Running head: SOCIAL SKILLS FOR ASD INDIVIDUALS USING ... MP 2014.pdf · 3/17/2014  · Developing...

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Running head: SOCIAL SKILLS FOR ASD INDIVIDUALS USING CÉILÍ DANCE 1 Developing the Social Life Task for Individuals with High Functioning Autism Using Irish Céilí Dance A Summary Paper Presented to The Faculty of Adler Graduate School _____________________ In Partial Fulfillment of the Requirements for The Degree in Master of the Arts in Adlerian Counseling and Psychotherapy _____________________ By: Elizabeth Clarice Pitchford March 17, 2014

Transcript of Running head: SOCIAL SKILLS FOR ASD INDIVIDUALS USING ... MP 2014.pdf · 3/17/2014  · Developing...

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Running head: SOCIAL SKILLS FOR ASD INDIVIDUALS USING CÉILÍ DANCE 1

Developing the Social Life Task for Individuals with High Functioning Autism

Using Irish Céilí Dance

A Summary Paper

Presented to

The Faculty of Adler Graduate School

_____________________

In Partial Fulfillment of the Requirements for

The Degree in Master of the Arts in

Adlerian Counseling and Psychotherapy

_____________________

By:

Elizabeth Clarice Pitchford

March 17, 2014

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SOCIAL SKILLS FOR ASD INDIVIDUALS USING CÉILÍ DANCE 2

Abstract

This paper presents a curriculum for developing the social life task by teaching and

practicing social skills for higher functioning individuals with a diagnosis of autism spectrum

disorder through the medium of dance, specifically Irish céilí dancing. The paper also

presents the Adlerian aspects present in learning and doing Irish céilí dance and in the

teaching of social skills to individuals on the autism spectrum. There is a high need in the

autism community for utilizing active and varied approaches to teaching social skills and

offering ample opportunity to integrate the learned skills. Research presented in this paper

shows the importance of teaching social skills to individuals on the spectrum, that teaching

these skills is best done in group settings, and that there has been success in teaching skills

through the medium of dance and exercise and, specifically, through what is commonly

referred to as special interests of those on the spectrum.

Keywords: Céilí dance, Irish dance, Adults, Autism, Social Skills

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Acknowledgements

Barb Luskin: For your deep knowledge and understanding of autism and willingness to share that

knowledge has been enlightening and empowering. Thank you for the support and

guidance.

Meg Williams: For having another Adlerian voice in the field of Autism: Thank you. Your

passion is inspiring.

Cormac, Natalie O’Shea, and Becky Bollinger: For supporting me through the art of Irish dance

and for knowing that I need to dance: Go raibh maith agaibh!

Mary Branick Ujda: For your friendship and enthusiasm for all my schemes and undertakings! I

will always admire your zen-like approach to life and dance.

William Pitchford: My late father who unknowingly taught me more about the life of an

undiagnosed Aspie than any book or article ever will.

Marilyn Pitchford: My late mother to whom I am grateful for her dogmatic teachings to me of

social skills, reading people, and appreciating people for who they are and who they want

to be.

Roain Pitchford McCormick: My beloved eldest nephew who is the future of high functioning

autism. It is for you and all your peers that my passion soars in this field and I promise to

not slow down in advocating for you and educating the world about your strengths and

just how wonderful you are.

Erik Zakis: For the endless opportunities to practice what I preach, for the encouragement, and

for all the cooking!

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Table of Contents

Abstract ........................................................................................................................................ 2

Acknowledgements ...................................................................................................................... 3

Defining Autism Spectrum Disorder ........................................................................................... 5

Individual Psychology and Autism Spectrum Disorder ............................................................... 7

Social Skills ................................................................................................................................. 8

The Social Life Task .................................................................................................................. 12

Dance/Movement Therapy and Individual Psychology ............................................................. 15

Significant Findings ................................................................................................................... 15

Individual Psychology and Irish Dance ......................................................................................16

General Psychological Benefits of Dance ...................................................................................20

Dancing as an Intervention ........................................................................................................ 22

Dance as a Teaching Tool for Social Skills ................................................................................ 23

Irish Céilí Dance ........................................................................................................................ 24

Developing and Integrating Social Skills .................................................................................. 26

Future Study ................................................................................................................................29

Curriculum ................................................................................................................................. 30

References ...................................................................................................................................42

Appendix

Social Interaction Anxiety Scale .................................................................................... 47

Pre-class Questionnaire ...................................................................................................49

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Developing the Social Life Task for Individuals with High Functioning Autism

Defining Autism Spectrum Disorder

The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) defines autism

spectrum disorder using two main criteria with specifics within each of those criterion. The first

criterion is “persistent deficits in social communication and social interaction across multiple

contexts” (APA, 2013, p. 50). This criterion includes marked deficits in social-emotional

reciprocity, joining groups in conversation, sharing experiences and emotions, and “failure to

initiate or respond to social interactions” (APA, 2013, p. 50). This first criterion also specifies

deficits in nonverbal communication, both in using nonverbal communication and in

understanding nonverbal communication, and deficits in “developing, maintaining, and

understanding relationships” (APA, 2013, p. 50).

