Poster
Running Head: EFFECT OF ART THERAPY ON AUTISTIC STUDENT 1
Giving Voice to an Autistic Child: The Effect of Art Therapy in Improving the
Communicative Skills and Self-Efficacy for Students with Autism
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 2
Abstract
The purpose of my action research project was to investigate whether art therapy can improve
the communication skills and self-efficacy of students with autism. My main participant was
an autistic kindergarten student named Anna study studying in K-4 grade of SLLIS. Anna’s
special education teacher, classroom teacher and mother were interviewed informally to
understand her communication and sharing abilities. Drawing art was mainly used to improve
her communication skills spread across various sessions. Data was collected by observing
and making notes in my personal journal about the improvement in Anna’s communication
skills and self-efficacy after each art therapy session and by conducting informal interviews
with Anna’s special education teacher, parents and art teacher. Results showed an
improvement in the Anna’s communication skill. If art therapy is used for a longer period of
time for autistic children like Anna, it would result in improving their communication skills
and self-efficacy to a very large extent.
Keywords: Autism, Art Therapy, Communication skills, self-efficacy
3
1. Introduction
1.1. Who I am as a Professional, and my Mission
My interest in Special Education began during my undergraduate studies at King Faisal
University. During this time, I became aware of the limited opportunities available for special
needs children in our public school systems. Many of the teaching approaches and resources
for this group seem far behind our contemporaries in the Western world. My professors were
excellent and compassionate people who challenged us to improve the conditions for special
needs students in Saudi Arabia. Due to the resistance of some Western mode of thought
amongst the most extreme members of my society, there is a distrust of anyone who comes in
trying to change things without considering the nuances of the Saudi culture. It is seen as an
“outsider” interference. As an insider, however, I hope to be able to bridge the gap between
the traditional Saudi method of education, and the progressive skills and strategies I have
learned here during my time at University of Missouri–St. Louis.
Immediately after graduation, I began working with my university at The National
Research Center for Giftedness and Creativity in their Early Start program, where we learned
to identify gifted children, and began the process of individualized educational plans. Many
gifted children are also autistic, and I began to recognize the overlap that often exists between
special needs students and gifted ones. Since then, autism has been my fascination and
research passion.
According to Al Moosa (2003) autism is still largely misunderstood here in the West.
Most of the people feel that autistic people are all the same, do not have feelings, do not like
to establish good relations, are a danger to the society on account of their aggressive
behavior, are savants, have no language skills and are incapable of accomplishing anything
on their own. These misconceptions are even more widespread in Saudi Arabia. I continued
to work alongside many brilliant professors and researchers, and I began to really have a
4
heart for these autistic children who seemed stuck in their own minds, often times incapable
of expressing their brilliant thoughts and creative ideas. Here in the States, I have been unable
to work because of my visa restrictions. However, I have volunteered at a center for children
with both Down Syndrome and autism. This school focused mainly on hygiene skills, as the
students were low-functioning autistic.
1.2. Reason of Interest
In the Holy Quran, there is honor given to all the children of Adam. There is to be no
special treatment of persons, whether they are abled differently from others, or based upon
their gender, race, or social class status. The generosity of the Lord is a legitimate right for all
the children of Adam. Even those born with special needs will receive the generosity of the
Lord. However, many people are not enlightened to this fact. The majority of people who are
not properly educated will never value these people. They seem unable to honor them, and do
not even look at their basic needs.
This has been a heart-breaking problem in Saudi Arabia. Many people who are not
educated see that a deformed or mentally disabled child will be bullied if they attempt to send
that child to school. Further, the lack of resources for special education is also a great
hindrance to this process of guarantee education for the group. In fear, and in wanting to
protect the child, they have often kept the child cloistered in the home. This is because many
people in Saudi Arabia do not know the latest modes and methods of working with children
with special needs. According to our national statistics, the number of births per year in Saudi
Arabia ranges between 400 to 500 thousand births yet due to limitations and the vigorous
tests that are required, many children with special needs are undiagnosed until 2-3 years. This
under-diagnosing is causing many parents to be shocked when the child isn’t developing their
cognitive functions at the proper time.
5
One study also showed that the number of people with special needs is counted at
approximately 730 thousand in Saudi Arabia, but the capacity to serve them is only at about
24 thousand people (Al-Othman, 2003). This is an impossible number to work with. It means
that only about 5% of Saudis will receive the services they need. That means there are still
about 700 thousand special needs people without services. These are not overly complicated
services; they are basic and fundamental. First and foremost, the most basic service which
can be given to those with special needs is education.
It is the right of every individual in any given community to get an education, and it is
the duty of every society to give everyone the right, commensurate with his abilities and
potential. Societies have an obligation to support people’s education at all levels and
categories. Sadly, in Saudi Arabia, special needs students have not been given the proper
opportunities. I have searched for information on statistics going back ten years. In the school
years between 2006 and 2008, the number of programs, institutes and centers of special
education altogether numbered 1921, which were expected to serve serving 25,540 students.
Programs for hearing impaired numbered 304, for the blind was a count of 171,
intellectual education and multi-disability had their share of 679 programs, those with
learning difficulties were served in 713 programs, autistic schools numbered 50, and finally,
schools for those with all disabilities (Service Centers in Special Education)numbered 4
centers only.
During the school year of 2008 and 2009, programs, institutes, and special education
centers, the number came to a total of 2,119, which served 30,618 students. Schools for the
blind dropped by 4. Schools for the hearing impaired dropped by 24. Learning disability
schools increased by 99; Autistic services increased by 1; and learning disabilities school
increased by 97. These numbers show us that while there are some trends to build more
structures and out more resources into specialty education, there are three areas which are
6
still being cut. They are: education for the deaf, education for the blind, and education for
autism. As of now, the latest national statistics published are last year's, 2012 – 2013. These
statistics gave programs, institutes and centers the overall number of 2847, with 38,300
serving as the current statistical figure representing the number of students classified as
special needs.
Statistics through previous years illustrate that special education programs are very
slow to establish, yet the number of students eligible for such services is on the rise. This is
where I am hoping to apply the knowledge gained from this and other classes, in order to
bring dignity and honor to those special needs people in Saudi Arabia who have been
mistreated for some time. I know I can do this because I have excellent teachers here, and the
guidance and wisdom of my God to push me forward to establish this system of social justice
in my home country. With the influence of Western education and progressive ideas coming
to Saudi Arabia, who send so many of its students abroad for this very purpose, perhaps one
day Saudi Arabia can be a new leader of special education through the Arabic world.
In addition, autism affects a person’s capability to communicate with and relate to
people surrounding them. Since the time I decided to have a career in the teaching field, I was
intrigued about the communication problems faced by autistic students with their peers and
others surrounding them, resulting in their lower social acceptance. As I referred to more
authenticate literature related to autism in children, I realized that speech, cognitive, and
behavioral interventions during the early growing years can help autistic children to improve
their communication and social skills. Amongst the various therapies that I read, I was
fascinated with studies wherein art therapy helped to improve the social and communication
skills of autistic children, thereby facilitating them to increase their value as an individual,
develop relations and improve coordination of their sensory system (Betts, 2005; Martin,
7
2007; Schweizer, Knorth & Spreen, 2014). Personally, I wanted to observe and learn the
effect of art therapy on autistic kids so that I could work towards creating a better learning
environment for such kids.
Before I started off with application of art therapy on autistic children, I tried to
empathize what the significance of “communication” in the lives of such children. As I had
completed Bachelor's degree in Special Education, I knew that for such kids language
comprises of the whole communicative structure that they have been exposed to since birth.
I confirmed my understanding by discussing with special educators who had mostly worked
with autistic children during their teaching career. I realized that it is the communicative
facets of art therapy that actually helped autistic children to convey their feelings and
thinking’s by providing them an added means for interpersonal dealings, thereby improving
their communication skills and self-efficacy. Other researchers such as National Research
Council (2001) and Pioch (2010) who have verified its relevance for autistic children have
further supported Art therapy. National Research Council (2001) has stressed that early
intervention services for autistic children like art therapy can drastically improve the overall
development in such children. Pioch’s (2010) study found that when art therapy is applied to
autistic children, it leads to a positive change in their social behavior and their level of
concentration.
Characteristics of the Setting
To practically understand the implication of art therapy on autistic children, I decided
to select an autistic child studying in grade K-4 in the Spanish language school under the St.
Louis Charter Schools System. I decided to focus my attention on one student of this class,
named Anna. She is white, English speaking Kindergarten student with autism and has
speech and language deficiency. She was diagnosed with autism when she was three years
old. Her parents had observed strange behavior like not responding to her name, playing in an
Commented [Muli1]: I have deleted a section from here and taken it to the RQ section).
Commented [Muli2]: Deleted a paragraph from this section and taken it to the setting and participant section
8
unusual repetitive manner with toys and becoming very aggressive when upset. They had
consulted a specialized psychologist who diagnosed her autism based on autism-specific
behavioral evaluations. Though she is proficient in reading and writing Spanish language, she
does not understand what she is reading or writing since she is unable to explain it. This was
confirmed by her teachers also. She also seems to have low self-esteem and is unable to
express her emotions with her parents, peers and teachers. Her verbal communication is
affected by her slow speech, as a result of which she has very limited social interactions. She
is interested in doing activities, but if she finds them difficult she gets frustrated easily. Her
condition made it difficult for me to explain her something as she could not understand and
was not ready to listen. She expressed her impatience, displeasure and frustration by saying
rude words, crying, leaving the class, kicking cabins and throwing backpacks kept on the
cabins. From our interaction, it is evident that she is unable to comprehend the real world and
does not accept any help till she becomes completely calm. She likes picture books and
shows a liking for colors and painting. Her capability to think visually and her interest in art
make her a perfect choice for art therapy.
Impact of the Study on the Teaching Practices
From my study of using art therapy on an autistic child, I would like to see the impact
that art therapy (visual; and practical) has on her communicative skills. The findings from
this study will help me as an educator to work with autistic students in a much better and
sensitive manner in future. It will enable me to fine tune my teaching methodologies in sync
with the child’s communication and self-efficacy needs. I strongly believe that if such kids
receive proper alternative therapy like art therapy at a young age they will find it much easier
to convey their thoughts as children are by nature more creative and arty and are usually very
comfortable with colors and markers as compared to verbal communication. I will be able to
give autistic children a good start during their early education years, which will help them to
Commented [Muli3]: Used Present tense as required
9
comprehend their surroundings in a much better manner and ease their learning and
interaction process in the future. It will be a good example for other teachers and special
educators dealing with autistic children as to how art therapies can be effectively used to
improve an autistic kid’s abilities to communicate, socialize and imagine. It can even help
control their emotional issues. I hope that the use of art therapy will really help autistic
children to improve their imagination capabilities, their ability to respond to others, to
manage sensory skills and ultimately improve their fine motor skills.
Literature Review
This section seeks to review previous publications and literature that has covered art
therapy and its effect on autistic student. I will explore the various communication issues of
autistic children and the different improvement practices that have been used for improving
the communication skills of autistic children. Of great importance will be literature
highlighting the importance of art therapy and consequently identifying the choices that were
made for the subject in this paper to study the effect of art therapy.
Communication Issues of Autistic Children
Before learning about how art therapy can be effectively used to improve the
communication skills of Anna, I realized that I had to gain an in-depth understanding about
the communication problems faced by autistic children. I started by looking at literature that
facilitated and broadened my understanding on this. According to American Psychiatric
Association (2000), autism is characterized by the children’s distinct inability to interact
socially and impairs their communication skills. They have limited, repetitive and peculiar
patterns of behavior, activities and areas of interest. It made me aware of the fact that these
diagnostic features of autism instilled a sense of fear in children about new circumstances and
changes and made them inflexible. It also slowed down their processing and response rate as
well as increased their sensory sensitivity. Their comprehension of social expectations
10
became limited, influencing their communication with others. One especially significant
social aspect that autistic children lack is failure to develop joint attention skills. Mundy and
Stella (2000, p. 132) have defined joint attention “as the ability to make usage of eye contact,
touch and body language for the sole purpose of social interaction and sharing their
experience with other people around them”. This incapability inhibited their ability to
express emotions and hence affected their social acceptance and compatibility with others.
Osterling and Dawson (1994, p. 256) found that autistic children paid little attention when
others tried to communicate, which was mostly the case with Anna. This included their
inability to identify and answer back to their own name.
