Exceptional Research Results


In a unique new research project conducted by Ziv Medical Center, which examined the integration of young children with autism spectrum disorder (ASD) with typically developed children of their age group, the researchers found that medical clowning therapy improves the communication and social skills of children with ASD.

The research results were presented at the first conference of “Autism Israel” in the Galilee, held in Ziv medical Center, in conjunction with the Faculty of Medicine in the Galilee, Bar Ilan University. The research was conducted in Ziv's Child Development Center, by Dr. Uri Yitskar, head researcher and head of Ziv's Department for Mental Health for Children and Adolescents and initiated by Dr. Ilene Lee, a researcher in the field of autism. The practical aspects of the research were conducted by Ms. Orna Gavrieli an occupational therapist, and Ms. Shoshi Ofir, a medical clown from the 'Dream Doctors' project. A research grant was received from the Magi Foundation.

Today there are no substantiated therapies offering such a wide range of appropriate stimuli alongside interaction with typically developed children. Following the extremely positive results of the initial research, it is appropriate to examine the subject further, says Dr. Uri Yitskar, the chief researcher.

The uniqueness of this study is in the integration of children with ASD with typically developed children and medical clowning therapy. This combination has yet to be examined elsewhere, says Ms. Orna Gavrieli, the occupational therapist from Ziv.

Five children diagnosed on the Autism spectrum participated in the study, in 2 separate cycles. Each child  met for 12 individual weekly sessions of 60 minutes each with a medical clown. In the second 30 minutes of each session they were joined by a typically developed child of their age.

The aims of the study were to 1) identify medical clowning techniques appropriate for young children with ASD; 2) define MC primary treatment goals for young children with ASD; and 3) document changes in children’s social, communication, and play skills pre-post intervention.

The participation of the medical clown was through the use of laughter, the absurd, and the dramatization and exaggeration of reality to create communication circles with the child with ASD (with an emphasis on enjoyment and fun), and  to aid in the instances where the level of interaction between the two children waned.

The results of the study, checked throughout the 24 weeks, were positive: the children with ASD, some of whom had no verbal capabilities, were able to make emotional-social contact with the typically developed children. In the summarizing conversations with the parents of these children, they explained how the positive effects of these meetings carried on at home, long after the hours spent with the therapists. The parents also said that even after the conclusion of the project the children exhibited considerably less signs of anxiety in situations of stimulus overload; they were able to connect spontaneously with children they were meeting for the first time. There were positive benefits for the typically developed children, as well, on the development of their moral and social values and making them more accepting of the “other”.

Dr. Lee had seen Shoshi, the medical clown, at work with a group of diabetic children in the children’s endocrinology clinic in Ziv. The group was of varying ages and from diverse cultural and religious backgrounds: Jewish children of both secular and religious backgrounds, Druze, Bedouin, new immigrants and others. The differences in their backgrounds posed no barrier to their communication during their play.

As a result of her observations, Dr. Lee decided to employ a medical clown for work with children with ASD and to create pairs whereby one was a typically developed child and one was a child with ASD.

The latest data show that one child in a hundred will be diagnosed as ASD; four times as many boys as girls. The autism spectrum (ASD), or PDD as it is sometimes called, is a developmental – neurological phenomena affecting social skills, communication and behavior. Included are such syndromes as Savant autism, Asperger and others. Studies of the past number of years have shown that a child can actually be diagnosed as young as six months.