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Art Therapy: Journal of the American Art Therapy

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The Effects of Directed Art Activities on the Behavior

of Young Children with Disabilities: A Multi-Element
Baseline Analysis
a a a a
Susan Banks MEd , Pat Davis MEd , Vikki F. Howard PhD & T. F. McLaughlin PhD
a
Gonzaga University, Spokane, WA
Published online: 27 Dec 2013.

To cite this article: Susan Banks MEd, Pat Davis MEd, Vikki F. Howard PhD & T. F. McLaughlin PhD (1993) The Effects of
Directed Art Activities on the Behavior of Young Children with Disabilities: A Multi-Element Baseline Analysis, Art Therapy:
Journal of the American Art Therapy Association, 10:4, 235-240, DOI: 10.1080/07421656.1993.10759018

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 Art Therapy: Journal of the AmericanArt Therapy m i a t i o n , lO(4) pp. 235-240 0 AAT4 Inc. 1993

The Effects of Directed Art Activities on the

Behavior of Young Children with Disabilities:
A Multi-Element Baseline Analysis

Susan Banks, MEd, Pat Davis, MEd, Vikki F. Howard, PhD, and T. F.
Mclaughlin, PhD, Gonzaga University, Spokane, WA
Downloaded by [University of Toronto Libraries] at 11:47 05 February 2015

Abstract skills; and the application of language concepts relat-

ing to form, shape, color, texture, and spatial rela-
The eflects of directed art activities on the be- tionships (Bailey & Wolery, 1984, p. 124). These ac-
havior of two preschool children and one kinder- tivities have also provided a “conduit for responding
garten child with disabilities in a rural classroom to experience and expressing the change that occurs
were examined. A multi-element baseline design at every developmental stage” (Ferrara, 1991).
across participants was used to compare directed art Through art, children are able to express feelings of
activities with typical preschool art activities. The aggression and anger, fear and anxiety as well as ex-
behaviors measured were aggression, eye contact, pressions of love (Salant, 1975). Preschool children
and social initiation. Each art activity directed b y have been particularly vulnerable to disruptions in
the teacher focused on an affective concept such as family life. When these children have been unable
anger or happiness. The control condition used the to express feelings of anger, fear, and pain, behavior
same art materials as the directed art activity, and problems and learning difficulties have often re-
the children chose how they would use the materials. sulted. Naumburg (1973) suggested that the proce-
The results indicated that the directed art activity dures of art therapy could be used in art education
had a larger effect than the control condition on the for both normal and emotionally disturbed students.
social behavior of two children, while the control Recently, Swenson (1991) illustrated the rela-
condition generated little eflect. Neither art activity tionship between art education, art therapy, and
had a measurable effect on the targeted behavior of special education. Aspects of art education have pro-
the third child. Implications for use by preschool vided value as therapy. These include participation
and other teachers were suggested. in group projects which have encouraged coopera-
tion as well as reduced competition and feelings of
isolation encountered by most children in special ed-
Introduction ucation. Kramer (1979) stated that when children
with emotional and behavior problems have inner
Art, as a part of child development, has been
studied in terms of creative expression, psychosocial Editor’s note: Preparation of this manuscript by the first two
authors was in partial fulfillment of the requirements of a Master
development, and cognitive development (Silver, of Education in Special Education from Gonzaga University. The
1978). Art activities have traditionally been included help and assistance of Diane Gemmill, Kathy Brown, and Jenny
in preschool programs for children with develop- Carter in the project was greatly appreciated. Requests for re-
prints should be addressed to T. F. McLaughlin, Department of
mental delays as they “provide the opportunity for Special Education, School of Education, Gonzaga University,
creative expression; practice of fine and gross motor Spokane, WA 99258-OOOl.

