(ASD)Grant for further research, Hillman Healthy Aging, Pittsburgh, PA
This article is based on my recently awarded grant for continued research on somatic-based movements in ASD individuals together with IGIA for Health.
Children diagnosed with autism spectrum disorder (ASD) exhibit neurodevelopmental challenges affecting various aspects of their development and interactions. These issues continue into adulthood and additional social stigmas make coping difficult.
Symptoms of ASD include deficits in verbal and non-verbal communication, struggle to adapt socially, and difficulties in peer relationships. ASD diagnosis typically occurs around age four, with a higher prevalence among males[1].
Movement abnormalities commonly manifest in early childhood, affecting locomotion, motor skills, and eye movements. Individuals with ASD engage in repetitive activities and may exhibit intense reactions when disrupted.
Motor challenges affect object manipulation of the hands, for example, ball or tool handling, and locomotion skills. Individuals with ASD often stabilize their walking by reducing their stride length, widening their step width, and expanding their base of support. They also spend more time in the stance phase[2].
Recent studies confirm that individuals with ASD exhibit distinct movement patterns characterized by increased jerk, acceleration, and velocity compared to typical individuals. This suggests that typical individuals may encounter challenges interpreting the actions of those with autism, just as individuals with autism struggle to interpret and predict typical movements.[3]
Eastern and Western Movement Therapy
Early movement interventions enhance fine motor skills, benefiting locomotion and object-handling abilities. However, continued individual movement therapies for ASD adults offer personalized support for overall treatment effectiveness[4].
Movement therapy encompasses a variety of Eastern and Western mindful practices that simultaneously address the mind, body, and spirit. These practices, rooted in ancient history, have been an integral component of human culture for millennia.
Research shows that forms of movement therapy, like dance, date back approximately 6 million years to our common ancestor with chimpanzees[5]. Therapies that involve physical activity help people with autism improve their physical and mental health, think better, and process sensory information by motivating them to take care of themselves.
Recent research has focused on exploring novel interventions like rhythm and robotic therapies in dance to enhance communication skills in autism[6]. Unlike conventional therapies, these unique strategies leverage children’s inherent strengths and preferences, making sessions enjoyable and motivating. Non-verbal ASD individuals can communicate more effectively through dance.
Integrating movement therapies such as dance with conventional medicine enables physicians to offer comprehensive, patient-centered care. This holistic approach, aligned with physical medicine and rehabilitation principles, aims to optimize patient outcomes and enhance quality of life by addressing the whole person, not just the illness.
Combining modern medicine with mind-body practices aligns with the World Health Organization’s definition of health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”[7].
Emotional Stress in ASD and Mind-Body Integration
Mind-body therapies actively engage psychological and physiological processes, contributing to the thriving field of psychoneuroimmunology in recent decades. Studies show that psychosocial stress triggers inflammation-related gene transcription and compromises leukocyte function[8].
Emotional stress in ASD individuals is higher than those without the disorder. A study revealed that individuals with ASD report significantly higher levels of emotional stress compared to controls in 31 studies[9]. However, a minority of studies in adults found similar cortisol stress responses and rhythms in both groups, reinforcing the benefits of movement therapies for everyone.
Similarly, focused studies suggest that meditation and deep-breathing practices, integral to movement therapies, modulate gene expression to shield against cell damage caused by chronic stress[10]. Clinically, yoga practitioners exhibit significantly lower rates of depression compared to those solely focusing on physical poses, emphasizing the importance of meditation and breathing techniques[11].
Diverse patient populations embrace movement-based therapies, and many new movement startups focus on adult ASD. International guidelines across various medical specialties endorse these non-pharmacologic integrative approaches.
For example, the American College of Physicians (ACP) strongly recommends exercises, multidisciplinary rehabilitation, mindfulness-based stress reduction, and other therapies as initial treatments for chronic low back pain[12].
Similarly, the United Kingdom National Guidelines advocate for Feldenkrais, yoga, tai chi, and Pilates as exercise therapies. As movement therapies for ASD gain mainstream recognition, some health insurance plans acknowledge their cost-effectiveness and engage in subsidizing them as part of preventive care.
