Spontaneous Play Profiles in Mandarin-Speaking Preschool Children With Autism, Developmental Delay, and Typical...

This study examined the spontaneous play behaviors of Mandarin-speaking preschool children with autism spectrum disorder (ASD), developmental delay (DD), and typical development (TD) during naturalistic parent-child interactions. Ninety children aged 36-72 months (30 per group) participated in a 15-min parent-child free-play session, and a standardized 10-min segment from each session (minutes 3-13) was coded and analyzed. Play behaviors were coded using a fine-grained developmental framework and analyzed using both unidimensional (duration and frequency) and multidimensional (variety, highest mastered play level and weighted average mastered play levels) indicators. After adjusting for FSIQ, spontaneous play duration (F(2, 86) = 14.54, p < 0.001, η ² = 0.25) and weighted average mastered play level (WA-MPL; F(2, 86) = 3.67, p = 0.03, η ² = 0.08) differentiated the ASD group from both the TD and DD groups. In contrast, symbolic play in this naturalistic context was more closely associated with cognitive level than with diagnostic status. At the subcategory level, Varied Action Sequences (VS) emerged as a particularly informative high-level form of pre-symbolic play: children with ASD showed lower VS frequency than both TD and DD peers, and reduced VS variety relative to the DD group. These findings underscore the importance of multidimensional assessment and fine-grained coding for capturing distinct play profiles in ASD and informing developmentally appropriate intervention targets.