- Email: [email protected]
Developing an iPad app for assessment in dance movement therapy
The Arts in Psychotherapy 51 (2016) 54–62
Contents lists available at ScienceDirect
The Arts in Psychotherapy
Research Article
Developing an iPad app for assessment in dance movement therapy Kim Dunphy a,∗ , Sue Mullane b , Laura Allen c a
Creative Arts Therapy Unit, University of Melbourne, 49 Thomas St, Hampton 3188, Victoria, Australia Making Dance Matter consultants, 32 Connors Rd, Lancefield 3435, Victoria, Australia c Department of Creative Arts Therapies, Columbia College Chicago, 600 S. Michigan Ave, Chicago, IL, 60605, USA b
a r t i c l e
i n f o
Article history: Received 18 October 2015 Accepted 21 September 2016 Available online 28 September 2016
a b s t r a c t Dance movement therapists face many challenges in implementing effective assessment practices, particularly a dearth of accessible assessment frameworks and functional tools that enable practitioners to collect data. Technological advances are as yet under-utilised in assessment processes. This article introduces Marking the Moves, an i-Pad app developed to expedite assessment of outcomes of dance movement therapy programs, and discusses pilot trials of its first applications in practice. This app is based on the Framework for Dance Movement Assessment devised by the authors for dance movement therapy programs for clients with disability, including intellectual disability, that measures progress across domains of physical, cognitive, emotional, personal and interpersonal growth. Findings of preliminary trials with therapists and peer professionals in two countries indicate favourable response to the app and its potential for use by dance movement therapists in different contexts and client groups. © 2016 Elsevier Ltd. All rights reserved.
Introduction The article discusses the trial of an iPad app, Marking the Moves, created to address challenges that dance movement therapist practitioners have in the lack of accessible assessment frameworks available for their use, and current low usage of technology in assessment processes. The development of the app is a response to the authors’ efforts to develop an assessment tool suitable for the context of Mullane’s dance movement therapy (henceforth, DMT, the acronym used in Australasia) practice in special education, for which no existing tool was suitable. The Framework for Dance Movement Assessment (Dunphy & Mullane, 2016) is a paper-based assessment process that uses twelve pages to include all goals that might be addressed in a DMT program for people with intellectual disabilities, and measures and scales to assess them. Its hard copy format does not allow for adaptation, even when a therapist has set specific goals that might not require the use of the entire Framework for any session. As therapist Mullane, like many others, works with clients in groups, the engagement with such a lengthy document simultaneous with leading a group program was found to be untenable. As well, the large amount of paperwork created by a 12-page assess-
∗ Corresponding author. E-mail address: [email protected] (K. Dunphy). http://dx.doi.org/10.1016/j.aip.2016.09.001 0197-4556/© 2016 Elsevier Ltd. All rights reserved.
ment document used for eight to ten students in a group, multiplied by a number of groups the therapist sees in a day, that needed to be dealt with after a day’s work running sessions, makes its use impractical. The incorporation of technology to address this need for efficiency was a logical development. A further challenge considered was the fact that the therapist in this situation was supported only by staff members who do not have DMT qualifications, and are therefore unable to assist in assessment process using tools that require very specialised training. We hypothesised that the field of DMT would be advanced and the evidence-base potentially bolstered by the development of a technological solution for efficient, comprehensive and theory-based assessment that could also be understood and possibly used by professionals who are knowledgeable about their population, individual clients and goals of the setting, but do not necessarily have DMT training. In the article to follow, a brief overview is provided of relevant bodies of literature including assessment practices and the emerging use of technology in assessment in dance movement and other therapies, and other relevant professions. The article then introduces the Framework for Dance Movement Assessment on which the app is based, before discussing the development of the app and its current form. The final section presents findings of two preliminary trials of the app undertaken in a special education setting in Melbourne, Australia and a community dance setting in Chicago, USA.
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
Recommendations for future research and development of the app based on these findings are made.
Literature review Assessment in dance movement therapy and related fields A literature review was undertaken to explore current research and documented practice about assessment in dance movement therapy. This was intended to inform our question of how a DM therapist can effectively assess clients’ progress where the professional context does not have established assessment schema for the DMT program, where support may only be provided by staff who are not DMT trained, and when s/he works with groups of clients and is on her feet moving throughout the therapy session. Use of technology to support data collection was also explored, given its potential to address practical challenges for assessment. Some literature was also examined from related professions including other creative arts therapies and psychotherapy and counselling. Material reviewed included recent publications on assessment in dance movement and other creative arts therapies, and major journals such as the American Journal of Dance Therapy; Body, Movement and Dance in Psychotherapy; The Arts in Psychotherapy; Music Therapy Perspectives and the Australian Journal of Music Therapy. This review was complemented by a web search (Google Scholar and Google search engines) to capture work not formally published. The review indicated that DM therapists face significant challenges in providing evidence-based assessment of their programs (Caldwell, 2013; Cruz, 2006; Cruz, 2013; Karkou, 2010; Miller, 2013). These challenges include a dearth of user-friendly comprehensive frameworks (Cruz & Koch, 2012; Powell, 2008), particularly a lack of frameworks that enable description of observable movement (Powell, 2008). Well-known tools for DMT assessment, the Kestenberg Movement Profile (Kestenberg Movement Profile, 2015) and the Movement Diagnostic Inventory (Davis, 1991) require a high level of specialist expertise that limits their use even by DM therapists (Cruz & Koch, 2012; Koch, Cruz, & Goodill, 2001). Such tools also require very specialised skills for understanding data generated. This reduces the usefulness of the information gathered to other stakeholders who do not have DMT training, such as funders, program managers, support staff, families/carers and clients themselves (Dunphy & Scott, 2003; Snow & D’Amico, 2009). As a result of these restricted options, DM therapists who undertake formal assessment very often use self-devised assessment tools and measures (Powell, 2008). This lack of systematic approaches and underuse of standardized instruments has many negative consequences for the field. These include reduced efficiency of individual practitioners, creation of data that does not meet the important scientific requirements of reliability and validity (Gantt, 2000) and loss of potential comparability of data gathered between practitioners and in different settings (Powell, 2008). None of the tools documented seem to offer feasible options for assessment of groups of DMT clients at the same time. The same finding was evident in examination of books about assessment for creative arts therapists. Brooke’s (2006) and Miller’s (2013) edited volumes offer detailed information about recent innovations in a range of creative arts therapy fields. However, tools discussed are largely focussed on clinical situations in which the therapist works one on one with a client, which allows time for detailed documentation of observations of individuals. A similar finding was evident with respect to assessment tools for counsellors and psychotherapists. A research project undertaken by the Psychotherapy and Counselling Federation of Australia
55
considered how data can be collected to increase the evidence base of counselling and psychotherapeutic professions and potentially enable sharing of data between practitioners (PACFA, 2015). A range of instruments were suggested to gauge clients’ feedback about their progress. None of these indicate the capacity for assessing clients who attend sessions in groups or for collection and recording of data while the therapist is engaged in moving with clients. No published evidence was found of specific technological tools currently being used by practitioners for assessment in dance movement therapy. Researcher Cruz reported the development of software technologies that have capacity to tag specific moments in video recordings of client movement and can recognise and record Laban Movement Analysis (Cruz, 2006). However, these seem not to be later reported in use. These findings about the lack of use of technology for assessment were confirmed in discussions about assessment with more than 100 DM therapists from more than ten countries who attended a series of professional development events we led in Australia, USA and Indonesia between 2010 and 2014 (presentations at three American Dance Therapy Association conferences, workshops run by the Dance Movement Therapy Association of Australasia and DMT workshops supported by the Asian Psychological Association). No participant offered information about systems they were using or knew of that would address these issues. Two conference presentations we made to education assessment specialists and dance educators also had similar results, with no new tool uncovered. An informal survey of ten Australian colleagues who practice DMT and also work in mainstream therapeutic disciplines (counselling, social work and mental health nursing) undertaken by author Dunphy confirmed this finding, with none of them involved in regular use of technological tools for assessment either. Technology-based assessment tools seem to be underdeveloped in other therapeutic professions as well. While Hahna, Hadley, Miller, and Bonaventura (2012) document a range of technological tools that music therapists have used for assessment since the 1980s, their own survey of use of apps by music therapists reported none in current use for assessment. For example, Magee, Siegert, Daveson, Lenton-Smith, and Taylor, (2014) document a current and sophisticated tool for music therapy assessment that requires manual entry of data into Excel sheets that need to be reentered into computer programs for statistical analysis. One recent major international initiative to encourage the sharing of assessment tools between mental health practitioners recommends a manual process of hard copy worksheets for data collection (Law & Wolpert, 2014). The emerging use of technology in assessment in other professions However, there is some evidence that other creative arts therapists are finding new technology useful in therapeutic processes. Apps used in visual arts therapy practice are documented by Choe (2014), Malchiodi (2012), Mattson (2015), Orr (2012) and Robards (2012), and in music therapy by Knight (2013), who comments that few peer-reviewed articles have been published on the topic. The use of technology for assessment seems somewhat more advanced in visual arts therapies, led largely by Korean researcher Kim. For example, development of a computer system designed to automatically rate elements of clients’ drawings is reported by Kim, Kang, and Kim (2009) and Kim (2010). These findings indicate the openness of therapists to the use of technology in the therapeutic space and potential for further developments. There is also a growing integration of technology and assessment in other related fields. A new initiative for assessment of the quality of performing arts programs uses an app to collect data about audiences’ experience (CultureCounts, 2015). Technology-
56
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
based assessment practice in education, which includes the use of devices such as tablets, has been growing over the past decade, mainly because of the acknowledged need for education to keep pace with societal trends (Fullan & Langworthy, 2014; Perrotta & Wright, 2010; Ripley, 2007). In the education field, technology is viewed as being beneficial for improving fundamental aspects of assessment such as reliability, scalability and efficiency (DEECD, 2008), as well as increasing authenticity, i.e. the use of assessment processes that reflect and are embedded in the natural learning process, in contrast to standardised testing (DEECD, 2008). A newly identified task for teachers and students engaged in learning is that they should “continuously discover and create digital learning tools to assess and share information on students’ learning abilities and dispositions” (Fullan & Langworthy, 2014, p. 13). The development of information and communication technologies in educational assessment practice also expands the range of skills, abilities, knowledge and understanding that can be assessed (Masters, 2013; Perrotta & Wright, 2010). This in turn provides unique diagnostic information to support personalisation of learning and assessment (Fullan & Langworthy, 2014; Masters, 2013; Perrotta & Wright, 2010). This literature indicates potential of the likely usefulness of an assessment tool with similar purpose for dance movement and other creative arts therapies. Having introduced the issues regarding assessment for DM therapists and discussed current practice, this paper now focuses on the Framework for Dance Movement Assessment and the app, Marking the Moves, that authors M and D have devised to address the above issues for DM therapists. The Framework for Dance Movement Assessment The Framework for Dance Movement Assessment was originally developed for DMT programs for clients with disability in community and educational settings, informed by an earlier assessment schema devised by Dunphy and Scott (2003). It was intended to assist therapists with planning and goal setting, support evidencebased understanding of client progress and assist with reporting to other professionals, funders and program managers. The Framework is underpinned by a holistic approach to wellbeing, with Therapeutic Domains comprising physical, cognitive, emotional, interpersonal and expressive/aesthetic domains. These categories derive from Hanna’s (2008) universal descriptors of learning that occurs through dance. They also correspond with aspects of wellbeing considered holistically. In this context, wellbeing is taken to mean a state of equilibrium, where individuals have a unique set of “psychological, social and physical resources . . .to meet a particular psychological, social and/or physical challenge” (Dodge, Daly, Huyton, & Sanders, 2012, p. 230). Aspects of Laban Movement Analysis (Laban, 1988) are used to frame analysis of observed movement. The Framework’s domains and accompanying indicators are used to record the client’s development of progress in the therapeutic process. The theory underpinning this Framework is discussed in more detail elsewhere (Dunphy & Mullane, 2016; Mullane & Dunphy, in press). These Therapeutic Domains are broken down further into Therapeutic Goals. In the Physical domain, for example, these goals are body awareness, mastery and expansion of movement range; fitness and coordination; and the ability to relax. The Therapeutic Goals are further defined by Measures of Progress that assess key nonverbal and verbal representations of client behaviour relevant to each goal. A Likert scale – 1 (least) to 9 (most) evidence of progress- is provided for each goal. Fig. 1 below provides an overview of the Framework and the Therapeutic Domains, Therapeutic Goals and Measures of Progress. Plain language is used as much as possible in the Framework, with only the minimal inclusion of specialist terminology, mostly
Laban Movement Analysis terms (Laban, 1988) to facilitate its use by non-specialists who might be working with a DM therapist. Plain language is also considered more useful because it will enable greater understanding of assessment results by other stakeholders such as host organisation staff, families and clients.
