ARTS-BASED THERAPY FOR CHILDREN WITH DISABILITIES

GRANT REQUESTED BY: Bhavini Gandhi

PROJECT DURATION: 8 Months

PROJECT PERIOD: 14th June 2010 to 31st March 2011

AMOUNT OF GRANT: Rs. 20,000 per month

PARTNER INSTITUTION: Victoria Memorial School’s Learning Center, Tardeo

CONTACT PERSON/S:
Ms. Bhavini Gandhi, Clinical Psychologist, Certified Arts Based Therapist
Add: 10/11, Mahalaxmi Building Number 2, 174, Sir Bhalchandra Road,
Dadar T.T., Mumbai- 400014
Ph: 022-24144894
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SUMMARY
Ms. Bhavini Gandhi, is a practicing clinical psychologist and a certified Arts Based
Therapist residing in Mumbai.

Since 2004, Ms. Gandhi has worked with various populations- Slum children, Children
and Adolescents ‘At-Risk’ for antisocial activities, Children with Autism, Attention-Deficit
Hyperactive Disorder, Cognitive difficulties, Behavioural Issues. She has done her Arts
Based Therapy in 2007-8 with the Institutionalized Children and Children in the Slums of
Antophill.

The main objective of the present project is to conduct Arts-Based Therapy with children
and young people with (intellectual) disabilities. A pilot study was conducted toward this
objective in Victoria Memorial School’s Learning Center, Mumbai. The pilot group
consisted of 8 children (between physical ages 9 – 15) with a range of multiple
disabilities that included low attention and concentration, high impulsivity, hyperactivity-
aggression, social skills issues, communication and limited imagination.

During and after ABT sessions the group showed positive impact in the key areas of
articulation, self-esteem (confidence), emotional expression and attention/concentration
span. Reduced hyperactivity and aggression were also noted. It was observed that ABT
has a huge potential to contribute substantially to education (learning) and rehabilitation
processes for children and young people with disabilities.

The present project is proposed to continue arts-based therapy in Victoria Learning

School’s Learning Center for a period of 8 months from 14th June 2010 to 31st March
2011. Through the project children can avail of Arts-Based Therapy for a sustained
period of time.

The core aim of the project is to empower children with disabilities to approach and
contribute to the world as a ‘person’, not as a mere disability. Neuroscientific research of
past 25 years stands evidence to the plastic capabilities of the brain. What was hitherto
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supposed a lost cause due to ‘permanent’ brain state (damage) is now known to be
amenable to change. In this context, Arts-Based Therapy offers unique and
personalized space to elicit newer neuronal pathways through creative learning and
interactions.
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1.0 ABOUT THE PARTICIPATING ORGANIZATIONS

1.1 VICTORIA MEMORIAL SCHOOL’S LEARNING CENTER

The VMS Learning Centre was established in June 1999 in collaboration with the
Centre of Special Education, SNDT Woman’s University. It aims to provide a suitable
infrastructure and education for children with disabilities

Population Served:
They have a total of 28 children in various classes. The disabilities of these children are
varied- some have multiple. They are slow learners, mentally challenged, cerebral
palsy.

Education and Rehabilitation Model:

The focus is on 'how' the child learns rather than 'what' the child learns. It consists of a
modified curriculum taught in especially designed multi-grade methodologies, where the
academic curriculum is graded according to individual levels of learning. The motive is
to integrate these children into the larger educational canvas, while building their self-
esteem and reinforcing positive behavior so that they become contributing members of
society.

Staff and care personnel:

Teaching staff mainly comprises of special educators and visiting consultants
from SNDT. They have cooking class, yoga class, pre-vocational activities and
various art activities.

Funding:
It is a non-profit entity which functions on the fees by parents. VMS Learning Center’s
Therapy Center functions on donations and a very nominal fees. However, the children
who need therapy come from a lower economic background and cannot afford the
therapy center fees or the consultants’ fees.
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1.2 ARTS BASED THERAPY

Arts-Based Therapy is a systematic and sustained intentional use of the art forms with
a definite therapeutic objective. It is an approach that integrates and creates a generic
vocabulary of arts media and materials from dramatherapy (DT), drum circle therapy
(DCT) dance and free movement, creative-expressive and artistic playing and individual
healing practices.

