To Fill the Gap: A Systematic Literature Review of Group Play-Based Intervention to Address Anxiety in Young Children with Autism

While anxiety conditions in children often manifest early in life, frequently before the age of five, and there is evidence that autism spectrum conditions (ASC) co-occur in this population, there is limited availability of interventions designed to meet the unique needs of children with both anxiety conditions and ASC. The current article examines non-pharmacological group/peer-mediated interventions for managing anxiety among children with ASC. More specifically, it focuses on the effectiveness of group play-based interventions that can alleviate anxiety in children with ASC aged 2-12 years. In doing so, this article addresses a critical gap in the existing literature and explores evidence-based strategies tailored to this specific population. Effective interventions are identified to address the needs of children of this age group. This research contributes significantly to the body of knowledge in the fields of early intervention and well-being studies.A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided comprehensive Systematic Literature Review (SLR) was conducted by searching seven prominent databases and utilising Covidence management software. The databases searched were: Academic Search Complete, ERIC, PsycInfo, Medline, Web of Science (core collection), Embase, and ProQuest Dissertations & Theses: A & I, specifically focusing on studies published in the most recent 15 years from 1996 to 2021. The review included studies concerning autistic children aged 2 to 12 years that aimed at reducing anxiety as their primary outcome. It was carried out systematically and transparently, with each step of the process clearly explained, and the rationale for the five reviewers’ choices and assumptions and decisions given.The initial search yielded 7,300 studies, eventually narrowing down to 81 full-text articles selected for critical review. Among these, 44 proved relevant. 28 out of 35 studies that focused on cognitive behavioural therapy (CBT) displayed efficacy in reducing anxiety among children. Five out of eight studies centred around play-based approaches also showed effectiveness. One study employing Lego®-based therapy exhibited partial effectiveness in addressing childhood anxiety among autistic children. Among the 44 studies, four specifically centred on children aged 4 to 6 years with both anxiety and autism, and showed that group CBT effectively reduced anxiety.This review identified nine evidence-based strategies.