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Beyond Utterances: Embodied Creativity and Compliance in Dance and Dementia

Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland
Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
Author to whom correspondence should be addressed.
Soc. Sci. 2023, 12(5), 304;
Submission received: 19 December 2022 / Revised: 3 May 2023 / Accepted: 9 May 2023 / Published: 17 May 2023
(This article belongs to the Special Issue Rethinking Artful Politics: Bodies of Difference Remaking Body Worlds)


Practices of creativity and compliance intersect in interaction when directing local dances remotely for people living with dementia and their carers in institutional settings. This ethnomethodological study focused on how artistic mechanisms are understood and structured by participants in response to on-screen instruction. Video data were collected from two long-term care facilities in Canada and Finland in a pilot study of a dance program that extended internationally from Canada to Finland at the onset of COVID-19. Fourteen hours of video data were analyzed using multimodal conversation analysis of initiation–response sequences. In this paper, we identify how creative instructed actions are produced in compliance with multimodal directives in interaction when mediated by technology and facilitated by copresent facilitators. We provide examples of how participants’ variably compliant responses in relation to dance instruction, from following a lead to coordinating with others, produce different creative actions from embellishing to improvising. Our findings suggest that cocreativity may be realized at intersections of compliance and creativity toward reciprocity. This research contributes to interdisciplinary discussions about the potential of arts-based practices in social inclusion, health, and well-being by studying how dance instruction is understood and realized remotely and in copresence in embodied instructed action and interaction.

1. Introduction

1.1. Arts-Based Practices and Technology in Ageing and Dementia

Arts-based practices have become an important area of focus due to their potential for social and artistic inclusion, life enrichment, well-being, and quality of life in elderly and dementia care (Chappell et al. 2021; De Medeiros and Basting 2014; Herron et al. 2023; Zeilig et al. 2018). In dementia research, studies of dance and creativity are calling attention to the importance of the embodied expression of agency and self, with implications for new directions in practice (Kontos et al. 2020a, 2020b; Motta-Ochoa et al. 2021). As opportunities to participate in music and dance activities are increasingly mediated by technology, new questions arise as to their access and affordances for diverse abilities. Critical gerontechnology and ageing studies are shifting focus from finding solutions to the health-related problematization of ageing to understanding how complex multimodal relationships of ageing and technology are intertwined. There is keen interest in the community conditions for sharing arts and technologies into existing arrangements of care (Jones et al. 2021; Peine et al. 2021; Skinner et al. 2018). Hills et al. (2022) proposed a methodological expansion to look more closely at the “how” of practice mechanisms, how the various components of an artistic activity are understood, interpreted, and incorporated into activity structures (Hills et al. 2022). Situating our study within these interdisciplinary discussions, our focus is on such mechanisms, in situated interactions of older people, including people living with dementia (PLWD) and their carers, as they participate in dance class through technology. Specifically, we focus on how creative action, which is inherent in artistic practice, emerges in and through participants’ variably compliant responses to directive instruction.

1.2. An Interactional Approach to the Study of Remotely Instructed Dances

The arts have evolved through social processes both creative and compliant in forming languages and connecting communities. In ballet, a recognizable form of creative compliance is the plié. A bending and straightening, the plié is an embodied example of how, over time, artforms become collective cultural representations. Through practice in compliance with form, the plié is perfected and prepares the dancer’s body to propel itself in performance and expression of technique. Its name derives from the French word plier, rooted in both compliance and completion. In etymology, compliance infers a process of joining and bending together in practice—a completion of something—a granted request or wish, a followed direction or instruction. In conversation, compliance is contingent upon the initiation that must precede it. It is a sequential phenomenon which constitutes a central mechanism in interaction that serves the promotion of social solidarity (Clayman 2002). In music, this solidarity is achieved as members keep together, aligning in compliance with rhythm and time (McNeill 1995). A shared beat enables the prediction and coordination of behavior—our synchronous singing and dancing are a feature of our human social adaptation (Merker 2000). Thus, while compliance has come to be associated with obedience to a set of laws, it is not necessarily defined in deference to external regulatory structures that humans obey. Rather, it can be created in interaction socially through coordinated and creative practices.
To look at how the mechanisms of artistic practice are understood and incorporated into structures of interaction in dance activities, we analyze what Garfinkel referred to as the “artful practices” of how people accomplish social action. What characterizes this ethnomethodological approach is how it attends to participants’ intelligibility of action (e.g., instructions, directives, and responses) in their displays and interpretations of understanding with each other (Garfinkel 2002). Using conversation analysis grounded in ethnomethodology (thus, EMCA), we seek to reveal the orientations that govern naturally occurring interactions, assuming that this governance is created and complied with in an ongoing manner by the actors themselves. Our objective is to describe the procedures of participants (older people living with dementia, their carers, and their facilitators) as they make sense of their own and others’ practices (Heritage 1984; Arminen 2017) in complex relationships of language, embodiment, and the material environment in the creative activity context (Goodwin 2000). Specifically, using multimodal conversation analysis of transcribed video data, we describe sequences of initiating and responsive actions (Schegloff 2007). We focus on responsive, instructed actions (Garfinkel [1967] 1984) in sequential structures of social interaction in an online dance program.

