Developmentally appropriate play is different from age-appropriate play. Age-appropriate play is determined by looking at a child’s chronological age and determines what types of toys and activities a child should be using and participating in to match their peers interests and abilities. Developmentally appropriate play first looks at the child’s abilities to communicate, move their bodies, and operate in a social environment to determine their ‘developmental age’.  Their social-emotional development dictates their developmental age, and for children with diagnoses like autism and other delays, their developmental age is younger than their chronological age. This distinction is important because when we are working with a child at their developmental age, we’re going to be more successful at encouraging development and growth. However, if we work with a child at their chronological age, then we’re trying to teach them skills based on when they were born without considering which of the many prerequisite skills they may be missing from their developmental profile.  Each set of skills we learn as young children allow us to progress to the next milestone of development and enable us to fully understand what we’re doing and why. This concept strongly applies to play, a child’s primary medium for learning.

Imagine you were trying to teach a 13- or 14-year-old child algebra before they had mastered addition and subtraction. Because they are 13 or 14 years old, they should ideally be able to learn algebra, but it doesn’t mean they’re ready for algebra. Similarly, a child who is three or four years old, ideally should be socially playing with cars, figurines, dollhouses, et cetera, and doing what we call symbolic or pretend play.  However, their age does not mean that they’re ready for that type of play.  They first need to develop an understanding of their bodies and the world around them, and how to interact with it in a controlled, purposeful, and intentional manner.  If we skip the precursors/prerequisites to any set of skills, we never fully grasp what we’re doing at the higher levels.  This applies to play, academics and social skills, and basically every other thing we learn.  Seeing as humans grow from the ‘ground up’, pretty much everything we learn has necessary precursors that have allowed us to get to the next point where we are able and ready to learn that thing.    

When some children with social-emotional delays engage in ‘age-appropriate’ play they tend to use the toys in a rigid, repetitive, or self-involved manner. Instead of experiencing play in a truly social and emotionally engaging manner with peers or other adults, they engage in play in progressively antisocial patterns, and these behavioral patterns can become habitual and extremely hard to break in the future.  Many children begin to experience some level of comfort and familiarity from these types of play by rigidly and/or repetitively manipulating these objects leading to greater self-involvement and isolation.  This lack of social play further prevents a child from developing social-emotional connections and contributes to the child struggling to develop relationships, communication, and adaptive behavior.

Many therapists, educators, and doctors will say that independent play is appropriate and should even be encouraged. Unfortunately, they are not taking into consideration if the child is able to engage, interact, and communicate first.  Before a child learns to do anything independently, we must make sure that they can first build relationships, sustain social engagement, interact, and communicate. These are all precursors to interdependence (the real long-term goal, not independence). If we reverse the order, then some children, who may have instabilities (sometimes imperceptible) in their social-emotional development, will choose the ‘path of least resistance’ and do what’s easiest.  Playing on our own is easier than dealing with someone else and adapting to their ideas/challenges. However, it is far less socially emotionally rewarding, and over time this lack of socialization leads to psychological and behavioral challenges.

If we truly want to help a child develop in as natural a way as possible, it’s important that we focus on understanding their developmental age and encouraging developmentally appropriate play to facilitate growth. As children grow from infants to toddlers, they experience different developmental processes and progress through different milestones of development.  How they perceive, understand, and interact with the world around them changes as they hit each of these moments in life.  It’s each of these milestones of development that drives their interest in the world and allows them to engage in different types of social activities and play. 

As newborn’s, children experience the world as stimulus and/or sensation. They hear things, they see things, they feel things, they move, et cetera. It is these sensations that they begin playing with. They are touching mommy’s hair, spinning it in their fingers or even putting it in their mouth. They’re wanting to be rocked, swung, and bounced on mommy’s knee. They listen to the sounds of our voice when we sing and make silly sounds. They like tickles and raspberries on their belly. These are all different types of movement, visual, auditory, and tactile activities where we stimulate their body in fun patterns and rhythms.  They are hearing our voice, seeing our face, feeling our touch, and they begin to understand sensory and emotional exchanges within a meaningful relationship.

