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Benefits of medical clowning in the treatment of young children with autism spectrum disorder

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Abstract

We investigated the contribution of group therapy delivered by a medical clown to young children diagnosed with autism spectrum disorder (ASD). So far, scientific publications regarding medical clowning focus on general health advantages. The current study is the first controlled research examining the use of medical clowning in the therapy for children with ASD. Twenty-four children aged 2–6 years old with ASD enrolled in our special education intensive program were examined before and after group sessions with clown intervention (CI) and other intervention (OI). We tested stereotypic behaviors, verbal expression, play reciprocity, and social smiles. Data was collected during 12 weeks of intervention, and the trajectory of change was evaluated in addition to the pre-/post-intervention.

Conclusion: improvement over time in all measures: Significant increase in word production, play reciprocity, and amount of social smiles during CI as compared with OI. We also found a reduction in frequency of stereotypic behaviors during and following CI as compared with before CI. These preliminary results indicate that medical clowning may be beneficial for young children with ASD, since it promotes communication and social reciprocity in a fun and lively interventional setting.

What is Known:

• Many therapies are used and proven as efficacious interventions for children with ASD.

• So far, medical clowning was not tested as an intervention or therapy for ASD.

What is New:

• Medical clowning sessions with children with ASD elicited enhanced communication during the interventions as compared with other interventions.

• Medical clowning sessions contributed to a decrease in frequency of stereotypic movements over time, in children with ASD.

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Abbreviations

ADOS-2:

Autism Diagnostic Observation Schedule-2nd Edition

ASD:

Autism spectrum disorder

CI:

Clown intervention

MC:

Medical clowning

OI:

Other intervention

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Funding

This study was partially funded by Magi Foundation and Foundation Adelis.

Author information

Authors and Affiliations

  1. Weinberg Child Development Center, The Chaim Sheba Medical Center, 5262000, Tel HaShomer Ramat Gan, Israel

    Shahar Shefer, Odelia Leon Attia, Ruth Rosenan, Hamutal Ende & Lidia V. Gabis

  2. Center of Academic Studies, Or Yehuda, Israel

    Ori A. Wald

  3. Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel

    Lidia V. Gabis

Authors
  1. Shahar Shefer
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  2. Odelia Leon Attia
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  3. Ruth Rosenan
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  4. Ori A. Wald
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  5. Hamutal Ende
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  6. Lidia V. Gabis
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Contributions

Shahar Shefer: Conception and design of the research, initial draft of the article.

Ruth Rosenan: Data analysis, editing of final draft and final approval of the version to be published.

Odelia Leon Attia: Data analysis and interpretation of results, approval of final draft.

Hamutal Ende: Medical clown, performed the interventions in the study and contributed to data collection, approval of final draft.

Ori A. Wald: Data collection and data processing, approval of final draft.

Lidia V. Gabis: Conception and design of study, interpretation of results and drafting the initial article.

Corresponding author

Correspondence to Shahar Shefer.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Helsinki committee at the Sheba Medical Center, Ramat-Gan, Israel, approval no. SMC-0551-13, approved the current study.

Informed consent

Informed consent was obtained from all parents of the children whom participated in the study.

Additional information

Communicated by Mario Bianchetti

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Shefer, S., Leon Attia, O., Rosenan, R. et al. Benefits of medical clowning in the treatment of young children with autism spectrum disorder. Eur J Pediatr 178, 1283–1289 (2019). https://doi.org/10.1007/s00431-019-03415-7

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  • DOI: https://doi.org/10.1007/s00431-019-03415-7

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