Communication and Play Development

PlaySocial CommunicationAutism Red Flags

13 to 17 months
Pursues toy and returns toy to caregiver
Purposeful exploration of toys
Quickly locates the part of the toy responsible for operation
Attempts a variety of motor schemas (pushing, pounding, pulling) turning)
Hands toy to an adult because of inability to operate it / Uses gestures and vocalization to request, command, call attention to self, establish interaction, greet, protest and label / Pursues toy, but doesn’t return the toy (requires social interaction)
Repetitivemotor schemas, limited variety (uses toy in only one way, non-purposeful carrying or attachment to a toy)
Proto-imperative gesturing (nonsocial pointing to obtain an object, pointing for naming, picking out of an array) may be the only form of gesturing present
17 to 19 months
Single pretend play such as drinking from a cup, pretending to go to sleep
Child is aware he is pretending
Tool us (uses stick to reach toy)
Finds a toy hidden invisibly
Imitates house work and other actions / True verbal communication begins
Refers only to present situations
Uses words to show recurrence, existence, nonexistence, rejections and denial / May show functional or sensory play, but pretend play is absent
Imitation of actions is absent
May have words but because of lack of: gaze shift, showing, proto-declarative pointing (joint attention) child does not show the functions of recurrence, existence, nonexistence, rejections and denial.
Labeling may be only function present
19 to 24 months
Symbolic play extends beyond the child’s self; plays with dolls, pretends with more than one person
Combines two toys in pretend play
Plays house
Demonstrates short sequence of events; stirring food in pan, putting food on plate, feeding baby, etc. / Refers to objects and persons not present
Word combinations
Semantic markers / If child has more elaborate toy play, can an adult join the play? Is the play repetitive?
Proto-imperative gesturing is still present
All communicative behaviors which require joint attention are absent or very rarely present
24 to 36 months
Represents events less frequently observed or experienced; e.g. doctor visit or teaching
Multiple schemas within a single theme, sequence of events evolve
Associative play
Reenactment of experienced events with new outcomes / Responds to wh- questions
Asks wh- questions by putting wh- at the beginning of the sentence / See above
Play may focus on letters, numbers, puzzles, small manipulatives
Play may be hard to redirect
Verbal attempts may include movie scripts, commercials, rote counting with no communicative intent
Speech may be echolalic
Tantrum may be the primary form of communication

Key indicators of autism at 18 months are lack of two or more of the following: pretend play, proto-declarative pointing, social interest, social play, and joint attention.

Bindy Brown & Marilyn Finn Heartland’s Autism Resource Team September, 2000