Theater Arts as a Beneficial and Educational Venue in Identifying and Providing Therapeutic Coping Skills for Early Childhood Adversities: A Systematic Review of the Literature

Abstract


Introduction
This literature review highlights the utility of identifying early childhood adversities through dramatic play and theater arts. Understanding the impact of early childhood education, our focus included beneficial, qualitative observations of the positive therapeutic outcomes when participating in theater arts activities. We chose to search these individually (a) to understand how to identify adversities in early childhood and (b) to learn about the therapeutic effects that theater arts and dramatic play have on children. The findings amongst our articles show similar beliefs that theater arts can have a positive effect on a child's social and emotional development. Theater arts can be utilized as a venue for children to express themselves. We strongly believe that future studies should be conducted to further explore how theater arts and dramatic play can provide a means for identifying and treating children who have experienced early childhood adversities. Ending our literature review, we feel compelled to further investigate similar studies and/or design a study focused on identifying early childhood adversities using dramatic play and incorporating expressive arts as a therapeutic intervention. Particularly now, as the world determines how to navigate the multiple adversities of the COVID-19 pandemic, research informing educators, community leaders, and families of ways to protect children against the toxicity of pervasive stressors is vital. early childhood adversities can have a huge impact on their development. Perry and Conners-Burrow (2016) provide a range of outcomes that children with adverse experiences could display as poor social and emotional developmental skills, such as attachment difficulties, poor skills in peer play, inaccurate interpretations of social cues, and higher risk of mental health problems (p. 25). Adversities (a) can affect children's ability to cope with their personal thoughts and emotions and, importantly, (b) have shown children not to be school ready at the beginning of their educational career (p. 26).
Empathetic educators, as most are, want to find ways to provide students with a medium to help identify and overcome adversities. Teachers can help in providing a beneficial foundation to students' social and emotional development by having wholesome, responsive interactions with them (Magnuson & Schindler, 2019, p. 60). This is where teachers are able to "recognize and attend to children's many cues, including verbal ones such as crying and nonverbal ones such as a face expressing fear" (p. 59). Building rapport with students and displaying a genuine concern with personalized support can alleviate some of the stress that builds up within them (p. 60). Perry and Conners-Burrow (2016) identify long-term negative experiences as toxic stress, which "describes exposure to stressors-in the absence of a nurturing caregiver-that can lead to a prolonged activation of the body's stress-response system. Toxic stress in very young children can result in long-term changes to their brain's architecture (National Scientific Council on the Developing Child, 2005/2014)" (pp. 24-25). The Center on the Developing Child at Harvard University (2020) released resources, guides, and an infographic addressing what COVID-19 means for child development and the stress levels children face now and, potentially, in the future.
Dramatic play and pretend and learn centers in early childhood educational settings could possibly be the key in identifying adversities in young children. Expressive arts (e.g., visual arts, music, drama) for selfdiscovery and change can be used in the context of intervention, where art is often healing and lifeenhancing, benefiting individuals with emotional problems as well as those coping with grief and trauma (Forrest-Bank et al., 2016, p. 431). Essentially, theater arts allow children "the opportunity to articulate their views and share their experiences through a [beneficial] medium" (Salmon & Rickaby, 2014, p. 39).
In this review of the professional literature, we want to identify the correlations that have been reported between children with early childhood adversities and the possible benefits that theatre arts and drama can provide in identifying and alleviating the stress that comes from dealing with or being exposed to such adversities. Throughout the years, in our own personal instructional experiences, we have seen an increase of intervention programs primarily focused on children who have learned the art of expressing their thoughts and emotions arising from adverse situations. Our focus is on children who have yet to develop those oral expressive skills, though still yearn for a safe, stable environment, filled with love, structure, and care that every child deserves to have.
Throughout our review, we discovered that there are several definitions that warrant clarity and meaning. Galvan and Galvan (2017) state that if we have many identifiably related variables, providing a table of definitions will facilitate the reader's ability to scan and identify similarities and differences (p. 88). Because of the considerable number of articles used in our literature review, we felt compelled to ensure that any necessary definitions facilitating the understanding of our review should and have been defined. Table  1 consists of terms and definitions pertaining to early childhood adversities, development, and theater arts.