1.3. Multimodality and Embodiment in Instructions and Directives

Instructions initiate responding actions, instructed actions that are interactionally achieved (Garfinkel 2002). In classical conversation analysis (i.e., of talk), responding actions may be considered to complete the second half of an adjacency pair—the key sequential structure that organizes turns of talk (Schegloff 2007). In an adjacency pair, a responsive turn refers to a previous turn and displays understanding of its conditions (Sacks et al. 1974). An instructed action then, as a response to a previous turn, reveals what the social actor finds relevant in the conditions of the instruction.
Closely related to instructions are directives, also a first pair part of an adjacency pair. Directives are used to “get someone to do something” (Goodwin 2006, p. 517). Directives can be verbal or embodied (Goodwin 2000; Goodwin and Cekaite 2013) or combine multimodally to project upcoming action. Using the body in demonstrating an action to be taken contributes multimodally to the evolution of structure (Hofstetter and Keevallik 2020; Keevallik 2010). In turn, responses can be verbal, embodied, and multimodal, implicating the body in action sequences that can be analyzed (Hazel et al. 2014). In the examples of dance interactions that we analyze in this article, instructions and instructed actions are organized in sequences that are initiated by verbal, embodied, and multimodal directives, which, in turn, are responded to and creatively developed, moment-by-moment, by participants in relation to each other.

1.4. On Compliance in Directed Embodiment

Discussions about compliance are relevant to sequence organization, as compliance is considered the interactionally preferred second pair part to a directive (Schegloff 2007). This is the case every time a directive is designed to get someone to do something (see Kent 2012). Craven and Potter (2010) distinguish directives as having tendencies to tell rather than to ask, where noncompliance leads to upgraded directives that highlight the entitlement of the speaker rather than on contingencies of the recipient. Responding actions and response relevance analyses have shown that the design of directives is consequential in how they are met with responses (Stevanovic and Peräkylä 2012; Curl and Drew 2008; Sacks et al. 1974). Stivers and Rossano (2010) analyzed response relevance as a scalar variable and explored the potential of turn design features to increase recipients’ accountability in mobilizing response. In response to this, Schegloff (2010) asserted that what is relevant is not necessarily getting somebody to do something or the degree to which turn design features increase compliance but how elements of conduct are shaped in interaction and what their structural organization says about the occasions from which data are taken.
With respect to the structural organization of interactional sequences, Clayman (2002) argued that conversation analysis offers a procedural approach by identifying and analyzing practices to avoid conflict and to promote social solidarity. While some actions constrain responses in how they set them up to agree or disagree, accept or design, answer or follow, etc., response alternatives differ in their cooperativeness, affiliation, and alignment. Sequence organization itself is a form of solidarity in that it provides empirical evidence of how participants promote solidary actions (Clayman 2002). Compliance, in this context then, as a preferred response in sequential organization, is a form of prosocial solidarity. In analysis, the features of a preferred response can be described in terms of their affiliation with what they are responding to (Heritage 1984), as well as their alignment with the structure of the action (Schegloff 2007). Alignment can be considered a structural level of cooperation, and affiliation can be considered an affective level of cooperation (Stivers 2008).

