The Role of Art Therapy in Autism Treatment
Intro
Art therapy stands at the intersection of creative expression and psychological healing, particularly serving those who navigate the complexities of autism. Autism, with its spectrum of behaviors and communication styles, presents unique challenges for individuals and their families. In a world where words may not always suffice, art therapy emerges as a beacon of hope, allowing individuals to express themselves beyond the limitations of verbal communication.
By harnessing the power of artistic mediums—be it painting, drawing, or clay modeling—those on the autism spectrum can articulate feelings, share experiences, and connect with others. This article seeks to shine a light on this intersection of art and therapy, delineating key concepts, findings, and potential areas for future research that deepen our understanding of this impactful modality.
Key Concepts and Terminology
Definition of Key Terms
Before diving deeper, it’s crucial to define some terms that will guide our exploration:
- Art Therapy: A therapeutic practice that utilizes the creative process of making art to improve an individual’s physical, mental, and emotional well-being.
- Autism Spectrum Disorder (ASD): A range of neurodevelopmental conditions characterized by challenges with social skills, repetitive behaviors, and communication. Each individual with ASD experiences these to varying degrees.
- Non-Verbal Communication: A form of communication that doesn’t rely on spoken or written words. Art therapy is a significant avenue for non-verbal expression, especially for individuals who may struggle with traditional forms of communication.
Concepts Explored in the Article
Several interconnected ideas stand out in the context of art therapy and autism:
- Emotional Expression: Art therapy offers a channel for individuals to express emotions that might be difficult to convey through words. This can range from joy to frustration, and understanding these feelings is essential for emotional development.
- Social Skills Development: Through collaborative creative activities, individuals with autism can learn and practice social interactions in a supportive environment. This nurtures skills like sharing, cooperation, and empathy.
- Therapeutic Modalities: The article examines various approaches within art therapy and how they address the unique needs of individuals with autism, emphasizing the flexibility and adaptability of these modalities.
Findings and Discussion
Main Findings
The review showcases that art therapy fosters notable improvements across various domains for individuals with autism:
- Enhanced Communication Skills: Many individuals find they can communicate more freely when engaging in art-making, which can bridge the gap between thought and expression.
- Emotional Regulation: Using art as a coping mechanism allows individuals to better manage overwhelming emotions, promoting self-control and awareness.
- Increased Self-Esteem: As individuals create, they often gain a sense of accomplishment and value, boosting their overall self-image.
Art therapy allows for exploration without the constraints of traditional language, offering a voice to those who often feel unheard.
Potential Areas for Future Research
While current findings underscore the profound impact of art therapy, gaps remain in understanding its full potential. Future exploration could include:
- Longitudinal Studies: Observing individuals over time to assess long-term benefits of art therapy in various developmental stages.
- Cross-Cultural Perspectives: Analyzing how different cultures utilize art therapy approaches, considering diverse backgrounds and artistic traditions.
- Integration with Other Therapeutic Practices: Investigating how art therapy can complement traditional therapy methods for an all-encompassing treatment approach.
Preamble to Autism Spectrum Disorders
The journey of understanding autism spectrum disorders (ASD) is one that has gained significant momentum over the years. The relevance of examining autism cannot be overstated, especially considering how deeply it affects individuals and their families. In this article, we aim to explore not only the characteristics of autism but also the substantial role that art therapy can play in its treatment. It is crucial to set the stage for what autism is, how it manifests, and its implications in therapeutic settings.
Defining Autism
Autism spectrum disorder is a complex developmental condition that encompasses a range of challenges related to social skills, repetitive behaviors, and communication difficulties. The term ‘spectrum’ aptly describes the diversity in symptoms and severity levels, suggesting that while some individuals may interact with the world quite differently, they all share core features. This elsewhere somewhat vague categorization often leads folks to define autism in various ways. For instance, one might say it involves an intense interest in specific topics, like trains or dinosaurs; however, it can also manifest in how a person may prefer solitude over social gatherings.
The intricate behaviors associated with autism often mean that a one-size-fits-all definition is elusive. Understanding autism requires sensitivity to the individual person behind the diagnosis. Moreover, recognizing the distinctiveness of each individual aids in breaking down stereotypes, promoting acceptance rather than misunderstanding.
