Is PLAY Related to Spoken Language Development in Children with Autism: Preliminary Evidence from Project IMPACT Intervention

Background: Spoken language is a strong predictor of developmental and academic outcomes in children who have ASD (Lincoln et al., 1988; Howlin et al., 2000). In typically developing children, social experiences and play facilitate language development (Adamson et al., 2009, Dawson, 2008, & Kuhl, 2010; Carpenter et al., 1998; Toth et al., 2006). Thus, children with ASD are at risk for language delay given the social impairments characteristic of the disorder. Social communication is the most common outcome measured by early intervention programs. However, the specific dimensions of social communication as they relate to spoken language gains are not well understood.

Objectives: The primary purpose of this study is to investigate whether an evidence-based parent-mediated social communication (Project ImPACT intervention; Ingersoll & Dvortcsak, 2010) will increase social communication and spoken language in young children with ASD. The second objective is to examine the relation between three dimensions of social communication: play, social engagement, and imitation as measured by the Social Communication Checklist (SCC; Ingersoll & Dvortcsak, 2010) and spoken language as measured by the MacArthur Bates Communicative Development Inventories (MB-CDI; Fenson et al., 2007).

Methods: The data were collected as part of a larger ongoing study of the Project ImPACT intervention. Children (average age 31.63 months; 16 M; N=18) participated in Project ImPACT, where interventionists coach caregivers on strategies to support their children in the areas of social engagement, language, social imitation, and play for 12 weeks. Preceding and following therapy, each child’s caregiver and clinician assessed communication, language, and social interactions through the SCC and the MB-CDI. Pre- and post-intervention assessments of language and play by parents and clinicians were analyzed using Spearman’s correlation.

Results: Following intervention, 68% of the parents reported improved language, as measured by MB-CDI scores. Amount of play, as reported by the parent post-intervention, was significantly correlated with post-intervention scores on MB-CDI Vocabulary subsections: Sound Effects and Animal Sounds (r= .63, p= .009); Vehicles (Real or Toy; r= .57, p = .021); Toys (r= .519, p= .039); Furniture and Rooms (r= .618, p=.014); Small Household Items (r= .662, p= .005); Outside Things and Places ( r= .631, p= .009); Quantifiers (r= .519, p= .039). 37% of post-intervention MB-CDI scores showed significant correlation to the amount of play reported by parents post-intervention. All Actions and Gestures subsection scores were significantly correlated with the amount of reported play (First Communicative Gesture, r= .632, p=.009; Games and Routines (Gestures), r= .603, p= .015; Actions with Objects, r= .525, p= .037; Pretending to be a Parent, r= .593, p= .016; Imitating Other Adult Actions, r= .552, p= .027).

Conclusions: Preliminary findings following twelve-week Project ImPACT intervention indicate strong correlations between play and spoken, as well as non-verbal communication for turn-taking and initiation of interaction. Play is an accessible and age-appropriate strategy that can be used by caregivers in their homes to facilitate early development of language and social skills, and this study contributes to understanding the role of play in development of communication in children on the autism spectrum.