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 summary

Children with autism are often referred to AT for a range of problems. Their self-image and self-esteem 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.

The art therapist facilitates and supports the child to express him or herself. Behavioural changes are expected to be achieved by experiencing art materials and making personal art work. Development of emotional, cognitive, social and physical functioning is stimulated. The nonverbal character of AT can offer an opportunity for children with communication problems.

Knowledge about the effects of art therapy with children diagnosed with autism is mostly based on practice experiences. Scientists, policymakers and a growing number of art therapists feel the need to expand this knowledge. Clarifying typical elements in art therapy that contribute to treatment outcomes are important as a vital step towards extensive research on the effects.

In two former studies, typical elements in art therapy with children diagnosed with autism were identified in practice and in literature. The current study is aimed to investigate professionals’ consensus regarding these typical elements. Referrers and art therapists have been invited to give their opinions: do they concur with the previous findings?

There is consensus about typical elements for art therapy with children diagnosed with autism in five areas: (1) the problems that lead to children with autism being referred to art therapy; (2) art materials and forms of expression; (3) the handling of the art therapist; (4) contextual issues (such as duration of the therapy, and involvement of parents and teacher); and (5) criteria for treatment outcomes.

The results of this study will be applied as building blocks in further planned research into the effects of an AT treatment programme.

KEYWORDS:

• Art therapy
• autism spectrum disorders
• consensus
• Delphi study
• focus group

Acknowledgements

Our gratitude goes to all participants who contributed to this study with their expertise and with great commitment. Also many thanks to art therapy student Lisan Meints, who worked as a peer researcher with the focus group coding.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Celine Schweizer is an art therapist and doctoral candidate at Groningen University and lecturer at the art therapy education of NHL Stenden University of Applied Sciences in Leeuwarden, the Netherlands.

Erik J. Knorth is an emeritus professor in child psychology at Groningen University, the Netherlands.

Tom A. Van Yperen is a professor in child psychology at Groningen University.

Marinus Spreen is a professor in sociology and methodology at NHL Stenden University of Applied Sciences.