Methodology
The measures in acquiring a meaningful analysis of literature came through the process of explicitly narrowing our topic of interest. This process was implemented by precisely selecting keywords in our article search. We refined our search to consist of a substantial number of manageable articles pertaining to our focus and manifesting significant academic standards (Galvan & Galvan, 2017, p. 29). Subsequent to several attempts in finding the exact keywords (which could potentially give us our desired results), we considered the possibility of identifying two different aspects within our research that could potentially be studied independently from each other. Our study discovered that in effectively narrowing our search criteria, we also needed to provide specific and suitable keywords. The initial process of simply typing up a phrase revealed a broad collection of articles. In looking for a more specific result, we used the key terms documented in Table 2. Terms utilized in our search consisted of drama, child development, adverse childhood development, adversities, and art. Subsequently, we found a mixture of studies that did not entirely include all aspects of our intended search within one article. In conducting our database search, we specified that all articles needed to be peer-reviewed in order to be considered part of this analysis.
After choosing WorldCat as the virtual database to search (Galvan & Galvan, 2017, p. 20), the initial focus was on the title and keywords that described the studies. While reviewing the articles, we read through the abstracts and focused on the ones that pertained to the benefits of theater arts and identifying childhood adversities, to attain our final relevant sources. In Table 2, we provide an audit trail of our search, displaying the terms used in our search and the Boolean operators, the number of possible sources located, and the number of relevant sources that were acquired.
Our team reviewed a total of fifteen articles, of which five articles focused on the studies and findings of identifying and addressing early childhood adversities. The remaining 10 articles provided studies and findings of various children-based theatre arts programs, benefiting their social and emotional development where some (not all) participants have been exposed to, or are currently dealing with, a type of adversity during their early childhood.

Analysis
Galvan and Galvan (2017) recommend tables to summarize literature effectively (p. 88). We provide two research methods tables. Tables 3.1 and 3.2 include information on the participants, methodology, and findings. This is to provide a helpful summarization of the methods employed in each of the articles (p. 89). In order to give the reader an understanding of the methodologies used, we have provided demographic information of the participants, indicated the experimental design used (if any), and included a summary of the authors' findings. We organized our review of the reported methodology and findings into two sections. Table 3.1 is a summary of the research that covers early childhood adversities in an educational setting, while Table 3.2 is a summary of research  Duch et al. (2019), "John Bowlby first conceptualized attachment as the bond between caregiver and infant, formed from infants' need for security and closeness as a sensitive and consistent caregiver responds to the child (Bowlsby, 1969)" (p. 174).
constructivism According to Budd (2016), "constructivism can broadly be understood as a theory of cognition that attributes learning to the active construction of knowledge through a learner's encounters with their environment" (p. 310).
creative and performing arts participation Refers to attendance and/or participation in dance, drama, music, visual arts, and mediums such as film (Mansour et al., 2016, p. 240 broadened by the natural limitations in a young child's capacity for self-protection" (Holmes et al., 2015(Holmes et al., , p. 1650. expressive art According to Forrest-Bank et al. (2016), "the use of the art disciplines, including visual art, music, dance, writing, and drama, for self-discovery and change (Malchiodi, 2013). Expressive art is often used in the context of intervention; referred to as art therapy (Malchiodi, 2013)" (p. 431).
longitudinal study According to the Institute for Work & Health (2015), longitudinal study is observational; researchers do not interfere with the subjects, but they conduct observations of the same subjects over a period of time (some lasting for years).
play According to Mages (2018), "play is the source of development and creates the zone of proximal development" (p. 225).
preschool theatre arts (PTAR) rubric According to Susman-Stillman et al. (2018), a PTAR rubric is "an observational tool developed to assess children's preschool theatre arts skills in the context of storytelling/story acting" (p. 250).
social emotional learning According to Zinsser et al. (2016), "[Social Emotional Learning] SEL describes the process by which children acquire social-emotional skills including recognising their own and others' emotions, managing their emotions, showing social awareness and empathy, forming and maintaining positive relationships, and making responsible decisions (Collaborative for Academic, Social, and Emotional Learning 2012)" (p. 269).
theatre art skills According to Susman-Stillman et al. (2018), "a set of skills that children use to participate in what is commonly referred to as creative drama or improvised guided enactment" (p. 250).
toxic stress A "term coined to describe exposure to stressors-in the absence of a nurturing caregiver-that can lead to a prolonged activation of the body's stress-response system" (Perry & Conners, 2016, p. 25).
trust According to Griffith and Larson (2015), trust "is defined as confidence in another person-a judgement that the person is dependable and has one's best interest in mind (Rotenberg, 2010)" (p. 791).
focusing on theatre arts studies and programs.
