BACKGROUND: Individuals with Avoidant/Restrictive Food Intake Disorder (ARFID) experience restrictive or highly selective eating problems that interfere with growth and development. Despite the increasing number of referrals for ARFID, no evidence-based treatments exist. This compilation of case composites describes a novel manualized treatment, Psychoeducational and Motivational Treatment (PMT) for children with ARFID, focusing on exploring motivation to change eating behaviors. This approach is based on motivational non-directive psychotherapy models, psychoeducational interventions, and the usefulness of play to support psychotherapeutic learning in school-age children.
METHODS: Three cases of children with ARFID treated using PMT are presented: a 7-year-old, a 10-year-old, and a 12-year-old. These cases illustrate how a clinician delivers PMT interventions in the context of developmental abilities and common comorbidities associated with ARFID.
CONCLUSIONS: PMT is a promising therapy for ARFID in school-age children. Challenges and strategies are discussed, including ways to address obstacles such as young age, comorbidities, and use of the virtual environment.

Adolescence can be a challenging time, but even more so when diagnosed with a serious or chronic illness. Starlight Children\'s Foundation established the Livewire program after recognizing the unique needs of adolescents in hospitals. This article describes our experience of implementing an art-based project within the Livewire program, designed to facilitate the voice of adolescents with a serious or chronic illness and their siblings. We invited young people across Australia to contribute their artwork which would be used as the design for a deck of playing cards. The final 54 cards were a creative reflection of the unique interests, personalities, and experiences of 45 young people. In this article, we also share the experiences of two young people who contributed to this project. We conclude with our learnings in delivering an art-based project for young people that is not presented directly as \"therapy\".

Complementary and reciprocal interactions are a defining feature of sibling relationships for young children. However, the social and communication difficulties of children with autism spectrum disorder (ASD) can make reciprocal play more difficult and play between siblings can be less rewarding. Sibling play can serve an important role in intervention and family cohesiveness, but there is no consistent method for involving siblings in intervention benefitting the sibling dyad. This study evaluated a novel treatment package including training siblings on play strategies to increase positive sibling play in combination with a sibling support group to offer social support for the neurotypical sibling (NT). The effects of the treatment package on NT sibling play and fidelity of implementation of naturalistic play strategies was examined using a concurrent multiple-baseline design across six dyads, five of whom completed the intervention. After behavior skills training, all NT siblings increased the number of strategies they used, and increased the frequency of initiations towards their sibling with ASD. In addition, the percentage of reciprocal play between siblings increased. Generalization probes and follow-up probes demonstrated above-baseline levels of performance across most dyads, indicating that the skills learned generalized across other toys and were maintained over time. Only three of the sibling support group sessions were completed due to the COVID-19 pandemic. Although the effectiveness of the sibling support group cannot be determined, social validity questionnaires suggest siblings and parents valued and liked the support group.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s43494-021-00043-5.

The school playground can promote PA for large numbers of children. This study identifies areas of the playground that children visited at break-times, the decisions according to gender and the influence of contextual and environmental variables on PA levels. The playground of a culturally diverse primary school was observed during morning break-times and lunchtimes. Counts of sedentary, LPA, and MVPA episodes, and the contexts in which they occurred were recorded using the system for observing play and leisure in youth (SOPLAY). Ball sports areas had higher counts of boys (mean ± SD; 9.9 ± 4.8) compared to girls (2.0 ± 3.5); areas promoting climbing and social interaction had higher counts of girls (7.9 ± 7.2) compared to boys (3.5 ± 2.9). The proportion of MVPA episodes during break-times was 34% ± 26%. Areas of the playground with organised activities had 2.70 (95%CI: 1.87 to 3.91) times higher MVPA counts than areas \"not organised\". Areas with \"supervision\" were associated with higher MVPA counts (1.34; 1.18 to 1.53) compared with \"not supervised\" areas. Organisation and supervision might influence PA choices and PA levels of children in the primary school playground. Further investigation is required to explore different playgrounds settings, and context and gender preferences.

I argue that an enactivist framework has more explanatory power than traditional philosophical theories of cognition when it comes to understanding the mechanisms underlying human-animal relationships. In both intraspecies and interspecies exchanges, what we often find are novel forms of cognition emerging from such transactions, but these \"co-cognitive\" processes cannot be understood apart from the interaction itself. I focus on a specific form of human-animal interaction-play, as it occurs between humans and domestic dogs-and argue that the best theory suited to the task of explaining how these two species create unique thought processes is a \"sympoietic enactivism.\" Rather than the more common \"autopoietic\" arguments defended by many enactivists, I argue that what is more accurately occurring during bouts of human-dog play is sympoietic, or \"collectively producing.\" Drawing on several different disciplines that converge on similar conclusions about creativity and collaboration, I show that human-dog play is a quintessential case of cognition that cannot be readily understood by appealing to the inner workings of either individual among the dyad. Thinking, on this view, is a form of play, and in playful interaction what gets created are wholly intersubjective modes of thought.

