Symbolic Play in Severely Mentally Retarded and in Autistic Children

SUMMARY Children aged 3–14 on one census day, known to the services for severe mental retardation, or having items of behaviour found in early childhood autism, were identified from the Camberwell register. The children can be divided into 3 groups: (a) 42 with no symbolic play; (b) 23 with stereotyped, repetitive, copying play, (c) 43 who have flexible, varied symbolic play. The last occurs only in children with language comprehension age above the 19 month level, and is seen in less than half of the school‐age severely retarded children. The majority of children with no symbolic play, or with stereotyped play, have marked autistic features or the full autistic syndrome. Only 2 of those with true symbolic play have any behaviour like that found in autism and none has the full syndrome. A small group of children with “repetitive” speech and stereotyped play is identified and the relationship with childhood autism is considered. The educational implications of the findings are discussed.