Structured play-based motor activities and joint-attention behaviors in autistic individuals: an exploratory repeated-measures mixed-methods pilot study

Background Structured play-based motor activities may provide meaningful opportunities for shared attention, social engagement, and task participation in autistic individuals. However, evidence from real-world institutional contexts remains limited, particularly when exploratory observational measures are used. Objective This study aimed to describe within-participant changes in observed social-behavioral scores during a structured play-based motor program with psychomotor and developmental features, and to contextualize these findings through qualitative observations. Methods This exploratory uncontrolled repeated-measures mixed-methods pilot study included ten autistic individuals who met predefined adherence and assessment-completion criteria. The program was delivered twice weekly over 14 weeks in an institutional adapted physical activity setting. Social behaviors were assessed at five time points using the Social Skills Observation Script through Bodily Practices, which evaluates social interaction initiation, response to interaction, sharing, joint attention, turn-taking, emotional expression, conflict resolution, and group participation. Quantitative data were analyzed using Friedman tests and exploratory baseline-to-final Wilcoxon comparisons, with Benjamini–Hochberg false discovery rate correction. Qualitative data were obtained from field observations, weekly records, and reports from caregivers, teacher, and monitor, including an embedded illustrative case. Results No ROHS domain showed a statistically significant change across the five assessment moments, either before or after correction for multiple comparisons. Joint attention showed a descriptive increase over time, but this pattern was not statistically significant. Qualitative findings suggested contextual changes in task engagement, responsiveness to cues, adaptation to structured routines, and participation quality. Conclusion The program appeared feasible in a real-world institutional context and may inform future hypothesis-driven studies. Findings should be interpreted as exploratory and feasibility-oriented, not as confirmatory evidence of intervention efficacy. Future controlled studies with larger samples, validated outcomes, blinded assessment, and psychometric validation of the observational instrument are warranted.