How Play Therapy Can Enhance Treatment

for Children with ASD

Valery G. Zullo, M.S., BCaBA, Lysmary Cadavieco, M.S., Hannah M. Browning, M.S., &

Rita M. Rivera, M.S., CBIS, CTP, CAIP

Autism Spectrum Disorder (ASD), as defined by the DSM-5-TR, is a neurodevelopmental condition characterized by persistent deficits in social communication, repetitive behaviors, and sensory sensitivities. These traits emerge early in development and impact various aspects of daily functioning, including social and academic settings. ASD presents differently in each individual, with some adapting compensatory behaviors while others require significant external support (APA, 2022). Group psychotherapy can be a valuable treatment approach for individuals with autism, including children, as this modality offers unique benefits such as a structured and controlled social environment (Gates et al., 2017). Group psychotherapy can provide a supportive and inclusive space that supports children with autism in building meaningful connections, developing social skills, and consequently, improving their overall quality of life and well-being. The present article discusses some of the unique social challenges often experienced by children diagnosed with ASD and the potential benefits of incorporating novel approaches, such as play therapy, into group treatment for these individuals.

Children on the autism spectrum often encounter distinct challenges when navigating social and emotional situations. The intricacies of social cues, unspoken rules, and non-verbal interactions that come naturally to others can overwhelm these children. Recognizing the significance of effective interventions to support individuals’ social development, integrating board games into social skills groups has emerged as a highly promising approach (Hill, 2016; Noda et al., 2019; O’Neill & Holmes, 2022). Board games can provide a structured and engaging platform for children to actively practice and enhance their social abilities within a supportive and controlled environment (Bayeck, 2020). As such, by engaging in interactive gameplay group sessions, children with autism can develop crucial skills, including effective communication, cooperation, and acceptance of others (Guivarch et al., 2017).

Furthermore, using board games in social skills groups not only fosters adaptability, as children learn to navigate the changing dynamics of gameplay, but it can also promote  self-confidence by allowing them to engage more comfortably with their peers and express themselves assertively (O’Neill & Holmes, 2022). Board games can facilitate spaces for children to cultivate essential skills for emotional regulation, like patience and tolerance, as they learn to take turns, respect rules, and cooperate with others. These skills extend beyond the board game and group setting, positively impacting their interactions across various social contexts, including their home and school environments. Another advantage of integrating board games in group psychotherapy is that this intervention can be used to model effective conflict resolution and response strategies (Bayeck, 2020; O’Neill & Holmes, 2022). Children can thus learn to manage disagreements, practice problem-solving, and empathize with their peers by engaging in collaborative gameplay.

            Overall, children diagnosed with ASD commonly exhibit specific and limited interests, resulting in reduced engagement in socially-based recreational activities than neurotypical children (Memari et al, 2015). Board games offer distinct benefits through their inherent reward systems, making them particularly stimulating compared to alternative interventions. Additionally, these types of games can function as effective tools for teaching joint attention, strategic thinking, and appropriate social behaviors in response to other players. Children with ASD can hone their abilities to maneuver group settings and establish peer relationships by joining in board game activities. As they become familiar with the rules, many ASD children can interact with minimal reliance on adult assistance, fostering a sense of autonomy. Research has also shown that board games create valuable opportunities for neurodivergent children to connect and participate in naturally motivating activities, such as enjoying a game together (Atherton & Cross, 2021). Playing these games within diverse groups facilitates learning from each other along with developing empathy skills. Although existing literature on creative group therapy modalities with children with ASD is promising (Vaisvaser, 2019), further research is needed to further identify appropriate modalities as well as cultural considerations and possible limitations.


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