Art Therapy for Children with ADHD and Anxiety Disorders

on Feb 19 in Behaviors, Creative Interventions, For Professionals, General Information, Learning, Parent's Corner by

Those of us who have children with ADHD or have worked professionally with children with this disorder know the challenges of trying to engage them in an activity that they can sustain AND use their minds purposefully. I have both; a son with this disorder and I have had clinical cases with this disorder. As a parent of a child with this disorder, I know that giving my son opportunities to build his self-esteem is a very important aspect to sustainable focus. In other words, when the child can gain mastery in a particular activity, their confidence builds and hence they ”stick with it”.

 

The arts can be a great vehicle in this endevour. Engaging in creative activities such as art, music and dance have been shown to help children with ADHD calm down because it utilizes the part of the brain that controls emotions. When the emotions are under control, the focusing can be much easier. Most of us have experienced this; when we are upset about a personal issue….isn’t hard to concentrate at work? So, therefore reaching the emotional brains through the arts can infact increase focus.

 

Basically, children with ADHD find it difficult to slow down their minds and bodies in order to concentrate on basic activities. When use art based activities, we usually see a shift in mood. The creative mind helps most children (and adults) get to a focused state of “being in the flow”. If we in fact find the right fit of a creative activity, we can truely help the child with attentional issues have a fuller experience of engaement as well as see them feeling happy and confident.

 

For similar reasons, children suffering from other anxiety based disorders and issues can also benefit from creative activities and art therapy. When they become involved with expressing their feelings in a creative way, they are too busy and focused to be concerned about negative thoughts, the passage of time, or other distractions. Of course , this does not happen right away……we must build trust and assess the develolmental level of the child in order to offer the right approach.

 

I beleive in a flexible structure based on the needs of the child. Some children with ADHD will need more more breaks, specific times to complete a task, reminders about impulses and behaviors, etc…. Overall, the benefits of art therapy are the ways in which it can access the right brain and allow the child to be in the creative process; even within a structured environment. In addition when working with several children in a small group, we can involve cooperative art making which enhances social skills and communication; all things that children with ADHD can use.

Things to keep in mind:

1) Allow for choice and try to find something that interests the child

2) Limit the amount of art materials that are offered- it can over stimualte the child

3) Create structure for the child such as time limitations, behaviors that are not to be tolerated and scheduled breaks

4) Use praise when child completes the task, prompt child to remain on task when distractions take over

5) Encourage expression about feelings; acknowledge when they are frustrated and support their process

DIR®/Floortime Model and Creative Arts Therapy

on Jul 28 in Behaviors, Creative Interventions, General Information, Learning, Parent's Corner by

In recent years, there has been a great effort to meet a rising need and demand for innovative and therapeutic services that can give children on the Autism Spectrum the best chance to develop intellectually and socially; to discover their talents and to cope with their challenges. There are more creative art therapists offering services for this population, but are seeking effective and imaginative ways to work without compromising the goals of the field.

Art Therapy can help the child with Autism in many ways. Some main areas that art therapists focus on include: increasing communication and social skills, developing a sense of individuality, building of relationships, and facilitating sensory integration (Betts, 2005). Children on the Autism Spectrum struggle with all these challenges in varying degrees however communication is an area that will affect them the greatest. We need to define what communication is for the child with Autism. It is not just language as a form of communication, but rather the totality of the communicative framework that appears from infancy onward which experts such as Daniel Stern and Donald Winnicott theorize. (Evans and Dubowski, 2007). We need to understand these basic areas and become aware of the level which the child with Autism is functioning developmentally in order to provide appropriate therapeutic interventions.

The DIR®/Floortime™ Model( Developmental, Individual Difference, Relationship-based) is a systematic way of working with the child that enables him to climb the developmental ladder and takes him back to the milestones that may have been missed earlier on (Greenspan and Weider, 1998). The six milestones within the model include: 1) Self regulation and interest in the world, 2) Intimacy, 3) Two-way communication, 4) Complex communication, 5) Emotional ideas, and 6) Emotional thinking. This model is a framework that helps clinicians, parents and educators perform a comprehensive assessment and develop an intervention program tailored to the unique challenges and strengths of children with Autism Spectrum Disorders and other developmental challenges.
Greenspan explains that the five activities to engage children in Floortime are to observe, approach, follow the child’s lead, extend and expand play, and let the child close the circle of communication.

The Creative Arts Therapies combined with the DIR®/Floortime™ Model creates a unique and comprehensive approach that accomplishes these tasks. The blend of a child-centered focus along with creative and expressive modalities brings together a dynamic and integrative model that children thrive on. Art Therapy can help children with sensory issues or deficits “play” with materials in
their own way and at their own pace; then develop a system of regulation to participate in artistic expression. Dance and Movement Therapy has been incorporated successfully as well; using the kinesthetic qualities to help children move purposefully and engage socially in sensorial activities. Dr. John Carpente, a music therapist has incorporated the DIR®/Floortime™ Model into his work as well. He states that the therapist’s task is to improvise music built around the child’s responses, reactions, responses, and/or movements to engage him or her in a musical experience that will facilitate (musical) relatedness, communication, socialization, and awareness (Carpente, 2009).

