Consensus-based typical elements of art therapy with children with autism spectrum disorders

Abstract

Art therapy (AT) offers a specific treatment for developmental, social and behavioural problems of children with autism spectrum disorders (ASD). In this study typical elements of AT with ASD diagnosed children are specified and validated in a two-round Delphi study with 19 art therapists and 10 referrers. In the first round, relevance and applicability of the elements were rated. The degree of consensus per element was computed using the Gower coefficient. Results were subsequently, to the extent necessary, clarified by a focus group discussion involving seven professionals (five art therapists; one psychologist-ASD specialist; one social worker with an ASD diagnosis who is also a parent of an ASD diagnosed child). Consensus was achieved on 46 elements which relate to goals, means, and outcomes of AT, including therapists' appropriate attitude and behaviour. The findings are helpful to clarify the role of AT in treatments for children with ASD. Plain-language summaryChildren with autism are often referred to AT for a range of problems. Their self-image and selfesteem is often low. A lack of flexibility often appears in daily life and at school. Also these children often have difficulties in expressing themselves. These problems have consequences for their social behaviour.

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

“…This concerns the awareness of children diagnosed ASD of their own experiences during art making (acting and feeling), and how these relate to the art making (Schweizer et al, 2019). A 'sense of self' is described in Stern's theory (Stern, 1985), specifying the developmental steps that are assumed to represent the process of 'getting grip' on experiences related to oneself.…”

“…Previous steps for the development of rating instruments to monitor AT were described in a Delphi study Schweizer, Knorth, Van Yperen, & Spreen, 2019. In that study consensus determined the relevance and applicability of 46 elements typical of art therapy with children diagnosed with ASD. 'Elements' are defined as identified self-standing parts of a treatment that contribute to the treatment result (Spanjaard, Veerman, & Van Yperen, 2015).…”

“…These consensus-based elements are related to the art making processes of children diagnosed with ASD and to the behaviour of the art therapists. Both 'areas of defined typical elements' are assumed to be crucial for achieving positive outcomes (Schweizer et al, 2019;Goense et al, 2016;Van Lith et al, 2017;Van Yperen, Van der Steege, Addink, & Boendermaker, 2010). Consensusbased elements typical for AT with children diagnosed ASD can contribute to a 'promising' level of practice-based evidence (Van Yperen, Veerman, & Bijl, 2017).…”

Evaluation of ‘Images of Self,’ an art therapy program for children diagnosed with autism spectrum disorders (ASD)

“…'Images of Self' is a recently developed art therapy (AT) treatment program for children with problems related to Autism Spectrum Disorders (ASD). The program is designed on the basis of a series of practice-based studies (Schweizer, Knorth, & Spreen, 2014;Schweizer, Spreen, & Knorth, 2017;Schweizer, Knorth, Van Yperen, & Spreen, 2019a, 2019b. In this series, consensus was reached among 32 art therapists and 28 referrers about what they considered to be typical elements of AT for children with ASD.…”

“…the child's self-perception (what do I feel, like or dislike?) (Schweizer et al, 2019a). A better self-perception and awareness of success during artmaking are expected to contribute to an improved self-image and selfconcept.…”