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Kanzari C, Hawani A, Ayed KB, Mrayeh M, Marsigliante S, Muscella A. The Impact of a Music- and Movement-Based Intervention on Motor Competence, Social Engagement, and Behavior in Children with Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2025; 12:87. [PMID: 39857918 PMCID: PMC11764137 DOI: 10.3390/children12010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 01/06/2025] [Accepted: 01/08/2025] [Indexed: 01/27/2025]
Abstract
BACKGROUND/OBJECTIVES The main objective of this manuscript is to evaluate the effects of training, music, and movement intervention on motor functions, social engagement, and behaviors in autistic children. METHODS Twenty-one children with a diagnosis of mild autism spectrum disorder (ASD), with an age range of 5-to-13 years, were divided into two groups: the experimental group (n = 10) and the control group (n = 11). All participants were examined before (T0) and after the intervention (T1) to evaluate their motor functions (Bruininks-Oseretsky Motor Performance Test (BOT-2)), maladaptive behavior (RCS (Response to Challenge Scale)), and enjoyment and engagement (PACES (Physical Activity Enjoyment Scale)). RESULTS Statistical analysis showed that music and movement intervention significantly improved motor functions such as balance and bilateral coordination (p < 0.0001), social engagement (p = 0.002), and adaptive behaviors (p = 0.005) in children with ASD. Our research supports the feasibility of music and movement intervention and documents the interest in participating in children with ASD. CONCLUSIONS This study demonstrates the benefits of movement and music interventions and can be considered a useful way to manage autism spectrum disorders in the future.
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Affiliation(s)
- Chayma Kanzari
- High Institute of Sport and Physical Education of Kef, University of Jendouba, El Kef 7100, Tunisia; (C.K.); (K.B.A.)
| | - Aymen Hawani
- Higher Institute of Sport and Physical Education (Ksar Saïd), University of Manouba, Manouba 2010, Tunisia; (A.H.); (M.M.)
- Physical Activity, Sport and Health, Research Unit (UR18JS01), National Observatory of Sport, Tunis 1003, Tunisia
| | - Karim Ben Ayed
- High Institute of Sport and Physical Education of Kef, University of Jendouba, El Kef 7100, Tunisia; (C.K.); (K.B.A.)
| | - Maher Mrayeh
- Higher Institute of Sport and Physical Education (Ksar Saïd), University of Manouba, Manouba 2010, Tunisia; (A.H.); (M.M.)
- Physical Activity, Sport and Health, Research Unit (UR18JS01), National Observatory of Sport, Tunis 1003, Tunisia
| | - Santo Marsigliante
- Department of Biological and Environmental Science and Technologies (DiSTeBA), University of Salento, 73100 Lecce, Italy;
| | - Antonella Muscella
- Department of Biological and Environmental Science and Technologies (DiSTeBA), University of Salento, 73100 Lecce, Italy;
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Angelis LO, Orsati FT, Teixeira MCTV. LEGO ®-Based Therapy in School Settings for Social Behavior Stimulation in Children with Autism Spectrum Disorder: Comparing Peer-Mediated and Expert Intervention. Brain Sci 2024; 14:1114. [PMID: 39595877 PMCID: PMC11591641 DOI: 10.3390/brainsci14111114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Revised: 10/23/2024] [Accepted: 10/24/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND LEGO®-based therapy is a social development protocol that uses LEGO® activities to support the development of a wide range of interaction skills, enhancing prosocial behaviors and mitigating the challenges associated with mental health difficulties and behavioral issues commonly observed in children with autism spectrum disorder (ASD). OBJECTIVES This study aimed to explore the effects of LEGO®-based therapy on the social behavior and mental health of children with ASD, comparing stimulation mediated by expert and stimulation mediated by non-autistic peers. This study was approved by the Ethical Committee at Mackenzie Presbyterian University, ensuring adherence to ethical standards throughout the research process. METHODS This study involved 18 children with ASD, levels 1 or 2, with an intelligence quotient (IQ) above 70, and three typically developing peers, intelligence quotient (IQ) above 80, aged between 5 and 8 years old, of both sexes. Participants were randomized into three groups for stimulation (stimulation mediated by expert, by a non-autistic peer and control group). The measures were the Wechsler Abbreviated Scale of Intelligence, the Strengths and Difficulties Questionnaire (parent and teacher versions), the Inventory of Difficulties in Executive Functions, Regulation, and Aversion to Delay-Child Version, the Developmental Coordination Disorder Questionnaire, the Autism Behavior Checklist, and the Autistic Behavior Inventory. RESULTS After 14 sessions of 45 min in school settings, the participants of both groups (mediated by experts and non-autistic children) showed significant gains on social behavior. A statistically significant difference was observed between baseline sessions and probes (χ2 (5) = 25.905, p < 0.001). These gains were maintained in both follow-up points, 30 and 90 days after the completion of the stimulation sessions. Additionally, maladaptive behavior showed a significant decline when compared pre- and post-intervention. These improvements were sustained during follow-up assessments at 30 and 90 days. CONCLUSIONS The results suggest that a structured intervention combined with peer-mediated stimulation may be an effective method for promoting adaptive and prosocial behaviors in children with ASD.
