Abstract
Children with autism spectrum disorders (ASD) face pervasive challenges in symbolic and social play development. The Integrated Play Groups (IPG) model provides intensive guidance for children with ASD to participate with typical peers in mutually engaging experiences in natural settings. This study examined the effects of a 12-week IPG intervention on the symbolic and social play of 48 children with ASD using a repeated measures design. The findings revealed significant gains in symbolic and social play that generalized to unsupported play with unfamiliar peers. Consistent with prior studies, the outcomes provide robust and compelling evidence that further validate the efficacy of the IPG model. Theoretical and practical implications for maximizing children’s developmental potential and social inclusion in play are discussed.
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Notes
Due to the timing of the study with onset at the beginning of the academic school year, the first group of participants was unable to participate in the baseline assessment phase 3-months prior to treatment.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
American Speech-Language-Hearing Association. (2006). Knowledge and skills needed by Speech-Language Pathologists for diagnosis, assessment, and treatment of Autism Spectrum Disorders across the life span. http://www.asha.org/policy/KS2006-00075.htm. doi:10.1044/policy.KS2006-00075.
Attwood, A., Frith, U., & Hermelin, B. (1988). The understanding and use of interpersonal gestures by autistic and Downs syndrome children. Journal of Autism and Developmental Disorders, 18, 241–257.
Bakeman, R. (2000). Behavioral observations and coding. In H. T. Reis & C. K. Judd (Eds.), Handbook of research methods in social psychology. New York: Cambridge University Press.
Baron-Cohen, S. (1987). Autism and symbolic play. British Journal of Developmental Psychology, 5(2), 139–148.
Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high-functioning children with autism. Child Development, 71(2), 447–456.
Bottema-Beutel, K. (2011). The negotiation of footing and participation structure in a social group of teens with and without Autism Spectrum Disorder. Journal of Interactional Research in Communication Disorders., 2, 61–83.
Boucher, J., & Wolfberg, P. J. (2003). Editorial special issue on play. Autism: The International Journal of Research and Practice, 7(4), 339–346.
Brown, S. (2009). Play: How it shapes the brain, opens the imagination, and invigorates the soul. New York: Avery-Penguin.
Brown, F. (2012). Playwork, play deprivation and play: An interview with Fraser Brown. American Journal of Play, 4(3), 267–283.
Calder, L., Hill, V., & Pellicano, E. (2013). Sometimes I want to play by myself: Understanding what friendship means to children with autism in mainstream primary schools. Autism, 17(3), 296–316.
Carter, A., Davis, N. O., Klin, A., & Volkmar, F. R. (2005). Social development in autism. In F. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (3rd ed., pp. 312–334). NJ: Wiley.
Chamberlain, B., Kasari, C., & Rotheram-Fuller, E. (2007). Involvement or isolation? The social networks of children with autism in regular classroom. Journal of Autism and Developmental Disorders, 37, 230–242.
Charman, T., & Baron-Cohen, S. (1997). Brief report: Prompting pretend play in autism. Journal of Autism and Developmental Disorders, 27, 325–332.
Corbett, B. A., Schupp, C. W., Simon, D., Ryan, N., & Mendoza, S. (2010). Elevated cortisol during play is associated with age and social engagement in children with autism. Molecular Autism, 1(13), 1–12.
Dawson, G., Jones, E. J., Merkle, K., Venema, K., Lowy, R., Faja, S., et al. (2012). Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 51(11), 50–1159.
DiSalvo, C., & Oswald, D. (2002). Peer-mediated socialization interventions for children with autism: A consideration of peer expectancies. Focus on Autism and Other Developmental Disabilities, 17, 198–207.
Dissanayake, C., Signman, M., & Kasari, C. (1996). Long-term stability of individual differences in the emotional responsiveness of children with autism. Journal of Child Psychology and Psychiatry, 37(4), 462–467.
Dominguez, A., Ziviani, J., & Rodger, S. (2006). Play behaviours and play objects preferences of young children with autistic disorder in a clinical play environment. Autism, 10(1), 53–69.
