A Review of Music Therapy, Art Therapy and Daily Life Therapy Alex Mellor.

A Review of Music Therapy, Art

Therapy and Daily Life Therapy

Alex Mellor

Sources and information

PsycINFO – “music therapy” and “autism”, “art PsycINFO – “music therapy” and “autism”, “art therapy” and “autism”, “daily life therapy”, and therapy” and “autism”, “daily life therapy”, and “Higashi”.“Higashi”.

Youtube videos found by searching “music therapy”, Youtube videos found by searching “music therapy”, “Nordoff-Robbins”, “art therapy”, and “Higashi”.“Nordoff-Robbins”, “art therapy”, and “Higashi”.

Emails to the American Music Therapy Associate Emails to the American Music Therapy Associate (AMTA) resulted in a bibliography of “evidence-(AMTA) resulted in a bibliography of “evidence-based” studies.based” studies.

What is music therapy?

““well-established allied health profession that uses well-established allied health profession that uses music therapeutically to address behavioral, social, music therapeutically to address behavioral, social, psychological, communicative, physical, sensory-psychological, communicative, physical, sensory-motor, and/or cognitive functioning”. motor, and/or cognitive functioning”.

www.musictherapy.orgwww.musictherapy.org

Teaching a skill/goal through music, presented Teaching a skill/goal through music, presented through song or rhythmic cue. Gradually through song or rhythmic cue. Gradually fading the cue over time.fading the cue over time.

National Standards ProjectNational Standards Project

What is music therapy?

Difficult to define “music therapy”Difficult to define “music therapy”

All participants exposed to music in some form.All participants exposed to music in some form.

Kaplan (2005)Kaplan (2005)

41% - language and communication41% - language and communication

39% - behavior and psychosocial goals39% - behavior and psychosocial goals

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! handbook: make sure your child gets what works! Lynden, WA: SKF Books Lynden, WA: SKF Books USA, Inc.USA, Inc.

History of music therapy

1944 – Michigan State University1944 – Michigan State University

American Music Therapy Associate (AMTA) American Music Therapy Associate (AMTA) founded in 1998 after a merger between the founded in 1998 after a merger between the National Associate for Music Therapy (NAMT, National Associate for Music Therapy (NAMT, 1950) and the American Associate for Music 1950) and the American Associate for Music Therapy (AAMT, 1971). Therapy (AAMT, 1971).

What does music therapy claim to do?

Music therapy interventions can be used to:Music therapy interventions can be used to:

““promote wellnesspromote wellness

manage stressmanage stress

alleviate painalleviate pain

express feelingsexpress feelings

enhance memoryenhance memory

improve communicationimprove communication

promote physical rehabilitation”promote physical rehabilitation”

www.musictherapy.orgwww.musictherapy.org

What does music therapy claim to do?

Address the characteristics of autismAddress the characteristics of autism

Motivate and engage children with ASDMotivate and engage children with ASD

Enable people without language to Enable people without language to “communicate”“communicate”

Develop and express emotionsDevelop and express emotions

Provide multi-sensory stimulationProvide multi-sensory stimulation

Structure and securityStructure and security

Emphasize “innate musical talents”Emphasize “innate musical talents”

????

Jammin’ Jenn!

http://www.jamminjenn.com/JJMTC/Welcome.html

What do you think?What do you think?

http://www.youtube.com/watch?v=OFLJJlOCVsw http://www.youtube.com/watch?v=OFLJJlOCVsw

http://www.facebook.com/group.php?gid=200118661850&ref=ts

What they say…

Association for Science in Autism Treatment Association for Science in Autism Treatment (ASAT)(ASAT)

““preliminary evidence suggests that music preliminary evidence suggests that music therapy could be effective in enhancing therapy could be effective in enhancing functioning (Kaplan, & Steele, 2005; Whipple, functioning (Kaplan, & Steele, 2005; Whipple, 2004), but this approach has not been evaluated 2004), but this approach has not been evaluated in studies with strong experimental designs.”in studies with strong experimental designs.”

www.asatonline.org/intervention/treatments/music.htmwww.asatonline.org/intervention/treatments/music.htm

What they say…

ASATASAT

““researchers may wish to conduct studies with researchers may wish to conduct studies with strong scientific designs to evaluate music strong scientific designs to evaluate music therapy. Professionals should present music therapy. Professionals should present music therapy as untested and encourage families who therapy as untested and encourage families who are considering this intervention to evaluate it are considering this intervention to evaluate it carefully.”carefully.”

www.asatonline.org/intervention/treatments/music.htmwww.asatonline.org/intervention/treatments/music.htm

What they say…

National Autism Center’s National National Autism Center’s National Standards ProjectStandards Project

Emerging treatments Emerging treatments – further research – further research may produce favorable results, but more may produce favorable results, but more research needed to ensure not harmful research needed to ensure not harmful treatment.treatment.

Experimental control?

Varied independent variable – only common Varied independent variable – only common aspect is that music is involved.aspect is that music is involved.