Prevalence and Diagnosis
In the last couple of decades, the prevalence of autism spectrum disorders has notably increased. According to the Centers for Disease Control and Prevention (CDC) in the United States, approximately 1 in 44 children is diagnosed with an ASD. It’s essential to acknowledge that these figures may not tell the whole story, as awareness and diagnostic criteria have evolved over time, leading to more children being identified than in previous years.
The process of reaching a diagnosis often involves a multidisciplinary approach, including psychologists, pediatricians, and speech therapists. Parents might notice developmental delays or atypical behaviors during early childhood, prompting them to seek evaluation. Early intervention is crucial; the sooner a diagnosis is made, the better the support strategies can be tailored for the child’s unique needs.
"An early diagnosis can open doors to necessary support and coping mechanisms."
By understanding the intricacies of ASD, we can better appreciate why innovative therapeutic approaches, such as art therapy, have gained traction. They can provide a constructive outlet for emotions and lead to improved communication and social skills—elements that are often challenging for those on the autism spectrum.
Understanding Art Therapy
Art therapy is increasingly recognized as a powerful tool for therapeutic change, especially for individuals on the autism spectrum. This method helps bridge the gap in communication and emotional barriers that many face in traditional therapeutic settings. Its significance in this context cannot be overstated; it helps to create a non-threatening space for expression and creativity. Focusing on visual language allows for a more intuitive means of communication, making it accessible even for those who struggle with verbal skills.
Concepts of Art Therapy
At its core, art therapy is about using creative processes to facilitate healing and personal insight. The essential concepts include:
- Expression through Creativity: Individuals can articulate feelings and experiences through art when words might fail.
- Therapeutic Relationship: The bond between therapist and client is foundational to the process, as it fosters trust and safety.
- Non-Verbal Communication: Utilizing medium like paint, clay, or collage can often transcend the limitations of language.
- Reflective Practice: Engaging with artworks encourages reflection on feelings, perspectives, and their implications for one’s life.
Art therapy often follows a client-centered approach, where the therapist acts more as a facilitator than a director, allowing participants to guide their own therapeutic journeys. This aspect is particularly important in autism therapy since many individuals prefer to operate on their own terms.
History and Development
Art therapy's roots can be traced back to the mid-20th century, stemming from both psychological therapy and visual arts. Initially, art was seen more as a tool for self-expression, mainly focusing on the therapeutic benefits of creating art in a supportive environment. Over time, as research and practice evolved, art therapy began to adopt structured methodologies and theoretical foundations, such as:
- Jungian Psychology: Carl Jung emphasized the importance of symbols and images in achieving psychological healing. His ideas paved the way for incorporating visual arts into therapeutic settings.
- The Rise of Professional Organizations: The American Art Therapy Association, formed in the late 1960s, marked a milestone in formalizing the practice. This helped to develop standardized practices and establish credentialing programs for art therapists.
- Emerging Research: Studies over the years have illuminated how art therapy can alleviate anxiety, improve mood, and foster social connections among individuals on the autism spectrum.
With time, art therapy has developed various approaches and techniques, making it adaptable to different populations and settings. It now encompasses a wide range of activities—from painting and drawing to sculpture and digital media—tailored to the unique needs of clients. This evolution has not only enhanced the effectiveness of art therapy but also bridged connections across disciplines, making it relevant in social work, education, and psychology.
"Art speaks where words are unable to explain." - Unknown
As we dive deeper into how art therapy specifically impacts individuals with autism, it becomes clear that this therapeutic approach holds promise not just for self-expression but as a catalyst for deep emotional and social growth.
Theoretical Frameworks Supporting Art Therapy
Understanding the various theoretical frameworks that support art therapy is essential for fully grasping its effectiveness, especially in the context of autism. The frameworks provide a roadmap for practitioners, guiding the therapeutic process and enhancing the overall impact on individuals with autism. They allow therapists to tailor interventions according to the unique needs of their clients, ensuring that art therapy sessions are not merely activities but profound and meaningful experiences. Different theoretical approaches emphasize various aspects, such as emotional processing, cognitive development, and social interaction, making them crucial for informed practice.
Psychodynamic Approaches
Psychodynamic approaches to art therapy are rooted in the theories of Freud and other psychoanalysts. These methods focus on exploring unconscious feelings and past experiences that may influence current behaviors and emotions. For individuals with autism, who may struggle to articulate their thoughts and feelings verbally, art provides a valuable alternative for expression. Through creative processes, clients can project their inner worlds onto the canvas, allowing therapists to uncover underlying issues.
