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Below is a submission paper I (Anne Martens) wrote for consideration in a 2024 conference and in preparation for my Capstone Project.

Title

Harmonizing Movement and the Mind; Integrating Sensory Play in Group Creative Movement for Neurodivergent Children

Introduction

     This presentation explores breathing, humming, and percussion exercises that include mirroring and attunement. These exercises are designed for early elementary children, with consideration given to neurodivergent individuals participating in group creative movement/group dance sessions. This presentation leverages insights from the Polyvagal Theory to guide neuroception to a perceived state of safety and, therein, enhance learning via the internalization of safety and well-being. 

     Group creative movement sessions offer therapeutic opportunities that support the development of proprioception, social skills, and self-regulation skills; however, sensory processing in a group creative movement environment may be challenging (Fan & Ko, 2023; Devereaux, 2017; Takahashi, 2023). Once in a flight, freeze, or fight-like response, the body may be overwhelmed such that the benefits of the group session are diminished. This poses challenges to the instructors/therapists who contend with the question: ‘What do I do?’ (i.e., what exercises should I include and how should I include the exercises in the session?). Some approaches suggest reprimanding the children, including neurodivergent children expressing sensory dysregulation. However, this method may subject neurodivergent participants to unfair punishment that derides the fundamentals of occupational justice (Mellifont, 2023). Including play-based, age-appropriate exercises that strive to elicit the parasympathetic nervous system in the creative movement class helps support the cohesive groups’ sense of doing (engaging in the occupation of play), being (being content in one’s environment), belonging (socializing as a part of a larger group), and becoming (developing a variety of skills) (Wilcock, 1998). 

Abstract

     The discussion for this presentation is creative movement exercises that facilitate engagement via play and stimulation of the parasympathetic nervous system. The reviewed exercises are designed and selected for group dance/creative movement sessions with particular consideration for neurodivergent children. This approach leverages art as a medium that fosters a conducive learning environment by way of the Polyvagal Theory.

      The human experience is deeply rooted in and shaped by sensory interactions. It has long been understood that throughout the lifespan individuals each uniquely perceive, sense, and process their internal and external environment. These perceptions shape one’s neurologic threshold, habituation, self-regulation, stress management, and more (Damasio, 1999; DeGangi, 1989; Dunn, 2001). This presentation discusses age-appropriate creative play exercises centered on breathing, humming, and music/body percussion creation that consider mirroring and attunement. These exercises result from a retired dancer and creative movement instructor’s efforts to tailor inclusive classes. By including exercises that stimulate the parasympathetic nervous system to negate sensory overload, children may integrate their external and internal environment to benefit from creative group movement. 

Body of Submission

     There is a strong connection between art and occupational science; in this regard, the presentation strives to present early elementary school-aged creative activities that promote inclusivity and overall health and well-being. The creative dance environment of group movement may be overwhelming for children, particularly marginalized neurodivergent children. In turn, these children may enlist coping mechanisms that are protective responses but are inhibitory to the process (Ryland et al., 2022). 

     This presentation is grounded in Stephen Porges’ “The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation” (2011). Porges’ Polyvagal Theory (2011) provides insight into neuroscience by exploring the autonomic nervous system to stress/highlight the biological/fundamental need for safety and connection to effectively regulate functions that are imperative to learning and social interaction (Porges, 2011). According to Porges (2021), social interaction and play are imperative aspects of maintaining a balanced polyvagal system and, therein, health and well-being.       Unfortunately, neurodivergent children are at risk for social deprivation and group play deprivation, which is particularly relevant to the creative dance environment in which a lack of education and ‘know-how’ works against the inclusion of neurodivergent children. This presentation presents 'tried and true' primary creative exercises resulting from a creative dance instructor’s effort over 20+ years of teaching and working with neurodivergent children in the group movement setting. 

