# data[].attributes.body
Symbolic play involves children using objects or toys to represent something else that the child wants or needs for their pretend scenario. Symbolic play can be done with any object or material and the scenarios are all created by the child's imagination. Some examples of Symbolic play include:
-A box becomes a boat
-A kitchen utensil becomes a microphone
-A stick becomes a sword

# data[].attributes.headline
The importance of Symbolic Play for PreK children

# data[].attributes.subject
The importance of Symbolic Play for PreK children

# data[].attributes.body
The inclusion of Symbolic play for PreK children is crucial for their play experiences along with the five developmental domains. Social, Emotional, Physical, Cognitive, and Language Development. When it comes to socializing, any form of play allows children to socialize. Symbolic play increases their social skills and creativity. Symbolic play greatly enhances a child's ability to express their emotions which is very important. Children use their imaginations to express their feelings and emotional needs, they also use problem solving skills during symbolic play because they are choosing an everyday object and deciding what they want it to represent. For Physical development, Symbolic play encourages gross and fine motor skills which help children's bodies to grow and develop. Lastly, Symbolic play has been linked to increasing children's Cognitive and Language development skills. Both Cognitive and Language development skills share similar developmental building blocks which later help to increase these domains.

# data[].attributes.body
Outdoor Play allows children to explore, wonder, create, and experience the world around them in their backyards, at playgrounds, and in the woods. Outdoor play allows children to have crucial exposure to the outside world.

# data[].attributes.headline
The importance of Outdoor Play for PreK children 

# data[].attributes.subject
The importance of Outdoor Play for PreK children 

# data[].attributes.body
The inclusion of Outdoor play for PreK children is crucial for their play experiences along with the five developmental domains. Social, Emotional, Physical, Cognitive, and Language Development. Outdoor play supports the development of social and emotional skills because children learn to be patient while waiting their turn at the playground and working with others to play games and build sandcastles. Outdoor play allows children to develop social relationships and conflict resolution skills. Outdoor play strongly supports physical development. When children play outdoors, they tend to play for longer and are far more active versus playing indoors. Outdoor play allows children to exercise their large muscle groups along with enhancing their cardiovascular endurance. Children's exposure to fresh air reduces respiratory infections, the spread of germs and promotes a healthy immune system. Lastly, Outdoor play promotes Cognitive and Language development because they can express themselves, have louder voices, and stretch their abilities.

# data[].attributes.body
In order to support children with special needs through symbolic play, this article explains how children with disabilities are able to play the same symbolically as their other peers they just may not see this type of play as being symbolic. Children with special needs can play symbolically with added support of their parents or other individuals.

# data[].attributes.attachment_link.readable_text
Abstract

Children with autism are often described as having deficient play skills, particularly symbolic play. We compared the play of 35 children with autism to 38 children with other developmental delays. All children were preschool-age and produced less than 20 different words. Results indicated no significant differences across the two groups in their play. Children with autism engaged in more conventional play, that is, putting objects together according to how the toys were constructed (e.g., pieces in a puzzle, lid on a teapot). Results also indicated high correlations between play, language, and cognitive measures. Findings indicate that play relates to language and cognitive levels yet may not discriminate children with autism and children with other developmental delays early in their development.

Keywords: Autism, Symbolic play, Developmental delays, Preschool, Cognition, Language delays

Introduction

Children engage in symbolic play by using one object to represent another object or event (e.g., use a bucket for a hat). Studying children's play may provide insight into underlying symbolic understanding that might not be obvious through other cognitive and language assessments. Several studies have reported deficits in symbolic play of young children with autism, and some propose a distinctive play deficit ( Sigman and Ruskin 1999; Ungerer and Sigman 1981). Other researchers have reported similarities when comparing symbolic play of children with autism to typically developing children ( Dominguez et al. 2006), and to children with other developmental delays (DD) ( Libby et al. 1997). The aim of the present study is to address these contradictory reports by examining different play behaviors of children with autism and other DD by using comprehensive play measures.

Play Differences and Similarities

Efforts to illuminate the possible distinctive play abilities of typically developing children and children with DD including autism have focused on defining specific developmental levels of play ( Belsky and Most 1981; Libby et al. 1997). In one of the first studies to validate a developmental progression of play, Belsky and Most showed that infant play behavior followed a sequence from mouthing and simple manipulation of toys, to recognition of conceptual relationships between objects (i.e., functional play), to increasingly decontextualized play (i.e., symbolic or pretend play). The outcomes suggested that children's play was a valid and reliable way to evaluate progressively complex and cognitively demanding behaviors, and paved the way for the development and use of sequential play classifications ( Lifter 2000; Lifter and Bloom 1989; Lifter et al. 1993).

Pretend or symbolic play typically develops in children around 18-24 months. During symbolic play children pretend that an object is something it is not (e.g., a block is a car), or assign properties to an object that it does not have (e.g., holds bottle to dolls hand as if it could hold it; Baron-Cohen 1987). Prior to the development of symbolic play, children engage in functional play. Actions on toys reflect an appropriate use of the object (e.g., put puzzle together, put cup on saucer). Assessing play of children with autism and other DD may provide insight into underlying symbolic understanding not apparent through other cognitive and language assessments. In fact, assessment of symbolic play is included as part of some diagnostic assessments (e.g., the Autism Diagnostic Observations Schedule, ADOS; Lord et al. 1999).

Deficits across all of these levels of play have been identified in children with autism. Williams et al. (2001) found that young children with autism engaged almost exclusively in simple play acts with the same objects compared to children with Down syndrome (DS) and typically developing children who demonstrated more complex play routines with a variety of objects. Sigman and Ruskin (1999) found that children with autism engaged in less varied symbolic play than children with DS or DD. Early studies reported less engagement in and fewer number of functional play acts, less pretend doll play, and shorter play sequences ( Sigman and Ungerer 1984; Ungerer and Sigman 1981). To measure functional play, these authors constructed a checklist with 62 objects and asked a nurse to identify objects that she believed the child could use in a functional way; children's actions on objects was not observed in a play context. Further, play skills of a comparison group of typically developing children or those with other DD was not assessed.

Some research on children with autism has shown more similarities than differences in play, however. Dominguez et al. (2006) found that although children with autism showed less interest in specific types of toys (e.g., construction toys, dolls, and house toys) than peers without disabilities, there were no differences in overall rates of functional or symbolic play behaviors. In this study, the authors combined functional and symbolic types of play into one behavioral category. Others have found that children with autism engage in symbolic play and can attend to and imitate symbolic play acts (e.g., cook an egg, or feed a doll) similar to mental-age matched children ( Warreyn et al. 2005). Similarly, when differences in age and developmental levels were considered, Naber et al. (2008) reported no differences in length of play time or time spent in manipulative, functional, or symbolic play between groups of children with and without autism. Warreyn et al. used a more conservative method of scoring symbolic play, in that the child had to express a vocalization or story in combination with the symbolic act. The play context used in Naber et al. was free play with a familiar play partner, the mother.

Other studies have shown that children with autism do demonstrate an understanding of symbolic play, and demonstrate higher play levels in structured situations ( Jarrold et al. 1993, 1994; Libby et al. 1997). Jarrold and colleagues reasoned that perhaps difficulties reported for children with autism relate to a performance deficit verses a competence deficit. That is, a lack of spontaneous play may not be due to an inability to play symbolically (competence in), but under the right conditions they can exhibit (performance in) pretend play similar to language matched controls. The comparison group of typically developing children in Libby et al. (1997) often told the examiner "no" when asked to use toys in a pretend way (e.g., use a block as a cup and pretend to drink); whereas the children with autism imitated the act without protest. Libby et al. suggested that the children with autism may have successfully imitated symbolic acts due to the adult-guided context, possibly without interpretation of the act as symbolic.