No dependent variableNo dependent variable

Difficult to demonstrate experimental controlDifficult to demonstrate experimental control

Evidence-based?Edgerton (1994)Edgerton (1994)

Parents reported behavior change, speech therapists did not.Parents reported behavior change, speech therapists did not.

Evaluators not blind.Evaluators not blind.

Buday (1995)Buday (1995)

10 children learned to vocalize and sign words better when put to music compared to when just read out loud.10 children learned to vocalize and sign words better when put to music compared to when just read out loud.

21 studies21 studies

14 peer reviewed14 peer reviewed

11 successful11 successful

9 improvements “related to music”9 improvements “related to music”

http://www.musictherapy.org/factsheets/bib_autism.pdf

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s handbook: make sure your The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child child works! works! Lynden, WA: SKF Books USA, Inc.Lynden, WA: SKF Books USA, Inc.

Lim, H. A. (2010). Effect of “developmental Lim, H. A. (2010). Effect of “developmental speech and language training through music” speech and language training through music” on speech production in children with autism on speech production in children with autism spectrum disorders. spectrum disorders. Journal of Music Therapy, Journal of Music Therapy, XLVII, (1),XLVII, (1), 2-26. 2-26.

Compared music training, speech training and Compared music training, speech training and no-training.no-training.

50 children, 3-5 years old, diagnosis of ASD.50 children, 3-5 years old, diagnosis of ASD.

36 target words36 target words

Music (DSLM) – 6 songs, each with 6 target wordsMusic (DSLM) – 6 songs, each with 6 target words

Speech – 6 stories, each with 6 target wordsSpeech – 6 stories, each with 6 target words

Both conditions used PECs symbols.Both conditions used PECs symbols.


Correct verbal response defined as: Correct verbal response defined as: semantics (correct target word), phonology semantics (correct target word), phonology (correct pronunciation), pragmatics (correct pronunciation), pragmatics (relationship between language and (relationship between language and behavior), and prosody (intonation).behavior), and prosody (intonation).

Verbal production evaluation scaleVerbal production evaluation scale

Speech therapists coded data – 0-6 points.Speech therapists coded data – 0-6 points.

IOA – 99.9%IOA – 99.9%


““low functioning” – greater changes in the music low functioning” – greater changes in the music condition.condition.

““high functioning” – positive change in music high functioning” – positive change in music and speech conditions.and speech conditions.

Defined according to the CARSDefined according to the CARS


““music and speech training are effective for music and speech training are effective for enhancing speech production”enhancing speech production”

“ “ the difference between music and speech the difference between music and speech training is not statistically significant”training is not statistically significant”


LimitationsLimitations

Validity of VPESValidity of VPES

Sample sizeSample size

Use of PECsUse of PECs

Definition of “correct”Definition of “correct”

Do not experimentally show relationship Do not experimentally show relationship between IV and DV.between IV and DV.

Music as a reinforcer…

Watson (1979)Watson (1979)

Used music as a reinforcer to increase spontaneous speechUsed music as a reinforcer to increase spontaneous speech

Nordoff-RobbinNordoff-Robbin

http://www.youtube.com/watch?v=_CuAjiU7RBg

http://www.youtube.com/watch?v=Xpr2hC0OcdQ

““music lessons for autistic individuals provide a way for them to music lessons for autistic individuals provide a way for them to make friends and get involved in the community. Above all, you make friends and get involved in the community. Above all, you need to remember that music can be plain old fun.” (p.194).need to remember that music can be plain old fun.” (p.194).

Shore, S. M., and Rastelli, L. G. (2006)Shore, S. M., and Rastelli, L. G. (2006). Understanding Autism for Dummies. Understanding Autism for Dummies. Wiley Publications, Inc. Hoboken, NJ.. Wiley Publications, Inc. Hoboken, NJ.

Is music therapy an effective autism intervention?

What is the purpose?What is the purpose?

““Treat” characteristics of autism?Treat” characteristics of autism?

Teach functional skills?Teach functional skills?

Decrease undesirable behaviors?Decrease undesirable behaviors?

Provide a service that the child enjoys and finds Provide a service that the child enjoys and finds fun?fun?

What is art therapy?““a psychological discipline that specializes in using visual art a psychological discipline that specializes in using visual art making and the creative process to help clients bring about making and the creative process to help clients bring about therapeutic change”therapeutic change”

Six major ASD treatment goalsSix major ASD treatment goals

Imagination/abstract thinking deficitsImagination/abstract thinking deficits

Sensory regulation and integrationSensory regulation and integration

Emotions/self-expressionEmotions/self-expression

Developmental growthDevelopmental growth

Recreation/leisure skillsRecreation/leisure skills

Visual-spatial deficits Visual-spatial deficits

www. www. arttherapyandautism.comarttherapyandautism.com

History of art therapy

Emerged as a distinct profession 1940sEmerged as a distinct profession 1940s

Early 20Early 20thth century – psychiatrists became century – psychiatrists became interested in artwork created by patients with interested in artwork created by patients with mental illness.mental illness.

