1

AWARENESS OF ART THERAPY IN TREATING CHILDREN WITH AUTISM SPECTRUM

DISORDER

A Research Paper presented to the faculty of Gullas college of medicine

University of Visayas- Gullas College of Medicine

Banilad, Mandaue City, Cebu

In partial Fulfilment

Of the Requirements for the Degree of

Doctor of Medicine

________________

By:
Bhatia Deepika Amit

Veeramraju Nagasrilakshmi Sivani

Pusapati Bhagya Sri

Bogadi Sai Jyothi

Karanam Sai Jyothsna

Karri Poojitha

Mohammad Arif Siddiqui

Sakarwala ,Mohammad Anas Mohammad Asif

Fenandes, Sean Roman

Baladhandayudham Ashwini

Kuruba Pavana Srija

Panthada Joshini Ramya

May 2023
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CHAPTER 1

The Problem and its Setting

Social communication and interaction, and repetitive behavior, interests, or
activities. As per the Centers for Disease Control (CDC), approximately one in 54
children in the United States has been diagnosed with an ASD in 2020 (CDC, 2020).
Although there is no universally accepted cure for ASD, various interventions such as
behavioral therapy, speech therapy, occupational therapy, and medication have been
found to be effective in treating ASD symptoms.

Art therapy is a creative and expressive intervention that is increasingly being

recognized as a valuable treatment option for children with ASD. According to the
American Art Therapy Association (AATA), art therapy is a mental health
profession that uses the creative process of art-making to improve and enhance the
physical, mental, and emotional well-being of individuals of all ages (AATA, n.d.).
Studies have shown that art therapy can help children with ASD in various domains
such as communication, social skills, emotional regulation, and sensory integration
(Malchiodi, 2013; Karterud & Hope, 2013).

According to Malchiodi (2013), children with ASD often struggle with verbal
communication and expressive language. Art therapy provides a safe and nonverbal
way for them to express themselves and communicate their thoughts and feelings.
Additionally, Karterud and Hope (2013) suggest that art therapy can help children
with ASD improve their social skills by providing opportunities for group interaction
and collaboration. Furthermore, art therapy can help children with ASD regulate their
emotions and manage sensory overload by providing a calming and therapeutic
environment for them to explore and create (Malchiodi, 2013).

In summary, art therapy is a promising treatment option for children with ASD
as it can help them improve their communication, social skills, emotional regulation,
and sensory integration. As the incidence of ASD continues to rise, it is essential for
healthcare.
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Conceptual Framework
INPUT PROCESS OUTPUT
Demographic Profile  Questionnaire Output of the research
 Data gathering is for the awareness
 Age
 Data Analysis
 Gender of the autism and
 Religion treatment like
 Nationality
 Civil status  Speech remedy
 Language
remedy
 Art remedy (As
a treatment)

Statement of the problem

This study given to determine the awareness of art therapy in treating children
with autism spectrum disorder. Specifically, it seeks to find the awareness of the
following:
1) What is the profile of the respondents following:
1.1 Age
1.2 Sex
1.3 Nationality
1.4 Religion
1.5 Marital status
2) What is the level of awareness of the respondents on art therapy?
3) How can we diagnose ASD in early stage?
4) How do Art remedy help in treating ASD children?
Significance of the study
This is the study conducted for the Awareness of Autism and Art remedy as a
treatment option among UV Students.
This study will benefit the following:
UVGCM: The affair of the study are the students of UVGCM knowing about the
Autism in children, opinion and treatment. There are numerous procedures in treating
autism like speech remedy, language remedy (PDD-NOS) and art remedy. But art
remedy is preferred in treating children as they can express their passion through art.
If any future doctor of GCM encounters children with autism they can use this way to
treat children.
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Society
This study will pave the way for the society to know further information about
autism, opinion, problems, emotional gesture and art remedy as treatment.By this
study we would guide families and teachers who are facing difficulties in raising
Autistic children.