235
 THE EFFECTS OF DIRECTEDART ACTMTlES

conflicts, they are often inaccessible to education Subjects

through normal teaching practices.
Art therapy has a long history of application for Jack was a 6-year-old child enrolled in the com-
children with serious behavioral, intellectual, and bination preschoolkindergarten program. Jacks cog-
emotional problems. However, there is very little nitive skills were not a concern as he appeared to be
empirical evidence to support such applications. developing normally. Since he had not been referred
Furthermore, since practices vary widely depending for services, his IQ scores were not available. The
on the theoretical foundations of the practitioner, no Vineland Adaptive Scale (Sparrow, et al., 1984)
single method can be viewed as “art therapy.” The showed a social skills composite standard score of 47
present study relied primarily on Kramer’s view- (3 SD below the mean) with a composite score of 70.
point that art therapy does not need to involve inter- The child frequently displayed sensory integration
pretation or assumption of underlying pathology. problems (inability to screen out stimuli, unable to
Rather, art can be a form of communicating emo- complete tasks), aggression, and psychosocial coping
tions which might then be healing. This study was skill loss as observed by the classroom teacher. His
developmental in nature as great care was taken to mother reported that he had a history of experienc-
incorporate materials, activities, and discussions to ing violence &thin the family.
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facilitate emotional responses at the children’s devel- Jerry was a 4-year-old boy with significant cog-
opmental levels (Silver, 1978). Behavioral techniques nitive delays. His IQ composite score was 64 accord-
used throughout the activities included modeling, ing to the Stanford-Binet Intelligence Scale (Terman
contingent reinforcement, and prompting (Roth, & Merrill, 1973; Thorndike, Hagen, & Sattler,
1987). 1986). The Vineland Adaptive Behavior Scale indi-
This study was designed to measure the direct cated a social skills composite standard score of 70 (2
effects of art therapy. Its purpose was to evaluate the SD below the mean). He also showed significant
effects of directed and nondirected art activities uti- delays in speech and language, gross and fine motor
lizing some strategies of art therapy within a behav- skills, and social development. Jerry was non-
ioral context on high-risk, preschool and primary compliant and displayed frequent temper tantrums.
grade students with developmental disabilities. Di- His mother reported that he had been a victim of
rected art activity was selected to attempt to facili- physical violence within his family.
tate an emotional outlet which would then allow the Andy was a 4-year-old boy with an IQ score of
children to be ready to experience a successful peer 121 on the Stanford-Binet Intelligence Test. The
encounter. Vineland Adaptive Behavior Scale showed a com-
posite social skills standard subscale score of 85. Al-
though his social skills subscale composite score was
too high to qualify him for developmental delay in
Method social skills, he had difficulties playing cooperatively
with his peers. He qualified for the preschool special
Participantsand Setting education program because of delays in gross and
Three children were chosen as participants. A fine motor skills.
kindergarten child with attention deficit disorder was For the first half of the study, the children’s
selected for the study because of excessive aggres- classroom was located in the basement of a 61-year-
sion resulting in poor social interaction with peers. old school building. The remainder of the study took
The two other children were preschoolers and were place in a new preschoolkindergarten through sixth
selected because of delays in social development and grade school building in a small rural community.
poor interactions with peers as observed by the The entire population of the school included 110 stu-
classroom teacher. The children attended a combina- dents. Approximately 25% of the students received
tion preschool/kindergarten program consisting of special education or related services. A large portion
nine kindergarten children with and without dis- of the community was comprised of families of lower
abilities as well as six preschoolers who were all clas- socio-economic status.
sified as developmentally delayed. The Vineland
Adaptive Scale (Sparrow, Balla, & Cicchetti, 1984) Materials
was used to determine delays in social skills for each Selected art materials were appropriate to the
child. A social skills subscale composite score of 70 developmental levels of the children and included
(below-2 SD) indicates a delay in social skills and watercolors and paintbrushes, play dough, chalk,
qualifies a child for preschool services. crayons, fingerpaints, and paper and glue.

