JSC 2026 Vol21 Article 6

School Counselor Use of Play to Support Autistic Students: A Review and Recommendations 

Ann L. Tilman & Emilia C. Simeone

School counselors have an ethical and professional responsibility to support all students, not just a select few, in the academic, college/career, and social-emotional development school counseling domains (American School Counselor Association [ASCA], 2022a, 2022b). This includes students with disabilities, and specifically those who have been diagnosed with autism spectrum disorder (ASD) or who have demonstrated characteristics of autism. With a growing number of students identified as ASD in the classroom (Shaw et al., 2025; Zeidan et al., 2022), school counselors have a duty to understand and advocate for them in the school and community (ASCA, 2022a, 2022b, 2025). Thus, practices should be designed to address students’ needs, strengths, and areas for growth through the mindsets and behaviors for student success (ASCA, 2021a, 2022b). Play promises to provide an accessible way to support autistic students in developing those mindsets and behaviors within the comprehensive school counseling program (CSCP), though existing school counseling research insufficiently addresses how best to meet the needs of autistic students through play; thus, identifying a need for further research (Krell & Pérusse, 2012).  

This literature review (a) provides an exploration of the existing literature that addresses autism, school counseling, and play therapy/counseling as three domains of focus; (b) identifies a need for intersection of those domains, and (c) structures the existing literature and frameworks to make the claim that play therapy/counseling is a reasonable intervention for autistic students within the context of a CSCP (Churbock, 2013; Hirschheim, 2008). The current body of autism literature examines intervention populations outside the K-12 range, in clinical environments, and through non-school counseling school intervention (classroom or applied behavior analysis [ABA]), or school counseling interventions that exclude a focus on play, leaving gaps that require further investigation (Corbett et al., 2023; Raju et al., 2026; Silvester & Rankine, 2024; Wergeland et al., 2022). This study identifies gaps in the literature relating to school counselor support for autism, school counselors using play, or the use of play to support autistic students. Then, it builds on the conceptual design frameworks of theory synthesis and adaptation and argues for a revised approach for school counselors to support autistic students with play interventions (Crossler et al., 2018; Hirschheim, 2008; Jaakkola, 2020). This is accomplished by connecting the three theoretical domains and describing the population (autism), context (schools/CSCPs), and way of intervening (play therapy/counseling). The authors will use the identity-first term, autistic, to reflect the preferences within the disability rights community (Best et al., 2022; Grant, 2021; Taboas et al., 2022).  

Literature Review 

Part A: The Three Domains 

Domain 1: Autism 

The American Psychiatric Association (2022) characterizes ASD by social deficits and “restricted, repetitive patterns of behavior, interests, or activities” that manifest differently across different individuals. Language referring to autistic social behaviors as deficits emphasizes the individual’s differences compared to behaviors that align with cultural norms. Researchers operating through the neurodiversity framework critique such terminology and prefer to view it instead as diversity and variations (Pellicano & den Houting, 2022; Silvester & Rankine, 2024). The Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition, Text Revision (DSM-5-TR) outlines the levels of support for autistic individuals as: Level 1 ”Requiring support,” Level 2 “Requiring substantial support,” and Level 3 “Requiring very substantial support” (American Psychiatric Association, 2022).  

The Centers for Disease Control and Prevention (CDC, 2025) reports that one in 31 children at age eight has been diagnosed with ASD, present across all races, ethnicities, and socioeconomic levels. Autistic students attend US schools and require varying degrees of support (Ahlers et al., 2023). Consideration of this range is imperative, since not all autistic students require services, and the variance in strengths and challenges is individualized. Thus, it must not be assumed that there is an inherent need to be “fixed.” Instead, the school counselor can advocate for autism affirming practices that consider the needs of the individual within the school environment.  

Autism affirming practices are student-centered and individualized to the autistic student, accommodating their communication styles, special interests, and other needs, and empowering them through encouraging agency (Grant, 2025b; Silvester & Rankine, 2024). School is a setting where autistic students progress in their identity development; thus, empowering autistic students is crucial to counseling them (Cohen et al., 2022; Gallo et al., 2016). Emphasizing students’ strengths and utilizing autism affirming practices cultivates a positive sense of self, grounded in autistic identity (Cohen et al., 2022; Grant, 2025b).  