Definition of Terms
• ASD - Autism spectrum disorder
• PDD-NOS - Pervasive developmental disorder Not Otherwise Specified.
• Autism Spectrum Disorder - Autism spectrum disorder (ASD) is a developmental
disability caused by differences in the brain.
• Autistic traits - People with ASD often have problems with social communication
and interaction, and restricted or repetitive behaviors or interests.
• Asperger's Syndrome - a form of autism spectrum disorder, is a developmental
disorder. Young people with Asperger's Syndrome have a difficult time relating to
others socially and their behavior and thinking patterns can be rigid and repetitive.
• Pervasive developmental disorders (PDD) - now known as autism spectrum
disorder (ASD), are characterized by delays in the development of social and
communication skills.
• Repetitive behavior - represents a broad range of responses that include
stereotyped motor movements, self-injurious behavior, repetitive manipulation of
objects, compulsions, rituals and routines, insistence on sameness, and circumscribed
interests
• Speech difficulties - Speech impediment, or speech disorder, happens when your
child can't speak or can't speak so people understand what they're saying
• Augmentative and alternative communication (AAC) - describes multiple ways
to communicate that can supplement or compensate (either temporarily or
permanently) for the impairment and disability patterns of individuals with severe
expressive communication disorders.
• Cognitive issue's - Cognitive impairment is when a person has trouble
remembering, learning new things, concentrating, or making decisions that affect
their everyday life.
• Federal approval - FDA approval of a drug means that data on the drug's effects
have been reviewed by CDER, and the drug is determined to provide benefits that
outweigh its known and potential risks for the intended population.
• Etiology - the investigation or attribution of the cause or reason for something,
often expressed in terms of historical or mythical explanation.
• Fatigue - extreme tiredness resulting from mental or physical exertion or illness.
• Seizures - extreme tiredness resulting from mental or physical exertion or illness.
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Review of the Related Literature

Diagnosis
Autism diagnosis
(Auto means “self”) Autism Isolate from social.
For autism diagnosis, there are no blood test, urine test help to diagnoses this
sign Autism is related to neurological disorders. (APA 4th ed.) Prior to 2013, the
"Diagnostic & statistical Manual for mental Disorders, fourth edition" described autism
as widespread developmental disorder that included Asperger Syndrome, childhood
disintegrative disorders and pervasive developmental disorder.
Due to Asperger syndrome's language and cognitive issues. It is also known as
high functioning form of autism. Solely social contact and nonverbal communication
often manifest late. Loss of acquired social and communicative skills (2- to 10-year-
old) is symptom of pervasive developmental disorder.
Following 2013, ASD will be recovered by childhood Disintegrative Disorder,
PDD-NOS & Asperger Syndrome in the "Diagnostic & Statistical Manual for mental
Disorders, 5th Ed revision. (APA 5th ed.)
The two components of autism are measured using this term of spectrum is social
connection & communication and limited and repetitive.
Social connection and communication: - child social reactions, desire to
something, communication that is nonverbal & difficulties in the relationship.
Limited and repetitive: - uncontrolled body movement, child cannot listen when
someone calling, flapping hand.
Diagnosis of autism is not based on etiology it’s based on the Observation of
behavior like: - [Testing data, school data, observational behavior, lack of eye
contact, not interacting with toys, no interaction with other child (prefer to be alone),
repetitive behavior (such as walking spinning, etc.) Cannot tolerate smell of food,
textures & color, Not responding, High sensitivity to thermal and family history.].
Autism is common in U k. A new study research 100 in 10000 around world
diagnosed with ASD according to recently study autism. Revealing 134 autism linked
genes. According to new articles we can diagnose Autism before symptom show the
test which is still within early Autism is common in U K. A new study research 100 in
10000 around world diagnosed with ASD according to recently study autism.
Revealing 134 autism linked genes.
According to new articles we can diagnose Autism before symptom show the
test which is still within early stage of Improvement by the startup Linus bio and way
from federal approval may be demonstrative help implied to help clinicians in
disguising extreme introverted Ness (Autism) but not to be depended on alone.
Problem faced by Autistic children
ASD can be diagnosed in children when they are 2 or 3, or sometimes within
first 6-12 months. Young children with ASD have developmental issues between 12
and 24 months, mostly in language and responsiveness. They may not able to answer
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their name or recognize the objects that others point out. ASD children may also have
the following problems.
They avoid others.
• They don’t show any facial expressions.
They can't understand or recognize others feelings.
• Difficulty in expressing their feelings They are Sensitive to sounds, smell and taste.
• Repeat the actions and words many times.
• Gets upset with minor things
• Have obsessive interests. They follow certain daily routine.
• Face problem during social interaction in schools which causes stress, anxiety and
social isolation
Family members and care takers of autism spectrum experience their own
problems. Raising an ASD child is challenging and others may feel restless, have
trouble eating, or speaking, experience frustration, meltdowns and seizures. It takes
time and patience to understand the behavior of ASD children as they repeatedly do
many things such as watching the same video many times, jumping endlessly which
may lead families to fatigue and frustration. Families Start to accept their child and
begin to educate themselves according to child's behavior and also educate others.
Teachers may also face difficulty in understanding the children unique way of learning
and remembering things.
ART THERAPY allows children with ASD to use their gifted visual mind to
communicate through artistic way. Autistic children can record and memorize visual
data, images, events and express Memories and ideas that are unable to speak
verbally. Autistic children are born with high mathematical or artistic skills. Parents
and teachers understanding them and guiding them can help the children leading a
better life.

