integrating art therapy and the dir
DESCRIPTION
This presentation describes how the theoretical framework of DIR (Developmental, Individual, Relationship)is a natural partnership with creative Art TherapyTRANSCRIPT
INTEGRATING ART THERAPY AND THE DIR/FLOORTIME MODEL FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS
Pamela Ullmann, ATR-BC, LCAT, CCLS
Presentation Outline
I. Overview of Autism Spectrum DisorderII. Strategies of Working with ASDIII. Description of the DIR/ Floortime
ModelIV. Dr. Greenspan VideosV. Art Therapy with ASD/DIR Approach VI. Case Study of Child with ASDVII. Autism Awareness Puzzle Piece Art
Project
Autism Spectrum Disorder
Childhood Disintegrative Disorder Rett's Disorder Autistic Disorder Pervasive Developmental Disorder (PDD) Asperger’s Syndrome
A person with ASD is a person diagnosed with one of these five disorders. The disorders within this “spectrum” are often ordered from low functioning to high functioning. (1 lowest- 5 highest)
Strengths and Weaknesses
Auditory memory
Visual memory Memory for
routines
Stimulus over-selectivity Attending to irrelevant stimuli Failure to generalize Impaired language & imitation
skills Issues with attention/focus Crave routine and sameness Sensory and behavioral issues Cannot process visual and
auditory information simultaneously
Strengths Weaknesses
Misreading Behaviors
Inattentive/daydreaming Doesn’t understand what to do or where to start (executive functioning)
Child asks visitor, “When are you leaving”/rude behavior
Child may have an obsession with time, doesn’t know it is rude to ask
Child interrupts or acts outs, attention-getting behavior
May not know what questions are for him or the group, or that others may want to speak, too
Angry, upset, or frustrated for no reason
Sensory issues/ sensitivities
Observed Behavior What may be happening
What “communication” may look like Primitive to more sophisticated:
Tantrums Vague gestures Motoric Objects Pictures or PECS* Specific gestures or signs Written words Expressive verbal language
*Picture Exchange Communication Symbols
Things to keep in mind……..
Not too many tasks at once Keep it simple
Even with good cognitive skills! State positively Concrete/operationally defined Teach/practice the skills/ repetition Confirm directions by asking child to
repeat back
What is DIR/ Floortime?The Interdisciplinary Council on Developmental and Learning Disorders
Dr. Greenspan Video
Dr. Stanley Greenspan founder of Floortime speaks.wmv
DIR/ Floortime Overview
Developed by Dr. Stanley Greenspan Developmental ( 6 developmental milestones
that every child must master for healthy emotional and intellectual growth)
Individual Differences Relationship Based Floortime™ is a specific technique to both follow
the child’s natural emotional interests (lead) and at the same time challenge the child towards greater and greater mastery of the social, emotional and intellectual capacities.
DIR Comprehensive Framework Tailored to the child’s unique challenges &
strengths Problem-solving exercises Emphasizes the critical role of parents and
other family members because of the importance of their emotional relationships with the child
Affect based interactions to the child’s individual differences and developmental capacities
6 Developmental Stages
Stage 1: Self-regulation and interest in the world
Stage 2: Intimacy, engagement, & falling in love Stage 3: Two-way communication Stage 4: Complex communication Stage 5: Emotional ideas Stage 6: Emotional & logical thinking
Individual Differences
Children with special needs have a variety of biological challenges that affect their ability to function in the world
Difficulty with sensory reactivity Processing difficulty Difficulty with motor planning and
sequencing
Each type of challenge makes it difficult for the child to relate to and communicate with his parents and caregivers and thus impedes his ability to learn, to respond, and to grow.
