Understanding Play Therapy as an Intervention for Autistic Children

Play therapy

Young children use play as a means of learning. As they play, they build both their social and physical skills to try on different characters and personalities (Hillman, 2018). however, research evidence (Phytanza and Burhaein 2019) show that autistic children typically play differently: they are likely to play alone or adopt repetitive play habits, all with no goal in mind. When they are left to play alone, they tend to be stuck and unable to explore their interests or abilities (Stutey, et al 2018). as a remedy, play therapy has been used as a tool to help autistic children fully explore their interests and abilities. When used under the right circumstances, it facilitates parents or adults to fully relate with autistic children.

Kottman & Meany-Walen (2018) define play therapy as a psychotherapy tool that is used in helping people with mental illness, anxiety, and trauma to cope with their conditions. In that regard, play, therefore, becomes a way for children to find the coping mechanism and express their feelings. There are several theoretical reasons why any child with autism would need the help of a play therapist. For instance, according to Blanco et al (2017), autism is a communication disorder, where, for example, instead of using a doll like a baby, they may intensely focus on the object and use it for self-stimulation, this becoming fully absorbed in it. In this scenario, a play therapist would help the child to move beyond this self-absorption into a shared and real interaction with others (El-Nagger et al, 2017). when properly implemented, play therapy can facilitate the autistic child to explore their environment, feelings, and relationships with peers, siblings or parents. Furthermore, as per Stutey et al (2017), adults can use play therapy to build stronger and more meaningful relationships with their autistic children. However, explored in the next few paragraphs, play therapy is a process that involves various aspects of the child’s experiences and environment.

With the right opportunity, children would reveal their needs and feelings in an expressive fashion like that of adults. Even though the dynamics of expression and mode of communication in children differ from that of adults (Schaefer, 2017), their expressions (as in satisfaction, fear, anger, frustration, and happiness) are similar to that of adults (Shen 2017). autistic children may have significant difficulties in expressing what they feel or how they have been affected by their experiences. However, if permitted, in the presence of a sensitive, empathetic and caring adult, they may reveal these feelings through toys and other objects they choose, what they do to and with the objects. As such, according to Badamian & Ebrahimi (2017), the play therapy process acts as a relationship between the child and the therapist. The child uses the therapy to explore their personal world as well as to safely engage with the therapist.

According to HosseinKhanzadeh (2017), play therapy effectively provides an opportunity for the child to live out during their play experiences and any other associated feelings. This process enables the therapist to personally and interactively experience the various dimensions of the child’s world (Ritzi et al, 2017). Consequently, according to Bilqis (2021), a therapeutic environment develops to facilitate healing and growth for the child.

Because the child operates in a world of activity and actions, play therapy presents an opportunity for the therapist to explore the child’s world. According to Heller & Taglialatela (2018), it creates an environment where the child has no limitations as to discussing what happened; rather, the child lies past the experience and any of its associated feelings (Senko & Bethany, 2019). If the reason for the child being referred to a play therapist is anti-social behaviour due to stress and anxiety, the therapist finds an opportunity to experience this behaviour firsthand as the child experiences the stress and anxiety. Without the presence of play materials, the therapist could only talk to the child about the anti-social behaviour exhibited by the child a few days ago; rather than now. Thus, whatever the reason for a child’s referral to a play therapist, the therapist finds an opportunity to actively experience and immediately deal with the problem (El-Nagger et al, 2017). This problem is one that allows the child to reveal their negative feelings, face them and learn how to abandon or control them.

One of the most common play therapy techniques that can be used to achieve this is floor time play therapy. According to Kottman & Meany-Walen (2018), floortime play therapy is a technique whereby the therapist or teacher plays on the floor with the child and does so on the child’s own terms. So, the teacher joins the child and plays the same game with them while adding a few items to the game. According to HosseinKhanzadeh (2017), the additions might be in the form of a second toy or some words to introduce language into the game.

The objective is to create a back-and-forth engagement with the child to encourage communication and add more aspects of communication into the game. This can facilitate emotional growth and more focused thinking among the children. Studies have also proven that children who have had floor time play therapy for at least 25 hours per week for over 24 months can improve in all developmental areas. However, critics of play therapy claim that for such results to be achieved, the therapist or teacher must have an in-depth understanding of the child, their history and personality (Phytanza and Burhaein 2019). Furthermore, HosseinKhanzadeh (2017) claimed that the process of floor time play therapy may become drawn-out. Similarly, it might be difficult to find the right therapist for the child.

Autistic children can benefit from play therapy when applied in different settings: even when they are mixed with non-autistic children. Through a play therapy technique known as integrated playgroups (IPG), therapists combine autistic with non-autistic children to play together while following their peers. In IPGs, adults set the tone of the game and ultimately leaves the children to take over. As per Kottman & Meany-Walen (2018), children who play in IPG tend to play more and thus have more chances of improving their social skills while interacting with peers. But Senko & Bethany, (2019) noted that for IPGs to be effective, they need to run for up to three hours per week. In this regard, existing research has shown that autistic children who participate in 30-minute IPG sessions per week for four consecutive months tend to develop the improved quality of play by using the toys in a more useful fashion and develop improved social interaction with their peers. However, PIGs have also been criticised for several limitations. For instance, HosseinKhanzadeh (2017) strongly argued that as a play therapy technique, PIG may not work for every child as there are mixed pieces of evidence on its effectiveness. Moreover, just like floor time play therapy, PIGs may turn out to be lengthy and drawn-out (El-Nagger et al, 2017).

