Eighteen-month follow-up of a play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder

Background/aim: There is a well‐documented need for interventions to successfully address the social difficulties of children with attention deficit hyperactivity disorder. This study aimed to further the development of a previously conducted pilot of a play‐based intervention. To achieve this, children's social play outcomes pre–post and 18‐month following the intervention were examined by raters unaware of the study's purpose. Additionally, parents’ experiences of the intervention were explored.

Methods: Participants included five children with attention deficit hyperactivity disorder who had participated in a play‐based intervention and their typically developing playmates; parents of children with attention deficit hyperactivity disorder also participated. Children and their playmates attended an 18‐month follow‐up play session and parents participated in semi‐structured interviews. The Test of Playfulness was used to measure children's play outcomes in the context of social play with a peer, pre–post and 18‐months following the intervention. Wilcoxon signed‐ranks (Z) and Cohen's‐d were used to measure effect. Thematic analysis was used to analyse reoccurring themes from parents’ interviews.

Results: Children's social play outcomes improved pre–post intervention (Z = 2.02; P = 0.04; d = 1.6) and were maintained 18‐month post intervention (Z = 0.14; P = 0.89; d = −0.4). Core themes included: the intervention as an enjoyable experience, a common language for talking about play/social interactions, an observable change in children's skills, transference of skills and the need for support to refresh learnt lessons over time.

Conclusions: The intervention demonstrated preliminary and long‐term efficacy in developing the social play skills of children with attention deficit hyperactivity disorder. Further research is required to optimise intervention feasibility and parent involvement prior to conducting a large‐scale research.