 There is a misconception that we should never intervene with Autistic play. Honouring Autistic play and neurodiversity ...... and intervention are not mutally exclusive. We can be respectful and neuro-affirming, yet help our Autistic children by exposing them to new experiences, encouraging skills rather than forcing them, taking their lead with interests and motivations, addressing their sensory needs and supporting their development. In my last article, I explored the "why" underlying repetitive play patterns. If you have not read that article, pause here and go back to the article HERE. The article also encouraged us to consider on what the child finds beneficial about their play with reflective questions. You may also be interested to read about strategies when a child says "no" in this BLOG ARTICLE. One challenging area is when this repetitive play is dangerous and unsafe for the child or others. In this article, we will explore a real case study. Background Information: Let's call my 3 year old friend, Ben (not his real name). He lives with his parents and older sister in an apartment complex. Ben has a developmental delay and no other diagnosis (at time of referral). He selectively speaks but this is infrequent. One of Ben's favourite activities is to go onto the balcony and throw items off the balcony onto the street below. The balcony was located situated off the open plan living room and kitchen. The family did not have air conditioning in their apartment and opened the door to allow for air flow. They lived 6 stories above street level and the balcony had a metal balustrade (with openings about a hand space). Ben was indiscriminate with what he threw from the balcony from toys to any other object that he could squeeze through the balustrade. He had not yet learnt how to climb up to the hand rail to throw over the railing, however his parents were worried that he would learn to do this. Throwing occurred daily, often when his parents were busy (eg. cooking). Ben's parents were concerned about his safety and whether he would eventually climb onto furniture to throw items. They were concerned about the falling items on people passing by underneath. Fortunately they lived on a quiet street so there were not a lot of people regularly walking under the apartment. Ben's parents were also starting to resent needing to go down to the street to retrieve the items thrown. Ben was enjoying the "game" of his parents shouting when they saw him rush onto the balcony, sometimes trying to physically grab him to stop him and then taking the elevator (lift) down stairs to retrieve the items. He laughed and wanted to do it again. Intervention: * Environmental - It was recommended that a fly screen (security) door could be added to the balcony to allow for secure air flow. Ben's parents were renting and needed to seek permission for this to occur. * Environmental - It was recommended that the balcony door be shut when Ben's parents could not provide supervision. * Environmental - It was recommended that furniture be removed from the balcony so that Ben did not learn to climb onto the furniture on the balcony. When considering Ben's desire to throw things, we introduced a range of activities with this action while providing varying targets too. These were not forced, but gradually introduced (one or two per session) to show him options. * Throwing items included balls, bean bags, soft toys, scarves, plastic rings, small plastic animals, juggling balls, fidget toys, cushions, plastic fruit, pipe cleaners, pop tubes, oven mitts, hats, stress balls, splat toys. * Targets to throw towards included buckets/containers (from large to small sizes), onto sensory gel tiles, onto the sofa, onto a table, under a table, onto a bath mat, onto a towel, onto the wall (for sticky objects), through a hoola hoop, between someone's legs, under a chair, towards another person. When considering Ben's enjoyment of being above and seeing things land... we changed his physical environment providing opportunities to climb indoors and lean over (eg. lying over the sofa or therapy ball to play with items on the floor), standing on a stool to place things onto a vertical surface, throwing items from a chair that had a string or a magnet (such as a fishing rod) attached to retrieve item. Standing on a balance cushion or a bilibo also provided sensory input. When considering Ben's enjoyment of connection and engagement with his parents. We worked on shared enjoyment opportunities where his parents could provide lots of laughs, squeals and joy! One of our favourite games was throwing scarves at each other like snow balls. We also played parachute games, tugging pop tubes, pull along games on lycra sheets, peek-a-boo type games with scarves/blankets. Ben's parents were encouraged to reduce their response if he threw things from the balcony and become more expressive at other times. Conclusion: Over time, Ben found enjoyment in some of the repetitive play patterns which were introduced to him. He received sensory input (tactile, visual, proprioception, auditory) as well as the desired interaction with his parents. We introduced sensory proprioceptive activities such as