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Play Therapy for Autistic Children


Kim Gunkel/

Children with autism typically do not relate well to others. They avoid interaction with adults, peers, and even their parents and siblings. They prefer to spend their time focusing on favorite activities and interests. Autistic children like to keep things the same. It makes them feel safe and secure. However, fear, anger, behavior issues, and a lack of language and social skills can come from inadequate brain development.

Related: Social Skills Training for Autism

Play therapy seeks to correct these brain imbalances. It strives to teach autistic children how to connect to others on their own level, control their behavior, understand cause and effect, and improve communication. While most children have difficulty grasping the abstract concepts used in traditional play therapy, many child-centered and direct-approach techniques can give children with autism the critical experiences necessary for growth.

What is Play Therapy?

There are many different types of play therapies, but most fall into one of two categories: those that use a non-directive approach, like Child-Centered Play Therapy, and those that use a more direct protocol like Theraplay. There are also individual play therapists that use a combination of the two models, as well as popular combination programs like the Floortime Approach. Therapeutic play differs from regular play. It provides a well-structured, playroom environment where a child can receive unconditional acceptance, genuine interest, and feel safe enough to attempt communication through play therapy activities.

Depending on the model, a therapist will either encourage the child to choose something to play with and then comment on what she sees the child do (a non-directive approach), or will attempt to directly engage the child through nonverbal, physical contact without toys. Combination models take principles from both approaches, depending on a child’s particular needs. Some also add additional techniques, like getting down on the floor with the child.

During sessions, therapists gain insight into what frightens the child, what preoccupies him, and what his interests and motivations are. This knowledge helps a therapist interpret the child’s actions later on, as to what he may be trying to communicate. Therapists also constantly comment on, or share what they believe the child is feeling. Conscious awareness helps a child learn that the therapist is genuinely interested in him. The process also involves the parents, who learn how to use these insights and techniques in therapy sessions themselves, or at home.

Right and Left Brain Development

Most autistic children lack the ability to understand and use abstract thought. That makes meaningful verbal expression difficult and creates problems understanding complex issues, motives, and feelings. All children find it easier to communicate through play. They use it to act out thoughts, feelings, and experiences they find difficult to put into words. However, children with autism do not always have that ability. Often, developmental delay due to immature brain function interferes with self-empowerment and prevents growth.

The first part of the brain to develop controls survival instincts: body systems that function unconsciously like breathing, digestion, heart rate, sexual urges, and instincts to run, fight, or freeze. It also forms the foundation for the mid brain that governs an individual’s emotions. In turn, the middle part of the brain needs to be organized appropriately for the higher brain to mature properly. The higher brain controls abstract and logical thinking, reasoning ability, language processing, judgment, and problem solving – what many autistic children struggle with.

A child’s greatest brain development begins in the womb by the last trimester of pregnancy and starts to slow down around the age of two. By five, the brain is almost completely mature. This makes early intervention for children with autism crucial. What a child experiences during those first five years will impact the rest of his life. However, reaching an autistic child and helping him meet developmental milestones must come through games and activities that align with his current brain development and emotional level, rather than his chronological age.

Why Do Children with Autism Need Therapeutic Play?

Therapeutic play offers an autistic child the chance to become master of his own environment. Depending on the child’s developmental and emotional level, it encourages self-initiated or therapist-driven activities in hopes of using play and social interaction to improve the child’s ability to communicate and create relationships. In addition to teaching autistic children “how” to play, therapy:

  • increases self awareness and well being (self esteem)
  • teaches how to control anger, frustration, and behavior (Related: Applied Behavior Analysis (ABA) for Autism)
  • helps understanding of cause and effect
  • guides children to be less passive
  • helps express feelings
  • teaches how to make decisions
  • shows how to use the imagination
  • helps to increase eye contact
  • enables children to seek out others to share with
  • helps children to stop using tantrums to communicate
  • guides children to be less passive
  • teaches awareness of others
  • models how to show interest in what others are doing
  • teaches how to ask for help
  • guides children to be more flexible to change

While play therapy treats a wide range of emotional and behavioral problems, Dr. Stanley I. Greenspan, creator of the Floortime Approach, also feels it physically restructures the brain, helps improve neuronal connections, and paves the way for the central nervous system to mature. When given critical developmental experiences during therapeutic play, autistic children can experience intellectual and emotional growth in both right and left brain functions, enabling them to master new capabilities.

How to Make Play Therapy Techniques More Effective

During play therapy, both verbal and nonverbal autistic children use play to communicate. Its structure, positive approach, empathy, and high regard for the child’s interests and feelings offer a means for learning, problem solving, insight, and a way to embrace new coping skills and eventually self-mastery. Therapy play techniques also allow children to experience change, and to resolve inner conflicts and emotional difficulties in a safe, comfortable, playroom environment.

While therapeutic programs seek to improve communication and social skills, this type of autism treatment does not focus on getting a child to talk. The goal is to create and build a relationship, where both individuals become emotionally attached. What a child plays with is not as important as the attitude, actions, and emotional involvement of the parents.

For play therapy activities to be effective, parents must find time to “be” with their child. Not just in body, but in mind, spirit, and focus. That means every day. However, a lengthy activity is not necessary. A short 15- or 20-minute session, or even less (depending on the child’s attention span or desire to interact), can begin the construction of a relationship between parent and child – a special time the child will look forward to and want to participate in.

In essence, to improve a child’s behavior permanently, parents must do what a play therapist does, and zero in on what the child is doing and feeling at that moment. Through verbally acknowledging what the child is doing or feeling, complimenting him when appropriate, and showing enthusiasm and excitement along with the complement, parents can help their child learn how to gain control over his behavior and life.

  • References
    • 1. Booth, Phyllis B., Ann M. Jernberg, and Ann M. Jernberg. Theraplay: Helping Parents and Children Build Better Relationships through Attachment-based Play. San Francisco: Jossey-Bass, 2010. Print.
    • 2. Bratton, Sue C., Dee Ray, Tammy Rhine, and Leslie Jones. “The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes.” Professional Psychology: Research and Practice36.4 (2005): 376-90. Web. 13 Sept. 2011.
    • 3. Drewes, Athena A., Sue C. Bratton, and Charles E. Schaefer. Integrative Play Therapy. Hoboken, NJ: John Wiley & Sons, 2011. Print.
    • 4. Greenspan, Stanley I., Serena Wieder, and Robin Simons. The Child with Special Needs: Encouraging Intellectual and Emotional Growth. Reading, MA: Addison-Wesley, 1998. Print.
    • 5. Landreth, Garry L. Play Therapy Interventions with Children’s Problems: Case Studies with DSM-IV-TR Diagnoses. Lanham, MD: Jason Aronson/Rowman & Littlefield, 2010. Print.

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