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Prediction Of Playfulness By Pretend Play, Severity Of Autism Behaviors, And Verbal Comprehension In Children With Autism Spectrum Disorder

Authors Chen KL, Chen CT, Lin CH, Huang CY, Lee YC

Received 18 July 2019

Accepted for publication 15 October 2019

Published 13 November 2019 Volume 2019:15 Pages 3177—3186

DOI https://doi.org/10.2147/NDT.S223681

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 2

Editor who approved publication: Dr Yuping Ning


Kuan-Lin Chen,1–3 Cheng-Te Chen,4 Chien-Ho Lin,5 Chien-Yu Huang,6 Ya-Chen Lee7

1Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan (R.O.C); 2Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan (R.O.C); 3Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan (R.O.C); 4Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan (R.O.C); 5Department of Psychiatry, Chi Mei Medical Center, Youngkang Dist., Tainan City 710, Taiwan (R.O.C); 6Department of Occupational Therapy, I-Shou University, Yanchao District, Kaohsiung City 824, Taiwan (R.O.C); 7Department of Occupational Therapy, College of Medical and Health Science, Asia University, Wufeng, Taichung, Taiwan (R.O.C)

Correspondence: Ya-Chen Lee
Department of Occupational Therapy, College of Medical and Health Science, Asia University, No. 500, Lioufeng Road, Wufeng, Taichung, Taiwan (R.O.C)
Tel +886-4-23323456 Ext. 20007
Email jennyleenet@hotmail.com

Background: Children with autism spectrum disorder (ASD) often exhibit deficits in pretend play and have less playfulness. The purpose of this study was to evaluate the relationship between pretend play and playfulness in children with autism spectrum disorder, while controlling for severity of autism behaviors, verbal comprehension, and age.
Methods: A sample of 72 children with ASD aged between 3 and 12 years were assessed with the Child-Initiated Pretend Play Assessment, Test of Playfulness, and Childhood Autism Rating Scale, respectively, for their pretend play, playfulness, and severity of autism behaviors. Correlation and multiple regression analyses were conducted.
Results: The results of Pearson correlation coefficients revealed that the pretend play variables had mild to moderate associations with the playfulness variables (r = −0.25 to 0.68). The multiple regression analyses showed that, overall, the internal locus of control was the significant predictor of the pretend play variables (accounting for 5–47% of the variance, p < 0.001). The six pretend play variables were all important predictors of all playfulness variables (explaining 41–76% of the variance, p < 0.001–0.047). Particularly, the elaborate pretend play action was a significant predictor of all four playfulness variables. Our findings indicated that the more children with ASD engaged in pretend play, the more they experienced playfulness.
Conclusion: Clinicians could help children with ASD improve their feeling of being in charge of their play in order to develop better performance in pretend play. Assisting children with ASD to engage in pretend play is important to promote their internal experience of playfulness.

Keywords: autism spectrum disorder, pretend play, playfulness, severity of autism behaviors

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