“When you do what your child loves, then the child will love to be with you. That is the essence of the P.L.A.Y. Project.”
  – Dr. Rick Solomon, Medical Director of the P.L.A.Y. Project at The Ann Arbor Center for Developmental and Behavioral Pediatrics

Entering the Child’s World Through Play
Many children who have autism want life to be predictable. In an effort to maintain order in their world, they may reject their parents’ attempts to interact and bond. This rejection can be heartbreaking for parents. Repeated rejections can also make it intimidating for parents to continue to reach out to their child since their child constantly fails to meet their expectations.

According to the philosophy of play-based therapy, parents must give up any ideas that they might have about what they would like to accomplish with their child. They must accept the child for exactly who he or she is. That acceptance will paradoxically allow the parent to help the child develop. The child’s sense of self will grow as the child watches the parents follow the lead he or she has set and thereby validating the child’s actions. The playtime empowers and allows the child to recognize his or her own ideas. Those ideas then become the driving force for the child’s development. The P.L.A.Y. (Play and Language for Autistic Youngsters) project is a child-centered, play-based autism therapy that teaches parents how to connect to their child and thereby facilitate their child’s development.

In play-based therapy, parents learn to join the child and meet the child in the child’s comfort zone. Many children with autism live primarily in a visual world. They prefer to watch the world, and this desire keeps them from interacting socially. It may also be the source of their repetitive behaviors and their tendency toward watching things such as ceiling fans (visual stimming). Parents, therefore, often need to turn to more physical ways of engaging the child. This can include chasing, capturing, counting, swinging, and squishing. These physical activities may be the best way to connect with a child with autism. Thus, if the child likes to spin, then the parents can spin. Of course, that is just the beginning. Once the parents have joined the child, then the child inevitably starts to respond to the parents.

Play-based therapy seems to be most effective for young children. Many experts believe that approximately 90 percent of brain growth is complete by age seven. Consequently, most basic life skills are acquired by age seven. It is for this reason that the P.L.A.Y. Project focuses on young children. Evidence seems to suggest that play-based therapy can make a profound difference in the lives of these young children.

Play-based Therapy
The P.L.A.Y. Project is one of many play-based approaches to autism therapy. Play-based therapies are based upon the Greenspan model of child development and focus on the feeling life of the child. As Dr. Rick Solomon, Medical Director of the P.L.A.Y. Project at The Ann Arbor Center for Developmental and Behavioral Pediatric states, “Successfully engaging with your child is tremendously healing.” Perhaps the most well-known play-based or social-pragmatic therapy program is FloortimeTM. Other play-based approaches include the SCERTS (Social Communication, Emotional Regulation, and Transactional Support) model and Communication Partners. When play-based approaches are viewed together as a category of autism therapy, the evidence suggests that they can help children recover from autism.

Any discussion of efficacy, however, should begin with two questions: 1) What are the therapeutic goals? 2) How can success be measured in a clinical trial?

Play-based vs. ABA
Applied behavior analysis (ABA) has risen to the top of the list of autism therapies and has become the gold standard. Many studies have documented the efficacy of ABA. ABA is often used to help children achieve academic goals, improve cognition, and achieve developmental milestones. In the case of ABA, efficacy is frequently measured as improved Intelligence Quotient (IQ). IQ is an established metric that is easy for parents, teachers, and therapists to understand and recognize.

Many features distinguish play-based therapies from ABA. The main focus of play-based therapies is to teach the child how to connect with people and have a sense of self that originates from within. Play-based therapies aim to improve the quality of interaction between the parent and child. Success is often measured by an emotional quotient (EQ) or, more specifically, long contingent-reciprocal exchanges. Children are watched for improvements in ability to pay attention to others, regulate their own emotions, and have long, complex, two-way communication. Proponents of play-based therapies believe that the EQ is critical for the emotional health of the child and is crucial for recovering a child from autism. Dr. Solomon describes it thus, “If you are successful in helping your child march up social developmental levels, then your child will be connected with you in a real way that will eventually thin the autistic veil.”

Dr. Solomon and colleagues presented the preliminary results of their controlled clinical trial of the P.L.A.Y. Project for children with autism at the 39th National Conference of the Autism Society of America. The pilot study showed that parent-child interactions appeared to be improving under the P.L.A.Y. Project. The data also revealed the need for improved tools to measure play and parent-child interactions. Dr. Solomon and colleagues have submitted a proposal for the next phase of study to the National Institute of Mental Health (NIMH). With these promising early results, Dr. Solomon feels hopeful that federal funding will allow for a more thorough study of the efficacy of the P.L.A.Y. Project.

ABA and play-based therapies are not mutually exclusive and, for some children, they may prove to be excellent complimentary approaches.

Joining the P.L.A.Y. Project
The P.L.A.Y. Project is a revolutionary addition to autism therapy — it is inexpensive and can be disseminated very quickly. Evidence of this is found in its growth throughout the country. Although only seven years old, the P.L.A.Y. Project now includes over 100 home consultants from more than 40 agencies (including Easter Seals) who provide families with intensive programming in 17 states. In the state of Utah, for example, all birth-to-three therapists are trained in the P.L.A.Y. Project approach. A current list of agencies that have P.L.A.Y. Project Home Consulting Programs can be found at the P.L.A.Y. Project Web site ( www.playproject.org ). The Web site offers a DVD for parents and therapists who would like to learn more about play-based therapy.

The P.L.A.Y. Project infrastructure is constantly growing and evolving. Recently, the P.L.A.Y. Project partnered with www.relatenow.com to provide online tools that allow for consultants to make recommendations to families on techniques and refer them to content within the system. At www.relatenow.com , parents can upload videos and have them reviewed by P.L.A.Y Project Home Consultants. The Relate Now archives also contain libraries, resources, blogs, and chat rooms that facilitate learning from other parents.

Suggested Resources

• www.playproject.org
• www.relatenow.com
• www.healingthresholds.com
• www.easterseals.com
• www.floortime.org

What is the P.L.A.Y. Project?

• Designed for young children
• Training for parents and professionals
• Affordable and interactive

The P.L.A.Y. Project is Designed to Resolve Three Core Deficits in Autism

• Self-isolation and impaired social skills
• Language delay and impaired communication
• Stereotyped and repetitive behaviors

The P.L.A.Y. Project Vision
To be a community-based, national autism training and early intervention center dedicated to empowering parents and professionals to implement intensive, developmental interventions for young children with autism in the most effective and efficient way.

The P.L.A.Y. Project Mission

• Promote early identification and early intervention
• Educate community regarding National Academy of Science recommendations
  1) Begin interventions early (18 months to 5 years)
  2) Use intensive interventions 25 hours per week
  3) Have a teacher/play partner to child ratio of 1:1 or 1:2
  4) Use interventions that are engaging
  5) Have a strategic direction (e.g. social skills, language, etc.)
• Use community-based approaches to promulgate Developmental, Individualized, and Relationship-based interventions (DIR®)
• Support families in a parent-professional partnership
• Scientifically evaluate effectiveness of the program