Play Therapist Perspective Autism | Cadabams CDC

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1. Defining Play Therapy in the Context of Autism

Play therapy is a structured, evidence-based approach where trained therapists use play to help children express feelings, practice skills, and build relationships. Unlike casual play, each activity is chosen to target specific goals such as joint attention, turn-taking, or sensory integration.

The Therapist’s Lens: Viewing Autism Through Play

From the play therapist’s viewpoint, repetitive spinning or lining up toys is not “bad behavior.” It’s data. These patterns reveal sensory needs, cognitive processing styles, and preferred communication modes. By entering the child’s play, therapists decode this data and gently expand it.

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2. The Science Behind Play Therapy and the Brain

Neuroplasticity and Play in Early Childhood

The brains of young children are highly plastic—meaning they reorganize in response to experience. Play activates multiple neural networks at once:

• Motor cortex (movement)
• Prefrontal cortex (planning)
• Limbic system (emotion)

Repeated playful interactions strengthen synaptic connections, making later learning easier.

How Play Affects Social-Communication Pathways

Functional MRI studies show that joint play increases activity in the mirror-neuron system, the brain network responsible for understanding others’ intentions. When a child hands a toy to a peer during a game, the same neurons fire as when they perform the action themselves. Over time, this “shared neural mapping” improves empathy and reciprocal communication.

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3. Core Stages of Play in Children With Autism

Sensorimotor and Exploratory Play

In this earliest stage, children explore textures, sounds, and movements. Therapists might introduce:

• Sensory bins with rice, beans, or kinetic sand to desensitize tactile defensiveness.
• Therapy trampolines to meet proprioceptive needs.

Functional and Relational Play

Here, toys are used for their intended purpose—driving a car, feeding a doll. Therapists model simple cause-and-effect sequences to expand play scripts and invite shared attention.

Pretend and Sociodramatic Play

The most complex stage, involving storylines and role-play. Therapists use miniature figures or dress-up clothes to practice:

• Perspective-taking: “How does the firefighter feel?”
• Problem-solving: “What can the princess do when the bridge is broken?”

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4. Common Play Disorders Observed in Autism

Restricted and Repetitive Play Patterns

• Perseverative spinning of wheels instead of pushing the car.
• Hyperfocus on one aspect (e.g., only red Lego bricks).

Limited Peer Interaction

Children may play beside others (parallel play) without shared goals. Therapists introduce “bridging toys” (e.g., a marble run needing two sets of hands) to encourage cooperation.

Sensory Seeking vs Avoidance Behaviors

• Seekers crash into pillows or mouth objects.
• Avoiders cover ears or retreat from textured materials.

Identifying the sensory profile guides toy selection and room setup.

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5. Evidence-Based Play Therapy Approaches

Child-Centered Play Therapy (CCPT)

Principles:

• Follow the child’s lead.
• Reflect feelings: “You look frustrated the blocks fell.”

Research shows CCPT reduces anxiety and increases spontaneous language within 12–16 sessions.

DIR Floortime Model

Developed by Dr. Stanley Greenspan, Floortime focuses on developmental “circles of communication.” The therapist meets the child at their developmental level, then stretches interactions one step further:

• Child pushes car.
• Therapist puts a roadblock.
• Child vocalizes protest → New circle closed.

Integrating Occupational Therapy Goals

Play therapists at Cadabams CDC collaborate with occupational therapists to embed:

• Fine-motor tasks (pinching Play-Doh).
• Sensory diets (swinging before table-top play).

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6. What Happens in a Typical Play Therapy Session?

Initial Assessment and Goal Setting

• Parent interview captures developmental history and daily challenges.
• **Structured play observation