INTRODUCTION:

Art therapy, a form of psychotherapy, uses creative processes to facilitate emotional expression and enhance personality. It primarily focuses on the individual's process and experiences, rather than the aesthetic outcome, fostering self-confidence and self-appreciation in children^1,2.

Children with Autism Spectrum Disorder (ASD) often face challenges in emotional expression, verbal communication, and understanding others' emotions, which can impact their social, emotional, and intellectual health. However, individuals with ASD frequently exhibit strengths in visual processing, which is leveraged in successful visual support and video-based interventions. This visual strength suggests potential benefits for using visual art therapy to improve emotional connection and expression in children with ASD³. Although research is limited, existing literature indicates that visual art therapy can be a valuable tool for promoting adaptability, self-esteem, and social communication skills in individuals with ASD. For example, findings include improved social interaction, communication, and motor skills in ASD children and adolescents^4,6 non-verbal self-expression and emotional regulation through art-making^7,8 increased self-image, flexibility, and behavioral improvements^2,9 and broader boosts in communication, emotional processing, fine motor control, social skills, self-esteem, and adaptability^10,13.

PROBLEM STATEMENT:

Music with art intervention:

An integrated approach among children with ASD.

OBJECTIVES:

· To assess mood and feelings among children with ASD by mood and feelings questionnaire: stated by children in experimental group and in control group.

· To assess mood and feelings among children with ASD by mood and feelings questionnaire: stated by mothers in experimental group and in control group.

· To identify the relationship of mood and feelings among children with ASD stated by children and stated by mothers in experimental group and in control group.

· To find out the effectiveness of music with art intervention on the mood and feelings of children with ASD in terms of decreased mood and feelings score by comparing experimental and control groups.

Variables:

* Dependent variable: mood and feelings of children.

* Independent variable: music with art intervention.

METHODOLOGY:

Research Design:

‘Time series Non-equivalent control group design

Variables of the Study:

Independent variables:

Art therapy. Dependent variables:

Mood and feeling among children with ASD.

Setting of the study:

This study was conducted in two separate centres of special schools, i.e. Sunshine Autism Care Society, Dum Dum Park, Kolkata, for the experimental group and Club Good Hope, DumDum Park, Kolkata for control group.

Population and sampling:

The population composed of children with ASD Sampling

Technique and sample size:

For this study, we adopted Non probability purposive sampling is used. The sample size was 30, 15 samples for the experimental group and 15 samples for the control group.

Inclusion criteria:

1. Attending weekend special schools pre vocational unit.

2. Autism Diagnostic Observation Schedule (ADOS) Age Range: from 12m to adulthood, 0 = three or more descriptive, more than one of them outside Demo Task done by RCI holder special educators of selected settings.

3. Children with ASD who are experiencing some difficulty in settlement at newly started sessions.

4. Parents with children with ASD who can write, read and understand English.

5. Parents who are willingly participating in this research.

6. Children who have only ASD diagnosis.

Exclusion Criteria:

ASD children with multiple developmental disorders.

Tools:

1. Mood and Feelings Questionnaire (MFQ): A standardized questionnaire to assess mood and feelings among children with ASD, completed by both children and their mothers.

2. Tools on Demographic variables.

Development of Intervention: Protocol for Rabindrik Music Intervention (RTMI) for Children:

Purpose:

With the help of Rabindrik music, children will show interest in music, which will encourage exploration of different feelings and emotions. Music therapy has been shown to improve communication, emotional regulation, and social interaction among children with autism spectrum disorder (ASD)^14,16.

Resources:

Live trained Rabindrik music vocalist / recorded audio / instrumental music without words

Related musical instruments:

Easy, relaxing body movements (preferably meaningful movements)

Sound system (optional)

Visual art materials: watercolor, paint brush, color pens, crayons, cloth pieces, chalk, paper^17,18

Schedule:

Sessions will be conducted 45 minutes, 2 days per week (Saturday and Sunday), for 1 month, by an RCI-certified therapist. Structured and consistent scheduling enhances engagement and therapeutic outcomes in children with ASD¹⁹.

