The emergence of object play in young children at elevated likelihood for autism.

Abstract

This prospective study investigated object exploration and combination play, in addition to (pre-)symbolic play in children at elevated likelihood for autism (EL; younger siblings of autistic children and very preterm children). Play of EL-children with (n = 22) and without (n = 61) a best-estimate research diagnosis of autism at 36 months was measured using detailed coding of direct observations at the (corrected) age of 10 and 14 months. As expected, autistic and non-autistic EL-children progressed to (pre-)symbolic play following the onset of combination play. There were no significant differences between both groups for most play behaviours at 10 and 14 months. Non-autistic EL-children did engage in more general combination play acts than autistic EL-children at 10 months. Moreover, 25% of the non-autistic EL-children showed general combination play, versus none of the autistic EL-children at 10 months. At 14 months, non-autistic EL-children spent slightly more of their playtime in spontaneous (pre-)symbolic play than autistic EL-children at 14 months. Object play behaviours were more similar than different between autistic and non-autistic EL-children at 10 and 14 months when playing alone. Our findings do not offer strong support for using solitary object play assessment as a method to identify autism in these very young EL-children.