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Integrating Art Therapy and the DIR/Floortime Model For Children with Autism Spectrum Disorders ,[object Object],Pamela Ullmann, ATR-BC, LCAT, CCLS,[object Object]
Presentation Outline,[object Object],Overview of Autism Spectrum Disorder,[object Object],Strategies of Working with ASD,[object Object],Description of the DIR/ Floortime Model,[object Object],Dr. Greenspan Videos,[object Object],Art Therapy with ASD/DIR Approach ,[object Object],Case Study of Child with ASD,[object Object],Autism Awareness Puzzle Piece Art Project,[object Object]
Autism Spectrum Disorder,[object Object], Childhood Disintegrative Disorder,[object Object], Rett's Disorder ,[object Object], Autistic Disorder ,[object Object], Pervasive Developmental Disorder (PDD),[object Object], Asperger’s Syndrome,[object Object],	A person with ASD is a person diagnosed with one of these five disorders. The disorders within this “spectrum” are often ordered from low functioning to high functioning. (1 lowest- 5 highest),[object Object]
Strengths and Weaknesses,[object Object],Strengths,[object Object],Weaknesses,[object Object],Auditory memory,[object Object],Visual memory,[object Object],Memory for routines,[object Object],Stimulus over-selectivity,[object Object],Attending to irrelevant stimuli,[object Object],Failure to generalize,[object Object],Impaired language & imitation skills	,[object Object],Issues with attention/focus ,[object Object],Crave routine and sameness,[object Object],Sensory and behavioral issues,[object Object],Cannot process visual and auditory information simultaneously,[object Object]
Misreading Behaviors,[object Object],Observed Behavior ,[object Object],What may be happening,[object Object]
What “communication” may look like,[object Object],Primitive to more sophisticated:,[object Object],Tantrums,[object Object],Vague gestures,[object Object],Motoric,[object Object],Objects,[object Object],Pictures or PECS*,[object Object],Specific gestures or signs,[object Object],Written words,[object Object],Expressive verbal language,[object Object],*Picture Exchange Communication Symbols,[object Object]
Things to keep in mind……..,[object Object],Not too many tasks at once,[object Object],Keep it simple,[object Object],Even with good cognitive skills!,[object Object],State positively,[object Object],Concrete/operationally defined,[object Object],Teach/practice the skills/ repetition,[object Object],Confirm directions by asking child to repeat back,[object Object]
What is DIR/ Floortime?,[object Object],The Interdisciplinary Council on Developmental and Learning Disorders ,[object Object]
Dr. Greenspan Video,[object Object]
DIR/ Floortime Overview,[object Object],Developed by Dr. Stanley Greenspan,[object Object],Developmental ( 6 developmental milestones that every child must master for healthy emotional and intellectual growth),[object Object],Individual Differences,[object Object],Relationship Based,[object Object],Floortime™ is a specific technique to both follow the child’s natural emotional interests (lead) and at the same time challenge the child towards greater and greater mastery of the social, emotional and intellectual capacities.,[object Object]
DIR Comprehensive Framework,[object Object],Tailored to the child’s unique challenges & strengths,[object Object],Problem-solving exercises ,[object Object],Emphasizes the critical role of parents and other family members because of the importance of their emotional relationships with the child,[object Object],Affect based interactions to the child’s individual differences and developmental capacities ,[object Object]
6 Developmental Stages,[object Object],Stage 1: Self-regulation and interest in the world,[object Object],Stage 2: Intimacy, engagement, & falling in love,[object Object],Stage 3: Two-way communication,[object Object],Stage 4: Complex communication,[object Object],Stage 5: Emotional ideas,[object Object],Stage 6: Emotional & logical thinking,[object Object]
Individual DifferencesChildren with special needs have a variety of biological challenges that affect their ability to function in the world,[object Object],Difficulty with sensory reactivity,[object Object],Processing difficulty,[object Object],Difficulty with motor planning and sequencing,[object Object],Each type of challenge makes it difficult for the child to relate to and communicate with his parents and caregivers and thus impedes his ability to learn, to respond, and to grow.,[object Object]
Relationship Based,[object Object],Learning relationships with caregivers, educators, therapists, peers, and others,[object Object],Strong relationships help foster learning opportunities for child’s individual differences and developmental capacities ,[object Object],Ultimately enables progress in mastering the essential foundations ,[object Object]
Floortime Technique,[object Object],Follow the child’s natural emotional interests (lead),[object Object],Challenge the child towards greater mastery,[object Object],With young children these playful interactions may occur on the “floor”, but go on to include conversations and interactions in other places,[object Object]
