Open Access
Published:
July 2025
Licence: CC BY-NC-4.0
Issue: Vol.20, No.1
Word count: 3,785
About the authors

Building a stronger sense of self and others: Creative Connections in an early intervention setting

Natalie Kang Qian Yi and Chong Kai Wen

Abstract 

This practice-based paper explores the implementation of Creative Connections, an integrated art therapy and music therapy programme designed for an early intervention centre. The programme aims to enhance the sense of self, others, and the environment through the co-creation of singable books. Vignettes from two classrooms share how children aged four to six, living with developmental difficulties, engaged in creative expression, fostered social bonds, and developed a stronger sense of identity. Through the co-creation of singable books, this multi-sensory approach facilitated individualised self-expression and meaningful interactions, promoting social inclusion and enhancing school readiness. Creative Connections presents a promising model for supporting children with developmental difficulties in early intervention.

Keywords

Developmental difficulties, early intervention, sense of self, creative arts therapy, art therapy, music therapy

Cite this practice paperKang, N.Q.Y. & Chong, K.W. (2025). Building a stronger sense of self and others: Creative Connections in an early intervention setting. JoCAT, 20(1). https://www.jocat-online.org/pp-25-kang-chong

The early years of a child’s life are the most critical in shaping their future development (Stevens et al., 2023). During this foundational period, the brain undergoes rapid growth, forming neural pathways that support cognitive, emotional, and social functioning (Thompson, 2024). Consequently, early intervention services are vital for children who have or are at risk of developmental delays and difficulties (Shin et al., 2025). Targeted at children from birth to six years old, these services are typically facilitated by multidisciplinary teams, including teachers, social workers, psychologists, and therapists, all aimed at promoting holistic child development and providing family support. Early intervention programmes are designed to address developmental concerns at their earliest stages, offering children the opportunity to develop key social, emotional, and cognitive skills during this critical developmental window, thereby maximising their potential for independence (Early Childhood Development Agency, 2024).

For children with developmental difficulties, including those with autism spectrum disorder (ASD) and global developmental delays (GDD), early intervention is especially vital. Children with these conditions often face challenges in social communication, emotional regulation, and cognitive development, which can impact their ability to engage meaningfully with peers, caregivers, and their environment. ASD, a neurodevelopmental condition that affects approximately one in 54 children worldwide (National Center for Health Statistics, 2020), is characterised by difficulties in forming social connections, interpreting social cues, and engaging in reciprocal communication (Thomas et al., 2023). Similarly, children with GDD, which refers to a delay in multiple areas of development such as motor skills, speech, and cognitive functioning, often experience delays in forming a cohesive sense of self and in establishing social connections (Bailey, 2016). These challenges can lead to heightened anxiety, difficulties in peer relationships, and a sense of isolation, making early therapeutic interventions critical in addressing these issues (Montaser et al., 2023).

Creative arts therapies, such as art therapy and music therapy, have emerged as promising interventions for children with developmental delays and are increasingly integrated into early intervention curricula (Martínez-Vérez et al., 2024). These therapies provide unique approaches to fostering self-expression, emotional regulation, and social interaction. Art therapy, which involves using various artistic media to express thoughts and feelings, offers children a non-verbal outlet to explore and communicate their internal experiences while supporting emotional regulation (Bernier et al., 2022; Deleon, 2024). Music therapy, similarly, uses sound, rhythm, and melody to help children engage with their emotions and establish connections with others (Geretsegger et al., 2014). Both therapies create a supportive, non-judgmental space where children can express themselves freely, bypassing some of the verbal communication barriers they may face. This is particularly beneficial for children with developmental difficulties, as they often find it easier to convey emotions through creative outlets rather than words (Novenia, 2019).

A systematic review by López-Escribano and Orío-Aparicio (2024) found that creative arts therapies significantly reduced anxiety, supported emotional expression, and improved social interaction skills in children with developmental difficulties (Bosgraaf et al., 2020). Semi-structured activities such as co-creating singable storybooks or collaborative artworks provide opportunities for meaningful peer engagement, helping children build social bonds and a sense of belonging (Thomas et al., 2023; Bosgraaf et al., 2020). These interpersonal benefits are particularly crucial for children who struggle with reciprocity and social connection.

