Art, therapy and autism

Samantha A Hutchison draws Michael responding to a barely audible soundIt is now common knowledge that some individuals with a diagnosis of AS (Autism Syndrome) or PDD-NOS (Pervasive Developmental Disorder, not otherwise specified) are exceptionally gifted. Stephen Wiltshire whom I mentionned in a previous posting is one of these. Though many AS children are quite capable drawers from an early age, many tend to focus on parts rather than the whole. The ability to assess the global picture, integrating information in context, is key to giving meaning to any situation.  ’Central coherence’ a term first coined by Frith (1989), is found lacking in many AS individuals who process information in a relatively context independant manner. For some this is seen as a cognitive style more than a deficit and has been found to be an asset in tasks that benefit from a focus on details. Planning is thus often impaired, resulting in pictures that are either fragmented or where attention to detail prevents a more global rendering of the whole. We are of course referring to realistic drawing from life which is at times precocious in AS children and often a preferred mode of representation.  They seek to reproduce what they see or remember, preferring the factual rather than expressive feeling pictures. But there are exceptions here too and the AS/PDD-NOS labels are too broad to account for all variants.  As Temple Grandin PhD likes to repeat, « we think in pictures. » Ms Grandin diagnosed with autism at an early age, over the years has cumulated numerous awards for her ground breaking work in animal science, while on a mission to demystify Austism and Asperger at conferences across America. See her description of  thinking styles  differences on her personal web site. If you have yet to see the movie made about her life, it is an entertaining way to learn more about the challenges an AS diagnosis poses,  but also to see in action the incredible gifts that are also made possible.

In the US, a group of American Art Therapists developed a specialised service for AS children. They divide specific therapeutic goals into broad categories that are considered to present particular challenges to the youth.  They are: (for a more descriptive list see their website).

1. Imagination/abstract thinking deficits

2. Sensory regulation and integration

3. Emotions/Self-expression

4. Developmental Growth

5. Recreation/Leisure skills

6. Visual-spatial deficits

Much of the literature in art therapy often promotes a hands off approach to self-expression through art. However in working with AS/PDD challenged children it is necessary to be active, to model and promote the targeted changes. They explain:

So how do art therapists and clients reach these goals? Although a therapy session is pretty complicated to explain, it basically involves the interaction of three dynamics: the therapeutic relationship between therapist and client(s), the art materials, and therapist adaptations/interventions. When working with people with autism, the therapist must be the driving force within a session (though the more you can incorporate and engage the client’s interests, the better) by providing directives designed to address treatment goals. Making art with the client as a way to engage, model, build friendship, and encourage communication (whether physical assistance is needed or not) is important. Projects might involve materials such as paints, clays, pencils, creams, feathers, and beads and processes such as puppetry, printmaking, sculpture, or mural painting. Safety is the only limit. Initial sessions will (ideally) involve family consultation, observation, assessment, establishment of treatment goals, and relationship/trust building. Therapy is often (but not always) long-term (as are most ASD therapies) due to the pervasive and permanent (though improvable) nature of autism.

This is another example of a modified version of how art therapy is implemented and adapted to the clients needs and capabilities.

To see and to read———————

For more art therapy related reading see (many are available from the web):

  1. Evans and Dubowski (2001). Art Therapy with Children on the Autistic Spectrum beyond words. (Book)
  2. Martin, N. (2009) Art Therapy and Autism: Overview and Recommendations (paper)
  3. Martin, N. (2008). Assessing Portrait Drawings Created by Children and Adolescents with Autism Spectrum Disorder (paper)
  4. Epp, K.M. (2008). Outcome-Based Evaluation of a Social Skills Program Using Art Therapy and Group Therapy for Children on the Autism Spectrum. (paper)
  5. Emery, M.J.  (2004). Art Therapy as an Intervention for Autism (paper).
  6. Osborne, J. (2003). Art and the child with Autism: therapy or education? (paper)

And for those alternative views in mental health the Autism rights mouvement (ARM)  promotes a more positive understanding of autism. Autism is understood as a form of neurodiversity instead of specific neuro-deficits, a cognitive style more than cognitive deficits.

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Catégorisé dans Arts, Société, Thérapie.

Publié le 29 juil 2010

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