Relationship of Play, Language and Cognitive Skills

Are play skills commensurate with other cognitive skills or do they reflect a different construct that may independently relate to language within and across various diagnostic groups? Symbolic play has been related to language development in both typical populations ( Kelly and Dale 1989; Laakso et al. 1999; McCune-Nicolich 1981) and in children with autism and other DD ( Cunningham et al. 1985; Kasari et al. 2001; McDonough et al. 1997; Sigman and Ruskin 1999; Stone et al. 1990). Typically developing toddlers using single words engage in more symbolic play than toddlers not using words. Eisert and Lamorey (1996) reported significant relationships between play and language development, with developmental level a stronger predictor of play level than chronological age.

Similar relationships between symbolic play abilities and later language skills have been documented for children with autism, DS, and DD. Sigman and Ruskin (1999) compared the number of different functional and symbolic play acts for preschoolers with autism, DS, DD, and typically developing (TD) children. The children with autism engaged in significantly fewer functional play acts only compared to the children with DS; and less varied symbolic play skills than all the other groups. Children with autism who showed a higher number of different functional play acts between the ages of 2 and 6 years had higher expressive language skills 7-10 years later. These groups were not matched on language age. Further, preschoolers with autism who play with a wider variety of different toys have been reported to show greater gains in expressive vocabulary 1 year later ( Sigman and Ruskin 1999; Yoder 2006).

Unfortunately, some studies do not describe child characteristics as related to receptive and expressive language skills, severity of autism symptoms, and some lack a comparison group ( Libby et al. 1997; Ungerer and Sigman 1981; Yoder 2006). Attending to language differences as a mediating variable is important given the wide range in degree of severity of language performance in children with autism and other DD. One way to accomplish this is to examine differences in play of children with autism compared to those with other DD at similar communication levels. For example Warreyn et al. (2005) reported that children with autism with more developed language skills tended to engage in more symbolic play than children with lower language. Hence, controlling for cognitive level would seem to be important for determining the specificity of play deficits across populations.

In summary, reports describing play development of children with autism and other DD have drawn similar conclusions in some areas, and conflict in others. As described above, possible reasons for these contradictory findings include: (a) sensitivity of the coding and play measurement system, (b) the sampling context in terms of play partner, number and type of toys, and structure, (c) varying definitions of functional and symbolic play behaviors across play taxonomies, and (d) a lack of reporting on severity of language deficits and autistic symptoms. The present study was designed to address inconsistencies in these reports by assessing play behaviors of children with autism and other DD with similar language abilities, using free play and thematic (structured) play sets.

The current study focuses on two sets of research questions. The first question addresses contradictory findings on whether or not there are significant differences in play behaviors of children with autism and children with other DD. Based on previous research showing marked deficits in attending to, imitating, and responding to actions and social behaviors of others, we are also asking about the specificity of a play deficit for children diagnosed with autism. We hypothesized that preschoolers with autism would demonstrate more limited symbolic play skills compared to preschoolers with other DD.

The second set of questions focuses on the nature of play, and cognitive and language development. Specifically, what are the relationships between play, nonverbal cognitive measures, and language measures for pre-schoolers with severe communication delays and autism or other DD? We predicted that child performance on our measures of play would correlate to standardized measures of cognitive and language performance for both children with autism and other DD. Secondarily, we were interested in examining the relationship between play and language after controlling for cognitive development. Gaining insights into possible parallels between play and language will be important in our longitudinal analyses of language growth for these two populations as we follow their development over the next 2 years.

Methods

Participants

Play assessments were completed on 73 preschool children with developmental disabilities between the ages of 37 and 71 months, with an average age of 49.5 months. Thirty-five children had a diagnosis of autism (mean age 49.2 months), and 38 had other DD (mean age 49.7 months). All 73 participants were part of a larger longitudinal study investigating child and environmental predictors of communication success; therefore, the groups were not equally matched in number. Of the participants with autism, 6 were girls and 29 were boys. There were 11 girls and 27 boys in the group with other DD (see for demographic participant information). At the start of the study, each participant was administered all subtests on the Mullen Scales of Early Learning (MSEL, Mullen 1995) and the Preschool Language Scale-4 (PLS-4, Zimmerman et al. 2003) (see ).

Table 1

Table 2

Participants were selected based on the following: (a) chronological age between 3 and 6 years and attending preschool, (b) expressive vocabulary of less than approximately different 20 words (included spoken words or signs), (c) score of more than one standard deviation below the mean on the MSEL ( Mullen 1995), (d) eligible to receive special education services through the school district, (e) motor skills sufficient to select a symbol or activate a switch with at least one hand or arm, and (f) vision corrected to 20/80 or better in at least one eye and hearing levels 25 dB HL or better in at least one ear.

A diagnosis of autism was reported for 35 participants based on meeting a minimum of three of the following four criteria: educational or clinical diagnosis of autism by school district personnel or a credited agency not affiliated with the authors' research lab, results on the ADOS ( Lord et al. 1999), results on the Childhood Autism Rating Scale (CARS, Schopler et al. 1993), clinical features defined by DSM-IV ( APA, 1994), and scores of 15 or above on the Social Communication Questionnaire (SCQ, Rutter et al. 2003). The SCQ was administered to parents by project staff. Completion of all other diagnostic assessments was confirmed through parent report.

Materials and Measures

Toy Sets

Five play sets were used to assess children's play in unstructured (Set 1) and semi-structured (Sets 2-5) activities for a total of 15 min of play (3-min per set) with an examiner. These play sets and activities were adapted from Kasari et al. (2001, 2006). We wanted to observe children's spontaneous play behaviors; therefore, only one symbolic play act was modeled for the child for each toy set. If the child immediately imitated the examiner's symbolic act, it was not coded. Reported play deficits for this population may stem from difficulties orienting to and imitating the salient actions of others ( Wetherby 2006). Thus, we reasoned that one modeled act with one toy from an array of toy options would not markedly influence independent play behaviors. See for play sets and examples of symbolic play acts modeled by the examiner.

Play Level Measure

The play measure used to assess participants play development was based on research by Lifter (2000; Lifter and Bloom 1989; Lifter et al. 1993), specifically the Developmental Play Assessment (DPA) Instrument. The DPA consists of eight play levels, and 15 play categories within these levels. For this project, we included 11 of the 15 DPA play categories. The four levels not included were single scheme sequences, multi-scheme sequences, sociodramatic play, and thematic fantasy play. We did not include these four levels because the early work of Lifter et al. showed that preschool children with DD rarely demonstrated these higher level play skills. The 11 categories comprised four Play Levels: Level 1: Indiscriminate Actions, Level 2: Functional Play/Object Use, Level 3: Functional Combinatorial, and Level 4: Symbolic Play (see and Lifter et al. 1993 for details). Level 1, Indiscriminate Actions (i.e., mouthing, shaking, banging, and inspecting) were considered undifferentiated play, and therefore were not included in any play measures or analyses.

On-Line Play Coding Program

All play categories were entered into an on-line play coding program modeled after one created by Tapp and Yoder (2001) and adapted for this study. The program consisted of a list of every type of toy in each toy set and a list of 'anticipated' play actions, that is, a list of actions that we predicted or expected a child would perform with each toy or combination of toys. We were interested in the number of unique actions on each toy, and did not code the same action used with the same toy (e.g., child puts puzzle piece in twice, only counted as one play act; child puts a block in shape sorter then puts block in a cup coded as two acts). Based on the types of toys in each set, anticipated actions were not possible for every play category. For example, in play Set 1, unstructured play, no doll was present therefore Doll as Agent did not have any anticipated actions. Possible anticipated play actions ranged from 6 to 11 across the five play sets. We included a category called "Unexpected Substitutions" in order to capture each symbolic play act that was not predicted. Coders were able to enter a code for this unexpected symbolic play act.