236
 BANKS ET AL.

Behavior Definition and Measurement bal statement, “Boys and girls, you have 15 minutes
Procedures for this activity.” During this phase the entire class
participated in the activities, but data were collected
Target behaviors were selected based upon the on the targeted subjects only. No adult direction was
classroom teacher’s observation and consultation given to the students except when inappropriate be-
with various support service providers. Physical ag- haviors were observed. Teachers observed the ac-
gression, the behavior under study for the first child, tivity. The art media were preselected to maintain
was defined as hitting, kicking, choking, pushing, or consistency with the directed art activity. Each child
grabbing toys from a peer. Prior to the study, Jerry determined how the materials would be used and
initiated interactions primarily with adults. A deter- what product they developed. Target students did
mination was made to attempt to increase the fre- not receive special attention during the activity.
quency of self-initiated peer interaction. The third Data were collected 5 minutes after the art lesson,
child had poor attending skills, lack of impulse con- and again 30 minutes later.
trol, and eye contact. Eye contact was chosen as the Directed art activities: The second phase con-
targeted behavior in an attempt to increase overall sisted of directed art activities utilizing preselected
attending skills. Since he rarely engaged in even media which matched the corresponding control
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fleeting eye contact, frequency of eye contact was se- condition and a period of 5 minutes in which the
lected rather than duration. teacher directed the children to focus on a “feeling”
The three target behaviors were selected with word or concept (mad, happy, love). The “feeling”
the overall goal of increasing adaptive social skill in- word was written on the board and the teacher then
teractions with peers. These students had developed asked, “What makes you (feeling)? A 15-minute pe-
no sustaining peer relationships, although each ver- riod for execution of the art activity followed. Verbal
bally expressed a desire to have a friend. cues to refocus on the concept were given as needed
For ease of classroom management, all target during the activity; for example, “(Child’s name),
behaviors were measured by a frequency count. think about what (feeling) means to you” or “How do
Data collection lasted for an interval of 5 minutes. you feel when you’re (happy, sad, etc.)?” When the
Two data collection periods per day were conducted time period ended, each child was asked to describe
during center time: the first immediately after the how hisher artwork reflected the focus concept. The
treatment probe and the second 30 minutes later. class discussion lasted 10 minutes. The following
Center time consisted of bee exploration with toys, script was used:
games, puzzles, and books and peer social contact
within a small group (three to four children). Two 1. “(Child’s name), tell us about your (picture).’’
observations were carried out to assess possible gen- 2. “How do you feel about your (picture)?”
eralization of effects across time. Data were again collected immediately after the di-
rected art activity and 30 minutes later during center
Experimental Design and Experimental time as the target behaviors were more likely to
Conditions occur at that time.

A multi-element baseline design (McLaughlin,

1983; Ulman & Sulzer-Azaroff, 1975) replicated Interobserver Agreement
across individuals was chosen to evaluate the use of A paraprofessional was trained to observe the
various art activities. This design calls for alternating target behaviors of each child. These data were
conditions so that contrasts between the two treat- taken twice for each child. Reliability of measure-
ment probes could be examined. The condition in ment was calculated by dividing the smaller number
effect was first determined by a coin toss. An alter- by the larger number and multiplying by 100. Inter-
nating pattern was followed throughout the re- observer reliability was 93% (range 83%to 100%).
mainder of the study (Kazdin, 1982). Reliability data were taken during initial observation
Baseline: Baseline data were collected in ab- (the first 5 minutes of center time).
sence of either treatment condition. Data were col-
lected during center time which usually lasted 1
Independent Variable
hour per day. This condition was in effect for 5
school days. After she had been verbally informed of the
Control condition: During the control condi- methodology for the procedures to note for which
tion, art materials were provided along with the ver- type of art activity (directed or control condition)was

237
 THE EFFECTS OF DIRECTEDART ACTIVITIES

being conducted, an outside observer randomly vis- Jack

ited the classroom following baseline. The parapro-
fessional observed the class three times. Agreement
as to the implementation of the independent vari-
able was 100%. 12
Basellne i Treatment
-
I
5 minutes
30 minutes
- - +- Control 5 minutes
-- -
i~ Control30 minutes

10 - Directed 5 minutes
Directed 30 minutes
2 .
e
3
Y .
R
Visual analysis of the data indicated that both 6 -
experimental and control art activities resulted in a Control

therapeutic improvement of social behaviors across 4 -

individuals. Furthermore, social behavior following

directed art activities was more improved than fol-
lowing control art activities. Of the three subjects,
Jacks data showed the most marked improvements. 0 10 20
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Overall, the mean rate of aggression per session was