Doody, K. R., & Mertz, J. (2013). Preferred play activities of children with autism spectrum disorder in naturalistic settings. North American Journal of Medicine and Science., 6(3), 128–133.
Elkind, D. (2007). The power of play: How spontaneous, imaginative activities lead to happier, healthier children. Cambridge, MA: De Capo Press.
Fromberg, D. P., & Bergen, D. (Eds.). (2015). Play from birth to twelve: Contexts perspectives, and meanings (3rd Ed.), New York: Routledge.
Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 693–705.
Hauck, M., Fein, D., Waterhouse, L., & Feinstein, C. (1995). Social initiations by autistic children to adults and other children. Journal of Autism and Developmental Disorders, 25(6), 579–595.
Hobson, J. A., Hobson, P., Malik, S., Kyratso, B., & Calo, S. (2013). The relation between social engagement and pretend play in autism. British Journal of Developmental Psychology, 31, 114–127.
Hobson, R. P., Lee, A., & Hobson, J. A. (2009). Qualities of symbolic play among children with autism: A social-developmental perspective. Journal of Autism and Developmental Disorders, 39(1), 12–22.
Howes, C., & Matheson, C. (1992). Sequences in the development of competent play with peers: Social and social pretend play. Developmental Psychology, 28, 961–974.
Iovannone, R., Dunlop, G., Huber, H., & Kincaid, D. (2003). Effective educational practices for students with ASD. Focus on Autism and Other Developmental Disabilities, 18(3), 150–165.
Jarrold, C. (2003). A review of research into pretend play in autism. Autism: The International Journal of Research and Practice, 7(4), 379–390.
Jarrold, C., Boucher, J., & Smith, P. (1996). Generativity deficits in pretend play in autism. British Journal of Developmental Psychology, 14, 275–300.
Jarrold, C., & Conn, C. (2011). The development of pretend play in autism. In A. Pellegrini (Ed.), Oxford handbook of the development of play (pp. 308–321). New York: Oxford University Press.
Jordan, R. (2003). Social play and autistic spectrum disorders. Autism: The International Journal of Research and Practice, 7(4), 347–360.
Julius, H., Wolfberg, P. J. Jahnke, I., & Neufeld, D. (2012). Integrated play and drama groups for children and adolescents on the autism spectrum: Final report. Alexander von Humboldt TransCoop Research Project, University of Rostock, Germany with San Francisco State University, USA.
Kasari, C., Roheram-Fuller, E., Locke, J., & Gulsrud, A. (2012). Making the connection: Randomized controlled trial of social skills at school for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 53(4), 431–439.
Lantz, J. F., Nelson, J. M., & Loftin, R. L. (2004). Guiding children with autism in play: Applying the integrated play group model in school settings. Exceptional Children, 37(2), 8–14.
Leslie, A. M. (1987). Pretence and representation: The origins of “theory of mind”. Psychological Review, 94, 412–426.
Lewis, V., & Boucher, J. (1988). Spontaneous instructed and elicited play in relatively able autistic children. British Journal of Developmental Psychology, 6(4), 325–339.
Libby, S., Powell, S., Messer, D., & Jordan, R. (1998). Spontaneous play in children with autism: A reappraisal. Journal of Autism and Developmental Disorders, 28, 487–497.
Lord, C., Rutter, M., Dilavore, P., & Risi, S. (1999). Manual: Autism diagnostic observation schedule. Los Angeles, CA: Western Psychological Services.
Lowe, M., & Costello, A. J. (1976). Manual for the symbolic play test. Windsor: National Foundation for Educational Research.
MacKinnon, D. P., & Dwyer, J. H. (1993). Estimating mediated effects in prevention studies. Evaluation Review, 17, 144–158.
Manning, M. M., & Wainwright, L. D. (2010). The role of high level play as a predictor of social functioning in autism. Journal of Autism and Developmental Disorders, 40(5), 523–533.
McCune-Nicolich, L. A. (1981). Toward symbolic functioning: Structure of early pretend games and potential parallels with language. Child Development, 52, 785–797.
