Child Interaction Research Articles

The Dark Side of Fun: Understanding Dark Patterns and Literacy Needs in Early Childhood Mobile Gaming

Play has always been recognized as an essential aspect of human development, particularly during early childhood, as it contributes to learning, the formation of meanings, and experiencing the world. In today's digitalized society, early childhood education has increasingly integrated digital media into its practices, both in schools and at the family level. Mobile digital games (MDG) have received significant attention due to their impact on children's interactions, play, and learning. However, as young children engage more with MDGs, concerns about problem gaming have arisen, referring to conflicts and issues that emerge from game playing within everyday sociocultural contexts. Scholars such as Zagal et al. (2013) have identified certain game design patterns as "dark", which can be considered unethical as they manipulate players against their best interests. Given the prevalence of mobile gaming in early childhood, studying these dark patterns becomes even more crucial. This study aims to investigate the presence of dark patterns in MDG for young children (0-5 years old), through qualitative analysis. The five most popular free games for this age range on App Store (February 2023) were analysed, particularly focusing on the presence of temporal, monetary, social, and/or psychological dark patterns. The analysis uncovers the presence of temporal, monetary, and psychological dark patterns, including aesthetic manipulations, paywalls, and periodic rewards resembling gambling elements. The games also employ advertising strategies and engagement tactics that challenge young children's navigation. Parental control mechanisms offer limited safeguards, requiring continuous monitoring and parental involvement in play dynamics. The study highlights the importance of adult media and digital literacy in supporting children's online play effectively, while also emphasising the responsibility of game designers and developers to create healthier and less risky game experiences.

تأثير العلاج بأوميغا-3 على الأطفال المصابين بالتوحد في الرياض، المملكة العربية السعودية

This comprehensive review article explores the effect of omega-3 medication on autistic children in Riyadh, Saudi Arabia. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by challenges in social communication and repetitive behaviors. Traditional treatment approaches for ASD have limitations, necessitating the exploration of alternative treatments. Omega-3 fatty acids, which are essential nutrients found in certain foods, have been associated with various health benefits, including potential benefits for managing ASD symptoms. The review begins by providing a detailed overview of the prevalence and characteristics of ASD, as well as the current treatment approaches and their limitations. It emphasizes the importance of exploring alternative treatments for ASD due to the need for more effective interventions. Next, the article delves into an in-depth exploration of omega-3 fatty acids, explaining their sources, types, and associated health benefits. The role of omega-3 supplementation in managing ASD symptoms is discussed, highlighting the potential mechanisms through which omega-3 fatty acids may exert their effects on the neurodevelopmental processes relevant to ASD. To support the potential benefits of omega-3 supplementation for autistic children, the review examines relevant research studies conducted on this topic. A comprehensive review of randomized controlled trials (RCTs), systematic reviews, and meta-analyses is provided, summarizing the key findings and conclusions. The review explores the varied outcomes observed in terms of improvements in social interaction, communication, and repetitive behaviors in autistic children after omega-3 supplementation. It also discusses the limitations and gaps in the existing research, highlighting the need for further studies to provide a clearer understanding of the effects of omega-3 medication on ASD symptoms.

A Tale of Two Identities: The Value, Attitude, and Behavior of Adult Children towards Family Tourism Experiences

