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

Abstract

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

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

“…The art therapists evaluated the progress of the child during treatment with the 'Observation in Art Therapy of a child diagnosed with ASD' (OAT-A, Schweizer et al, 2019b). This instrument has 22 items covering four subscales: 'sense of self', 'emotion regulation', 'flexibility' and 'social behavior'.…”

“…'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.…”

“…Observation of a Child with ASD in Art Therapy: OAT-A; II. Evaluation of the Art Therapist working with a child with ASD: EAT-A) were also developed to enable program evaluation, including studying the treatment integrity of the art therapist (Schweizer et al, 2019b).…”

“…For example, a child with ASD often has difficulties with perceiving his/her own feelings and experiences. During artmaking, the child may explore and develop preferences and new skills, based on a better processing of feelings and experiences (Ben Itzchak, communication' problems (Schweizer et al, 2019b). Development of sense of self starts with a focus on personal experiences, i.e.…”

The “Muscles of the Psyche”: From Body Literacy to Emotional Literacy

“…Expressive art therapies, dance/movement therapy and music therapy are also recognized as effective approaches and tools in the treatment of ASD, as evidenced in the increasing number of studies in the field ( Emery, 2004 ; Martin, 2009 ; Reschke-Hernández, 2011 ; Simpson and Keen, 2011 ; Aithal et al, 2019 ). Visual art can serve as an alternative means for dialog and communication, and there are many examples of empirical research and case studies describing the art therapist’s work with ASD ( Emery, 2004 ; Lee and Hobson, 2006 ; Lim and Slaughter, 2008 ; Stichter et al, 2010 ; Schweizer et al, 2014 , 2019 ; Van Lith et al, 2017 ; Malhotra, 2019 ). The basic assumption is that art serves as an appropriate channel for communication with the child who tends to withdraw from concentrated one-to-one interaction, as it diverts the focus from the personal, intimate relationship by introducing the “art work” as a “third party” ( Bragge and Fenner, 2009 , p. 18).…”