In Table 4, we summarize the strengths, weaknesses, and gaps that were found in the studies. Table 4 also includes some pertinent quotes that are important to this review.

Discussion and Findings
We noticed a pattern when searching for early childhood adversities and arts in education where most literature reviews were predominately qualitative in nature. This could be due to the "argument made by many arts researchers that they should only focus on qualitative work that is richly descriptive of the arts themselves, believing quantitative work threatens research and work in the arts" (Goldstein et al., 2017(Goldstein et al., , p. 1510. After selecting our five articles based on early childhood adversities, we identified that the pattern of qualitative work continued. Qualitative research was predominantly the structure of the studies acquired on identifying early childhood adversities; addressing and treating them through their early childhood education. As we became more familiar with our articles, we discovered that, in some cases, some researchers quoted one another amongst their studies. For instance, Susman-Stillman et al. (2018, p. 258) quoted studies by Mages in both 2008 and 2015.
We felt that this gave further credibility to the articles we were reviewing. Our discovery of one author citing another displays an evident common interest amongst scholars, through a snowball effect (Sage, 2020), towards the cultivation of studies addressing early childhood adversities and the benefits of theater arts in identifying and providing early interventions.
We found two nonexperimental studies. The observational style of data collection that Mansour et al. (2016) conducted looks at the relationship between the students' creative and performing arts participation along with their self-concept of the arts (p. 240). Mages' (2018) method of study followed a nonexperimental style of research; conducting a "quasiexperimental multi-site study us[ing] a pretest-posttest design with a treatment group and comparison group" (p. 229). Evidential findings in the Mansour et al. (2016) study show that the researchers used casualcomparison studies (p. 246). Data were collected in prior achievement measures where previous research has found that there is a relationship between arts participation and student achievement (p. 246). Both Mages (2018) and the Mansour et al. (2016) looked into cause-and-effect and focused on the effect on the participants during the study. As Mages highlighted: [I]t is worth noting that the inclusion of a TIE [theatre-ineducation] program did not detract from the children's acquisition of skills that contribute to school readiness; the scores on assessments of language, perspectivetaking, and imagination were similar for children in the intervention and comparison conditions. Thus, this study suggests that the inclusion of high-quality theatre arts curricula in early childhood education can provide young children with an entertaining and engaging preschool drama experience while providing academic supports commensurate with those of more traditional early childhood programs. (p. 224) WorldCat 2014 to 2019 July "benefits of drama" AND "children with adversities" 10 0 WorldCat 2014 to 2019 July "child development" AND "theatre art education" AND "elementary school" 25 5 WorldCat 2014 to 2019 July "drama" AND "arts" AND "early childhood" 55 3 WorldCat 2014 to 2019 July "drama" AND "theatre" AND "child" 48 1 WorldCat 2014 to 2019 July "theatre" AND "arts" AND "children" 133 1 WorldCat 2014 to 2019 July "identifying" AND "child behavior" AND "early childhood" AND "adverse childhood experiences" AND "play" 104 3 WorldCat 2014 to 2019 July "trauma" AND "interventions" AND "early childhood" AND "behavior" AND "attachment" AND "preschool setting" 46 2 "The purpose of the focus group was to gather qualitative information of the CARING (a preventative, play-based, parent-child intervention designed to promote preschoolers' social-emotional development by strengthening their bonds with their parents) program, as well as to obtain feedback to make programmatic improvements" (p. 176).
Hope of a preventive, low-cost intervention program for families facing adversities and for parent/child relationships (p. 186).
Holmes et al.
"Roughly 150 participants were referred for assessment for Head Start Trauma Smart (HSTS) intensive services during the 2011-2012 school year" (p. 1655).  (2019) "Social and human service programs and policies that serve low-income families and early childhood caregivers (parents or teachers) currently facing adversities" (p. 60).
