Literature Review
For your Literature Review, you will be synthesizing the sources from your Article Analyses (and other sources you may have found on autism at children) to write the Literature Review portion of your Final Proposal Paper. A reminder: the Final Proposal Paper is a minimum of 6 page (not including Title or Reference Pages), and the Literature Review portion will make up about 4 pages of the Final Proposal Paper.
Running head: GUIDED IMAGERY AND PROGRESSIVE MUSCLE RELAXATION
2
12
Guided Imagery
Guided Imagery
and
Progressive Muscle Relaxation
in Group Psychotherapy
Hannah K. Greenbaum
Department of Psychology, The George Washington University
PSYC 3170: Clinical Psychology
Dr. Tia M. Benedetto
October 1, 2019
Guided Imagery and
Progressive Muscle Relaxation in Group Psychotherapy
A majority of Americans experience stress in their daily lives (American Psychological Association, 2017). Thus, an important goal of psychological research is to evaluate techniques that promote stress reduction and relaxation. Two techniques that have been associated with reduced stress and increased relaxation in psychotherapy contexts are guided imagery and progressive muscle relaxation (McGuigan & Lehrer, 2007). Guided imagery aids individuals in connecting their internal and external experiences, allowing them, for example, to feel calmer externally because they practice thinking about calming imagery. Progressive muscle relaxation involves diaphragmatic breathing and the tensing and releasing of 16 major muscle groups; together these behaviors lead individuals to a more relaxed state (Jacobson, 1938; Trakhtenberg, 2008). Guided imagery and progressive muscle relaxation are both cognitive behavioral techniques (Yalom & Leszcz, 2005) in which individuals focus on the relationship among thoughts, emotions, and behaviors (White, 2000).
Group psychotherapy effectively promotes positive treatment outcomes in patients in a cost-effective way. Its efficacy is in part attributable to variables unique to the group experience of therapy as compared with individual psychotherapy (Bottomley, 1996; Yalom & Leszcz, 2005). That is, the group format helps participants feel accepted and better understand their common struggles; at the same time, interactions with group members provide social support and models of positive behavior (Yalom & Leszcz, 2005). Thus, it is useful to examine how stress reduction and relaxation can be enhanced in a group context.
The purpose of this literature review is to examine the research base on guided imagery and progressive muscle relaxation in group psychotherapy contexts. I provide overviews of both guided imagery and progressive muscle relaxation, including theoretical foundations and historical context. Then I examine guided imagery and progressive muscle relaxation as used on their own as well as in combination as part of group psychotherapy (see Baider et al., 1994, for more). Throughout the review, I highlight themes in the research. Finally, I end by pointing out limitations in the existing literature and exploring potential directions for future research.
Guided Imagery
Features of Guided Imagery
Guided imagery involves a person visualizing a mental image and engaging each sense (e.g., sight, smell, touch) in the process. Guided imagery was first examined in a psychological context in the 1960s, when the behavior theorist Joseph Wolpe helped pioneer the use of relaxation techniques such as aversive imagery, exposure, and imaginal flooding in behavior therapy (Achterberg, 1985; Utay & Miller, 2006). Patients learn to relax their bodies in the presence of stimuli that previously distressed them, to the point where further exposure to the stimuli no longer provokes a negative response (Achterberg, 1985).
Contemporary research supports the efficacy of guided imagery interventions for treating medical, psychiatric, and psychological disorders (Utay & Miller, 2006). Guided imagery is typically used to pursue treatment goals such as improved relaxation, sports achievement, and pain reduction. Guided imagery techniques are often paired with breathing techniques and other forms of relaxation, such as mindfulness (see Freebird Meditations, 2012). The evidence is sufficient to call guided imagery an effective, evidence-based treatment for a variety of stress-related psychological concerns (Utay & Miller, 2006).
