Introduction
With the increase in the number of children with autism spectrum disorder (ASD) globally, new paradigms that effectively meet the diverse and complex needs of this population are needed. Play therapy, a type of psychotherapy, employs games rather than words as a tool for communication with children. This method enables a therapeutic connection with children in a non-verbal way, making it useful particularly for children who have difficulty with language. Although the methods of play therapy have some general commonalities in the core therapy principles, they differ fundamentally in communication styles, goals, and types. These differences mainly depend on the underlying philosophical perspective guiding the therapeutic approach. Gilles Deleuze and Félix Guattari, two prominent post-structuralist philosophers, critiqued the use of Freudian and Lacanian psychoanalysis with existing educational and psychotherapy systems. Given the compatibility of their philosophy with disability studies, many researchers have applied Deleuze and Guattari's theoretical framework in exploring autism. From birth, play is fundamentally sensory-motor in nature. When language is absent or insufficient, sensory-motor play may emerge and dominate certain stages of development in children, as commonly seen in ASD. The present study aims to develop and validate a play therapy program for children with ASD based on Deleuze and Guattari’s philosophy, utilizing sensory-motor play as the core intervention strategy. 

Methods
This is a qualitative study using the inductive content analysis method. To gather relevant texts, we conducted a comprehensive search for articles and books related to Deleuze and Guattari's philosophy in online databases, published from 1953 to 2023, which led to the finding of 125 books and articles. After carefully screening for duplicates and irrelevancy, 13 books and articles were included in a systematic review, where key topics were identified, coded, and grouped into broader thematic categories. The analysis led to the identification of the central components of Deleuze and Guattari’s philosophy as they pertain to communication, disability, and transformation. These components were then synthesized with principles of sensory-motor play therapy to develop an appropriate therapeutic program.
To assess the content and construct validity of the play therapy program, the model was sent to ten experts in the fields of ASD, play therapy, and Deleuze and Guattari’s philosophy. Feedback was solicited from these experts, and based on their responses, the program underwent four rounds of revisions. In addition, content validity ratio (CVR) and content validity index (CVI) were measured to assess the program's content validity and ensure that it was suitable for implementation.

Results
The analysis revealed the primary components of Deleuze and Guattari’s philosophy, which were then integrated with key therapeutic principles related to ASD and sensory-motor play therapy. Based on this integration, a comprehensive play therapy program for autistic children was developed. This program consists of 14 core components: Immanence, Life, Assemblage, Vertical View, Body without Organs, Becoming, Rhizome, Strata, Preference of Action over Expression, Perception of the Other, Smoothing, Deterioration & Reterioration, Spaces of Encounter, and Repetition. These components were categorized into three domains: format, content, and method.
The validity of the developed play therapy program was confirmed through both qualitative expert feedback and quantitative assessments using CVR and CVI. The results indicated that the program is both theoretically sound and practical for use in therapeutic interventions for children with ASD.

Conclusion
Recent research has emphasized the integration of philosophy with psychological practices to create more holistic and effective interventions. This trend reflects the growing recognition of the complex, multifaceted nature of autism and the necessity of incorporating both scientific and philosophical perspectives in developing interventions. Furthermore, ongoing research into the ethical and philosophical dimensions of autism, such as that presented in Hens’ work, aims to deepen our understanding of the condition and improve intervention strategies. By integrating Deleuze and Guattari's philosophical concepts with sensory-motor play therapy, this study attempted to develop a play therapy program for children with ASD. 
In this study, the use of sensory-motor play therapy directly addressed the challenges faced by children with ASD in establishing verbal communication. By emphasizing communication through the body and sensory experiences, the designed program provides an alternative method of expression that aligns with the developmental needs of children with ASD. This approach is supported by studies in attachment theory, which highlight the link between sensory processing and emotional-social connections. The findings of this study suggest that the philosophy of Deleuze and Guattari offers a robust and flexible framework for interventions in the field of autism. Given the novel application of their philosophy to psychotherapy interventions for autism, further research is needed to explore the development of educational, therapeutic, and parenting programs for parents of children with ASD. These programs could be researched either alone or in combination with the play therapy program developed in our study. 

Ethical Considerations

Compliance with ethical guidelines
All ethical principles were observed in this study. Participation in this study was voluntary. The participants were free to leave the study at any time. They were informed about the research process, and their information was kept strictly confidential. This study was approved by the Ethics Committee of Allameh Tabataba’i University (Code: IR.ATU.REC.1403.111).

Funding
This article was extracted from the PhD thesis of Nasrin Behnamnejad at the Department of Psychology and Education of Exceptional Children, Faculty of Psychology and Educational Sciences, Allameh Tabataba’i University, Tehran, Iran. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors.

