Research Opportunities in the Area of Mental Health Promotion, Prevention, and Intervention for Children and Youth

doi:10.5014/ajot.2014.685001

Free

Research Article | September 2014

Research Opportunities in the Area of Mental Health Promotion, Prevention, and Intervention for Children and Youth

Article Information

American Journal of Occupational Therapy, September/October 2014, Vol. 68, 610-612. doi:10.5014/ajot.2014.685001

Abstract

The American Occupational Therapy Association (AOTA) Evidence-Based Practice Project has developed a table summarizing the research opportunities on mental health promotion, prevention, and intervention for children and youth. The table provides an overview of the state of current available evidence on interventions within the scope of occupational therapy practice and is based on the systematic reviews from AOTA’s Occupational Therapy Practice Guidelines Series. Researchers, students, and clinicians can use this information in developing innovative research to answer important questions within the occupational therapy field.

Planning a research project requires consideration of many factors. Level of interest and knowledge in a specific area, access to appropriate populations of participants, support of mentors and other researchers, and funding availability all help determine the focus of a future project. An additional component to be considered is whether adequate, up-to-date research has already been completed on a topic; if sufficient evidence is available in a given core area, this area might not be the best choice for another research project.

The best research topic may be one in which either little research has been done or the research to date is insufficient, inconclusive, or mixed. In addition, when research conducted to date provides a low level of evidence and is of limited quality, additional high-quality research in the area is needed.

The “Research Opportunities Table on Mental Health Promotion, Prevention, and Intervention for Children and Youth” provides an overview of the state of current available evidence on interventions within the scope of occupational therapy practice. The table is based on the systematic reviews from the Occupational Therapy Practice Guidelines Series developed by the American Occupational Therapy Association's Evidence-Based Practice Project. The table lists specific interventions and indicates either that the evidence is sufficient to support the intervention or that moderate, mixed, or few studies support the intervention and therefore it is a priority research area. Please refer to the Occupational Therapy Practice Guidelines for Mental Health Promotion, Prevention, and Intervention for Children and Youth (Bazyk & Arbesman, 2013) and the American Journal of Occupational Therapy article “Systematic Review of Occupational Therapy and Mental Health Promotion, Prevention, and Intervention for Children and Youth” (Arbesman, Bazyk, & Nochajski, 2013) for more information on the topic area and the systematic review process.

This table also is posted online for researchers to use to inform the occupational therapy community about their work. The table is linked to Google Drive and offers a place for researchers to include information on recently completed and ongoing research. It is hoped that this information will make the research planning process easier, minimize duplication of research efforts, and stimulate discussions among researchers with similar interests, which can then facilitate the creation of research networks and multisite studies. Researchers, students, and clinicians can use this information in developing innovative research to answer important questions within the occupational therapy field. To add current or ongoing research to the table, visit http://www.aota.org/researchopportunitiestables.

Researchers are also encouraged to enter their projects into AOTA’s Researcher Database at http://myaota.aota.org/research/. This database provides AOTA with information such as relevant clinical settings and populations, International Classification of Functioning, Disability and Health level (World Health Organization, 2001), funder (if any), and key words to help guide research advocacy and policy initiatives.

Research Opportunities Table on Mental Health Promotion, Prevention, and Intervention for Children and Youth