Coding Play Behaviors

Play skills were coded in three ways. First, we calculated a weighted play score. Similar weighting procedures have been used to measure other areas of development such as communication ( Greenwood et al. 2003; Luze et al. 2001). We calculated weighted play by assigning one point for any Level 2 play act, two points for any Level 3 act, and three points for any Level 4 act. Thus, each different play act (or unique action) was assigned a score of 1, 2, or 3. For example, a child who took two nesting cups apart received one point for that act (Level 2, Functional Play-Takes apart combinations), and a child who put a piece of sponge on a spoon and fed a baby doll received three points for that act (Level 4, Symbolic Play-Substitutions). Each unique play act was assigned a score, and then these scores were totaled to obtain a weighted play score for each child reflecting complexity of play across all toys played with. Scores were continuous and we included individual child scores in our analyses.

Second we calculated an 'object interest' score, which assessed each child's differentiated intentional actions on objects. Object interest was assessed given reports of a restricted range of interest in a variety of toys for children with autism and those with other DD ( Bruckner and Yoder 2007; Sigman and Ungerer 1984). Across all five play sets, the total number of times a child acted on a different toy (e.g., puts shape in shape sorter; stacks blocks, or opens toy phone) was counted and summed per child. If two toys were acted on in combination, both were counted. For example, placing a cup on a saucer would count as two objects of interest.

The third play variable was the highest level of play that was described as emerging and/or or mastered based on the type and number of play acts observed in play levels 2, 3 and 4 (not including Level 1: Indiscriminate actions on objects; see ). Emerging was defined as demonstration of a minimum of two different play acts at one level. Mastered was defined as demonstration of four or more play acts at one level. These definitions were based on research by Lifter et al. (1993) and Kasari et al. (2006).

Cognitive and Language Measures

Nonverbal cognitive ability was calculated by combining the Fine Motor and Visual Reception subtest raw scores on the MSEL, following the work of Wetherby et al. (2004) and Yoder (2006). These two subtests do not assess expressive language or speech production. This MSEL nonverbal cognitive measure was used in the correlational analyses, as were the raw scores obtained on the PLS-4 ( Zimmerman et al. 2003). Although there was a range of cognitive and language abilities across the two groups, both groups demonstrated significant developmental delays as evidenced by the outcomes of these two assessments (see ). The children with DD had slightly superior receptive language skills compared to the children with autism on both the Mullen and the PLS-4 auditory comprehension subtests.

Procedures

Examiners were instructed to arrange the toys in the play sets in specific ways to elicit a wider variety of anticipated play acts (e.g., some pop beads together and some apart, puzzle pieces outside of the puzzle, and doll sitting up or laying down). With the exception of the first free play toy set, the examiner modeled one symbolic play act using each pretend object (i.e., for toy sets two through five, see ). After this model, a timer was started and the child could play with an array of toys within each toy set for 3-min. The examiner was instructed to touch or play only with those toys that the child had already picked up or played with. It was acceptable to imitate the child's actions on a toy, but not to play with a toy in a way the child had not demonstrated (i.e., that may prompt child to use a higher level of play). If a child fixated on a specific toy for 1-min or longer in a perseverative way, that toy was replaced with another one. Examiners were trained to limit language facilitating strategies.

Each play session was videotaped on a Flip mino HD camera, uploaded to a computer in the research lab and then burned to a DVD. A trained research assistant (RA) opened the on-line play coder program on a desktop computer and observed the child's play on the DVD via Windows Media or VLC Media Player. The RA stopped the tape at each instance of a different play act on a toy and entered the time in minutes and seconds. The RA then selected the appropriate Play Set (1 through 5), and the specific toy that was acted on. The RA then selected the child's action from a drop down menu of all anticipated actions listed in the program for that toy. This continued until all play acts on objects in each set were coded. Symbolic play acts that occurred within 5-s of the examiner's model were not coded.

Inter-Rater Reliability

Four RAs were trained on the play coder program, and were considered reliable when their agreement with the first author was at a minimum 80% inter-rater agreement on total play actions over three different play assessments. Percent agreement was calculated by dividing the total # of play acts matched by both coders by the total # of acts observed by the primary coder plus the # of acts observed by the secondary coder. A total of 40% (29 of 73) of the play assessments were randomly selected and coded by a second RA to measure inter-rater reliability. The average inter-rater reliability was 88.3% (range 67-100%). Interclass correlation coefficients (ICCs) were also calculated for the weighted play score and object interest. The ICC for the overall weighted play score was quite high at .99. The ICCs for the individual play types that were combined to form the weighted play score were also quite high ranging from .87 for Takes Apart Combinations to .99 for Child as Agent and Specific Combinations. For the measure object interest, the ICC was 1.00. Another play outcome variable of interest in the current analysis was highest play level mastered. Twenty-three of the 29 play observations that were coded for reliability had sufficient play acts (4 play acts) within a category to have mastered that play level. Of these 23 mastered level scores, 21 (91%) were consistent between the primary and secondary raters. The two discrepancies resulted from very small differences in the number of substitution play acts observed (e.g., for one child the primary coder observed three and the reliability coder observed five substitutions; for a second child, the primary coder observed four and the reliability coder observed three substitutions). This small difference resulted in a different highest play level mastered score between the raters.

Analysis Approach

To test if the play skills of the children with autism were significantly lower than those of the children with other DD, independent samples t tests were used to examine differences between the two groups on average weighted play and average object interest scores. In addition to analyses of the main levels of play, between group differences were also investigated in the play subcategories (across categories 2 through 11, see ). Independent samples t tests were also used to compare the rates of each of the individual types of play acts. We also used descriptive statistics to summarize the proportion of children in each group who were emerging or had mastered specific play levels and z tests to determine if the proportions were significantly different across groups. We used Pearson correlations to determine if cognitive and language abilities (raw scores on MSEL and PLS-4) were related to play (average weighted score) and also used partial correlations to control for the relationship with nonverbal skills. Raw scores were used in the analyses due to limited variability in this sample in standard scores, with most scores at or near the bottom of the possible standard scores for a given age

Results

Group Differences in Play Levels, Object Interest, and Mastery

The first question to be addressed in the analysis was whether there were differences in play behaviors between children with autism and those with other DD. There were three different but related play outcome variables of interest used to address this question: total weighted play score (based on play levels), object interest, and highest play level mastered. Means and standard deviations for weighted total play and object interest for each group are presented in . Shapiro-Wilk Tests for normality of weighted total play scores within each group indicated that the scores were not significantly non-normal. Levene's Test of Equality of Variances was significant indicating that the variance of the autism group was significantly smaller than the variance of the DD group. Therefore, the Welch-Satterthwaite correction was used to compare the mean weighted total play scores. The weighted total play scores were not significantly different across groups ( t(67.9) = −.40, p = .69, d = −.09). Additionally no significant differences between the two groups were found for object interest scores ( t(71) = −.94, p = .35, d = −.22).

Table 6

In order to determine if there were differences between the two groups on emerging symbolic play, a z test for the difference in two proportions was used. Ten of the 13 children in the autism group (26%) and 10 of 38 children in the DD group (29%) met the criteria for emerging at the symbolic level of play (at least two acts). These proportions were not significantly different from one another ( z = −.05, p > .05). Similarly, there were no significant differences in levels of play mastered ( z = .10, p > .05). Across the different categories, three (9%) of the children with autism had mastered symbolic play (Level 4) compared to two (5%) of the children with other DD. Twenty-one (60%) of the children with autism had mastered functional combinatorial (Level 3) play, compared to 20 (53%) of the DD children. These were not significantly different proportions, z = .40, p > .05. Finally, five children in both groups (14% of the children with autism; 13% of children with other DD) had mastered functional play/object use (Level 2). These were not significantly different proportions, z = −.20, p > .05. Overall, there were no significant group differences in the play outcomes of the two groups of children across any of the three play measures.

