Can I Learn to Play? Randomized Control Trial to Assess Effectiveness of a Peer-Mediated Intervention to Improve Play in
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ORIGINAL PAPER
Can I Learn to Play? Randomized Control Trial to Assess Effectiveness of a Peer‑Mediated Intervention to Improve Play in Children with Autism Spectrum Disorder Cally Kent1 · Reinie Cordier1,5 · Annette Joosten2 · Sarah Wilkes‑Gillan3 · Anita Bundy4
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Play is often used in interventions to improve social outcomes for children with autism spectrum disorders (ASD). Play is a primary occupation of childhood and, therefore, an important outcome of intervention. The Ultimate Guide to Play, Language and Friendship (PLF) is a peer-mediated intervention for 6–11-year-old children with ASD. A total of 68 dyads were randomized to either a 10-week treatment first or waitlist control group. Results revealed a significant moderate intervention effect from pre- to post-intervention, which was maintained to the 3-month follow-up clinic session and generalized to the home environment. The findings support that the PLF intervention can be used to positively improve play in 6–11-year-old children with ASD. Australian New Zealand Clinical Trials Registry, https://www.anzctr.org.au/ (ACTRN12615000008527; Universal Trial Number: U1111-1165-2708) Keywords Autism · Play · Intervention · Video modeling
Introduction Play is essential for social development and the primary occupation of childhood (Lane and Bundy 2011). Play is frequently used as a medium to deliver intervention to improve other developmental areas such as social skills and language; however, play as an independent outcome is often neglected and not reported (Kent et al. 2019). Children with ASD have difficulty playing with peers (MacDonald et al. 2009) and are frequently observed to have fixed interests, * Cally Kent [email protected] 1
School of Occupational Therapy, Speech Pathology and Social Work, Curtin University, Perth, WA, Australia
2
School of Allied Health, Australian Catholic University, Melbourne, VIC, Australia
3
Discipline of Occupational Therapy, University of Sydney, Sydney, NSW, Australia
4
Department of Occupational Therapy, Colorado State University, Colorado, USA
5
Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
concrete and repetitive behaviours, reduced symbolic quality, lack of flexibility and impaired social skills that impact their play (MacDonald et al. 2009). Social play interactions become more complex across middle childhood (between 6 and 12 years of age) as children develop their language skills and individual interests (Del Giudice 2014). Difficulty with peer social play in middle childhood influences other areas of life, including reduced engagement in school activities, difficulties developing and maintaining friendships and developing social anxiety. This can lead to social withdrawal, isolation and feelings of loneliness (Zeedyk et al. 2016). As a result, both girls and boys with ASD have higher rates of social exclusion in middle childhood than younger children with ASD or their t
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