A new use of the children’s play therapy instrument to assess the playing skills of children with autism spectrum disorder in psychomotor therapy

Background Very few instruments have been validated in order to verify the clinical efficacy of psychodynamic and relational therapies in developmental age. The Children’s Play Therapy Instrument (CPTI) (Kemberg, Chazan, Normandin,1998) examines child's play activity in individual psychotherapy. Its use was reported in a case study describing the efficacy of the psychotherapeutic treatment of a 2.4 yr-old child with autistic features. Further clinical researches, on larger samples, are needed in order to assess clinical processes and outcome in child relational therapies. Aim To propose the use of CPTI for the assessment of the efficacy of psychomotor relational therapy of children with autism spectrum disorder. Methods Ten children aged 22 to 87 months fulfilling Diagnostic and Statistical Manual of Mental Disorders-5 criteria for Autism Spectrum Disorder were enrolled at the Child and Adolescent Mental Health Department of San Gerardo Hospital. The children were evaluated three times: at the time of diagnosis and after the first and the second year of psychomotor therapy. All the children were assessed using the Autism Diagnostic Observation Schedule (ADOS) and the CPTI. Parents underwent the Austism Diagnostic Intervew Revised (ADI-R). CPTI rating scale divides the psichomotor therapy session into segments of Non-Play, Pre-Play, Play Activity, and Play Interruption. The longest segment of Play Activity within a session is then analysed on three levels: Descriptive, Structural, and Functional. Results All children have changed significantly after two years of the psichomotor therapy as evidenced by the scores carried out at the ADOS, ADI, and CPTI. The progresses observed at the CPTI scores were correlated to those observed at the ADOS and ADI and the evolution of the symptomatology. All instruments used concurred in highlighting the significant improvements, both globally and in specific areas of the development. Discussion The importance of play activity in child development is well known, as well as its alterations in autistic spectrum disorders. The CPTI seems to be a reliable measure of play activity in the psychomotor therapy of children with autistic spectrum