Group Differences in Play Subcategories

Analysis of the specific subcategories of symbolic play revealed that the groups were similar in this regard as well. Twenty (57%) of the children with autism performed at least one substitution play act, compared to 21 (55%) of the children with other DD. These were not significantly different proportions, z = −.07, p > .05. One child with autism engaged in at least one symbolic play act that involved 'doll as agent' compared to three children with other DD; however, this difference was not significant, z = .43, p > .05. The only play category with a significant difference between groups was the 'presentation combination' category ( t(71) = −3.27, p = .002, d = .76); in that children with autism averaged 2.14 play acts while children with other DD averaged 1.16 play acts. This is considered to be a moderate effect size ( Cohen 1988).

Group Differences in Cognition and Language

We investigated the possibility of group differences in cognition and language by analyzing raw score mean differences on the tests of cognitive and language development across groups (see ). Tests for normality indicated that PLS-4 Auditory Comprehension scores were not normally distributed for either the autism or DD groups. Additionally, the MSEL Receptive Language raw score was not normally distributed in the autism group. Examination of the distribution of scores indicated that a few children in each group scored exceptionally high for their group and that variability was larger in the DD group. presents the box plots for these language comprehension scores and shows the distributions for both groups.

Independent samples t tests using the Welch-Satterthwaite correction indicated that children in the two groups differed in terms of their receptive language abilities as there were significant mean differences on the PLS-4, Auditory Comprehension Raw Score ( t(59.40) = 2.50, p = .015, d = .58) and the MSEL Receptive Language Raw Score ( t(69.04) = 2.03, p = .047, d = .47). For both receptive language measures, the means for the DD group were significantly higher than the means for the autism group. No significant differences between groups were observed for expressive language abilities ( t(71) = −.85, p = .40) or nonverbal cognitive skills (i.e., Fine Motor and Visual Reception subtests of the MSEL) ( t(56.26) = −.47, p = .15).

Relationship of Play, Language, and Cognitive Measures

The second set of questions examined the relationship between play, language, and cognitive behaviors, and the effect of group on this relationship. Preliminary Pearson correlations were examined between weighted total scores and cognitive (MSEL) and language (MSEL, PLS-4) raw scores. Weighted total score was the only play measure we included in these analyses because all three of the play measures were highly correlated with each other, and the weighted total score appeared to be the best reflection of overall play level. We calculated correlations within each group (autism and other DD). For the children with other DD, results indicated significant correlations ranging from .44 to .71 ( p < .01 for all) between weighted play scores and raw scores on the MSEL Receptive, MSEL Expressive, PLS-4 EC, and PLS-4 AC. Correlations between weighted play and MSEL Composite and MSEL nonverbal (i.e., Fine Motor and Visual Reception subtests) raw scores were even higher, at r = .83 and r = .84 respectively for the DD group. For the children with autism, correlations between weighted total play and raw scores on the MSEL Receptive, MSEL Expressive, PLS-4 EC, and PLS-4 AC were notably smaller and not statistically significant. Correlations were statistically significant between weighted play scores and raw scores on the MSEL Composite (r = .49, p < .01) and MSEL Nonverbal (r = .50, p < .01) for the autism group. The MSEL Composite raw score includes performance across all four subtests. When partial correlations controlling for the effect of cognitive development were examined (partialing out the nonverbal scores from the MSEL), none of the correlations for either group remained significant. For the DD group, all correlations which were previously significant were now less than .10. For the children with autism, correlations which were insignificant before remained insignificant after controlling for nonverbal IQ.

Discussion

In this study, we utilized a systematic observational paradigm to measure and determine differences in play skills of developmentally delayed preschool children with and without autism. All children had severe communication impairments. We were unable to confirm our hypothesis that preschool children with autism would engage in fewer symbolic play acts. Results revealed no significant differences between the two groups of children in level of play, or expressed interest in playing with different toys. Our data showed a likeness across the groups in terms of emergence and mastery of symbolic play; although for all children, symbolic play was the least frequently observed type of play. We also failed to find any group differences in diversity of object play. Thus, in contrast to other findings, the level and diversity of functional and symbolic play of children with autism was not lower than that of children with other DD. These results add support to research documenting more play similarities than differences between preschoolers with autism and other DD ( Dominguez et al. 2006; Naber et al. 2008); specifically for children with similar expressive language skills.

We were somewhat surprised that overall, the children with autism did as well as the children with other DD on our play measures. Given the comparable play behaviors across the two populations, the results do not provide evidence for a specific play deficit for children with autism. It is possible that we did not find significant differences between the two groups due to recruiting children who were nonverbal or minimally verbal, lending to greater expressive and cognitive similarities across the groups. Although the children were not matched on cognitive and language skills; they were placed in each group based on our recruitment criteria. Thus, group differences may have, in effect, been erased by recruiting participants with a narrow range of language and cognitive abilities.

Play deficits characteristic of young children with autism may be due to difficulties orienting to and imitating caregiver's actions on objects ( Wetherby 2006). Such difficulties may disrupt turn-taking and lead to less developed knowledge and mental representations of objects and events ( Yoder 2006). Thus, a limited interest in and ability to act on objects appropriately in play contexts may be due to a problem in social learning ( Bandura 1977), or a lack of attention to adult models and reinforcement. For example, recreating action schemas in a pretend play sequence such as feeding a baby doll, burping the doll, and putting the doll to bed requires orienting to the social actions of others, a significant challenge reported for individuals with autism compared to those with other DD such as DS ( Sigman and Ruskin 1999). We need more studies to confirm if social learning problems, and/or difficulties attending to salient actions of others, are at the root of reported play deficits for this population. We did find one play difference between the two groups, in that the children with autism combined toys together in a conventional way (e.g., putting a puzzle together, nesting cups, and matching shapes in shape sorter) more so than children in the DD group. This type of play behavior may be easier for children with autism to recreate as it requires an understanding of how objects go together based on knowledge of object properties, a skill less dependent on adult models to learn.

The most common type of play across both groups of children was functional play. They played with objects in conventional ways (e.g., stacked blocks), related objects to self (e.g., brought toy phone to ear to talk), and extended actions to others (i.e., fed examiner with a bottle). Although limited, symbolic play was not completely missing from their play repertoires. For example, a few children would place the sponge on a spoon and pretend to feed the baby doll. Although more children with other DD engaged in symbolic play with dolls, this difference was not significant. Hobson, Lee, and Hobson (2009) posed a cognitive based view for this apparent lack of pretend play by some children with delayed language. Difficulties assigning meaning to toys in a pretend way may be due to limitations in identifying and adopting other people's perspectives. This cognitive view has been discussed as relevant for children with autism; however in the current study, children without autism demonstrated a similar absence of pretend play. Perhaps, regardless of an autism diagnosis, preschool children with significant language and cognitive deficits have not yet developed the cognitive underpinnings and social understanding necessary to play with toys symbolically.

In order to better understand play development of children with autism or other DD, it will be necessary to examine current play taxonomies and find more consistent and sensitive methods to measure more subtle developments in play. For example, decontextualized play described by Belsky and Most (1981) included 'pretend self' and 'pretend other' (or Child as Agent) behaviors. These same behaviors were categorized as 'elaborated functional play' in later research ( Williams et al. 2001), and more recently categorized as a subtype of symbolic play ( Dominguez et al. 2006; Stanley and Konstantareas 2007). Williams et al. (2001) found play differences only when elaborated or combined play and pre-linguistic behaviors were examined. Children with autism spent less time playing with multiple objects at the same time, or using vocalizations and/or gestures in play. Further, children with autism engage in fewer symbolic play behaviors that involve attribution of false properties and making reference to an absent object ( Libby et al. 1998). These authors suggest there is greater contextual support for substituting one object for another, whereas decontextualized symbolic play requires the child to construct ideas based on events removed from the immediate context. These categories of symbolic play require relatively advanced language abilities. Our participants were all beginning communicators, so the fact that we did not find any differences across groups may reflect floor effects for these more advanced play behaviors. Assessing sequential and elaborated play, or combinations of concurrent play and language behaviors, may be more sensitive to identify differences across populations of children with developmental disabilities.

