How is Play Therapy Used to Treat Autism?

Don’t underestimate the power of play.

Even goofing off and horsing around can have serious therapeutic benefits for kids on the autism spectrum. Add some structure and rules in a more formal game and you have a powerful tool for developing and refining everything from motor skills and coordination to communication, listening and social skills.

Play is all about interacting with others in a cooperative and competitive way, communicating needs and wants, strategizing, interpreting the intentions of others, and taking turns… Kind of sounds like the perfect practice for a kid struggling to develop these skills, doesn’t it? Well, that’s the whole concept behind play therapy.

And the beauty of play therapy is that it doesn’t always need to be guided by a professional therapist. With a little coaching, parents, siblings, friends and caregivers can all work to bring out the therapeutic benefits of play at home and on the playground.

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What is the Difference Between Directive and Non-Directive Play Therapy?

Non-directive play therapy is the more unstructured type of play. This is where children are left to guide themselves with fewer boundaries and are left to work through problems on their own.

Directive play therapy is just the opposite. It is a more guided approach, where a parent or therapist engages the child more often and directly and might make suggestions or try to move the session along.

Floor time and other play therapy styles used with children with ASD often use both non-directive and directive approaches. Sessions often begin with little or no direction, allowing the child to pick the initial activity. As the session moves along a therapist or parent might prompt or nudge the child to choose a new toy or to make a request or communicate in some way, making the session more directive in nature.

Play therapy is focused on the individual needs of the child and each session is designed to fit those needs. Approaches are adjusted from session to session and from child to child.

What’s the Purpose of Floor Time Sessions?

Floor time sessions – one approach to play therapy – sometimes involve the child, therapist, and parents all working – that is, playing – together.

There are six key goals floor time sessions are designed to achieve:

  • The child shows they understand the mechanics of the toy or game, i.e. they will want to roll the ball instead of putting it in their mouth
  • The child actively engages the therapist and/or parent(s)
  • Some kind of two-way communication is achieved
  • The child becomes aware of their own wants and needs within the game play
  • The child makes gestures to communicate these wants and needs, which may be as simple as pointing to a toy
  • The child calms themselves if they get upset

These goals are achieved in a number of ways throughout the session. First, the child gets to lead the play session. Parents and the therapist get on the floor and play with toys and games that the child chooses, many of which may come from the home or be things that the parents or therapist know the child already enjoys. These items may have been placed out at the beginning of the session for the child to choose from.

Bubble blowing is a popular place to start. Children also love toys that move, light up, vibrate or make sounds—think Transformers or Bop It! Anything that is actively engaging and does something is always a positive.

As the session continues, the therapist or parents will give the child new toys or activities, perhaps swapping out or adding toys that make the play more complex and dynamic. For example, a shape matching box might be introduced where the child would put blocks of various shapes into the corresponding holes, when before the child was only playing with the different shaped blocks. This additional level of challenge simply adds to the complexity of the skill the child was already engaging in.

According to a study conducted in the American Journal of Orthopsychiatry, this method of play therapy has a success rate of 58% when using the six goals named above as a metric for success.

Can I Do Play Therapy At Home?

As a parent, you play an important role in your child’s play therapy. Not only will you be an active participant in play therapy sessions, but many parents choose to undertake play therapy on their own living room carpets!

Many play therapists are willing and able to work with parents on teaching play therapy techniques that are easy to use in the home. There are also many video and book programs out there to help parents with home play therapy options.

The most important things to remember when engaging your child in play therapy at home are to…

  • Always stay engrossed in what your child is doing
  • Make sure to comment on what they are doing, even if they don’t continue the conversation
  • Try to mirror and imitate your child as a way to help them feel more comfortable and secure in their play
  • Add simple, small actions. If you are playing with toy cars and your child is driving their car around, consider adding a sound effect with yours!
  • Remember, it’s all about baby steps! Don’t try to push them too far and always meet them at their current level.

Play therapy can be a wonderful opportunity to interact with your child and build on your relationship, as well as for your child to continue to develop invaluable social skills.

Where Can I Find a Qualified Play Therapist?

It’s important to note that there are certification programs out there for play therapy but none of them are officially recognized by any of the national therapeutic associations. That does not mean that certified play therapists aren’t well-qualified. Many are highly qualified ABA professionals, with much experience and training. Just don’t put a lot of stock in any credentials specific to play therapy.

The BACB’s (Behavior Analyst Certification Board) BCBA (Board Certified Behavior Analyst) credential remains the best recognized designation in the world of autism behavioral therapy. In fact, most state autism insurance mandate laws require providers to hold the credential in order for the services they offer to be eligible for reimbursement.