A clinician’s guide to how structured and unstructured play-based approaches can support developmental goals for children with autism, ADHD, learning disabilities and developmental delays.
What do we mean by play therapy?
Play can be a meaningful way for children to communicate, explore ideas and practise emerging skills. However, formal play therapy is a psychological intervention delivered by a suitably trained practitioner within a defined therapeutic model. It is not simply giving a child toys or allowing unstructured play. Play-based developmental intervention and play-based teaching are related approaches, but they are not automatically formal play therapy.
For children with developmental or learning needs, the purpose of play should be clear. The therapist identifies the skills or experiences being supported, selects activities that match the child's developmental level and sensory preferences, and reviews progress with caregivers.
How play-based work may support different needs
Autism spectrum disorder
Individualised, play-based social-communication strategies may create opportunities to build joint attention, shared engagement, imitation, reciprocal interaction and functional communication. NICE recommends play-based strategies involving parents, carers or teachers, adapted to the child's developmental level and delivered with appropriate professional guidance. The aim is meaningful communication and connection—not forcing eye contact or making a child communicate in a single prescribed way.
ADHD
Structured games with clear, achievable rules can provide opportunities to practise turn-taking, waiting, shifting attention, following directions and persisting with a short task. Activities should be brief, engaging and adjusted to the child's needs, with movement breaks where useful. Game-based intervention research is a developing area; it should not be presented as proof that generic play therapy treats ADHD or replaces established ADHD care.
Global developmental delay
Play activities can be selected to support specific developmental goals such as imitation, functional play, early communication, problem-solving, motor coordination and participation in everyday routines. The activity should be matched to the child's developmental profile: achievable enough to encourage participation, while offering a manageable next step.
Dyslexia, dysgraphia and dyscalculia
Play can support prerequisite and related skills—for example, sound awareness, sequencing, fine-motor coordination, spatial language, number concepts and confidence with learning. However, play therapy does not cure a specific learning disability. Children with dyslexia need explicit, systematic literacy instruction; children with dysgraphia need targeted support for the particular writing difficulties; and children with dyscalculia need individualised teaching of number concepts and mathematical skills. Play-based activities may complement, but should not replace, these interventions.
Structured and child-led play
Structured play has a planned learning or therapeutic purpose, such as practising turn-taking, matching, sequencing or requesting help. Child-led play gives the child greater choice and can help the practitioner understand interests, preferences and communication. Depending on the child's goals, a thoughtful programme may use both. Neither approach should be applied mechanically: developmental level, language, sensory profile, attention, emotional state and the child's preferences matter.
What should parents look for?
- Clear, individualised goals linked to the child's everyday functioning.
- An explanation of whether the service is formal play therapy, play-based developmental intervention or play-based teaching.
- A practitioner with relevant training and experience for the intervention being offered.
- Caregiver communication and practical strategies that can be used naturally at home.
- Regular review of progress, with changes to the plan if the child is not benefiting.
What does the evidence tell us?
The American Academy of Pediatrics describes play as important to children's development and relationships. Research on parent-mediated play-based approaches for autistic preschool children reports potential benefits for social communication, although results vary and study findings are heterogeneous. NICE supports play-based social-communication strategies for autistic children when appropriately individualised. Research into digital and game-based interventions for ADHD is a separate field and should not be conflated with formal play therapy.
For children with global developmental delay and specific learning disabilities, play can be incorporated into an individualised, multidisciplinary plan. The intervention must still target the child's identified needs and should be reviewed rather than relying on play alone.
A final thought for parents
Play is not a one-size-fits-all treatment. Its value lies in how thoughtfully it is selected, what developmental or emotional goal it serves, and whether it is helping the child participate and learn. A good plan starts with understanding the child—not with choosing a toy or activity first.