Relationships between play, language, and cognitive skills have been examined repeatedly across populations of children with varying cognitive and language developmental profiles. Our results showed high correlations between play, language, and cognitive measures, indicating that play is commensurate with these measures and perhaps does not add any unique insights into a child's language abilities; at least within a single time point comparison. Over time, however, play skills have been found to predict later language outcomes, and studies examining children's communication growth have emphasized the importance of including play as an important prelinguistic treatment goal ( Yoder 2006). Through our ongoing longitudinal study we will be able to evaluate how play develops over the pre-school years, and determine if play differences between children with autism and other DD emerge during the transition from pre-linguistic to linguistic communication.

Limitations

It could be construed that the adult modeling of a symbolic play act at the beginning of each play set and replacing toys if a child fixated on a toy, may have inflated the child's symbolic play or object interest behaviors. Even though we did not give a child credit for spontaneous symbolic play if their action immediately followed this model, it is possible that the children imitated this model within the 3 min play set. When models are provided, children with autism can imitate symbolic play acts even better than children with DS and typically developing children ( Libby et al. 1997); however, even when no play models are provided children with autism continue to produce symbolic object substitutions at comparable rates to these same groups of children ( Libby et al. 1998). When symbolic play models are provided, it would be beneficial to evaluate how often a child imitates this model, and perhaps code only novel symbolic acts to determine if the child truly understands symbolic play. In relation to object interest, few children in the current study required this modification in test administration, and replacement of toys was comparable across the two groups.

One possible explanation for our findings of no significant group differences is that the sampling context did not allow the child to express the range and 'type' of play skills he/she was capable of. For example, the majority of our participants were boys (75%) and two play sets, the Tea Set and Grooming, may have been less appealing to their interests, and concurrently affect motivation to engage in play. Further, the coding system was based on what adults 'anticipated' the child would do in a specific play situation. Observing play behaviors of typically developing children engaged with the same play sets and adding their play acts to the coding system is one future option. Also, adding sequential play actions to the coding system, and perhaps tracking multiple acts on different toys may lead to greater group differences. On the flip side, the play context in this study was very structured with the exception of the initial warm-up. The sets of toys included specific objects that could be used to pretend; therefore, the context may have led to a higher number of symbolic play acts than would have been observed in a less structured, free play context.

Conclusions

In summary, we did not find group differences in quantity of play with different objects and symbolic play behaviors between preschoolers with autism and other DD. This is most likely because we recruited participants at similar language and cognitive stages of development. Future research using common classification systems is needed to illuminate reported play discrepancies and behaviors of young children with DD. This task may also be accomplished by breaking down current classification systems into more detailed behaviors, and including a wider range of symbolic play behaviors that children may engage in without much effort. As expected, strong correlations were found between play, language, and cognition, and the correlations were so strong that when the nonverbal cognitive measures were partialled out, play no longer correlated with language. Over time, our longitudinal analyses may complement current research and show that play is a significant predictor of language, and other early communication skills.

Acknowledgments

The research was funded by the National Institutes of Health-National Institute on Deafness and other Communication Disorders (R01 DC 007684); and the National Institutes of Health-National Institute of Child Health and Human Development (P01 HD 018955). We would also like to thank the core support service of the Kansas Intellectual and Developmental Disabilities Research Center, University of Kansas, funded by National Institutes of Health-National Institute of Child Health and Human Development (P30 HD 002528). We gratefully acknowledge our project coordinators and research assistants for their diligent efforts on this project, and the participating families for their time and ongoing support.

References

Naber F, Bakermans-Kranenburg MJ, van IJzendoorn MH, Swinkels S, Buitelaar JK, Dietz C, et al. Play behavior and attachment in toddlers with autism. Journal of Autism and Developmental Disorders. 2008;38:857-866. [[PMC free article] [PubMed] Google Scholar]

# data[].attributes.attachment_link.title
Symbolic Play of Preschoolers with Severe Communication Impairments with Autism and Other Developmental Delays: More Similarities than Differences

# data[].attributes.attachment_link.description
Children with autism are often described as having deficient play skills, particularly symbolic play. We compared the play of 35 children with autism to 38 children with other developmental delays. All children were preschool-age and produced less than 20 different words. Results indicated no significant differences across the two groups in their play.

# data[].attributes.body
In order to support children with special needs through outdoor play, this article lists many different ways to adapt fun outdoor actives for them so they can still be included. It covers: Hearing loss, Wheelchair, Vision, Asthma, Speech, Limited use of hands and arms, and Cognitive Impairment inclusions. It also lists how we can best explain differences to other children, general tips for overall team inclusion, and checking with the child about the activity so that they have a choice. Children with special needs can play outdoors with supports of their parents and other individuals.

# data[].attributes.attachment_link.readable_text
Fifteen percent of children ages 3 through 17 have one or more developmental disabilities. Children with chronic conditions and disabilities benefit from regular outdoor activity, movement, and athletics just as their peers do; however, children with disabilities and/or chronic health conditions may need different accommodations than their peers.

Understanding the common accommodations for children with differing abilities will help you provide kids who need different accommodations with the most enriching experiences, and help them build their confidence and skills. We've compiled a list of some of our favorite outdoor activities along with some modifications that are helpful to kids who need different accommodations.

Since 2002, CoachArt has provided free lessons in arts and athletics for children impacted by chronic illness. Some of the inclusions tips we'll be sharing are from our work with children of different abilities, and we've added some additional resources to help modify specific outdoor activities for kids.

The inclusion tips we'll be sharing include accommodations for kids with vision impairment, hearing loss, asthma, speech impairments, limited use of hands and arms, and cognitive impairments, and for children who use wheelchairs. These adaptations are suggestions; accommodations for children should always be considered individually. Whenever appropriate, speak with your child's doctor prior to participation in a new activity and, if necessary, obtain the doctor's written consent.

10 FUN OUTDOOR ACTIVITIES THAT CAN BE MODIFIED FOR KIDS WHO NEED DIFFERENT ACCOMMODATIONS:

1. Basketball

Basketball gives children the opportunity to learn teamwork. Working as a part of a team while playing is a great way for kids to adopt a "team spirit" and work through challenges together. Manchester University has a great guide for adapting basketball for children of differing abilities, including general modifications such as using a softer ball when needed, lowering baskets, or enlarging baskets.

2. Baseball

3. Miniature Golf

Miniature golfing is a fun outdoor activity for kids that be played as a group, or as a fun family activity. When playing with children who need different accommodations, you may consider using a different size club or ball if necessary, allowing the child to explore the course before jumping right in, encouraging the child to practice with the club to be comfortable using it and swinging it, and trying a non-peak time to give the child more time to be comfortable. Mark Riccobono, the Executive Director of the National Federation of the Blind, wrote a wonderful article with tips to help children with visual impairments: Introducing Your Blind Child to Miniature Golf!

4. Outdoor Art Projects

If you want to take a regular activity outside, moving art projects outdoors is a fantastic way to get fresh air and allow a child to be creative. Try a mixed media project using nature, such as leaves. This adds an extra element of creativity and discovery. For children with asthma, be aware of potential triggers, especially if the pollen count is high. For children with disabilities affecting fine or gross motor skills, be sure to check out our post on adaptive crafts and art materials.

5. Nature Walks

As a group activity, or one-on-one, being outdoors - in nature - encourages children to use their senses, connect with nature, and get the body moving. This is an especially beneficial activity if a child is shy or needs less rigorous movement activities. For children who use wheelchairs, m any parks list accessibility on their websites, but if not, make a quick phone call to be sure that there is accessibility. If a child has difficulty walking distances, try coupling it with a picnic. In addition to the health benefits of being active, one study found that just five minutes spent being active outside causes significant improvements in self-esteem, mood, and depression.

