Thursday, August 19, 2010

“Hands-on” Learning for ASD Through Visual and Creative Modalities

Many children with autism tend to be visual learners and traditional methods of instruction can often be quite challenging. For example, while the average child learns language through social interactions by mimicking the words they hear in everyday conversations, children with autism spectrum disorder may not absorb speech and language skills as readily. Often, children with autism do not imitate others in the same way that average children do, making it necessary to take a more direct approach. Signed speech, which uses sign language in conjunction with spoken language to visually reinforce new words and concepts, is a hands-on approach to teaching speech and language skills.

Hands on projects use that same principle of multisensory learning, combining visual, tactile, and verbal stimuli to teach new skills and concepts, appealing to the learning characteristics of many autistic children. Hands on projects can be integrated into nearly any learning experience. For example, you can tell a story while working together to illustrate it with simple drawings that can aid in comprehension, while keeping children engaged in social interaction. Paper cutouts, used to act out a story as it is read can be great literacy and comprehension reinforcement, and having the child participant in creating them offers another hands-on activity.

• Drawing and coloring flashcards can help in the development of fine motor skills while teaching letter and number recognition, or decorating them with fabrics and objects of varying textures can add tactile elements to the lesson.
• Mixing instant puddings or homemade play dough can help children learn to follow simple instructions with the help of tactile stimulation to maintain attention.
• Older children can benefit from cooking or baking projects, learning math skills through measuring ingredients and gaining competency in following directions. Also, getting to eat the finished product is a tangible reward for a job well done.
• Art projects that correspond with lesson plans for the day can be very helpful in reinforcing academic subjects, such as making clay models of animals or objects learned about earlier in the day.
• Model building, painting, or drawing projects can bring history or social studies lessons firmly into focus for autistic children, and lessons on plant biology can be brought home with a plant growing project.

Short attention spans are common in children with autism, another issue that is often eased with the use of hands on projects for autistic students. Active learning can be a great help in keeping children focused, alert, and engaged, making it easier to stay on task. If attention span becomes an issue when hands on projects are underway, divide each project into small steps with breaks given after each one. Lengthening those intervals between breaks gradually can help the child slowly build a more appropriate attention span.

Hands on projects are a great way to teach children on the spectrum. In fact, all child can benefit from the combination of activity and education that these modalities offer. In an integrated learning environment, hands on projects can help children with autism interact and cooperate with other children, promoting understanding and fostering those vital social and communication skills. And of course hands on projects are much more fun for all involved.

Thursday, August 12, 2010

ASD Parent-Child Dyad

I found in my practice with ASD that the parent-child dyad can be a wonderful way to work if the circumstances are right. It enables me to model for the parent and offer creative strategies and techniques for their child. But even beyond that it is an enriching experience for me as the therapist as well. I learn how parent and child relate and communicate with each other; helping me work better for the child.
I currently have a client where I am fortunate to have this situation. The mom is very open to working with her son (around 9 years old with moderate ASD) and helping him to discover his inner creativity. Having her part of the session is also a great asset because she can comfort and "regulate" him when over stimulation occurs. She then becomes a model for me as well!

So how does this dyad really work? Besides having mom there for a comfort to the child, she is able to tap into her own process. In addition, I can sense the energy and synergy between mother and child; bringing them back to the beginning stages of attachment. This helps the child explore the creative modalities that I present to the both of them. The trust is there and the child and mom play off each other with my direction.

However, the session must still have a structure. This child (like most ASD children) thrives on this and behavorial strategies are still incorporated maintaining focus and engagement. I have adapted a child-centered approach by combining it with behavorial techniques-not easy, but possible. There is a lot of mirroring, but also redirecting. Slightly contradictory in nature, but still balances the session quite nicely. There are limits set and he responds well to this. However, within the limits, I always include choice making.

The mom and I set the stage together. We create a "schedule" for her son to visually see and have him make choices (he is verbal) about what activities he would like to include. Throughout the course of the session, we refer back to the schedule and cross off the activities that we have already completed. This feels comforting for the child as he maintains awareness and control by actively knowing what is next.

I also allow for breaks when needed. This allows the child to regulate his sensory needs. He gets up and jumps, stretches, goes to the bathroom, has a snack, or just relaxes. Sensory issues and/or basic needs can sometimes come up during the session and all that is needed is a "mini" break. For example, he has oral needs and will eat a chewy fruit snack and be fine. I may have not known this if mom was not available.

I am not sure if this approach would work for all children. I do know that at the end of the session, it appears that both this mom and her child are satisfied and have enjoyed the creative process and activities presented. At times, she becomes so overwhelmed by his accomplishments it is quite emotional to witness. The artwork lines the kitchen counter and both mom and her son gaze together very proud; feeling good about the time spent together making art.

Thursday, August 5, 2010

Art Therapy Groups for ASD- How to Manage Behaviors in a Creative Environment

One of the challenges of conducting therapy groups for children is to balance structure with creative freedom. This is especially true for children with Autism Spectrum Disorders, because their behaviors can be very unpredictable causing the group to become chaotic and unsettling. So therefore a structured environment is essential and very often what this population thrives on. So, how can the art therapist still allow for creativity and mastery when behaviors are getting in the way? Not an easy task, but it can be done.


What kind of structure is needed? Well, it basically depends on the functioning level of the group but all in all I find it best to have a set plan of art making within a theme that the children can enjoy and relate to. For example "The Beach" or "Zoo Animals" and then have materials to support the theme, even sensory toys and books related to the theme helps to have on hand. Although as art therapists we try not to influence the art making, I always try to make a "sample" of the project to allow the children to have a visual representation; this very often is helpful to get them started. It is also useful to have "group rules" established before engaging in activity; this serves as a behavioral structure and will set boundaries for unaccepted behaviors.


Building social skills are a big component to ASD groups. Art making can allow for this to occur by designing the groups to "work together" or cooperatively. Murals, group collages and quilt making can allow this to happen. While children are engaging in the art making process, the therapist should always be mirroring back the accomplishments of each child's successes. Something as small as sharing a crayon can reinforce the skills being built. In addition, commenting on art elements within the child's work is great way to encourage individual creativity and to engage others in sharing thoughts as well. Making connections within the group is very powerful too. For example saying, "Look Johnny….. Billy's painting has the same bright green that your picture has……is that one of your favorite colors? Maybe it's Billy's favorite color, let's ask him…."


Some children on the spectrum who are lower functioning will need more assistance in order to participate in the group. Until they are comfortable in their surroundings some children will require a 1:1 aide within the group to help manage behaviors. It will benefit the child as well as the therapist to have this extra help in order to maintain group cohesion. As the child becomes more adaptable, the aide can be less involved and eventually weaned out of the group. In addition, the groups should have a manageable number of children based on available aides and volunteers. The ratio should be determined based on functioning level as well. An ideal group size is about 4-6 children with a lead therapist and at least one assistant as well as an aide for behavioral children.


One last thing to keep in mind when working with children on the spectrum is the choice of materials for art making. Make sure you are aware of sensory issues within the group as well as allergies and aversions which children with ASD often have. It is best to build up a tolerance to messier materials which can often be regressive. Painting is fine, however put out small amounts and use spill proof containers. Make sure that when messy materials are being presented there are enough aides to provide support and "hand over hand" assistance. Letting parents know beforehand is a good idea for dressing down and having smocks is a good idea as well.


Hope this is helpful and will have more on this topic to come………