Play Assessments and Developmental Skills in Young Children With Autism Spectrum Disorders

Abstract

Appropriate play behaviors facilitate language skills, increase cognitive skills, and provide opportunity for social interaction. However, play skills often present differently in children with Autism Spectrum Disorders (ASD). Currently, there are several global standardized ASD measures used during diagnostic evaluations that include, but are not limited to, assessment of play. However, it is unclear whether these measures examine similar aspects of play. This uncertainty is important to explore to better understand the whole profile of children’s play competencies to implement developmentally appropriate interventions and create fitting goals. The current study explored the relations of children’s play measured by clinicians’ observations (Autism Diagnostic Observation Schedule [ADOS], Childhood Autism Rating Scale–Second Edition [CARS2-ST]) and parents’ reports (Adaptive Behavior Assessment System–Second Edition [ABAS-II], Communication and Symbolic Behavior Scales Developmental Profile–Infant/Toddler Checklist [CSBS DP-ITC]). Participants (n = 34) were toddlers and preschool-aged children with ASD. A play composite was created for each aforementioned measure, which included extracted items that specifically examined play skills. Initial results suggested minimal similarities in play composites across measures. Play composites were also compared with children’s developmental skills (Mullen Scales of Early Learning [MSEL]) to explore the reciprocal relationship between play/developmental skills. Results revealed that expressive and receptive language skills, fine motor skills, and visual reception skills (from MSEL) were significantly correlated with specific play composites. This study’s innovative identification of play composites from standardized ASD diagnostic measures highlights the importance of (a) using multiple methodologies to gain a whole profile of children’s play/developmental skills, and (b) selecting interventions matched on children’s current play/developmental skills.

Examining the relationship between social communication on the ADOS and real-world reciprocal social communication in children with ASD

“…While other studies have compared ADOS composite scores to general play behaviors and developmental skills (e.g., Pierucci et al, 2015; Rodman et al, 2010), this study is the first that compares scores of Social Communication on the ADOS to peer communication in a structured, naturalistic setting. The activities and questions used to elicit behaviors that are scored on the ADOS Social Communication algorithm are able to be performed by a clinician in a short span of time in a clinical environment.…”

“…Pierucci and colleagues (2015) examined play in preschool-aged children by comparing clinician measures of play to parent reports of play and a measure of developmental skills. They compared a composite of the play scores from the ADOS (Module 1 and Toddler Module) and the Childhood Autism Rating Scales 2 nd Edition, Standard Form (CARS2-ST; Schopler, Van Bourgondien, Wellman, & Love, 2010) to play scores from the parent-reported Communication and Symbolic Behavior Scales Developmental Profile, Infant-Toddler Checklist (CSBS DP-ITC; Wetherby & Prizant, 2002) and Adaptive Behavior Assessment System, 2 nd Edition (ABAS-II; Harrison & Oakland, 2003).…”

“…They did not find a significant agreement between clinicians’ ratings on the ADOS and the CARS-2ST, and parents’ ratings on the CSBS DP-ITC and the ABAS-II in relation to the level of play skills in children. However, ADOS play scores correlated with the developmental skills of children as measured on the Mullen Scales of Early Learning (MSEL; Mullen, 1995) Expressive Language scale ( r = − .46) and Fine Motor Skills scale ( r = −.51; Pierucci et al, 2015). …”

Pretend Play and Social Engagement in Toddlers at High and Low Genetic Risk for Autism Spectrum Disorder

“…Thus, the current study adds to the literature on early signs of autism in HR siblings by assessing delays or deficits in pretend play in both unstructured and structured contexts that are distinct from standard diagnostic assessments, while also rating social engagement with a play partner. Although limited pretend play is one diagnostic criterion for ASD, standard measures of pretending are only modestly correlated in preschool children with a diagnosis of ASD (Pierucci et al 2015). Therefore, this study of HR siblings at 22 months provides additional insight into characteristics of both play behavior and social interaction during play, associated with emerging ASD in toddlerhood.…”

Effects of English versus heritage language on play in bilingually exposed children with autism spectrum disorder

“…Consistent with previous research that has found better performance in heritage language intervention sessions (Lang et al, ), the present study found that bilingually exposed children with autism demonstrated more play behaviors in the presence of their heritage language. Because play is an important part of children's development (Pierucci, Barber, Gilpin, Crisler, & Klinger, ) and children with ASD often have impaired play skills (Baron‐Cohen, ; Jung & Sainato, ; Lang et al, ), this is not only an important but also a socially valid and relevant finding.…”