Facilitating pretend play skills for youngsters with autism through literacy based interventions
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Facilitating Pretend Play Skills for Youngsters with Autism through Literacy-Based Interventions. ISAAC, 2012 Joanne M. Cafiero Cynthia Pearl. Rationale for Project. High engagement in repeated readings using adapted literature Absence or low levels of pretend play

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Facilitating Pretend Play Skills for Youngsters with Autism through Literacy-Based Interventions

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Facilitating Pretend Play Skills for Youngsters with Autism through Literacy-Based Interventions

ISAAC, 2012

Joanne M. Cafiero

Cynthia Pearl

Rationale for Project

  • High engagement in repeated readings using adapted literature

  • Absence or low levels of pretend play

  • Absence or low levels of interactive play

  • Prior Action Research on Pretend Play with Preschoolers with ASD

Facilitating Pretend Play through Literacy Interventions

  • Environments:

    • self-contained ASD program in general education environment

    • Home

  • Inclusion opportunities:

    • in Specials, Recess and planned activities with typical peers

  • Partnership with teacher, family and consultant

  • Action Research Model

Action Research

  • Research conducted within the environment that results will be utilized

  • Goals, research questions taken from IEP or questions of practitioners

  • Can be messy and evolving

  • Utilizes qualitative and quantitative measurements

  • Facilitates immediate implementation of results

Why is Pretend Play Important?

  • Play is the “work” of childhood

  • Presumes perspective taking

  • Skills correlate with language development

  • Evolves from solitary to parallel to interactive in typical children

Why is literacy important?

  • Visual medium targets strengths.

  • Current research dictates that providing opportunity facilitates literacy learning.

  • Literacy and AAC are inextricably entwined.

  • Reading and writing can segue into functional communication.

Teaching Pretend Play Scripts to Pre-K students with ASD Through Adapted Literature(Cafiero, Manthey-Silvio& Pearl, 2007; Cafiero & Pearl, 2009)

  • Collected language samples from typical kids

  • Developed adapted literature (text above; adapted text below) from sample

  • Read book in group reading for 3 weeks

  • Videotaped independent unprompted play for baseline and 5 intervention probes

Joanne M. Cafiero PhD, 2011

It’s Time to Play with My Toy Carsby Cindy Pearl

Pretend Play: Time to Get Gas

  • Book read in group instruction.

  • Each student had his/her own book.

  • Related Balanced Literacy activities with target words & sentences daily.

  • Videotaped baseline, intervention and 3 probes of individual students

  • Data taken from videotapes

Pretend-play Behaviors: Gas Station: Actions

Putting man in car

Driving to gas pump

Putting in nozzle; filling up

Leaving gas station

Joanne M. Cafiero PhD, 2010

Pretend-play Behaviors: Gas Station: Scripts

“This is my car”

“Uh-oh, I’m out of gas.”

“I’m putting in gas.”

“I’m putting in more gas”

“Gas is finished, bye-bye.”

Joanne M. Cafiero PhD, 2010

Joanne M. Cafiero PhD, 2010

Joanne M. Cafiero PhD, 2010

Integrated Literacy Activities Using Balanced Literacy Model

  • Word Study Using Target Words

    • Word building

    • Phonics

    • Phonemic awareness

  • Writing Using Target Words

    • Sentence building

    • Close writing activities

  • Self-Selected Reading

    • Books made available for independent reading

Thematic Curricular Unit: Car Wash

Results: Teaching Pretend Play Through Adapted Literature

  • Qualitative:

    • “crystal clear” speech and spontaneous generating of appropriate language.

    • Longer periods of engaging in targeted pretend play behaviors

    • Fewer off-task and stereotypic and self-stimulatory behaviors

    • Maintained play and language at 18 month probe

Joanne M. Cafiero PhD, 2011

Pretend Play Skill Maintenance: 1.5 years later

  • Students maintained play scheme skills without book; more skills with book present

  • Students who learned scripts (Baby to Bed) maintained the non-linguistics (lullabye, “shhh”, kiss good night)

  • Students independently requested to play and generalized to novel objects & environments

New Findings: 3 years later

  • Students from original study requested opportunities to pretend play with targeted items when given the opportunity.

  • Target students maintained 20-40% of scripts and 100% of actions

  • Target students selected Pretend Play activity as highly preferred reinforcer

Facilitating Pretend Play Toy Cars: Phase 2

  • Primary Autism Class

  • Implemented intervention with modeling and literature

  • Did not include robust literacy extension activities

  • Baseline & 3 Video Probes

Identifying Specific Play Behaviors

  • Observed typically developing kids engaging in the targeted pretend play

    • Pretend play included concrete figures, objects

  • Charted actions and scripts

  • Took photos of identified actions

  • Created literature using photos and scripts

Pretend Play Skill Acquisition


  • Increases in play actions

  • No Increases in play language (scripts)

  • Demonstrated interest in play schemes when others were engaged with it.

  • More interest in interactive play than in previous pilot study with younger CWA

Pretend Play in the home: My Restaurant

  • Restaurant theme selected from favorite pretend play activity of two typical brothers, 8-9 years old

  • Videotape of Restaurant play; actions & scripts identified

  • Selected 10 of most appropriate actions & scripts for book

  • Photographed boys engaged in activity for book: excluded adults and prompts

Pretend Play: Teddy & Kenneth

  • Twin boys, 9 years old, Dx ASD

  • Non-verbal & limited speakers

  • Participated in structured literacy program in school

  • Majority of play time is solitary screen time (iPad, TV, videos)

  • Engaged parents

    • Read story 2x/day

    • Played restaurant 1x/day

My Restaurant

  • Parents and caregiver read story 2x day

  • Once with props; acting it out

  • Once without

  • Limited related literacy activities around target vocabulary (sentence building)

  • Weekly coaching and videotaped probes

My Restaurant

Bethany is a customer in My Restaurant

Hi. Welcome to My Restaurant.

Here is your menu.

Bethany reads the menu.

Can I take your order?

What do you like to drink?Bethany says “I want some water, please.”

Here is your drink.

What would you like to eat?

Bethany says: “I’d like a pizza”.

Here is your pizza.

Bethany eats her pizza.

Here is your check.

Bethany pays the check.

I put the money in my pocket.

Thank you, please come back.


My Restaurant: Measuring Outcomes

  • Simple data collection method

  • Weighted prompts for coding % independence

    • 3 fully independent

    • 2 Gestural prompt

    • 1 Verbal prompt

    • 0 No response

  • Observations of activity around theme noted anecdotally

My Restaurant

% Independence in Pretend Play: Kenneth

% Independence in Pretend Play: Teddy


  • Increases in % independence in actions

  • Increases in % independence using scripts

  • More novel pretend play around toy foods

  • Increased engagement with play partners

  • Increases in independent performance of play actions and scripts with book present

What We Learned:

  • Data collection should represent smaller increments of performance

  • Applying gentle pressure by putting hand on shoulder breaks autistic inertia in some children

  • Total package (story, word study, cross curricular activities) total immersion may be the factor that defines greater levels of Pretend Play skill acquisition

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