Use of school recess time in the education and treatment of children with autism spectrum disorders: A systematic review

14 Jun

Use of school recess time in the education and treatment of children with autism spectrum disorders: A systematic review is, as you will see, a small study on what is a relatively unstudied area: recess as part of the educational day for autistic students. This caught my eye for a simple reason: I think a lot about recess. I think about special education kids, kids who are working really hard, who need the break that recess provides as much or more than anyone.

Here is the abstract:

School recess is an opportunity to include students with autism spectrum disorders (ASD) with their typically developing peers and is a setting in which instruction can occur. However, the educational opportunities for children with ASD within recess are often overlooked and recess time is being reduced or eliminated in the United States. This review involved a systematic search and analysis of 15 studies that utilized recess to implement academic, social, or behavioral interventions for students with ASD. Each identified study that met pre-determined inclusion criteria was analyzed and summarized in terms of: (a) participant characteristics, (b) intervention procedures, (c) dependent variables, and (d) intervention outcomes. This review has three main aims: (a) to evaluate and synthesize the evidence-base, (b) to inform and guide teachers interested in utilizing recess time for educational purposes, and (c) to stimulate and guide future research in this area. Results demonstrate that recess time can indeed be used to teach target behaviors to students with ASD.

Here is the first part of the conclusion

Systematic search procedures identified 15 studies that used recess time to deliver intervention to preschool and elementary school students with ASD. Summaries of the studies revealed that a variety of different interventions have targeted a range of behaviors including challenging behavior, social skills, play, and communication. The most common dependent variables were social skills, and the most common intervention component involved typically developing peers serving as models of target behavior or as therapists with an active role in prompting and reinforcing target behaviors (e.g., McGee et al., 1992). Overall, the existing literature base is perhaps best described as limited given the paucity of studies and the relatively low number of participants (N = 46). However, despite these limitations several important points do emerge.

Baseline levels of dependent variables across the included studies demonstrate that, prior to intervention, students with ASD engaged in high levels of stereotypy and challenging behavior and low levels of appropriate play and social interaction. Therefore, unlike typically developing students who benefit simply by being given access to recess (e.g., Pellegrini & Smith, 1993), students with ASD may need additional supports in order to benefit form educational and social opportunities on the playground ([Lang et al., 2009a], [Lang et al., 2009b] and [Lang et al., 2009c]). Consequently, if a student lacks the skills necessary to meaningfully participate in recess, goals and objectives related to recess should be included in their individualized education plans.

OK, even as a review, where they pool data from multiple other studies, this is small: 46 participants.

The authors note that (a) recess is important for kids, especially younger children and (b) recess time seems to be declining in general (possibly due to the no child left behind laws in the U.S.).

I really have to pose the question: how much is recess valuable precisely because it is self-directed time? How do you define if “a student lacks the skills necessary to meaningfully participate in recess”? If a typical child spends recess in a corner of the playground reading a book or doing homework, is that a meaningful participation in recess? If an autistic kid needs that time to blow off steam in some other way, is that “meaningful”? Who defines “appropriate play”? If a child, say, spends recess screaming–is that “inappropriate play” or is that a sign that the classroom environment may be overstressing the child? Sure, if a student has the desire, but not the skills, to use recess for social interaction, let’s see about supporting that. If a child enjoys working on play skills, again. But I have a bit of a reservation about making recess into more time for work.

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10 Responses to “Use of school recess time in the education and treatment of children with autism spectrum disorders: A systematic review”

  1. usethebrainsgodgiveyou June 14, 2011 at 12:15 #

    All kids need down time. It doesn’t have to be socialization…just freedom to make their own choices.

    Self-directed was a very good choice of words.

  2. farmwifetwo June 14, 2011 at 12:44 #

    Lovaas style ABA – the Provincially funded one in my part of Ont – was anti-OT and anti-speech. They would work on neither. They had their program and the child had to conform. Then they blamed all behaviour on the child – after the child was forced to sit and drill for 3hrs, 1hr for lunch, 3hrs drill. Child finally clawed male T’s neck and he was removed. They were removed a month later. They told me he should never be allowed to play on his own. That I should have him “work” at a task all the time. The free time at the daycare – went 2 days/wk for social/respite – they took over with their book of activities so he never got any free time. FWIW… I ignored them and gave him his downtime after they left.

    The public school wanted me to leave him on Risperdal – was on 6mths from July to Dec Gr 3yr – and again blamed any behaviour on the child. It was a bad fit class to start with, not the one we had been promised, and I spent all year getting him out. They weren’t doing a proper sensory program although the OT had set one up.

    The Gr 4 yr he has spent in self-contained for multiple LD’s. He is the only severely autistic one in it. Due to proper OT, proper sensory programs, recess and other school or self regulated activity times he has thrived, personally and socially. Ironically last fall it was the other kids that didn’t know what to make of his inability to play with them…. they’ve learned how to play with him, how to interact with him, to give him space and how to push to include him… children are much smarter than adults.

    Free time, even if it’s simply bouncing and flapping and laughing at the other children is important IMO. Everyone needs time to decompress. Everyone needs time to “shake the sillies out”. Yes, some of the recess time should be in directed activities b/c everyone should learn to kick a ball, to play tag etc… but not hours of it. Start with a few minutes and let it go. They won’t master it when they are 5, but maybe by Gr 6 they’ll be interested.

    So, I’m on the half and half about using recess as a learning opportunity. If the child is interested – stands and watches – they need to be directed to play. The child should be asked to play, shown how to and if they wander away, let them go. Try again the next time. Everyone needs time to be themselves. Mine happens to like to run the fence – and find any escape routes 🙂 – but he also likes to play bleyblades with the 5/6 boys. He’s allowed and with support does both. Which is how it should be.

