How Could Play Therapy Support My Child on the Autism Spectrum?
What is Play Therapy?
Play therapy is a developmentally appropriate and safe way for children to express experiences they may not be able to verbalize. Play therapy can be directive, meaning that the therapist provides a prompt to the child or engages them in a particular activity or game, or nondirective, meaning that the child chooses what they would like to engage with in the playroom while the therapist provides observations about the child’s play and undivided attention in the safe space.
What is Autism Spectrum Disorder?
Autism spectrum disorder is a group of neurodevelopmental disorders characterized by altered communication, difficulties in social interactions and in understanding relationships, restricted and repetitive interests, cognitive inflexibility and strict adherence to routines, and differences in reactivity to sensory input.
Research Support of Play Therapy for ASD
Studies have demonstrated that play based therapy is related to increases in attention, environment exploration, language, social interaction, and regulation (Lopez-Nieto et al, 2022). In addition, Schottelkorb and researchers found that children who participated in child centered play therapy demonstrated decreased symptoms of ASD including externalizing and aggression (2020).
Congruence of Play Therapy with ASD
Each child with Autism is wildly different from another child with Autism, and their challenges may vary greatly. Play therapy is a good fit for children on the Spectrum because of its uniquely tailored and child-led approach. Gary Landreth, the founder and director of the Center for Play Therapy, identified 10 tenets of play therapy, all of which are relevant to the Autistic population, but several are especially applicable to why play therapy in particular is a beneficial resource for children on the spectrum.
Tenets five and six speak to the innate tendency for children to grow and to positively self-direct when they have the environment to do so. In other words, a child has natural insight to determine the direction they would like to grow in and given support and resourcing, will heal their struggles without interference from an adult. Children on the Autism spectrum are no different; they have innate knowledge and wisdom of how they would like to grow and given the opportunity, support, and safety provided in play therapy, can learn and adapt the same way a neurotypical child can. Providers can ensure that Autistic individuals can experience safety through accommodations and extra support. In the play space, building the safety for change could look like sensory related items, such as a weighted blanket or stuffed animal and low lighting to decrease stimulation.
Tenet eight speaks to the child’s right to remain silent in play therapy. The nature of play therapy allows for many methods of communication aside from strictly verbal. All clients can communicate indirectly through play, art, and body language. This aspect of play therapy is especially relevant for folks on the spectrum that may be nonverbal and/or communicate in ways other than verbal communication, such as through AAC.
Finally, tenet ten defines that a child’s growth cannot be sped up. As a play therapist, I always try to meet my clients where they are at in their growing process. I accept them as they are. As Carl Rogers said, “The curious paradox is that when I accept myself just as I am, then I can change.” Play therapy creates a safe environment where the client is accepted just as they are by the therapist, showing and allowing the child to accept themself. A child on the spectrum may have been previously subject to the expectation of the world, their family, even the expectations they have for themselves to fit in with other children. This belief that something is “wrong” with them carries heavy shame and pain that may even be contributing to the difficulties and behaviors they engage in at home or school. The therapeutic space is sacred in the way that a child can be just as they are, which is highly important for a child on the spectrum who may struggle to feel that it is okay to be just as they are.
How is Play Therapy Different from ABA?
A common modality used with Autistic folks is Applied Behavioral Analysis (ABA). ABA seeks to increase or decrease certain behaviors that children on the Autism spectrum frequently struggle with or engage in. ABA is a behavioral therapy, meaning that it focuses on reinforcing behaviors that a caregiver or behavioral technician wants a child to engage in more frequently and punishing behaviors that are unwanted. ABA is a controversial therapy and has been identified by many Autistic folks as traumatic, and research by Kupferstein demonstrated that Autistic individuals who had been exposed to ABA therapy as children later experienced Post-Traumatic Stress symptoms as adults, with longer exposure predicting more severe post-traumatic stress symptoms (2018).
Different from ABA, Play therapy prioritizes the relationship between the child and the therapist, and supports that change is made through relationships not behavioral strategies. By understanding and tending to the emotions and motivations underneath behaviors that a child is struggling with, the child will stop feeling the need to engage in the unwanted behaviors.