Adult children accompanying their parents on trips is a particular form of family tourism. During family travel, adult children assume two roles: as tourists, they pursue personal hedonic experiences, while as children, they also bear the responsibility of showing filial piety towards their parents. These two roles entail inherent contradictions. How this conflict influences the formation of family tourism values between adult children and their parents, and ultimately impacts adult children’s intention to accompany their parents on future trips (re-travel intention), requires further in-depth analysis. Based on the perspective of tourist-to-tourist interaction and role conflict theory, this study applied a “value–attitude–behavior” model to empirically analyze the relationship between the interactions of adult children and parents during the tourism and their re-travel intention. An empirical investigation was conducted with 566 adult children from Jiangsu, Zhejiang, and Shanghai. The result of the structural equation modeling (SEM) analysis indicates that both positive interactions and role conflict have significant impacts on the formation of family tourism values, and these impacts are moderated by self-efficacy. Furthermore, these two variables influence attitude through the values of filial piety and family connection, which, in turn, affect the re-travel intentions of adult children. This study confirmed that the higher the self-efficacy of adult children, the better effect the positive interaction has and the less impact the role conflict has, which ultimately affects adult children’s re-travel intention. At the theoretical level, this study reveals the process of the formation of “adult children–parents” family tourism values, and provides practical insights for family tourism marketing.

Altered dynamic network interactions in children with ASD during face recognition revealed by time-varying EEG networks.

Although the electrophysiological event-related potential in face processing (e.g. N170) is widely accepted as a face-sensitivity biomarker that is deficient in children with autism spectrum disorders, the time-varying brain networks during face recognition are still awaiting further investigation. To explore the social deficits in autism spectrum disorder, especially the time-varying brain networks during face recognition, the current study analyzed the N170, cortical activity, and time-varying networks under 3 tasks (face-upright, face-inverted, and house-upright) in autism spectrum disorder and typically developing children. The results revealed a smaller N170 amplitude in autism spectrum disorder compared with typically developing, along with decreased cortical activity mainly in occipitotemporal areas. Concerning the time-varying networks, the atypically stronger information flow and brain network connections across frontal, parietal, and temporal regions in autism spectrum disorder were reported, which reveals greater effort was exerted by autism spectrum disorder to obtain comparable performance to the typically developing children, although the amplitude of N170 was still smaller than that of the typically developing children. Different brain activation states and interaction patterns of brain regions during face processing were discovered between autism spectrum disorder and typically developing. These findings shed light on the face-processing mechanisms in children with autism spectrum disorder and provide new insight for understanding the social dysfunction of autism spectrum disorder.

Helping families help themselves: The (Un)intended impacts of a digital parenting program

Parenting practices play a crucial role in child development. We evaluate the impact of a free digital stress management and positive parenting intervention designed to improve caregiver’s mental health and positive caregiver–child interactions in El Salvador. Drawing on the prior success of in-person interventions, we study the effects of digital intervention delivery and examine differential treatment effects by caregiver’s sex. Using an individual-level experiment, we find that the intervention increased stress and anxiety and lowered caregiver–child interactions among male caregivers. In contrast, among female caregivers, we did not detect changes in mental health and observed a decrease in the use of physical violence against children. We also find that family structure and the severity of economic deprivation greatly moderated the intervention’s impact, especially among male caregivers. Our findings indicate that one-size-fits-all digital parenting interventions may not serve all caregivers effectively, emphasizing the need for thorough evaluations prior to extensive implementation.

Association of Parental Support with Reduced Stereotypy in Children with Autism Spectrum Disorder: A Cross-Sectional Study.

Background and Objectives: To analyze the influence of parental presence and use of risperidone on social interaction and apathy among patients with Autism Spectrum Disorder (ASD). Materials and Methods: Cross-sectional study in a reference center for patients with ASD in a city in northeastern Brazil. The research was carried out using a sociodemographic questionnaire, the Dimensional Apathy Scale, and the Social Communication Questionnaire (SCQ) with the domains of social interaction, language, stereotypy, and communication. The referred questionnaire was answered by the parents or guardians of the children with ASD according to the DSM V criteria. Data were analyzed via independent t-test using the SPSS software version 20. Results: Interviews were conducted with 51 parents/guardians of autistic children with a mean age of 8.8 years (±2.95) and a predominance of males, 34 (66.7%). Of this total, 49 (96.1%) of the children attended school; 40 (78.4%) children were on medication, of which 38 (74.5%) were on risperidone. Those children on risperidone had a higher score on the SCQ scale (p = 0.049) and on the domain of stereotyped behaviors (p = 0.033), which indicated greater impairment. Another statistically relevant variable was the presence of married parents, whereby children who did not have the presence of married parents had a higher average of stereotyped behaviors compared to those who had married parents. Conclusions: The results showed differences in the means of social interactions for children on risperidone, especially regarding stereotyped behaviors. However, it is not possible to state whether this difference was due to the use of risperidone or whether they used risperidone precisely because of these behaviors. Also important was that children who had the presence of married parents showed fewer stereotyped behaviors. There was no difference in apathetic behavior between children.