The second criterion notes patterns of behavior such as restricted patterns, inflexible

thinking, or repetitive motor movements. The DSM-5 also notes that the symptoms must be

present before the age of three and not be better explained by an intellectual disability or other

developmental delay. There are three levels of severity that can be assigned and which are

decided upon based on how much support that individual needs. It is important to recognize that

individuals on the spectrum may need very substantial support (the highest severity level) in

some areas but in other areas only need some support (the lowest severity level). This uneven

pattern of development is referred to as splinter skills and is a characteristic present in every

person on the autism spectrum.

The medical and mental health communities are certain that autism is a neurological

difference in the brain but many specifics of those differences are still currently being

researched. Brain overgrowth, connectivity differences, brain volume, head and brain size, and a

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difference in white and grey matter in the brain are areas of significant study. There is a strong

genetic component present in many families with autistic members, but that is not the case for

every family.

Autism is not a mental health disorder. However, anxiety and depression are frequent

comorbid diagnoses for autistic individuals and especially common in those individuals with

high functioning autism (HFA). For people with autism, benefits gained from therapy and

coaching include help decoding the social and sensory world and, in cases where the autism

greatly impairs the individual, improving functioning. Many people with high functioning

autism, which was formerly referred to as Asperger’s Syndrome, need social skills taught in a

direct and methodological way whereas many neurotypical children learn these skills implicitly

through watching others and experience.

Correctly perceiving and recognizing social cues displayed in a person’s face and body

posture are, in part, essential for appropriate social interaction. Faces and body postures

both tell us about a person’s emotional state, whether that person is friend or foe, whether

that person is attending to us, what that person intends to do, and what actions we should

take subsequently. (Reed, Beall, Stone, Kopelioff, Pulham, & Hepburn, 2007, p. 1576)

The same authors as above note “without strategies for processing other people’s bodies,

individuals with ASD are missing a critical source of social information.” Hidden and unspoken

social rules, such as how far to stand from a person with whom you are speaking, need to be

directly explained to individuals on the spectrum especially for individuals who have difficulty

reading nonverbal language. In a casual conversation with the author, one individual on the

spectrum described going out into his community as being like walking into a pack of wolves: he

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never knew when he was going to do something to set the wolves off and he had no way of

knowing what they were communicating to each other or trying to communicate to him.

Individual Psychology and Autism

While it is currently accepted that autism is in fact a neurological difference in the brain,

people with autism are not exempt from developing mistaken beliefs, striving vertically,

safeguarding and other side shows that neurotypical clients utilize. Therapy that is beneficial for

an individual with autism largely depends on where they are with regards to cognitive

functioning. Talk therapy is less beneficial to most people on the spectrum while cognitive

behavioral therapy and acceptance and commitment therapy has, in general, been shown to be

effective with this population. It is crucial for a therapist working with an individual on the

spectrum to be aware when a symptom may be an element of autism as opposed to a more

standard mistaken belief. The symptom can still be challenged by the therapist, but should be

approached more as a psychoeducational moment than a “spit in their soup” moment. This is

especially true for adults who were diagnosed later in life and have spent much of their life

struggling with what seemed to come easily for others.

Mistaken Beliefs and Social Skills Differences

We know that the origin of many social skills differences in individuals on the autism

spectrum is neurological. Temple Grandin discusses an article published in the Journal for

Autism and Developmental Disorders in her book, The Autistic Brain (2013), which found the

following through fMRI scans:

What a neurotypical person feels when someone won’t make eye contact might be what a

person with autism feels when someone does make eye contact. And vice versa: What a

neurotypical feels when someone does make eye contact might be what an autistic feels

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when someone doesn’t make eye contact. For a person with autism who is trying to

navigate a social situation, welcoming cues from a neurotypical might be interpreted as

aversive cues. (p. 35)

Despite this well accepted information about a biological origin, there is still potential for

mistaken beliefs be developed based on negative social experiences. For example, a young

individual may experience great difficulty in processing what is being said to him or her while

simultaneously making eye contact which in turn causes them to develop the idea that it is

always a bad idea to make eye contact. While a therapist may not be able to change the difficulty

of processing verbal information while making eye contact, the therapist can help the individual

learn under which conditions he or she can safely make eye contact. The therapist can also help

dispel any myths associated with making eye contact such as the idea that neurotypical

individuals make constant eye contact.

Social Skills

Being systematically taught social skills is a shared experience for almost every young

person who is diagnosed as autistic due to the fact that while the “symptomology of the broad

spectrum of autism may be rather heterogeneous and confusing…there is general consensus that

a marked social deficit is included among its primary symptoms” (Berger, Aerts, van

Spaendonck, Cools, and Teunisse, 2003, p. 502). While many young people might be ambivalent

about the classes, adults on the spectrum who received their diagnosis well after the time when a

school-based class could have assisted them may lament the missed opportunity. Much focus is

on children receiving interventions as research has shown that early intervention is most effective

(Corsello, 2005) and social skills classes for adults are harder to fill partially due to a lack of

understanding as to what exactly can be learned in a social skills class.

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“[S]ocial skills are the specific behaviors that an individual uses to perform competently

or successfully on particular social tasks (eg. starting a conversation, giving a compliment,

entering … [a] group” (Gresham, Sugai, and Horner, 2001, p. 333). Based on this definition of

what social skills are, Gresham et al. provide a concise definition of what a deficit in social skills

is:

Social skill acquisition deficits refer either to the absence of knowledge for executing a

particular social skill even under optimal conditions, or a failure to discriminate which

social behaviors are appropriate in specific situations. […] Acquisition deficit can be

thought of as ‘can’t do’ deficits, whereas performance deficits are ‘won’t do’ deficits (p.