The app: Marking the Moves The iPad app, Marking the Moves, uses the Framework of Dance Movement Assessment content organised onto an app platform and Filemaker ProTM software operating through Filemaker GoTM interface, which is freely downloadable from iTunes. The app’s functions include storage of client personal data such as name, contact details, information about health and a photo, to accompany assessment data. An Attendance function allows monitoring of client participation in a program, while a Groups function enables individual client records to be organised into groups as clients might be in DMT settings, to enable easier group assessment. The app facilitates the therapists’ selection of therapeutic domains and goals from the comprehensive range for an individual or group. These goals can remain consistent over time or be changed as appropriate for the overall program or an individual session. The app allows collection and provision of information that is relevant for various stages of the therapeutic process. A broad overview of a client’s movement profile can be made for intake assessment at the beginning of a program. Data gathering can be focussed narrowly on pre-determined therapeutic goals, or more broadly to capture overall client progress. Data can reflect client progress at specific points in the therapeutic process (formative assessment) and at the end (summative assessment) (Masters, 2013). Data may also signal emergent or potential movement: intermittent or micromoments of observable behaviour could indicate ‘what is to come’ as the client transforms in the DMT process (Exiner & Kelynack, 1994). The possibility of comparison between clients in a group or between groups is also enabled. Data is created by the assessor tapping the screen for the appropriate measure. An assessor can decide to tap once at the time a behaviour or movement is observed in a session, or multiple times to indicate frequency of occurrence of the behaviour or movement, or at particular time intervals throughout a session. The app records of the total number of taps made and the range and average score for that measure for the session. Data can be viewed in graph form for each session or for a period of time immediately following input of the information. This instantaneous visual feedback of client progress is expected to be affirming to the assessor, who is able to see patterns in the client profile that would not be available in hard copy assessment processes until after time spent collating information. Figs. 2 and 3 below provide examples of assessment data created by the app. Additional functions in the app enable capture of the breadth of individualised expression in more detail than the Framework’s indicators of progress alone. Video and Photo options allow for visual recording of particular movement moments. A Notes function allows the therapist to type written comments to augment quantitative observations, while a Drawing function enables pictorial responses. All of these are integrated into and correspond with quantitative assessment ratings. Raw data can be exported from the iPad by email in the form of an Excel file. The file collates client data in rows for the assessable period, with each row listing client name; sessions by date; therapeutic goal; specific indicator of progress measured and assessment ratings. Information collected, including individual files, can be exported for other use, archiving or back-up, by email and transfer to iTunes.
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
Fig. 1. Overview of the Framework for Dance Movement Assessment.
Fig. 2. Client profile in numerical data.
57
58
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
Fig. 3. Client profile in graph form.
Research methodology Trial sites Two pilot trials were undertaken to determine the apps’ usefulness and functionality for DMT practice, both sited in dance programs for children with special needs. The first trial was undertaken at Sunshine Special Developmental School (SDS) in Melbourne, Australia. It was led by DM therapist and special education teacher Mullane in her DMT program that is part of the school’s normal enrichment programs of arts, literacy and physical education. Two class groups of ten moderately intellectually disabled students (aged 6–11 years) were assessed in weekly sessions over ten weeks. Assessment practices used in the classroom at that time included use of the paper-based version of the Framework discussed above for reporting on student progress at mid and end of year. A second trial was conducted in the Caring For Kids class at the Rehabilitation Institute of Chicago, USA.. One group of students (6–16 years) with developmental and/or learning disabilities and cerebral palsy were assessed in weekly sessions over twelve weeks. There were no established assessment practices in this program at the time of the trial.
lege participants valued the potential of the trial to contribute to evidence-based practice in DMT. They were also motivated to support the novel use of technology in DMT practice and to undertake an international collaboration, which they saw as valuable for the development of the DMT profession. With respect to technological expertise, all participants reported that they used technology (computers and hand-held devices) every day, with levels of confidence ranging from ‘a little’ to ‘very’ confident. Only modest regular use of iPads and apps was reported, with no participants ever having used any type of tablet or app for assessment processes previously. Therefore, while both trials involved similar populations (young clients with disability), they were also dissimilar, offering significant possibilities for comparison. They took place in an educational context and a community context, providing opportunity for comparison between different types of DMT practice. They were held in Australia and the USA, enabling cross-national comparison. Professional expertise was diverse, with skills in DMT, special needs education and assessment ranging from low to high level.
Research participants
Ethical issues
A total of ten participants trialled the app, eight in Australia and two in the USA. These participants were recruited for their diverse expertise in DMT, assessment and special education, as detailed in Table 1. This difference between participants was perceived as a strength of the methodology, as it afforded a perspective as to how useful the app would be for those with differing backgrounds, particularly those who are not trained in DMT. Participants at the SDS agreed to be involved in the trial to contribute to the evidence-base for the school’s DMT program, and to explicate the educationally valuable aspects of the program, as recommended by Ross (1994). School leaders recognised the potential for data gathered by the app to facilitate a fuller understanding of student learning in dance for the whole school. Chicago Col-
The Australian trial was formally approved by the Department of Education and Early Childhood Development (DEECD). An assessment of “low risk” was authorised, as the app was being trialled in researcher Mullane’s classroom as part of her normal activities, where school students did not directly use the app and all research participants other than visiting DMT co-author Dunphy were regular staff members. In Chicago, permission to trial the app as part of an approved internship was granted by the program instructor. This was with the understanding that client data was not being stored, with the emphasis of the trial being researchers’ interface with the app. When use of the app was found to be distracting for students, an immediate change was made, and the app was used after, rather than during, the session.
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
59
Table 1 Research participants, professional roles and relevant expertise. Location
Professional role
Expertise
Number
Sunshine Special Development School, Melbourne Australia
DM therapists
Professional Members DTAA; strong special ed. and assessment skills Strong special ed. and assessment skills; no DMT training Strong special ed. and assessment skills; no DMT training Basic training in special ed; no formal assessment skills; experience in supporting DMT program
2
School principal Leading teacher Educational support (ES) staff
Caring For Kids class, Rehabilitation Institute of Chicago, Chicago, USA
DM therapists in training at Columbia College Chicago, supported by DMT professor (state-licensed counsellor, ADTA board certified)
Preparation In preparation for the trial, participants were provided training regarding the domains, goals and measures in the assessment Framework, and the functioning of the app. In Australia, hands-on training was provided in the DMT classroom, while instruction was provided for American participants in written form and by Skype, augmented by a practice session using the app to analyse video footage of a DMT session.
Two semesters of DMT Masters study; no skills in special ed; some assessment training in university classes only
1 1 4
2
During the trial • researchers’ observations of participants’ use of the app in situ (Australia only, n = 8) • participants’ ratings of clients on identified goals, and other goals they determined were relevant to exhibited client behaviour in that session n = 10 • discussion with school staff during, and at the end of sessions to compare assessment ratings (Australia only, n = 8). Post-trial
Research questions The trial explored the following questions: • Does the app make assessment in DMT more efficient than a paper-based assessment process? If so, how? • Can the app be used by people with a range of technological skills? • Can DM therapists as well as professionals without specialist DMT expertise use the app for meaningful assessment? • How does expertise with a particular client group impact capacity for useful assessment using the app? • How do existing skills in assessment impact capacity to use the app? • Can the app produce data on client progress that is useful and relevant to the therapist? • Can the app produce data suitable for reporting to other professional stakeholders in the therapeutic process (eg. non-specialist staff, other professionals, management)? • Do the assessment goals and measures developed in Australia translate to national contexts? • How could the app be developed to expand its usefulness? Data collection A range of data collection strategies were used in the trials, with more strategies used in Australia than the US, because of researchers’ ease of access to participants in Australia. These comprised:
Pre-trial • a questionnaire of all participants regarding their use of and capability with technology; attitudes regarding the role of technology in assessment; assessment expertise and DMT expertise; and aspects of client progress they would assess.