Analyse des représentations parentales dans le discours de parents d’enfant de 4 mois

AimThe child's place in our society has largely evolved over the past few decades. This has led to numerous public policies to tackle social inequalities in health care from an early age. Parenting support is one of the enhanced strategy actions and aims put in place, in particular, to strengthen the bonds of attachment and promote a child's development. The quality of attachment and parent–child interactions is correlated with parents’ representations of their children. The objective of the study is to report current parental representations of newborn children in the French population in general. MethodAs part of the PERL study, an ancillary study was conducted on parental representations. The interviews were conducted with the control families. The analysis was based on the method of conceptual categories in order to bring out the salient elements relating to parental representations and feelings associated with parenthood. ResultsAmong the analyzed discourses, parents have constructed the representations of their child, from the child's age of 4 months. These representations identify the 4-month-old child as being capable of making choices, having preferences, acting in the environment, and communicating with others. In addition, parents’ representations of themselves highlighted various feelings experienced concerning parenthood, the exercise of this new role, and the new parental behaviors towards the child, as a result of the disruption of being a parent. Parents also experienced a variety of feelings associated with parenting, parenthood, and their new role.

The impact of the Covid-19 pandemic restrictions on children entering and leaving care in Scotland

ObjectivesThe Covid-19 pandemic caused huge upheaval across the world, and the Scottish children’s social care sector was not exempt from this. This study explored the extent to which the Covid-19 pandemic restrictions impacted on the rate at which children and young people were entering and leaving care in Scotland.
 MethodsAnalysis was conducted on the Scottish Government’s ‘Longitudinal Looked After Children’ dataset which contains information on the care journeys of all children who were ‘looked after’ in Scotland between April 2008 and July 2021. Through a descriptive analysis, the study determined how the pandemic restrictions impacted the rates of children entering care, the rates of children leaving care, and the stability and duration of care placements at this time.
 ResultsDuring the initial year of the pandemic, there was a marked reduction in the number of children both entering (38%) and leaving (22%) care when compared to the year prior. The reduction in entries to care were less notable for infants under the age of 1 than it was for older age groups. Fewer children entered care under compulsory measures, with an increased proportion entering through ‘voluntary’ Section 25 measures. The impact on entries to care and exits from care varied substantially across local authorities in Scotland. The stability and duration of children’s placements were also impacted, with children moving placements less and staying in care for longer periods of time.
 ConclusionThe pandemic restrictions had a substantial impact on the interactions of children and young people with the ‘care system’. At a time where there is great focus on improving the experience of young people in care within Scotland, it is important that lessons are learned and implemented for future disruptive events.

Applying the Theoretical Domains Framework to Develop an Intervention to ‘Re-implement’ Parent–Child Interaction Therapy (PCIT)