Guided Imagery in Group Psychotherapy
Guided imagery exercises improve treatment outcomes and prognosis in group psychotherapy contexts (Skovholt & Thoen, 1987). Lange (1982) underscored two such benefits by showing (a) the role of the group psychotherapy leader in facilitating reflection on the guided imagery experience, including difficulties and stuck points, and (b) the benefits achieved by social comparison of guided imagery experiences between group members. Teaching techniques and reflecting on the group process are unique components of guided imagery received in a group context (Yalom & Leszcz, 2005).
Empirical research focused on guided imagery interventions supports the efficacy of the technique with a variety of populations within hospital settings, with positive outcomes for individuals diagnosed with depression, anxiety, and eating disorders (Utay & Miller, 2006). Guided imagery and relaxation techniques have even been found to “reduce distress and allow the immune system to function more effectively” (Trakhtenberg, 2008, p. 850). For example, Holden-Lund (1988) examined effects of a guided imagery intervention on surgical stress and wound healing in a group of 24 patients. Patients listened to guided imagery recordings and reported reduced state anxiety, lower cortisol levels following surgery, and less irritation in wound healing compared with a control group. Holden-Lund concluded that the guided imagery recordings contributed to improved surgical recovery. It would be interesting to see how the results might differ if guided imagery was practiced continually in a group context.
Guided imagery has also been shown to reduce stress, length of hospital stay, and symptoms related to medical and psychological conditions (Scherwitz et al., 2005). For example, Ball et al. (2003) conducted guided imagery in a group psychotherapy format with 11 children (ages 5–18) experiencing recurrent abdominal pain. Children in the treatment group (n = 5) participated in four weekly group psychotherapy sessions where guided imagery techniques were implemented. Data collected via pain diaries and parent and child psychological surveys showed that patients reported a 67% decrease in pain. Despite a small sample size, which contributed to low statistical power, the researchers concluded that guided imagery in a group psychotherapy format was effective in reducing pediatric recurrent abdominal pain.
However, in the majority of guided imagery studies, researchers have not evaluated the technique in the context of traditional group psychotherapy. Rather, in these studies participants usually met once in a group to learn guided imagery and then practiced guided imagery individually on their own (see Menzies et al., 2014, for more). Thus, it is unknown whether guided imagery would have different effects if implemented on an ongoing basis in group psychotherapy.
Progressive Muscle Relaxation
Features of Progressive Muscle Relaxation
Progressive muscle relaxation involves diaphragmatic or deep breathing and the tensing and releasing of muscles in the body (Jacobson, 1938). Edmund Jacobson developed progressive muscle relaxation in 1929 (as cited in Peterson et al., 2011) and directed participants to practice progressive muscle relaxation several times a week for a year. After examining progressive muscle relaxation as an intervention for stress or anxiety, Joseph Wolpe (1960; as cited in Peterson et al., 2011) theorized that relaxation was a promising treatment. In 1973, Bernstein and Borkovec created a manual for helping professionals to teach their clients progressive muscle relaxation, thereby bringing progressive muscle relaxation into the fold of interventions used in cognitive behavior therapy. In its current state, progressive muscle relaxation is often paired with relaxation training and described within a relaxation framework (see Freebird Meditations, 2012, for more).
Research on the use of progressive muscle relaxation for stress reduction has demonstrated the efficacy of the method (McGuigan & Lehrer, 2007). As clients learn how to tense and release different muscle groups, the physical relaxation achieved then influences psychological processes (McCallie et al., 2006). For example, progressive muscle relaxation can help alleviate tension headaches, insomnia, pain, and irritable bowel syndrome. This research demonstrates that relaxing the body can also help relax the mind and lead to physical benefits.
Progressive Muscle Relaxation in Group Psychotherapy
Limited, but compelling, research has examined progressive muscle relaxation within group psychotherapy. Progressive muscle relaxation has been used in outpatient and inpatient hospital settings to reduce stress and physical symptoms (Peterson et al., 2011). For example, the U.S. Department of Veterans Affairs integrates progressive muscle relaxation into therapy skills groups (Hardy, 2017). The goal is for group members to practice progressive muscle relaxation throughout their inpatient stay and then continue the practice at home to promote ongoing relief of symptoms (Yalom & Leszcz, 2005).
