Chapter 1

THE RESEARCH PROBLEM AND ITS BACKGROUND

Introduction

Children of all ages and social class can have Autism

Spectrum Disorder, or ASD. It is a wide ranged disorder and no

two people with autism will have exactly the same symptoms. As

well as experiencing varying combinations of symptoms, some

people will have mild symptoms while others will have severe

ones. It is mainly characterized by impaired social interaction

and verbal and non verbal communication. Researchers link this

condition primarily to genetic factors and studies on how to

prevent this condition are currently done. It is now recognized

that some individuals with this condition is able to adapt and

lead and independent life whereas others who do not receive

therapy may be affected severely and have a low quality of life.

The increasing prevalence rate of children having autism spectrum

disorder has elevated public concern. (Elsabbagh et al., Insar-

Autism Research, 2012)

A 2012 review of global prevalence estimates of autism

spectrum disorders found a median of 62 cases per 10,000 people.

Though, there is a lack of evidence from low and middle income

countries. (Elsabbagh et. al, Global Prevalence of Autism and

other Pervasive Developmental Disorders, 2012). Today, with no

specific treatment for Autism, psychologists and other researches

focus on the different types of therapy to aid the

characteristics of Autism.

Advancements in the management of autism have lead to the

development of various approaches and techniques in addressing

the symptoms. It was a consistently tedious and taxing hunt for

effective means of addressing the condition. In one study, it is

said that “there is little evidence of for the relative

effectiveness of treatment options.” (Seida et.al, Systematic reviews of

psychosocial interventions for autism: an umbrella review, 2009) Researchers

realized that a combination of these approaches was proven

intensive but contributory over the course of treatment. And over

the years, they have meticulously procured medical breakthroughs,

one of which involved animals.

Over the course of years, terminally ill people have been

accompanied by domesticated animals, most notably dogs and cats,

over the course of palliative care. The addition of these animals

to the management of several medical cases leads to the renewed

interest in unconventional therapy.

The Philippine Animal Welfare Society, an organization that

facilitated the rescue and adoption of neglected and maltreated

animals, introduced a program called Dr. Dog. The ‘Doctor Dogs’

main purpose was to alleviate the loneliness of the elderly and

the ill as they played and performed tricks with them.

Clearly, the fundamental roles of household animals have

been taken to a larger scale, and soon the rest its household

brethren followed suit. This has become evident in the

Philippines, where every household virtually owns at least one

pet. Dogs and cats are commonplace in virtually every house in

the country, and the popularity of these four-legged mammals has

brought people to the attention of other more economical choices,

specifically the rabbit.

But the use of pets in the care process is not entirely new.

In fact, the potential of pets as instruments in rehabilitation

has been tapped into by AAT’s main proponent, a psychologist

named Dr. Boris M. Levinson. In one study made by Liana J.

Urichuk, BSc, PhD that cited Dr. Levinson’s “Pet Psychotherapy: Use of

Household Pets in the Treatment of Behavior Disorder in Childhood,” it was stated

that the first recorded use of animals in therapy settings

happened in York Retreat in England in 1965. Levinson himself

cited several researchers and observed that the positive effect

of pet interaction to humans is, to quote him, “strictly

coincidental.” So Levinson’s primary concern was to develop

planned and controlled ways of introducing the pet into a

therapeutic interaction with a child. Only in this fashion

may we develop adequate methodology for use of pets.” (Levinson,

1965)

Among the relatively unorthodox approaches in health care,

Animal Assisted Therapy (AAT), or most commonly known as Pet

Therapy, is already being used and improved in human

rehabilitation. These days, AAT is in a regulated and therapeutic

environment. AAT is now being tested and introduced as a therapy

that can help children with autism with their social abilities.

Pet therapy describes programs in which animals help people just

by visiting with them. Today, different conditions are being

aided by animal assisted therapies. The researchers of this

study wanted to test if animal assisted therapy can improve the

social interactivity of these children.

Man has always benefited from his relationship with animals.

From assisting him in livelihood to simply being a companion,

animals have played an increasingly big role in the lives of

people. And as Man’s world becomes more complex and demanding,

animals, especially the domesticated variety, maintain their

steadfast relationship with humankind.

This study aimed to revive interest in the integration of

pets in the rehabilitative process of children with an autism

spectrum disorder and their effects on the socialization of these

children with other people.

Statement of the Problem

This study aims to answer the following queries:

1. What is the demographic profile of the respondents in

terms of

a. Age

b. Gender

c. Social Status

2. What is the social interactivity of the participants as

observed by the parents?