Parent–Child Interaction Therapy (PCIT) is an empirically supported treatment for childhood conduct problems, with increasing numbers of clinicians being trained in Aotearoa/New Zealand. However, ensuring sustained delivery of effective treatments by trained clinicians in routine care environments is notoriously challenging. The aims of this qualitative study were to (1) systematically examine and prioritise PCIT implementation barriers and facilitators, and (2) develop a well specified and theory-driven ‘re-implementation’ intervention to support already-trained clinicians to resume or increase their implementation of PCIT. To triangulate and refine existing understanding of PCIT implementation determinants from an earlier cross-sectional survey, we integrated previously unanalysed qualitative survey data (54 respondents; response rate 60%) with qualitative data from six new focus groups with 15 PCIT-trained clinicians and managers in Aotearoa/New Zealand. We deductively coded data, using a directed content analysis process and the Theoretical Domains Framework, resulting in the identification of salient theoretical domains and belief statements within these. We then used the Theory and Techniques Tool to identify behaviour change techniques, possible intervention components, and their hypothesised mechanisms of action. Eight of the 14 theoretical domains were identified as influential on PCIT-trained clinician implementation behaviour (Knowledge; Social/Professional Role and Identity; Beliefs about Capabilities; Beliefs about Consequences; Memory, Attention and Decision Processes; Environmental Context and Resources; Social Influences; Emotion). Two of these appeared to be particularly salient: (1) ‘Environmental Context and Resources’, specifically lacking suitable PCIT equipment, with (lack of) access to a well-equipped clinic room appearing to influence implementation behaviour in several ways. (2) ‘Social/Professional Role and Identity’, with beliefs relating to a perception that colleagues view time-out as harmful to children, concerns that internationally-developed PCIT is not suitable for non-Māori clinicians to deliver to Indigenous Māori families, and clinicians feeling obligated yet isolated in their advocacy for PCIT delivery. In conclusion, where initial implementation has stalled or languished, re-implementation may be possible, and makes good sense, both fiscally and practically. This study suggests that re-implementation of PCIT in Aotearoa/New Zealand may be facilitated by intervention components such as ensuring access to a colleague or co-worker who is supportive of PCIT delivery, access to suitable equipment (particularly a time-out room), and targeted additional training for clinicians relating to the safety of time-out for children. The feasibility and acceptability of these intervention components will be tested in a future clinical trial.

Research on Interactive Children's Teaching Mode Driven by Artificial Intelligence Technology

This paper designs an interactive system of intelligent robots for children's education, which includes interactive desktop devices and interactive robot devices. Teaching and interactive content can be displayed through the display surface of the interactive desktop device. A user manipulates the display surface via gesture manipulation or teaching tools. Interactive desktop devices perform interactive information gathering. A new time series similarity measurement method is given. The display surface and the interactive robotic device provide interactive feedback to the user through sounds, images, and lights. The guidance and interactive operation of the interactive robot on the display surface enhances the effect of the interactive operation. The effectiveness of this method is verified by simulation experiments.

The social significance of children’s work in cashew supply chain activities in Ghana

ABSTRACT The aim of this paper is to investigate the social significance of children’s work in cashew supply chain activities in Ghana. Using survey and semi-structured interviews, we gathered data from 218 children working in cashew supply chain activities in Ghana. Data were analysed using descriptive statistics and thematic analysis approach. The results show that children’s involvement in various stages of cashew supply chain activities is highly gendered. Working in cashew supply chain allowed children to gain farming and life skills, earn income to meet some school expenses, and support household livelihood building efforts. Work allowed children to meet their peers outside of the home economy to engage in conversational activities that are not easily supplied by leisure activities. While there are perceived negative implications of children’s work on schooling, we conclude by reiterating the need for policy to recognise the significant learning opportunities and social interaction for children working on family cashew farms.

