Skip to main content
SpringerLink
Log in

Developmental Changes in Pretend Play from 22- to 34-Months in Younger Siblings of Children with Autism Spectrum Disorder

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

Developmental trajectories of children’s pretend play and social engagement, as well as parent sensitivity and stimulation, were examined in toddlers with an older sibling with autism spectrum disorder (ASD, high risk; HR) and toddlers with typically-developing older siblings (low risk; LR). Children (N = 168, 97 boys, 71 girls) were observed at 22, 28, and 34 months during free play with a parent and elicited pretend play with an examiner. At 28 and 34 months, children were asked to imagine the consequences of actions pantomimed by the examiner on a pretend transformation task. At 36 months children were assessed for ASD, yielding 3 groups for comparison: HR children with ASD, HR children without ASD (HR-noASD), and LR children. Children in all 3 groups showed developmental changes, engaging in more bouts of pretend play and obtaining higher scores on the elicited pretend and transformation tasks with age, but children with ASD lagged behind the other 2 groups on most measures. Children with ASD were also less engaged with their parents or the examiner during play interactions than either LR or HR-noASD children, with minimal developmental change evident. Parents, regardless of group, were highly engaged with their children, but parents of HR-noASD children received somewhat higher ratings on stimulation than parents of LR children. Most group differences were not accounted for by cognitive functioning. Instead, lower social engagement appears to be an important correlate of less advanced pretend skills, with implications for understanding the early development of children with ASD and for early intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (text revision). Washington, DC: Author.

    Google Scholar 

  • Belsky, J., & Most, R. K. (1981). From exploration to play: A cross-sectional study of infant free play behavior. Developmental Psychology, 17, 630–639.

    Article  Google Scholar 

  • Brownell, C. A., & Carriger, M. S. (1990). Changes in cooperation and self-other differentiation during the second year. Child Development, 61, 1164–1174.

    Article  PubMed  Google Scholar 

  • Brownell, C. A., & Kopp, C. B. (2007). Transitions in toddler socioemotional development: Behavior, understanding, and relationships. In C. A. Brownell & C. B. Kopp (Eds.), Socioemotional development in the toddler years: Transitions and transformations (pp. 1–40). New York: Guilford Press.

    Google Scholar 

  • Bryk, A., & Raudenbush, S. W. (1992). Hierarchical linear models for social and behavioral research: Applications and data analysis methods. Newbury Park: Sage.

    Google Scholar 

  • Campbell, S. B., Leezenbaum, N. B., Schmidt, E. N., Day, T. N., & Brownell, C. A. (2015a). Concern for another's distress in toddlers at high and low genetic risk for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 3594–3605.

    Article  PubMed  PubMed Central  Google Scholar 

  • Campbell, S. B., Leezenbaum, N., Mahoney, A., Day, T., & Schmidt, E. (2015b). Social engagement with parents in 11-month-old siblings at high and low genetic risk for autism spectrum disorder. Autism, 19, 915–924.

    Article  PubMed  Google Scholar 

  • Campbell, S. B., Leezenbaum, N. B., Mahoney, A. S., Moore, E. L., & Brownell, C. A. (2016). Pretend play and social engagement in toddlers at high and low genetic risk for autism spectrum disorder. Journal of Autism and Developmental Disorders, 46, 2305–2316.

    Article  PubMed  PubMed Central  Google Scholar 

  • Campbell, S. B., Moore, E. L., Northrup, J., & Brownell, C. A. (2017). Developmental changes in empathic concern and self-understanding in toddlers at genetic risk for autism spectrum disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-017-3192-3.

  • Charman, T., Swettenham, J., Baron-Cohen, S., Cox, A., Baird, G., & Drew, A. (1997). Infants with autism: An investigation of empathy, pretend play, joint attention, and imitation. Developmental Psychology, 33, 781–789.

    Article  PubMed  Google Scholar 

  • Christensen, L., Hutman, T., Rozga, A., Young, G. S., Ozonoff, S., Rogers, S. J., et al. (2010). Play and developmental outcomes in infant siblings of children with autism. Journal of Autism and Developmental Disorders, 40, 946–957.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, T., et al. (2010). Randomized controlled trial of an intervention for toddlers with autism: The early start Denver model. Pediatrics, 125, e17–e23.

    Article  PubMed  Google Scholar 

  • Fein, G. (1981). Pretend play in childhood: An integrative review. Child Development, 52, 1095–1118.

