Community Health Journal

Community Health Journal

The Effect of Sand Play Therapy with a Cognitive Behavioral Approach on the Reduction of Emotional Recognition Problems and Social Growth in Boys with Autism Spectrum Disorder

Document Type : Original Article

Authors
ZS MirGhafourian 1
Sh Nohi 2
M Taher 2
1 PhD Student, Dept of psychology, Islamic Azad University, Shahrood Branch, Shahrood, Iran.
2 Assistant Prof, Dept of psychology, Islamic Azad University, Shahrood Branch, Shahrood, Iran.
10.22123/chj.2022.293494.1742
Abstract
Introduction: Disability to recognize emotions in children with autism will cause their aggressive behaviors against themselves and others, which brings about weakening of social interaction and psychological problems. Therefore, this study was conducted to determine the effect of sand play therapy with a cognitive-behavioral approach on the reduction of emotional recognition problems and social growth in boys with autism spectrum disorder.
Materials and Methods: This was a semi-experimental study with pre-test, post-test, and follow-up. Boys with autism spectrum disorder with high performance admitted to the Ehya autism center in Tehran in 2019 formed the statistical population of the study. A number of 30 individuals were selected by available sampling and they were randomly assigned to two experimental and control groups. Data were collected by Gilliam autism rating scale, Matson social skills questionnaire, and Benton facial recognition test. In the experimental group, the treatment program was performed in 8 sessions, 1 session per week and each session for 1 hour, but the control group did not receive this treatment. Data were analyzed using analysis of variance with repeated measures.
Results: The results showed that the level of social growth (η=0.543, p=0.007, F=7.36) and Emotional recognition (η=0.609, p=0.005, F=22.12) of the experimental group increased significantly compared to the control group and this increase was remained steady in the follow-up.
Conclusion: Based on the findings of this research, sand play therapy with a cognitive-behavioral approach can be used as an effective intervention method to improve the emotional and social status of people with autism.
Keywords
Sand play therapy
Emotional recognition
Social growth
Autism
  1. Coulter BA, Bade A, Jenewein EC, Tea YC, Mitchell Near-point findings in children with autism spectrum disorder and in typical peers. OVS 2021; 98(4):384-93.
  2. Maenner MJ, Shaw KA, Baio J, Washington A, Patrick M, DiRienzo M, et al. Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 Sites, United States, 2016. MMWR Surveill Summ 2020; 69(4):1-12.
  3. Valilou SF, Alavi A, Pashaei M, Ghasemi Firouzabadi S, Shafeghati Y, Nozari A, et al. Whole-exome sequencing identifies three candidate homozygous variants in a consanguineous Iranian family with autism spectrum disorder and skeletal problems. Molecular Syndromology 2020; 11(2):62-72.
  4. Li B, Bos M, Stockmann L, Rieffe C. Emotional functioning and the development of internalizing and externalizing problems in young boys with and without autism spectrum disorder. Autism 2020; 24(1):200-10.
  5. Thompson SF, Zalewski M, Kiff CJ, Moran ML, Cortes R, Lengua An empirical test of the model of socialization of emotion: maternal and child contributors to preschoolers’ emotion knowledge and adjustment. Developmental Psychology  2020; 56(3):418-30.
  6. Styliadis C, Leung R, Özcan S, Moulton EA, Pang E, Taylor MJ, et al. Atypical spatiotemporal activation of cerebellar lobules during emotional face processing in adolescents with autism. HBM 2021; 42(7):2099-114.
  7. Au AH, Shum KK, Cheng Y, Man-yan Tse H, Wong RM, Li J, et al. Autism spectrum disorder screening in preschools. Autism 2021; 25(2):516-28.
  8. Fuentes J, Hervás A, Howlin ESCAP practice guidance for autism: a summary of evidence-based recommendations for diagnosis and treatment. European Child and Adolescent Psychiatry 2021; 30(6):961-84.
  9. Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele Autism spectrum disorder. Lancet 2018; 392(10146):508-20.
