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Pass, S. (2018). Beginning to Play: Parent-Child Therapy with a Young Autistic Child. Fort Da, 24(1):39-56.

(2018). Fort Da, 24(1):39-56

Beginning to Play: Parent-Child Therapy with a Young Autistic Child

Stephanie Pass, Ph.D.

Nick is sobbing furiously. It's the end of the play therapy session, just a few months in. It's time for him to go and he understands “go” but not time, not the logic of a 50-minute hour or the abstraction of minutes and hours.

It was a lovely hour. Four-year-old Nick and his father, Robert, had actually, if tenuously, played; they'd stacked blocks, knocked them down, and laughed together at the satisfying crash. There had been moments of emotional connection and reciprocity, and it had felt good to each of us. But the end of the session threw Nick into misery.

With Nick, these brief episodes of play are hard won. Just a few months ago, they weren't happening. The shared delight in doing something playful together is just emerging, and the play is young and simple. Clearly Nick has an appetite for it, and that's encouraging.

But now, with the end of the session, he's abruptly experiencing good turned bad. He was playing in my office and having fun with his dad and me, and now … not. He's four years old, but I think he feels the shift like an infant does. Contentedly playing and then sudden, terrible, and global discontent.

Why go now? Not even that question comes up; he doesn't ask “why?” about anything. Asking why would mean taking perspective and wondering about me and recognizing and then questioning my authority — all things that ordinarily happen well before age four, but are not yet happening with Nick.

Next week we'll meet here again — and then again and again — but he lives in the present. And because his sense of time has not yet developed, he's not imagining a future where we might do this again, or a future where he'll feel just as good in another setting. It's all now and there's no comforting him. No story — no language — no sentence in his mind says, “This good feeling will happen again.” When I let myself fully imagine being Nick at this moment, it's devastating.

Nick's unhappiness is palpable. Robert looks steely. He tried to comfort Nick but failed, as I did, so he eventually resorts to scooping him up and carrying him, limbs flailing, out of my office and down the stairs.

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