中華心理衛生協會

Purpose: Joint attention (JA) interventions for children with autism have focused on improving joint engagement (JE) and JA. Although recent research has demonstrated positive JA and JE, however, these skills have been limited by poor generalization and unstable efficacy. The purpose of this study was to develop a caregiver-mediated JE intervention program based on the perspective of creative dance/movement therapy to investigate its impact on JE and JA and the collateral abilities of young children with autism. Methods: A multiple case design was used. We recruited 3 children with autism (a 33-month-old girl with high function, a 46-month-old boy with middle function, and a 46-month-old boy with low function). The program consisted of 20 sessions with one hour per session twice a week. Sessions were conducted with the target child and his/her mother. Three major strategies were applied: following and imitation, forming a play routine, and improving the JE state. The creative movement approach to dance therapy was used throughout these strategies. Intervention outcomes were collected through unstructured activities and standardized tools/tasks by independent testers both pre- and post- intervention and at 3-months post-intervention. The threshold for intervention efficacy defined by the gain scores in our measurements equaled or exceeded the values in the intervention groups in published studies. Results: Greater JE and JA improvement was identified for the children with middle and high function than for the low function child. The improvement of collateral abilities such as cognition and language persisted 3 months after intervention. Conclusions: The creative movement approach to dance therapy through caregiver-mediated joint engagement intervention can effectively enhance an autistic child's JE state and JA sharing intention. Further empirical studies are needed for clinical application.