Domain 2: School Counseling 

The CSCP is the framework within which all student interventions are implemented. The ASCA National Model, now in its fifth edition (ASCA, 2025), guides school counselors in developing and managing their CSCPs, including ensuring that each and every student is supported, including those who are autistic. School counselors deliver direct and indirect student services (ASCA, 2025). Direct services may be delivered in classroom, small group, or individual settings. Through counseling, school counselors deliver time-sensitive assistance in any of the three school counseling domains to an individual or group of students (ASCA, 2025; Fye & Rainey, 2021). The ASCA Student Standards guide the delivery of direct student services through 10 steps (involving identifying the counseling need of the student, developing a plan, implementing it, and reflecting on the outcome) that ultimately implement the objectives of developing healthy mindsets, learning strategies, self-management skills, and social skills for students (ASCA, 2021a). Consideration of the ASCA framework of services is vital to the planning and implementation of play interventions for autistic students. 

Domain 3: Play Therapy/Counseling 

Play is a vital part of child development that supports physical, social-emotional, language/literacy, and cognitive development (American Academy of Pediatrics, 2021; Parker et al., 2022; Raju et al., 2026). There is a rich history of play therapy in schools to support students’ readiness to learn, though there is a need for further research in its use with autistic students at school (Axline, 1947; Bills, 1950; Cowen & Cruickshank, 1948). The Association for Play Therapy (APT) defines play therapy as "the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development" (APT, n.d.-a). It must be noted that this definition speaks from a clinical perspective, as opposed to educational, calling for a shift in perspective and language (i.e., clients versus students). 

Play therapy research includes a clear focus on play therapy interventions to address a variety of issues; however, there is little research that focuses on play therapy implemented by (or intended to be implemented by) school counselors within their CSCPs (Meany-Walen et al., 2016-2017; Schoonover & Perryman, 2023; Smith et al., 2022; Swank et al., 2020). Even less school counseling play therapy research focuses on specific student populations, such as students with disabilities and autism (Schottelkorb et al., 2020; Shen, 2016). While not all school counselors use play therapy per se, there is still an opportunity for the use of play to positively impact autistic students within the CSCP.  

Play therapy is a modality that can be used to provide therapeutic intervention and consists of many of the same counseling theories/approaches used in traditional counseling. APT (n.d.-b) has identified seminal and historically significant theories of play therapy that are supported by a solid body of research (Bratton et al., 2005; Ray et al., 2015). This includes Adlerian Play Therapy (AdPT), Attachment Theory and Theraplay, Child-Centered Play Therapy (CCPT), Filial Therapy, Cognitive Behavioral Play Therapy (CBPT), Ecosystemic Play Therapy, Gestalt Play Therapy (GPT), Jungian Analytical Play Therapy, and Psychoanalytical Play Therapy (APT, n.d.-b). Some emerging approaches are well-suited for autistic students at schools, including AutPlay (Grant, 2017). These theories/approaches to play therapy can be adapted to the school model to be less clinical and more educational in nature, which includes an adjustment in the descriptor from therapy to counseling, since school counselors do not provide therapy. Thus, therapy/counseling will be used to explain that the research involves play therapy, but the adapted version for school counselors is play counseling. 

Part B: The Intersection of the Domains of Autism, School Counseling, and Play Therapy/Counseling 

All Three 

There is limited research that covers the use of play interventions with autistic students in a school setting, especially within the CSCP. In a search using Google Scholar and library search engines, the search terms, autism, school counseling, and play therapy yielded few results when used together. The existing research finds play interventions in schools with autistic students to be effective; however, there is a need for further, more rigorous research regarding the intersection of all three domains of autism, school counseling, and play therapy/counseling (Kossyvaki & Papoudi, 2016; Rautenbach et al., 2025). Some existing research explicitly recommends for school counselors to use play interventions with autistic students, particularly CCPT (Darfashi et al., 2025; Jenkins, 2023). Research that addresses the intersection points of school counseling and autism, schools/CSCPs and play, and play therapy/counseling theories and autism indicates a possible compatibility between the three domains. 