Autistic children often face issues in developing and handling social relations with
their peers. Sigman and Ruskin (1999) observed that autistic children preferred to play and
remain in isolation and liked to be involved in self-stimulatory actions. Social isolation also
lowered their self-esteem as happened in the case of Anna. I wondered if these characteristics
got amplified in children with autism during their early school years, mainly due to their
transition from a secure home environment to an outside world having many more children
surrounding them and rules to follow. However, it became very clear as to what
communicative problems I should expect when dealing with Anna and the reasons behind
them. This made me mentally ready to handle the communication gaps that would come up
when interacting with her and gave me a direction to think of multiple ways that could help to
improve her communication skills. Understanding about the various communication
problems of Anna will help in planning out my lessons to overcome the specific drawbacks,
thereby giving my project the correct direction.
Different Improvement Practices for Enhancing Communication Skills in Autistic
Children
Commented [Muli4]: Quotation Marks
11
As I looked out for different practices that have been used in the past to improve the
communication skills of autistic children, I found several interesting options. Most of the
literature, including Dawson (2008) and National Research Council (2001) that I referred to
suggest that early intervention in autistic children played a major role in honing their
interaction abilities, thereby improving their chances of communication in future. My main
objective is to improve Anna’s communication skills at this stage, so that she can easlity
adapt to these techniques and face less communicating problems when she grows up.
One of the widely used techniques to teach spoken language is Pivotal Response
Training (PRT). It is a naturalistic behavioral approach supported by various empirical
studies like those of Koegel, O'Dell and Koegel (1987). I found that PRT helped to improve
the language skills in autistic children and simultaneously decreased improper and
troublesome behavior. It improved the ability of speech simulation, categorization and
impulsive speech and accelerated the development of functional speech in previously non-
communicative autistic children.
According to Mesibov and Shea (2008), having a daily class program, either by
using pictures or printed words, or a mixture of both can assist in organizing the
understanding of students with autism. It would become much easier for autistic children to
comprehend their class environment, if they are clearly separated and the scheduled activities
are clearly explained before. This made me realize that autistic students become more
anxious and confused when their room is messed up, when their schedules are not well-
demarcated and explained in advance and when some unexpected thing comes up. I realized
the importance of creating a supportive and organized environment and schedule for Anna, if
positive changes are to be expected from her. She, being an aggressive and impatient student,
seems to get upset easily and expressed her frustration by crying, yelling and hitting other
students. As she loves books with pictures, likes pink and purple colors and has been
Commented [Muli5]: Deleted Unnecessary and unexplained terminologies
12
exposed to various art sessions as part of the Kindergarten curriculum, I have decided to
explore more about how art therapy could help in calming her and enable in better
comprehension of her surroundings as well as in improving her communication skills.
Understanding the various practices being used gave me an idea about the environment,
techniques and alternatives that I could use for the art therapy sessions.
Effect of Art Therapy On Communication and Self-Efficacy
According to Henley (1998) the purpose of art therapy, irrespective of the situation in
which it is being used, is to motivate children to communicate their feelings, partake in new
activities, which require better concentration and to be creative. Pioch (2010) has proved that
when art therapy is applied to autistic children, it results in a positive change in their social
conduct and improves their concentration. This was further endorsed by Gilroy (2006, p.250)
who suggested that art making accelerates the emotional and cognitive development in
autistic children, facilitates relations and results in decline of destructive behavior. Her
endorsement was based on various publications regarding application of art therapy on
autistic children. Schweizer et al. (2014, p. 591) also proved that art therapy enabled autistic
children to improve their concentration, flexibility, behavior and verbal communication.
Eisdell (2005) has described art-making as a method to bring out the inexplicable part of an
individual. Art therapy could be a significant activity-based intervention for promoting
growth and self-efficacy of autistic children like Anna as children are more likely to be
expressive and organized during creative activities (Emery, 2004; Sheila, 2009). This
supported my belief that young children tend to view art and drawing as one of the handy
methods to deal with their surroundings. It gave them a sense of accomplishment and joy
similar to when they moved their fingers through sand or in porridge and observed their
movements creating patterns. I hoped that the art therapy will bring out creativity in Anna,
which may help her in handling her problems. Various case studies of the past showed that art
13
therapy aims to increase the self-esteem, develop coping skills, achieve insight, structure
behavior, reduce stress and develop interpersonal skills, all of which I wanted to see in Anna
(American Art Therapy Association, 2014; Malchiodi, 2003). Having positive assurance
about the implication of art therapy, I wanted to understand how the distinctive constituents
of art therapy like handling and touching art materials or assessing the visual picture can lead
to these changes, especially in a tough student like Anna.
Brain distortion in the right hemisphere mainly gives rise to negative emotions like
anger, depression and frustration. Prager (1993, p.8) and Schweizer et al. (2014, p. 591) have
suggested that art therapy can help an autistic child in toning down some of these emotional
feelings. It can enable them to slowly gain control on their impulse behavior (Betts, 2005). As
art therapy gives the autistic children an opportunity to express themselves freely, I
understood that it stimulated the process of idea creation, motor skills, focus on task, shape
identification, increased eye contact and spatial insight. While drawing, the child processes
information regarding the emotion portrayed on the subject’s face with the help of visual,
motor and cognitive skills (Martin & Lawrence, 2008). The playful nature of visual
interactions can stimulate emotional verbal communications. Drawing enables the child to be
creative as well as use their entire personality, thereby helping them to discover who they are
(Eisdell, 2005). All these qualities enable them to develop their communication skills and
improve their self-confidence. Even though art therapy is mostly non-verbal, I felt that Anna
may start talking about her experience with the various art materials and express her thoughts
through the symbols made by her. She may also express her inbuilt fears through her art
work, which would enable others to help her cope and overcome them. I felt that art therapy
will give me an opportunity to work with her more closely, understand her requirements,
support and assist her without getting her frustrated, make her listen and understand verbal
directions and thus, built a close, trustful and friendly relation with her. Amongst the various
14
improvement practices that I explored, I felt that art therapy would be the best choice for
Anna as it would give her a free medium to showcase her true self and how she wanted others
to treat her. Thus, this helped me to understand not only about how art therapy will be
beneficial but also how it works to improve the communication skill. This knowledge will
help me in planning my lesson plans so that they get the best results for Anna. As I really
wished to see some positive changes in Anna during the course of my study, I decided to
explore some past case studies wherein art therapy was used to develop positive changes in
autistic children, so that I could be reassured that I am following the right direction.
Evidence-Based Studies
Kornreich and Schimmel (1991, p.6) have proved the positive impact of art therapy
on autistic child. During their experiment, they found that the typical characteristics of
autistic children like remaining isolated could be controlled by using art therapy. Proper
guidance and training during the art therapy sessions enabled the child to individually execute
simple and small tasks like finding where the various art materials were kept, selecting the
right materials as per the requirements of a particular project or cleaning up on their own after
the completion of project. Art therapy also helped build a trustful relation with the art
therapist or teacher, which slowly eased the process of interaction and creating relation with
classmates and others.
I also read about the pilot study titled "Portrait Drawing Assessment" created and
conducted by Martin & Lawrence (2008) to find out how autistic people including children
comprehended face details and to establish whether their drawings reflected iconic judgment.
She selected this type of study as autistic people usually face problems in understanding the
facial expressions of other people, adding to their uneasiness and anxiety. Martin & Lawrence
(2008) has specifically stated that autistic children find it difficult to focus on the human face
and to make eye contact. From the drawing portraits made by autistic children, Martin &
15
Lawrence (2008) found that it was an effectual method to associate and engage in a fruitful
relation with them. He concluded that drawing turned out to be a controlled manner to
establish a relation with those having autism. Research conducted by Emery (2004) to study
the effectiveness of art therapy on a six year old autistic boy also highlighted the benefits that
art therapy can yield for autistic children like Anna.
I also read many testimonials of parents who had opted for art therapy for their
autistic child. After having read all the relevant literature as well as case studies and
testimonials, I was assured that art therapy could help an autistic child like Anna to relate
with her surrounding environment and will give her a better opportunity to express herself. I
believed that through art therapy, Anna would be able to understand my language and vice
versa, thereby fulfilling her intent to communicate. I decided to use mainly drawing art to
improve her communication skills. This decision was based on her inclination towards
pictorial books and particular colors. I felt that giving preference to her likings would make
her feel important and interested. Moreover, many autistic people like Anna have an
exceptional capability to think visually. This ability of hers could be utilized to improve her
memory, visual information and record images and enable her to express ideas by drawing. I
was determined to give Anna a free hand during the art therapy session so that she could
create art work by her own imagination, instead of being instructed by me so as to sustain her
interest in these sessions and gain her confidence. Drawing art, I conclude, would give her a
medium of expression that requires minimal or no verbal communication and would open
new avenues of communication for her just like other children benefitted from it. I am
confident enough that art therapy would open up a new world of opportunity for autistic
children like Anna. I have gained some important insights about the materials and techniques
that can be used for an autistic Kindergarten child during the art therapy sessions.
Materials and Techniques for an Autistic Kindergarten Child
Commented [Muli6]: Changed tense
16
One of the foremost steps that I would initiate for Anna in her classroom is make her
classmates supportive. This would be beneficial for the regular students also. Wagner (1999)
has rightly said that when peers of autistic children are informed about the issue and are given
a chance to portray the role of peer buddies or tutors, they imbibe the qualities of acceptance
and understanding, and become more conscious about personal qualities. This would help to
create a favorable class environment for Anna. I plan to give her themes on certain days and
then allow her to explore her creativity related to the themes. This would increase her
concentration level and flexibility. I would make sure to explain her about the theme in as
much detail as possible so that she may not get irritated or frustrated and resort to her
tantrums. If I find she is not very comfortable with the themes, she would be given full
freedom to draw whatever she likes and explain what she has drawn.
Martin (2007) has correctly stated that there is exceptional quality associated with art
therapy, which enables it to achieve various therapy objectives by making the most of the art
materials that are harmonious with the symptoms of autism. Art therapy enhances the mental,
physical and emotional comfort of autistic children by using the visual art-making and
creative techniques (Dawson, 2008). The art materials would be creatively used by me to
develop Anna’s ability to imagine, communicate and socialize. This will allow her to
understand and have insight of her feelings, at her own pace. I intend to use simple art
materials like markers, color pencils, pens, paints, colored chalks and pastels along with
brushes of various sizes and blank white sheets of paper to enable her to express her ideas
and feelings. I would be observing her response to various drawing materials and allow her to
continue with those she would appear to be comfortable. She would be given A3 or A4 sheets
of paper as I believe that bigger paper size would give her a chance to draw both big and
small pictures and arrange her ideas as per her will. If required, I may provide her with an art
“starter sheet”, which would decrease her anxiety and pressure caused by a blank sheet of
17
paper. It will have cut-outs from magazines or drawn items, which she would be required to
complete. Art apron would be used, which would indicate to her that it is time for art therapy.
She could co-relate it with period for practically applying her creativity. This would enable
her to build associative connection in her brain, which could be slowly applied to other
situations as well. Visually representation using symbols will enable her to learn new words
related to various situations, thereby improving her understanding and communication skills.
This gave me a clear idea about what material and techniques will be most suitable to be used
with Anna.
The thorough literature study carried out by me for this project broadened my outlook
and understanding regarding a number of aspects that are significant for this project. It gave
me a comprehensive idea of what all communication problems autistic children face, which
helped to prepare myself while dealing with Anna. Understanding the benefits of art therapy
strengthened my belief and determination to give my best to improve the communication
skills and self-efficacy of Anna. It helped to understand how art therapy works for autistic
children and guided me towards planning my sessions with Anna. The information about
materials further aided my planning for the sessions. I hope that with all the knowledge
gained through the literature review, I will succeed in delivering a positive result from this
project.
Purpose of the Study
The primary purpose of my study was to investigate the effect of art therapy in
improving the communication skills and self-efficacy of child with autism spectrum.
Personally, I wanted to observe and learn the effect of art therapy on autistic kids so that I
could work towards creating a better learning environment for such kids. To achieve this
objective, my research question is the following: “How can art therapy improve the
Commented [Muli7]: Added several references to support arguments
18
communication skills and self-efficacy of a Kindergarten student having autism in a language
immersion setting?”
I intended to start my research in the kindergarten class of this school. The success of
my study could help me have a better understanding of the effect of how an autistic child like
Anna can improve their self-esteem, comprehension of surroundings, enhance social
interaction and acceptance by primarily honing the communication skills. Anna, though
friendly most of the times with others, was difficult to handle once she got upset. Her main
reason to get upset was she could not communicate her needs clearly to others and sometimes
she misunderstood what others were saying about her. Once she got angry, she exhibited
aggressive behavior, which was harmful for herself and others around her and did not listen
to anybody till she calmed down. Through the application of art therapy, I hope to give Anna
an alternative medium to express herself and her emotions and to continue to do so in her
home environment or other settings. I also hope to share my strategies and findings with other
practitioners, teachers and parents working with autistic children. I wanted to explore how art
therapy can improve their interaction skills and enhance their understanding of other people’s
emotions, thereby finding answer to my secondary research question regarding how art
therapy can contribute to the emotional and cognitive development in autistic children.