Selection of Songs:

Different Porjay songs according to mood, festival, and time of day.

Songs can be any Rabindra Sangeet appropriate for therapeutic context.

Parents may allow the child to select a preferred song for the session, fostering autonomy and emotional expression²⁰.

Steps:

1. Orientation (5 minutes, 1st day only): Introducing the children and parents to the therapy process, setting a comfortable environment.

3. Introductory Phase (5 minutes): Warm-up with simple rhythm, breathing, or humming exercises.

4. Interventional Process (30 minutes): Active listening, singing along, body movement with music, use of art materials for visual expression, and therapist-guided emotional exploration²¹^-²³.

5. End Phase (5 minutes): Cool-down with soft instrumental Rabindra Sangeet, relaxation, and sharing of feelings if possible.

Ethical Consideration:

1. Taken permission from the institution's authority

2. Taken consent from parents as well as from participants

3. Confidentiality is assured

Data analysis

Table 1: Mean, mean difference, SEM_D, and unpaired ‘t’ t-values showing the difference of mood and feelings with the 1st, 2nd, and 3rd observation between the experimental group and the control group. stated by the mother. N-30, n- 15, n- 15

Sl No. Observation		Mean	SD	SEM	Unpaired ‘t’ value
1	EO₁	10.33	1.23	0.23	1.72#
1	CO₁	7.67	5.86	1.51	1.72#
2	EO₂	4.93	2.58	0.67	2.1017*
2	CO₂	8.2	5.44	1.4	2.1017*
3	EO₃	5.53	2.83	0.73	7.0803*
3	CO₃	14.4	3.94	1.02	7.0803*

Significance level at 0.05 level, ‘t’ ₍₂₈₎ =2.05, E=Experimental group, C= Control group

Major findings:

This study found the majority of children with ASD have improvement in mood and feelings in post post-test than pre-test in the experimental group. A study found that mothers' reported mood and feelings and children's reported mood and feelings have significant relationships in all three observations. Throughout observations (01, 02,03) in the control group (paired t value 01-02– 3.0835*, 02-03—3.274*, 01-03–3.680*) children's mood and feelings score deteriorate significantly, but in the experimental group (paired t value 01-02–9.3224, 02-03—1.198#, 01-03–6.555*), they improved significantly at the 0.05 level of significance, reported by both mother and child. In the pretest, there was no significant difference in mood and feelings score among children between the experimental and control group (unpaired t value 01-02–1.72#). But in the second and third observations (02, 03) between the control group and experimental group, children's mood and feelings scores significantly differ (unpaired t value, 02-03—2.1017*, 01-03–7.0803*), at the 0.05 level of significance, reported by both mother and child.

DISCUSSION:

October 13, 2017, London. Alicia Round, William J. Baker, Christopher Rayner,conducted a qualitative descriptive Case Study within the theoretical framework of Art as therapy. This article discussed visual art as therapy experiences and the impacts upon students’ communication, social interaction, and self-esteem. Ke X, Song W, Yang M, Li J, Liu W.2022 Oct 6, done A systematic review and meta-analysis on Effectiveness of music therapy in children with autism spectrum disorder concluded that MT can improve social skills in children with ASD.

CONCLUSION:

There is a limited but promising body of literature that suggests visual music and Art therapy can be beneficial for individuals with ASD and provide opportunities for them to develop flexibility, self-esteem, and social communicative behaviour. Mostly, we found therapies are used for improving the functionality of children with ASD, whereas our study focuses on the well-being of children with ASD to promote development at their own unique pace. Individuals with ASD are struggling constantly to fit into a neurotypical society. Music, dance, art, story, and drama can bridge the gap between both neurodiverse and neurotypical individuals.

REFERENCES:

1. Verywell Health. What Is Art Therapy? [Internet]. Available from: https://www.verywellhealth.com/art-therapy-5212229.

2. Schweizer C, Knorth EJ, Spreen M. Art therapy with children with autism spectrum disorders: A review of clinical case descriptions on 'what works'. Arts Psychother. 2014; 41(5): 577–593.

