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Background:
The outcomes of psycho-educational interventions for Autism Spectrum Disorders (ASDs) comorbid with severe to moderate intellectual disability (ID) are insufficiently documented. In this prospective study, we examined a developmental individual, interactive and intensive approach, called the '3i method', which is based on play therapy....
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There is no targeted drug treatment for autistic children. Educational intervention and rehabilitation are the main ways to improve the ability development of autistic children. However, there are great differences in the individual symptoms and abilities. It is an urgent need for educators, practitioners and parents of autistic children to find ef...
Background: The main purpose of the present study was to investigate the effectiveness of play therapy training to mothers of autistic children on verbal and non-verbal improvement of their children.
Materials and Methods: 30 autistic children with intermediate degree of autism were selected based on availability sampling procedure and were divided...
Purpose: Autism is a neuro-developmental disorder that appears in the first three years of life and its main characteristic is a defect in communication and social interactions. Autism affects people's understanding of the world and their interactions with people. Communication skills are one of the most important issues for patients with this diso...
Citations
... This effect was achieved after approximately 2 years of therapy. [11] 153 Lego-therapy ...
Autism is an abnormality in functioning that influences how people interact with others, communicate, learn new things and behave. According to the WHO, autism already occurs in 1 in 100 children. Although it affects people of all ages it is mostly diagnosed in children. This makes the essence of autism management to support the child's development. Autism Syndrome Disorder (ASD) has become a target of research and interest in modern medicine, especially psychiatry pediatrics and psychology. Help and support during the development of a child with ASD have big influence in alleviating symptoms and developing functioning. The multitude of modern therapies makes it available to provide comprehensive care for the child. According to a recent analysis, therapies such as music therapy have positive effects. They can boost a child's communication, interpersonal, social and language skills. They improve the child's overall functioning which converts into his quality of life in adulthood. The profits of occupational or individual therapies are a new case in the context of people with ASD. It requires more extensive randomized studies, but it offers great hope and optimism for the improvement of therapies and a multifaceted support system for children with ASD.
... Making contact with animals and natural environments can be effective in drawing children's attention and concentration (25). The complete perception of childhood experiences would necessitate knowing and paying attention to the physical and biological environments where a child exists (26). Nature is among the most important realms with which children deal in their most sensitive years of life. ...
... In line with the findings of this study, Elbeltagi et al. (22) reported that play therapy helps children with ASD to experience feeling out various interaction styles. In addition, Tilmont-Pittala et al. (26) reported that play therapy improved the social and communication interactions of children with ASD. ...
... Play therapy is the best form of counseling intervention for children. In this type of intervention, children can express their worries in a psychologically secure environment, practice new skills, and discover creative solutions to their challenges to overcome difficult situations (26). In play therapy, children with autism can express their emotions and fears. ...
Background: Children with autism spectrum disorder (ASD) and their families need to use rehabilitation services to improve their functions in social interactions and communication skills. Objectives: The present study aimed to investigate the effectiveness of DIR/floor time play therapy in the social skills and emotion regulation of children with ASD. Methods: The present study was a quasi-experimental with a pretest/posttest design. The statistical population included all the autistic children visiting Golhay-e Behesht Autism Center in Qom, Qom Province, Iran. The convenience sampling method was employed to select 30 participants, who were randomly assigned to an experimental group (n = 15) and a control group (n = 15). The experimental group received the DIR/floor time play therapy intervention for 23 twenty-minute sessions. The research instrument included Bellini’s Social Skills Profile Questionnaire and Emotion Regulation Checklist. Descriptive statistics and the repeated measures ANOVA were adopted for data analysis in SPSS 22. Results: According to the results, the DIR/floor time play therapy method improved emotion regulation components (i.e., instability/negativity and emotion regulation) and the indices of social skills (i.e., social interaction, social participation, and detrimental behavior). The results lasted until the follow-up step (P < 0.001). Conclusions: The DIR/floor time play therapy method caused positive changes to emotion regulation and social skills in autistic children. Therefore, it can be an effective intervention in children with ASD.
