Family-centred dance movement psychotherapy with children with autism : a qualitative, arts-based study

Abstract

Autism refers to a neurodevelopmental condition characterised by 1) persistent atypicalities in social communication and interaction, and 2) restricted and repetitive behaviours or interests. Family-centred practices and Dance Movement Psychotherapy (DMP) have each been found to be beneficial for children with autism. The evidence base for family-centred practices combined with creative arts therapies has also grown in recent decades. However, at the outset of this PhD, there were no publications on Family-centred DMP (FDMP) in autism, highlighting a research gap. The objective of this thesis was to develop and investigate neurodiversity-affirming Family-centred Dance Movement Psychotherapy (FDMP) for children with autism. To begin development of FDMP, a literature review and configurative systematic review were conducted. Later, as this PhD took place during the lockdowns of the COVID-19 pandemic, telehealth interventions became necessary. A pre-pilot study was conducted, informing the pilot study, which revealed the benefits and challenges of Family-centred Tele-DMP. These studies laid the foundation for the main study, FDMP in person. Following ethical approval, 14 families with children with autism were recruited from a school in West London, and 7 families completed the programme. All the children had mild, moderate, or severe learning disabilities, and were non-verbal or limited verbally. The parents took part in interviews pre-therapy, involving the ‘Two Hands’ movement-based assessment to develop the verbal account. Then, participants took part in weekly FDMP for six weeks, in groups. With permission, sessions were video recorded. Post-therapy, both the children and parents were interviewed. For the children, this involved using a Structured, Child-Friendly Interview (SCFI). For the adults, focus groups were held according to their therapy groups. The various forms of data collected were analysed to answer the research questions of the main study, pertaining to feasibility and impact. This entailed using simple calculations to obtain distribution of data; textual analyses using Interpretative Phenomenological Analysis (IPA) and Multimodal, Longitudinal IPA (MLIPA); and movement analyses using the Parent Child Movement Scale (PCMS), supplemented with Laban Movement Analyses (LMA). Lastly, it involved integration of textual and movement analyses, resulting in the ABCD model, created for this study to better understand the mechanisms of change in FDMP. Four themes emerged. The first two themes, capturing the participants’ experiences, emerged from IPA: “Moving allows the child to engage” and “Parents find strength from being understood”. The next two themes, capturing the changes in participants following therapy, emerged from the integrative analysis: “Child development”, and “Parent development”. The children progressed in social communication and interaction, and restricted and repetitive behaviours. The parents gained acceptance of autism and autistic traits. Through the ABCD model, relevant changes in parent-child movement parameters and therapeutic factors were identified for each of these areas of progress. Bearing in mind limitations, the outcomes demonstrated promising evidence of feasibility and impact, supporting the use of neurodiversity-affirming FDMP for children with autism. Further studies will improve the generalisability of these findings; refine the understanding of the mechanisms of change; and strengthen the validity and reliability of the novel methods created for this study. (500 words)