impact of sandplay therapy in reducing self-handicapping behaviors and improving the quality of life in children with autism spectrum disorder (asd)

This study aimed to examine the effectiveness of sandplay therapy in reducing self-handicapping behaviors and improving the quality of life in children with autism spectrum disorder (asd). a randomized controlled trial was conducted with 30 children diagnosed with asd, who were randomly assigned to either the experimental group (n = 15) receiving sandplay therapy or the control group (n = 15) receiving no intervention. the intervention consisted of eight 90-minute sessions conducted over eight weeks. self-handicapping behaviors were measured using the self-handicapping scale (shs), and quality of life was assessed using the pediatric quality of life inventory (pedsql), both of which demonstrated established validity and reliability. assessments were conducted at pre-test, post-test, and five-month follow-up. data were analyzed using repeated-measures anova, with post-hoc comparisons conducted using the bonferroni test. the results indicated a significant reduction in self-handicapping behaviors in the experimental group from pre-test (m = 42.85, sd = 4.31) to post-test (m = 31.76, sd = 3.76) and further at follow-up (m = 29.45, sd = 3.45), while no significant changes were observed in the control group. similarly, quality of life improved significantly in the experimental group, with scores increasing from pre-test (m = 52.12, sd = 5.12) to post-test (m = 63.45, sd = 4.78) and follow-up (m = 67.32, sd = 4.50), whereas the control group remained stable. anova results confirmed significant main effects of time and group, as well as a significant interaction effect (p < 0.05). bonferroni post-hoc comparisons indicated that improvements were sustained at follow-up. sandplay therapy is an effective intervention for reducing self-handicapping behaviors and enhancing the quality of life in children with asd, with sustained benefits observed at follow-up. these findings highlight the potential of nonverbal, expressive therapies in supporting emotional regulation and adaptive functioning in children with asd.