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Affiliation(s)
- Luciana Oliveira Angelis
- Human Developmental Sciences Graduate Program, Mackenzie Presbyterian University (UPM), Sao Paulo 01302-907, SP, Brazil
| | | | - Maria Cristina Triguero Veloz Teixeira
- Human Developmental Sciences Graduate Program, Center for Research on Childhood and Adolescence, Mackenzie Presbyterian University (UPM), Sao Paulo 01302-907, SP, Brazil;
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Dabiri Golchin M, Ripat J, Verdonck M. Assistive technology to facilitate children's play: a scoping review. Disabil Rehabil Assist Technol 2024; 19:2419-2429. [PMID: 38166593 DOI: 10.1080/17483107.2023.2298825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Play is a fundamental human right and one of the most important occupations in children's lives. Fewer opportunities exist for children with physical disabilities (CWPD) to play. This study aimed to conduct a scoping review of published peer-reviewed literature on using AT to enable "play-for-the-sake-of-play" by CWPD. METHOD The review was conducted using a widely accepted scoping review methodology. Literature searches were conducted from January 2000 to March 2022 using MEDLINE, Central, CINAHL, ERIC, Scopus, and EMBASE. Pairs of reviewers used an online systematic review system to manage title, abstract, and full-text screening. Excel was used for data extraction and charting. Data was charted based on type of AT, play types according to LUDI definitions, and level of evidence. RESULTS The search yielded 5250 papers after the removal of duplicates. Title and abstract screening identified 58 studies for full-text screening. The final sample included 31 papers. Seven types of AT were identified in studies: power mobility, virtual reality, robots, adaptations for upper limb differences, switch-adapted games, augmentative and alternative communication devices, and mobility aids. Twenty-three papers addressed cognitive play, seven addressed social play, and one addressed both cognitive and social play. Most studies used case study, descriptive, or repeated measures designs. CONCLUSION There is limited evidence regarding the use of AT to support play-for-the-sake-of-play in CWPD. Given the importance of play, further research using rigorous methodologies and the development of assistive technology dedicated to promoting play-for-the-sake-of-play is warranted.
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Affiliation(s)
- Minoo Dabiri Golchin
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Jacquie Ripat
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Michèle Verdonck
- Department of Occupational Therapy, School of Health, University of the Sunshine Coast, Sippy Downs, Australia
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Crasta JE, Martis J, Kromalic M, Jarrott S, Wengerd L, Darragh A. Characterizing Occupational Therapy Intervention for Children on the Autism Spectrum. Am J Occup Ther 2024; 78:7805205210. [PMID: 39029101 DOI: 10.5014/ajot.2024.050734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
IMPORTANCE Occupational therapy is one of the most used interventions for children on the autism spectrum. There is a critical need to develop an operationalized list of key treatment components of usual-care occupational therapy practice for children on the autism spectrum. OBJECTIVE To identify and develop consensus on definitions and examples of key treatment components of usual-care occupational therapy for children on the autism spectrum, ages 6 to 13 yr. DESIGN We conducted a Delphi study to obtain feedback from a panel of experts. SETTING Electronic survey. PARTICIPANTS 17 occupational therapy panelists with expertise in autism intervention. OUTCOMES AND MEASURES Panelists rated the definition and example of each treatment component and provided feedback through multiple rounds of survey. RESULTS On the basis of the panelists' feedback on Delphi Round 1, the criteria rating form was revised to include four questions for the definition and example of each treatment component. Through four Delphi rounds of consensus building, we developed an operationalized list of 20 treatment components with definitions and examples that incorporated elements of usual-care occupational therapy intervention for children on the autism spectrum. CONCLUSIONS AND RELEVANCE This operationalized list of treatment components serves as a foundational framework to improve education, practice, and research of occupational therapy intervention for children on the autism spectrum. Plain-Language Summary: This study identified and developed consensus on definitions and examples of key treatment components used in usual-care outpatient occupational therapy for children on the autism spectrum. Through four rounds of consensus building with 17 occupational therapy experts in autism, we identified 20 key treatment components central to occupational therapy practice. Our results have the potential to serve as a framework to improve education, practice, and clinical research in autism.
