Choosing Toys for a Child with Autism

Exceptional Parent, October 2000

When my son was eleven months old, he went to his first birthday party. The birthday boy received a truck, a Disney sing-along video tape, a learn-to-dress Sesame Street doll, and a ball. He was extremely excited about all of his toys, going from one to the other, squealing with the abandon only a baby can muster. I remember thinking, with a sinking heart, that my baby would not like any of those toys. I did not know he was autistic at the time; I only knew that he didn’t seem to like, or even notice, toys.

I have come a long way since those days of being mystified and heartsick. It hasn’t been easy, but I have now figured out just what toys works for Nat and what toys don’t. The following contains some toys that he has liked and some pointers for how I choose toys successfully for my autistic child:

Don’t pay attention to the ages listed by the manufacturers — except in terms of choking hazards.

If your child is developing atypically, as is the case with Pervasive Developmental/Autism Spectrum Disorders, then it doesn’t matter if the box says: “ages four to six” and he is eight. He may be ready for the toy at eight or ten, but not before. What matters is getting your kid to play with something, to expand his horizons. Of course, parents should always pay attention to the choking warnings on products and keep in mind that children with autism may mouth things inappropriately, so small pieces may be a problem way beyond the usual age of three.

If something does not appeal to your child, try it at another phase of his life.

The all-time best toy for my child actually was something that his friend got that day for his first birthday, but that did not work for my son until he was four: the Disney sing-along videos. These little gems are collections of songs from all the Disney movies, starting with “Snow White,” going all the way to “Aladdin,” “The Hunchback of Notre Dame,” and “The Lion King.” The predictability of a video along with the accessibility of song proved a magical combination for my son, and it happened much later for him than would be the case for a typical child. The sing-alongs were a very positive experience for him, because they were videos which you could play over and over, and the characters in them are very familiar because you see them everywhere.

Animated videos were a very important communication facilitator for Sheila D., a Massachusetts mother of a boy on the autism spectrum. Her son’s particular favorite (at age 3) was a Ninja Turtles video. Her son was not very verbal at the time, but he did watch videos. One afternoon, Sheila noticed that “he kept doing something over and over… and saying this thing all the time. Then I saw him watching the video and I saw them saying this same thing. When I saw it I thought, ‘That’s where that came from,’ and I tried it, I said exactly what they were saying… and he lit up! It was the first time we actually played together. We played it for about an hour.”

Even if you think he’s beyond a particular toy, take it again out in a few years: Shape-O Ball, Music Blocks, Ooglie.

When my son was about a year old, my sister Laura brought him a “Shape-o Ball.” This was a big red and blue polygon with different shaped holes cut into the sides, and about ten yellow shapes that would fit into the corresponding openings. This toy mildly interested our child when he was a baby. He would choose a shape and mouth it; I would then hold the ball and rotate it until the correct shape turned up, and I would help him slide his shape into the hole. This was a satisfying interaction for us.

But our use of Shape-o did not end there. When my son was seven, part of his I.E.P. was to learn shapes. After school I would take out the old Shape-o ball and he could by then name the shapes and insert them himself. He loved this for the predictability, the tactile satisfaction of dropping the shape correctly into the hole, and for the way he felt knowledgeable about shapes.

Another infant-toddler toy that is particularly good for autistic children of any age is Music Blocks, by Neurosmith. Nancy M., a mother of three from Philadelphia, loves this toy because it holds her autistic son’s interest for a while, yet is an appropriate toy because it utilizes sequencing and music. Music Blocks contains different musical cartridges that are inserted into the blocks, which are of different shapes. Depending on how you shift the blocks, the music played by the blocks varies. The EToys Web site (www.etoys.com) describes the toy as follows: “Kids can mix and match the violin, the bassoon, the flute, the piano, the trumpet, and an ensemble of all of them, by arranging the blocks in whatever combination they please. The composition played back will be unique to their creation.”

Nancy M. also recommends the Ooglie, by Playmates, a mechanical creature whose eyes light up, and which makes strange noises and vibrates when you pull its tail. “Henry loves it,” Nancy says. Apart from the benefit of capturing a child’s interest, it can help teach cause and effect.