Global Research in Dance and Movement Therapies
Global research highlights the efficacy of music rehabilitation training therapy (MT) and dance movement rehabilitation training therapy (DMT) in helping individuals with ASD. Furthermore, targeted research indicates DMT's potential to enhance multiple health areas for people with ASD.[13]
DMT actively improves physical and mental behavioral symptoms in children with ASD, addressing movement-related deficiencies to embellish healthy behaviors[14]. Today, movement therapies are becoming more innovative because of the past work of so many pioneers in the field.
Bethkalish Weiss, an American therapist, pioneered research into the psychodynamic personality and motor behavior of autistic children in the 1960s[15]. Scharoun et al. observed improved group cohesion and reduced aggression with DMT group interventions for autism[16].
Dance therapist Nicholas Kasovac ingeniously integrated movement analysis and Kesternberg Movement Profile (KMP) concepts into DMT techniques, establishing better motion communication in ASD individuals.
Hildebrandt et al. orchestrated a two-year study outlining DMT’s effectiveness in improving social skills in ASD patients[17]. Nelson et al. employed circle dancing interventions to enhance social awareness in children with ASD[18].
Lastly, research by Magulanmu further supports the efficacy of DMT in improving social communication skills and reducing behavioral issues in children with ASD. His work has helped foster their physical development and interpersonal communication[19].
Conclusion
Dance movement activities offer an effective avenue for enhancing the sensory experiences of children and adults on the autism spectrum. Rather than focusing solely on specific movement standards and difficulties, dance therapy prioritizes individuals’ spontaneous movements and inner emotions, encompassing activities like walking, talking, and even simple rest and breathing.
Individuals with autism often face challenges related to body shape, function, and muscle tension, creating issues with proprioception. Therapists and dance instructors must adapt their approach by assessing clients’ capabilities rather than limitations.
By observing nonverbal communication patterns, instructors can identify and address issues, encouraging participants to develop body awareness and express themselves through movement. This process supports new psychological functions and enhances intervention outcomes, requiring the prudent organization of dance-movement programs[20].
Various theoretical schools of Western dance therapy have developed distinct therapeutic approaches, encompassing mind-body exercise therapy, gestalt therapy, Jungian dance therapy, empiric therapy, creative dance therapy, and other similar methods. Instructors design treatment plans based on the functional level of children with autism spectrum disorder, regularly adjusting methods to optimize training outcomes[21].
References
[1] NIMH. “Autism Spectrum Disorders (ASD).” National Institute of Mental Health, https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd.
[2] Kindregan, Deirdre, Louise Gallagher, and John Gormley. “Gait Deviations in Children with Autism Spectrum Disorders: A Review.” Autism Research and Treatment, vol. 2015, 2015, pp. 741480. doi:10.1155/2015/741480.
[3] Edey, Rosanna, et al., “Interaction Takes Two: Typical Adults Exhibit Mind-Blindness Towards Those With Autism Spectrum Disorder.” Journal of Abnormal Psychology, vol. 125, no. 7, September 2016, DOI:10.1037/abn0000199.
[4] Kaplánová, Adriana, et al. “Physical Education and Development of Locomotion and Gross Motor Skills Children with Autism Spectrum Disorder.” MDPI, Multidisciplinary Digital Publishing Institute, 20 Dec. 2022, www.mdpi.com/2071-1050/15/1/28#B1-sustainability-15-00028.
[5] Hattori, Yuko, and Masaki Tomonaga. “Reply to bertolo et al.: Rhythmic swaying in chimpanzees has implications for understanding the biological roots of music and dance.” Proceedings of the National Academy of Sciences, vol. 118, no. 2, 22 Dec. 2020, https://doi.org/10.1073/pnas.2017986118.
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[7] Constitution of the World Health Organization Addendum to the Forty-Fifth Edition. Am J Public Health. 2006:1–18.
[8] Littrell, Jill. “The mind-body connection.” Social Work in Health Care, vol. 46, no. 4, 28 Feb. 2008, pp. 17–37, https://doi.org/10.1300/j010v46n04_02.
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[19] Magulanmu. “Intervention Research on the Effect of Dance/Action Therapy on the Physical and Psychological Health of Autistic Children.” Shanghai University of Sport, 2020.
[20] Li, Weixiao. Introduction to Dance Therapy. China Light Industry Press, 2018, p. 63.
[21] Pang, Jia. Dancing Therapy for Special Children. Nanjing Normal University Press, 2015, pp. 251–255.
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