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Affiliation(s)
- Jewel E Crasta
- Jewel E. Crasta, PhD, OTR/L, is Assistant Professor, Occupational Therapy Division, Ohio State University, Columbus;
| | - Joseph Martis
- Joseph Martis, MA, is Research Associate, Occupational Therapy Division, Ohio State University, Columbus
| | - Meredith Kromalic
- Meredith Kromalic, OTD, BS, OTR, is Research Assistant, Occupational Therapy Division, Ohio State University, Columbus
| | - Shannon Jarrott
- Shannon Jarrott, PhD, is Professor, College of Social Work, Ohio State University, Columbus
| | - Lauren Wengerd
- Lauren Wengerd, PhD, OTR/L, is Assistant Professor, NeuroTech Institute, Ohio State University, Columbus
| | - Amy Darragh
- Amy Darragh, PhD, OTR/L, FAOTA, is Professor, Occupational Therapy Division, Ohio State University, Columbus
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Matsushima K, Kato T. An Exploratory Study on the Association between Atypical Behavioral Responses to Tickling and Autistic Traits in Japanese Children. Occup Ther Health Care 2024; 38:666-685. [PMID: 38174406 DOI: 10.1080/07380577.2023.2297358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
Although play is an essential occupation for children, parents of children with autistic traits tend to struggle with play-based interpersonal interaction with them. Tickling play appears to be one of the most interpersonal forms of play because nobody can tickle themselves. However, atypical tactile processing (e.g. tactile sensitivity) has been reported in children with autistic traits, who may exhibit atypical behavioral responses during tickling play. Our aim was to investigate the association between autistic traits and behavioral responses during parent-child tickling play in Japanese young children. We recorded tickling interaction between children and their parents using behavior coding with six behavioral items. Autistic traits and tactile sensitivity were measured using parent-reported questionnaires. Results showed two behavioral responses were significantly associated with autistic traits in all children: "approach with positive emotional response" and "no response" were negatively and positively correlated with autistic traits, respectively. This exploratory study suggests that behavioral responses during tickling play may be associated with autistic traits.
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Affiliation(s)
- Kanae Matsushima
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Toshihiro Kato
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
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Linimayr J, Lindahl-Jacobsen L, Farias L. Teachers' perceptions of barriers and facilitators to peer play between children with autism spectrum disorder and typically developing peers in early childhood education: a research circle study in Austria. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2023; 71:237-245. [PMID: 39990091 PMCID: PMC11843634 DOI: 10.1080/20473869.2023.2230410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 02/25/2025]
Abstract
Children with autism spectrum disorder (ASD) are increasingly being integrated into primary and secondary mainstream education. Yet, little is known about teachers' challenges in supporting peer play for children with ASD in early childhood education. This study explores teachers' perspectives on the barriers and facilitators to supporting peer play between children with ASD and their typically developing peers. Observations and research circle meetings were conducted with eight teachers from an urban area in Austria. Material from the meetings was analysed using qualitative content analysis and participants' feedback. Findings illustrate how teachers perceive and manage multiple factors that influence peer play, including child-level factors (e.g. irritability to noise), peer and family factors (e.g. negative roles attributed to children with ASD), and institutional factors (e.g. large group sizes and lack of rooms without distractions). This study also highlights teachers' ambivalence about safeguarding children's participatory rights when encouraging children with ASD to engage in peer play when children with ASD need to disengage. This ambivalence is linked to the need for expanding the comfort zone of typically developing children by raising their awareness of diverse ways to interact and participate in play to support all children's needs in inclusive education.
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Affiliation(s)
- Johanna Linimayr
- Institute of Occupational Therapy, Zurich University of Applied Sciences (ZHAW), Winterthur, Switzerland
| | | | - Lisette Farias
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
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Elbeltagi R, Al-Beltagi M, Saeed NK, Alhawamdeh R. Play therapy in children with autism: Its role, implications, and limitations. World J Clin Pediatr 2023; 12:1-22. [PMID: 36685315 PMCID: PMC9850869 DOI: 10.5409/wjcp.v12.i1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/08/2022] [Accepted: 11/23/2022] [Indexed: 01/03/2023] Open
Abstract
Play is a pleasurable physical or mental activity that enhances the child's skills involving negotiation abilities, problem-solving, manual dexterity, sharing, decision-making, and working in a group. Play affects all the brain's areas, structures, and functions. Children with autism have adaptive behavior, adaptive response, and social interaction limitations. This review explores the different applications of play therapy in helping children with autism disorder. Play is usually significantly impaired in children with autism. Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels. The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development. Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways. It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words. Play therapy also helps those children to experience feeling out various interaction styles. Every child with autism is unique and responds differently. Therefore, different types of intervention, like play therapy, could fit the differences in children with autism. Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others. This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way. Despite weak evidence, play therapy still has potential benefits for patients and their families.
