Sora wrote:
I think this inability to pretended play is connected to playing a game of pretense with other children. I played scripts and was extremely creative in dreaming up dream worlds and adventurous scenarios, but I never knew how to play "Mother-Father-Child" (Note: This game may have a different name in English) together with other children, because I didn't know what the expectations were or what I should do.
Bingo! I think you nailed it perfectly, there. I remember that. I'd play with my toys (Star Wars obsession, don't you know), and make up short scenarios to do with them. It also helped that most had moving parts that I could move around, see when they'd fall over, when they'd stand, operate a moving hand, leg, lift the lid off, put it back on (you get the idea). But just freeform interaction with other kids? I remember not being able to do that. And I kept my toys pristine, so when other children wanted to play with them, I remember my mum commenting that I'd visibly tense up every time another child picked up one of my toys, in case they did it wrong or damaged it (she thought that was funny: really, not so much). But freeform? Cops and Robbers, Cowboys and Indians, Playing House? Was never interested, and I still remember a game of Cops and Robbers, IIRC the only one I ever tried to take part in, where I was just bewildered as to what the heck I was supposed to do! In primary school during recess, I'd just walk around, around, and around any fixed point, try to avoid the other kids and their imaginary play. Walking, walking, walking.
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I'd say that a person is unable to true pretended play (=a play that is based on cooperation and strictly creative, not script based), when the intuitive social understanding is there to some extent. For example, I have like zero. But there are lots of those with asperger's that I know that have a fairly good understanding of social interactions, lesser than that of an NT, but way better than me. And this is where it gets tricky. How much impairment can a person show in social skills? If there is a small basis of understanding social interactions, does it somehow impair the child despite this? And how severe does the child display rituals and does the language development match the criteria?
That's a really good question. I'm borderline Aspie, and my stepmother is an autism specialist, and from what I've picked up from a reasonably long phone conversation with her, she tends to view things, once she's established that a child is
somewhere on the spectrum, in terms of how much help a diagnosis may or may not be. If the label will help, if the services will help, then that's the direction you push, if it seems like the child is doing OK on their own, then don't go that route and just keep an eye on them in case they run into difficulties later. That seems to me to be a very sensible attitude - healthcare should be about benefitting the patient, so how much the impairment matters and therefore how to go about diagnosis should be tailored to what you believe will help. To a degree, many of the clinical criteria are value judgements - what is "clinically significant?" It's obvious in some patients, but in the borderline cases, you just need to try to work out what will be best for the patient you're treating.
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