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AUTHOR Casner, Mary W.; Marks, Susan F.TITLE Playing with Autistic Children.PUB DATE Apr 84NOTE 13p.; Paper presented at the Annual Convention of the

Council for Exceptional Children (62nd, Washington,DC, April 23-27, 1984).

PUB TYPE Speeches/Conference Papers (150) -- ReprtsDescriptive (141)

EDRS PRICE MF01/PC01 Plus Postage.DESCRIPTORS *Autism; Children; *Peer Relationship; *Play Therapy;

Program Descriptions; *Program Development; Toys

ABSTRACTThe paper looks at the development of a play group

for autistic children with descriptions of the autistic population,the daily program, the program's philosophy, the play group model,and actual lessons. Children, who ranged in age from 5 to 9 years,often chose activities which were self-stimulating and/or repetitive.The daily program included daily motor, lunch, and recess periods tooffer a chance to mainstream the children into a group of multiplyhandicapped students; academics; and therapy and speech/languageservices on an individual or small group basis. The play group wasdesigned to facilitate any positive social interactions, eitherverbal or nonverbal. Play-group design allowed the clinician tostructure activities to accommodate the child's level of functioning.Toys were selected for a play group lesson with consideration of feu:features--realism, structure, responsiveness, and functionalcomplexity. (A sample lesson plan for three therapy sessions isoffered). At the end of the program year, children were demonstratingmany modeled interactions not seen in the early stages of the playgroup. (SW)

************************************************************************ Reproductions supplied by EDRS are-the best that can be made *

* from the original document. *

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'..

?LAYING viITh AUTISTIC CrIILCREN

US. DEPARTMENT OP EDUCATIONNATIONAL INSTITUTE OF EOUGATION

EDUCATIONAL RESOURCES INFORMATIONCENTER tERICIirks dOtoment has been 0.0101,400 as

ree,tri horn 'se off, >00 or of ganaaucv.WIWA(.94Wk., crieboOs see been nude to onprOveproducoon oualIV

Ponis Or ,..4.0, o, oo.r.Orts stated er thbs doc,,rtont op not orceSlarov revesellOti.cwil MEPOsVon oO.., v,

Presente6 by: Lary w. Casner & Sus :n F. :`,arks

62nd Annual CEC Conv,mtion

April, 19b4

Kashington, D.C.

2

PERMISSION TO REPRODUCE THISMATERIAL HAS BEEN GRANTED BY

70 THE EDUCATIONAL RESOURCESINFORMATION CENTER (ERICI-

PLAYING Willi AUTISTIC COILDREN

Presented by: Mary W. Casner & Susan F. Marks

A. Introduction

B. Description of typical autistic behavior.Description of this populationDescription of the daily program

C. Our definition of PlayThe Play group model - -goals and desired resultsThe type of training

D. Selection and exa.pplec:, of toysActual lessons

E. Questions from eXperienCe

PLAYING wITH AUTI6TIC CHILDREN

Presented by: Clary W. Casner & Susan F. marks

This paper is a eescription of the development of a play group for autistic,children. Included are descriptions of the autistic population and theirdaily program, our basic philosophy, the play group model and actuallessons.

Because most of the recent literature on language developrnt and disordersemphasizes the interaction of social, as well as cognitive ane linguisticfactors in language learning, the authors cnose a play group as the mediumto proviae languace stimulation and training. In addition to the socialsetting, the play group model provided several variables which could help .

facilitate communication among these autistic chilaren. Given the strikingcommunication problems evidenced it these children, it seemed they mightinteract more easily in a play situation than in a rigia classroom or .*therapy setting. A play group could provide opportunities for each child tointeract at his on level or cosafort. ,pith eleven chiLiren and aclulte

in our large group activities the levelz 0.5 interaction as 4ell Ac theopportunities for interaction were plentiful.

