Volume 23, Issue 3 (Fall 2017)                   IJPCP 2017, 23(3): 260-277 | Back to browse issues page


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abazari K, malekpour M, ghamarani A, abedi A, faramarzi S. Impact of Individual Differences Intervention (Floortime) Based on Parents’ Expressed Emotion on Children’s Social Skills With High-Functioning Autism Disorder. IJPCP. 2017; 23 (3) :260-277
URL: http://ijpcp.iums.ac.ir/article-1-2565-en.html
1- phd student Department of Psychology and Education of Children With Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran , Email:kabazari@yahoo.com
2- PhD in Psychology and Education of Children With Special Needs, Professor Department of Psychology and Education of Children With Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
3- PhD in General Psychology, Assistant Professor Department of Psychology and Education of Children With Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
4- PhD in Psychology, Associate Professor Department of Psychology and Education of Children With Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
5- PhD in Psychology and Education of Children With Special Needs, Associate Professor Department of Psychology and Education of Children With Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
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Extended Abstract
1. Introduction

Studies show that high expression of emotions results in increased probability of relapse and poor outcome in vulnerable patients [1, 2]. Researchers have argued that emotions expressed by parents of children with autism spectrum dysfunction are higher than parents of normal children. This causes behavioral problems and more social and social problems in their children [3-6]. 
Children under the age of 7 years who have symptoms of autism spectrum disorders benefit principally from intensive care [7]. Some of the most important treatments for autism is Lovas and Applied Behavior Analysis (ABA), but its benefits on autistic children are limited. Another well-known therapeutic approach used for autistic children is the therapeutic methods of social realism [8, 9]. A prototype of the main social interventions that manifests individual and developmental differences, Developmental Individual-difference Relationship–based model (DIR) is “Floortime model”. In this behavioral model, the child’s inner mental state is not seen or underestimated. While in floortime model, communication circles are encouraged in targeted activities. Therefore, instead of learning through habit and repetition, children create a connection between their behavior and intention [10].
The present study intends to develop a rehabilitation program to avoid the limitations of ABA intervention by combining floortime and ABA interventions and considering the influence of the expressed excitement of parents of autistic children. The impact of this program and the impact of ABA intervention on the social skills of children with high-performance autism are measured.
2. Methods
Step 1: Mixed method research

Mixed method research was used to formulate therapeutic package. The mixed method research focuses on collecting, analyzing, and integrating quantitative and qualitative data in a single study, or in a series of studies. The type of combination method used in this research is embedded design mixed research method. The statistical population of this study consists of all mothers of autistic children and normal children within the ages of 3 to 13 years in Tehran city in 2014. At this stage, 50 children were selected from each group, and the emotions expressed by their mothers were reviewed.
Step II: Test method for pre-test and post-test design with control group
At this stage, 20 autistic children aged 3-6 years old were assessed by psychiatrists, those who fulfilled the selection criteria were selected. Children who had autism severity in the mild range (50-100) in the ASSQ test, and their intelligence in the Stanford Binet Intelligence Test was above 70 were selected by available sampling method and were randomly assigned into two groups of 10 subjects each. The expressed emotion-based Floortime intervention program was then presented in 23 sessions of 2 hours each, once a week. During the intervention, there was a drop in the number of mothers in both control and experimental groups and the samples were reduced to 14 patients, 7 each in experimental and control group.
Measuring tools
Demographic characteristics questionnaire, ASSQ test, Stanford Binet intelligence test, Family Questionnaire (FQ), Quiz Questions Expressed Emotion, Gilliam autism scale, Social skills test (villand) were used as measuring tools.
3. Results
Table 1 shows the demographic characteristics of mothers of children with autism and normal children in the first stage of research.
The results of statistical analysis of the expressed emotions of parents of autistic children were compared (Table 2). A significant difference was revealed between parents of all three sub-scales, namely total score of expressed emotion (P=0.0001), extreme emotional involvement (P=0.0001), and critique (P=0.003). Results of data analysis of the qualitative section led to the production of five main themes that included “worrying about others, worrying about the future of the child, ignoring oneself and the child’s needs for their needs and the needs of other members of the family, comparing their child with other children, criticizing the child all the time” (Table 3).
Results tabulated in Table 4 indicate that there is no significant difference between the experimental and control groups with respect to the variables of social skills, and social adjustment, but there is a significant difference between the two groups with respect to communication variable (P=0.028).