• a written questionnaire supplemented by interviews re participants’ feedback on use of the app, perceptions of its contribution to effective assessment and key knowledge acquired (n = 10). Data analysis Data analysis processes included survey and interview responses and collation, summary and comparison of participants’ assessment ratings. This enabled understanding of the influence of participants’ existing skills in technology use, DMT, assessment and special needs education. The potential for inter-rater reliability of assessments made using the app was explored by a comparison of ratings (on a Likert scale of 1–9) made between the eight Australian participants. Each session generated up to 40 scores, with as many as eight clients being scored five or more times, each session for a series of ten sessions. Findings Efficiency and effectiveness of data collection All participants were unanimous in reporting the speed and efficiency that the app enabled in their assessments. They perceived benefit in the large amount of data that could be generated and managed effectively, with up to ten clients being able to be assessed across a number of goals within in a short session. The app’s capacity to depict data in both table form and as a graph was noted as useful in offering options for reading and then interpreting data. DM therapist Mullane reported on the significant improvement of her assessment practice that the app allowed, in comparison to previous paper-based assessment using the Framework. The app’s function that enabled ratings for each client to be seen on the spot helped to ensure that all clients were assessed across all important goals each session. This priority was very difficult to ensure when using the Framework on paper. Paper forms required a significant investment of time to transfer data from hard copy to electronic
60
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
form before it was useable, a demand far beyond the time available in that work situation. In contrast, the app provided a very large increase of detail and substantiation of assessment ratings that could be completed and organised by the end of the session, requiring no further investment of time. One of the expected benefits of converting the paper-based Framework into an app was the streamlining of the visual appearance of the assessment tool enabled. The app displays only the aspects of the assessment data and/or process required for a specific moment, rather than all of the content being on view, as in paper versions. It was hypothesized that this function of tablet technology would assist the assessor to keep focussed on the task of that moment. The app’s visual displays that change in response to the assessor’s notations, offering immediate evidence of the assessment, was expected to be a further enhancement, providing the assessor an immediate reward for their action. This benefit was confirmed by two participants who had also previously used the paper-based Framework. The app was much less confusing for them to use than the Framework, which required shuffling the twelve pages of the tool (multiplied by the numbers of clients) backwards and forwards throughout a session. The app afforded quick transition between different goals being assessed, and between clients in a session, with all the data processed by the app by the end of the session before the next group of clients arrived. It also allowed the possibility that data could be collected about a goals that had not been part of the pre-determined goals for that session or program, as the additional goals were still retrievable from the app. Impact of technological expertise Research participants, as discussed above, had a range of expertise in using technology, with none being regular users of tablets and apps. As might have been expected, those with strongest technology skills, especially with like products, were quickest to navigate this app adeptly. However, within one session, even those with no previous similar technological experience were able to navigate through the app to record clients’ attendance data and assess movement. The main obstacle reported by those with least experience was the non-linear navigation of the app, which, while a standard aspect of such technological tools, is very unlike paper tools. These navigational challenges were noted and considered in subsequent revisions of the app.
in the DMT program and the assessment process appeared to be strengthened by use of the app, because they could more easily gain a sense of students’ learning during a specific session and also track cumulative change over time. School leaders corroborated this observation, in discussing ES staff’s increased confidence to make assessments, and how this further empowered the ES staff by enabling their recognition of their own unique contribution to student learning. The finding that this assessment tool can be used effectively by those who are not specialists means that the app may be particularly useful for the many DM therapists who work without skilled DMT colleagues and who have significant pressures on their time, including limited time allocation for assessment. Other possibilities for improved assessment practice would be the employment of additional staff to support the DM therapist in the assessment process. An unexpected outcome of this trial was the benefits perceived by participants who were DM therapists in training. These participants who had, as yet, little experience with the specific population or assessment practice, reported positively about use of the app and the underpinning framework. They commented that using the app and the framework deepened their understanding of the progress of their clients in the dance program. The structure of the framework, augmented by the capacity of the app to display only the information required for the particular assessment task, helped them develop observational skills by ‘guiding their eyes.’ This assisted them to focus on behaviours that could be specifically tracked and assessed for change. They reported how their group leaders’ debriefs after classes were shaped and clarified by observations recorded with the tool. This experience seemed particularly valuable because it assisted them to hone important clinical skills at an earlier stage in their training than expected. These findings indicate that participation in an assessment process using a structured framework written in lay language increases the capacity of non-DMT trained support staff to recognize outcomes of DMT, as well as becoming more engaged as co-facilitators of the DMT process. It also indicates the likelihood that non-DMT professionals could become more useful in their workplaces as they ‘see’ more and feel more skilled and empowered. It also indicates potential for improved practice of trainee DM therapists whose skills are in development. Relevance of the data to DM therapists in diverse contexts and other professionals
Impact of assessors’ skills and training Participants had a very diverse range of expertise in DMT, special education and assessment. This different expertise did not prevent them from making useful assessments, as evidenced by concordance between scores made by Australian participants. The most frequent outcome was a score the same or within one rating point for each client. This concordance occurred in ratings made by the DM therapists, but also between the DM therapists and the Educational Support (ES) staff. This occurred in trial sessions in which participants discussed their ratings with each other and researcher/DM therapist Dunphy as they were making them, but also when they made them independently and compared later. This finding also bodes well for the likely inter-rater reliability strength of these tools. Outcomes of app use for professional practice By the end of the trial at Sunshine SDS, DM therapist Mullane reported that ES staff had become more valuable contributors in the DMT program because they could produce data on student learning that she considered useful and relevant. ES staff’s engagement both
DM therapist Mullane reported that the data both she and ES staff collected with the app was useful. She expected to be able to use it for evidence-based assessment of her students at a level previously impossible with paper-based assessment. School leaders also confirmed that data generated by the app was useful to them as education specialists without DMT expertise. Using the app for assessment helped them see what DM therapists look for in client progress. In so doing, the app’s use both contributed to validation of the DMT program as well as offering the leaders fresh perspectives on the capacities and challenges of their students. The collaboration with US participants offered several insights. First, that the app was useful in that community setting for DMT, as well as the educational setting of the trial in Australia. Second, that the US trial site was like many DMT settings in Australia in having no established assessment practice, thus indicating the potential benefit of a user-friendly assessment tool. These findings offer modest support for the view that, despite the historically rich development and presence of DMT in the US compared with Australia, the need for assessment tools that are effective and user-friendly for practitioners is equally as urgent there. This finding confirms the original motivation of the staff of that training institution to be involved in
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
the trial because they were aware that such tools are not in common use in the US, and yet are much needed. While both trial contexts involved use of the app with children with special needs, feedback from other peers indicate that the app is likely to be useful in other settings. Responses to the app from DM therapists at the various professional development opportunities detailed above were very positive. Therapists who work with clients with a range of issues, not just disability, confirmed that the idea of the app was relevant to their professional situations and that the version of the app presented seemed functional and accessible. The literature and our informal survey of colleagues in related professions (counselling and social work) indicated that like technology-based assessment tools are not in consistent use in those professions. This finding and the current priority for all health professionals to be using evidence-based approaches indicate the significant possibility that a version of the app may be relevant and useful for other psychotherapeutic professionals, especially those who work with clients in groups. Informal feedback from a range of professional peers, including mainstream and special needs educators and dance teachers, indicate the app’s potential usefulness for them too. Specific feedback offered from such peers has informed ongoing improvements to the app. This possibility of use by professionals working in different contexts can be facilitated by adjustment of the therapeutic/learning outcomes and measures on the app. Future research and development for this client group and others During the trials, a number of desirable improvements of the app became apparent. Some of these, such as adaptations for more logical navigation processes, were addressed as soon as they were identified. Several suggestions for additional functions were made. Participants indicated that the app’s additional functions of written comments and/or photos and videos to complement quantitative data would have been a valuable complement to their assessment ratings, although these functions were not tested in this trial. Timestamping of recorded observations was requested to allow tracking of assessment in relation to specific activities in any session. The provision of video samples within the app offering examples of desirable outcomes for each therapeutic goal was recommended by participants, i.e. as a ‘this is what you are looking for’ guide for optimum movement responses. This may be particularly valuable for novice assessors. School-based research participants noted that the app would be more useful if it included information linking client progress in DMT to broader educational curricula or goals to increase efficacy for reporting to school leadership and families. Assessors in other professions are likely to have similar requirements. This first version of the app used a simple Likert numerical scale (1–9) for assessment points. Current technology enables the possibility of continuous measurement devices such as visual analogue scales, which are valid, reliable and accurate (see for example Reips & Funke, 2008). This alternative might be a useful option that could be considered in a developed version. Several challenges with the app became apparent in this trial. The most significant was the need for integration of data about DMT with host organisations’ data systems. This capacity to be integrated in larger accountability systems is particularly important in institutions such as schools, where teacher-therapists are mandated to report within a particular structure. The data generated by the app could not be synchronised with the SDS’s closed internal electronic reporting system because of the complexity of the required integration. This challenge is well recognised in the technologically-driven assessment field. A national education assessment framework for managing mainstream school data recently launched by the Aus-
61
tralian Council for Educational Research (ACER, 2015) creates results that are similarly unable to be integrated into individual school reporting systems. ACER’s acknowledgement that they are not planning to tackle this problem given the diversity of systems in schools across Australia, confirms the likely difficulty in attempts to undertake this for the huge diversity of circumstances in which DM and other therapists work. Other ways of using data generated by the app that do not require full system integration will need to be developed. While the app enables new possibilities for the collection of data, it also provides new challenges for the management, transmission and storage of such data. Ensuring privacy and confidentiality of client data is the responsibility of an ethical therapist. As a tool with international application, diverse regulations about health record management apply to the app’s use. These issues were not addressed in the pilot stage of the app’s development, although the need for solutions for these was evident, confirmed by trial participants and their institutions. Now that the initial pilot has indicated the app’s potential as a useful tool, further development will be required to ensure the security of client data. Possibilities include password-restricted access to the app and to specific client files, automatic timing out of the app functions after a period of inactivity, and secure options for exporting data. Future possibilities for research exploration include widening of the scope of trial participants, most importantly to clients themselves. The use of the app to date has not included client engagement in the assessment process, yet client self-assessment is well acknowledged as being beneficial, for example, in promoting student learning (Earl, 2013; Elwood & Klenowski, 2002; Munns & Woodward, 2006) and therapeutic outcomes (Caldwell, 2013). Engagement in assessment would be expected to assist clients’ sense of ownership of the therapeutic experience and in becoming vital and engaged participants (Stephen & Alex, 2006). It may also assist them to identify their own goals for therapy. Inclusion of other relevant professional staff such as classroom teachers and other professionals in the trial process would provide indication of its usefulness in offering additional insights about their clients or students. Parents/carers of clients could also be included as trial participants to help determine how data collected by the app compares with traditional reports in terms of its value for families. Exploration of the app’s use by related professionals such as other creative arts therapists could offer information about its likely usefulness in their different contexts. Trialling of complementarity and integration of different data forms (such as videos, photos and qualitative written responses) would also be useful.
