Dysregulation of pretend play and communication development in children with autism.
Autistic children show uniquely disorganized pretend play compared to IQ-matched peers, with dysregulation linked to communication delays — giving you an early clinical marker.
01Research in Context
What this study did
R et al. observed 21 children with autism, 14 children with global intellectual impairment, and 15 typically developing children matched for age during free play.
The team scored every pretend act for organization and regulation, looking at whether actions formed coherent sequences or broke off, dissociated, or became unstable.
They also assessed communication development to see whether play dysregulation was linked to language delays.
What they found
Children with autism showed significantly disordered play regulation — actions broke off, dissociated, and were unstable more than in the other groups.
In directed play, however, the autistic children's actions were more structured and reached a better developmental level, suggesting context matters.
Dysregulation in play was associated with delayed and uneven development of communication skills in the autism group.
How this fits with other research
C et al. (literature) found autism can be spotted by age 2 and stays stable. R et al. now show one reason why: disorganized play and slow language growth are observable red flags that appear early.
Zajac et al. (literature) saw that autistic people struggle to form the average face. R et al. show a similar difficulty in forming the average story. Both studies point to a broader challenge with integrating pieces into a coherent whole.
A et al. (literature) and Chiara et al. (literature) mapped separate deficits in global intellectual impairment. R et al. place autism apart: play is more scattered and language more delayed in autism even when IQ is matched to the comparison group.
Why it matters
If a preschooler lines up cars but never makes them "drive," note it. Short, broken play sequences alongside communication delays can support an earlier autism referral.
The study also shows that directed play produces more organized behavior in autistic children — a finding you can use therapeutically. Structuring play contexts may support both symbolic play and language development.
Model two-step scripts like "fill cup, give drink" and wait for the child to add the next move. Longer play chains often bring longer utterances with them.
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02At a glance
03Original abstract
We hypothesized that the difficulties of the child with autism originate from disorders of organization and regulation of actions according to environmental changes. Autism impoverishes general mental representation skills, which are the basis of symbolic play and the development of communication. Twenty-one children with autism were compared with 14 children with global intellectual impairment and 15 matched typically developing children, on both regulation of play activities and communication development. Regulation of play was very disordered in children with autism, with breaking off, dissociation and instability of actions. However, in directed play their actions were more structured and corresponded to a better developmental level. In addition, dysregulation was associated with delayed, heterogeneous development of communication skills. The results of this study are in line with our hypotheses and emphasize the role of symbolic play in differential diagnosis and the value of therapies based on regulation processes and symbolic play.
Autism : the international journal of research and practice, 2005 · doi:10.1177/1362361305053253