4. Conclusion
Results show that despite the high expressed emotion of mothers of children with autism in comparison with mothers of normal children between control and test nodes in the post-test phase, social skills and social adjustment variables were significantly different after the intervention of floortime. Based on the excitement expressed by mothers in the control group and the experimental group, it was observed that only the experimental group had a better performance.
Results of this study were not consistent with other studies done on the efficacy of floortime intervention on communication problems and social skills of children with autism spectrum disorder [7, 11-14]. The lack of coherence between the results of these studies and the results of this study is that in all of these studies, the group receiving floortime intervention was compared with a group that did not receive any intervention. The floortime intervention group simultaneously receiving ABA when compared with the control group receiving ABA intervention only had no significant difference in terms of achieving social skills. Of course, some studies also found that flutter-mediated intervention did not affect social skills. Of course, all of these studies provided floortime without considering the emotional characteristics of mothers and these studies were compared with ABA intervention. It was noted that this study did not have any effect on the communication skills of the subjects in the groups that received floortime and ABA [15].
Due to dispersion and lack of parental cooperation, there is failure to implement follow-up evaluation to verify the effect of postoperative performance stabilization over time. Due to ethical issues there were no control groups that did not receive any intervention and there was no current intervention with that control group without intervention.
This study was conducted in other groups of children with autism spectrum disorder. The comparison is based on family-based group-based interventions (based on parenting education) and center-based (based on employee and mentor training) and the combination of these two. Workshops were conducted to reduce the expressed emotion of parents in order to influence the various interventions for parents of autistic children.
Acknowledgments
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of Interest
The authors declared no conflicts of interest.


References
  1. Karst JS, Van Hecke AV. Parent and family impact of autism spectrum disorders: A review and proposed model for intervention evaluation. Clinical Child and Family Psychology Review. 2012; 15(3):247–77. doi: 10.1007/s10567-012-0119-6
  2. Eisenhower AS, Baker BL, Blacher J. Preschool children with intellectual disability: syndrome specificity, behaviour problems, and maternal well-being. Journal of Intellectual Disability Research. 2005; 49(9):657–71. doi: 10.1111/j.1365-2788.2005.00699.x
  3. Aydın A. Acomparison of the alexithymia, self-compassion and humor characteristics of the parents with mentally disabled and autistic children. Procedia - Social and Behavioral Sciences. 2015; 174:720–9. doi: 10.1016/j.sbspro.2015.01.607
  4. Hooley JM, Parker HA. Measuring expressed emotion: An evaluation of the shortcuts. Journal of Family Psychology. 2006; 20(3):386–96. doi: 10.1037/0893-3200.20.3.386
  5. Benson PR, Daley D, Karlof KL, Robison D. Assessing expressed emotion in mothers of children with Autism. Autism. 2010; 15(1):65–82. doi: 10.1177/1362361309352777
  6. Bader SH, Barry TD. A longitudinal examination of the relation between parental expressed emotion and externalizing behaviors in children and adolescents with Autism spectrum disorder. Journal of Autism and Developmental Disorders. 2014;  44(11):2820–31. doi: 10.1007/s10803-014-2142-6
  7. Hooley JM, Gotlib IH. A diathesis-stress conceptualization of expressed emotion and clinical outcome. Applied and Preventive Psychology. 2000; 9(3):135–51. doi: 10.1016/s0962-1849(05)80001-0
  8. Eisenberg N, Gershoff ET, Fabes RA, Shepard SA, Cumberland AJ, Losoya SH, et al. Mother's emotional expressivity and children's behavior problems and social competence: Mediation through children's regulation. Developmental Psychology. 2001; 37(4):475-90. doi: 10.1037//0012-1649.37.4.475
  9. Greenberg JS, Mailick Seltzer M, Hong J, Orsmond GI. Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with Autism. American Journal on Mental Retardation. 2006; 111(4):229–49. doi: 10.1352/0895-8017(2006)111[229:beoeea]2.0.co;2
  10. Wasserman S, Weisman de Mamani A, Mundy P. Parents’ criticisms and attributions about their adult children with high functioning Autism or schizophrenia. Autism. 2010; 14(2):127–37. doi: 10.1177/1362361309354757
  11. Griffith GM, Hastings RP, Petalas MA, Lloyd TJ. Mothers' expressed emotion towards children with autism spectrum disorder and their siblings. Journal of Intellectual Disability Research. 2014;  59(6):580-87. doi: 10.1111/jir.12178
  12. Kelly AB, Garnett MS, Attwood T, Peterson C. Autism spectrum symptomatology in children: The impact of family and peer relationships. Journal of Abnormal Child Psychology. 2008; 36(7):1069–81. doi: 10.1007/s10802-008-9234-8
  13. Wilson R. Assessing Expressed Emotion in parents in association with children’s social competence, language ability and their understanding of others. Manchester: Manchester Metropolitan Universityک 2011.