334).

A class which teaches these skills would focus on detailed, direct, and systematic

teaching of those skills which are pertinent to the deficits, or differences, that each individual

experiences. Furthermore, “dance/movement therapists’ unique facility for understanding,

reflecting, and expanding nonverbal expressions can help those with autism to improve

socialization and communication, build body awareness, and can directly affect motor deficits”

(Dance/Movement Therapy & Autism, para. 1).

Addressing Joint Attention and Motivation

Joint attention is defined as the “capacity to coordinate attention among self, other, and

an object or event to share an interest or an experience” (Vismara & Lyons, 2007, p. 214). This

skill is a common deficit in the autism population and is one of the defining characteristics of the

disorder. Joint attention is the seeking to spontaneously share an experience with another

individual and is one of the first social interactions humans engage in. Jones and Carr (2004) cite

Bruner & Sherwood (1983), Gómez, Sarriá, & Tamarit (1993), Mundy (1995) and Tomasello

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(1995) as recognizing the fact that “the function of joint attention, then, is social, reflecting the

infant’s growing understanding of the world and motivation to interact with adults about

interesting objects” (p. 14). Infants who do not engage in joint attention are often later diagnosed

with autism.

What makes joint attention so significant is the amount of information the individual is

missing due to not looking at the face of another individual or following their gaze or pointing.

Many studies have been dedicated to investigating joint attention and developing interventions

for teaching it because “the social motivation component of joint attention [must be] …

addressed through intervention, [because] children with autism may never learn to develop more

sophisticated social–communicative behaviors” (Vismara & Lyons, 2007, p. 215). Most of the

research regarding interventions for joint attention is focused on children with autism as it is

imperative that joint attention challenges be met with early intervention as early intervention

lessens the likelihood of more significant challenges in social skills later in life. In order to

encourage joint attention, Isaksen and Holth encourage frequently incorporating a type of reward

throughout the intervention. In order to identify what the individual finds rewarding, they

conducted an interview with the parents of their participants with “the purpose … to assess the

child’s interest for objects and pictures to use as material in the training” (2009, p. 224). This

concept will be incorporated in the curriculum outlined below.

Difficulty initiating activity or feeling motivated is another common characteristic in the

autism population. Once again researchers call on the assistance of a characteristic already

present in many individuals with autism: special interests. Special interests refer to the “highly

restricted, fixated interests that are abnormal in intensity or focus” as mentioned in the DSM 5

criteria for the diagnosis of an autism spectrum disorder. While not every individual on the

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spectrum has a designated special interest, which are sometimes referred to as perseverative

interests or restricted interests, it is a common characteristic and provides an opening for

building rapport, offering rewards for preferential behavior, and to sustain motivation. Research

that focuses on encouraging motivation in academics “supports the use of restricted interests as

evidence-based best practice” (Mancil & Pearl, 2008, p. 12). Koegal, Singh, & Koegal (2010)

found that utilizing “motivational components in academic tasks resulted in faster completion

rates, decreased disruptive behavior, and improved interests” (p. 1064). The motivational

components in the Koegal et al study are not limited to incorporating special interest but also

include natural reinforcers, choice, and the interspersal of easier tasks.

Of importance to note is the fact that while joint attention or theory of mind may be the

culprits behind poor social skills, if an individual on the autism spectrum has not received early

intervention and has spent a lifetime feeling lost in regard to social interactions, “understanding

what others want and expect might end up being of little use without the basic drive to act in

accordance with these desires and expectations” (Chevallier, Molesworth, & Happé, 2012, p. 4).

Hence finding the key to motivating individuals or helping them identify what is motivating is a

critical component in teaching social skills. As Lequia quotes Szatmari in her article, “when

working with children with ASD, it is our responsibility to enter their world, to discover what

motivates or interests them and to use this strong interest or motivator as a tool to teach them

new skills” (2011, p. 406). The author contends that this statement holds true for adults on the

autism spectrum as well as “ASD is a heterogeneous disorder, and research aimed at

understanding treatment must address this heterogeneity” (Voos, Pelphrey, Tirrell, Bolling,

Vander Wyk, Kaiser, McPartland, Volkmar, Ventola, 2012, p. 9).

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Recognizing Biological Contributions to Social Skills Deficits: Oxytocin

In addition to neurological origins of social skills deficits, there are potential biological

origins as well. “Oxytocin and the structurally similar peptide, vasopressin (two amino acids

differentiate them), have also been found to be critically involved in affiliative behaviors,

including sexual behavior, mother-infant and adult-adult pair-bond formation, separation

distress, and other aspects of social attachment” (Hollander, Bartz, Chaplin, Phillips, Sumner,

Soorya, Anagnostou, & Wasserman, 2006, p. 1). Hollander et al remark that “given that deficits

in social interaction and affiliation are a core feature of autism and that oxytocin is involved in

the regulation of affiliative behaviors, it is believed that oxytocin might play a role in autism” (p.

1). Their 2006 study found that individuals who received a dose of oxytocin helped individuals

with autism identify and retain social information that they previously could not. Another study

published in 2011 written by Lischke, Berger, Prehn, Heinrichs, Herpertz, & Domes also

presented positive results finding that intransal doses of oxytocin “promotes emotion recognition

from dynamic facial expressions” (p. 6). However, side effects were not addressed at length and

only one report identified the potential hazard of the intervention causing memory deficits.