Art- forms (music, dance, drama etc) have the capacity to stimulate all dimensions of a
human being. The therapeutic use of art forms can help an individual to access his/her
multi-dimensionality. It can act as a sensory and extra sensory integrator. By integrating
all dimensions, a person can make use of inherent" functional plasticity" of dimensions.
Functional Plasticity being the process wherein undamaged dimensions act to assume
the functions that were normally handled by damaged areas. Through the use of play,
imagination and metaphors, an arts-based therapist can change perception or simulate
alternative realities. ABT cannot heal anybody. Individuals heal themselves. At all times
people are in charge of their own healing.

ABT can be practiced by a certified practitioner from WCCL Foundation, Pune.

WCCLF is an NGO that
• Researches in the domain of art forms & their healing effect (Arts-Based
Therapies),
• Implements Arts Based Therapies in other institutions/NGOs working with special
populations.
• Trains Individuals in a way that enables them to apply ABT & research further.

WCCLF was established in November 2001. the Foundation’s (past & current) projects
focus on De-addiction centres, halfway homes for mentally ill, residential facilities for
mentally challenged adults, and special schools for children with disabilities.
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2.0 BACKGROUND

2.1 STUDIES ON ARTS-BASED THERAPY AND DISABILITIES

Past ABT project done by Ms. Gandhi with institutionalized street children, Mumbai
states that ABT has helped them to :
• increase their self esteem
• social interaction
• group bonding
• reduce aggression
• clarity in speech
• better expression
• reduce fear

Past study by WCCLF with mentally challenged adults at Sadhana Village (June 03 to
05) suggests that Drama, Music & Dance therapy can:
• Enhance communication & social skills
• Teach emotional cognition & expression in a structured environment
• Significantly affect the limbic system – enhance motor movement and perception-
stimulus.
• Enhance memory – Short term and long term.
• Significantly reduce impulsive behavior – marked difference in aggressive
behavior, reduction in anxiety (homesickness), release of stress

Another ongoing ABT project run by WCCL Foundation with children with cognitive
disabilities at Prasanna Autism centre is effectively working at:
• Cognitive rehabilitation,
• Social interaction, building communication channels (individually & in a group),
• Speech and language development,
• Behavior modification,
• Attention & memory.
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2.2 PILOT STUDY

A pilot study was conducted in Victoria Memorial School’s Learning Center from
December 2009- March 2010.

The pilot group consisted of 8 children (between physical ages 9 – 15) with a range of
disabilities that included low attention and concentration, high impulsivity, hyperactivity-
aggression, social skills issues, communication and limited imagination.

The group participated willingly and joyfully in the sessions because it was seen as play
and fun time. The bar of challenge was slowly and gradually raised for group and this
helped most to slowly but surely attempt to do little more than what they could
previously do. However, due to various functioning levels in the group, some exhibited
more change than the others.

During and after ABT sessions, the group showed positive impact in key areas:
• Articulation
• self-esteem (confidence)
• emotional expression
• attention / concentration span.
• Lower aggressive outbursts- towards calm self

For detailed information on the pilot study, refer to Annexure 2.

3.0 THE NEED: ABT IN INDIAN CONTEXT

3.1 ABT IN INDIA

Modern Therapies established themselves as “humane care” (Pinel, Dorothea Dix) for
people with disabilities and psychological disorders in the 20th century. Since post World
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War I (1920s) individual practitioners in the West experimented with using drama, music
and other art forms for therapeutic purposes.

Music therapy, dramatherapy came to be formulated and practiced in the West since
1960s. Since then there is a huge body of work, research, and training institutions
sanctifying this work.

However, within India, there is no known long-term training or practice of these

therapies. No doubt, there are individuals doing this kind of work in various formats in
various parts of the country, but there is no sustained long-term work, which practices
(action) and validates (research) the use of arts in healing/therapy.

3.2 ABT AND HEALING/THERAPY

Modern healing practices and medicine is ever researching the possibility of creating a
significant change in the state of being of those afflicted by disabilities.

The arts have existed in our cultures – with a purpose – for eons. But the modern times
have seen the erasure of using the art forms within the community for healing, learning
or communication.

At the edge of scientific research, many brain studies are exploring and debating
whether ‘the mind and the brain are one and the same?’ (Spangler 1998). These newer
and newer advances in the scientific realm are breaking down the established
Newtonian (in physics) view of world or Descartes’ (in neurology) world of human brain
as functional system like a machines. In fact, host of researches now propose the
outside world as affected by the creator-observer (observer affects the observed in the
outside quantum world) and emphasize the holistic and plastic nature of brain
(everything is not fixed forever in the inside neurological world) (Doidge 2007). These
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studies also implicate the significance of will, creative learning, imagination and
intentionality in our life, experiences and abilities.

