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About “Functional Play”

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When I was a child, I had severe deficiencies or delays in functional play skills, particularly with imaginative and cooperative play. (Or, that’s how a psychologist would put it.) I was taught some play routines — I learned to dress and feed a doll, assemble plastic food in a play kitchen, or move a stuffed animal as though it was running or walking. My grandfather built me and my sister beautiful dollhouses, and I could carefully set up each room with Playmobile furniture and even tiny figurines. But then I would hand the dollhouse over to my sister, and wander off. I couldn’t depict any kind of imaginative scene unless someone else was creating it for me and telling me what to do. And I wasn’t really interested in figuring out how to, either.

What I did instead was pace, for about 8-10 hours a day. Back and forth, back and forth, wearing footpaths in the grass until my Dad would make me move to a different part of the yard so the grass could have a chance. (It wasn’t usually able to grow back. There were plenty of days where 10 hours was an undercount.) Sometimes I would walk on my toes; sometimes I’d adopt big, stiff postures, or bounce up and down. I’d move my arms high or low or to the side, but my arms were always moving — I’d flap my hands, or shake a stick, or, most often, shake a book in my hands. The book had to be just the right size, with just the right kind of paper, held in just the right spot. I destroyed dozens of books over the years this way; pretty soon, my parents learned to buy me cheap paperbacks specifically for this, to keep the other books safe. My mouth was open and my face was vacant. Sometimes you could hear me talking to myself, and if you listened, you would hear that I was scripting, or reciting lists. Usually I was silent. I would avoid other children and I refused to play with my own siblings; I wanted to do this instead. I would do this at preschool, at family gatherings, at church, and in the store. I would do this all day.

It alarmed everyone.

I did this through high school. I learned not to do it where other people could see, but the intensity didn’t abate. It only began to slowly fade away after I turned 17, replaced by other stims and some cognitive-motor changes and, perhaps, growing up.  If you saw it when I was little, you can still find the traces of it now — I still pace when I’m working out a new idea. I wrap beads around my wrist instead of shaking a book to pieces. I still spend hours most nights doing repetitive activities while my mind wanders. 

No one considered this “functional” play. Every expert saw this as something that was very likely harming my development — or, best case scenario, as an indication that I was having a hard time, with the behavior as a barometer for how bad things were. My parents ultimately didn’t try to get me to stop outright (for which I am profoundly grateful), but everyone agreed that it would be good if I could, and any fleeting reduction was celebrated or, at least, seen as a sign of progress. 

I still don’t have the skills for imaginative play. Toddlers are happy to boss me around, but preschoolers get frustrated that I can’t keep up or contribute my own ideas to the play. I love stories (although my narrative comprehension is limited,) and sometimes with friends I can co-create something heavily scaffolded — but even Dungeons & Dragons is beyond me. I will obediently set up a highly realistic dollhouse for you, although it still bothers me that the house is usually missing an entire side. That can’t be safe.

My point in sharing all of this is to say: I would have been considered an ideal candidate for therapies aimed at building typical play skills. My disability in this area was obvious and highly visible and often, especially to people outside my family, disturbing. I am still lacking some basic skills possessed by most three year olds. 

And yet.

And yet.

My play — not my “behavior,” my play — was deeply functional, for me. Those hours and hours of often silent scripting while regulating my body let me develop a deep bank of fluent language that other people could understand. When I can rattle off fluid paragraphs to you about a topic, it’s because I’ve put in those hours of scripting and practice, even today — and because, long before I was practicing how to explain autism or talk about policy, I was practicing different sentence structures for hours in the backyard. That was not at all apparent from an outside point of view. But that’s what I was doing. And when I wasn’t scripting, I was making and reciting lists and schedules — and that was giving me a structure for understanding my world. 

And most importantly? It just felt good. It was calming and reassuring. I am told that is one of the main developmental purposes of play, in fact.

There’s an intense debate raging right now about what constitutes appropriate targets of intervention for autistic children. Self-advocate opposition to abusive practices such as applied behavioral analysis (ABA) has become so vocal and well-known that service providers, researchers, and parent advocates are being forced to admit that perhaps some common therapeutic approaches may not be universally welcomed by the autistic children subject to them. There is more and more interest in discussing what a neurodiversity-informed approach to therapy for autistic kids might look like. (Tip: it’s probably not therapy, and it’s definitely not an “intervention”.) This is a good and long-overdue thing, but it’s not necessarily yielding the fundamental rethinking needed. Even when folks agree that ABA isn’t the way to go — and there are still far too many folks clinging to that golden calf — would-be allies still frequently fall into the trap of changing their language or their aesthetics without changing their beliefs or the core of their practices.

