We review evidence of non-verbal, embodied narratives in human infancy to better understand their form and function as generators of common experience, regulation, and learning. We examine their development prior to the onset of language, with a view to improve understanding of narrative as regular motifs or schemas of early experience in both solitary and social engagement. Embodied narratives are composed of regular patterns of interest, arousal, affect, and intention that yield a characteristic four-part structure of (i) introduction, (ii) development, (iii) climax, and (iv) resolution. Made with others these form co-created shared acts of meaning, and are parsed in time with discreet beginnings and endings that allow a regular pattern to frame and give predictive understanding for prospective regulation (especially important within social contexts) that safely returns to baseline again. This characteristic pattern, co-created between infant and adult from the beginning of life, allows the infant to contribute to, and learn, the patterns of its culture. We conclude with a view on commonalities and differences of co-created narrative in non-human primates, and discuss implications of disruption to narrative co-creation for developmental psychopathology. 

Narrative as co-regulation: A review of embodied narrative in infant development.

Emotion Regulation is a key factor in the psychological well-being of children on the autism spectrum. Therapeutic co-regulation is posited here as fundamental to addressing Emotion Regulation needs. A therapeutic combination of Child-Centred Play Therapy and Rhythmic Relating is assessed in its potential to improve Emotion Regulation outcomes (over 10 months; 25 weekly sessions), via co-regulatory experience, in a case study of a 5-year-old autistic boy. The parent-rated Emotion Regulation Checklist (Shields & Cicchetti, Developmental Psychology, 33, 1997, 906) was completed every week. Mean Start and Finish scores were taken for checklist total and all subscales. Emotion Regulation percentage-change-over-time values are calculated for the participant and, using percentiles, are compared and statistically ranked in relation to our comparison group: Autistic boys without concurrent cognitive impairment, not receiving psychological or behavioural therapies (over 10 months; N = 66). A graphical representation of Emotion Regulation demonstrates weekly change. As compared to our comparison group, our participant's overall Emotion Regulation improvements (over 10 months) are statistically likely to be due to his participation in therapy (p < 0.04). Graphical representation of Emotion Regulation over time demonstrates a compelling blind correlation between the period of significant positive change in our participant's Emotion Regulation and the therapist's clinical notes on positive change observed in the clinic. 

Child‐Centred Play Therapy and Rhythmic Relating improves emotion regulation in autism: A single‐N pilot intervention study

Music therapy as a meta-verbal therapy method has a clear bodily connection, which can be associated with embodiment processes. In cognitive science, embodiment refers to the interactions between body and psyche in mental processes. Embodied cognition denotes that sensory and motor functions are fundamentally integrated into cognitive processing. The traditional top-down model of stimulus processing, controlled solely by the brain, is expanded to include bottom-up and circular processes originating in the body. Non-verbal behaviour is physical and plays a central role in social interaction. Developmental psychology models, based on infant research, are revealing: Damasio describes the mutual influence of bodily states and behaviour. Meltzoff embraces cross-modal perception and early imitation behaviour. Stern focuses on communication via dynamic »micro-shifts« in all forms of expression and places the body at the centre of the core self. Trevarthen and Malloch speak of communicative musicality in interaction, which can be directly transferred to music therapy. In music therapy literature, embodiment is mainly addressed in the field of autism spectrum. In assessment tools such as the Assessment of the Quality of Relationship (AQR) or the Music-based Scale for Autism Diagnostics (MUSAD), the body plays an important role in therapy evaluation and diagnostics. It would be desirable to link music therapy research and practice to the newer findings and models of cognitive research and developmental psychology. 

Embodiment, frühkindliche Entwicklung und musikalische Kommunikation

The discipline of Creative Arts Therapies (CATs) has begun to articulate mechanisms of change and therapeutic factors that are shared across the various modalities (dance/movement, drama, music, art, poetry) while also identifying specific factors within a discipline. Further development of this work is imperative towards establishing theories that can be tested to advance the efficacy of the CATs. Through an in-depth literature review and a supporting clinical case study, Aesthetic Mutuality (AM), a CAT fundamental mechanism, is further developed to provide a theoretical framework and taxonomy for “picking up” within dance/movement therapy (DMT). Furthermore, the theory of AM reveals, deepens, and connects shared aspects of active ingredients within the Arts in Health discipline while also differentiating from the CATs through the therapeutic relationship. Specifically, eight components of the therapeutic movement relationship are identified and described within DMT. Aesthetic mutuality enriches both the CAT and AiH disciplines, offering implications for education, research, and practice. 

Aesthetic Mutuality: A Mechanism of Change in the Creative Arts Therapies as Applied to Dance/Movement Therapy

learning, Pum was instructed how to understand and use social verbal language. And she worked hard to learn speech, reading, and writing through copying particular demonstrations of these, and with obsessive attention to detail of politeness and needs of others. This led to an unintegrated sense of self, which was eventually expressed in mental health symptoms of chronic anorexia and depression. It was only many years later in adult life, after ongoing therapy and some decades of self-reflection and analysis that she came to understand that she had developed a disjunction between what we now know as her Core Self – her core affective, perceptual, and embodied Self – and her more artificial, rational, and reflective Tertiary Self.

Prologue: The Interpersonal World of the Autistic Infant, Part 2: Modes of Treatment

We propose Rhythmic Relating for autism: a system of supports for friends, therapists, parents, and educators; a system which aims to augment bidirectional communication and complement existing therapeutic approaches. We begin by summarizing the developmental significance of social timing and the social-motor-synchrony challenges observed in early autism. Meta-analyses conclude the early primacy of such challenges, yet cite the lack of focused therapies. We identify core relational parameters in support of social-motor-synchrony and systematize these using the communicative musicality constructs: pulse; quality; and narrative. Rhythmic Relating aims to augment the clarity, contiguity, and pulse-beat of spontaneous behavior by recruiting rhythmic supports (cues, accents, turbulence) and relatable vitality; facilitating the predictive flow and just-ahead-in-time planning needed for good-enough social timing. From here, we describe possibilities for playful therapeutic interaction, small-step co-regulation, and layered sensorimotor integration. Lastly, we include several clinical case examples demonstrating the use of Rhythmic Relating within four different therapeutic approaches (Dance Movement Therapy, Improvisational Music Therapy, Play Therapy, and Musical Interaction Therapy). These clinical case examples are introduced here and several more are included in the Supplementary Material (Examples of Rhythmic Relating in Practice). A suite of pilot intervention studies is proposed to assess the efficacy of combining Rhythmic Relating with different therapeutic approaches in playful work with individuals with autism. Further experimental hypotheses are outlined, designed to clarify the significance of certain key features of the Rhythmic Relating approach.

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Penelope Dunbar

Papers

Rhythmic Relating: Bidirectional Support for Social Timing in Autism Therapies