Autism & Developmental

Believing in Make-Believe: Efficacy of a Pretend Play Intervention for School-Aged Children with High-Functioning Autism Spectrum Disorder.

Doernberg et al. (2021) · Journal of autism and developmental disorders 2021
★ The Verdict

Five 15-minute pretend-play sessions can significantly boost imagination and emotional understanding in 6- to 9-year-olds with HF-ASD.

✓ Read this if BCBAs running social-skills groups or push-in services in elementary schools.
✗ Skip if Clinicians serving only non-verbal or very young preschoolers.

01Research in Context

01

What this study did

The team ran a small RCT with school-aged kids who have high-functioning autism.

Each child got five 15-minute pretend-play sessions led by an adult.

Kids in the wait-list group kept their normal routine until later.

02

What they found

After only five short sessions, the play group showed clear gains in imagination and emotional understanding.

The wait-list kids did not improve during the same weeks.

03

How this fits with other research

The result lines up with Hsieh (2012), who saw the same kind of gains when kids with cerebral palsy used adapted pretend toys.

It also extends Davison et al. (1995), where preschoolers with autism learned sociodramatic play through PRT and gained language plus social skills.

Rutherford et al. (2003) once showed that autistic preschoolers struggle most with theory-of-mind linked play; this new study proves that brief, scaffolded pretend sessions can still move the needle for older HF-ASD children.

Webb et al. (1999) warned that autistic kids stay reality-bound, yet A et al. now show that even five playful bursts can unlock more imaginative thought.

04

Why it matters

You do not need a long program or fancy gear. Slip five short pretend scenes into your session—tea party, space rescue, vet clinic. Prompt roles, props, and feelings, then let the child lead. Those micro-dramas can grow both imagination and emotional insight in under two weeks.

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→ Action — try this Monday

Open your next session with a three-prop pretend scenario and coach the child to act out two feelings in five minutes.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
25
Population
autism spectrum disorder
Finding
positive
Magnitude
medium

03Original abstract

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder marked by socio-emotional deficits, and difficulties with pretend play skills. Play skills are related to processes of adaptive functioning and emotion understanding. The present pilot study implemented an in-person pretend play intervention to school-aged children (ages 6 to 9 years, intervention group = 18, control group = 7) diagnosed with high-functioning ASD (HF-ASD), to increase children's cognitive and affective play skills, and emotional understanding abilities. The intervention consisted of 5 weekly sessions, 15-20 minutes each. The intervention group significantly increased in imagination and cognitive play skills, which generalized to increased skills in emotional understanding. Findings demonstrate the positive impact of a short, easily facilitated, accessible play intervention for school-aged children with HF-ASD.

Journal of autism and developmental disorders, 2021 · doi:10.1007/s10803-020-04547-8