... Okul öncesi dönem çocuklarının okula uyum sürecinde yaşamış oldukları sorunlarla baş edebilme ve sosyal yetersizlik duygularını kontrol altına alabilme üzerine BDOT' nin etkili olduğu belirtilmektedir (Stone & Stark, 2013). Son yıllarda yapılan çalışmalara bakıldığında çeşitli oyun tekniklerinin otizm, hiperkinezi ve dikkat eksikliği ve hiperaktivite bozukluğu ile çalıştığı ve çocuklarda içgörü sağlayarak bozukluk belirtilerini hafiflettiği belirtilmektedir (Panksepp, 2017;Pittala, Saint-Georges-Chaumet, Favrot, Tanet, Cohen, & Saint-Georges, 2018). VanFleet, Sywulak ve Caparosa (2018)'e göre oyun terapisinin okul öncesi dönemde görülebilen 'karşıt olma-karşıt gelme bozukluğu, kaygı, akut travmalar, dikkat eksikliği ve hiperaktivite bozukluğu, travma sonrası stres bozukluğu, bağlanma problemleri ve gelişimler bozukluklar' üzerine etkilidir. ...
A STUDY ON COGNITIVE BEHAVIORAL THERAPY APPLICATIONS FOR CHILDREN: A REVIEWS
... Ada 6 Level Perkembangan Fungsional dalam penerapan DIR/Floortime: (1)regulasi diri dan ketertarikan terhadap lingkungan sekitar (2)keterlibatan dan relasi, (3)interaksi emosional yang bermakna, (4)kemampuan memecahkan masalah sosial, (5)ide-ide kreatif, dan (6)berpikir secara logis (Pajareya & Nopmaneejumruslers, 2012). Pendekatan DIR/Floortime sesungguhnya memiliki pandangan yang serupa dengan terapi bermain SonRise dan terapi bermain Perkembangan dan Timbal-Balik, yaitu membangun kemampuan berelasi anak secara responsif dan menyenangkan dengan orang dewasa agar anak bisa membangun relasi dengan teman sebayanya (Tilmont Pittala et al., 2018). ...
This study aims to determine the effectiveness of the application of Developmental, Individual, Relation-Based (DIR / Floortime) based therapy in children who experience disorders related to the neurological system and brain, such as autism and attention deficit disorder and hyperactivity. The application of this intervention is based on 3 basic principles, namely (1) developmental tasks, (2) differences in the neurological processes of each individual, and (3) affective relationships between parents / therapists and children. This systematic literature review was conducted in 7 journals based on predetermined inclusion and exclusion criteria. The results of the literature review show that the DIR / Floortime intervention is an intervention that can improve the communication ability of children with neurodevelopmental and brain disorders, especially autism. Parents are more adaptable in developing children's abilities according to their level of development. This intervention is also an ideal alternative intervention for the lower middle class so as not to spend too much special money to see professionals to get regular therapy.Penelitian ini bertujuan untuk mengetahui efektivitas penerapan terapi berbasis Developmental, Individual, Relation-Based (DIR/Floortime) pada anak-anak yang mengalami gangguan terkait sistem neurologis dan otak, seperti autis dan gangguan pemusatan perhatian dan hiperaktif. Penerapan intervensi ini berbasis pada 3 prinsip dasar, yaitu (1) tugas perkembangan, (2) perbedaan proses neurologis masing-masing individu, dan (3) hubungan afektif antara orang tua/terapis dengan anak. Ulasan tinjauan Pustaka sistematis ini dilakukan pada 7 jurnal berdasarkan kriteria inklusi dan eksklusi yang telah ditetapkan sebelumnya. Hasil ulasan literatur menunjukkan bahwa intervensi DIR/Floortime merupakan intervensi yang dapat meningkatkan kemampuan berkomunikasi anak dengan gangguan perkembangan saraf dan otak, khususnya autism. Orang tua lebih bisa beradaptasi dalam mengembangkan kemampuan anak sesuai dengan level perkembangannya. Intervensi ini juga merupakan alternatif intervensi yang cukup ideal bagi masyarakat kelas ekonomi menengah ke bawah agar tidak mengeluarkan biaya khusus terlalu banyak untuk menemui tenaga profesional demi mendapatkan terapi secara rutin.
... Berbagai keterampilan yang dapat dikembangkan melalui permainan edukatif adalah keterampilan kognitif, emosional, dan psikologis (Pittala et al., 2018). Permainan edukatif yang berkaitan dengan motorik halus banyak dipilih pada masa kanak-kanak, salah satunya melibatkan menyatukan bentuk angka dan huruf menggunakan dudukan plastisin atau Alat bantu tanah liat adalah mainan tanah liat atau plastisin playdough yang terbuat dari tanah liat (tepung terigu), yang merupakan alat bantu belajar yang mudah dilatih dan bermanfaat untuk merangsang motorik dan melatih koordinasi tangan-mata dalam keterampilan motorik halus pada masa kanak-kanak (Avriani, Hasibuan, & Trihariastuti, 2022). ...