Educators found that art expressions are Educators found that art expressions are reflectedreflected

http://www.musictherapy.org/factsheets/http://www.musictherapy.org/factsheets/bib_autism.pdfbib_autism.pdf

What art therapy can do!Single-case research supporting art therapy to help:Single-case research supporting art therapy to help:

ADD/ADHD/AspergersADD/ADHD/Aspergers

Aging/Elderly/GeriatricAging/Elderly/Geriatric

Chemical dependency/Substance abuseChemical dependency/Substance abuse

Grief/bereavementGrief/bereavement

MedicalMedical

Mentally retarded/Developmentally delayedMentally retarded/Developmentally delayed

PTSD/TraumaPTSD/Trauma

Prison/IncarcerationPrison/Incarceration

PsychiatricPsychiatric

School/AcademicSchool/Academic

Sexual AbuseSexual Abuse

Traumatic Brain InjuryTraumatic Brain Injury http://www.musictherapy.org/factsheets/bib_autism.pdfhttp://www.musictherapy.org/factsheets/bib_autism.pdf

Nicole Martin

Webmaster of Webmaster of www.arttherapyandautism.com

Author “Art as an Early Intervention Tool for Children Author “Art as an Early Intervention Tool for Children with Autism.”with Autism.”

Discusses prompting hierarchyDiscusses prompting hierarchy

Using “behaviorism” to manage difficult behaviors.Using “behaviorism” to manage difficult behaviors.

Incorrectly defines “autism” on her webpage and in the Incorrectly defines “autism” on her webpage and in the book.book.

http://www.youtube.com/watch?v=UbrvF7zUk8M&feature=related

What they say…

ASATASAT

““there have been no scientific studies of art there have been no scientific studies of art therapy for individuals with ASD”therapy for individuals with ASD”

““researchers may wish to conduct studies with researchers may wish to conduct studies with strong scientific designs to evaluate art therapy. strong scientific designs to evaluate art therapy. Professionals should present art therapy as Professionals should present art therapy as untested and encourage families who are untested and encourage families who are considering this intervention to evaluate it considering this intervention to evaluate it carefully”carefully”

What they say…

““the cost of autism, as well as the the cost of autism, as well as the characteristics of the disorder, may by characteristics of the disorder, may by reduced 2/3 with early diagnosis and reduced 2/3 with early diagnosis and appropriate interventions such as art therapy”appropriate interventions such as art therapy”

?? www.art-therapy.us/autism/www.art-therapy.us/autism/

htmhtm

What they say…

Art therapy based on Freudian philosophy – people with autism Art therapy based on Freudian philosophy – people with autism need to develop their ego.need to develop their ego.

Help to organize their sensory worldHelp to organize their sensory world

Art used to “reach” the childArt used to “reach” the child

Similar to sensory integration therapySimilar to sensory integration therapy

No defined treatment protocolNo defined treatment protocol

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s handbook: make sure The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! your child gets what works! Lynden, WA: SKF Books USA, Inc.Lynden, WA: SKF Books USA, Inc.

Evidence-based?

Kearns, S. D. (2004). Art therapy with a child experiencing Kearns, S. D. (2004). Art therapy with a child experiencing sensory integration difficulty. sensory integration difficulty. Art Therapy: Journal of the Art Therapy: Journal of the American Art Therapy Association, 21 (2), American Art Therapy Association, 21 (2), 95-101. 95-101.

Case study (disguised as single-case design!)Case study (disguised as single-case design!)

Teacher assessed behavior on a positive or negative scale, Teacher assessed behavior on a positive or negative scale, compared to the control group.compared to the control group.

Reported an increase in “positive behaviors” after the art Reported an increase in “positive behaviors” after the art therapy.therapy.

Concluded that art therapy was a “useful intervention”Concluded that art therapy was a “useful intervention”

http://www.americanarttherapyassociation.org/upload/http://www.americanarttherapyassociation.org/upload/OutcomeSingSubjectStudies2007.pdfOutcomeSingSubjectStudies2007.pdf

Evidence-based?

Smitheman-Brown, V. R., and Church, R. P. (1994). Mandala drawing: Smitheman-Brown, V. R., and Church, R. P. (1994). Mandala drawing: Facilitating creative growth in children with ADD or ADHD. Facilitating creative growth in children with ADD or ADHD. Art Therapy: Art Therapy: Journal of the American Art Therapy Association, 13 (4), Journal of the American Art Therapy Association, 13 (4), 252-262.252-262.

Multiple baseline designMultiple baseline design

““ongoing behavioral data were charted through direct observation”ongoing behavioral data were charted through direct observation”

Independent observersIndependent observers

““Objective”Objective”

Reported an increase in creative growth.Reported an increase in creative growth.

http://www.americanarttherapyassociation.org/upload/OutcomeSingSubjectStudies2007.pdfhttp://www.americanarttherapyassociation.org/upload/OutcomeSingSubjectStudies2007.pdf

Empirically supported?