School Counseling and Autism 

Searches using Google Scholar and various library search engines yielded little with the search terms of school counseling and autism, indicating another gap in the literature. Current school counseling and autism literature focuses on transition planning, social stories, executive functioning support, counseling and academic support, and student empowerment (Connor et al., 2021; Gallo et al., 2016; Goodman-Scott et al., 2018; Griffin, 2015; Krell & Pérusse, 2012; Renzulli & Austermann, 2025). More research examines the interaction between school psychologists and autistic students, in terms of identification, training, and services (Margiano et al., 2023; Marshall et al., 2023; Mathews et al., 2024). While these studies provide a foundation upon which school counselors can build knowledge on autism, further research specific to school counseling/CSCPs would increase that support and potential for training. 

Schools/CSCPs and Play 

While the existing literature identifies gaps, overlaps can guide school counselors in how to intervene with autistic students within the CSCP through play. Play is an accessible way to support autistic students for service provision (occupational therapy [OT], speech/language [SLP], ABA) and indicates more improvement in straight CCPT groups than those paired with ABA (Chung & Ray, 2025; Raju et al., 2026; Rautenbach et al., 2025). Jenkins (2023) found that licensed professional counselors and state-certified school counselors were primarily familiar with the theoretical lens of CCPT, which is identified as a promising practice in evidence-based research clearinghouses (California Evidence-Based Clearinghouse, 2026; Hirsch et al., 2023; Title IV-E Prevention Services Clearinghouse, 2022). 

There have been some powerful meta-analyses looking primarily at CCPT that point to a continued need for research on this intersection, primarily to shift the focus from clinical play therapist/researcher implementation of play therapy in schools versus school counselor use of play within the CSCP (Bratton et al., 2005; Leblanc & Ritchie, 2001; Parker et al., 2021; Ray et al., 2015). While meta-analyses are able to evaluate outcomes on a larger scale and combine participant totals of the studies they analyze, much of the play therapy research consists of studies with small sample sizes, not delivered by school counselors within the CSCP or not focusing on the autistic student population (Jenkins, 2023; Müller & Donley, 2019; Rautenbach et al., 2025; Silvester & Rankine, 2024). The literature affirms the effectiveness of play interventions implemented in a school context, but further research is needed. 

Play Therapy/Counseling Theories and Autism 

Current research indicates that play therapy interventions are beneficial to children with varying support needs and from different cultural backgrounds, such as those who are deaf, autistic, Black, Muslim, bilingual children with expressive linguistic disorders, and those who have experienced adverse childhood experiences (Ashori & Shamsi, 2023; Baggerly & Parker, 2005; Casey et al., 2020; Duncan, 2024; Jenkins, 2023; Patterson et al., 2018; Ray et al., 2021; Rezaeerezvan et al., 2022; Schoonover & Perryman, 2023; Tapia-Fuselier & Ray, 2019; Taylor & Ray, 2021). While autistic students and students from different cultural backgrounds do not always need counseling, issues such as marginalization and identity development can be addressed through school counseling services (ASCA, 2021a, 2022a). 

Strength-based play therapy theories and approaches do not require much, if any, speaking in the therapeutic process, which can be extremely helpful if a student has difficulties with verbalization. Additionally, CCPT allows students to direct their own play, resulting in increased agency while aligning with autism best practices (Schottelkorb et al, 2020). Play therapy theories can vary in directiveness, from nondirective to semi-structured to directive/structured. When integrating theories, literature suggests nondirective/CCPT as a foundation upon which more structured theories can be layered (Grant, 2022). School counselors may not be trained in CCPT but do have training in a person-centered approach; allowing them to use that foundation to design and provide theory-driven semi-structured play activities.  

A promising approach to play therapy with neurodivergent individuals is AutPlay®. The AutPlay® framework was designed specifically to be utilized with neurodivergent children ages 3-18, which includes school-age children. It involves three phases of play therapy: (1) Intake and Assessment, (2) Structured Play Intervention, and (3) Termination (AutPlay® Therapy, n.d.). It is based on play therapy and behavioral therapy approaches, both of which have been established in schools (Grant, 2017). AutPlay® primarily integrates elements of CCPT, Theraplay, Filial Therapy, family play therapy, Gestalt Play Therapy, and CBPT (Grant, 2022). School counselors working with autistic students should become familiar with this framework to apply play services to school counseling in a way consistent with autism best practices. 

