Review of the literature related to the use and 
effectiveness of performing arts interventions for autistic children to improve social skills

1. Introduction
According to some researchers wellbeing and quality of life can be defined as stable when people have the 
means needed to overcome their own psychological, physical and/or social challenges (Dodge et al., 2012). 
When these challenges are related to a lack of social skills or socialisation, as it often happens within autistic 
people (Goldstein et al., 2017), it may be hard to identify what resources we can provide them with, in order 
1
for them to overcome them. 
In this global picture, it is important to highlight the importance not only of drama interventions as a tool 
to improve social skills, but also, to give agency to the children involved, in terms of enabling them to “initi-
ate and lead the action as much as possible” (Beadle-Brown et al., 2017, p.3). 
The ‘Capability theory approach’ as well as the role of education to be able to give agency to children 
(Terzi, 2005, p.219), both support the idea that improving social skills could lead to an increase in inclusion 
and, therefore, an increase in opportunities (Terzi, 2005).
This project is inspired by a number of articles identified on drama techniques and their  effectiveness 
on autistic children. The general idea behind the research included in this study is that, since theatre plays 
such an important role in developing empathy and theory of mind (Verducci, 2000; Levy, 1997; Metcalf, 
1931), theatre-based interventions could be used with children on the spectrum to improve skills related to 
these areas.  
A number of researches have demonstrated the importance of social cognitive skills in people’s everyday 
life (Trowsdale & Hayhow, 2013; Goldstein and Winner, 2012), and some research at European level on the-
atre studies and performance started to meet cognitive sciences, resulting in international programmes and 
collaborations (Muscat and Schranz, 2007). Nevertheless, a lot can still be done in order to investigate the 
deep link between the arts and cognitive neuroscience (Goldstein et al., 2017; Falletti, Sofia &Jacono, 2017). 
Some work has been done to review the literature on school based drama interventions regarding health 
promotion (Joronen et al., 2008), and literacy outcomes (Anderson, et al., 2017), as well as to test efficacy of 
drama interventions when paired with scientific designs (Lerner and Mikami, 2012). Müller et al. (2017) re-
search included a literature review on studies about teaching art techniques to students and its “collateral gains 
in social and emotional learning” (Müller et al., 2017, p. 156). Although Müller’s literature review includes 
many of the studies identified by this project under the US results section, no reference is made to UK based 
intervention studies or articles from other countries. A recent systematic review (Mpella, Evaggelinou, 2018) 
has investigated the role of theatrical play in promoting social skills in autistic students, identifying twelve 
English studies in the school settings. Findings indicated benefits on social skills improvement, and all studies 
agreed on the aspect of training for teachers implementing theatre programmes in schools.  
Although reviewing the literature on the effectiveness of theatre-based interventions in improving social 
skills in autistic children is the main aim of this study, it is important to have a clearer understanding of the 
 This study will take into account the terms “autistic” and “people on the autism spectrum” as these have been considered preferred 
1
terms to describe autism from the UK autism community (Kenny et al., 2016).
-  - 5
concepts underpinning this study, such as: the concept of ‘Triad of impairments’ (Cashin & Barker, 2009, p. 
189), the link between creative arts and social skills. as well as the reason why, among all different creative 
arts, this study will focus specifically on theatre-based interventions. 
The current Autistic Spectrum Disorder diagnostic criteria include what has been defined traditionally as 
the ‘triad of impairments’ which involve an impairment in communication, social skills and behavioural flexi-
bility (Cashin & Barker, 2009).  Some research suggests that “latent social skills” can be found in those peo-
ple on the autism spectrum, who may not develop them due to a lack of opportunities to engage in ‘successful 
peer interactions’ (Lerner, 2013, p.7).   
Learning how to channel these abilities in useful skills (Happé & Frith, 2009), might bring personal satis-
faction to autistic people, and working on elements like “envisioning, expressing” (Goldstein et al., 2017, p.8) 
through art and drama, can target the above mentioned impairments and improve communication, theory of 
mind (ToM) and imaginative thinking (Corbett, 2016).  
