There are well-documented play deficits in autism beginning with infant object and social play. To create effective interventions, the predictors of play deficits in autism must be established. Individuals with autism spectrum disorder (ASD) frequently report sensory processing difficulties including poor praxis; however, these are potential predictors of play that have not been well studied. Using a data set of 162 individuals with ASD, this study examined the direct and indirect relationships between sensory processing and social play performance via structural equation modeling. The best fitting model suggested that sensory system functions predict praxis and play in combination, providing preliminary evidence that sensory functions are related to social play in combination with praxis in children with ASD. The findings suggest future avenues for research.
American Occupational Therapy Association. (2008a). AOTA's societal statement on play. American Journal of Occupational Therapy, 62, 707–708.
2.
American Occupational Therapy Association. (2008b). Occupational therapy practice framework: Domain and process (2nd ed.). American Journal of Occupational Therapy, 62, 625–683.
3.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
4.
AyresA. J. (1979). Sensory integration and the child. Los Angeles, CA: Western Psychological Services.
5.
Ben-SassonA.HenL.FlussR.CermakS. A.Engel-YegerB., & GalE. (2009). A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 1–11.
6.
BlumbergS. J.BramlettM. D.KoganM. D.SchieveL. A.JonesJ. R., & LuM.C. (2013). Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007 to 2011–2012. National Health Statistics Reports, 65, 1–12.
7.
BrownS. (2009). Play: How it shapes the brain, opens the imagination, and invigorates the soul. New York: Penguin Books.
8.
BryneB. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming (2nd ed.). New York: Routledge.
9.
BundyA. C. (1989). A comparison of the play skills of normal boys and boys with sensory integrative dysfunction. The Occupational Therapy Journal of Research, 9, 84–100.
10.
BundyA. C.ShiaS.QiL., & MillerL. J. (2007). How does sensory processing dysfunction affect play?American Journal of Occupational Therapy, 61, 201–208.
11.
CliffordJ. M., & BundyA. C. (1989). Play preference and play performance in normal boys and boys with sensory integrative dysfunction. The Occupational Therapy Journal of Research, 9, 202–217.
12.
CraigJ., & Baron-CohenS. (1999). Creativity and imagination in autism and Asperger's syndrome. Journal of Autism and Developmental Disorders, 29, 319–326.
13.
DichterG. S.LamK. S. L.Turner-BrownL. M.HoltzclawT. N., & BodfishJ. W. (2009). Generativity abilities predict communication deficits but not repetitive behaviors in Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 39, 1298–1304.
14.
DominguezA.ZivianiJ., & RodgerS. (2006). Play behaviours and play object preferences of young children with autistic disorder in a clinical play environment. Autism, 10, 53–69.
15.
DowellL. R.MahoneE. M., & MostofskyS. H. (2009). Associations between postural knowledge and basic motor skill with dyspraxia in autism: Implication for abnormalities in distributed connectivity and motor learning. Neuropsychology, 23, 563–570.
16.
DziukM. A.LarsonGidley J. C.ApostuA.MahoneE. M.DencklaM. B., & MostofskyS. H. (2007). Dyspraxia in autism: Association with motor, social, and communicative deficits. Developmental Medicine and Child Neurology, 49, 734–739.
17.
ElkindD. (2007). The power of play. Cambridge, MA: De Capo Press.
18.
GalleseV.RochatM.CossuG., & SinigagliaC. (2009). Motor cognition and its role in the phylogeny and ontogeny of action understanding. Developmental Psychology, 45, 103–113. doi:10.1037/a0014436.
19.
GaoS.MokhtarianP. L., & JohnstonR. A. (2008). Nonnormality of data in structural equation models. Transportation Research Record, 2082, 116–124. doi:10.3141/2082-14.
20.
GinsburgK. R., American Academy of Pediatrics Committee on Communications, & American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. (2007). The importance of play in promoting healthy child development and maintaining strong parent-child bonds. Pediatrics, 119, 182–191.
21.
HobsonR. P.LeeA., & HobsonJ. A. (2009). Qualities of symbolic play among children with autism: A social developmental perspective. Journal of Autism and Developmental Disorders, 39, 12–22.
22.
HolmesE., & WilloughbyT. (2005). Play behaviour of children with autism spectrum disorders. Journal of Intellectual and Developmental Disability, 30, 156–164.
23.
