The Power of Play Therapy for Autism: Benefits, Techniques, Tips

Amanda Unrau
CCC-SLP
September 02, 2024

Play Therapy for autism is a treatment for children that targets communication and relationship building. Children with autism tend to play differently than their neurotypical peers. They often play by themselves and engage in a limited repertoire of activities. Play therapy helps children with autism learn play techniques, connect with others, express themselves, and regulate emotions.

What is Play Therapy for Autism?

In Play Therapy for autism, children engage in play activities of their choosing, such as playing with toy cars or trains, sculpting with playdough, or jumping on a trampoline. This allows children to express themselves in ways that they are comfortable with. This type of therapy is child-centered, versus most behavioral therapies that are therapist-led. Play is used as the means in which the play therapist enters the child’s world to build a relationship. The relationship is then used as the catalyst for change.

Play and autism can be combined in play therapy to help children move from an internal self-absorbed state into shared interactions. Play therapy activities for autism can help children observe and explore their environment, develop relationships with peers, teachers, parents, and siblings and discover their emotions. Chosen toys or activities used in play-based therapy for autism are the words that children use to communicate. 

As a speech language pathologist who often works with children who have limited verbal skills, I understand that children will find another way to communicate if they can’t use words. We just have to listen and observe. As stated above, since children learn and engage through play, they will often use play, including toys and games, as a means of communication. In turn, we as professionals and parents can use play as a way to build relationships and respond to their communication. 

Benefits of Play Therapy for Children with Autism

Play Therapy offers multiple benefits for children with autism. While it may look like a normal playtime, children are actually developing new skills, including those listed below: 

• Children who are nonverbal or have limited verbal skills have a way to communicate. Playing with toys or through games and activities offers an accessible and concrete mode of communication without needing words.

• Children also develop their communication skills. Both verbal and nonverbal skills are used during interactive play with others. Children have to participate in some form of reciprocal communication in order to share toys, play games, or participate in pretend play. 

• Children with autism learn to experience empathy. Most children with autism have difficulty taking on others’ perspectives or empathizing with others. These skills can be nurtured in the play relationship.

• Children learn to regulate their emotions. It can be difficult for children with autism to manage their emotions. This skill can be improved as children learn responsibility and have gentle limits set in the play therapy setting. 

• Children develop improved social skills. Children with autism can practice peer interactions in a relaxed environment through play. Learning to share, take turns, and work as a team during cooperative play can generalize to improved social skills in other settings. 

• Children improve their fine and gross motor skills. Play therapy involves manipulating small and large objects, as well as various types of physical movement. Children are able to practice their motor skills in a fun way without even realizing it. 

• Children are accepted as they are. Instead of being viewed as a problem that needs to be fixed, which can happen in more traditional behavioral therapies, children have the right to be different. This in turn can reduce maladaptive behaviors since they can be themselves.

How Does Play Therapy Work?

Autism play therapy will vary, depending on the therapist and the unique needs of each child. 

1. Play therapy begins with an observation of the child playing. The play therapist may also conduct interviews with the child and with important adults in the child’s life, such as parents and teachers. The therapist also conducts a thorough assessment to determine the child’s current level of functioning and their specific needs.
2. The therapist will set goals for therapy, choose any parameters, and formulate a plan for the therapy sessions. 
3. As therapy begins, the play therapist observes the child playing independently, and how they handle separation from their parents and their reaction upon the parents’ return.
4. As play therapy continues, observations continue to inform next steps. A child may use different toys to act out their emotions or solve problems. Goals may be updated as new behaviors lessen or appear. 
5. Filial therapy may also be incorporated. Filial therapy is when family members such as parents or siblings join in the play therapy. This allows the family to work on family relationships and resolving conflicts.

Play Therapy Sessions

Play therapy sessions are usually held once a week and generally last 30-60 minutes. The frequency and duration of sessions will be adjusted based on the needs of each child and how they respond to the therapy. Sessions can be conducted individually or in groups.

While play therapy for autism is child-centered, the therapist may take a directive or nondirective approach:

• With a directive approach, the therapist chooses the toys or activities for the session. They guide the play in order to target a specific goal. 

• With a nondirective approach, the child chooses the toys and games throughout the session. During this less structured approach, the therapist observes the child and joins at appropriate intervals while limiting instructions.

Play Therapy Techniques

Some strategies the play therapist may incorporate include role-playing, storytelling, sensory play, dolls and action figures, puppets, masks, stuffed animals, sand and water play, blocks, arts and crafts, dance, and music.

The therapist may guide play therapy to get to know the child better and help them understand social situations and their emotions. For example, a therapist may provide costumes and suggest role-playing upcoming events the child is nervous about or a past social scenario that the child found challenging. 

Below are three examples of play types that can be incorporated into play therapy sessions: Structured Play, Sensory Play, and Pretend Play.

• Structured Play utilizes specific games or activities to address specific goals. Structured play activities provide rules or guidelines and set up situations for children to practice following directions, taking turns and waiting for their turn, solving problems, resolving conflict, and working as a team. Examples of activities that can be used for structured play include board games, puzzles, building blocks, Lincoln logs, or legos. 

• Sensory Play helps children with autism explore their environment by incorporating activities that stimulate the senses. Many children with autism have difficulty processing their sensory experiences, and sensory play can improve sensory regulation. Examples of items that can be used for sensory play include: sensory bins filled with materials such as sand, rice, or beans, a water table with water toys, or moldable material such as silly putty, clay, or playdough. 

