SENSE study examines theatre participation’s effect on stress, self-perception in autism

Photo of SENSE Theatre participants

VKC investigator Blythe Corbett, Ph.D., recently published findings on the effects that theatre arts participation may have on adolescents on the autism spectrum, including their levels of psychological stress in social settings as well as their self-perception of stress. The findings were reported in the journal Autism.

According to the American Psychiatric Association, autism spectrum disorder (ASD) is characterized by impairment in social competence as well as restricted or regimented interests and/or behaviors. Because of these characteristics, those with ASD tend to shy away from stressful situations such as large social gatherings or group activities. Corbett, who is associate professor of Psychiatry & Behavioral Sciences and Psychology, has spent years studying the effects that involvement in theatre arts activities might have on social functioning and the stress generated from such social settings.

Headshot of Blythe Corbett, Ph.D.

Blythe Corbett, Ph.D.

Corbett is founder and principal investigator of SENSE Theatre. In this intervention program, a variety of acting techniques are used, including role-play, scripts, and improvisation. These techniques provide an opportunity for participants with ASD to explore and to practice social interaction skills in a safe and supportive environment. Children with autism are paired with typically developing actors of a similar age and gender who, in addition to being co-actors in a production, serve as the participants’ peer models.

“If we want to learn about something, we ask an expert,” said Corbett. “We can view actors as experts of self-expression, which can be a helpful tool when working with adolescents with autism. Theatre techniques help us express ourselves through social communication. Those with ASD can be a bit rigid in the way they respond to the social world, so we’ve brought these two communities together.”

There are two sessions of SENSE Theatre Camp held during the year, in winter (experimental) and in summer (wait-list control group). Participation is open to children and youth ages 8 to14 years who have a high-functioning ASD diagnosis. The campers are randomized into an experimental group or a control group. Those in the control group take part in data collection the winter before entering the treatment group during the summer session.

Campers begin their involvement as early as 2 to 3 months before camp actually starts by having their cortisol measured at home multiple times over 4 days to determine baseline levels. Cortisol, a hormone used to measure psychological stress and anxiety, is easily obtained through a saliva sample.

“Cortisol follows a diurnal rhythm,” said Corbett. “It’s elevated first thing in the morning to help us prepare for the day, and then it is lower in the evening when we’re winding down for bedtime.”

The campers also spend an afternoon at the Vanderbilt Kennedy Center to take part in a coordinated peer interaction (called Peer Interaction Paradigm or PIP) on the Susan Gray School playground. During this time, campers meet and interact with typically developing peers whom they have never met. The peers are given cues via a tiny earpiece connected to a microphone in the SENSE Lab. Cortisol levels are taken before and after the activity to determine the camper’s peer play baseline, and behaviors are observed via surveillance cameras mounted around the playground.

When the camp portion of the study begins, participants engage in peer-mediated theatre games, such as mirroring, which involves imitating a partner’s actions, thoughts, or feelings. Acting provides the opportunity for the children with ASD to interact with peers and indirectly to practice social skills. Researchers continually monitor campers’ cortisol levels before, during, and after camp day to assess stress/arousal levels. Also, participants report their state-anxiety (current, contextual to surroundings) and trait-anxiety (persistent, more stable) before and after the intervention.

Campers and peers participate in 10 4-hour Saturday sessions, rehearsing an original play that they perform for the public at the end of camp. Blythe Corbett writes these plays with collaboration from director Catherine Coke and music from Ed Bazel and Tammy Vice.

SENSE Theatre participant

SENSE Theatre participant

“The topics of the plays are very intentional,” Corbett said. “We sing and talk about belonging, acceptance, and diversity to share our mission of how to respond to people with intellectual and developmental disabilities.”

Cortisol levels are collected twice again in the following months, both at home and in peer interaction on the playground.

Based on the cortisol tests, Corbett found elevated levels of cortisol in group settings throughout and after the camp experience, which were associated with more social interaction with peers. Importantly, campers reported lower anxiety after the camp concluded.

“It has been well-established that performing tasks that are challenging requires a greater level of effort and arousal. For children with ASD, interacting with novel children on a playground may be considered a challenging task and therefore require more arousal,” said Corbett. “Thus, the finding that higher cortisol is associated with more interaction after the treatment may have more to do with the effort required to engage with others, than the idea that social interaction is simply ‘stressful.’

“Our research in SENSE Theatre thus far is showing that engaging with supportive peers in theatre not only improves social competence in youth with ASD,” she continued, “but also that participants report feeling much less anxious when interacting with others.”

Preparation is underway for the Summer 2017 SENSE Theatre Camp, with performances set for June 16 and 17. For more information about SENSE Theatre, visit http://sensetheatre.com/.

Elizabeth Turner is program coordinator for VKC Communications. 

Photos courtesy SENSE Theatre

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