Overall, by using art therapy, and although the time spend with Anna is short, I hope to make
a significant difference in Anna’s life by aiding the development of communication skills,
and help her have better control of their expressions and emotions.
Setting and Participant
Setting - The School
The school where I conducted my research is The Spanish School in the St. Louis
Public Schools System. This school offers a complete immersion program to students who
19
speak English, but have the desire to become fluent in Spanish. This school serves only ages
Kindergarten through 6th Grade as it grows annually by one grade until it will cover the
whole K-12 curriculum. 3 of the children are reported to be mixed race. Approximately one
half of the school receives free or reduced lunch. The school does provide services to both
academically gifted students and special needs. It serves mostly students from the St. Louis
area, and is open to any student who wishes to learn the Spanish language, in order to prepare
them, for the growing need for bilingual students in the global marketplace. The vision of the
school is to welcome any student who lives in the area for an opportunity to learn a second
language. They provide educational supports for students as indicated in their IEP, grades K-
4, with various disabilities and diagnoses mild to moderate cross categorical. The school uses
positive behavior support and that is why they are very keen on using visuals such as
timelines, charts, schedules, and understood symbols posted everywhere. The purpose of this
use of visuals is to support easy language learning by linking words to objects. It helps
students to easily understand the rules especially among those students who have difficulties
communicating in their native language, which for most of the students is English.
The school offers a complete Spanish immersion program for English-speaking
students. The school is located in an urban setting and has students coming from different
cultures, backgrounds and socio-economical status. A majority of the students in each class
are Afro-Americans, a few are white and there are very few students belonging to Hispanic
and Asian communities. Most of the students belong to low-income families who receive free
reduced lunch. The students in the Kindergarten class has Math, Spanish language, Social
Studies and Science subjects along with other subjects like PE, yoga, art, library and
technology during their school session between 8.30 a.m. and 3.10 p.m. All the instructions
during the classes are in Spanish. Most of the classes do not have doors and complete walls,
which causes noise from the hallways, other classes and gym to interfere with the sessions in
Commented [Muli8]: Rephrased
20
the class. A teacher assistant, who works in small groups or one on one basis, assists the
students in the implementation of the teacher's instructions, thereby helping in their academic
progress.
I allotted four days for every lesson to make sure that she completely understands it
and can use it correctly. Each session was for 20 minutes per day. Thereafter I used to observe
her for the rest of the day. I arranged a suitable time with her normal class teacher every day
so that I can take her to the special education class as it was quieter and she could focus more.
During her class I took out there emotional face cards as cue that it now time for fun and
learning. I evaluated the behavior of student and her mastery using what she learned in the
school to improve her self-confidence and communicative skills.
My Role in the School
Once I was welcomed into the school, I have worked as a volunteer within regular
class and special class. During my time at the school, I have dedicated a lot of time in
observing Anna, who is the subject of this study, within her regular classroom during her
regular school hours. Firstly, I have been very keen on making every observation regarding
her interaction with other students as well as the progress she makes in learning activities.
Secondly, despite my focus on Anna, I made sure my observation and interaction was not
overbearing by ensuring minimal interruptions to her normal day in school.
In order to have a good environment for kids with special needs such as Anna, I
observed that the real physical space within the classroom was well planned, organized,
uncluttered and structured. Too much hanging from the ceilings and cluttering of wall was
avoided as it would become difficult for the special kids to process. The classroom was
organized in a sequence of diverse and discrete spaces. There is a large group space, small
group space and center space for different arrangements and activities. Learning area is
divided using bookshelves or partition. Overall, in a special Kindergarten class attempts are
Commented [Muli9]: Deleted unnecessary part
21
made to create a comfortable atmosphere to make children more receptive and to unlock their
learning potential. Sections related to arts and extra-curricular activities are segmented from
quiet spaces for reading and writing. Pictures of special Kindergarten class are attached in
Appendix B.
Participant
There are three main participants involved during the application of the art therapy
sessions –Anna is the primary participant, while her regular class teacher and her special
education teacher are important for providing secondary information and insights that are
important for application of art therapy.
Anna is a white, English-speaking autistic child of six years studying in grade K-4.
The school authorities had conducted an educational diagnosis to confirm that Anna has
autism. This was essential during her admission to school for her to be eligible to have access
to resources that can impact and her behavior, communication and sensory. Such a diagnosis
implied her disability to perform satisfactorily within the school setting. It also documented
concerns and behaviors that have been exhibited by her over a reasonable time period as
shown in Appendix R.
Anna has Informal interviews with her regular class teacher, special education teacher and
mother helped me to gather a lot of information about her behavior and reaction in various
situations, which could be useful to me while conducting the art therapy sessions. According
to her teachers and mother, her immediate need is to improve communication problems and
social understanding of what other people are telling to her. She is enrolled in the regular
class and attends school from 8.30 a.m. to 3.30 p.m. Her mother confirmed that she was
admitted to the immersion language on the recommendation of her speech therapist to help
her understanding of English. Anna is proficient at reading and writing the Spanish language.
Commented [Muli10]: Rephrased to show the Ann is the main subject of the study
22
However, she does not comprehend what she is reading or writing. She behaves well when
she is busy and engaged in various activities, but if she feels that the activity is difficult she
gets frustrated easily and does not respond in a positive manner. She likes playing with toys,
stuffed animals, play dolls and puppets. Pink and purple are her favorite colors. She does like
colors and painting, but she prefers writing a list of names. Dragons are her favorite cartoon.
She loves reading books having lots of pictures. She prefers to have the same spot during
circle meetings. She has a habit of not listening when she does not understand what the other
person is trying to explain her. She expresses her frustration by saying rude words, crying,
leaving the class, kicking cabins and throwing the backpacks placed on the cabins. She cries
or yells a lot when she is irritated and frustrated. She needs to calm down first before
anybody can help her. Her impatience and her behavior when irritated are her main issues.
Sometimes she runs away from the classroom, cries for 20 minutes and even hits other
students. She is happy when she feels she is being given importance and there is oral positive
reinforcement from the other person. Reinforcement strategies used by teacher to calm her
include showing her a puppet who is conversing to her. Her main challenge and concern of
her parents is that she fails to comprehend the real world around her. Her first IEP was
conducted in 2013 when she was enrolled for kindergarten. She is repeating her Kindergarten
class and is showing improvement in writing her name and address as confirmed by her
special education teacher. Her most recent IEP was conducted in October 2014 and the
projected date for the next triennial IEP evaluation is October 2017. Her annual IEP
evaluation takes place in the month of October. Her IEP team consists of her mother, regular
class teacher, special class teacher, LEA representative, speech and language pathologist, an
occupational therapist and a professional who can interpret instructional implications of the
evaluation results. Anna shows positive interest during art classes, which are scheduled once
a week and likes working with colors and pictures.
Commented [Muli11]: Edited to remove repetition
23
Anna’s mother also gave valuable information about her family background during
the informal interview. She was born after a traumatic birth and had difficulty meeting
milestones. She is the second child of her parents and has a ten year elder brother. She gets
along well with him as well two of her cousins aged 3 and 5 years and gets sufficient care at
home. She likes animals and takes good care of her pet dog, Lexi, especially when they go
out. She loved music and musical instruments, ponies, super heroes and princess dolls. She
tries to do well and becomes frustrated when she feels she is failing. Her language and
reading skills have improved since the last year. Though she may not understand everything
being said to her, she will infer meaning through facial expressions and body language, which
she may misinterpret. She follows her routine at home with the help of visual/vocal reminders
of what’s to be expected from her throughout the day. She enjoys writing with chalk, blowing
bubbles, riding her bike, swims and reads stories every night. According to her mother,
communicating her needs and understanding what other people are saying to her are big
challenge for her. She does not like Candies, but likes Chips. Thus, the information collected
about Anna helped me to understand her overall personality, her main issues and her
preferences and disliking. All these information will help me in handling Anna better during
the art therapy sessions and make use of things that can increase her interest during the
sessions.
Anna’s regular class teacher, through the informal interview, informed that she has a
degree in Early Childhood Education and has worked for 14 years in Peru as a pre-school and
Kindergarten teacher. She has experience in working with two autistic students during her
teaching in a regular school in Peru but they were not so aggressive and hyper like Anna.
Since she was Anna’s class teacher, she had the maximum interactions with her. Anna
considered herself close to her regular class teacher the most. Whenever Anna cried and went
outside the classroom, she wanted her regular class teacher to follow her.
24
The background about Anna’s special education teacher was gained through the
informal interviews conducted with him. He had completed his Bachelor’s of Science degree
(Health Education) from Southern Illinois University Edwardsville (SIUE) in May 2007. He
has worked as substitute teacher in Monroe County, IL schools for one year, after which he
worked as a teacher’s assistant at the Illinois Center for Autism for two years. During the two
years at Illinois he earned a special education certificate from SIUE. He then taught at
Centraila High school in a self-contained BD class for two years, after which he worked in
similar settings at Epworth School for a year. Currently, he is working as a resource teacher at
St. Louis Language Immersion School. He was in the process of creating a visual schedule
for Anna. He conducted one-to-one sessions with Anna to increase her phonemic awareness
ability to orally blend the phonemes with consonant-vowel-consonant length words. Anna
was showing progress during these sessions (85% accuracy).
The interviews with Anna’s regular class teacher and special education teacher helped
me understand the educational background of those helping Anna overcome her challenge as
well as gave me a lot of information about their way of dealing with Anna. They also
expressed their concern for Anna’s lack of communication skills.
Collaborators Involved in Anna’s Regular Schedule
For my study besides getting support from the school authorities (Appendix C) and
Anna’s parents (Appendix D), I needed support from Anna’s lead teacher, her special
education teacher, art teacher, head of the Spanish school and mother. The teachers are very
crucial in this process as they have long history with Anna, who they have interacted with for
a longer time and hence better placed to provide important insights that can help me to
understand Anna. The teachers are very important as they are able to get feedback from them
about her schedule and behavior in class. For this project to be successful it is very essential
Commented [Muli12]: Deleted the repeated paragraph on the researchers’ credentials
25
to understand Anna’s likings, disliking, interests and her manner of reacting to various
situations, which I can get from only those who deal with her on a daily basis. Her parents
are also involved in this therapy as Anna can use the techniques of this therapy at home also
to express her feelings. Their inputs regarding Anna helped me understand her personality
outside home and amongst people she was comfortable with. The feedback from her art
teacher is also important to understand Anna’s level of interest during art sessions, which are
once a week. Her art teacher’s feedback gave me an idea about Anna’s approach towards
drawing based on which I could plan my art therapy sessions.
Interventions
To enhance Anna’s comprehension of the real world, it was important to improve her
communication skills. Her aggressive behavior not only interrupted her academic
performance but also disturbed other students in the class. It was important that she learnt to
convey her feelings to others rather than get upset and become aggressive. She showed
positive interest during her regular art classes. Based on her IEP, interest in art and the
extensive literature that I studied I decided to apply art therapy techniques and activities
related to art. Drawing art was mainly used to improve Anna’s communication skills, her
capability to understand and respond to various emotions and to enable her to connect visual
images with verbal skills. I planned to teach Anna vocabulary through art where I would have
three sessions weekly for art. During the initial stages of art therapy, she would be
encouraged to develop communicative skills and her self-efficacy needs. Autistic patients are
more likely to perceive visual images as compared to verbal phrases. Drawing will enable
Anna to learn new words by visual representation, in the form of symbols. She was given a
variety of art materials like colored pens or pencils, paints and brushes and colored chalk and
her acceptance and comfort with these art materials were examined. However, in order to
ensure best outcomes, I seek to ensure that there is minimum interference to her normal
Commented [Muli13]: Changed tense
26
school life. I spent four hours for four days every week with Anna. I continued my sessions
for four weeks. Her each session was for 20 minutes. I observed her for the rest of the time.