• Pretend Play encourages children with autism to think creatively and use their imagination. Children with autism tend to be black and white thinkers, and can have difficulty viewing items or situations in multiple ways. Pretend play scenarios give children the opportunity to think outside the box and develop their social and communication skills. Examples of pretend play include a dress-up station with costumes, rooms in a home such as a kitchen, laundry room, bedroom, or community places such as a grocery store, post office, doctor office.

Is Play Therapy Evidence-Based?

There have been limited research studies conducted on autism play therapy as researchers are in the initial stages of determining the effectiveness of this therapy. Continued research is needed, particularly research including larger groups of children who are receiving only play based therapy for autism. 

According to a literature review published in 2023, play therapy has positive effects on the social and communication skills of children who participate in sessions. Apart from direct improvements for the child, play therapy was also found to improve family relationships, especially the bond between children and their parents, as parents are a key part of therapy. 

Several case studies following children receiving play therapy have been conducted. One such case study reviewed the play therapy sessions of a 6-year-old boy with severe autism. The child built rapport and a solid relationship with the play therapist, and demonstrated improvement in autonomy and pretend play skills. There were mild improvements in the child’s ritualistic play and behaviors. The child also demonstrated generalized skills at home of greater independence and empathy. These results indicate that this therapy combining play and autism may improve communication and social skills of children with severe autism. 

Most available studies included children who were receiving other therapies in conjunction with play-based therapy for autism. These studies reported that play therapy and behavioral therapy work well as a combined approach to a well-rounded treatment plan for children with severe autism.

How to Find a Play Therapist for Autism

Play therapists have been trained in using play-based interventions necessary for implementing play therapy for children with autism. These therapists set up a relaxed and nurturing play environment and develop individualized treatment plans and choose techniques specific to each child to facilitate growth of social skills, emotional regulation, and effective communication. Play therapists engage directly with the child and coach the child’s family on incorporating play therapy techniques into daily routines.

When looking for a play therapist, check with children’s hospitals, pediatric clinics, autism clinics, and schools for help locating a certified play therapist. Some local early intervention programs and specialized preschool programs may offer play therapy for children with autism. Occupational therapists or child psychologists specializing in autism may also provide play therapy services. The Association for Play Therapy (APT) has a directory of licensed mental health professionals who are trained as play therapists. 

Using Forbrain in Play Therapy

Play Therapy can be used on its own or in conjunction with other therapies or tools. Forbrain is one such tool that can be combined with play therapy in order to boost its effectiveness. Forbrain is an auditory stimulation device that is worn as a headset. It utilizes the natural auditory feedback loop to improve attention, memory, and focus. 

Both verbal and nonverbal children can wear the Forbrain device during play therapy sessions. Wearing the device can improve self-awareness. When a child is more aware of their own speech, they may exhibit increased vocalizations and social interactions. They may be more motivated to practice key skills, which can lead to increased progress in these areas over time. 

Final Words

Play therapy provides an opportunity for children with autism to practice various skills in a natural environment. When a play therapist or family member joins a child during play activities of their choosing, they can build relationships and practice and improve social, emotional, and communication skills. As parents, educators, and healthcare professionals, be sure to consider the suggestions shared in this article when considering play therapy for a child with autism. 

References

Apex ABA Therapy. (2024, June 16). What is Play Therapy for Autism. Apex ABA Therapy. https://www.apexaba.com/blog/what-is-play-therapy-for-autism

Elbeltagi, Reem, Al-Beltagi, Mohammed, Saeed, Nermin Kamal, Alhawamdeh, Rawan. (2023, January 9). Play Therapy in Children with Autism: Its Role, Implications, and Limitations. World Journal of Clinical Pediatrics, 12(1). 10.5409/wjcp.v12.i1.1

Galindo, Eliana. (2023, November 26). Play Therapy for Autism: 6 Specific Techniques. Find a Therapist. https://www.find-a-therapist.com/play-therapy-for-autism/

Harkin, Christine. (Accessed 2024, August 22). Autism Spectrum Disorders and Play Therapy. Play Therapy Melbourne. https://www.playtherapymelbourne.com/autism-spectrum-disorders-and-play-therapy/

Hillman, Heidi. (2018, January 1). Is Play-Therapy an Evidence-Based Intervention for Children With Autism? Autism Spectrum News. https://autismspectrumnews.org/is-play-therapy-an-evidenced-based-intervention-for-children-with-autism/

Josefi, Orit, & Ryan, Virginia. (2004, October). Non-Directive Play Therapy for Young Children with Autism: A Case Study. Clinical Child Psychology and Psychiatry, 9(4). https://doi.org/10.1177/1359104504046158

NeuroLaunch. (2024, August 11). Play Therapy for Autism: Enhancing Communication and Social Skills Through Play. NeuroLaunch. https://neurolaunch.com/play-therapy-for-autism/

Pietrangelo, Ann. (2019, October 11). How Play Therapy Treats and Benefits Children and Some Adults. Healthline. https://www.healthline.com/health/play-therapy#overview

Rudy, Lisa Jo. (2023, July 28). Benefits of Play Therapy and Autism. VeryWell Health. https://www.verywellhealth.com/play-therapy-and-autism-the-basics-260059

Sutton, Jeremy. (2017, July 27). Play Therapy: What Is It and How Does It Work? Positive Psychology. https://positivepsychology.com/play-therapy/

Topper, Akiva. (2024, June 21). Play-Based Therapy for Autism. Behavioral Intervention for Autism. Source.

Amanda Unrau

-

Amanda is a speech language pathologist by day, and a freelance writer during the in between times. She has worked with children of all ages in a variety of private practice and school settings, as well as telepractice. She enjoys research and tries to make her speech therapy and writing as functional as possible.