Yu (2004) examined the effects of multimodal progressive muscle relaxation on psychological distress in 121 elderly patients with heart failure. Participants were randomized into experimental and control groups. The experimental group received biweekly group sessions on progressive muscle relaxation, as well as tape-directed self-practice and a revision workshop. The control group received follow-up phone calls as a placebo. Results indicated that the experimental group exhibited significant improvement in reports of psychological distress compared with the control group. Although this study incorporated a multimodal form of progressive muscle relaxation, the experimental group met biweekly in a group format; thus, the results may be applicable to group psychotherapy.
Progressive muscle relaxation has also been examined as a stress-reduction intervention with large groups, albeit not therapy groups. Rausch et al. (2006) exposed a group of 387 college students to 20 min of either meditation, progressive muscle relaxation, or waiting as a control condition. Students exposed to meditation and progressive muscle relaxation recovered more quickly from subsequent stressors than did students in the control condition. Rausch et al. (2006) concluded the following:
A mere 20 min of these group interventions was effective in reducing anxiety to normal levels
. . . merely 10 min of the interventions allowed [the high-anxiety group] to recover from the stressor. Thus, brief interventions of meditation and progressive muscle relaxation may be effective for those with clinical levels of anxiety and for stress recovery when exposed to brief, transitory stressors. (p. 287)
Thus, even small amounts of progressive muscle relaxation can be beneficial for people experiencing anxiety.
Guided Imagery and Progressive Muscle Relaxation in Group Psychotherapy
Combinations of relaxation training techniques, including guided imagery and progressive muscle relaxation, have been shown to improve psychiatric and medical symptoms when delivered in a group psychotherapy context (Bottomley, 1996; Cunningham & Tocco, 1989). The research supports the existence of immediate and long-term positive effects of guided imagery and progressive muscle relaxation delivered in group psychotherapy (Baider et al., 1994). For example, Cohen and Fried (2007) examined the effect of group psychotherapy on 114 women diagnosed with breast cancer. The researchers randomly assigned participants to three groups: (a) a control group, (b) a relaxation psychotherapy group that received guided imagery and progressive muscle relaxation interventions, or (c) a cognitive behavioral therapy group. Participants reported less psychological distress in both intervention groups compared with the control group, and participants in the relaxation psychotherapy group reported reduced symptoms related to sleep and fatigue. The researchers concluded that relaxation training using guided imagery and progressive muscle relaxation in group psychotherapy is effective for relieving distress in women diagnosed with breast cancer. These results further support the utility of guided imagery and progressive muscle relaxation within the group psychotherapy modality.
Conclusion
Limitations of Existing Research
Research on the use of guided imagery and progressive muscle relaxation to achieve stress reduction and relaxation is compelling but has significant limitations. Psychotherapy groups that implement guided imagery and progressive muscle relaxation are typically homogeneous, time limited, and brief (Yalom & Leszcz, 2005). Relaxation training in group psychotherapy typically includes only one or two group meetings focused on these techniques (Yalom & Leszcz, 2005); thereafter, participants are usually expected to practice the techniques by themselves (see Menzies et al., 2014). Future research should address how these relaxation techniques can assist people in diverse groups and how the impact of relaxation techniques may be amplified if treatments are delivered in the group setting over time.
Future research should also examine differences in inpatient versus outpatient psychotherapy groups as well as structured versus unstructured groups. The majority of research on the use of guided imagery and progressive muscle relaxation with psychotherapy groups has used unstructured inpatient groups (e.g., groups in a hospital setting). However, inpatient and outpatient groups are distinct, as are structured versus unstructured groups, and each format offers potential advantages and limitations (Yalom & Leszcz, 2005). For example, an advantage of an unstructured group is that the group leader can reflect the group process and focus on the “here and now,” which may improve the efficacy of the relaxation techniques (Yalom & Leszcz, 2005). However, research also has supported the efficacy of structured psychotherapy groups for patients with a variety of medical, psychiatric, and psychological disorders (Hashim & Zainol, 2015; see also Baider et al., 1994; Cohen & Fried, 2007). Empirical research assessing these interventions is limited, and further research is recommended.
