Child initiated play appears as a means for children to express their inner world and personality and works as a milestone promoting their overall development. Internalized emotional disturbances constrain children’s functioning and have an impact on their general behavior, hindering their development. Most of the times, it appears challenging for teachers to identify a child with internalizing problems in the preschool classroom and most interventions are targeting children with externalized problems. Since play is a way for children to express, observations of children’s behavior while playing, provide information about their inner thoughts and concerns. The aim of the present study was to identify play behaviors and tendencies in types of play that children with typical and atypical internalized emotional disturbances show in free play situations in preschool. A systematic literature review was conducted in order to reach this goal. Six articles were included in which five internalized emotional disturbances were mentioned -one typical and four atypical. Findings revealed eight overt play behaviors, with prevalent these of non-play, solitary-passive behavior, unconscious play activity and desire for peer play but no attempt for it. Regarding engagement in play types, children exhibiting internalized problems were more prone to constructive and creative play and less engaged in symbolic play, which can be possible indicator of developmental delays. This study works as a tool for professionals in order to identify play behaviors of children with internalized emotional disturbances in preschool child initiated play. Subsequently, the findings assist interventionists on providing adequate support and clinicians on shedding light on the dubious field of emotional and behavioral disorders in early childhood.

The estimated prevalence of Autism spectrum disorder (ASD) in 2007 was approximately 6,5-6,6 per 1000 children. Symbolic play is, one of the diagnostic criteria in the cases of ASD. In preschool, symbolic play is predominant form of play. However, children with ASD show lower levels of symbolic play. It takes them more time to start with symbolic play and have problems in performance of it. Nevertheless, they might even never develop symbolic play skills. The need for interventions targeting symbolic play of children with ASD is increasing. Generally speaking, there appear to be very limited number of symbolic play interventions for children with ASD. Even if done, most have been performed in laboratory conditions. The interventions that have been undertaken to support symbolic play have taken form of being child centered, peer mediated or adult mediated, with emphasized role of caregivers as interventionists. The aim of this systematic literature review is to address parents and teachers implemented interventions targeting symbolic play of preschool aged children with ASD, with an emphasis on characteristics of these interventions and pretend play sequences. Findings reveal that interventions implemented by either parents or teachers in natural environment give positive outcomes in terms of symbolic play and its instances of preschool aged children with ASD. The review presented a limited number of studies dealing with this kind of interventions. Since all interventions show that symbolic play can be facilitated in this population, special attention should be payed to the methods used to improve symbolic play behaviours and defining and dividing symbolic play. More focus should be put on implementing interventions targeting symbolic play of children with ASD by caregivers, i.e. parents and teachers, in natural context. Inclusion of peers in these kinds of interventions emerges as possible and potentially successful as well.The estimated prevalence of Autism spectrum disorder (ASD) in 2007 was approximately 6,5-6,6 per 1000 children. Symbolic play is, one of the diagnostic criteria in the cases of ASD. In preschool, symbolic play is predominant form of play. However, children with ASD show lower levels of symbolic play. It takes them more time to start with symbolic play and have problems in performance of it. Nevertheless, they might even never develop symbolic play skills. The need for interventions targeting symbolic play of children with ASD is increasing. Generally speaking, there appear to be very limited number of symbolic play interventions for children with ASD. Even if done, most have been performed in laboratory conditions. The interventions that have been undertaken to support symbolic play have taken form of being child centered, peer mediated or adult mediated, with emphasized role of caregivers as interventionists. The aim of this systematic literature review is to address parents and teachers implemented interventions targeting symbolic play of preschool aged children with ASD, with an emphasis on characteristics of these interventions and pretend play sequences. Findings reveal that interventions implemented by either parents or teachers in natural environment give positive outcomes in terms of symbolic play and its instances of preschool aged children with ASD. The review presented a limited number of studies dealing with this kind of interventions. Since all interventions show that symbolic play can be facilitated in this population, special attention should be payed to the methods used to improve symbolic play behaviours and defining and dividing symbolic play. More focus should be put on implementing interventions targeting symbolic play of children with ASD by caregivers, i.e. parents and teachers, in natural context. Inclusion of peers in these kinds of interventions emerges as possible and potentially successful as well.