Theme	Specific Intervention	Strength of Evidence
Tier I: Universal mental health promotion and prevention services
Social skills	Whole-school and emotional learning programs to improve social and emotional skills	Research sufficient
	After-school programs incorporating a goal of social skills to improve social behaviors and reduce problem behaviors	Research sufficient
	School-based bullying prevention programs to prevent bullying and victimization	Research sufficient
	Problem-solving skills to improve coping behavior	Research sufficient
	Problem-solving skills to improve peer interaction in preschool-age children	Priority research area
	Parent education to improve child compliance	Priority research area
	Parent education as part of a multicomponent school program to prevent aggressive behaviors in at-risk kindergartners	Priority research area
Health promotion	School-based stress management programs for Grades 3–8 to reduce stress and improve coping skills	Research sufficient
	Mental health literacy programs for adolescents to improve knowledge and attitudes about mental illness	Priority research area
	Back education program for elementary school children to improve back posture while lifting objects and carrying backpacks	Priority research area
	Yoga to improve physical fitness and cardiorespiratory health	Priority research area
	Yoga to reduce negative behaviors in response to stress	Priority research area
	School-based programs to improve self-efficacy	Priority research area
Play, recreation, and leisure	Participation in performing arts programs to improve social interaction and social skills	Research sufficient
	Use of recreation facilitators in after-school programs to increase participation in physical activity	Priority research area
	Participation in performing arts programs to reduce emotional problems	Priority research area
	Team-building activities during physical education to improve self-concept	Priority research area
	Teaching of cooperation skills to elementary school children to increase cooperation and reduce competitive behaviors	Priority research area
	Skill-based activity groups to reduce involvement with the legal system	Priority research area
	Skill-based activity groups to improve behavioral outcomes	Priority research area
	Participation in performing arts programs to improve social interaction and social skills	Priority research area
Tier II: Targeted mental health services
Social skills	Social skills training for disliked or rejected children and adolescents to improve social interaction, peer acceptance, and social standing	Research sufficient
	Social skills programming for at-risk, aggressive, or antisocial children and adolescents to improve attention to tasks, peer interaction, and prosocial behaviors and to reduce aggressive, delinquent, and antisocial behaviors	Research sufficient
	Social skills programming for children and adolescents with learning disabilities and ADHD to improve communication and social and functional skills and reduce problem behaviors	Research sufficient
	Social and life skills programs for children with intellectual impairments and developmental delays to improve life skills, conversation turn taking, initiation of social interaction, self-management, and compliance and decrease problem behaviors	Research sufficient
	Parenting programs for teenage mothers and their children to improve mother–infant interaction and parental attitudes and knowledge, maternal mealtime communication, self-confidence, and identity	Research sufficient
Health promotion	Yoga for adolescents with irritable bowel syndrome to reduce gastrointestinal symptoms	Research sufficient
	A program of yoga, massage, and relaxation for children with behavioral difficulties to improve self-confidence and increase communication	Priority research area
	A guided imagery program combined with coping strategies for withdrawn or rejected first graders to increase socialization	Priority research area
	A multicomponent training program for children and adolescents with asthma to improve knowledge of asthma and internal locus of control and to decrease days off of school	Priority research area
	Yoga for youth with Type 2 diabetes to increase weight loss and self-esteem	Priority research area
	An activity-based group intervention for siblings of children with cancer to improve cancer-related knowledge, mood, and communication skills	Priority research area
Play, recreation, and leisure	Play groups for abused or neglected children to improve play skills, self-esteem, and positive feelings and to reduce solitary play and behavior problems	Research sufficient
	Play and music for children with intellectual and language impairments to improve social skills and attention to peers	Research sufficient
	Recreation, leisure, and physical education programs for children and adolescents with intellectual disabilities to improve social interaction	Research sufficient
	Structured recreation and activity program for children with extreme shyness to increase extraversion and decrease timidity	Priority research area
	Creative activities for children and early adolescents with peer difficulty to improve self-confidence in managing peer conflict	Priority research area
	Activity-based summer program for children with cleft lip and palate to improve social interaction	Priority research area
	Activity-based after-school program for children with identified behavior problems to improve self-concept	Priority research area
Tier III: Intensive mental health services
Social skills	Social skills training for children and adolescents with ASD to improve social behavior, social competence, and self-management	Research sufficient
	LEGO^® social skills group for children with ASD to reduce social difficulties and improve social interaction	Research sufficient
	Social skills interventions for children and youth with diagnosed mental illness or serious behavior disorder to improve social behaviors	Research sufficient
	Friendship skills group for children with ASD to improve social skills	Priority research area
	Cognitive–behavioral therapy for children with ASD to reduce parent-reported anxiety	Priority research area
	Social communication intervention that includes joint attention for preschoolers with autism to improve language and adaptive behavior	Priority research area
	Cognitive–behavioral therapy and activities and games for children with ASD to improve assertive behavior and reduce hyperactivity and problem behaviors	Priority research area
	Video modeling or direct group instruction in social skills for children and adolescents with ASD to improve prosocial behaviors and social interactions	Priority research area
	Self-management strategies, change in instructional content, and differential reinforcement for children with ASD to reduce challenging behaviors	Priority research area
Play, recreation, and leisure	Music-related activities (singing, listening to music, playing an instrument) for children with autism to improve nonverbal and verbal communication skills and reduce problem behaviors	Research sufficient
	Wilderness experiences for adolescents with behavior disorders to improve cooperative behaviors	Priority research area
	Play activities for school-age children with autism to increase play and cooperative behaviors	Priority research area
	Use of a program to identify life mission (e.g., Instrumentalism in Occupational Therapy program) for adolescents with emotional and behavioral difficulties to improve participation in occupations	Priority research area

