Lesley University

DigitalCommons@Lesley

Graduate School of Arts and Social Sciences

Expressive Therapies Capstone Theses (GSASS)

Spring 2019

Feeling Colors: Reflections on the Creative Process of a Child with

Autism Spectrum Disorder
Kimberly Ann Knowles
Lesley University, [email protected]

Follow this and additional works at: https://digitalcommons.lesley.edu/expressive_theses

Part of the Social and Behavioral Sciences Commons

Recommended Citation
Knowles, Kimberly Ann, "Feeling Colors: Reflections on the Creative Process of a Child with Autism
Spectrum Disorder" (2019). Expressive Therapies Capstone Theses. 120.
https://digitalcommons.lesley.edu/expressive_theses/120

This Thesis is brought to you for free and open access by the Graduate School of Arts and Social Sciences
(GSASS) at DigitalCommons@Lesley. It has been accepted for inclusion in Expressive Therapies Capstone Theses
by an authorized administrator of DigitalCommons@Lesley. For more information, please contact
[email protected], [email protected].
Running Head: FEELING COLORS 1

Feeling Colors:

Reflections on the Creative Process of a Child with Autism Spectrum Disorder

Development of a Method

Capstone Thesis

Lesley University

Submitted April 15th, 2019

Kimberly Knowles

Art Therapy Specialization

Professor Raquel Stephenson, ATR-BC, LCAT

FEELING COLORS 2

Abstract

This thesis explored the implications of choice in individual art therapy sessions with a child

with Autism Spectrum Disorder, contrasting the creative process of unstructured expression and

a more directed book-making activity focused on emotions. Research took place within the

scope of six weekly 45-minute individual art therapy sessions with a 12-year-old boy in a

therapeutic day school. The design of this study was based on the pre-established presenting

needs of the student, focusing on growing skills for self-regulation, addressing social-emotional

deficits, and providing an outlet for positive self-expression. The sessions were documented by

the clinician, a clinical intern studying art therapy at the Master’s level, in clinical and personal

notes. This researcher conducted an extensive literature review and applied analysis via a

detailed process of response artwork and reflection. Observations and initial findings suggested

prominent themes of space and containment, attunement, and connection. In result, data

indicated that both directive and unstructured artistic exploration of emotion may show effective

significance with children with Autism Spectrum Disorder, with emphasis on the importance of

growing self-efficacy in the process.

Keywords: art therapy, autism spectrum disorder, social-emotional, emotional

expression, creative process, response art, self-efficacy

FEELING COLORS 3

TABLE OF CONTENTS

1. INTRODUCTION ………………………………………………………………………..page 5

2. LITERATURE REVIEW ………….……………………………………………………..page 6

Art Therapy …………………………………………………………………………page 6

Origins and Definition……………………………………………………….page 6

Specific Populations ………………………………………………………...page 8

Autism Spectrum Disorder………………………………………………………....page 10

Diagnosis and Definition…………………………………………………...page 10

Emotional Expression & Understanding.…………………………………..page 11

Expressive Therapies & ASD …………….………………………………..page 13

Theoretical Backgrounds of Development……..………………………………….page 14

Piaget’s Developmental Theory...……………………….……….………...page 14

Lowenfeld’s Creative Development …………………..….………………..page 15

Bandura’s Social Learning Theory …………….…………………………..page 17

Artistic Expression …………………..…………………………………………….page 18

Storytelling, Narrative, and Self-Exploration………………………………page 18

Emotional Regulation via Art-Making……………………………………..page 19

Self-Efficacy in Artwork……………………………………………………page 19

3. METHODS …………..………………………………………………………………….page 20

Materials ………………..…………………………………………………………page 20

Research Environment & Participant………………………………………page 20

Experimental Materials ……………………………………………………page 20

Procedure ………...…...………………………….………………………………..page 21
FEELING COLORS 4

Methods of Analysis ..…...………………………………….……………………..page 22

4. RESULTS ……………………………………………………………………………….page 22

Introduction……..…………………………………………………………………page 22

Initial Phase…………….…………………………………………….……………page 23

Week 1…….………………………………………………….…………….page 23

Week 2 …….………………………………………………….……………page 24

Free Art-Making………..………………………………………………….………page 25

Week 3…….………………………………………………….…………….page 25

Week 4…….………………………………………………….…………….page 27

Week 5 …….………………………………………………….……………page 28

Character Development……………………………………………………………page 29

Week 6 ……………………………………………………….…………….page 29

Summary ………………….………………………………………………………page 31

5. DISCUSSION …………………………………………………………………………..page 32

Discoveries ………………………………………………………………………..page 32

Limitations ………………………………………………………………………..page 37

Implications ……………...………………………………………………………..page 38

Conclusions………………………………………………………………………..page 38

REFERENCES ………………………………………………………………………….page 39

APPENDIX A: Researcher Art Responses………………………………………………page 41

FEELING COLORS 5

Feeling Colors: Reflections on the Creative Process of a Child with Autism Spectrum Disorder

Introduction

Art therapy has expanded upon traditional psychoanalytic techniques to provide

individuals with a refuge, emotional expression, and potential for meaning-making (Malchiodi,

2012). For children with Autism Spectrum Disorder, many of whom face challenges regarding

recognizing and communicating emotions in themselves and others, art therapy has offered an

alternative avenue for connection and understanding (Capps, Yirmiya & Sigman, 1992). This

thesis aimed to investigate visual art-making, in the contexts of both directive and process-

oriented creation, as a therapeutic tool for the emotional expression and understanding in a youth

population with Autism Spectrum Disorder.

The purpose of this study strove to explore how fluid and structured art-making

experiences impact a client with social-emotional deficits, within the therapeutic setting of

individual art therapy sessions. A detailed review of literature examined the roles of Piaget’s

Theory of Cognitive Development, with a focus on the roles of natural motivation and growth

through frustration. Research also touched upon Lowenfeld’s Creative Development, with an

investigation of the esteem-building forces behind creative expression. Finally, theoretical

background was informed by Bandura’s Social Learning, contrasting and applying theories of

observational learning and self-efficacy with a population which often faces natural challenges

with social interactions.

As the principal researcher, I was acting in dual roles for the duration of this inquiry, also

serving as the primary clinician within these sessions. Data was collected throughout the six-

week study via observations and notations, with analysis in the form of response artwork. The

research questions included: How did emotion-focused art therapy interventions impact a client
FEELING COLORS 6

with social-emotional deficits? What differences emerged between process-oriented art-making

and a book-making directive for emotional expression and understanding? How did art therapy

benefit a child with Autism Spectrum Disorder?

Literature Review

This literature review explored classic techniques, modern approaches, and future

implications related to the distinct topics of art therapy, Autism Spectrum Disorder, theoretical

backgrounds of development, and artistic expression. The subject matter has been partitioned

into more precise sub-categories that delineate further meaning. Initial literary investigation

delved into the field of Art Therapy, focusing on a) Origins and Definition, and b) Specific

Populations. Autism Spectrum Disorder was explored in relation to a) Diagnosis and Definition,

b) Emotional Expression, and c) Expressive Therapies. Following this, foundational

psychological theories informed a section of Theoretical Background of Development, separated

into the work of a) Piaget’s Theory of Development, b) Lowenfeld’s Creative Development, and

c) Bandura’s Social Learning Theory. Finally, the over-arching topic of Artistic Expression was

explored through a) Storytelling, Narratives and Self Exploration, b) Emotional Regulation via

Art-Making, and c) Self-Efficacy in Artwork. A final encapsulation of relevant sources and

information in the field was provided in the Summary of Literature.