Directions for Future Research
There are additional considerations when interpreting the results of previous studies and planning for future studies of these techniques. For example, a lack of control groups and small sample sizes have contributed to low statistical power and limited the generalizability of findings. Although the current data support the efficacy of psychotherapy groups that integrate guided imagery and progressive muscle relaxation, further research with control groups and larger samples would bolster confidence in the efficacy of these interventions. In order to recruit larger samples and to study participants over time, researchers will need to overcome challenges of participant selection and attrition. These factors are especially relevant within hospital settings because high patient turnover rates and changes in medical status may contribute to changes in treatment plans that affect group participation (L. Plum, personal communication, March 17, 2019). Despite these challenges, continued research examining guided imagery and progressive muscle relaxation interventions within group psychotherapy is warranted (Scherwitz et al., 2005). The results thus far are promising, and further investigation has the potential to make relaxation techniques that can improve people’s lives more effective and widely available.
References
Achterberg, J. (1985). Imagery in healing. Shambhala Publications.
American Psychological Association. (2017). Stress in America: The state of our nation.
https://www.apa.org/news/press/releases/stress/2017/state-nation
Baider, L., Uziely, B., & Kaplan De-Nour, A. (1994). Progressive muscle relaxation and guided imagery in cancer patients. General Hospital Psychiatry, 16(5), 340–347.
https://doi.org/10.1016/0163-8343(94)90021-3
Ball, T. M., Shapiro, D. E., Monheim, C. J., & Weydert, J. A. (2003). A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain in children. Clinical Pediatrics, 42(6), 527–532.
https://doi.org/10.1177/000992280304200607
Bernstein, D. A., & Borkovec, T. D. (1973). Progressive relaxation training: A manual for the helping professions. Research Press.
Bottomley, A. (1996). Group cognitive behavioural therapy interventions with cancer patients: A review of the literature. European Journal of Cancer Cure, 5(3), 143–146.
https://doi.org/10.1111/j.1365-2354.1996.tb00225.x
Cohen, M., & Fried, G. (2007). Comparing relaxation training and cognitive-behavioral group therapy for women with breast cancer. Research on Social Work Practice, 17(3), 313–323.
https://doi.org/10.1177/1049731506293741
Cunningham, A. J., & Tocco, E. K. (1989). A randomized trial of group psychoeducational therapy for cancer patients. Patient Education and Counseling, 14(2), 101–114.
https://doi.org/10.1016/0738-3991(89)90046-3
Freebird Meditations. (2012, June 17). Progressive muscle relaxation guided meditation [Video]. YouTube.
Hardy, K. (2017, October 8). Mindfulness is plentiful in “The post-traumatic insomnia workbook.” Veterans Training Support Center.
http://bit.ly/2D6ux8U
Hashim, H. A., & Zainol, N. A. (2015). Changes in emotional distress, short term memory, and sustained attention following 6 and 12 sessions of progressive muscle relaxation training in 10–11 years old primary school children. Psychology, Health & Medicine, 20(5), 623–628.
https://doi.org/10.1080/13548506.2014.1002851
Holden-Lund, C. (1988). Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing & Health, 11(4), 235–244.
http://doi.org/dztcdf
Jacobson, E. (1938). Progressive relaxation (2nd ed.). University of Chicago Press.
Lange, S. (1982, August 23–27). A realistic look at guided fantasy [Paper presentation]. American Psychological Association 90th Annual Convention, Washington, DC.
McCallie, M. S., Blum, C. M., & Hood, C. J. (2006). Progressive muscle relaxation. Journal of Human Behavior in the Social Environment, 13(3), 51–66.
http://doi.org/b54qm3
McGuigan, F. J., & Lehrer, P. M. (2007). Progressive relaxation: Origins, principles, and clinical applications. In P. M. Lehrer, R. L. Woolfolk, & W. E. Sime (Eds.), Principles and practice of stress management (3rd ed., pp. 57–87). Guilford Press.
