Effects of Parent-Child Sandplay Therapy for preschool children with autism spectrum disorder and their mothers: A randomized controlled trial

Purpose: To evaluate the effects of the Parent-Child Sandplay Therapy (PCST) Program on autism behaviors, social responsiveness and sleep quality among preschool children with autism spectrum disorder (ASD), and their mothers' parenting stress.Design and methods: A prospective, randomized controlled, parallel-group trial was employed. Fifty-two child-mother dyads were randomly assigned to an intervention group (n = 26) or a control group (n = 26) from Feb-ruary 2017 to February 2019. The intervention group was treated with a 20-week PCST Program plus an Applied Behavior Analysis-based program (ABA-based program), whereas the control group received only the ABA-based program. Outcome measures included the Autism Behavior Checklist total scores, Social Responsiveness Scale scores, Children's Sleep Habits Questionnaire scores, and Parenting Stress Index-Short Form scores, measured at baseline, post-intervention (20 weeks after baseline) and follow-up assessments (32 weeks after baseline).Results: Finally, 43 dyads completed the study. The linear mixed model analysis resulted in a significant group*time interaction effect of ABC score (Est = 2.027, t = 3.277; p < 0.01), SRS score (Est = 3.377, t = 6.095; p < 0.01), PSI-SF score (Est = 3.873, t = 4.253, p < 0.01), and CSHQ score (Est = 3.158, t = 6.485; p < 0.05).Conclusion: Our findings suggested that the PCST Program could potentially improve social interaction and sleep quality of preschool children with ASD while decreasing parenting stress.Practice implications: The PCST Program was found to be a feasible and a promising treatment for children with mild-to-moderate ASD as well as for their parents. It was a nurse-led program, which could be integrated into the usual nursing care of children with autism spectrum disorder in special education schools. Trial registration: Chinese Clinical Trials Registry, ChiCTR2100047699.(c) 2023 Published by Elsevier Inc.