Using humor, puppets in play therapy can enhance social, communication skills for kids with autism

Lifelike puppets like this are great for imaginary play and can help
improve social skills and communication for children with autism.
                                               Examiner.com Photo/Mike Frandsen

Teaching humor to children with autism through imaginary play can encourage engagement, facilitate interaction, and promote the development of abstract thought. Studies have even shown that the ability to role-play in children with autism is related to communication abilities. 

Traditional autism therapies have focused on the behavioral aspects of autism, but while structured skills taught at a desk have their place, many children with autism have trouble generalizing those skills into the real world.

Joking around with children with autism, especially using puppets for symbolic play, is an underused and underappreciated way of promoting creative, imaginative, and spontaneous thought.

Humor and pretend play can help children generalize what they have learned so they can use it socially, and in meaningful ways in natural environments.

In the book “Engaging Autism” by Dr. Stanley Greenspan and Dr. Serena Wieder, Greenspan wrote, “Children with autism spectrum disorders (ASD) often take everything literally. One of the most effective activities is pretend or imaginative play. Encourage role play and play with puppets.”

Symbolic play, which involves understanding that a toy represents a real life object or person, can be hard for children with autism to understand. Developing the skill of symbolic play can result in improvements in social, cognitive, and communication skills.

In a study published in the Journal of Autism and Developmental Disorders in 2007, M. Mary Konstantareas and Gillian C. Stanley showed that play therapy may improve the cognitive and language ability of children with autism. The study, “Symbolic Play in Children with Autism Spectrum Disorder," also showed that the ability to participate in symbolic play is related to language ability.

Using humor with puppets can help children with autism understand symbolic or role-play, and can be an opportunity for shared interaction, which has been shown to be helpful in learning. Role-play with puppets may also help children learn theory of mind, which is the ability to use empathy, or to imagine what someone else is feeling or thinking.

Using puppets or stuffed animals in play therapy can even spur the desire to communicate, both verbally and non-verbally through joint attention and using words meaningfully, through emotions rather than through rote memorization.

In addition to using puppets and stuffed animals, jokes saying the opposite of what is expected, hyperboles, or puns may enhance abstract thought, though jokes should be customized for the child’s abilities.

Comedians tailor their jokes to their audiences, and likewise, therapists, teachers, and parents should customize humor to each child. Remember, like even the best stand-up comedians, you may bomb and not get a great reaction every time. Start simply and slowly. Of course, some of the jokes and stories below are best for high functioning children and may be too involved for certain children for whom simple puppet play may be more appropriate.  

It should be noted that since children with autism often have trouble regulating their emotions, getting too excited can be a problem in addition to becoming uncontrollably upset. Sometimes children can get so wound up after viewing puppets that it’s hard for them to come down. Other times they may have a hard time transitioning from joking back to doing work. So transitioning should be practiced as well. Some of the same calming techniques used for children having meltdowns can also be used when they get too excited (count to 10, take deep breaths, etc.).

One other potential pitfall is that children can get obsessed with a certain joke, which can take time away from other activities. But the benefits of humor clearly outweigh any disadvantages. Most importantly, using humor during play therapy is fun for the children.

Below are examples of humor successfully used in autism therapy.

Puppets

Dog Bites Man

Use a puppet, preferably a dog, and ask him what his name is. He doesn’t tell you. Then say, “I can’t hear you.” Bring the puppet next to your ear. All of a sudden, have the puppet tug on your ear and bite it. Say, “Hey, ouch!” Tell the dog not to bite you and have him do a timeout.

Then bring the dog back. Scrunch up your hand to give the dog facial expressions. Open the dog’s mouth wide to evoke surprise. Use rapid and slow movements interchangeably to give the dog personality.

Say, “Are you going to be good?” Have the dog nod his head emphatically "yes."  Then look away from the dog and have him emphatically shake his head "no". The kids will point to the dog and say, “Hey, he said 'no!'” Then ask the dog again if he’ll be good and have him nod. Then look away again and have him shake his head "no."  Then have the dog reach for the toes or the hands of the child.

When kids point to puppets they are using joint attention. When kids take turns using the puppets themselves and then with each other during play dates, they are involved in shared interaction. Both of these skills are critical to improving communication abilities.

When the dog puppet routine was done day after day in a class with several children with autism, minor breakthroughs were seen. Many of those kids showed more engagement and verbal interaction during the puppet play than during all other times combined. This type of play can also be used as a reward for getting work done.

Magic Wand

After the dog has “bitten” the therapist or child, use a “magic wand” to turn the dog into a smaller version of the dog by having a smaller puppet inside a bag. Say “A la peanut butter sandwiches!” (taken from Sesame Street), or some other catchy phrase. Then put the puppet back in the bag and bring out the smaller puppet. Repeat the routine but pretend the magic wand is broken and turn the puppet into a different animal.

Brush Teeth

Tell a stuffed animal, “Your breath is terrible! You need to brush your teeth!” Recoil back from the stuffed animal. Have it go to a mirror and brush its teeth. This can also be used as a way to teach functional life skills.

Resource Room

Have a stuffed animal panda (or any other stuffed animal) “bite” the teacher or student, or engage in other bad behavior. Put the panda in a “transition room” or “resource room” much like many schools use for students to cool down. After this skit, one student spontaneously decided to look at his blank computer monitor to “check up on panda,” pretending that the monitor was showing the panda in the room.

Or do role-play with several stuffed animals, having the first two correctly answer questions, while the third one is non-compliant. Then make the third one do a timeout or go to a transition room. Having the children lead the play can help them learn theory of mind by pretending to be the teacher.