In this framework, the art-making process becomes a tool for exploration. For example, a young person with autism might create a piece that seemingly revolves around a subject unrelated to their actual feelings. A skilled therapist can recognize the layers of meaning within the artwork, shaping the therapeutic conversation around these insights. Thus, the psychodynamic approach not only aids in unveiling hidden emotions but also fosters therapeutic rapport, enabling the client to feel understood and validated.
Cognitive-Behavioral Approaches
Cognitive-behavioral approaches (CBT) offer another potent lens through which to view art therapy for individuals with autism. This framework centers on the premise that thoughts and beliefs influence emotions and behaviors. Therefore, changing negative thought patterns can lead to more positive emotional states and actions. In the context of art therapy, cognitive-behavioral techniques can be incorporated into creative sessions to help clients identify and reframe harmful beliefs.
Art therapy can be a hands-on method for illustrating these concepts. A client might express their frustration or anxiety through chaotic brush strokes or overwhelming color choices. A therapist applying CBT principles can guide the client to articulate their feelings while reflecting on the artwork's meaning. This could involve discussing the emotions that arise during the creative process and connecting them to cognitive distortions they might hold.
Overall, using cognitive-behavioral approaches within art therapy sessions cultivates emotional regulation and builds coping strategies, proving beneficial for individuals on the autism spectrum.
Ultimately, the choice of theoretical framework informs the structure and dynamics of art therapy, laying the foundation for tailored strategies that address both individual needs and therapeutic goals.
Art Therapy Techniques with Autism
Art therapy techniques hold significant value in the context of autism, providing various avenues through which individuals can express themselves and connect with the world around them. Through these techniques, art becomes a bridge, enabling communication in ways that traditional methods sometimes cannot. It offers a non-verbal platform that can be particularly beneficial for those with autism, often aiding in the development of key skills and fostering a sense of agency.
Individual Art Sessions
Individual art sessions offer a tailored therapeutic approach, providing a space where an individual can explore their thoughts and feelings through creative expression. Unlike group settings, individual sessions allow therapists to focus directly on the needs and preferences of the client. This bespoke environment is crucial, as each individual on the autism spectrum has their unique way of processing experiences.
In these sessions, clients can work with various mediums such as paint, clay, or even digital art tools, allowing for a personal exploration of identity and emotions. For instance, a child who struggles to verbalize their experiences might find relief in molding clay to mirror their frustrations. This practice can lead to increased self-awareness and understanding of their feelings, which is often a crucial step in emotional regulation.
Furthermore, these sessions can be structured to introduce specific goals, such as helping the individual navigate sensory sensitivities or enhance their focus. Through consistent one-on-one interaction, the therapist can track progress over time, adjusting techniques to best suit the evolving needs of the individual.
Group Art Therapy
Group art therapy presents a different dynamic, where individuals with autism can benefit from social interaction alongside the therapeutic aspects of art. In this setting, participants engage in collective projects, fostering a sense of community while developing both their artistic skills and interpersonal abilities. Group activities often encourage collaboration, which can be particularly enriching for individuals who experience social challenges.
In group therapy, members often share materials and ideas, creating a collective piece that reflects their diverse perspectives. For example, a mural created by all participants can showcase individual styles while emphasizing teamwork. This fosters not only creativity but also important social skills like cooperation and communication.
However, leading group sessions requires thoughtful facilitation to ensure that each participant feels comfortable and included. It’s vital for therapists to create an environment where individuals can express themselves freely without fear of judgment. This not only helps in enhancing communication skills but also builds trust and rapport among participants, essential for personal growth.
Art therapy provides a myriad of expressions, enabling individuals to navigate their world through creativity.
As we consider the array of techniques available, both individual and group sessions play a pivotal role in the journey of individuals with autism. The question isn’t just about the art being created; it’s about building connections, enhancing self-expression, and developing skills that can lead to broader social interactions beyond the therapy room.
Additional resources for further understanding include American Art Therapy Association, which provides insights into the practices and benefits of art therapy in various contexts.