3. Is there a significant difference between the pretest and

post test scores for the level of social interactivity in

the participants as observed by the parents?

Significance of the Study

This study primarily intended to identify pet therapy as a

potential addition to the management of children with autism

spectrum disorder. The following people may benefit from this

investigation.

Future Researcher. The result of the study will serve as a guide

and reference baseline in improving and building knowledge in the

future researcher’s study. It also gave ample insights on the

effectiveness of pet therapy on the children with autism’s

interactivity. Thus, this will contribute on future research

study.

SPED Administrators. The result of the study will be helpful on

their decisions in planning programs or new programs to promote

animal assisted therapy. It will encourage them to carry out more

information to the public especially to families of children with

autism spectrum disorder. It will put emphasis on the importance

of this therapy in aiding social interactivity.

Students and Faculty. The results will be beneficial to students

and faculty as this will increase their awareness of the helpful

effects of pet assisted therapy on the children with autism

spectrum disorder’s interactivity. In addition, this will serve

as a training guide in students in using this type of therapy. It

will bear out that pet therapy will be much helpful in improving

the interactivity children with autism spectrum disorder. Thus,

this will eventually help them develop further competencies in

providing this therapy. Moreover, the study may allow for the

recognition of AAT as part of the approved rehabilitation

alternatives for ASD.

Children with Autism Spectrum Disorder. This study will help them

utilize pet therapy to aid their social interactivity. Through

this, therapy will be more accessible to them especially those

who were born in families with lower income and lower class.

Families of children born with ASD. This study will benefit them

as to this therapy is economical. This will help them provide

alternative therapy if they don’t have means of consulting a

therapist. The pet used in this study, a rabbit, does not need

maintenance and can eat only grass which can be picked anywhere

on the streets. It does not require almost the same meal as the

family has compared to other pets used in AAT like dogs and cats.

Owning a rabbit instead of cats or dogs will be the economical

choice for immediate caretakers, especially working class

families who may be interested in the therapy but is particular

with cost.

The Health Care Team. The health care team, comprised of

professionals who collaborate on client care for these cases, can

include animal-assisted therapy to their current care plan should

the involvement of pets be successful.

Scope and Delimitations

This study covered the social interactivity pretest and

posttest scores of the respondents observed by the parents. This

research’s respondents are 6 to 10 years old children living and

under the care and supervision of or under the rehabilitative

care/management of Zion Circle Center for a year and are formally

diagnosed with autism spectrum disorder by a registered

clinician. The pets involved in the study are domestic rabbits.

The intervention involved 20 and ran for 6 weeks.

This study did not involve children whose ages are below or

beyond the inclusive age range and those who were outside the

care of Zion Circle Center. Any other animal which is not a

domestic rabbit was not used for AAT. Also, this study did not

involve other symptoms which do not encompass social

interactivity.

Definition of Terms

For cleared understanding of the terms used in the study,

below are their meanings:

Autism spectrum disorder - a group of developmental

disabilities that can cause significant social,

communication and behavioral challenges. It is also known as

ASD.

Domestic Rabbit – the animal which will be used in AAT

Pet Therapy – a type of therapy which will involve the use

of an animal, specifically a domesticated rabbit, in

providing companionship and alleviating stress in humans;

also known as the Animal Assisted Therapy (AAT).

Chapter II

REVIEW OF RELATED LITERATURE

The study of autism spectrum disorder and the evolution of

its management and treatment modalities is a continuous and

lengthy ordeal. Part of what makes the process taxing is the fact

that the cause of autism is still unknown. Scientists have not

determined the exact causes of ASD, but research suggests that

both genetics and environment play vital roles.

In the United States of America, studies are continuously

pursued. A survey by the Centers for Disease Control and

Prevention (CDC) of health and school records of 8-year-olds in

14 communities throughout the country found that in 2008, the

rate of ASD was higher than in past U.S. studies, around 1 in 88

children. Boys are about four to five times susceptible than

girls.

