The Impact of a Neurocollaborative Theraplay®-Informed Intervention on the Presentations of Developmental Trauma and Attachment Difficulties in a Sub-Group of Autistic Looked after Children: a Retrospective Service Evaluation

Vollständiger Abstract

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Abstract The intersection between autism, developmental trauma, and attachment disruption contributes to unique difficulties for care experienced autistic children. However, understanding regarding the efficacy of Theraplay ® for this cohort is lacking. This study evaluated the impact of a 30-hour neuro-collaborative Theraplay ® -informed psychotherapeutic intervention on the presentations of developmental trauma and attachment difficulties in care experienced autistic children compared to a non-autistic group. Between April 2020 and April 2024, intervention efficacy was evaluated utilising a mixed design with an autistic group ( N = 35) and non-autistic group ( N = 172). The 30-hour intervention included 10-hours of therapy informed by Theraplay ® principles for parents and children, 10-hours of sensory regulation delivered directly to children or psycho-educationally to parents, and 10-hours of therapeutic parenting informed by the principles of dyadic developmental parenting. Therapeutic outcomes were measured at pre- and post-therapy utilising the Trauma Symptom Checklist for Young Children (TSCYC), the Child Behaviour Checklist (CBCL), the Behaviour Rating Inventory of Executive Function 2nd Edition (BRIEF-2), and the Assessment Checklist for Children (ACC). Paired t-tests showed that post-treatment scores significantly improved compared to pre-treatment scores in the full cohort and non-autistic group in the TSCYC and CBCL and analyses of covariance (ANCOVA) controlling for age and gender showed no difference in treatment outcome between autistic and non-autistic children. While t-tests did not demonstrate significant improvements in the smaller autistic group, there was movement in the direction of improvement accompanied by encouraging effect sizes. The 30-hour neuro-collaborative Theraplay ® -informed intervention was shown to be effective for children with a history of developmental trauma and attachment disruption, and it may be effective for children who are also autistic but further studies with larger samples will be required to confirm this. Implications for practice are discussed.