The Social Life Task

The social life task is at the core of many of the challenges individuals with autism face.

Difficulties engaging in social activities are considered to be a core symptom of

individuals with Autism Spectrum Disorder (ASD). Both the literature and our clinical

observations suggest that most individuals with ASD have a desire to engage in social

activities, but social skill deficits make social interaction challenging, and in turn can lead

to feelings of loneliness and isolation (Koegel, Ashbaugh, Koegel, Detar, & Regester,

2013, p. 899).

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The research conducted by Koegel et al lends support to the author’s hypothesis that

working with individuals to enhance the social life task through a dance class integrating social

skills curriculum will increase their level of functioning in the remaining life tasks.

In The Science of Living (2011), Alfred Adler writes, “the goal of Individual Psychology

is social adjustment” (p. 84). Given the marked social deficits experienced by individuals on the

autism spectrum, much time is spent on training those individuals with social skills in order to

improve their quality of life, their ability to gain work, and increase their connectedness to their

community. According to Koegel, Kim, Koegel, and Schwartzman (2013), “especially alarming

… that these social impairments increase the risk that adolescents with ASD will develop

comorbid disorders, most commonly anxiety and/or depression” (p. 2121-2122 ) and,

furthermore, “Given the interrelationships between anxiety, depression, and social challenges it

seems that interventions that focus on improving social skills could potentially yield a broader

impact that helps alleviate these other psychological factors” (Hillier, Fish, Siegel, & Beversdorf,

2011, p. 269).

For individuals who are considered to be on the higher functioning end of the autism

spectrum, social skills classes consist of direct lecture, modeling, and experiential opportunities

to integrate taught social skills such as how to join a group conversation, how to approach

someone in order to talk to them, and how and why to engage in small talk as well as more subtle

skills such as reading facial expressions and body language. “Research has documented that

without systematic social intervention, adolescents with ASD can exhibit limited or nonexistent

initiations towards typical peers” (Koegel, et al., 2013, p. 2121). This paper outlines a new

approach to teaching and integrating social skills for adults with the HFA designation. By

integrating social skills into an Irish céilí dance class, individuals with the HFA diagnosis will be

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able to learn, practice, and integrate social skills such as eye contact, joining a group,

approaching another individual to converse, proprioception, and turn taking.

At a breakout session of a support group for adults with ASD, the author taught some

céilí dances and explained the social skills pertinent in each. The dancers were receptive to this

approach of teaching and practicing skills and one reported that it was an effective way for her to

think about better integrating those skills into her daily life.

Individuals with autism can learn social skills and while the learned social skills may

always feel like a “second language” for them, they are able to use the skills in a proficient

manner after systematic practice in various scenarios. A paper by Mayo and Eigsti (2012) notes

that while their study found strong evidence of implicit learning in autistic individuals, “studies

have also indicated that individuals with ASD demonstrate difficulty with skills that are

implicitly learned in typically developing individuals” (p. 2476). At this point, it is important to

note that every individual with autism presents symptoms, deficits, and differences in a unique

pattern. This fact explains the often-varied results of research when that research is trying to

present a generalization about a symptomatically multifarious population.

There is significantly more importance to knowing social skills than just connecting to

other people. Social skills are what help people advocate for their needs. The needs may be as

basic as asking for a drink of water or more complex such as asking for a mentor in the

workplace. However complex the need may be, there are basic social skills involved at each step

of the process. Having good social skills promotes contentment in all three of the Adlerian life

tasks which is one part of strong mental health, the other part being social interest.

Social Interest

Many individuals on the autism spectrum are accused of not being interested in other

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people or in their community. This is simply not true. Some people on the spectrum seem to have

developed a mistaken belief that there is no reason they should interact in their community, but

upon further investigation, most of these individuals will divulge bad social interaction

experiences that is the root of their lack of community involvement. Most autistic individuals

want to feel connected to their community; they simply require some training in how to connect

which is where explicit teaching of social skills can be highly beneficial.

Dance and Movement Therapy in the Framework of Individual Psychology

Movement and the astute analysis of movement have been a part of the Adlerian

approach from the earliest writings of Alfred Adler. In The Science of Living (2011), Adler writes

that “movements themselves are expressed or imbedded in attitudes, and the attitudes are an

expression of that whole attitude to life which constitutes what we call the style of life” (p. 135).

Currently, most dance and movement therapists (D/MTs) do not approach therapy from an

Adlerian perspective. The dance therapy known as Authentic Movement is based on the theory of

Carl Jung while practitioners certified by the American Dance Therapy Association have a

separate theory based on the idea that “body movement, as the core component of dance,

simultaneously provides the means of assessment and the mode of intervention for

dance/movement therapy” (“About dance/movement therapy,” 2009, para 2). However, it is the

opinion of the author that Adlerian concepts such as social interest, moving from a felt minus to a

perceived plus, striving, belonging, and the courage to be imperfect and the courage to fail, can

all be effectively applied to dance not only in a typical dance therapy method which is

characterized by freeform movement, but also to a formal, structured dance class such as one

featuring Irish céilí dance. As the only formal dance training for the author being in Irish dance,

it is imperative to the author to be able to link the psychological benefits of being an Irish dancer

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despite the perception that this particular style of dance is thought to be lacking in expressive

emotion and, therefore, less linked to the subconscious.