"The focus is on programs implemented with economically disadvantaged families and children." Programs such as Mobility Mentoring, Ready for Routines, Family Check-Up (FCU), mindfulness training, Chicago School Readiness Project, ideas42, Mental Health Outreach for Mothers (MOM) Partnership, and READY4K" (p. 67).
"Their findings show that there is potential to boost caregiver (and child) self-regulation and executive function. Though rigorous evaluations are needed to better understand whether the programs are effective, including more attention to a broad range of parenting behaviors and children's outcomes, as well as consideration of how long program impacts persist" (p. 71). (2016) Research focused on children in foster care who were served in child care settings as an example of how Early Childhood Mental Health Consultation (ECMHC) builds the capacity of other adults in the child's life to serve as buffers of toxic stress (p. 25).

Perry & Conners
The use of Early Childhood Mental Health Consultation (ECMHC) as a support to home visitors and child care workers who are serving young children exposed to or at high risk for early adversity (p. 25).
Findings acknowledge the vital role that those who spend many of their waking hours with other people's children play in mitigating the risk factors to which young children may be exposed in their homes and communities. "The hopeful part is the evidence that biological stress response systems are malleable and that we can make positive changes in children's physiology when we improve their relationships with the important adults in their lives" (pp. 32-33). Zinsser et al. (2016) Total of 12 participants: 1 private preschool executive, 1 professional program evaluator, 1 mid-level manager at the office of Head Start, 1 retired superintendent, 3 former administrators (served in advisory capacities), and 5 current center directors (p. 272).
"Interviews were conducted and recorded (with permission) by phone (n=5) or in person (n=7). They were then transcribed and analyzed via NVivo qualitative coding software. The software helped them code and categorize keywords or phrases used in their study" (p. 272).
Their findings have connected developmental theory and educational practices and how the leader's emotional environmental climate strongly affects the teachers' emotional experiences at work and children's social and emotional learning (p. 286). Surveys were done prior to the beginning of the program and immediately after the last workshop (pp. 434-435).
Social work focuses on identifying effective interventions. This study found that when arts professionals collaborated with social workers, they should develop guidelines for managing youth behavior. Studies support that future study needs to explore the efficiency of the arts and child development (p. 439). Goldstein et al. (2017) "21 exemplary case studies, covering an age range from 18 months to 17 years old" (p. 1505).
Children are naturally drawn to the arts and engage happily throughout childhood. Current work is beginning to bridge the understudied activity with developmental science (pp. 1510-1511).
Griffith & Larson (2015)  "The quantitative part of the study involved objective tests administered to young children, including the Story-Telling Test (STT) and the Test for Creative Thinking-Drawing Production (TCT-DP), and two other subjective tests, including parents' ratings of the students' behavioural characteristics and teacher questionnaires" (p. 317).
"The current findings suggest that young children exposed to a single art form (drama and visual arts) tend to gain more in verbal creativity than those to integrated art forms" (p. 323).
(No other specifications given on participants).
Using perspective-taking interventions for students' perspectives to be voiced and inclusive scientific literacy is in reach (p. 278).
There is a need to challenge teachers to integrate the arts with other disciplines to value students' perspective taking as cultural skill (p. 278). This will help students understand from different points of view.
Mages ( There is an instrumental role in home, school and community play in nurturing people's arts self-concept and participation (p. 251). Salmon & Rickaby (2014). 35 young people total, 14 had been part of care system, only 10 agreed to be interviewed post production, 7 females, 3 males (p. 32).
"While the researchers were independent from the creative endeavour, both researchers worked hard to forge relationships with young people prior to commencing the fieldwork; this included meeting them in advance, explaining their role, encouraging questions and attending rehearsals" (p. 32).
"The qualitative evidence presented here supports previous claims that young people's involvement in the arts can develop emotional literacy and improve confidence and social skills" (p. 39). "The present study is an initial assessment of the psychometric properties of the Preschool Theatre Arts Rubric (PTAR), a new observational measure of preschool children's theatre arts skills developed for use in the context of an early childhood theatre arts outreach program that emphasizes storytelling (ST) and story acting (SA)" (p. 252).
