, the potential for this
experience can extend into every aspect of their daily lives.
REFERENCES
Axline, V. (1989) Play Therapy. Edinburgh: Churchill Livingstone
Bennett, N., Wood, L. & Rogers, S. (1997) Teaching through Play. Buckingham: Open
University Press
Goleman, D. (1996) Emotional Intelligence. London: Bloomsbury Publishing
Kaufman, B. (1994) Son Rise - The Miracle Continues. Canada: H J Kramer Inc
Kaufman, R. (2001) ‘From Autism to Recovery’ Autismfile issue7 pp 21 - 23
Long, R. & Fogell, J. (1999) Supporting Pupils with Emotional Difficulties. London:
David Fulton Publishers
McMahon, L. (1992) The Handbook of Play Therapy . London: Routledge
Moyles, J. (1989) Just Playing. Buckingham: Open University Press
Moyles, J. (ed) (1998) The Excellence of Play. Buckingham: Open University Press
Nind, M. & Hewett, D. (1995) Access to Communication. London: David Fulton
Publishers
Sherratt, D. (1999) ‘The Importance of Play’. Good Autism Practice. Sept. pp 23-31
Birmingham: The University of Birmingham
Wilson, K., Kendrick, P. & Ryan, V. (1992) Play Therapy – A Non Directive Approach
for Children and Adolescents. London: Bailliere Tindall
Williams, D., (1998) Autism – An Inside- Out Approach. London: Jessica Kingsley
Winnicott, D (1990) Playing and Reality. London: Routledge
For further information contact:
Diana Seach
50 Cambrai Avenue
Chichester. West Sussex
PO19 2JY
Tel: 01243 531925
Email: diana@smile-autism.co.uk
Website: www.autism-smile.co.uk
Interactive Play
for Children
with Autism