Past attachment experiences, the potential link of mentalization and the transmission of behavior to the child by mothers with mental health problems: cross-sectional analysis of a clinical sample

Maternal capacity to mentalize (= reflective functioning, RF), secure attachment and emotionally available parenting has an impact on the child’s development. The transmission of mothers’ past attachment experiences gained with both her caregivers in her own childhood and the impact on current mother–child interaction is part of the ‘transmission gap.’ This study explores the transgenerational transmission mechanisms and the potential moderating effect of RF in a clinical sample of 113 mother–child dyads suffering from mental health problems. In a cross-sectional study, the associations between maternal attachment experiences, RF (coded based on Adult Attachment Interviews) and current mother–child interaction (Emotional Availability Scales) were examined with univariate correlation, moderator analyses, and structural equation models. We found relationships between attachment experiences and mother–child interaction, but RF had no moderating effect. Past loving experiences and perceived neglection, particularly with the own father in childhood, were predictors for the present mother–child interaction. There seems to be an intergenerational transmission of attachment experiences to the ongoing generation. Particularly past adverse childhood experiences with the own father seem to explain currently disruptive interactions with the child.Trial registration: DRKS00017008 and DRKS00016353.

The BabyView camera: Designing a new head-mounted camera to capture children's early social and visual environments.

Head-mounted cameras have been used in developmental psychology research for more than a decade to provide a rich and comprehensive view of what infants see during their everyday experiences. However, variation between these devices has limited the field's ability to compare results across studies and across labs. Further, the video data captured by these cameras to date has been relatively low-resolution, limiting how well machine learning algorithms can operate over these rich video data. Here, we provide a well-tested and easily constructed design for a head-mounted camera assembly-the BabyView-developed in collaboration with Daylight Design, LLC., a professional product design firm. The BabyView collects high-resolution video, accelerometer, and gyroscope data from children approximately 6-30 months of age via a GoPro camera custom mounted on a soft child-safety helmet. The BabyView also captures a large, portrait-oriented vertical field-of-view that encompasses both children's interactions with objects and with their social partners. We detail our protocols for video data management and for handling sensitive data from home environments. We also provide customizable materials for onboarding families with the BabyView. We hope that these materials will encourage the wide adoption of the BabyView, allowing the field to collect high-resolution data that can link children's everyday environments with their learning outcomes.

Kia Tīmata Pai (Best Start): a study protocol for a cluster randomised trial with early childhood teachers to support children’s oral language and self-regulation development

IntroductionOral language skills are associated with children’s later self-regulation and academic skills; in turn, self-regulation in early childhood predicts successful functioning later in life. The primary objective of this study...

Positive effects of wood in Vorarlberg’s (Austria) timber kindergartens

Abstract The application of sustainable materials and their integration into newly constructed, valuable, and cultural architecture is a topic currently often mentioned in connection with the new initiative called the New European Bauhaus. The aim of this paper is to highlight the impact of wood material in the interiors of preschool institutions, its positive influence on the development of children and its inclusivity in education. The use of wooden furniture and wooden structural elements in kindergarten interiors opens a new area of research and interest in the context of promoting diversity and access for every child, regardless of their abilities or limitations. The article analyses the architecture of kindergartens in Vorarlberg, which serves as an excellent reference example for the development of new school projects. The authors raise questions as to how such architectural and design thinking can support the promotion of inclusive education of children and whether it can positively influence their cognitive abilities, ultimately affecting their overall quality of life. The findings presented in the article can inspire new ideas and solutions for the creation of preschool architecture that aims to provide an inclusive environment for children where they can expand their knowledge and gain new experiences, while applying innovative design thinking. The selected analyses and comparisons focused on whether the presence of wood material can positively impact the well-being of children in the physical environment of kindergartens. The paper aims to prove that interiors with exposed wood can improve the quality of teaching and support social interaction and playful learning of children. The results of this study can serve as a strong argument for the New European Bauhaus initiative advocating for the implementation of renewable materials such as wood in accordance with the principles of biophilic, restorative environmental, and salutogenic design in practice.

A new way to co-play with digital media: Evaluating the role of instructional prompts on parent–child interaction quality.

A new way to co-play with digital media: Evaluating the role of instructional prompts on parent–child interaction quality.

