Teaching Functional Play to Students with Autism

HI Everyone!  I am finally back with a new post!  September has been a crazy busy month with the start of school and it has been made even crazier with the EAs in our board on work to rule.  With the WTR campaign, I have had to do all prep for my classroom on my own and haven't had any time for blogging!  But, today is my day to post for the We Teach SPED group and I've got a great post of teaching play for you!

The Importance of Play

Play skills can sometimes be seen as unimportant, or delegated to the bottom of the list of important skills to teach to students with Autism or other developmental disabilities in school settings.  Play skills affect a variety of learning situations, and a child who cannot play appropriately will have a very hard time making social connections. This is because for children, much of their communication and interaction occurs through play. Small children don’t introduce themselves, shake hands, exchange business cards, and begin to debate the state of the economy. A child walks up to another child, says “Wanna play?”, and a friendship is born. If your students lack appropriate play skills they will be at a social disadvantage, as well as have difficulty with basic concepts such as: sharing/negotiation, conflict resolution, turn taking/reciprocity, manners/rules, etc. Small children often learn these basic concepts through the intricate complexities of play.

The Floor Time Model

When students first enter my classroom, I take two weeks to complete assessments on them.  This includes assessing their play skills.  For most of my students, especially my Kinders, they have severe limitations and deficits in their ability to play.  And because is so closely linked to social and communication skills for children, my students always have goals related to play skills on their IEPs.  In my classroom, we use a few different methods to teach and expand my student's play skills, including Greenspan's Floor Time Model.

Floor Time is child directed and adult supported. It provides an opportunity to transform perseverative play into more meaningful and developmentally beneficial behavior, and works to expand the play themes of children with autism spectrum disorders. At the same time, it is designed to help the child develop relationships with others. Floor Time involves five steps:

1. The adult observes the child playing in order to determine how to approach him/her.
2. The adult approaches the child and joins the activity while trying to match the child’s emotional tone.
3. The child directs the action and the adult follows the child’s lead.
4. The adult expands on the child’s chosen play theme without being intrusive.
5. When a child builds on the adult’s input, the child “closes the circle of communication” and starts a new circle.

It is crucial that the adult does not use Floor Time as a time to teach a particular skill. It is also important to remember that the child is the leader of the activity.

Floor Time can be used to change perseverative behavior. For example, if a child is fixated on lining up blocks, the adult joins in and adds blocks to the child’s line. Then the adult may place a block perpendicular and start the line going in a different direction. When the child continues the new line, he/she has “closed the circle of communication.” Some suggestions for Floor Time include inserting obstacles into play and helping the child problem-solve. If a child has very limited play themes, it may be helpful to use sensory toys (e.g., sand tables, shaving cream, bubbles) or use popular characters that the child enjoys to gain attention.  This video is a great example of a Floor Time session.

Where do I Start?

The starting point for teaching play will vary depending on your student's abilities.  For the purposes of this blog post, I am going to focus on teaching early play skills for young students.  For these students, the first step in teaching play is to identify what types of toys they are interested in.  To help determine the types of toys or activities a student might enjoy, we can look at the types of self-stimulating behaviors he engages in and investigate the way he reacts to a variety of sights, sounds, tastes and movements in the environment.  

Many of the first toys and activities chosen to introduce to the child may be considered "stimmy" toys. For example, tops, spinning wheels, gears, or ribbon sticks. In other words, if left alone with the toy, the child may choose to watch it or interact with it over and over in a repetitive way.  It is important not to let the child "play" with the toy in this fashion because self-stimulating behaviors tend to reinforce themselves. We don't want to increase the child's self-stimulating behaviors by allowing them unlimited access to these toys. What we are trying to do is pair the reinforcer (stimmy toy) with talking and interacting with you. These are toys that should be kept up and away in a special place to only be played with when engaged with an adult. It is important that the teacher maintain control over the toy or parts of the toy to keep the child from "stimming" and ignoring the adult. If you find one toy or activity the child is interested in, try to find others that may offer the same or similar sensory stimulation to the child or use it to pair even more varied toys and activities.

Another set of toys or activities to look closely at are those which combine some "cause and effect" with pretend play. For example, a car wash that really squirts water, stoves that make bubbles when you cook or toy sinks that squirt out real water when they're pushed. If the child enjoys the "cause and effect" part of the toy, you can often get the child to respond to you by controlling that part of the toy yourself. For example, if the child wanted to see the bubbles from the stove, he's more likely to request, "cook" if you're holding onto the burner knob.