While the individual benefits of art and music therapy have been well documented (Bernier et al., 2022; Schweizer et al., 2014; Zhao et al., 2025), the combined use of these therapies in a structured programme remains an area of limited exploration, particularly within early intervention settings. This paper aims to address this gap by sharing the implementation of Creative Connections, an integrated art and music therapy programme aimed at creating singable books in two early intervention classrooms at an early intervention centre in Singapore. It seeks to highlight the collaborative potential of creative arts therapies in supporting the development of self-awareness and interpersonal awareness in children with developmental difficulties, offering valuable insights as part of a holistic early intervention strategy.

Overview of Creative Connections

Creative Connections was implemented at an early intervention centre in Singapore, designed to support children with medium to high levels of developmental challenges, including autism spectrum disorder (ASD), global developmental delay (GDD), and speech and language delays. In Singapore’s early intervention landscape, children are typically classified into different levels of need based on the degree of developmental delay across domains such as communication, motor skills, adaptive functioning, and social-emotional development (Early Childhood Development Agency, 2024). These classifications guide the intensity and type of support provided, with higher-need profiles requiring more structured, targeted, and frequent interventions. The children participating in Creative Connections were primarily from the moderate to low needs group. While they demonstrated emerging challenges across developmental domains, they were generally able to engage in small-group routines with support, making them suitable candidates for structured, multidisciplinary interventions aimed at enhancing social participation and school readiness.

Children attended the centre in two- or three-hour blocks, and the programme was seamlessly integrated into their regular classroom routines, intentionally aligned with existing class themes. The primary goal was to foster connections with self, peers, and the environment through the guided creation of singable books. In doing so, the programme aimed to enhance self- and social awareness within a familiar and supportive structure.

All children from the Sunshine (n = 5) and Rainfall (n = 8) classes participated in Creative Connections during school hours, as part of their scheduled classroom programme. Therapists entered the classrooms to conduct the sessions, ensuring that the intervention took place within the children’s natural learning environment, without requiring them to be pulled out. While participation was encouraged, children were given space to engage at their own pace and could choose not to participate in specific moments or components if they felt unready. The programme ran for eight consecutive weeks, with one 45-minute session each week per class.

Each session followed a general structure, beginning with a check-in through a hello song to acknowledge each child’s presence and help establish a sense of routine and community. This was followed by a time of art-making or semi-structured directives, where children designed their respective pages for the singable book, composed lyrics based on a guided framework, created musical instruments, and recorded their singing both individually and as a group. Sessions concluded with a goodbye song to support closure and transition. Co-facilitated by an art therapist and a music therapist, the collaboration allowed the visual and musical components to be integrated seamlessly, with therapeutic goals intentionally embedded throughout. This dual approach provided a dynamic, multi-sensory experience that supported children in exploring their identities and social relationships. Table 1 summarises the group profiles, including need levels and age ranges of the participating children.

Table 1. Summary of class profile and age ranges.

Group vignette one: Sunshine class

A total of five children, aged five to six years old, presenting with moderate developmental needs participated in Creative Connections. The primary focus was to enhance children’s sense of self and increase awareness of their peers. As the class theme for the term was ‘occupations’, the children were encouraged to introduce themselves and their aspirations for the future, which would be incorporated into a class singable book.

As part of the creative process, each child was invited to create a visual representation of themselves using colours and images that reflected their likes and aspirations. Based on each child’s sharing, the art therapist sourced additional images that visually represented their preferences and future goals, incorporating these into their individual pages. This process supported communication for children with emerging verbal skills and offered a sense of agency within the semi-structured format of the programme.

The children were then guided to collaboratively compose the lyrics for a singable storybook, introducing themselves through their favourite colour, items or routines, and a chosen occupation. Verbal and pictorial prompts were given for children who required more support in articulating their preferences and aspirations. This integration of personal preferences into a familiar nursery rhyme provided a simple and enjoyable way for the children to engage with the melody and lyrics. For example, one child chose water play as their favourite activity and expressed his hope of making friends, while another wanted to be a teacher and incorporated his love for playgrounds into his verse (see Figure 1 for the process of art-making).

Figure 1. The process of creating their individual pages for the singable book. Names of the children are intentionally blurred to protect their identities.

