Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Although autism is a heterogeneous disorder and people with autism present with varying clinical pictures, sensorimotor difficulties are often present in all of them. Sensory problems cause difficulties in different areas, including sensory, emotional, behavioral, and cognitional domains. Also, sensory problems prevent the normal play development during childhood and deprives the child from benefits of play. Problems in motor–planning, expressive and receptive communication, imitation, and fine and gross motor skills are obstacles which children with autism face during play. Psychological interventions for children use play as a substitute for language. One way of working on sensorimotor problems is to use play capabilities in psychological interventions. Regarding the importance of play in communicating with children and the significant role of sensory play in communication with autistic children, this systematic review aims to study the role of play in sensorimotor interventions of autistic children and investigate the quality of using play in them.
Methods: A systematic review was used in this research. Articles published between 2000 and 2023 were searched with the keywords, “play,” “play therapy,” “sensory play,” “sensorimotor play therapy,” “sensorimotor problems,” “sensorimotor interventions,” “sensory games and therapy” in PubMed, ProQuest, PsycINFo, Sciencedirect, Google scholar, and Springer databases. Also, the same keywords in Persian were searched in Magiran and SID databases. The articles were reviewed using the PRISMA guidelines and 12 articles were selected according to the inclusion and exclusion criteria. According to PRISMA guidelines several descriptive components were classified: the title of the research, profile of the authors, year of implementation of the research, target variables, expertise of the researcher, number of samples, duration of intervention, and the measures used in each research. To increase the validity of the research, kappa coefficient was used to estimate interrater reliability. This indicator showed a moderate agreement (0.6) in terms of selecting the articles.
Results: The study results show that sensorimotor–based play interventions reviewed in these studies are divided into two categories. First interventions include the whole body in sensorimotor activities and second interventions include just one sense which was the sense of touch. The present study shows that despite many problems of autistic children with other senses such as hearing, taste, smell, play–based research studies have not targeted such senses. The studies investigate on a wide range of autism symptoms and problems due to the fundamental role of sensorimotor problems in all symptoms of autism. Social behaviors, behavioral problems, negative behaviors, verbal skills and social skills, vestibular sense, balance, challenging behaviors, anxiety, clinical signs of autism, gross motor skills, hand–eye coordination, severity of autism symptoms, motor development, cognitive functions (number span and attention tracking), auditory processing profile, individual goal achievement, sensory behaviors, functional behaviors, adaptive behaviors, and expressive language skills were the target variables of these interventions. Only one study reported children's play skills after the intervention. The games of most of the studies reviewed were movement games. These movement games are divided into two categories: games that use the body as a toy (jumping, running, hopping, etc) and games that use a device and brings the whole body into play (for example, the use of virtual reality glasses, balls, sensory tunnels, swings). Other games used in research studies have provided sensory stimulation for the child by using a tool such as sand play or doll play. A group of articles have examined the nature of the game theoretically and stated their desired definition and philosophy of the game. Another group of studies have mentioned the function of the game and its benefits.
Conclusion: The use of movement games and leisure games that engage the child's whole body in the game activity is more effective than other game methods in attracting the cooperation of a child with autism spectrum disorder and improving a wide range of symptoms. In addition, the duration of sensory–motor play therapy interventions can be an effective factor in improving the effectiveness of these interventions.