DMT- Autism and Dance

A research paper by Angela Lowry completed April 2022- BFA candidate in dance at Oakland University

In this paper I will be exploring nonverbal communication and advantages to using dance as therapy with peoples afflicted with ASD. 1 in 34 boys are afflicted with ASD and 1 in 145 girls born are afflicted. (Shaw et al., webpage) According to Erdman it is now reported that 10-15% of all births are associated with disorders of neurobehavioral development, where 1 in 68 children in the United States is diagnosed with some form of an autism spectrum disorder (ASD).

Autism spectrum disorder is classified as a mental disorder. Affecting communication and interaction with other people. They have restricted interests and repetitive behaviors along with symptoms that affect their ability to function in school, work, and other aspects of daily life. According to the National Institute of Mental Health “Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first two years of life.”

Anyone can be affected by ASD no matter ethnic background or race. (Mayo Clinic, N.D)

What is nonverbal communication? Nonverbal communication can and is usually defined as the aspect of communication that is not expressed in plain words. Under the assumptions that ‘one cannot communicate’ (Watzlawick et al., 1967, p. 51) and that all movements are to some degree expressive. Showing us how all nonverbal gestures are gathered under this word “nonverbal”.

What constitutes ASD? As stated in the title of the disorder it is a “spectrum” disorder with many falling on the scale at different intervals. According to the CDC “autism spectrum can range from gifted to severely challenged”. According to The Journal of autism and developmental disorders “Early communication impairment is among the most-reported first concerns in parents of young children with autism spectrum disorder (ASD)”

why does it matter to us? – sensory perception to autistic persons is different than sensory perception to “normal” people. (Itoi, C., Kato, N. & Kashino, M., 2019)

ASD and dance movement therapy is particularly used with the children and parents of those afflicted with ASD can be helped through dance. Dance can be conceptualized as human behavior composed of purposeful, intentionally rhythmical, and culturally influenced sequences of nonverbal body movements and stillness in time and space and with effort. Symbolization, another key concept as integral to dance as to verbal language, is a fundamental cognitive activity that people use on an ongoing basis. People may be prewired to recognize or create metaphoric associations across disparate sensory, perceptual, enactive, and affective domains of experience (Seitz, 2005)

Dance Movement Therapy sessions are focused on movement and behavior as it comes forward through the guided session. Through this exposure, a therapist will use movement to help a client achieve emotional, cognitive, physical and social integration. The benefits include stress reduction and mood management. This information comes from The American Dance Therapy Association website. Professional dancers and trained therapists can become certified in Dance Movement Therapy and be able to treat and conduct classes on patients with ASD. Another study shows how only using mirroring in DMT is not sufficient to promote growth or promote synonymity in movement past the class held. (Manders et al., 2021) They also studied interactions with a partner and beyond the movements requested interactions did not improve. The study concludes more testing and research is needed.

There are three main types of treatments for ASD and involving DMT. The first being a group setting. The second being an individual session and the third is a parent child dyad. Factors that determine types of therapy are mainly cost and opportunities. Depending on socioeconomic status some children receive little to no intervention for their disorders. Those who are treated do tend to have positive responses to treatment and socialization is improved through continuous sessions. (Chiang et al., 2016)

History points to dance as captivating nonverbal communication. Evolutionary biologists note that human beings need to attend to motion as a tool for survival—to distinguish prey and predator and to select a mate. Human beings have to anticipate others’ actions and respond accordingly. Perceptual and motor systems play major roles in survival. The body gives clues. It “talks” and people “listen.” Human beings first learn through movement, and movement facilitates learning. Sensory–motor activities form new neural pathways and synaptic connections throughout life, and the merger of body, emotion, and cognition leads to effective communication. (Hanna. 2008. p 494)

Interrelation between dance and expression is inherent in humans as a species. Before written word there was movement and gesture for language. A feature of ASD includes limited verbal communication abilities. Dance used as therapy in many ways can promote ones ability to communicate, mirror movement and express emotion in more advanced ways. Tantam shows us in his book Can the World Afford Autistic Spectrum Disorder? How important non-verbal communication ins to the human race through body posture, gaze and expression, proxemics (body position and touch) humans communicate in many ways that we otherwise would not appreciate if we only considered words and pictures as valid forms of communication.