Children with autism spectrum disorder (ASD) have difficulties with play, social interaction with peers and generalisation of intervention outcomes. The Ultimate Guide to Play, Language and Friendship (PLF) has demonstrated effectiveness in improving play performance of children with ASD and their typically developing (TD) peers. The aim of this investigation was to examine the changes in play performance when an additional TD child is added to an existing dyad of a child with ASD and a TD playmate to inform future delivery and adaptations of the intervention.
Participants in this multiple case study design were five children with ASD and their TD peer who completed a dyad intervention as part of a randomised control trial investigation of the PLF and an additional TD peer who joined the play dyad. A trained occupational therapist delivered an adapted version of the PLF to the triad over four clinic sessions. An independent rater scored each child (N = 15) on The Test of Playfulness at pre- and post-triad intervention. Line graphs were used to examine case data and compare to dyad play performance and patterns of interaction.
Four of the five children with ASD generalised their play performance from the dyad to the triad social environment. However, the triad intervention did not demonstrate improvements in play performance. The play performance scores for the children with ASD and their TD peers were variable and demonstrated changes in their play pattern from the dyad to the triad.
This investigation delivered preliminary evidence of play performance generalisation from a dyad to a triad with TD peers for children with ASD. Careful consideration of characteristics of all playmates is recommended for delivering the intervention to support play performance of children with ASD.

This article introduces \'Ding Ding Lok\' (DDL), a group game especially designed for persons affected by mild-to-moderate intellectual disability and explores its utility in rehabilitation service settings in Hong Kong. Reports from service staff who participated in the pilot project were analysed using thematic analysis. Two key questions were explored: (1) staff members\' perceived benefits of the game for service users and (2) source of enjoyment for staff members in the game process. Results of the thematic analysis generated four themes, including \'Social Repertoire Expansion\', \'Exercising Cognitive Abilities\', \'Leisure & Recreation\' and \'Personal growth\' for the first question on perceived benefits and five themes including \'Positive interactions\', \'Users\' positive feelings\', \'Increased understanding\', \'Game design\' and \'Users\' improvement\' for the second question on source of enjoyment for staff members. On the whole, DDL was perceived to be highly beneficial for the service users and were regarded as very enjoyable to the participating service staff.

Children with ASD are known to have lower play skills than their typically developing peers. However, the play skills of children with ASD are rarely investigated using observational measures in the context of their everyday peer-to-peer play interactions. To explore the play skills of children with ASD and their aged matched classmates during a peer-to-peer play interaction.
Using convenience sampling, four children with ASD (5-11 years) attending mainstream schools were recruited for this multiple case design study. Each child with ASD was paired with one of their aged matched typically developing classmates. Children\'s play skills were measured using the Test of Playfulness (ToP). Additional case data were collected through teacher-reported social skills and behaviours. Rasch analysis was utilised to convert raw ToP scores into an interval level overall score for each child. Children\'s individual ToP item scores, social skills and behaviours are presented by case.
The two children with ASD who had the highest ToP scores, also had the highest teacher-reported social skills. All children with ASD had greatest difficulty on ToP items reflecting suspension of reality and framing. Two children with ASD had higher ToP scores than their classmate. In these two cases, the classmates had similar play skills of children with ASD.
The play skills of children with ASD varied by case. Across the cases, teacher-reported social skills, classmate age and existence of friendship between children were all factors observed to influence play. These findings require replication and investigation in larger scale studies.

On the 40th anniversary of its publication, the author re-reads Winnicott\'s The Piggle - a case of \'on demand analysis\' with a child suffering from psychotic night terrors - in light of new information about the patient. Conversations between the author and \'Gabrielle\' explore two areas not regarded as priorities by Winnicott: the transgenerational transmission of pathology/trauma, and the ways that language, in general - and given names, in particular - organize individual subjectivity. The question raised is to what degree Winnicott - who described the treatment as \"psychoanalysis partagé [shared]\" due to the parents\' involvement - thought of the pathology itself as \'shared.\' The goal is not to supplant but to expand Winnicott\'s understanding of the case, borrowing insights from the work of Lacan and others.

Play therapy is a treatment modality in which the therapist engages in play with the child. Its use has been documented in a variety of settings and with a variety of diagnoses. Treating within the context of play brings the therapist and the therapy to the level of the child. By way of an introduction to this approach, a case is presented of a six-year-old boy with oppositional defiant disorder. The presentation focuses on the events and interactions of a typical session with an established patient. The primary issues of the session are aggression, self worth, and self efficacy. These themes manifest themselves through the content of the child\'s play and narration of his actions. The therapist then reflects these back to the child while gently encouraging the child toward more positive play. Though the example is one of nondirective play therapy, a wide range of variation exists under the heading of play therapy.