6. Scavenger Hunts

Scavenger hunts are not only a great way to get outdoors with kids, but they offer hands-on learning that can aid children of all abilities in boosting problem-solving skills, they are easily customizable to a child's specific needs, and they encourage group cooperation and working together as part of a team. Be sure that the scavenger hunt is suitable for individual needs. For example, use flat surfaces, and ensure that the area is free of tripping hazards and easily accessible. For students with , consider a smaller area. Utilizing a team system or buddy system gives kids who need different accommodations the chance to work as a team, with support and assistance. visual impairments

7. Tennis

Tennis rackets: Rackets come in a variety of shapes and sizes, including ones that are shorter, smaller, and lighter, which make gripping the racket and hitting the ball easier, especially if range of motion is an issue. Sometimes athletic tape or a gripping device is used to secure the racquet to the hand and forearm.

Two-bounce rule: Allow the ball to bounce twice before a return volley.

Tennis balls: There are numerous kinds of tennis balls that vary in size and compression. Larger tennis balls are easier to hit and lower compression means that tennis balls will move more slowly and be less likely to bounce overhead, allowing rallies to last longer.

Tennis courts: Even courts can be reconfigured for adaptive tennis play. For instance, reducing the playing area means longer points and more fun. Lower tennis nets and portable nets are also available to modify the playing areas to whatever works best for learning and playing, even off the tennis court on a flat surface like a blacktop, driveway, or playground. There are also swing tee stands to practice stroke mechanics.

Wheelchairs for Tennis: Special wheelchairs with cambered wheels can be used for better stability and maneuvering, but for introductory learning, a child's regular wheelchair can be used.

8. Soccer

9. Flag Football

10. Outdoor Yoga

GENERAL INCLUSION TIPS AND MODIFICATIONS FOR KIDS WHO NEED DIFFERENT ACCOMMODATIONS:

WHEELCHAIR INCLUSION

INCLUSIONS TIPS AND MODIFICATIONS:

COMMUNICATION

Whenever possible, put yourself at eye level to facilitate conversation by sitting in a chair or crouching down.

Do not speak loudly and/or slowly to an individual using a wheelchair unless you know that doing so is necessary to communicate.

Always ask permission before pushing somebody's wheelchair.

Make conversation with students when you push their wheelchairs, just as you would if you were walking with a student who does not use a wheelchair.

VISION IMPAIRMENT INCLUSION

INCLUSIONS TIPS AND MODIFICATIONS:

CHECKLIST

1. Are you prepared to provide the students with verbal directions about all parts of the activity?

2. Is the space clear to allow for easier movement?

3. Are frequently-used resources kept in the same accessible place, and labeled?

4. Have you taken time to allow the child to explore in a way that's helpful for them?

HEARING LOSS INCLUSION

Hearing loss is the most common disability in the U.S.; three out of every 100 school-age kids have a significant hearing loss.

INCLUSIONS TIPS AND MODIFICATIONS:

Obtain the student's attention prior to speaking.

Reduce auditory distractions (background noise).

Enhance speech-reading conditions (avoid hands in front of the face, keep mustaches well-trimmed, no gum chewing).

Face your students and make eye contact when speaking. Clearly enunciate speech.

As a general rule, always stand close to a student who is hard of hearing when giving instructions.

Use visual supplements (predetermined visual signals or signs, whiteboards, or visual charts).

Do not exaggerate your lip movements, but slowing down a little may help some students.

Use facial expressions, gestures, and body language to help convey your message, but don't overdo it.

Repeat others comments and/or questions before responding to make sure the hard-of-hearing student heard.

INCLUSIONS TIPS AND MODIFICATIONS:

Check in with the child, and offer a rest break from activity if necessary.

Have the child's inhaler nearby and ready to be used.

If a child is uncomfortable with activities that include running, consider a slower pace or for group games, try a position that requires less running if necessary.

UNDERSTAND POTENTIAL ASTHMA TRIGGERS:

TYPES OF ASTHMA:

Child-onset Asthma: This type of asthma happens because a child becomes sensitized to common allergens in the environment - most likely due to genetic reasons.

Exercise-Induced Asthma: Some people only experience asthma symptoms during physical exertion. With proper treatment, a person who suffers from exercise-induced asthma may not have to limit his/her athletic goals.

Steroid-Resistant Asthma (Severe Asthma): Steroid-resistant asthma refers to inflammation and constriction of the airways that does not respond to treatment with steroids.

SPEECH IMPAIRMENT INCLUSION

INCLUSIONS TIPS AND MODIFICATIONS:

When speaking with people who have difficulties with speech, you should:

Be patient- don't rush them or finish their sentences.

Always ensure you understand what the person has said before proceeding.

Ask the student, if necessary, to repeat what they have said or write it down.

Consider working out a better way of communicating with each other- use pictures, diagrams, and drawings to make or clarify your point.

During group activities, allow the use of predetermined hand signals if it is helpful for a child.

LIMITED USE OF HANDS AND ARMS INCLUSION

INCLUSIONS TIPS AND MODIFICATIONS:

COGNITIVE IMPAIRMENT INCLUSION

INCLUSIONS TIPS AND MODIFICATIONS:

Repeat instructions

Provide frequent feedback

Break down tasks into smaller steps

Display rules

Prepare students for transitions

Reduce distractions

Buddy student up with a strong student or volunteer

Find out the student's strengths and emphasize them

Be flexible about expectations

Seek advice from parents/guardians

TYPES OF COGNITIVE IMPAIRMENT:

A student with a cognitive impairment may:

Have a short attention span

Have speech and language difficulties

Have a range of difficulty with physical/ motor skills

Be overwhelmed by a large amount of new information at once

View each learning experience as new, instead of attaching new knowledge to prior learned ideas

Behave inappropriately due to difficulty reading social situations

Have low self-esteem

GENERAL TIPS FOR GROUP/TEAM INCLUSION

1. If possible, offer a volunteer buddy if extra support is needed. This gives every child the chance to work on cooperative and teamwork skills.

2. When working in groups, discuss with the group what modifications are going to be made to the game, sport, or activity.

3. Be prepared to field questions so that all participants understand and feel included in the process.

HOW TO EXPLAIN DIFFERENCES TO CHILDREN

Children have a natural curiosity to try to understand the world around them, including differences among themselves and others. Children learn to view differences with acceptance when adults model respectful behavior and acknowledge curiosity with honest explanations that children can understand.

When explaining differences and accommodations:

Say "he/she uses a wheelchair" (not wheelchair bound).

Say "children with illness" or "children who are differently-abled" (not cancer patients, disabled kids, etc.)

Say "same-age peers" or "children without disabilities" (not normal, able-bodied, etc.)

CHECKING IN WITH A CHILD ABOUT THE ACTIVITY

Before the Activity: Ask the student for their thoughts on how they would like to modify an activity.

During the Activity: Check in with the student during the activity privately if necessary, and revise or make additional accommodations as needed.

After the Activity: Check in with the child after activity to see what went well and what they might like to try differently next time.

GENERAL COMMUNICATION TIPS

Speak directly to the student (as opposed to a caretaker)

Be clear and comprehensive

Avoid assuming preferences

Ask questions

Relax and have fun!

ADDITIONAL RESOURCES:

PE Central offers several general adaptation suggestions for specific activities with kids who need different accommodations.

Scholastic provides excellent suggestions to help children with a variety of abilities to feel welcome and able to participate outdoors.

CoachArt Special Needs Inclusion offers tips for communicating with special needs children and inclusion tips for kids who need different accommodations.

Think outside the box! For many outdoor activities, a child may not require different accommodations. Always be aware and encourage a child to participate in a way that makes them feel comfortable. It's okay to be creative - there are ALWAYS options for adaptations. And most important, have FUN! The more fun you have, the more a child will be open to trying fun, new, and challenging activities.