Introduction: Play therapy is a form of counseling or psychotherapy using games. There are many kinds of game media that train fine motor skills, one of which is assembling the shapes of numbers and letters using playdough media. Playdough media is a toy dough or plasticine toy made of clay (flour), as a learning aid that is easy to shape and very good at training hand and eye coordination in early childhood. Objective: The purpose of this play therapy activity is to improve children's fine motor skills through play therapy using playdough media. Method: This service method is collaborative, with a play therapy approach involving writers and classroom teachers. Data was collected by observing, interviewing, and documenting preschool children in grades A1 and B1 at Angkasa Kindergarten, Langensari District, Banjar City. Result: The results of this activity showed that all participants during the play therapy activity were able to form numbers and letters with their fingers according to the instructions, using playdough media and the children were very enthusiastic and felt happy in doing this play therapy activity. Conclusion: Based on the evaluation of the KPSP questionnaire from this activity, it can be concluded that overall children aged (4-6 years) in TK Angkasa Langensari have fine motor categories that are in accordance with their age development.
... A prospective exploratory study was carried out to assess benefits for patients [19]. Twenty "3i" patients were followed-up with for 2 years, and their developmental skills progression towards communication, socialization and imitation was assessed using Vineland Adaptative Behavior Scale (VABS) [20], Nadel's imitation scale, and the PsychoEducational Profile Revised (PEP-R); ASD severity was assessed by the Childhood Autism Rating Scale (CARS) and the Autism Diagnostic Interview-Revised (ADI-R). ...
... Most of the participants received the intervention at home, wherever in France, whereas three of them followed the method in the Lud'eveil centre in Courbevoie (Courbevoie municipality had created a centre providing play-rooms for those families who can't find a place to set one in their own home). At this stage, there is no evidence suggesting a difference in the effectiveness of the method between participants in home care or in educational centres [19]. Three participants who followed 3i refused evaluation. ...
... The 19 oldest files were those of children previously included in the prospective study conducted on patients who began the intervention between January 2013 and December 2013. In this published study, patients were assessed with CARS and ADI-R but also with PEP-R and VABS at the beginning and after 2 years of 3i intervention [19]. ...
Background
The Intensive, Interactive, and Individual (3i) intervention approach aims to decrease the severity of autism spectrum disorder (ASD) using intensive developmental play therapy (3i). We performed a retrospective study of 90 children who were enrolled for 2 years in the 3i approach to assess changes and predictors of changes in ASD severity at follow-up (FU).
Methods
The ASD severity of all patients (N = 119) who began 3i intervention between 2013 and 2018 was systematically measured using the childhood autism rating scale (CARS) and autism diagnosis interview-revised (ADI-R). Among them, 90 patients (mean age 5.6 ± 3.7 years) had a second assessment at the 2 year FU. CARS and ADI-R scores after 2 years of 3i intervention were compared to baseline scores using paired student’s t-tests. We used multiple linear regression models to assess the weight of baseline variables (e.g., age, oral language, sex, treatment intensity) on changes at the 2 year FU.
Results
Mean CARS and ADI-R subscores (interaction, communication, repetitive behaviour) decreased significantly by 20, 41, 27.5 and 25%, respectively (effect sizes: d > 0.8). Moreover, 55 and 46.7% of participants switched to a lower category of ASD severity based on the CARS scale and ADI-R interview, respectively. Multiple linear models showed that (i) a higher treatment intensity (more than 30 h per week) was significantly associated with a greater decrease (improvement) in the ADI-R interaction score; (ii) patients categorized as verbal subjects at baseline were associated with a better outcome, as ascertained by the CARS, ADI-R interaction and ADI-R communication scores; and (iii) older patients were significantly associated with a greater decrease in the ADI-R interaction score. However, we found no impact of sex, severity of ASD or comorbidities at baseline.
Conclusion
This study performed on 90 children suggests that 3i therapy may allow for a significant reduction in ASD severity with improvements in interaction, communication, and repetitive behaviours. A study using a control group is required to assess the efficacy of 3i play therapy compared to other interventions.