Dance Movement Therapy is growing as a field and as a quality-of-life enhancer for many types of afflictions. In a controlled study preformed on ASD patients 12 Years old the findings were quite positive and hopeful for the future of the field as a whole. Functional independence changes were observed in relation to self-care, sphincter control, locomotion, and communication domains. Children's "quality of life" reports by parents showed changes in functional capacity, vitality, mental health, physical and social aspects, and general state of health domains. These findings suggest that regular dance practice can underlie psychosocial adjustments in children with DS and ASD. Parents are key in the functionality and success of treatments (Adorno et al., 2021 web)

The state of the field is on the upswing with more children being diagnosed with ASD than ever before. The use of DMT for ASD has been researched since the 1970’s. Today overall studies of the treatments from 1970- 2018 have shown “that imitation (mirroring) interventions helped individuals with ASD improve their social skills.” (Takahashi et al., 2019) Currently, Most dance and movement therapists used music that had a 4⁄4 time signature (64 %), was

moderato tempo (45 %), and had lyrics (76 %). Qualitative findings validated why these were the most common features of music and rhythm. These musical elements could regularly be integrated into new music and rhythm-based interventions targeting communications skills and social development for children with autism to improve their therapeutic potential. (Morris et al.,

2021) Another study goes on to show encouraging results and coincides with the benefits of dance movement therapy described in some case studies, for example, the increase of empathy and self-awareness in children with ASD. This study adds new insight to the limited quantitative evidence and research on DMT for young adults with ASD and demonstrates the far-ranging effects of DMT. Additionally the authors of the paper go on to say that unfortunately, this study, as in many other studies working with longitudinal designs with clinical samples, there was a comparably high drop-out rate that led to two critical problems. First, a large amount of missing data needed to be accounted for. Although we carefully considered all possible methodic approaches and abided by statistical rules to avoid biased results, a great portion of valuable information was unavailable. This lead to the second problem: Due to the missing data, we could not comply with the required sample size of 90 participants to detect a medium to large effect with a power of 0.8 computed prior to the study. Taking the effect size found in this trial (generalized η2 = 0.009) as a basis, the required sample size to detect it would be even higher. (Hildebrant, et al., 2016 p 4,11) This means additional studies are required to solidify findings from the study and quantify them on a large scale.

Integrating music and other artistic forms of expression into dance movement therapy sessions may be the future of the field. Integrating further avenues for exploration non-verbally and promoting social interaction in those afflicted with ASD will and continue to be the goal of the field. Dance as therapy is a growing and emerging field and additional research is required to determine the actual reliable results of dedicated DMT therapy with ASD afflicted individuals. I hope to affect the field personally in the future with research and dedicated hands on study of ASD afflicted patients using DMT as therapy in nonverbal communication and increasing social and cognitive benefits in those we treat.

Bibliography

Tantam, D. (2009) Can the world afford autistic spectrum disorder? : nonverbal communication, Asperger syndrome and the interbrain. London ;: Jessica Kingsley Publishers

Adorno, Dos Santos, D. C. de J., DeJesus, B. M., Passos, A. A., & Teixeira-Machado, L. (2021). Dance, functioning and quality of life in children with Down syndrome and autism spectrum disorder dance, functioning and quality of life in Down syndrome and autism spectrum disorder. Clinical Child Psychology and Psychiatry, 13591045211061795–13591045211061795. https://doi.org/10.1177/13591045211061795

Manders, E. et al. (2021) The Mirroring Dance: Synchrony and Interaction Quality of Five Adolescents and Adults on the Autism Spectrum in Dance/Movement Therapy. Frontiers in psychology. [Online] 12717389–717389.

Hildebrandt, M. K. et al. (2016) ‘We Dance and Find Each Other’1: Effects of Dance/Movement Therapy on Negative Symptoms in Autism Spectrum Disorder. Behavioral sciences. [Online] 6 (4), 24.

Morris, P. O. et al. (2021) Dance, rhythm, and autism spectrum disorder: An explorative study. The Arts in psychotherapy. [Online] 73101755.

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Itoi, C., Kato, N. & Kashino, M. People with autism perceive drastic illusory changes for repeated verbal stimuli. Sci Rep 9, 15866 (2019). https://doi.org/10.1038/s41598-019-52329-9

Shaw KA, Maenner MJ, Bakian AV, et al. Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ 2021;70(No. SS-10):1–14. DOI: http://dx.doi.org/10.15585/mmwr.ss7010a1external icon.

Chiang, C.-H., Chu, C.-L., and Lee, T.-C. (2016). Efficacy of caregiver-mediated joint engagement intervention for young children with autism spectrum disorders. Autism 20, 172–182. doi: 10.1177/1362361315575725

Takahashi, H. et al. (2019) The Effectiveness of Dance/Movement Therapy Interventions for Autism Spectrum Disorder: A Systematic Review. American journal of dance therapy. [Online] 41 (1), 55–74.

Mayo Clinic, Autism spectrum disorder, https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928

Seitz, J.A. (2005) The neural, evolutionary, developmental, and bodily basis of metaphor. New Ideas in Psychology 20052327495

Hanna, Judith Lynne. “A Nonverbal Language for Imagining and Learning: Dance Education in K-12 Curriculum.” Educational researcher 37.8 (2008): 491–506. Web.