Effects of improved creative play interventions on social communication, behavioral, and cognitive function in children with autism spectrum disorder: a randomized controlled trial

Background Children with autism spectrum disorder (ASD) often exhibit deficits in social communication, repetitive behaviors, and cognitive delays. Play-based interventions have shown effectiveness in the treatment of ASD. This study aims to investigate the impact of improved creative play interventions combined with routine rehabilitation on these domains in autistic children. Methods This single-blind randomized controlled trial enrolled 72 children aged 3–8 years with ASD. Participants were randomized to the control group ( n = 36; routine rehabilitation) or intervention group ( n = 36; routine rehabilitation + improved creative play intervention). Assessments were conducted at baseline and post-intervention (week 12) using the Aberrant Behavior Checklist (ABC), Autism Treatment Evaluation Checklist (ATEC), Childhood Autism Rating Scale-2 (CARS-2), Social Responsiveness Scale-2 (SRS-2), and the Chinese version of Psychoeducational Profile-3 (C-PEP-3) to measure changes in social skills, behavior, and cognitive functioning. Results The intervention group showed greater improvements than the control group in the SRS-2 T-score ( p 0.001). No significant group × time interactions ( p 0.05) were found on aberrant behavior (ABC) or overall autism severity (CARS-2). Significant advantages in the intervention group were also observed across all four ATEC subscales and the total score ( p 0.001) compared with the control group. The improved creative play intervention group achieved significantly greater gains in fine motor, hand-eye coordination, cognitive performance, and verbal cognition domains of C-PEP-3, with particularly large differences in cognitive performance ( p 0.001). Conclusion The improved creative play intervention combined with routine rehabilitation significantly enhances social, behavioral, and cognitive outcomes in ASD children.