Impact of child-centered play therapy intervention on children with autism reflected by brain EEG activity: A randomized controlled trial

Objective: Research into the effects of child-centered play therapy (CCPT) consistently highlights its positive impact on autistic children. However, its effectiveness at the neural level is underexplored. To address this research gap, the present study investigates the influence of CCPT interventions on autistic children, specifically focusing on measurable changes in brain activity through electroencephalography (EEG) alpha power analysis. Methods: Autistic children were randomly assigned to an experimental group (EXP; n = 34; Mage = 7.50) and a waitlist group (WL; n = 31; Mage = 7.47). The EXP group underwent weekly 45-minute individual CCPT sessions for 8 weeks. Pre- and post-intervention EEG recordings during a social activity with varied social contexts were obtained. In addition, behavioral data from the Social Responsiveness Scale-2 (SRS-2), Autism Spectrum Quotient-Child (AQ-child; social skills subscale), and Adaptive Behavior Assessment System-II (ABAS-II; social domain) were collected before and after the intervention. Results: Linear mixed models revealed a significant increase in alpha amplitude post-intervention across all social activities and conditions in the EXP group. Notably, significant differences in SRS2, AQ-child (social skills), and ABAS-II (social domain) scores were observed between pre- and post-CCPT intervention in the EXP group. In contrast, impacts on both neural and behavioral activity remained nonsignificant in the WL group. Conclusion: CCPT exhibits a significant positive effect on autistic children, as evidenced by changes in EEG alpha power and improvements in SRS-2, AQ-child (social skills), and ABAS-II (social domain) scores. These results provide data for future investigation of the intricate neural mechanisms underlying the CCPT-enhanced social behavior observed in autistic children.