Резюме. This study has been conducted with the aim of comparison of play skills and social skills characteristics of children with autism spectrum disorders.
This study has been carried out on 6-year-old autistic, mentally retarded and normally developed 150 children studying at special education institution and kindergartens in Edirne, Kırklareli, Tekirdağ city centers and their towns with the participation of mothers of the children. In the study, as data collection instruments „General Information Form“, „Preschool and Kindergarten Behavior Scale-2“ (PKBS-2) and „Play Skills Assessment Scale“ (PSAS) are used.
The study results show that according to the results of Play Skills Assessment Scale, the score means of normally developed children are higher than the score means of autistic and mentally retarded children and the score difference is found statistically significant [F(2-147)=70,44, p<0.05]. However, mentally retarded ones’ score means are revealed to be higher than the score means of autistic children but the score difference is not found statistically significant [F(2-147)=70,44, p>0.05]. According to the Results of Social Skills Scale, the score means of normally developed children are higher than the score means of autistic and mentally retarded children and the score difference is statistically significant [F(2-147)=50,57,p<0.05]. The score means of mentally retarded children are higher than autistic ones but the difference is not statistically significant [F(2-147)=50,57, p>0.05].

Ключови думи: Autism, Play, Play Skills, Social Skills, Mentally Retarded Children

1. Introduction

Autism spectrum disorders (ASD) are present from birth or very early in development and effect essential human behaviors such as social interaction, the ability to communicate ideas and feelings, imagination and the establishment of relation with others. Autism is a developmental disability that significant impacts verbal and nonverbal communication and social-emotional behavior (American Psychiatric Association, 2000; The National Research Council, 2005; Kogel & Kogel ,2006).

Early social-communication can be conceptualized as serving three separate but related communicative functions; social interaction, behavior problems. All three of these skills emerge by end of the first year for typical developing infants. But children with autism have deficit in these skills. Different challenging skill area for children with ASD is play. Children with ASD exhibit differences in quality and quantity of play when compared to both typical developing children as well with other developmental disability (Dykstra et al, 2012). Moreover, children with ASD develop play skills very late; also they sometimes even never have play skills. Disability of play skills causes that they can’t have eye-contact with peers, can’t use jest and mimics, can’t start a game or can’t continue the game started by someone else (Szatmari, 1992; Özdemir, 2008; Machalicek et al., 2009; Banda et al., 2010; Sun & Allision, 2010 ).

Children with ASD perform very little success in communicating with people around them compared to their peers because of disabilities of play skills. Disability of play skills makes difficult for autistic children to learn many behaviors that they see around and causes to be seen problem behaviors in children with ASD. Problem behaviors of children with ASD and other children are among the most challenging and stressful issues faced by schools and parents in their efforts to provide appropriate educational programs. Problem behaviors such as property destruction, physical aggression, self injury, and tantrums are major barriers to effective social and educational development. Such behaviors put young children at risk for exclusion and isolation from social and educational and community and family activities. Especially observing problem behaviors affects the relations of children with ASD with their peers negatively and causes their exclusion from play groups. (The National Academies, 2005).

The general aim of the study is stated as the comparison of play skills characteristics and social skills characteristics of children with autism spectrum disorders (ASD).

2. Method

Study Group

In this research, what is aimed is to describe play and social skills of children with ASD and relations between these skills by comparing play skills characteristics and social skills characteristics with help of parents of 6-year-old children with Autism Spectrum Disorder, mentally retarded children, and normally developed children. The method of this research is descriptive research.

The study group consists of 6-year-old autistic, mentally retarded, and normally developed 150 children who are studying at special education institution and kindergartens in Edirne, Kırklareli, Tekirdağ city centers and towns in 2012 – 2013 academic years. The method used to choose sample is simple random sampling method. Information about mental diagnosis of autistic children in research is collected from Counseling and Research Center. A checklist with the combined ASD criteria from DSM-IV and ICD-10 was used to diagnose ASD. Participants were examined as three groups, one group ASD (n=50), the other 50 participant children with mental retardation (mild level IQ score, between 50 – 75) who did not meet criteria an ASD used as a control group, and last group is 50 normal developing children. Two Master student raters independently examined the participants on socialization domain, the communication domain, and the restrictive/repetitive domain from The DSM-IV and ICD-10 checklist.