The oldest and most comprehensive surveys of ASD in Asia

come from Japan and China. Studies in this region had population

size ranging from 3,606 to 609, 848. Since 2000, prevalence rates

varied from 2.8/10,000 to 94/10,000 with a median value of

11.6/10,000. This rate of ASD is lower than current estimates

from a comparable number of studies in Northern Europe but

resembles estimates from older studies in that region. The study

conducted in Indonesia estimated the rate in ASD to be

11.7/10,000. (Elsabbagh et al., Insar-Autism Research, 2012)

Autism is one of the severest disorders in childhood. It is

characterized by absorption in daydreaming and fantasy, a failure

to relate with others, lack of speech, disturbed motor

behaviours, intellectual impairment and demands for sameness in

the environment. (Zulueta and Fernandez-Distajo, Abnormal

Psychology, 2011)

The National Institute on Mental Health (NIMH), a part of the National

Institutes of Health in the U.S., featured a comprehensive overview of

the condition which included the signs and symptoms and the

screening procedures. In their report, they listed three main

areas for observation – social impairment, communication

difficulties and repetitive and stereotyped behaviours.

Researchers are trying to determine if certain unusual

reactions from children with autism are related to differences in

integrating multiple types of information from the senses.

According to the Diagnostic and Statistical Manual of Mental Disorders,

Fourth Edition - Text Revision, some affected children may exhibit

behaviors like making little eye contact, looking or listening

less to people and their environment, not readily sharing their

enjoyment of activities or things by pointing them to others, and

responding inappropriately to others’ distress or affection. This

is because they fail to pay attention to social cues. In turn,

this gives them no idea of how to react to emotional cues, so

they misinterpret what was coming across. And without a firm

grasp on the expected way to respond to certain stimuli as in a

normal child, their actions tend to be contradictory. Their

facial expressions usually do not match what they are saying.

Social impairment results from these behaviors, and this becomes

a problem as they grow older.

Children with ASD are difficult to understand. Some children

with autism may fail or be slow to respond to their name or other

verbal attempts to gain their attention, Fail or be slow to

develop gestures, such as pointing and showing things to others,

coo and babble in the first year of life, but then stop doing so,

develop language at a delayed pace, learn to communicate using

pictures or their own sign language, speak only in single words

or repeat certain phrases over and over, seeming unable to

combine words into meaningful sentences, repeat words or phrases

that they hear - a condition called echolalia - and use words

that seem odd, out of place, or have a special meaning known only

to those familiar with the child's way of communicating. Some

would even scream or shout until they are taught of a proper

means of expressing themselves.

Aside from social and communication deficits, children

affected with ASD exhibit stereotyped behaviors. The NIMH

provides a description of this odd activity:

Children with ASD often have repetitive motions or unusual behaviors.

These behaviors may be extreme and very noticeable, or they can be mild and

discreet. For example, some children may repeatedly flap their arms or walk in

specific patterns, while others may subtly move their fingers by their eyes in what

looks to be a gesture. These repetitive actions are sometimes called "stereotypy"

or "stereotyped behaviors."

Children with ASD also tend to have overly focused interests. Children with

ASD may become fascinated with moving objects or parts of objects, like the

wheels on a moving car. They might spend a long time lining up toys in a certain

way, rather than playing with them. They may also become very upset if

someone accidentally moves one of the toys. Repetitive behavior can also take

the form of a persistent, intense preoccupation. For example, they might be

obsessed with learning all about vacuum cleaners, train schedules, or

lighthouses. Children with ASD often have great interest in numbers, symbols, or

science topics.

While children with ASD often do best with routine in their daily activities

and surroundings, inflexibility may often be extreme and cause serious

difficulties. They may insist on eating the same exact meals every day or taking

the same exact route to school. A slight change in a specific routine can be

extremely upsetting. Some children may even have emotional outbursts,

especially when feeling angry or frustrated or when placed in a new or

stimulating environment.

It was also stated that no two children will be alike in

terms of manifesting said symptoms. To identify the disparities

between the normal and expected behaviors from the unusual ones,

screening is administered to children suspected of ASD

affectation.

The diagnosis of ASD involves general checkups involving the

pediatrician and a health worker. The testing becomes more

specific as specialists such as registered clinicians and a team

of other health professionals collaborate on establishing an

accurate basis for identifying autism. Autism should be

distinguished from childhood schizophrenia, a much rarer

condition. (Zulueta and Fernandez-Distajo, 2011)

There is no cure for ASD as of the moment. Treatments are

primarily focused on supportive therapeutic residences or on more

structured operant conditioning programs in which rewards and

punishments and systematically manipulated. One type of treatment

is called applied behavioral analysis wherein behaviors are

reduced, reshaped or reinforced so that such behaviors will be

acceptable.