Benefits of Art Therapy for Individuals with Autism
Art therapy offers a unique path for individuals on the autism spectrum, acting as a bridge to enhance personal growth and emotional well-being. Given the diverse range of challenges faced by people with autism, art therapy is not merely a creative outlet; it serves as a versatile tool that targets core areas such as communication, emotional expression, and social skills. The intrinsic value of art therapy lies in its ability to create a safe environment where individuals can share their experiences and feelings without the barriers often posed by traditional communication methods.
Enhancing Communication Skills
Many individuals with autism encounter hurdles when it comes to verbal communication. Art therapy provides an alternative avenue to express thoughts and feelings that might be otherwise difficult to articulate. Through various artistic mediums—be it painting, sculpting, or even drawing—participants may find their voices in colors and shapes.
Art can convey messages without needing words, allowing individuals to illustrate their perceptions of the world around them. For example, a child might draw a storm to express feelings of anxiety, thus making the internal external and opening avenues for further discussion with therapists or parents.
Moreover, the act of creating art itself can improve fine motor skills and coordination, which are often areas of difficulty in individuals with autism. So, while enhancing communication, these sessions layer in other skills that bolster confidence and overall interaction.
Facilitating Emotional Expression
Art therapy acts like a mirror, reflecting emotions that might not be immediately evident. Individuals on the autism spectrum may struggle with identifying and communicating their feelings, which can lead to frustration or behavioral outbursts. By engaging in art therapy, they can explore complex emotions in a more abstract form, which can be less intimidating than direct discussion.
Through various art exercises, they may uncover feelings of joy, sadness, or anger. For instance, as they splash paint on a canvas, the variety in colors can represent different emotions. A calming blue abstract could symbolize peace, while chaotic splatters might represent confusion or distress.
This freedom of expression often has therapeutic effects, helping them process emotions and recognize their significance. Art becomes not just a medium but a pathway to understanding oneself.
Fostering Social Interaction
The social dimension of art therapy cannot be overlooked. Engaging in group art sessions creates opportunities for individuals to interact with their peers in a structured yet flexible environment. As they collaborate on projects or share their creations, a sense of community often emerges. This social aspect can lead to improved social skills—sharing, taking turns, and even complimenting one another's work. In a group setting, participants are encouraged to express themselves in ways that promote listening and empathy among peers, reinforcing social bonds without the pressures of spoken communication. Take, for instance, a mural project: collaborating on a shared canvas requires not only communication but also compromise. Navigating these interactions fosters vital skills that extend beyond art therapy into everyday life.
Challenges in Implementing Art Therapy
Implementing art therapy within the context of autism is not a walk in the park. Despite the promising benefits, there are hurdles that can make this therapeutic avenue challenging. Understanding these obstacles helps stakeholders—whether they are educators, parents, or therapists—navigate the nuances of providing effective art therapy to individuals with autism. This section will delve into resource limitations and the diverse individual differences among clients that can complicate the therapy.
Resource Limitations
One of the significant challenges is the scarcity of resources. Many institutions, especially in low-income areas, lack sufficient funding to offer specialized art therapy programs. This can lead to long waiting lists or, in some cases, no access at all. When funds are tight, practitioners often find themselves stretched thin, making it difficult to provide tailored and high-quality interventions. Moreover, art materials can be costly. For example, high-quality paints, easels, and other tools might not be an everyday expense for many programs, leading to a compromise in quality.
Unavailability of trained art therapists is another concern. Although the idea of using art as a therapeutic mode is gaining traction, there are still relatively few professionals fully equipped to work with autistic individuals. This lack of specialists may mean that individuals do not receive the quality of therapy they deserve.
"Art therapy isn't just about creating art; it’s about creating possibilities. And when resources are limited, those possibilities shrink."
Furthermore, logistical issues can arise, such as insufficient space for sessions. In environments like schools or community centers, space can be a luxury. This often limits the effectiveness of the therapy since many autistic individuals thrive in structured yet flexible environments. All these factors can create significant barriers, leading to less effective interventions and ultimately hindering individual progress.
Individual Differences Among Clients
Not all autistic individuals are cut from the same cloth; they have a wide spectrum of needs and abilities. This variability poses a unique challenge in art therapy. Understanding individual differences is key, but it can complicate the approach a therapist takes. Some clients may be highly verbal and able to express feelings through conversation, while others may struggle with communication or emotional expression altogether.
