Running Head: ART THERAPY AND AUTISM

The literature review focuses on the characteristics and epidemiological theories of autism spectrum disorder; the triad of impairments: socialization, communication and imagination; the benefits and theoretical approaches of art therapy when working with individuals with autism spectrum disorders and their families; assessing individuals with autism spectrum disorder; and the family culture of autism spectrum disorder. Adlerian theory is the perspective upon which this literature review focuses. The literature review strives to answer the research question: do art therapy interventions and assessments improve socialization, communication and imagination in individuals with autism spectrum disorder, and in turn reduce stresses in the family culture? This researcher determines to discover effective ways of treating and assessing individuals with autism spectrum disorder and their families, as the prevalence is growing at a fast pace. This researcher speculates that effective treatments for individuals with autism spectrum disorder may reduce the triad of impairments and therefore, enhance the lives of individuals with autism spectrum disorder. The results indicate that art therapy is an effective way to treat and assess individuals with autism spectrum disorder and their families. ART THERAPY AND AUTISM 3 Art Therapy and Autism Spectrum Disorder: A Review of Literature The purpose of this literature review is to discover effective treatment for individuals with Autism Spectrum Disorder (ASD) and their families. Literature is collected, analyzed and summarized below to reveal effective ways to detect, diagnose, assess, treat and support individuals with ASD and their families. To accomplish this, the literature review outlines six sections of study for clarity: description of the criteria for ASD, outline of the theory of mind hypothesis, explanation of the “triad of impairments”, benefits of art therapy, procedures of assessing individuals with ASD, and a report of the family culture and available supports. The first section provides a description of the impairments associated with ASD, and the possible theory of mind deficit that some researchers suggest to be the cause of the impairments that make up the criteria for ASD in the Diagnostic Statistical Manual IV-TR. The intention of this section is to offer clarity and understanding of ASD to create a foundation for the sections that follow. The next section provides further information about the impairments associated with ASD, specifically “the triad of impairments.” Socialization, communication and imagination are included impairments in this triad. The purpose of this section is to identify possible reasons as to why individuals with ASD may have these impairments. This section focuses upon the theory of mind deficit as the primary reason for the “triad of impairments.” A brief explanation of art therapy is offered in the next section, as well as a summary of four case studies that outline the benefits of using art therapy with individuals with ASD. This section includes suggestions and implications for the relevance of art therapy and indicates noted progress demonstrated by individuals with ASD. This section provides evidence of the benefits ART THERAPY AND AUTISM 4 of art therapy with individuals with ASD, as well as the therapeutic approaches used to foster these benefits. The fourth section describes the criticality of early identification of ASD, and methods for detecting ASD in toddlers. This section also provides assessments for comorbid disorders amongst individuals with ASD. The intention of this section is to present effective assessments for ASD, because effective assessments provide for effective treatments. The fifth, and final, section illuminates the family culture associated with ASD. This section aims to provide an understanding of the context in which the individual lives because having an understanding of the context in which the individual lives is essential in offering effective treatment. Additionally, this section details resources shown to be helpful in supporting the families of individuals with ASD. It is pertinent to collaborate with families, as it may improve the life functioning of the individual with ASD. Adlerian assessments and interventions are included throughout this literary review. Adlerian theory is based on capitalizing the strengths of individuals to improve their life functioning. Moreover, this literary review aims to discover effective ways to treat individuals with ASD by reducing their “triad of impairments” while strengthening their “triad of strengths” (Baron-Cohen, 2004, p. 73). Autism Spectrum Disorder The research describes Autism Spectrum Disorder (ASD) as having different “triads.” Simon Baron-Cohen (2004), a seminal researcher of ASD, identifies three triads related to ASD: triad of behavioral domains (social development, communication, and repetitive behavior/obsessive interests); triad of impairments (social interaction, communication and imagination); and triad of strengths (attention to detail, limited yet profound interests, islets of ART THERAPY AND AUTISM 5 ability). Baron-Cohen (1985) hypothesized that deficits in a theory of mind might be a cause of the triad of impairments in individuals with ASD. The following paragraphs summarize the characteristics of ASD and the theory of mind hypothesis. Criteria of Autism Spectrum Disorder The American Psychological Association (2000) place Autism, clinically known as Autistic Disorder, in the Pervasive Developmental Disorders (PDD) category in the Diagnostic Statistical Manual (DSM IV-TR). Also included in the PDD category are Rett’s Disorder, Childhood Disintegrative Disorder, Asperger’s Syndrome (AS) and Pervasive Developmental Disorder, not otherwise specified (PDD-NOS). These disorders are similar to Autism but hold distinct differences. This paper will not describe the differences of Rett’s Disorder or Childhood Disintegrative Disorder, but will focus on Autism Spectrum Disorders (ASDs). Clinicians often refer to Autistic Disorder, AS and PDD-NOS as ASDs (Rutter, 2005, as cited in Rice, 2006). Individuals with AS present with the same characteristics as autism, but have no history of speech delay. Individuals diagnosed with PDD-NOS do not meet criteria for a specific PDD, but have significant impairments in social interaction, communication and behavior (American Psychological Association, 2000). An individual receives the diagnosis of ASD when the individual has abnormalities in the triad of behavioral domains: socialization, communication and restricted interests and activities. An individual must also have the triad of impairments: socialization, communication and imagination. These impairments manifest themselves in individuals with ASD to greater or lesser degrees, ranging from severe learning disabilities to superior cognitive skills. This literature review will detail the triad of impairments later in the literature review (American Psychological Association, 2000; Martin, 2009). ART THERAPY AND AUTISM 6