  14. Handley RL. Aggressive and self-injurious behavior: Towards a community early intervention strategy [PhD thesis]. Birmingham: University of Birmingham; 2014.
  15. Solomon R, Necheles J, Ferch C, Bruckman D. Pilot study of a parent training program for young children with autism. Autism. 2007; 11(3):205–24. doi: 10.1177/1362361307076842
  16. Roberts J, Williams K, Carter M, Evans D, Parmenter T, Silove N, et al. A randomised controlled trial of two early intervention programs for young children with autism: Centre-based with parent program and home-based. Research in Autism Spectrum Disorders. 5(4):1553–66. doi: 10.1016/j.rasd.2011.03.001
  17. Mudford OC, Martin NT, Eikeseth S, Bibby P. Parent-managed behavioral treatment for preschool children with autism: Some characteristics of UK programs. Research in Developmental Disabilities. 2001; 22(3):173–82. doi: 10.1016/s0891-4222(01)00066-x
  18. Kasari C, Freeman SFN, Paparella T. Early intervention in autism: Joint attention and symbolic play. International Review of Research in Mental Retardation. 2000; 23:207–37. doi: 10.1016/s0074-7750(00)80012-9
  19. Siller M, Sigman M. The behaviors of parents of children with autism predict the subsequent development of their children's communication. Journal of Autism and Developmental Disorders. 2002; 32(2):77–89. doi: 10.1023/a:1014884404276
  20. Greenspan SI, Wieder S. Engaging Autism: Using the floortime approach to help children relate, com-municate, and think. Boston, Massachusetts: Da Capo Lifelong Books; 2009.
  21. Greenspan SI, Wieder S, Simons R. The child with special needs: Encouraging intellectual and emotional growth. New York: Perseus Publishing; 1998.
  22. Ingersoll BR. Teaching social communication: A comparison of naturalistic behavioral and development, social pragmatic approaches for children with Autism spectrum disorders. Journal of Positive Behavior Interventions. 2009; 12(1):33–43. doi: 10.1177/1098300709334797
  23. Greenspan SI, Wieder S. Developmental patterns and outcomes on Infants and children with disorders of relating and communicating: A chart Review of 200 cases of  children with Autistic Spectrum Diagnoses. Journal of Developmental and Learning Disorders. 1997; 1(1):87-141.
  24. Aldred C, Green J, Adams C. A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. Journal of Child Psychology and Psychiatry. 2004; 45(8):1420–30. doi: 10.1111/j.1469-7610.2004.00338.x
  25. Hilton JC, Seal BC. Brief report: Comparative aba and dir trials in twin brothers with Autism. Journal of Autism and Developmental Disorders. 2007; 37(6):1197–201. doi: 10.1007/s10803-006-0258-z
  26. Minjarez MB, Williams SE, Mercier EM, Hardan AY. Pivotal response group treatment program for parents of children with Autism. Journal of Autism and Developmental Disorders. 2010; 41(1):92–101. doi: 10.1007/s10803-010-1027-6
  27. Pajareya K, Nopmaneejumruslers K. A pilot randomized controlled trial of DIR/Floortime™ parent training intervention for pre-school children with autistic spectrum disorders. Autism. 2011; 15(5):563–77. doi: 10.1177/1362361310386502
  28. Dionne M, Martini R. Floortime play with a child with Autism: A single-subject study. Canadian Journal of Occupational Therapy. 2011; 78(3):196–203. doi: 10.2182/cjot.2011.78.3.8
  29. Orsmond GI, Seltzer MM, Greenberg JS, Krauss MW. Mother–child relationship quality among adolescents and adults with Autism. American Journal on Mental Retardation. 2006; 111(2):121–37. doi: 10.1352/0895-8017(2006)111[121:mrqaaa]2.0.co;2
  30. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. [A. Kiamenesh, J. Sarayi, Persian Trans]. Tehran: AAyizh; 2010. 
