52 KneuroKnits: Evaluating social participation and anxiety response associated with participation in a knitting group for youth with neurological conditions (pilot study)
Authors: Kapur Alisha , Penner Melanie , Nguyen Jenny , Wiegelmann Justine , Hartman Laura , Kushki Azadeh , Cook Katelin , Waters Patti 
Published: August 2020

Abstract

Background
Knitting as a creative practice has a reputation for being therapeutic. There are many programs that use crafts as a method of creating social community and reducing anxiety for youth; however, there is no existing research that demonstrates these benefits. We designed a novel study to explore the benefits of a social skills knitting group on engagement and anxiety for youth with neurodevelopmental disorders.

Objectives
1. To evaluate the social engagement experience of youth with neurological conditions participating in the KneuroKnits program.
2. Evaluate the impact of KneuroKnits intervention on anxiety levels of participants.

Design/Methods
We designed a 4-week knitting group for youth with neurodevelopmental disorders and acquired brain injuries. Each session included a lesson involving a knitting skill and a social skill. To evaluate social engagement, we used the Self-reported Experience of Activity Settings (SEAS) questionnaire at the first and final sessions. The five subcategories of the SEAS (Personal Growth, Psychological Engagement, Social Belonging, Meaningful Interactions and Choice & Control) were analyzed following the first and the last session. Qualitative interviews were conducted with participants, parents, and facilitators in the month following the final session and were analyzed using an interpretive phenomenological approach to outline commonly occurring themes in social engagement. To evaluate anxiety levels, participants completed the State-Trait Anxiety Inventory (STAI) at the beginning and end of the first and final sessions, respectively, and the Symptom Checklist-90-R (SCL-90) anxiety subscale; qualitative analysis included themes involving levels of anxiety from the interviews.

Results
There were 14 total participants with a mean age of 17.4 ± 2.2 years. Participants had primary diagnoses of ASD (n=9), acquired brain injury/concussion (n=4), and developmental coordination disorder (n=1). Social engagement results for the SEAS questionnaire showed a general increase in mean scores of all subcategories with a significant increase in the category of “Meaningful Interactions (p=0.02). This quantitatively demonstrated that the group had an impact on creating meaningful social connection. Qualitative analysis of the interviews revealed three commonly occurring themes: The balance of organic and facilitated social interaction, a sense of community from shared experience and direct benefits of knitting (pride, productivity, relaxation, a choice to be social). For the evaluation of anxiety levels, the STAI demonstrated a significant decrease in anxiety following both Session 1 (p=0.02) and Session 4 (p=0.006). The SCL-90-R Anxiety subsection scores significantly decreased between the first and final session (p=0.01). Participants voiced that the sessions made them feel calmer.

Conclusion
This knitting group merged a creative skill and social skill, and was novel in its approach to studying social engagement and anxiety within this population. Our study found that participants, their families and facilitators found KneuroKnits to be a valuable and rewarding program. Further study is needed in a larger sample to confirm our findings.