Banks, S., Davis, P., Howard, V. F., and McLaughlin, T. F. (1993). The effects Banks, S., Davis, P., Howard, V. F., and McLaughlin, T. F. (1993). The effects of directed art activities on the behavior of young children with disabilities: of directed art activities on the behavior of young children with disabilities: A multi-element baseline study. A multi-element baseline study. Art Therapy: Journal of the American Art Art Therapy: Journal of the American Art Therapy Association, 10 (4), Therapy Association, 10 (4), 235-240.235-240.

Studied effects of art on behaviorStudied effects of art on behavior

Multielement baseline across participantsMultielement baseline across participants

Target behaviors – aggression, eye contract, social initiation.Target behaviors – aggression, eye contract, social initiation.

Data –baseline and during intervention, 5 mins and 30 mins after art lesson.Data –baseline and during intervention, 5 mins and 30 mins after art lesson.

““both experimental and control art activities resulted in therapeutic both experimental and control art activities resulted in therapeutic improvement in social behaviors, across individuals”improvement in social behaviors, across individuals”

One participant showed no improvement.One participant showed no improvement.

http://www.americanarttherapyassociation.org/upload/OutcomeSingSubjectStudies2007.pdfhttp://www.americanarttherapyassociation.org/upload/OutcomeSingSubjectStudies2007.pdf

Is art therapy an effective autism intervention?

““Based on the scientific research to date, there is Based on the scientific research to date, there is no evidence to conclude that Art Therapy is an no evidence to conclude that Art Therapy is an effective treatment for improving symptoms effective treatment for improving symptoms characteristics of autism” (p. 253)characteristics of autism” (p. 253)

Art is a fun activity, that can be a reinforcer for children Art is a fun activity, that can be a reinforcer for children with autism – there is no evidence to suggest that it with autism – there is no evidence to suggest that it is an “intervention”is an “intervention”

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! handbook: make sure your child gets what works! Lynden, WA: SKF Books Lynden, WA: SKF Books USA, Inc.USA, Inc.

Music and Art

““Reach” the child – what is the operational Reach” the child – what is the operational definition of “reach”?definition of “reach”?

Daily Life Therapy/Higashi

““Our Mission is to help children and young adults with Autism Our Mission is to help children and young adults with Autism Spectrum Disorder learn to reach their full potential through the Spectrum Disorder learn to reach their full potential through the application of the methodology of Daily Life Therapy®. This unique application of the methodology of Daily Life Therapy®. This unique educational philosophy, developed by the late Dr. Kiyo Kitahara of educational philosophy, developed by the late Dr. Kiyo Kitahara of Tokyo, Japan incorporates a broad and balanced curriculum Tokyo, Japan incorporates a broad and balanced curriculum including academics, art, music, physical education, computer including academics, art, music, physical education, computer technology and social education. Students take on challenges, technology and social education. Students take on challenges, learn to overcome obstacles and gain confidence from their own learn to overcome obstacles and gain confidence from their own success. This process allows our students to develop a love for success. This process allows our students to develop a love for learning so they may fully enjoy their family, community, and all learning so they may fully enjoy their family, community, and all that life has to offer. As each student grows and learns, their that life has to offer. As each student grows and learns, their personality and individual character matures allowing them to personality and individual character matures allowing them to benefit from and most importantly contribute to society as adults.”benefit from and most importantly contribute to society as adults.”

http://www.bostonhigashi.org/about.php?id=1http://www.bostonhigashi.org/about.php?id=1

What is Daily Life Therapy?

Educational approach based on three principlesEducational approach based on three principles

““foster the development of human dignity and self-foster the development of human dignity and self-esteem in the growing child and allow him or her to esteem in the growing child and allow him or her to contribute to and benefit from society”contribute to and benefit from society”

““education should by conducted in an environment education should by conducted in an environment of normality” of normality”


Three “pillars” of DLT

Create a predictable environment to help stabilize Create a predictable environment to help stabilize emotions so the child can the master skills for emotions so the child can the master skills for independence, subsequently making them feel independence, subsequently making them feel accomplished and proudaccomplished and proud

Establish a “rhythm of life and physical health and Establish a “rhythm of life and physical health and well-being” through exercisewell-being” through exercise

Broad, age-appropriate, individualized curriculum Broad, age-appropriate, individualized curriculum to stimulate intellectual and cognitive growth. to stimulate intellectual and cognitive growth.


Quill (1989)

5 principles that underlie the therapy:5 principles that underlie the therapy:

Physical therapyPhysical therapy

Art-based curriculumArt-based curriculum

Group instructionGroup instruction

Learning through imitationLearning through imitation

Highly structured routinesHighly structured routinesFreeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism The Complete Guide to Autism

Treatments. A parent’s handbook: make sure your child Treatments. A parent’s handbook: make sure your child gets what works! gets what works! Lynden, WA: SKF Books USA, Inc.Lynden, WA: SKF Books USA, Inc.