Art Therapy

Origins and Definitions. A relatively young modality within the psychological field,

Art Therapy has reached beyond traditional techniques to combine the healing aspects of the

creative process with classic approaches in mental health, presenting a therapy which can

connect to, and support, a variety of populations in pursuit of wellness. Carson and Becker

(2004) accentuated that “creativity is paramount to the therapeutic process,” emphasizing the
FEELING COLORS 7

importance of creative thinking and flexibility from all clinicians, regardless of theoretical

background, and touched upon the healing aspects of playfulness for the client within the context

of a session (p. 111). It was a small step, then, to expand these ideals about creativity to the

specific processes at work within the safe space of an art therapy session, where the co-creative

process and trusting therapeutic relationship between client and clinician could make space for

expression through methods that go beyond verbal communication. Art therapy has grown from

origins within the foundational dream imagery of Freud or the symbolism and collective

unconscious of Jung, to also understand the healing potential of artistic self-expression (Durrani,

2014). The integration of perspectives, focused respectively on the symbolic values of the art

created in session and the innate healing nature of the creative process, has proved powerful in

helping clients express what they cannot say with words, whether it be due to trauma,

development, or differing abilities.

On a base level, many art therapy sessions have involved materials and prompts that aim

to engage a client in self-expression through visual means. Malchiodi proposed that “the process

of image-making and creative expression heals and transforms unpleasant experiences through

symbolic communication” (Durrani, 2014, p. 102). Though goals and methods within art

therapy have varied from session to session and case to case, dependent on an individual’s needs,

the use of art as a form of communication and conversation without words has remained a

pivotal asset to this field. The role of the art therapist, then, included fostering a safe space for

this expression, building a sense of therapeutic relationship, and use of the therapist’s “third

hand” of metaphors and artistic techniques which help to guide the progress of a client.

Malchiodi presented background knowledge of artistic materials that expand beyond general

artistic knowledge of the mixing of colors or reactions between different paints, into a
FEELING COLORS 8

knowledge of a client’s needs and how they interact with materials. Guided by the framework

outlined by Hinz’s “Expressive Therapies Continuum,” or ETC, art therapists could choose

materials that are fluid and elicit greater affect, or that have structure and encourage more

contained, cognitive processing (Malchiodi, 2012, p. 122). Similarly, considerations have been

given to the openness of a prompt, with open studio models supporting less structure compared

with high complexity in very structured and specific directives. Newer perspectives in the field

have emphasized transitions between these different states, allowing the clinician to help artfully

conduct a client through layers of resistance and helpful containment.

Newer research into the impact of art therapy techniques and their interactions with the

brain have added further levels of significance to understanding how this creative healing

process may unfold. Art materials and prompts have elicited reactions on different levels of the

ETC, like the kinesthetic/ sensory level or the symbolic/ cognitive level, which each stimulated

different areas of the brain. For example, implementing sensory stimulation, through a water

table or textured materials, resonated in the diencephalon, the midbrain region responsible for

motor skills, stress responses, and attunement. Implementing these tools during session could

have been beneficial with client goals involving self-soothing, connection and approval, and

routines or rituals in session. The symbolic/ cognitive level stimulated the cortex with executive

function, communication, and self-image, and may have been involved with bibliotherapy and

art exercises for self-esteem building (Malchiodi, 2012). Ultimately, these theoretical

perspectives and artistic tools could be adapted to the goals of many, making art therapy a

versatile and effective approach.

Specific Populations. Art therapy acted as an avenue for bridging the gaps of

connection and communication for many individuals within populations for whom typical verbal
FEELING COLORS 9

language is a challenge (Capps, Yirmiya, & Signman, 1992). This could range from young

children or those with developmental delays, who may not yet have developed the language or

cognition to verbally discuss their emotions and experiences, to individuals who lack the ability

to verbally communicate, and even to overcome language and cultural barriers, or communicate

with those experiencing the loss of language that might stem from growing older. Individuals

who have experienced trauma, overwhelming experiences which may come with triggers and

emotions too overwhelming to discuss in traditional words, could also benefit from this

externalizing and empowering method. Durrani commented on the “inadequacy of language in

reflecting the inner, emotional world,” an observation which can be readily addressed through

the range of techniques and materials available within art therapy, allowing the experience to

more readily be tailored to the needs of each client (2014, p.102). This holistic approach to

therapy has stimulated both hemispheres of the brain, as well as applying creativity and problem

solving that could have helped adapt the experience for resistant clients while deepening the

meaning-making process (Hecker, Lettenberger, Nedela, & Soloski, 2010).

When working with the specific population of children, art therapy has acted through a

common “language of play” (Hecker, Lettenberger, Nedela, & Soloski, 2010, p. 193). Materials

like toys, crafts, and other art supplies, were an approachable and familiar tool within the session

space. Though their purposes may have been more deeply informed by therapeutic intention,

they still evoked a sense of fun and allowed children to communicate and express in ways that

seemed more comfortable or natural than sitting still to simply verbalize with an adult.

Furthermore, children were able to continue moving, playing, and creating throughout a session,

centering the space around an activity rather than around themselves, which may have added an

extra layer of comfort for some youths.

FEELING COLORS 10

When working with a population of individuals with Autism Spectrum Disorder, art

therapy may also have been particularly effective. Traditional language is a skill which often

develops with some delays in individuals with ASD, and an individual may have experienced

struggles in modulating social interactions. Numerous factors may have contributed to these

difficulties, including inhibited sensory regulatory abilities which cause overwhelming sensory

overload, a predisposition for comorbid anxiety, and lack an intrinsic desire to communicate with

others (Durrani, 2014). In art therapy, communication could have taken place through visual art

rather than verbal language, aided with repetition and mirroring in the process. Furthermore, an

art activity itself may have acted as a rewarding experience to help motivate an individual with

ASD to engage and feel seen and understood (Hecker, Lettenberger, Nedela, & Soloski, 2010).

Autism Spectrum Disorder

Diagnosis and Definition. Autism Spectrum Disorder, also referred to as ASD, was a

term given to a neurodevelopmental disorder which was defined by social-emotional difficulties

and stereotypic behaviors, with an onset in early development (Ashburner, Ziviani, & Rogers,

2008). Though autism has been a known condition for several decades, it was not until the most

recent 5th edition of the Diagnostic and Statistical Manual of Mental Disorder, or DSM, that ASD

became a diagnostic continuum that also enveloped Asperger’s syndrome and Pervasive

Developmental Disorders: Not Otherwise Specified, with different abilities of physical and

cognitive abilities appearing in different severities across a spectrum within the same diagnostic

label. ASD was characterized by, and perhaps most known for, the presentation of Criterion A,

“persistent deficits in social communication and social interaction across multiple contexts,”

including lacking reciprocity and verbal communication abilities within a social context, and

Criterion B features, like restricted interests, repetitive movements, and hyper- or hypo- sensory
FEELING COLORS 11

sensitivity (American Psychiatric Association, 2013, p. 50). The DSM also outlined criteria for

an onset in early development, and for a clinically significant impact on an individual’s

functioning.

Autism Spectrum Disorder has been diagnosed in early developmental stages, typically

around age two, with early intervention having showed significant implications for long-term

success (Durrani, 2014). Perhaps the most well-known components of ASD have been sensory

dysregulation and difficulties with self-regulation, presented in rigid thought patterns, repeated

behaviors, challenges with social interactions, and struggles with sensory overstimulation

(American Psychiatric Association, 2013). Atypical responses to sensory stimuli were most

commonly thought to include auditory and visual cues, between which an individual with ASD

may have a slower than typical response time when shifting focus, which have appeared as being

hyper-focused or easily-distractible (Rogers, 2005). This sensory overload may also have

included proprioceptive, vestibular, and tactile responses, and each individual has their own

individual sensitivities. Furthermore, ASD has often presented with impaired early attachment to

caregivers, as well as children facing challenges with communication and peer socializations

while growing up, which may in part have been due to the unpredictability of sensory output in

other individuals and led to withdrawal as an early coping method (Kuoch & Mirenda, 2003).

