Ideational Praxis and Playfulness in Children With and Without Autism Spectrum Disorder

PURPOSE: Ideational praxis is the ability to generate ideas for actions with and on specified objects that indicate recognition of the specific affordances offered by the individual objects (Lane, Ivey, & May-Benson, 2014). Playfulness consists of intrinsic motivation, suspension of reality, and an internal locus of control. It also includes deciding what to do in play and interacting with objects. Deficits in ideational praxis may impact these skills, which may reduce a child’s overall level of playfulness. Play deficits in children with autism spectrum disorder (ASD) are well documented, but little is known about factors contributing to these problems. Impaired generativity of ideas rather than difficulty executing mechanics of play may be an important cause of poor play. This study examined the relationship between ideational praxis and playfulness and how ideation differed between children with ASD and typical peers.

DESIGN: This was an exploratory study of deidentified existing video-recorded data collected as part of a larger study examining praxis and play in children with and without ASD. Participants were 12 children with ASD (M age = 60.5 mo, SD = 6.4) and six non-ASD peers (M age = 49.33 mo, SD = 14.6). Participants included 16 boys and two girls, and all mothers had a college degree or higher.

METHOD: The total score on the Test of Ideational Praxis (TIP), a reliable and objective measure, assessed the ability to generate ideas for actions (May-Benson & Cermak, 2007). The Test of Playfulness (ToP), a valid and reliable tool, measured a child’s playfulness, reflecting play elements of intrinsic motivation, suspension of reality, and internal locus of control (Bundy, Nelson, Metzger, & Bingaman, 2001). Total score and subscores for categories of Extent, Intensity, and Skill are obtained. ToP data were collected during 15 min of free play. Raters were blind to diagnoses, age, and demographic information of participants.

RESULTS: Spearman’s correlations (n = 18) found no significant relationships between TIP and ToP total scores or subscores of Extent, Intensity, and Skill (r = –.03 to .07, p = nonsignificant). A t test found no significant differences in TIP score between groups, t(18) = .61, p = nonsignificant. Effect size for difference between TIP scores was moderate, d = .31. Comparison of TIP scores from the ASD and non-ASD groups by age against previously established norms found greater effect sizes for ASD groups (d = 0.25 to 5.34) than non-ASD groups (d = –0.01 to 0.96).

CONCLUSION: Ideational abilities did not relate to playfulness; however, examination of the relationship between ideation and play skills would help determine if ideation is related to other aspects of play. The mean age of the ASD group was 11 mo higher than the non-ASD group. Early work on the TIP found differences in performance based on age (Lane et al., 2014), with older children scoring higher than younger children; thus, the group with ASD was expected to perform better than the group without ASD in our study simply due to age. However, the mean TIP score for children with ASD was lower than the mean for children without ASD, despite their age advantage, indicating poorer ideation abilities in children with ASD. Effect size between ASD and non-ASD groups was moderate, suggesting a difference between the groups even if not at a significant level. Children without ASD scored close to age norms, while children with ASD had much larger effect sizes than non-ASD children to age-matched norms, suggesting poorer ideation skills than typical peers.

IMPACT STATEMENT: Better understanding of the relationship between ideational praxis and ASD could improve the efficacy of therapies for children with ASD. Understanding ways that ideation relates to specific elements of play could allow for more targeted intervention strategies promoting better engagement in the occupation of play.

References

Bundy, A. C., Nelson, L., Metzger, M., & Bingaman, K. (2001). Validity and reliability of a test of playfulness. OTJR: Occupation, Participation and Health, 21, 276–292. https://doi.org/10.1177/153944920102100405

Lane, S. J., Ivey, C. K., & May-Benson, T. A. (2014). Test of Ideational Praxis (TIP): Preliminary findings and interrater and test–retest reliability with preschoolers. American Journal of Occupational Therapy, 68, 555–561. https://doi.org/10.5014/ajot.2014.012542

May-Benson, T. A., & Cermak, S. A. (2007). Development of an assessment for ideational praxis. American Journal of Occupational Therapy, 61, 148–153. https://doi.org/10.5014/ajot.61.2.148