Conclusion This article introduced the iPad app, Marking the Moves, developed to assist dance movement therapists to articulate, qualify and quantify therapeutic outcomes for clients with disability in DMT, and to articulate those outcomes to key stakeholders. The Framework for Dance Movement Assessment that underpins the app was introduced briefly. This framework defines a range of therapeutic goals and measures to assess them that are posited as appropriate for dance movement therapy programs for this client group. These initiatives were developed in response to the prescient need in DMT recognised by the authors, for relevant and practical assessment tools that facilitate the gathering of data about client progress that is informative for a range of stakeholders. Two small pilot trials of the app involving ten participants, in a special school in Melbourne, Australia, and a community setting in Chicago, USA, indicate positive outcomes of its use. The app appears likely to be able to contribute to improved practice in therapeutic assessment by expediting effective and efficient processes in the
62
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
real world setting of the DM therapist, who often works with groups of clients and has limited access to assessment options as she does that work. The trials indicate that the app facilitates the collection of data that is valuable for reflection and reporting of client progress to other institutional staff as well. They also demonstrate that the app is user-friendly for staff without DMT expertise, enabling nonDMT program support staff to contribute to collection, recording and comparison of information about client outcomes. Promising indications of the likelihood of inter-rater reliability in assessments generated by the tool were demonstrated. Future research possibilities include the trial of the app by other professionals including creative arts, and other therapists, and teachers. Funding The support is acknowledged of the Psychotherapy and Counselling Federation of Australia and an anonymous charitable foundation for the trial in Australia, and the Hanny Exiner Memorial Foundation for the development of the app. Acknowledgements Our appreciation goes to collaborators in Australia at Sunshine SDS, led by Principal Michael Devereaux, and in the USA at Columbia College, including Associate Professor Susan Imus and students Hannah Bailey and Patrick Justin. App developers Advaita Digital (Frank Ryder, Dennis Claringbold and Gary Bass) applied themselves with great diligence to the problems for DMT assessment that we provided them. We also thank anonymous reviewers of the article who provided valued suggestions for improvement of the article. Authors Dunphy and Mullane were recipients of the American Dance Therapy Association’s Award for Innovation in 2015 for Marking the Moves app. References ACER. (2015). Collecting and visualising data from everyday school based activities. In Professional development seminar http://www.acer.edu.au/ professional-learning/events/acer-q-central-collecting-and-visualising-datafrom-every-day-school-based Brooke, S. L. (Ed.). (2006). Creative arts therapies manual. In A guide to the history, theoretical approaches, assessment, and work with special populations of art, play, dance, music, drama, and poetry therapies. Springfield, Il: Charles C. Thomas. Caldwell, C. (2013). Diversity issues in movement observation and assessment. American Journal of Dance Therapy, 35, 183–200. Choe, S. (2014). An exploration of the qualities and features of art apps for art therapy. The Arts in Psychotherapy, 41(2), 145–154. Cruz, R. F., & Koch, S. (2012). Issues of validity and reliability in the use of movement observations and scales. In R. F. Cruz, & C. Berrol (Eds.), Dance/movement therapists in action: A working guide to research options (2nd ed., pp. 45–68). Springfield, Ill: Charles C. Thomas. Cruz, R. F. (2006). Assessment in dance/movement therapy. In S. L. Brooke (Ed.), Creative arts therapies manual: A guide to the history, theoretical approaches, assessment, and work with special populations of art, play, dance, music, drama, and poetry therapies (pp. 133–143). Springfield,Il: Charles C Thomas. Cruz, R. F. (2013). Evaluation and assessment in dance movement therapy. In R. F. Cruz, & B. Feder (Eds.), The arts and science of evaluation in arts therapies (2nd ed., pp. 307–333). Springfield, Ill: Charles C. Thomas. CultureCounts. (2015). CultureCounts. http://culturecounts.cc/ Accessed 4.05.15 Department of Education and Early Childhood Development (DEECD). (2008). Digital learning Showcase–eLearning planning learning, teaching & assessment, reporting.. http://epotential.education.vic.gov.au/showcase/elearning planning/learning teaching assessment reporting Accessed 24.08.13 Davis, M. (1991). Guide to movement analysis methods part 2: Movement Psychodiagnostic Inventory. Unpublished manual; available from Martha Davis, New York. Dodge, R., Daly, A., Huyton, J., & Sanders, L. (2012). The challenge of defining wellbeing. International Journal of Wellbeing, 2(3), 222–235. http://dx.doi.org/ 10.5502/ijw.v2i3.4
Dunphy, K. & Mullane, S. (2016). Framework for Dance Movement Assessment. www.makingdancematter.com.au. Dunphy, K., & Scott, J. (2003). Freedom to move: Movement and dance for people with intellectual disabilities. Sydney: Elsevier. Earl, L. (2013). Assessment as learning: Using classroom assessment to maximize learning (2nd ed.). California: Corwin. Elwood, J., & Klenowski, V. (2002). Creating communities of shared practice: The challenges of assessment use in learning and teaching. Assessment & Evaluation in Higher Education, 27(3), 243–256. Exiner, J., & Kelynack, D. (1994). Dance therapy redefined: A body approach to therapeutic dance. Springfield: Charles C. Thomas. Fullan, M., & Langworthy, M. (2014). A rich seam: How new pedagogies find deep learning. London: Pearson. http://www.newpedagogies.info/wp-content/ uploads/2014/01/A Rich Seam.pdf Accessed 31.12.15 Gantt, L. (2000). Assessments in the creative arts therapies: Learning from each other. Music Therapy Perspectives, 18(1), 41–46. Hahna, N. D., Hadley, S., Miller, V. H., & Bonaventura, M. (2012). Music technology usage in music therapy: A survey of practice. The Arts in Psychotherapy, 39(5), 456–464. http://isiarticles.com/bundles/Article/re/df/72256.pdf Hanna, J. L. (2008). A nonverbal language for imagining and learning: Dance education in K–12 curriculum. Educational Researcher, 37(8), 491–506. http:// dx.doi.org/10.3102/0013189X08326032 Karkou, V. (Ed.). (2010). Arts therapies in schools—Research and practice. London: Jessica Kingsley. Kestenberg Movement Profile. (2015). Kestenberg movement profile.. www. kestenbergmovementprofile.org Accessed 4.03.15 Kim, S., Kang, H.-S., & Kim, Y.-H. (2009). A computer system for art therapy assessment of elements. The Arts in Psychotherapy, 36, 19–28. Kim, S. I. (2010). A computer system for the analysis of color-related elements in art therapy assessment. The Arts in Psychotherapy, 37(5), 378–386. Knight, A. (2013). Uses of iPad® applications in music therapy. Music Therapy Perspectives, 31(2), 189–196. Koch, S., Cruz, R. F., & Goodill, S. (2001). The kestenberg movement profile: Performance of novice raters. American Journal of Dance Therapy, 23(2), 71–87. Laban, R. (1988). Modern educational dance (3rd ed.). Plymouth: Northcote House. Law, D., & Wolpert, M. (2014). Guide to using outcomes and feedback tools with children, young people and families. London: CAMHS. Magee, W., Siegert, R., Daveson, B., Lenton-Smith, G., & Taylor, S. (2014). Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC): Standardisation of the principal subscale to assess awareness in patients with disorders of consciousness. Neuropsychological Rehabilitation, 24(1), 101–124. http://dx.doi.org/10.1080/09602011.2013.844174 Malchiodi, C. (2012). Art therapy: There’s an app for that (Blog post).. Accessed www. psychologytoday.com/blog/the-healing-arts/201202/art-therapy-there-s-app1 Masters, G. (2013). Reforming educational assessment: Imperatives, principles and challenges. Melbourne: Australian Council for Educational Research. http:// research.acer.edu.au/aer/12/ Accessed 23.5.14 Mattson, D. (2015). Usability assessment of a mobile app for art therapy. The Arts in Psychotherapy, 43, 1–6. http://dx.doi.org/10.1016/j.aip.2015.02.005 Miller, C. (Ed.). (2013). Assessment and outcomes in the arts therapies: A person centred approach. In. London: Jessica Kingsley. Citation removed for blind review. Munns, G., & Woodward, H. (2006). Student engagement and student self assessment: The REAL framework. Assessment in Education, 13(2), 193–213. Orr, P. (2012). Technology use in art therapy practice: 2004 and 2011 comparison. The Arts in Psychotherapy, 39(4), 234–238. PACFA. (2015). PACFA data collection project for client informed therapy.. www.pacfa. org.au Accessed 31.3.15 Perrotta, C., & Wright, M. (2010). New assessment scenarios. Futurelab. http://www. futurelab.org.uk/sites/default/files/New assessment scenarios.pdf Powell, M. (2008). Assessment in dance/movement therapy practice: A state of the field survey. In Masters thesis From http://dspace.library.drexel.edu/handle/ 1860/2944 Accessed 26.6.12. Drexel University. Reips, U. D., & Funke, F. (2008). Interval-level measurement with visual analogue scales in Internet-based research: VAS Generator. Behavior Research Methods, 40(3), 699–704. Ripley, M. (2007). E-assessment–an update on research, policy and practice. Futurelab. http://www.futurelab.org.uk/resources/documents/lit reviews/ Assessment Review update.pdf Accessed 5.7.12 Robards, J. (2012). How effective is the iPad as an art therapy medium? Accessed from. http://www.academia.edu/6888155/ How Effective is the iPad as an Art Therapy Medium Ross, J. (1994). The right moves: Challenges of dance assessment. Arts Education Policy Review, 96(1), 11–18. Snow, S., & D’Amico, M. (Eds.). (2009). Assessment in creative arts therapies: Designing and adapting assessment tools for adults with developmental disabilities. Springfield: Charles C Thomas. Stephen, J., & Alex, L. (2006). Positive therapy: A meta-theory for positive psychological practice. New York: Routledge.
