From play to talk: symbolic play a cusp in early development of social communication skills

Deficits in communication skills, both verbal and nonverbal, are central in Autism Spectrum Disorder (ASD) and Social (Pragmatic) Communication Disorder (SCD). Treatment goals focused on the acquisition of functional communication skills are among the most prevalent targets for instruction in education plans for persons with developmental disabilities (Sigafoos, 1997). This thesis explores the importance of teaching symbolic play skills in early interventions and its role in developing early social communication skills in young children with developmental disabilities, with a focus on children with ASD. This thesis comprises: (i) two parallel systematic reviews on measures used by authors since 2000 for assessing early social communication and for assessing symbolic play, (ii) a report of an intensive one-on-one daily targeted symbolic play intervention for a three-year-old child diagnosed with Pervasive Developmental Disorder- Not Otherwise Specified (PDD-NOS), and (iii) a report of a developmental trajectory study involving both children with ASD (n=4) and neurotypical children (n=4), tracking their play and language development over three time-points across a six-month period. The two systematic literature reviews on measures revealed a total of 46 different measures being employed for assessing early social communication and 26 measures for symbolic play. Of these measures, eight were reported in both reviews. Psychometric properties of the top ten most frequently cited measures on both lists were listed. Implications of the results were discussed. The author put forward the proposition that symbolic play and early social communication are closely linked in early childhood development, such that teaching symbolic play can lead to improvements in early social communication and potentially result in collateral gains in language. Supporting evidence for this hypothesis was presented. A single participant behavioural paradigm was employed to present findings on a targeted symbolic play intervention. Teaching and learning processes are explicated from this experiment. The child made gains in her play skills, becoming a more active player and was able to display more pretend play and more combinations of toys. Even though language skills were not explicitly targeted, the child made gains in language skills, especially in her expressive communication, as assessed by Preschool Language Scale, Fifth Edition (Zimmerman, Steiner, & Pond, 2011). From the developmental trajectory study, the neurotypical group of children made better progress compared to the group of children with ASD, both in their language and in their play skills. The group of children with ASD had a greater percentage of indiscriminate play actions. Indiscriminate play actions are non-specific and non-targeted interactions with the toys or materials presented such as mouthing, sniffing and rubbing the toys against the skin, dropping or throwing the toys off the play table or floor play area. The findings provide validity support for the selected measures used in this study. The child who received targeted symbolic play intervention made significant gains in her play skills, including self pretend play and making many different toy combinations. She also made gains in her expressive communication skills even though these skills were not directly targeted. Overall, this study has provided supporting evidence that targeted symbolic play may be a cusp to developing social communication skills, with collateral gains in language skills. Going beyond using play as a backdrop to teaching various skills, the author argued that symbolic play targets are worthy early intervention goals by themselves.