Art Therapy has unique qualities that help the child with Autism. Many children with Autism tend to be visual learners and traditional methods of instruction can often be quite challenging. Therefore, visual art directives and projects are a great way to help children with Autism learn and communicate, as well as interact and function in the world.

References

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.

Carpente, J (2009). The Effectiveness of Nordoff-Robbins Music Therapy within a
Developmental, Individual-Differences, Relationship-based (DIR®)/Floortime™
Framework to the Treatment of Children with Autism. Dissertation, Temple
University.

Evans, K., & Dubowski, J. (2001). Art Therapy with children on the Autistic
Spectrum: Beyond Words. London, UK: Jessica Kingley.

Greenspan, S. and Wieder, S. (1998). The child with special needs. USA: Da Capo
Press.

 

Playtime for Children on the Spectrum

on Jun 23 in Behaviors, Creative Interventions, General Information, Parent's Corner by

Children with Autism have many challenges with socialization and communication. They find it extremely difficult to relate to others; especially to their peers.  Instead of playing with toys in imaginative ways (such as pretending a doll is really “my baby”) they may use toys for self-stimulation, perseverate on objects, and become entirely self-absorbed.

For typical children, play allows learning and social skills to build naturally. We usually do not have to “teach” children to play. However, a child on the spectrum may need some guidance. Play can be a great tool for helping children to go beyond autism’s self-absorption into a real and shared interaction. When directed properly, creative play can also help children explore their feelings and their environment. Eventually this can lead to stronger relationships with parents, siblings and peers.

Theories such as DIR/Floortime, a model created by Dr. Stanley Greenspan emphasize the use of play. The idea is to follow the child’s natural emotions and interests which he says is essential for learning and developing various parts of the mind and brain. In typical play therapy, clinicians are usually interested in letting the child take the lead. The therapist reflects back to the child their observations of what is happening in the session and mirrors back. Play Therapy with the Autistic child is a bit more challenging. We need to establish their functioning level and adapt to it. As stated above, they may not have the ability to play imaginative or symbolically. We need to be very animated and show them how to do this.

We may need to will get down on the floor with the child and truly engage him through the modality of play. For example, we might set out a number of toys that the child finds interesting, and allow them to decide what, if anything, interests her. If they pick up a toy car and run it back and forth without purpose, the therapist might pick up another car and place it in front of the child’s, blocking its path and saying “beep beep”. If the child responds — verbally or non-verbally– then a relationship has begun. If there is little reaction, the therapist might look for sensory or high-interest, options to engage the child. Bubble blowing is often successful, as are toys that are “cause and effect”- they can move, squeak, vibrate, and otherwise do something.

As the therapy builds, the therapist can build reciprocal skills, such as sharing, taking turns, and imaginative skills (pretending to feed a toy animal, cook pretend skills) and even abstract thinking skills (putting together puzzles, solving problems). Eventually, as the child becomes better able to relate to others, participating in a small group of peers would help further by engaging in more social play.

 

Challenges of Autism: Creative Strategies To Use Before the Meltdown

on Jun 11 in Behaviors, Creative Interventions, Parent's Corner by

Most children who are diagnosed on the autism spectrum have difficulty regulating their emotions and maintaining a calm state as we know. Children with autism and special needs go through similar emotional challenges as typical children do, but it takes them longer to get through them and it may take some creative techniques. In addition, it is sometimes difficult to recognize which emotions may be prominent in the child with ASD because sensory needs may look like an emotional or behavioral reaction.

Parents, teachers and therapists can help by recognizing the emotions and offering empathy when behaviors escalate. De-escalation is the key. By learning about the child’s sensory issues, and behavioral triggers wecan begin to recognize the signs before hand; and thereby help the child regulate and avoid an emotional meltdown.

If and when emotions become overwhelming to the child, try to acknowledge those feelings and not stop them from being expressed. Tellthe child that when he cries it is caused by a feeling and  that it will pass like a dark cloud. The sun will come out again, even though it feels like the sky is falling. Help him learn to take a few slow deep breaths when he first begins to feel upset.

In our creative arts therapy groups or in any other social skills or therapeutic groups, we can address these issues both in neutral times, when there is no upset as well as when a child in the group starts have difficulties. We can praise the children when we see them regulating themselves and we can offer mirroring for when we notice that negative behaviors are escalating.

Example

A child may start banging the table and fidgeting, so we need to recognize this behavior whether out of frustration or another sensory need and take it as a “sign”. We may reflect back to the child either verbally, “I see you are banging the table Johnny, sometimes it is hard to stay in our seats…. And you are doing so well…..” Or perhaps, non-verbally bang along with the child and create a playful interchange. (I have offered clay or model magic and that seems to work wonders for frustration control) However, that banging on the table could have in fact been a sensory need to move, or hear sound, or just feel the table against his hands. We may not always get it right, but we are still recognizing the need. In any case, as we get to know the children in our classes or groups we can distinguish their needs, emotions and behaviors.

Taking breaks and using sensory toys and art materials may help a child regulate when frustration levels seem overwhelming within the group. When a child needs that break, have an aide work with them for a set amount of time a little bit away from the group; not leaving the room entirely unless necessary. Then allow that child to slowly rejoin the activity when ready and then praise them for their efforts.