The Effects of Playing Snake Ladder Game in the Family to Increase Gross Motor Skills in Kindergarten Children with Autism Spectrum Disorder: A Case Series
Objective: To evaluate and compare the gross motor skill of the kindergarten children (KC) with autism spectrum disorder (ASD) before and during the period of playing snake ladder game (SNG) in the family (according to the pre-set schedule and pattern of playing).
Methods: The participants were specifically selected: must be 4-6 years old and must have a diagnosis of ASD by a child and adolescent psychiatrist. The tools used in this study included (1) the 210 centimeters x 210 centimeters SNG sheet, built by the research team, for playing by the family. The SNG had a playing guideline. Playing instruction included walking, jumping, standing, sitting and crossing. SNG must be played 1 hour/day, 3 days/week for 5 consecutive weeks. At first, playing the SNG was demonstrated by the research team, then the family practiced playing until meeting with the pre-set guideline. Afterward the family continued playing SNG at home. The authors had a regular home visits to observe and regulate the SNG playing at the first, 4th, 8th and the 12th play. (2) questionnaire to interview parents on demographic and clinical characteristics of both participants and their parent(s). (3) The gross motor skill assessment scale which was developed by the research authors. Each playing SNG would occurred after the finishing of each assessment. Two authors alternately assessed the gross motor skill on the morning of Monday, Wednesday and Friday. A total of 19 assessments were included: the first 4 assessments during the baseline period and the 15 consecutive assessments during the intervention period. The results of the study were presented by a raw data (demographic, and gross motor skill score) and single subject design graphs.
Results: Both The SNG and the assessment scale were approved unanimously by 3 ASD experts (one physical therapist, one special education teacher and one child and adolescent psychiatrist) to be sound to the purpose of the research. There were a total of 3 KC participants: one was from the Khon Kaen University Autistic Research Center and two were from Special Education Center 9. Keeping with the schedule and pattern of play, the family SNG play could increase gross motor skills in KC with ASD. The increased motor skill could be sustained throughout the intervention period.
Conclusion: the increase in gross motor skill was due to the appropriate playing, goal directed, and regularly repeated practice. The play was also participated by the family. For the gross motor skill to be progressively enhanced, the family should keep on playing snake ladder game regularly and continually.
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