Play in Relation to Autism Traits in Young Children at Elevated Likelihood for Autism Spectrum Disorder.

Researchers watched how 2-year-olds play, comparing children who have siblings with autism, children born very early, and typical children. They found that children with autism or development delays played less with pretend/symbolic games. For children with autistic siblings, how much they played this way predicted autism traits later. This wasn't true for premature children, suggesting different paths to autism development.

This observational study examined play behaviors in 24-month-old children from three groups: siblings of children with autism (n=44), very preterm children (n=44), and typically developing children (n=36). Researchers observed spontaneous and elicited symbolic play behaviors and measured associations with later autism traits. Children with ASD and atypical development showed reduced spontaneous symbolic play compared to typically developing peers. In siblings of children with autism, both spontaneous and elicited symbolic play duration predicted later autism traits, while this association was not found in preterm children.

The findings suggest different developmental trajectories toward autism across populations and highlight the potential value of early play assessment beyond traditional high-risk sibling studies.

Results suggest symbolic play assessment may be valuable for early autism identification, particularly in siblings of autistic children. However, different populations may require tailored assessment approaches. Clinicians should consider play behaviors as part of comprehensive developmental evaluation while recognizing population-specific patterns.

Single timepoint observation at 24 months limits understanding of developmental trajectories. Sample sizes are relatively small for subgroup analyses. Study type and specific methodological details are not provided in the abstract, limiting assessment of study quality.

Play of younger siblings of children with autism spectrum disorder (ASD) (siblings; n = 44), very preterm children (preterms; n = 44), and children at typical likelihood for ASD (n = 36) was observed at 24 months. Children with ASD and atypical development engaged less in spontaneous (pre-)symbolic play than typically developing children. Total duration of spontaneous and elicited (pre-)symbolic play was associated with later ASD traits in siblings. However, no association between most play variables and ASD traits was found in preterms.

This suggests possible different ASD-trajectories between siblings and preterms. Thus, spontaneous (pre-)symbolic play may be indicative of developmental challenges across several populations, and results highlight the need to move beyond studying only siblings in order to broaden our understanding of ASD.