Sample
REPORT-1 VALLABH
The first thing I have observed VALLABH during our time is that he showed
definite signs of autism which can be scored as problematic on the ADOS (Autism
Diagnostic Observation Schedule). His mother also clearly stated or described about
his behavior that suggests autism. After spending some time with Vallabh’s mother
and Vallabh , the mother endorsed more than enough signs for diagnosis.
Consultation report of the department of behavioral medicine.
Reason for consultation:
When the Vallabh was at the age of 1 year 2 months his parents consulted an
occupational therapist due to Vallabh’s oral tactile defensiveness. After 3 months his
social and language skills were reported and declined. Vallabh started banging his
head against wall on regular basis and he currently has an expressive vocabulary of
40-60 words.
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Consultation History:
Vallabh was being seen by occupational therapist to assist with his language and
social skills. His mother noticed that whenever he gets mad (or) when he does not
get what he wants He starts banging his head against the wall.
On April 2019 Vallabh was evaluated by a special team near locality and that
evaluation found Vallabh to be displaying autistic – like behavior. Such as
“inappropriate social interactions other than his immediate family and self-stimulating
ritualistic behavior”. He even has 20-50% delay in areas of communication, social and
emotional development.
Vallabh was also taking speech therapy twice a week and his vocabulary has
also started improving. The speech therapist also made recommend the it was
better if he was seen by a child psychologist (or) development pediatrician.
Prenatal and perinatal history:
Vallabh was born after full term, followed by an emergency Cesarean section.
The mother was in labor for about 16-18 hours. Vallabh was born with umbilical cord
wrapped around his neck twice.it was also reported that his heart rate was dropped,
and he required some therapy and was born mildly jaundice.
Medica history:
Vallabh was a healthy boy who does not have a history of major problems (or)
illness except if few ear infections and had the hearing problem.
Developmental history:
Vallabh rolled over ‘lately’ and sat on his own at the age of eight month, and
walked out at the age of 1year 2 months and for the first time he said 'mama’ and he
started naming object at about 3 years. He usually points at the objects he wants
(or) He also takes his mother hand and puts on the object that he wants and he was
also potty trained by his mother.
Behavioral Observations:
During our time together with Vallabh had his mother that is about 2hours He
would not interact with any of the adults in the room even after multiple attempts. He
even banged His head against wall with full force and He didn’t play with any toys in
the room such as crayons, cars, blocks etc. Instead, He would pick a phone and held
it near his ear, and then drop it and He would again pick it up and drop it.Towards the
end of our time together Vallabh turned over the strolled and spin the wheels.
Assessment finding and impression:
He showed several signs of autism and displayed difficulties in cell areas
namely social interaction communication. And Stereotyped behaviors and interests.
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Chapter 2
Methodology
This chapter provides information regarding the research design, research
respondents, research locale, research instruments, ethical considerations, data
gathering procedures and statistical treatment.
Research Design
This study will use the correlation method of research. In consideration of the
general purpose of the study which is to determine AWARENESS OF ART THERAPY IN
TREATING CHILDREN WITH AUTISM SPECTRUM DISORDER AMONG MEDICAL
STUDENTS
Research Respondents
Respondents of the study will consist of 50 students of 3RD YEAR level of U V
Gullas College of Medicine.
Research Locale
The study will be answered by 50 students of 3rd year level of U V Gullas College
of Medicine through online google form. The main campus is located in Banilad, Cebu
City.
Research Instrument
This research instrument has been designed by the researchers to assess the
level of awareness of the art therapy in treating children with autism spectrum
disorder among medical students of UV Gullas College of Medicine. The purpose of
this study is to determine the effectiveness of educational interventions that can
improve the awareness of art therapy as a treatment option for children with autism
spectrum disorder. It will be drafted though the use of google form and consist of the
following: The first is the demographic information of the respondents. The second
part is a questionnaire of awareness level of art therapy which has only one section.
The last part is to measure the level of awareness the respondents will have, all the
questionnaire will consist of structured, close-ended questions making it simple and
quick to answer. The research instruments will be validated through Criterion validity.