"While more research is needed, the PTAR is a promising tool to observe preschool children's theatre arts skills in research, classroom, and programmatic contexts" (p. 260).  173-175). "Caring is a preventive, play-based, parent-child intervention designed to promote preschoolers' social-emotional development by strengthening their bonds with their parents" (p. 171). Weaknesses: Low participation attendance hindered focus groups (p. 185). "Reasons for low program participation were also responsible for the inability to attend focus groups (e.g., lack of child care, having moved, having changed schools)" (p. 185). Gaps: A focus mainly on Mexicans resulted in less generalizable findings (p. 185). "Our sample was entirely first-generation Latino parents and predominantly Mexican, our findings concerning the impact of CARING cannot be generalized to other populations" (p. 185).
"We present parents' own voices to describe the impact the intervention had on themselves, their children, and their relationship with each other" (p. 185).
Forrest-Bank et al. (2016) Strengths: Focused on proving that youth overcome adversities, even when exposed to risks and disadvantages, when they are supported with positive development using expressive arts interventions (p. 429). Weakness: Results between both groups varied greatly because of the many differences (ethnic background, gender, …) in the sample groups (pp. 437-438). "Demographic differences between the two groups and a limitation of our study was our inability to adequately assess them" (p. 437). Gaps: Behavior expectations between the professional artists and social workers need to be aligned (p. 439).
"Preventing problematic behavior in youth might be optimally accomplished by focusing on fostering protective factors in at-risk youth rather than targeting specific risks or negative behavioral outcomes" (p. 430). "Further research is needed regarding the efficacy of specific expressive arts interventions as well as examining their potential for Positive Youth Development (PYD) in nonclinical populations served in the context of after-school programs" (p. 432).

Goldstein et al. (2017)
Strengths: Authors discussed "how the arts are no more difficult to study than other real-world developmental phenomena and deserve a thorough examination" (p. 1505). The focus was on methodological studies of child development through the use of fine and performing arts (p. 1507). Weakness: None noted Gaps: None noted "Parents and teachers have long claimed they see development and change as a result of involvement in the arts but have done so without recourse to systematic definition and measurement" (p. 1506). "Arts classes become more complex and developmentally appropriate to the growing child's ability over time-a progression developmental scientists can well take advantage of" (p. 1510). "Current work is beginning to bridge this critically understudied activity with developmental science" (p. 1511).

Griffith & Larson (2015)
Strengths: Showed the effectiveness of youth programs for building trust overtime through different activities and interactions. Review effectively broke down the processes. Clearly stated the study methods, participants, data analysis that show the effectiveness of youth programs for building trust overtime through different activities and interactions (p. 801). Weakness: Only focused on effective programs, so there doesn't seem to have been a comparison with programs that had negative outcomes (p. 792). Gaps: None noted "Theory and research across fields of social science demonstrate multiple ways in which trust can enhance the functioning of individual behavior and human interactions" (p. 790).

Holmes et al. (2015)
Strengths: Focused on detecting childhood trauma early enough to be able to provide interventions as soon as possible. "HSTS 1 represents an innovative integration of evidence-informed modalities for the purposes of creating a developmentally appropriate intervention to address complex trauma among young children …" [and] "integrates three evidence-informed modalities to create a model that includes training, classroom consultation, intensive therapy, and peer mentoring" (p. 1657). Weaknesses: Throughout the article, there was a large number of acronyms used. This made the article difficult to understand. Results were based on the data collected. Some measurement forms were incomplete by participants (pp. 1656-1658). Gaps: Incomplete data collection did not help provide an accurate representation of results (pp. 1656-1658) leading to discrepancies in the study. Note 1. "Head Start Trauma Smart (HSTS), an early education/mental health cross-systems partnership designed to work within the child's natural setting-in this case, Head Start classrooms" (p. 1650).