Note. ADHD = attention deficit hyperactivity disorder; ASD = autism spectrum disorder.

View Large

Research Opportunities Table on Mental Health Promotion, Prevention, and Intervention for Children and Youth

Theme	Specific Intervention	Strength of Evidence
Tier I: Universal mental health promotion and prevention services
Social skills	Whole-school and emotional learning programs to improve social and emotional skills	Research sufficient
	After-school programs incorporating a goal of social skills to improve social behaviors and reduce problem behaviors	Research sufficient
	School-based bullying prevention programs to prevent bullying and victimization	Research sufficient
	Problem-solving skills to improve coping behavior	Research sufficient
	Problem-solving skills to improve peer interaction in preschool-age children	Priority research area
	Parent education to improve child compliance	Priority research area
	Parent education as part of a multicomponent school program to prevent aggressive behaviors in at-risk kindergartners	Priority research area
Health promotion	School-based stress management programs for Grades 3–8 to reduce stress and improve coping skills	Research sufficient
	Mental health literacy programs for adolescents to improve knowledge and attitudes about mental illness	Priority research area
	Back education program for elementary school children to improve back posture while lifting objects and carrying backpacks	Priority research area
	Yoga to improve physical fitness and cardiorespiratory health	Priority research area
	Yoga to reduce negative behaviors in response to stress	Priority research area
	School-based programs to improve self-efficacy	Priority research area
Play, recreation, and leisure	Participation in performing arts programs to improve social interaction and social skills	Research sufficient
	Use of recreation facilitators in after-school programs to increase participation in physical activity	Priority research area
	Participation in performing arts programs to reduce emotional problems	Priority research area
	Team-building activities during physical education to improve self-concept	Priority research area
	Teaching of cooperation skills to elementary school children to increase cooperation and reduce competitive behaviors	Priority research area
	Skill-based activity groups to reduce involvement with the legal system	Priority research area
	Skill-based activity groups to improve behavioral outcomes	Priority research area
	Participation in performing arts programs to improve social interaction and social skills	Priority research area
Tier II: Targeted mental health services
Social skills	Social skills training for disliked or rejected children and adolescents to improve social interaction, peer acceptance, and social standing	Research sufficient
	Social skills programming for at-risk, aggressive, or antisocial children and adolescents to improve attention to tasks, peer interaction, and prosocial behaviors and to reduce aggressive, delinquent, and antisocial behaviors	Research sufficient
	Social skills programming for children and adolescents with learning disabilities and ADHD to improve communication and social and functional skills and reduce problem behaviors	Research sufficient
	Social and life skills programs for children with intellectual impairments and developmental delays to improve life skills, conversation turn taking, initiation of social interaction, self-management, and compliance and decrease problem behaviors	Research sufficient
	Parenting programs for teenage mothers and their children to improve mother–infant interaction and parental attitudes and knowledge, maternal mealtime communication, self-confidence, and identity	Research sufficient
Health promotion	Yoga for adolescents with irritable bowel syndrome to reduce gastrointestinal symptoms	Research sufficient
	A program of yoga, massage, and relaxation for children with behavioral difficulties to improve self-confidence and increase communication	Priority research area
	A guided imagery program combined with coping strategies for withdrawn or rejected first graders to increase socialization	Priority research area
	A multicomponent training program for children and adolescents with asthma to improve knowledge of asthma and internal locus of control and to decrease days off of school	Priority research area
	Yoga for youth with Type 2 diabetes to increase weight loss and self-esteem	Priority research area
	An activity-based group intervention for siblings of children with cancer to improve cancer-related knowledge, mood, and communication skills	Priority research area
Play, recreation, and leisure	Play groups for abused or neglected children to improve play skills, self-esteem, and positive feelings and to reduce solitary play and behavior problems	Research sufficient
	Play and music for children with intellectual and language impairments to improve social skills and attention to peers	Research sufficient
	Recreation, leisure, and physical education programs for children and adolescents with intellectual disabilities to improve social interaction	Research sufficient
	Structured recreation and activity program for children with extreme shyness to increase extraversion and decrease timidity	Priority research area
	Creative activities for children and early adolescents with peer difficulty to improve self-confidence in managing peer conflict	Priority research area
	Activity-based summer program for children with cleft lip and palate to improve social interaction	Priority research area
	Activity-based after-school program for children with identified behavior problems to improve self-concept	Priority research area
Tier III: Intensive mental health services
Social skills	Social skills training for children and adolescents with ASD to improve social behavior, social competence, and self-management	Research sufficient
	LEGO^® social skills group for children with ASD to reduce social difficulties and improve social interaction	Research sufficient
	Social skills interventions for children and youth with diagnosed mental illness or serious behavior disorder to improve social behaviors	Research sufficient
	Friendship skills group for children with ASD to improve social skills	Priority research area
	Cognitive–behavioral therapy for children with ASD to reduce parent-reported anxiety	Priority research area
	Social communication intervention that includes joint attention for preschoolers with autism to improve language and adaptive behavior	Priority research area
	Cognitive–behavioral therapy and activities and games for children with ASD to improve assertive behavior and reduce hyperactivity and problem behaviors	Priority research area
	Video modeling or direct group instruction in social skills for children and adolescents with ASD to improve prosocial behaviors and social interactions	Priority research area
	Self-management strategies, change in instructional content, and differential reinforcement for children with ASD to reduce challenging behaviors	Priority research area
Play, recreation, and leisure	Music-related activities (singing, listening to music, playing an instrument) for children with autism to improve nonverbal and verbal communication skills and reduce problem behaviors	Research sufficient
	Wilderness experiences for adolescents with behavior disorders to improve cooperative behaviors	Priority research area
	Play activities for school-age children with autism to increase play and cooperative behaviors	Priority research area
	Use of a program to identify life mission (e.g., Instrumentalism in Occupational Therapy program) for adolescents with emotional and behavioral difficulties to improve participation in occupations	Priority research area