a lycra tunnel, animal walks, pushing and pulling items. Oral motor activities were also introduced to encourage deep breathing and assist with regulation. Multisensory activities such as shaving cream and kinetic sand were also enjoyed by Ben. Gradually as Ben developed rapport with OT, he participated in multiple step activities and we could increase the play routines. We tried other repetitive play routines (eg. play with a teddy, muscial instruments, cars). We developed a relationship where routines could be modelled and copied if he wanted to try it out. Ben was given opportunities to continue with repetitive play routines that he found comforting, while expanding the repertoire he could choose from. He was less interested in throwing things from the balcony, however there were occasions where he continued to do this. Ben's attention to alternative tasks also increased with a desire to try new things. We tried other activities that have an underlying (throw/put into something) but the activities also became more skilful using tools such as hammers, golf sticks, pencils and scissors. Smaller and more directed actions such as shape sorters, button snakes, posting objects were also achieved over time. Ben also began learning how to catch thrown items. What else would you have tried with Ben? Do you work with someone who also enjoys throwing things from a balcony. Did you gain some ideas from my case study? This month I have been promoting the FULL SPECTRUM OF PLAY conference which is about to start (March 17-20 - northern hemisphere dates which tend to be almost 12 hours behind us here in Sydney)! This FREE 4-day event is designed to help you confidently use neurodiversity-affirming, play-based therapy strategies to support autistic kids in ways that truly matter. 15 expert speakers share actionable strategies on integrating play into therapy with many many case studies. The FREE TICKET will give you 24 hour access to each day's program (March 17-20). You can also upgrade your ticket for VIP Access ($US). VIP access allows you to listen or watch the talks anytime (starting as soon as you purchase the ticket) with life time access (so you can tak your time too). You will also receive an extensive workbook with summaries of each talk, podcast access, additional information from each speaker and there are 17 accredited learning hours with AOTA and other organisations, once you complete an assessment. Parents, you will also benefit from this conference, however it is catered mainly for a professional audience.
For those of you who have already registered for the PLAY Conference, let me know what you are looking forward to the most! If you also have questions, you can find the FAQ page HERE or also please feel free to contact me [email protected]. I would also love to hear from you if you like reading case studies (as I haven't shared in this way before). Until next time,   Cindy is a registered occupational therapist practising in Sydney, Australia. She has two growing children who are a constant source of inspiration and learning. Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete). Cindy is the author of the Occupational Therapy blog Your Kids OT. Read more articles from Your Kids OT at https://www.yourkidsot.com/blog
Cindy is a contributing author of the Functional Skills for Kids Therapy Team. They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK. The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. YKOT shop: https://www.yourkidsot.com/store/c1/Featured_Products.html Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured Facebook: https://www.facebook.com/yourkidsot Instagram: https://www.instagram.com/yourkidsot/ Pinterest: https://www.pinterest.com.au/yourkidsot/
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 Repetitive play patterns are commonly seen with young children. They are also a typical way our Autistic children play. We may see repetitive play in a few different forms. Here are a few examples:
 Repetitive play can help autistic children process sensory information and create a sense of order. The structure, order and predictability can help a child to regulate. These actions/play are internally driven and motivation is high. When we feel a sense of "control" over objects or actions, we can feel calmer as we know what to expect. Some repetitive play may be considered "stimming". The actions are repeated for comfort. As caregivers and therapists, we don't want to take this away from children as it is way of communication. Sometimes the actions are repeated for soothing input, sometimes when the child is excited, sometimes because they are bored or frustrated. The more we become "attune" to our children, we can interpet and understand why they do these actions. Some repetitive play may be considered "unsafe, dangerous, annoying" or even labelled "antisocial or not socially appropriate". We should take a step back and look at the "why" the child is doing these actions. Not all behaviour should be changed or suppressed. In fact it could be more dangerous to prevent the behaviour, may cause stress or a meltdown. We can ask ourselves these questions when considering all repetitive behaviour...