The treatment and management of ASD incorporates several

alternatives which includes animal assisted therapy (AAT). One of

its main proponents is Dr. Boris M. Levinson. In his report, Pet

Psychotherapy: Use of Household Pets in the Treatment of Behavior Disorder in

Childhood, Levinson stated that the use of pets in the therapeutic

encounter brings a new dimension to child psychology. (Levinson,

1965)

In his recount, one treatment in York Retreat involved

animals. He quoted Samuel Tuke, one of the main proponents in

mental health reform in the 1790s and the innovator behind The

Retreat, saying the care of domestic animals by mental patients

provided “innocent pleasure” and “awakened social benevolent

feelings.” A host of animals were used in the sessions, and the

patients responded positively by treating animals as “their own.”

From rabbits to poultry, Tuke incorporated these animals in the

management of the mentally-ill occupants of the humane asylum of

its time, The Retreat. The use of animals in the therapeutic

environment yielded positive results, at least according to

Levinson. But as stated in the Introduction of this study, the

psychologist called for a controlled setting for AAT.

The psychologist is looking for a measure of empiricism in

testing the effectiveness of animal assisted therapy. And the

professional society responded over the years. As professionals

continue their pursuit for the most effective intervention, the

discipline has become more open-minded in terms of the potentials

of other treatment varieties, giving families and the medical

health team more liberty in selecting the right course of

treatment for children with ASD.

THREORETICAL FRAMEWORK

Belongingness and Love Needs

Abraham Maslow proposed that there is a hierarchy of needs,

ascending from the biological needs to more complex psychological

motivations that become only important only after the basic needs

have been satisfied. The needs at one level must be at least

partially satisfied before those at the next level become

important motivators of action. Carl Roger also argues that the

basic force motivating the human organisms is the actualizing

tendency-a tendency toward fulfillment or actualization of all

the capacities of the self. According to him, children come to

develop an actualized self through the experience of

unconditional positive regard from their care givers.

(Introduction to Psychology, Atkinson & Hilgard)

Children with Autism

Dr. A. Jean Ayers developed sensory integration theory.

According to this theory, problems with sensory perception and

integration interfere with the ability to attend and respond

appropriately to complex stimuli in the environment, making

organized behavior difficult. In addition to that, researches had

supported the existence of sensory processing and motor problems

in persons with autism spectrum disorder as well as with complex

information processing. Sensory deficits have been found to

involve both over-responsiveness and under-responsiveness to

sensory stimuli. Researchers have also suggested that

neurological deficits within the limbic system of persons with

autism may create impairments in motivation, such that behaviors

and stimuli that are reinforcing to most children are not

reinforcing to those with autism (Bauman & Kemper, 1994).

According to Mailloux & Rouley, A combination of these and other

neurological problems may particularly affect social interactions

in children with autism. (American Occupational Therapy Association, Volume

60, 268-274). Autism is a lifelong neurodevelopmental condition.

Since the earliest epidemiological surveys in the 1960s, a wealth

of data has become available, indicating a much higher prevalence

of the condition than previously thought.

Pet Therapy

In recent years the use of animals in medical and

mentalhealth treatment has become increasingly common. According

to the “biophilia” hypothesis, humans have adapted to be

attentive to both human and nonhuman life forms in their

environment (Kellert, 1997). According to Edward O. Wilson, there

is an instinctive bond between human beings and other living

systems. He defines biophilia as "the urge to affiliate with

other forms of life". With respect to child development, an

increasing number of developmentalists have begun to adopt a

“biocentric” perspective. Such an approach departs from the more

traditional anthropocentric (human only) focus in theory and

research, and suggests that children exhibit a natural interest

toward animals and other nonhuman aspects of their environments.

One of the most profound and moving examples of the potential

power of the biophilic approach to understanding human

development in general, and autism in particular, comes from the

writings of Temple Grandin, a PhD and professor of animal science

who is herself diagnosed with autism. Her writings about her life

have provided insights into an inner world of autism that until

recently medical science thought could not exist, while

simultaneously describing a unique and sensitive understanding of

animal behavior. In her 1995 book, Thinking in Pictures: And Other Reports

from My Life with Autism, Dr. Grandin wrote,“Being autistic has helped

me to understand how they [animals] feel. People often fail to

observe animals” (p. 155). She attributes her success in animal

science to her connection with animals. Recent developmental

research suggests that both normally developing children (Melson,

2003) and children with autism (Martin & Farnum, 2002; Redefer &

Goodman, 1989) exhibit a natural interest toward animals and

other nonhuman aspects of their environments, the incorporation

of animals into occupational therapy may be a natural extension

of the philosophy of the sensory integration approach.

