Of course lining up toy engines, in and of itself, is not a sign of autism. For children, "play" is really developmental work, and the process of learning to play is the process of learning to successfully engage in the world. Lining up toys, when it's clinically significant, is really a manifestation of several underlying issues that, together, are red flags for autism. Those issues include:
- Lack of imitation skills. Typically-developing children watch how others play with toys and imitate them. For example, a typically-developing child might choose to line up blocks one next to the other the first time they play with them. But as soon as the typically developing child sees others build with the blocks, he will imitate that behavior. A child with autism may not even notice that others are playing with blocks at all, and is very unlikely to observe others' behavior and then intuitively begin to imitate that behavior.
- Lack of symbolic play skills. Symbolic play is just another term for pretend play, and by the age of three, most children have developed fairly sophisticated tools for engaging in symbolic play both alone and with others. They may use toys exactly as they're designed -- playing "house" with a pretend kitchen and eating plastic food. Or they may make up their own creative pretend play, turning a box into a fortress or a stuffed animal into a talking playmate. Children with autism rarely develop symbolic play skills without help: They may enjoy placing engines on a track, but they're unlikely to enact scenes, make sound effects, or otherwise pretend with their toy trains.
- Lack of social communication skills. In order to be successful in pretend play and imitation, typically developing children actively seek out engagement and communication, and quickly learn how to "read" the intentions of other people. Children with autism tend to be self-absorbed, and have little desire to communicate or engage with playmates.
If lack of play skills is a possible symptom of autism, is it possible to teach a child with autism to play? The answer, in many cases, is an enthusiastic YES. In fact, several therapeutic approaches focus largely on building and remediating play skills, and parents (and siblings) can take an active role in the process. These include:
- The Floortime Method
- Relationship Development Intervention (RDI)
- The Play Project
- Naturalistic Applied Behavioral Therapy
LC Murdock. "Picture Me Playing: Increasing Pretend Play Dialogue of Children with Autism Spectrum Disorders."J Autism Dev Disord. 2010 Sep 25.
LC Murdock. "Teaching reciprocal imitation skills to young children with autism using a naturalistic behavioral approach: effects on language, pretend play, and joint attention." J Autism Dev Disord. 2006 May;36(4):487-505.
MM Manning. "The role of high level play as a predictor social functioning in autism." J Autism Dev Disord. 2010 May;40(5):523-33.