  31. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, California: Sage; 2013.
  32. Kasechi, M. [Reliability and validity of the Persian version of autism spectrum disorder screening questionnaire (Persian)] [MA Thesis]. Tehran: Shahid Beheshti University of Medical Sciences and Health Services; 2012.
  33. Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E.. The Autism-Spectrum Quotient (AQ): Evidencefrom Asperger Syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders. 2001; 31(1):5–17. doi: 10.1023/a:1005653411471
  34. Farid F, Kamkari K, Safarinia M. Afrooz, S. [The comparison of diagnostic validity of new version of Tehran- Stanford Binet intelligence scales (TSB-5) and wechsler intelligence scales for children- fourth edition (WISC-4) in children with learning disability (Persian)]. Journal of Learning Disability. 2013; 4(2):70-83. 
  35. Shiri Aminloo M, Kamkary K, Shokrzadeh S. [The Concurrent validity of the new version of the Tehran-Stanford-Binet ‎Intelligence Scale with the Wechsler Intelligence Scale for Children-Revised (Persian)]. Exceptional Education. 2013; 7(120):50-61. ):??
  36. Wiedemann G, Rayki O, Feinstein E, Hahlweg K. The Family Questionnaire: Development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Research. 2002; 109(3):265–79. doi: 10.1016/s0165-1781(02)00023-9
  37. Khodabakhshikoolayi A. [Compare the effectiveness of family “model of family management” and “psycho-educational McFarlane” to reduce relapse in schizophrenia patients’ mothers, mothers expressed emotion and psychological pressure on them (Persian)] [PhD thesis]. Tehran: AllamehTabatabayi University; 2007
  38. Gilliam JE. Gilliam autism rating scale GARS. London: Pearson; 1995.
  39. Ahmadi J, Safari T, hematian M, Khalili Z. [Psychometric Properties of the diagnostic test of autism (GARSE) (Persian)]. Journal of Cognitive and Behavioral Sciences. 2011; 1(1):87-104.
  40. Behpajouh A, Soleimani M, Afrooz GH, Lavasani GH. [The impact of social skills training on social adjustment and academic performance of slow learner (Persian)]. Journal of Educational Innovations. 2010; 9(33):163-86.
  41. Sparrow SS, Cicchetti DV, Balla DA. Vineland-II: Vineland adaptive behavior scales. London: Pearson; 2005.
  42. abazari K, melekpour M, ghamarani A, abedi A, faramarzi S. [Understanding the Factors Influence Expressed Emotion in Mothers of Children Autistic with Autism (Mixed-Method Research) (Persian)]. Journal of Qualitative Research in Health Sciences. 2017; 6(1):22-34.
  43. Davis TE, Moree BN, Dempsey T, Hess JA, Jenkins WS, Fodstad JC, et al. The effect of communication deficits on anxiety symptoms in infants and toddlers with Autism spectrum disorders. Behavior Therapy. 2012; 43(1):142–52. doi: 10.1016/j.beth.2011.05.003
  44. Luby M. The impacts on the parent and child: A comparative analysis of aba and dir interventions for young children with Autism spectrum disorders [PhD thesis]. Berkeley, California:  Wright Institute; 2014.
  45. Habibi D, Mirkoohi M. [Floortime effectiveness of play therapy based on high-performance communication skills of children with Autism (Persian)]. Paper presented at: The Social Psychology Conference and Cultural Damage. 26 September 2015; Qom, Iran. 
  46. Makrygianni MK, Reed P. A meta-analytic review of the effectiveness of behavioural early intervention programs for children with Autistic Spectrum Disorders. 2010; 4(4):577–93. doi: 10.1016/j.rasd.2010.01.014
  47. Hayward DW, Gale CM, Eikeseth S. Intensive behavioural intervention for young children with autism: A research-based service model. Research in Autism Spectrum Disorders. 2009; 3(3):571–80. doi: 10.1016/j.rasd.2008.12.002
  48. Holtzer J. Efficacy of DIR: Floortime in children with Spectrum Disorder [PhD thesis]. New York: Hofstra University; 2014.