See no evil, hear no evil, speak no evil: assessing complex trauma in young children

AbstractComplex trauma generally refers to a child's exposure to multiple traumatic events often within the context of an interpersonal relationship. Childhood traumatic events are commonplace and can have significant implications for physical and mental health. However, traumatic events are often not assessed by clinicians involved in their care. This paper outlines an approach to assessing complex trauma in young children in clinical settings. This approach involves an initial interview, an assessment of traumatic events and trauma symptoms in the child, an assessment of the parent–child interaction, an understanding of the child's functioning in multiple settings, and an assessment of parental trauma where relevant. Complex trauma takes time to assess and is dependent on the parent's ability to recognise and acknowledge the effect trauma has had. The paper concludes with some of the challenges when assessing complex trauma in young children in clinical settings.

L’anti-Œdipe du point de vue de la philosophie des sciences et des perspectives foucaldiennes du savoir-pouvoir

BackgroundFreud identified his theory of the Oedipus complex as his greatest scientific contribution, made it the centerpiece of his clinical theory of the etiology and cure of the psychoneuroses, and adamantly defended it throughout his life. The theory dominated psychoanalysis for almost a century and determined how the problems of countless patients were interpreted. However, recent scholarship suggests that the arguments Freud used to support the theory are unsound and that, far from being harmless pseudoscience, the Oedipal theory constitutes an oppressive form of Foucauldian “knowledge-power” that rearranges family relationships in sociosyntonic but emotionally harmful ways. Continued identification of psychoanalysis with Oedipal theory poses an obstacle to fresh psychoanalytic thinking and psychoanalytic credibility. To liberate psychoanalysis from its Oedipal shackles, a clear understanding of the theory's faulty origins and deleterious effects is essential. Objectives and methodsThis paper distills the conclusions of two recent books that consider how and why Freud staunchly defended the Oedipal theory and the deleterious effects on the modern family that resulted. After the failure of his seduction theory, Freud developed the Oedipal theory to defend his central theoretical claim, the sexual theory of neuroses. However, the Oedipal theory remained an entirely ad hoc, scientifically unpersuasive defense without novel evidential support less dependent on psychoanalytic method, which had also been cast into doubt by the seduction theory's failure. Freud attempted to provide such “more direct” evidence in the case of Little Hans, on which my analysis focuses. Regarding the evaluation of Freud's evidence, the method is philosophy-of-science logical reconstruction, analysis, and evaluation of the arguments Freud offered. Regarding the theory's effects, the method is neo-Foucauldian analysis of how acceptance of the theory changed family power relations — that is, the theory's knowledge-power. ResultsI identify four pivotal arguments Freud presents in the Hans case to support Oedipal theory. Each argument is brilliant as a logical construction but unsound when compared to the evidence of the Hans case history. I then analyze the knowledge-power of the Oedipal theory as it appears in the Hans case as well as in modern family life. Acceptance or awareness of the theory serves to create a sense of danger in mother-son physical affection, leading to separation of children from parents — especially at bedtime — and thus protection of the marital bed in the new era of egalitarian sexual and emotional marriage that started at about the time that Oedipal theory was proposed. ConclusionsFreud's arguments defending Oedipal theory are brilliantly conceived, but Freud misreads the facts of the Hans case so that his arguments are unsound. In failing to confirm novel predictions, Freud's Oedipal theory remains ad hoc and scientifically unacceptable. It was nonetheless widely accepted because of its distinctive knowledge-power, which supported the evolving nature of marriage in a way that limited parent–child interaction, co-sleeping, and affection. The theory of the Oedipus complex of both false and harmful, and in clinical intervention it is a form of theoretical counter-transference.