7.2 for baseline (range 3-10), 5.0 after control art ac- SESSIONS

tivities (range 0-9), and .75 after directed art activi- Figure 1. The frequency of aggressive behaviors during
ties (range 0-2). During baseline, Jack emitted ag- each of the various experimental manlpula-
gressive behaviors an average of 7.8 times (range lions.
7-10) at the beginning of circle time, and an average
of 6.6 times (range 3-9) 30 minutes later (see Figure
1). A comparison of aggression at 5 and 30 minutes Jerry
following treatment conditions showed means of .5
and 1.0 respectively after directed art activities
(ranges: 1-2 at 5 minutes; 0-2 at 30 minutes) and
means of 5.0 and 5.2 respectively after control art ac-
Treatment
- 5 minutes
30 minutes
Control 5 minutes
tivities (ranges: 3-9 at 5 minutes; 0-8 at 30 minutes). ! Directed Ad
--*-
Control 30 minutes
Directed 5 minutes
In an overall comparison of social initiations,
Directed 30 minutes
Jerry emitted a mean of . 2 responses per session
(range 0-1) during baseline; a mean of 1.6 responses
per session (range 0-4) following control art activi-
ties; and a mean of 3.4 responses per session (range
1-5) following d irected art activities. T h e data
showed that in circle time Jerry emitted an average
of . 2 responses during both the first 5 minutes and
30 minutes later (see Figure 2). Directed art activi- 1
ties were followed by increased social initiations 0 10 20

means of 3.6 (range 2-5) and 3.2 (range 2-5). By con- SESSIONS
trast, self-initiated responses were emitted an aver-
age of 1.7 times (range 0-3) and 1.5 times (range Figure 2. The frequency of social lnltlation durlng each
0-4) respectively at 5 minutes and 30 minutes fol- of the various experimental manipulations.
lowing control art activities.
Differences across conditions were less marked
for Andy than for either Jack or Jerry. An overall 0-2) respectively for the first 5 minutes and then 30
comparison revealed a mean of . 6 ey e contacts minutes later. Mean number of eye contacts follow-
(range 0-2) per session during baseline; a mean of ing directed art activities were 1.5 (range 1-3) and .8
1.5 eye contacts (range 0-3) per session following (range 0-2) respectively at 5 and 30 minutes follow-
control art activities; and a mean of 1.9 eye contacts ing treatment. Similarly, eye contact was observed
(range 0-3) per session following directed art activi- an average of 1.5 (range 1-3) at 5 minutes and 1.0
ties. During baseline, Andy was observed establish- (range 0-2) 30 minutes later following control art ac-
ing eye contact an average of .8 and .4 times (ranges tivities.

238
 BANKS ET AL.

Andy tor which warrants further investigation to deter-

Traalrnent
mine the real potential of art therapy in the class-

-
-
5 minutes
r 30 minutes
room.
Using directed art activities seemed practical,
cost-effective, and manageable in an integrated set-