... For a more comprehensive view of the Italian context, we report below some of the most recent prevalence studies. According to ISTAT data published in 2018 on the position of students with disabilities in primary and secondary schools, for the school year 2016-2017, 25.6% of pupils with disabilities in primary school and 21.7% of pupils with disabilities in lower secondary school have been diagnosed with a developmental disorders (Autism Spectrum Disorders) with a prevalence of 0.84% of the total [10]. A recent study that aimed to assess the prevalence of ASD in 10,138 children aged 7 to 9 in the province of Pisa (Italy) estimated a 0.79% prevalence [11]. ...
Developmental approaches characterized interventions based on the typical sequences of the child's development, paying particular attention to the linguistic, motor and socio-emotional aspects, within a relational perspective. The purpose of this paper was to identify developmental interventions for children with Autism Spectrum Disorders (ASD) aged between 0 and 12 years old. A literature review was carried out searching on MEDLINE, PsycINFO, and PsycARTICLES and manually on key journals and reference lists of key articles [...] This review highlights the need for improved research on intervention programs and the important service needs for families and children with Autism Spectrum Disorders.
... The most widely-recognized programs include Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) [5,6], Applied Behavioral Analysis (ABA) [7] and its derivative Pivotal Response Training (PRT) [8], the Early Start Denver Model (ESDM) [9] and the Developmental, Individual-Differences and Relationship-based (DIR) Model [10,11]. Other alternative developmental approaches based on play therapy, such as the Son-Rise Program® [12], Exchange and Development Therapy [13], and the 3i method [14] have been investigated, but only in the context of pilot studies. Parentmediated social communication therapy (PACT) has been found to have a positive impact at long term follow-up when the intervention is introduced early [15]. ...
Background:
Children with autism spectrum disorder (ASD) and moderate to severe intellectual disability (ID) face many challenges. There is little evidence-based research into educational settings for children with ID and ASD and in France. Little is known about how this unserved population could benefit from intervention and education. This study assessed the feasibility and efficacy of a new intervention model using an individualized educational approach.
Methods:
We conducted a randomized, single-blind controlled trial to assess a novel intervention: the "Developmental and Sequenced One-to-One Intervention (DS1-EI)". In DS1-EI, trained teachers worked one-to-one with each child in a small classroom setting, offering 10 h per week of the intervention. The focus was on encouraging spontaneous communication, promoting skills through play with peers, supporting positive interactions, and developmental and sequenced learning. We enrolled 5- to 9-year-old children with ASD and ID across 11 French child care institutions for children with co-occurring ASD and ID. Participants were matched in dyads by developmental quotient and randomized to the treatment-as-usual (TAU) group or the DS1-EI group. Independent raters blindly assessed the primary variables: The Childhood Autism Rating scale (CARS) and the Psychoeducational Profile, third edition (PEP-3). The secondary variables included the Vineland Adaptive Behavior Scale II (VABS-II) and the Clinical Global Assessment Scale (CGAS). Here we perform interim analyses at 24 months.
Results:
At baseline, 72 participants were randomized. Nine patients (5 in the DS1-EI group and 4 in the TAU group) dropped out of the study. Using linear mixed models, both intent-to-treat (ITT) and per-protocol (PP) analyses at the 12-, 18- and 24-month outcomes showed no significant group nor group-by-time interaction effects. However, we found significant improvements in most primary and secondary variables over time in both groups.
Conclusions:
The study did not show that DS1-EI was superior to TAU in treating children with ASD and ID over 24 months. However, the low dropout rate shows that DS1-EI is feasible, and well accepted. As the study is still ongoing, we need to wait for data at 36 months to ensure whether DS1-EI could be recommended.
Trial registration:
ANSM130282B-31 (April 16, 2013) and ACTRN12616000592448. Registered 6 May 2016, retrospectively registered, http://www.anzctr.org.au/.
... ASD was diagnosed by one psychiatrist and one pediatric ASD specialist using the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). ADI-R was usually used as a diagnostic instrument [12], while ADOS was useful for studying the longitudinal changes of core autism symptom severity. ...