The familiar melody structure of the nursery rhyme helped make the creative process more accessible for the children, providing a predictable rhythm and format that supported engagement. At the beginning of the programme, many of the children demonstrated limited group awareness, where they were more focused on their own tasks and showed little recognition of their peers’ presence, contributions, or shared experiences. This was observed in behaviours such as avoiding eye contact during group activities, not responding to peers’ names in the song, or showing hesitation to sing along unless directly prompted. Given this, the therapists found it helpful for teachers and therapists to actively participate in the process, singing alongside the children, modelling enthusiasm, and verbally affirming each child’s part. This consistent adult involvement helped scaffold a sense of safety, built therapeutic rapport, and gradually fostered a collective sense of identity within the class. Over time, the resulting song evolved into a shared class anthem, which the children continued to reference and sing even after the programme concluded. Below are the lyrics of the singable storybook created with the children, with pseudonyms used for confidentiality:

1, 2, 3, let’s go! (adapted to the tune of ‘Skip to my Lou’)

I am Yun Zhi, I like water play, I am Yun Zhi, I want to be a friend.
I am Annabelle, I like jumping, I am Annabelle, I want to be a nurse.
I am Shazam, I like to play Lego, I am Shazam, I want to be a postman.
I am Abraham, I like playground, I am Abraham, I want to be a teacher.
I am Ahman, I like blue, I am Ahman, I want to be a doctor.
I am Teacher Kiki, I like music, I am Teacher Anne, I like food,
I am Teacher Kaiwen, I like blind box, I am Teacher Nat, I like travelling.
We are Sunshine class!

Through the creative process, children became more aware of their peers’ preferences, and their growing awareness was observed both within and outside of the sessions. For instance, class teachers shared that Shazam, who had previously displayed limited social engagement, remarked on his peer Ahman’s favourite colour, then passed him a blue pencil during a non-programme activity. This small act indicated an emerging awareness of others and the ability to generalise concepts learned during the sessions.

One particularly notable achievement was observed in Yun Zhi, who was initially non-verbal and disengaged. As the sessions progressed, Yun Zhi became more participative, from moving away from the group to being able to be with the group throughout the session. He also showed increased interest in his peers, pointing at them when their part of the song was sung. By the end of the programme, he was able to hum along and made multiple attempts to articulate the song, marking a significant milestone in his expressive communication abilities. In fact, he was also the one who gave the song its title, ‘1, 2, 3, let’s go!’

Teachers also noted improvements in the children’s ability to focus and follow directions during structured group activities beyond the programme. The multi-sensory nature of the programme through combining visual art-making, music and movement seemed to support these children in staying engaged, sustaining attention and emotional regulation. For example, children who were typically restless during other routines were observed sitting for longer periods during painting and song composition, often humming or swaying along as they worked. Integrating the use of hello and goodbye songs as rituals also helped ease transitions and provided a predictable structure. The act of combining art making, lyric writing, and singing offered multiple entry points for engagement, allowing children with different sensory preferences to participate meaningfully. The children showcased their creations through the visual storybook; as well as the video that was put together by the art therapist. Their sense of pride and social connections formed was evident as they pointed to their own creations and friends as the video played along. They repeated phrases, and asked to watch it again during their regular circle time. As such, the culmination of the project into a shared group product appeared to reinforce both their individual contributions and their connection to the group.

Group vignette two: Rainfall class

Eight children aged four to six years old with moderate to low developmental needs from Rainfall class participated in the programme. With some children transitioning to mainstream primary schools the following year, the programme aimed to strengthen their awareness of self, others, and the environment, which are soft skills essential for school readiness in fostering friendships and group interactions.

The sessions began by discussing the different spaces in the school, as well as the children’s favourite activities in school. Thereafter, the children went about the different spaces in and around the early intervention centre that came up in their discussion, such as the classroom, walkways, community playground, and the indoor gym room. The children took pictures of their favourite spaces while engaged in their favourite activity. For instance, Afif, who shared that he enjoys jumping during gym time, took pictures of himself jumping in the gym room; while Nabila took pictures of herself drawing in class, as that was her favourite activity and space. These pictures were later incorporated into the creative art-making process (see Figure 2) and developed into individual pages for their singable book, showcasing children’s favourite spaces and activities while drawing connections between themselves and their classmates.

Figure 2. Nabilah’s and Afif’s pages in the singable book. Faces and names of the children are intentionally blurred to protect their identities.

