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Why Do Children with Autism NotPretend Play?According to the American Psychological Association(APA), Autism is the most severe developmentaldisability. It appears within the first three years of life and comprises ofdeficiencies in social interaction forinstance, being conscious of the feelings of other’s.
It also includesimpairments in verbal and nonverbal communication (“Autism andAutism Spectrum Disorders”, n.d.). Also, according to the National HealthService, it is estimated that around 1 in every 100 people in the UnitedKingdom has Autism spectrum disorder(ASD) and it is known that less girls are diagnosed compared to boys(“Autism spectrum disorder (ASD)”, n.d.). As stated by Hess (2006),children with autism have deficient play abilities, especially when playinvolves pretence which in turn, significantly affects their process indeveloping social skills.
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Their pretend play is missing substitution of objectsfor real objects. As stated by Weisberg (2015), pretend play is a method of playfulbehaviour that implicates action that is nonliteral. While from the outside,this act seems to be only for enjoyment, research has recently uncovered thatpretend play in children links to crucial social and cognitive skills (e.g.theory of mind).
It is debated why autistic children tend not to displaypretend play. Some suggest it is due to impaired language development where assome argue it is due to a lack of theory of mind. Gould (1986) acknowledged that pretend play, whichdevelops in the ordinary infant during their second year of life, is commonlysaid to be closely connected with the development of language. It was confirmedin a longitudinal study by Shimada, Sano, and Peng (1979) that there is anassociation between pretend play and language development. They examined thedevelopment of play in four two-year-old Japanese infants from the period of 12to 21 months of age, finding a suggested positive relationship between play andlanguage development. According to National Institute on Deafness and Otherwith Communication Disorders (NIDCD), children with ASD may have difficulty inlanguage development (“Autism Spectrum Disorder: Communication Problems inChildren”, 2016) thus, as language development and pretend play areconnected (as suggested by Gould, 1986), this may explain why children withautism rarely play pretend. Gould’s (1986) findings support this explanation.She used the Symbolic Play Test to study language development.
This is apopular test that helps recognise the primary skills essential for thedevelopment of language. This is done through observing the child as they playwith tiny objects in a range of scenarios. In doing this test, it specifies aclear image of a child’s early perception construction and symbolisation. Theseare skills that lead and progress beside language (“Symbolic PlayTest”, n.d.). She gave 31 socially deficient and 29 sociable children wholacked language understanding who were in the same age range (five years uptill twelve years) and intelligence. It was found that in the sociablechildren, spontaneous pretend play and their play test age were at the samenormal level that was expected for their intelligence level thus, correlatedhowever, those socially impaired had pretend play that was lower than whattheir play test age would foretell.
To further back up this theory of languagedevelopment and pretend play in autistic children having a link, those sociallyimpaired with a normal play age showed no substantial dissimilarity in languagecomprehension age. For example, when doll-related pretend play is expected,half of the socially impaired children with a play age above 20 months, had nospontaneous imaginative play at all (Gould 1986). This suggests that there isindeed a link between pretend play and autistic children’s slower languagedevelopment.
However, there are limitations to this supporting evidence.Numerous studies that look into pretend play in autism have utilised poordescriptions of what ‘pretend’ is. For instance, Gould (1986) uses the Lowe& Costello (1976) definition of pretend which states that pretend behaviourcomprises of behaviours as doing one’s own makeup or a doll’s nails, or sippingempty tea cup (Baron-Cohen, 1987).
The downside to this definition is thatthere is nothing essentially ‘pretend’ about them as it assumes that play withtoys that are miniature is certainly pretend as they are just smaller versionsof real world objects however, this postulation might not be consistent as forthe child, the tiny object may be seen as merely a tiny object but an objectthat is real and exists. Subsequently, this study by Gould (1986) maymiscalculate the occurrence of pretend play due to the utilisation ofinadequate conditions and definitions. However, further provide supporting evidence forthis theory, Wing & Gould (1979) discovered that many children who weresocially impaired with comprehension of speech well above the level at whichimaginative play would be expected, had little or no spontaneous pretend play.
Perhaps this is why children with autism don’t pretend play due to their slowerlanguage development, as a certain standard of language and cognition isrequired to play pretend. Further findings support this theory for instance,further evidence from Hill and Nicolich (1981) in which they examined therelationship between cognitive functioning of Down’s syndrome subjects andtheir play. Each participant was observed during a one hour play period.
