Which types of play are characteristic of autism spectrum disorder (ASD)?

Updated: Sep 30, 2019
  • Author: James Robert Brasic, MD, MPH; Chief Editor: Caroly Pataki, MD  more...
  • Print
Answer

Baron-Cohen and colleagues demonstrated that the absence of symbolic play in infants and toddlers is highly predictive of a later diagnosis of autism. [111, 112] Therefore, screening for the presence of symbolic play is a key component of the routine assessment of well babies. The absence of normal pretend play indicates the need for referral for specialized developmental assessment for autism and other developmental disabilities.

Odd play may take the form of interest in parts of objects instead of functional uses of the whole object. For example, a child with autistic disorder may enjoy repeatedly spinning a wheel of a car instead of moving the entire car on the ground in a functional manner. The nonfunctional play of a boy with autism is illustrated in the video files below. Please note that videos represent a diagnostic assessment of a child. The child is allowed to exhibit the abnormal behaviors to demonstrate those items on a video for confirmation by blind raters. If the child exhibited behaviors danger to himself, such as self-injurious behaviors, or dangerous to other, such as attacking others, then the examiner would intervene to prevent injury to the child and others. The videos do not in any way represent treatment for the disorder. (The second and third videos also demonstrate an aforementioned trait, the lack of appropriate interaction with family members.) [114]

A 7-year-old boy with autistic disorder took daily vitamins and no other medications at the time of assessment. The examiner repeated movements of the telephone receiver and tapping on the telephone receiver initially exhibited by the subject. The examiner repeated the subject's actions several times in an attempt to elicit repetition of the movement by the subject. Instead, the subject does not acknowledge the presence of the examiner. He looks away from the examiner. He turns his back to the examiner. The subject spins by rotating on a central vertical axis in his body. He exhibits nonfunctional play with the telephone. He displays frequent finger wiggling and the other hand stereotypies. He frequently vocalizes indecipherable sounds and briefly rocks. He tilts his head and looks out of the corner of his eye for a few seconds. Please note that media file represents a diagnostic assessment of a child. The child is allowed to exhibit the abnormal behaviors to demonstrate those items on a video for confirmation by blind raters. If the child exhibited behaviors danger to himself, such as self-injurious behaviors, or dangerous to other, such as attacking others, then the examiner would intervene to prevent injury to the child and others. The media files does not in any way represent treatment for the disorder.
The examiner may attempt to establish a sequence of taking turns hitting a plate with a block. The examiner says, "My turn," and then taps the plate. The examiner gives the block to the subject and says, "Your turn." The subject may be physically assisted in the activity if the desired response does not occur. The following is a clinical example: A 7-year-old boy with autistic disorder took daily vitamins and no other medications at the time of assessment. The examiner attempted to elicit turn-taking by hitting the plate with a block. The child repeatedly jumps and rotates. He exhibits nonfunctional play with the telephone. He tilts his head and peers out of the corner of his eye. He is interested in the feel of the stick. He exhibits quick hand movements with small toys. When his father and his brother leave the room, the child does not acknowledge their departure. When his father returns to the room, he does not run to greet him. He appears indifferent to the departure and the return of his father. He repeatedly touches the surface of the wooden block. He touches the surface of a furlike cloth. He also places this cloth to his mouth to feel the texture on his lips. He is also fascinated with a string of yarn. He moves the string of yarn up and down and back and forth. This is nonfunctional play with ordinary items. Please note that media file represents a diagnostic assessment of a child. The child is allowed to exhibit the abnormal behaviors to demonstrate those items on a video for confirmation by blind raters. If the child exhibited behaviors danger to himself, such as self-injurious behaviors, or dangerous to other, such as attacking others, then the examiner would intervene to prevent injury to the child and others. The media files does not in any way represent treatment for the disorder.
The following is a clinical example that continues the segment of prior video: A 7-year-old boy with autistic disorder took daily vitamins and no other medications at the time of assessment. He appears indifferent to the departure of his brother from the room. He also does not respond with a greeting when his brother returns. He appears interested in his nonfunctional play. He displays minimal acknowledgment of the departure and return of his brother. In particular, he does not respond to his brother's touching him on the shoulder to greet him. Instead, he demonstrates inappropriate friendliness with the psychologist who is evaluating the procedures. Although he never saw her before this assessment, he suddenly goes to her to kiss her. Please note that media file represents a diagnostic assessment of a child. The child is allowed to exhibit the abnormal behaviors to demonstrate those items on a video for confirmation by blind raters. If the child exhibited behaviors danger to himself, such as self-injurious behaviors, or dangerous to other, such as attacking others, then the examiner would intervene to prevent injury to the child and others. The media files does not in any way represent treatment for the disorder.

Children with autistic disorder may enjoy repeatedly lining up objects or dropping objects from a particular height. They may also be fascinated with items that are not typical toys, such as pieces of string, and may enjoy hoarding rubber bands, paper clips, and pieces of paper. In addition, children with autistic disorder may spend hours watching traffic lights, fans, and running water. Some parents report that they must lock the bathroom door to prevent the child from flushing the toilet all day long.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!