Contents lists available at ScienceDirect
The Arts in Psychotherapy
Research Article
Developing an iPad app for assessment in dance movement therapy Kim Dunphy a,∗ , Sue Mullane b , Laura Allen c a
Creative Arts Therapy Unit, University of Melbourne, 49 Thomas St, Hampton 3188, Victoria, Australia Making Dance Matter consultants, 32 Connors Rd, Lancefield 3435, Victoria, Australia c Department of Creative Arts Therapies, Columbia College Chicago, 600 S. Michigan Ave, Chicago, IL, 60605, USA b
a r t i c l e
i n f o
Article history: Received 18 October 2015 Accepted 21 September 2016 Available online 28 September 2016
a b s t r a c t Dance movement therapists face many challenges in implementing effective assessment practices, particularly a dearth of accessible assessment frameworks and functional tools that enable practitioners to collect data. Technological advances are as yet under-utilised in assessment processes. This article introduces Marking the Moves, an i-Pad app developed to expedite assessment of outcomes of dance movement therapy programs, and discusses pilot trials of its first applications in practice. This app is based on the Framework for Dance Movement Assessment devised by the authors for dance movement therapy programs for clients with disability, including intellectual disability, that measures progress across domains of physical, cognitive, emotional, personal and interpersonal growth. Findings of preliminary trials with therapists and peer professionals in two countries indicate favourable response to the app and its potential for use by dance movement therapists in different contexts and client groups. © 2016 Elsevier Ltd. All rights reserved.
Introduction The article discusses the trial of an iPad app, Marking the Moves, created to address challenges that dance movement therapist practitioners have in the lack of accessible assessment frameworks available for their use, and current low usage of technology in assessment processes. The development of the app is a response to the authors’ efforts to develop an assessment tool suitable for the context of Mullane’s dance movement therapy (henceforth, DMT, the acronym used in Australasia) practice in special education, for which no existing tool was suitable. The Framework for Dance Movement Assessment (Dunphy & Mullane, 2016) is a paper-based assessment process that uses twelve pages to include all goals that might be addressed in a DMT program for people with intellectual disabilities, and measures and scales to assess them. Its hard copy format does not allow for adaptation, even when a therapist has set specific goals that might not require the use of the entire Framework for any session. As therapist Mullane, like many others, works with clients in groups, the engagement with such a lengthy document simultaneous with leading a group program was found to be untenable. As well, the large amount of paperwork created by a 12-page assess-
∗ Corresponding author. E-mail address: [email protected] (K. Dunphy). http://dx.doi.org/10.1016/j.aip.2016.09.001 0197-4556/© 2016 Elsevier Ltd. All rights reserved.
ment document used for eight to ten students in a group, multiplied by a number of groups the therapist sees in a day, that needed to be dealt with after a day’s work running sessions, makes its use impractical. The incorporation of technology to address this need for efficiency was a logical development. A further challenge considered was the fact that the therapist in this situation was supported only by staff members who do not have DMT qualifications, and are therefore unable to assist in assessment process using tools that require very specialised training. We hypothesised that the field of DMT would be advanced and the evidence-base potentially bolstered by the development of a technological solution for efficient, comprehensive and theory-based assessment that could also be understood and possibly used by professionals who are knowledgeable about their population, individual clients and goals of the setting, but do not necessarily have DMT training. In the article to follow, a brief overview is provided of relevant bodies of literature including assessment practices and the emerging use of technology in assessment in dance movement and other therapies, and other relevant professions. The article then introduces the Framework for Dance Movement Assessment on which the app is based, before discussing the development of the app and its current form. The final section presents findings of two preliminary trials of the app undertaken in a special education setting in Melbourne, Australia and a community dance setting in Chicago, USA.
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
Recommendations for future research and development of the app based on these findings are made.
Literature review Assessment in dance movement therapy and related fields A literature review was undertaken to explore current research and documented practice about assessment in dance movement therapy. This was intended to inform our question of how a DM therapist can effectively assess clients’ progress where the professional context does not have established assessment schema for the DMT program, where support may only be provided by staff who are not DMT trained, and when s/he works with groups of clients and is on her feet moving throughout the therapy session. Use of technology to support data collection was also explored, given its potential to address practical challenges for assessment. Some literature was also examined from related professions including other creative arts therapies and psychotherapy and counselling. Material reviewed included recent publications on assessment in dance movement and other creative arts therapies, and major journals such as the American Journal of Dance Therapy; Body, Movement and Dance in Psychotherapy; The Arts in Psychotherapy; Music Therapy Perspectives and the Australian Journal of Music Therapy. This review was complemented by a web search (Google Scholar and Google search engines) to capture work not formally published. The review indicated that DM therapists face significant challenges in providing evidence-based assessment of their programs (Caldwell, 2013; Cruz, 2006; Cruz, 2013; Karkou, 2010; Miller, 2013). These challenges include a dearth of user-friendly comprehensive frameworks (Cruz & Koch, 2012; Powell, 2008), particularly a lack of frameworks that enable description of observable movement (Powell, 2008). Well-known tools for DMT assessment, the Kestenberg Movement Profile (Kestenberg Movement Profile, 2015) and the Movement Diagnostic Inventory (Davis, 1991) require a high level of specialist expertise that limits their use even by DM therapists (Cruz & Koch, 2012; Koch, Cruz, & Goodill, 2001). Such tools also require very specialised skills for understanding data generated. This reduces the usefulness of the information gathered to other stakeholders who do not have DMT training, such as funders, program managers, support staff, families/carers and clients themselves (Dunphy & Scott, 2003; Snow & D’Amico, 2009). As a result of these restricted options, DM therapists who undertake formal assessment very often use self-devised assessment tools and measures (Powell, 2008). This lack of systematic approaches and underuse of standardized instruments has many negative consequences for the field. These include reduced efficiency of individual practitioners, creation of data that does not meet the important scientific requirements of reliability and validity (Gantt, 2000) and loss of potential comparability of data gathered between practitioners and in different settings (Powell, 2008). None of the tools documented seem to offer feasible options for assessment of groups of DMT clients at the same time. The same finding was evident in examination of books about assessment for creative arts therapists. Brooke’s (2006) and Miller’s (2013) edited volumes offer detailed information about recent innovations in a range of creative arts therapy fields. However, tools discussed are largely focussed on clinical situations in which the therapist works one on one with a client, which allows time for detailed documentation of observations of individuals. A similar finding was evident with respect to assessment tools for counsellors and psychotherapists. A research project undertaken by the Psychotherapy and Counselling Federation of Australia
55
considered how data can be collected to increase the evidence base of counselling and psychotherapeutic professions and potentially enable sharing of data between practitioners (PACFA, 2015). A range of instruments were suggested to gauge clients’ feedback about their progress. None of these indicate the capacity for assessing clients who attend sessions in groups or for collection and recording of data while the therapist is engaged in moving with clients. No published evidence was found of specific technological tools currently being used by practitioners for assessment in dance movement therapy. Researcher Cruz reported the development of software technologies that have capacity to tag specific moments in video recordings of client movement and can recognise and record Laban Movement Analysis (Cruz, 2006). However, these seem not to be later reported in use. These findings about the lack of use of technology for assessment were confirmed in discussions about assessment with more than 100 DM therapists from more than ten countries who attended a series of professional development events we led in Australia, USA and Indonesia between 2010 and 2014 (presentations at three American Dance Therapy Association conferences, workshops run by the Dance Movement Therapy Association of Australasia and DMT workshops supported by the Asian Psychological Association). No participant offered information about systems they were using or knew of that would address these issues. Two conference presentations we made to education assessment specialists and dance educators also had similar results, with no new tool uncovered. An informal survey of ten Australian colleagues who practice DMT and also work in mainstream therapeutic disciplines (counselling, social work and mental health nursing) undertaken by author Dunphy confirmed this finding, with none of them involved in regular use of technological tools for assessment either. Technology-based assessment tools seem to be underdeveloped in other therapeutic professions as well. While Hahna, Hadley, Miller, and Bonaventura (2012) document a range of technological tools that music therapists have used for assessment since the 1980s, their own survey of use of apps by music therapists reported none in current use for assessment. For example, Magee, Siegert, Daveson, Lenton-Smith, and Taylor, (2014) document a current and sophisticated tool for music therapy assessment that requires manual entry of data into Excel sheets that need to be reentered into computer programs for statistical analysis. One recent major international initiative to encourage the sharing of assessment tools between mental health practitioners recommends a manual process of hard copy worksheets for data collection (Law & Wolpert, 2014). The emerging use of technology in assessment in other professions However, there is some evidence that other creative arts therapists are finding new technology useful in therapeutic processes. Apps used in visual arts therapy practice are documented by Choe (2014), Malchiodi (2012), Mattson (2015), Orr (2012) and Robards (2012), and in music therapy by Knight (2013), who comments that few peer-reviewed articles have been published on the topic. The use of technology for assessment seems somewhat more advanced in visual arts therapies, led largely by Korean researcher Kim. For example, development of a computer system designed to automatically rate elements of clients’ drawings is reported by Kim, Kang, and Kim (2009) and Kim (2010). These findings indicate the openness of therapists to the use of technology in the therapeutic space and potential for further developments. There is also a growing integration of technology and assessment in other related fields. A new initiative for assessment of the quality of performing arts programs uses an app to collect data about audiences’ experience (CultureCounts, 2015). Technology-
56
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
based assessment practice in education, which includes the use of devices such as tablets, has been growing over the past decade, mainly because of the acknowledged need for education to keep pace with societal trends (Fullan & Langworthy, 2014; Perrotta & Wright, 2010; Ripley, 2007). In the education field, technology is viewed as being beneficial for improving fundamental aspects of assessment such as reliability, scalability and efficiency (DEECD, 2008), as well as increasing authenticity, i.e. the use of assessment processes that reflect and are embedded in the natural learning process, in contrast to standardised testing (DEECD, 2008). A newly identified task for teachers and students engaged in learning is that they should “continuously discover and create digital learning tools to assess and share information on students’ learning abilities and dispositions” (Fullan & Langworthy, 2014, p. 13). The development of information and communication technologies in educational assessment practice also expands the range of skills, abilities, knowledge and understanding that can be assessed (Masters, 2013; Perrotta & Wright, 2010). This in turn provides unique diagnostic information to support personalisation of learning and assessment (Fullan & Langworthy, 2014; Masters, 2013; Perrotta & Wright, 2010). This literature indicates potential of the likely usefulness of an assessment tool with similar purpose for dance movement and other creative arts therapies. Having introduced the issues regarding assessment for DM therapists and discussed current practice, this paper now focuses on the Framework for Dance Movement Assessment and the app, Marking the Moves, that authors M and D have devised to address the above issues for DM therapists. The Framework for Dance Movement Assessment The Framework for Dance Movement Assessment was originally developed for DMT programs for clients with disability in community and educational settings, informed by an earlier assessment schema devised by Dunphy and Scott (2003). It was intended to assist therapists with planning and goal setting, support evidencebased understanding of client progress and assist with reporting to other professionals, funders and program managers. The Framework is underpinned by a holistic approach to wellbeing, with Therapeutic Domains comprising physical, cognitive, emotional, interpersonal and expressive/aesthetic domains. These categories derive from Hanna’s (2008) universal descriptors of learning that occurs through dance. They also correspond with aspects of wellbeing considered holistically. In this context, wellbeing is taken to mean a state of equilibrium, where individuals have a unique set of “psychological, social and physical resources . . .to meet a particular psychological, social and/or physical challenge” (Dodge, Daly, Huyton, & Sanders, 2012, p. 230). Aspects of Laban Movement Analysis (Laban, 1988) are used to frame analysis of observed movement. The Framework’s domains and accompanying indicators are used to record the client’s development of progress in the therapeutic process. The theory underpinning this Framework is discussed in more detail elsewhere (Dunphy & Mullane, 2016; Mullane & Dunphy, in press). These Therapeutic Domains are broken down further into Therapeutic Goals. In the Physical domain, for example, these goals are body awareness, mastery and expansion of movement range; fitness and coordination; and the ability to relax. The Therapeutic Goals are further defined by Measures of Progress that assess key nonverbal and verbal representations of client behaviour relevant to each goal. A Likert scale – 1 (least) to 9 (most) evidence of progress- is provided for each goal. Fig. 1 below provides an overview of the Framework and the Therapeutic Domains, Therapeutic Goals and Measures of Progress. Plain language is used as much as possible in the Framework, with only the minimal inclusion of specialist terminology, mostly
Laban Movement Analysis terms (Laban, 1988) to facilitate its use by non-specialists who might be working with a DM therapist. Plain language is also considered more useful because it will enable greater understanding of assessment results by other stakeholders such as host organisation staff, families and clients.