Toys for gross motor development are a good bet: Sit and Spin, trampolines, and bicycles.

Many children with autism enjoy a Sit and Spin because they crave the spinning motion, and this is a way for them to satisfy this need safely and appropriately. Similarly, a large-size trampoline, can be very therapeutic and fun for children with autism. Children with autism universally seem to like trampolines. Aneesa Usman, occupational therapist and clinic manager at Healthsouth Braintree Pediatric Center in Chestnut Hill, Massachusetts, explains that trampolines feel good to children with sensory-imbalanced systems because they can provide excellent proprioceptive (awareness of one’s body positions) input and vestibular (how the body responds to movement through space) motion feedback. “Kids with atypical sensory development lack the body’s ability to organize the senses…” Ms. Usman says, “[and] interconnection and interplay of all those senses is crucial” to a feeling of well-being in a child. Jumping and balancing on a trampoline can help physically and sensory integrate the body’s different systems. She cautions that parents ought to practice caution and good sense when using a trampoline, and to “read the visual cues of your child. Watch for excessive laughing, drooling, anything that looks like a child is becoming unsafe.” Getting brothers and sisters involved provides a huge social benefit, too.

A far more common childhood toy that has worked well in our family is the bicycle, with and without training wheels. Nancy M. bought her autistic son a bicycle attachment called a Kangaroo. This enables her son to peddle with her, but Nancy does the steering and braking. “He usually peddles, too, though,” says Nancy. “He loves it. The family bike ride is something we can do now.” Aside from the obvious benefit of getting some exercise — which can be crucial to some of these kids who may become rather sedentary once they pass early childhood and come to depend on computers and video games for entertainment — there’s the additional benefit of learning the rules of the road. Currently my son is working on paying attention to the “walk” and “don’t walk” signs at intersections so that he may one day be completely independent on his bike; being left alone on the bike is a good motivator for him.

Try the old standbys: board games, puzzles, CDs, and books.

Four very typical leisure items have worked well for us: Candyland, puzzles, CDs, and books. Candyland is the simplest turn-taking board game, and most kids relate to the pictures of candy. I started with Candyland when my son was very young, and the first times I would take his turn with him, using hand-over-hand techniques as I moved his piece around the board. As he got older, he could turn over his own card and tell me what color square or what item was on the card — with prompting. By asking him what he should do next, and by repeating out loud what color he had picked, I was able to keep him focussed on the game. One caution: Candyland has a lot of “go back to square one” kind of turns. This can be a problem with kids who have attentional difficulties. If it takes too long to actually finish, then pick a reasonable ending point so that you can feel satisfied with what you’ve played. Or change the rules to suit your family. My rule is that you can’t repeat the same “go back” more than once. It works better that way.

Jigsaw Puzzles are an excellent leisure activity that help my child feel confident. I started small, using the foam letter puzzles that had different surfaces which would interest his sense of touch. Then I moved up to more typical jigsaw puzzles. Now he does 36-piece puzzles with relative ease. Although he prefers to do the same ones over and over, I do introduce new puzzles from time to time.

The best puzzle I found for him actually taught him the concept of reading. It was actually an educational toy called “Spell-A-Puzzle” from Battat. Spell-A-Puzzle contains about twenty small words puzzles, like dog, bird, and cake. When you put together the word puzzle, you also create the corresponding picture of the object spelled. Hence, when you spell “dog,” you make a dog picture as well. This ingenious toy was successful because it puts together images with words and breaks the words up into letters, which can work very well for atypical learners who may not learn to read phonetically or as whole word. “Putting together the parts to the whole — the pictures and the letters [is a very successful way to grasp the concept of reading] for atypical learners,” says Beth Williams, a reading/writing specialist from Brookline Public Schools. “[This sort of puzzle] allows for a simultaneous presentation of a visual cue and the word,” which can be extremely satisfying to a child with a learning disorder such as autism. And from a sensory perspective, occupational therapist Aneesa Usman points out that all puzzles provide some tactile satisfaction in the snapping together of the pieces, and also proprioceptive feedback because kids with ASD and PDD often crave the “additional joint compression” provided by pushing at the pieces. This may explain why children like mine enjoy puzzles so much.