Emotional Expression & Understanding. For individuals with ASD, social

interactions and communication have been particularly challenging, in part because of difficulty

with affect expression and emotional recognition (Capps, Yirmiya, & Sigman, 1992). Verbal

communications may also have been interpreted as odd or different by typically developing

peers, verbal deficits and difficulties maintaining a back-and-forth conversation (American

Psychiatric Association, 2013). Difficulties with overwhelming sensory experiences and lack of
FEELING COLORS 12

regulation may also have led to lack of curiosity or interest in communicating with others. At

times, an individual with ASD who experienced overactive or underactive sensory stimuli might

have either withdrawn or created sensory output like sounds or disjointed movements, in efforts

to re-regulate their sensory experience (Durrani, 2014). These deficits in traditional

interpersonal communication could have made communicating one’s emotional states

challenging, especially for children with ASD. In addition, these children might have

experienced difficulties creating and recognizing appropriate expressions, which might have

inhibited their individual abilities to understand the emotions of others, as well as to have had

their own emotions be understood.

In a study by Capps, Yirmiya, and Sigman (1992), different groups of children with ASD

and typically functioning children in a control group were asked to identify emotions in

videotape scenarios, as well as to relate them to personal experiences when they had felt the

similarly. Previous studies have focused primarily on basic emotions, while this study chose to

expand to include more complex and socially instigated feelings, like pride and embarrassment.

The children with ASD were found to, on average, take longer to identify more complex

emotions, though this could have been in part due to how much more familiarity there was to

happiness while less repeated education was given about feelings like pride. There were

occasional errors, with some children misidentifying the emotions for other behaviors, although

their overall abilities to relate to and identify these emotions were strong. The largest

implications revealed how, despite an ability to identify these feelings, the process of taking

longer to evaluate social context and label them appropriately, compared with their typically-

functioning peers, could have had a negative impact on socialization with peers. Responding in

a social situation to a peer who is feeling joy, with the misinterpreted response that one would
FEELING COLORS 13

give a peer who is feeling itchy, reflected an example how traditional verbal communication

could have led to misunderstandings for individuals with Autism Spectrum Disorder.

Expressive Therapies & ASD. For children with ASD, where traditional verbal

communication has been a challenge, studies have revealed a need for creative therapeutic tools

like play-based interventions, improvisational music therapy, and art therapy. In 1981, the

Denver Model utilized play therapy, focusing on interpersonal relationships and language

development, by using play strategies and toys to connect to children with autism (Rogers,

2005). The strategies elicited increased interest and prolonged engagement from participants,

and were credited with increasing success. Music therapy has also been shown to be an effective

tool with individuals with Autism Spectrum Disorder. Specifically, a study examined the use of

improvisation in music therapy, discovering that by focusing on the attunement between the

clinician/parent and the child, and using the sensory stimulating tool of music, auditory mirroring

and turn-taking improved interpersonal interactions with young children (Kim, Wilgram, &

Gold, 2008). Children were not only able to feel connected and understood, but also have a way

to communicate without verbal language through spontaneous music-making expression.

The current field has been lacking in research about art therapy and application to the

needs of individuals with autism. It was proposed that, because of the ability to engage so many

different senses with art materials and techniques, this multi-sensory approach could easily be

altered to fit the individual needs of a client. Furthermore, expanding beyond meeting the

sensory needs of a child, art has also been a way to engage in repeated movements and

expression; by sharing this expression with the therapist in the room, the child has been able to

connect and relate to an individual and thus part of the world around them. Many studies about

art therapy as an intervention with Autism Spectrum Disorder in children have focused on
FEELING COLORS 14

cognitive and behavioral aspects of treatment, however there has been a need for more research

addressing the previously neglected potential psychological implications for the social and

emotional development of children (Durrani, 2014).

Theoretical Backgrounds of Development

Piaget’s Developmental Theory. Piaget’s Theory of Cognitive Development centered

around the role of the child as an active force, in their own right. Based on a stage model, Piaget

formulated four periods, including Sensorimotor Intelligence, Preoperational Thought, Concrete

Operations, and Formal Operations, and additional sub-stages which outlined specific

development which occurred between birth and age 12. Period I, from birth to age two, included

development of reflexes, various reactions, and object permanence. Period II continued until age

seven, expanding their thinking to include symbols, later use of language, and egocentrism.

Egocentrism, the inability to view a situation from another’s point of view, typically ended as a

child entered Period III, when thought began to resonate more with logic and organization from

ages seven until 11. As a child transitioned into Period IV, they functioned with more abstract

thought and hypothetical constructs. Learning theorists argued with Piaget’s model, drawing

attention to the impact of external forces such as environmental reinforcement and being taught

by other individuals. Piaget, however, retained that the natural learning that occurred through a

child’s actions, frustrations, and a drive to adapt or act despite those frustrations, were the

strongest influences in children constructing their own worlds (Crain, 2016).

Piaget built these stages modelled after typical development, so application to a child

with Autism Spectrum Disorder, for example, has brought up interesting connections as well as

short-comings. This theory posited that although stages were outlined in a specific order, it was

not due to a genetic schedule, but was rather a logical progression of advancing skills (Crain,
FEELING COLORS 15

2016). If it were an assumed progression of skills, with a genetically induced delay, such as

ASD, then that progression would change. So, one could have argued that the same natural

progression would have occurred, merely at different ages than Piaget originally proposed, as the

skills would still be acquired over time or with assistance. Furthermore, an interesting difference

with this theory was the notion of natural curiosity, something which was hindered with autism,

presumably as a protective factor due to the sensory overstimulation that often occurred

unpredictably in many social settings and new environments. Perhaps, in accordance with

Piaget’s ideals, then, differences revealed a need for more manufactured curiosity, fostered and

encouraged via a safe space for exploration, which may help an individual progress through the

stages.

Lowenfeld’s Creative Development. Lowenfeld’s developmental model explored six

artistic stages that individuals encountered on a fluid track of creativity. Stages began at age

two, outlined via graphic features and content through age 17. This theory studied children’s

artwork to find commonalities in the scribble stage, pre-schematic stage, schematic stage,

dawning realism/ gang stage, pseudo-naturalistic stage, and finally the crisis of adolescence

(Lowenfeld & Brittain, 1987). Malchiodi (2012) stated that “art making not only was a source of

self-expression but also had the potential to enhance emotional well-being,” revealing a holistic

view of creativity and self, and a theory of development in which the two are fundamentally and

positively linked (p. 115). Particularly interesting, in context of this study, were stages three,

four, and five. The participant fit a biological age of 12, overlapping with the dawning realism

and psycho-naturalistic stages, though his cognitive developmental deficits would place him in a

younger age range of the schematic stage.

FEELING COLORS 16

The schematic stage, ages seven through nine, was characterized by individualized

schemas, informed symbols which appeared in a two-dimensional world with a spontaneous

appearance, free from concern for design aesthetics. In the subsequent stage, from ages nine

through 12, children began to transform their still-present symbols into smaller, more detailed

forms. Above age 12, the pseudo-naturalistic stage appeared in artwork with a self-critical eye

from the child, and concern for accuracy in representation of proportions. Despite some basic

physical abilities necessary for fine and gross motor functions in art techniques, Lowenfeld &

Brittain (1987) dismissed these factors as insignificant, explaining that young children “are

satisfied with their own means of representation,” thus enabling them to internalize this

contentment (p. 18). This theory also acknowledged the fluidity and individuality of these

stages, as well as explaining the driving factors for creative development to be seeking

understanding and curiosity.