Relationship Based
Learning relationships with caregivers, educators, therapists, peers, and others
Strong relationships help foster learning
opportunities for child’s individual differences and developmental capacities
Ultimately enables progress in mastering the essential foundations
Floortime Technique
Follow the child’s natural emotional interests (lead)
Challenge the child towards greater mastery
With young children these playful interactions may occur on the “floor”, but go on to include conversations and interactions in other places
Circles of Communication Video
Floor time with child, parent and Dr. Greenspan
Circles of Communication.wmv
How the DIR/Floortime Approach is a “natural”
partnership with creative modalities
Art Therapy and Autism
Focus: Behavioral Approach
Sessions are more structured
Goals are established
Modeling of behaviors
Reward systems
Use of praise
© 2009 Pamela Ullmann
Major Deficits or Difficulties in ASD
© 2009 Pamela Ullmann
Using the Creative Process to Enhance Skills and Functioning
Treatment Goals of Art Therapy
Abstract Thinking (Imagination) Communication and Socialization Regulation and Integration of Sensory Help Creative Expression Developmental Progress and
Growth (DIR) Recreational Skills Visual/ Spatial Deficits
The Art Therapy/ DIR Connection To focus on Communication, Imagination,
and Socialization To address behaviors without pressure Foster strengths and abilities Adapt to child’s functioning level Allow choice for child Design groups to develop social skills &
friendships Creative Expression, both 1:1 and groups
© 2009 Pamela Ullmann
Floor Time and Art Therapy Video
Emotional Expressions- Therapist models for the parent
Autism Play Project (Floortime) _Drawing_.wmv
Group Art Therapy with ASD
Establish structure to session Have appropriate ratio for function
level (trained aides or volunteers) Incorporate a theme (optional) Allow for flexibility-go with the group Make it fun and social Reinforce good behavior and model for
others Use of alternative forms of
communication (picture boards, schedules, or behavior charts/rules)
© 2009 Pamela Ullmann
Individual and Dyad Art Therapy Benefits of 1:1- customize Setting goals DIR concepts in action Structure, yet allow for changes Routines, materials and methods Parent/Child Dyads
Case study: “Nathan” and Mom
9 years old, male Moderate to severe ASD Oral fixation ADD tendencies Limited expressive
language Delayed drawing skills High functioning fine motor Sensory: tactile tolerance Prone to meltdowns
Highly educated Understands therapeutic
process Enjoys participating with
Nathan Helps set boundaries Helps create limit setting Incorporates behavior mod Creative and expressive
modeling Sensory support
Nathan Mom
Goals of Art Therapy for Nathan
Support behaviors that he is working on Introduce new creative materials Allow for choice making Encourage self expression Develop drawing skills Tie in the three areas:
Communication Socialization Imagination
Setting up the session- comfort in routine
Image making with alternative materials
“Wiki” sticks are waxy, colorful, and bendable allowing Nathan to explore shapes and image making without the pressure of drawing with traditional media. Also a sensory material to appeal to his tactile and fine motor strengths
Combining foam building stickers and drawing media to create the “garden”. Nathan needs concrete directions to complete picture (“show me where the grass grows”)
More image making with alternative materials
Telling a story and using sensory materials
Model magic used as flat, 2-D image making and having Nathan and mom create together a story about horseback riding; helping Nathan to express- needs “prompts” at times
Helping with transitions
Nathan is starting a new school. Mom and therapist talk about “what to expect” by creating images and talking to Nathan. Nathan chooses placement colors and repeats back about scenarios.
Using strengths/preferences to help create art
•Cutting
•Stickers
•Model Magic
•Markers
•Using steps
•Color recognition
Redirecting Obsessions
Oral sensory needs
Focused on earning jelly beans
Redirect into art making
Use skills for success
Cut Paper Collage
Brief Q&A andAutism Awareness Project
Why Puzzle Pieces? The puzzle pieces reflect the mystery and complexity of autism. The different colors and shapes represent the diversity of people and families living with this disorder. The brightness of the pieces signals hope – hope through research and increasing awareness through people like you!!! Directive•Create a puzzle piece that represents your interpretation of Autism•Materials : Sharpie markers, assortment of letters and stickersThank you for coming today
References and Resources http://arttherapyandautism.com http://www.autismspeaks.org http://www.autismtoday.com http://www.icdl.com/ Betts, D. J. (2005). The art of art therapy: Drawing individuals out in creative
ways. Advocate: Magazine of the Autism Society of America, 26-27. Betts, D. J. (2003). Developing a projective drawing test: Experiences with the
Face Stimulus Assessment (FSA). Art Therapy: Journal of the American Art Therapy Association, 20(2), 77-82.
Greenspan, S & Wieder, S (2006). Engaging Autism: using the Floortime approach to help children relate, communicate and think. PerseusBooks
Henley, D. (2001). Annihilation anxiety and fantasy in the art of children with Asperger's Syndrome and others on the autistic spectrum. American Journal of Art Therapy, 39, 113-121.
Kellman, J. (2001). Autism, art, and children: The stories we draw. Westport, CT: Bergin & Garvey
Martin, N. (2009). Art as an early intervention tool for children with autism. London: Jessica Kingsley.
Martin, N. (2008). Assessing portrait drawings created by children and adolescents with autism spectrum disorder. Art Therapy: Journal of the American Art Therapy Association, 25(1), 15-23.
Miller, E. (2008). The girl who spoke through pictures: Autism through art. London: Jessica Kingsley. (Illustrations by Kim Miller)
Presenter's Websites and Contact Info
www.colorsofplay.com
www.healingartsfc.org
WEBSITES
http://colorsofplay.blogspot.com
http://creativefamilies.wordpress.com
INFORMATIVE BLOGS
EMAILS: [email protected] and [email protected]