What does DLT claim to do?

Help children:Help children:

Form bondsForm bonds

Relate to othersRelate to others

CommunicateCommunicate

Control their anxietiesControl their anxieties


History of Daily Life Therapy

Created by Dr. Kiyo Kitahara in 1964, introduced to the USA in 1987.Created by Dr. Kiyo Kitahara in 1964, introduced to the USA in 1987.

Kindergarten teacher, worked with one child with autism.Kindergarten teacher, worked with one child with autism.

Based on vigorous physical activity and fine artsBased on vigorous physical activity and fine arts

No certified practionersNo certified practioners

Mirrors Japanese philosophyMirrors Japanese philosophy

Group interaction rather than 1:1Group interaction rather than 1:1

Theory that children learn when exposed to interactionTheory that children learn when exposed to interaction

Shore, S. M., and Rastelli, L. G. (2006). Shore, S. M., and Rastelli, L. G. (2006). Understand Autism for Dummies.Understand Autism for Dummies. Wiley Publication, Inc: Wiley Publication, Inc: Hoboken, NJ. Hoboken, NJ.

Boston Higashi School

http://www.youtube.com/watch?v=uGcyF_XE7ks&feature=related

http://www.youtube.com/watch?v=shjiPeg26NM&feature=related

http://www.youtube.com/watch?v=shjiPeg26NM&feature=related

Boston Higashi SchoolRandolph, MARandolph, MA

Opened in 1987Opened in 1987

Higashi means “east”Higashi means “east”

Day program runs 217 days a year, residential program is 304 days.Day program runs 217 days a year, residential program is 304 days.

Two 2 week vacations in Winter and Spring, 4 weeks in the summer.Two 2 week vacations in Winter and Spring, 4 weeks in the summer.

3-22 years old 3-22 years old

Diagnosis of Autism, Autistic-like, Asperger Disorder, PDD, PDD-NOSDiagnosis of Autism, Autistic-like, Asperger Disorder, PDD, PDD-NOS

3:1 student teacher ratio3:1 student teacher ratio


Physical conditioning

Regular and rigorous exerciseRegular and rigorous exercise

Jogging/unicycle/stiltsJogging/unicycle/stilts

Reduce “stimming” and aggressionReduce “stimming” and aggression

Increase sleeping habitsIncrease sleeping habits

No data!No data!

Emotional regulation

““mastery of self care skills is believed to help mastery of self care skills is believed to help with the development of self-esteem and with the development of self-esteem and contributes to emotional stability, which is contributes to emotional stability, which is important in getting along with others and important in getting along with others and yourself.” (p. 156)yourself.” (p. 156)

Shore, S. M., and Rastelli, L. G. (2006). Shore, S. M., and Rastelli, L. G. (2006). Understand Autism Understand Autism for Dummies.for Dummies. Wiley Publication, Inc: Hoboken, NJ. Wiley Publication, Inc: Hoboken, NJ.

Academics

““as much as possible instructors at the school as much as possible instructors at the school strive to teach their students as close to grade strive to teach their students as close to grade level as possible” (p. 156)level as possible” (p. 156)

Shore, S. M., and Rastelli, L. G. (2006). Shore, S. M., and Rastelli, L. G. (2006). Understand Understand Autism Autism for Dummies.for Dummies. Wiley Publication, Inc: Wiley Publication, Inc: Hoboken, NJ. Hoboken, NJ.

Medication

““The fundamental mission of the Boston The fundamental mission of the Boston Higashi School is to provide education. Daily Higashi School is to provide education. Daily Life Therapy does not rely on medications, Life Therapy does not rely on medications, vitamins or other chemical substances in the vitamins or other chemical substances in the treatment of children with autism. Dr. treatment of children with autism. Dr. Kitahara’s philosophy is that “the child need Kitahara’s philosophy is that “the child need to over its disability by its own strength”to over its disability by its own strength”


Strike a pose?

““DLT is also not a behavior modification DLT is also not a behavior modification approach. We utilize basic body postures approach. We utilize basic body postures throughout the day to encourage children to throughout the day to encourage children to increase their self control.”increase their self control.”


What they say…

““Based on the research to date, very little can be Based on the research to date, very little can be concluded about the efficacy of Daily Life Therapy” (p. concluded about the efficacy of Daily Life Therapy” (p. 116)116)

““If the Higashi school is to be considered a legitimate If the Higashi school is to be considered a legitimate educational option for children with autism, I would need educational option for children with autism, I would need to see strong data from a study which has, at minimum, a to see strong data from a study which has, at minimum, a hypothesis stating that those children who participate in hypothesis stating that those children who participate in the Higashi School over the period of a year are expected the Higashi School over the period of a year are expected to show a decrease in the symptoms associated with to show a decrease in the symptoms associated with autism.” (p. 116)autism.” (p. 116)

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s handbook: make The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! sure your child gets what works! Lynden, WA: SKF Books USA, Inc.Lynden, WA: SKF Books USA, Inc.