Significant Findings in Research Regarding Dance and Movement Therapy

In a 1977 article, Joan Lavender details her first two years as a dance therapist working

with a man diagnosed with undifferentiated schizophrenia. She “came to understand that dance

provides its own structure, according to the thoughts and feelings of the dancers. It is the

emotional context of the dance that motivates the dancer to expand his/her movement/emotional

world” (Lavender, p. 128). She describes the two years she worked with Nick and highlights the

breakthroughs and what she came to see as regressions, which are a part of the therapeutic

process. Nick was encouraged to use whatever movement he felt appropriate at the time and this

included finger-pointing, punching, and Greek folkdance as Nick was of Greek descent. This

author finds it significant that Nick chose to use elements of the folk dances from his culture of

origin. Ghorol (2007) reports that regression to childhood behaviors and familiarities can happen

when an adult is under stress. Utilizing dances from one’s own culture such as Irish dance, or

Greek dance in the case of Nick, can be a significant comfort to someone under stress and one

should keep in mind that the therapeutic process itself can be a stressor. As an advantage of using

the freeform movement in dance therapy, the chosen movements by the dancer can be used to

say what language cannot. Adler (1956) wrote that “in mimic and physiognomy, in the

expressive movements of the emotions, in rhythms of the dance and of religious ecstasy, in

pantomime and in art, and most eloquently in music, this organ dialect renounces language as a

means of communication in order to impress us the more” (p. 221). So while dance therapy does

not specifically use the teachings of Adler, this is an example of how movement can be utilized

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and viewed from an Adlerian perspective to assist in the communication to a therapist where

words fail the client/dancer.

Individual Psychology and Irish Dance

Belonging and Social Interest

In social dances such as céilithe, there are many reasons as to why it is imperative that the

dancers work together, be socially interested, not the least of which is to properly execute the

dance. Experienced dancers know that a dance can quickly fall apart if participants leave the

dance floor mid-dance or if they give up properly executing the steps. While it may be perceived

by an individual to be more fun to go in whichever direction he or she feels the music

commands, the togetherness and execution of the dance would then be destroyed, dancers would

not have partners, and, in the progressive dances, much confusion would ensue. In fact, in

well-attended dances, it is not uncommon to feel the floor move up and down with the

synchronous dancing but this is only accomplished if all the dancers not only move in time to the

music, but also dance together. One Irish céilí dancer says “What is it like when the dancing is

really good? I always compare it to flying. When your partner and you are in synch and

everything works and you’re both stepping off together, and, you know, you don’t seem to be

spending much time touching the floor. I just say it feels like flying” (Allen, 2003, p. 111).

Gemeinschaftsgefühl/Community Feeling

At the heart of Adlerian psychology is the concept that mental health depends on the

ability of a person to engage in gemeinschaftsgefühl which has been translated to “social interest”

or “community feeling.” The concept states that an individual must be interested in not only what

is good for him or her but also for the community at large. For example, in an article in the

Journal of Individual Psychology, La Voy, Brand, and McFadden (2013) share a personal

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communication from S. Blahut of the gemeinschaftsgefühl developed by mountain climbers. By

working together, the climber developed a sense of togetherness. A common characteristic of

individuals on the autism spectrum is that of a sort of self-centeredness. While some literature

calls this a lack of empathy, a more accurate description would be low community feeling. In

order to increase community feeling in individuals on the autism spectrum, it is most beneficial

to bluntly explain the benefits of community and provide specific opportunities for them to get

involved in their community. These specific opportunities can vary widely but in order to be

successful, the opportunities should be related to the individual’s special interest(s).

Striving for Success and Goal Oriented

Competitive Irish dance can be used as a metaphor for the Adlerian concepts of striving

for success and being goal oriented. Adler’s concept that life is teleological in that one is always

striving for a future fictional goal can also be portrayed via metaphor in Irish dance. Irish dance

form requires tight control of the feet and to dance as if one is on a balance beam at all times;

straight lines are the mainstay in Irish dance form. There is also the patterns made by the dancer

as he or she move across the floor and that the dancers are trained to plan their route so as to

utilize as much of the space provided to them as possible.

Felt Minus to a Perceived Plus

Lavender wrote that her client Nick often would ask her to grade his dancing. He was

concerned with getting an “A” in the “class.” Nick was striving from a felt minus to a perceived

plus. In looking at formal dance lessons, the idea of constant practice and hard work is an

example of moving from a felt minus to a perceived plus. If a dancer takes the study and practice

of dance seriously and notes that his or her own movements are not as well executed as those of

other students or as those of the teacher, he or she will work harder in order to better execute the

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movements. A perfectionist may never see that he or she is doing the movements acceptably well

while one with an inferiority complex may think he or she will never get the movement good

enough. It is important for the Adlerian dance therapist to note these attitudes and look for ways

to help set the dancers back to the useful side of life.

Courage

A common example of having the courage to fail is the child who is learning to walk. No

one succeeds in walking at the first try; everyone falls and gets up again and again. The same is

true in dance: extremely rare is the dancer who executes a leap correctly the first time. The

successful person will make many attempts in his or her chosen field be it dance, music, or

business to achieve his or her standard. Mistakes are required in learning how best to accomplish

one’s chosen task.