The detailed timeline for the various interventions during this project is shown below in
tabular form:
Day 1 - Feb 13 Day 2 - Feb 16 Day 3 - Day - Feb
17
Day 4 - Feb 18
• Meeting with the head of the
Spanish school,
Spanish teacher
and parents
• Receive the consent
• Look over IEP
• Collect baseline data
• look over the student
evaluation
• Interview with the head of the
Spanish school
• Interview with the special
education teacher
• Interview with the regular class
teacher
• Observe Anna in class to note her
behavior
• Elect more data about the student
Day 5 - Feb 23 Day 6 - Feb 24 Day 7 - Feb 26 Day 8 - Mar 2
• Observe Anna in her different
class
• Elected more data about the
student
• Meeting with the Anna's mother
• Work with student; begin
collecting
• Observe Anna in her different class
• Continue working with
Anna
• Continue data collection
• Observe Anna in her different class
• Meeting with the Anna's teachers
• Observe Anna in her different class
• Collect data
Day 9 - Mar 3 Day 10 - Mar 4 Day 11 - Mar 9 Day 12 - Mar 10
• Observe Anna in her different
class
• Observe and make sure the
teacher follow
the new learning
method for
• Continue working with
Anna
• Observe Anna in her different
class
• Collect data
• Observe Anna in her different
class
• Observe and make sure the
teacher follow
the new learning
method for Anna
• Continue working with
Anna
• Collect data
27
Anna
• Collect data
• Collect data
Day 13 - Mar 12 Day 14 - Mar 4 Day 15 - Mar 9 Day 17 - Mar 10
• Observe and make sure the
teacher follow
the new learning
method for Anna
• Collect data
• Observe and make sure the
teacher follow the
new learning
method for Anna
• Continue working with
Anna
• Collect data
• Continue working with Anna.
• Meeting with the Anna's mother
Day 18 - Mar 20 Day 19 - Mar 23 Day 20 - Mar 25 Day 21 - Apr 1
• Observe and make sure the
teacher follow
the new learning
method for Anna
• Work with Anna
• Observe and make sure the
teacher follow the
new learning
method for Anna
• Observe and make sure the
teacher follow the
new learning
method for Anna
Initially, before starting with the application of art therapy, I carried out an informal
interview with Anna’s regular teacher (Appendix E), special education teacher (Appendix F),
the head of the Spanish school (Appendix G) and her mother (Appendix Q). These informal
interviews enabled me to understand about their individual background as described in the
Participants section, the educational environment of Anna and provided me with in-depth
information about Anna’s behavior, level of communication skill during her regular class and
her likings and disliking. I also interviewed her art teacher to understand about her special
interests and preferences during art classes.
28
I wanted to convince Anna to express her feelings and frustrations through art. I
wanted to make her understand that she can express her negative emotions by developing
ideas on paper as per her own will. Gradually, she should learn to use art as a medium to
express her emotions freely without any imposed boundaries of social restraints and control.
Anna was given a wide range of colorful paints, brushes of various sizes, blank white
sheets of paper to allow her to express ideas freely and to enable her to arrange her ideas.
Anna preferred these drawing materials and was comfortable working with them as
confirmed by her mother. She was also provided with an art apron, which would indicate her
that it is time for art therapy.
There were some issues for application of art therapy in the regular class. I felt that
her regular class teachers were not able to cooperate with me as needed, as they had to attend
to the other children. To overcome this issue and have a better understanding of Anna’s needs,
I observed the reactions and behavior of Anna throughout the day with the help a behavior
checklist (Appendix J).
Before the start of every lesson I opened for her a YouTube Angry Birds video to
make her comfortable. Also, it was her favorite cartoon, according to her social education
teacher . This was very essential as she had to accept the activity and should feel happy while
doing it so as to have an expected positive result from the therapy. However, I felt that this is
not a good cartoon for her as she learns to make angry faces or feels angry from this cartoon.
Thereafter I started every lesson with a You Tube video, which showed emotional faces. It
prompted questions like : “Can you make a Happy face?”. I also started another video for
teaching children with autism titled “Faces and Emotions” having both audio and visual
effect. As she likes pink, I made sure to use everything pink during the sessions like pink box,
pink pens and even a pink color tray. I even shared these things with her regular class teacher
and mother so that they could give her to use these things during the remaining time. I
29
worked with her on a one-to-one basis for 20 minutes executing a specific activity as
described below and her behavior during that activity was also closely observed by me using
another behavior check list (Appendix K).
First Session: The objective of this lesson was to teach the student how she could represent
different emotions by drawing emotional faces. When she was shown the chart depicting
various emotions (Appendix H), I asked if she could spot the differences between them. She
replied negatively. She was unable to decipher about what, where and when she would have
felt each of the emotions shown in the chart. She was demonstrated how the faces look in
reality. I personally made each of the faces to explain her. I tried to explain situations related
to her in which she experienced the different emotions. I drew the different emotions on
paper and then asked her to do the same. She was even given a blank drawn face to fill in
emotions and was asked to explain as to which expression she had drawn. She was given
colored pencils, crayons, paper with blank faces drawn on it and blank papers for this activity.
This understanding is essential to express herself as well as understand how and what others
are saying. If she starts understanding emotions, she will feel comfortable in expressing
herself, thereby indicating an improvement in her communication skills. Eyes, nose and
mouth were drawn on a blank face picture. I instructed Anna to fill out different emotions on
the blank faces as done by me and color them (Appendix L).
Second Session: During my second session, my aim was to teach her the difference between
the different emotional faces and why, where and when she could feel each of these emotions.
I intended to explain her causes of different emotions and the reasons behind them. She was
again shown the chart depicting various emotions (Appendix H). The chart had different level
of faces representing different facial expression to imply emotions. I explained her various
emotions using corresponding facial expressions and helped her to understand the situations
that cause these emotions like happiness, sadness and excitement. I used other charts also as
30
shown in Appendix M. To assess how much she understood, I asked her to try and imitate
these emotions. I tested her understanding by showing her the chart containing various
emotions and randomly asked her the emotions related with various pictures. I even gave her
a blank worksheet in which she could draw emotions and then write down the name of
emotion and the reason behind her. This activity helped her to think on her own about her
varied experiences and the way she reacted. This also helped me understand if she had
understood my explanations correctly. Having a clear understanding about the various
emotions will help to improve her communication skills.She responded positively and
showed me each of these emotions. She also discussed with me as to when she feels these
emotions like being happy or angry.
Third Session: The objective of this session was to find out whether she clearly understood
the various emotions and whether she could correctly match the pictures to the various
emotions they represented. She was given pieces of paper with names of various emotions
and was asked to draw the emotions. She was given another set of paper with pictures of
various emotions and was asked to identify the name tag represented by that particular
picture. This was a mix and match activity (Appendix N). She did get confused two times. I
again explained her and she understood. Thus, understanding the various emotions correctly
was essential to improve her social interactions.
Fourth Session: Having made her understood the various emotions, I know wanted to explain
her which emotional expressions are acceptable in school and which are not. She was again
shown the chart depicting the various emotions. I explained her that emotions numbered from
1 to 3 are allowed in school, whereas emotions numbered 4 and 5 can be expressed by her at
home and not in school. This understanding was crucial for her to be socially accepted by her
peers now and in future.
31
The sessions conducted so far taught Anna important things for understanding
and improving her behavior. She clearly understood as to which emotions she should use in
school and which are not acceptable within the school. During the sessions whenever I used
to ask her how she felt, she always pointed toward number 3 on the chart showing various
emotions (Appendix H) conveying that she felt nervous. Also one day, when I was observing
her in class she got up while working on her worksheet and went to talk with her teacher.
While her teacher was busy with another student, her mood started to change. This gave me a
good opportunity to evaluate her understanding about the various emotional expressions.
When I approached her and asked her how she was feeling, she initially ignored me and gave
a sad expression on her face. She lay down on the ground and her mood gradually changed to
4 (upset mood). When I took out the emotional chart, I asked her to point out how she felt.
She remained silent, with no reaction. I explained her that I felt sad for her by pointing
towards the sad face as I did not know what Anna felt. Suddenly she reacted by pointing her
finger to the angry face on the chart. I felt very happy at this moment as this exercise showed
that the art therapy had actually helped to convey her feelings.
I also provided her with a “How Do I Feel Today Chart?” (Appendix O) to enable her
to express her overall emotions or feelings during each day. During the initial sessions, I
explained her class teacher as to how she should be helped in filling this chart. Gradually,
Anna got used to filling this chart on her own. She could use this chart at home also to
express her feelings with her family.
During each of the art therapy sessions, I tried to improve her communication skills
step by step. Before she could learn to communicate, it was essential that I teach her the
meaning of various emotions, which was done in session one. To understand if she had
grasped the meanings and could recall, she was asked to draw the emotions in session two. To
further test her understanding, she was given a matching exercise in session three, wherein
32
she had to match name tags with various emotions. Finally in session four she was made to
understand the emotions acceptable in public places like school. I believe that the various
sessions have helped Anna in improving her understanding of emotions.
Data Collection
I planned to observe and follow up Anna’s progress throughout the semester I was
working with her. With the application of art therapy, I wanted to see improvement in her
communication skills and self-efficacy needs to help me achieve this objective, I gathered
data from a variety of sources, which included artifact observational and inquiry data to
ensure data triangulation and to increase the validity of my study. I also use interview
schedules with the teachers and Anna to collect more appropriate and relevant data for the
study.
Artifact Data Collection
Review of Archival Data. In order to have a better understanding of Anna’s needs and
goals, and besides interviewing the teachers who work closely with Anan, I decided to review
her IEP etc. IEP would allow me to work in close synchronization with the team most
concerned for Anna like her parents and special education and regular class school teachers. I
opt for IEP so that Anna can get a chance to improve by remaining in the regular school
culture. This thinking is supported by Friend (2010) who suggests that students with special
requirements gain by being part of general education and by participating in general
education course. I understood her current level of academic achievement and functional
performance as well as about her strengths and weaknesses. IEP report (Appendix S) has
enabled me to understand her behavior in various situations, which could be tactfully
managed during the art therapy sessions. It has allowed me to gain knowledge about the
different aspects of Anna like preference regarding colors, cartoons, toys and books and her
attitude. She finds it difficult to comprehend spoken languages, particularly when it is in
33
figurative or sarcastic in nature. She is unable to understand jokes, idioms, and metaphors and
read social cues and often thinks that others talk negatively about her. This makes it all the
more difficult to initiate or maintain peer relations. She uses lines from movies to
communicate her feelings, wants and needs, if she does know how to answer a question. She
switches topics quickly and is unable to follow basic directions. Neither was is she able to
socially respond to emergency situations, nor understand social cues about her own or others
safety. She cannot verbally communicate with those she is uncomfortable. She exhibits delay
in visual-motor integration and motor control. Her handwriting is illegible. She faces
difficulty in letter formation, spacing and line usage. During coloring, she does not make
adequate usage of forearm or wrist movements. She cannot even fill in simple shapes and has
frequent strokes outside the lines. She gets upset easily. Sufficient time is needed to calm her,
along with positive prompts to rejoin the class. It is difficult for her to adjust to transitions
and needs someone modeling behaviors and positive cues. She becomes irritated with loud
noise and gets upset to somebody laughing continuously. Her most recent evaluation results
are shown in Appendix P. The evaluation results helped to understand her actual condition
based on the various tests. The different tests provide measures of development in different
domains of her functioning.All the tests have different significance as explained below:
Stanford Binet Intelligence Scales, Fifth Edition: SB-5 provides a highly reliable
assessment of intellectual and cognitive abilities across the life span, based on a large
normative sample. Anna’s average score of 96 in this test indicated that she needed plenty of
time to master assignments and allow hands-on learning. She can especially benefit from
direct instructions.
Kaufman Test of Educational Achievement, Second Edition (KTEA-II): It is an in-depth
assessment of key academic skills in reading, math and written language .its standard score is
100. Her score of 118 in reading indicates she is very good in reading, as confirmed by her
34
teachers also. Her score of 74 in writing shows she needs help in this. Math score of 100
indicates she understands the concepts taught in class.
Adaptive Behavior Assessment System, Second Edition (ABAS-II): It assesses the cognitive
and developmental disabilities with adaptive behavior rating scales. The General Adaptive
Composite score (GAC) summarizes performance across all skill areas. Because the GAC
provides the most complete measure of adaptive behavior, it is likely to be the most reliable
and accurate estimate of overall adaptive functioning. Anna’s average score in this is 84,
which gives her a below average rating. Her true score is likely to fall within the range of 79-
85 at a 95% level of confidence. Anna’s current overall level of adaptive behavior is in the
Below Average range, as high or higher than as high as or higher than the score of 12.0% of
children of the same age.
Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2): It is an
individually administered test that uses engaging, goal-directed activities to measure a wide
array of motor skills in individuals ages 4 through 21. The average, below average and well-
below average indicates Anna’s proficiency in various areas. The areas having below average
and well-below average rating need immediate attention.
Beery-Buktenica Developmental Test of Visual Motor Integration (Beery VMI): It helps
assess visual-motor skills in children and adults. It determines the degree of assimilation of a
person’s motor and visual capabilities. It is commonly used to identify children who are
having significant difficulty with visual-motor integration and to determine the most
appropriate course of action. Her visual motor integration and visual perception or ability to
visually perceive things were better as compared to her motor coordination skills. She shows
delay in visual motor integrations and motor control, which affects her handwriting, coloring
and fine manipulative skills in the school setting. Due to poor motor coordination skills her
legibility is inconsistent. When coloring, she turns her paper frequently, not using sufficient
35
forearm/wrist movements. She does not fill in simple shapes completely and has frequent
strokes outside the lines. However, she can cut out simple shapes 1/8” from the line.