Lowenfeld’s Theory of Creative Development placed importance on the connections with

self-expression and positive self-esteem. Art education was mentioned at length, with a focus

being placed on growing creativity ability, not specific artistic skills, as that ability could grow

and exist free from external validation, especially in children and teens. Art was also explained

to be an opportunity for an experimental spirit and to take responsibility for oneself. Creative

meaning-making was explored as not only an individual process, but as a form of social

communication. Lowenfeld & Brittain (1987) elaborated that “expressing the self on a sheet of

paper also means viewing that expression… the viewing and looking at one’s own work and

one’s own ideas is a first step in communicating these thoughts and ideas to others,” and thus an

individual art process has become an expression of thoughts and feelings not only to oneself, but

to others (65).
FEELING COLORS 17

Bandura’s Social Learning Theory. Bandura’s theories of development were based on

the ideals of observational learning, detailing how individuals learn from the people and

situations around them. This theory focused on the cognitive processes of observing, where an

individual’s mind absorbs an entire string of information at once. Learning new skills, songs,

and other specific mimicking, was dependent on specific attentional and retention processes.

Processes of retention focused on visual symbols and verbal cues, proposing that an individual

can imitate something observed long after the initial observation, using a symbol or cue to trigger

the entire string of informational memory. Attentional processes required interest from the

viewer, which could come from the content itself, the environment, or the model who was

presenting. Bandura, unlike some other theorists, disbelieved in spontaneous interest. Instead,

he insisted that, for this social learning process to occur, an individual must have an interest or

motivation, because they were ultimately believed to be acting in search of a goal (Crain, 2016).

This theory of observational learning shared similarities with the theories of conditioning,

proposing that consequences could be observed and learned vicariously, without directly

experiencing them, and impacting future actions. This could be seen in examples of social

norms and culturally accepted practices, like socially acceptable aggression in sports and video

games, where behaviors are modeled without consequences and thus learned to be acceptable.

Bandura further delineated the concepts of self-regulation and self-efficacy, proposed as more

complex and internalized reactions to this learning model. Self-efficacy explored the

complexities of an inner critic and motivation, with higher motivation persisting despite failures

and setbacks when an individual believes that they are good or can achieve things. Building an

ability to reflect on oneself and remain confident that they can achieve, would, in fact, have

increased their ability or potential to achieve. With self-regulation, standards of internalized

FEELING COLORS 18

rewards and punishments guided individuals on how to act or how to adjust their actions in

different situations (Crain, 2016). Children have often not yet internalized these regulations and

must instead rely more on following the modeled behaviors of adults and other models around

them, while individuals with Autism Spectrum Disorder often struggle with understanding these

unspoken social standards. For individuals with ASD, the natural processes of pro-social

behavior and social learning may have been hindered, though an expectation for regulated

behaviors remains, leading to a need for specific therapy or assistance to learn these skills.

Artistic Expression

Storytelling, Narratives, and Self-Exploration. Creating a narrative, and feeling

empowered to explore one’s own story, has been a contained form of expression that has allowed

for an individual to safely process life situations, supported growing empathetic responses, and

may have served as a tool to envision one’s personal life narrative (Chavis, 2011). Writing and

artwork were a natural pair of expressive tools, as expressive writing often finds its origins in

other forms of expression, including sound, physical movement, and visual art-making.

Storytelling may have involved written words, as well as offering another nonverbally accessible

avenue for communication being fostered through movement, drama, and imagery (Durrani,

2014). These tools informed the technique of the social story, an intervention designed to model

life situations and appropriate responses for individuals with Autism Spectrum Disorder (Carson

& Becker, 2004; Kuoch & Mirenda, 2003). For children especially, storytelling through art has

provided a way to tell and retell stories about their own challenges, helping them learn about

themselves and explore responses and adjustments to life changes. Chavis (2011) directed that,

“we can all be writers capturing the truth of our own lives… if we give ourselves a chance to
FEELING COLORS 19

trust our voice,” further emphasizing that constructing narratives not only allows for learning and

expression, but also improved self-esteem (p.160).

Emotional Regulation via Art-Making. Emotional regulation has been a self-

regulatory skill lacked by many children with Autism Spectrum Disorder, which can affect

attention, behavioral responses, and even educational experiences (Ashburner, Ziviani, &

Rogers, 2008). Dysregulation often appeared in children with autism when severe sensory

dysfunction and unprotected changes arise. Art-making has provided sensory stimuli which can

be controlled by the client, allowing them to adjust input and output and provide an opportunity

to understand these sensations (Durrani, 2014). Clients have worked to increase awareness and

understanding, as well as externalize problems. Furthermore, they could have created a concrete

product which could give an external focal point that may help reduce the stress of

uncomfortable sensory experiences (Hecker, Lettenberger, Nedela, & Soloski, 2010). Art-

making could be inexpensive and not time-consuming, with materials that could be guided by an

art therapist to provide more containment or expression in accordance with the ETC (Carson &

Becker, 2004).

Self-Efficacy in Artwork. Building a sense of self-worth and self-efficacy, or belief in

one’s abilities, could be fostered throughout the art-making process. The concrete nature of a

final art piece allowed it to exist beyond the creation of it, serving as a reminder of

accomplishment as well as a reminder of overcoming challenges in the art-making process. The

breadth of materials and techniques available to individuals during art-making in an art therapy

session could have allowed a child access to a directed space where they can make choices and

be in control (Kim, Wilgram, & Gold, 2008; Rogers, 2005). A child with ASD could make a

choice based on their own interests, something which has been shown to increase motivation and
FEELING COLORS 20

which subsequently can increase the positive judgments in self-efficacy appraisals, part of a

positive self-reflective cycle (Crain, 2016). Furthermore, this experience of expressing without

language, which may lower anxiety and feel like a more accessible form of communication for

an individual with autism, and related language deficits, could have led to powerful experiences

of being able to express, to be heard, and to succeed in being understood.

Methods

Materials

Research environment & participant. This research took place within a therapeutic

day school, which functioned with near proximity to an urban center on the East Coast. The

primary participant was a full-time day student at the school. This student was a 12-year-old

male, to be referred to under the pseudonym Anthony, who presented with behaviors consistent

with Autism Spectrum Disorder. Anthony was from a South American, supportive, single-parent

home, where English is not the primary language spoken. He was a client for individual therapy

sessions, where I acted in a dual role as researcher and clinician, meeting once weekly for a 45-

minute session. This client was familiarized to this process, as he had attended similar sessions

with expressive therapies interns during the past two school years, and met with this clinician for

approximately one month before research began. Typical session space was a multi-purpose

room on the lower level of the building, which held at times held a small library and meeting

space, and was used by the clinical interns as a primary session space. This room was the

location of this research, with occasional departure from the space due to use of a sink in the

adjacent lunch-room. A large, conference-style table was centered in the room, and acted as the

workspace.
FEELING COLORS 21

Experimental materials. Materials available to the participant were vast and varied, and

the clinician supported his independence and freedom in exploring different textures, mediums,

and experimenting within his choices. Anthony was encouraged to use any materials in the

room, which included a shelf with board games, various play figurines, a dollhouse, and sand-

tray. He was also given access to the art cabinet, which contained various paints and papers,

craft materials like feathers, string, and beads, fabric, glue, tapes, containers, brushes, pre-cut

magazine images for collage, dry materials like colored pencils, crayons, and oil or chalk pastels.

When Anthony chose to engage in unstructured art-making, he was allowed to select any art

materials he felt drawn to, with the clinician offering help if he was seeking a certain tool or

substance. When he chose to work with his picture-book directive, Anthony was offered paints

or oil pastels and an 11 x 17 in paper, though he was allowed to select any additional or

alternative materials to work with.