"There is a clear need for applied evidence-informed interventions and trainings . . . few developmentally appropriate options exist, particularly when the goal is not only to address the specific child in need but also to create an overall trauma-informed model that can help build the resiliency of the larger community" (p. 1658). Hui et al. (2015) Strengths: The creative partnership project on creativity and arts education in early childhood was designed with both qualitative and quantitative methods, which is seldom found for studies in the arts. "The current paper focused on quantitative analysis" (p. 317). Weaknesses: The shortness of the time frame given to the study put a limitation on acquiring results that would prove if the creative thinking would continue over time (p. 324). "The partnership project was implemented for one academic year only. Longitudinal studies covering a longer period are required to investigate whether this increase in creative thinking can be sustained for further development" (p. 324). Gaps: Age gaps can create discrepancies in findings as children have different abilities and interests (p. 325).
"The present study examined whether young children's creativity improved after their participation in a creative partnership project" (p. 317). "Pre-test and post-test design with both quantitative and qualitative methods… quantitative part of the study involved objective test administered to young children, including the Story-Telling Test (STT) and the Test for Creative Thinking-Drawing Production (TCT-DP), two other subjective tests, including parents' ratings of the students' behavioral characteristics and teacher questionnaires" (p. 317). Kahn & Zeilder (2016) Strengths: Showed strong support of perspective-taking in science classrooms through the support of the humanities, arts, and social sciences. One method is the use of method acting (pp. 269-272). Weakness: The main focus was on how to implement the use of the arts in a science classroom, rather than using the arts in helping students overcome adversities (p. 278). Gaps: The focus of the study was mainly on science classroom and not on other disciplines, which limits the findings on child development overall (p. 278).
"This approach might require some coaching as students are more accustomed to being asked for an opinion and then backing it up; they are not accustomed to looking inside themselves for places of congruence with opponents or opposing points of view, yet this is precisely the skill that we are trying to build in order to prepare students to approach multifaceted problems" (p. 271).

Table 4 (cont)
Mages (2018) Strengths: Focused on how theater in education can promote child development and proved that children participating in drama were not negatively affected in their academic achievement (p. 235). Weaknesses: There was an anomalous pattern with the results of the comparison group, failing the "false-belief" question but passing the "belief-based" question which hypothesized that those pattern results could not happen (p. 233). Gaps: The researchers could not pinpoint the exact reason for the anomalous pattern, they presented multiple possible reasons for this pattern (p. 233).
"Drama and theatre activities provide tangible, language-rich, social contexts for decontextualized language, in which children are introduced to new language structures and vocabulary, and are offered opportunities to use their verbal and physical communication skills to actively engage with both adults and peers" (p. 226). "This study suggests that the inclusion of high-quality educational drama and theatre curricula in early childhood education can provide young children with an entertaining and engaging preschool experience while providing academic support commensurate with those of more traditional early childhood programs" (p. 235).

Magnuson & Schindler
Strengths: We are provided an explanation on how caregivers dealing with their own adversities can additionally affect children with adversities (p. 63). "With low compensation and few opportunities for professional of economic advancement, but increasingly high expectations to ensure that young children are developing to be ready for school, early care providers are vulnerable to work stress and may experience negative emotional reactions to work-related challenges (Whitaker, Dearth-Wesley, & Gooze, 2015)" (p. 63). Weaknesses: All the programs mentioned are in the developing stages, not much longitudinal research has been done to truly tell of its effectiveness (p. 71). Gaps: None noted "A social structural lens can help explain why some parents and caregivers do not provide high-quality care to their children. In particular, low-income and economically disadvantaged families face many obstacles and challenges in raising their children. Likewise, the under-resourced contexts in which they provide care to children present a challenge to lowwage early care and education workers" (pp. 60-61).

Mansour et al. (2016)
Strengths: We can see the relationship between young people's creative and performing arts participation and how it affects their arts self-concept (p. 240). Authors explained the process step by step. Weakness: The limitation seen is the lack of more "objective" measures as part of their data, and they recommend it should be included in future studies (p. 251). Gaps: None noted "When students are actively engaged in an activity such as the arts, they are more likely to experience and develop well-established indicators of positive development such as self-worth (Blomfield & Barber, 2011), healthy social relationships (Rose-Krasnor, Busseri, Willoughby, & Chalmers, 2006), and pro-social behavior (Catterall, 2009)" (p. 249). "Both receptive and active arts participation are related to mental health and life satisfaction; however, active arts participation is the stronger predictor of these outcomes" (p. 243).