Note. ADHD = attention deficit hyperactivity disorder; ASD = autism spectrum disorder.

Acknowledgments

AOTA acknowledges the work of Matthew Bernardo, Stacia Matthews, and Melissa Stutzbach, who participated in the development of the Research Opportunities tables while at the American Occupational Therapy Association in Bethesda, MD. This work is based on the American Journal of Occupational Therapy article “Systematic Review of Occupational Therapy and Mental Health Promotion, Prevention, and Intervention for Children and Youth” (Arbesman, Bazyk, & Nochajski, 2013) and the Occupational Therapy Practice Guidelines for Mental Health Promotion, Prevention, and Intervention for Children and Youth (Bazyk & Arbesman, 2013), all from the AOTA Evidence-Based Practice Project.

References

Arbesman, M., Bazyk, S., & Nochajski, S. M. (2013). Systematic review of occupational therapy and mental health promotion, prevention, and intervention for children and youth. American Journal of Occupational Therapy, 67, e120–e130. http://dx/doi.org/10.5014/ajot.2013.008359 [Article] [PubMed]

Bazyk, S., & Arbesman, M. (2013). Occupational therapy practice guidelines for mental health promotion, prevention, and intervention for children and youth. Bethesda, MD: AOTA Press.

World Health Organization. (2001). International classification of functioning, disability and health. Geneva: Author.

Research Opportunities Table on Mental Health Promotion, Prevention, and Intervention for Children and Youth

Theme	Specific Intervention	Strength of Evidence
Tier I: Universal mental health promotion and prevention services
Social skills	Whole-school and emotional learning programs to improve social and emotional skills	Research sufficient
	After-school programs incorporating a goal of social skills to improve social behaviors and reduce problem behaviors	Research sufficient
	School-based bullying prevention programs to prevent bullying and victimization	Research sufficient
	Problem-solving skills to improve coping behavior	Research sufficient
	Problem-solving skills to improve peer interaction in preschool-age children	Priority research area
	Parent education to improve child compliance	Priority research area
	Parent education as part of a multicomponent school program to prevent aggressive behaviors in at-risk kindergartners	Priority research area
Health promotion	School-based stress management programs for Grades 3–8 to reduce stress and improve coping skills	Research sufficient
	Mental health literacy programs for adolescents to improve knowledge and attitudes about mental illness	Priority research area
	Back education program for elementary school children to improve back posture while lifting objects and carrying backpacks	Priority research area
	Yoga to improve physical fitness and cardiorespiratory health	Priority research area
	Yoga to reduce negative behaviors in response to stress	Priority research area
	School-based programs to improve self-efficacy	Priority research area
Play, recreation, and leisure	Participation in performing arts programs to improve social interaction and social skills	Research sufficient
	Use of recreation facilitators in after-school programs to increase participation in physical activity	Priority research area
	Participation in performing arts programs to reduce emotional problems	Priority research area
	Team-building activities during physical education to improve self-concept	Priority research area
	Teaching of cooperation skills to elementary school children to increase cooperation and reduce competitive behaviors	Priority research area
	Skill-based activity groups to reduce involvement with the legal system	Priority research area
	Skill-based activity groups to improve behavioral outcomes	Priority research area
	Participation in performing arts programs to improve social interaction and social skills	Priority research area
Tier II: Targeted mental health services
Social skills	Social skills training for disliked or rejected children and adolescents to improve social interaction, peer acceptance, and social standing	Research sufficient
	Social skills programming for at-risk, aggressive, or antisocial children and adolescents to improve attention to tasks, peer interaction, and prosocial behaviors and to reduce aggressive, delinquent, and antisocial behaviors	Research sufficient
	Social skills programming for children and adolescents with learning disabilities and ADHD to improve communication and social and functional skills and reduce problem behaviors	Research sufficient