Procedure

The framework for this study was built on the development of a method. A participant,

who was already newly familiar with me since I had taken over as his clinician at the start of the

school year, was chosen due to his presenting diagnosis of Autism Spectrum Disorder, as well as

his inclination towards creative and artistic expression. The method would be applied in

individual therapy sessions with Anthony, occurring weekly for 45 minute blocks, with the

protocol running for six weeks throughout the fall semester. Sessions would follow a prescribed

format, with an opening check-in, choice of art activity, and mindful-breathing closing exercise.

Check-in, with the client using a familiar “Zones of Regulation” chart to identify a color-coded

feeling and color combination for his current emotional state, and closing, with a breathing

exercise acting as a mindful and containing cool-down, were implemented to keep consistency
FEELING COLORS 22

with the pre-established routine of the participant. The main activity in each session, as

developed by this method, required this clinician to ask Anthony to choose to either a) engage in

free-form art-making, with materials and process of his choosing, or b) work on an on-going

picture-book project, “Mr. Cat’s Emotions.” Anthony was given agency over how to spend his

own time within sessions, with the sessions focusing on social-emotional growth through

experiencing emotional expression or building emotional understanding, respectively, through

these options.

Methods of analysis

Data consisted of observations from my sessions, collected in clinical and personal notes

after each session. Information was recorded regarding the essence of statements made by the

participant, descriptions of client artwork, and the process of artistic interactions within the

session. Artistic reflections as part of an altered book were also provided by me, in response to

each of the six sessions within the protocol. These artistic reflections were used as a form of

analysis, looking for themes, providing a visual filter for emotions, and allowing for another

medium for processing my personal experiences during research, within the limits of this

procedure. Ultimately, data was organized by weekly session number, and presented within

groupings of similar client processes, including an Initial Phase (weeks one and two), Free Art-

Making (weeks three, four, and five), and Character Development (week six).

Results

Introduction

Research based on the topics of exploring emotions through non-directive art expression

and structured book-making prompts revealed extensive results. Through a multi-step process, a

participant with Autism Spectrum Disorder, Anthony, was first presented with a choice between
FEELING COLORS 23

art-making styles each session, thus experiencing a creative process, and I, the researcher, made

observations followed by processing and analysis via my own art responses. Results included

information gathered from observations, conversations with the participant, and my personal

experience, as documented in both my personal notes and artistic responses. Examining the

process through an objective lens of art, as well as viewing them within larger thematic contexts,

allowed me to gain data about the use of structures and non-directive artwork with an individual

with Autism Spectrum Disorder.

Initial Phase

Week 1. In the initial stages of research, taking place during weeks 1 and 2, I introduced

the proposed content with which participant began to interact. Anthony transitioned smoothly to

the session, following a typical routine of color and feeling check-ins using “Zones of

Regulation,” as a creative activity, and closing breaths. He selected a color to self-report a

positive emotional state upon arrival, but further discussed a negative state when asked about

classroom and peer challenges. He selected a board game that involved tumbling and stacking,

offering a nonverbal invitation to me to join him. He was observed to exhibit low impulse

control, often throwing the game pieces and making noises when excited or frustrated,

responding positively to redirection around safety and boundaries from this clinician. At the end

of the game, I prompted Anthony about a new book project, explaining that he could choose

between three formats: an “All About Anthony” book, an emotion character book, or a book

about his toy cat’s adventures. Anthony chose the book option about feelings, fidgeting with art

supplies while engaging in a back-and-forth question and answer about which feelings to focus

on. He was asked to select an emotion and pair it with a color for each, with me acting as scribe,

as well as prompting with questions. At one point, Anthony stated the name of his toy, but was
FEELING COLORS 24

able to verbalize without prompting, that he understood that imaginary friends and feelings were

different. Finally, the six emotions selected included anger, sadness, fear, disgust, confusion,

and an original word coupled with an open-arm motion, with the selected title “Mr. Cat’s

Emotions.” Anthony requested to work on the book in the next session before closing.

After the session, my reaction art, Figure 1, was a pen sketch within an altered book. It

contained loose line-work, making the images of feathers in a diagonal across the page. It was

made without color or shading, excepting the dark overlapping lines in the same feather style in

the top right and bottom left corners. Materials were chosen in part because of availability, and I

connected with their ease of movement across the smooth page. I was inspired by the motions

used by the client during the session and I focused on the word “following,” reflecting upon the

importance of working from a client-centered approach in these sessions, yet retaining a

structured holding environment. I processed feelings about flexibility and flow in a loose and

brief art-making process.

Week 2. During the second session, the client entered the clinical space with visibly

increased body movements from baseline, moving around the room with a toe-walk to explore

organizational changes. Anthony identified a feeling of frustration in regard to his lost glasses,

shaking and bending the wire frames of a temporary pair while perseverating over calling his

mom and finding the original pair. I confirmed that we could call his mother together after the

session, and made a large paper envelope, instructing Anthony to put his glasses and negative

feelings inside before he slid it across to the far end of the table. After the introduction of the

new picture-book project the past week, this was the first session that Anthony was given the

choice of free-choice art-making or working on the book project. He chose to work on the book,

following me in a tandem process of visual directions to fold large paper into a book format,
FEELING COLORS 25

done while standing and pressing on the table to allow for movements and proprioceptive

stimulation. Anthony actively engaged in the process, watching my movements and repeating

them quickly but silently, with minimal verbalizations of prompting from me. When given the

choice about what to do next, Anthony sat down and chose to open different blue Play-Doh

containers, twisting and squishing it through his fingers in one hand before closing the session.

Themes in my subsequent response art, Figure 2, included pressure, understanding when

something is done, and organic forms. The image was made of acrylic paints in an altered book,

with a minimal palette of red, white, blue and gray. Water and mixing of colors were used to

turn an initial layer of a red blob into a form with depth and shadows. My reflections were based

on the organic nature of the unstructured art-making forms that the client made at the end of

session, formed by the pressure of his hand, yet showing a natural shape that seemed to resemble

a completely organic form in nature. There was also an element of my process which responded

to the synchronized folding process. I strived to see what it felt like to attune to the client’s art

process, without over-working the materials, but rather letting them almost fall to the paper in

their own intended form, after the end of the session.

Free Art-Making

Week 3. During the subsequent three weeks, Anthony engaged in processes of

improvisational art-making. Anthony began the 3rd session of this research period by bringing in

a cat figurine, selecting a positive color for check-in, and describing a negative emotional state

due to pain from a shot, as well as a positive state of relief at finding his glasses. When offered a

choice in creative process, he chose to make art without a directive, immediately standing up to

get the bottles of tempera paint from the cabinet. I covered the table with a large paper to act as

a drop cloth, and Anthony began a process that involved opening containers of paint and pouring
FEELING COLORS 26

them directly onto the paper. He squirted paint directly on top of the cat figurine, moving it

across the paper in a gesture that appeared like it was walking, leaving a pattern of footprints

along the paper. I observed a fluid and creative process, with Anthony mixing paints in a water

container, pouring it over the cat and paper, then dipping the cat into different “paint-water”

mixtures. At different points, Anthony identified appropriate daily functions involving water in

brief verbal narrations about the figure, such as bathing.

At several points, water and paint spilled from containers or overflowed the paper, and

I prompted Anthony with permission to be messy, as long as we kept it within the boundaries

(for example, the paper or table), or we would have to stop to clean up. This initiated a rhythm

of problem solving and learning boundaries as cues for slowing down or pausing, with me

prompting Anthony by asking if he needed paper towels, prompting to slow down, and

structuring the free-form and sensory materials he was drawn to working with. Anthony

responded well to repeated prompting, at times reaching quickly for the paper towels as water

began to spill on himself or exclaiming a one-word need for containment as a verbal request for

my help. During clean-up, I asked Anthony if he wanted to keep the table covering, pointing out

that it was almost like an accidental painting. Anthony expressed surprise at how big and

colorful the painting had become and confirmed wanting to keep it. We closed the session and

upon transition back to class, Anthony responded to his teacher’s inquiry that today he had made

a “masterpiece.”