There was one additional reason for choosing the playing group format. Dueto the children's daily schedule (which will be described more fully at alacer point), speech and language services were necessarily episoaic andancillary. The authors believed that in a play group the children woulddevelop sKi'ln which would he more easily generalized to free time and/or athome social per

The first description of the behavior of the autistic child (Kanner 1943),included delay e,i languace and laniiiage abnormalities such as immediate anddelayed ecnolalia and pronomial problems. Since then, communicationprobloos of autistic children have consistently been mentioned wnen behaviordeficit:3 are des'orthed. tlowever, etiology, diacnosis and tr,:atment remainare of rat controversy. Recent research emphaiizes lanhuage andcor,T.unication deficit, as the central nroolem of autism (Prizant, Ruttar).It was around this rk-!searon that tnc play-arouil was designed. The autisticchilaren witt: tie -.1,roo.am had a wi=le range of soecch, lanuane andcommunication 71-:;(fleIts. Even the chile with the most fluent seec4 pact rileand correct linguitic structures had severe cot,ununication probloths.

Playing wien Autistic Celle:a-enCasner & Yarx8 1364

4

Our children ranged in age from 5 to 9 years. Some spoke in linguisticallyand phonemically correct seven- and eight-word sentences; one used only afew speech sounds along with some grunts and gestures. The childi whodemonstrated the most social and communicative behaviors was.alsr 75%unintelligible. cognitive funccioning ranged from moderately retarded toabove average. At the beginning, some children responded to aaulestimulation, but few, if any, appropriate peer interactions were achieved.when allowed free time, the children most often chose activities which wereself-stimulating and/or repetitive. If interactions occured, tnel were inthe form of squabbles to determine odnership of a toy or a space.

For most of the day, the children were grouped in two separate classrooms.The groupings were determined by considering the children's cognitivefunctioning, behavior characteristics and age. In retreespect however, themost salient feature of the division was the child's verbal ability, withone classroom having those children who were most verbal and the other thosewho were less verbal. For the most part, the children's verbal abilitycorresponded positively with their cognitive functioning, although therewere some exceptions. The children's verba) ability aid not corresponddirectly to their communicative ability. During the chldren's math andclassroom language arts periods, some re-grouping of the children tookplace.

Daily rotor, lunch and recess periods provided the children a chance to bemainstreaee into a e,oeulaiion of eelitiely handicapsed special eeucatienstudents. Occueational therapy, physical therapy, speech/laneuale serviceswere provided to individuals or small groups of children throughout theweek.

The children's schedules provided tines for academic work as well astraining self -telp skills. Academics included math or concept development,and reading or language arts. These areas were generally taught throughdrill with materials for the session including both the Dieter Language andsath progreme. :,elf -eele skills were taught in sequenced _tees taeen fromstaff-eeveloeec task analysis flow charts. Performance in both academic andself-help skills b.as counted and charted to determine progress. Anti-socialbehaviors were identified so behavior manacement techniques to facilitateextinction of these behaviors could be instituted. Both positivereinforc:ereot ane punisnment W4S used to decrease unnesirable behavior. Petsi'iply, the overall program was behaviorally oriented.

Playing wit... 4utistic Children 3,Casner & etazks 1904

1

OUR DEFIwICIOA OF PLAY

Play is a word Oat :eems to elude definition- -yet all feel they know whatit is. For this play group, the pragmatic /interactive piae of play wasstudied. Because earliest play takes the. form of zocial rituals (i.e.; amother playing with her child might say, "Say Mammy") , interactions on avery low level were accepted as play. These very early rituals lay thegroundwork for establisning turn-taking, sharing and then team work. Anattempt was made to incorporate the ideas expressd by DoctorsKirschenblatt-Gixbiett ana Garvey in Johnson and Johnson's Pediatric RoundTable:3, when trle planning for the play group. The doctors suggestedroutines took on a playrul quality when:

1. Thete was-mutual involvement or it was ashared `activity.

2. There were alternating turns, usually accompaniedby some sort of "turn" signals.

3. There were repetitions of the entire interactions;a succession of turns.

4. Tnere was non-literality or more than a literalmeaning to the aat. For e;:ample, rolling a bailvas not an act :%rfor:red for itelf, therean intended reaction - -tue return o: the hail. It

was .7. way for an interaction with another person.