Sensory modulation activities, or as we call them, Sensory Play, are the initial type of play that most children engage in with their caregivers.  It is these types of experiences that facilitate effective co-regulated interactions where the child is experiencing sensation in the form of sound, touch, movement, pressure, sight, and they’re doing it with a nurturing caregiver and engaging in a continuous interactive pattern. Children can model the movements and even facial expressions of the caregivers as early as two weeks of age, and over time, they don’t just show an interest in their caregivers and fall in love with them, and they also become more consistently responsive to them. When their caregiver is about to tickle them, they respond to the caregiver with open arms and looks and smiles to show them they want more. It’s this type of play that unfortunately many children with sensory-affect-motor integration challenges struggle with.  Because of these challenges we need to go back and continue to master these types of interactions and play before we can move onto more complex exchanges.

Early in life, and sometimes as they get older, a child who struggles to understand and/or tolerate sensation, requires this type of developmentally appropriate play.  Instead of swaddling them in a blanket, at age two or three we may be using a swing or a trampoline or some spandex fabric that’s being hung like a hammock. The goal is to help them experience these sensations with a nurturing caregiver within a meaningful interaction.  Ideally, they learn to experience and perceive these sensory and emotional exchanges in an organized and modulated manner by combining the sensation with the caregivers emotional feedback in the form of smiles, sounds, touch, etc.

Once they develop the ability to modulate sensation and the world around them is less over stimulating, distracting, and disorganized they move on to what we call Object-based Play. Because their bodies are more calm and focused, they are more aware of their environment and the different objects within it.  They begin to purposefully explore by moving through space as well as manipulating the various objects in it.  This is where children become more curious. It’s also where children start engaging in games like peekaboo, chase, and other visual-motor activities that help them develop their visual processing and improve their motor coordination. These types of interactive games treat the person, the person’s face, or the child’s favorite toy as an object of interest. It is our job to move and manipulate those objects of interest within the environment. We move them behind things, inside of things, on top of things, and all around the room. The child is learning to coordinate their movements with their visual perceptions and understand how space is oriented around them. However, and most importantly, it’s not just that they’re learning to move their bodies and explore space. They’re also learning about the social emotional components of other people in that space. This is the difference between playing peekaboo with someone and seeing a warm smiling face behind the hands versus pushing a button and having a jack in the box pop up.

Both are kind of cause-and-effect visual-motor activities, but only one of them provides the child with an emotionally meaningful experience where they get to read and respond to the caregiver sounds, facial expressions, and experience a rich emotional environment.  They also get to respond to the caregiver with their own emotional feedback, and there’s a continuation of that adaptive social pattern and communication. Unfortunately, when a child gets an opportunity to play with the Jack in the Box toy and they push the button over and over, it’s the exact same pattern repetitively, and the child is not having the rich, emotional co-regulated affective interaction that is a necessary component of child development.  While they may develop some visual processing skills and understand there’s something inside the box, they’re not actually developing the full social-emotional integration with their sensory and motor systems.  This integration is necessary to master as we get older and start to explore the world in more complex ways.

A child who is predisposed to visually hyperfocus on toys and get stuck in repetitive/rigid patterns is going to gravitate towards objects like the Jack in the box because it’s easier for them to understand and respond to versus playing the games like peekaboo, hide and seek, chase games, and ‘treasure hunts’ with different toys and people because those fixed repetitive patterns are simple and familiar and are easier for them to understand.  Object-based play is where children learn to coordinate larger sequences of dynamic motor and social patterns in response to another person’s actions. They’re moving through space, coordinating more complex movements, but they’re doing it with social intent and purpose. Remember, in order for a child to integrate all of these systems, we cannot target each system individually during separate tasks isolating each one. We must learn to use them altogether within rich, nurturing, social-emotional experiences as young children.   