Tuberous sclerosis complex (TSC) is a genetic disorder with a high prevalence of associated autism spectrum disorder (ASD). The pathophysiology of TSC mainly involves the hyperactivation of mammalian target of rapamycin (mTOR) induced by TSC1 (hamartin) and TSC2 (tuberin) heterozygosity. The mTOR inhibitor, everolimus, is a therapeutic target for TSC-related ASD. The efficacy of everolimus may be affected by iron and copper neurotransmission and oxidant-antioxidant systems. Creatine has an antioxidant activity related to the cytoprotective paradigm. Additionally, TSC-related epileptic activity may influence the development of autistic symptoms. This case series examined the efficacy of everolimus in relation to the serum levels of the iron mediator (transferrin (Tf)), the copper mediator (ceruloplasmin (Cp)), the oxidant marker (oxidized low-density lipoprotein (oxLDL)), the antioxidant marker (total antioxidant power (TAP)), and creatine in four cases of TSC accompanied with autism. Everolimus improved autistic symptoms with increased serum Cp and Tf levels in all four cases. Serum TAP and creatine levels showed positive correlations with decreased total Aberrant Behavior Checklist (ABC) and Social Responsiveness Scale (SRS) scores, respectively. As everolimus regulates iron homeostasis and increased copper levels suppress mTOR signaling, everolimus improved autism symptoms with increased serum levels of Cp and Tf via homeostatic control of mTOR activity, accompanied with the considerable overlap of oxidant-antioxidant systems, such as TAP and creatine. Everolimus had no effect on TSC-related epileptiform discharges; thus, the autistic symptoms and epileptic activity may be two independent end results of a common central nervous system including mTOR hyperactivity.
... Une évaluation prospective de la méthode sur un petit échantillon de 20 sujets a déjà été publiée [41] récemment, montrant des progrès relationnels objectivés par des outils standardisés. Ici nous présentons une plus vaste étude, longitudinale observationnelle et rétrospective (le patient étant son propre témoin) sur 120 enfants suivis pendant 2 ans par cette méthode ; cette étude s'appuie sur une analyse qualitative des dossiers rendue quantifiable par la constitution d'une grille. ...
... Dans une petite étude prospective sur 20 sujets [41], il est montré une évolution positive des patients au cours des 2 ans de méthode 3i. Les résultats de la présente étude sur 2 ans, rétrospective mais sur 120 patients, sont cohérents avec ceux de l'étude prospective. ...
... Et ces formes de base de l'interaction sociale pourraient être mobilisables même chez une personne avec un autisme déjà ancien. En effet, comme dans notre étude prospective [41] nous constatons dans cette étude que l'âge de début de la prise en charge ne constitue pas un facteur prédictif de l'évolution sur les domaines évalués, ce qui suggère que la méthode a une efficacité même chez des patients plus âgés. Ces résultats confortent les travaux scientifiques de Nadel [37] qui montrent que contrairement aux idées reç ues, les compétences en imitation sont bien présentes chez les personnes autistes, à condition que l'on commence par les imiter, ce qui a une valeur d'échange et de marque d'intérêt pour ce qu'ils produisent. ...
Résumé
Objectif
L’objectif de cette étude rétrospective est de décrire l’évolution des compétences en communication et relation d’un groupe d’enfants porteurs de trouble du spectre autistique et traités par la méthode des 3i pendant 2 ans.
Méthode
Cent-vingt dossiers d’enfants ayant poursuivi cette méthode pendant 24 mois ont été inclus dans cette étude. Un score de 1 à 3 dans une échelle d’acquisition de compétences (1 : non acquise, 2 : partiellement acquise, 3 : acquise) a été attribué à chaque sujet pour chacun des six indicateurs choisis (Imitation, Qualité du regard, Régulation sociale et émotionnelle, Expression verbale, Expression non verbale et Compréhension verbale). Les scores initiaux sont comparés aux scores finaux après 24 mois de méthode 3i.
Résultats
L’analyse statistique montre que pour chaque indicateur le groupe de patients a significativement progressé au cours des 24 mois de méthode 3i. En moyenne, les sujets acquièrent un stade supérieur dans 4 domaines de compétences sur 6. La progression est plus grande dans les domaines de l’imitation et de la communication non verbale.
Discussion
Malgré les limites liées au caractère rétrospectif de l’étude et à une grille d’évaluation non standardisée, les résultats sont cohérents avec une précédente étude prospective sur 20 sujets avec des outils internationaux. Ce résultat suggère que les handicaps liés aux troubles du spectre autistique diminuent au cours de la prise en charge 3i.
Conclusion
Celle-ci pourrait permettre de réduire l’intensité du syndrome autistique et d’améliorer les capacités d’interaction avec l’environnement.