	Social and life skills programs for children with intellectual impairments and developmental delays to improve life skills, conversation turn taking, initiation of social interaction, self-management, and compliance and decrease problem behaviors	Research sufficient
	Parenting programs for teenage mothers and their children to improve mother–infant interaction and parental attitudes and knowledge, maternal mealtime communication, self-confidence, and identity	Research sufficient
Health promotion	Yoga for adolescents with irritable bowel syndrome to reduce gastrointestinal symptoms	Research sufficient
	A program of yoga, massage, and relaxation for children with behavioral difficulties to improve self-confidence and increase communication	Priority research area
	A guided imagery program combined with coping strategies for withdrawn or rejected first graders to increase socialization	Priority research area
	A multicomponent training program for children and adolescents with asthma to improve knowledge of asthma and internal locus of control and to decrease days off of school	Priority research area
	Yoga for youth with Type 2 diabetes to increase weight loss and self-esteem	Priority research area
	An activity-based group intervention for siblings of children with cancer to improve cancer-related knowledge, mood, and communication skills	Priority research area
Play, recreation, and leisure	Play groups for abused or neglected children to improve play skills, self-esteem, and positive feelings and to reduce solitary play and behavior problems	Research sufficient
	Play and music for children with intellectual and language impairments to improve social skills and attention to peers	Research sufficient
	Recreation, leisure, and physical education programs for children and adolescents with intellectual disabilities to improve social interaction	Research sufficient
	Structured recreation and activity program for children with extreme shyness to increase extraversion and decrease timidity	Priority research area
	Creative activities for children and early adolescents with peer difficulty to improve self-confidence in managing peer conflict	Priority research area
	Activity-based summer program for children with cleft lip and palate to improve social interaction	Priority research area
	Activity-based after-school program for children with identified behavior problems to improve self-concept	Priority research area
Tier III: Intensive mental health services
Social skills	Social skills training for children and adolescents with ASD to improve social behavior, social competence, and self-management	Research sufficient
	LEGO^® social skills group for children with ASD to reduce social difficulties and improve social interaction	Research sufficient
	Social skills interventions for children and youth with diagnosed mental illness or serious behavior disorder to improve social behaviors	Research sufficient
	Friendship skills group for children with ASD to improve social skills	Priority research area
	Cognitive–behavioral therapy for children with ASD to reduce parent-reported anxiety	Priority research area
	Social communication intervention that includes joint attention for preschoolers with autism to improve language and adaptive behavior	Priority research area
	Cognitive–behavioral therapy and activities and games for children with ASD to improve assertive behavior and reduce hyperactivity and problem behaviors	Priority research area
	Video modeling or direct group instruction in social skills for children and adolescents with ASD to improve prosocial behaviors and social interactions	Priority research area
	Self-management strategies, change in instructional content, and differential reinforcement for children with ASD to reduce challenging behaviors	Priority research area
Play, recreation, and leisure	Music-related activities (singing, listening to music, playing an instrument) for children with autism to improve nonverbal and verbal communication skills and reduce problem behaviors	Research sufficient
	Wilderness experiences for adolescents with behavior disorders to improve cooperative behaviors	Priority research area
	Play activities for school-age children with autism to increase play and cooperative behaviors	Priority research area
	Use of a program to identify life mission (e.g., Instrumentalism in Occupational Therapy program) for adolescents with emotional and behavioral difficulties to improve participation in occupations	Priority research area