Type of Study: Original Research | Subject: General
Received: 2016/09/17 | Accepted: 2017/01/21 | Published: 2017/10/1

References
1. Karst JS, Van Hecke AV. Parent and family impact of autism spectrum disorders: A review and proposed model for intervention evaluation. Clinical Child and Family Psychology Review. 2012; 15(3):247–77. doi: 10.1007/s10567-012-0119-6 [DOI:10.1007/s10567-012-0119-6]
2. Eisenhower AS, Baker BL, Blacher J. Preschool children with intellectual disability: syndrome specificity, behaviour problems, and maternal well-being. Journal of Intellectual Disability Research. 2005; 49(9):657–71. doi: 10.1111/j.1365-2788.2005.00699.x [DOI:10.1111/j.1365-2788.2005.00699.x]
3. Aydın A. Acomparison of the alexithymia, self-compassion and humor characteristics of the parents with mentally disabled and autistic children. Procedia - Social and Behavioral Sciences. 2015; 174:720–9. doi: 10.1016/j.sbspro.2015.01.607 [DOI:10.1016/j.sbspro.2015.01.607]
4. Hooley JM, Parker HA. Measuring expressed emotion: An evaluation of the shortcuts. Journal of Family Psychology. 2006; 20(3):386–96. doi: 10.1037/0893-3200.20.3.386 [DOI:10.1037/0893-3200.20.3.386]
5. Benson PR, Daley D, Karlof KL, Robison D. Assessing expressed emotion in mothers of children with Autism. Autism. 2010; 15(1):65–82. doi: 10.1177/1362361309352777 [DOI:10.1177/1362361309352777]
6. Bader SH, Barry TD. A longitudinal examination of the relation between parental expressed emotion and externalizing behaviors in children and adolescents with Autism spectrum disorder. Journal of Autism and Developmental Disorders. 2014; 44(11):2820–31. doi: 10.1007/s10803-014-2142-6 [DOI:10.1007/s10803-014-2142-6]
7. Hooley JM, Gotlib IH. A diathesis-stress conceptualization of expressed emotion and clinical outcome. Applied and Preventive Psychology. 2000; 9(3):135–51. doi: 10.1016/s0962-1849(05)80001-0 [DOI:10.1016/S0962-1849(05)80001-0]
8. Eisenberg N, Gershoff ET, Fabes RA, Shepard SA, Cumberland AJ, Losoya SH, et al. Mother's emotional expressivity and children's behavior problems and social competence: Mediation through children's regulation. Developmental Psychology. 2001; 37(4):475-90. doi: 10.1037//0012-1649.37.4.475 [DOI:10.1037//0012-1649.37.4.475]
9. Greenberg JS, Mailick Seltzer M, Hong J, Orsmond GI. Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with Autism. American Journal on Mental Retardation. 2006; 111(4):229–49. doi: 10.1352/0895-8017(2006)111[229:beoeea]2.0.co;2 [DOI:10.1352/0895-8017(2006)111[229:BEOEEA]2.0.CO;2]
10. Wasserman S, Weisman de Mamani A, Mundy P. Parents' criticisms and attributions about their adult children with high functioning Autism or schizophrenia. Autism. 2010; 14(2):127–37. doi: 10.1177/1362361309354757 [DOI:10.1177/1362361309354757]
11. Griffith GM, Hastings RP, Petalas MA, Lloyd TJ. Mothers' expressed emotion towards children with autism spectrum disorder and their siblings. Journal of Intellectual Disability Research. 2014; 59(6):580-87. doi: 10.1111/jir.12178 [DOI:10.1111/jir.12178]
12. Kelly AB, Garnett MS, Attwood T, Peterson C. Autism spectrum symptomatology in children: The impact of family and peer relationships. Journal of Abnormal Child Psychology. 2008; 36(7):1069–81. doi: 10.1007/s10802-008-9234-8 [DOI:10.1007/s10802-008-9234-8]
13. Wilson R. Assessing Expressed Emotion in parents in association with children's social competence, language ability and their understanding of others. Manchester: Manchester Metropolitan Universityک 2011.
14. Handley RL. Aggressive and self-injurious behavior: Towards a community early intervention strategy [PhD thesis]. Birmingham: University of Birmingham; 2014.