There is a huge need to bridge these newer scientific studies and their underlying
values with the therapeutic paradigms within India. In our country, where healthcare and
resources for them are severely limited, it will be a huge jump to validate a fundamental
community resource like the art forms in healing. ABT practiced systematically and over
a sustained period of time can address problematic states of being, like a disability, and
aid the community’s efforts to educate and rehabilitate children with special needs.
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4.0 THE PROJECT DESIGN

4.1 STUDY PROPOSITIONS

Action Research proposition is a particular understanding tested and refined through

action methods during the project period. The proposition for this project is:

“Active engagement with the art forms with specific intentions for
therapy/healing triggers behavioural and neurobiological changes such
that children with disabilities (mental retardation, mild/severe learning
disabilities, limited speech and physical abilities) can experience an
improvement in their overall functioning, especially registering a positive
change in their specific areas of dis-ability”.

Areas under study

a) Disability
The project will actively seek to define and re/define the concepts of ability and
disability.
Can ABT enhance a disabled child’s abilities to support faster learning and
rehabilitation?

b) Arts-Based Therapy (ABT)

ABT is the systematic and sustained intentional use of the art forms with a definite
therapeutic objective. Culturally, art forms are an accessible way to reach a child –
playing motivates as much as it entertains. In fact, developmental schema show that
a large part of our human knowledge and understanding is collected through ‘play’
based interactions and the mini-worlds that are invented and rehearsed therein.
(Cohen & MacKeith 1991). Owing to their condition, children with disability,
especially in India, suffer double deprivation due to lack of playing opportunities and
spaces.
For a child with special needs, can ABT restore a vital developmental link
to body, intellect, and emotions?
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c) Neuroplasticity and Behaviour

Is the brain really plastic….? Can people with mental retardation and other
disabilities work to inspire other brain areas to take over the impaired
functions?...Much research and results in the area of neuroplasticity since 1960s,
points to the possibility of the brain having the possibility to change itself. One way to
approach these changes is to track the changes within a person’s responses to the
environment and behaviors over a period of time.
Can ABT trigger neuroplastic capacity of the brain?

4.2 OBJECTIVES AND STRUCTURE

The project brings the tools and experiences of arts-based therapy to this group of
children to make a creative-artistic world of their own, where they fit-in - an artistic
cosmos that they own, that suits their needs, perceptions
To Walk their Own Way
and abilities. Through such experiences, the project aims at
with Dignity and Choice
providing them opportunities and abilities to approach the
‘real world’ outside with faith and confidence of being complete in who they are, instead
of grappling at the margins.
The broad objectives for all groups are as follows:
A. BUILDING SOCIAL SKILLS AND COMMUNICATION
• To develop emotional cognition: recognizing emotions
• Expressing self and emotions in a structured environment
• Containment and inhibition: Reduction in impulsive, aggressive and hyperactive
behaviors; Reduction in stress and anxiety
B. AUDITORY PERCEPTION
• Identify and discriminate sounds
• Develop meaning to the sound and follow instructions
C. ATTENTION/CONCENTRATION
• Better attention span
• Sustain a task
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The objectives are accomplished through the following project activities:

1. Selection of group/s
• The institution (school) recommends children for therapy.
• Group/s are constituted on the basis of the baseline data provided by the
institution
• Each group consists of 6 – 12 children with specific disability profile/s.
• Individual sessions are conducted where the attention needed is intensive and
exclusive
• Depending on the group profile, each group will be conducted for a duration of 6
to 12 months.

