A Longitudinal Study of Pretend Play in Autism

Abstract

This study describes a longitudinal design (following subjects described in Rutherford & Rogers [2003, Journal of Autism and Developmental Disorder, 33, 289-302]) to test for predictors of pretend play competence in a group of children with autism. We tested the hypothesis that developmental change in pretend play performance can be predicted by earlier measures of either executive function, intersubjectivity, imitation, or general development. Participants at the time of follow-up testing were 28 children with autistic disorder (mean chronological age (CA) 57.6 months), 18 children with other developmental disorders (mean CA 59.0 months), and 27 typically developing children (mean CA 30.1 months). Children with autism were profoundly delayed given both competence (prompted) measures as well as performance (spontaneous) measures. Joint attention at time 1 strongly and uniquely predicted pretend play development.

Impaired Competence for Pretense in Children with Autism: Exploring Potential Cognitive Predictors

“…On the assumption that this ability is a capacity to represent mental states, then the results provide support for the mentalising deficit theory. This is consistent with the observation that children with autism lack early mind sharing behaviors, such as joint attention behaviors and, moreover, that early joint attention behaviors predict later ability to produce pretense (Rutherford et al, 2007). Interventions might therefore aim to facilitate both symbolizing and early mentalising ability in young children with autism.…”

“…This is consistent with findings reported by Rutherford et al (2007) but inconsistent with earlier reports of intact comprehension (Jarrold et al, 1994b;Kavanaugh & Harris, 1994). However, in both of these earlier studies the children watched the experimenter pour an imaginary substance (e.g.…”

“…Rutherford et al (2007) showed that both spontaneous (performance measure) and scaffolded pretense (competence measure) was significantly impaired in children 6 with autism relative to matched controls. In addition, Bigham (2008) reported that children with autism were more likely than ability-matched controls to make literal errors when interpreting another person's pretend gestures.…”

“…For example, Taylor and Carlson (1997) and Suddendorf, Fletcher-Flinn, and Johnston (1999) found that children who passed ToM tasks produced significantly more imaginary object pretense than children who failed these tasks. Moreover, in a study of children with autism and matched controls, Rutherford et al (2007) found that development in the production of pretend play could be predicted by earlier measures of joint attention. Joint attention is believed to directly reflect a capacity for mental representation (Baron-Cohen, 1989) and is 5 precursor to ToM development (Rochat & Striano, 1999).…”

Intact emotion facilitation for nonsocial stimuli in autism: Is amygdala impairment in autism specific for social information?

“…Behavioral, psychophysiological, and neuroimaging studies in autism consistently demonstrate deficits in the building blocks for social interaction, such as impaired recognition and memory for facial and vocal expressions (Golan et al, 2006;Humphreys et al, 2007;Paul et al, 2005); reduced use and recognition of emotionally salient aspects of imitation and gesture (Colgan et al, 2006;Hobson & Meyer, 2005); and limited consideration of others' mental states in joint attention or theory of mind tasks (Baron-Cohen et al, 1999;Rutherford et al, 2006).…”