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PLAY THERAPY-REACHING THE CHILD WITH AUTISM Natasha Parker and Patrick O !rien University of Southern Queensland This paper proposes that play therapy can be an appropriate intervention in working with children with autism in schools especially when working with children who have little in the way of social skills and poor communication. It proposes that play therapy may offer school counsellors opportunities that the more cognitive therapies do not. Through the use of case study research, the paper discusses and illustrates an intervention with a seven year old boy with autism across 1 sessions of sandplay in a school in Queensland, !ustralia. This paper draws our attention to the legitimate use of case study research in counselling. It also advocates for the use of sandplay, "an e#pressive therapy intervention$ with a child who is autistic and who at first plays chaotically. This paper draws the counsellor%s attention to the developmental stages that will follow when the child feels secure enough to proceed. The lack of well researched longitudinal &uantitative or mi#ed method research in play therapy is also noted. Introduction In the special education setting, it is vital to have a repertoire of interventions to best meet the needs of all children. Geldard and Geldard (1997) stated that the skilled counsellor is one who can take advantage of opportunities that occur through pla and intervenes in a purposeful wa . !ccording to some researchers, autism is an increasing disabilit area within our schools ("esibov, !dams, # $linger, 1997) and recent estimates of the prevalence of autism are higher than ever before. %owever, there is little research on the most appropriate techni&ues to use with students with autism and this paper aims to e'plore how pla therap can be seen to be effective through the use of a single case stud . (ase studies have been used e'tensivel in the social science because the can provide the scientific rigour and the t pe of detail that practitioners re&uire in implementing strategies effectivel (%artle , )**+).(ase studies are particularl suited to research that seeks to e'plain the processes that individuals are involved in during the research period. ,he are usuall undertaken over time and in this case the sub-ect was observed in the counselling process for one hour a week over a twelve week period. .uring this time independent measures of behaviours were being recorded b his class teacher who had not e'perienced the behaviours that are often associated with autism. /chools in 0ueensland are still undergoing a push for inclusive education with the implementation of the Inclusive 1ducation /tatement 2 )**3. !s more students with special needs occup caseloads, it is important for practitioners to obtain appropriate communication strategies for students with special needs. "esibov, !dams, and $linger (1997, p. 43), acknowledge that students on the autism spectrum are renowned for having difficulties with communication, stating that, one of the most striking characteristics of autism is the uneven profile of language and cognitive abilities. ,his paper looks at wa s that school counsellors could work with students on the autism spectrum who are e'periencing communication difficulties. "uch of the current research in school counselling is about mainstream students using the traditional methods of counselling which involves using verbal interactions (567rien # 7urnett, )***) and it is the lack of these skills that often differentiates the child on the autistic spectrum. In recent times, the mental health of students with special needs has attracted considerable attention (8ose, %owle , 9ergussen, # :ament, )**9). %owever, a hurdle has been e'perienced in