The author uses the concept of the courage to fail in a pep talk with her own dance

students, ages 5-16, when they are convinced that a dance is too advanced for them to even

attempt. The theory usually makes sense to them, encourages them, and they begin working in

earnest on “failing” the step until they no longer fail. In dance circles, this pep talk is more often

referred to as “fake it until you make it.”

Encouragement

The role of a dance teacher is very similar to that of a therapist. As teachers/therapists

watch their dancers/clients, they observe how the students/clients move whether they are moving

on a stage or through the world. In The Individual Psychology of Alfred Adler (1956), Adler

writes that the “aim of Individual Psychology treatment is always to increase an individual’s

courage to meet the problems of life” (p. 362). By increasing the confidence of a client/dancer,

counselors/teachers can help build self-esteem and the ability for the individual to build a

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metaphor between struggles in dance and struggles in life. If they think, “I once could not do that

dance move but I can now, then perhaps if I cannot succeed at this one event in life I will be able

to succeed with more attempts” then the dance teacher/therapist has succeeded. In returning to

the Adler (1930) quote that “movements themselves are expressed or imbedded in attitudes,” (p.

135) one can also see examples of that in the posture of Irish dance students. The students with

correct posture: straight back and arms, head held in a neutral but strong position, will be able to

execute a dance more accurately than that of the dancer who shows that they feel discouraged:

hunched shoulders, head down, arms aloft. In encouraging the dancers to correct their dance

posture, one hopes that it will carry into their daily approach.

General Psychological Benefits of Dancing

In a case study performed in Great Britain, one participant said the following about line

dancing:

I had major depression, which was diagnosed 3 years ago. I couldn't pull myself up from

a very dark place. My family suffered too -- my partner and kids were upset to see me so

low. I think it all goes back to my childhood … but I don't know … I felt scared and

unfocused most of the time. Counselling and antidepressants helped, but I really picked

up when I joined the line dancing class. It took some courage to go on my own, but my

practice nurse really sold it to me. After only 2 weeks I began to feel better mentally and

physically, and after 6 months I was a different person. It is brilliant when we all make

the same moves at the same time. I have such a happy feeling, you know … part of

something … it’s hard to explain. And it doesn't matter if you get the steps wrong, new

people join all the time.” (Macdonald, 2010, p. 31)

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By dancing together the sense of belonging quickly swells. In Irish social dancing as well

as other folk dancing such as contra dancing, many of the dances feature a changing of partners

as the dance progresses. This serves as a non-verbal ice breaker as by the end of the dance,

almost every dancer in the room has met and danced together. Well-run dance events will start

out with one of these progressive dances so as to contribute to the good rapport at the event. For

individuals who may be living with anxiety, depression, or other neuroses, a sense of belonging

to a community, even a temporary one such as a social dance, can alleviate symptoms.

Children who are taught how to dance and how to work together so as to properly execute

a dance in a performance, learn that teamwork can be rewarding. Even for an introverted child or

adult, being included and feeling that they belong teaches them that they too have an important

role in the dance. This can help them learn the social skills needed to successfully navigate a

world where, as Susan Cain (2012) discussed in her presentation on TED “The Power of

Introverts,” extroverts are more valued. Hence, the benefits of dance are not lost on introverts as

there are many opportunities to dance that do not necessarily involve group work.

In Irish dance schools where competition is a focus, it is not uncommon to witness

dancers helping each other learn and perfect their dances. Despite the fact that once on-stage at a

competition they are competing against each other, it is understood that it is better for their dance

community (specifically, their school) to have dancers placing well in the results. Again, there is

a sense of what is better for our community (dance school) is also better for me. So despite the

fact that the competition itself is an example of striving on the vertical plane, it is important for

dancers to come back to the horizontal plane when the results are in. If the dancer did not do

well, he or she will still celebrate the success of a fellow dancer. Of course, this is not always the

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case and there are plenty of examples of animosity not only between specific dancers but also

between entire dance schools.

In “Dance as Metaphor of the Psychotherapeutic Encounter,” Mosak and Rasmussen

(2002) note that “from military drills to religious ceremony, by moving in synchrony with others,

cultures and communities have emerged, defined not by geographic locale but by unique forms

of communal movement” (p. 109). The sense of belonging to a community can be reinforced at

social dances and dance classes. Many people who dance not only say to others “I dance” but

rather “I am a dancer.” It is an identity and it is a part of who they are. They belong to the greater

community that is the Dance Community. Another dancer was quoted in the article “Irish Céilí

Dance and Elderly Dancers” by Allen (2003) as saying “I think dance has a lot of health benefits,

it’s not only the exercise, it’s the mental, because you’re, uh, you’re visiting with people, you

know . . . you wouldn’t get a chance to know ‘em if you didn’t have something in common, and

you can really form friendships in that area” (p. 120). The camaraderie and sense of community

that is created at social dances can help bring people out of their self and help them refocus on

the bigger picture if they have perhaps been too focused on their inner self. This example is

reminiscent of the famous story where Adler suggested to a patient he was treating for

melancholy to have someone over for a cup of tea.

Dancing as an Intervention for Mental Imbalances

In Ehrenreich’s 2006 book Dancing in the Streets; A History of Collective Joy, she

reports that the 18th

century writer, Richard Browne, did a scientific study that resulted in the

findings that “singing and dancing could cure melancholy … by stirring up ‘secretions’” (p.

149). He went on to prescribe “an Hour or more at a convenient time after every Meal.”

