Art Therapy for Children Diagnosed with Autism Spectrum Disorders: Development and First Evaluation of a Treatment Programme

Evaluation of art therapy for children with problems related to autism This PhD concerns the development and evaluation of the art therapy programme ‘Images of Self’ for children diagnosed with Autism Spectrum Disorders (ASD). In general, these children are referred to art therapy (AT) when they are insecure or depressed, have negative thoughts in their minds about themselves, suddenly become very angry and / or anxious, have difficulties with sudden changes, have problems with making friends or understand social manners, or have combinations of these kinds of problems.Creating something with art materials is an important part of AT. The therapist offers support to help the child to have (success) experiences and develop skills and insights. Each art material offers opportunities for expression; carpentry, for example, offers other experiences than painting. The art therapist supports the child in becoming more aware of (un) pleasant experiences and in developing awareness of his or her preferences and difficulties.Based on literature study and interviews with art therapists, two measuring instruments were developed and tested, with which the development of children and the actions of the therapist were evaluated. As a result of the treatment evaluation a majority of the children have become more flexible and social and have learned to express what is in their minds. Most children feel better and are happier after the therapy, even at home and in the classroom. Parents and teachers are very satisfied with the treatment

Exploring change in children's and art therapists' behavior during ‘Images of Self’, an art therapy program for children diagnosed with Autism Spectrum Disorders:A repeated case study design

(1) Background: ‘Images of Self’ (IOS) is a recently developed and evaluated art therapy program of 15 sessions to reduce difficulties in ‘sense of self’, ‘emotion regulation’, ‘flexibility’, and ‘social behavior’ of children diagnosed with Autism Spectrum Disorders (ASD). In this paper is explored whether change in the child’s behaviors corresponds to the therapist’s actions during IOS and 15 weeks later. (2) Method: In a repeated case study design, twelve children and seven therapists participated. Art therapists monitored their own and the children’s behavior by applying two observation instruments: the OAT (child behavior) and EAT (therapist behavior). Child behaviors during art making were - individually and as a group - compared with therapist actions at three moments during the program. (3) Results: Ten of twelve children showed a substantial or moderate positive behavior change considering all OAT-subscales at the end of the program and fifteen weeks after treatment. Improvement of ‘social behavior’ stood out. Halfway treatment art therapists most prominently showed support of ‘emotion regulation’, ‘flexibility’, and ‘social behavior’. Clear one-on-one relationships between changes in children’s behavior and actions of therapists could not be identified. (4) Conclusion: The study provides new insights in the AT-treatment process by monitoring children’s and therapists’ behavior. The art making itself and the art therapy triangle (child, art making, therapist) offer opportunities to improve verbal and nonverbal communication skills of the child

Exploring change in children's and art therapists' behavior during ‘Images of Self’, an art therapy program for children diagnosed with Autism Spectrum Disorders:A repeated case study design

(1) Background: ‘Images of Self’ (IOS) is a recently developed and evaluated art therapy program of 15 sessions to reduce difficulties in ‘sense of self’, ‘emotion regulation’, ‘flexibility’, and ‘social behavior’ of children diagnosed with Autism Spectrum Disorders (ASD). In this paper is explored whether change in the child’s behaviors corresponds to the therapist’s actions during IOS and 15 weeks later. (2) Method: In a repeated case study design, twelve children and seven therapists participated. Art therapists monitored their own and the children’s behavior by applying two observation instruments: the OAT (child behavior) and EAT (therapist behavior). Child behaviors during art making were - individually and as a group - compared with therapist actions at three moments during the program. (3) Results: Ten of twelve children showed a substantial or moderate positive behavior change considering all OAT-subscales at the end of the program and fifteen weeks after treatment. Improvement of ‘social behavior’ stood out. Halfway treatment art therapists most prominently showed support of ‘emotion regulation’, ‘flexibility’, and ‘social behavior’. Clear one-on-one relationships between changes in children’s behavior and actions of therapists could not be identified. (4) Conclusion: The study provides new insights in the AT-treatment process by monitoring children’s and therapists’ behavior. The art making itself and the art therapy triangle (child, art making, therapist) offer opportunities to improve verbal and nonverbal communication skills of the child

Evaluating art therapy processes with children diagnosed with Autism Spectrum Disorders:Development and testing of two observation instruments for evaluating children’s and therapists’ behaviour