Goldman-Fristoe Test of Articulation, Second Edition (GFTA-2): It helps to evaluate
regarding the communication capability of a child by means of samples recorded during
making of imitative and impulsive sounds. The main aim of this evaluation is to provide
speech-language pathologists with a technique of gauging how well a person can express
consonant sounds. Her results indicate her problem with phonemes at the word level.
Clinical Evaluation of Language Fundamentals, Fifth Edition (CELF-5): It determines
language strengths and weaknesses and provides Receptive Language and Expressive
Language scores, and additional composite scores-Language Structure, Language Content,
Language Content and Memory, and Working Memory. Her score in this test indicates she
has a wide range of deficits in the linguistic areas of syntax, semantics, pragmatics and
morphology.
Comprehensive Assessment of Spoken Language (CASL): This assessment was developed
to identify, diagnose, and provide follow-up evaluation of language and communication
disorders in kids, teenagers, and youngsters between 3 and 21 years of age. Language
processing skills including comprehension, expression, and retrieval are measured in fifteen
tests across four different groups of language structure namely syntactic, pragmatic, semantic
or lexical and supralinguistic. Her standard score represent how far from average her score
falls in the areas of antonyms, syntax construction, paragraph comprehension and pragmatic
judgment. This indicates her lack of communication skills.
Northwest Evaluation Association Testing: It creates computer adaptive interim and
formative K – 12 assessments that help teachers differentiate instruction and measure the
growth of every child. When taking this test, the difficulty of each question is based on how
well a student answers all the previous questions. As the student answers correctly, questions
36
become more difficult. If the student answers incorrectly, the questions become easier. In an
optimal test, a student answers approximately half the items correctly and half incorrectly.
The final score is an estimate of the student’s achievement level. Percentile Rank indicates
the percentage of students in the NWEA norm group for this grade that this student’s score
equaled or exceeded. Her percentile score of 20 in mathematics and 50 in and reading
respectively indicate that she scored as well as, or better than 20% and 50% respectively in
both subjects of the students in the norm group.
Thus, the various test scores of Anna, as mentioned in her IEP report, helped me to
understand the development level and coordination ability of Anna. This helped me to
understand how I should plan my lessons so that the deficiencies mentioned in these tests can
be overcome at least to some extent.
I took help from her other teachers to educate the normal students about her condition,
so to establish a supportive environment for her within the regular class. Her progress at
school and home will be discussed regularly with the IEP team.
Observational Data
I planned to observe very closely the art work made by Anna. I wanted to use it as
measurable result of the art process and to examine carefully whether the art therapy results
are as per the desired and set objectives. Her behavior during the regular class and art therapy
session were recorded using a check list (Appendix J and Appendix K). Appendix J helped
her to record the number of times she became aggressive and exhibited behaviors like
screaming, crying and kicking. This would help me to understand the situations, which
prompted her to act like this so that they are not repeated during art therapy sessions.
Appendix K helped to record her behavior during art therapy sessions. These helped to record
and analyze her level of interest, interaction and the gradual improvement in her
understanding and communication skill. The interactions during the art therapy sessions were
Commented [Muli14]: Changed the tense
37
recorded after each art therapy session in my journal. This enabled me to track results and
check whether the results were as per the planned strategy every time. Her art work was used
to evaluate the improvements in her communication, emotional and cognitive conditions. It
was based on simple directives and standard usage of art materials as finalized in IEP
meetings. As the art therapy session progressed, Anna was asked to interpret what she has
drawn to understand her comprehension during the session. Slowly she was encouraged to
weave a story related to her drawing, thereby facilitating association with various situations
in which she felt the particular emotion thereby helping her to improve her verbal skills.
I made notes of my interactions with Anna during the art therapy sessions in my
personal journal, which enabled me to assess if her utterances of English and Spanish
vocabulary has improved as a result of the therapy. Recordings were entered on a daily basis
about what she liked to draw, her preference for art materials and her response to the therapy
sessions using behavior check list (Appendix K). This enabled me to track progress of Anna
after each session and to measure the effectiveness of art therapy. I shared the recorded
objective knowledge with other autism experts, so that they could make thorough
assessments to help me improve the art therapy sessions and suggest alternatives if required.
The journal also contained a short informal list of accommodations that I had roughly
jotted down to make sure that Anna has all the important materials required for the art process
and is comfortable with her surroundings. The informal list consisted of a comfortable sitting
place, a suitable table, sharpened pencils, colorful paints, new or washed brushes, and blank
sheets of paper. I casually went through the list before the start of every art therapy session so
that things were in place before Anna starts with her session. Getting all the things that were
required for making the art therapy session interesting for Anna ensured that she could focus
her mind on creativity during the art therapy session and was not distracted due to lack of
anything.
38
Inquiry Data
I continued to meet Anna, her special education teachers and her parents, particularly
her mother as many times as possible during the duration of the project to understand Anna’s
comfort level with me and effectiveness of the strategies being used. I made it a point to meet
them at least once a week for timely feedback. The crucial information emerging from the
interviews was noted in my journal. The important points during the informal interviews
during the art therapy session were recorded in my journal. Feedback regarding improvement
in her communication skills was an indicator to know if she felt comfortable and was open to
further interaction. It also gave me an idea about her needs and helped me to plan the next
session accordingly. Her level of joy from sharing her emotional experiences through
drawing indicated how relaxed and comfortable she felt during these sessions. Overall, this
enabled me to productively interact with her, encouraging her more to express verbally and
through pictures.
Informal interviews were conducted with her special education teacher (Appendix F),
Kindergarten teacher (Appendix E), art teacher and mother (Appendix Q). This gave me an
opportunity to understand her psychology, behavior and communication problems. Her
teachers talked about her as well other people’s response to her behavior. I could comprehend
their way of response to Anna’s behavior and their expectations from the art therapy sessions.
Understanding her would enable me to plan initiatives as per her likes and dislikes and
gradually build a trustful relation with Anna. This information helped me to plan my lesseon
using the materials liked by her and ensured that I created an atmosphere in which she was
most comfortable. Also, I could understand what she expected from others when she got
upset, which I could take care of for smooth conduct of art therapy sessions.Her mother and
art teacher confirmed that she liked coloring with markers and crayons and paints with
brushes but is not comfortable with finger painting. This information guided me as to which
39
drawing material should be used with Anna during the art therapy sessions. The first
interaction with her mother was for 25 minutes to take her approval for the project and
understand about Anna. I also met her mother before spring break for 30 minutes to make her
understand how she could used the emotional face cards with Anna at home. All the
interactions with teachers and her mother were conducted within the school premises. I used
to meet her teachers often as they were within the school. I met her mother twice for
interviewing and informing her.
Thus, the informal interviews enabled me to collect and gain in-depth understanding
about Anna’s condition before beginning the art therapy. It was used to assess Anna’s
communicational abilities, her willingness to share emotions, ideas and feelings.
Validity of Study
In order to increase the validity and credibility of my study, I used the strategies
recognized by Hendricks (2013). He has advocated the usage of various sources of data to
increase the validity associated with the accuracy of the results of the project. I made sure
that there was no bias in my mind towards Anna or the expected outcome of the project. The
continuous observations made during the art therapy session by entering information in my
journal and by interacting with Anna’s parents and teachers allowed evaluating the
improvement in her communication skills and her self-efficacy needs from different
perspectives. Apart from discussing Anna’s progress with her parents and teachers, I also
discussed her assessment with autism experts who had dealt with autistic children and could
give me unbiased opinion and suggestion for changes to be incorporated during art therapy
sessions for further improvement. The feedback and suggestions obtained from various
sources were invaluable, enabling me to improve on any shortcomings that may have been
ignored by me. Thus, democratic and dialogic validity strategies were part of the action
research. Democratic validity ensures that all the concerned people can give their input
40
during the project, which was done for Anna’s case. Dialogic strategy enabled me to reduce
bias and be receptive towards other interpretation of results, thereby increasing the neutrality
of the project. This not only increased my understanding but also the accuracy of the whole
research study. All the stakeholders (members of IEP team) worked together towards
achieving improvement in the communication skills and self-efficacy of Anna. They all were
given sufficient opportunities to express their opinion and feedback. I want the results to be
useful to other students also. Peer debriefing was employed to increase the validity of study.
This study was discussed with my peers who were not directly involved in this project so as
to get an unbiased feedback, inputs that could help me interpret my findings in a different
manner and could help in deciding my further action. Member checks were also used to
reduce bias and increase credibility of the study. My interpretation was discussed with Anna’s
teachers and mother to understand their viewpoint regarding change in the communicative
skill of Anna.
The project ensured process validity. Sufficiently persistent and prolonged
observation and accurate data recording was ensured through the interviews, observational
notes, checklists and other types of data like IEP information. Triangulation (using of
multiple sources to collect data) has improved the validity and credibility of my research
study. Regular and timely recording of observations ensured process validity as it guaranteed
the accuracy of observations and resulting interpretations.
The action research also used outcome and catalytic validity as this study was used to
increase the understanding of myself and other teachers dealing with autistic children. The
expected outcome is improvement in the communication skills of Anna, which was the main
challenge for her. I would want to have continuous, ongoing reflective planning. The findings
of this study can be used by me and other teachers in future for similar situations. I am sure
41
that I will be able to use the different techniques used in this project’s intervention plan for
other autistic students also.
Applicability/transferability and consistency/dependability validity have been applied
during the intervention and analysis process. The results of this project can be applicable in
different settings and context and with different autistic students. I have provided sufficient
description of setting, study, participants and research methods. Also, I have explained the
various lesson plans in sufficient details for easy adoption by other teachers. During this
project, I also tried to ensure that Anna continues to use art therapy with other teachers and at
different settings other than her classroom. I understand that the results may vary for different
students, however, similar type of intervention can be used by other teachers after changing
simple details as per the requirement of the autistic child.
For better validity of my research study, I would recommend carrying out art therapy
sessions for longer duration or at least one year before its actual effectiveness can be
assessed.
of Data Analysis
The data collected in the research aimed at answering the research question. The
purpose of the research was to investigate whether art therapy can improve the
communication skills and self-efficacy of kindergarten students with autism. The research
focused on Anna, an autistic student in the kindergarten. Various data collection methods
were employed in an attempt to get information that would be relevant to answer the research
problem. The three methods of data collection used included; artefact data collection that
focused on the Individual Education Program, inquiry data and observational data. The data
collection methods had significant influence in providing the required information.
Each and every data collected through the various sources was scrutinized and
analysed in order to verify whether the option of applying art therapy for an autistic child like
42
Anna yielded the expected results and what more could be rectified while using this strategy
in future.
Inquiry Data
Informal data collected during the initial meeting with head of Spanish school, Anna’s
regular and special education teacher as well as with her parents helped me to gather a lot of
information about her behavior, level of understanding and her communication skills. The
questions were mostly related to her educational environment in school, her behavior,
challenges, likings and disliking, self-confidence as well her comprehension about the world
around her. The notes made during these informal interviews were analyzed in-depth by me. I
could understand about her good qualities as well as the problems she faced while
understanding and communicating with others including her classmates. I could figure out
about how she expressed her frustrations and anger. It was very essential to gather in the
beginning as much information as possible about Anna from those who deal with her every
day and are close to her like her parents and class teachers. The information so gathered
helped me in planning my project as per the requirements of Anna and conduct the art therapy
in such a manner that she would accept and could use it in future rather than feel offended or
get upset by it.
Anna normally behaved in a good manner when she was busy in activities of interest
to her and those which she understood, but if she felt that it is a tough activity she got
frustrated easily and did not cooperate. This indicated that I should create a good rapport with
her and explain her as much as required about the art activity at the start so that she does not
find it tough. As she had poor communication skills, she expressed her inability to complete
tasks by yelling or crying. This happened almost on a daily basis. This made it very clear to
me that I should focus on improving her communication skills during the art therapy sessions,
which will help her to convey her feelings and enable her to maintain her calmness.
43
Sometimes she even misinterpreted what other students say to her as she had comprehension
problems. With the help of art therapy sessions I needed to improve her self-confidence,
which could improve her dealings with other people, especially her classmates.