Response art to this third session, Figure 3, took form by expanding to stretch across two

pages of the altered book, with a focus on texture and choosing a familiar crafting material. The

image was made with small squares of tissue paper, in shades of pink, blue, and purple in a

gradient from dark to light as the pieces rose through the page. My thoughts during this process
FEELING COLORS 27

flowed from a place of satisfaction. The session contained a strong dynamic of push and pull,

with vigilance around repeated cuing in my hopes to help Anthony slow down, leaving me

feeling drained. However, observing Anthony as he saw his accidental finished art piece, which

was in many ways a visual representation of his process, and then witnessing him express the

closest thing to pride that I had seen him experience so far, was fulfilling. That energy and

feeling, of being substantiated in the significance of trusting that artistic process, stayed with me

as I made this piece. Once dried, I re-visited the image, adding grounding lines at two different

baselines in my own response to a desire for an increased sense of grounding.

Week 4. In the 4th session, Anthony arrived with an orange cat puppet, who spoke for

him during the check-in. He had the puppet report that it was a good day to visit school, and

Anthony used the puppet to draw an image with an orange crayon, with check-in reflecting the

puppet’s favorite color and mood. Anthony then used his own voice to tell me that the cat

needed a nap, carefully placing the puppet in the art cabinet while I asked him which choice he

wanted to work on that day. Anthony verbalized wanting to work on his book, selecting paints

from the cabinet. He began to squirt paints into containers and pour water in them, mixing and

pouring for a substantial amount of time. I provided frequent reminders about boundaries for the

art materials and cued for pauses when mixtures overflowed, providing a safe space and the tools

to make paper towel dams on the edge of the table. He returned to the cabinet, tip-toeing and

making an exaggerated facial expression when he reached in for tape, nodding when I whispered,

“are you trying to not wake the cat?” He let out an audible sigh, assumed to be relief, when he

closed the cabinet door and proceeded to tape over the container filled with the paint and water

mixture, overlapping the tape and even adding paper into the covering as he worked. I prompted

Anthony that time was almost up, and asked if he wanted to keep his creation for the next
FEELING COLORS 28

session. He verbally confirmed and helped with cleaning up the space before we closed the

session with a mindful breathing exercise.

The artwork created in response to the fourth session, Figure 4, was made with simple

acrylics and pen on another page in my altered book. The ebb and flow of the energy of this

session resonated with me as I squirted acrylic paint onto my page. I had first drawn a circle in

pen, then surrounded it with loose and overlapping brushwork, with the same high energy,

informed by the fluid creativity I had just witnessed, as well as the sometimes-haphazard

motions that lacked some body awareness throughout the process. I allowed myself let go of the

expectations of the session, letting go of the questions in my mind—if Anthony made a verbal

choice but acted in direct contradiction, should I have redirected him about that boundary, or

would that have cut off his innate expression? I let myself focus on the sensory satisfaction of

feeling my brush glide through thick paint, spreading it but remaining in a bordered boundary.

As the paint dried, I added a pen barrier around the outside, connecting to my own role of

holding that safe space, allowing for mess and the freedom to express and explore within those

session walls.

Week 5. Due to a school holiday, session five was scheduled for a different time, which

was a change in the typical routine for Anthony. At check-in, Anthony described a negative or

neutral state, using short phrases and brief answers as is typical of his communication style. He

selected a color, wrapping yarn repeatedly around a toy car while he spoke with me. His focus

fell on excitement around the holidays, but in response to my questions, also reflected on dislike

of the heightened volume, which was congruent with his sensory sensitivities. Anthony engaged

with me in a pre-scheduled portfolio review, selecting four pieces that he would want to show

and noting aloud how much work he had created. I reinforced that he had been working very
FEELING COLORS 29

hard and had been very creative thus far. Anthony then chose free art-making for the session,

and while I took out his choice of paints, he took a skein of yarn and wrapped it on objects in

loops around the room; he benefitted from repeated questions or prompting before he brought the

yarn to his seat and began painting. He used the water and paint in a familiar style of pouring

and mixing, making narrative statements out loud to observe changes or asking questions while

maintaining his eye-contact and focus within his art materials. Anthony and I cleaned up, then

he returned to the closet for scissors and proceeded to cut the wrapped yarn, still left on his toy

car from the beginning of session, noting in response to my question, that it was a good feeling.

My fifth piece of response art began with a material choice directly influenced by

Anthony’s yarn wrapping in session. In figure 5, I punched holes in my altered book page,

adding concentric circles in oil pastel before stringing an embroidery thread through and around

these spaces, then added the words that came up for me—connections and boundaries. I

connected with the rhythm that Anthony seemed to explore so much in session, wrapping on

different scales and pouring, back and forth. I noticed my own frustration at the loose wrapping

I did, how the materials kept moving, and thought through the importance of pressure in the

wrapping that Anthony did. Our session was prior to a larger school event, and in my reflections

while wrapping, I could imagine Anthony’s desire for pressure, control, and containment, in the

face of a loud, chaotic, and atypical afternoon schedule. I also thought about the natural creative

flow, and how just like ripples in a pond, sometimes our bodies know what artistic flow we need

to express and ground ourselves in within that moment.

Character Development

Week 6. The 6th session was focused on character development, marking the first-time

Anthony had actively engaged with his personified emotions through artwork. Anthony
FEELING COLORS 30

transitioned into the beginning of this session with excess energy increased from his baseline,

seen in wiggly body movements. I asked him what would help settle his body into the session,

even offering to do the session on a picnic table outside, amongst other options, and Anthony

chose making art. He checked in by describing how his body wanted to move, confirming my

initial impressions of dysregulated behaviors, and making a fidget by repeatedly driving a toy car

through paint that he squirted onto the paper that covered the table. When given a choice for the

session, Anthony verbalized wanting to do his book, but kept adding paint to his car and

repeating his motions within the boundaries of the paper. I asked him if he wanted to finish his

car tracks before starting his book, or if he changed his mind, and Anthony both confirmed still

wanting to work on his book, as well as accepting my suggestion of setting a timer. Anthony

continued covering the car in paint and engaging in mark-making on the paper until the timer

went off, transitioning to a new spot as I directed.

He remained standing, using a large brush and orange paints to create a stick-figure cat,

made of simple geometric shapes with a single pass of a lightly saturated brush that let the bristle

marks show in the painted lines. I asked him questions about the character while he worked,

creating an image of the new emotion that he made up a name for. He reported the feeling to be

a positive and relaxed feeling, which lived far away, and told me what it would feel like by

likening it to a cat. After he declared that he was done, he chose to work on sadness next. He

used the oil pastels this time, making a large blue oval head and two big circles on top, then

adding simple details for a face, and lines which he explained were tears. Anthony told me about

this character as a bear that lived under the sea, while he collected pom-poms to place on the

nose and each ear. He helped clean up before closing with a breathing exercise and returning to

class.
FEELING COLORS 31

The sixth piece of response art, Figure 6, was highly process-oriented, made with acrylic

paints on a page of my altered book. I covered the page in an orderly series of dots, progressing

down each column while gradually mixing in other colors to shift as a subtle gradient from one

color to the next. There was a slow rhythm of dipping my brush in the paint and tapping the

page, repeating again and again. I found myself once again reflecting on the scaffolding that I

placed in a session with Anthony, how I helped him shift and transition in order to do the things

he wanted to do without getting stuck, all the while trying to follow his own process. There was

a meditative and mindful quality in my simple painting process, leaving me with a more

grounded sense than before.

