Culturally Adapted Play-Based Behavioural Intervention for Autism

NCT06859541 | Completed DMC

• 1 other identifier: 322/07/2024/ISRB/UGSR/SCPT
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

This study compared Culturally Adapted Play-Based Behavioural Intervention (PPBI) and Applied Behaviour Analysis (ABA) for children with Autism Spectrum Disorder (ASD) in semi-rural Tamil Nadu through a double-blinded randomized controlled trial with 56 participants. The PPBI approach integrated traditional Tamil games such as Paandi (hopscotch), Kuzhi Thanda (hole-and-peg game), and Paramapadham (snakes and ladders) to encourage social interaction, cooperative play, motor skill development, and emotional self-regulation. Activities were structured to progress through various developmental goals, including turn-taking, gesture-based communication, sensory-motor coordination, language expression, peer collaboration, and real-life scenario practice. Additionally, storytelling, music-based play, and movement exercises were included to enhance communication and social awareness. On the other hand, the ABA-based program utilized structured techniques focused on positive reinforcement, imitation training, guided communication, and step-by-step skill-building. The primary goal was to reduce problem behaviors while reinforcing desirable social and communication skills. Parents and teachers were provided with structured training on how to apply ABA strategies consistently at home and school.

Conditions

Autism Spectrum Disorder

Keywords

Adaptive Behaviour; Autism Spectrum Disorder; Behaviour Therapy; Play Therapy; Semi-Rural Tamil Nadu

Outcome Measures

Primary Outcomes (1)

• Strengths and Difficulties Questionnaire (SDQ)

  The 25 item Strengths and Difficulties Questionnaire (SDQ) measures behavioral and emotional function. These 25 items are divided into 5 subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. The Strengths and Difficulties Questionnaire is scored on a 3-point Likert-type scale, with total scores (excluding the prosocial scale) ranging from 0 to 40. Higher scores reflect greater behavioral and emotional difficulties and lower scores reflects lesser behavioural and emotional difficulties.

  Baseline, 4th week, 8th week, 12th week

Study Arms (2)

Culturally Adapted Play-Based Behavioural Intervention Group

EXPERIMENTAL

The Culturally Adapted Play-Based Behavioural Intervention (PPBI) incorporated traditional Tamil games and folk storytelling to enhance social awareness, emotional regulation, and language development. Over 12 weeks, the program progressed through key developmental areas: Weeks 1-2: Focused on engagement and communication through interactive activities. Weeks 3-4: Developed sensory and motor skills using creative play. Weeks 5-6: Strengthened language and expression with role-playing and storytelling. Weeks 7-8: Addressed emotional regulation through structured games and music therapy. Weeks 9-10: Encouraged social interaction with group play and problem-solving tasks. Weeks 11-12: Emphasized real-world application through community-based activities.

Behavioral: Culturally Adapted Play-Based Behavioural Intervention

Applied Behaviour Analysis

ACTIVE COMPARATOR

The Applied Behaviour Analysis (ABA) program was structured into progressive stages, each targeting specific behavioral improvements. Weeks 1 \& 2: Introduced structured learning techniques, focusing on basic commands, eye contact training, and reinforcement strategies, such as reward-based motivation systems. Weeks 3 \& 4: Emphasized early communication development, incorporating imitation exercises, visual schedules, and simple verbal response training. Weeks 5 \& 6: Implemented behavior modification techniques, including token-based reinforcement, redirection methods, and gradual shaping of desired behaviors. Weeks 9 \& 10: Focused on independent task execution, covering self-care routines such as dressing, eating, and personal hygiene, with structured multi-step guidance. Weeks 11 \& 12: Aimed at generalizing learned behaviors, ensuring that children could apply their skills effectively in home, school, and social environments.