However antiquated this may seem, current research supports that exercise can make one feel

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happier. Lehman and Herkenham’s 2011 study showed that mice that had the opportunity to

regularly exercise could more effectively deal with stress. Dance is, of course, a form of exercise

but with the added benefit of music and music also has been shown to be a good mood enhancer

(DivaVillage, 2009). Assuming that one enjoys the music and the type of dance, it can very well

be a solution for those who suffer from anxiety, depression, and other mood disorders. Or as one

local dancer says, “When my body executes a dance (and doesn't require my brain to take part), I

get a rare and fleeting reprieve from the constant mental analysis that plagues my life. My brain

gets a mini vacation and it is pure bliss” (A. Moen, personal communication, May 19, 2012).

Dance as a Teaching Tool for Social Skills

Social dances have historically served many purposes including community bonding,

ways to meet new people (including future spouses), and also as a way to teach manners, values,

and social expectations. “Social reformers taught folk dances from the ECD [English Country

Dance] and American traditions as a way to transmit values and modes of expression from an

imagined essential ‘natural’ rural past they saw threatened by the presumed 'artificiality' of urban

life” (Walkowitz, 2006). For an individual with a neurotypical brain, one that does not have any

neurological differences such as autism, ADHD, or intellectual disabilities, social skills are

learned implicitly in these social dances. These social skills include responding to requests from

strangers, how to follow nonverbal cues, focus on tasks, sequences, and turn taking. These skills

can be explicitly taught for individuals who may not learn them implicitly as Reed et. al. (2007,

p. 1582) noted “Imitation therapies that emphasize attention to body postures could provide a

generalizable tool that individuals with ASD could use across a variety of social situations and

environments.”

In The Individual Psychology of Alfred Adler (1956), Adler expresses his positive view of

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dancing as a developmental aid for children: “Dancing is a type of activity in which two people

have to accomplish a common task, and I think it is good for children to be trained in dancing. I

do not exactly mean the dancing we have today, where we have more of a show than of a

common task. If, however, we had simple and easy dances for children, it would be a great help

for their development” (p. 436). While Irish céilí dances may not meet Adler’s criterion of

“simple,” they are predictable, learnable dances that depend on everyone working together to

make the shapes, patterns, and rhythms in response to the music provided. Regardless of whether

the dances are learned in a formal class setting or on the fly at public céilí dances, teamwork and

a sense of community are quickly learned and integrated.

Irish Céilí Dance

Terms and Definitions

• Céilí: (pronounced kay-lee, emphasis on first syllable) in Irish dance lexicon, a social dance

event where dances consist of couples or small groups in geometrical formations (lines,

squares, circles, etc.). Danced mostly to reels (4/4 time signature) and jigs (6/8 time signature).

• Irish step dance: a form of dance that originates in Ireland; characterized by brisk, rhythmic

movements of the legs and feet while the upper body, arms straight at the side, is controlled and

still; danced in both a soundless soft shoe called a ghillie as well as a shoe with fiber glass tips

and heels called a jig, heavy, or hard shoe. The type of shoe worn depends on the type of tune

being danced to. For example, slip jigs are always danced in ghillies while a hornpipe requires

the hard shoe.

• Step or steps: a specific set of movements which when done together consist of a whole section

of an Irish dance; always performed in completion starting with the right foot then repeated

symmetrically starting with the left foot.

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• Feis: (pronounced “fesh”) An Irish dance, art, music, and soda bread baking competition.

Formally started by the Gaelic League in order to resuscitate the traditional arts in Ireland.

The word “céilí” translates to “social gathering.” The term is still used in Ireland and

Scotland (where it is spelled “céilidh”) to mean a social gathering as well as referring to a dance.

Historically, social dances were not always referred to as céilí dances (plurual: céilithe). They

were first called céilí dances in 1934 by a London member of the Gaelic League: Séan Ó

Ceallaigh. In fact, the Irish diaspora in England and America is largely responsible for changing

the meaning of the word from “social gathering” to more often meaning “social dance.” In

Ireland, the Public Dance Hall Act of 1935 further removed social gatherings, which often

included music and dance, from homes and pushed them into licensed dance halls, which could

have possibly further distanced the word from its original meaning.

For many young people céilí dances were, and continue to be, the social mixers and for

young people are often their first experience intimately interacting with those of the opposite sex.

At the céilithe, dancers learn more than just the dance: they learn how to ask someone to dance

(interpersonal skills), how to accept rejection (being turned down for a dance), how to maintain

space between bodies (proprioception), and how to make eye contact as the only way to not get

very dizzy in a “céilí spin” is to look your dance partner directly in the eyes. The last factor is of

utmost importance to individuals with autism as eye contact is often a learning objective in social

skills classes.

Irish Dance and Neurogenesis

In the May/June 2011 issue of Feis America, an Irish dance themed magazine, they note

that “as you learn new steps and dances you are promoting neurogenesis. When those steps

become second nature, the cognitive benefits of dancing diminish. Irish dancing can promote

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neurogenesis when you learn new skills and make rapid decisions” (Dorrity, p. 43).

Consequently, it is paramount to continue learning new steps and skills throughout one’s dance

career in order to reap the benefits of Irish dance when it comes to building new neural

pathways. Dong and Greenough (2004) cite a 1999 study by van Pragg, Christie, Sejnowski, and

Gage that

experience-induced neurogenesis in hippocampus was found to be positively correlated

with general improvements in performing tasks that tested spatial learning and memory.