The app: Marking the Moves The iPad app, Marking the Moves, uses the Framework of Dance Movement Assessment content organised onto an app platform and Filemaker ProTM software operating through Filemaker GoTM interface, which is freely downloadable from iTunes. The app’s functions include storage of client personal data such as name, contact details, information about health and a photo, to accompany assessment data. An Attendance function allows monitoring of client participation in a program, while a Groups function enables individual client records to be organised into groups as clients might be in DMT settings, to enable easier group assessment. The app facilitates the therapists’ selection of therapeutic domains and goals from the comprehensive range for an individual or group. These goals can remain consistent over time or be changed as appropriate for the overall program or an individual session. The app allows collection and provision of information that is relevant for various stages of the therapeutic process. A broad overview of a client’s movement profile can be made for intake assessment at the beginning of a program. Data gathering can be focussed narrowly on pre-determined therapeutic goals, or more broadly to capture overall client progress. Data can reflect client progress at specific points in the therapeutic process (formative assessment) and at the end (summative assessment) (Masters, 2013). Data may also signal emergent or potential movement: intermittent or micromoments of observable behaviour could indicate ‘what is to come’ as the client transforms in the DMT process (Exiner & Kelynack, 1994). The possibility of comparison between clients in a group or between groups is also enabled. Data is created by the assessor tapping the screen for the appropriate measure. An assessor can decide to tap once at the time a behaviour or movement is observed in a session, or multiple times to indicate frequency of occurrence of the behaviour or movement, or at particular time intervals throughout a session. The app records of the total number of taps made and the range and average score for that measure for the session. Data can be viewed in graph form for each session or for a period of time immediately following input of the information. This instantaneous visual feedback of client progress is expected to be affirming to the assessor, who is able to see patterns in the client profile that would not be available in hard copy assessment processes until after time spent collating information. Figs. 2 and 3 below provide examples of assessment data created by the app. Additional functions in the app enable capture of the breadth of individualised expression in more detail than the Framework’s indicators of progress alone. Video and Photo options allow for visual recording of particular movement moments. A Notes function allows the therapist to type written comments to augment quantitative observations, while a Drawing function enables pictorial responses. All of these are integrated into and correspond with quantitative assessment ratings. Raw data can be exported from the iPad by email in the form of an Excel file. The file collates client data in rows for the assessable period, with each row listing client name; sessions by date; therapeutic goal; specific indicator of progress measured and assessment ratings. Information collected, including individual files, can be exported for other use, archiving or back-up, by email and transfer to iTunes.
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
Fig. 1. Overview of the Framework for Dance Movement Assessment.
Fig. 2. Client profile in numerical data.
57
58
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
Fig. 3. Client profile in graph form.
Research methodology Trial sites Two pilot trials were undertaken to determine the apps’ usefulness and functionality for DMT practice, both sited in dance programs for children with special needs. The first trial was undertaken at Sunshine Special Developmental School (SDS) in Melbourne, Australia. It was led by DM therapist and special education teacher Mullane in her DMT program that is part of the school’s normal enrichment programs of arts, literacy and physical education. Two class groups of ten moderately intellectually disabled students (aged 6–11 years) were assessed in weekly sessions over ten weeks. Assessment practices used in the classroom at that time included use of the paper-based version of the Framework discussed above for reporting on student progress at mid and end of year. A second trial was conducted in the Caring For Kids class at the Rehabilitation Institute of Chicago, USA.. One group of students (6–16 years) with developmental and/or learning disabilities and cerebral palsy were assessed in weekly sessions over twelve weeks. There were no established assessment practices in this program at the time of the trial.
lege participants valued the potential of the trial to contribute to evidence-based practice in DMT. They were also motivated to support the novel use of technology in DMT practice and to undertake an international collaboration, which they saw as valuable for the development of the DMT profession. With respect to technological expertise, all participants reported that they used technology (computers and hand-held devices) every day, with levels of confidence ranging from ‘a little’ to ‘very’ confident. Only modest regular use of iPads and apps was reported, with no participants ever having used any type of tablet or app for assessment processes previously. Therefore, while both trials involved similar populations (young clients with disability), they were also dissimilar, offering significant possibilities for comparison. They took place in an educational context and a community context, providing opportunity for comparison between different types of DMT practice. They were held in Australia and the USA, enabling cross-national comparison. Professional expertise was diverse, with skills in DMT, special needs education and assessment ranging from low to high level.
Research participants
Ethical issues
A total of ten participants trialled the app, eight in Australia and two in the USA. These participants were recruited for their diverse expertise in DMT, assessment and special education, as detailed in Table 1. This difference between participants was perceived as a strength of the methodology, as it afforded a perspective as to how useful the app would be for those with differing backgrounds, particularly those who are not trained in DMT. Participants at the SDS agreed to be involved in the trial to contribute to the evidence-base for the school’s DMT program, and to explicate the educationally valuable aspects of the program, as recommended by Ross (1994). School leaders recognised the potential for data gathered by the app to facilitate a fuller understanding of student learning in dance for the whole school. Chicago Col-
The Australian trial was formally approved by the Department of Education and Early Childhood Development (DEECD). An assessment of “low risk” was authorised, as the app was being trialled in researcher Mullane’s classroom as part of her normal activities, where school students did not directly use the app and all research participants other than visiting DMT co-author Dunphy were regular staff members. In Chicago, permission to trial the app as part of an approved internship was granted by the program instructor. This was with the understanding that client data was not being stored, with the emphasis of the trial being researchers’ interface with the app. When use of the app was found to be distracting for students, an immediate change was made, and the app was used after, rather than during, the session.
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
59
Table 1 Research participants, professional roles and relevant expertise. Location
Professional role
Expertise
Number
Sunshine Special Development School, Melbourne Australia
DM therapists
Professional Members DTAA; strong special ed. and assessment skills Strong special ed. and assessment skills; no DMT training Strong special ed. and assessment skills; no DMT training Basic training in special ed; no formal assessment skills; experience in supporting DMT program
2
School principal Leading teacher Educational support (ES) staff
Caring For Kids class, Rehabilitation Institute of Chicago, Chicago, USA
DM therapists in training at Columbia College Chicago, supported by DMT professor (state-licensed counsellor, ADTA board certified)
Preparation In preparation for the trial, participants were provided training regarding the domains, goals and measures in the assessment Framework, and the functioning of the app. In Australia, hands-on training was provided in the DMT classroom, while instruction was provided for American participants in written form and by Skype, augmented by a practice session using the app to analyse video footage of a DMT session.
Two semesters of DMT Masters study; no skills in special ed; some assessment training in university classes only
1 1 4
2
During the trial • researchers’ observations of participants’ use of the app in situ (Australia only, n = 8) • participants’ ratings of clients on identified goals, and other goals they determined were relevant to exhibited client behaviour in that session n = 10 • discussion with school staff during, and at the end of sessions to compare assessment ratings (Australia only, n = 8). Post-trial
Research questions The trial explored the following questions: • Does the app make assessment in DMT more efficient than a paper-based assessment process? If so, how? • Can the app be used by people with a range of technological skills? • Can DM therapists as well as professionals without specialist DMT expertise use the app for meaningful assessment? • How does expertise with a particular client group impact capacity for useful assessment using the app? • How do existing skills in assessment impact capacity to use the app? • Can the app produce data on client progress that is useful and relevant to the therapist? • Can the app produce data suitable for reporting to other professional stakeholders in the therapeutic process (eg. non-specialist staff, other professionals, management)? • Do the assessment goals and measures developed in Australia translate to national contexts? • How could the app be developed to expand its usefulness? Data collection A range of data collection strategies were used in the trials, with more strategies used in Australia than the US, because of researchers’ ease of access to participants in Australia. These comprised:
Pre-trial • a questionnaire of all participants regarding their use of and capability with technology; attitudes regarding the role of technology in assessment; assessment expertise and DMT expertise; and aspects of client progress they would assess.
