ART THERAPY AND AUTISM

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1 ART THERAPY AND AUTISM

2 Overview Artistic development, like speech and language development is necessary for symbolic functioning, social interaction and communication Impairments indicative of autism impact on artistic development Art therapy assists artistic development through the use of art material and creative activity

3 Inter-Subjective Communication The autism condition is a neurologically based collection of syndromes with impairment in social interaction and communication (inter-subjective communication) Inter-subjective communication difficulties seem to be a connected to unusual sensory-perceptual and cognitive-symbolic experience (unusual ways of seeing and ways of processing and interpreting a sense of meaning) A capacity for representation and symbolic thought are necessary components for social interaction and communication Our first experiences of symbolic thought are through reciprocal play including scribbling and babbling. (shared meaning)

4 Typical Artistic Development

5 Artistic Development Stage 1: Scribbling and Kinaesthetic-Sensory Experience The earliest manifestation of mark-making behaviour is the scribble stage Experimental mark-making or scribbling activity is part of the evolution of general development Scribbling behaviour emerges as a kinaesthetic-sensory experience around the age of 18 months Marks of meaning or scribbles are critical to the neural development of the visual, verbal and emotional thinking in the child. (Sheridan, S. R. 2004: 10)

6 Scribbling is the first stage of self-expression. (Lowenfeld, V. 1978:187) The activity is exploratory and what the activity feels like in the body is the most important experience Scribbling behaviour is a concrete shaping of experience (Evans, K. 1998:17)

7 Scribbling and Babbling Behaviours An early sign and absolute indicator for referral for assessment for autism is delayed or impaired babbling behaviour Both scribbling and babbling behaviours are typically innate and emergent. Both behaviours are connected: Hands and mouths are neighbours on the sensory motor cortex, linking the work of the hands and gesturing to speech. (Sheridan. 2004: 10) Scribbling and babbling behaviours function as neural organisers encouraging the bi-hemispheric turn-taking necessary for translating verbal information into visual and vice versa Both behaviours contribute to the acquisition of symbol systems for intersubjective communication. (Sheridan, S. R. 2004: 10) Babbling and scribbling are the building blocks we use to develop our capacity for representation and for symbolic thinking Atypical scribbling behaviour may be an early sign of delay or impairment in the development of social interaction and communication skills

8 Artistic Development Stage 2: Affective-Perceptive experience By the age of 24 months increased motor control leads to the production of patterns and geometric shapes in scribbles The child is intuitively building on a vocabulary of marks, or marks of meaning along with the communicative skills necessary for later social relations At this developmental stage typically developing children engage in imaginative play and interpersonal relationships. They romance or name their scribbles, demonstrating awareness of the link between symbol and what it might represent to others The social interchange surrounding drawing is as engrossing as the actual scribbling activity itself. (Shotwell, Wolf, Dennie and Gardner. 1980: 47-48)

9 At this stage of development the circle symbol becomes evident as a result of practice and manipulative skill. This symbol marks the onset of an awareness of inside and outside. This is potentially the first symbol for self and not self ; self and other; inside self and outside world.

10 Artistic Development Stage 3: Cognitive-Symbolic experience By the age of 36 months and onwards the typically developing child has moved from kinaesthetic mark making towards picture making and symbols. Complex unconscious and conscious processes such as symbolisation now come into play (Ranenken, M. 2007)

11 Atypical Artistic Development and Autism Art therapists working with individuals with autism observe that there seems to be a resistance to, difficulty with or an inability to make sequential or cumulative progression through these three typical stages of artistic development without direction and/or assistance. The emerging patterns of communication that result in the development of more sophisticated methods of communication such as language and representational art have their origins during the earliest stages of life, but for some children with autism the symptoms of the disorder may affect these earliest communicative strategies in such a way that the later emergence of language is severely blocked and a stable shaping of experience and expression into form cannot be achieved consistently. (Evans, K and Dubowski, J. 2001: 49-59)

12 Atypical Artistic Development and Autism Impairments indicative of autism may also result in an unusual or idiosyncratic use of art material. There may be a dependency on formulaic devices There may be an auto-sensuous and auto-stimulatory use of art material. Mono-processing or an inability to use more than one sensory channel at a time might make the use of art materials over-stimulating. (Williams, D. 1996: 95) There may be difficulty processing visual stimuli resulting in unusual responses to sensory experience. Sensory hypersensitivity, managed by avoiding direct eye-contact with visual stimuli can result in an avoidance of mark-making behaviour, or difficulty making eye contact with marks produced by scribbling.

13 Atypical Artistic Development and Autism There may also be a difficulty with global processing When two dots and a line arrive inside a circle shape this particular combination of marks carries symbolic content for the non-autistic child, who learns from observers that this can represent a face, with eyes and a mouth. A difficulty with global processing results in difficulty seeing the whole picture: the image is always seen as two dots, a line and a circle shape, rather than a symbol for a face.