HolmesR. M., & ProcaccinoJ. K. (2009). Autistic children's play with objects, peers, and adults in a classroom setting. In ClarkC. D. (Ed.), Transactions at play: Play and culture studies (Vol. 9, pp. 86–103). New York: University Press of America.
24.
HoneyE.LeekamS.TurnerM., & McConachieH. (2007). Repetitive behaviour and play in typically developing children and children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 1107–1115.
25.
HooperD.CoughlanJ., & MullenM. (2008). Structural equation modeling: Guidelines for determining model fit. Journal of Business Research Methods, 6, 53–60.
26.
JarroldC. (2003). A review of research into pretend play in autism. Autism, 7, 379–390.
27.
JordanR. (2003). Social play and autistic spectrum disorders: A perspective on theory, implications and educational approaches. Autism, 7, 347–360. doi:10.1177/1362361303007004002.
28.
KlineR. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York: Guilford Press.
29.
LewisV. & BoucherJ. (1988). Spontaneous, instructed and elicited play in relatively able autistic children. British Journal of Developmental Psychology, 6, 325–339.
30.
LewisV., & BoucherJ. (1991). Skill, content and generative strategies in autistic children's drawings. British Journal of Developmental Psychology, 9, 393–416.
31.
LewisV., & BoucherJ. (1995). Generativity in the play of young people with autism. Journal of Autism and Developmental Disorders, 25, 105–121.
32.
MaillouxZ.MulliganS.RoleyS. S.BlancheE.CermakS.ColemanG. G., & LaneC. J. (2011). Verification and clarification of patterns of sensory integrative dysfunction. American Journal of Occupational Therapy, 65, 143–151.
33.
MarcoE. J.HinkleyL. B. N.HillS. S., & NagarajanS. S. (2011). Sensory processing in autism: A review of neurophysiologic findings. Pediatric Research, 69, 48R–54R.
34.
May-BensonT. A., & CermakS. A. (2007). Development of an assessment for ideational praxis. American Journal of Occupational Therapy, 61, 148–153.
35.
Miller-KuhaneckH.EckerC. E.ParhamL. D.HenryD. A., & GlennonT. J. (2010). Sensory processing measure- preschool (SPM-P): Manual. Los Angeles: Western Psychological Services.
36.
MoranL. A.GuyattG. H., & NormanG. R. (2001). Establishing the minimal number of items for a responsive, valid, health-related quality of life instrument. Journal of Clinical Epidemiology, 54, 571–579.
37.
ParhamL. D.EckerC.Miller-KuhaneckH.HenryD. A., & GlennonT. J. (2007). Sensory processing measure manual. Los Angeles: Western Psychological Services.
38.
ParhamL. D., & MaillouxZ. (2010). Sensory integration. In Case-SmithJ. & ObrienJ. C. (Eds.), Occupational therapy for children (6th ed., pp. 325–372). Maryland Heights, MO: Mosby.
39.
PellegriniA. (2009). The role of play in human development. Oxford, England: Oxford University Press.
40.
ReillyM. (1974). Play as exploratory learning. Thousand Oaks, CA: SAGE Publications.
41.
RoeyersH.Van OostP., & BothuyneS. (1998). Immediate imitation and joint attention in young children with autism. Development and Psychopathology, 10, 441–450.
42.
RutherfordM. D., & RogersS. J. (2003). Cognitive underpinnings of pretend play in autism. Journal of Autism and Developmental Disorders, 33, 289–302.
43.
SchoenS. A.MillerL. J.Brett-GreenB. A., & NielsenD. M. (2009). Physiological and behavioral differences in sensory processing: A comparison of children with autism spectrum disorder and sensory modulation disorder. Frontiers in Integrative Neuroscience, 3, 29.
44.
SkainesN.RodgerS., & BundyA. (2006). Playfulness in children with autistic disorder and their typically developing peers. The British Journal of Occupational Therapy, 69, 505–512.
45.
WilliamsE. (2003). A comparative review of early forms of object-directed play and parent—infant play in typical infants and young children with autism. Autism, 7, 361–377.
46.
WilliamsJ. H. G.WaiterG. D.GilchristA.PerrettD. I.MurrayA. D., & WhitenA. (2006). Neural mechanisms of imitation and ‘mirror neuron’ functioning in autistic spectrum disorder. Neuropsychologia, 44, 610–621.