    Article  Google Scholar 

  • Gangi, D. N., Ibañez, L. V., & Messinger, D. S. (2014). Joint attention initiation with and without positive affect: Risk group differences and associations with ASD symptoms. Journal of Autism and Developmental Disorders, 44, 1414–1424.

    Article  PubMed  PubMed Central  Google Scholar 

  • Garvey, C. (1990). Play (2nd ed.). Cambridge: Harvard University Press.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Hobson, J. A., Hobson, R. P., Malik, S., Bargiota, K., & Calo, S. (2013). The relation between social engagement and pretend play in autism. British Journal of Developmental Psychology, 31, 114–127.

    Article  PubMed  Google Scholar 

  • Hollingshead, A. A. (1975). Four-factor index of social status. Unpublished manuscript. Yale University, New Haven, CT.

  • Howes, C., Unger, O., & Seidner, L. B. (1989). Social pretend play in toddlers: Parallels with social play and with solitary pretend. Child Development, 60, 77–84.

    Article  Google Scholar 

  • Hutman, T., Rozga, A., DeLaurentis, A. D., Barnwell, J. M., Sugar, C. A., & Sigman, M. (2010). Response to distress in infants at risk for autism: A prospective longitudinal study. Journal of Child Psychology and Psychiatry, 51, 1010–1020.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jarrold, C. (2003). A review of research into pretend play in autism. Autism, 7, 379–390.

    Article  PubMed  Google Scholar 

  • Kasari, C., Paparella, T., Freeman, S., & Jahromi, L. B. (2008). Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76, 125–137.

    Article  PubMed  Google Scholar 

  • Kavanaugh, R. D., & Harris, P. L. (1994). Imagining the outcome of pretend transformations: Assessing the competence of normal children and children with autism. Developmental Psychology, 30, 847–854.

    Article  Google Scholar 

  • Landa, R. J., Holman, K. C., & Garrett-Mayer, E. (2007). Social and communicative development in toddlers with early and later diagnosis of autism Spectrum disorders. Archives of General Psychiatry, 64, 853–864.

    Article  PubMed  Google Scholar 

  • Lausberg, H., & Sloetjes, H. (2009). Coding gestural behavior with the NEUROGES-ELAN system. Behavior Research Methods, Instruments, and Computers, 41, 841–849.

    Article  Google Scholar 

  • Lillard, A. (2007). Pretend play in toddlers. In C. A. Brownell & C. B. Kopp (Eds.), Socioemotional development in the toddler years: Transitions and transformations (pp. 149–176). New York: Guilford Press.

    Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–695.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E., Leventhal, B., DiLavore, P., et al. (2000). Autism diagnostic observation schedule-generic: A standard measure of social and communicative deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.

    Article  PubMed  Google Scholar 

  • Malesa, E., Foss-Feig, J., Yoder, P., Warren, Z., Walden, T., & Stone, W. L. (2012). Predicting language and social outcomes at age 5 for later-born siblings of children with autism spectrum disorders. Autism, 17, 558–570.

    Article  PubMed  PubMed Central  Google Scholar 

  • Manning, M. M., & Wainright, L. D. (2010). The role of high level play as a predictor of social functioning in autism. Journal of Autism and Developmental Disorders, 40, 523–533.

    Article  PubMed  Google Scholar 

  • McCune-Nicolich, L. (1981). Toward symbolic functioning: Structure of early pretend games and potential parallels with language. Child Development, 52, 785–797.

    Article  Google Scholar 

  • Mullen, E. (1995). The Mullen scales of early learning. Circle Pines: American Guidance Service.

    Google Scholar 

  • NICHD Early Child Care Research Network. (1999). Early child care and mother-child interaction in the first three years of life. Developmental Psychology, 35, 1399–1413.

    Article  Google Scholar 

  • Ozonoff, S., Young, G. S., Carter, A., Messinger, D., Yirmiya, N., Zwaigenbaum, L., et al. (2011). Recurrence risk for autism spectrum disorders: A baby siblings research consortium study. Pediatrics, 128, e488–e495.

    PubMed  PubMed Central  Google Scholar 

  • Ozonoff, S., Young, G. S., Belding, A., Hill, M., Hill, A., Hutman, T., et al. (2014). The broader autism phenotype in infancy: When does it emerge? Journal of the American Academy of Child and Adolescent Psychiatry, 53, 398–407.

    Article  PubMed  PubMed Central  Google Scholar 

  • Piaget, J. (1962). Play, dreams, and imitation. New York: Norton.

