Teaching symbolic play skills to children with autism using pivotal response training
Abstract
Used Pivotal Response Training (PRT) to teach 7 children with autism to engage in symbolic play behaviors. Symbolic play, complexity of play behavior, and creativity of play were assessed. In addition, generalization measures were obtained across settings, toys, and play partners. Interaction with the play partners and comparison with typical controls were also examined. Results indicated that children with autism rarely exhibited symbolic play before training or after a control condition. After specific symbolic play training using PRT, all of the children learned to perform complex and creative symbolic play actions at levels similar to that of language-matched typical controls. In most cases the children generalized their play to new toys, environments, and play partners and continued to engage in symbolic play behavior after a 3-month follow-up period. In addition, interaction skills improved after training. Treatment implications for these findings are discussed.
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Many autism studies using single subject designs have demonstrated positive effects of parent-delivered interventions for reducing problem behaviors, improving nonverbal and verbal communication, and increasing appropriate play and imitation.
“many autism studies using single subject designs have demonstrated the positive effects of parent-delivered interventions for reducing problem behaviors, improving children’s nonverbal and verbal communication skills, and increasing appropriate play and imitation skills.”
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
&NA; (1988) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-198802020-00022 · Cited by 12,603 · see citing works
Drake, M. M. (1988) · American Journal of Occupational Therapy · doi:10.5014/ajot.42.10.683b · Cited by 5,303 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, 3rd ed
Kendell, R. E. (1980) · American Journal of Psychiatry · doi:10.1176/ajp.137.12.1630 · Cited by 5,201 · see citing works
AN IMPLICIT TECHNOLOGY OF GENERALIZATION <sup>1</sup>
Stokes, T. F., & Baer, D. M. (1977) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.1977.10-349 · Cited by 3,351 · see citing works
Single Case Experimental Designs: Strategies for Studying Behavior Change
Barlow, D. H., Nock, M. K., & Hersen, M. (1976) · Cited by 3,036 · see citing works
Single case experimental designs: Strategieṡ for studying behavior change
Matson, J. L. (1985) · Applied Research in Mental Retardation · doi:10.1016/0270-3092(85)90012-8 · Cited by 1,193 · see citing works
Expressive One-Word Picture Vocabulary Test
(2012) · Springer eBooks · doi:10.1007/springerreference_184242 · Cited by 970 · see citing works
A natural language teaching paradigm for nonverbal autistic children
Koegel, R. L., O'Dell, M. C., & Koegel, L. K. (1987) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01495055 · Cited by 506 · see citing works
Baron‐Cohen, S. (1987) · British Journal of Developmental Psychology · doi:10.1111/j.2044-835x.1987.tb01049.x · Cited by 462 · see citing works
Generalization and Maintenance: Life-Style Changes in Applied Settings
Horner, R. H., Dunlap, G., & Koegel, R. L. (1988) · Medical Entomology and Zoology · Cited by 372 · see citing works
Symbolic Play and Language Comprehension in Autistic Children
Ungerer, J. A., & Sigman, M. (1981) · Journal of the American Academy of Child Psychiatry · doi:10.1016/s0002-7138(09)60992-4 · Cited by 365 · see citing works
Expressive One-Word Picture Vocabulary Test
Michalec, D., & Henninger, N. (2010) · Springer eBooks · doi:10.1007/978-0-387-79948-3_1544 · Cited by 359 · see citing works
TEACHING CHILDREN WITH AUTISM TO INITIATE TO PEERS: EFFECTS OF A SCRIPT‐FADING PROCEDURE
Krantz, P. J., & McClannahan, L. E. (1993) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.1993.26-121 · Cited by 328 · see citing works
Training parents to use the natural language paradigm to increase their autistic children's speech
Laski, K. E., Charlop, M. H., & Schreibman, L. (1988) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.1988.21-391 · Cited by 316 · see citing works
SYMBOLIC PLAY IN SEVERELY MENTALLY RETARDED AND IN AUTISTIC CHILDREN
Wing, L., Gould, J., Yeates, S. R., & Brierly, L. M. (1977) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1977.tb00426.x · Cited by 298 · see citing works
Spontaneous, instructed and elicited play in relatively able autistic children
LEWIS, V. A., & Boucher, J. (1988) · British Journal of Developmental Psychology · doi:10.1111/j.2044-835x.1988.tb01105.x · Cited by 266 · see citing works
Symbolic play in autism: A review
Jarrold, C., Boucher, J., & Smith, P. K. (1993) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01046221 · Cited by 249 · see citing works
How To Teach Pivotal Behaviors to Children with Autism: A Training Manual.