• a written questionnaire supplemented by interviews re participants’ feedback on use of the app, perceptions of its contribution to effective assessment and key knowledge acquired (n = 10). Data analysis Data analysis processes included survey and interview responses and collation, summary and comparison of participants’ assessment ratings. This enabled understanding of the influence of participants’ existing skills in technology use, DMT, assessment and special needs education. The potential for inter-rater reliability of assessments made using the app was explored by a comparison of ratings (on a Likert scale of 1–9) made between the eight Australian participants. Each session generated up to 40 scores, with as many as eight clients being scored five or more times, each session for a series of ten sessions. Findings Efficiency and effectiveness of data collection All participants were unanimous in reporting the speed and efficiency that the app enabled in their assessments. They perceived benefit in the large amount of data that could be generated and managed effectively, with up to ten clients being able to be assessed across a number of goals within in a short session. The app’s capacity to depict data in both table form and as a graph was noted as useful in offering options for reading and then interpreting data. DM therapist Mullane reported on the significant improvement of her assessment practice that the app allowed, in comparison to previous paper-based assessment using the Framework. The app’s function that enabled ratings for each client to be seen on the spot helped to ensure that all clients were assessed across all important goals each session. This priority was very difficult to ensure when using the Framework on paper. Paper forms required a significant investment of time to transfer data from hard copy to electronic
60
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
form before it was useable, a demand far beyond the time available in that work situation. In contrast, the app provided a very large increase of detail and substantiation of assessment ratings that could be completed and organised by the end of the session, requiring no further investment of time. One of the expected benefits of converting the paper-based Framework into an app was the streamlining of the visual appearance of the assessment tool enabled. The app displays only the aspects of the assessment data and/or process required for a specific moment, rather than all of the content being on view, as in paper versions. It was hypothesized that this function of tablet technology would assist the assessor to keep focussed on the task of that moment. The app’s visual displays that change in response to the assessor’s notations, offering immediate evidence of the assessment, was expected to be a further enhancement, providing the assessor an immediate reward for their action. This benefit was confirmed by two participants who had also previously used the paper-based Framework. The app was much less confusing for them to use than the Framework, which required shuffling the twelve pages of the tool (multiplied by the numbers of clients) backwards and forwards throughout a session. The app afforded quick transition between different goals being assessed, and between clients in a session, with all the data processed by the app by the end of the session before the next group of clients arrived. It also allowed the possibility that data could be collected about a goals that had not been part of the pre-determined goals for that session or program, as the additional goals were still retrievable from the app. Impact of technological expertise Research participants, as discussed above, had a range of expertise in using technology, with none being regular users of tablets and apps. As might have been expected, those with strongest technology skills, especially with like products, were quickest to navigate this app adeptly. However, within one session, even those with no previous similar technological experience were able to navigate through the app to record clients’ attendance data and assess movement. The main obstacle reported by those with least experience was the non-linear navigation of the app, which, while a standard aspect of such technological tools, is very unlike paper tools. These navigational challenges were noted and considered in subsequent revisions of the app.
in the DMT program and the assessment process appeared to be strengthened by use of the app, because they could more easily gain a sense of students’ learning during a specific session and also track cumulative change over time. School leaders corroborated this observation, in discussing ES staff’s increased confidence to make assessments, and how this further empowered the ES staff by enabling their recognition of their own unique contribution to student learning. The finding that this assessment tool can be used effectively by those who are not specialists means that the app may be particularly useful for the many DM therapists who work without skilled DMT colleagues and who have significant pressures on their time, including limited time allocation for assessment. Other possibilities for improved assessment practice would be the employment of additional staff to support the DM therapist in the assessment process. An unexpected outcome of this trial was the benefits perceived by participants who were DM therapists in training. These participants who had, as yet, little experience with the specific population or assessment practice, reported positively about use of the app and the underpinning framework. They commented that using the app and the framework deepened their understanding of the progress of their clients in the dance program. The structure of the framework, augmented by the capacity of the app to display only the information required for the particular assessment task, helped them develop observational skills by ‘guiding their eyes.’ This assisted them to focus on behaviours that could be specifically tracked and assessed for change. They reported how their group leaders’ debriefs after classes were shaped and clarified by observations recorded with the tool. This experience seemed particularly valuable because it assisted them to hone important clinical skills at an earlier stage in their training than expected. These findings indicate that participation in an assessment process using a structured framework written in lay language increases the capacity of non-DMT trained support staff to recognize outcomes of DMT, as well as becoming more engaged as co-facilitators of the DMT process. It also indicates the likelihood that non-DMT professionals could become more useful in their workplaces as they ‘see’ more and feel more skilled and empowered. It also indicates potential for improved practice of trainee DM therapists whose skills are in development. Relevance of the data to DM therapists in diverse contexts and other professionals
Impact of assessors’ skills and training Participants had a very diverse range of expertise in DMT, special education and assessment. This different expertise did not prevent them from making useful assessments, as evidenced by concordance between scores made by Australian participants. The most frequent outcome was a score the same or within one rating point for each client. This concordance occurred in ratings made by the DM therapists, but also between the DM therapists and the Educational Support (ES) staff. This occurred in trial sessions in which participants discussed their ratings with each other and researcher/DM therapist Dunphy as they were making them, but also when they made them independently and compared later. This finding also bodes well for the likely inter-rater reliability strength of these tools. Outcomes of app use for professional practice By the end of the trial at Sunshine SDS, DM therapist Mullane reported that ES staff had become more valuable contributors in the DMT program because they could produce data on student learning that she considered useful and relevant. ES staff’s engagement both
DM therapist Mullane reported that the data both she and ES staff collected with the app was useful. She expected to be able to use it for evidence-based assessment of her students at a level previously impossible with paper-based assessment. School leaders also confirmed that data generated by the app was useful to them as education specialists without DMT expertise. Using the app for assessment helped them see what DM therapists look for in client progress. In so doing, the app’s use both contributed to validation of the DMT program as well as offering the leaders fresh perspectives on the capacities and challenges of their students. The collaboration with US participants offered several insights. First, that the app was useful in that community setting for DMT, as well as the educational setting of the trial in Australia. Second, that the US trial site was like many DMT settings in Australia in having no established assessment practice, thus indicating the potential benefit of a user-friendly assessment tool. These findings offer modest support for the view that, despite the historically rich development and presence of DMT in the US compared with Australia, the need for assessment tools that are effective and user-friendly for practitioners is equally as urgent there. This finding confirms the original motivation of the staff of that training institution to be involved in
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
the trial because they were aware that such tools are not in common use in the US, and yet are much needed. While both trial contexts involved use of the app with children with special needs, feedback from other peers indicate that the app is likely to be useful in other settings. Responses to the app from DM therapists at the various professional development opportunities detailed above were very positive. Therapists who work with clients with a range of issues, not just disability, confirmed that the idea of the app was relevant to their professional situations and that the version of the app presented seemed functional and accessible. The literature and our informal survey of colleagues in related professions (counselling and social work) indicated that like technology-based assessment tools are not in consistent use in those professions. This finding and the current priority for all health professionals to be using evidence-based approaches indicate the significant possibility that a version of the app may be relevant and useful for other psychotherapeutic professionals, especially those who work with clients in groups. Informal feedback from a range of professional peers, including mainstream and special needs educators and dance teachers, indicate the app’s potential usefulness for them too. Specific feedback offered from such peers has informed ongoing improvements to the app. This possibility of use by professionals working in different contexts can be facilitated by adjustment of the therapeutic/learning outcomes and measures on the app. Future research and development for this client group and others During the trials, a number of desirable improvements of the app became apparent. Some of these, such as adaptations for more logical navigation processes, were addressed as soon as they were identified. Several suggestions for additional functions were made. Participants indicated that the app’s additional functions of written comments and/or photos and videos to complement quantitative data would have been a valuable complement to their assessment ratings, although these functions were not tested in this trial. Timestamping of recorded observations was requested to allow tracking of assessment in relation to specific activities in any session. The provision of video samples within the app offering examples of desirable outcomes for each therapeutic goal was recommended by participants, i.e. as a ‘this is what you are looking for’ guide for optimum movement responses. This may be particularly valuable for novice assessors. School-based research participants noted that the app would be more useful if it included information linking client progress in DMT to broader educational curricula or goals to increase efficacy for reporting to school leadership and families. Assessors in other professions are likely to have similar requirements. This first version of the app used a simple Likert numerical scale (1–9) for assessment points. Current technology enables the possibility of continuous measurement devices such as visual analogue scales, which are valid, reliable and accurate (see for example Reips & Funke, 2008). This alternative might be a useful option that could be considered in a developed version. Several challenges with the app became apparent in this trial. The most significant was the need for integration of data about DMT with host organisations’ data systems. This capacity to be integrated in larger accountability systems is particularly important in institutions such as schools, where teacher-therapists are mandated to report within a particular structure. The data generated by the app could not be synchronised with the SDS’s closed internal electronic reporting system because of the complexity of the required integration. This challenge is well recognised in the technologically-driven assessment field. A national education assessment framework for managing mainstream school data recently launched by the Aus-
61
tralian Council for Educational Research (ACER, 2015) creates results that are similarly unable to be integrated into individual school reporting systems. ACER’s acknowledgement that they are not planning to tackle this problem given the diversity of systems in schools across Australia, confirms the likely difficulty in attempts to undertake this for the huge diversity of circumstances in which DM and other therapists work. Other ways of using data generated by the app that do not require full system integration will need to be developed. While the app enables new possibilities for the collection of data, it also provides new challenges for the management, transmission and storage of such data. Ensuring privacy and confidentiality of client data is the responsibility of an ethical therapist. As a tool with international application, diverse regulations about health record management apply to the app’s use. These issues were not addressed in the pilot stage of the app’s development, although the need for solutions for these was evident, confirmed by trial participants and their institutions. Now that the initial pilot has indicated the app’s potential as a useful tool, further development will be required to ensure the security of client data. Possibilities include password-restricted access to the app and to specific client files, automatic timing out of the app functions after a period of inactivity, and secure options for exporting data. Future possibilities for research exploration include widening of the scope of trial participants, most importantly to clients themselves. The use of the app to date has not included client engagement in the assessment process, yet client self-assessment is well acknowledged as being beneficial, for example, in promoting student learning (Earl, 2013; Elwood & Klenowski, 2002; Munns & Woodward, 2006) and therapeutic outcomes (Caldwell, 2013). Engagement in assessment would be expected to assist clients’ sense of ownership of the therapeutic experience and in becoming vital and engaged participants (Stephen & Alex, 2006). It may also assist them to identify their own goals for therapy. Inclusion of other relevant professional staff such as classroom teachers and other professionals in the trial process would provide indication of its usefulness in offering additional insights about their clients or students. Parents/carers of clients could also be included as trial participants to help determine how data collected by the app compares with traditional reports in terms of its value for families. Exploration of the app’s use by related professionals such as other creative arts therapists could offer information about its likely usefulness in their different contexts. Trialling of complementarity and integration of different data forms (such as videos, photos and qualitative written responses) would also be useful.
