Facilitating Attachment in Children With Autism Through Art Therapy a Case Study

When I was approached by Sasha to work with her sons using the Sensory-Based Relational Art Therapy Approach (Durrani, 2020), I was completely thrown out of my condolement zone.

Not only were Sasha and I separated by multiple time zones until then I had not considered the possibility of 'S-BRATA  online'. S-BRATA is a framework that originated from my doctoral research on dumb zipper and Sensory Integration Dysfunction (SID) in children with autism. Information technology positions the art therapist every bit an zipper effigy and targets both attachment and SID concurrently in children on the spectrum. The approach aims to improve impaired attachment past lowering anxiety caused past SID which is implicated in zipper disruption in children with ASD. Underpinning the S-BRATA is an extremely sensitive, attuned reciprocity between child and therapist, involving nuanced layers of explicit and implicit interactions mediated through art materials and art-making. Hence, telehealth does not present every bit a viable pick or at least that is what I believed until recently.

Sasha'south boys Ali (12-years-quondam) and Ahad (9-years-old) are on the spectrum. They are not-exact and have significant communication and behavioural challenges. Sasha had read my publications on ASD (Durrani 2014; 2018; 2019; 2020) and was intrigued by what she thought was a "dissimilar way of working with children on the spectrum". Sasha's immense dedication towards her boys had made her leave her land of origin as a single mother to provide them with the all-time opportunities to accomplish their potential. Her eagerness to try something out of the box that resonated with her overall arroyo to raising her kids convinced me to attempt 'Due south-BRATA online' with her. Some other significant factor that influenced my decision was that Sasha was enrolled in an undergraduate art therapy program which meant that she was familiar with the inherent qualities of art materials and the ability of relational artmaking. I felt a sense of community with her that further instilled in me the confidence for the undertaking.

Permit the sessions begin

We decided to concord sessions once a week. Since I was not there in person, I would guide and railroad train Sasha through directives and shut observation of her interaction with the boys. Every bit such I would be facilitating dyad therapy remotely. A few things had to be put in place before sessions could begin. I recommended a list of fine art materials that Sasha had to set such equally paints in clasp bottles, brushes, coloured sand,  shaving foam and a big plastic sheet to cover the living room floor where the sessions would be held. Also, Sasha had to figure out the optimal placement of the camera that would let me a practiced view of the boys and their artmaking on Zoom.

Goals

My goal for Ali is to facilitate communication through art which is a form of expression he enjoys and is motivated to employ. Ali's artwork can go a conduit for his feelings which he struggles to express verbally. Joint artmaking between Ali and Sasha can mimic a chat where a verbal exchange is non necessary.

Ahad needs are unlike from Ali'due south. He appears to be more anxious and his receptive and expressive language is significantly more than limited than his brother. My goal for Ahad is to induce regulation through fine art materials in social club to lower his anxiety and to give significant to his marks.

For both Ali and Ahad, Sasha is the attachment figure that in my volume Sensory-Based Relational Art Therapy Approach. Supporting Psycho-Emotional Needs in Children with Autism (Durrani 2020) is a role that I emulated as an fine art therapist.

Sneak peek into a session

Ali

I had Sasha laminate some photos of Ali taken at the trampoline park that he enjoyed visiting. The programme was to ask Ali to cull a photograph and to create an association betwixt his brush/paw strokes and the epitome of him jumping (action) and enjoying (feeling). Afterward pointing to a photograph, Ali picked upwards red paint and poured it on the newspaper using his easily to spread it out. Sasha prompted Ali to add together more colours related to the moment the image represented, emphasizing the activeness and the emotion. My role was to observe and guide Sasha'southward interactions and responses to Ali'due south behaviour. For case (a) when Sasha should pace in to facilitate Ali'southward process (b) when she should hold dorsum interaction (c) when to utilise exaggerated affect (d) torso positioning and so on. Ali created the artworks (Figures one&2) requiring frequent exact prompts and encouragement. This session was remarkable because in the previous ones he imitated Sasha'southward artmaking whereas in this ane he created the artworks independently.

  Effigy 2

After Ali's artmaking, I reflected with Sasha on his process and her interaction with him. I recalled how Ali struggled with lack of structure and was always looking to either imitate or be directed to do something as was the norm in school and otherwise. Moreover, I observed that Sasha had the tendency to scaffold him or step in to help if he was non responding every bit per the expectations. Nevertheless, the flexible structure of the S-BRATA that emphasizes meeting the child at their level and following their lead seemed to accept struck a notation with Ali.