3. Wikipedia. Art therapy [Internet]. Available from: https://en.wikipedia.org/wiki/Art_therapy.

4. Malhotra M, Raj T. Efficacy of Art Therapy in Autism Spectrum Disorder: A Systematic Review. Int J Art Ther. 2024; 29(2): 85–97.

5. Martin L, Hsu L. The role of art therapy in enhancing communication skills in ASD. Arts Psychother. 2019; 64: 16–24.

6. Evans K, Dubowski J. Art therapy for children with autism or autistic spectrum disorder: A review. Clin Child Psychol Psychiatry. 2001; 6(3): 395–408.

7. Verywell Health. Art Therapy for Autism [Internet]. Available from: https://www.verywellhealth.com/art-therapy-for-autism-260054.

8. Schweizer C. The healing power of creative expression in ASD children. Int J Art Ther. 2023; 28(1): 45–52.

9. Cross River Therapy. Benefits of Art Therapy for Autism [Internet]. Available from: https://www.crossrivertherapy.com/autism/the-benefits-of-autism-art-therapy.

10. ABA Centers WA. Art Therapy in Autism: Boosting Communication and Creativity [Internet]. Available from: https://www.abacenterswa.com/blog/art-therapy-in-autism.

11. Hidden Gems ABA. Benefits of Art Therapy for Autism [Internet]. Available from: https://www.hiddengemsaba.com/articles/benefits-of-art-therapy-for-autism.

12. God’s Own Child. Art Therapy for Autism: Boosting Creativity and Well-being [Internet]. Available from: https://godsownchild.com/article/art-therapy-for-autism-boosting-creativity-%26-well-being.

13. Tuma F, Nisar T. Creative arts interventions for children with autism: A systematic review. Front Psychol. 2022; 13: 957565.

14. Geretsegger M, Elefant C, Mössler KA, Gold C. Music therapy for people with autism spectrum disorder. Cochrane Database Syst Rev. 2014; 6: CD004381.

15. Bieleninik Ł, Geretsegger M, Mössler K, Assmus J, Thompson G, Gattino G, et al. Effects of improvisational music therapy vs enhanced standard care on symptom severity among children with autism spectrum disorder. JAMA. 2017; 318(6): 525–535.

16. Sharda M, Tuerk C, Chowdhury R, Jamey K, Foster N, Custo-Blanch M, et al. Music improves social communication and auditory–motor connectivity in children with autism. Transl Psychiatry. 2018; 8(1): 231.

17. Schweizer C, Knorth EJ, Spreen M. Art therapy with children with autism spectrum disorders: A review of clinical case descriptions on “what works”. Arts Psychother. 2014; 41(5): 577–593.

18. Evans K, Dubowski J. Art therapy with children on the autistic spectrum: Beyond words. Jessica Kingsley Publishers; 2001.

19. Gold C, Wigram T, Elefant C. Music therapy for autistic spectrum disorder. Cochrane Database Syst Rev. 2006; 2: CD004381.

20. Kim J, Wigram T, Gold C. The effects of improvisational music therapy on joint attention behaviours in autistic children: A randomized controlled study. J Autism Dev Disord. 2008; 38(9): 1758–1766.

21. Vaiouli P, Grimmet K, Ruich LJ. "Bill is now singing": Joint engagement and the emergence of social communication of three young children with autism. Autism. 2015; 19(1): 73–83.

22. Thompson G, McFerran KS, Gold C. Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: A randomized controlled study. Child Care Health Dev. 2014; 40(6): 840–852.

23. Katagiri J. The effect of background music and song texts on the emotional understanding of children with autism. J Music Ther. 2009; 46(1): 15–31.

Received on 29.01.2025 Revised on 26.06.2025

Accepted on 03.09.2025 Published on 25.10.2025

Available online from November 04, 2025

Asian J. Nursing Education and Research. 2025;15(4):231-234.

DOI: 10.52711/2349-2996.2025.00047

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.