Authors contributions
Supervision and project management: Saeid Rezaei; methodology: Noorali Farrokhi; investigation: Ahmad Salahshoori and Nasrin Behnamnejad; validation, conceptualization, resources, and visualization: Nasrin Behnamnejad.

Conflicts of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to thank the experts who participated in this study for their time and cooperation.




 

1. Haney JL. Reconceptualizing autism: An alternative paradigm for social work practice. Journal of Progressive Human Services. 2018; 29(1):61-80. [DOI:10.1080/10428232.2017.1394689]
2. Parker N, O’Brien P. Play therapy-reaching the child with autism. International Journal of Special Education. 2011; 26(1):80-7. [Link]
3. Landreth GL. History and development of play therapy. In: Landreth GL, editor. Play Therapy. New York: Routledge; 2023. [DOI:10.4324/9781003255796-3]
4. Milton D. Tracing the influence of Fernand Deligny on autism studies. Disability & Society. 2016; 31(2):285-9. [DOI:10.1080/09687599.2016.1161975]
5. Wiame A. Mapping, Thinking, Performing: Deligny’s, Deleuze’s and Guattari’s Theatres of Subjectivity. 2016; 9(1):38-58. [Preprint]. [Link]
6. Houzel D. Autism and psychoanalysis in the French context. The International Journal of Psychoanalysis. 2018; 99(3):725-45. [DOI:10.1080/00207578.2018.1468220] [PMID]
7. Abou-Rihan F. Finding Winnicott: Philosophical encounters with the psychoanalytic. London: Routledge; 2023. [DOI:10.4324/9781003352488]
8. Barnes J. For Donald Winnicott, the psyche is not inside us but between us.Melbourne: Aeon Media Group Ltd; 2020. [Link]
9. Deleuze G. Thousand Plateaus: Capitalism and Schizophrenia. Minneapolis: University of Minnesota Press; 1987. [Link]
10.  Deleuze G, Guattari F. Anti-Oedipus: capitalism and schizophrenia. European Journal of Psychotherapy & Counselling. 2021; 23(3):390-4. [DOI:10.1080/13642537.2021.1966934]
11.  Goodley D. Towards socially just pedagogies: Deleuzoguattarian critical disability studies. International Journal of Inclusive Education. 2007; 11(3):317-34. [DOI:10.1080/13603110701238769]
12.  Skott-Myhre HA, Taylor C. Autism: Schizo of postmodern capital. Deleuze and Guattari Studies. 2011; 5(1):35-48. [DOI:10.3366/dls.2011.0004]
13. Goodley D. Becoming rhizomatic parents: Deleuze, Guattari and disabled babies. Disability & Society. 2007; 22(2):145-60. [DOI:10.1080/09687590601141576]
14.  Stephens L, Ruddick S, McKeever P. Disability and Deleuze: An exploration of becoming and embodiment in children’s everyday environments. Body & Society. 2015; 21(2):194-220.[DOI:10.1177/1357034X14541155]
15. Knight L. Not as it seems: Using Deleuzian concepts of the imaginary to rethink children’s drawings. Global Studies of Childhood. 2013; 3(3):254-64. [DOI:10.2304/gsch.2013.3.3.254] 
16. Bayliss P. Against interpretosis: Deleuze, disability, and difference. Journal of Literary & Cultural Disability Studies. 2009; 3(3):281-94. [DOI:10.1353/jlc.0.0023]
17. Kokubun K. Principles of Deleuzian Philosophy. Edinburgh: Edinburgh University Press; 2020. [DOI:10.3366/edinburgh/9781474448987.001.0001]
18. Murphy M, Done EJ. Autism and intuitive practice as the art of the prevailing middle. Journal of Research in Special Educational Needs. 2016; 16(4):272-9. [DOI:10.1111/1471-3802.12084]
19. Rodriguez LS. At the limits of the transference: Psychoanalysis and autism. Analysis. 1993; (4):73-6. [Link]
20. Smith JC. The embodied becoming of autism and childhood: A storytelling methodology. Disability & Society. 2016; 31(2):180-91. [DOI:10.1080/09687599.2015.1130609]
21. Holland EW. Deleuze and Guattari’s’ A thousand plateaus’: A reader’s guide. London: Bloomsbury Publishing; 2013. [Link]
22. Colebrook C. Understanding deleuze. London: Routledge; 2020. [DOI:10.4324/9781003118312] 
23. Deal WE, Beal TK. Theory for religious studies. New York: Routledge; 2004. [DOI:10.4324/9780203340073]
24. Olsson L. Movement and experimentation in young children’’s learning: Deleuze and Guattari in early childhood education. London: Routledge; 2009. [DOI:10.4324/9780203881231]
