Two-year follow-up of 90 children with autism spectrum disorder receiving intensive developmental play therapy (3i method)

Abstract

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.

Play therapy in children with autism: Its role, implications, and limitations

“…Their results suggested that the 3i method can be a valuable tool for children with ASD by improving their daily interactions and social environment[ 129 ]. Brefort et al [ 130 ] did a more extensive controlled study that involved 90 children with ASD receiving 3i therapy (intensive developmental play therapy) for two years. They found that 3i therapy improves ASD severity with observed interaction, communication, and repetitive behavior improvements[ 130 ].…”

“…Brefort et al [ 130 ] did a more extensive controlled study that involved 90 children with ASD receiving 3i therapy (intensive developmental play therapy) for two years. They found that 3i therapy improves ASD severity with observed interaction, communication, and repetitive behavior improvements[ 130 ].…”

Medicine Insufficient Evidence for the Efficacy of Massage as Intervention for Autism Spectrum Disorder: A Systematic Review

“…The refractory and life-long nature of the disorder places a heavy burden on families and society [ 11 ]. Early screening and intervention are important for promoting positive development and improving outcomes for children with ASD [ 12 , 13 ]. This has prompted a demand for complementary and alternative medicine (CAM) treatments for children with ASD [ 14 ].…”

Multifaced therapies in the care of children with Autism Spectrum Disorder - A literature review

“…Children became more willing to interact non-verbally, make eye contact with other interlocutors and share attention with others. [10] Looking at children with ASD and moderate to severe intellectual disability, 3i therapy also made it easier to function in similar aspects of life. Improvements were particularly noted in the areas of perceptual skills, social abilities, and communication skills.…”