McGraw, K. O., & Wong, S. P. (1996). Forming inferences about some intraclass correlation coefficients. Psychological Methods, 1(1), 30–46.
National Autism Center. (2009). Addressing the need for evidence-based practice guidelines for autism spectrum disorders. National Autism Center’s National Standards Project: Findings and Conclusions.
National Research Council. (2001). Committee on educational interventions for children with autism, Division of behavioral and social sciences and education. Educating children with autism. Washington, DC: National Academy Press.
O’Connor, T. (1999). Teacher perspectives of facilitated play in Integrated Play Groups. Unpublished Master Thesis, San Francisco State University, CA.
Ochs, E., Kremer-Sadlik, T., Sirota, K. G., & Solomon, O. (2004). Autism and the social world: an anthropological perspective. Discourse Studies, 6(2), 147–183.
Parten, M. B. (1932). Social participation among preschool children. Journal of Abnormal and Social Psychology, 27, 243–269.
Reichow, B., & Volkmar, F. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40(2), 149–166.
Richard, V., & Goupil, G. (2005). Application des groups de jeux integers aupres d’eleves ayant un trouble envahissant du development (Implementation of integrated play groups with PDD students). Revue Quebecoise de Psychologie, 26(3), 79–103.
Rogoff, B. (1990). Apprenticeship in thinking. New York: Oxford University Press.
Sigman, M., & Ruskin, E. (1999). Continuity and change in the social competence of children with autism, Down syndrome, and developmental delays. Monographs of the Society for Research in Child Development, 64, 1–114.
Sigman, M., Spence, S. J., & Wang, A. T. (2006). Autism from developmental and neuropsychological perspectives. Annual Review of Clinical Psychology, 2, 327–355.
Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290–312.
Stanley, G. C., & Konstantareas, M. M. (2006). Symbolic play in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(7), 1215–1223.
Toth, K., Munson, J., Meltzoff, A. N., & Dawson, G. (2006). Early predictors of communication development in young children with autism spectrum disorder: Joint attention, imitation and toy play. Journal of Autism and Developmental Disorders, 36, 993–1005.
Ungerer, J. A., & Sigman, M. (1981). Symbolic play and language comprehension in autistic children. Journal of the American Academy of Child Psychiatry, 20, 318–337.
Volkmar, F. R. (1987). Social development. In D. J. Cohen, A. M. Donnellan, & R. Paul (Eds.), Handbook of autism and pervasive developmental disorders. New York: Wiley.
Vygotsky, L. S. (1967). Play and its role in the mental development of the child. Journal of Russian and East European Psychology, 5(3), 6–18.
Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.
Westby, C. E. (2000). A scale for assessing development of children’s play. In K. Gitlin-Weiner, A. Sandgrund, & C. E. Schaefer (Eds.), Play diagnosis and assessment (2nd ed., pp. 131–161). New York: Wiley.
Williams, E. (2003). A comparative review of early forms of object-directed play and parent-infants play in typical infants and young children with autism. Autism: The International Journal of Research and Practice, 7(4), 361–377.
Williams, E., Reddy, V., & Costall, A. (2001). Taking a closer look at functional play in children with autism. Journal of Autism and Developmental Disorders, 31(1), 67–77.
Wing, L., & Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification. Journal of Autism and Developmental Disorders, 9(1), 11–29.
Wolfberg, P. J. (1994). Case illustrations of emerging social relations and symbolic activity in children with autism through supported peer play. Doctoral dissertation, University of California at Berkley with San Francisco State University. Dissertation Abstracts International, 9505068.
Wolfberg, P. J. (2003). Peer play and the autism spectrum: The art of guiding children’s socialization and imagination (integrated play groups field manual). Shawnee Mission, KS: Autism Asperger Publishing Company.
Wolfberg, P. J. (2009). Play and imagination in children with autism (2nd ed.). New York, NY: Teachers College Press.
Wolfberg, P. J., Bottema-Beutel, K., & DeWitt, M. (2012). Integrated play groups: Including children with autism in social and imaginary play with typical peers. American Journal of Play, 5(1), 55–80.