Perry & Conners-Burrow
Strengths: Gave a tremendous amount of information on Early Childhood Mental Health Consultation's (ECMHC) optimal implementations on children in foster care (p. 24). "This article shares best practices from the field of early childhood mental health consultation (ECMHC) as a strategy to help reduce the impact of stressors on young children" (p. 24). Weaknesses: There was not a clearly stated methodological procedure within this article. Gaps: There is not a sufficient amount of research to prove the program's effectiveness (p. 31). "At present, there are limited published studies of the effectiveness of ECMHC inhome visiting" (p. 31).
Salmon & Rickaby (2014). Strengths: The method used for data collection was based on constant comparative analysis, which allowed the researchers to easily jump back and forth between speculation previously found, data and analysis and personal reflection (p. 34). "The sample size enabled interview transcripts to be analysed using a traditional 'cut and paste' approach whereby the researcher reads and re-reads the transcripts drawing out themes and sub-themes (Gibbs, 2007) ... describe as an iterative process of revisiting themes" (p. 34). Weaknesses: Lack of funding did not allow for a continuation of the research, therefore limiting the study (p. 38). "Financial constraints... remains a limitation of the study, as it is not possible to assess the degree to which the outcomes explored here were sustained or built on over time" (p. 38). Gaps: None noted "Moreover, it not only engaged young people for the duration of the project, it inspired and enthused young people to maintain and extend their involvement in terms of their continued involvement in artsbased projects and courses" (p. 39). "Friendships and social connectedness were key impacts of the project" (p. 39).
Strengths: Researchers awareness of the newness of the study. They are conscious that there are gaps in the measurement of theatre arts effect on child development. Their goal is to create measurements to close those gaps for further research (p. 252). "Our goal was to fill an important measurement gap by creating an observational measure of preschool children's theatre arts skills that would demonstrate necessary psychometric properties of reliability and validity" (p. 252). "This measurement gap limits the ability of researchers to document the extent to which theatre arts affect children's development and examine potential mechanisms by which they may support children's outcomes" (p. 258). Weaknesses: None noted Gaps: None noted "With the resurgence of attention to arts integration in early childhood education, and its potential to improve the quality of early care and education, engage early learners, and improve children's developmental outcomes, a new generation of research on the impact of the arts is dawning" (p. 258). "However, research examining the developmental processes and potential benefits of theatre arts/creative drama on young children's development suffers from a lack of psychometrically rigorous measures of arts skills (Mages, 2008(Mages, , 2015" (p. 258). Zinsser et al. (2016) Strengths: It helps realize and emphasize the relationship between educational and administrative theory and what is actually practiced (p. 286). "The findings of this study highlight interesting connections between developmental theory and educational practice. Specifically, all three components of the Positive Early Emotional Leadership model identified by our administrators, in addition to aligning with emotion socialization theory, are process-based mechanisms that don't resemble traditional measures of director qualification or management proficiency in education realms" (p. 286). Weaknesses: None noted Gaps: This study was only focused on administrators who had an association with the Head Start program. Further studies should be performed with a greater diversity of early childhood educational administrators (p. 287).
"One of the most fundamental ways in which early-childhood directors can influence the emotions of staff and students in their buildings is through direct interactions through sharing of their own emotions or by being empathic to the emotions of others" (p. 277).
The research by Holmes et al. (2015) was an experimental study in which "treatments were administered to participants for the purposes of the study and their effects [were] assessed" (Galvan & Galvan, 2017, p. 66). The "Head Start Trauma Smart (HSTS) staff did identify and utilize standardized instruments from the beginning in order to measure systematic improvements in the classroom (as measured by CLASS scores) and whether the children who were receiving individual treatment were making clinical progress" (Holmes et al., 2015(Holmes et al., , p. 1655). Throughout the experimental study "children were identified for referral to the program by either the child's teacher or parent, and typically, although not always, were referred due to the child's externalizing behaviors" (p. 1654).
Limitations were distinctly stated by the authors of the majority of the articles reviewed, yet some were not clearly established nor made reference to. Though not all of the authors clearly stated their limitations, we were able to locate a few that were clearly identifiable as the limitations which the researchers faced within their studies. Mages (2018) discusses the results and mentions that the study demonstrates the importance of implementing high-quality theater arts and drama in early childhood education. Mages (2018) does not mention any limitations within her article; however, she goes into discussion of the results and mentions that the study demonstrates the importance of implementing high-quality theater arts and drama in early childhood education (p. 235). In the Mansour et al. (2016) closure, the researchers give a clear statement in regards of the limitations and provide future directions for prospective research.