As in the Sunshine class, the familiar song structure was adapted from one of their class songs, ‘Walking through the jungle’ by Stella Blackstone. This particular song was selected because children were often observed singing it spontaneously during transitions or classroom tasks, indicating a strong sense of familiarity and enjoyment. This familiarity helped support the integration of new concepts into the co-created storybook. The lyrics the children composed reflected their personal preferences and included action-based elements to encourage peer engagement. For example, as they sang about walking through corridors or dancing in the classroom, they began to recognise and refer to their peers’ favourite spaces and actions, thereby strengthening social bonds and shared group identity.

Here are the adapted lyrics to the tune of ‘Walking through the jungle’ by Stella Blackstone (with pseudonyms used for confidentiality):

Making friends in Rainfall, making friends in Rainfall,
Who do you see? Who do you see?
I see my friends in Rainfall, smile, smile, smile! Smiling at me.

Drawing at the table, drawing at the table,
Who do you see? Who do you see?
I think I see Nabilah, draw, draw, draw! Drawing at the table.

Jumping in the gym, jumping in the gym,
Who do you see? Who do you see?
I think I see Afif, jump, jump, jump! Jumping in the gym.

Walking through the corridor, walking through the corridor,
Who do you see? Who do you see?
I think I see Kai Qin, walk, walk, walk! Walking through the corridor.

Dancing in the classroom, dancing in the classroom,
Who do you see? Who do you see?
I think I see Debra, dance, dance, dance! Dancing in the classroom.

Skipping through the void deck, skipping through the void deck,
Who do you see? Who do you see?
I think I see Aryan, skip, skip, skip! Skipping through the void deck.

Sliding down the slide, sliding down the slide,
Who do you see? Who do you see?
I think I see Arkash, slide, slide, slide! Sliding down the slide.

Playing with the toys, playing with the toys,
Who do you see? Who do you see?
I think I see Hannah, play, play, play! Playing with the toys.

Reading at the corner, reading at the corner,
Who do you see? Who do you see?
I think I see Darren, read, read, read! Reading at the corner.

Having fun in EIPIC, having fun in EIPIC,
Who do you see? Who do you see?
I see my friends and teachers, having fun with me!

The children’s collaboration with the therapists in creating the lyrics prompted not only individual expression but also shared decision-making, negotiation, and co-construction. During group discussions, children listened to one another’s ideas and sometimes suggested changes or added lines based on what a peer had shared. For example, after Afif named the gym as his favourite space, another child excitedly proposed adding jumping actions to match Afif’s activity. This type of responsive engagement illustrated how the children were not only contributing their own ideas but also building upon and validating their peers’ contributions.

The creative process sparked conversations about favourite spaces, activities, and hobbies, revealing both shared interests and unique preferences. Children began to notice commonalities, such as a mutual love for playgrounds or drawing, and these discoveries often led to playful exchanges or affirming gestures, such as mimicking each other’s dance moves or referencing a classmate’s line in the song. This interplay reflected early forms of collaboration, where children adjusted their participation in response to others, deepening peer connections.

As they co-created the storybook and participated in group actions, the children demonstrated increasing levels of engagement and cooperation. They returned to their work with enthusiasm, referenced their peers’ parts during the singing, and showed pride in the collective product. Teachers observed that children became more aware of one another’s actions and interests, often pointing them out during sessions and in classroom routines. One teacher shared, “I feel like time always goes by so fast during the session,” reflecting the shared enjoyment and group cohesion that emerged through the process.

The programme contributed to improved group dynamics as the children gradually shifted from working side-by-side to working with one another. As their comfort and familiarity grew, so did their willingness to wait for their turn, offer help, and participate in group decisions, such as choosing the order of song verses or instruments for the recording.

Through the co-creation of the book, children also learned important skills such as turn-taking, collaboration, and contributing ideas in a group setting, skills vital for school readiness. The action-based learning reinforced concepts of peer awareness and friendship, making these skills more tangible and accessible. These moments of co-construction, mutual recognition, and joint participation reflected early foundations of collaboration within a supportive, therapeutic environment.

