The present study was conducted to evaluate the impact of visual expressive art therapy on enhancing nonverbal communication skills in children with auditory impairments. Non-verbal communication plays a crucial role in the social and emotional development of children who experience hearing loss, as it often serves as a primary means of interaction. Recognizing this, the intervention aimed to explore whether engaging in visual art-based therapeutic activities could foster improvements in the children’s ability to communicate non-verbally. The results of the study demonstrated a marked improvement in non-verbal communication abilitiesfollowing the implementation of the therapy. Specifically, the average (mean)score of participantsincreased from 35 in the pre-intervention phase to 46.11 after the therapy was administered. This notable increase suggests a positive shift in the children’s communication competencies. Furthermore, a paired t-test was conducted to determine the statistical significance of the observed change. The analysis yielded a t-value of 14.06, which was found to be significantly higher than the critical value at the 0.001 level of significance. This strong statistical outcome indicates that the improvement was not due to random chance, but rather, it can be confidently attributed to the effect of visual expressive art therapy. Based on these findings, it can be concluded that visual expressive art therapy is a highly effective approach for improving non-verbal communication skills in children with hearing impairments. The structured use of visual arts appears to provide a meaningful outlet for expression, thereby enhancing the children’s ability to convey emotions, thoughts, and needs through non-verbal means. This therapy could be considered a valuable addition to existing educational and therapeutic programs for children with auditory challenges, promoting better social interaction and emotional well-being.

Keywords: Visual expressive, art therapy, nonverbal communication skills, auditory impairment

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1. Integrity. Art Therapy in Special Education: Does It Really Help? Available from: https://www.integrityinc.org/unlocking-potential-with-art-therapy-in-special-education/
2. Kim KS. Acute bacterial meningitis in infants and children. Lancet Infect Dis. 2010 Jan;10(1):32– 42. doi: 10.1016/S1473-3099(09)70306-8. PMID: 20129147.
3. Martínez-Vérez V, Gil-Ruíz P, Domínguez-Lloria S. Interventions through Art Therapy and Music Therapy in Autism Spectrum Disorder, ADHD, Language Disorders, and Learning Disabilities in Pediatric-Aged Children: A Systematic Review. Children (Basel). 2024 Jun 7;11(6):706. doi: 10.3390/children11060706. PMID: 38929285; PMCID: PMC11201401.
4. Clunn PA. Child Psychiatric Nursing (Psychiatric Nursing Series). Mosby; 1990 Oct 1.
5. Shalev O. Art Therapy during COVID-19 with a Deaf Client Diagnosed with Schizophrenia: A Case Report. OBM Integr Complement Med. 2023;8(3):028. doi:10.21926/obm.icm.2303028.
6. Verywell Mind. What Is Expressive Arts Therapy? Available from: https://www.verywellmind.com/expressive-arts-therapy-definition-types-techniques-and-efficacy-5197564.
7. Census Digital Library. Disabled population by type of disability, age and sex (all), NCT of Delhi - 2001. Available from: https://censusindia.gov.in/nada/index.php/catalog/22991.
8. Times of India. Deafness in Tamil Nadu 3 times higher than national average. 2013. Available from: https://timesofindia.indiatimes.com/india/deafness-in-tamil-nadu-3-times-higher-thannational-average/articleshow/20300895.cms.
9. Duncan J. Conversational Skills of Children with Hearing Loss and Children with Normal Hearing in an Integrated Setting. ERIC; 2003. Available from: https://eric.ed.gov/?id=EJ627931.
10. Gupta S. The short textbook of pediatrics. 13th ed. Missouri: Jaypee; 2009.
11. Kyle T, Ricci SS. Maternity and pediatric nursing. China: Lippincott Williams & Wilkins; 2009.
12. Lodentiorwitz EG. Visually speaking: Art therapy and the deaf. Philadelphia: Chalsec; 2000. Available from: https://mys1cloud.com/cct/ebooks/9780398077167.pdf.
13. Barker DH, Quittner AL, Fink NE, Eisenberg LS, Tobey EA, Niparko JK; CDaCI Investigative Team. Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication. Dev Psychopathol. 2009 Spring;21(2):373–92. doi: 10.1017/S0954579409000212. PMID: 19338689; PMCID: PMC2730756.
14. Lewis J, Boucher L, Lupton S, Watson V. Relationships between symbolic play, functional play, verbal and non-verbal ability in young children. Int J Lang Commun Disord. 2000;35(1):117–27. doi:10.1080/136828200247287.
15. Bitan M, Regev D. Clinicians’ Perceptions of Parent-Child Arts Therapy with Children with Autism Spectrum Disorders: The Milman Center Experience. Children (Basel). 2022 Jun 29;9(7):980. doi: 10.3390/children9070980. PMID: 35883964; PMCID: PMC9318189.