Measuring parameters
S.no Parameters Verbal information Qualitative data
1. 4.20 – 5.00 Strongly agree Very much aware
2. 3.40 – 4.20 Agree Quiet aware
3. 2.60 – 3.40 Neutral Likely aware
4. 1.80 – 2.60 Disagree Aware
5. 1.00 – 1.80 Strongly disagree Not aware
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Data Gathering:
Our research data gathering instruments that we take from 3rd Year MD
students from UV Gullas college of medicine in Philippines. We designed a
questionnaire for the researcher based on our expertise. The researcher chooses this
approach to data collection because it is well recognized to be the least expensive.
The researcher describes the purpose of their research and each respondent is
assured of confidentiality, privacy and anonymity. The tool will be distributed to
respondents and they will be given sufficient time to answer all the questions. The
researcher is distributing the data in the form of questionnaires. The researcher
interpreted and analyzed the data after receiving the respondents' responses, and the
results were then documented.

Ethical Considerations
Data protection and privacy are very important ethical consideration, as the
survey may collect personal information from the respondent. Researcher are
bounded to ensure that appropriate measures are in place to protect the
confidentiality of the respondent’s responses and to comply with relevant data
protection legislation.
Researcher is considering the potential biases of the survey questions, and the
potential implications of the survey results for art therapy practice and policy.
Researchers are ensuring that survey is unbiased, and focused on the relevant issues,
and to interpret the results in a fair and evidence-based manner. Researcher are
ensuring that the results are communicated in a way that is accessible to the relevant
stakeholders, such as art therapists, educators, and policymakers, and that any
implications for practice or policy are based on sound research evidence and ethical
considerations.
The key of ethical consideration is obtaining informed consent from the
respondents participating in the survey. Respondents should be fully informed about
the nature and purpose of the survey, how the information will be used, and what
their participation entails. It is also important to ensure that their participation is
voluntary and anonymous or confidential, as appropriate depending on the nature of
the survey.
Art therapy is a sensitive and personal topic, and the survey questions are
designed and administered in a way that minimizes harm or distress to the
respondents.