Menzies, V., Lyon, D. E., Elswick, R. K., Jr., McCain, N. L., & Gray, D. P. (2014). Effects of guided imagery on biobehavioral factors in women with fibromyalgia. Journal of Behavioral Medicine, 37(1), 70–80.
https://doi.org/10.1007/s10865-012-9464-7
Peterson, A. L., Hatch, J. P., Hryshko-Mullen, A. S., & Cigrang, J. A. (2011). Relaxation training with and without muscle contraction in subjects with psychophysiological disorders. Journal of Applied Biobehavioral Research, 16(3–4), 138–147.
https://doi.org/10.1111/j.1751-9861.2011.00070.x
Rausch, S. M., Gramling, S. E., & Auerbach, S. M. (2006). Effects of a single session of large-group meditation and progressive muscle relaxation training on stress reduction, reactivity, and recovery. International Journal of Stress Management, 13(3), 273–290.
https://doi.org/10.1037/1072-5245.13.3.273
Scherwitz, L. W., McHenry, P., & Herrero, R. (2005). Interactive guided imagery therapy with medical patients: Predictors of health outcomes. The Journal of Alternative and Complementary Medicine, 11(1), 69–83.
https://doi.org/10.1089/acm.2005.11.69
Skovholt, T. M., & Thoen, G. A. (1987). Mental imagery and parenthood decision making. Journal of Counseling & Development, 65(6), 315–316.
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Trakhtenberg, E. C. (2008). The effects of guided imagery on the immune system: A critical review. International Journal of Neuroscience, 118(6), 839–855.
http://doi.org/fxfsbq
Utay, J., & Miller, M. (2006). Guided imagery as an effective therapeutic technique: A brief review of its history and efficacy research. Journal of Instructional Psychology, 33(1), 40–43.
White, J. R. (2000). Introduction. In J. R. White & A. S. Freeman (Eds.), Cognitive-behavioral group therapy: For specific problems and populations (pp. 3–25). American Psychological Association.
https://doi.org/10.1037/10352-001
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). Basic Books.
Yu, S. F. (2004). Effects of progressive muscle relaxation training on psychological and health-related quality of life outcomes in elderly patients with heart failure (Publication No. 3182156) [Doctoral dissertation, The Chinese University of Hong Kong]. ProQuest Dissertations and Theses Global.
Autism
Ha Nguyen (Hana)
California State of Fullerton
CAS 301
Professor: Sarah Culbertson
October 1, 2019
Autism
Autism children often have challenging behaviors in their daily routine ( Fragale & Rojeski & O’ Reilly, 2016). Autism children are just like typical kids and always go to their happy places, but they just stay there for a lot of longer. Therefore, as teachers, they have to guide children in the right way with full development (Hanley and Mary, 2017). Autism children desire all opportunities like normal kids, but they need extra help, extra time to impact their good behaviors far from the future. Autism children usually do everything to follow their parents and teacher and if anything changes, they might get angry and don’t want to follow.
Autism kids need a small classroom two on one, study step by step, and repeat multiple times ( Hanley and Mary, 2017). For example, in a class with five autistic kids, the teacher asked a boy,” what is it?” He didn’t reply. The teacher told him for a second time, “You didn’t tell me what it is?” and the boy answered, “It is a bus.” The teacher replied, ” Yes, it is a school bus.” The boy repeated “ school bus” after the teacher. The teacher engages the boy to notice the object by asking. The teacher explains discrete trial teaching Antecedent Behaviour Consequences ( ABCs) is an invention method utilizing applied behavioral analysis. ABCs is one of the main approaches educators use with children who exhibit autism ( Kreibich SR, Chen M, Reichle J, 2015). The teacher helps children connect with special instruction and then gives them a prompt. After that, children will respond, but it is either right or wrong. For the right response, the teacher will give them a positive award, remain the activity or shake head for the wrong response. Thus, consequences depend on what children do—for instance, Miss. Duchez sat down and told the boy,” Do everything that I do,” She put the toy on the board and used two hands to touch her head. The boy did exactly what she was doing, and the teacher smiled and used his favorite action to reward him. Autism children have a goal to achieve, although their behaviors are good or bad. Also, educators have applied behavioral analysis (APA) principles to fit their needs, such as break down into small steps, communicate appropriately with peers, quickly show work, and know-how to express their feelings or know other feelings ( Callahan K, Foxx RM, Swierczynski A, et, 2019). as parents, they should take a step back to understand their children and not emotionally. Grace is one of the autism children in the classroom; she was a very anxious child and always in a crying mood. After following the early interventional program, she has positive skill change, increases language, socially significant, and play skills. When she sat with her teacher and her friend Eco, the teacher asked her how her friend felt, and she could say Eco was sad because he was crying. According to her parents, she is not completely like a normal kid, but she went a lot of further than the first moment she was. When the teacher took all her students into the new room to study music with a different teacher, they were not scared and could adapt the lesson.
