Art therapy and austism

By: shruti Nair

Autism is a pervasive developmental disorder that is characterized by impairments in social interactions, interests and activities, and language development. Children with autism are deprived of the resources from which the mind develops and organizes. For example, children with autism may exhibit severe language deficits, may not relate well to people, often have a desire for repetition, exhibit exacting attention to detail, and display rigid behaviors. If the children’s routines, patterns, or objects change in their external world, they may experience emotional intensity and distress. These behaviors are often challenging to parents and professionals. A child with autism looks like any child, with or without a label. Parents have identified and promoted effective treatments throughout the history of treating children with autism. The behaviors and the developmental needs for a child with an autistic spectrum disorder can be as different and unique as the individual child.

Children’s art is a developmental process and is expressed by schematic stages that reflect that development. The schemata are repeated in much the same way as words are used. In this sense they are signs. Thus, in schematic representation, the same shapes repeated constantly come to express entire complexes of ideas. Artistic expression can reflect a child’s object constancy, growth and development, and the ordering of his or her internal world. As an art therapist, one can assess a child’s relationship to important objects through drawings. Children who have autism cannot order and keep constant their relationship to objects in their inner world as other children do throughout development. Children with autism continually insist on sameness; behavioral rigidity and specialized interests may be explained by their intense need for order and object constancy. This is a new concept in that the behaviors of autism are not viewed as strange or odd, but as fitting into the larger picture of defining the behaviors as normal to their growth and developmental needs. All children’s behavior has a purpose. The world of children with autism is not one of confusion and baffling behaviors, but involves a different way of ordering their world. The metaphor of an inner mirror that cannot reflect may help describe their experience.

The mechanisms that allow children to relate and to develop language skills are not well understood. Visual cues can give the neurotypical child a sense of familiarity. In neurotypical child development, objects can be related to because they remain constant in the child’s inner experience. That is why neurotypical children love to draw as they are ordering the objects that represent theirinner world. Children also like to talk while drawing and this may also contributeto object constancy.

Young children are inaesthetically tied to their art expressions and can physically and emotionally relate to the drawing as they execute it. An art therapist often gets a sense of a child’s world by observing the execution of his or her drawing and the emotional importance attached to every object through color, line, and body language. This experience becomes less as children mature and art expression is intellectualized. However, symbolic meaning often continues to exist, and therefore, artwork remains highly expressive.

What drives children with autism is very different from what drives neurotypical children in the developmental process. Willful action is dependent on the ability to monitor one’s intentions and understand one’s mind. For example, neurotypical children will exhibit emotional preferences when choosing activities whereas autistic children often do not display emotions in such situations. Autistic children may repeatedly play with and direct their attention to objects that appear to have no significance. The idea of closure, completion, or satisfaction seems unimportant, but process apparently is.

CASE STUDY

As observed in an interview, the growth and progress of a 6-year-old boy diagnosed with autism without mental retardation will now be discussed. His development has given me a glimpse of his world and a new understanding of children with autism. Autistic children do not develop imagery schema, and they show little interest in drawing or even doing a scribble. This is considered abnormal, and yet the world of autism has no apparent inner order for relating to objects or for developing such schema. The 6-year-old boy with whom the therapist met had not developed schemata for objects. For example, when she asked him to draw a house, he would write the word “house.” When she asked him to draw a person, he would write his name. There was no object in his imagination or in his mind for familiar words as per the therapist. His language skills were poor, and his voice was high pitched and repetitive. The child had started speaking around age 4 according to his mother. Eye contact was difficult, and his attention was hard to keep for any significant time. The therapists’ overall sense of this child was that he was experiencing an inner sense of chaos and was constantlystruggling to order the objects in the playroom. One set of soft and multicolored alphabet letters was always his choice with which to play or work. She later discovered from talking with his mother that he had the same set athome.

STAGES OF DRAWING:

The process of drawing contributed to the young boy’s development. The boy began the process by working with colored play dough. He made a ball and then flattened it out on paper in the shape of a circle. The process was laboriousfor him. Following the therapists’ directive and example, he drew a line around the flattened circular shape using a marker. The play dough and the pounding was a kinesthetic experience for the little boy. She encouraged him to continue and to repeat this process. His motor skills were poor, and when he tried to trace, his hand went far from the round shape. However, he repeated the exercise over and over for several months and gained control of tracing around the circular shape. After tracing, he progressed to cutting the clay in cookie-cutterfashion.

After several months of repeating this process as per the therapist, the child drew a figure that was fragmented with a head disconnected from a body. From this point in his artistic development, she could observe his progress in his voice, which was now in a more normal tone and not as high pitched. He also improved his eye contact with her during therapy. In the middle stage of therapy, he chose to use puppets in his interaction. He would hand a puppet and talk through his selected puppet in a normal voice without the usual high pitch. He could now be engaged through the safe transitional space of a puppet. Following the work with puppets, without any direction, he chose to draw. His early figures of people were fragmented and disconnected as in his earlier drawing. “However, when he drew a figure with a neck that was connected to the body, his behavior at home and in the school, setting improved” said the therapist. He continued to seek out paper and markers and to order and develop a schema of objects through his drawings.

During one session after drawing several figures, he said, “These are called people.” she also observed that his joy in the process of drawing was remarkable. Towards the end of the middle stage of therapy, he was able to have a conversation in a voice that sounded less mechanical.

This boy’s progress was largely due to his mother’s constant and unconditional regard for his well-being. Although his imaginative play continued to lack the spontaneity of neurotypical children, he understood a small joke that she made during a session using representational play. He was playing with a toy school bus and had selected figures of schoolchildren and placed them in the bus. However, one figure that he selected was a toy dog. She made the comment, “It looks like someone brought their dog to school.” Her tone of voice implied asubtle joke. He laughed spontaneously and enjoyed her joke, as he then removed the toy dog from the school bus and replaced it with a toy child. The boy’s language skills and his ability to relate and enjoy the joke revealed importantprogress.

“A concrete language user will not understand riddles and humor, which require one to understand figurative language or plays on words”.

CONCLUSION

Autistic children do not develop imagery schema, and they show little interest in drawing or even doing a scribble. This is considered abnormal, and yet the world of autism has no apparent inner order for relating to objects or for developing such schema. The use of nonverbal expression through the experience of making art encourages children with autism to begin to represent their experiences. Forms represent objects and the very act of drawing with intention may encourage attachment to the object. Children create art because it is rooted in the need to relate to their world. Children with autism appear to lack the need to relate. However, art therapy for normal or autistic children may serve as a path toward increased awareness of the self. The sense of self remains a cornerstone for relating. Experiencing the self is a developmental process. It can be very difficult for some children and is particularly true for children with autism. Seeing children’s behaviors through the eyes of normal developmental milestones can be important in helping children with autistic spectrum disorders. Art for children will always prove to be an evolutionary process that leads to the next stage. Art therapy for autistic children can be an important activity-based intervention for encouraging theirgrowth.

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Shruti Nair
Dawn Centre for Differently Able
Pune

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