Other studies have shown that physical activity increases cell proliferation, cell survival,

and net neurogenesis in the adult hippocampal dentate gyrus; improves hippocampus-

dependent spatial learning; and enhances long-term potentiation (functional synaptic

plasticity) in the dentate gyrus (p. 86).

In combining exercise in the form of dance to learn social skills, the hope is that the

neurogenesis encouraged by learning new skills with the body will also benefit the learning of

new social skills.

Developing and Integrating Social Skills with Dance

While many social skills classes currently use a method of lecture, modeling, and

integrated skill practice, there has been some movement towards teaching skills through special

interests of individuals with HFA. One school in Columbus, Ohio, is using dance to teach

students in a standard classroom social skills. “…[Y]ou’ll see fifth-graders who eagerly hold one

another’s hands, look one another in the eye and move in close in fine dance formation. You’ll

hear ‘please’ and ‘thank you’ and see every single kid standing straight and tall. Proud”

(Richards, 2013, para 2). While these students are most likely learning these skills through

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implicit learning or with minimal guidance, individuals with HFA generally need the social skills

to be more blatantly discussed.

Laban Movement Analysis

Observations regarding the manner of movement and possible meanings and metaphors

of those movement patterns would be best recorded using the language of Laban Movement

Analysis (LMA). In most everyday activities, the focus of a given movement is the outcome,

while the form with which it is executed is incidental. However, in dance, the process of motion

is oftentimes emphasized more than the outcome of a movement. Thus, when observing

movement, dancers are often much more finely attuned to subtle variations in a mover’s form

than are members of the general population. Using Laban Movement Analysis may allow

psychologists to tap into the subtleties that otherwise may have eluded them. LMA can

provide psychologists with a well established and widely accepted systematic language

for describing movement, and at the same time, allow observers to describe movement

qualitatively. (Levy, Duke, 2003, p. 44)

LMA not only allows the instructor/therapist a deeper understanding of movement but

also provides a language with which to record actual movement. The language consists of a

tremendous lexicon of characters that can be used to record not only which body part is moving

but also how it is moving.

Specific Curriculum

The class is designed for individuals who are considered to be high functioning. In this

case, high functioning is defined as having the ability to respond to verbal instruction, have

significant gross motor control, and not experience significant processing delays. Irish dance is

intense, anaerobic, high impact, and would require the participants to be cleared for intense

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exercise by a doctor. A waiver will be signed by all participants releasing the dance studio,

instructor, and any possible sponsoring agencies from any liability related to injury. The class is

designed for a minimum of six participants and a maximum of twelve. Considering the

challenges in motivation mentioned previously in this paper, good candidacy is further

characterized by an interest in learning and practicing social skills in a group setting and, most

importantly, an interest in learning Irish céilí dance. While individuals who have a broader

interest in dance may also be good candidates, individuals with a special interest in Irish or

Celtic culture will most likely be most motivated to join the class. Individuals with a sensitivity

to touch, who experience discomfort in group settings, or who experience significant (over 30

seconds) processing delays would not be good candidates for the class as it is currently designed.

The class is to be scheduled in a way such that it ends a week prior to one of the monthly

public céilí dances so as to offer the opportunity for the participants to then implement the skills

in an alternate setting and with unfamiliar people. The class is currently designed for individuals

over the age of eighteen. Exceptions can be made for individuals who meet the above criteria

who are under eighteen if they have a significant special interest in Irish dance as special

interests are generally enough of a motivator for the individual to overcome any challenges

presented by age.

Assessments and Measures

Establishing an initial baseline of social skills will be measured by administering the

Socialization Domain of the Vineland Adaptive Behavior Scales (VABS) as it is the most widely

researched adaptive behavior scale used with autism (Wells, Condillac, Perry, & Factor, 2009).

The VABS is widely used in research to establish baselines though a drawback is that it does not

typically successfully reflect changes in behavior over a short period of time. Consequently, it

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may not reflect any advances made in the six week course and, therefore, the Social Interaction

Anxiety Scale (Mattick & Clarke, 1998) will be administered both at the beginning of the course

and at the conclusion. An opportunity to evaluate the class, the instructor, and to provide

feedback will also be presented at the conclusion of the class.

The Beck Anxiety Inventory will also be given prior to the start of the class and then

again after the conclusion of the class in order to monitor general anxiety. Individuals scoring in

the moderate anxiety and severe anxiety may require cooperation with the individual’s therapist.

In that case, a release will be signed allowing the instructor to communicate any concerns back

to the therapist.

Of note, Adlerian concepts to be openly discussed with the class will be: felt minus to a

perceived plus, the courage to fail and be imperfect, and sense of community feeling.

Future Study

In doing research for this paper, the author experienced frustration in the lack of research

involving adults on the autism spectrum. There is significant need to address the challenges that

adults on the spectrum experience, and, particularly, those challenges faced by those designated

as high functioning. These individuals often receive the diagnosis late in life and have

experienced a lifetime of significant challenges and have experienced many social failures. They

may develop entire life styles based on their failures that have been exasperated by not knowing

that they were autistic.

Also of interest would be, if this class proves to be successful, if other forms of social

dance could also be used in lieu of Irish céilí dance such as English country dancing, contra

dancing, salsa dancing, and other group-based dancing.

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Appendix

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