Effect of Movement Therapy on Socialization Skills among Autism Children at selected Special School, Coimbatore

 

Kiruthika. M¹, Mrs. A. Suganthi², Dr. T. Nirmala³

¹B.Sc (N) Student, College of Nursing, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore,

²Professor, College of Nursing, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore,

³Principal, College of Nursing, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore,

 

ABSTRACT:

The study was conducted to assess the effect of movement therapy on socialization skills among autism children at selected special school, Coimbatore. The research design used for the present study was true experimental design. By using stratified random sampling technique thirty samples were selected and their socialization skills was assessed by structured questionnaire. Movement therapy was given for 5 days. Post test was done using the same questionnaire. The obtained data was analyzed using paired ‘t’ test. The mean score before and after movement therapy was 54.93 and 59.33 and the standard deviation was 1.64 with the mean difference of 4.4. The calculated ‘t’ value 52.05, was greater than the table value at 0.001 level of significance. Hence, it was concluded that movement therapy was effective in enhancing socialization skills among autism children.

 

 

 

INTRODUCTION:

Autism is one of five developmental disorders included under the umbrella of the Pervasive Developmental Disorders. Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person’s ability to communicate, and interact with others. Prevalance of Autism between 1 in 500 (2/1, 000) to 1 in 166 children (6/1, 000) have an Autism Spectrum Disorder (Center for Disease Control). Incidence extrapolations for India for Autism 11, 914 per year, 250 per month, 57 per week, 8 per day, 1.4 per hour (Rehabilitative council of India).

 

 

The issue of social impairment is complex. Even those who deal with autism spectrum disorders (ASDs) every day can find it difficult to explain these social deficits to someone unfamiliar with them. Often people are not consciously aware of their own ability to instantly process social cues, interpret people's intentions, or choose responses, let alone able to picture what it would be like to live without this ability. A child with autism at a moderate level can communicate with people in a clumsy way, or make offensive comments or just behave in a different way than other. Kids with severity in symptoms might be simply uninterested in social communications and withdraw themselves.

 

A movement therapy session includes a variety of techniques to help the person overcome the disability symptoms. While in some sessions the therapist might leave the patients on their own with the music played on and let the patient react to the stimuli (music) and perform their own movements, while other sessions might be specifically directed to teach them more goal oriented movements.

NEED FOR THE STUDY:

Autism children have difficulty in communication leads them to become highly socially isolated and encapsulated in their own private mental words. On comparison with mentally retarded children autistic children have much lower frequency of attention sharing behavior. People with Autism could have huge benefits from movement therapy. These patients often loose the awareness of their mind and body. Since, dance movement therapy focus on the mind-body approach and thus helps them in reestablishing the mind –body connection and return to harmony. A Movement Therapy session includes a variety of techniques to help the person overcome the disability symptoms.

 

Many studies and research findings have supported the positive implication of dance therapy of people with autism. A study conducted on 31 young adults with ASD to find out the effect of the therapy on body awareness, sense of well-being, social skills, empathy and self-other distinction found that the participants reported an increased sense of wellbeing, self-other distinction, empathy, social skills and body awareness. Although studies with bigger group of samples and a comparative one with a control group is yet to be conducted. However, verbatim reports from parents, family, friends and teachers have positively reinforced the fact of dance movement therapy having a huge impact on improving many of the autism symptoms.

 

While other session might be specifically directed to teach them more goaloriented movements. The techniques used are,

1.     Simple imitation of the patient`s movements.

2.     Mirroring techniques like the patient is stimulated to copy the movements.

 

Thus movement therapy is used for the improvement of socialization of autism children.

 

STATEMENT OF THE PROBLEM:

Effect of movement therapy on socialization skills among Autism children at selected special schools, Coimbatore.

 

OBJECTIVES:

1.     To assess the socialization skills of autism children.

2.     To evaluate socialization of autism children after implementation of                movement therapy.

3.     To find out the association between selected demographic variables with socialization.

 

OPERATIONAL DEFINITION:

1. Children:

Children are who diagnosed as mild and moderate type of autism belongs to 4-10 years of old have impaired socialization skills.

