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Children with autism more likely to engage in play when initiated by peers

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Children diagnosed on the autism spectrum typically have impaired social skills, leading to difficulties initiating and sustaining social interactions, including during play and conversation. This characteristic of autism spectrum disorder (ASD) leads to a limited ability to interact with peers at school and in the community, often resulting in social isolation.

Many early intervention, social skill and applied behavior analysis (ABA) therapy programs seek to teach children with ASD to initiate social interactions and play at home, in schools and in the community. The teaching progression of such programs may begin by identifying what the preferred activity of the child is, such as tag or basketball, providing the child with a basic script on how to initiate an interaction with peers engaged in that activity, such as watching their peers play, waiting for a pause in the activity and asking, "Can I play too?" While many children on the spectrum succeed in following these steps, many may experience heightened social anxiety, exacerbated by the possibility that they may be rejected.

A recent study published last week in the Journal of Child Psychology and Psychiatry posits an alternative approach to facilitating social interactions by looking at play initiated by typical peers.

The researchers studied 66 children between the ages of 8 and 12, 38 of whom were diagnosed with ASD while 28 were typically developing. Peer interactions on playgrounds were analyzed utilizing three peers at a time; one with ASD, one typical peer playing independently and a third typical peer, a "confederate," who was trained to invite the other two children to play. The interactions were monitored through microphones and observed from a lab overlooking the playground, while the confederate received instructions through an earpiece.

Although this study confirmed the fact that children with ASD engaged in fewer social interactions overall than their typical peers, the researchers found that the approach of using a typical peer to initiate play lead to increased reciprocal social interactions by peers with ASD.

In addition, the researchers took saliva samples of the participants throughout the day to measure levels of cortisol, a stress hormone, in comparison to before and after the playground interactions. They found that cortisol levels were significantly higher after the social interactions, indicating a level of discomfort and increased stress as a result. However, the increased stress levels found in the study should not dissuade parents, caregivers and teachers from facilitating such interactions, as increased positive practice will help decrease anxiety associated with such play.

The inherent limited social skills in children with autism, as well as the findings of this research, should indicate to parents, caregivers and teachers methods with which to aid typical peers and children with ASD engage in successful social interactions at school and in the community.

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