Two instruments were developed and examined to enable treatment evaluation of art therapy (AT) with children diagnosed with Autism Spectrum Disorders (ASD). One instrument is the OAT-A (Observation in Art Therapy with a child diagnosed ASD), the other is the EAT-A (Evaluation of actions of the Art Therapist during treatment of a child diagnosed ASD). Both scales were refined in a three round procedure. In each round raters (art therapists and students) observed and coded four videos of different AT sessions. For each round interrater reliability was tested and when necessary items were revised. In each round the first video was used for training purposes only. Both instruments showed in the third round an acceptable level of intercoder agreement. Using the OAT-A and EAT-E in clinical research requires extensive training of raters who preferably work in pairs, thereby enabling comparison of their assessments. It is concluded that important steps have been taken to enable systematic evaluation of art therapy with children diagnosed ASD including the actions of the art therapist

Exploring Change in Children’s and Art Therapists’ Behavior during ‘Images of Self’, an Art Therapy Program for Children Diagnosed with Autism Spectrum Disorders: A Repeated Case Study Design

(1) Background: ‘Images of Self’ (IOS) is a recently developed and evaluated art therapy program of 15 sessions to reduce difficulties in ‘sense of self’, ‘emotion regulation’, ‘flexibility’, and ‘social behavior’ of children diagnosed with Autism Spectrum Disorders (ASD). In this paper, it is explored whether change in the child’s behaviors corresponds to the therapist’s actions during IOS and 15 weeks later. (2) Method: In a repeated case study design, twelve children and seven therapists participated. Art therapists monitored their own and the children’s behavior by applying two observation instruments: the OAT (Observation of a child with autism in Art Therapy) and EAT (Evaluation of Art Therapist’s behavior when working with a child with autism). Child behaviors during art making were—individually and as a group—compared with therapist’s actions at three moments during the program. (3) Results: Ten of twelve children showed a substantial or moderate positive behavior change considering all OAT subscales at the end of the program and 15 weeks after treatment. Improvement of ‘social behavior’ stood out. Halfway treatment art therapists most prominently showed support of ‘emotion regulation’, ‘flexibility’, and ‘social behavior’. Clear one-on-one relationships between changes in children’s behavior and actions of therapists could not be identified. (4) Conclusion: The study provides new insights in the AT treatment process by monitoring children’s and therapists’ behavior. The art making itself and the art therapy triangle (child, art making, therapist) offer opportunities to improve verbal and nonverbal communication skills of the child

Art therapy with children with Autism Spectrum Disorders: A review of clinical case descriptions on 'what works'

Well-ordered empirical information on ‘what works’ in art therapy with children diagnosed with Autism Spectrum Disorders (ASD) hardly exists. For that reason a systematic review was undertaken covering the period 1985–2012. Our study explored academic and practice-based sources with the aim to identify core elements of art therapy for normal/high intelligent target group children up to 18 years. Eighteen descriptive case-studies were found and analyzed according to the Context Outcomes Art Therapy (COAT) model. The results indicate that art therapy may add to a more flexible and relaxed attitude, a better self-image, and improved communicative and learning skills in children with ASD. Art therapy might be able to contribute in mitigating two main problem areas: social communicative problems, and restricted and repetitive behavior patterns. Typical art therapeutic elements such as sensory experiences with sight and touch may improve social behavior, flexibility and attention-abilities of autistic children. Considering the limited evidence that was found, primarily existing of elaborated clinical case descriptions, further empirical research into the process and outcomes of art therapy with ASD children is strongly recommended

Evaluation of ‘Images of Self', an art therapy program for children diagnosed with Autism Spectrum Disorders (ASD)

The art therapy (AT) program for children diagnosed with Autism Spectrum Disorders (ASD), ‘Images of Self’, has been evaluated with repeated single case studies (n = 12) in a mixed-methods design. The program focuses on children's difficulties with their ‘sense of self’, ‘emotion regulation’, ‘flexibility’ and ‘social behavior’. Parents, teachers and art therapists scored the BRIEF and CSBQ, instruments for rating child behavior. Children filled out the SPPC, a self-image scale. To evaluate the quality of the program, therapists used a child observation scale (OAT-A) and a therapists’ self-evaluation scale (EAT-A). All instruments were applied three to five times per case, depending on the corresponding measurement objectives: one week before the start of the program (T0), during session 3 (T1), session 8 (T2), session 15 (T3), and 15 weeks after termination of the treatment (T4). Parents and teachers were invited to complete a form for qualitative comments which was structured around the four problem areas. Therapists video-recorded three sessions and evaluated these with parents and - during training sessions - with the principal investigator. At the end of the treatment parents, teachers and art therapists gave a rating for their overall satisfaction with the treatment. Main improvements after treatment were seen in children's flexible and social behavior. Overall satisfaction regarding the program showed averages between 7.1 and 7.7. Implications of our study for the AT-practice and future research are discussed