The role of play therapy in the development of social skills in children with ASD

Abstract

In pursuit of reducing the severity of autism spectrum disorder (ASD), the Intensive, Interactive, and Individual (3i) intervention method employs rigorous developmental play therapy. A retrospective analysis was conducted on 12 children engaged in the 3i approach over a 3-month period to evaluate alterations in ASD severity and identify potential influencing factors at follow-up. Systematic assessment of ASD severity using the childhood autism rating scale (CARS) and autism diagnosis interview-revised (ADI-R) was performed on 25 patients commencing 3i intervention between September and December of 2023. Of these, 12 patients (average age: 4) underwent a second evaluation at the second month of follow up. Statistical comparison via paired student’s t-tests revealed noteworthy reductions in CARS and ADI-R scores after 2 months of 3i intervention, showcasing declines of 10%, 21%, 22.5%, and 20% in interaction, communication, and repetitive behavior subscores, respectively. Approximately 34% and 40.7% of participants shifted to lower ASD severity categories based on CARS scale and ADI-R interview, respectively. Multiple linear regression models demonstrated that higher treatment intensity (exceeding 10 hours per week) correlated significantly with greater improvements in the ADI-R interaction score. Patients initially classified as verbal subjects displayed better outcomes in CARS, ADI-R interaction, and ADI-R communication scores. Additionally, older patients exhibited more substantial improvements in the ADI-R interaction score. Nevertheless, no substantial impact was observed concerning gender, ASD severity, or comorbidities at baseline. This study, involving 12 children, suggests that 3i therapy yields significant reductions in ASD severity while enhancing interaction, communication, and repetitive behaviors. Future investigations incorporating control groups are imperative to gauge the comparative efficacy of 3i play therapy against alternative interventions.