  10. Shaw KA, Maenner MJ, Baio J, Washington A, Christensen DL, Wiggins LD, et al. Early identification of autism spectrum disorder among children aged 4 years-early autism and developmental disabilities monitoring network, 6 Sites, United States, 2016. MMWR Surveill Summ 2020; 69(3):1-11.
  11. Rana M, Kothare S, DeBassio The assessment and treatment of sleep abnormalities in children and adolescents with autism spectrum disorder: a review. JCACAP 2021; 30(1):25-35.
  12. Muris P, Ollendick Selective mutism and its relations to social anxiety disorder and autism spectrum disorder. Clin Child Fam Psychol Rev 2021; 24(2):294-325.
  13. Guo J, Li D. Effects of image-sandplay therapy on the mental health and subjective well-being of children with autism. IJPH 2021; 50(10):2046-2054.
  14. Kent C, Cordier R, Joosten A, Wilkes-Gillan S, Bundy A. 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. JADD 2021; 51(6):1823-1838.
  15. Maras A. Play therapy in the prevention of behavioural disorders of school-aged children. Global Journal of Guidance and Counseling in Schools: Current Perspectives 2021; 11(1):37-44.
  16. Rajeswari SR, Chandrasekhar R, Vinay C, Uloopi KS, RojaRamya KS, Venkata Ramesh Effectiveness of cognitive behavioral play therapy and audiovisual distraction for management of preoperative anxiety in children. IJCPD 2019; 12(5):419-22.
  17. Humble JJ, Summers NL, Villarreal V, Styck KM, Sullivan JR, Hechler JM, Warren Child-centered play therapy for youths who have experienced trauma: a systematic literature review. Journal of Child & Adolescent Trauma 2019; 12(3):365-75.
  18. Delavar A. Theoretical and practical foundations of research in the humanities and social sciences. 1nd ed. Tehran: Roshd Publications, 2020.[Persian]
  19. Siyadat SM, Khajevand Khoshli A, Akbari H. Effectiveness of acceptance and commitment therapy on psychological well-being and spiritual attitude in mothers with autistic children. IJRN 2019; 5(4):59-64.[Persian]
  20. Gorji R, Hassanzadeh S, Ghasemzadeh S, Qolamali Lavasani M. Sensitivity and specificity of Gilliam autism rating scale in diagnosis of autism spectrum disorders: a systematic review. The Neuroscience Journal of Shefaye Khatam 2020; 8(4):80-90.[Persian]
  21. Boik BL, Goodwin EA. Sandplay therapy: a sept by step manual for psychotherapists of diverse orientations. 1nd ed. New York: Norton & Co, 2000.
  22. Azimigarosi S, Arjmandnia A, Mohseni Ezhei A, Asgari M. Effectiveness of hydrotherapy on communication skills of children with autism spectrum disorder: a single case study. JCMH 2020; 6(4):35-50.[Persian]
  23. Matson J, Rotatori AF, Helsel WJ. Development of a rating scale to measure social skills in children: the matson evaluation of social skills with youngsters (MESSY). Behaviour Research and Therapy 1983; 21(4):335-40.
  24. Ashori M, Yazdanipour M. Investigation of the effictiveness of group play therapy training with cognitive-behavioral approach on the social skills of students with intellectual disability. Journal of Rehabilitation 2018; 19(3):262-75.[Persian]
  25. Jalili F, Bahrami H, Nejati V. Comparing diagnostic ability of basic emotional states in children with high performance autism disorder with normal peers. ZJRMS 2012; 14(2):39-44.[Persian]
  26. Sezici E, Ocakci AF, Kadioglu Use of play therapy in nursing process: a prospective randomized controlled study. Journal of Nursing Scholarship 2017; 49(2):162-69.
  27. Morshed N, Babamiri M, Zemestani M, Alipour A comparative study on the effectiveness of individual and group play therapy on symptoms of oppositional defiant disorder among children. KJFM 2019; 40(6):368-72.
  28. Carruthers S, Pickles A, Slonims V, Howlin P, Charman Beyond intervention into daily life: a systematic review of generalisation following social communication interventions for young children with autism. Autism Research 2020; 13(4):506-22.
  29. Yamada T, Miura Y, Oi M, Akatsuka N, Tanaka K, Tsukidate N, et al. Examining the treatment efficacy of PEERS in Japan: improving social skills among adolescents with autism spectrum disorder. JADD 2020; 50(3):976-97.
  30. Gilmore S, Frederick LK, Santillan L, Locke The games they play: observations of children with autism spectrum disorder on the school playground. Autism 2019; 23(6):1343-53.