In the next blog post, I will explore a case study looking at how to respectfully help a child who is repeating unsafe play routines. In the meantime, if you are interested in Autistic play, register for THE FULL SPECTRUM OF PLAY CONFERENCE! This FREE 4-day event is designed to help you confidently use neurodiversity-affirming, play-based therapy strategies to support autistic kids in ways that truly matter. 15 expert speakers share actionable strategies on integrating play into therapy. Whether you are a early childhood educator, OTP, speechie, physio, psychologist or teacher... you will learn so much. The FREE TICKET will give you 24 hour access to each day's program (March 17-20). You can also upgrade your ticket for VIP Access ($US) with an early bird price prior to the conference start date. VIP access allows you to listen or watch the talks anytime (starting as soon as you purchase the ticket) with life time access (so you can tak your time too). You will also receive an extensive workbook with summaries of each talk, podcast access, additional information from each speaker and there are 17 accredited learning hours with AOTA and other organisations, once you complete an assessment. Parents, you will also benefit from this conference, however it is catered mainly for a professional audience.
I promote this conference as an affiliate (I will earn a small percentage of any purchases made) and because I genuinely love the content. I have already downloaded my own VIP pass and started to listen to the talks. I can not overstate how amazing the content is and the value you will receive. Each speaker has also generously offered bonuses which you can access. Until next time,   Cindy is a registered occupational therapist practising in Sydney, Australia. She has two growing children who are a constant source of inspiration and learning. Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete). Cindy is the author of the Occupational Therapy blog Your Kids OT. Read more articles from Your Kids OT at https://www.yourkidsot.com/blog
Cindy is a contributing author of the Functional Skills for Kids Therapy Team. They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK. The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. YKOT shop: https://www.yourkidsot.com/store/c1/Featured_Products.html Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured Facebook: https://www.facebook.com/yourkidsot Instagram: https://www.instagram.com/yourkidsot/ Pinterest: https://www.pinterest.com.au/yourkidsot/  OT BINGO is a new challenge that I'm introducing in 2025 to the Your Kids OT community. Each month I share a board of 9 prompts and recap any activities that I have done in the previous month. So much energy in February with children and teachers returning back to school in Australia. There is lots of excitement with new classes. A flutter of anxiety with some new children, new parents and new teachers too! It doesn't take too long to settle into routines and schedules. I always love to start with fresh activity ideas and this year is no different. In February I focused on squigz, putty and masking tape from my OT Bingo prompts! Squigz Squigz (aka "suckers") are fun suction construction pieces that can be stuck to itself or smooth surfaces such as whiteboards, tiles, glass, trays, etc. They are well-loved by occupational therapists! Fun fine motor qualities especially with the mini squigz (which are my preference). A little hand strength is required when removing the squigz from their suctioned surface. Water helps with suction! The sound is also very satisfying! This month, we have been using Squigz with yarn as well as using ideas from the archives! Watch Squigz with yarn using the link below. Also check out the popular Squigz ideas from the archives!  Putty Theraputty is a well used tool in my OT bag. Classic! My putty has been used for so many years that I have forgotten where I purchased it from originally. The benefit of putty vs playdough is that the in-built resistance means that we can work on hand strength skills just by playing with it. Playdough can be great for little hands but I love using putty for older children. The warning is that putty loves to stick to things that it shouldn't - like watches, hair and clothing. Be mindful of that! My catchphrase with putty is that "putty sticks to putty" so we can use the putty to help clean up fingers and surfaces like glass, tabletops and plastic too (just avoid those other things I mentioned before). I have a well loved video of various ways to use putty (which you can watch here), however this month we have focused on stretching the putty to make "putty people".  