Classical Conditioning

Ivan Pavlov’s theory has been used in explaining how to

explain people’s seemingly irrational responses to stimuli. A

child with ASD, who has sensory deficits, is not capable of

discriminating stimuli.

Conceptual Paradigm

Figure 1. Relationship between Pet Therapy and impaired social

interactivity among children with autism spectrum disorder.

The independent variable which is the Pet therapy is introduced

to the respondents with autism spectrum disorder and determines

if the intervention is effective in developing one’s social

interactivity.

CHAPTER III

RESEARCH METHODOLOGY

Research Design

The study utilizes Quantitative Research Design which

involves investigation of phenomena that lend themselves to

precise measurement and quantification, often involving a

rigorous and controlled design as stated by Polit and Beck

(2007). The Quantitative Research Design is particularly an

Experimental Design which actively introduces an intervention or

treatment, they are also considered by many to be gold standard

because they come closer than any other design in meeting the

criteria for inferring causal relationships. Quasi-experimental

designs involves an intervention but lack randomization as stated

by Polit and Beck (2007).

The researchers will use a one-group pretest-posttest design

as shown below where in O1 represents pre-test while X

represents the intervention and O2 which represents post-test.

O1 X O2

Pre-test design is the collection of data prior to the

experimental intervention; sometimes called baseline data. It is

also the trial administration of a newly developed instrument to

identify flaws or assess time requirements. Treatment is the

experimental intervention under study. Post-test design is the

collection of data after introducing an intervention as stated by

Byers et.al. (2006).

Research Locale

The study will be conducted at Zion Circle Center. The

researchers conducted the study here because they wanted to find

ways to assist the said institution with its vision and plans for

the children with ASD. The institution is a Christian school

which caters to children with special needs. It is located at the

3rd floor of the Zion Christian Center in Grace Park, EDSA,

Caloocan City. The participants of this study are 6 to 10 year-

old children who are diagnosed with ASD by a registered clinical

psychologist.

Sample and Sampling Technique

The researchers used non-probability sampling specifically

convenience sampling. Convenience sampling - members of the

population were chosen based on their relative ease of access

(Polit and Beck, 2007).

  The total population of Zion Circle Center as of 2013 is

100. The total population of children with autism spectrum

disorder is 20. There were 20 participants included in the study.

These 20 participants stood as the representatives of the whole

population of children with ASD in Zion Circle Center.

The inclusion criteria set by the researchers for the

participants were the following:  The child with autism,

female/male must be between 6 to 10 years old and must be a

diagnosed to have autism spectrum disorder by a licensed

physician and has been under the care of Zion Circle Center for a

year. Our earliest social behaviour can be seen as early as 2

months of age. The average child smiles at the sight of its

mother’s and father’s face. (Introduction to Psychology, Atkinson

& Hilgard). As infants, children with autism may not smile and

coo in response to their caregivers or initiate play with their

caregivers, the way most young infants do. By definition, the

symptoms of autism have their onset before the age of 3. However,

children with autism are not simply delayed in their development

of important skills. When they do develop language or social

interaction patterns, there is a striking deviance in the nature

of these. (Abnormal Psychology, S. Hoeksema). Across studies, the

concern that most commonly led to referral from medical

professionals was language delay or regression in language

skills, followed by social difficulties. Most children received

the diagnosis of ASD between 3 and 6 years. (Juneja et. al.,

2004; Kalra et. al., 2005).

The exclusion criteria for the participants were the

following: Children whose ages are not between 6 to 10. Children

that are not properly diagnosed with autism spectrum disorder and

those who have stayed in Zion Circle Center beyond the 12-month

inclusion will not participate in this study.

Instrumentation

In this study, an adopted questionnaire will be utilized as

data-gathering instrument to determine the level of interactivity

of a child with ASD before the pet therapy. This questionnaire

was adopted from the study Improving Health Through Animal Assisted

Therapy by Liana Urichuk with Dennis Anderson. The first part of the

questionnaire includes the open-ended question asking about the

age, educational background, occupation and religion. The second

part includes 15 multiple choice questions that gauges the

interactivity of the child with ASD observed by the parent or

caregiver.

The researchers administered a pre and post test

questionnaire. The post test is the equivalent form of the

pretest having the questions paraphrased to determine if the

level of interactivity of the children with ASD are enhanced and

as well as to avoid the “practice effect” for maintaining

internal validity. The researchers interpreted the result based

on the interactivity’s score before and after the pet therapy.