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distinguishing whether displa ed behaviours are a mental health issue or part of a disabilit diagnosis. ,he challenge of defining and diagnosing a mental health issue in a student who has a disabilit is often difficult. !ccording to 8ose, et al ()**9) some studies have indicated a high occurrence of depression and an'iet among people with autism and !sperger s ndrome. 9inding an accurate assessment tool to assist in the attribution of behaviour would be beneficial in the area of treating students with special needs who also have mental health issues. 5ne of the wa s to assess whether children with special needs have mental health issues is b observing changes in behaviour such as disturbances in sleep, changes in appetite and energ level (8ose, et al.). Given that students with special needs are often identified and referred to ps chologists and ps chiatrists for mental health issues but no diagnosis is forthcoming, a challenge arises in how to successfull communicate with and work with students in schools who often have limited language and deficits in overall communication. ,his paper will suggest that one effective wa could be the use of pla therap and will demonstrate through a case stud method and outcomes, how a therapeutic intervention with one child resulted in dramatic changes to their pla and to their school and classroom behaviour. ! literature review' play therapy and therapy with children with autism <andreth, 8a , and 7ratton ()**9) stated that school counsellors are gravitating towards pla therap because children e'press themselves more naturall through pla . It is a wa that the professionals can enter into the child6s world. 5ther research shows that pla has been linked to man areas of development including intellectual, social and emotional growth (%ughes, 1999= 8ubin # (oplan, 199;= /ullivan, 193> in %olmes # ?illoughb , )**3). (hildren communicate best through pla and it allows the child to problem solve, e'press feelings, and use to s to transfer fears, an'ieties, fantasies, and guilt to ob-ects rather than people. Implementing pla therap successfull re&uires the school practitioner to be specificall trained in that area. ,here are techni&ues to use and theoretical models to follow. !n e'tensive review of the research related to the use of pla as a therap indicates that a client centred approach is considered to be foundational to most introductor processes (!llen, 9olger, # @ehrsson, )**+). !nother therap that has been heavil researched in recent ears is the use of cognitive behavioural pla therap . ,he use of (ognitive 7ehaviour ,herap ((7,) has been verified b man research e'periments but it has been argued as earl as 199* b (ampbell (199*) that ()T is beyond the grasp of most preschoolers and remarked upon again b $nell (199;, p. )9). 5ne could therefore e'pect that children with autism will also have difficult with cognitive behavior therap because of the nature of the condition. !utism occurs along a spectrum and no two students with !utism are the same. !utism as defined b <anda ()**7, p. 14) is a neurodevelopmental disorder defined by impairments in social and communication development, accompanied by stereotyped patterns of behaviour and interests. !utism is usuall diagnosed when three common characteristic are present. ,hese fall into a triad of deficits in the areas of communication, socialisation and interests or activities (%eflin # !liamo, )**7). (ommunication and social interaction skills are usuall needed for effective traditional verbal counselling sessions. Given that children with autism usuall have a deficit in communication, traditional cognitive counselling methods ma not be appropriate. ,here has been some research in this area beginning with !'line (19+7), but a review of the literature reveals that there there is currentl no published &uantitative research which looks specificall at children on the autism spectrum and a therapeutic intervention involving pla to improve emotional wellAbeing. ! problem with the research so far has been the debate around whether children with autism do pla effectivel . "uch of the e'isting research has been conducted in laborator settings, not mainstream school settings (<anda, )**7) and <anda has emphasised that oung children with autism often have difficult in social pla and with developing the appropriate word s mbols into language. <anda ()**7 p. 19) suggest that, *through early intervention, communication and social development may be improved. (onsidering that traditional counselling re&uires the abilit of the child to communicate with a counsellor, pla and in particular sandpla ma be a more appropriate medium to e'press their thoughts and feelings, and in a safe place develop problem solving skills. "astrangelo ()**9, p. >3) sa s children with !S+ do e#hibit play, although the type and &uality of their play varies from those children who appear to be

