Do unusual play patterns in autism improve with age? 

Unusual play patterns, such as solitary, repetitive, or highly structured play, are among the most recognisable features of autism in early childhood. But can they improve with age? 
NICE guidance suggest that while many children retain distinctive play preferences, play flexibility, social engagement, and imagination often increase gradually as cognitive, emotional, and social skills develop. 

How play evolves over time 

A 2023 scoping review by Gentles et al. followed over 6,000 autistic children and found that social play and engagement often improve during middle childhood, particularly when emotional regulation and communication also strengthen. However, repetitive and solitary play styles tend to persist, especially when anxiety or sensory sensitivities remain. 

In a 2025 prospective study, Du et al. found that six months of early play-based interventions, such as the Early Start Denver Model (ESDM) and Applied Behaviour Analysis (ABA), led to measurable gains in imaginative play, joint attention, and emotional expression. These improvements were most evident when parents actively participated, highlighting the importance of family involvement. 

As children mature into adolescence, some develop stronger peer connections and broader leisure interests, while others continue to prefer structured or independent play. According to NICE guidance, interventions should adapt to developmental stage, supporting flexibility, confidence, and choice as children grow. 

Why emotional and cognitive growth matters 

Improvements in social communication, executive function, and emotional regulation are key drivers of play development. Children who learn to manage frustration, shift attention, or interpret others’ emotions tend to engage more in group play and imaginative scenarios. 

Conversely, difficulties with anxiety, rigidity, or sensory sensitivities can maintain repetitive play styles into adolescence. This makes targeted, structured interventions, such as social communication therapy, play-based CBT, or collaborative play strategies, especially valuable. 

When to seek extra support 

If your child’s play remains extremely limited or repetitive despite support, or if social anxiety prevents peer interaction, it may help to consult a neurodevelopmental specialist. 
Services such as Autism Detect offer NICE-aligned assessments and aftercare, helping families access play-based and emotional regulation therapies designed to evolve with each child’s developmental stage. 

Takeaway 

Unusual play patterns in autism often soften but don’t disappear entirely with age. The greatest progress occurs when children receive early, consistent support targeting social communication and emotional flexibility, and when families join in play to nurture confidence, curiosity, and connection. 

According to both NICE and NHS guidance, progress is not about “normalising” play but about helping each child find joy and meaning in it, at every age.