Exploring Play in Toddlers With and Without Language Delay

• In Event: Poster Session 11
  In Poster Session: PS 11 Topic - Developmental Disabilities

Abstract

Background: Early play skills are linked with several critical areas such as cognition, social communication, and language. Substantial research has examined play in preschoolers with developmental delays, including autism spectrum disorder (ASD), revealing less sophisticated play and less diversity of play compared to typically developing (TD) peers. Less is known about play in toddlers with delays, particularly language delay (LD). Given the link between play and language development, we aimed to examine play in 18-month-old toddlers with LD with and without ASD outcomes. We hypothesized that toddlers with LD would show reduced frequency of play as well as less sophisticated play and less diversity in play compared to TD, with more pronounced deficits in toddlers with an ASD diagnosis at outcome.

Methods: Toddlers with LD (n=32) or TD (n=62) were drawn from longitudinal studies of significant, early LD as a risk factor for ASD. Toddlers with early LD were classified based on a diagnosis of ASD (LD-ASD; n=13) or non-ASD (LD-NonASD; n=19) after an evaluation at 36 months. A coding scheme (Figure 1) was used to code play during a video-recorded 15-minute parent-child interaction with a standard set of toys obtained at 18 months. The following play variables were examined: total number of play actions, proportion of actions across four play levels, and diversity of play (number of different play actions and different toys played with).

Results: Table 1 provides a summary of descriptive statistics. Hierarchical linear regression models were run, with demographic variables (age, race, ethnicity, maternal education, sex) entered in Step 1, nonverbal developmental quotient (NVDQ) in Step 2 (since NVDQ was correlated with play variables), and group in Step 3. There were no significant group differences in total play actions or across levels of play, with the exception of Level 1: Indiscriminate play. Specifically, after controlling for nonverbal functioning, differences in the proportion of play classified as Level 1 were as follows: TD < LD-NonASD < LD-ASD. There were also significant group differences for both indicators of play diversity.

Conclusions: This study describes the play of a unique sample of toddlers within a naturalistic parent-child interaction. Consistent with our hypotheses, LD at 18 months was associated with less sophisticated play compared to TD, with differences greater for toddlers with ASD outcomes. However, this difference was only significant at the indiscriminate level of play. While significant variability was observed, toddlers in the LD-NonASD group showed similar frequency and diversity of play to TD. This was surprising given the relationship between language and play development in the literature. Play deficits in toddlers with LD may only become more apparent over time based on the development of a child’s language and increasing play demands. Following this LD sample over time to examine how play develops with age along with language and social communication will be important in informing a more complete picture of the play of toddlers with LD, including those who do and do not present with significant symptoms of ASD, with the goal of informing more targeted interventions.

Authors

• Stacy Shumway Manwaring, University of Utah
  Non-Presenting Author

• Danielle Mead, San José State University
  Non-Presenting Author

• Erica Hill, University of Utah
  Presenting Author

• Elise Mori, University of Utah
  Non-Presenting Author

• Tyler T. Christopulos, University of Utah
  Non-Presenting Author

• Lauren Thompson, Washington State University
  Non-Presenting Author

• Audrey Thurm, National Institute of Mental Health
  Non-Presenting Author