According to Shaughnessy (2012), the ‘triad of impairments’ (Shaughnessy, 2012, p.323), as described 
above, maps into the three areas of drama: imagination, interaction, and communication, which explains why 
theatre, of all performing arts,  has been considered as a school for emotion (Levy, 1997). Also, it is widely 
believed that the reason why theatre plays such a huge role in ‘teaching how to feel’ is linked to the way mir-
ror neurons work, by lighting up when a person observes another person doing something in order to interpret 
their intentions (Ferrari, 2012). 
Able to educate children to feel and to be a ‘stimulus for emulation’ (Levy, 1997, p.68),  theatre has been 
considered the most useful to develop empathy and theory of mind (Goldstein and Winner, 2012, p. 20) 
among all different forms of performing arts (dance, music, puppetry, drama, etc.), due to its “holistic” nature 
(Mirabella, 2017, p.160) and its ability to address both emotions and body perception.  
Theatre companies and associations also play an important part in the development of these activities and 
in providing opportunities for autistic children to be exposed to these interventions, as only 50% of schools 
seem to offer this opportunity (Goldstein et al., 2017) in the UK and some research has identified a good per-
centage of use of drama activities in mental health in the north of Italy (Valli et al., 2016), although not specif-
ically aimed at children on the autism spectrum, but more generally at people with mental health conditions. 
The growing number of programmes involving theatre and drama addressed to autistic children (Gabriel et al., 
2017) suggests the need for analysing the theatrical elements and techniques that they encompass, in order to 
understand which are the most used and most effective so far. 
For these reasons, this project aims at reviewing studies based on those drama/theatre interventions that 
consider autistic children as the main protagonists of the activity, and not as spectators of someone else’s ac-
tions like in other therapies (i.e. drama-therapy). 
Research questions  
The present research aims at analysing the following research questions:  
• the number of studies conducted on the topic of theatre interventions and autistic children;  
• the effectiveness of the identified studies in terms of social skills improvement;  
-  - 6
• which are the different drama-based interventions that have been implemented with children on the 
spectrum, with a special focus on interventions implemented in the UK and in Italy;  
• differences and similarities among the interventions identified by the scoped literature in terms of 
positive outcomes; 
• which theatre elements have been used with children on the spectrum; 
Purpose 
The purpose of this project is to review the literature on the nature and effectiveness of theatre-based 
interventions in improving social skills in autistic children by using a qualitative methodology. Moreover, 
studies reviewed were synthesised according to their positive outcomes, in order to understand benefits of 
theatrical interventions in terms of social skills.
 2. Method
Although researchers have stated the importance of developing rigorous studies in the field by implement-
ing interventions with strong designs (Muscat & Schranz, 2007), the majority of studies identified in this field 
in an initial search varies substantially in terms of design, participants characteristics, settings, countries, types 
of interventions, aims and findings. This is linked to the fact that some of the studies develop the theme of 
theatre with autistic children from an artistic perspective, whilst others adopt a scientific approach and others 
are still interdisciplinary in nature and combining theatre studies with neuroscientific literature (Falletti et al., 
2016).  As such, a qualitative approach to the review is more appropriate than a quantitive approach such as 
meta-analysis.  

 Search strategy and selection of studies 
Searches were conducted by analysing results from a) electronic search of the following databases: Google 
Scholar, Zetoc Online, SCOPUS, PsycINFO, EBSCO host, British Education Index, WorldCat Dissertations 
and Theses; b) online hand-search for 2018 issues of the journals where relevant literature had been identified 
through the databases; c) paper hand-search undertaken in libraries of the following most relevant Italian 
scientific publications in the field of theatre, autism and developmental disabilities for the period between 
2014 and 2018: Autismo e disturbi dello sviluppo; Hacca Parlante; Difficoltà di Apprendimento e Didattica; 
Catarsi, teatri delle diversità. 
77 full-text articles assessed for eligibility, but were additionally screened to check if they: a) focused on 
social skills improvement; b) applied theatre-based interventions; c) were dissertations not older than 2016. 
However, the hand-search of the above mentioned publications as well as a search of the databases with 
terms in Italian, produced only four articles referring to interventions, as most of the results focused on social 
theatre as a tool to increase social inclusion and fighting stigma, a topic which would benefit from further 
-  - 7