Ideally, we play these games because our mommy or daddy was the one who hid the toy. When we find it, we go back and we look at them with a big smile on our face and wait for them to do it again.  This is different from a therapist who’s simply trying to teach a child to play hide and seek or to follow instructions.  Gene Ayres, the mother of Sensory Integration, said that integration only occurs when the sensory experiences are combined with a social component and that the child is responding in a purposeful and intentional manner. For many children with sensory integration and processing challenges, which all children on the autism spectrum have, their holistic development is not being nurtured when they’re engaging in self-involving visual activities where they’re playing with symbolic toys that are not developmentally appropriate for them.  They may be taught how to use them in an age-appropriate manner so they can look like their peers, but they are not learning the most important components of play because they’re not doing it in a fun socially-emotionally engaging manner.

In these instances, the activity or object itself is still the predominant interest of the child and is possibly leading to self-involvement or distraction.  They need to strengthen their perception of the social world, move through space, understand their bodies and how they are supposed to respond in the face of different obstacles and challenges. They see stairs, they start going up the stairs, but they’re doing this as part of a social experience and responding to someone who just ran up those stairs because they’re chasing after them.

As a child develops these systems all in an integrated manner, they begin to understand their perceptions of the world more completely and with more texture. At this moment, a child moves from understanding perceptions and reacting to them in a physical manner, immediately and sometimes impulsively, to perceiving the world of options and determining the best response or course of action.  The picture they create with sound, sight, smell, taste, touch, movement, et cetera, is now combined with rich emotional perceptions of the experience itself.  The challenge of climbing up a new jungle gym and experiencing the success and smiling down at our mom, dad, or babysitter, all come together.  These types of perceptions become freestanding, and they not only cause us to respond, but they cause us to pause and think at these moments. We start moving from perception/response patterns to becoming symbolic thinkers.  Symbolic thinking is when we can create freestanding ideas and is when children are able to engage in long patterns of emotional exchanges. Dr. Greenspan called this Meaningful Symbolic Ideation the 5th Milestone of his developmental framework.

 As children move into the fifth milestone, they begin to use more language and are developmentally ready for Symbolic Play. This play can involve using a doll or an action figure as a superhero/character or taking a toy car and driving it to school or home. Before a child is able to develop their own freestanding ideas, they engage in continuous affective back and forth exchanges with nurturing caregivers. Before this develops, those types of toys are either not interesting to the child or are so interesting, yet misunderstood, that the child becomes self-involved and/or repetitive and rigid with them. This third type of play, symbolic play, often emerges somewhere between 18 months and 2.5 years of life. However, for many children with developmental challenges this play can develop much later and sometimes not at all.  When we’re using these objects to represent our freestanding ideas, we can take a plastic banana and pretend to eat it or even turn it into a telephone or something else.  We can see objects as representations or symbols of something else, and we use them as such. Language is emerging and so is our understanding of numbers, words, and other types of symbols.

Remember, the goal is not to teach the type of play we want a child to engage in, but instead to nurture the child’s social-emotional development by making sure the types of play they have access to are developmentally appropriate. If we expect a child to be able to learn symbolic play because of their age, and they are unfortunately missing the precursors that allow them to get there, they might learn to move a certain animal or character, but they will have no idea why they’re doing it.  As a result, they can’t adapt it and they can’t truly use it to interact with their peers in a functional way. They will need more support and guidance every step of the way because they weren’t naturally developing these skills through social-emotional interactions. They were being taught them through memorization. As time goes on, they will continue to lose out on many rich social opportunities because they don’t have the necessary social emotional precursors that allow them to understand social patterns.

If we can identify the appropriate developmental play for each child, and nurture their growth from the ground up, then we can have our cake and eat it too.  We can help them achieve these higher levels of social-emotional functioning in a voluntary and enjoyable manner without forcing them or teaching them to exhibit specific behaviors, outcomes, or memorized patterns.

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