Summary

In summation, this six-week study served as a solid grounding for future work with

Anthony, as well as having strong implications for future work with the implementation of

choice and social-emotional art therapy for populations with Autism Spectrum Disorder. This

process showed Anthony to have moments of growth, creativity, trust, and creative expression.

Throughout my extensive documentation, it was ultimately the process of my art-making which

was the largest guiding force in my making-meaning from this study. The establishment of a

routine, with emotion-based check-ins, choice of art materials and subject matter, and a

grounding breath exercise to close, seems to have been a necessary scaffolding to engage and

contain the participant within the desired art content.

At the end of this research, I was able to review with Anthony, asking him about his

progress and goals moving forward. Since Anthony often opted to engage in free art-making, I

was curious to see if his engagement with character development and an emotional story book

was merely due to an internalized obligation. When reviewing our work together, Anthony was
FEELING COLORS 32

able to confirm a desire to continue on with the same dual topic format during sessions, and

elaborated that the scope of making his own storybook seemed overwhelming at times. He

accepted my suggestion to continue using a timer to help structure the time in session into

manageable pieces, reserving space for both expression and cognitive exploration while

maintaining an element of choice in the order of events each time. This need for containment,

the creative processes, and moments of attunement that I found through reflection in my art

journals were fundamental parts of the course of events and progress made.

Discussion

Discoveries

Over the duration of the study, three prominent themes emerged: a) space and

containment, b) connection, and c) fluid processing. Space and containment are concepts that

first came to my attention during the response art phase. It was through this reflection that it

became clear that a primary role of this art therapist was to act as a containing support,

maintaining a safe space that would facilitate Anthony’s exploration of his chosen art materials

(Malchiodi, 2012). Some of the work that Anthony focused on throughout the session revolved

around boundaries, his movements often took up a great deal of space, while he worked with me

to also learn about safety in boundaries. As he moved through the space with different sensory

materials, engaging in visual, auditory, and proprioceptive stimulation, there was a visible shift

towards regulation in the pace and scope of his movements, as well as his sounds (Kuoch &

Mirenda, 2003). The materials also served a significant purpose in containing, with both choices

serving dual purposes. When Anthony engaged in the picture book process, it was a structured

prompt with which he engaged on a cognitive level, working with symbols and reflection. When

he chose instead to pour paint and water together, and to explore new materials in an open
FEELING COLORS 33

fashion, he expressed his current state and externalized emotions often through silent

exploration. In those instances, the structure of the session acted as containment, with notable

transitions through different stages of the Expressive Therapies Continuum (Malchiodi, 2012).

Connection and attunement were themes that served an important role as this therapeutic

relationship grew. As I witnessed the creative process for Anthony, I grew an understanding of

his unspoken voice through motions and marks. Watching him connect to his creative process

connected to the basic psychological theories upon which the study was based. Piaget had

posited that an individual had a natural rhythm of frustration and growth, and though Anthony

did not align with this theory’s age-oriented process, I saw a willingness in Anthony to try

despite small moments of failure, gaining knowledge and experience through these repeated

patterns (Crain, 2016). Perhaps the most relevant theory to this experience was Lowenfeld’s

self-efficacy, with the creative aspect of these art therapy sessions serving as a strong motivator

for Anthony’s interest, keeping him engaged even during more dysregulated sessions. During

the session when Anthony discussed his final product as a masterpiece, I was able to see the

importance of the roles of choice and satisfaction in his product, witnessing him verbalize a

statement that reflected pride and positive self-worth (Lowenfeld & Brittain, 1987). Due to the

individualized nature of these sessions, Bandura’s models of observational learning were less

relevant. However, during one session, Anthony followed this clinician through the steps of

folding paper for his book (Crain, 2016). The success of that fluid skill transference made me

curious for the potential of future implications regarding more focus on multi-person sessions, in

order to further explore the involvement of modeling.

Overall, the fluid processing throughout the study reinforced my knowledge that the

creative process is an individual one. I was merely there to hold the space and serve as guidance,
FEELING COLORS 34

but the true dynamics at play were between Anthony and the art. The creative process allowed

him a narrative, at times constructed on the future pages of a book about a cat’s emotions, and at

times through the nonverbal expression of color and line, which substituted for the words he did

not always possess (Capps, Yirmiya, & Signman, 1992). This externalizing force appeared to be

a positive and beneficial influence on Anthony’s days.

With minimal research done examining visual art therapy and individuals with Autism

Spectrum Disorder, this study discovered strong implications of connections between the

nonverbal communication supplied by art therapy and the need for nonverbal communication

within the autism community. Art has supplied an avenue for connecting and communicating for

Anthony within these sessions, and could potentially be explored with others to help overcome

these barriers (Capps, Yirmiya, & Signman,1992). Anthony benefited from the symbolic

communication within sessions, as he could substitute colors for emotions in a system that was

part of his routine and predetermined to avoid unpredictability. At times, Anthony might have

struggled with a verbal communication due to factors like anxiety and lack of social initiative,

which are present for many individuals with Autism Spectrum Disorder. However, sessions

allowed a trusting space where he could explore communication that would be witnessed by

myself, as well as the reciprocity that comes with sharing artwork and feeling understood (Kim,

Wilgram, & Gold, 2008). The building blocks of back-and-forth musical improvisation have

shown similar connection and skill building moments as Anthony was able to experience as he

engaged in improvised art-making and communicated with me, responded to my questions, or

shared his images with me (Rogers 2005).

Durrani (2014) outlined the overwhelming depth of emotion that individuals can often

find difficult to put into words, especially when that deficit is experienced by an individual who
FEELING COLORS 35

already struggles to communicate with others, as some individuals with Autism Spectrum

Disorder experience. Anthony’s characters served as a language substitute, allowing him to

convey the complexities of emotions that he experiences but may not understand fully or in

others. Both emotion characters made by Anthony during these sessions were said to have

homes in different far away places, potentially providing a metaphor for the disconnect that

Anthony might feel at times from this realm of emotions when in overwhelming situations or

socializing with peers. Capps, Yirmiya and Sigman (1992) also explored the difficulties with

affect expression and emotional recognition that add extra challenges to peer socializations for

many individuals with Autism Spectrum Disorder. By allowing Anthony to make his own

emotion-based characters with the intent to develop a story about them, it allowed him to make a

personal connection to and build understanding of these emotions in context. Anthony was able

to talk about his personified feelings, which took the apparent forms of a cat and a bear, and

perhaps build a familiarity with them that could allow for quicker or more accurate identification

in other contexts. Anthony did not assign a face to his first emotion, but associated it with a

sense of calm described by a cat’s purr, adding a sensory component and personal observation

that show a connection to real-life implications. By the second image, Anthony depicted his sad

bear in blue, and added tears, showing a connection to the actual representation of the emotion

on an individual. He was able to start exploring and building knowledge about emotions by

using familiar art processes and approachable materials, a strategy that could continue to scaffold

building further pro-social behaviors (Hecker, Lettenberger, Nedela, & Soloski, 2010).