    Google Scholar 

  • Rogers, S. J. (2009). What are infant siblings teaching us about autism in infancy? Autism Research, 2, 125–137.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rutherford, M. D., Young, G. S., Hepburn, S., & Rogers, S. J. (2007). A longitudinal study of pretend play in autism. Journal of Autism and Developmental Disorders, 37, 1024–1039.

    Article  PubMed  Google Scholar 

  • Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Shire, S. Y., Gulsrud, A., & Kasari, C. (2016). Increasing responsive parent-child interactions and joint engagement: Comparing the influence of parent-mediated intervention and parent psychoeducation. Journal of Autism and Developmental Disorders, 46, 1737–1747.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sigman, M., & Ungerer, J. A. (1984). Cognitive and language skills in autistic, mentally retarded, and normal children. Developmental Psychology, 20, 293–302.

    Article  Google Scholar 

  • Sutherland, S. L., & Friedman, O. (2013). Just pretending can be really learning: Children use pretend play as a source for acquiring generic knowledge. Developmental Psychology, 49, 1660–1668.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Chawarska, K., Dawson, G., Georgiades, S., Landa, R., Lord, C., et al. (2016). Prospective longitudinal studies of infant siblings of children with autism: Lessons learned and future directions. Journal of the American Academy of Child and Adolescent Psychiatry, 55, 179–187.

    Article  PubMed  PubMed Central  Google Scholar 

  • Talbott, M. R., Nelson, C. A., & Tager-Flusberg, H. (2015). Maternal gesture use and language development in infant siblings of children with autism Spectrum disorder. Journal of Autism and Developmental Disorders, 45, 4–14.

    Article  PubMed  PubMed Central  Google Scholar 

  • Watson, M. W., & Fischer, K. (1977). A developmental sequence of agent use in late infancy. Child Development, 48, 828–836.

    Article  Google Scholar 

  • Weisberg, D. S. (2015). Advanced review: Pretend play. WIREs Cognitive Science, 6, 249–261.

    Article  PubMed  Google Scholar 

  • Weisberg, D. S., Zosh, J. M., Pasek, K. H., & Golinkoff, R. M. (2013). Play, language development, and the role of adult support. American Journal of Play, 6, 39–54.

    Google Scholar 

  • Willett, J. B., Singer, J. D., & Martin, N. C. (1998). The design and analysis of longitudinal studies of development and psychopathology: Statistical models and methodological recommendations. Development and Psychopathology, 10, 395-426.

  • Zwaigenbaum, L., Thurm, A., Stone, W., Baranek, G., Bryson, S., Iverson, J., et al. (2007). Studying the emergence of autism spectrum disorders in high-risk infants: Methodological and practical issues. Journal of Autism and Developmental Disorders, 37, 466–480.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the National Institute of Mental Health R01 MH091036 to Dr. Campbell. We thank Dr. Nancy Minshew, Dr. Mark Strauss, Dr. Carla Mazefsky, Dr. Holly Gastgeb, Ms. Stacey Becker, Ms. Taylor Day, and the staff at Autism Center of Excellence, University of Pittsburgh for overseeing recruitment and assessment of participating families. The Autism Center of Excellence was supported by award number HD055748 (PI Minshew) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Recruitment was also facilitated by the Clinical and Translational Science Institute, supported by the National Institutes of Health through Grant Numbers UL1 RR024153 and UL1TR000005. Thanks are due to Kristen Decker, Rachel Fleming, Stephanie Fox, Monica Kim, Phebe Lockyer, Christy Lucas, Kristen McMillen, Maura Natale, Kayla Pavlock, Emily Schmidt, and Amy Tavares for assistance with data collection and coding. Special thanks go to the parents and children who participated in this study.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Pittsburgh, 210 South Bouquet Street, Pittsburgh, PA, 15260, USA

    Susan B. Campbell, Amanda S. Mahoney, Jessie Northrup, Elizabeth L. Moore & Celia A. Brownell

  2. University of North Carolina, Chapel Hill, NC, USA

    Nina B. Leezenbaum

Authors
  1. Susan B. Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amanda S. Mahoney
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jessie Northrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elizabeth L. Moore
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nina B. Leezenbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Celia A. Brownell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susan B. Campbell.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all participating parents at each study visit.

Electronic supplementary material

ESM 1

(DOCX 21 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Campbell, S.B., Mahoney, A.S., Northrup, J. et al. Developmental Changes in Pretend Play from 22- to 34-Months in Younger Siblings of Children with Autism Spectrum Disorder. J Abnorm Child Psychol 46, 639–654 (2018). https://doi.org/10.1007/s10802-017-0324-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-017-0324-3

Keywords

Search

Navigation