I learnt that Anna used crying as a means to express her frustrations and manipulate a
situation in her favor. Once angry, she was not ready to listen to anybody and reacted by
saying rude words, cried, left the classroom, kicked the cabins and threw the backpacks kept
on the cabins. She wanted people especially teachers to pay personalized attention to her and
wanted them to pacify her by moving around her in school. When she did not get the desired
attention, she simply burst out and even hit other students in her anger. This behavior of h ers
disturbed the entire class. She had to regain her calmness before anybody could assist her
further. This implied that I should pay full attention to her during the art therapy sessions else
she may lose interest and get upset. Giving her full attention will ensure that I can study her
mood variations closely and respond correspondingly to help her. She responded positively to
reinforcement strategies like showing a puppet talking with her, praising her and giving her
high fives. I had to take care that I should praise her efforts repeatedly during the art therapy
session to keep her motivated and positively engaged in the activity. Understanding the real
world and her impatience was her biggest challenge according to her parents and teacher,
which would improve only once her communication skills and self-confidence improved.
Even though Anna was very good at reading and writing Spanish language, she could
not comprehend what she was reading or writing. She was interested in stuffed animals, dolls
and puppets. She loved pink and purple color indicating that she did like working with colors
and would like to be interested in drawing art. Even though she liked colors and painting, she
preferred to write a list of names. She loved pictorial books, which further indicated that she
would love working with pictures. Autistic children have the ability to understand things
visually rather than verbally. This quality was to be used to the maximum by me during the
44
art therapy sessions to improve her communication skills. She was not interested in playing
with other children as she lacked the proper communication skills. This situation could be
improved only once her interaction skills and confidence level increased. For her comfort, a
rocking chair was provided within the class and she was free to move whenever required. She
did not like too much of noise, which meant that there should be cooperation from the other
children and teachers of her class. She did not like being instructed to do something like
staying back with others for lunch and became frustrated, which meant I should instigate her
interest in drawing during art therapy sessions by being a part of it rather than instructing her
to just follow my instructions. Once she calmed down, she did not remember why she started
crying or became angry and started with the next activity. She became frustrated during
transitions indicating that I had to take care not to upset her during the transition phase while
starting and exiting from the art therapy session.
Anna’s teachers wanted to know how they could control her without allowing her to
manipulate the situation by crying or yelling. I felt that this could be achieved only after she
learns to convey her feelings and thoughts by working on her communication skills and self-
confidence. Apart from the initial interaction, the informal interactions I had during the
course of my study with Anna’s teachers and mother helped me a lot in gaining feedback
about the improvements seen in the communication abilities of Anna and what more could I
add or modify during my art therapy session to make it more productive or useful for Anna.
Observational Data
I observed Anna during the art therapy sessions and during the remaining classes
within the six weeks of my study. I focused my observation on how she behaved during the
normal classes as well as during the art therapy sessions, whether she understood the various
emotional expressions explained to her, if she could use the explained method to convey her
feelings and about the improvements in her self-confidence and communication abilities.
45
Every day after observing Anna, I would go through the recorded observations during the
evening hours and try to improve the strategies for the next day as per the observations made.
This helped me to come up with better approaches to ignite and keep her interest continued in
the art therapy sessions.
As recorded in my observation, she felt happy and satisfied with the individual
attention that I was giving her during the art therapy session. As I explained her in brief,
especially through actions, of what was supposed to be done during each of the 20 minute art
therapy sessions, she felt happy. This assured of her cooperation during the sessions and that
she would use them to express her emotions, including negative ones, by developing ideas on
paper. Her attention was constantly drawn towards the chart depicting various emotional
expressions. During the first session, when I demonstrated her how each of the emotional
faces look in reality, her excitement for the activity increased and she started showing more
interest. This visual representation helped her to understand more about the various emotions.
When she was given drawing material and asked to draw the emotional faces like I had
showed, she immediately started drawing and coloring them indicating she had somewhat
understood what I had explained so far.
During the second session, I wanted to explain her causes behind each of the
emotional faces. She also tried to imitate the various emotions. She even discussed the
various situations she could recall where she had experienced these emotions. This helped me
understand what made her express her anger in the manner she usually did at school, which I
discussed with her parents and teachers. She also showed an improvement in self-confidence
during her interaction with me.
During the third session of mix and match activity she was supposed to draw
emotions corresponding to names of various emotions as well as match pictures of various
emotions with the corresponding name tag. She did get confused during identification of two
46
emotions – level 2 (“This sometimes bothers me”) and level 3(“This can make me feel
nervous”). However, instead of instructing or rebuking her, I again calmly explained the
difference between these two so that her mood doesn’t change and her interest in the activity
continues. She did respond positively to my efforts and understood clearly the difference.
While repeating the activity she performed as per my expectations.
During the fourth session, I explained to her the emotions that were acceptable in
school. I explained her reasons behind this. She had some query like what she should do if
the teachers did not respond to her positively or other children made fun of her. When I
explained that she could express her feelings by drawing them, she understood that indeed
drawing can be used to effectively communicate her feelings and maybe other requirements,
which she could not communicate properly.
During the sessions, especially during the first two sessions, whenever I asked her
how she felt she mostly pointed to level 3 indicating she felt nervous. This I assumed was
because of her lack of communication skills and self-confidence. However, during the last
two sessions her nervousness decreased. There was an increase in her self-confidence, which
could be seen in the way she interacted with me, asked me queries and even gave answers to
my questions. She was, in fact, happy that she had a way to express her feelings in such a
manner that others could understand her. She was excited when I praised her for her correct
answers.
One day, when I was observing her during the regular class she got up while working
on her task and proceeded to talk with her teacher. As her teacher was busy with another
student, she felt she was being ignored and she exhibited mood transition. When I asked her
to express about her feeling, initially she ignored me and showed a sad expression on her
face. It was visible she was upset. She did not even respond to the emotional chart that I
showed to express her feelings. When I told her that I felt sad for her by pointing to the sad
47
face on the emotional chart, she responded positively by pointing her finger towards the
angry face on the chart conveying she felt very angry at that time. This confirmed that she
had understood what was explained during the art therapy sessions and she could effectively
use them in future to communicate.
After the start of art therapy sessions, I also observed how effectively her
teacher followed the new learning method for Anna during the regular classes. I had
explained her how it worked and what points she should take care of. This was necessary so
that Anna would not get confused between the two learning styles and there is
synchronization between the two. This also ensured that Anna could apply the teachings of
art therapy session in her routine life. I did point out to the teacher, based on my observations,
how the teacher could improve her working with Anna in a better manner using the art
therapy. I had also given Anna a “How Do I Feel Today?” chart (Appendix O) after the fourth
session. The filling of this chart was explained to her teacher so she could help Anna in doing
it. During the last session with Anna, I found that she had started using it to express her
feelings during the various days of the week. This was helpful for her at home also as
confirmed by her mother.
Behaviour Check List
I created and used two check-lists (Appendix J and Appendix K) to help me evaluate
Anna’s behaviour during her regular class as well as during the art therapy sessions. The
checklist attached in Appendix J listed 20 behaviours of Anna that made it easier for me to
mark whenever she exhibited the particular behaviour during each of the day long
observation. The checklist attached in Appendix K consisted of 11 behaviours that I observed
during each art therapy session. For most of the behaviours, I gave her a marking out of 10
which would help to analyse whether she was showing any improvement in her
communication skills, self-confidence and overall behaviour. 10 was the maximum mark for
48
an ideal situation. Although there was an improvement in most of her traits, I could not allot
her ideal mark of 10 for any of the behaviour as there was still scope for improvement, which
could be achieved with longer duration of art therapy sessions. There was a decrease in her
negative behaviour like shyness and nervousness as seen in the below charts.
Overall Improvement in Anna’s Behaviour (Appendix Q)
This graph or excel table shows improvement in Anna with respect to three key
aspects: Self-confidence, communication skills and understanding emotional faces, two of
which relate to the title of the project. I have used the checklist used in appendix as reference.
I have marked Anna out of 10 marks. 10 is the ideal situation. The rising graph indicates that
there has been improvement in Anna, though she has not reached the ideal situation. This
answers the RQ- how art therapy can help in improving the communication skills and self-
confidence of autistic children. I have used observational data as it is mentioned that the
markings have been given while observing her during the art therapy session and regular
class.
49
Change in Anna's Behaviour during Art Therapy Sessions (Appendix R)
Thus, art therapy did help Anna in improving her understanding of various emotions,
improving her communication skills and her self-confidence. It gave her an alternative to
convey her feelings. It was interesting to note the changes in Anna’s behaviour, especially the
increase in her self-confidence to communicate, by the end of the art therapy sessions. The
changes were confirmed by her teachers and mother also. She was now able to better control
her emotions at school as she had clearly understood as to which emotions were acceptable at
school. Having been successful in teaching her to convey her emotions using art therapy, I am
confident that this technique could be used in future by her special education teacher and
parents to similarly explain her other things and improve her communication skills on a
continual basis.
The methods of data collection used were effective in providing the required data for
the research. The data was relevant to the research question hence the conclusions to be made
would be based on eligible information. The data helped in providing a comprehensive
answer to the research topic hence the data would be credible to use in a research proposal.
50
Appendix Q
Overall Improvement in Anna's Behavior
Activity/ Week* Week
1
Week
2
Week
3
Week
4
Week
5
Week
6
Understanding Emotional Faces 0 2 4 6 7 8
Self-confidence 1 2 5 7 8 8
Communication skills 1 3 5 7 7 8
*Score out of 10 (10 being maximum)
Week 1 indicates start of activity
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 51
Appendix R
Change in Anna's Behavior During Art Therapy Session
Behavior/ Week*
Week
1
Week
2
Week
3
Week
4
Week
5
Week
6
Attentiveness and Interest 1 3 5 6 7 8
Asks questions 0 1 3 5 6 7
Shyness & Nervousness 9 8 6 4 3 1
Responds & Follows instructions 1 4 6 6 8 9
Is active 2 4 5 7 7 8
* Score out of 10 (10 being maximum)
Week 1 indicates start of activity
Implications of This Study
Applying art therapy on an autistic child like Anna was a very enriching experience
for me. It taught me that children, especially those suffering from autism, need individual
attention and care to understand their needs. If they feel they are being given importance they
will definitely cooperate in the learning process, yielding positive results. I helped Anna
overcome her shyness, increase her self-confidence and improve her communication skills
using art therapy. I realized that such children respond very well to visual aids. She was
taught as to which behaviors are acceptable at school and which are not during these sessions.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 52
This helped her to control her emotions at school. Gradually, I hope she will learn to control
her feelings at other public places also. Art therapy gave her a medium to express her
emotions, which she was not able to do till now and caused her frustration. Personally
demonstrating the various emotions further expanded her understanding. Working with Anna
will help me as a teacher to deal with autistic children in a much better manner in future.
Thus, art therapy has proved to be a valuable remedial method for sorting out emotional
issues, promoting self-awareness, development of social skills, controlling behavior,
decreasing anxiety, solving communication issues, assisting understanding of reality and
boosting self-esteem of autistic children like Anna.
I would definitely recommend other teachers to adopt this method for improving
communication skills of autistic children. I am sure that other teachers who have to deal with
autistic children will definitely find this study useful. Using such techniques will enable me
and other teachers to give the autistic children a good start during their early learning years,
which can improve their comprehension of their surroundings and hone their communication
skills. Overall autistic children will definitely benefit from application of alternative therapies
like art therapy.
Challenges Faced During the Study
I felt that time was a strong limiting factor in my study. I had just six weeks to prove
the effect of art therapy in improving the communication skills and self-confidence of autistic
children. I strongly believe that art therapy, if continued, for a longer period of time would
have helped me in achieving more and better results for Anna.
I would like to try this therapy with more autistic children. In this case study, I applied
and observed the effect of art therapy on Anna only for whom it proved to be beneficial.
However, to generalize the positive impact and extent of art therapy in improving the
communication skills of autistic children I would like to apply it on more autistic children.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 53
Initially I did not get the required support from the other students of Anna’s class.
However, as I explained the other students of their importance in this session, they helped to
create a comfortable environment for Anna.
I could not observe how Anna was expressing her emotions at home when the art
therapy sessions were in progress. Though I got positive feedback from her parents, still I felt
that she needed more encouragement at home from her family members to use this technique
to communicate on a continuous basis.
The Next Step
I would like other teachers to study my project and adopt similar practices while
dealing with autistic children. They could learn from my project as well as provide
suggestions as to what could have been done better.
I would like to see the application of similar projects in my country (Saudi Arabia). I
want my project to be shared across all schools of Saudi Arabia so that more and more
children can benefit. I really want that children with such issues should benefit from my study
rather than being side-lined in the society. My project will open up plethora of options related
to interventions that were unheard of in my country till now and can be successfully
implemented. In future, I would also like to contact a professional art therapist to get first -
hand experience of how they work and what could have been improved in my study. Their
experience and assessment methods will definitely help many autistic children of my country
to improve their life. I do not want my project to just remain as bunch of papers; rather I want
it to have practical implications benefitting many autistic children in Saudi Arabia and across
the world.