Discussion

Through the two group vignettes discussed here, Creative Connections demonstrated how the integration of art and music therapies as creative arts modality can effectively support the challenges faced by children with developmental difficulties, particularly in areas of self-awareness, social interaction, and peer relationships. It also highlights how the multisensory nature of the programme allowed for individualised expression while fostering key developmental skills that are often challenging for children with developmental difficulties. For instance, one of the primary developmental challenges for children with ASD is the difficulty in expressing emotions and understanding social cues. Creative Connections offered children the opportunity to explore their identities and communicate their preferences in ways that felt more comfortable and accessible than traditional verbal communication. Self-awareness and intra-personal development were observed in moments where children expressed clear preferences, made creative choices, or took ownership of their contributions. This process allowed for a deeper connection with their inner selves, enhancing their self-awareness. For example, children like Yun Zhi, who had been non-verbal, showed increased participation as they began to hum along and engage with their peers through the shared creation of the song. This indicates that the use of music and art can support expressive language development, even for children who struggle with verbal communication.

Next, the act of contributing to a group project, particularly one that emphasised shared interests and actions, allowed children to learn about and acknowledge each other’s preferences while reinforcing a sense of belonging. Teachers from both classes expressed how children eagerly looked forward to the sessions and the opportunity to express themselves creatively, through the process of art-making, and singing and dancing along to their singable book. This enthusiasm for the creative process and repeated revisiting of the singable book signalled not only engagement but also a growing connection to the group and ownership of the shared creation.

Finally, the creation of these personalised singable books and having them made into a video showcased during the centre’s year-end graduation celebrations have further reinforced a positive sense of self and developed the children’s confidence and self-esteem. The children took pride in their creations, as evident by repeatedly returning to the singable book and requesting for the song to be played following the end of the project. This was especially evident in the Rainfall class, where the completed video and book served as a symbolic graduation gift, pieced together by the therapists and shared with each child’s family as a memento of the shared memories created during the programme and at the early intervention centre.

Therapeutic containment was carefully upheld throughout this process. While parental consent was obtained at the programme’s outset, children’s continued assent was monitored and respected. Their active and joyful engagement, such as singing along during playback, pointing to their own and peers’ parts, and asking to view the video again, was taken as meaningful expression of willingness and ownership. No child was required to participate in the final showcase if they expressed discomfort or lack of interest. Instead, participation was guided by each child’s readiness, ensuring the experience remained empowering, respectful, and aligned with the therapeutic aims of the programme. Given the positive outcomes observed, Creative Connections presents a promising model for supporting the progress of children with developmental difficulties, contributing meaningfully to their school readiness and overall social inclusion.

Conclusion

Creative Connections demonstrated the potential of integrating art and music therapies within early intervention settings to support the developmental needs of children with developmental difficulties. By fostering self-expression, peer awareness, and early signs of emotional adaptability such as improved turn-taking, group participation, and tolerance of sensory input, the programme provided a supportive environment for children to build stronger social bonds and a clearer sense of self. These outcomes highlight the effectiveness of a structured, multi-sensory approach in early intervention. Ultimately, this programme illustrates how an interdisciplinary, therapist-led directive can promote interpersonal skill development and support children in navigating the relational demands of classroom settings. This lays important foundations for school readiness and inclusion.

Acknowledgements

The authors would like to express their heartfelt thanks to all the teachers and children in the classes involved in this paper. Their participation and support brought this paper to life and enriched its findings in ways that would not have been possible without them.

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Authors

Natalie Kang Qian Yi
MAAT, BA(Hons), AThR, AThS

Natalie is an art psychotherapist based in Singapore. At THK EIPIC Centre, she integrates creative approaches to support the development and well-being of children with developmental needs. She is also the founder and principal therapist of Art Play Psychotherapy, a private practice offering therapy and programmes for children, youth, and families. Her clinical work draws on a range of expressive modalities including art, sand, LEGO, and play within a trauma-informed framework. Bridging clinical practice, research, and training, her professional interests lie in how art and creative expression can foster mental health, resilience, and relational healing.

Chong Kai Wen
MMus(MusThrpy), RMT

Chong Kai Wen is a music therapist based in Singapore at THK EIPIC Centre, working mostly with children with Autism Spectrum Disorder (ASD) and Global Developmental Delay (GDD). She adopts a humanistic and resource-oriented approach, focusing on each child’s strengths and potential. Passionate about collaboration, she enjoys working closely with colleagues to develop creative, client-centred interventions that support children’s Individualized Education Program (IEP) goals. Her practice emphasises empathy, connection, and the expressive power of music. Outside of her professional role, she enjoys singing on the guitar as a personal form of self-expression.