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Neurological soft signs (NSS) comprise subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts, which are typically observed in the majority of schizophrenia patients, including chronic cases and neuroleptic-naïve first-episode patients. However, recent studies clearly demonstrate that NSS are not a static feature of schizophrenia but vary in the clinical course of the disorder. This effect was investigated in a meta-analysis based on 17 longitudinal studies published between 1992 and 2012. Studies included between 10 and 93 patients with schizophrenia spectrum disorders (total number 787) with follow-up periods between 2 and 208 weeks. Beside the Neurological Examination Scale, the Cambridge Neurological Inventory and the Heidelberg NSS Scale were used to assess NSS. All but three studies found NSS to decrease in parallel with remission of psychopathological symptoms. This effect was more pronounced in patients with a remitting compared to a non-remitting, chronic course (Cohen’s d 0.81 vs. 0.15) and was significantly correlated with length of the follow-up period (r = −0.64) but not with age (r = 0.28). NSS scores did not decrease to the level typically observed in healthy controls. From a clinical perspective, NSS may therefore be used to identify subjects at risk to develop schizophrenia and to monitor disease progression.

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Theraplay is an interactive form of short-term play therapy that incorporates the dynamics of a "healthy mother-child relationship" such as structuring, challenging, engaging, nurturing, and attachment. Additionally, Theraplay therapists use interpersonal contact and touch in joyful interactive play. The therapeutic objective is to improve the social interaction ability of infants and toddlers and, in this study, to prepare them for the subsequent treatment of their communication disorders. Two research studies are reported: 1) a controlled, longitudinal study (CLS), and 2) a Multi-Center Study (MCS). Both were designed to evaluate the effectiveness of Theraplay. The CLS, initiated in 1998, was conducted in one region of Germany, and includes an accumulated sample of 60 clinically conspicuous infants and toddlers diagnosed as having both communication and behavior disorders. All were treated using Theraplay. In a follow-up study 29 of the 60 children were evaluated to measure the lasting effects of Theraplay two years after discharge from individual treatment. This article reports the results of a selected sample of 22 of the 60 treated children who manifested clinically significant shyness and co-morbid communication disorders. They are compared with a control sample of 30 clinically unobtrusive children, matched for sex and age. The MCS, initiated in 2000, was conducted in 9 different institutions in Germany and Austria. The sample consists of 251 randomly selected children whose Theraplay treatment was completed during the years 2000-2003. Reported are the results on 125 of those children diagnosed with communication disorders and clinically significant shyness. When therapy began each child was markedly impaired. The results of both studies show that after treatment with Theraplay the target symptoms were both clinically and statistically reduced. In each study about 18, 30-minute sessions were needed to achieve the desired therapeutic outcome.