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Affiliation(s)
- Reem Elbeltagi
- Department of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Bahrain
| | - Mohammed Al-Beltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
- Department of Pediatrics, University Medical Center, King Abdulla Medical City, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Bahrain
| | - Nermin Kamal Saeed
- Pathology Department, Salmaniya Medical Complex, Manama 12, Bahrain
- Pathology Department, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Bahrain
| | - Rawan Alhawamdeh
- Pediatrics Research and Development Department, Genomics Creativity and Play Center, Manama 0000, Bahrain
- School of Continuing Education, Masters in Psychology, Harvard University, Cambridge, MA 02138, United States
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Domínguez-Lucio S, Compañ-Gabucio LM, Torres-Collado L, de la Hera MG. Occupational Therapy Interventions Using New Technologies in Children and Adolescents with Autism Spectrum Disorder: A Scoping Review. J Autism Dev Disord 2023; 53:332-358. [PMID: 35048236 PMCID: PMC9889430 DOI: 10.1007/s10803-022-05431-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 02/04/2023]
Abstract
New technologies (NT) are increasingly used in Occupational Therapy (OT) interventions in people with Autism Spectrum Disorder (ASD). We conducted a scoping review to describe OT interventions investigated in scientific literature which use NT in children and adolescents with ASD. Two authors independently searched the scientific databases PubMed, EMBASE, Scopus and Web of Science, carried out a peer-review screening of articles and extracted data. Twenty studies met the inclusion criteria. OT interventions lasted between 1 week and 12 months, consisted of between 1 session per day and 5 sessions per week, were carried out exclusively by an occupational therapist, and the most used NT was the computer (n = 12). The duration of the interventions and assessment measures used varied greatly between studies.
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Affiliation(s)
- S Domínguez-Lucio
- Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain
| | - L M Compañ-Gabucio
- Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain
- de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, 03010, Alicante, Spain
| | - L Torres-Collado
- Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain.
- de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, 03010, Alicante, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain.
| | - M García de la Hera
- Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain
- de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, 03010, Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain
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Effects of Integrative Autism Therapy on Multiple Physical, Sensory, Cognitive, and Social Integration Domains in Children and Adolescents with Autism Spectrum Disorder: A 4-Week Follow-Up Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121971. [PMID: 36553414 PMCID: PMC9776954 DOI: 10.3390/children9121971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
This study aimed to compare the effects of conventional autism therapy (CAT) and integrative autism therapy (IAT) in children and adolescents with autism spectrum disorder (ASD). A convenience sample of 24 children with ASD was recruited and underwent either CAT or IAT for 60 min/day, twice a week, for 20 sessions over 10 weeks. Outcome measures included the following: (1) physical domain (pediatric balance scale, PBS), (2) sensory domain (short sensory profile), (3) cognitive domains (functional independence measure, FIM; and childhood autism rating scale), and (4) social integration domain (Canadian occupational performance measure, COPM; short falls efficacy scale; and pediatrics quality of life questionnaire). Two-way repeated analysis of variance (ANOVA) was used to determine the intervention-related changes in the four domains across the pre-test, post-test, and follow-up test at p < 0.05. ANOVA showed significant interaction effects on the PBS, FIM, and COPM (p < 0.05) variables. Moreover, time main effects (p < 0.05) were observed in all four domain variables, but no group main effect was noted. This study provides promising evidence that IAT is more effective than CAT for managing children and adolescents with ASD.
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Fedewa M, Watkins L, Barnard-Brak L, Akemoglu Y. A Systematic Review and Meta-Analysis of Single Case Experimental Design Play Interventions for Children with Autism and Their Peers. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00343-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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A Systematic Review of Play-Based Interventions Targeting the Social Communication Skills of Children with Autism Spectrum Disorder in Educational Contexts. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00286-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractChildren with autism spectrum disorder (ASD) experience social communication difficulties which can be compounded by increased social demands and expectations of the school environment. Play offers a unique context for social communication development in educational settings. This systematic review aimed to synthesize play-based interventions for the social communication skills of children with ASD in educational contexts and identified nine studies. Overall, studies in this review provided a promising evidence base for supporting social communication skills through play in education for children with ASD. The review also highlighted gaps in research on play-based interventions for the social communication skills of children with ASD within naturalistic educational settings.