One can’t do a toy survey for children with autism in the twenty-first century without covering computers. My son first learned how to use a computer during occupational therapy sessions; he was around six years old. The therapist wanted to improve his hand-eye coordination, and using a mouse was a good goal to that end. She started him off with a touchscreen, so that he could grasp the concept of sending commands to the computer with a touch. He quickly graduated to a mouse.

The software he began with was the CD “Thinking Things,” by Edmark. The programs were very simple, asking him to identify which item was different from the rest, or matching programs. This coincided well with his I.E.P. goals, and he thoroughly enjoyed the animation. He now enjoys a lot of different software, most of which tie in with books he knows; the “Living Books” software, by Broderbund, are wonderful, with many titles to choose from. One caution in using computers: autistic children can become self-stimulatory on one aspect or another in the software. My son loves to watch the credits of most CDs, over and over. I have to use credits as a reward for actually playing with the software appropriately.

In terms of satisfaction and encouraging expansion of horizons, nothing can quite compare to a book. Books were the absolutely irreplaceable item in my son’s life. Reading to him was the very first thing I was able to do together. When he was around eight months old, I began reading him the board book “Corduroy: A counting book.” I read this to him so many times, I can still remember the text exactly. I would sit and read it through and then start again. I can remember so clearly the first time he took his thumb out of his mouth, took the closed book from my hand, turned it back to the beginning and grunted, telling me he wanted to hear it again. It was the first interaction we had ever had that wasn’t about a basic need.

Since then, my son has enjoyed many books and I am certain he learned language from them, because of his love for them. His fondness for books was most certainly due to the predictability of a book, once he heard it a few times. But I’d like to think it is also due to the security he derived from the contact of leaning against me, the pleasure of hearing my voice. Even now, at age then, he brings books to me to read to him, even though he can read. His all-time favorites are (and I have asterisked the ones that have corresponding videos; more on that below): Where the Wild Things Are, by Maurice Sendak*; Corduroy, by Don Freeman*; The Snowy Day, by Ezra Jack Keats*; Lost, by David McPhail; Strega Nona, by Tomie DePaola…* There’s a Nightmare in my Closet, by Mercer Mayer; The Story about Ping, by Marjorie Flack and Kurt Wiese; Mike Mulligan and the Steam Shovel, by Virginia Lee Burton*; Blueberries for Sal, by Robert McCluskey*; any Dr. Suess*; any Curious George*; and the Children’s Visual Dictionary, by Jane Bunting.

Any book goes over better with my son if there is a video or a computer game that goes with it. Check out the Weston Woods video series. They animate many of the classic Caldecott award kind of books. Most are available in public libraries. When my son can go from reading a book, to seeing it on T.V., to playing an interactive version like Green Eggs in Ham on CD, he’s a really happy guy. It makes the stories come alive for him.

Don’t despair over the difficulty of entertaining your child.

Toys that worked for my child would not work for every child with autism. But keeping in mind that developmental rules don’t apply here, and also remembering the autistic child’s love of predictability and repetition, as well as the need for sensory input and multi-modal approaches, ought to help you choose toys with reasonable success. The most important thing is to try not to despair if toys you’ve picked don’t seem to interest him right away. Try them again at a later date, or understand what this dislike implies about your child’s tastes. It’s crucial to observe your child in his likes and his dislikes because the knowledge you will gain will be highly useful when trying to teach him new things. Likes and dislikes are strong motivators, and make handy rewards.

Buying a toy for an autistic child can be a chore and a heartbreaking endeavor. But with a little observation of your child and a willingness to fail and to try again, parents can find the right toys and expand their child’s abilities with them. As long as we accept our children for the unusual people they really are, and try to appreciate their uniqueness, it is possible to play with them and to get them to interact with us meaningfully and pleasurably.