Note. ADHD = attention deficit hyperactivity disorder; ASD = autism spectrum disorder.

View Large

Research Opportunities Table on Mental Health Promotion, Prevention, and Intervention for Children and Youth

Theme	Specific Intervention	Strength of Evidence
Tier I: Universal mental health promotion and prevention services
Social skills	Whole-school and emotional learning programs to improve social and emotional skills	Research sufficient
	After-school programs incorporating a goal of social skills to improve social behaviors and reduce problem behaviors	Research sufficient
	School-based bullying prevention programs to prevent bullying and victimization	Research sufficient
	Problem-solving skills to improve coping behavior	Research sufficient
	Problem-solving skills to improve peer interaction in preschool-age children	Priority research area
	Parent education to improve child compliance	Priority research area
	Parent education as part of a multicomponent school program to prevent aggressive behaviors in at-risk kindergartners	Priority research area
Health promotion	School-based stress management programs for Grades 3–8 to reduce stress and improve coping skills	Research sufficient
	Mental health literacy programs for adolescents to improve knowledge and attitudes about mental illness	Priority research area
	Back education program for elementary school children to improve back posture while lifting objects and carrying backpacks	Priority research area
	Yoga to improve physical fitness and cardiorespiratory health	Priority research area
	Yoga to reduce negative behaviors in response to stress	Priority research area
	School-based programs to improve self-efficacy	Priority research area
Play, recreation, and leisure	Participation in performing arts programs to improve social interaction and social skills	Research sufficient
	Use of recreation facilitators in after-school programs to increase participation in physical activity	Priority research area
	Participation in performing arts programs to reduce emotional problems	Priority research area
	Team-building activities during physical education to improve self-concept	Priority research area
	Teaching of cooperation skills to elementary school children to increase cooperation and reduce competitive behaviors	Priority research area
	Skill-based activity groups to reduce involvement with the legal system	Priority research area
	Skill-based activity groups to improve behavioral outcomes	Priority research area
	Participation in performing arts programs to improve social interaction and social skills	Priority research area
Tier II: Targeted mental health services
Social skills	Social skills training for disliked or rejected children and adolescents to improve social interaction, peer acceptance, and social standing	Research sufficient
	Social skills programming for at-risk, aggressive, or antisocial children and adolescents to improve attention to tasks, peer interaction, and prosocial behaviors and to reduce aggressive, delinquent, and antisocial behaviors	Research sufficient
	Social skills programming for children and adolescents with learning disabilities and ADHD to improve communication and social and functional skills and reduce problem behaviors	Research sufficient
	Social and life skills programs for children with intellectual impairments and developmental delays to improve life skills, conversation turn taking, initiation of social interaction, self-management, and compliance and decrease problem behaviors	Research sufficient
	Parenting programs for teenage mothers and their children to improve mother–infant interaction and parental attitudes and knowledge, maternal mealtime communication, self-confidence, and identity	Research sufficient
Health promotion	Yoga for adolescents with irritable bowel syndrome to reduce gastrointestinal symptoms	Research sufficient