Part C: Structuring the Existing Frameworks and Literature 

Integration with the ASCA National Model and MTSS 

School counselors do not need to start from the ground up when implementing play with autistic students in their CSCP; rather, they can rely on existing frameworks that they already use and adjust accordingly. The ASCA National Model (2025) considers the impact of systemic barriers on student achievement and encourages leadership, advocacy, and collaboration to create systemic change. This includes barriers that under-supported autistic students may face. When considering how to support autistic students with play, the ASCA National Model (2025) provides a framework for CSCPs. While some students have already been staffed in Exceptional Student Education (ESE) or 504 Programs, some may still receive interventions through Multi-Tiered System of Supports (MTSS), and all provide a space for interventions to be delivered (ASCA, 2021b). 

Define. “Define” asks school counselors to determine the knowledge, skills, and attitudes needed to implement play in counseling with autistic students. This includes identifying the needs within the school, available resources, and how the ASCA Student Standards: Mindsets & Behaviors for Student Success can be addressed for these students through play interventions (ASCA, 2021a). An additional consideration that should be brought to awareness is a double empathy problem that can arise due to lack of knowledge or miscommunication between the allistic (neurotypical) school counselor and the autistic student; this can be avoided by establishing a more structured and predictable play environment (Milton et al., 2022; Silvester & Rankine, 2024). 

Developmental Considerations: Level or Need. Play is a natural fit for school counselors to use with their elementary-aged students, and it can be adapted to work with middle and high school students as well. Grant & Turner-Bumberry (2025) developed play interventions for social navigation groups of neurodivergent children, addressing different implementations for children and adolescents. School counselors can similarly adjust play activities to match the developmental needs of autistic students in middle and high school. While school counseling literature on autism does address developmental considerations, such as college readiness and postsecondary transition planning, there is a gap in the literature regarding play interventions with the group (Krell & Pérusse, 2012). 

Identifying the Need. Since the COVID pandemic, schools have reported escalated levels of mental health-related needs for students (Brown & Carrington, 2025; National Center for Education Statistics, 2022, 2025). Research indicates even greater needs among more vulnerable or traditionally underserved populations (Holm et al., 2024; Jones et al., 2021; Kang et al., 2025; Pincus & Beller, 2025; Woodcock et al., 2025). According to Holm et al. (2024), students with disabilities had higher rates of anxiety, depression, and unmet needs for support at school in 2021 than students without disabilities. Considering this, school counselors can team with ESE teachers, the MTSS team, and other appropriate stakeholders to review data and identify the needs of autistic students. Using data to identify students’ needs will guide the intervention effectively (Young & Kaffenberger, 2018).  

Manage. Moving on in the process, school counselors may examine student achievement gaps for autistic students, collect stakeholder feedback to plan how to teach the ASCA Mindsets & Behaviors, and determine the amount of time to allocate to the services for this population. Included among the supports are determining what other indirect services are needed, such as advocacy and professional development for school staff on autism-affirming practices. Also important is to provide literature on the purpose and value of school counseling play services. 

Scheduling Playtime. School counselors can work with teachers and other staff to use play in class or specials, whether the activity is for one autistic student or the whole class, including neurotypical and neurodiverse students. School counselors can work with physical education teachers, for example, to advocate for autistic students as students with disabilities to ensure they are included, and their needs are met during play activities (Webb et al., 2011). This kind of advocacy work applies to other subjects in which play can be meaningfully involved. It may focus on students’ social skills during play with one another or modifications to activities to accommodate autistic students (Jenkins, 2023). 