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following a typical developmental tra,ectory. ,his research also goes on to sa that given children with !/. usuall have strengths in the visual domain, using visuall based approaches will generall ield e'cellent pla skills. ,hrough pla it is suggested that children with autism can e'press their needs, share attention with another person while both people are pa ing attention to the same ob-ect. (hildren also learn strategies for solving problems through s mbolic pla . / mbolic pla seems to be the most useful pla therap approach as children use language to make and manipulate stories related to their lives, make inferences about causes and predictions about future events and e'press mental e'periences. ,he main benefit of s mbolic pla is best described b /igman and "und , (19;7, p. ++) who state that, the autistic child may not understand other people because people are more difficult to fathom than non-social ob,ects, which operate by simpler rules. It ma therefore be easier for a child with autism to use ob-ects to communicate than communicate verball with another person. It is particularl important that the use of pla in the counselling situation utilises the visual strengths of children with autism and involves the use of ob-ects to which some s mbolic meaning can be attached. ! particularl useful form of pla therap that involves high sensor stimulation is sandpla . /ensor stimulation is e'perienced through shaping and moulding the sand and through the selection and placement of a variet of ob-ects into the /andtra . ,he senses are further stimulated b soft soothing music being pla ed in the background. /andpla is one of the 1'pressive therapies (@earson # ?ilson, )**9). It has also been linked to %oward Gardner6s theor of "ultiple Intelligence (567rien # 7urnett, )***). Given that students who have !/. have difficulties within the communication area, sand pla (according to both @earson and ?ilson # 567rien and 7urnett) ma provide an additional dimension to the counsellor6s work b forming a highl stimulating visual bridge between verbal and e'pressive therapies and that this is increased through the use of the multiple intelligences throughout the pla session. !nother advantage of using sandpla therap within a counselling session is that students are likel to reveal inner thoughts and feelings through pro-ection of thoughts and feelings onto the to s and s mbols that the choose (<andreth, )**9). ,he t pe of s mbols selected for pla therap can be significant. ,o s for students with !/. should be chosen carefull to make sure the are suitable. !ccording to %olmes # ?illougb ()**3. p. 134), it is common for children with !utism to choose play ob,ects based on the sensory stimulation they provide and as such may lead to overstimulation with some children. /andpla uses a form of s mbolic pla and the process of sandpla is defined as, a psychotherapeutic techni&ue that enables clients to arrange miniature figures in a sandbo# or sand tray to create a sand world corresponding to various dimension of his.her social reality (.ale # ?agner, )**> as cited in Goss # (ampbell, )**+. p. )11). ,here are discrepancies within the sandpla research around how and whether or not therapists should interpret the sand pictures. ,his is widel debated and interpretative techni&ues are currentl lacking the empirical support provided b scientific validation (Goss # (ampbell, )**9). "ore studies need to be conducted around this aspect sandpla . !nother positive factor about the use of sand pla is that it was reported b @earson ()**>) as being the techni&ue most favoured b child clients in his stud of 0ueensland Guidance 5fficers. !s with an pla based intervention there ma be some negative views such as /iehl ()**1) (cited in Goss # (ampbell, )**+. p. )14) who stated that the term play is often associated with time wasting and is fre&uently considered to be inappropriate in a school setting where children should be learning and working. ,raining in sandpla is also another factor to consider and training opportunities are fairl limited and e'pensive within !ustralia (Goss # (ampbell, )**+). %owever, the biggest challenge is the lack of scientific research available to support its effectiveness in schools. ! (ase Study /ethodology ,he methodolog selected was that of case stud research. ,his methodolog was selected because of the acceptance of the work of 9l vb-erg ()**4, p. )19) who argued that case stud research suffered from five basic misunderstandings which were largel undeserved. ,hese five misunderstandings were that theoretical knowledge can be more valuable than practical knowledge, and that one cannot generaliBe from a single case, therefore, the singleAcase stud cannot contribute to scientific development. !nother misunderstanding, he posited was that the case stud can be most useful for generating h potheses, whereas other methods are more suitable for h potheses testing and theor