The most obvious example of this shows up as attempts to usher in a “new” ABA. This might look like “play-based” ABA, Pivotal Response Training, or a model that purports to blend ABA with a developmental approach. Only positive reinforcement is used, and that reinforcement is as “natural” and as (disturbingly) relationship-based as possible. The kid and the therapist are both on the floor, laughing, playing, and having fun. But it’s still at its core all about shaping autistic traits into neurotypical-seeming behavior. There’s a list of things typical children do, and the goal is to, over time, mold autistic children’s natural ways of being until they do the same things the other kids do. It’s just the same old ABA with a new hat on.

A therapy doesn’t even have to be ABA to have that same goal, either. Many developmental approaches have this same bias and can be applied in the same way. Oh, they use nicer language — they talk about wanting to get autistic kids connecting, relating, and playing. But the same fundamental assumptions are there. If we aren’t doing things the way other kids are, that must mean we aren’t connecting, relating, playing, learning, developing. If an intervention succeeds, we might not look exactly like the other kids, but at least we’ll be hitting the same milestones and doing the same kinds of things. We know those things are important, because the other kids are doing them. Simple as that.

There are a hundred things I could say about why these ways of thinking are so harmful. ASAN just put out a whole toolkit covering this, and self-advocates have written about different elements of this for almost 30 years. Ari Ne’eman has a great piece on passing goals if you want to start there. But for today, let’s stay focused on play. Rachel Dorsey has a fantastic  illustration of the issues we’re talking about in the images below:  

[Image description: Yellow-orange background with a circular image of a hand pulling up a zipper. Brand logo is center, bottom of the slide. The headline reads “Instead of Shaping Autistic Play into Neurotypical Play . . .” Below that is text which reads, “Ex. Julio loves zippers. First, you “bond” with him with his favorite zippers. Then, you find dolls that have clothing with zippers and clap and praise him as you encourage him to dress up and hug and kiss the doll. Then you find clothing without zippers and praise Julio for doing the same thing. It seems like he is enjoying the play (and he might be, to some extent), but he is, without a doubt, more invested in making you happy and getting more praise.”]

[Image Description: Light golden orange background. At th right is a circular image of hands fitting different shaped wooden blocks together. At the bottom, center is the brand logo. The headline at the top reads, “Try to Understand and, Then . . . Embrace Autistic Play!” Below that, at left, is text which reads, “Julio loves zippers. You find backpacks, pants, jackets, etc. with all sorts of zippers and bond over them together. You find out that Julio likes zippers so much because of the satisfaction of the parts fitting together. You find other things that fit perfectly together, like puzzles, Duplo blocks, large locks and keys – not to change his play but to bring more Autistic joy. And if he doesn’t like those? No problem. Think creatively of what else to do with zippers.”]

These slides provide a vivid contrast between two approaches to autistic play. And it shows how easily the language of neurodiversity can be co-opted to describe the same-old, same-old. Many practitioners would describe the approach used in the first example as strengths-based, play-based, and person-centered. Many would say that by using that approach, they are affirming neurodiversity. But at its core, that approach is still clearly about shaping autistic traits into neurotypical-passing behavior — gently and cheerfully, perhaps, but inexorably. And that harms autistic kids. That is the opposite of what neurodiversity-affirming therapies are supposed to be about.

Who cares if the kid learns to play with the doll like other kids. 

Who cares. 

Certainly not the kid!

I think it’s hard for some NTs to understand what the “harm” is in that first example. How does learning to play with a doll “harm” anyone? The kid even seems happy! Often the answers self-advocates come back with are about the long-term harm of masking, and that’s a true and important piece of it. But I think these slides also do a really great job of illustrating the harm that comes from what doesn’t happen. When you focus on shaping the behavior of playing with the doll, you are missing the chance to genuinely connect with the child in his interest — which means he is missing an opportunity to experience an adult valuing and being deeply engaged with something he cares about. He misses out on that experience of shared joy and connection. He misses out on that validation and safety. And he doesn’t get support building critical skills like expressing why something is important to him, or exploring other things that match his interest in fitting things together, or building off of that connection to learn other things in a way that will make sense to him, in a trusted relationship with an adult who values his point of view. He doesn’t get those things. 