Recommendations for Other Teachers
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 54
In this section I would like to share with my colleagues belonging to the teaching
community some important advice and tips that need to be taken care of while dealing with
autistic children. I have learnt these things while working with Anna.
Early intervention will have significantly important results for children with autism.
Hence, the earlier such interventions like art therapy are introduced, the better they can learn
to communicate and develop their self-worth. It is very essential for a teacher to understand
and gather complete information about the autistic child; his/her likes and dislikes,
psychology, behavior and mode of expression before starting any kind of intervention. Once
intervention like art therapy has been finalized they should try to instigate the interest of the
child in the activity before instructing anything. Such children like getting individual
attention. Hence, all attempts should be made to give them personalized attention during such
therapy sessions and to take care they are not distracted by surrounding environment. Autistic
children like to be explained about the activity in advance. They should have a fixed schedule
for the day. The teacher should demonstrate how to do the activity rather than instructing the
child. Indicating that the teacher is a part of the whole activity would be a morale booster for
the autistic child. If they get confused or find the activity tough they may lose interest in the
session and ultimately the objective will not be achieved. A reinforcement strategy like
praising them motivates the autistic children to take more interest in the learning activities. To
teach them communication skills, use as much visual aids as possible to make them
understand the various expressive modes like I used the chart depicting various emotions and
make them identify situations where they themselves have experienced it. The teachers
should be patient and maintain their calm during these sessions as autistic children take extra
time to understand and execute things as compared to normal children. Do educate the
parents and regular teachers about the new method so that they too can use in normal routine
and the child does not feel the need for transition.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 55
Each child is a unique individual. It is not necessary what worked with Anna can be
used for another autistic child. Hence, the strategy to be used should be based after studying
the student’s background and interests and after discussing it with the parents and teachers to
get suitable feedback. The regular teachers at school and parents of the child should be
continuously involved as their feedback will help to improve the strategies in coming
sessions or in future. Teachers should keep themselves updated to know and learn about the
various latest methods being used across the world for such children. Discussion of these
strategies with other teachers and experts in the field of autism will only help to widen the
knowledge base.
During the data collection period, the teacher should use as many sources as possible
to get complete information. Always keep a diary in hand to record any incident or behavior
during and after the session. This will help during analysis time and one can improve on the
strategies used.
As I did with Anna, try to understand what makes them frustrated and avoid creating
such situations. Best results are obtained when the child’s interests are kept in mind like I
used drawing art for Anna as she liked pink and purple colors and preferred pictorial books.
Carrying out behavioral evaluation on a regular basis is a great way of understanding the
child and the improvements achieved. Thus, a teacher should start using an intervention only
after proper assessment and understanding of what will work best for the autistic child.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 56
References
Al Moosa,N. (2003). What society wants from educators and what educators wants from the
community (Working Paper). Retrieved from Ministry of Education, Riyadh.
Al Othman, I. (2003). Autism programs of the secretariat. Riyadh: Ministry of Education.
American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental
disorders (4th ed.). Washington, DC: Author.
Betts, D. J. (2005). The art of art therapy: Drawing individuals out in creative ways.
Advocate: Magazine of the Autism Society of America, 26-27.
Dawson, G.(2008). Research: Early behavioral intervention, brain plasticity, and the
prevention of autism spectrum disorder. Development and Psychopathology, 20,775–
803.
Eisdell, N. (2005). A conversational model of art therapy. Psychology and Psychotherapy:
Theory, Research and Practice, 78, 1-19.
Emery, M.J. (2004). Art therapy as an intervention for autism. Journal of the American Art
Therapy Association, 21(3), 143-147.
Friend, M. (2010). Special education: Contemporary perspectives for school
professionals (3rd ed., pp. 56–59). Englewood Cliffs, N.J: Prentice Hall.
Gilroy, A. (2006). Art therapy, research and evidence-based practice. Thousand Oaks,
London: Sage Publications Ltd.
Henley, D. (1998). Art therapy in a socialization program for children with attention deficit
hyperactivity disorder. American Journal of Art Therapy, 37(1), 2 – 11.
Koegel, R.L., O'Dell, M,C. & Koegel, L.K.(1987). A natural language teaching paradigm for
nonverbal autistic children. Journal of Autism and Developmental Disorders, 17 (2),
187–200.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 57
Kornreich, T.Z. and Schimmel, B.F. (1991). The world is attacked by great big snowflakes:
Art therapy with an autistic boy. The American Journal of Art Therapy, 29, 77 – 84.
Malchiodi, C. A. (2003). Handbook of art therapy. New York / London: Guilford Press.
Martin, N. (2007). Home page. Retrieved October 26, 2009, from
http://arttherapyandautism.com/index.html.
Martin, N.& Lawrence,K.S. (2008). Assessing portrait drawings created by children and
adolescents with autism spectrum disorder. Art Therapy: Journal of the American Art
Therapy Association, 25(1), 15-23.
Mesibov, G. B., & Shea, V. (2008). Structured teaching and environmental supports. In K. D.
Buron & P. Wolfberg (Eds.), Learners on the autism spectrum (pp. 114-137). Shawnee
Mission, KS: Autism Asperger Publishing.
Mundy, P. & Stella, J. (2000). Joint attention, social orienting, and nonverbal communication
in autism. In A. M. Wetherby. & B. M. Prizant (Eds.), Autism spectrum
disorders (pp. 55-77). Baltimore: Brookes.
National Research Council.(2001). Educating children with autism. Washington DC: National
Academy.
Osterling, J. & Dawson, G. (1994). Early recognition of children with autism: A study of first
birthday home videotapes. Journal of Autism and Developmental Disorders, 24(3),
247–257.
Pioch, A. (2010). Arts Therapies in a school environment: Research report. RENN4:
Groningen .
Prager, A. (1993). The art therapist’s role in working with hospitalized children. American
Journal of Art Therapy, 32(1), 2 – 10.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 58
Sheila, C. (2009). Review of 'the hidden world of autism: Writing and art by children with
high functioning autism. Journal of Autism & Childhood Schizophrenia, 39(7), 1094-
1095.
Sigman, M. & Ruskin, E. (1999). Continuity and change in the social competence of children
with autism, down syndrome and developmental delays. Monographs of the Society
for Research in Child Development, 64(1), 115-130.
Schweizer, C., Knorth, E.J. & Spreen, M. (2014). Art Therapy with children with Autism
Spectrum Disorder. A report on of ‘what works’ elements. Arts in Psychotherapy,
41(5), 577-593.
Wagner, S. (1999). Inclusive programming for elementary students with autism. Arlington,
TX: Future Horizons, Inc.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 59
Appendix A: Pictures of Regular Kindergarten Class
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 60
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 61
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 62
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 63
Appendix B: Pictures of Special Kindergarten Class
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 64
Appendix D: Parental Consent Form
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 65
Appendix E: Informal Interview with Anna’s Regular Class Teacher
1. Tell us something about your background.
2. Do you move faster to get her what she wants when she cries?
3. Are there built-in benefits perhaps to her crying that she might get from you?
4. Do you change in some way when she cries so that she would feel it is an effective
way to communicate?
5. Have there been times when she cries and then you stay longer? Or open the door etc?
6. What is happening right before she does this behavior?
7. What do people do when she does it? Do people become “concerned” and therefore
“tense” or “ill at ease” with her? If so, then she can pick up on this, and also this will
alter the person’s behavior.
8. Do you think this shows her that this may be an effective way to communicate
something with others?
9. Can you give me a brief description of your educational role and your setting (grade
level, subject, etc.) for this student?
10. What setting and characteristics can be shared regarding your school and students?
(Grade or age range, socio-economic-status (SES) via free & reduced lunch rates,
ethnic composition, gender composition, and location such as urban, rural, suburban)
11. Can you give me a description, in sufficient detail, for the setting and participants in
your class, so the context of your educational environment can be understood? If you
have another teacher with you in class, please explain for me please the nature of the
collaboration.
12. Can you give a brief background about Anna? What makes your student shine
13. Please give a description of the child's status and behavior.
14. What is her main challenge?
Commented [Muli15]: Deleted the answers and left the interview schedule as required
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 66
15. What is she interested in?
16. What color does she love?
17. What cartoons does she love?
18. What is she excited about?
19. What book does she love?
20. How does she ask for help?
21. What is her main problem?
22. What are the common problems that you face with the student?
23. What makes her happy/ angry/ sad?
24. What is the reinforcement strategies used with her?
25. Does she like colors and painting?
26. Do you have classes for drawing?
27. Do you offer other art classes?
28. What is her method of expressing anger or sadness?
29. What challenges does she, as an autistic student, face with language acquisition?
About the Classroom
1. How does the Center divide the students in classes - according to what?
2. How many students are in class, and how old are they?
3. Describe the students in general, if you can. For example: “The students have few
language and communication skills.”
4. How do you teach them, and what do you use?
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 67
5. How is the environment for the class? How many learning corners are there? Can you
describe and give details? What materials, resources, and games are there?
6. Do you provide a student with his/her own special schedule for the day?
7. Schedule for Anna: what do they look like? Filled with words or pictures?
8. Is there any special note about Anna?
9. How is the sequence of the day for Anna?
Anna’s Typical Behavior
1. How frequently does she behave strangely?
2. Is there a pattern to when it occurs (e.g., time of day, activity, setting, audience)?
3. What happens just before the behaviour?
4. What happens following the behavior? Is there a consistent response from others or a
consequence to the behavior?
5. What is Anna’s reaction to the response or what is the consequence of other people’s
response? Does her behavior change (e.g., frequency or intensity)?
6. What are the probable reasons for such behavior of Anna (e.g. to gain or escape
something)?
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 68
Appendix F: Informal Interview with Anna’s Special Education Teacher
1. Tell me something about your background.
2. Can you give me a brief description of your educational role and your setting (grade
level, subject, etc.) for Anna?
3. What setting and characteristics can be shared regarding your school and students?
(Grade or age range, socio-economic-status (SES) via free & reduced lunch rates,
ethnic composition, gender composition, and location such as urban, rural, suburban)
4. Can you give me a description, in sufficient detail, for the setting and participants in
your class, so the context of your educational environment can be understood? If you
have another teacher with you in class, please explain for me please the nature of the
collaboration.
5. Please give a brief background about Anna: what makes her shine?
6. Could you give a description of the child's status and behavior? What are the
problems that you face with the student?
7. What makes her happy/ angry/ sad?
8. What reinforcement strategies are used with her?
9. Does she like colors and painting?
10. Do you have classes for drawing?
11. Do you offer other art classes?
Commented [Muli16]: Deleted the answers and left the interview schedule as required
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 69
12. What is her method of expressing anger or sadness?
13. What challenge does she, as an autistic student, face with language acquisition?
14. Do you move faster to get her what she wants when she cries?
15. Are there built-in benefits perhaps to her crying that she might get from you?
16. Does your response change in some way when she cries so that she would feel it is an
effective way to communicate?
17. Have there been times when she cries and then you stay longer? Or open the door etc?
18. What happens right before she does this behavior?
19. What do people do when she does it? Do people become “concerned” and therefore
“tense” or “ill at ease” with her? If so, can she pick up on this, and also will this alter
the person’s behavior?
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 70
Appendix G: Informal Interview with the Head of the Spanish School
1. How many employees do you have on staff?
2. Do you accept volunteers - especially during summer school?
3. Are your teachers highly qualified?
4. Do they go through an intensive training program before working as a full time
teacher?
5. Do you accept students from all ages, and with learning disabilities?
6. Does your center have programs for both children and adults?
7. Does your center offer specialized support for the students and the families?
Commented [Muli17]: Deleted the answers and left the interview schedule as required
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 71
Appendix H: Chart Depicting Different Emotions
Level Person, Please or thing Makes me feel like this 5
This could me lose
control !!
4 This can really upset
me.
3 This can make me feel
nervous.
2 This sometimes bothers
me.
1 This never bothers me.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 72
Appendix I: Action Plan for each Session
Lesson 1
Teaching student to draw emotion faces
The stepwise Activities
Class range: Kindergarten
Completion Period: 20 minutes
Addressed subjects: Drawing, shading, language
Lesson Objective: The objective of this lesson is to teach the student how they can draw
emotion faces. The student will also fill out different emotions on blank faces as per the
teacher’s instructions.
Materials:
Colored pencils
Crayons
Paper with blank faces drawn on it
Blank papers
Words to Learn: Happy, sad, crying, surprised, angry, confused
Directions:
1. Teach the child many faces
2. Demonstrate how the faces look in reality
3. Draw them on paper
4. Ask the child to draw
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 73
5. Draw eyes nose and mouth on a blank face picture
6. Ask the child to do the same and color the faces
Lesson 2
Teaching the child when and why we experience these emotions
The stepwise activities
Class range: Kindergarten
Completion Period: 20 minutes
Addressed subjects: Listening and observing
Lesson Objective: The objective of this lesson is to explain to the student what causes the
different emotions that people experience and why they experience them
Materials:
Charts of different level of faces showing different facial expressions to imply emotions.