Data Collection Methods

„General Information Form“, „Play Skills Assessment Scale“, and „Preschool and Kindergarten Behavior Scale“ are used as data collection instrument.

General Information Form

General Information Form developed by researchers themselves is used in order to collect demographic information of parents who have participated in the research. In this scope, 16 questions are asked to the parents of normally developed children and their answers are expected. 20 questions are asked to the mothers of autistic and mentally retarded children and their answers are expected.

Play Skills Assessment Scale

In the research, Play Skills Assessment Scale is used as the second scale. The reliability and validity study of the scale have been conducted by Fazlıoğlu et. al. (2013). For the items on „Play Skills Assessment Scale“, five items Likert Scale has been used for ranking. This ranking is as follows: I totally agree (1), I do not agree (2), I am not sure (3), I agree (4), I totally disagree (5). AFA and DFA analysis have been used for validity and reliability study of the scale. As a result of these analysis, one dimension 27 item Play Skill Assessment Scale has been created. In the light of the literature in this subject, Exploratory Factor Analysis (AFA) has been decided to be used as models and it is thought to be suitable statistically. Also, these results confirm the construct validity of the scale. At the same time, Cronbach alpha reliability co-efficiency is .93 and this high rate proves the reliability of the scale. It has been thought that this scale can be applied on six-year-old preschool education children’s parents, teachers and the people who know them closely, and that it can be used to get information about play skills of children. (Fazlıoğlu et al., 2013).

Preschool and Kindergarten Behavior Scale

In the research, Preschool and Kindergarten Behavior Scale(PKBS-2) is used as the primary scale. Preschool and Kindergarten Behavior Scale is behavior assessment scale designed in order to assess problem behaviors and social skills of 6-year-old normally developed students who are studying in preschool. It was developed by Kenneth W. Merrell in 1994, and it was revised and its norm study was done in 2003 ( Merrell, 2003). The validity and reliability of this scale have been done and adapted to Turkish by Fazlıoğlu et. al. (2011). The scale consists of two parts such as Social Skills Scale and Problem Behavior Scale. Problem Behavior Scale has two sub-dimensions which are externalizing problems and Internalizing problems. Social Skills Scale is also composed of 3 sub-dimensions like Social Cooperation(SC), Social Interaction(INT), and Social Independent(IND). The focus of scale is typical, general, and common social competence and problem behaviors of children seen in school or at home. The scale is quite useful as it assesses children’s problems of behavioral, social, emotional, and developmental areas, and it is designed to emphasize common skills and problems. Each of problem behaviors and social skills stated in 76 items by participants are graded according to the frequency in last 3 months as the following: 0 = never (if the child doesn’t display the behavior apparently), 1 = rarely (if the child rarely displays the behavior, but doesn’t repeat often), 2 = sometimes (if the child sometimes displays the behavior), 3 = often (if the child displays the behavior very often). The increase of the points collected from Problem Behavior Scale is resulted as the frequency of problem behavior is raised.

Data Collection and Analysis

Before the research, the necessary permission is received to pursue the study. In order to collect the research data, the scales used in the study has been filled by mothers of the children in sample group. The mothers who accept to participate in the study are included in the research. The analysis of data gathered from the scale used in the research is proved with 0.05 significance level. SPSS 17.0 is used to analyze the data in the study. In the research, following methods are used to analyze the data: statistical arithmetic mean, standard deviation, independent sample t-test, one-way variance analysis (one-way ANOVA), two-way variance analysis (Twoway ANOVA), Scheffer, correlation analysis.

3. Results

When total score means of play skills assessment scale of autistic, mentally retarded, and normally developed children is analyzed in Table 1, total score means of children with ASD is calculated as =79,98; total score means of mentally retarded children is found as X = 81,16; and total score means of normally developed children is sum as X = 118,52. Once average score means of play skills of children with ASD is compared to normally developed ones’ score means, it is understood that total score means of normally developed children is higher than autistic ones’ score means. The difference is statistically significant [F(2-147)=70,44, p<0.05].

If play skills’ total score means of mentally retarded children is compared to autistic ones’ score, total score means of mentally retarded children is found much higher than total score means of autistics and the difference between scores is analyzed as not statistically significant [F(2-147)=70,44, p>0.05].

Moreover, the results show that when total score means of play skills of mentally retarded children is compared to normally developed ones’ total score means of play skills, normally developed children’s total score means is quite higher than mentally retarded ones’ total score means. The difference between scores is analyzed as statistically significant [F(2-147)=70,44, p<0.05].