REFERANCES:
"Ilg, J., Clément, C., Hauth-Charlier, S. (2012). Evaluation questionnaire for
knowledge about Autism Spectrum Disorder. Unpublished manuscript, Interuniversity
Laboratory of Education and Communication Sciences, University of Strasbourg."
Diagnostic and statistical manual of mental disorder, 4th edition. (DSM-IV), by the
American Psychiatric Association Washington, D.C., APA, 1994,
873pp.,S54.95;S42.95(paper).
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American Psychiatric Association (2022). Diagnostic and statistical Manual of Mental

Disorder (5th Ed., text rev.).
Grandin, T. (2006). Thinking in pictures: My life with autism (Exp. ed.). New York:
Vintage Books. (Pg. 47.)
Volkmar, F., & Klin, A. (2005). Issues in the classification of autism and related
conditions. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive
Developmental Disorders (pp.5-41). Hoboken, NJ:John Wiley & Sons.
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217-
250.
American Art Therapy Association. (n.d.). About Art Therapy.
https://arttherapy.org/about-art-therapy/
Centers for Disease Control and Prevention. (2020). Data and Statistics on Autism
Spectrum Disorder. https://www.cdc.gov/ncbddd/autism/data.html
Karterud, H. N., & Hope, K. W. (2013). An overview of art therapy interventions for
children with autism. Art Therapy, 30(2), 62–68.
https://doi.org/10.1080/07421656.2013.774059
Malchiodi, C. A. (2013). Art therapy and autism: Overview and practical
considerations. In C. A. Malchiodi & D. Crenshaw (Eds.), Creative arts and play
therapy for attachment problems (pp. 225–251). Guilford Press.
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Research Instruments
Please fill out all necessary information in this survey form. We, the
researchers, guarantee your anonymity and we put your privacy into a paramount
degree. We adhere to the ethical standards of doing research and rest assure that
your responses will always remain confidential.
Demographic Information:

1. Age: ______ years

2. Gender: Male/Female
3. Any prior training or education in art therapy: Yes/No
4. Nationality: _______
5. Religion: ____________
6. Marital status: ___________
Awareness level of art therapy:
This Questionnaire is adapted from Development and Validation of a Survey of
knowledge of autism spectrum disorder by Laura Katherine Hansen.
s.n QUESTIONS STONGLY DISAGREE NEUTRAL AGREE STRONGLY
o
DISAGREE AGREE
1. ASD/autism is
contagious.
2. Is an early
diagnosis for ASD
important?
3. ASD/autism is
nearly five times as
likely to occur in
boys as girls.
4. Individuals with
Autism Spectrum
Disorder (ASD)
may experience
challenges in
navigating and
communicating in
social situations.
4. An ASD/autism
diagnosis is often
based on parental
interviews and
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observations of
behavior.
5. Individuals with
Autism Spectrum
Disorder (ASD)
may experience
changes and
challenges as they
progress through
different stages of
their lives.
6. Children with older
parents have a
higher risk of
developing
ASD/autism.
7. With support,
therapy, and
medication,
ASD/autism can be
cured.
8. After being
diagnosed,
ASD/autism
symptoms remain
stable throughout
the individual's life.
9. All individuals with
ASD/autism have
lower than average
IQs.
10. An early symptom
of ASD/autism is a
failure to attend to
facial expressions,
gestures, and
speech.
11. Children with
ASD/autism have
patterns of play
that are similar to
their typically –
developing peers.
12. Individuals with
ASD/autism often
engage in
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restrictive,
repetitive behaviors
(e.g., lining up
cars, strictly
adhering to
schedules).
13. Individuals with
ASD/autism have
difficulty interacting
socially.

14. Individuals with

ASD/autism rarely
form intimate
relationships, even
with their parents.

15. ASD/autism can be

fatal over time.