Planning Play Activities. Jenkins (2023) examined the experiences of licensed professional counselors and state-certified school counselors to determine how play therapy can be most effectively implemented with autistic children. Strategies to include in planning are not placing an age limit on toys in the playroom, making a variety of play categories available to the student (e.g., role-play/narrative play, sandtray therapy, expressive arts), allowing the student to make modifications (to rules of games, toys, activities, techniques), stabilizing the student’s emotional regulation, and developing a connection between the school counselor and the student (Jenkins, 2023). Connections can be established through allowing routine/repetitiveness, flexibility between directive and nondirective counseling, connecting with parents, and special interests (Jenkins, 2023). These recommendations emphasize flexibility and a strong therapeutic relationship, guiding play intervention planning by adapting to each student’s needs throughout the process.  

When it comes to autistic students, play may look different. Grant (2025b) identified one aspect of neurodiversity affirming care as respecting neurodivergent children’s preferred type of play, which potentially corresponds to their special interests. This includes validating the use of various forms of play and not forcing a particular type. Additionally, autistic children may engage in very little verbal interaction or social play (Rautenbach et al., 2025). Affirming these differences in play can ensure that interventions are effective. This is accomplished through recognizing the importance of addressing matters of regulation, identifying, and affirming neurodivergent children’s expressions of communication beyond verbal, thus encouraging autonomy (Grant, 2025b). 

Play preferences and special interests may be particularly relevant when selecting the category of play. For example, a student who prefers or has a special interest in science may be better engaged in a science or STEM-related play activity. Selecting a category of interest to the autistic student can lead to a more positive play experience and create a sense of security that helps them emotionally regulate, which is key to effective outcomes (Grant, 2025a; Nowell et al., 2021). 

Preparing for Implementation. Theory should provide the foundation guiding how school counselors implement autism play interventions. Additionally, they should informally evaluate the student’s developmental, personal, and social needs to guide their use of play interventions. Additional considerations for autistic students include identifying sensory needs, receptive and expressive language, special interests, physical or motor skill needs, and readiness to engage; information that could be most efficiently gained through collaboration with OTs, SLPs, and PTs and the student’s existing educational plan. School counselors may already use play activities with general education students but can design them to be more accessible to individual autistic students.  

Table 1 considers play therapy/counseling as a modality, corresponding theories, autism affirming practices, and cross-disciplinary strategies in the identification of categories of play and descriptions of related play activities. The first play category, “Sensory,” considers what sensory needs would be most helpful to address and for what purpose. An example is if the plan notes a need for self-regulation, the school counselor can look for play activities that include vestibular (using the swing for 5 minutes) or tactile (using alternatives to sand in a sand tray activity). Having a foundation upon which to design play activities can contribute to school counselors' confidence in their implementation.  

Table 1  

Categories of Autism Play Interventions 

Deliver. Providing Tier 1 classroom instruction to all students addresses concerns faced by autistic students as well, especially related to peer relationships and self-management. Tier 2 interventions can target autistic students’ needs through small group counseling topics such as stress management. Tier 3 individual counseling topics, such as self-advocacy, target the needs of individual students and all direct services can be implemented using play counseling. Indirect services include ongoing consultation and collaboration with stakeholders.   

Collaboration. In the fifth edition of the ASCA National Model (2025), ASCA identifies the ingredients for systemic change: leadership, advocacy, and collaboration. Collaborative educational teams can be particularly helpful in ensuring that autistic students’ needs are met (Gallo et al., 2016; Grant, 2024). Through defined roles and collaboration, teams can incorporate autism-affirming practices into educational programming, especially during transitions and throughout student development. Collaboration is a vital indirect student service in the ASCA National Model and is emphasized for students with disabilities, including autism (ASCA, 2022b, 2025). The collaborative MTSS, IEP, and 504 approach aligns with best practices for supporting autistic students (Kunze & Machalicek, 2021). 

Assess. Another component of collaboration is measuring and communicating the impact of school counseling play services for autistic students at different levels of intensity (Tier 1, Tier 2, Tier 3, or IEP/504 goals). Just as in the identification of student needs, school counselors can gain feedback from stakeholders on their observations of the autistic student’s progress. Especially since a team approach is encouraged when working with autistic students, sharing outcome data from the play interventions with administration, connecting to the overall school climate, student outcomes, and identifying adjustments for future implementation will help gain buy-in. Other stakeholders, such as parents/guardians, benefit from hearing successes as well. 