25. Stover C. Affect, play, and becoming-musicking. In: Bohlmann MPJ, Hickey-Moody A, editors. Deleuze and children. Edinburgh: Edinburgh University Press; 2018.  [Link]
26. Kennedy D. Epilogue-Becoming Child, Becoming Other: Childhood as Signifier. In: Anja M, editor. Childhood in the English Renaissance. Trier: Wissenschaftlicher Verlag Trier; 2013. [Link] 
27. Ryall E, Russell W, MacLean M. The philosophy of play. London: Routledge; 2013.  [DOI:10.1332/205316214X14111262947891]
28. Piaget J. The origins of intelligence in children. New York: W. W. Norton & Company; 1952. [DOI:10.1037/11494-000]
29. Kasari C, Chang YC. Play development in children with autism spectrum disorders: Skills, object play, and interventions. In: Volkmar FR, Paul R, Rogers SJ, Pelphrey KA, editors. Handbook of Autism and Pervasive Developmental Disorders, Fourth Edition. New Jerse: John Wiley & Sons, Inc; 2014. [DOI:10.1002/9781118911389.hautc11]
30. Foley GM. Play as regulation: Promoting self-regulation through play. Topics in Language Disorders. 2017; 37(3):241-58.  [DOI:10.1097/TLD.0000000000000129]
31. Boring EG. A history of experimental psychology. New York: Century Company; 1929. [Link]
32. Schultz DP, Schultz SE. A history of modern psychology. Boston: Cengage Learning; 2011. [Link]
33. Segal J. Psychodynamic therapy. In: Dryden W, Reeves A, editors. The handbook of individual therapy. California: SAGE; 2014.  [Link]
34. Edgcumbe R. Anna Freud: A view of development, disturbance and therapeutic techniques. London: Routledge; 2002. [DOI:10.4324/9780203131466] 
35. Johnson JL. The history of play therapy. In: Schaefer CE, O'Connor KJ, editors. Handbook of play therapy. Wiley; 2015. 
36. O’Connor KJ, Schaefer CE, Braverman LD. Handbook of play therapy. New Jersey: John Wiley & Sons; 2015. [DOI:10.1002/9781119140467]
37. Levy AJ. Psychoanalytic approaches to play therapy. In: Schaefer CE, editor. Foundations of play therapy. New Jersey: Wiley; 2011. [Link]
38. Winnicott DW. Playing; Its theoretical status in the clinical situation. The International Journal of Psycho-Analysis. 1968; 49:591. [Link]
39. Koichiro K. Interdisciplinary research on autism across philosophy and medical science: Deleuzian philosophy and autistic studies. KAKENHI Project 19H01183. [Link]
40. Deleuze G, Guattari F, Ricke G, Voullié R. Tausend Plateaus: Kapitalismus und Schizophrenie. Berlin: Merve; 1992. [Link]
41. Deleuze G. Essays critical and clinical. New York: Verso; 1998. [Link]
42. Green SA, Hernandez L, Bookheimer SY, Dapretto M. Salience network connectivity in autism is related to brain and behavioral markers of sensory overresponsivity. Journal of the American Academy of Child and Adolescent Psychiatry. 2016; 55(7):618-26.e1. [DOI:10.1016/j.jaac.2016.04.013] [PMID] 
43. Glaser B, Strauss A. Discovery of grounded theory: Strategies for qualitative research. New York: Routledge; 2017. [DOI:10.4324/9780203793206]
44. Fernandez W. Using the Glaserian approach in grounded studies of emerging business practices. Electronic Journal of Business Research Methods. 2003; 2(2):109-20. [Link]
45. Kaduson HG, Schaefer CE. Play therapy with children: Modalities for change. Washington, D.C: American Psychological Association; 2021. [DOI:10.1037/0000217-000]
46. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3(2):77-101.[DOI:10.1191/1478088706qp063oa]
47. Creswell JW, Poth CN. Qualitative inquiry and research design: Choosing among five approaches. California: Sage Publications; 2016. [Link]
48. Terry G, Hayfield N, Clarke V, Braun V. Thematic analysis. The SAGE Handbook of Qualitative Research in Psychology; 2017.[DOI:10.4135/9781526405555.n2]
49. Tracy SJ. Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. New Jersey: John Wiley & Sons; 2024. [Link]
50. Lawshe CH. A quantitative approach to content validity. Personnel Psychology. 1975; 28(4):563-75.  [DOI:10.1111/j.1744-6570.1975.tb01393.x]