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building. ,he belief that case studies contain a bias toward verification also limits their acceptance as a research methodolog . ,he fifth assumption is that it often difficult to summariBe specific case studies. 9l vb-erg also argued (p. )))) In a teaching situation, well-chosen case studies can help the student achieve competence, whereas conte#t-independent facts and rules will bring the student ,ust to the beginner%s level. It is in the achievement of competence b counselling practitioners who read this article that the authors are most interested. ,he sub-ect for this case stud was selected b use of informationAoriented sampling, as opposed to random sampling as the child attended a school visited b one of the researchers in a countr town in regional 0ueensland and the data obtained was found to be rich. ,welve counselling sessions of +3 minutes per session were conducted with a seven ear old bo diagnosed as being on the autistic spectrum. ,he bo had been referred to the guidance officer because of the number of incidents involving classroom tantrums, hitting and biting of other children in the pla ground and refusal to participate in classroom activities. ,hese behaviours were targeted in discussion with the classroom teacher and data collected on a dail basis over the twelve weeks. @revious attempts to shape his behaviour had been made though referral and discussion with support teachers on the school6s social -ustice and support committee and through the individual intervention of the school6s special needs teachers, the guidance officer, and collaborative work with the parents and the visiting teacher (autistic spectrum disorder). @earson and ?ilson ()**1, p.31) suggest that 0ften chaotic pictures or stories appear. In children%s plays battles are common. +eath, opposition, threats, isolation, danger and relationships are some themes in the early stages and Cin discussion with the counsellor the client may make links between the story and their current life problems. The sandplay scene may suggest helpful strategies . ?hat is interesting in this case stud is how the stages of the sandpla mirrored the stages suggested b @earson and ?ilson and the data collected shows a noticeable reduction in targeted behaviours in both the classroom and the pla groundD Res"#ts .uring the research period the client6s pla is seen to move through four stages common in sandpla therap , which have been labelled chaos, battles, and the rise of a hero figure and finall pla with an apparentl secondar or deeper meaning. !t the same time significant differences in his classroom and pla ground behaviour were noted b his teachers and were evident in school behaviour records. In the first three sessions, the bo was encouraged to pla in a /andtra . ,he photograph (9igure 1) depicts what was common in his pla E disorganisation, chaos and a lack of order.

$i%"re&' Ear#( cha)tic *#a( !t first the client was reluctant to enter the room but having been introduced to the sand and the s mbols and having created the scene of chaos, he became reluctant to leave as if not knowing how to change what he had created or able to find alternatives to the scene that he had created. 1ach session the child was asked Is there anything you would like to change any e#tra symbols you would like to include or any symbols you would like remove from the tray1 It was at the end of the third session that the client actuall made a change b using a second tra into which he simpl placed more ob-ects. ,o

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overcome the reluctance to leave the therapist decided to set a time limit showing the client what the clock would look like when it was time to leave and introduced prompts that the client was approaching the time to conclude for the da . In /ession + the client e'perimented with a number of s mbols, did not ask for water and selected common s mbols from a range of s mbols that depicted television characters such as Gumb and some superheros. 7 the fifth session some order was evident in the pla and the oung bo began regular pla each week that involved battles sometimes between animals, sometimes animals against forest clearers, and sometimes between characters tr ing to storm a castle. ,he pla usuall started as disorganised affairs and usuall resulted in a chaotic victor b one side but graduall b week seven evolved into more of a strategic set of manoeuvres that showed a clear strateg and a clear victor.

$i%"re +' !att#es ,he seventh session saw the emergence of hero figures in the battle lines. !round this time teachers began to report that he seemed much happier in class and was cooperating with the teacher but still had problems with other children.

$i%"res , - .' The rise )/ the her) /i%"re In these photographs one can see /piderman but in the second bo' notice the beginnings of pla with @eter @an, with whom the oung bo seemed to identif heavil . ,he client used @eter @an each week for the ne't few weeks. Fote how organised the pla is now as his world seems to reflect an abundance of beaut and riches rather than chaos and disorganisation. %is class teacher said that his behaviour was now much better and he seemed a little too friendl with another bo in the class. /he said that both classroom outbursts and pla ground incidents had decreased dramaticall . In the last pictures we see two pla s that seem to have a deeper meaning. ,ra 3 involved a stor much like Foah and the !rc where all the animals filed into the ship to start a new life. ,he client told the therapist that the animals were leaving behind the wa that the did things in the past and were going to a new world. 9igure 4 depicted the new world which was a place of great beaut and full of treasure. ,hese pla s could be a s mbolic representations of the client6s new changing view of his world as his

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personal view of the world became more organised he ma have felt more in control, more able to manipulate the s mbols and the sand to achieve a result with which he was satisfied.