 

 

2. Socialization skills:

It refers to play skills, emotional skills and communication skills of autism children.

3. Movement Therapy:

It refers to selected dance movement along with music is implemented for 30 minutes.

4. Effect:

It refers to changes in the socialization skills of autism children.

 

CONCEPTUAL FRAME WORK:

Conceptual framework of this study was based on the helping theory by Weidenbach`s Precriptive Theory in 1963. The theory focuses on three concepts such as identification, ministration and validation. The prescriptive theory directs action towards an explicitgoal. The factors included in prescriptive theory are central purpose, prescription and realities.

 

LITERATURE REVIEW:

Katherine Ann Porter [2012] conducted a study Dance/movement therapy and autism. This study explores the development of the therapeutic relationship with a child with autism through dance/movement therapy. The purpose of this study is to describe how movement mirroring in dance/movement therapy affects the development of the therapeutic relationship with a child with autism, through the analysis of the ways of seeing approach. The data collected in this clinical case study consisted of video tapped sessions and laban movement analysis transcription of the session. The child participated in five dance/movement therapy sessions over five consecutive days. A relationship was created that produced growth for both the child and dance/movement therapy researcher.

 

Sarav M. Scharoun Nicole J. Reminders, Pamela. J. Bryden, Paula C. Fletcher [2014] conducted a study dance/movements therapy as an intervention for children with autism spectrum disorder. Autism spectrum disorder is one of the most common forms of developmental disabilities of childhood, rooted in atypical language and social development, in conjunction with repetitive and patterned behaviors. Creative movement and dance were given to the children. The result suggest that dance movement therapy (DMT) for children with ASD, despite providing both physical and psychological benefits for children with autism.

 

METHODS AND MATERIALS:

RESEARCH DESIGN:

The research design selected for the study was True experimental research design pre and post design with control group and was used to evaluate the effect of movement therapy on socialization among autism children.

SETTINGS:

The study was conducted at Jeyam special school, Steps rehabilitation centre, was runned by private organization located at Lakshmipuram, Ramanathapuram, Coimbatore. Both the school provide education to special children with autism, mental retardation, attention deficit hyperactive disorder. The total strength of the schools was 83 and 52 respectively.

 

POPULATION:

The targeted population for the study were autism children belonging to age group of 4 -10 years. The accessible population were children within the age group of 4-10years, studying at Jeyamspecial school and Steps rehabilitation centre located in Coimbatore.

 

CRITERIA FOR SAMPLE SELECTION:

Inclusive Criteria:

1.     Autism children age between 4 to 10 years have impaired communication.

2.     Autism children diagnosed as mild and moderate types.

 

Exclusive Criteria:

1    Children above 10 years and below 4 years.

2    Autism children diagnosed as severe type.

3    Children diagnosed as autism with mental retardation.

4    Autism children who are physically challenged.

5    Children who are not willing to participate the study.

 

VARIABLES OF THE STUDY:

The independent variable of the study was movement therapy. Dependent variable was the socialization skills among autism children.

 

TOOLS FOR DATA COLLECTION:

The following tools were used for data collection.

Section A: Demographic profile

Section B: Autism social skill profile [Scott Bellini, 2006]

 

Demographic Profile:

Demographic profile consist age, gender, class, education status of father and mother, occupation of father and mother and family income.

 

Modified Autism Social Skill Profile:

The autism social skills profile (ASSP) was developed by Scott Bellini in 2006.The autism social skills profile (ASSP) is a new assessment tool that provides a comprehensive measure of social functioning in children and adolescent with ASD. The ASSP is designed to assist with intervention planning and to provide a measure of intervention outcomes. The 49 items on the ASSP represents a broad range of social characteristics typically exhibited by individuals with ASD including initiation skills, reciprocity, perspective taking and non-verbal communication. ASSP has excellent psychometric properties with respect to internal consistency, test-retest reliability and concurrent validity. (Scott Bellini, Andrea Hopf, 2007).

 

Scoring:

0 -  Never or almost never exhibits the skill or behavior;

1 -  sometimes or occasionally exhibits the skill or behavior;

2 -  often or typically exhibits the skill or behavior;

3 -  very often exhibits the skill or behavior.