-
-- Control 5 minutes
0- ting where all children could benefit in individual
--*-Control 30 minutes ways. In further studies, it would be advantageous to
-a=- Directed 5 minutes
collect data on the entire class using videotape. The
Directed 30 minutes
tape could be analyzed, target behaviors selected,
and permanent data records kept. Moreover, the
child who made the greatest gains in the study was
behaviorally involved (aggressive), and further rep-
lication with a target population of children exhibit-
ing aggression may further validate the results or re-
0 to 20 veal some comparison data.
Although most early childhood special education
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SESSIONS
teachers are not trained art therapists, their educa-
Figure 3. The frequency of eye contact during each of tion has typically included a good background in the
the varlous experlmental manipulations. psychology of younger children as well as research
methodology. Provided that they work closely with
school psychologists and counselors to refer cases to
Discussion trained specialists when necessary, knowledge of art
therapy techniques could be invaluable as a preven-
The results of this study indicate that directed tative measure with children who are developmen-
art activities may be effective for improving social tally delayed and at risk for developing emotional
behaviors for children. The process of pairing manip- and behavioral problems.
ulation of selected art materials and activities with Though the current study revealed that art ther-
communication between children and the teacher apy could be effective, additional research is war-
seems to be an effective outlet of emotional ex- ranted to establish the generalizability of these find-
pression, particularly for students who have a history ings to other populations. A study contrasting the
of repression and violence. Although the data for combination of art and discussion with just a discus-
Andy were not as dramatic, some change was found. sion of emotions would be advantageous in establish-
Halfivay through the study this pupil was also absent ing the critical elements involved in the behavior
a large percentage of the time. Later, it was deter- changes. The maintenance and effectiveness of em-
mined that due to his type of sensory motor prob- ploying various types of art activities also warrant
lems, he was not capable of engaging and maintain- further study; for example, whether or not the medi-
ing eye contact without physical and verbal prompts. um employed in the art activity would produce dif-
The changes noted in the students’ behaviors ferent rates of behavior and if behavior changes
after the nondirected activity may have resulted could be maintained over time. Finally, the use of
from a whole group activity as opposed to small methodology from applied behavioral analysis allows
group art activities that were previously conducted one to evaluate and make appropriate data-based
in the class. A large group may also have stimulated judgments as to the effectiveness of new interven-
students’ expressive output (Thompson, 1990). The tions, including art-based interventions, for children
outcomes here appear to support strategies used in with disabilities.
the work of Malchiodi (1990) [facilitating emotional
responses], Roth (1987) [behavioral techniques], and
Silver (1978). [child development]. References
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It’is possible that when students are exposed to Bailey, D., & Wolery, M. (1984). Teaching infants and
directed art activities for a period of months rather preschoolers with handicaps. Columbus, OH: Charles
than weeks, the impact would be more enduring. E. Memll Publishing.
Though there was an immediate impact on all chil- Ferrara, N . (1991). Art as a reflection of child develop-
dren, the results were not sustained from day to day. ment. American Journal of Art Therapy, 30,4440.
Thus, the length of time spent in art therapy is a fac- Kazdin, A. E. (1982). Single case research designs: Meth-

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 THE EFFECTS OF DIRECTEDART ACTIVITIES

o h for clinical and applied settings. New York: Oxford skills through a r t . Baltimore, MD: University Park
University Press. Press.
Kramer, E. (1979). Childhood and art therapy. New York: Sparrow, S. S . , Balla, D. A., & Cicchetti, D. V. (1984).
Schocken. Vineland Adaptive Behavior Scales. Circle Pines, MN:
Malchiodi, C. (1990). Breaking the silence: Art therapy American Guidance Service.
with children from violent homes. New York: Brunnerl Swenson, A. B. (1991). Relationships: Art education, art
Mazel. therapy, and special education. Perceptual and Motor
McLaughlin, T. F. (1983). An examination and evaluation Skills, 72, 40-42.
of single subject designs used in behavior analysis re- Terman, L. M . , & Merrill, M. (1973). Stanford-Binet ln-
search in school settings. Educational Research Quar- telligence Scale: 1973 Norms Edition. Boston: Houghton
terly, 7 , 3 5 4 2 . Main.
Naumburg, M . (1973). An introduction to art therapy. Thompson, C. M. (1990). ‘‘I make a mark’: The signifi-
New York: Teachers College Press. cance of talk in young children’s artistic development.
Roth, E. A. (1987). A behavioral approach to art therapy. Early Childhood Research Quarterly, 5 , 215-232.
In J. A. Rubin (Ed.), Approaches to art therapy (pp.
Ulman, J. D., & Sulzer-Azaroff, B. (1975). Multi-element
213-232). New York: BrunnerIMazel.
design in educational research. In E. A. Ramp & G.
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Salant, E. G. (1975). Preventative art therapy. American Semb (Eds.), Behavior analysis: Areas of research and
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Silver, R. A. (1978). Developing cognitive and creative tice-Hall.

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