15. Solomon R, Necheles J, Ferch C, Bruckman D. Pilot study of a parent training program for young children with autism. Autism. 2007; 11(3):205–24. doi: 10.1177/1362361307076842 [DOI:10.1177/1362361307076842]
16. Roberts J, Williams K, Carter M, Evans D, Parmenter T, Silove N, et al. A randomised controlled trial of two early intervention programs for young children with autism: Centre-based with parent program and home-based. Research in Autism Spectrum Disorders. 5(4):1553–66. doi: 10.1016/j.rasd.2011.03.001 [DOI:10.1016/j.rasd.2011.03.001]
17. Mudford OC, Martin NT, Eikeseth S, Bibby P. Parent-managed behavioral treatment for preschool children with autism: Some characteristics of UK programs. Research in Developmental Disabilities. 2001; 22(3):173–82. doi: 10.1016/s0891-4222(01)00066-x [DOI:10.1016/S0891-4222(01)00066-X]
18. Kasari C, Freeman SFN, Paparella T. Early intervention in autism: Joint attention and symbolic play. International Review of Research in Mental Retardation. 2000; 23:207–37. doi: 10.1016/s0074-7750(00)80012-9 [DOI:10.1016/S0074-7750(00)80012-9]
19. Siller M, Sigman M. The behaviors of parents of children with autism predict the subsequent development of their children's communication. Journal of Autism and Developmental Disorders. 2002; 32(2):77–89. doi: 10.1023/a:1014884404276 [DOI:10.1023/A:1014884404276]
20. Greenspan SI, Wieder S. Engaging Autism: Using the floortime approach to help children relate, com-municate, and think. Boston, Massachusetts: Da Capo Lifelong Books; 2009.
21. Greenspan SI, Wieder S, Simons R. The child with special needs: Encouraging intellectual and emotional growth. New York: Perseus Publishing; 1998.
22. Ingersoll BR. Teaching social communication: A comparison of naturalistic behavioral and development, social pragmatic approaches for children with Autism spectrum disorders. Journal of Positive Behavior Interventions. 2009; 12(1):33–43. doi: 10.1177/1098300709334797 [DOI:10.1177/1098300709334797]
23. Greenspan SI, Wieder S. Developmental patterns and outcomes on Infants and children with disorders of relating and communicating: A chart Review of 200 cases of children with Autistic Spectrum Diagnoses. Journal of Developmental and Learning Disorders. 1997; 1(1):87-141.
24. Aldred C, Green J, Adams C. A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. Journal of Child Psychology and Psychiatry. 2004; 45(8):1420–30. doi: 10.1111/j.1469-7610.2004.00338.x [DOI:10.1111/j.1469-7610.2004.00338.x]
25. Hilton JC, Seal BC. Brief report: Comparative aba and dir trials in twin brothers with Autism. Journal of Autism and Developmental Disorders. 2007; 37(6):1197–201. doi: 10.1007/s10803-006-0258-z [DOI:10.1007/s10803-006-0258-z]
26. Minjarez MB, Williams SE, Mercier EM, Hardan AY. Pivotal response group treatment program for parents of children with Autism. Journal of Autism and Developmental Disorders. 2010; 41(1):92–101. doi: 10.1007/s10803-010-1027-6 [DOI:10.1007/s10803-010-1027-6]
27. Pajareya K, Nopmaneejumruslers K. A pilot randomized controlled trial of DIR/Floortime™ parent training intervention for pre-school children with autistic spectrum disorders. Autism. 2011; 15(5):563–77. doi: 10.1177/1362361310386502 [DOI:10.1177/1362361310386502]
28. Dionne M, Martini R. Floortime play with a child with Autism: A single-subject study. Canadian Journal of Occupational Therapy. 2011; 78(3):196–203. doi: 10.2182/cjot.2011.78.3.8 [DOI:10.2182/cjot.2011.78.3.8]
29. Orsmond GI, Seltzer MM, Greenberg JS, Krauss MW. Mother–child relationship quality among adolescents and adults with Autism. American Journal on Mental Retardation. 2006; 111(2):121–37. doi: 10.1352/0895-8017(2006)111[121:mrqaaa]2.0.co;2 [DOI:10.1352/0895-8017(2006)111[121:MRQAAA]2.0.CO;2]
30. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. [A. Kiamenesh, J. Sarayi, Persian Trans]. Tehran: AAyizh; 2010.
31. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, California: Sage; 2013.
32. Kasechi, M. [Reliability and validity of the Persian version of autism spectrum disorder screening questionnaire (Persian)] [MA Thesis]. Tehran: Shahid Beheshti University of Medical Sciences and Health Services; 2012.
33. Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E.. The Autism-Spectrum Quotient (AQ): Evidencefrom Asperger Syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders. 2001; 31(1):5–17. doi: 10.1023/a:1005653411471 [DOI:10.1023/A:1005653411471]
34. Farid F, Kamkari K, Safarinia M. Afrooz, S. [The comparison of diagnostic validity of new version of Tehran- Stanford Binet intelligence scales (TSB-5) and wechsler intelligence scales for children- fourth edition (WISC-4) in children with learning disability (Persian)]. Journal of Learning Disability. 2013; 4(2):70-83.
35. Shiri Aminloo M, Kamkary K, Shokrzadeh S. [The Concurrent validity of the new version of the Tehran-Stanford-Binet ‎Intelligence Scale with the Wechsler Intelligence Scale for Children-Revised (Persian)]. Exceptional Education. 2013; 7(120):50-61.) :??
36. Wiedemann G, Rayki O, Feinstein E, Hahlweg K. The Family Questionnaire: Development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Research. 2002; 109(3):265–79. doi: 10.1016/s0165-1781(02)00023-9 [DOI:10.1016/S0165-1781(02)00023-9]
37. Khodabakhshikoolayi A. [Compare the effectiveness of family "model of family management" and "psycho-educational McFarlane" to reduce relapse in schizophrenia patients' mothers, mothers expressed emotion and psychological pressure on them (Persian)] [PhD thesis]. Tehran: AllamehTabatabayi University; 2007
38. Gilliam JE. Gilliam autism rating scale GARS. London: Pearson; 1995.
39. Ahmadi J, Safari T, hematian M, Khalili Z. [Psychometric Properties of the diagnostic test of autism (GARSE) (Persian)]. Journal of Cognitive and Behavioral Sciences. 2011; 1(1):87-104.
40. Behpajouh A, Soleimani M, Afrooz GH, Lavasani GH. [The impact of social skills training on social adjustment and academic performance of slow learner (Persian)]. Journal of Educational Innovations. 2010; 9(33):163-86.
41. Sparrow SS, Cicchetti DV, Balla DA. Vineland-II: Vineland adaptive behavior scales. London: Pearson; 2005.
42. abazari K, melekpour M, ghamarani A, abedi A, faramarzi S. [Understanding the Factors Influence Expressed Emotion in Mothers of Children Autistic with Autism (Mixed-Method Research) (Persian)]. Journal of Qualitative Research in Health Sciences. 2017; 6(1):22-34.
43. Davis TE, Moree BN, Dempsey T, Hess JA, Jenkins WS, Fodstad JC, et al. The effect of communication deficits on anxiety symptoms in infants and toddlers with Autism spectrum disorders. Behavior Therapy. 2012; 43(1):142–52. doi: 10.1016/j.beth.2011.05.003 [DOI:10.1016/j.beth.2011.05.003]
44. Luby M. The impacts on the parent and child: A comparative analysis of ABA and DIR interventions for young children with Autism spectrum disorders [PhD thesis]. Berkeley, California: Wright Institute; 2014.
45. Habibi D, Mirkoohi M. [Floortime effectiveness of play therapy based on high-performance communication skills of children with Autism (Persian)]. Paper presented at: The Social Psychology Conference and Cultural Damage. 26 September 2015; Qom, Iran.
46. Makrygianni MK, Reed P. A meta-analytic review of the effectiveness of behavioural early intervention programs for children with Autistic Spectrum Disorders. 2010; 4(4):577–93. doi: 10.1016/j.rasd.2010.01.014 [DOI:10.1016/j.rasd.2010.01.014]
47. Hayward DW, Gale CM, Eikeseth S. Intensive behavioural intervention for young children with autism: A research-based service model. Research in Autism Spectrum Disorders. 2009; 3(3):571–80. doi: 10.1016/j.rasd.2008.12.002 [DOI:10.1016/j.rasd.2008.12.002]
48. Holtzer J. Efficacy of DIR: Floortime in children with Spectrum Disorder [PhD thesis]. New York: Hofstra University; 2014.

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