Words to Learn: Happy, sad, crying, surprised, angry, confused, loved, upset, excited, loved
Directions:
1. Explain the various emotion with the appropriate facial demonstrations
2. Explain situations that bring about the emotions for example happiness, sadness and
excitement
3. Ask the child to try and imitate
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 74
Lesson 3
Mix and match activity
The stepwise activities
Class range: Kindergarten
Completion Period: 20 minutes
Addressed subjects: mixing and matching, cognition.
Lesson Objective: The objective of this lesson is to find out whether the student has
understood the various emotions and whether she can match the pictures to the emotion they
represent.
Materials:
Pieces of paper with names of various emotions
Pieces of paper with pictures of various emotions
Words to Learn: Happy, sad, crying, surprised, angry, confused, loved, upset, excited, loved
Directions:
1. Place the pictures on the table in random order (mixed)
2. Give the pieces of paper with names of various emotions to the student
3. Ask her to match name tags with the pictures they represent
4. Help the student and correct if wrong
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 75
Lesson 4
Accepting Emotions
The stepwise activities
Class range: Kindergarten
Completion Period: 20 minutes
Addressed subjects: Which emotions clarification accepted or unacceptable at school,
cognition
Lesson Objective: The objective of this lesson is to teach the student which emotions
clarification accepted or unacceptable at school
Materials:
Charts of different level of faces showing different facial expressions.
Words to Learn: Happy, sad, crying, surprised, angry, confused, loved, upset, excited, loved
Directions:
1. Explain her that emotions 1 to 3 are acceptable in school with reasons.
2. Explain her that emotions 4 and 5 are not acceptable in school with reasons.
3. Ask her to repeat which emotions are acceptable at school.
4. Help the student and correct if wrong.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 76
Appendix J: Behavior Check List Used during Day-Long Observation
Behavior Check-List
Student Name: Anna Age:6
Behavior. Check.
Screaming.
Crying.
Able to have a smooth transition between activities.
Kicking / Hitting.
Eye contact.
Anger.
Excitement.
Head shaking / head nodding.
Resists physical contact.
Having Anxiety.
Facial expression.
Annoyed by Sounds.
Self-Injuries behaviors.
Dose not follow simple commands.
Engagement.
Joyful expression.
Ignoring others / walking away.
Difficulty to calm self-down after tantrum.
Engaging in self-stimulatory behavior.
Not responsive to own name when being called / No response to others.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 77
Appendix K: Behavior Check List Used During Art Therapy Session
Student Name: Anna Age:6
Behaviors Check.
Attentive
Showing interest to the subject matter
Asks questions
Follows keenly through change of activities
Shy and avoids eye contact
Ask questions and clarification
Follows instruction
Can match faces to the emotions they represent
Is responsive to teachers advice
Takes an active role in all activities
Gives good feedback about the activity
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 78
Appendix L: Anna’s Work during First Session (Drawing Various Emotions)
Various Emotional Faces
Blank Picture given to Anna to Draw Emotions
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 79
Appendix M: Second Session (Understanding the Various Emotions)
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 80
Blank Sheet given to Anna to Express the Reason behind the Expression
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 81
Appendix N: Third Session (Mix and Match Activity)
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 82
Blank Picture given to Anna to Draw Emotions as per the Specified Tag
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 83
Appendix O: How Do I Feel Today?
Happy Bother
Sad Angry Upset
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 84
Appendix P: Recent Evaluation Results of Anna
Name of Test Specific Areas Score Level / Comment
Stanford Binet Intelligence Scales, Fifth
Edition (SB-5) - 96 Average
Kaufman Test of Educational
Achievement , Second Edition (KTEA-
II)
Reading
Composite
Score
118
- Math
Composite 100
Written
Language
Composite
74
T1 P1 P2 -
Adaptive Behaviour Assessment
System, Second Edition (ABAS-II)
GAC 89 65 (99) -
Conceptual 96 61 104 -
Communication 7 2 9 -
Functional
Academics 10 3 12 -
Self-Direction 7 6 11 -
Social 90 81 102 -
Leisure 6 7 10 -
Social 9 6 11 -
Practical 91 60 (91) -
Community
Use 6 2 11 -
Home Living 7 4 11 -
Health and
Safety 8 2 5 -
Self Care 10 6 7 -
Bruininks-Oseretsky Test of Motor
Proficiency, Second Edition (BOT-2)
Fine Motor
Integration - Average
Manual
Dexterity - Average
Upper-Limb
Coordination - Average
Balance - Average
Running Speed
and Agility - Below Average
Strength - Below Average
Fine Motor
Precision - Well Below Average
Age
Equivalence - Less than 4 years
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 85
Beery-Buktenica Developmental Test of
Visual Motor Integration(Beery VMI)
Visual Motor
Integration
39%
-
Visual
Perception 23% -
Motor
Coordination 3% -
Goldman-Fristoe Test of Articulation,
Second Edition (GFTA-2) - -
Incorrect Phonemes at
the word level
Clinical Evaluation of Language
Fundamentals, Fifth Edition (CELF-5) Core Language
Score 64 -
Comprehensive Assessment of Spoken
Language (CASL) Standard Score 66 -
General State(MAP/MAP-A) - - Not of age/grade level to
take MAP
Northwest Evaluation Association
Testing
Mathematics 134
Ranked in 20th
percentile
Reading 145
Ranked in 59th
percentile
Formal /Informal age appropriate
transition assessments - -
Does not require
transition assessments at
this time.
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 86
Appendix Q: Interview with Anna’s Mother
1. Why did you decide to go with language immersion?
2. Tell us something about your background.
3. Do you move faster to get her what she wants when she cries?
4. Are there built-in benefits perhaps to her crying that she might get from you?
5. Do you change in some way when she cries so that she would feel it is an effective way
to communicate?
6. Have there been times when she cries and then you stay longer?
7. Is she in after-school program etc?
8. Tell us about your family background (does Lily have any other siblings? etc.).
9. How frequently does she behave strangely?
10. What makes her happy/ angry/ sad?
11. Can you give a brief background about Lily? What makes Anna shine?
12. Please give a description of the child's status and behavior.
13. What is her main challenge?
14. What is she interested in?
15. What color does she love?
16. What cartoons does she love?
17. What is she excited about?
18. What book does she love?
19. How does she ask for help?
20. Does she like colors and painting?
21. Do you have classes for drawing?
22. What is Lily's reaction to the response or what is the consequence of other people’s
response? Does her behavior change?
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 87
Appendix R: Educational Diagnosis of Anna
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 88
Appendix S: IEP Report of Anna
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 89
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 90
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 91
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 92
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 93
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 94
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 95
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 96
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 97
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 98
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 99
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 100
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 101
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 102
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 103
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 104
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 105
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 106
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 107
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 108
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 109
Name, phone, job title, school: Volunteer Student
SLLIS
Project Title: The Effect of Art Therapy in Improving the Communicative Skills and self-efficacy for
Students with Autism.
Main Question: How can art therapy improve the communication skills and self-efficacy needs of a
Kindergarten student having autism in a language immersion setting?
Sub-Questions? (if any)
List Topics to Research in the Literature Review
o Communication Issues of Autistic Children.
o Different Improvement Practices for Enhancing Communication Skills in Autistic Children (Most Recent and Best Practices).
o Effect of Art Therapy in improving the communication skills of autistic children.
o Previous Case Studies authenticating the positive impact of art therapy for autistic children.
o Materials and Techniques for an Autistic Kindergarten Child.
Setting & Participants The Spanish School under the St. Louis Charter Schools System.
One participant in the case study: “Anna”: a white, English speaking, six year old
Kindergarten student with autism and speech and language deficiencies on whom art
therapy will be applied. The other participants in this study include Anna’s regular class
teacher, special education teacher and I who will help her benefit from art therapy.
Collaborate with Anna’s parents, regular class teacher and special education teacher.
Interventions
• Art therapy techniques and activities related to Art. Particularly, drawing art will be chosen to improve Anna’s communication skills, her ability to address and respond
emotions in full spectrum, connecting visual images with verbal skills.
• Initially will be conducting an informal interview with Anna’s special education teacher and regular class teacher to get feedback about her behavior in school and
understand about her study environment.
• Modeling the use of artistic materials for Anna to eventually use. It will be reasonable to use the colorful spectrum of paints, brushes of various sizes, blank
white sheets of paper to let Anna express her ideas. It will be useful to distribute her
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 110
sheets of paper of A3 or A2 format, - the bigger format we use the best Anna can
show her ideas in paper, as she can draw both big and small pictures, arranging the
set of ideas.
• Helping Anna understand that the art apron means it is time for therapy. The art apron is a symbol of work process that will bring Anna pleasure from applying her
creativity practically. If Anna understands this, she will learn to build correct
associative connections in her brain, in relevance to other situations as well.
• Convincing Anna to express frustrations through art. We should let the girl understand that she can express her negative emotional resources developing ideas
on paper, and there is no limit in work with imagery this way. Day by day, she must
learn how to use art to let her emotions free from the justified boundaries of social
restraints and control.
• Building vocabulary through art. At the first stages of art therapy process, Anna can be encouraged to develop communicative skills to express her emotions using a
chart depicting various emotions like happiness, anger, et al. By the way, it is
known that autism patients are more likely to perceive visual images than verbal
phrases. Speech can be considered a supplementary form of interaction; however,
drawing will help Anna to learn new words by means of representing them visually,
in the form of symbols (like apron case and emotional faces on the chart) related to
different situations.
• Using a variety of artistic mediums and seeing which one Anna responds best to. Art therapy may include using different expressive means. We can give Anna
alternative mediums: colored pens or pencils; paints and brushes; colored pieces of
chalk, etc. to check her response to these art materials.
• Using two kinds of checklist to observe her behavior during the regular class and during the art therapy session.
• Working with Anna on an individual basis for 20 minutes conducting a specific activity.
• Eventually providing her with a “How Do I Feel Today Chart?” to enable her to express her overall emotions during each day at school and home.
• Data Collection ( List all data sources and types) and explain how they would
answer your RQ:
Explain:
I am looking to track Anna’s progress throughout the semester in the areas of
communication and self-confidence in expressing her feelings. I am hoping to see
improvement in communication in terms of increase in the number of utterances in English
and Spanish.
• Artifacts Data:
Review of Archival data: Student’s IEP (Individual Education Program) will be relevant to
the current strategy which I am going to apply. It will allow me to build a close interaction
with a team of those who care about Anna like her parents, school, teachers and more
importantly learn about the student’s immediate needs and goals so that I can develop
helpful strategies/interventions.
Student art work: Art enables children on the autism spectrum to develop powerful means
EFFECT OF ART THERAPY ON AUTISTIC STUDENT 111
of channeling their inner life, feelings and experiences. I will have Anna draw pictures of
her own feelings such as happy, angry, scared and sad. She will apply color to them by
shading them. Color prominence and implied energy on the pictures will help me to track
progress regarding communication and self-confidence. It will be cross-checked each time
with the objectives and strategies decided in IEP meetings. I will test her understanding by
asking her to explain what and why she has drawn. Thus, Portrait Drawing Assessment
(PDA) will be used with Anna.
Lesson plans: All the activities with goals/objectives, materials and directions developed.
• Observational Data
Personal Journal: Tracking progress with Anna through each meeting, the observations
made on how Anna is able to express her emotions through drawings will help in assessing
her communication progress. Consistency in using the same picture to express a feeling
over time, such as drawing a happy face to illustrate that she is happy, will help in the
measurement of Anna’s progress in self-confidence. She will also be randomly asked to
convey her present state of feeling to test how much she has understood. These will help to
track the effectiveness of the art therapy. In addition, such objective knowledge can be
easily shared with other autism experts, so that they can make assessment and recommend
alternatives.
• Checklist: Two behavior check lists will be used. One will used to record her
behavior during the regular class. The second will be used to record her behavior
and interaction level during the art therapy session. Both will help to show how
much benefit she has gained from the art therapy sessions and the improvement in
her communication skills and self-confidence.
Inquiry Data
• Informal/regular conversations with Anna, her classroom teacher, special education
teacher and mother: to learn more about the student, her needs and IEP goals and to
check on her progress and effectiveness of strategies used. Her mother can provide
feedback whether she has started using the art therapy techniques to convey her
feelings at home. Important points will be recorded in my journal.
Timeline for Interventions & Data collection:
Questions or Issues you have about project: