Does Art Therapy Help Children with Autism?
A book review on: Art Therapy with Children on the Autistic Spectrum: Beyond Words, by K. Evans and J. Dubowski, 2001, London: Jessica Kingsley Publishers.
What is the book about?
The book covers a model of art therapy created by its authors in the 1990s, called “interactive art therapy”. It gives detailed descriptions of the therapy sessions that immerses the readers in the book, making them feel as though they too are attending the sessions,
The theoretical side of interactive art therapy
The interactive art therapy model was built by linking the developmental models of Donald Winnicott and Daniel Stern to the stages of art-making. The authors believed that children with autism did not move through all the stages in the developmental models the same way as typically developing children did, when they were infants. The missing stages contributed to their core skill deficit of using symbols and social reciprocation. Symbols are basically an item or image that can mean many things at one time, e.g. a toy banana can represent food in pretend play, but children also use it as a phone or a gun. However, a toy banana will always be a toy banana for children with autism.
So, how can making art help the core deficit of ASD?
Art is used as a medium of therapy. By engaging in the stage of image-making linked to the missing stage of the developmental models, the child learns new skills from the missing developmental stage. Interactive art therapy in practice builds a triad of relationships between the child, the therapist and the art-making process as well as the final image. The engagement of art materials and the final product are the child's expression of their reaction to the environment. The role of the therapist is to help the child to find the meaning in their expression, leading to a greater understanding of themselves and their autism.
Is the book well written?
'Most of the book is written in plain language that flows very well between chapters and can be easily understood by most people since it is written for parents with children on the autistic spectrum, as well as art therapists and other professionals. However, for readers who are unfamiliar with developmental psychology, chapter 5 is jargon-heavy. It would be helpful if there was a glossary at the end of the book, so the readers can refer to the meaning of technical terms throughout their reading'
Does it include evidence that shows interactive art therapy is effective?
In a nutshell, not very strong evidence. There are a few case studies and phrases like “research shows......” but no actual mentioning of any research. Bear in mind this book was written in 2001 and the model was developed in the 1990s, so it is more of a summary of the author's work, rather than a research paper on its own. Numerous research has been conducted on art therapy and children with ASD since the book was published. So despite the book not showing strong evidence in itself, art therapy in itself is a discipline of psychology and is regulated by the Health & Care Professions Council.
Can all children from the autistic spectrum access art therapy?
While all children from the ASD spectrum can take part in an art therapy session and have a therapeutic experience, the authors did admit that for children with a tendency of social demand avoidance and sensory-based stereotypy (in ABA we often call it “stimming”), it is challenging to make significant progress. Nevertheless, the authors showed humility in their self-reflection and should be respected for that.
To conclude, this book is very well written in terms of style and content, providing the innovative notion of using art therapy in relationship building with children on the autistic spectrum. The question it leaves its readers to ponder on would be, “Could some children benefit from other types of therapy first, to obtain the foundational skills they need to access art therapy in a more meaningful way?’’
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