  3. LBC June 14, 2011 at 13:38 #

    We are in the middle of this exact issue at our school right now. My son is seven and he hates recess. Fair enough. But he hates recess because (a) he is not sporty and (b) he does not know how to “play” and (c) he is “lost” and uncomfortable during unstructured social times. For a while the teacher was allowing him to stay inside for a portion of recess time to engage in a favored activity (something he had to earn via “response cost”). But by that point in the day he’s been inside for five hours, in a classroom with no windows, so I was unhappy with them keeping him indoors. I asked why his favored activity couldn’t go with him to the playground. They’d never thought of that, apparently.

    This issue has a lot to do with the teachers and how skilled and creative they are (or are not, as the case may be). A teacher who is going to force an ASD kid to interact and participate in ongoing playground activities is making a mistake. But a teacher who is going to use the ASD child’s strengths to help that child interact socially is doing the right thing. For example, “Hey everybody, Tammy wants to go to the back of the field to feel the bark on all the different trees. Who wants to come with us?” is one way to use recess time as part of the inclusion, socialization, and educational process for Tammy. I would say this shouldn’t be done every day. Maybe work on playground skills (taking advantage of the natural/difficult social environment) on Tuesday and Thursdays, leaving Monday, Wednesday, and Friday for “free play” on the part of the ASD child.

    My son becomes somewhat frantic at recess because he simply doesn’t know what to do with himself. There are other, non-ASD kids who are also “on the fringes” and could use a little assistance organizing a structured game or activity.

    I think if your school does a great job of providing inclusion activities or social skills training throughout the school day, it would be fine to leave recess alone. But in our school, social skills are taught in a pull-out! So they remove my son from his social group to teach him to interact socially with his social group? At least on the playground you have a natural, unstructured social group where an adult can lead an activity, giving special (and hopefully discreet) assistance to the children who need it. That seems less stigmatizing to me, and might help the ASD kids understand how to play certain games they’ll be faced with at recess and PE for years. They might even find one they like. Again, it comes down to personnel. If the teacher or paraprofessional is negative and doing this kind of thing begrudgingly, it will do more harm than good.

  4. usethebrainsgodgiveyou June 14, 2011 at 14:57 #

    I had one teacher one year who allowed my son to do his homework at recess. He took ritalin at school, he was more “focused” and I didn’t give it to him at night for homework. He had to sleep sometime, of course there is another pill for that….

    He brought homework home like 10 times that year. Previously, he would work on it up to 4 hours a night. His teacher must have been LD, also. She loved him and gave him every break. It was the year we all BREATHED…

  5. Catherina June 14, 2011 at 15:45 #

    our school has a “Playground Friendship Squad” – volunteer 4th graders who go round in breaks with a backpack full of games, asking lonely kids in corners whether they *want* to be lonely or would like to play.

  6. Lynne June 14, 2011 at 15:56 #

    We had a really great experience with using recess to teach. My son has a strong desire to socialize but doesn’t know how to engage and hits when he gets frustrated. By 2nd grade recess was a disaster and had escalated to the point where I really thought the school was going to forbid him to participate. Instead, what they did was have G attend his own recess on the opposite side of the school from the playground. He selected one classmate to attend with him and the draw for the NT kidis was that G was allowed activities the general recess was not, like sledding or sidewalk chalk, so it was a treat for them. His recess was directed by the school psychologist who actively worked on facilitating play and building relationships.

    Over the course of the year, they increased the number of kids who attended G’s special recess from 1 to 5 and as the group grew they started teaching some of the general recess games G wanted to play but couldn’t figure out in the chaos, like 4-square or freeze tag. Then at the last trimester they phased him back into the general recess, accompanied by the school counselor, who was the best aide ever. She reminded G of what he’d learned and corrected other kids in situations where G would have previously responded to conflict by hitting. The kids who routinely attended his recess took on the role of ambassadors and helped him join in the same kids of games they played with him. He even developed a close friendship with another boy. He still attends recess with an aide but now has the social and communication skills he needs to play with typical children. It was a very positive experience for our family.

  7. Leila June 14, 2011 at 18:26 #

    I love the idea of the friendship squad, Catherina.

    At this point my son is doing okay at recess because he has the option between ball games and pretend play games. He’ll go for the ball games and sometimes the play structure. I’m afraid it will get harder as kids get older and the games become more sophisticated.

    Recess is definitely an important teaching opportunity for our kids.

  8. julia June 15, 2011 at 00:36 #

    As a kid with Asperger’s, grade school recess was very unpleasant. I frequently told the teachers that i wanted to stay indoors. Most of the time other kids were either bullying me or were standing around in various sized groups pointing and gossiping about me. Perhaps they were scheming on how best to bully me? I hated those times between classes until I went to collage.

    The programs and techniques described sound great if administered by skilled people.

  9. Kassiane June 15, 2011 at 19:22 #

    I *hated* recess.

    Recess is Lord of the Flies–I swear sociopaths learn from observing recesstime. Kids are MEAN and they get away with it.

    By the time recess came around I was so completely, utterly done (sensory issues! Poor auditory processing! Trying to catch everything anyway!) that all I wanted to do was be alone & up a tree or upside down for a bit. That never happened. I was at that point where one more interaction would send me into inconsolable body-wracking sobs for about 45 minutes. It was AWFUL.

    Kids are shits & decided this was funny. Little monsters. The teachers were monsters too, for allowing it.

    • Sullivan June 15, 2011 at 23:10 #

      I think I see both sides of what I was thinking of when I wrote the above. First–the need for some kids to “decompress” or even avoid what is an unpleasant experience. Second, the opportunity to assist kids who want the help to join in “standard” recess.

      I hope we can find a way to reduce the bullying.

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