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Gibson JL, Pritchard E, de Lemos C. Play-based interventions to support social and communication development in autistic children aged 2-8 years: A scoping review. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2021; 6:23969415211015840. [PMID: 36381525 PMCID: PMC9620698 DOI: 10.1177/23969415211015840] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background and aims Play is used by practitioners from across disciplinary backgrounds as a natural and enjoyable context for providing intervention and support in early childhood. In the case of autism interventions, many therapies are based on the association between social play and the development of social skills, language development, and communication skills, as these are often particular areas of challenge for autistic children. However, play is a wide-ranging concept and the extant literature on play-based interventions is large and heterogeneous. This means it is challenging for practitioners and families to navigate the evidence base and make choices about differing intervention strategies. This review aims to provide a comprehensive map of the research on this topic and to develop a conceptual framework to inform clinical decision-making. Methods An initial stakeholder consultation confirmed the relevance of the topic to practitioners and autistic people. A scoping review methodology (preregistered) was used to identify relevant literature. We systematically searched seven databases to find peer-reviewed primary intervention studies of play-based approaches targeting language, social and communication outcomes for autistic children aged 2-8 years. We then summarised the literature using narrative synthesis and Evidence Gap Maps (EGMs). The literature was summarised according to a range of characteristics, including study design, population characteristics, agent of intervention and outcomes measured, among others. These summaries were then used to develop a framework for some key considerations for practitioners appraising play-based approaches. Results 388 studies met inclusion criteria. Approximately 21% of studies were RCTs, and over 50% had ≤10 participants. Over 45% of studies reported multiple relevant outcomes, with social play skills being the most common single intervention target. Girls and minority background groups are under-represented. A range of intervention types were identified, and some high-level categorisations are proposed.Main contribution: On the basis of the evidence synthesis we suggest important dimensions for appraisal of play-based interventions, including the role of play within an intervention (as a context, a key developmental mechanism, or a component of a larger approach), the underpinning philosophy (e.g. behaviourist or developmental), and the role of the practitioner (providing parent feedback, 1:1 intervention, group facilitation). Conclusions The wide range of approaches uncovered by this review is a testament to the wonderful diversity inherent to both play and autism. However, research could usefully focus on consolidating the evidence base for existing approaches, rather than aiming for further diversification. Implications: The conceptual framework proposed in this review can help practitioners appraise the literature and aid their advice to families when making shared intervention decisions.
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Affiliation(s)
- Jenny L Gibson
- Play & Communication Lab, Play in Education
Development and Learning Research Centre, Faculty of Education, University
of Cambridge, Cambridge, UK
| | - Emma Pritchard
- Play & Communication Lab, Play in Education
Development and Learning Research Centre, Faculty of Education, University
of Cambridge, Cambridge, UK
| | - Carmen de Lemos
- Play & Communication Lab, Play in Education
Development and Learning Research Centre, Faculty of Education, University
of Cambridge, Cambridge, UK
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A Systematic Review on Clinimetric Properties of Play Instruments for Occupational Therapy Practice. Occup Ther Int 2020; 2020:2490519. [PMID: 32821250 PMCID: PMC7416293 DOI: 10.1155/2020/2490519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/24/2020] [Accepted: 06/16/2020] [Indexed: 11/29/2022] Open
Abstract
Play is considered the main occupation for children. Pediatric occupational therapists utilize play either for evaluation or intervention purpose. However, play is not properly measured by occupational therapists, and the use of play instrument is limited. This systematic review was aimed at identifying play instruments relevant to occupational therapy practice and its clinimetric properties. A systematic search was conducted on six databases (Academic Search Complete, CINAHL, MEDLINE, Psychology and Behavioral Science Collection, Scopus, and ASEAN Citation Index) in January 2020. The quality of the included studies was evaluated using Law and MacDermid's Appraisal for Clinical Measurement Research Reports, and psychometric properties of play instruments were evaluated using Terwee's checklist while the clinical utility is extracted from each instrument. Initial search identifies 1,098 articles, and only 30 articles were included in the final analysis, extracting 8 play instruments. These instruments were predominantly practiced in the Western culture, which consists of several psychometric evidences. The Revised Knox Preschool Play Scale is considered the most extensive and comprehensive play instrument for extrinsic aspect, whereas the Test of Playfulness + Test of Environmental Supportiveness Unifying Measure is a promising play instrument for intrinsic aspect on play, where both instruments utilize observation. My Child's Play is a potential questionnaire-based play instrument. However, the current development of play instruments in the occupational therapy field is immature and constantly evolving, and occupational therapists should exercise good clinical reasoning when selecting a play instrument to use in practice.
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