 

Interpretation:

The score were interpreted as <49 – Poor social skill; 50 -98 Average social skills; 99-147 –Good social skills.

 

METHOD OF DATA COLLECTION:

The Modified autism skill profile was used to identify the level of socialization skills. A total of 30 students were selected and thereby, using alternative method they were equally divided into 15 as experimental group and control group respectively. The experimental group was given movement therapy for half an hour daily for five consecutive days. The control group was allowed to continue their routine. At the end of a week, posttest was done to assess the level of socialization skills. The effectiveness of movement therapy was determined through comparing the pretest scores.

 

Age distribution revealed 12(80%) children were belong to 4-6 years of age, 3(20%) children were belongs to 7-9 years of age in experimental group and 7(47%) children were belong to  4-6 years of age, 3(20%) children were belongs to 7-9 years of age, 5(33%) children were belongs to 10-12 years of age in control group.

 

Among 30 samples 12(80%) children were male, 3(20%) children were female in experimental group and 11(73%) children were male, 4(27%) children were female in control group. Out of 30 samples 11(73%) children were belongs to primary, 4(27%) children were belong to secondary in experimental group and 8(53%) children were belong to primary, 7(47%) children belong to secondary in control group.

 

The educational status of fathers showedthat, among 30 autism children 5(33%) of the children`s fathers had primary school education, 3(20%) of the children`s fathers had higher secondary education and 7(47%) were graduates in experimental group and 1(7%) of the children`s fathers had primary school education, 1(7%) of the children`s fathers had higher secondary education and 13(86%) were graduates in control group.

 

 

Table no : 1  Data analysis and interpretation Demographic variables of autism children

 

Table No: 2 Level of socialization skills before and after movement therapy among autism children   (n=30)

Si. No	Level of the students	Number of respondents
		Pre test				Post test
		Experimental group		Control group		Experimental group		Control group
		Frequency	Percentage %	Frequency	Percentage %	Frequency	Percentage %	Frequency	Percentage %
1. 2. 3.	Poor Average Good	8 7 0	53 47 0	9 6 0	60 40 0	8 7 0	53 47 0	9 6 0	60 40 0

 

The educational status of mothers showed that, among 30 autism children 6(40%) of the children`s mothers had primary school education, 1(7%) of the children`s mothers had higher secondary education, 8(53%)were graduates in experimental group and 1(7%) of the children`s mothers had primary school education, 2(13%) of the children`s mothers had higher secondary education, 12(80%) were graduates in control group.

 

In regards of father’s occupational status, 5(33%) children father’s occupation were business, 1(7%) children father were doctor in experimental group and 6(40%) children father’s occupation were daily wager, 1(7%) children father were manager in control group.

 

In regards of mother`s occupational status, 14(93%) children mother’s occupation were housewife, 1(7%) children mother were manager in experimental group, 11(73%) children mother’s occupation were housewife, 1(7%) children mother were post officer in control group.

The particulars of family’s annual income is, out of 30 samples ten(67%) children`s family income less than 3, 00, 000-, two(13%) children`s family income ranged between Rs.4, 00, 000-6, 00, 000-, three (20%) children`s family income ranged between Rs.10, 00, 000-12, 00, 000-, in experimental group and twelve (80%) children`s family income ranged between Rs.0-3, 00, 000-, three(20%) children`s family income ranged between Rs.4, 00, 000-6, 00, 000- in control group.

 

The above table gives a picture on the assessment of pretest and post test socialization skills among autism children. The result shows that, during the pretest the majority of, 9(60%) children scored between 0-49 in experimental group, 8(53%) children scored between 0-49 in control group, 7(47%) children scored between 49-98 in experimental group, 6(40%) children scored between 49-98 in control group. None of them had scored between 98-147.

 

 

During the post test the majority of, 9(60%) children scored between 0-49 in experimental group, 8(53%) children scored between 0-49 in experimental group, 8(53%) children scored between 0-49 in control group, 7(47%) children scored between 49-98 in experimental group, 6(40%) children scored between 49-98 in control group. None of the respondents had scored between 98-147.