Following this, they were measured by the Bayley Scales of Infant Development(which measures the developmental performance of children (Hack, 2005))and behaviour record. It was found that play levels were more correlated with mentalage versus actual age. Therefore, providing additional support for the linkbetween hindered language development and pretend play as it shows evidencethat a lower mental age (hindered cognitive development) positively correlateswith lower play levels. Moreover, the finding that mental age is more relatedto play levels rather than their actual age shows support for the theory thatpretend play is an accurate representation of cognitive development. Despite this evidence, others argue that childrenwith autism do not pretend play due to other reasons.
Some argue it is due toautistic children lacking a ‘theory of mind’. As stated by Goldman (n.d.),’theory of mind’ indicates the cognitive capability to attribute mental statesto self and others. There is a suggested link between autism and theory of mindin that, they lack the ability to perceive and attribute the mental states oftheir own and others’. Baron-Cohen, Leslie & Frith (1985), studiedcognitive deficiency and suggested that they could explain a fundamentalelement of the social impairment in childhood autism. One of the displays of abasic metarepresentational capability is a ‘theory of mind’.
If an autisticchild lacked theory of mind, they wouldn’t be able to attribute beliefs toothers and to thus, foresee their behaviour. This explains their lack of socialskills. There is evidence that proposes that autistic children lack such a’theory of mind’, such as when Cohen, Leslie & Frith (1985) tested whetherautistic children lack a ‘theory of mind’ using a puppet play. They used normalchildren and individuals with Down’s syndrome as controls for a set of childrenwho were autistic. While the mental age of the autistic children was greaterthan the controls’, they in fact failed to attribute beliefs to others.Therefore, suggesting that those who are autistic, lack a ‘theory of mind’.Because of this evidence, some argue that due to this their lack of, this iswhy they don’t tend to pretend play.
A commonly used test to measurea theory of mind is a false-belief task. As defined by Bauminger-Zviely (2013)A false-belief task is based on understanding of false beliefs. This is theunderstanding that an individual’s belief may differ with actuality. Hughes& Dunn (1997) state that children with autism show noticeable delay intheir awareness of mental states (i.e. theory of mind) and their pretend play.Evidence such as this propose that the deficiency of pretend play and theory ofmind frequently observed in children with autism may be more meticulously tiedto the particular field of “theory of mind” than to general cognitive factorssuch as language development.
Oswald and Ollendick (1989) deployed a deceptiongame called the ‘penny-hiding game’ with individuals with autism and found animpaired capability for deception which connected with scores on a false belief(or theory of mind) test. Evidently, this study doesn’t involve pretend playexplicitly thus, it isn’t concrete support for this theory however, pretendplay does have an element of deception when it comes to autism as they do nothave the capacity to play ‘pretend’. If they played pretend with an adult, itwould almost be deception for the autistic child as they are more likely tobelieve that what is happening is actually real, that it isn’t pretend thus,being deceived. Baron-Cohen (1985) conducted an experiment that involved apuppet condition that involved attribution of a false belief and a mental performance task with autistic and non-autisticchildren. If these tasks are measuring their theory of mind thus, there shouldbe constant results in these two tasks.
Most of the autistic children failedconsistently on both tasks therefore, further suggesting that because autisticchildren have a poor theory of mind, this is why they do not pretend play.However, some autistic children performed inconsistently (i.e. performed wellon one task but not on the other) thus, lowering the validity of this studyfurthermore, reducing its credibility as support for this theory. In conclusion, there are multiple studies thatprovide explanations as to why autistic children do not pretend play.
However,none of these findings show a direct causal link therefore, we cannot know forsure why this is. Jarrold (2003) recommends that future research may thereforeneed to focus less on the child’s mental state, when they are pretending, or onthe actions that they produce to enact pretend scenarios, and instead return tothe question of why they bother engaging in this unusual behaviour in the firstplace. Jarrold (2003) suggests that nevertheless, practically, estimatingwhether an individual is truly pretending is remarkably difficult thus, pretendplay only gives us subsidiary indications as to what children might bepretending if, in fact they are. In fact, Jarrold (2003) also argues thatindividuals with autism may have an unbroken fundamental capability to pretend,though some reason aren’t able to transform this into action. Therefore, theymay be able to pretend play, but there are underlying deficits that preventthem from doing so.