Reflection

In this part of the essay, I reflect on how the module has changed my view of autistic children and how it has developed my practice to become a better teacher in future. My experience the module began when I questioned my abilities to work with and support autistic children. Despite having some prior teaching experience with my siblings, I found myself doubting my abilities to support autistic children in a mainstream class. As such, I realised that I could only succeed if I became proactive and intentional with every aspect of my practice.

As an educator, one of the most challenging tasks I had was to deal with was to constantly reflect on my skill and knowledge. However, this allowed me to acknowledge that I needed to support all the students in my class, including autistic ones. Consequently, I managed to swallow my pride and develop the necessary professional skills required to improve the educational outcome for both autistic and non-autistic students. One of the most important lessons I have learned from this module is the importance of asking for help. Throughout the module, I consulted with experienced colleagues to seek help and benefit from their experience in autism. Nonetheless, through research and experience from practically dealing with t students, I have witnessed the benefits that practical training and education on autism spectrum disorder can have for educational professionals, parents, and ultimately, autistic students. By engaging with other professionals on the challenges I encountered, I managed to improve my practice.

The module has also helped me change my approach to handling autistic students. Against this backdrop, I wonder if we, as educators, ever stop to simply ask the parents “how is everything taking you”, “are you finding it challenging to support your child with education or at home?” “How can I help you support your child?” asking parents these simple questions can be useful in developing a collaborative working relationship between educators and parents of autistic children. An area that I consider to be significantly important is to work with the parents to develop a fully collaborative relationship that fosters their children’s education. Furthermore, I have learned that it is vital to create a consistent message between parents and educators on the common goals while maintaining a significant level of openness and trust. Once such an environment is in place, autistic children can access the curriculum.

I have also learned that as an educator, I can only be of great value to autistic pupils if I allow them to express their worries and fears, as well as what triggers their anxieties. Even though autistic pupils have significant communication challenges, this does not mean that they cannot communicate. A typical example where an autistic child can feel isolated is when they disrupt a quiet class by shouting out; or interrupt while somebody else is speaking or reading. Such an occurrence might not be as a result of negative behaviour but as a result of the child’s peaking anxiety. By giving the child an opportunity to express themselves (through techniques such a splay therapy), it is easier to identify the peaking anxiety and address it early enough. In future, the key for me as an educator and advocate for children autistic children is to identify and piece together the various events that led to the child’s problematic event through various theoretical tools such as the A-B-C (antecedent, behaviour, consequences) model.

References

Badamian, R. and Ebrahimi Moghaddam, N., 2017. The effectiveness of cognitive-behavioral play therapy on flexibility in aggressive children. Journal of Fundamentals of Mental Health, 19(special issue), pp.133-138.

Bilqis, F., 2021. Does Adlerian Play Therapy Increase Social, Physical, and Task Appeal More Than Content Mastery Services in Elementary School Students?. Child Education Journal, 3(1), pp.1-18.

Blanco, P.J., Holliman, R.P., Muro, J.H., Toland, S. and Farnam, J.L., 2017. Long term Child-Centered Play Therapy effects on academic achievement with normal functioning children. Journal of Child and Family Studies, 26(7), pp.1915-1922.

Cochran, J.L. and Cochran, N.H., 2017. Effects of child-centered play therapy for students with highly-disruptive behavior in high-poverty schools. International Journal of Play Therapy, 26(2), p.59.

El-Nagger, N.S., Abo-Elmagd, M.H. and Ahmed, H.I., 2017. Effect of applying play therapy on children with attention deficit hyperactivity disorder. J Nurs Educ Pract, 7(5), p.104.

Heller, C. and Taglialatela, L.A., 2018. Circus Arts Therapy® fitness and play therapy program shows positive clinical results. International Journal of Play Therapy, 27(2), p.69.

Hillman, H., 2018. Child-centered play therapy as an intervention for children with autism: A literature review. International Journal of Play Therapy, 27(4), p.198.

HosseinKhanzadeh, A.A., 2017. The effect of child-centered play therapy on the self-efficacy in peer relations among students with oppositional defiant disorder symptoms. Quarterly Journal of Child Mental Health, 4(3), pp.49-59.

Kottman, T. and Meany-Walen, K.K., 2018. Doing play therapy: From building the relationship to facilitating change. Guilford Publications.

Phytanza, D.T.P. and Burhaein, E., 2019. Aquatic activities as play therapy children autism spectrum disorder. International Journal of Disabilities Sports and Health Sciences, 2(2), pp.64-71.

Ritzi, R.M., Ray, D.C. and Schumann, B.R., 2017. Intensive short-term child-centered play therapy and externalizing behaviors in children. International Journal of Play Therapy, 26(1), p.33.

Schaefer, C.E., 2017. Play therapy. In Children's Play (pp. 109-122). Routledge.

Senko, K. and Bethany, H., 2019. Play therapy: an Illustrative case. Innovations in clinical neuroscience, 16(5-6), p.38.

Shen, Y.J., 2017. Play therapy with adolescents in schools: Counselors’ firsthand experiences. International Journal of Play Therapy, 26(2), p.84.

Stutey, D.M. and Wubbolding, R.E., 2018. Reality play therapy: A case example. International Journal of Play Therapy, 27(1), p.1.

Stutey, D.M., Dunn, M., Shelnut, J. and Ryan, J.B., 2017. Impact of Adlerian play therapy on externalizing behaviors of at-risk preschoolers. International Journal of Play Therapy, 26(4), p.196.

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