$i%"res 0 - 1' Or%anised *#a( 2ith dee*er 3eanin%' ,he graph below has been constructed from data held b the class teacher and from the schools lunchtime detention program. ,he G a'is represents the + stages noticed in the pla . ,he H a'is represents the average number of negative behaviours per week. It can be seen that over the research period there is a decline in all behaviours.

$i%"re 45 A6era%e 2eek#( 7eha6i)"rs rec)rded )6er the research *eri)d Iisits to the school lunchtime detention centre ma have been influenced b other behaviours than those targeted in the research period and ma have been over one or two da s depending on the severit of the behaviour that resulted in detention. .ata has been presented in table 1, as weeks 1A>, weeks +A4, week 7 and weeks ;A1) as the stage changes were noticed in these periods the photographs were taken in these periods. Disc"ssi)n 8esearch to date has never indicated that pla therap is ineffective, rather that its effectiveness is difficult to scientificall validate. ,he literature over man ears abounds with case studies where changes in behaviour are noted as a result of an intervention using pla therap . <iterature reviewed b

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the author included the use of pla with children who had a histor of reading problems (7ills, 193*= 9isher, 193>), learning disabilities (!'line, 19+9= Guerne , 1979, 19;>= <andreth, :ac&uot # !llen, 1949) speech difficulties (!'line # 8ogers, 19+3= .upent, <andsmen # Ialentine, 193>), mental disabilities (7ernhardt # "ackler, 1973= <i, 19;1= "und , 1937= Fewcomer # "orrison 197+= / wulak, 19;+), separation an'iet ("ilos # 8eiss, 19;)), child abuse (In # "c.ermott, 1974), d sfunctional families (1aker, 19;4) and with traumatised children ($uhli, 1979). ,hese studies all demonstrated the effectiveness of pla therap . Fot one mentioned its use with children with autism. ,he e'ception over the ears has been the novel +ibs' In search of self b Iirginia !'line (1971) but this was never presented as a scientific stud . It would seem that in sandpla the child at first perceives their world to be chaotic and pla s in a chaotic wa . !s children change their view of the world through e'perimentation in pla within the supportive non -udgemental counselling environment, the learn to become more organised and in doing this begin to see the world in a new and different wa . In the use of the figurines children begin to e'periment with battles and often a favoured character, a hero is seen to arise. ,his hero moves from one situation to another as the child e'periments with different stories constructed in the sand. ,he child consistentl uses the hero6s strengths and talents in these different conte'ts in what has become a predictable world controlled b the child within the sandtra . ! skilful counsellor is able to assist the child to find these same strengths and talents within themselves and then take these skills into the school and classroom environment. ,he literature around autism and educational intervention promotes the use of developmentall appropriate strategies (/mith, @ollowa , @atton # .owd , )**4). @la as an intervention is developmentall appropriate for children. Intervention strategies for children with autism have been man and varied ranging from 7erard6s (199>) auditor integration training to self management ($oegel # $oegel, 199*), and applied behavioural anal sis (<ovaas, 19;7). Generall there is consensus in the literature that because children with autism are seen as on a spectrum, man and varied strategies are re&uired when intervening. It is interesting in the intervention strategies reviewed, that not one recommended ongoing counselling for students with autism. ,his is in spite of recognition that man of the behaviours associated with autism are the result of an'iet . ! renowned autism e'pert in !ustralia ,on !twood, is fond of sa ing !utism is an#iety looking for a target . (,. !twood, personal communication, :anuar )*1*). It has been well documented that counselling can assist clients to e'ternalise an'iet such that individuals see themselves as troubled b an'iet rather than being overwhelming and finding it difficult to control (Geldard # Geldard, )**9). 1ven though the work of 9l vb-erg ()**4) in respect to the usefulness of case stud research has been cited, there has been limited research in the area of ongoing counselling and its effectiveness with children with autism. "ore research is needed in the area of the effectiveness of the e'pressive therapies in schools and in particular the effectiveness of sandpla . 1ffectiveness is a best studied through longitudinal &uantitative or mi'ed method studies that can then be generalised to indicate the likelihood of effectiveness with larger populations. Given that students with autism have deficits in verbal language and social interactions, a traditional verbal counselling session ma not be the best counselling method available. @la therap ma be one of the man wa s that educators could reach the child with autism. Re/erences !llen, I., 9olger, ?., # @ehrsson, .. 1. ()**+). 8eflective @rocess in @la ,herap E ! @ractical "odel for /upervising (ounselling /tudents. 2ducation, 1 3 "4$, +7)A+79. 8etrieved, 1), 5ctober, )**9, from, httpEJJlib3.us&.edu.auJBportal J !'line, I.". (19+7). 5lay Therapy. (ambridgeE %oughton "ifflin. !'line, I. ". (19+9). @la therap E ! wa of understanding and helping reading problems. (hildhood 2ducation, 6, 134A141. !'line, I. ". (1971). +ibs' In search of self. "iddlese', 1nglandE @enguin. !'line, I. ". # 8ogers, (. 8. (19+3). ! teacher therapist deals with a handicapped child. 7ournal of !bnormal and Social 5sychology, 48, 119A1+). 7erard, G. (199>) %earing e&uals behaviour. <ondonE $eats @ublishing. 7ernhardt, "., # "ackler, 7. (1973). ,he use of pla therap with the mentall retarded. 7ournal of Special 2ducation, 9"4$, +*9A+1+. 7ills, 8. (. (193*). Fondirective pla therap with retarded readers. 7ournal of (onsulting 5sychology, 14, 1+*A1+9.