Koegel, R. L. (1988) · Cited by 189 · see citing works
Symbolic play in autistic, Down's, and normal children of equivalent mental age
Riguet, C. B., Taylor, N. D., Benaroya, S., & Klein, L. S. (1982) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01531618 · Cited by 132 · see citing works
Oke, N. J., & Schreibman, L. (1990) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02216054 · Cited by 108 · see citing works
Pretend Play and Patterns of Cognition in Down's Syndrome Children
Hill, P. M., & McCune-Nicolich, L. (1981) · Child Development · doi:10.1111/j.1467-8624.1981.tb03087.x · Cited by 98 · see citing works
A Neurophysiological View of Autism
Courchesne, E. (1987) · Springer eBooks · doi:10.1007/978-1-4899-1992-2_16 · Cited by 85 · see citing works
Pretend Play and Patterns of Cognition in Down's Syndrome Children
Hill, P. M., & McCune-Nicolich, L. (1981) · Child Development · doi:10.2307/1129181 · Cited by 84 · see citing works
Schreibman, L., Ploog, B. O., & Oke, N. J. (1988) · Springer eBooks · doi:10.1007/978-1-4613-0993-2_12 · Cited by 65 · see citing works
Structural and Affective Dimensions of Play Development in Young Children with Down Syndrome
Beeghly, M., Perry, B. W., & Cicchetti, D. (1989) · International Journal of Behavioral Development · doi:10.1177/016502548901200208 · Cited by 63 · see citing works
TASK DIFFICULTY AND TASK PERFORMANCE IN AUTISTIC CHILDREN
Clark, P. D., & Rutter, M. L. (1979) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1979.tb00514.x · Cited by 51 · see citing works
Symbol Use by Developmentally Disabled Children
Atlas, J. A. (1987) · Psychological Reports · doi:10.2466/pr0.1987.61.1.207 · Cited by 1 · see citing works
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Cited by
Sorted by citations
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., et al. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2407-8 · Cited by 1,421 · see citing works
Self-citationEvidence-Based Comprehensive Treatments for Early Autism
Rogers, S. J., & Vismara, L. A. (2008) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410701817808 · Cited by 984 · see citing works
Kasari, C., Freeman, S., & Paparella, T. (2006) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2005.01567.x · Cited by 951 · see citing works
Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., Guo, M., & Dawson, G. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.08.003 · Cited by 713 · see citing works
Corsello, C. M. (2005) · Infants & Young Children · doi:10.1097/00001163-200504000-00002 · Cited by 452 · see citing works
Behavioral treatments in autism spectrum disorder: what do we know?
Vismara, L. A., & Rogers, S. J. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.121208.131151 · Cited by 376 · see citing works
Can one hour per week of therapy lead to lasting changes in young children with autism?
Vismara, L. A., Colombi, C., & Rogers, S. J. (2009) · Autism · doi:10.1177/1362361307098516 · Cited by 331 · see citing works
Infants and Toddlers With Autism Spectrum Disorder: Early Identification and Early Intervention
Boyd, B. A., Odom, S. L., Humphreys, B. P., & Sam, A. M. (2010) · Journal of Early Intervention · doi:10.1177/1053815110362690 · Cited by 272 · see citing works
Jordan, R. (2003) · Autism · doi:10.1177/1362361303007004002 · Cited by 248 · see citing works
Assessing Change in Early Intervention Programs for Children with Autism
Kasari, C. (2002) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1020546006971 · Cited by 212 · see citing works
Tiede, G., & Walton, K. M. (2019) · Autism · doi:10.1177/1362361319836371 · Cited by 180 · see citing works
Parent education for families of children with autism living in geographically distant areas
Koegel, R. L., Symon, J. B., & Kern Koegel, L. (2002) · Journal of Positive Behavior Interventions · doi:10.1177/109830070200400204 · Cited by 165 · see citing works
The Effects of an Accelerated Parent Education Program on Technique Mastery and Child Outcome
Stahmer, A. C., & Gist, K. (2001) · Journal of Positive Behavior Interventions · doi:10.1177/109830070100300203 · Cited by 129 · see citing works
Self-citationSocial skills training for youth with autism spectrum disorders
Bellini, S., & Peters, J. K. (2008) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2008.06.008 · Cited by 80 · see citing works
Blake, B. E., & McCoy, K. A. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.04.021 · Cited by 20 · see citing works
- Authors
- Stahmer, A. C.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Stahmer, Aubyn C.
- ORCID
- Stahmer, Aubyn C.
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 1995-04
- Volume
- 25
- Issue
- 2
- Pages
- 123-141
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- OpenAlex
- W2049166709
- Cited by
- 307
- References
- 28
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 7 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 14 · 2019: 12 · 2018: 9 · 2017: 13 · 2016: 10 · 2015: 14 · 2014: 17 · 2013: 27 · 2012: 21
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1f31mh010385-01)
- National Institute of Mental Health (MH 28210, MH 39434, MH10385)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
- Keywords
- pretend play, pivotal response training, autism spectrum disorder, play skills, generalization, social interaction, children with autism
- MeSH terms
- Autistic Disorder, Behavior Therapy, Child, Child, Preschool, Creativity, Follow-Up Studies, Generalization, Psychological, Humans, Language Development Disorders, Male, Play and Playthings, Problem Solving, Reference Values, Social Environment, Symbolism, Treatment Outcome
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