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Eur J Pediatr. 2019 Aug;178(8):1283-1289. doi: 10.1007/s00431-019-03415-7. Epub 2019 Jun 26.

Benefits of medical clowning in the treatment of young children with autism spectrum disorder.

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Weinberg Child Development Center, The Chaim Sheba Medical Center, 5262000, Tel HaShomer Ramat Gan, Israel.
Weinberg Child Development Center, The Chaim Sheba Medical Center, 5262000, Tel HaShomer Ramat Gan, Israel.
Center of Academic Studies, Or Yehuda, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.


We investigated the contribution of group therapy delivered by a medical clown to young children diagnosed with autism spectrum disorder (ASD). So far, scientific publications regarding medical clowning focus on general health advantages. The current study is the first controlled research examining the use of medical clowning in the therapy for children with ASD. Twenty-four children aged 2-6 years old with ASD enrolled in our special education intensive program were examined before and after group sessions with clown intervention (CI) and other intervention (OI). We tested stereotypic behaviors, verbal expression, play reciprocity, and social smiles. Data was collected during 12 weeks of intervention, and the trajectory of change was evaluated in addition to the pre-/post-intervention.Conclusion: improvement over time in all measures: Significant increase in word production, play reciprocity, and amount of social smiles during CI as compared with OI. We also found a reduction in frequency of stereotypic behaviors during and following CI as compared with before CI. These preliminary results indicate that medical clowning may be beneficial for young children with ASD, since it promotes communication and social reciprocity in a fun and lively interventional setting. What is Known: • Many therapies are used and proven as efficacious interventions for children with ASD. • So far, medical clowning was not tested as an intervention or therapy for ASD. What is New: • Medical clowning sessions with children with ASD elicited enhanced communication during the interventions as compared with other interventions. • Medical clowning sessions contributed to a decrease in frequency of stereotypic movements over time, in children with ASD.


Autism spectrum disorder; Complementary and alternative therapies for ASD; Medical clowning; Treatment


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