He learns how to dress a doll. 

We know that play has a variety of important functions for child development. Play helps children develop a wide range of motor, cognitive, emotional, and social skills. In typically developing children, play moves in close synch with language and cognitive skills and social development — imaginative play and symbolic thinking grow in tandem and support complex language, and cooperative imaginative play reinforces increasingly abstract thought. Kids use play to process emotional events, practice new skills and ideas, self-regulate, and decompress. This is all true. 

But wouldn’t it stand to reason that if autistic kids develop on a different set of trajectories than typical kids, with brains that process information and relate to the world in fundamentally different ways, our play might look different as well? 

And wouldn’t it be worth asking how autistic children are playing, and how that play might already meet those core developmental needs, rather than assuming that if we aren’t doing the same things as other children, we aren’t doing anything worthwhile at all?

And conversely, perhaps — if an autistic kid is meeting their need for play in a different way, what makes us think that learning to dress a doll is going to be particularly “functional” for them?

“Functional” play is an interesting phase. I’ve been using it this whole essay. It’s a commonly-used, widely-accepted, quasi-scientific word. It’s one of those ubiquitous phrases that works its way into every framework, and folks never stop to question what it’s doing there, what ideas it’s embedding into their approach. It turns out there’s a lot this little phrase is bringing with it.

First of course there’s the implicit idea that if “functional” play exists, so does “nonfunctional” play. This is the idea made explicit when autistic children’s play is dismissed as stimming, as pathological, as diminished or lacking or insufficient and in need of intervention. 

And then there’s the meaning of “functional” play itself. Functional play — that sounds pretty important! It must mean something pretty big. Well. I hate to disappoint you, but it just means to “play with toys or objects according to their intended function (e.g., rolling a ball, pushing a car on the floor, pretend to feed a doll).” I pulled that definition off of a random therapeutic website, but only because it’s the same definition used virtually verbatim by the vast majority of practitioners almost anywhere you look. It’s using toys the “right” way. That’s it.

(This is where I’ll note that autistic people are often clinically described as having a “limited range of responses to [our] environment.” But there’s only a set number of acceptable ways to play with a car. Okay.)

You can go ahead and teach an autistic kid the Approved Routines for using a toy. There’s plenty of programs out there promising to do just that. Most of us will learn the routine with enough practice — not all of us, but most. But that doesn’t mean that learning to perform a routine — even if we learn to do it in a way that seems very natural and playful — will actually serve the functions of play for us. It doesn’t mean that it will be functional play for us. It doesn’t mean that it will be a meaningful experience to us at all.

There’s nothing magical about dressing a doll. It’s just a toy. 

Fundamentally, I want us to raise the question of what “functional” play is. Instead of broadly labeling certain types of play (or behavior) as functional or nonfunctional, we should be talking about how a certain type of play might be functional for that child. If we want to talk about how typical children play, we can just say “typical play.” And then we can remember that whether or not an action is typical is value-neutral — but a therapy aimed at shaping a child’s appearance or behavior or development into something more typical is decidedly not.

We can support autistic kids in joyous, obsessive, atypical play. We can support them in play that NTs might not recognize as “play” at all. We can look at the sensorimotor, language, cognitive, emotional, and social experiences and skill building that play can provide, and we can find ways to make sure that autistic kids are getting that practice in ways that work for them. And we can back off and let autistic kids be autistic kids.

If my pacing and scripting had been recognized as meaningful play for me, it would have given my team clues as to how I was (and wasn’t) processing language and what support I needed to communicate more easily. It would have tipped off my team to how I learned best, how I processed what was happening in my life, what fascinated me, and what brought me joy. And they could have used those things to help me. They could have used those things to connect with me and build mutual joy and trust and safety. And they could have let me pace and do the work my brain needed to do (because it’s a cliche but it’s true, play is children’s work), without worrying about it.

I’m grateful to the thousands of hours I spent pacing and scripting and “off in my own world.” I’m grateful to the nonfunctional “garbage behavior” that my family let consume my childhood. Without it, I wouldn’t be able to write this essay. I wouldn’t have been able to process my world. I wouldn’t have been able to self-regulate, or free up brain space to learn new things. And even if those hours hadn’t fulfilled those functions, they made me happy. 

And I believe children — even autistic children — are owed some hours of happiness. 

“Play,” as it were.

Written by Julia

December 20, 2021 at 3:33 pm

Posted in disability