 

Table No: 3 Effect of movement therapy on socialization skills among experimental group in autism children                (n=15)

Sl. No	Test	Mean	Standard deviation	Mean difference	‘t’ value
1	Before intervention	54.93	1.64	4.4	52.05
2	After intervention	59.33

*Significant at 0.05 level

 

Paired ‘t’ test was used to analyze the effect of movement therapy on socialization skills among autism children. The pretest and posttest mean socialization skills score was 54.93 and 59.33respectively, with the mean difference of 4.4. Pretest and posttest standard deviation was 1.64 respectively. Calculated ‘t’ value 52.05. At the degree of freedom (n-1=14) the calculated ‘t’ value was greater than the table value at 0.05 level of significance. Hence, the hypothesis ‘There will be a significant difference in the socialization skills among autism children before and after implementation of the movement therapy’ was accepted.

 

LIMITATIONS:

1.     The study was restricted to small numbers of subjects and shorter period which limits generalization.

2.     Movement therapy was not administered continuously due to the school functions and holidays.

 

RECOMMENDATIONS:

1.     Nurses working in any set up can utilize this movement therapy as a method to improve children condition.

2.     Teachers and special trainers in special schools can practice movement therapy as one of the routine teaching technique to teach the additional health related information to school children.

 

NURSING IMPLICATIONS:

The pediatric nurses have a most important role in providing compassionate care to children. They have a immense accountability in promoting, preventing and managing care to children as well as the family.

 

Nursing Education:

Administration of movement therapy is an effective method of improve their socialization skills. Care takers and teachers can in addition utilize this method to improve their children’s condition at home and school. It can be conducted in community settings to endorse the school health programme in order to improve the socialization skills among autism children. As per the current study’s report, this method is giving the impression to be a useful method to improve the condition of autism children.

 

Nursing Administration:

In future, the Nurse administrator can draw written policy to employ movement therapy as one of the intervention to improve the condition of autism children. Based on the policies, the staff nurses possibly can use this movement therapy as a technique to improve the condition of hospitalized children.

 

Nursing Practice:

The nursing researchers are giving more significance for interventional studies on different aspects. The present study has tested the effect of movement therapy on socialization skills among autism children. Teachers and special school health nurses those who are all working in the special school unit, can utilize this process for improving the condition of children in all health related aspects along with other interventions.

 

CONCLUSION:

Autism is a developmental disorder affecting all races and ethnic groups. It severely impairs the child`s socialization, language and communication skills. Socialization skills are the ultimate determining factor in the child`s future success, happiness and acceptance. Since there is no cure for autism, parents seek various therapies and interventions like meditations, behavioral intervention, speech therapy, occupational therapy, diet therapy like gluten free and casein free diet, massage therapy and movement therapy that quality of life and functional independence. The researcher adopted movement therapy to improve the socialization skills among autism children. The result revealed in the present study is found with evidence that, regular movement therapy brings substantial improvement in the child`s socialization skills and behavior.

 

REFERENCES:

1.      Manders E, Polansky M (2014) Moving together: An ongoing study of dance/ movement therapy for teens and adults with autism.

2.      Koch SC, Mehl L, Sobanski E, Sieber M, Fuchs T (2015) Fixing the mirrors. A feasibility study of the effects of dance movement therapy on young adults with Autism Spectrum Disorder. Autism 19: 338-350

3.      Warren ZE, Sanders KB, Veenstra-Van der Weele J (2010) Identity crisis involving body image in a young man with autism. American Journal of Psychiatry 167: 1299-1303.

4.      Srinivasan SM, Bhat AN (2013) A review of “music and movement” therapies for children with autism: embodied interventions for multisystem development. Front. IntegrNeurosci 7: 22.

5.      Behrends A, Mueller S, Dziobek I (2012) Moving in and out of synchrony: a concept for a new intervention fostering empathy through interactional movement and dance. The Arts in Psychotherapy 39: 107–116.

6.      Sandel SL, Chaiklin S, Lohn A (Eds.) (1993) Foundations of dance/movement therapy: The life and work of Marian Chace. Columbia, MD: American Dance Therapy Association.

 

 

 

 

 

Received on 30.01.2019         Modified on 20.02.2019

Accepted on 28.03.2019       ©A&V Publications All right reserved