In expressing their suggestions to further their study, they suggest the need to possibly include objective performing and achievement arts measures and incorporating the use of instruments as a method of self-expression (p. 251).  (2014) displayed a great amount of information such as the social and emotional benefits received by participating in this program. They added validity to this by displaying direct quotes throughout their findings (pp. 34-38). In reviewing our studies, we see that there appears to be a correlation between the positive impact that theater arts have on children with early childhood adversities.

Implications and Conclusions
We believe that early childhood educators along with teachers of all grade levels have an extra-large heart. As teachers of children with a demographic range consisting of large volumes of low socioeconomic families and English language learners, we have witnessed our fair share of children who are currently in, or have been through, one or more adverse situations. A noted limitation in attaining in-depth information is that the majority of early childhood children are not fluent in their oral skills to effectively express what situations they are going through or how they are feeling. "The wide range of behaviors exhibited by young children impacted by trauma can present challenges in an early childhood education setting as effects may be seen in multiple domains: affective, behavioral, physiological, and relational (Lieberman et al. 2011;Cook et al. 2005)" (Holmes et al., 2015(Holmes et al., , p. 1651. Every new school year, we receive a new group of children, unaware of what they are going through or have been through. By observing a child's manner of play and social interactions, we might gain insight of possible adversities, address them, and help them acquire skills, social and emotional skills, that all children can benefit from, especially children who have dealt or are dealing with adversities (Magnuson & Schindler, 2019, p. 60).
When we look at the studies focused on the dramatic arts, plays, and expressive arts, we find that they were applied as a venue for children to be able to express their emotions and thoughts. "Various forms of expressive arts are known to have associations with positive academic, social, and behavioural outcomes in addition to offering important therapeutic benefits for children and adolescents" (Forrest-Bank, 2016, p. 429). Many children who suffer from adversities in early childhood might not have a way to express or cope with the emotions that they may be experiencing. However, through the use of theater arts and dramatic play, we might be able to create a venue for children to gain therapeutic coping skills towards their adversities to help them cope. We were surprised to find that there are a limited number of peer reviewed articles that involve studies relevant to our focus. As per Goldstein et al. (2017), educational journals such as Child Development are prone to focus their "articles on factors such as temperament, vocabulary, executive function, decision making, social groups, and ethnic identity but almost never [focus] on involvement [of] the arts, despite prima facie observations that these above-mentioned factors are deeply entwined in the context of arts engagement and learning" (p. 1505). We also believe it important to note the importance of identifying demographic data and considering generalizability or transferability and trustworthiness in research, such as in the case of Duch et al. (2019) who focused on first-generation Latino parents, predominantly Mexican, in their study (p. 185).
Although we see that these studies come to similar findings, it is evident that future studies are still needed. Due to COVID-19, we agree that, "these factors are continuing to contribute to children experiencing high levels of stress as the sense of normalcy is lost from their lives and they are bombarded with new expectations and responsibilities. Children need social and emotional support now more than ever" (Kamei & Harriott, 2021, p. 365). According to Goldstein et al. (2017), any activity in the arts is likely to have important cognitive, social, and emotional functions (p. 1511). They conclude their article by stating that specialists in their field, such as "developmental psychologists and artists can create rich and diverse partnerships with which to investigate these issues in the real world" (p. 1511). Implementing theater and dramatic arts in early childhood education "improv[es] our understanding of the impact and mechanisms by which theatre arts can affect children's developmental outcomes" (Susman-Stillman et al., 2018, p. 260). As mentioned in the Forrest-Bank et al. (2016) study, their findings support further studies of the efficacy of theater and expressive arts on a child's social and emotional development (p. 439). In accordance, we believe that additional research should be done in exploring the benefits that theater arts and dramatic play can have on children who have suffered early childhood adversities. Future studies should utilize theater arts and dramatic play to identify early childhood adversities and should incorporate expressive arts as a therapeutic response.