Individuals with developmental disabilities may be at a greater risk for being maltreated as compared to their typical peers (Hibbard and Desch 2007; Kerns et al. 2015). Berg et al stated that common characteristics of autistic children, youth, and adults are that they can be socially naive and inappropriate, which may make them more prone to victimization (Berg et al. 2016; Hoover 2015; Kerns et al. 2015, 2017).
I wondered about this and thought about my own experiences as an autistic child/teenager and can relate to an extent. I also personally believe that like me many autistic people use the fawning coping mechanism in response to the repeated trauma in attempting to navigate friendships and social groups, ‘if they are my friend, they won’t be mean to me”. Whilst at times this did indeed help there were also times that it left me open to victimization as a ‘people pleaser’, something many autistic people may relate to. I have seen this form of victimisation called 'mate crime', an example of this can be found here https://www.demographicauk.com/post/mate-crime
Trauma can reduce an individual’s ability to trust and relate (Perlman and Courtois, 2005). The impact on this with client work is that it may take longer to gain trust and build a relationship with an autistic person. The first step to a trauma informed practice is to establish a therapeutic relationship to facilitate relational and internal safety (Herman 1997). Trauma informed practice puts the therapeutic relationship as the means to which recovery is promoted (Butler et al., 2011; Elliott et al., 2005).
Art therapy has the potential to address these complex issues due to its multisensory nature and relational approach (Hass-Cohen & Findlay, 2015). I feel it is not significantly recognized due to a lack of quantitative research, which is considered the benchmark for evidence-based practice (Van Lith, Stallings, & Harris, 2017). As an autistic adult and the parent of autistic children I understand how behavioural approaches and early intervention can appear like a lifeline however I am exploring the relational gap that Art Therapy can offer.
The early attachment relationship with a primary caregiver is how human infants, born completely helpless, learn about themselves and their environment through interaction with others (Bowlby, 1973). Developmental delays and social and emotional differences can negatively affect the attachment pattern of an autistic child compared to his or her neurotypical peers (Sivaratnam, Newman, Tonge, & Rinehart, 2015). Later relationships in life can replace earlier patterns (Siegel, 2003). So, an attachment between the art therapist and an autistic child can have positive implications (Martin, 2009).
Art therapy has a unique potential to disrupt hierarchical social structures, particularly through the nature of the physical relationship between artist or client and materials (Fabre-Lewin, 1997). Sensory regulation is often less stressful for the autistic client in art therapy because the art provides a product to focus on beyond the process of integrating uncomfortable sensory experiences (Martin, 2019). As a profession, art therapy predominantly serves marginalized people (Talwar, 2010).
References
Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation. New York, NY: Basic Books.
Berg, K. L., Shiu, C., Acharya, K., Stolbach, B., & Msall, M. (2016). Disparities in adversity among children with autism spectrum disorder: A population-based study. Developmental Medicine & Child Neurology, 58, 1124–1131.
Butler, L. D., Critelli, F. M., & Rinfrette, E. (2011). Trauma-informed care and mental health. Directions in Psychiatry, 31, 197–210.
Elliott, D. E., Bjelajac, P., Fallot, R. D., Markoff, L. S., & Reed, B. G. (2005). Trauma-informed or trauma-denied: Principles and implementation of trauma-informed services for women. Journal of Community Psychology, 33, 461–477.
Fabre-Lewin, M. (1997). Liberation and the art of embodiment. In S. Hogan (Ed.), Feminist approaches to art therapy (pp. 115– 124). London, UK: Jessica Kingsley.
Hass-Cohen, N., & Findlay, J. C. (2015). Art therapy and the neuroscience of relationships, creativity, and resiliency. New York, NY: W. W. Norton & Company.
Herman, J. (1997). Trauma and recovery. New York, NY: Basic Books.
Hoover, D. W. (2015). The effects of psychological trauma on children with autism spectrum disorders: A research review. Review Journal of Autism and Developmental Disorders, 2, 287–299.
Hibbard, R., & Desch, L. (2007). Maltreatment of children with disabilities. Pediatrics, 119(5), 1018–1025.
Kerns, C., Newschaffer, C., & Berkowitz, S. (2015). Traumatic childhood events and autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(11), 3475–3486.
Kerns, C., Newschaffer, C., Berkowitz, S., & Lee, B. K. (2017). Brief report: Examining the association of autism and adverse childhood experiences in the national survey of children’s health: The important role of income and co-occuring mental health conditions. Journal of Autism and Developmental Disorders, 47, 2275–2281.
Martin, N. (2009). Art as an early intervention tool for children with autism. London, United Kingdom: Jessica Kingsley.
Martin N (2009) ‘Art therapy and autism: overview and recommendations’, Art Therapy: Journal of the American Art Therapy Association, 26(4), pp. 187–190. Available at: http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105287130&site=eds-live
Pearlman, L. A., & Courtois, C. A. (2005). Clinical applications of the attachment framework: Relational treatment of complex trauma. Journal of Traumatic Stress, 18, 449–459.
Siegel, D. J. (2003). An interpersonal neurobiology of psychotherapy: The developing mind and the resolution of trauma. In D. J. Siegel & M. F. Solomon (Eds.), Healing attachment, trauma, mind, body, and brain, (pp. 1–56). New York, NY: W.W. Norton.
Sivaratnam, C. S., Newman, L. K., Tonge, B. J., & Rinehart, N. J. (2015). Attachment and emotion processing in children with autism spectrum disorders: Neurological, neuroendocrine, and neurocognitive considerations. Review Journal of Autism and Developmental Disorders, 2(2), 222–242.
Talwar, S. (2010). An intersectional framework for race, class, gender, and sexuality in art therapy. Art Therapy: Journal of the American Art Therapy Association, 27(1), 11–17.
Van Lith, T., Stallings, J. W., & Harris, C. E. (2017). Discovering good practice for art therapy with children who have autism spectrum disorder: The results of a small-scale survey. The Arts in Psychotherapy, 54, 78–84.