School counselors can collaborate with others to efficiently design and implement play counseling interventions in their CSCP. Table 2 breaks down components of the ASCA National Model, play interventions that support autistic students, and important considerations in their implementation.  

Table 2  

Application of School Counseling Play Interventions and the ASCA National Model 

Recommendations for Future Practice and Research 

One potential barrier for school counselors providing play interventions to support autistic students is their self-efficacy to do so. Counselors who have less experience working with individuals with disabilities report lower self-efficacy in the provision of services (Frawley et al., 2023). Self-efficacy is an essential strength in school counselors’ pursuit of support for autistic students; the higher one’s self-efficacy, the more likely one is to intervene (Emmons & Zager, 2018). This dynamic empowers school counselors to become equipped with the tools and confidence needed to effectively support autistic students through play interventions. 

Achieving self-efficacy requires targeted training, more opportunities for direct experience, and collaboration with a multidisciplinary team of school stakeholders to build skills in working with students with disabilities. School counselor preparation programs can support pre-service school counselors by including learning modules, assignments, and internships that focus on students with disabilities (Meskin et al., 2025). These programs should also provide training in the use of play for all students, with special attention to strategies for autistic students. 

For current school counselors, ongoing professional development is essential. This can include workshops on best practices for supporting neurodivergent students, particularly those that promote an autism affirming perspective. Hands-on training opportunities, such as practicing play counseling interventions, can further build confidence and competence. School districts might also consider bringing in trainers for specialized approaches for autistic students, such as AutPlay®. Finally, districts can foster systemic change by integrating an autism affirming perspective throughout their practices, shifting away from models that focus on "fixing" negative behaviors and instead promoting acceptance and support for autistic students. 

To further develop training, more research on how school counselors support students with disabilities, autism, and their use of play is needed. Additionally, insight into school counselors’ self-efficacy in these areas is essential for implementation. Other topics of consideration are how school counselors collaborate with school stakeholders and implement school counseling play with autistic students within the CSCP. There is currently a paucity of research in the use of play for autism in general, and the training needs of pre-service and practicing school counselors on this topic. This lack of research makes it more difficult for school counselors to advocate for their use of play with autistic students, and the need should be addressed. 

Conclusion 

This review of the literature included (a) an exploration of the existing literature that addresses autism, school counseling, and play therapy/counseling as three domains of focus; (b) identified the need for intersection of those domains, and (c) used the existing literature to make the claim that play therapy/counseling is a reasonable intervention for autistic students within the context of a CSCP (Churbock, 2013; Hirschheim, 2008).  

While the use of school counseling play with autistic students is a developing specialty, play therapy/counseling’s role in student well-being is well established (Axline, 1947; Bills, 1950; Cowen & Cruickshank, 1948), and a robust evidence base for play therapy continues to grow (Lin & Bratton, 2015; Pester et al., 2019; Ray et al., 2015). There is a significant gap in the existing literature about the intersection of school counselor use of play and autism. This emerging specialty considers both the duties of school counselors and the distinct environment of schools, a setting that is fundamentally different from clinical environments in structure, goals, and day-to-day interactions. Another gap to consider is a paradigm shift to neurodiversity affirming practices in schools (Grant, 2025b).  

Play holds significant promise in empowering autistic students to embrace and take ownership of their identities. Through play counseling, autistic students can authentically explore how they self-identify, consider if and how to disclose their identity to peers, celebrate their strengths, and co-construct personal definitions that help redefine autism (Cohen et al., 2022). This review examined how play interventions with autistic students can be affirming and thoughtfully integrated into existing frameworks, such as MTSS, IEPs, and 504 plans, and how that might look in action.  

While further research is needed on the intersection of play and autism-affirming practices, school counselors are well-positioned to build upon the existing foundations of play therapy/counseling and autism specialties. By doing so, they can effectively plan, implement, and evaluate interventions that foster belonging and positive self-concept within comprehensive school counseling programs. The claim of this review is that within their comprehensive school counseling programs, school counselors can effectively design and implement play counseling interventions with autistic students. While there are gaps in the literature, there are overlaps and each domain is well-established in the literature, supporting preliminary exploration of this claim. 

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