What they say…

““If the children in the Higashi School fair better If the children in the Higashi School fair better than the children in the public school system, then than the children in the public school system, then we would know that the Higashi School is indeed a we would know that the Higashi School is indeed a viable alternative to the public educational system viable alternative to the public educational system for children with autism. The next step would be for children with autism. The next step would be doe the Higashi School to test its intervention doe the Higashi School to test its intervention model against the other specialty school programs model against the other specialty school programs and home-based intensive behavioral intervention and home-based intensive behavioral intervention models designed for children with autism” (p. 117)models designed for children with autism” (p. 117)

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! handbook: make sure your child gets what works! Lynden, WA: SKF Books USA, Lynden, WA: SKF Books USA, Inc.Inc.

What they say…

““If you would like to enroll your child, I would suggest you If you would like to enroll your child, I would suggest you consider the fact that due to the lack of data showing that consider the fact that due to the lack of data showing that this method is effective, you may want to augment your this method is effective, you may want to augment your child’s treatment with a well-settled treatment program so child’s treatment with a well-settled treatment program so that your child will progress at least when that your child will progress at least when not not in school (p. in school (p. 118)118)

““based on the scientific research to date, there is based on the scientific research to date, there is insufficient evidence that Daily Life Therapy has an insufficient evidence that Daily Life Therapy has an effective curriculum for decreasing the symptoms effective curriculum for decreasing the symptoms associated with the condition of autism in children” (p. associated with the condition of autism in children” (p. 118)118)

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s handbook: make The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! sure your child gets what works! Lynden, WA: SKF Books USA, Inc.Lynden, WA: SKF Books USA, Inc.

What they say…

ASATASAT

No information about Daily Life Therapy/HigashiNo information about Daily Life Therapy/Higashi

National Autism Center’s National Standards National Autism Center’s National Standards ProjectProject

No information about Daily Life Therapy/HigashiNo information about Daily Life Therapy/Higashi

What they say…

National Autistic Society (U.K)National Autistic Society (U.K)

““The goal of this educational approach is for the children to The goal of this educational approach is for the children to develop as closely to normal physically, emotionally, develop as closely to normal physically, emotionally, intellectually and to achieve social independence and dignity.”intellectually and to achieve social independence and dignity.”

““This web-page has been written to provide information on a This web-page has been written to provide information on a particular intervention/approach and any research connected particular intervention/approach and any research connected with it, not as a recommendation. This outcome of any with it, not as a recommendation. This outcome of any approach will depend on the needs of the individual, which approach will depend on the needs of the individual, which vary greatly, and the appropriate application of the vary greatly, and the appropriate application of the intervention”intervention”

http://www.autism.org.uk/living-with-autism/approaches-therapies-and-http://www.autism.org.uk/living-with-autism/approaches-therapies-and-interventions/service-based-interventions/daily-life-therapy-interventions/service-based-interventions/daily-life-therapy-higashi.aspxhigashi.aspx

“Hope for the Shadow Children”

London Sunday Times Magazine – March 1988London Sunday Times Magazine – March 1988

““severe autism affects 5 in 10,000 children”severe autism affects 5 in 10,000 children”

In 1988, one year at Higashi cost $47,000In 1988, one year at Higashi cost $47,000

Dr KitaharaDr Kitahara

““Autistic children are like wild horses the parents don’t know Autistic children are like wild horses the parents don’t know how to control”how to control”

““when her students return home they will inevitably slip back when her students return home they will inevitably slip back into their odd behaviors. But years of training will eventually into their odd behaviors. But years of training will eventually win”win”

http://www.maryellenmark.com/text.magazines/london_sunday_times/http://www.maryellenmark.com/text.magazines/london_sunday_times/904G-000-010.html904G-000-010.html


PromptingPrompting

““behind each chain of marching children a teacher is crouched, behind each chain of marching children a teacher is crouched, physically manipulating those children who remain remote physically manipulating those children who remain remote from the razamatazz”from the razamatazz”

““the majority do make they journey across the stage on their the majority do make they journey across the stage on their own and the rest either carry their Hoppas or sit looking own and the rest either carry their Hoppas or sit looking remote but happy until their instructors hand guides them remote but happy until their instructors hand guides them ahead”ahead”

““The use of helpers as physical prompts is integral to the The use of helpers as physical prompts is integral to the Kitahara system. It may take months, even years before the Kitahara system. It may take months, even years before the child will raise his arm for himself, but, eventually, he will”child will raise his arm for himself, but, eventually, he will”



““Reaching” the childrenReaching” the children

““In the classroom there is an air of urgency, only the teacher’s In the classroom there is an air of urgency, only the teacher’s voice and the strength of his gaze stop the children slipping voice and the strength of his gaze stop the children slipping back into the remote darkness of their own words”back into the remote darkness of their own words”

““Gershan, a 14-year old becomes excited and shouts “moon, Gershan, a 14-year old becomes excited and shouts “moon, moon” over and over again. His neighbor deliberately breaks moon” over and over again. His neighbor deliberately breaks his pencil and stabs the point into his own palm. The girl his pencil and stabs the point into his own palm. The girl behind rocks and examines her fingers. Stephen sits with an behind rocks and examines her fingers. Stephen sits with an empty, angelic smile on his face”empty, angelic smile on his face”


Larkin, A. S., and Gurry, S. (1998). Brief report: Larkin, A. S., and Gurry, S. (1998). Brief report: Progress reported in three children with autism Progress reported in three children with autism using daily life therapy. using daily life therapy. Journal of Autism and Journal of Autism and Developmental Disorders, 28 (4). Developmental Disorders, 28 (4). 339-342.339-342.