Behavioral: Applied Behaviour Analysis

Interventions

Culturally Adapted Play-Based Behavioural Intervention BEHAVIORAL

The Culturally Adapted Play-Based Behavioural Intervention (PPBI) integrates traditional Tamil games and folk storytelling to enhance social, emotional, and communication skills in children with Autism Spectrum Disorder (ASD). This 12-week structured program focuses on engagement, motor development, language, emotional regulation, social interaction, and real-world skill application, making it a culturally relevant and accessible intervention for improving adaptive behaviours.

Culturally Adapted Play-Based Behavioural Intervention Group

Applied Behaviour Analysis BEHAVIORAL

The ABA-based program utilized structured techniques focused on positive reinforcement, imitation training, guided communication, and step-by-step skill-building. The primary goal was to reduce problem behaviors while reinforcing desirable social and communication skills. Parents and teachers were provided with structured training on how to apply ABA strategies consistently at home and school.

Applied Behaviour Analysis

Eligibility Criteria

• Age: 8 Years - 12 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children aged 8 to 12 years diagnosed with Autism Spectrum Disorder (ASD) (mild to moderate severity).
• Diagnosis confirmed using the Indian Scale for Assessment of Autism (ISAA). Classified as Level I to III in the Communication Function Classification System.
• Attended regular sessions throughout the 12-week intervention. Parents or guardians provided informed consent and participated in training sessions.
• Completion of behavioral assessments using the Strengths and Difficulties Questionnaire (SDQ).

You may not qualify if:

• Children with severe ASD or comorbid neurological/psychiatric disorders. Those undergoing intensive behavioral therapy or other structured interventions.
• Children with uncorrected sensory impairments (e.g., hearing or visual deficits) that could interfere with intervention activities.
• Families unable to commit to the full 12-week study period.

Sponsors & Collaborators

• Saveetha University: lead

Study Sites (1)

Aadhuraa Special School

Kanchipuram, Tamil Nadu, 631501, India

Location

Related Publications (5)

• Kumar A, Bhattacharya S. Unveiling autism spectrum disorder in South East Asia through a public health Lens. Front Child Adolesc Psychiatry. 2024 Dec 4;3:1489269. doi: 10.3389/frcha.2024.1489269. eCollection 2024.

  PMID: 39816604 RESULT

• Chauhan A, Singh M, Jaiswal N, Agarwal A, Sahu JK, Singh M. Prevalence of Cerebral Palsy in Indian Children: A Systematic Review and Meta-Analysis. Indian J Pediatr. 2019 Dec;86(12):1124-1130. doi: 10.1007/s12098-019-03024-0. Epub 2019 Jul 13.

  PMID: 31300955 RESULT

• Dey I, Chakrabarty S, Nandi R, Shekhar R, Singhi S, Nayar S, Ram JR, Mukerji S, Chakrabarti B. Autism community priorities in diverse low-resource settings: A country-wide scoping exercise in India. Autism. 2024 Jan;28(1):187-198. doi: 10.1177/13623613231154067. Epub 2023 Mar 31.

  PMID: 36999343 RESULT

• Leaf JB, Leaf R, McEachin J, Taubman M, Ala'i-Rosales S, Ross RK, Smith T, Weiss MJ. Applied Behavior Analysis is a Science and, Therefore, Progressive. J Autism Dev Disord. 2016 Feb;46(2):720-31. doi: 10.1007/s10803-015-2591-6.

  PMID: 26373767 RESULT

• Deniz E, Francis G, Torgerson C, Toseeb U. Parent-mediated play-based interventions to improve social communication and language skills of preschool autistic children: A systematic review and meta-analysis protocol. PLoS One. 2022 Aug 15;17(8):e0270153. doi: 10.1371/journal.pone.0270153. eCollection 2022.

  PMID: 35969530 RESULT

MeSH Terms

Conditions

Autism Spectrum Disorder

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Madhanraj S

  Tutor

  PRINCIPAL INVESTIGATOR

• Jeevarathinam Thirumalai

  Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 23, 2025
• First Posted: March 5, 2025
• Study Start: August 5, 2024
• Primary Completion: November 16, 2024
• Study Completion: December 7, 2024
• Last Updated: July 30, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

IN (1)