The developmental stage of each client is also a critical aspect. A toddler with autism will engage with art materials differently compared to a teenager. Some clients may shy away from certain media altogether, while others might express themselves richly through painting or sculpting. This means that therapists must be adaptable and willing to change techniques based on each client’s preferences and capabilities.
Moreover, sensory sensitivities can affect engagement in art therapy. For example, a client who finds textures overwhelming may resist using certain materials. This requires therapists to be resourceful in finding alternative materials that are accessible and engaging for the client. In order to customize the therapeutic process effectively, practitioners are faced with the ongoing challenge of continually assessing and addressing these individual differences—there is no one-size-fits-all approach in art therapy.
Case Studies on Art Therapy and Autism
The examination of case studies regarding art therapy and individuals with autism offers a profound understanding of the impact this therapeutic approach can wield. These examples serve not only to illustrate the real-life benefits experienced by individuals but also to highlight the nuances involved in applying art therapy effectively. Each case presents a unique narrative that adds depth to the theoretical framework established thus far. This section focuses on two main aspects of case studies: successful outcomes and lessons learned.
Successful Outcomes
When analyzing successful outcomes from art therapy, one cannot overlook the stories that emerge from these sessions. For instance, in one case from a community art therapy program, a young boy named Jake, diagnosed with autism at an early age, struggled significantly with verbal communication. Initial sessions resulted in Jake expressing himself through colors and shapes on canvas rather than spoken words. His paintings became a medium of dialogue between him and his therapist, ultimately leading to an improvement in his verbal skills.
- Jake's experience illustrates several key points:
- Symbolism and Communication: By using art, Jake found a way to represent his feelings without the constraints of language.
- Therapeutic Alliance: The bond formed between Jake and his therapist enhanced his willingness to engage further in conversations.
- Parental Feedback: Jake’s parents noted a reduction in frustration levels as their son was able to express himself visually.
This case underlines how success in art therapy often transcends typical expectations and highlights personal growth and healing, reflecting the adaptability of art as a therapeutic tool.
Lessons Learned
Through the examination of various case studies, lessons emerge that can inform future practice and application of art therapy for individuals with autism. One significant lesson involves recognizing the individual differences among clients. For example, another case study involved a girl named Mia who, unlike Jake, initially resisted art therapy. Through careful observation, her therapist discovered that Mia had a passion for music rather than visual arts. Shifting the focus to incorporate musical elements within her sessions led to a breakthrough in engagement and emotional expression.
This situation highlights several critical insights:
- Tailored Approaches: Understanding that each individual may need a different approach is vital. Not all clients will respond positively to traditional art methods.
- Flexibility in Techniques: Integrating other forms of expression, such as music or drama, can provide alternative pathways for communication and emotional release.
- Continual Assessment: Regular feedback and adjustments to the therapeutic approach help align sessions with the client's evolving needs and interests.
In summary, case studies provide invaluable lenses through which to view the integration of art therapy in the treatment of individuals with autism. They not only showcase successes but also carve a path toward continuous learning and adaptation. Art therapy stands out not merely as a therapeutic intervention but as a dynamic interaction between therapist, client, and their unique experiences. This depth of understanding can lead to more effective therapies and ultimately, enhance the quality of life for individuals on the autism spectrum.
"Art enables us to find ourselves and lose ourselves at the same time."
– Thomas Merton
For further information on art therapy, you may find these resources helpful:
Future Directions in Art Therapy Research
The exploration of future directions in art therapy for individuals with autism stands as a pivotal facet of this article. As the unique needs of individuals on the autism spectrum continue to evolve, it becomes increasingly essential for art therapy practices to adapt and innovate. Future research will not only lead to the optimization of existing frameworks but can also foster a deeper understanding of how art can catalyze meaningful change in clients' lives.
By investigating cutting-edge methodologies and improving the efficacy of therapeutic interventions, researchers can enhance communication, emotional expression, and social interaction in those on the spectrum. An emphasis on continuous learning and development in this field allows practitioners to remain attuned to the expanding landscape of autism treatment.
"The future of art therapy lies in its ability to adapt, innovate, and meet the diverse needs of individuals with autism in a way that traditional therapies may not."