Circles of Communication Video,[object Object],Floor time with child, parent and Dr. Greenspan,[object Object]
How the DIR/Floortime Approach is a “natural” partnership ,[object Object],with creative modalities,[object Object],Art Therapy and Autism,[object Object]
Focus: Behavioral Approach,[object Object],Sessions are more structured,[object Object],Goals are established,[object Object],Modeling of behaviors,[object Object],Reward systems,[object Object],Use of praise,[object Object],© 2009 Pamela Ullmann,[object Object]
Major Deficits or Difficulties in ASD,[object Object],Using the Creative Process to Enhance Skills and Functioning ,[object Object],© 2009 Pamela Ullmann,[object Object]
Treatment Goals of Art Therapy,[object Object],Abstract Thinking (Imagination),[object Object],Communication and Socialization,[object Object],Regulation and Integration of Sensory,[object Object],Help Creative Expression,[object Object],Developmental Progress and Growth (DIR),[object Object],Recreational Skills,[object Object],Visual/ Spatial Deficits,[object Object]
The Art Therapy/ DIR Connection,[object Object],To focus on Communication, Imagination, and Socialization,[object Object],To address behaviors without pressure,[object Object],Foster strengths and abilities,[object Object],Adapt to child’s functioning level,[object Object],Allow choice for child,[object Object],Design groups to develop social skills & friendships,[object Object],Creative Expression, both 1:1 and groups ,[object Object],© 2009 Pamela Ullmann,[object Object]
Floor Time and Art Therapy Video,[object Object],Emotional Expressions- Therapist models for the parent,[object Object]
Group Art Therapy with ASD,[object Object],Establish structure to session,[object Object],Have appropriate ratio for function level (trained aides or volunteers),[object Object],Incorporate a theme (optional),[object Object],Allow for flexibility-go with the group,[object Object],Make it fun and social,[object Object],Reinforce good behavior and model for others,[object Object],Use of alternative forms of communication (picture boards, schedules, or behavior charts/rules),[object Object],© 2009 Pamela Ullmann,[object Object]
Individual and Dyad Art Therapy,[object Object],Benefits of 1:1- customize ,[object Object],Setting goals,[object Object],DIR concepts in action,[object Object],Structure, yet allow for changes,[object Object],Routines, materials and methods,[object Object],Parent/Child Dyads,[object Object]
Case study: “Nathan” and Mom,[object Object],9 years old, male ,[object Object],Moderate to severe ASD,[object Object],Oral fixation,[object Object],ADD tendencies ,[object Object],Limited expressive language,[object Object],Delayed drawing skills,[object Object],High functioning fine motor,[object Object],Sensory: tactile tolerance,[object Object],Prone to meltdowns ,[object Object],Highly educated,[object Object],Understands therapeutic process,[object Object],Enjoys participating with Nathan,[object Object],Helps set boundaries,[object Object],Helps create limit setting,[object Object],Incorporates behavior mod,[object Object],Creative and expressive modeling,[object Object],Sensory support ,[object Object],Nathan,[object Object],Mom,[object Object]
Goals of Art Therapy for Nathan,[object Object],Support behaviors that he is working on,[object Object],Introduce new creative materials,[object Object],Allow for choice making ,[object Object],Encourage self expression,[object Object],Develop drawing skills,[object Object],Tie in the three areas:,[object Object],Communication,[object Object],Socialization,[object Object],Imagination,[object Object]
Setting up the session- comfort in routine,[object Object]
Image making with alternative materials,[object Object],“Wiki” sticks are waxy, colorful, and bendable allowing Nathan to explore shapes and image making without the pressure of drawing with traditional media. Also a sensory material to appeal to his tactile and fine motor strengths,[object Object]
More image making with alternative materials,[object Object],Combining foam building stickers and drawing media to create the “garden”. Nathan needs concrete directions to complete picture (“show me where the grass grows”),[object Object]
Telling a story and using sensory materials,[object Object],Model magic used as flat, 2-D image making and having Nathan and mom create together a story about horseback riding; helping Nathan to express- needs “prompts” at times,[object Object]
Helping with transitions,[object Object],Nathan  is starting a new school. Mom and therapist talk about “what to expect” by creating images and talking to Nathan. Nathan chooses placement colors and repeats back about scenarios.,[object Object]
Using strengths/preferences to help create art,[object Object],[object Object]
Stickers
Model Magic
Markers
Using steps

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Integrating Art Therapy And The Dir