Play-Based Interventions for Mental Health:A Systematic Review and Meta-Analysis Focused on Children and Adolescents with Autism Spectrum Disorder and Developmental Language Disorder

Background and Aims Play-based interventions are used ubiquitously with children with social, communication, and language needs but the impact of these interventions on the mental health of this atypical group of children is unknown. Despite their pre-existing challenges, the mental health of DLD and ASD children should be given equal consideration to the other more salient features of their disability. To this aim, a systematic literature review with meta-analysis was undertaken to assess the impact of play-based interventions on mental health outcomes from studies of children with DLD and ASD, as well as to identify the characteristics of research in this field. Methods The study selection process involved a rigorous systematic search of seven academic databases, double screening of abstracts, and full-text screening to identify studies using RCTs and quasi-experimental designs to assess mental health outcomes from interventions supporting children with social, communication, and language needs. For reliability, data extraction, as well as risk of bias assessments were conducted by two study authors. Qualitative data were synthesized and quantified data was used in the meta-analytic calculation. Main contribution A total of 2 882 papers were identified from the literature search which were double screened at the abstract (n = 1 785) and full-text (n= 366) levels resulting in 10 papers meeting the criteria for inclusion in the review. There were 8 RCTs and 2 quasi-experiments using 7 named play-based interventions with ASD participants only. Meta-analysis results found a significant overall intervention effect (Cohen’s d = 1.57) for studies addressing positive mental health outcomes (n = 5) in contrast to a non-significant overall intervention effect for negative mental health outcomes (Cohen’s d = -0.17). Conclusions A key observation is the diversity of study characteristics relating to study sample size, duration of interventions, study settings, background of interventionists, and variability of specific mental health outcomes. The heterogeneous nature of studies stand out although only a few studies were eligible for inclusion. Implications This review provides good evidence of the need for further research into how commonly used play-based interventions designed to support the social, communication, and language needs of students may impact the mental health of children with ASD or DLD.