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(ampbell, /. (199*) 7ehaviour problems in preAschool children. Few HorkE Guilford .empse , I., # 9oreman, @. ()**1). ! 8eview of 1ducational !pproaches for Individuals with !utism. International 7ournal of +isability, +evelopment and 2ducation, 4:"1$, 1*>A114. .epartment 1ducation ,raining and the !rts ()**3) Inclusive 1ducation /tatement 2 )**3 accessed )*J1*J*9 and available at httpEJJwww.education.&ld.gov.auJstudentservicesJlearningJdocsJinclusedstatement)**3.pdf .upent, :. :., <andsmen, ,., # Ialentine, ". (193>). ,he treatment of dela ed speech b client centered pla therap . 7ournal of (onsulting 5sychology, 1:, 1))A1)3. 1aker, 7. (19;4). Knlocking the famil secret in famil pla therap . (hild and !dolescent Social ;ork, <"4$, )>3A)3>. 9isher, 7. (193>). Group therap with retarded readers. 7ournal of 2ducational 5sychology, 44, >34A >4*. 9l vb-erg, 7. ()**4). 9ive "isunderstandings !bout (aseA/tud 8esearch, Qualitative In&uiry, 1 " $, )19A)+3 Geldard, $. # Geldard, .. (1997) (ounselling children ' ! practical introduction. ,housand 5aks, (alfE /age. Geldard, .. # Geldard, $. ()**9) 7asic personal counselling. (4 th 1dition) 9renchs 9orest, F./.?. !ust.E @earson Guerne , <. (1979). @la therap with learning disabled children. 7ournal of (linical (hild 5sychology, 9, )+)A)++. Guerne , <. (19;>). @la therap with learning disabled children. In (. 1. /chaefer # $. <. 56(onnor (1ds.), =andbook of play therapy (pp. +19A+>3). Few HorkE ?ile . Goss, /. # (ampbell, ". ()**+). ,he Ialue of /andpla as a ,herapeutic ,ool for /chool Guidance (ounsellors. !ustralian 7ournal of >uidance ? (ounselling, 14 " $, )11A))*. %artle , :. ()**+) In (. (assell, # G. / mon, ( 1ds.) 1ssential guide to &ualitative methods in organisational research (pp >)>A>>>). <ondonE /age. %eflin, <. :. # !laimo, .. 9. ()**7) /tudents with autistic spectrum disordersE1ffective instructional practices. Kpper /addle 8iver , F. :. E @earson %olmes, 1., # ?illoughb , ,. ()**3). @la behaviour of children with autism spectrum disorders. 7ournal of Intellectual ? +evelopmental +isability, <8 "<$, 134A14+. In, @. !., # "c.ermott, :. 9. (1974). ,reatment of child abuse. 7ournal of !merican !cademy of (hild 5sychiatry, 1@"<$, +>*A++*. $nell, /. (199;). (ognitiveA7ehavioural @la ,herap . 7ournal of (linical (hild 5sychology , 3 "1$, );A>>. $oegel ,8. <.,# $oegel, <. $. (199*). 1'tended reductions in stereot pic behavior of students with autism through a selfAmanagement treatment package. 