14 Atypical Artistic Development and Autism As part of a research project in 2008 I observed visual and behavioural responses to a circle stimulus by children aged 3-6 years old with no behaviours indicative of autism and children with a primary diagnosis of ASD A sample of responses to the circle stimulus by 3 year olds with no behaviours indicative of autism reveals an awareness of the potential of mark making as a symbol system for communication

15 Atypical Artistic Development and Autism A sample of responses to the circle symbol by children with a primary diagnosis of ASD illustrates delayed or compromised symbolic awareness 4 years old 5 years old 6 years old

16 Atypical Artistic Development and Autism Children with a primary diagnosis of ASD also demonstrated: A difficulty making eye contact with the marks produced An ongoing lack of interest in shared experience or social interchange accompanying the activity Little or no interest in developing the symbolic and communicative properties of these patterns without direction and assistance ( showing or romancing )

17 Comparative Case 36 months old non- or pre-verbal avoids eye-contact with me repeatedly marks and maps surfaces with the same rapid kinetic spirals no eye contact with the marks no attempt to name or share the images does not invite interaction

18 30 months old no behaviours indicative of autism production of the image is a performance invites a response to the marks names the image Nana indicates the eyes with her finger Comparative Study These behaviours demonstrate an awareness of the symbolic, interactive and communicative properties of the scribbling activity.

19 Savantism Through media documentation of exceptional ability autism has become associated with reports of savantism. Savant artists make up a very small percentage of the autism population Drawing skills appear to be at an advanced stage of artistic development, well beyond the scribble stage These individuals seem 'to have acquired sets of drawing skills or approaches to the activity which become fixed and rigidified (Evans and Dubowski ) What appears to be sophisticated drawing can actually be a symptom of autistic behaviour The formula driven approach serves as a safety net, (Evans. 1998) a defence strategy, an attachment to a special interest and/or an attempt to alleviate stress and anxiety There seems to be no motivation or drive to develop a symbol system of shared meaning

20 Why Art Therapy? Art Therapy can encourage the development of communicative abilities beyond the sensory-kinaesthetic stage of artistic development Emphasis is placed on careful observation of behaviour and body language in the therapeutic setting in order to pick up subtle and barely perceptible cues relating to sensory experience (hyper- and hypo-sensitivty) All behaviour is a method of communication. The person with autism will communicate in whatever way they can. We must let them make choices, be patient and wait (Gillingham. 1995: 58)

21 Why Art Therapy? By directing social interaction through a focus on the use of art material a form of relating which the person with autism can tolerate, and build up tolerance for, becomes established. Beginning with the assumption that the use of materials is nonor pre-representational and non- or pre-verbal a new vocabulary can be developed, which can be slowly extended and expanded through the introduction of new experience and material

22 The Aims and Objectives of Art Therapy Provide a secure environment within which the client feels safe Structure and routine are provided through the boundaries of time and space help reduce anxiety Facilitated in a contained space without interruption, enabling the client to receive, regulate and process information in their own time Non-directive approach where client chooses what material to use and how to use it, enabling them to regulate stimulation

23 Art therapy can encourage relationship building through the interaction and integration of different materials and colours. The person with autism should be encouraged to touch colour, join with it through covering themselves with it. It evokes emotion. Choosing to approach and make peace with colour is part of the process of making peace with emotion. (Williams. 1996: 84)

24 Difficulties with connection and mono-processing can result in what appears to be a 2D experience of the world. Collage can be touched and seen with the hands. Collage and clay-work sculpture help experience wholeness and connectedness. It is a three dimensional experience. (Williams. 1996: 287) Art therapy can provide a space to make choices about what material to use and how to use it.

25 Art therapy offers new material which can encourage a regular and temporary replacement of special interest objects (autistic objects) with unexpected objects to build tolerance to unfamiliar experience Allowing the child to lead the interaction enables him to regulate the amount of stimulation received. (Dawson. 1991: 207)

26 Art therapy encourages the exploration of interpersonal relationships through creative and reciprocal play

27 Art therapy encourages an exploration of relationships through mirroring mark making; non-verbal dialogue If a favoured configuration is repeated it may have a special meaning for the child. Produced by a certain posture it can be seen as a self-portrait directly related to the child s body. If images include enclosures the child may be exploring insides and outsides. Colour may be a mood. Several marks on paper may form some kind of map or exploration of the space afforded by the paper. (Case and Dalley. 1990: 19)

28 In art therapy attention is paid to sensorial experiences to encourage the development of primary and sensory integration (hard/soft, cold/warm, dry/wet)

29 Art therapy invites relaxation through use of pleasurable material and stimulation and motivation through use of sensory material Choice and the use of pleasurable materials can help motivate. Sensorial, pleasurable, metallic and aromatic materials are more likely to be attended to. (Williams. 1996: 282)

30 Art Therapists Art Therapists/Art Psychotherapists are trained to Masters level and registered with HCPC Monthly Clinical Supervision is mandatory Art Therapists work to the Code of Professional and Ethical practice outlined by the British Association of Art Therapy (BAAT)

31 Rachael Johnson Rachael Johnson is an artist and Art Psychotherapist living and working in Northern Ireland. She completed her MA in Art Psychotherapy in Cork and is continuing research on Artistic Development and the Diagnosis of Autism for publication. Since 2002 Rachael has been working predominantly with people on the autism spectrum, and with children and young people experiencing emotional and behavioural difficulties. She provides an art therapy service for individuals and groups in autism units across the province, and facilitates Art Therapy and Autism Awareness sessions and workshops for staff teams in schools and health centres.