Autistic children's play has routinely been determined to deviate from accepted trajectories and patterns and is consistently interpreted as a deficit requiring remediation. An extensive review of the literature on functional play in autistic children led to the identification of 10 articles comparing autistic and typically developing children's functional play patterns. Data were extracted regarding the duration, frequency, diversity, and integration of structured and free functional play in autistic children. The results indicated the majority of studies found that autistic children do engage in functional play. Significant differences were identified in the diversity and integration of autistic children's functional play skills. The theory of monotropism is used to interpret these findings using a neurodiversity affirming approach. Using this approach, innovative intervention practices and areas for future research are discussed.