Effects of parent-child painting and creative crafting therapy on preschool children with autism spectrum disorder and their mothers: a prospective randomized controlled trial
LIU Gui-Hua, OU Ping, HUANG Long-Sheng, XIE Na-Mei, LIN Jin-Ling, HE Ying-Shuang, HU Rong-Fang
Child Healthcare Centre, Fujian Maternity and Child Health Hospital/Teaching Hospital of Fujian Medical University, Fuzhou 350001, China
Abstract Objective To study the effects of parent-child painting and creative crafting therapy on the core symptoms of preschool children with mild-to-moderate autism spectrum disorder (ASD) and the parenting stress and hope level of their mothers. Methods A total of 56 preschool children with mild-to-moderate ASD and their mothers were divided into an experimental group and a control group using the block randomization method, with 28 pairs in each group. The subjects in the control group received an applied behavior analytic intervention and those in the experimental group received parent-child painting and creative crafting therapy in addition to the intervention in the control group. The intervention time was 20 weeks for both groups. Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Parenting Stress Index-Short Form (PSI-SF), and Herth Hope Index (HHI) were used to evaluate the core symptoms of children and the parenting stress and hope level of their mothers before and after 20 weeks of intervention. Results Forty-nine child-mother pairs completed the study (25 pairs in the intervention group and 24 pairs in the control group). The children in the experimental group had significantly lower scores of social interaction, language, social communication, and social motivation and total scores of ABC and SRS compared with those in the control group (P<0.05). The mothers in the experimental group had significantly lower scores of parental distress and parent-child dysfunctional interaction and total score of PSI-SF (P<0.05) and significantly higher total score of HHI and scores of each dimension compared with those in the control group (P<0.05). Conclusions The combination of applied behavior analytic intervention with parent-child painting and creative crafting therapy can more effectively improve the core symptoms and social interaction of preschool children with mild-to-moderate ASD, reduce the parenting stress of mothers and improve their hope level.
Corresponding Authors:
Hu R-F, Email: hulu2886@sina.com
E-mail: hulu2886@sina.com
Cite this article:
LIU Gui-Hua,OU Ping,HUANG Long-Sheng et al. Effects of parent-child painting and creative crafting therapy on preschool children with autism spectrum disorder and their mothers: a prospective randomized controlled trial[J]. CJCP, 2021, 23(8): 779-785.
LIU Gui-Hua,OU Ping,HUANG Long-Sheng et al. Effects of parent-child painting and creative crafting therapy on preschool children with autism spectrum disorder and their mothers: a prospective randomized controlled trial[J]. CJCP, 2021, 23(8): 779-785.
Lord C, Elsabbagh M, Baird G, et al. Autism spectrum disorder[J]. Lancet, 2018, 392(10146): 508-520. DOI: 10.1016/S0140-6736(18)31129-2. PMID: 30078460. PMCID: PMC7398158.
Pickles A, Le Couteur A, Leadbitter K, et al. Parent-mediated social communication therapy for young children with autism (PACT): long-term follow-up of a randomised controlled trial[J]. Lancet, 2016, 388(10059): 2501-2509. DOI: 10.1016/S0140-6736(16)31229-6. PMID: 27793431. PMCID: PMC5121131.
Wang F, Lu L, Wang SB, et al. The prevalence of autism spectrum disorders in China: a comprehensive meta-analysis[J]. Int J Biol Sci, 2018, 14(7): 717-725. DOI: 10.7150/ijbs.24063. PMID: 29910682. PMCID: PMC6001678.
Maenner MJ, Shaw KA, Baio J, et al. Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2016[J]. MMWR Surveill Summ, 2020, 69(4): 1-12. DOI: 10.15585/mmwr.ss6904a1. PMID: 32214087. PMCID: PMC7119644.
5 Jalambadani Z. Art therapy based on painting therapy on the improvement of autistic children's social interactions in Iran[J]. Indian J Psychiatry, 2020, 62(2): 218-219. DOI: 10.4103/psychiatry.IndianJPsychiatry_215_18.
