Poster #16 - Play in Toddlers With and Without Language Delay From 18 to 24 Months

• In Event: Poster Session 07

Abstract

Background: Play in preschoolers with developmental delays, including autism spectrum disorder (ASD), is reported to be less sophisticated and less diverse compared to typically developing (TD) peers. Less is known about play in toddlers who show early language delay (LD). Previous work presented from our labs found that 18-month-old toddlers with LD showed many similarities in play to TD toddlers. However, toddlers with LD, particularly those with ASD outcomes, showed more indiscriminate play and less diverse play. The present study extends our previous work by examining play at 24 months and the change in play from 18 to 24 months. We hypothesized that toddlers with LD would show less sophisticated and diverse play at 24 months and less growth in play over time compared to TD.

Methods: Toddlers with LD (n=30) or TD (n=61) were drawn from longitudinal studies of early LD. Toddlers with early LD were classified based on a 36-month evaluation as ASD (LD-ASD; n=11) or non-ASD (LD-NonASD; n=19). A coding scheme (Figure 1) was employed for a video-recorded 15-minute parent-child interaction with a standard set of toys obtained at 18 and 24 months. Variables examined as outcomes in hierarchical linear regression models included: total play actions, proportion of actions across four play levels, and diversity of play.

Results: Demographic variables were entered in Step 1, nonverbal developmental quotient (NVDQ) in Step 2, and group in Step 3. Consistent with our 18-month findings, at 24 months, there were no significant group differences in total play actions or across levels of play, except for Level 1: Indiscriminate play (Table 1). After controlling for NVDQ, differences in the proportion of play classified as Level 1 were as follows: TD < LD-NonASD < LD-ASD. For play diversity at 24 months, toddlers in the LD-ASD group (but not LD-NonASD) engaged in significantly fewer different play actions than the TD group. A series of mixed-effects models examined change over time within and across groups, while controlling for demographics and nonverbal functioning. There was a main effect of time for Play Levels 1 and 3, and the TD group had significant gains in total play actions and number of different play actions.

Conclusions: As hypothesized, toddlers with LD, and particularly those with ASD outcomes, engaged in less sophisticated play compared to TD toddlers as well as less diverse play during a parent-child interaction beginning at 18 months and persisting at 24 months. While significant variability was observed, toddlers in the LD-NonASD group showed similar diversity of play to TD toddlers, a surprising result given the relationship between language and play development reported in the literature. Regardless of group, toddlers engaged in less indiscriminate play and more functional/conventional play from 18 to 24 months. As hypothesized, toddlers with LD did not show the significant growth in play that was observed in the TD group. It is possible that the lack of change among the LD toddlers was due to small sample sizes that yielded larger standard errors compared to the TD group.

Authors

• Stacy Shumway Manwaring, University of Utah
  Presenting Author

• Danielle Mead, San José State University

• Erica Hill

• Lauren Thompson, Washington State University

• Jada Voth, University of Utah

• Audrey Thurm, National Institute of Mental Health