The response art portion of my research and data analysis process has lent depth to my

observations and added meaning to my role as a researcher. Arguably, this step was one of the

most beneficial in helping me to sort through the data and contemplate the perspective of my
FEELING COLORS 36

dual roles of researcher and clinician, helping me to pull further meaning from this process. In

my own artwork, themes of time and patience emerged. My personal material choices often

involved paint, requiring drying time by nature of the wet material, as well as including layers or

potential mixed media components of line work in pen. This process allowed me time to live

with my artwork, helping to structure a space in my brain to process the evidence of my sessions

for research purposes, as well as to filter through my emotions. There was also an aspect of

choice, either leaving me images and imperfections that emerged from the initial paint, or

clarifying and altering them through continued work. A mixture of both styles emerged,

becoming a mindful practice of knowing when a process was complete. This process was

particularly important in my role as a researcher, as my clinical work continued past the end of

the period of the study. Excepting the need to let go, and remain grounded within, only the data

collected within the duration of these six weeks was difficult as I continued to see growth and

results through continual work in similar styles to those which were documented in this paper.

As I began to review the data of the study and formulate findings on my results in this

thesis in general, a final piece of reflection art took the form of Figure 7. I applied layers of

gesso and paint to cover a previously yellow page, tapping rhythmically at first in order to apply

a base, with later additions of swirls from gathered paper towel. This process was experimental

and not at all product oriented, as I acted without specific intention, except hoping process the

overwhelming scattered thoughts and various data that needed to be understood. The final piece

was process oriented and rhythmically soothing, as I let the materials guide me. Tapping

motions mixed paint in different amounts on different parts of the paper, while the twirling

motions picked up and removed much of the pigmented color, leaving voids of the original white

gesso behind. The circles became like ripples in the pond, each affecting and overlapping the
FEELING COLORS 37

marks made by the others. This became a metaphor for this capstone research process, with each

layer of the research process informing the next, the client affecting my own artistic process in

each response peace, and ultimately reflecting a hope for this research to add to the field and

leave a reverberating influence of its own in future studies.

Limitations

There were several inescapable limitations within the scope of this study. On a base

level, the setting for this research took place within a therapeutic day school site. The school’s

schedule at times changed the routine of sessions. Furthermore, holding sessions within the

hours of a school day often led to unpredictable external factors entering the space, like

difficulties with peer bullying and exhaustion from a day of academics. The space within the

school where individual therapy sessions took place was a multipurpose room without a sink,

which, along with other material restrictions, was a potential hindrance to the free art-making. A

general time restraint for the collection of data also had potential to impair the significance of

this study. The study itself only ran for six sessions over six weeks, though the work itself

continuing with this participant throughout several months until the end of the school year. In

addition, the nature of restrictions on data collection opened the door for more potential bias in

reporting, as the images from this participant and his exact words are not available to the reader.

There was potential for bias within my interpretations, not only because I was unable to confirm

my results by providing more direct data from the participant, but also due to my roles as

researcher and clinician. As I was the individual conducting the research as well as analyzing it,

there was potential for my own hopes and intentions of this study to have influenced how I

interpreted the final data. One final limitation is the potential for bias that needs to be named due

to my dual roles of researcher and clinician. Sticking to a more steadfast methodology may have
FEELING COLORS 38

led to more distinct data, however at times I had to default to the priority of being a clinician, and

put the needs of this client first over the intentions of the research.

Implications

The implications of this study had both long and short term significance. In the short

term, sessions continued as outlined in this capstone until the end of the school year. The

elements of choice, structured and unstructured art-making, and a focus on identity and emotions

all aligned with the participant’s goals and continued as part of his treatment plan. In the long

term, this study indicated a need for more opportunities for choice in sessions with children with

Autism Spectrum Disorder. Ultimately, it indicated a need for continued research utilizing art

therapy with a focus beyond traditional behavioral impacts, and into the realms of socialization

and communication.

Conclusions

In conclusion, this study revealed themes of containment, connection, and fluid

processing through a six-week series of individual art therapy sessions with a child with Autism

Spectrum Disorder. There as a place for art therapy experiences for individuals with ASD, and

within that there was a significant role of choice. Furthermore, emotion-focused interventions,

like creation of a structured children’s book about emotion characters or simply using open art

materials to externalize and express feelings, could have a significant and positive impact on

clients. Though each of these prompts, and each session, looked different, the regulation of

overwhelming sensory input for Anthony was mediated through his own actions and his own

creative communications. Benefits have had the potential to reach beyond my initial research

goal and hypothesis of building understanding, and into the realm of contributing toward

building a sense of self.

FEELING COLORS 39

REFERENCES

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC: Author.

Ashburner, J., Ziviani, J., & Rogers, S (2008). Sensory processing and classroom emotional,

behavioral, and educational outcomes in children with autism spectrum disorder.

American Journal of Occupational Therapy, 62 (5), 564-573. doi: 10.5014/ajot.62.5.564.

Capps, L., Yirmiya, N. & Sigman, M. (1992). Understanding of simple and complex

emotions in non- retarded children with autism. Journal of Child Psychology and

Psychiatry, 33, 1169 – 1182.

Carson, D.K., & Becker, K.W. (2004). When lightning strikes: Reexamining creativity in

psychotherapy. Journal of Counseling & Development, 82, 111 – 115.

Chavis, G. G. (2011). Poetry and story therapy: The healing power of creative

expression. London: Jessica Kingsley Publishers.

Crain, W. (2016). Theories of development: Concepts and applications. New York:

Routledge.

Durrani, H. (2014). Facilitating attachment in children with autism through art therapy: A case

study. Journal of Psychotherapy Integration, 24(2), 99 – 108.

http://dx.doi.org/10.1037/a0036974.

Hecker, L., Lettenberger, C., Nedela, M., & Soloski, K. (2010). The body tells the story: Using

art to facilitate children’s narratives. Journal of Creativity in Mental Health, 5(192), 193

– 203. doi: 10.1080/15401383.2010.485104.

Kim, J., Wilgram, T., & Gold, C. (2008). The effect of improvisational music therapy on joint

attention behaviors in autistic children: A randomized controlled study. Journal of Autism

FEELING COLORS 40

and Developmental Disorders, 38(9), 1758 –1766. doi: 10.1007/s10803-008-0566-6.

Kuoch, H. & Mirenda, P. (2003). Social story interventions for young children with

autism spectrum disorders. Focus on Autism and Other Developmental

Disabilities, 18(4), 219 – 227. doi: 10.1177/10883576030180040301.

Lowenfeld, V., & Brittain, W. L. (1987). Creative and mental growth. New York:

Macmillan Publishing Company.

Malchiodi, C.A. (2012). Handbook of art therapy. New York: The Guilford Press.

Rogers, S. J. (2005). Play interventions for young children with autism spectrum disorders. In L.

A. Reddy, T. M. Files-Hall, & C. E. Schaefer (Eds.), Empirically based play

interventions for children (pp. 215 – 239). Washington, DC: American Psychological

Association. http://dx.doi.org/10.1037/11086-014.
FEELING COLORS 41

APPENDIX A: Researcher Art Responses

Figure 1. “Week 1,” Pen, 2018. Figure 2. “Week 2,” Acrylic, 2018.

Figure 3. “Week 3,” Mixed media, 2018.

FEELING COLORS 42

Figure 4. “Week 4,” Pen & acrylic, 2018. Figure 5. “Week 5,” Mixed media, 2018.

Figure 6. “Week 6,” Acrylic, 2018. Figure 7. “Final Thoughts,” Acrylic, 2018.
 THESIS APPROVAL FORM
Lesley University
Graduate School of Arts & Social Sciences
Expressive Therapies Division
Master of Arts in Clinical Mental Health Counseling: Art Therapy, MA

Student’s Name: ______Kimberly Knowles____________________________________

Type of Project: Thesis

Title: ___________ Feeling Colors: Reflections on the Creative Process of a Child with Autism Spectrum Disorder

Date of Graduation: ___________May, 2019_________________________________________________________________________

In the judgment of the following signatory this thesis meets the academic standards that have been established for the above
degree.

Thesis Advisor:___________Raquel Stephenson_______________________ _______