Moreover, the family of an autism kid should have a good connection with school because the family needs to educate to communicate and deal with nonverbal or aggressive children (Harris & Sandra, 2005). Schools should be able to help families with autism kids so that the child will have more benefit from both environments. Providing more materials that help autism kids learn. Also, creating more opportunities for parents to bring their kids to school such as: buses take their kids to school for parents who don’t have transportation or don’t have time. Teachers should share some experiences and be thoughtful to the families, so they can feel more trust and less anxious.
Conclusion
In conclusion, the Early Intervention Program helps autism children gain their goals little by little. Parents might understand how their autism child learns at school, how teachers work with them, and how cooperation with teachers can bring the best success. Autism children can go back to normal life if they can receive the right treatment. They will release their anxiety, develop vocabulary, and skill socialization. Also, parents should partner with school because good outcomes always come along with the home environment. To educate the family effectively, parents need to pay attention to building a complete family, in which all members have obligations and responsibilities to each other. Build a well-ordered lifestyle, suitable to the excitement’s needs, to promote the positive aspects of the child. In particular, parents and adults must maintain their exemplary role in the family and in society. Regularly contacting schools and unions to grasp educational purposes, with close coordination. Actively participating in the school’s parent association, paying attention to helping the school build facilities and teaching facilities so that the school has conditions to improve the quality of education. At school-organized meetings, parents need to go fully to understand the educational requirements of the school that is incorporated.
References
Callahan, K., Foxx, R. M., Swierczynski, A., Aerts, X., Mehta, S., McComb, M.-E., Nichols, S. M., Segal, G., Donald, A., & Sharma, R. (2019). Behavioral artistry: Examining the relationship between the interpersonal skills and effective practice repertoires of applied behavior analysis practitioners.
Journal of
Autism
and Developmental Disorders
, Vol 49(9), Sep 15, 2019. pp. 3557-3570.
http://dx.doi.org.lib-proxy.fullerton.edu/10.1007/s10803-019-04082-1
Kreibich, S. R., Chen, M., & Reichle, J. (2015). Teaching a child with autism to request breaks while concurrently increasing task engagement. Language, Speech, and Hearing Services in Schools, 46(3), 256–265.
http://dx.doi.org.lib-proxy.fullerton.edu/10.1044/2015_LSHSS-14-0081
Fragale, C., Rojeski, L., O’Reilly, M., & Gevarter, C. (2016). Evaluation of functional communication training as a satiation procedure to reduce challenging behavior in instructional environments for children with autism. International Journal of Developmental Disabilities, 62(3), 139–146.
http://dx.doi.org.lib-proxy.fullerton.edu/10.1080/20473869.2016.1183957
Hanley, M., Khairat, M., Taylor, K., Wilson, R., Cole-Fletcher, R., & Riby, D. M. (2017). Classroom displays—Attraction or distraction? Evidence of impact on attention and learning from children with and without autism. Developmental Psychology, 53(7), 1265–1275.
http://dx.doi.org.lib-proxy.fullerton.edu/10.1037/dev0000271
Handleman, Jan S.; Harris, Sandra L. (2005)
Douglass Developmental Disabilities Center: An ABA program for children and adults with autism spectrum disorders.