As can be seen from PKBS-2 in Table 1, when total score means collected through Social Skills Scale’s sub-dimension called social cooperation scale is analyzed, it is found that autistic children’s total score means isX = 16,43; mentally retarded children’s total score means is X =16,55; and normally developed children’ total score means is X = 29,60. When children with ASD’s total score of social cooperation is compared to normally developed ones’ score, normally developed children’s social cooperation total score means is higher than total score means of social cooperation of children with autism. Also the difference between two group scores is found as statistically significant [F(2-147)= 49,86, p<0.05].

When mentally retarded children’s score means of social cooperation is compared to autistic ones’ total score means, what is resulted is that total score means of mentally retarded children is quite higher than autistic children’s score, however the difference is not statistically significant [F(2-147)= 49,86, p>0.05] . Also it is looked into the comparison of mentally retarded children’s total score means of social cooperation and normally developed children’s score, it is reached that normally developed children’s total score means is higher than the score means of mentally retarded ones. The difference between two group scores is commented as statistically significant [F(2-147)= 49,86, p<0.05].

The results total score means collected through Social Skills Scale’s sub-dimension called social interaction sub scale of PKBS-2 in table 1 show that autistic children’s total score is X =15,68; mentally retarded children’s total score is X = 16,53; normally developed children’s total score is X = 28,30. Total score of social cooperation of children withASD is compared to normally developed children’s total score; and the result is that normally developed children’s social interaction total score means is higher than autistic children’s social interaction total score. The difference is found statistically significant [F(2-147)=45,68, p<0.05]. When mentally retarded children’s social interaction total score means is compared to the total score of children with autism, mentally retarded children’s total score means is much higher than total score means of children with autism. The difference between mentally retarded and autistic children’s score is not statistically significant [F(2-147)=45,68, p>0.05]. When mentally retarded children’s social interaction total score means is compared to the total score of normally developed children, normally developed children’s total score means is much higher than total score means of mentally retarded children. The difference between two groups is found statistically significant [F(2-147)=45,68,p<0.05].

Total score means collected through Social Skills Scale’s sub-dimension called social independent scale of PKBS-2 in table 1 show that autistic children’s total score is X =17,03; mentally retarded children’s total score is X = 17,89; normally developed children’s total score is X = 27,50. Total score of social independent of children with ASD is compared to normally developed children’s total score; and the result is that normally developed children’s social independent total score means is higher than autistic children’s social interaction total score. The difference between two groups is found statistically significant [F(2-147)=40,15, p<0.05].

Total score of social independent of mentally retarded children is compared to autistic children’s total score; and the result is that mentally retarded children’s social independent total score means is higher than autistic children’s social interaction total score. The difference between two groups is not found statistically significant [F(2-147)=40,15, p>0.05]. When total score of social independent of mentally retarded children is compared to normally developed children’s total score, normally developed children’s social independent total score means is higher than mentally retarded children’s social independent total score. The difference between two groups is found statistically significant [F(2-147)=40,15, p<0.05].

When total score means of Social Skills Scale (TSSS) of autistic, mentally retarded, and normally developed children is analyzed in Table 1, total score means of children with autism is calculated as X =49,15; total score means of mentally retarded children is found as X = 50,97; and total score means of normally developed children is sum as X = 85,40. Once average score means of Social Skills Scale of children with ASD is compared to normally developed ones’ score means, it is understood that total score means of Social Skills Scale of normally developed children is higher than autistic ones’ Social Skills Scale score means. The difference is statistically significant [F(2-147)=50,57, p<0.05].

When average score means of Social Skills Scale of mentally retarded children is compared to autistic ones’score means, it is understood that total score means of Social Skills Scale of mentally retarded children is higher than autistic ones’ Social Skills Scale score means. The difference is not found statistically significant [F(2-147)=50,57, p>0.05]. Also when average score means of Social Skills Scale of mentally retarded children is compared to normally developed ones’ score means, it is understood that total score means of Social Skills Scale of normally developed children is higher than mentally retarded ones’ Social Skills Scale score means. The difference between two groups’ total score means is statistically significant [F(2-147)=50,57, p<0.05].

In Table 2 what can be seen is correlation analysis of scores obtained from Play Skills Scale and Preschool and Kindergarten Behavior Scale (PKBS-2) of autistic children.