Other Imaginary Play

Hot Lava

Pretend there is hot lava from a volcano on a line on the carpet or the floor and if you touch it you will burn your foot and have to cool it down in a bucket of ice. Then touch the spot on the ground and overreact, hopping on one leg, frantically asking where the ice bucket is. Then when the child points to you to touch the lava again, say that that is only a joke and there really isn’t any lava. But then start jumping around again as if you stepped in hot lava.

Man in the Computer, Woman in the Phone

One child was obsessed with the short jingle that the computer’s operating system made when starting up or shutting down. He was told that there was a little man in the computer playing the piano. The boy thought that was very funny. “What’s the man’s name,” he asked. “Uh…Billy Joel,” said the therapist. The student asked who was playing the piano in the phone. “Carole King,” the therapist said. (Apparently the therapist was a fan of 70s music).

Stories

The following story was used for a boy who went to Washington Nationals games and enjoyed the race during the seventh inning stretch between the president mascots: “Abe Lincoln is winning the race. Here comes George Washington. But wait, who is winning now? It’s Elmo! Elmo is winning the race! Elmo can’t run here – that’s not fair. But Elmo wins!”

Or make up a story such as, “The Nationals coach told the team they had two new players. He told Adam Dunn and Ryan Zimmerman they had to sit on the bench. He told the team that Johnny and James Doe will be playing instead.” (These are the names of the child and his brother).

“Adam and Ryan said, ‘Hey, that’s not fair! They’re too young! They’re only seven and eight years old!’ Then Johnny and James hit home runs and the Nationals won the game and everybody celebrated!”

Books

Animals

When reading books about animals or insects, you can point to the pictures and pretend to suddenly be bitten by them, exaggerating your reaction. Then as the child points for you to do it again, say, “That’s only a picture. It can’t hurt me. See. Watch.” Slowly and tentatively reach to touch the photo. Then overreact again, pretending that the animal has bitten you.

A sad lemon, an idea based on the book "How are You Peeling:
Foods with Moods" by Saxton Freymann. Photo by Mike Frandsen

Foods with Moods

This is based on a book called “How are You Peeling? Foods with Moods” by Saxton Freymann and Joost Eiffers. The book features photographs of fruits and vegetables that are modified to look like faces with expressions.

This is an excellent book for children with autism because food is very motivating, and the photos are bright and colorful. Secondly, the expressions on the “faces” of the foods each have a different emotion, and kids with autism usually have problems discerning emotions.  This book and others like it can give them much needed practice in identifying and understanding feelings.

The fruits and vegetables can also be used almost like puppets in that the teacher can have them act out the emotions and then have the student hold them and act out the feelings. Kids can help make the faces as an art project.

Phone

When the phone rings, don’t answer it, but put it up to your ear and pretend that it is a person or a puppet that has been involved in previous role-play. For example, tell a stuffed animal panda that was acting up, “You’ve been bad. You won’t get any bamboo to eat. You have to eat…ketchup!” (or something else unexpected and unpalatable).

You can also pretend that an animal such as a deer is on the phone. Tell the deer he cannot eat the tomatoes in the garden. Imaginative role-play like this can help get children to think abstractly.

Unexpected or Opposite Jokes

Sometimes a joke can be made out of something unexpected, such as telling a stuffed animal he has to eat a hot dog with syrup, or pancakes with ketchup. For children with autism who think literally, this can open up a door into thinking abstractly through unexpected humor. (However, this example did get overused by a particular child who got obsessed with the joke).

Another example of this was April Fools Day, when a therapist told a child that he was going to ask for a “haircut at McDonald’s” or a “hamburger at the barber shop.” April Fools Day is a good opportunity to explain the concept of jokes to children with autism.

One child’s favorite joke for a while was to talk about putting a TV in the garbage can. He used a comedy technique of talking about an item in an unexpected way. Later he was able to joke about a computer crashing, so it “should wear a seat belt.”

Knock-Knock Jokes and Puns

Knock-knock jokes are formulaic and can help the child understand humor. Many kids with autism like reading the same book over and over. Likewise they may enjoy the same patterns of jokes. For example, “Knock knock…Who is there? Lettuce…Lettuce who? Lettuce come in!” Puns can help children think creatively, understanding there can be multiple meanings for one word.

Rhymes

Rhymes can help children with autism learn words because word families are used together. Funny rhymes are even better and some kids with autism enjoy them immensely. An example would be the Dr. Seuss book “Hop on Pop.” Here are some rhymes that a high functioning child with autism developed with help from a therapist:

“It’s windy, Cindy…Don’t step in the mud, Jud…You’ll do great, Kate…Eat the cheese, Louise…Ride a bike, Mike…go up the hill, Bill.”

Trash Talk

For children capable of understanding that “trash talk” during sports is not to be taken literally, you can engage in some playful banter such as, “You better watch out, I’m going to beat you!” This can also help bring about the concept of friendly competition in sports.

Trampoline

While jumping on the trampoline, say something like, “I’m going to the moon to get some cheese!...Now I’m going to Mars. I’ll be back in a minute.”

Tag

For less advanced children, a simple game of tag can promote engagement and shared interaction, whether it is on a field or in a swimming pool.

Those are just a few examples of how humor can be used to foster engagement and interaction, which can in turn lead to improvements in social skills, cognitive skills, and even communication for children with autism. Joking around can also be a welcome respite from work that may not always seem meaningful to the child.

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