7ournal of !pplied )ehavior !nalysis < "1$, 11921)7. $uhli, <. (1979). ,he use of two houses in pla therap . !merican 7ournal of 0rthopsychiatry, 49"<$, +>1A+>3. <anda, 8. ()**7). 1arl (ommunication .evelopment !nd Intervention 9or (hildren ?ith !utism. /ental Aetardation !nd +evelopmental +isabilities Aesearch Aeviews , 1<, 14A)3. <andreth, G., :ac&uot, ?., # !llen, :. (1949). ! team approach to learning disabilities. 7ournal of Bearning +isabilities, "1$, )+A)9. <andreth, <., 8a , ..1., # 7ratton, /. ()**9). @la ,herap In 1lementar /chools. 5sychology in the Schools, 46 "<$, );1A);9. <i, !. (19;1). @la and the mentall retarded child. /ental Aetardation, 19"<$, 1)1A1)4. <ovaas, 5. I. (19;7). 7ehavioral treatment and normal educational and intellectual functioning in oung autistic children. 7ournal of (onsulting and (linical 5sychology, 33, >A9. "astrangelo, /. ()**9). %arnessing the @ower of @la A5pportunities for (hildren with !utism /pectrum .isorders. Teaching 2#ceptional (hildren, 4 "1$, >+A++. "esibov, G., !dams, <., # $linger, <. (1997). !utism' Understanding the +isorder. @lenum @ressE Few Hork. "ilos, ". 1., # 8eiss, /. (19;)). 1ffects of three pla conditions on separation an'iet in oung children. 7ournal of (onsultation and (linical 5sychology, @8, >;9A>93. "und , <. (1937). ,herap with ph sicall and mentall handicapped children in a mentall deficient hospital. 7ournal of (linical 5sychology, 1<, >A9. Fewcomer, 7. <., # "orrison, ,. <. (197+). @la therap with institutionalised mentall retarded children. !merican 7ournal of /ental +eficiency, 3:"6$, 7)7A7>>.

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567rien, @. :. # 7urnett @. (. ()***) (ounselling children using a multiple intelligences framework. )ritish 7ournal of >uidance and (ounselling. : "<$,. >3>A>71. @earson, ". # ?ilson, %. ()**1) Sandplay and symbolwork' 2motional healing ? personal development with children, adolescents and adults. "elbourne, IicE !(18 @earson, ". # ?ilson, %. ()**9) Using e#pressive arts to work with mind body and emotions' Theory and practice. <ondonE :essica $ingsle . 8ose, 8., %owle , "., 9ergusson, !. # :ament, :. ()**9) )ritish 7ournal of Special 2ducation, <6 "1$, >A; /mith, ,. 1. (., @ollowa , 1. !., @atton, :. 8., # .owd , (. !. ()**4) ,eaching students with special needs in inclusive settings. 7ostonE @earson. / wulak, !. (19;+). (reating a whole atmosphere in a group home for retarded adolescents. !cademic 5sychology )ulletin, 6, >)3A>)7. Iinturella, <. # :ames, 8. (19;7). /andpla E ! therapeutic medium with children. 2lementary School >uidance and (ounselling, 1 "<$, ))9A)>;.

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