Conclusion This article introduced the iPad app, Marking the Moves, developed to assist dance movement therapists to articulate, qualify and quantify therapeutic outcomes for clients with disability in DMT, and to articulate those outcomes to key stakeholders. The Framework for Dance Movement Assessment that underpins the app was introduced briefly. This framework defines a range of therapeutic goals and measures to assess them that are posited as appropriate for dance movement therapy programs for this client group. These initiatives were developed in response to the prescient need in DMT recognised by the authors, for relevant and practical assessment tools that facilitate the gathering of data about client progress that is informative for a range of stakeholders. Two small pilot trials of the app involving ten participants, in a special school in Melbourne, Australia, and a community setting in Chicago, USA, indicate positive outcomes of its use. The app appears likely to be able to contribute to improved practice in therapeutic assessment by expediting effective and efficient processes in the
62
K. Dunphy et al. / The Arts in Psychotherapy 51 (2016) 54–62
real world setting of the DM therapist, who often works with groups of clients and has limited access to assessment options as she does that work. The trials indicate that the app facilitates the collection of data that is valuable for reflection and reporting of client progress to other institutional staff as well. They also demonstrate that the app is user-friendly for staff without DMT expertise, enabling nonDMT program support staff to contribute to collection, recording and comparison of information about client outcomes. Promising indications of the likelihood of inter-rater reliability in assessments generated by the tool were demonstrated. Future research possibilities include the trial of the app by other professionals including creative arts, and other therapists, and teachers. Funding The support is acknowledged of the Psychotherapy and Counselling Federation of Australia and an anonymous charitable foundation for the trial in Australia, and the Hanny Exiner Memorial Foundation for the development of the app. Acknowledgements Our appreciation goes to collaborators in Australia at Sunshine SDS, led by Principal Michael Devereaux, and in the USA at Columbia College, including Associate Professor Susan Imus and students Hannah Bailey and Patrick Justin. App developers Advaita Digital (Frank Ryder, Dennis Claringbold and Gary Bass) applied themselves with great diligence to the problems for DMT assessment that we provided them. We also thank anonymous reviewers of the article who provided valued suggestions for improvement of the article. Authors Dunphy and Mullane were recipients of the American Dance Therapy Association’s Award for Innovation in 2015 for Marking the Moves app. References ACER. (2015). Collecting and visualising data from everyday school based activities. In Professional development seminar http://www.acer.edu.au/ professional-learning/events/acer-q-central-collecting-and-visualising-datafrom-every-day-school-based Brooke, S. L. (Ed.). (2006). Creative arts therapies manual. In A guide to the history, theoretical approaches, assessment, and work with special populations of art, play, dance, music, drama, and poetry therapies. Springfield, Il: Charles C. Thomas. Caldwell, C. (2013). Diversity issues in movement observation and assessment. American Journal of Dance Therapy, 35, 183–200. Choe, S. (2014). An exploration of the qualities and features of art apps for art therapy. The Arts in Psychotherapy, 41(2), 145–154. Cruz, R. F., & Koch, S. (2012). Issues of validity and reliability in the use of movement observations and scales. In R. F. Cruz, & C. Berrol (Eds.), Dance/movement therapists in action: A working guide to research options (2nd ed., pp. 45–68). Springfield, Ill: Charles C. Thomas. Cruz, R. F. (2006). Assessment in dance/movement therapy. In S. L. Brooke (Ed.), Creative arts therapies manual: A guide to the history, theoretical approaches, assessment, and work with special populations of art, play, dance, music, drama, and poetry therapies (pp. 133–143). Springfield,Il: Charles C Thomas. Cruz, R. F. (2013). Evaluation and assessment in dance movement therapy. In R. F. Cruz, & B. Feder (Eds.), The arts and science of evaluation in arts therapies (2nd ed., pp. 307–333). Springfield, Ill: Charles C. Thomas. CultureCounts. (2015). CultureCounts. http://culturecounts.cc/ Accessed 4.05.15 Department of Education and Early Childhood Development (DEECD). (2008). Digital learning Showcase–eLearning planning learning, teaching & assessment, reporting.. http://epotential.education.vic.gov.au/showcase/elearning planning/learning teaching assessment reporting Accessed 24.08.13 Davis, M. (1991). Guide to movement analysis methods part 2: Movement Psychodiagnostic Inventory. Unpublished manual; available from Martha Davis, New York. Dodge, R., Daly, A., Huyton, J., & Sanders, L. (2012). The challenge of defining wellbeing. International Journal of Wellbeing, 2(3), 222–235. http://dx.doi.org/ 10.5502/ijw.v2i3.4
Dunphy, K. & Mullane, S. (2016). Framework for Dance Movement Assessment. www.makingdancematter.com.au. Dunphy, K., & Scott, J. (2003). Freedom to move: Movement and dance for people with intellectual disabilities. Sydney: Elsevier. Earl, L. (2013). Assessment as learning: Using classroom assessment to maximize learning (2nd ed.). California: Corwin. Elwood, J., & Klenowski, V. (2002). Creating communities of shared practice: The challenges of assessment use in learning and teaching. Assessment & Evaluation in Higher Education, 27(3), 243–256. Exiner, J., & Kelynack, D. (1994). Dance therapy redefined: A body approach to therapeutic dance. Springfield: Charles C. Thomas. Fullan, M., & Langworthy, M. (2014). A rich seam: How new pedagogies find deep learning. London: Pearson. http://www.newpedagogies.info/wp-content/ uploads/2014/01/A Rich Seam.pdf Accessed 31.12.15 Gantt, L. (2000). Assessments in the creative arts therapies: Learning from each other. Music Therapy Perspectives, 18(1), 41–46. Hahna, N. D., Hadley, S., Miller, V. H., & Bonaventura, M. (2012). Music technology usage in music therapy: A survey of practice. The Arts in Psychotherapy, 39(5), 456–464. http://isiarticles.com/bundles/Article/re/df/72256.pdf Hanna, J. L. (2008). A nonverbal language for imagining and learning: Dance education in K–12 curriculum. Educational Researcher, 37(8), 491–506. http:// dx.doi.org/10.3102/0013189X08326032 Karkou, V. (Ed.). (2010). Arts therapies in schools—Research and practice. London: Jessica Kingsley. Kestenberg Movement Profile. (2015). Kestenberg movement profile.. www. kestenbergmovementprofile.org Accessed 4.03.15 Kim, S., Kang, H.-S., & Kim, Y.-H. (2009). A computer system for art therapy assessment of elements. The Arts in Psychotherapy, 36, 19–28. Kim, S. I. (2010). A computer system for the analysis of color-related elements in art therapy assessment. The Arts in Psychotherapy, 37(5), 378–386. Knight, A. (2013). Uses of iPad® applications in music therapy. Music Therapy Perspectives, 31(2), 189–196. Koch, S., Cruz, R. F., & Goodill, S. (2001). The kestenberg movement profile: Performance of novice raters. American Journal of Dance Therapy, 23(2), 71–87. Laban, R. (1988). Modern educational dance (3rd ed.). Plymouth: Northcote House. Law, D., & Wolpert, M. (2014). Guide to using outcomes and feedback tools with children, young people and families. London: CAMHS. Magee, W., Siegert, R., Daveson, B., Lenton-Smith, G., & Taylor, S. (2014). Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC): Standardisation of the principal subscale to assess awareness in patients with disorders of consciousness. Neuropsychological Rehabilitation, 24(1), 101–124. http://dx.doi.org/10.1080/09602011.2013.844174 Malchiodi, C. (2012). Art therapy: There’s an app for that (Blog post).. Accessed www. psychologytoday.com/blog/the-healing-arts/201202/art-therapy-there-s-app1 Masters, G. (2013). Reforming educational assessment: Imperatives, principles and challenges. Melbourne: Australian Council for Educational Research. http:// research.acer.edu.au/aer/12/ Accessed 23.5.14 Mattson, D. (2015). Usability assessment of a mobile app for art therapy. The Arts in Psychotherapy, 43, 1–6. http://dx.doi.org/10.1016/j.aip.2015.02.005 Miller, C. (Ed.). (2013). Assessment and outcomes in the arts therapies: A person centred approach. In. London: Jessica Kingsley. Citation removed for blind review. Munns, G., & Woodward, H. (2006). Student engagement and student self assessment: The REAL framework. Assessment in Education, 13(2), 193–213. Orr, P. (2012). Technology use in art therapy practice: 2004 and 2011 comparison. The Arts in Psychotherapy, 39(4), 234–238. PACFA. (2015). PACFA data collection project for client informed therapy.. www.pacfa. org.au Accessed 31.3.15 Perrotta, C., & Wright, M. (2010). New assessment scenarios. Futurelab. http://www. futurelab.org.uk/sites/default/files/New assessment scenarios.pdf Powell, M. (2008). Assessment in dance/movement therapy practice: A state of the field survey. In Masters thesis From http://dspace.library.drexel.edu/handle/ 1860/2944 Accessed 26.6.12. Drexel University. Reips, U. D., & Funke, F. (2008). Interval-level measurement with visual analogue scales in Internet-based research: VAS Generator. Behavior Research Methods, 40(3), 699–704. Ripley, M. (2007). E-assessment–an update on research, policy and practice. Futurelab. http://www.futurelab.org.uk/resources/documents/lit reviews/ Assessment Review update.pdf Accessed 5.7.12 Robards, J. (2012). How effective is the iPad as an art therapy medium? Accessed from. http://www.academia.edu/6888155/ How Effective is the iPad as an Art Therapy Medium Ross, J. (1994). The right moves: Challenges of dance assessment. Arts Education Policy Review, 96(1), 11–18. Snow, S., & D’Amico, M. (Eds.). (2009). Assessment in creative arts therapies: Designing and adapting assessment tools for adults with developmental disabilities. Springfield: Charles C Thomas. Stephen, J., & Alex, L. (2006). Positive therapy: A meta-theory for positive psychological practice. New York: Routledge.