Wolfberg, P. J., & Buron, K. (2014). Perspectives on evidence based practice and autism spectrum disorder: Tenets of competent, humanistic and meaningful support. In K. D. Buron & P. J. Wolfberg (Eds.), Learners on the autism spectrum: Preparing highly qualified educators (2nd ed.). Shawnee Mission, KS: AAPC.
Wolfberg, P. J., McCracken, H., & Tuchel, T. (2014). Fostering play, imagination and friendships with peers: Creating a culture of social inclusion. In K. D. Buron & P. J. Wolfberg (Eds.), Learners on the autism spectrum: Preparing highly qualified educators and related practitioners (2nd ed.). Shawnee Mission KS: Autism Asperger Publishing Company.
Wolfberg, P. J., & Schuler, A. L. (1992). Integrated play groups project: Final evaluation report (Contract#HO86D90016). Washington, DC: Department of Education, OSERS.
Wolfberg, P. J., & Schuler, A. L. (1993). Integrated play groups: A model for promoting the social and cognitive dimensions of play. Journal of Autism and Developmental Disorders, 23(3), 1–23.
Wolfberg, P. J., & Schuler, A. L. (2006). Promoting social reciprocity and symbolic representation in children with autism spectrum disorders: Designing quality peer play interventions. In: T. Charman, & W. Stone (Eds.), Social and communication development in autism spectrum disorders: Early identification, diagnosis, and intervention (pp. 180–218). New York: Guilford Publications.
Wolfberg, P. J., Zercher, C., Lieber, J., Capell, K., Matiaas, S. G., Hanson, M., et al. (1999). Can I play with you? Peer culture in inclusive preschool programs. Journal of the Association for Persons with Severe Handicaps, 24, 69–84.
Wong, C., Odom, S. L., Hume, K. Cox, A. W., Fettig, A., Kucharczyk, S., & Schultz, T. R. (2013). Evidence-based practices for children, youth, and young adults with autism spectrum disorder. Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-Based Practice Review Group.
Yang, T., Wolfberg, P. J., Wu, S., & Hwu, P. (2003). Supporting children on the autism spectrum in peer play at home and school: Piloting the integrated play groups model in Taiwan. Autism: The International Journal of Research and Practice, 7(4), 437–453.
Zercher, C., Hunt, P., Schuler, A. L., & Webster, J. (2001). Increasing joint attention, play and language through peer supported play. Autism: The International Journal of Research and Practices, 5, 374–398.
Acknowledgments
We wish to express our deep appreciation to Autism Speaks for the funding of our grant and the many people involved in our research project. We are especially indebted to the children and families, IPG guides, IPG assistants and partner school sites for their generosity and support. We extend special thanks to Kristen Bottema-Beutel for her research support and thoughtful critique of this study. We also thank our research assistants Cristina Blanco, Cornelia Bruckner, Jessica Dow, Jenny Hernandez, Elizabeth Hooper, Sophia Lo, Katrina Martin, Sarah Mast, Heather McCracken, Sunaina Nedungadi, Luke Remy, Nevin Smith and the UC, Berkeley student URAP teams. We are grateful to members of our steering committee, including the late Adriana Loes Schuler whose enduring spirit lives on in the IPG model.
Ethical standard
This study was approved by the Committee for the Protection of Human Subjects, Internal Review Board of the lead university, and therefore has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Informed written consent was obtained from a parent/legal guardian for all participants, and verbal assent was obtained for participants 9–10 years of age prior to inclusion in the study. Details that might disclose the identity of the subjects under study have been omitted.
Conflict of interest
The authors do not have a financial relationship with Autism Speaks, the organization that sponsored the research. The authors declare that they have no conflict of interest.
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Wolfberg, P., DeWitt, M., Young, G.S. et al. Integrated Play Groups: Promoting Symbolic Play and Social Engagement with Typical Peers in Children with ASD Across Settings. J Autism Dev Disord 45, 830–845 (2015). https://doi.org/10.1007/s10803-014-2245-0
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DOI: https://doi.org/10.1007/s10803-014-2245-0