How Does Play Provide Opportunities for Practising Social Skills in Autism? 

For children with autism, play is much more than a leisure activity, it’s a vital pathway for learning how to communicate, share, and connect with others. According to NICE guidance CG170, structured and naturalistic play provides opportunities to practise social communication, joint attention, and emotional regulation, forming the foundation of lifelong social skills. 

Why Play Matters for Social Development 

Play helps children experiment with social interaction in a safe, low-pressure environment. Through play, autistic children can learn turn-taking, imitation, emotional expression, and cooperation, key components of social competence. 

NHS advice on autism in children highlights that play can be used both therapeutically and at home to encourage communication and interaction. Whether it’s building with blocks, role-playing, or digital games, play opens doors to shared experiences and joint engagement, both essential for developing confidence in social settings. 

NICE and NHS Guidance on Play-Based Interventions 

NICE CG170 and NICE NG128 recommend play-based, social-communication interventions as part of core support for autistic children. These approaches aim to: 

• Improve joint attention and engagement 

• Support reciprocal communication and imitation 

• Encourage flexible, cooperative play 

Therapists often use modelling, video feedback, and guided routines to help children expand play and social understanding. For younger children, parents or teachers may lead sessions, while peer mediation is effective for older children in classroom or group settings. 

Evidence from Research (2020–2025) 

Recent, high-quality studies and reviews reinforce that structured and naturalistic play supports social-skill development in children with autism. 

Structured Play 

A controlled trial by Kok et al. (2002) at the National University of Singapore found that structured play sessions produced more frequent communicative acts and better social engagement than facilitated play. Both approaches increased interaction, but outcomes depended on developmental level, confirming the importance of individualisation. 

Play Therapy 

A 2023 review by Elbeltagi et al. reported that child-led play therapy enhances social communication, emotional expression, and independence in autistic children. Sensory play was found to regulate behaviour and reduce aggression, while therapeutic play encouraged self-expression and trust. 

Systematic Review of Game-Based Play 

A 2024–2025 systematic review led by Walsh et al. at University College Cork analysed 17 studies. The review found that game-based and peer play interventions consistently improved social skills, particularly when autistic children were directly involved in designing and setting goals for the activities. Programmes with clear skill targets produced the strongest outcomes. 

Naturalistic Play Interventions (ESDM, PRT, SCERTS) 

These interventions integrate play into natural routines, supporting children to practise social skills, communication, and emotional regulation in real-world contexts: 

Early Start Denver Model (ESDM) 

Developed by Rogers and Dawson, the ESDM integrates play within daily routines to enhance communication and imitation. RCTs from the US and Italy found significant improvements in developmental scores and reductions in autism symptoms, especially in younger children receiving intensive support. 

Pivotal Response Treatment (PRT) 

A 2017 study by Lei et al. found that PRT, a play-based behavioural therapy, significantly improved social initiations, communication, and engagement. Neuroimaging showed increased activity in brain regions linked to social processing, demonstrating how play impacts neurological as well as behavioural outcomes. 

SCERTS Model 

The SCERTS framework, tested in a 2018–2022 cluster RCT by Morgan et al., showed higher gains in adaptive communication, social skills, and emotional regulation compared to standard autism programmes. Parent-implemented SCERTS produced even greater developmental progress than classroom-only instruction. 

How Play Builds Social Practice 

Across settings, play serves as a rehearsal ground for core social skills: 

• Joint attention: Learning to share focus and respond to others’ cues 

• Imitation: Copying actions or words builds communication and understanding 

• Turn-taking: Builds patience, cooperation, and respect for others’ roles 

• Emotional regulation: Play helps children express and manage feelings safely 

• Perspective-taking: Encourages understanding of peers’ thoughts and reactions 

As a 2024 review by Chang et al. noted, joint attention and symbolic play are “central developmental targets” in autism intervention, essential not only for early therapy but for long-term social functioning. 

When to Seek Extra Support 

While many families can incorporate play-based approaches at home or in school, some children may benefit from additional professional guidance. If a child continues to struggle with social engagement, communication, or emotional regulation during play, it may be time to explore formal assessment or therapeutic support. 

Professional input can help identify the most effective strategies, whether through speech and language therapy, behavioural coaching, or structured play interventions such as SCERTS or PRT. 

If you’re considering an autism assessment or would like help accessing tailored therapies, you can connect with Autism Detect. Their CQC-rated “Good” team provides private autism assessments and aftercare services designed to support children’s communication, play, and social development in partnership with families and schools. 

Takeaway 

According to NICE and NHS guidance, play provides some of the most powerful opportunities for autistic children to practise social communication, emotional regulation, and cooperation. 

From structured peer play to naturalistic models like ESDM, PRT, and SCERTS, research shows that play bridges therapy and real life, helping children build lasting social confidence. When guided by trained professionals and supported at home and school, play becomes a key ingredient for social growth.