““Do students with autism make progress using Do students with autism make progress using Daily Life Therapy, and in what areas?”Daily Life Therapy, and in what areas?”

6 students in 1987-88, when returned in 1990, 6 students in 1987-88, when returned in 1990, followed up with 3.followed up with 3.

Attending behavior – “when child is demonstrating Attending behavior – “when child is demonstrating appropriate classroom behavior and/or watching the appropriate classroom behavior and/or watching the teachers and/or the task; and/or other students when teachers and/or the task; and/or other students when no specific response is requires of the student.”no specific response is requires of the student.”

Larkin, A. S., and Gurry, S. (1998). Brief report: Larkin, A. S., and Gurry, S. (1998). Brief report: Progress reported in three children with Progress reported in three children with autism using daily life therapy. autism using daily life therapy. Journal of Journal of Autism and Developmental Disorders, 28 (4). Autism and Developmental Disorders, 28 (4). 339-342.339-342.

Inappropriate responses – “when child is not on Inappropriate responses – “when child is not on task, not performing desired response and is task, not performing desired response and is making any inappropriate vocalizations or actions”making any inappropriate vocalizations or actions”

Appropriate responses – “when child is Appropriate responses – “when child is demonstrating appropriate classroom behavior and demonstrating appropriate classroom behavior and specific situational responses required of students”specific situational responses required of students”

Larkin, A. S., and Gurry, S. (1998). Brief report: Larkin, A. S., and Gurry, S. (1998). Brief report: Progress reported in three children with Progress reported in three children with autism using daily life therapy. autism using daily life therapy. Journal of Journal of Autism and Developmental Disorders, 28 (4). Autism and Developmental Disorders, 28 (4). 339-342.339-342.

Attending behavior – “substantial increase Attending behavior – “substantial increase between 1988 and 1990”between 1988 and 1990”

Inappropriate responses – “substantial Inappropriate responses – “substantial decrease…during data collection period”decrease…during data collection period”

Appropriate responses – “either they made no Appropriate responses – “either they made no progress in this area, or at least one student progress in this area, or at least one student appeared to lose skills that he had prior to appeared to lose skills that he had prior to enrolling at this school”enrolling at this school”

Larkin, A. S., and Gurry, S. (1998). Brief report: Larkin, A. S., and Gurry, S. (1998). Brief report: Progress reported in three children with autism Progress reported in three children with autism using daily life therapy. using daily life therapy. Journal of Autism and Journal of Autism and Developmental Disorders, 28 (4). Developmental Disorders, 28 (4). 339-342.339-342.

Children attending more, and showing more Children attending more, and showing more appropriate behavior, but are not gaining any appropriate behavior, but are not gaining any academic, social or communication skills.academic, social or communication skills.

““When making a decision about where to When making a decision about where to education children with autism, parents and education children with autism, parents and professionals in the US and internationally deserve professionals in the US and internationally deserve the most complete and honest data. Only then can the most complete and honest data. Only then can parents make well-informed decisions about the parents make well-informed decisions about the best educational program for their child.”best educational program for their child.”

Generalization?

DLT vs ABA?

““Daily Life Therapy is not just a set of protocols to reduce Daily Life Therapy is not just a set of protocols to reduce symptoms but takes as its mission and responsibility the task of symptoms but takes as its mission and responsibility the task of developing and educating the entire child”developing and educating the entire child”

““specialized services for students to meet deficits in various specialized services for students to meet deficits in various developmental domains are integrated and addressed throughout developmental domains are integrated and addressed throughout the entire day rather than offered on a 1:1 basis”the entire day rather than offered on a 1:1 basis”

““The goal is not remediation of deficits but new learning The goal is not remediation of deficits but new learning appropriate to developmental level. The teaching style and the appropriate to developmental level. The teaching style and the subject matter address these area in functional meaningful subject matter address these area in functional meaningful contexts rather than as “exercises” to be practiced”contexts rather than as “exercises” to be practiced”


Is Daily Life Therapy and effective autism intervention?

There is no empirical evidence!There is no empirical evidence!

Why is there only one school in the whole of Why is there only one school in the whole of the USA?the USA?

Any questions?