Considering Coese four features of play, development of the training modelwas begun.

It was found that the following questions had to be answered before actuallessons were planned:

that did we want to accomplish?

who should participate?

. How could we best include the teaching/aide staff?

. What physical surrounaings were best?

. What type of interactions dirl we want to establise?

. V.nat rules, if any, were necessary for tha grout?

Playing witn Autistic Children 4

Casnar es ,arks 196e

eacher/amide Staff - It was asked that one or two staff 'embers bepresent to observe tecnniques and to perform behavior protocols whennecessary. -

For this group the coal, simply stated, was to facilitate any positivesocial interations, either verbal or nonverbal. some of the key ouidelinesnecessary for maximum effectiveeess with this population included:

Physical Set Up - Any piece in the school or can the school groundswas acceptable. .ne area had tc be structured before the sessionto exclude oiscellaneoes toys and as many distracters as possible.

The Rules - No child was forced to participate but they did have toremain in tne designated area. Tney were not permitted to play withany objects otter the those. provided by the therapists.

The Participants - All the children in botn classes and two therapistswere include'. The children were to remain in the group enlesephysically eneanaerine tnemselves or others. They could also beremoved from the group by one of the autism etaff meobere should thechild not comply with his individual behavior protocol.

TYPE OF TRAININGI

The lessens were not to contain any form of rigid or 3ri11 therew:. eithintbr-S fraes,:ork, eac'l caiie was nel:Jeu co buil-e coynitive echethee forinteracting ac nis own level of functioning. the play-group design ellcweethe clinician to easily structure the activity to ,accommodate for individualdifferencee in ability to interact and communicete. The followirej is a listof swe of tne ways ii wnich the individual autistic children wereencourages to interact:

1. Watching the croup2. Sitting or etandine with the group3. Imitating social rituals4. Receiving an object or toy from an adult or peer5. Haneing an o6ject or toy to an adult or peer6. Coeurientihe on =et::: own activity7. Comeentine on the activity of another .

6. Relincuiehing a turn ty calling another child's name9. Relin.euiehiee a turn ty ir.-tructinq tne nest chil6's activityle. Requestine a turn by rains hare!11. Requeeting a turn by aekine12. etanginq or eanitulating onele own turn by requesting an object or

action

Playing with Autistic Children 5

Casner & darks l94

13. Touchine another child14. Allooting someone to touch them15. Initiating a new activity by demonstration for the group16. Initiating a new activity by request

It should be noted that no positive social interaction was disallowed.Also, tnis list does not represent an order in which interactions weretaught. Each day and each activity brou'Ot different responses from thechildren. It was uo to the clinician to capitalize upon tne situation andbuild from the point at witch the child presented himself.

A major deficit for this group was their initiation of interactions. Mostwould respond at some level (not always appropriately, but nevertheless,there was a response). rlowever, very few initiations were noted. rhus, itwas the clinicians' task tomove.the child from aconstant response-mode andplace him in a situation which demanded an initiation of communication orinteraction. Locking back at the list of ways in which the autistic childmight interact in the play-group, the clinician was primarily concerned withfacilitating those interacticn emanating from the self to the outsideworld, i.e., numbers 5.7,6,9,13,15 and 16.

Another facet of the program was to concentrate on developing andestablishing peer relationshies. It was often noted that a &did morefrequently interacted with the familiar adults than with his clasema-es.Thul, chit; to child interactions were more desirable than cnili to adultinteractions.

