Informing an Early Intervention Model for Children at Risk of Autism Spectrum Disorder and Other Developmental Disabilities

Background: Therapeutic playgroups are increasingly recognised as an important engagement point for vulnerable families accessing early intervention services for their children at risk of Autism Spectrum Disorder and other developmental disabilities. However, there is currently no clear description and specification for best practice in playgroup intervention which impedes effective playgroup implementation and evaluation. Researchers state inconsistent playgroup definitions, models and practice principles have hindered playgroup implementation and evaluation, calling for a common definition of playgroups components and identify the “active ingredients of playgroups to strengthen the evidence base for playgroup effectiveness. Therefore, the systematic development and evaluation of playgroups is novel and important to establish evidence based practice with findings being directly beneficial to children at risk of Autism Spectrum Disorder and other developmental disabilities.

Objectives: This study aimed to address a substantial evidence gap by providing a clear definition of therapeutic playgroups and playgroup practice principles that produce the most efficacious outcomes for children at risk of developmental disabilities and their families.

Methods: Using the Medical Research Council Framework for the Development and Evaluation of Complex Interventions this study identified the “active ingredients” of therapeutic playgroups. Initially, a scoping review was conducted to identify the evidence base for therapeutic playgroups. Secondly, parents (n=23) and health professionals (n=40) were consulted as stakeholders, and defined the “active ingredients” of playgroup intervention and theory. Finally, findings were triangulated to identify an overarching theoretical framework, modelling therapeutic playgroup process and evaluation.

Results: Therapeutic playgroups require a complex interplay of service provider (facilitator qualities), participant (shared experiences and social networking) and intervention characteristics (format, physical resources and information provision). The overarching frameworks that defined therapeutic playgroup intervention was family centred practice, self-efficacy theory and peer support theory.

Conclusions: These findings provide a definition of evidence based therapeutic playgroups with a clear description of the program, including theoretical frameworks, essential functions of the program and performance assessment. The program description enables the active ingredients to be taught, learned and implemented with good outcomes. Findings also contribute to our understanding about the role playgroups have in facilitating child and parent outcomes in children at risk of Autism Spectrum Disorder, whilst providing a protocol for how to develop and deliver effective playgroups which has implications nationally and international.

This study is the first to develop a therapeutic playgroup intervention framework using the Medical Research Council Framework, a critical step in establishing evidence based therapeutic playgroups for children and their families at risk of Autism Spectrum Disorder and other developmental disabilities.