Impact of one-to-one instruction on activity participation, playfulness and enjoyment in children with Autism Spectrum Disorder in Rwanda: A quasi-experimental study.

Background: Children with autism spectrum disorder often have limited engagement in daily activities, particularly in low-resource settings. This study aimed to evaluate whether individualised therapist-led intervention increases activity participation, enjoyment, and playfulness among children with...

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Publicado en:South African Journal of Occupational Therapy Vol. 56; no. 2; pp. 1 - 14
Autores principales: Uwihoreye, Potien, Ndyowaawe Bram, Arron, Barlow, Kate
Formato: research tables/charts Journal Article
Publicado: Occupational Therapy Association of South Africa Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
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      pub: Occupational Therapy Association of South Africa
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        10.17159/2310-3833/2026/vol56no2a14
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        atl: Impact of one-to-one instruction on activity participation, playfulness and enjoyment in children with Autism Spectrum Disorder in Rwanda: A quasi-experimental study.
      aug:
        au:
          Uwihoreye, Potien
          Ndyowaawe Bram, Arron
          Barlow, Kate
        affil: Department of Occupational Therapy, College of Medicine and Health Sciences, University of Rwanda, KG 11 Ave, Gasabo, Kigali, Rwanda
      sug:
        subj:
          Autism Spectrum Disorder Therapy
          Occupational Therapy
          Activities of Daily Living Evaluation
          Pleasure Evaluation
          Play and Playthings Evaluation
          Patient Preference Evaluation
          Human
          Rwanda
          Quasi-Experimental Studies
          Child, Preschool
          Child
          Male
          Female
          Clinical Assessment Tools
          Purposive Sample
          Data Analysis Software
          Paired T-Tests
          Chi Square Test
          Analysis of Variance
          Recreation
          Social Participation
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Male
          Female
      ab: Background: Children with autism spectrum disorder often have limited engagement in daily activities, particularly in low-resource settings. This study aimed to evaluate whether individualised therapist-led intervention increases activity participation, enjoyment, and playfulness among children with autism compared with standard group-based care. Methods: A quasi-experimental study was conducted at two centres involving 86 children with autism spectrum disorder (n=86), aged 3-12 years. Participants were assigned to either the intervention group (n = 43) which received 9 months' one-to-one instruction or a comparison group (n = 43) which received standard care. The Children's Assessment of Participation and Enjoyment, Children's Preferences for Activities, and the Test of Playfulness were used to evaluate the children both before and after the intervention. Results: Significant, statistically robust improvements were observed with one-on-one instruction in some activities. Participation increased across domains with the largest effects for quiet recreation and hobbies (Cohen's d ≈1.0-1.2; p<0.001) while enjoyment (p = 0.046, d = 0.45, ηp² = 0.21) and a marked improvement of playfulness (p<0.001). Preference shifts occurred within the intervention group but were not significantly different from controls after covariate adjustment. Conclusion: Individualised one -to-one instruction yielded meaningful participation gains and is promising for low-resource settings. Future research should include fidelity measurement, longer follow-up, and a larger sample to confirm effectiveness. Implications for Practice * One-to-one instruction should be considered as an effective option in clinical and school settings to increase participation and playfulness for children with autism spectrum disorder * Routine use of validated tools and fidelity audits is recommended to monitor outcomes, detect preference shifts, and guide individualised goal setting. * Interventions should target playfulness (extent, intensity, and skilfulness) alongside participation frequency because improvements in play quality drive meaningful engagement. * Pilot one-to-one instructional programmes in district centres, funding staff, training, and monitoring to broaden access in low-resource settings.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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