Play-based interventions to support social and communication development in autistic children aged 2-8 years: A scoping review

Abstract

Play is often considered by practitioners to be a natural and enjoyable context for providing intervention and support to autistic children. However, the literature on play-based interventions is large and heterogeneous.This means it is challenging for families and practitioners to navigate the evidence base and make choices about differing play-based approaches. This review aims to provide a comprehensive map of the research on this topic and to develop a conceptual framework to inform decision-making.We used a scoping review methodology to find peer reviewed intervention studies of play-based approaches totargeting language, social and communication outcomes for autistic children aged 2-8 years. We then summarised the literature using narrative synthesis and Evidence Gap Maps (EGMs).We identified 388 studies, covering many intervention types, for inclusion. Just over 50% had <10 participants. Girls and minority background groups were under-represented. In our summary we suggest important dimensions for appraisal of play-based interventions, including considering the role of play in an intervention and the extent to which approaches are child-led.

A Systematic Review of Play-Based Interventions Targeting the Social Communication Skills of Children with Autism Spectrum Disorder in Educational Contexts

“…Fifthly, using Reichow et al's (2008) quality criteria, the vast majority of studies in this review were classified as weak or adequate. This finding supports recommendations by Gibson et al (2020) (Gibson et al, 2020;Ke et al, 2018;Lindsay et al, 2017).…”

“…Finally, the majority of studies consisted of naturalistic behavioural approaches (e.g. Chang et al, 2016b;Goods et al, 2013;Lawton & Kasari, 2012;Thomas & Smith, 2004;Vincent et al, 2018) similar to findings reported in other systematic reviews in the field (Gibson et al, 2020;Kossyvaki & Papoudi, 2016). This is unsurprising given the current shift within the literature towards an integrated approach to learning involving both behavioural and developmental approaches for children with ASD (Frost et al, 2020;Hume et al, 2021;Schreibman et al, 2015).…”

“…Complementary backward chaining was also conducted given that database searching is not exhaustive (Evans & Benefield, 2001). The reference lists of the seminal articles identified (and listed) above were searched for eligible studies alongside the examination of the bibliographies of previous systematic reviews in the area (Alagendran et al, 2019;Cornell et al, 2018;Gibson et al, 2020;Godin et al, 2019;Jung & Sainato, 2013;Kent et al, 2020a;Kossyvaki & Papoudi, 2016;Kuhaneck et al, 2020;Lai et al, 2018;Lang et al, 2011;Lindsay et al, 2017;Lory et al, 2018;Mpella & Evaggelinou, 2018;Pyle et al, 2017). Overall, this process yielded an additional 130 citations resulting in a total of 1041 articles for potential inclusion.…”

“…There are several implications for future research in this area. Firstly, future research should explicitly report participant characteristics including IQ, functioning levels and presence of co-occurring needs in order to ascertain if results can generalize across all students with ASD given the heterogeneity of the spectrum, as recommended within similar reviews (Gibson et al, 2017(Gibson et al, , 2020Hansen et al, 2017;Kent et al, 2020a;Kossyvaki & Papoudi, 2016). Secondly, although all studies were conducted within educational contexts, future practicebased research may benefit from examining play-based interventions as part of classroom practice as opposed to isolated educational settings, as recommended within previous systematic reviews in the field (Bellini et al, 2007;Hansen et al, 2017;Jung & Sainato, 2013;Kent et al, 2020a) and broader research literature (Kasari & Koegel et al, 2012;Mazurik-Charles & Stefanou, 2010).…”

“…Thirdly, future research should consider seeking input from teachers, peers and also children with ASD, as reflected within broader participatory research recommendations (den Fletcher-Watson et al, 2019;Houting et al, 2020;Jivraj et al, 2014;Lau & Stille, 2014) and, consequently, add to the social validity of this evidence base. Fourthly, given that the vast majority of play-based interventions included in this review were based on predominately male samples across the UK and USA, future research may consider including more geographical and gender representative samples, as identified within other systematic reviews in the field (Gibson et al, 2020;Kossyvaki & Papoudi, 2016;Stiller & Mößle, 2018). Fifthly, using Reichow et al's (2008) quality criteria, the vast majority of studies in this review were classified as weak or adequate.…”