Anti-Oedipus from philosophy of science and Foucauldian knowledge-power perspectives

BackgroundFreud identified his theory of the Oedipus complex as his greatest scientific contribution, made it the centerpiece of his clinical theory of the etiology and cure of the psychoneuroses, and adamantly defended it throughout his life. The theory dominated psychoanalysis for almost a century and determined how the problems of countless patients were interpreted. However, recent scholarship suggests that the arguments Freud used to support the theory are unsound and that, far from being harmless pseudoscience, the Oedipal theory constitutes an oppressive form of Foucauldian “knowledge-power” that rearranges family relationships in sociosyntonic but emotionally harmful ways. Continued identification of psychoanalysis with Oedipal theory poses an obstacle to fresh psychoanalytic thinking and psychoanalytic credibility. To liberate psychoanalysis from its Oedipal shackles, a clear understanding of the theory's faulty origins and deleterious effects is essential. Objectives and methodsThis paper distills the conclusions of two recent books that consider how and why Freud staunchly defended the Oedipal theory and the deleterious effects on the modern family that resulted. After the failure of his seduction theory, Freud developed the Oedipal theory to defend his central theoretical claim, the sexual theory of the neuroses. However, the Oedipal theory remained an entirely ad hoc, scientifically unpersuasive defense without novel evidential support less dependent on psychoanalytic method, which had also been cast into doubt by the seduction theory's failure. Freud attempted to provide such “more direct” evidence in the case of Little Hans, on which my analysis focuses. Regarding the evaluation of Freud's evidence, the method is philosophy-of-science logical reconstruction, analysis, and evaluation of the arguments Freud offered. Regarding the theory's effects, the method is neo-Foucauldian analysis of how acceptance of the theory changed family power relations — that is, the theory's knowledge-power. ResultsI identify four pivotal arguments Freud presents in the Hans case to support Oedipal theory. Each argument is brilliant as a logical construction but unsound when compared to the evidence of the Hans case history. I then analyze the knowledge-power of the Oedipal theory as it appears in the Hans case as well as in modern family life. Acceptance or awareness of the theory serves to create a sense of danger in mother-son physical affection, leading to separation of children from parents — especially at bedtime — and thus protection of the marital bed in the new era of egalitarian sexual and emotional marriage that started at about the time that the Oedipal theory was proposed. ConclusionsFreud's arguments defending Oedipal theory are brilliantly conceived, but Freud misreads the facts of the Hans case so that his arguments are unsound. In failing to confirm novel predictions, Freud's Oedipal theory remains ad hoc and scientifically unacceptable. It was nonetheless widely accepted because of its distinctive knowledge-power, which supported the evolving nature of marriage in a way that limited parent–child interaction, cosleeping, and affection. The theory of the Oedipus complex is both false and harmful, and in clinical intervention it is a form of theoretical countertransference.

Music therapy improves social interaction and verbal communication skill among children with autism spectrum disorder: A systematic review and meta-analysis

The incidence of Autism Spectrum Disorder (ASD) is constantly increasing, in which 6 of 1000 ASD children are from Asia. Music therapy as a developing alternative is believed to improve communication and expression skills in children with ASD. Unfortunately, no specific meta-analysis has evaluated social interaction and verbal communication skills in children with ASD. Therefore, the aim of this meta-analysis was to evaluate music therapy in children with ASD. We performed a comprehensive literature review on PubMed, Scopus, Embase, Wiley, and Proquest to study the efficacy of music therapy as an ASD management therapy until October 20th, 2022. Twenty-three randomized controlled trials involving patients with ASD, where 1129 patients were assigned in the intervention group and 759 patients – in the control group, were included in qualitative and quantitative analysis. The pooled estimates revealed that music therapy increased the social interaction score with mean difference (MD)=2.08 (95% confidence interval [CI]: 0.35–3.81; p<0.02), social interaction score based on Autism Diagnostic Observation Schedule with MD: 0.77 (95% CI: 0.03–1.51; p<0.04), verbal communication skill based on Autism Diagnostic Interview-Revised with MD=0.90 (95% CI: 0.79–1.00, p<0.01). In conclusion, music therapy has excellent efficacy and strong potency as a part of ASD management. Nevertheless, more clinical trials with similar parameters are still required to confirm these findings.