ACTNOW Fact Sheet 6
CORE FEATURES OF AUTISM : PLAY AND BEHAVIOUR
by Dr Avril Brereton
Restricted, repetitive and stereotyped patterns of behaviour and interests are present in all children with autism. It is one of the core symptoms that must be present if a child is given the diagnosis of autism. However the nature of these behaviours and interests varies widely across individual children.
The DSM – IV criteria for restricted repetitive and stereotyped patterns of behaviour, interests, and activities in autism are:
Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:
- Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus;
- Apparently compulsive adherence to specific non-functional routines or rituals;
- Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements);
- Persistent preoccupation with parts of objects.
(American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000)
Restricted patterns of interest
Children with autism have restricted interests. Many children with autism have unusual preoccupations that they follow to the exclusion of other activities. Pre-schoolers may have fixations on certain toys or characters, such as Thomas the Tank Engine or Buzz Lightyear and simply manipulate these toys or watch TV or videos about them even though many other toys or videos are available. If access to the favoured toy or video is restricted or removed the child may become very distressed. In middle to late childhood, verbal children with autism are more likely to have a fascination with a particular subject, such as train timetables or the Titanic. The child may collect information and talk incessantly to others about this topic or may repeatedly ask questions about it.
Routines and rituals
Many children with autism insist on maintaining certain routines and/or rituals that seem to outsiders to have no purpose. Some examples of this include drinking only one type of drink from a specific cup, needing to have three spoons set at their place at the table despite only using one or having to follow a particular route to certain places. There is often an associated resistance to change in routine or the environment so that the child may become extremely distressed if, for example, a new route is taken going to school, the furniture in the house is rearranged, or the child is asked to wear new clothes.
Motor mannerisms
Most children with autism exhibit motor mannerisms. Hand/arm flapping, finger twiddling, tip-toe walking or twirling are common. Many children have their own unique repetitive body or facial movements that they regularly engage in. Some children become so preoccupied with these stereotyped behaviours that they have very few other play interests.
Preoccupation with parts
Many children with autism are more interested in parts of objects rather than the object as a whole. For example, they may be fascinated with the wheels on toy cars and may spin them but may not play with the car in any other way. There is often a fascination with movement of objects and children with autism may spin objects such as plates, balls or wheels. They may also closely watch a spinning fan. Visual scrutiny of the fine detail of an object such as the edge of a table, or pattern of spokes on a wheel is also common, as is the collection of objects, such as buttons or twigs.
Children with autism must exhibit behaviours from at least one of these categories to meet the criteria of a diagnosis of autism in DSM-IV (American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000), however some children may exhibit all of them.
Play Skills
Another behaviour that is affected in children with autism is the ability to play. An important aspect of each child’s development is the ability to fill in their day with useful activity and social contact. For typically developing young children, the day is spent in a combination of activities involving relating to other children and adults in their world, eating, resting and for many hours each day, playing. This range of daily activities is not typical for the young child who has autism.
Lack of creative and imaginative play is one of the diagnostic features of autism and the ability to play generally has to be taught to children with autism. Imaginative play is particularly difficult for children with autism. In a way, play becomes work for children with autism who would probably prefer to spend their time engaged in rituals and repetitive routines that exclude social contact and interest in what is going on around them. These behaviours (as described above) can become so entrenched that there is no time left for more useful, social and educational play activities.
It is known that the earlier play skills can be taught to young children, the better the chance that rituals and routines may decrease. It is also known that intrusion on the child’s isolation is an important way of establishing contact. This can be achieved by offering toys and objects and establishing play routines/games that the child finds enjoyable.
Teaching the child to play, by themselves and with others, serves a number of important functions:
- Children learn about their world through play.
- A child’s ability to communicate relates to their ability to play symbolically. Improved play skills can lead to improved communication skills.
- As play skills increase, rituals and routines tend to decrease.
- Interactive play can increase social skills, such as learning to take turns, sharing and co-operating.
- Play with toys provides an opportunity to teach the child new skills that are important for later formal education. Some examples are attending to others, attention to task, turn-taking, following instructions and opportunities and topics for conversation.
|