Ahad

Ahad who was seated at the table began drawing the shape of a serpent from his favourite Erik Carl volume. Sasha stepped in to help him. When she had completed the outline,  Ahad attempted to colour the snake. His body linguistic communication conveyed a sense of restlessness. Information technology is possible that the lack of structure in the session made him uncomfortable. Sasha shared that Ahad liked to do things fast so maybe he was struggling with the pace of the session where I was trying to go along his attention sustained for longer in an activeness. Therefore, I decided to follow Ahad's atomic number 82 and move from drawing ane animal to another at the pace he desired. Later on he had coloured the snake Ahad indicated that he wanted to depict a bear. When Sasha moved forward to help him this time I stopped her. Ahad scribbled a shape with a brown coloured pencil and I named it 'behave'.  In order to concord his attention, I quickly asked him what the acquit wanted to eat and he indicated 'bat'.  And so Ahad scribbled with a green pencil next to the bear representing the bat (Figure iii)

I discussed with Sasha how in hereafter sessions an action could be adult using Ahad'due south interest in animals and edifice a narrative around them. And then for the following session, Sasha and Ahad created a mural with papier mache animals  (Figure 4) that sustained Ahad's attention for significantly longer than the previous session.

 Figure 3

Figure four

According to Sasha:

"I love the fact that in the sessions, it is possible to work with each boy independently, co-ordinate to their power and they both are attracted to each other's sessions; they are interested in what will happen after they start. I was so happy when Ali painted his happy jumps and was able afterward to make upward a judgement describing his activity (similar to what we piece of work on with the SLP) and so write it on the writing lines ( in a like manner to what nosotros do with the OT). For Ahad,  after I told the SLP near what y'all did she asked him what he wanted and he chose the bat, then she gave him the marking to draw the bat ( in the past she would draw information technology for him). Side by side, she asked him "what do yous want the bat to consume" and he chose lollipops. She loved the thought of building on his selection instead of repeating descriptions of which animals he wants or sees. What I wanted to say is that your approach combined with the input from SLP and OT and me (the mom) was able to have a positive affect on the boys and me. On the other paw, your approach is educational activity their SLPs and OTs to follow the boys' lead in a creative way that they didn't utilize before, similar building on their choices, instead of repeating the same activeness. For me, this will accept great benefits for the boys. This all shows me how powerful your approach would be if information technology is incorporated in the IEP ( Individualized Educational Plan ) which is washed at the beginning of the school year or if it is included in the boys' activities regularly".

Futurity possibilities

So it seems that all is non lost with telehealth. In fact, had Zoom non been a forced tendency in these times, perhaps Sasha and I would non have entertained the thought of trying out Southward-BRATA online.

At that place is smashing value in training caregivers and teachers of children with autism in approaches like the Southward-BRATA, as it departs from the traditional focus on modifying behaviours and skill-building. It emphasizes the emotional, sensing, feeling child who can be in danger of getting lost in the flurry of conventional approaches. Besides, Due south-BRATA is not limited to the apply of art therapists but and can exist used as a guiding framework by all therapists using creative, multi-sensory, multi-modal approaches.

References

Durrani, H. (2020). Sensory-Based Relational Art Therapy Approach (S-BRATA): Supporting Psycho-Emotional Needs in Children with Autism. New York: Routledge.

Durrani, H. (2020). Sensory-Based Relational Fine art Therapy Approach (S-BRATA): A Framework for Art Therapy With Children With ASD, Art Therapy, DOI: 10.1080/07421656.2020.1718054

Durrani, H. (2019). Art Therapy's Scope to Accost Impaired Attachment in Children With ASD and Comorbid SID, Art Therapy, DOI: x.1080/07421656.2019.1677063

Durrani, H. (2018). A Case for Art Therapy as a Treatment for Autism Spectrum Disorder. Art Therapy: Periodical of the American Art Therapy Association, 0 (0), i-4.

Durrani, H. (2014). Facilitating Attachment in Children with Autism Through Fine art Therapy: A Example Written report. Journal of Psychotherapy Integration, 24 ( 2 ), 99-108.

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