     Congruent with the American Occupational Therapy Association’s “Occupational Therapy Practice Framework Domain & Process; 4th Edition” (2020), the presentation leans into the occupation of play because it serves as a medium that intrinsically motivates children to engage in a client-centered activity that is often used as leverage for intervention, and is frequently the figurative lens for which occupational scientists study young children (Brown & Lynch, 2023; Bundy et al., 2012; Bundy & Du Troit, 2019; Moore & Lynch, 2018).  Furthermore, play is the primary occupation of childhood and, as such, is the medium for which a substantial amount of growth and development occurs (Bundy, A.C, 2012). However, neurodivergent children are at increased risk of group play deprivation due to sensory integration issues (O’Connor et al., 2021). 

Breathing Exercises 

 Breathing exercises create a relatively quick positive shift in the autonomic nervous system, which operates at the unconscious level. The body may respond to deep breathing exercises to elicit a parasympathetic response that eases negative, overwhelming, stressful feedback for the polyvagal system (Porgess, 2011; Taylor et al., 2022). Aside from the Polyvagal Theory, it is well-documented that breathing exercises promote a sense of well-being that therein is the development of a stress-resistant technique (Chen et al., 2017; Croghan et al., 2023; Deadman, 2018). Furthermore, the beneficial power of breathing exercises in many cultures has traversed thousands of years (Deadman, 2018; Xu et al., 2022). The benefits of deep breathing exercises to regulate the autonomic system to promote well-being and support a sense of well-being are also documented in children and, therefore, are an imperative aspect of the selected exercises presented (Röwer et al., 2022). The presentation will review three breathing exercises designed in a playful manner for early elementary-age children, with consideration given to neurodivergent participants.

Music via Bodily Percussion 

Musical, bodily percussion engages the body in a rhythmic activity that helps support the parasympathetic nervous system to effectively reduce and/or prevent stress and anxiety. Additionally, self-generated music and rhythm promote the development of proprioception (Haglund et al., 2023). The presentation will discuss three musical, bodily percussion exercises designed in a playful manner for elementary-age children with consideration for neurodivergent participants. 

Humming 

Humming directly affects the vagus nerve to engage the parasympathetic nervous system (Porgess, 2011; Porgess, 2021; Weitzberg & Lundberg, 2002; Goldman et al., 2017). The presentation will review three humming exercises designed in a playful manner for elementary-age children, with consideration given to neurodivergent participants.

Mirroring and Attunement

Imperative to the presentation is the discussion of mirroring and attunement. Attunement can provide a participant and instructor with a sense of safety that supports the education process (Porgess, 2021; Porgess, 2011; Devereaux, C., 2017). In essence, the simple act of an instructor/therapist modeling breathing, percussion, and humming exercises followed by a call to action for the group to join in the exercises via mirroring supports, the cohesive co-regulation of the group (Resinicoff et al., 2023). Inclusive of the therapist/instructor, the mirroring and attunement of the class moving in synch with one another, similar to a flock and murmuration of birds, elicits a parasympathetic response. 

Conclusion

     The outcomes experienced with this integrative approach include improved participation and engagement in group movement activities, particularly denoted in neurodivergent children. 

Personal Statement

      My journey as a dance (primarily ballet) instructor and occupational therapy student is driven by a passion to explore and enhance the interplay between movement and art during child development. This project is the culmination of my experiences and a testament to my belief in the transformative power of integrating creative arts into occupational science. There is a need for neurodivergent support and acceptance in movement (dance) spaces. When dance is accessible, inclusive, and accepting of neurodivergent individuals, dance can serve as a therapeutic and expressive medium. In a society where discrimination against neurodivergent individuals remains deeply ingrained, both consciously and subconsciously, it is crucial to champion, cultivate, and support inclusive environments. As a prospective occupational therapist, I believe this can be accomplished via professional development/education platforms, tailored interventions, sensory accommodations, program development (i.e., specific and evidence-based classes designed specifically for autistic individuals of all ages), collaboration with professional art communities, and community awareness workshops. Mellifont’s (2023) exploration of discrimination within the legal system underscores systemic discrimination against neurodivergent individuals. Therein, Mellifont underscores the need for a paradigm shift to create and uphold safe spaces for the neurodivergent. In turn, the article elucidates that sanism and neurodivergent discrimination are systemic, highlighting that such biases and prejudices extend to a variety of societal contexts, including dance/movement spaces (Mellifont, 2023).

(References Available Upon Request)

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