2. Needs analysis
Each selected group goes through a period of needs analysis

3. Designing and Implementing ABT sessions

Twice a week ABT sessions are conducted, aiming at the specific needs of the
group

4. Monthly Review
Every month, ABT therapist conducts a review meeting with the teaching staff and
caregivers involved with the group. These meeting focus on:
• Review and documentation of significant changes (positive or negative) in the
group
• Specific case studies
• Useful sharing for integration of ABT in classroom teaching

5. Quarterly Review
Once in a quarter, ABT therapist conducts a review meeting with the parents of the
group members. These meeting focus on:
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• Review and documentation of significant changes (positive or negative) in the

group
• Useful sharing for dealing with issues at home

6. Evaluation
• Specific indicators are designed to assess the effectiveness of the project
objectives.
• The institutional head (and management) participate in assessment protocols
and evaluation once every three months (4 times during one academic year).
• Interim assessment/s are done and noted as against the intended outcomes to
help refine the action research cycle

7. Research study
The following are components of research study:
• Academic research: references and current scientific literature
• Inputs from experts: Senior doctors, researchers and WCCLF therapists working
in the same domain
• Research cycle: Review and refine/modify propositions on the basis of interim
outcomes, for better results during the next cycle
• Interim and final data analysis and presentation

8. Documentation
The documentation is done with evaluation and assessment in view. It also makes
notes of various ABT tools and techniques, and what responses they elicited during
the sessions.
• The therapist maintains notes of observations and insights
• A documenter makes written as well as audio-visual recordings
• Observation grids are made for objective observations (see Annexure 2A & 2B
from pilot study)
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9. Reports
A yearly project narrative and financial report will be submitted to the funding agency
(April 2011) with the details of project activities.
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5.0 GRANT REQUEST

5.1 DELIVERABLES

Sustained ABT sessions = more therapeutic results

The effectiveness of any therapy can be observed only during long-term, sustained
interventions. HENCE, Sustained ABT sessions over a period of two school years will
be beneficial towards education and rehabilitation of children with disabilities

Research Study on ABT and Disabilities in India

Checklists, evaluation parameters & statistical analysis will be sourced/created for

evaluation. Research, with academic literature review, and systematic approach will be
presented. The results from evaluation processes will be compiled a final research
report shall be created at the end of year two (June 2009).

5.2 BUDGET

Requested Project Budget:

Name of the Institution: World Centre for Creative Learning Foundation (WCCLF)
Title of the Project: ABT FOR CHILDREN WITH DISABILITIES
Total Grant Budget:
Grant Duration:
Sr. No. Line Item Total (In Rupees)
(for 8 months)
1 Design & Implement ABT sessions 68,000
2 Documentation 32,300
3 Research Evaluation 31,000
4 Programme & Art Materials 28,700
Total 1,60,000
For detailed break-up of each line item see Annexure 1
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ANNEXURE 1
BREAK UP OF LINE ITEM 1 (DESIGN & IMPLEMENT ABT SESSIONS)

SR. cost per unit no. of Total Cost

NO. Line Item Description (Rs) units (Rs)
1 Honorarium Honorarium for ABT 1000 68 68,000
(sessions) Practitioner

Roles & Responsibilities of ABT Practitioner:

1. Project Conceptualization
2. Design techniques, games, exercises in order to achieve therapeutic objectives
3. Create structured sessions, design individual sessions and group sessions
4. Implement designs and establish results
5. Coordinating between WCCLF, partner institution and all others
involved
6. Leading project effectively

BREAK UP OF LINE ITEM 2 (DOCUMENTATION)

SR. LINE ITEM Description Per Unit Cost No. of TOTAL

NO. (Rs.) Units
1 Honorarium Honorarium for documenter 400 68 27,200
2 Creating CD Editing and Burning 300 17 [Every 5100
4th
Session]

TOTAL 32,300

DETAILED BREAKUP OF LINE ITEM NO. 3 (RESEARCH EVALUATION AND MEASUREMENT)

SR. Line item Description Cost No.of Total

NO. units
1 Honorarium Honorarium for research 750 10 7500
(research) study design and inputs to
resource persons/ doctors /
Senior WCCLF Therapist/s

2 Research Honorarium for data 250 68 17,000

Study report analysis
Report writing 5000 15,000 5000
words
Report printing 5 per page 30 pgs 1500

TOTAL 31,000

DETAILED BREAK UP OF LINE ITEM 4 (PROGRAMME & ART MATERIALS)

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No. of
Sr. No. Line Item Description Cost per unit units Total
1 Program Ink Cartridge 850 1 850
Material Stationary 2500 2500
Video Casettes (blank) 120 5 600

2 Art materials drums for sessions 1250 8 10,000

(djembes)
Audio CDs (pre-recorded) 50 7 350
Audio CDs (Blank) 20 20 400

Percussion Instruments 200 10 2000

Clay and Craft materials 200 15 3000
Theatre props 300 10 3000
Painting materials 400 15 6000
TOTAL 28,700