Masking tape! Have you seen the tik tok or IG reels where people stand inside a masking tape square? They close their eyes while marching on the spot and see if they move off the spot over time. Invariably they move off and it is very funny to watch. This would be a fun body awareness activity to do with your kids! The masking tape square inspired me to create more OT activities. I have uploaded into the one video HERE. The activities include: * pom pom fine motor with large tweezers * pom pom blow * ball push and finger roll * craft stick lines and patterns * hand clap patterns * jumping patterns * golf tee line up * golf tee flicks * magnetic counters sweep * magnetic counter match up * Letter formation sensory snakes We also made a floor version of snakes and ladders using masking tape and pop tubes.  I hope that inspires you to with some activities! Do you carry squigz, putty and masking tape with you? Why not have a go with the bingo board for March and stay tuned to see what I come up with! * Silicon straw * Insert Puzzle * Mini Tongs * Crawl * Easter Egg * Wikki Stix * Vertical Surface * Wheels on the Bus * Roll Paper You can use these prompts to do one activity, a row, a column, a diagonal or even the whole board. There is no need to include two or more prompts in a single activity but you can if you want to! I have so many ideas using these prompts that I can't wait to try them out. Share your activity ideas by tagging @yourkidsot on Instagram or Facebook. You can also email [email protected]. March is going to be an exciting month! It's my birthday, the Play Conference: Full Spectrum of Play! (online) and I'm also heading to the US to make my way to the AOTA national conference! I can't wait to share what I learn. Meanwhile, click the links below to find out more about the Play Conference.... spoiler alert that it is not just for toddlers but for anyone interested in play! Until next time,  Are you interested in learning through play? Join the 2025 Play Conference!
 Cindy is a registered occupational therapist practising in Sydney, Australia. She has two growing children who are a constant source of inspiration and learning. Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. She is also addicted to making printables (even when they take a long time to complete). Cindy is the author of the Occupational Therapy blog Your Kids OT. Read more articles from Your Kids OT at https://www.yourkidsot.com/blog
Cindy is a contributing author of the Functional Skills for Kids Therapy Team. They have together published THE HANDWRITING BOOK, THE SCISSORS SKILLS BOOK and THE TOILETING BOOK. The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. Affiliate links are used throughout this website to promote recommended products. Your Kids OT receives a small commission if any purchases are made through these links. Please see my disclosure policy for more details. YKOT shop: https://www.yourkidsot.com/store/c1/Featured_Products.html Teachers Pay Teachers: https://www.teacherspayteachers.com/Store/Your-Kids-Ot You Tube Channel: https://www.youtube.com/channel/UCZUz_5nYEOCkj32DiOCQo4Q/featured Facebook: https://www.facebook.com/yourkidsot Instagram: https://www.instagram.com/yourkidsot/ Pinterest: https://www.pinterest.com.au/yourkidsot/ |
AuthorHi, I'm Cindy and I am an Occupational Therapist. I enjoy working creatively with children to see them reach their potential. Read more about me here. 
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Disclaimer: The information on this site is general in nature and should be used for educational and entertainment purposes. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions. This blog does not replace formal therapeutic professional advice given by a health professional or medical practitioner. Reviews and endorsements of products will only be made based on my expertise and personal opinion; and deemed worthy of such endorsement. The opinions shared in sponsored content will always be my own and not that of the advertising company or brand. Content, advertising space or posts will be clearly identified if paid, affiliated or sponsored. Affiliate links may be found throughout this website in advertising. This means that if you follow through with a purchase from these links, Your Kids OT will receive a percentage of the sale. Your Kids OT undertakes to meet the requirements of the "Social Media Policy" as published by Australian Health Practitioner Regulation Agency (AHPRA). Further information about this policy can be found here.
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AuthorHi, I'm Cindy and I am an Occupational Therapist. I enjoy working creatively with children to see them reach their potential. Read more about me here. 
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