The Development of Pretend Play in Pre-school Children with Autism

Background: Recent theory on the absence or limitations of the pretend play of children with autism has centered on the limitations of social interactive engagement and joint attention for these children, which underpins pretend play development.

Objectives: This paper examines the development of pretence in play for a group of 8 preschool children with autism to compare the sequence of imaginative play development with that of typically developing children and to look at the role of joint attention and interactive context in this development.

Methods: The children had all taken part in a joint-play intervention over a 5 month period and had limited engagement and play at the outset of the study. All went on to present conventional symbolic representation in play and meta-representational abilities, and a smaller number became involved in joint-imaginative scenarios and role-play. The onset and development of episodes of symbolic representation and pretence for the children is tracked as they appeared within the intervention sessions over 14 weeks, and sequencing in symbolic representation, and the role of joint attention and interactive context is examined.
Results: Results showed that for several children the entry into pretend play began with contingent imitation within joint attention. Conventional representation in ‘functional’ use of toys and objects appeared before meta-representation. Soft toys and puppets were used facilitatively by adult play partners to model interactions in imaginative scenarios and 6 of the children went on to give perspective giving responses to soft toys in pretend play. Of these children, 4 went on to become involved in imaginative play scenarios where they pretended to ‘do’ something, such as going shopping

Conclusions: It is concluded that the sequence of symbolic representation and imaginative play development for children with autism mirrors that of typically developing children and rests on joint attention in social interactive engagement.