SELECTION OF TOYS

Research chows that children under age 2 yeare'have a difficult tieeengagine in play with highly uerealietic toys. aecauee most of the autisticchildren relateo to ochers in primitive ways, ii at all, the toys used forthe play -group were kept in the realistic maim. A second feature of toys,that ie similar to realism, is their degree of structure. A structured tovi8 one that, by its very nature, implies specific ways in which it should beused. with more structured toys, less is require(' of the child. hxamplesof unstructured toys are clay, blocks and firigerpaint. Structured toyswould include care ant honseearee. enotlie'r feature of tovs which neeUs tobe conoiaereu is ite responeiveness. A reeponsive toy can teach thatbehavior eae consequencee, a cause and effect relationship. ehen the childfirst cmee in contact with a toy, an accieental trove may elicit theresconee froil the toy. Through exnerience, the child learns to oureoeefuliymanieulace the toe to elicit the desired re%;pon6e. slowly the cAil,:3 sees tiecan contiza pis enyironoent. chile resnonsive toys are desirable to hel?tne ceile becr,,fi t aware of his ability to manipulate his environment, tne toy

c

Playing witn Autiltic ChildrenCasner & viarks 19e4

;

.

0

should not do so much that the child becomes passive. The battery-operatedmonkey that beats a drum is responsive--the child must turn it on--but afterthat, the child need not be involved with the toy again.

The fourth feature of toys to be noted is the toy's functional complexity.Bow many ways could tne toy fuuction appropriately? A ball would to a goodexampie of a functionally complex toy--one may hit, throw, bounce, roll,kick, etc., a ball.

Summarizing, the four features of toys to be considered when planning aplay-group lesson are: 4-

1. Realism2. Structure3. Rerponsiveness4. Functional complexity

An activity can be planned to augment or delete any of these features. Forexamoile, paint is an unstructured toy but through planning can be used in astructured way.

Playing with Auti;tic Children 7

Caster & tarKs 19b4

SAMPLE LESSON PLAA

Three Tnerapy Sessions

The lessons that follow were designed to help the, children understand causeand effect as well as to facilitate interactions. The first lesson waspresented two times. iirst, to those who were less verbal, then to the r. oreverbal group. In tnta third session, the activity was varied comewhat tofurther establisn the cause and effect relationship. Also, the two groupsof children were combineo so interactions could he modeled at differentlevels for all the children.

Day 1 -Group I (Verbally Restricted Children)

Toys - pull toys with different responees

Physical setup - claL,srcom play area with only pull toys in reach

Desired Interactions

- watching group- initiating peer or adult

receiving or giving a toy- raising hand to request a turn- exchanging toys with peer

Caildren sit in a circle, toys are presented. Ctuil.iren ate enc.:A.:raged torequest a toy by raising their hands. Those who don't request are given atoy if they will acceot it. Toys must be used in appropriate ways.Children will be encouraged to "share" toyc as they are *Ailing or able todo so.

Day 2 - Grouo 2 (Verbal Children)

Toys and Physic 1 setup are the same

Desiru Interactions

watcning groupcovoenting cnown or other's interactionsrelinquit.nin3 turn o/ calling 0.1 or instructing anotner

- requestin.r t.. n by akinq- initiating new activity by request

10

SAMPLE LP. .:o :: P1,PN (contirl) 6

Casner 4 .e.rk4E. 19t4

Activity is the same except children are encouraged to verbally interact.Therapist may model the interaction, specificially direct the interaction(i.e., "Renee, toll Buddy it is his turn", or, "Sean, tell Anay to pull thetoy."), or prompt the interaction ty asking questions such as, "ohat shouldEvi do?" or, "what do you want?"

Day 3 - Croups 1 and 2 Combined

Toys - small toys with different color yarn pull strings tied to them

Setting - kidney shaped table

Desired interactions - any of tne above with an emphasis on verbalinteractions.

Children now nave some inea that pulling a strina causes tie toy to move.The yarn is first laid straight out from toys so cnildrtzn can pull the yarnon the toy that they want. After children are comfortable with this tack,the yarn is crossed so the visual tracxing is more difficult. Children mayobtain the toy only by pulling the yarn.