Every score has a corresponding interpretation. A score of “0”

means there is no interactivity. A score of “1-3” means there is

no change in the level of interactivity. A score of 4-7” means

that there is a slight improvement with the interactivity. A

score of “8-11” means there is an im improvement with the

interactivity. A score of “12-14”means a remarkable change in

interactivity. A score of “15” is equivalent to a complete change

in the child’s interactivity.”

The Pet Therapy Module

The program consists of a 30-minute exposure of the animal

to the child. The pet will be the primary play mate and source of

interactivity of the child for the entire duration of the

prescribed time per week. The inclusive minutes will include

activities such as play time and pet care with facilitation from

the guardian and the researchers. Prior to engaging with the

intervention, the parents or immediate guardian shall complete a

questionnaire to provide baseline information regarding the

interactivity of the child which they have observed. The

researchers will then explain the specifics of the intervention

to the parents and will administer the AAT to the child. This

program is expected to be completed in 6 weeks.

Data Collection Procedure

All communication protocols such as verbal communication to

Zion Circle Center were done. A communication letter will be

addressed and was brought to the administrators of the

institution prior to the implementation of the study on Pet Therapy

and Social Interactivity of Children with Autism.

Implementation

Pet therapy session took place 6 weeks, twice a week - every

Mondays and Thursdays from 10:00 am - 11:00 am and conduction was

held at Zion Circle Center in 418 B. Zion Christian Center

Gracepark, EDSA, Caloocan City. It was held from October 03, 2013

to December 3, 2013. The researchers have conducted discussion

about Pet therapy among parents and exposure of pet, particularly

domesticated rabbits to the children with ASD. At first the

respondents (parents or caregivers) were given a pre test and and

on the last day of therapy, they were given a post test.

Statistical Treatment

This research study will use both division of statistics

which are descriptive statistics and inferential statistics in

order to determine level of social interactivity among children

with ASD in a selected institution. The descriptive statistics is

concerned with gathering, classification, and presentation of

data and summarizing values to described group characteristics of

the data (Conception & Najjar). And the inferential statistics is

concerned with analysis of a sample data leading to prediction,

inferences, interpretation, or conclusion about the entire

population (Orines 2004).

P= FN x

100

The frequency distribution was used to answer the

demographic profile of the participants. It is one of the most

common graphical tools used to describe a single population. It

is a grouping of data into categories showing the number of

observations in each category (Concepcion & Najjar). It

summarizes and organizes the population or sample that the

researchers gathered. It is a tabulation of the frequencies of

each value that is why presenting data in a frequency

distribution makes inspection of the data set much more

manageable than presenting the entire set of raw data. It makes

easy to see the data particularly when two different data sets

are compared. For computing the percentage, the formula used was:

Where:

P = percentage

F = frequency associated with the demographic profile

of the respondents

N = total number of respondents

100 = constant

The weighted average was used to answer the demographic

profile of the participants. According to Polit and Beck, the

t=x1 – x2 - ∆

s12 + s22 n1 n2

bigger the weight given to any study, the more that study will

contribute to the weighted average. Thus, weights should reflect

the amount of information that each study provides (2008). For

computing the central tendency, the formula used was:

Where:

ES = represents effective size

The t-test (student’s T) was used to answer if there was any

significant difference between the level of level of social

interactivity among children with ASD before and after animal

assisted therapy. The t-test assesses whether the mean of 2

variables are statistically different from each other (Polit &

Beck, 2008). The formula used was:

Where:

x 1, and x 2 = are the means of the two samples

Weighted average =

sum of (ES x weight for that ES)

sum of the weights

X2=Σ(f (a) – f (e))f (e)

Δ = is the hypothesized difference between the

population means (0 if testing for equal means)

s1 and s2 = are the standard deviations of the two

samples

n1 and n2 = are the sizes of the two samples. The number

of degrees of freedom for the problem is the smaller

of n1− 1 and n2– 1.

The chi-square test was used to answer if there was a

significant relationship between level of interactivity of the

children with ASD after the intervention and their demographic

profile. Chi-square test is used to test hypotheses about the

proportion of cases that fall into different categories, as when

a contingency table has been created (Polit & Beck, 2008). The

formula used was:

Where:

X2 = chi-square

f (a) = actual frequency or number of observations in a

cell

f (e) = expected frequency or number of observations in

a cell in the theoretical distribution

Σ = symbol for “summation” the differences are

cumulative