Academic Journal Vol 1(4), pp. 301-311
http://dx.doi.org.lib-proxy.fullerton.edu/10.1037/h0100754
Method
Participant
The surveys give out when the parents come and pick up their child after school; they will answer the questions on the paper and return it the next few days or the next day. The purpose of this survey is to ask permission to come to their house to observe when only Mom or Dad plays with their Autism child. The children are from ages three to five. The purpose of the samples is to select a family with a Mom and Dad. The two samples were assigned to two independent groups: a) child interacts with Mom, and b) child interacts with Dad. The number of families participating in these samples will be 20 families.
Toys and Materials
The playtime for each parent with their child is 15 minutes. The participants are playing with the toys that the study provided. The toys included blocks, legos, stuffed animals, books, puppets. There are no electronics around because the children might not want to play with the toys if there are TVs or iPad around. The toys are set up on the carpet on the floor; the parents and children also sit on the rug.
Attachment Observation Protocol
The camera will secretly be setting up to record the play to avoid other people impacted in the play. The camera will set up and record the interaction and behavior of the autistic child with the parent. The record is divided into two parts; the first part is the Mom playing with her child; the second part of the video is the Dad playing with his child. The observer will watch all the videos and write down how many times children talk in a sentence, give parents toys, play with new toys, and stop playing. The observer wants to see who has more attachment to their child, a Mom, or a Dad. Observers also write down the child’s age because the development and behavior are different for each age group. Take note of inappropriate behavior such as crying, kicking, hitting, and yelling. The observer wants to know how parents play with their autistic child.
Procedure
The observer comes to the house at the weekend to make sure both Mom and Dad are at home. The surveys also ask what time is the playtime routine in the house because the child might not want to play in the bed or eating time. The results are not right; if recording the children at play and eat time, they might feel sleepy and low energy. The child and parents were asked to sit on the floor or carpet with the toys in front of them. The other Mom or Dad will be in another room of the house and wait for their turn to come in and play. After fifteen minutes, the other parent came in and repeated all the steps. The observer has to be outside or sit patiently in another room and wait for the timer to reach thirty minutes, and then come in to pause the camera. When the observer has the video, he/she can watch it and write down what they need on the paper to compare later.
Discussion
In this study, the autistic child might have no interest in any toys in front of them. When this happens, the observer can see what the parents will do if they sit there and have no reactions. There will be the time the child will interact with the parents; however, the child might want to play alone and get mad if anyone touches the toys. The child interaction is also based on the age they join the early intervention. The video will fail if the child does not want to cooperate and stay in the room; an autistic child will drag the adult hand to the door when they want to get out of the room.
The observer chooses the families with the Mom and Dad because that is the family member most families have. If the Mom or Dad stays at home more than the other, the child will feel more comfortable playing around that person. The internal validity is what the observer sees in the video; however, there might be a mistake if there is a problem with the camera. This study’s external validity is the child playing with toys and the parents around; this is what they usually do every day; nothing sets up except the camera. The toys are from the observer, so it is new to the child, it will grab their attention more than old toys.
The parents can ask for the video to use as the tools to see their children’s progress before or after joining the ABA program. The parent’s joint engagement is important because their children need to practice these skills in real life, not just in the class with professionals. If parents are less likely to play with their child less than fifteen minutes a day, this is an excellent opportunity for them to spend more time with their child. The limit in this study is the playtime because the observer needs to use the video for the same amount of time. While playing, the parents can observe the child and understand them more; they might show signs when needed.
The future direction researcher can set up the family activities who do not have a Mom or Dad; however, the primary caregiver will substitute the Dad or Mom in turn to play with the child. The caregiver can also see a close friend because they might be around the child to take care of and play with that child every day. The next researcher can see which toys are the best to set up to see as much as interaction they can see. They can also learn about the inappropriate behavior of the autistic child. The researchers who read this study will get some idea of setting up the activities with the family and what toys they should use.