Pongan E, Tillmann B, Leveque Y, et al. Can musical or painting interventions improve chronic pain, mood, quality of life, and cognition in patients with mild Alzheimer's disease? Evidence from a randomized controlled trial[J]. J Alzheimers Dis, 2017, 60(2): 663-677. DOI: 10.3233/JAD-170410. PMID: 28922159.
Wilk M, Pachalska M, Lipowska M, et al. Speech intelligibility in cerebral palsy children attending an art therapy program[J]. Med Sci Monit, 2010, 16(5): CR222-CR231. PMID:20424549.
8 Kanareff RL. Utilizing group art therapy to enhance the social skills of children with autism and Down syndrome[D]. Pepper Pike: Ursuline College, 2002.
Gavron T, Mayseless O. Creating art together as a transformative process in parent-child relations: the therapeutic aspects of the joint painting procedure[J]. Front Psychol, 2018, 9: 2154. DOI: 10.3389/fpsyg.2018.02154. PMID: 30483180. PMCID: PMC6243114.
Virués-Ortega J. Applied behavior analytic intervention for autism in early childhood: meta-analysis, meta-regression and dose-response meta-analysis of multiple outcomes[J]. Clin Psychol Rev, 2010, 30(4): 387-399. DOI: 10.1016/j.cpr.2010.01.008. PMID: 20223569.
14 Gau SSF, Liu LT, Wu YY, et al. Psychometric properties of the Chinese version of the Social Responsiveness Scale[J]. Res Autism Spect Dis, 2013, 7(2): 349-360. DOI: 10.1016/j.rasd.2012.10.004.
Cen CQ, Liang YY, Chen QR, et al. Investigating the validation of the Chinese Mandarin version of the Social Responsiveness Scale in a Mainland China child population[J]. BMC Psychiatry, 2017, 17(1): 51. DOI: 10.1186/s12888-016-1185-y. PMID: 28166747. PMCID: PMC5292795.
Yeh CH, Chen ML, Li W, et al. The Chinese version of the Parenting Stress Index: a psychometric study[J]. Acta Paediatr, 2001, 90(12): 1470-1477. DOI: 10.1080/08035250152708914. PMID: 11853348.
Chan KS, Li HC, Chan SW, et al. Herth Hope Index: psychometric testing of the Chinese version[J]. J Adv Nurs, 2012, 68(9): 2079-2085. DOI: 10.1111/j.1365-2648.2011.05887.x. PMID: 22111952.
Nayeri ND, Goudarzian AH, Herth K, et al. Construct validity of the Herth Hope Index: a systematic review[J]. Int J Health Sci (Qassim), 2020, 14(5): 50-57. PMID:32952505. PMCID:PMC7475204.
Stuckey HL, Nobel J. The connection between art, healing, and public health: a review of current literature[J]. Am J Public Health, 2010, 100(2): 254-263. DOI: 10.2105/AJPH.2008.156497. PMID: 20019311. PMCID: PMC2804629.
Korpa T, Pervanidou P, Angeli E, et al. Mothers' parenting stress is associated with salivary cortisol profiles in children with attention deficit hyperactivity disorder[J]. Stress, 2017, 20(2): 149-158. DOI: 10.1080/10253890.2017.1303472. PMID: 28264636.
Gilson KM, Davis E, Johnson S, et al. Mental health care needs and preferences for mothers of children with a disability[J]. Child Care Health Dev, 2018, 44(3): 384-391. DOI: 10.1111/cch.12556. PMID: 29430692.
Duncan AR, Jaini PA, Hellman CM. Positive psychology and hope as lifestyle medicine modalities in the therapeutic encounter: a narrative review[J]. Am J Lifestyle Med, 2021, 15(1): 6-13. DOI: 10.1177/1559827620908255. PMID: 33456415. PMCID: PMC7781058.