MAKING A DIFFERENCE FOR FAMILIES IMPACTED BY CHILDHOOD CHRONIC ILLNESS
What are some of your favorite outdoor activities for children who need different accommodations? We'd love to hear from you. Please share your experience with us in the comments.
CoachArt offers free art and athletic lessons to chronically ill children and their siblings between the ages of 5-18 in Los Angeles, San Francisco Bay Area, and San Diego. If your child has been diagnosed with a chronic condition, we invite you to fill out a student eligibility form or get in touch to learn if CoachArt is right for your child.

CoachArt creates a transformative arts and athletics community for families impacted by childhood chronic illness. Since 2001, CoachArt has matched volunteer coaches with kids for free one-on-one or group lessons in arts and athletics. We invite you to get involved !

# data[].attributes.attachment_link.title
10 Fun Outdoor Activities for Kids Who Need Different Accommodations - CoachArt

# data[].attributes.attachment_link.description
Fifteen percent of children ages 3 through 17 have one or more developmental disabilities. Children with chronic conditions and disabilities benefit from regular outdoor activity, movement, and athletics just as their peers do; however, children with disabilities and/or chronic health conditions may need different accommodations than their peers.

# data[].attributes.headline
Source for families and caregivers: Symbolic Play

# data[].attributes.subject
Source for families and caregivers: Symbolic Play

# data[].attributes.body
The article attached reviews different ways for families and caregivers to expand and promote symbolic play through examples of different symbolic play activities!

# data[].attributes.attachment_link.readable_text
Babies imitate silly faces. Preschoolers invent characters and scenes. By five, children are staging full-fledged dramas! It's all about imagination.
0 to 2 by Carla Poole

Sarah drinks from her bottle while cradled in the arms of her attentive caregiver. At two months, she looks up and begins to imitate the caregiver's silly faces - eyebrows up and mouth wide open. Several months later, when she is a toddler, Sarah reenacts these loving experiences, holding her doll carefully in her arms and pretending to feed it.

Infants have an amazing ability to imitate the facial expressions and gestures of the people around them. And they have well-developed memories that enable them to remember a lot of what they see, feel, and hear. These imitation games and warm memories help to lay the groundwork for the imaginative pretend play of the toddler years.
Real-Life Symbols
By the age of 12 to 14 months, most toddlers begin to use toys in specific and appropriate ways. One-year-old Tommy knows - most of the time, anyway - that the ball is for throwing and the toy car is for pushing. Within six months, symbolic play begins, and Tommy starts to use blocks to build garages for his toy cars.

Around his second birthday, Tommy squeals excitedly, "Daddy, baby, go, go!" as he puts two fingers in the toy car and pushes it around the table. He's using his imagination to understand real events in his life - such as being driven to the store by his father and to express his memories. Tommy's stories are simple and based on his own experiences, but he is developing the ability to create and tell stories using characters, action, and setting.
Fantastic Dramas
During their twos, toddlers gradually begin to engage in more imaginative play. A group of 2-year-olds can turn a long bench into a bus and, with the playful cooperation and suggestions of an adult, take a trip to the zoo.

Toddlers' grasp of the line between fantasy and reality, however, is very fragile. When Johnny roars loudly, pretending to be a lion at the zoo, his playmate Sam becomes scared. Sam wonders if his friend might really become a lion - he sure sounds like one!
Nurtured Imaginations
The quality of infant and toddler experiences has an effect on a child's play - a secure and happy 2-year-old will easily begin to develop more extended and imaginative play episodes. Comforting hugs and predictable routines help the toddler develop the focused energy for meaningful pretend play - and set the scene for the rich imaginary play that takes places in his threes and fours.
What You Can Do
You play an important role in helping infants and toddlers expand their ability to imagine and pretend - from how you interact with them to the toys you offer. Engage young children in activities that develop symbolic play and encourage imagination.

Give babies a variety of toys - rattles to shake, squeaking toys to pat, plastic blocks to bang. Exploring these helps infants learn that different toys have different purposes - an important step toward symbolic play.

When symbolic play begins, provide toys with a clear purpose. Sometime after their first birthday, toddlers need items that elicit specific dramas. Plastic spoons and plates and a small stove top, for example, will lead to pretend cooking and eating.

Play along and offer suggestions. Sometimes 2-year-olds need a little help expanding their play. If a child is busy pretending to make soup but doesn't know what to do next, for example, you can suggest that he pour some soup in a bowl so you can taste it - "Mmmm, yummy!"

3 to 4 by Susan A. Miller Ed.D.

A small group of 3-year-olds asks the teacher for some cardboard boxes. They're playing "moving," they announce. Maria is the mother. Ashley, she explains, is the little girl, and Romana is her sister. They fold the dress-up clothes and then pack them and the doll's dishes in the boxes. As they carry their packed possessions, they say good-bye to a neighbor - "We'll miss you!" - and then move to the block corner, where they discuss their new bedroom.

Three-year-olds' imaginative play is usually based on their own experiences, and chances are one or all of these girls has moved. Often the pretending is fixated on and extended by a special prop, such as the boxes. Language also has a large role in preschoolers' imaginative play. Threes like to talk to set the scene for their activity -- stating that they're playing "moving," for example and use dialogue to express their feelings, such as sadness about missing an old neighbor.
Character Actors
Three is a common age for children to create imaginary friends. A child may talk for and to this special friend and include him quite naturally in daily activities -- waiting for him to get dressed and saving him a seat at the snack table. Threes are also becoming adept at inventing characters and scenes. But these usually have a short run - 3-year-olds change roles quickly and switch plots just as rapidly. A 3-year-old girl can move easily from being a bride with a special veil at a wedding to a shopper at the mall.
Reality Check
At age 4, children expand on the themes they explored as threes adding more details and realism. Not content with just baking a cake, they ice it, sing "Happy Birthday and then eat it! Their dress and props become far more elaborate too. Pretending to be doctors, fours will wear white coats and gloves and carry stethoscopes - and if these aren't available, they'll make their own. Their dialogue also becomes more detailed and realistic.

Although their play includes a rich degree of fantasy, fours are also developing a firm grasp of the difference between reality and make-believe. As one 4-year-old puts on a cape and starts to fly off, his friend turns to the teacher and whispers, "He can't really fly."
Action Packed
"Bam! Pow! Crash!" These are the sounds of the loud, exciting play of 4-year-olds - especially boys. They frequently become caught up in the rough-and-tumble play of good guys and bad guys - with many of their plots influenced by books or TV shows. This make-believe play provides opportunities for fours to act out feelings of anger safely, to make choices, and to feel powerful and in control.
What You Can Do
Imaginative play gives threes and fours the opportunity to express their feelings and test out roles and situations. Help to encourage and extend their rich pretending.

Provide a wide variety of props. Offer items that reflect children's daily experiences - baby dolls, kitchen equipment, and toy telephones. Incorporate items from their various cultural backgrounds, such as empty grocery boxes in different languages and an assortment of clothing.

Include open-ended materials to encourage creativity. Provide large cardboard boxes to make castles, garages, and spaceships. Fabric can become a fascinating costume - or a night sky.

Extend books through imaginative play. After reading Fireflies, Fireflies, Light My Way, by Jonathan London (Viking), offer preschoolers flashlights and dim the lights - firefly play is guaranteed! Puppets and feltboard characters are another great way to retell and extend stories.

5 to 6 by Ellen Booth Church

"We can do it right here in the dramatic-play center!" Nikki excitedly announces. "All we need are some costumes and props!" And with that, children embark on the great adventure of play-making.

Today the subject is Cinderella. The teacher helps out by providing a variety of Cinderella books, costumes, and prop materials. Children work together on planning the performance and discussing the characters. By the end of the week, a most amazing rendition of Cinderella is presented at various "sets" around the room.