When playing with your student, try to avoid simply narrating what you see the student doing and instead participate in it. For example, if the student is rolling a train on a track, get another train and pretend to crash into his train or chase his train around the track. If he appears to be repeating the same activity over and over, interrupt him in a playful manner. For example, if the child is running in circles around the room, swoop him up into the air and "fly" him around the room instead.

Be aware that some children become increasingly excited when interacting with some toys, especially "stimmy" toys. If your student appears to become very active and seems to be unable to focus on what you're doing, take a break and do a different type of activity that involves different stimuli. For example, if a child begins jumping up and down and clapping while playing with a top you might ask him to sit then take a break and engage in an activity with a history of calming the child. You have to be careful not to unintentionally reinforce any negative behaviors by reacting to the student's behavior. Use the information but wait to switch to another activity when the student is exhibiting a desirable behavior if the new activity may be preferred over the current one.

Beginning Play

The following teaching techniques have been found to increase students' interest in people and/or toys. Remember the goal at this point is that the child "allows you" to enter his play and you become part of the reinforcement he is getting from the situation.

1. Build anticipation- Repeat the same words or sequence of movements over and over in the same manner then pause.

Ex: Play "Peek -a- Boo". Say, "ahhhhhh Boo!" as you gradually move toward your student and take a blanket off your head. As the student begins to attend to you, you will notice a smile and eye contact as you get closer. The student may begin to laugh as you remove the blanket. When you begin to see this happening, stop, right before you say, "Boo!". The student may fill-in "Boo" or try to take the blanket off your head for you!

2. Do something unexpected- Repeat an activity in the same manner then all of a sudden change the routine.

Ex: If your student is eating a cookie, say, "I'm hungry" and move toward the cookie taking a few pretend nibbles. After he has tolerated this a few times, move toward him and make loud, sloppy eating sounds!

3. Imitate what your student is doing then make a game of it.

Ex: The student is stomping on pinecones while you go for a walk. You take a turn stomping on the pinecones saying, "I found one! Stomp". Then tell him, "Your turn. Stomp" as he stomps on the pinecone. As this "game" progresses, perhaps you could find more pinecones and put them in a circle or another pattern to play the "stomp" game. I am not suggesting imitating stims, instead but turning them into meaningful play.

4. Interrupt the student's "play" by playfully obstructing.

Ex: The student is repeatedly going up and down an indoor slide, crashing into pillows at the bottom. Grab his leg (gently) at the top of the slide and "wiggle" him saying, "Oh, No! I caught you!" You will know whether or not the child finds this "fun" if he's smiling. Wait for the eye contact before saying, "Let go?" in a questioning manner then letting the student go down the slide. Or, if a student is running around in circles then crashing into the couch cushions, place some pillows on the floor and crash into them instead. Make sure you take turns crashing!

5. Pair words/sounds with what the student is doing.

Ex: As the student is drawing by himself, say "draw, draw, draw" or "around, around, around and stop", or "up and down, up and down." (Whatever describes what the student is doing.) Use the type of voice (i.e. sing-song, quiet, exaggerated) the student typically enjoys. Just the pairing of these words or sounds with reinforcement make it more likely that the student will use the words/sounds later. (automatic reinforcement)

6. Do something unexpected.

Ex: If the student is repeatedly scooping shovels full of sand or rice and watching it flow into a pail, pretend to eat it! Or bring a favorite character (i.e. Elmo? Barney?) over to the play to "eat".

7. Use exaggerated facial expressions/body movements to make yourself "stand out".

EX: Open your eyes wide, fall down with a big "boom!", cry with your mouth wide open and your hands rubbing your "tears".

8. Create meaning- Even if you don't think your student said a "real word", listen to the sounds he's making and act is if they have meaning.

Ex: While drawing, the student is babbling and says something that sounds like "sun". Quickly pick up a marker and draw a sun as if the student asked you to draw it. (A history of reinforcement creates "meaning".)

9. Introduce other "characters" into the play.

Ex: The student enjoys having you bounce him on a ball. Bring in other toys and let them bounce on the ball. If the student starts pushing these characters off the ball say, "Go away, Elmo" as the student pushes the characters away.

Most of these techniques are what parents naturally do with their infants and toddlers, but adults seem to forget about these when working with students in the classroom.  These techniques are very effective and I have used them in my classroom for years and have seen students who were initially very withdrawn and isolated in their own worlds become more social and develop more communication and language skills, not to mention expanding their play interests and abilities.

Have you used the Floor Time Model in your classroom?  What results have you seen?  I'd love to hear from you!  I also hope you will drop by on October 19th to read the second post in this series on Structured Play.

Until then,