Innovative Practices
Art therapy is not a static discipline; it evolves alongside the communities it serves. Upcoming innovative practices aim to harness technology, interdisciplinary collaboration, and tailored strategies to enhance therapeutic outcomes. For instance, the incorporation of digital art platforms allows clients to express their creativity while enjoying flexibility and accessibility that traditional media may not provide. Utilizing virtual reality environments can also open doors to immersive experiences, enabling clients to engage in calming scenarios or interactive storytelling, all while exploring their feelings.
In addition, integrating mindfulness practices with art therapy ranks high on the list of future strategies. Mindfulness art therapy can help individuals cultivate an awareness of their thoughts and emotions, enhancing emotional regulation in the process. Creative arts initiatives that involve partnerships with schools, communities, and organizations can also foster a supportive network to offer more holistic approaches.
Longitudinal Studies
Longitudinal studies in art therapy present a unique opportunity to assess long-term outcomes and the transformative effects of sustained engagement. These studies track the development of participants over an extended period, measuring growth in various areas such as social skills, emotional regulation, and creativity. Evidence from such research is invaluable for understanding how art therapy influences individuals and adapting protocols accordingly.
Through consistent participation in art therapy, clients often show gradual but significant improvements in critical areas. Longitudinal studies help elucidate the timing and frequency of interventions that yield the best results, as well as the sustainability of these changes over time. Awareness of these aspects can inform future practices, creating a feedback loop where knowledge continuously enriches therapeutic approaches.
In summary, the future directions in art therapy research hold the key to unlocking new methodologies and enhancing the understanding of how art impacts individuals with autism. Incorporating innovative practices and emphasizing the significance of longitudinal studies are crucial. By doing so, the field not only advances its own foundations but also deeply enriches the lives of those it aims to support.
For further reading on the latest in art therapy practices, you might explore Art Therapy Journal or relevant discussions on platforms like Reddit.
Consider also searching through academic databases such as those found on Google Scholar for peer-reviewed studies addressing these emerging themes.
The End: The Role of Art Therapy in Autism
Art therapy serves as a vital tool for individuals with autism, providing a unique avenue for communication, emotional expression, and social engagement. This article underscores how engaging with art can bridge gaps that are often left wide open by traditional therapeutic practices. The role of art therapy is not only beneficial but crucial in tailoring interventions that resonate with the distinct needs of autistic individuals.
Integrating Art Therapy into Treatment Plans
Integrating art therapy into treatment plans involves a thoughtful and tailored approach. It's essential to consider the individual's preferences, strengths, and challenges. Each person with autism has a varied experience with sensory input and social interaction, so a standardized approach might not work well for everyone.
- Personalization: Treatment plans should include assessments of communication abilities, emotional responses, and social skills. Artists like Pablo Picasso have noted that creativity allows for personal narratives to unfold, which can help shape these individualized plans.
- Collaboration with Professionals: Art therapists, psychologists, and educators should work together, ensuring that the therapy complements other therapeutic efforts. For instance, aligning art activities with speech therapy can help enhance both verbal and non-verbal communication.
- Flexibility: It’s key to remain flexible and responsive. Success in art therapy isn't measured by the final piece of art, but rather, the process and personal experiences of the individual during sessions.
Incorporating art therapy can expand the therapeutic landscape and offer more engaging, relatable methods for individuals on the spectrum.
Implications for Practitioners and Families
The implications of art therapy extend beyond the therapists' office and into the homes of families. For practitioners, understanding the multifaceted benefits of art therapy can inform their methodologies and enhance their effectiveness.
- Broader Understanding: Practitioners are empowered to recognize that art is not just a form of expression but also a therapeutic mechanism that helps to foster connections. These insights can lead to more effective engagement strategies.
- Support Families: Families often seek new ways to connect with their loved ones. Art therapy can serve as a shared activity, allowing family members to engage with each other in meaningful ways. This aspect of community can help reduce feelings of isolation often associated with autism.
- Educating Stakeholders: Practitioners should advocate for art therapy in educational and care settings, encouraging schools and organizations to recognize its potential alongside more traditional therapies in their curriculums.
In summary, incorporating art therapy into the lives of individuals with autism reflects a shift toward more accessible and engaging forms of therapy. It champions personal expression while helping to improve essential life skills. As research continues to develop, art therapy's role will likely expand, proving itself as an indispensable part of holistic autism care.
For further reading on autism therapies and resources, consider visiting Wikipedia or CDC.