When Table 2 is analyzed in detail, the following results can be stated: there is a positive mid-level significant difference between children’s scores of Play Skills Scale (PSAS), Social Skills Scale (SSS) (r =,67, p<0.05), and PKBS-2’ 3 sub-dimensions scales such as Social Cooperation (SC) (r =,67, p<0.05), Social Interaction (INT) (r =,64, p<0.05), and Social Independent (IND) (r =,58, p<0.05). When the total scores of scales are examined, the following this results are reached: if autistic children’s play skills are high, then their social skills are also high related to PSAS and TSSS relations.

4. Discussion

In a general view, it is accepted that children with autism, mentally retarded, and normal children all display different behaviors in play skills, social and behavioral patterns. In this research study, such differences were analyzed from the parents’ perspectives. The findings of the present study revealed that the children with autism had lower levels than the mentally retarded and children (Table 1). In other words, in line with the literature, the findings of this study shows that autistic children are less talented than normally developed children in pretend and cooperative plays (Tilton & Ottinger, 1964; Stahmer, 2006; Dykstra et.al., 2012; Thiemann-Bourque, 2012). Normally developed children easily engage in solitary and social plays. Although mentally retarded children also engage in plays, their engagement is slower than the normal children due to the language and communication difficulties they face. On the other hand, the stereotypic behaviors or focusing on a single object affect the functional play skills of autistic children negatively. Additionally, posture and gait abnormalities also hinder their participation in locomotor plays. Lack of eye contact, ambiguous gestures and mimics, and insufficient imitation abilities of autistic children also delay and create difficulties for participating in the plays. Therefore, from the early childhood, such children need to be encouraged to participate in the plays with their peers (Jung 2008).

In another study, Wulf (1985) compared the play skills of the autistic children in free play time with the normal children and found out that autistic children tended to stereotype body movements when they became free instead of creating or engaging in plays by ignoring the play materials. The parents of the autistic children in the present study also declared such similar statements about their children. In another study which displayed consistent results with the present study, Thiemann et al. (2012) compared 35 pre-school autistic children with 35 pre-school children with other developmental problems and determined significant differences in play skills between those two groups, and the study concluded that autistic children tended to engage in more conventional plays (Thiemann-Bourque, 2012).

Moreover, in 2007 Bray and Cooper compared types of playing games in their education institution of two groups which are respectively normally developed children and 48 to 84-months-old 12 special needs children in preschool. According to the results of the study, it was found that special needs children prefer to play more symbolic games in the environment of normally developed ones. The reason for the result is explained as special needs children have more chance to play games and are more encouraged in the environment of normally developed ones.

Another important result of the research is that total score means of Social Skills Scale’s sub-levels named as social cooperation and social interaction of children with ASD is statistically less than both normally developed children’s and mentally retarded peers’ scores (Table 1). The findings of this research are supported with literature review findings. Normally developed children start to play games that need cooperation in about their 6 years. Children choose their games in these ages and determine the rules of games themselves. On the other hand, both autistic and children with developmental delay may learn social cooperation skills late. They may need additional education in order to acquire these skills. Autistic children experience social interaction problems due to their communicating problems. On account of autistic’s mental hypothesis problems, they may have problems with commenting social situations, perceiving tricks and smartness in games. As they have very limited verbal interaction, they can’t chat with their peers and express their emotions, which make their development of mental hypothesis late. Tager – Flusber (1993) observed the dialog between 2-year-old autistics and children with down-syndrome with their mothers, and it’s found that autistic children have less common attention and perception of mental situation. It causes autistic children to experience more inabilities in social environment. As it is seen in the study, children with ASD have much more problems in social skills than mentally retarded and normally developed peers.

Cessna (2000) compared social skills of special needs children and normally developed children in preschool. As a result of the research, both parents’ and teacher’s assessment show that normally developed children have better social skills than special needs children. As normally developed children are always together with their peers, their social interaction is quite better; however, it is not the same for autistic and mentally retarded children, so it is thought that these children’s social interaction is very limited. Similar to the previous research’s findings, in their study, Hauck, et al. (1995) concluded that autistic children are not sufficient in initiating social interaction, which is an important problem. Another difficulty autistic ones experience is inabilities in social skills field. Children with autism usually don’t have an idea how to initiate interaction and how to continue the relationship with peers during the game. They may also have difficulty in understanding the jest and mimics of their peers during interaction ( Marlowe, 1986; Myles et al., 1993; Mayes et al., 1993).