But the play doesn't stop there - for weeks, children engage in reading and writing about Cinderella, making videos and audiocassettes of their performance, mapping the story, and analyzing the many characters. Through their imaginative play, children create their own integrated curriculum.
Curtains Up
For kindergartners, all the world is a stage. They love to pretend and can slip in and out of characters with ease and clarity. Throughout the kindergarten year, children develop a thorough understanding of the difference between real and pretend and come to understand when a story or character is a fantasy. This awareness gives them a stronger sense of self in relation to the world. Now they're entering a new realm of imagination where they can become other characters and still remain clear about their own identity.

Play in Many Acts The sophisticated pretend play of kindergartners is highlighted by their ability to extend a particular theme throughout the school day - and even longer. Their increased attention spans and awareness of details enable them to modify and embellish plots as they return to them each day, picking up where they left off.
Collaborative Productions
Five- and 6-year-olds apply their developing social skills to their pretending. While younger children often enjoy becoming characters on their own, kindergartners prefer to be part of a company of actors. Part of the fun is interacting with one another - discussing roles, sharing ideas for props, trying out different lines, and even talking about a character's motivation.
What You Can Do
You can encourage children's love of pretending by supplying story ideas and raw materials - and by connecting their play to the rest of the curriculum. Their rich imaginations are one of children's greatest learning tools - and the more you incorporate pretend play, the more they'll learn.

Encourage children to dramatize books, poems, and songs. Children's grasp of literature is always strengthened when they act it out. In doing so, they learn about story sequence and experience the creation of dialogue and the development of characters.

Share different versions of familiar stories. Reading the many adaptations of the Goldilocks story, for example, allows children to compare the different versions - and create their own.

Provide art and writing materials for making props. When children get involved in pretend play, encourage them to make props and costumes and to write signs and scripts.

Invite children to use their imagination to solve real-life problems. When social problems arise, suggest that children role-play possible ways to approach the situation.

# data[].attributes.attachment_link.title
Ages & Stages: Imagine & Pretend | Scholastic

# data[].attributes.attachment_link.description
Babies imitate silly faces. Preschoolers invent characters and scenes. By five, children are staging full-fledged dramas! It's all about imagination. 0 to 2 by Carla Poole Sarah drinks from her bottle while cradled in the arms of her attentive caregiver.

# data[].attributes.headline
Source for families and caregivers: Outdoor play

# data[].attributes.subject
Source for families and caregivers: Outdoor play

# data[].attributes.body
This article attached reviews different interesting outdoor activities that families and caregivers can create and do to expand on their PreK child's outdoor play time!

# data[].attributes.attachment_link.description
When your child’s main interaction with nature consists of playing Angry Birds, you know you have a problem! “Spending time outside is kids’ one chance to be kids and explore, without any kind of restrictions or limitations on their creativity or what they do,” says Debi Huang, writer and creator of…

# data[].attributes.body
This link provides 55 DIY symbolic play ideas

# data[].attributes.attachment_link.title
55 Symbolic/Imaginative Play ideas in 2021 | kids playing, imaginative play, activities for kids

# data[].attributes.attachment_link.description
Apr 9, 2021 - Symbolic/Imaginative Play Inspiration. See more ideas about kids playing, imaginative play, activities for kids.

# data[].attributes.body
This link provides outdoor activity ideas along with the estimated amount of time each activity takes.

# data[].attributes.attachment_link.title
Tinkergarten Activities - Outdoor activities designed for kids ages 3 to 5 years old

# data[].attributes.attachment_link.description
Tinkergarten play-based outdoor learning activities for kids are easy, fun and designed for learning skills that matter most. Try DIY activities with your kids, or take a class with a certified Tinkergarten leader.

# data[].attributes.body
This link provides a detailed presentation for teachers and how they can promote, encourage, and support symbolic play in a PreK classroom!

# data[].attributes.body
This link provides teacher resources for outdoor classroom ideas including ways to incorporate academics within outdoor activities!

# data[].attributes.attachment_link.readable_text
The sun is shining, and preschoolers are ready to play outside! Taking your classroom activities outdoors can be challenging at times, so we've come up with a list of six outdoor classroom ideas for your preschoolers.

1. Take Art Outside

Preschoolers often love to explore art in the messiest ways. Painting indoors can be a headache to clean up, so taking the paint outside is the perfect solution. The children in your care will love painting beautiful masterpieces in the warm sunshine. Another great outdoor activity for your preschoolers is rock sorting. First, have the children gather 15 to 20 rocks. Next, have them paint the rocks several different colors. Finally, when the paint on the rocks has fully dried, encourage your preschoolers to sort the rocks by color.

2. Make Math Fun with Outdoor Learning

Finding ways to teach math outside while keeping the children in your care focused can be a challenge. However, the Numbers Run activity is sure to keep your preschoolers actively engaged while learning about numbers.
Materials: What to do:

1. Ask the children to spread out, and let each child pick out a stick of sidewalk chalk.

2. Assign each child a number to write on the pavement with chalk. (Make sure they make the numbers large enough to be seen at a distance).

3. Explain that you will call out numbers, and the children are expected to run to the number called when they hear it. (Tell the children to stand on the number until you call the next number).

4. Begin!

5. Let the children have a turn calling out the numbers when they become comfortable with the activity.

3. Engage in Outdoor Sensory Play

Outside is the perfect place for sensory play! Encourage your preschoolers to engage their senses by playing with a mud mixing table or a water table. These outdoor classroom furniture pieces are excellent for exploratory and messy play. Getting messy is important for sensory learning and early childhood development.

4. Explore Science Concepts Outside

Gardening is a fantastic way to explore scientific concepts outside. As an educator, you can use gardening to teach the children in your care about plant growth as well as nutrition and the importance of eating healthy. Check out the Outdoor Learning section of our website for gardening tools to include in your outdoor classroom.

5. Encourage Outdoor Literacy Learning

Creative outdoor literacy activities are hard to come by, but we suggest exploring this literacy scavenger hunt activity with your preschoolers.
Materials: What to do:

1. Hide letter stones outside for children to find

2. When a child finds a letter, encourage them to make letter connections, and exercise their letter recognition skills. For example, "B is for bird. Did you see any birds on your scavenger hunt?"

3. Keep playing until all letters of the alphabet are found.

6. Enjoy Dramatic Play Outside

Playing house in outdoor playhouses is a classic dramatic play activity. Encourage children in your care to take turns playing different roles. Dramatic play is also great for children to explore professions. With the right accessories, children can enjoy pretending to be archaeologists, civil engineers, and environmental scientists. Pretending to fill these roles will not only entertain the children, but also teach them STEM concepts in an exciting way.

Additional Resources

Developing and Implementing an Outdoor Classroom
How to Create an Outdoor Art Studio
Creating Outdoor Play Environments for Infants and Toddlers
Why Getting Messy Is Essential to Early Childhood Development
Incorporating Gardening into Your Lesson Plans

# data[].attributes.attachment_link.title
Six Outdoor Classroom Ideas for Preschoolers

# data[].attributes.attachment_link.description
The sun is shining, and preschoolers are ready to play outside! Taking your classroom activities outdoors can be challenging at times, so we've come up with a list of six outdoor classroom ideas for your preschoolers. Preschoolers often love to explore art in the messiest ways.

# data[].attributes.body
https://www.sciencedirect.com/science/article/pii/S016363831500003X

https://empoweredparents.co/symbolic-play/

https://www.pgpedia.com/o/outdoor-play

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268009/

https://coachart.org/blog/10-fun-outdoor-activities-for-kids-who-need-different-accommodations/

https://www.scholastic.com/teachers/articles/teaching-content/ages-stages-imagine-pretend/

https://www.care.com/c/12-outdoor-
activities-for-kids

https://www.pinterest.com.au/kidsplayspace/symbolicimaginative-play/

https://tinkergarten.com/activities/ages/3-to-5-years-old

https://www.learnquebec.ca/documents/20181/71041/DevelopmentThroughSymbolicPlay.pdf/c336c06b-a564-43ab-8040-5de89cfb25f0

https://www.kaplanco.com/ii/outdoor-classroom-for-preschoolers