Playir,t t 1 'f :t.

h -1: . c% ;

many frol unf,-,rtunat(ly %i, e tild not

Dermit us t.) inc antor Curcio (1'..,62) thatecholaii 1. in flet cr tre tarr tom: In autistic to

w,1 1s in 1.4.h or -rZ.Inipulated

to flcilit.nt- counicatic exriorPd.

Anotner core,, ;l cr. tne, aarhor 1- tLE rittcr of fzrt ciation. Aher do youtry tc inoluuc a Chll] arou, an..1 wnri uo y'ou try to net a child tores..pcnci In a nor.: eel r.tinicaLiv !r- author`' wc-nt liv intuition ane

-tr:.:;t1 c.-111rt-n's !)t oonner ic thereweren't cuo.; that 1::licateu A c-tiln's ri,a6111.7.s to acteopt newlevels

Coservatirm CI t!JL autiltic crou; in (.17f.--rent =ocial settirqs av,ayfro.; 6c:.001 7ap? rodch rit'sc Could Le t.0,en interm.: of ral-litc Activitic, tmric.1 c!xz.erirs7,c at the sa;:c tirleavoirJin;

OUR (,,ACLUSIC_z-.)

One Ce"rk,..1 zrtuit the flay .7roc.i.) with the irpoverlent noted inthe cr,e-lenication ast,. intracrinr liownv2r, it can ofsaiq t!ai. tn cJil o11 i-dffe7 O''' 4.41%4 01 ve,ar, all the

two wi rt lit-1.1t=

c : cot. -""r11kl,;%r, a hil 3f2ravi.e11t o,::r f4.5t'4, t nar.c oi:cnil(!), 7,nric around in cire.0 ttio firt tiiw: a eirolt> 7a.-..e was attent:ted,

! A,! wr,7r in tr.... ,;%:nca of;1: Inrct

FtfC1'1,' :ur)n- '..oFt oz.

w,-re a.:ror,ciAt.-. in ,c.nir.u]atir,4 toys %yr.:r. In thet-hn 4:1'n to t!,e,1r

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12

Playina with Autistic Children 10Casner & Marks 1964

BIBLIOGRAPHY

Casby, A.W. and Ruder, K.F. (1983). Symbolic play and early languagedevelopmentation normal and mentally retarded children. Journalof Speech and Hearing Research, 26, 404-411.

Curcio, F. and Paccia, J.M. (1982). Strategies in evaluating autisticchildren's communication. Topics in Language Disorders, 3,43-49.

Kanner, L. (1943). Autistic disturbancs of affective contact. NervousChild, 2, 217-20.

Kirschenblatt-Gimblett, B. and Garvey, C. (1979). Pediatric round table:3.In P. Chance (Ld.)Learning Tnrough Play. New York: Jonnsoh andJonnson.

Newson, J. and Newson, E. (1979).Toys and Plsahings.. New York: PantheonBooks:.

Paccia, J. and Curcic, F. (1962). lanouane processino and forma ofecnolalia in autistic cni1.4.ren. Journal of Speeca and

Hearing Researcn, 25, 42-47.

RuLter, (1968). Concente of autism. Journal of Chili Psychology andPsychiatry, 9, 1-25.

Prizant, B.M. (1982). speech- language patholoais"4 and autistic children:shat is our role? Asha, 24, 463-468 and 531-535.

Prizant, a.m. (1962). Gestalt language and gestalt processing in autism.Topics in Language Disorders. 3, 16-23.

Silverman, C. (19B:d). Reacninq autistic children: a clinical ncte. Topicsin Language Disorders, 3, 58-63.

AatsDn, L.P.. and Lord, C. (1982) . Developing a social communicationcurriculua for autistic students. Topics in Language Disorders,3, 1-9.