October 15, 2014

Liesbet Manders is a PhD candidate in the Creative Arts Therapies Department at the Drexel College of Nursing and Health Professions. She was awarded a Fulbright Scholarship in 2013 for her research proposal, which later took her to Heidelberg, Germany to investigate whether participants in dance/movement therapy can learn to coordinate their body movement with a partner, and if this will improve their social interactions. Manders, who worked as a dance/movement therapist and mental health professional for a number of years, is now pursuing her PhD after witnessing a lack of research evidence in the field.

Chartings: Did you encounter patients with ASD prior to your project in Heidelberg?

Liesbet Manders: I have worked with children and adults with ASD for the past 14 years. I started as a volunteer playing with a little girl and then moved on to work with a whole range of children and adults in various capacities. I was everything from dance/movement therapist to behavior specialist overseeing wrap-around services for my clients. I have an extended family member with ASD and spent one year living with a family as live-in assistant for a young boy with ASD, so I have seen life with the diagnosis from both family and professional perspectives. 

During my dance/movement therapy (DMT) master’s program, I worked with clients from a few different populations. From that, I realized that the work with children with ASD was really what I enjoyed the most.

Chartings: How did it feel to be selected as a Fulbright Scholar?

Manders: It was wonderful! I was extremely excited and told everybody the news. The next day I heard I was also selected for the German Academic Exchange Service Fellowship. I felt a bit overwhelmed by the honor of being selected by both committees, so I actually did not tell many people about the second one.  I ended up picking the Fulbright because of the international prestige. I am very happy I made this decision, as the German Fulbright program offered me language classes, support in getting settled in Germany, and a great network of connections and friends in the form of other Fulbright scholars. I had a wonderful year.

Chartings: Tell us about your dissertation research. What aspects of ASD did you consider during your time abroad?

Manders: My dissertation research is about interactions and social engagement in teens and adults with high functioning ASD. By looking at movement synchrony and other characteristics of the movement during partnered activities in dance/movement therapy sessions, I hope to better describe differences in the nonverbal component of interactions when individuals appear more or less engaged in the interaction.  Synchrony between individuals increases positive feelings about the other person and builds group coherence. As delayed reaction times are common in individuals with ASD, I wanted to see if differences in synchrony were associated with differences in the assessment of emotional connection in interactions.  In the qualitative strand of the study, I am looking for other characteristics of the movement associated with more or less successful interactions. The participants in the parent study participated in 10 weeks of structured dance/movement therapy with the same partnered activities each week, so I am also looking at change over the course of the therapy.

Chartings: What are the goals of your study?

Manders: My study is a mixed methods secondary analysis of video of six participants and their partners in dance/movement therapy (DMT) sessions. The aims of this study are to: 1) Assess the relationship between various forms of movement synchrony between the partners and the quality of the interaction; 2) Describe other characteristics of the movements relevant to the interaction quality; and 3) Observe any changes over 10 weeks of DMT. I am addressing these aims through both quantitative ratings of synchrony and interaction quality and in-depth qualitative descriptions of the movements and interactions in the videos.

Chartings: What did you find surprising, if anything, about the research?

Manders: The number of things that could go not quite according to plan. It was not so much that things could go wrong, but when specific things happened, many were a complete surprise that I did not expect in that way. Also, the number of roles that I had to take on as the researcher, with training raters for my video and overseeing them as well as preparing and working with the materials for my secondary analysis and assisting in parts of the parent study.

Chartings: How do you foresee your research impacting the future of care and treatment for those with ASD?

Manders: Dance/movement therapy (DMT) uses the body-mind connection to work on strengthening and integrating social, physical, cognitive, and emotional health through movement explorations within the context of a therapeutic relationship. When people move, they communicate something about their experience of the world through the movements they do. As dance/movement therapists, we can use this to join the child with ASD and build a connection that matches that particular child’s movement style.  Many times in my years of clinical work, I made a connection with a “hard to reach” child by taking this time to build the relationship through the movement. I found that the child was usually more motivated to relate and work on therapeutic goals when it was fun according his or her own unique tastes. For verbal, higher functioning individual with ASD, dance/movement therapists can structure the movement to give them experiences of what it feels like in their body to coordinate with someone else, or be in charge, or stop, or slow down. While many other therapies may work on these same concepts on a cognitive level, dance/movement therapists translate it into a physical experience as well as processing it verbally when appropriate.

My research will help provide research on DMT as a therapy. As it has been primarily a clinical field with little research, there is little funding, so I am hoping that adding to the evidence base will increase the availability of DMT as a treatment for ASD. The more general aim of describing the qualities of movement associated with more and less engaged interactions in the study can be applied in both DMT and other therapies addressing social engagement. Increased understanding of the nonverbal motor aspects of social engagement can point to the areas that need to be addressed to reduce the social challenges that continue even after the individual learns basic social skills. This would get to a more subtle level of social interaction that nonetheless plagues people when others get a bad impression of the individual because the interaction feels wrong.

Chartings: Does conducting research to solve issues for people with ASD provide you with a sense of fulfillment?

Manders: Before I entered the PhD program, I worked as a therapist for children with ASD. It always felt wonderful to see the children make progress, knowing how much work each little step involved. I loved the feeling of making a connection through movement with the nonverbal children at the preschool.  When I was using their movement style to create a playful game and stayed fully in the moment with them, I often felt a very strong connection. At these times, we were both having fun being together, which is always rewarding to see, especially with a child who is usually isolated. Over the years, I also witnessed many moments of frustration in children and adults with ASD. Watching their struggles made me want to help them more. 

This desire to make connections and see the impact on children’s lives is what got me to come back to do research and help develop an evidence base for DMT, so that it can be available to more individuals with ASD. I do also want to keep doing clinical work to keep this personal connection to the work.

Please join us for our conference on November 8, 2014, Creating Integrated Healthcare Services for People with Autism Spectrum Disorder. Click here for conference information and to register.