Art has often helped children with autism communicate, creating a language that goes beyond words.

Dr Sunita Maleku Amatya is an anaesthesiologist and the chairperson of AutismCare Nepal Society (ACNS), an active non-governmental organisation dedicated to empowering people with autism. The space protects and promotes their rights and helps them explore their potentialities to participate meaningfully in society.

Addressing the needs of children with autism, especially in terms of their expression, exploration and interaction, art remains the apex of mediums. Colours, textures, and shapes foster their connectivity and help them navigate their sensory weight.

Amatya reflects on her observations, research, and experiences in understanding children, particularly her son, and witnesses how art invites experimentation, curiosity, and freedom in them better than other methods.

For many children with autism, communication does not happen through speech. How do colours, lines, textures, and shapes become alternative forms of expression, and what do they reveal that sometimes words can not?

For children with autism, communication is one of the core impairments which they carry throughout life. Art ultimately becomes one of the most powerful media of expression.

The autistic brain is different from others; its functions and understanding differ from those in the neurotypical world, where colours, textures and shapes are compositions that create an instant, holistic impression, promoting emotions and sensations. I want to believe that they perceive art and express themselves through it in their own unique ways.

Compared to conventional therapeutic approaches, what makes art therapy uniquely suited to meet the needs of autistic children?

Autistic children have difficulty navigating social situations or reciprocating with people. Conventional therapy or behavioural intervention mandates that therapists be involved to some extent.

One-on-one conversations or following restrictive instructions may sometimes not be in their interests. Although different therapy supports are part of their development trajectory, it is challenging to get them motivated to follow without reward or positive reinforcement.

In art therapy, art can be a random expression of colours, shapes, lines, dots, and play with hands, with visible outcomes to cherish. An exciting feeling of success for the creations.

I believe it builds their self-esteem and confidence by reinforcing a product. They can be in groups or enjoy the activities alone, which puts less pressure on them for reciprocation. In my experience, many children can stay calm and focused, enjoying the beauty of colours and movements of brushes.

Children with autism often experience intense emotions and sensory overload. How can art therapy be presented as a medium for them to navigate and understand their emotions, memories, perception and social interactions?

Lack of social awareness, difficulty with social reciprocity, difficulty with predictability and sensory differences can overload intense emotions for children with autism.

Art gives them the freedom to pour colours, shapes, lines, or any form of representation however they want, without imposing demands on them or provoking them to follow conventional social rules. Art is presented as a ground to express without placing expectations on them, helping them shape their emotions and perceptions of the world around them.

Social interaction is, by default, challenging and demand-driven for children on the spectrum. With the freedom to play and express, they will naturally reciprocate with the surrounding, which will improve their social awareness. This will indirectly foster their social connectedness and help them develop their comfort zone.

In a country like Nepal, where awareness around autism and mental health is still evolving. How do you see art therapy shaping the psychological and educational landscape in the years ahead?

In our country, there is minimal awareness about the power of art for the neurotypical or neurodiverse community in fostering their holistic development. Art is seen as an extracurricular activity or an added subject, not a necessity.

Regardless, the comprehension of autism and mental health is evolving. The past decade has been well served with the awareness of the word ‘autism’, but the fundamental understanding of the subject has still not been reached. Mental health remains the most marginalised subject.

Most people with autism need lifelong support depending on their functional status. Therapies are needed not only in childhood but throughout life, although the modalities and doses vary across individuals.

I want to fiercely advocate for mainstreaming these modalities into educational and treatment programmes in schools, within local communities, and beyond. This can act as one of their crucial components of overall development, including communication and social interaction through art and other therapeutic approaches.

Could you share a moment from your practice where art therapy brought a breakthrough, however small, that changed a child’s emotional or social trajectory?

To start with, my autistic son, who, from childhood, used to draw toilets, elevators and electrical poles most of the time. He not only drew them but also used to create the pieces through clay or flour dough. We eventually realised he has a very sharp visual memory, which he can bring down on paper or in clay work.

In 2024, we did his 35-piece solo art exhibition. Although he had difficulty with two-way communication, during his exhibition, he was very focused, poised, and enthusiastic, explaining his work to the audience. He was at his best. We could see his high self-esteem and his motivation to do more. Art has been one of his identities and a means of understanding society. He sketches temples, which he is not trained for, but does on his own.

Besides, we have conducted a few art workshops with our students at AutismCare Nepal Society for children with support needs at levels 2 to 3. They seemed to enjoy and explore colours. When they are framed and showcased at occasions, their faces bloom with satisfaction and self-esteem. For these reasons, art therapy should be mainstreamed.