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Case Reports
. 2022 Dec 7;19(24):16399.
doi: 10.3390/ijerph192416399.

COMSI®-A Form of Treatment That Offers an Opportunity to Play, Communicate and Become Socially Engaged through the Lens of Nature-A Single Case Study about an 8-Year-Old Boy with Autism and Intellectual Disability

Kristina Byström  1   2 , Björn Wrangsjö  3 , Patrik Grahn  1
Affiliations
Case Reports

COMSI®-A Form of Treatment That Offers an Opportunity to Play, Communicate and Become Socially Engaged through the Lens of Nature-A Single Case Study about an 8-Year-Old Boy with Autism and Intellectual Disability

Kristina Byström et al. Int J Environ Res Public Health. .

Abstract

This case study shows how an 8-year-old boy with autism and mild intellectual disability underwent positive psychological development in terms of play, social communication, and mentalization during a year and a half of group-based therapy using COMSI®-(COMmunication and Social Interaction). This eclectic treatment has a relational approach and is based on developmental psychology, knowledge of autism, and the impact of nature and animals on human health. The change in the child was been studied using both quantitative and qualitative methods. His general intellectual capacity was measured using the Wechler Preschool and Primary Scale of Intelligence, and his Mentalization Ability/Theory of Mind was assessed using three tests: Eva and Anna, Hiding the fruit and Kiki and the cat. Throughout the study period, change was documented with the help of the therapists' process notes and the parents' descriptions. The results show that support for the child comes from three different sources: nature, animals, and the therapists. Animals and nature form the basis for episodes of coordinated attention in conversation and play with therapists. The therapists' approach used sensitivity and compliance with the child's needs and focus of interest.

Keywords: autism; children; joint attention; mentalization; nature-and animal-based treatment.

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Conflict of interest statement

The first author is the creator of the model COMSI® but there has been no economic advantage coming from this. Patrik Grahn is a shareholder in a research company that handles intellectual property rights, NAHC Holding AB, of which the Swedish University of Agricultural Sciences is the majority shareholder through its subsidiary SLU (Swedish University of Agricultural Sciences) Holding. The authors declare no conflict of interest.

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Publication types

Grants and funding

This study was funded by various bodies in Sweden; Region Västra Götaland, Habilitation and Health, the Skaraborg Institute of Development and Research, the Wedding Fund of the King and Queen of Sweden, the Swedish University of Agricultural Sciences, the Formas Research Council; project ‘Sustainable outdoor living environments—systematic interdisciplinary studies of health effects and impact on social inequalities’ (D-nr 2019/01916) and the Formas Research Council; project “Estimating the role of exposure and access to natural environments for wellbeing, mental and cognitive health” (D-nr FS-2019/0019).

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