51. Waltz CF, Bausell BR. Nursing research: Design statistics and computer analysis. Pennsylvania: Davis Fa; 1981. [Link]
52. Smith DW. Essays on deleuze. Edinburgh: Edinburgh University Press; 2012. [Link]
53. Nichterlein M, Morss J. Deleuze and psychology: Philosophical provocations to psychological practices. London: Routledge; 2016. [DOI:10.4324/9781315741949]
54. Kokubun K. ‘Deleuze’s imagination and the question of autism’. Paper presented at: 11th International Deleuze/Guattari Studies Conference;. 2018; São Paulo, Brazil. [Link]
55. Lester S. 11 Playing in a Deleuzian playground. In: Ryall E, Russell  W, MacLean M, editors.The Philosophy of play. London: Routledge; 2013. [Link]
56. Matsumoto T. Lacanian and Deleuzian Perspectives on Autism (Lacan, Deleuze, and autism. English version). Deleuze Guattari Camp. 2019. [Link]
57. Bogue R. Deleuze on music, painting, and the arts. New York: Routledge; 2014. [DOI:10.4324/9781315822044]
58. Deleuze G. Spinoza: Practical Philosophy. San Francisco: City Lights Publishers; 1988. [Link]
59.  Deleuze G. Transcription: WebDeleuze and Le Terrier; modified transcription, Charles J. Stivale Translated by Christian Kerslake. Seminar on Anti-Oedipus, 1972-1973 Lecture 03, 14 May 1973. [Link]
60. Protevi J. Deleuze and life. In: Smith DW, Somers-Hall H, editors. The Cambridge Companion to Deleuze. Cambridge Companions to Philosophy. Cambridge: Cambridge University Press; 2012. [DOI:10.1017/CCO9780511753657.012]
61. Deleuze G, Rösch G, Guattari F. Tausend plateaus. Berlin: Merve; 1992.
62.  Williams J. Gilles Deleuze’s Difference and repetition: A critical introduction and guide. Edinburgh: Edinburgh University Press; 2013. [Link]
63.  Deleuze G. Difference and repetition. London: Athlone; 1968. [Link]
64. Deleuze G. 2002. The Logic of Sense. London: Athlone Press; 1969.
65. Williams J. Gilles Deleuze’s Logic of Sense: A critical introduction and guide. Edinburgh: Edinburgh University Press; 2008. [Link] 
66.  Badiou A. Gilles Deleuze, The Fold: Leibniz and the Baroque 1. In: Boundas CV, Olkowski D, editors. Gilles Deleuze and the theater of philosophy. London: Routledge; 2017. [DOI:10.4324/9781315112503-4]
67. Banerjee M, Ray SG. Development of play therapy module for children with autism. Journal of the Indian Academy of Applied Psychology. 2013; 39(2):245-53. [Link]
68. Camargo SPH, Rispoli M. Applied behavior analysis as an intervention for autism: definition, characteristics, and philosophical assumptions. Revista Educação Especial. 2013; 26(47):639-50. [DOI:10.5902/1984686X9694]
69. Bölte S, Richman KA. Hard talk: Does autism need philosophy? Autism. 2019; 23(1):3-7. [DOI:10.1177/1362361318808181] [PMID]
70.  Botha M. Critical realism, community psychology, and the curious case of autism: A philosophy and practice of science with social justice in mind. Journal of Community Psychology.  2025; 53(1):e22764.  [DOI:10.1002/jcop.22764] [PMID]
71. Pantazakos T, Vanaken GJ. Addressing the autism mental health crisis: The potential of phenomenology in neurodiversity-affirming clinical practices. Frontiers in Psychology. 2023; 14:1225152.  [DOI:10.3389/fpsyg.2023.1225152] [PMID] 
72. Gipps RG. Autism and intersubjectivity: Beyond cognitivism and the theory of mind. Philosophy, Psychiatry, & Psychology. 2004; 11(3):195-8. [Link]
73. Zakaria WH. Book Review: Towards an ethics of autism-a philosophical exploration. International Journal of Education and Literacy Studies. 2021; 9(4):289-91. [Link]
74. Hens K. Towards an Ethic of Autism: A Philosophical Exploration. Cambridge: Open Book Publishers; 2021. [DOI:10.11647/OBP.0261]
75. Leaf JB, Cihon JH, Leaf R, McEachin J, Liu N, Russell N, et al. Concerns about ABA-based intervention: An evaluation and recommendations. Journal of Autism and Developmental Disorders. 2022; 52(6):2838-53. [Link]
76. Lovaas OI, Smith T. A comprehensive behavioral theory of autistic children: Paradigm for research and treatment. Journal of Behavior Therapy and Experimental Psychiatry. 1989; 20(1):17-29.  [PMID]