Another finding of the research is that autistics’ and mentally retarded children’s total score means of PKBS-2’s Social Skills Scale’s sub-dimension named as social independent are lower than the scores of normally developed children and this difference is statistically significant (Table 1). The related literature review supports the research’s findings. Both the difficulties in social and communication skills and insistent stereotype ongoing behaviors affect autistic children’s inabilities in social independent skills negatively. Moreover, the fact that children with ASD have problems in attention and mimicking skills obstructs social skills developmental (Thurm et al., 2007). Late, limited interactional and social interest in ASD naturally prevents them from being independent. For that reason, children with ASD need adult support to fulfill both interactional and natural needs. As a result of intense parent support at first and then reducing and stopping support finally, children with ASD experience disability in social independent skills (Newman et al. 2000; Minshew et al., 2002).

Correspondingly to this research, Lutejin et al. (2000) compared children with ADHD and children with PDD-NOS in terms of social problems. PDD-NOS group has higher scores than the other group. Another social skills problem that autistic children suffer is social emotional perception. These children are not successful in making friends as they can’t understand people’s emotional and social expressions, which may cause them to be in a depressive mood and alone (Bauminger, 2002).

When table 2 is analyzed, the following two results are confirmed: there is a positive mid-level significant relationship between children’s scores of Play Skills Scale and scores of PKBS-2 Scale’s sub-dimensions called Social Cooperation, Social Interaction, and Social Independent. This result can be commented that children with autism who have high play skills may also be good at social skills.

Children may have an opportunity to express negative feelings via games. Children may dramatize some effective cases which are fears, anger, lost things and which influences them deeply. A game is such an important activity that it keeps children away from stress. Through games, children learn their personalities and how to develop empathy. They also achieve awareness being fair, obeying rules, cooperating at work/game, and social rules in friendship. Those social skills are effective in developing self-esteem and self-confidence (Charman, 1997). Children learn new terms and information that they have not heard before by interacting each other during games. Information transfer which is a result of this interaction is a very good evidence of social structure in a game. It is seen that there is a reverse relationship between autistic children’s play skills and behavior problems. In other words, if autistic children’s play skills are quite sufficient, then it is concluded that they suffer less behavior problems. Literature review shows that there is a reverse relationship between autistic children’s social skills and behavior problems. Autistics whose social skills are more sufficient show less behavior problems. While they are playing with peers, what children learn is problem solving, obeying game rules, respecting peers and peers’ rights in the game. Moreover, they also gain ability to feel love to others and to respect, to protect themselves and their friends from possible problems, to respect one’s rights, to manage peers in a game, to be managed by others, to accept the given role in a game, to trust themselves and others, to decide critically and apply this decision, to cooperate with other players. These are all social rules and they learn them through games (Blanc, 2005). Children with ASD are often observed to show social interaction problems directly and indirectly. Although children with ASD want to communicate with their peers, they can’t success it easily as normally developed ones do. As they are not able to internalize game rules and are not sure how to initiate and continue interaction in games mainstreaming environment, they are usually excluded out of the game. Inability in language, communication, and social skills may cause children to show different inappropriate behaviors (Williams-White et al., 2007). Stahmer (2006) emphasize that the reason for children’s inappropriate behaviors is their inability in social skills. Also Merril et al. (2001), Worden (2002), Denham and Weisberg (2005) and many academicians specify that children’s behavior problems are caused by inabilities in social skills (Özdemir, 2007; Wolfberg, 2012). In this research, with parallel to related literature review, negative relationship between inability of children’s social skills field and problem behaviors is confirmed.

Findings of the study ascertain that children with ASD experience have more troubles in play skills and social skills compared to both normally developed and mentally retarded peers. Besides, similar to children with ASD, mentally retarded children are observed to have difficulties in social problems. Thus, it is vital for both children with ASD and mentally retarded children to have opportunities for spending time and playing games together with peers beginning from early childhood years. Those children may improve their social and play skills through observations of normally developed peers during the games. It is also substantial for children with disabilities to attend intervention programs in order to develop interaction skills. Programs based on play and interaction may be effective solution for social and behavioral problems of children with disabilities. Especially peer education and parent education programs can reinforce these children’s participation in daily life normally.

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