Introduction: For people with wide spectrum of needs, creative activities have been used in occupational therapy since the very beginning of the profession as they have great therapeutic value. Individuals with special needs are often stigmatized because of their specialness – and their needs, thoughts, desires and emotions remain poorly understood. Self-expression is important for successful social interaction and daily functioning. Due to communication barriers, individuals with special needs have to express themselves in a different way, for example through creativity. Purpose: This systematic review aims to explore the meaning and positive effects of creative activities for self-expression of individuals with special needs. Methods: We followed the guidelines of the Centre for Reviews and Dissemination and conducted a systematic literature review. Based on the inclusion and exclusion criteria tudies were identified in the following databases: CINAHL, ERIC, OTseeker, PubMed and Web of Science. We also searched references manually to identify additional relevant sources. We also conducted descriptive and thematic synthesis. Results: Ten studies met the inclusion criteria and were included in the analysis, which we evaluated to their quality. We identified five themes that were repeated in the included studies and were positive outcomes of using creative activities in occupational therapy intervention as media for self-expression of individuals with special needs: self-expression and emotional processing, well-being, social interaction and community or relationship building, personal growth and self-confidence and filling the occupational void. Discussion and conclusion: Creative activities provide a medium for self-expression of individuals with special needs. With different materials and symbols they offer an alternative way of communication and enable expression through the creative process,. They take place in a safe and encouraging environment that allows expression without judgement. They are most often used for strengthening occupational performance,, well-being and self-confidence, thereby increasing the quality of life. The need for durther research is still great, especially in Slovenia, as self-expression is still poorly understood concept, and the use of creative activities as a medium for enhancing self-expression of individuals with special needs is unexplored.
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