Thank you Thank you

ReferencesBanks, S., Davis, P., Howard, V. F., and McLaughlin, T. F. (1993). The effects of directed art activities on the behavior of young children with disabilities: A Banks, S., Davis, P., Howard, V. F., and McLaughlin, T. F. (1993). The effects of directed art activities on the behavior of young children with disabilities: A

multi-element baseline study. multi-element baseline study. Art Therapy: Journal of the American Art Therapy Association, 10 (4), Art Therapy: Journal of the American Art Therapy Association, 10 (4), 235-240.235-240.

Freeman, S. K. (2007). Freeman, S. K. (2007). The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! The Complete Guide to Autism Treatments. A parent’s handbook: make sure your child gets what works! Lynden, WA: SKF Books Lynden, WA: SKF Books USA, Inc.USA, Inc.

Larkin, A. S., and Gurry, S. (1998). Brief report: Progress reported in three children with autism using daily life therapy. Larkin, A. S., and Gurry, S. (1998). Brief report: Progress reported in three children with autism using daily life therapy. Journal of Autism and Journal of Autism and Developmental Disorders, 28 (4). Developmental Disorders, 28 (4). 339-342.339-342.

Lim, H. A. (2010). Effect of “developmental Lim, H. A. (2010). Effect of “developmental speech and language training through music” on speech production in children with autism speech and language training through music” on speech production in children with autism spectrum disorders. spectrum disorders. Journal of Music Therapy, XLVII, (1),Journal of Music Therapy, XLVII, (1), 2-26. 2-26.

London Sunday Times Magazine. (1988). London Sunday Times Magazine. (1988). Hope for the Shadow Children. Hope for the Shadow Children. http://www.maryellenmark.com/text/magazines/london_sunday_times/904G-000-010.html

Kearns, S. D. (2004). Art therapy with a child experiencing sensory integration difficulty. Kearns, S. D. (2004). Art therapy with a child experiencing sensory integration difficulty. Art Therapy: Journal of the American Art Therapy Association, 21 Art Therapy: Journal of the American Art Therapy Association, 21 (2), (2), 95- 95-

Shore, S. M., and Rastelli, L. G. (2006). Shore, S. M., and Rastelli, L. G. (2006). Understand Autism for Dummies.Understand Autism for Dummies. Wiley Publication, Inc: Hoboken, NJ Wiley Publication, Inc: Hoboken, NJ

Smitheman-Brown, V. R., and Church, R. P. (1994). Mandala drawing: Facilitating creative growth in children with ADD or ADHD. Smitheman-Brown, V. R., and Church, R. P. (1994). Mandala drawing: Facilitating creative growth in children with ADD or ADHD. Art Therapy: Journal of the Art Therapy: Journal of the American Art Therapy Association, 13 (4), American Art Therapy Association, 13 (4), 252-262.252-262.

http://www.americanarttherapyassociation.org/upload/OutcomeSingSubjectStudies2007.pdf

http://www.art-therapy.us/autism.htm

www.arttherapyandautism.com

www.asatonline.org/intervention/treatments/music.htm

www.autism.org.uk/living-with-autism/approaches-therapies-and-interventions/service-based-interventions/daily-life-therapy-higashi.aspx

http://www.bostonhigashi.org/about.php?id=1

http://www.bostonhigashi.org/about.php?id=7

http://www.bostonhigashi.org/gallery.php?pageNum_RSphoto=11&totalRows_RSphoto=14&pageNum_RSalbum=0&year=2009&id=34http://www.bostonhigashi.org/gallery.php?pageNum_RSphoto=11&totalRows_RSphoto=14&pageNum_RSalbum=0&year=2009&id=34

http://www.facebook.com/group.php?gid=200118661850&ref=ts http://www.facebook.com/group.php?gid=200118661850&ref=ts

http://www.jamminjenn.com/JJMTC/Welcome.htmlhttp://www.jamminjenn.com/JJMTC/Welcome.html

http://www.musictherapy.orghttp://http://www.musictherapy.orghttp://

http://www.youtube.com/watch?v=UbrvF7zUk8M&feature=related http://www.youtube.com/watch?v=UbrvF7zUk8M&feature=related

http://www.youtube.com/watch?v=uGcyF_XE7ks&feature=related http://www.youtube.com/watch?v=uGcyF_XE7ks&feature=related

http://www.youtube.com/watch?v=shjiPeg26NM&feature=related http://www.youtube.com/watch?v=shjiPeg26NM&feature=related

http://www.youtube.com/watch?v=shjiPeg26NM&feature=related http://www.youtube.com/watch?v=shjiPeg26NM&feature=related

http://www.youtube.com/watch?v=Xpr2hC0OcdQhttp://www.youtube.com/watch?v=Xpr2hC0OcdQ

http://www.musictherapy.org/factsheets/bib_autism.pdf http://www.musictherapy.org/factsheets/bib_autism.pdf

A Review of Music Therapy, Art Therapy and Daily Life Therapy Alex Mellor.

Documents

Transcript of A Review of Music Therapy, Art Therapy and Daily Life Therapy Alex Mellor.