The present study was conducted to evaluate the impact of visual expressive art therapy on enhancing nonverbal communication skills in children with auditory impairments. Non-verbal communication plays a crucial role in the social and emotional development of children who experience hearing loss, as it often serves as a primary means of interaction. Recognizing this, the intervention aimed to explore whether engaging in visual art-based therapeutic activities could foster improvements in the children’s ability to communicate non-verbally. The results of the study demonstrated a marked improvement in non-verbal communication abilitiesfollowing the implementation of the therapy. Specifically, the average (mean)score of participantsincreased from 35 in the pre-intervention phase to 46.11 after the therapy was administered. This notable increase suggests a positive shift in the children’s communication competencies. Furthermore, a paired t-test was conducted to determine the statistical significance of the observed change. The analysis yielded a t-value of 14.06, which was found to be significantly higher than the critical value at the 0.001 level of significance. This strong statistical outcome indicates that the improvement was not due to random chance, but rather, it can be confidently attributed to the effect of visual expressive art therapy. Based on these findings, it can be concluded that visual expressive art therapy is a highly effective approach for improving non-verbal communication skills in children with hearing impairments. The structured use of visual arts appears to provide a meaningful outlet for expression, thereby enhancing the children’s ability to convey emotions, thoughts, and needs through non-verbal means. This therapy could be considered a valuable addition to existing educational and therapeutic programs for children with auditory challenges, promoting better social interaction and emotional well-being.

Keywords: Visual expressive, art therapy, nonverbal communication skills, auditory impairment

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Integrity. Art Therapy in Special Education: Does It Really Help? Available from: https://www.integrityinc.org/unlocking-potential-with-art-therapy-in-special-education/
2. Kim KS. Acute bacterial meningitis in infants and children. Lancet Infect Dis. 2010 Jan;10(1):32– 42. doi: 10.1016/S1473-3099(09)70306-8. PMID: 20129147.
3. Martínez-Vérez V, Gil-Ruíz P, Domínguez-Lloria S. Interventions through Art Therapy and Music Therapy in Autism Spectrum Disorder, ADHD, Language Disorders, and Learning Disabilities in Pediatric-Aged Children: A Systematic Review. Children (Basel). 2024 Jun 7;11(6):706. doi: 10.3390/children11060706. PMID: 38929285; PMCID: PMC11201401.
4. Clunn PA. Child Psychiatric Nursing (Psychiatric Nursing Series). Mosby; 1990 Oct 1.
5. Shalev O. Art Therapy during COVID-19 with a Deaf Client Diagnosed with Schizophrenia: A Case Report. OBM Integr Complement Med. 2023;8(3):028. doi:10.21926/obm.icm.2303028.
6. Verywell Mind. What Is Expressive Arts Therapy? Available from: https://www.verywellmind.com/expressive-arts-therapy-definition-types-techniques-and-efficacy-5197564.
7. Census Digital Library. Disabled population by type of disability, age and sex (all), NCT of Delhi - 2001. Available from: https://censusindia.gov.in/nada/index.php/catalog/22991.
8. Times of India. Deafness in Tamil Nadu 3 times higher than national average. 2013. Available from: https://timesofindia.indiatimes.com/india/deafness-in-tamil-nadu-3-times-higher-thannational-average/articleshow/20300895.cms.
9. Duncan J. Conversational Skills of Children with Hearing Loss and Children with Normal Hearing in an Integrated Setting. ERIC; 2003. Available from: https://eric.ed.gov/?id=EJ627931.
10. Gupta S. The short textbook of pediatrics. 13th ed. Missouri: Jaypee; 2009.
11. Kyle T, Ricci SS. Maternity and pediatric nursing. China: Lippincott Williams & Wilkins; 2009.
12. Lodentiorwitz EG. Visually speaking: Art therapy and the deaf. Philadelphia: Chalsec; 2000. Available from: https://mys1cloud.com/cct/ebooks/9780398077167.pdf.
13. Barker DH, Quittner AL, Fink NE, Eisenberg LS, Tobey EA, Niparko JK; CDaCI Investigative Team. Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication. Dev Psychopathol. 2009 Spring;21(2):373–92. doi: 10.1017/S0954579409000212. PMID: 19338689; PMCID: PMC2730756.
14. Lewis J, Boucher L, Lupton S, Watson V. Relationships between symbolic play, functional play, verbal and non-verbal ability in young children. Int J Lang Commun Disord. 2000;35(1):117–27. doi:10.1080/136828200247287.
15. Bitan M, Regev D. Clinicians’ Perceptions of Parent-Child Arts Therapy with Children with Autism Spectrum Disorders: The Milman Center Experience. Children (Basel). 2022 Jun 29;9(7):980. doi: 10.3390/children9070980. PMID: 35883964; PMCID: PMC9318189.