Objective: This study explored how children with neurodevelopmental disorders (NDD) experienced sensory-emotionalrelational integration during mother-child physical contact play, with the aim of describinge, the essential structure of their interactional changes and to identifying the transitional conditions for co-regulation specific to each diagnostic group.
Methods: Six children (aged 4-5 years) diagnosed with autism spectrum disorder (ASD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), or tic disorder (TD), and their mothers, participated in ten sessions of mother-child physical contact play. Video recordings, session transcripts, and researcher reflective memos were analyzed using Giorgi’s descriptive phenomenological method to derive the meaning units and articulate cross-case structural themes.
Results: The process of interactional change progressed as children gradually shifted from protecting themselves against touch, to accepting predictable tactile rhythms, and subsequently to initiating contact as active partners in shared interaction. As emotional attunement emerged, bodily rhythms synchronized and expressive emotional exchanges became increasingly reciprocal and flexible, Eventually, this allowed play to function as a space to reconfigure and sustain the relationship. Further, the conditions required for co-regulation differed by diagnostic profile: children with ASD, ID, and ADHD respectively required stable rhythmic predictability, sustained shared presence and role clarity, and co-regulation when interactional tempo was slowed, while children with TD deepened relational openness when reconnection after brief withdrawal was reliably supported.
Conclusion: This study showed that physical contact play operates not as a skill-training intervention, but rather an embodied developmental process through which sensory safety is restored, co-regulation becomes possible, and relational trust expands. These findings highlight the clinical significance of attunement-centered and rhythm-based approaches in supporting emotional and interactional development in children with neurodevelopmental disorders.