Session Information
99 ERC ONLINE 20 B, Inclusive Education
Paper Session
MeetingID: 826 3011 7817 Code: w1hz76
Contribution
During the COVID-19 pandemic, researchers are motivated to engage with a changed and changing reality. We argue that COVID has encouraged us to think about intervention, specifically the efficacy or usefulness of non-pharmacological intervention. We propose the Social Model of wellbeing that rather than bringing children and parents to a clinical environment, they are brought to a remote or non-clinical setting. COVID has accelerated the good work that has advocated for non-pharmacological and non-clinical intervention for children. To be specific, average anxiety severity scores increased 13% from August to December 2020 and then decreased 26.8% from December 2020 to June 2021 (Jia et al., 2021). Similar ups and downs were reported in the UK matching the lockdowns (O'Connor et al., 2021). COVID has demonstrated that not all intervention approaches require children and their supporters to attend therapeutic work in high-risk infectious clinical environments. The Social Model also links to sustainable development goals (SDGs).
For this presentation, we will report a systematic literature review (SLR). The following research question has been identified in order to investigate this topic: What are the available peer-mediated play-based interventions to reduce anxiety in young children with and without autism spectrum disorder (ASD)?
The objective of this SLR is to explore current non-pharmacological play-based group interventions to reduce anxiety for children with ASD.
Theoretical Background
Globally, the World Health Organization (2021) estimated that 3.6% of 10-14 year-olds and 4.6% of 15-19 year-olds experience an anxiety disorder. Whilst anxiety disorders in children were found to have early onset, before the age of five (Dalrymple et al., 2007), with 19.6% diagnosed by the age of three (Dougherty et al. (2013), there is no available intervention to address young children’s needs. The Health Service Executive (HSE) recommended talking to a general practitioner (GP) first, then seeking cognitive behavioural therapy (CBT) which is talking therapy for age 12 and above, and finally medications. Moreover, parents, teachers, and doctors lack a comprehensive framework to help young children with anxiety, sometimes restricted to a medical model, resulting in a long waiting periods in Ireland. For example, the national news Raidió Teilifís Éireann (RTE) reported a seven-year-old girl who has autism and suffering from severe anxiety, who has to wait for more than five years for an appointment at HSE (O Kelly, 2021). Hence, we argue that developing an innovative, group play intervention in a multidisciplinary programme of inclusive education, early intervention, and mental health is an alternative to the dominant, deficit medical model. The goal is to understand anxiety in children better and reduce their anxiety. Conceivably, the current overarching programme, which adopts a strength-based paradigm will address children’s needs, because there is no known cause of anxiety disorder, but a combination of three risk factors: genetic, temperament, and environment (Hudson & Rapee, 2004).
Theoretical framework
We will look at early models of anxiety (pre-1990), the Social Model of Anxiety and new models of anxiety (post-1990) as Theoretical Foundations of Anxiety. Next, we will review the Theory of Intolerance of Uncertainty (IU)(Carleton, 2012) to explain why children have anxiety. Specifically, IU, anxiety, ASD, and sensory sensitivity are found to be bidirectional (Neil et al., 2016). IU can inform intervention to integrate evidence-based strategies for children with anxiety and ASD. Moreover, the Developmental-transactional model of child behavioural inhibition and anxiety, adapted from Rubin et al. (2009), in Chronis-Tuscano et al. (2018) will be reviewed to explain risk factors of anxiety disorders and to guide prevention and intervention.
The Systemising-empathizing theory of autism (Baron-Cohen, 2009) will be employed to explain why the peer-mediated approaches work for typically developing (TD) and ASD children with anxiety.
Method
Methods: Covidence systematic review program was used. Six databases were included: in the areas of Social Sciences, Education, Psychology, Medical, and multidisciplinary respectively, as well as dissertations and Theses. The following databases were searched on 13th April 2021: Academic Search Complete, ERIC, Psycinfo, Medline, and Web of Science (core collection). ProQuest Dissertations & Theses: A & I. Studies in English, during 1996-2021, for children aged 2-12 years were included. Some examples of the search terminologies include: “autism“, “Asperger”, “ASD”, “anxiety”, “worry”, “children”, “intervention”, “group”, “therapy”, “peer”, “lego”, “duplo”, and “play therapy”. Results: PRISMA showed that 7300 studies were found, duplicates removed resulting in 6697, yielded 81 full-text reviews. A total of 50 relevant full texts were found: CBT (41), Lego-based therapy (1), and other approaches (8). This paper reported the results of 41 CBT approach. Specifically, the effectiveness of group CBT in reducing anxiety was reported. Mixed results were found for the outcome research of CBT on reducing anxiety in chidren, with no context and no Universal Design (UD).
Expected Outcomes
Results: PRISMA showed that 7300 studies were found, duplicates removed resulting in 6697, yielded 81 full-text reviews. A total of 50 relevant full texts were found: CBT (41), Lego-based therapy (1), and other approaches (8). This paper reported the results of 41 CBT approach. Specifically, the effectiveness of group CBT in reducing anxiety was reported. Mixed results were found for the outcome research of CBT on reducing anxiety in chidren, with no context and no Universal Design (UD). This study contributes by developing an emerging evidence base for Early Intervention, using the Universal Design for Learning (UDL) (Rose & Meyer, 2002) framework for inclusion. Choy, Mc Guckin & Twomey (2022) proposed this framework for understanding anxiety in a wider range of children such as children with learning disabilities. In short, this study uses an overarching and inclusive framework to inform early intervention, by working with schools, parenting groups, peers, context, culture, and technologies.
References
Choy, W.-w., S., Mc Guckin, C., & Twomey, M. (Accepted). Effectiveness of Peer-mediated Block Play for Reducing Anxiety in Children Aged 4 to 6 Years with and without Autism Spectrum Disorder. In Learning Disabilities in the 21st Century. (ISBN 978-1-914266-00-3). London: Proud Pen. Dalrymple, K. L., Herbert, J. D., & Gaudiano, B. A. (2007). Onset of Illness and Developmental Factors in Social Anxiety Disorder: Preliminary Findings from a Retrospective Interview. Journal of Psychopathology and Behavioral Assessment, 29(2), 101-110. https://doi.org/10.1007/s10862-006-9033-x Dougherty, L. R., Tolep, M. R., Bufferd, S. J., Olino, T. M., Dyson, M., Traditi, J., Rose, S., Carlson, G. A., & Klein, D. N. (2013). Preschool Anxiety Disorders: Comprehensive Assessment of Clinical, Demographic, Temperamental, Familial, and Life Stress Correlates [Article]. Journal of Clinical Child and Adolescent Psychology, 42(5), 577-589. https://doi.org/10.1080/15374416.2012.759225 Jia H, Guerin RJ, Barile JP, et al. (2021). National and State Trends in Anxiety and Depression Severity Scores Among Adults During the COVID-19 Pandemic — United States, 2020–2021. MMWR Morb Mortal Wkly Rep 70:1427–1432. DOI: http://dx.doi.org/10.15585/mmwr.mm7040e3external icon O'Connor, R. C., Wetherall, K., Cleare, S., McClelland, H., Melson, A. J., Niedzwiedz, C. L., & Robb, K. A. (2021). Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. The British Journal of Psychiatry, 218(6), 326-333. Soskil, M. 2021. Flip the system: How teachers can transform education and save democracy. New York: Routledge. World Health Organization global website (2021). Institute of Health Metrics and Evaluation. Global Health Data Exchange. Retrieved on 10/12/2021 http://ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/380dfa3f26639cb711d908d9a119ded2
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