Play in Children with Autism Spectrum Disorders

Children with Autism Spectrum Disorders (ASDs) have delayed pretend play skills.
They also have two unique patterns of play. These are called sensory-motor and
ritualistic play. sensory-motor play involves a combination of sensory and motor
based activities. Examples include mouthing or twirling objects, tapping or
banging objects or manipulating and touching objects in repetitive,
ritualistic and stereotypical fashions. Children with more severe forms of ASDs
who are nonverbal may have more of these patterns and behaviors then children
who are high functioning (HF).

The overall play pattern of children with ASDs is repetitive and lacks the creativity and imagination seen in age appropriate play. Children with ASDs often line up toys, cars or other characters and recognize and become upset if the objects are moved. They may
stack blocks in a sorted fashion by shape or color and may look at the
constructions from various angles including out of the corner of their eyes.
Often they are fascinated and fixated by movement patterns including the
spinning of wheels or fans. They may repetitively open and close doors or
cabinets and become upset if a door is left ajar. Rather than coloring with
pencils or crayons they may repetitively line them up or spin and flick them
back and forth.

Children with ASDs often prefer to play with common objects they find around the house rather than age appropriate toys and are able to spend expended periods playing with simple objects their age peers are bored with. Their play can be described as constructive involving blocks, computer games or puzzles or ritualistic where objects are sorted, matched or lined up. They often mix either of the above play patterns with sensory-motor play consisting of spinning, flicking, mouthing or banging a hand held object while performing another play activity. Their motor skill to accomplish this dual play is often quite amazing. While playing they often interrupt play to jump, run or
spin while making repetitive vocalizations. Games of chase or roughhousing
including wrestling or playing lap games are often preferred but the social
aspects of these activities are of less importance and interest. The body
movement during these activities appears to be the fascination as are other
sensory-motor aspects of play.

Visual play includes watching certain videos, video games or television shows over and over and often reveals a high skill level when completing puzzles or mastering video game levels. Certain topics are common aspects of fascination. These include trains, trucks and shape matching puzzles. Water and water play are often a fascination. Parents often report an advanced visual memory for car directions and recognition of any changes in the house layout including furniture or toys being reorganized.

The above play activities can persist for extended periods or change suddenly and be replaced by new patterns. Past patterns can suddenly return only to be lost again. Group activities where cooperation and the following of group rules are required are of little interest. Play activities where change is integral to the activity are confusing and often cause unease and discomfort. Frequently children with ASDs separate themselves from others and wander or elope to a more comfortable location. Children with high functioning ASDs of the Asperger Syndrome type may become frustrated by this inability to integrate with others during play and are at risk for being bullied
or victimized by peers.  High functioning children with autism generally show
minimal unease about this separation and are not concerned or frustrated with
being ignored.