	A program of yoga, massage, and relaxation for children with behavioral difficulties to improve self-confidence and increase communication	Priority research area
	A guided imagery program combined with coping strategies for withdrawn or rejected first graders to increase socialization	Priority research area
	A multicomponent training program for children and adolescents with asthma to improve knowledge of asthma and internal locus of control and to decrease days off of school	Priority research area
	Yoga for youth with Type 2 diabetes to increase weight loss and self-esteem	Priority research area
	An activity-based group intervention for siblings of children with cancer to improve cancer-related knowledge, mood, and communication skills	Priority research area
Play, recreation, and leisure	Play groups for abused or neglected children to improve play skills, self-esteem, and positive feelings and to reduce solitary play and behavior problems	Research sufficient
	Play and music for children with intellectual and language impairments to improve social skills and attention to peers	Research sufficient
	Recreation, leisure, and physical education programs for children and adolescents with intellectual disabilities to improve social interaction	Research sufficient
	Structured recreation and activity program for children with extreme shyness to increase extraversion and decrease timidity	Priority research area
	Creative activities for children and early adolescents with peer difficulty to improve self-confidence in managing peer conflict	Priority research area
	Activity-based summer program for children with cleft lip and palate to improve social interaction	Priority research area
	Activity-based after-school program for children with identified behavior problems to improve self-concept	Priority research area
Tier III: Intensive mental health services
Social skills	Social skills training for children and adolescents with ASD to improve social behavior, social competence, and self-management	Research sufficient
	LEGO^® social skills group for children with ASD to reduce social difficulties and improve social interaction	Research sufficient
	Social skills interventions for children and youth with diagnosed mental illness or serious behavior disorder to improve social behaviors	Research sufficient
	Friendship skills group for children with ASD to improve social skills	Priority research area
	Cognitive–behavioral therapy for children with ASD to reduce parent-reported anxiety	Priority research area
	Social communication intervention that includes joint attention for preschoolers with autism to improve language and adaptive behavior	Priority research area
	Cognitive–behavioral therapy and activities and games for children with ASD to improve assertive behavior and reduce hyperactivity and problem behaviors	Priority research area
	Video modeling or direct group instruction in social skills for children and adolescents with ASD to improve prosocial behaviors and social interactions	Priority research area
	Self-management strategies, change in instructional content, and differential reinforcement for children with ASD to reduce challenging behaviors	Priority research area
Play, recreation, and leisure	Music-related activities (singing, listening to music, playing an instrument) for children with autism to improve nonverbal and verbal communication skills and reduce problem behaviors	Research sufficient
	Wilderness experiences for adolescents with behavior disorders to improve cooperative behaviors	Priority research area
	Play activities for school-age children with autism to increase play and cooperative behaviors	Priority research area
	Use of a program to identify life mission (e.g., Instrumentalism in Occupational Therapy program) for adolescents with emotional and behavioral difficulties to improve participation in occupations	Priority research area

Note. ADHD = attention deficit hyperactivity disorder; ASD = autism spectrum disorder.