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The Play Therapy Room

Supporting Healing and Growth

A Short-term Play Therapy and ASD Intervention Report

Below is a summary of the impact of a short-term (12 week) play therapy intervention I conducted at a school proving support for children on the autistic spectrum. Eight children between the ages of 5 and 11 years old attended weekly one-on-one play therapy sessions for a period of 12 weeks. The focus of these sessions was encouraging appropriate social interaction, emotional expression, the development of play skills, and increased self and social awareness and wellbeing. TEACHER OBSERVATIONS Teachers completed an assessment form at commencement and completion of the intervention. This highlighted each child's level of functioning within social, emotional, behavioural, play and flexibility abilities, identifying: (1) areas of strength / acquired abilities (2) emerging abilities /areas that require support and encouragement (3) key target areas / abilities which are either not present or are areas of greatest difficulty. The assessment scale contained the following statements which were rated to identify specific areas of strength and difficulty. These were then used to set individual therapeutic goals for the children.

Social Will interact appropriately with an adult when approached Will interact appropriately with a peer when approached Seeks out an adult to share experiences with Will initiate appropriate interaction with a peer Shows interest in what others are doing Shows awareness of peers Will join what others are doing appropriately Uses eye contact appropriately Emotional Is confident Will ask for help Is fearful of many things Upsets easily Refuses help even when it is needed Tantrums easily without obvious cause Is reluctant to interact with new play objects and activities Behavioural Shows understanding of cause and effect of their own behaviour Is flexible in changes Can focus on an activity Tantrums as a means of communication /avoidance or control Is withdrawn and quiet Relies heavily on an adult Is independent to the point of controlling Play Uses play objects in a functional/appropriate way Will allow an adult to join their play Will allow a peer to join their play Will engage in make believe or role play activities Can share play space Can parallel play with shared objects (i.e. share a box of toys) Is rigid in choice of play objects and how they are used Flexibility Easily allows another persons presence in their personal area/ space Allows you to assist with an activity Calmly and easily handles limits and boundaries Allows you to make / add variations in their activity Is spontaneous within their activity

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The above areas are related to SEAL (Social and Emotional Aspects of Learning)* and contribute to PSHE education (Personal, Social, Health & Economic education) objectives. * See the end of this report for a breakdown of the specific SEAL objectives that underlie the above statements. Below is a comparison of the pre-play therapy and post-play therapy combined scores for the eight children who participated in the intervention.

Pre Play Therapy Intervention

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

55% 45% 42% 39% 32% 29% 16%

54% 48%

Score

29%

26%

20%

27%

25%

13%

Social

Em otional

Behavioural

Play

Flexibility

acquired ability / not an area of concern emerging ability / area that needs support targeted ability / area of greatest concern

Post Play Therapy Intervention

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

55%

Score

52% 41%

53% 36% 11% 39%

56% 48% 40%

22%

23% 7% 5% Behavioural Play 12%

Social

Em otional

Flexibility

Areas of improvement observed within the classroom: A comparison of scores highlights the improvements observed by teachers in all five ability areas. Following the play therapy intervention: · The number of acquired abilities / areas that are no longer of concern (green bars on chart) increased significantly, i.e. the children displayed new abilities while previously problematic behaviours / areas of weakness reduced significantly during the intervention · The number of emerging abilities (orange bars on chart) increased significantly, i.e. the children's existing abilities were strengthened during the intervention · The number of targeted abilities / areas of greatest concern (red bars on chart)reduced significantly, i.e. the children displayed fewer difficulties following the intervention

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Each child's pace and degree of progress varied, however all eight children showed improvements. In general, teachers observed: · An increase in the use of eye contact · An increase in awareness and interaction with peers · Increased confidence and sense of happiness · An improvement in emotional expression · Increased sense of containment and calm · An increase in focused attention · An increase in the display of play skills · Greater flexibility with acceptance of boundaries and variation in routine PLAY THERAPIST OBSERVATIONS Based on observations during play therapy sessions I identified additional therapeutic goals for each child which were focused on during each session through the means of interactive play. The following is an example list of such goals:

· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · Increase appropriate making and holding of eye-contact Increase acceptance of social initiations Increase initiation of social interactions Increase the spontaneous use of appropriate social requesting (please, thank you, eye contact) Increase emotional awareness Support appropriate emotional (positive and negative) expression Increase patience Increase understanding of cause and effect of own behaviour Acceptance of the therapist within child's play space Acceptance of the therapist touching items / expressing interest in items child is playing with Acceptance of the therapist's parallel play Expression of interest in the therapist's parallel play Acceptance of the therapist's initiation of joint play Initiation of joint play with the therapist Acceptance of the introduction of variation within his play Increase duration of interactive, non-exclusive/solitary play Follow the therapist's play ideas (relinquish need to `control' play) Expansion of play ideas Engage in symbolic / imaginative play Engage in reciprocal play / sharing and turn-taking Remain focused on single activity for increased duration Containment and reduced fidgeting Acceptance and adherence to boundaries Increase willingness to `try' and persevere with new / challenging tasks Reduce urgent need to `win' / be first Increase attempts and confidence in self help skills Reduction in autistic `isms' (shouting, hand flapping, scripting, echolalia etc) / difficult behaviours Accept help when needed Request help when needed Increase problem-solving skills

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Areas of improvement observed within the playroom: Each child's therapeutic process was unique however all of the children displayed an increased social and self awareness. Overall I observed: · Significant increase in the spontaneous use of appropriate eye contact and social manners · Significant increase in sense of containment, calm and focus, with reduced display / intensity of autistic behaviours. · Progression from the child's rejection of the play therapist in his play space to the child initiating play with the therapist · Increasing expression of enjoyment in interactive play · Increasing expansion of play ideas · Increase in spontaneity within the playroom

SOCIAL & EMOTIONAL ASPECTS OF LEARNING (SEAL) The following SEAL objectives were used in the design of the play therapy assessment form: · · · · · · · · · · · · · · · · · · · · · Have a positive approach to new experiences Be confident to try new activities and initiate new ideas Show increasing independence in selecting and carrying out activities Take risks and explore the environment Seek out others to share experiences Persist for extended periods of time at an activity of their choosing Feel safe and secure and demonstrate a sense of trust Relate and make attachments with members of their group Understand what is right and wrong and why Form relationships with adults and peers Express needs and feelings in appropriate ways Show confidence and ability to stand up for own rights Demonstrate flexibility and adapt their behaviour to different events, social settings and changes in routine Show confidence in linking up with others for support and guidance Consider the consequences of their words and actions for themselves and others Respond to significant experiences showing a range of feelings when appropriate Show curiosity Have a strong exploratory impulse Maintain attention, concentrate and sit quietly when appropriate Have an awareness of the boundaries set and behavioural expectations within the setting Have a positive self image and show that they are comfortable with themselves

Kelly Heath BA Psychology BA (Hons) Industrial Psychology MA in Play Therapy Mobile: 079 4993 9888 Email: [email protected] Website: www.theplaytherapyroom.com

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