1.5. Previous Research in Multimodal Responses

Our analysis contributes to the growing interests in intercorporeality and creativity in multimodal directive–response sequences. Previous studies on instruction interactions and multimodal response focused on compliance in the sense of accomplishing manual action. Lilja and Piirainen-Marsh (2022) demonstrated how complying bodily actions make relevant the depictive gestures used in multimodal instructions of a second-language cooking class. In the teaching and learning of a skill, Lindwall and Ekström (2012) emphasized that in achieving an instructed action, the skill is learned. Due et al. (2019) showed that, in video-mediated instructional sequences, the embodied demonstration can be designed to be mimicked. In air traffic control, Arminen et al. (2014) deconstructed the multimodal production of second pair parts. In demonstrating bodily quoting in dance correction sequences, Keevallik (2010) showed how the embodiment of a moving form can be understood as a compliant response to a directive in progress. In each of these examples, achievements of the instructed actions involve learning in language or skill. For our analysis, we are interested in how artistic instruction results in creative actions that are constituted socially, in interaction, moment by moment for people living with dementia.
Intercorporeality and creativity have also been investigated in atypical interaction focused on multimodal directive–response sequences. In the context of dementia care, embodied directive–response sequences were analyzed in sequential organization of helping people to sit in a chair (Majlesi et al. 2021); in accomplishing joint activities, such as baking (Majlesi and Ekström 2016); and in achieving wishes within institutional constraints (Kristiansen et al. 2019). In related studies of dance and aquatic activities for adults with intellectual disabilities, Matérne et al. (2022) shared their analysis of the coordinated accomplishments in a range of competencies, using multimodal resources. Hydén et al. (2022) provided evidence that embodiment communicates existing agency of PLWD in their contributions to intercorporeal interaction. Our study builds on this existing knowledge by looking at the embodied directive–response sequences in interactions of PLWD and their carers as initiated remotely in a creative activity. In terms of atypical interaction, our study seeks to understand how PLWD are multimodally afforded interactional resources through a technologically mediated creative activity. By looking at how PLWD embody creativity in variably compliant responses to multimodal directives, we hope to understand how arts practices afford them to do so in mediated settings.

2. Materials and Methods

The video data illustrated in the following analysis were collected at two long-term care facilities in dance classes with people living with dementia and staff and researcher facilitators. We analyzed data from a pilot study of a dance program that was extended internationally from Canada to Finland. The study was approved in Canada by the Research Ethics Boards at Trent University and Brandon University, and in Finland by the University of Helsinki Ethical Review Board of Humanities and Social and Behavioral Sciences, and by participating organizations according to their governance procedures. The study adheres to the ethical considerations when including PLWD (see Skinner et al. 2018; Kosurko et al. 2021). Informed consent for participants was obtained in cooperation with nursing staff and third-party signing authorities (where appropriate) of individual participants. Participants living with dementia were diagnosed at varying stages and types, each with cognitive impairments that affect physical and communicative competencies to degrees unknown to the researcher. Data for this paper include video excerpts from one long-term residential care institution (LTRC) in rural Canada, where eight hours of video were recorded during weekly sessions for eight weeks in 2019; and one excerpt from an LTRC in rural Finland, where five hours of video data were recorded during weekly sessions for five-week periods in 2022. The full corpus of data includes 34 hours of video recordings of online chair dance classes for older people who live with dementia in three (3) institutional settings in Canada and two (2) in Finland. Video excerpts chosen for analysis by the authors were identified as moments in which participants responded to instructions in compliant and creative ways. We considered creativity exhibited as an embodied flourish (also identified as a theme in the Canadian study; see (Kontos et al. 2020a)) or participating in the embodiment of an imaginary narrative scenario. We considered compliance as following instructions closely matched to the OSI or facilitator. The examples chosen do not comprise an exhaustive list of compliant and/or creative responses in the data but are part of an early exploration of the potential of the analytic method. To analyze these excerpts, we used multimodal conversation analysis focused on directive–response sequences (i.e., embodied and multimodal responses of participants to instructions (see Mondada 2011). Actions were transcribed in numbered turns, following multimodal conventions (Mondada 2019), with notations in the talk that follow the system of Jefferson (2004) (see Appendix A).

The Dance Program and Participation Framework

The online program Baycrest NBS Sharing Dance Older Adults (SDOA) was developed by Baycrest and Canada’s National Ballet School (NBS) to provide remote access to dance instruction for people with cognitive and physical challenges. The streamed, prerecorded video dance classes vary in length from 20 to 60 min and recur weekly, up to eight weeks. Each class begins with a warm-up, followed by a series of dances to piano accompaniment. In each dance, on-screen instructors (OSIs) first provide a demonstration of a dance movement or sequence, then cue the accompanying musician to start the music, and then cue participants to join with them in the dance. In demonstrating the dances, the OSIs talk through the steps (in English), embodying the movements, with accompanying verbal descriptions of what they are doing. At various points during sessions, in introductions and sometimes during the dance demonstrations, OSIs advise participants that the directives to follow are to be achieved according to the preference of participants by suggesting, “you can follow what I’m doing or feel free to do what you like.” As the instructions for the dance are prerecorded and presented to participants on a TV monitor, there is no monitoring, assessment, or evaluation on the part of the dance teacher.
A copresent local facilitator was deployed in each setting to encourage engagement in the online program by modelling the demonstrations in copresence and coparticipating. The goal of the SDOA instruction is not to teach a skill resulting in evidence of learning on the part of the recipient; rather, the purpose of the activity is to bring participants together in a shared dance moment-by-moment within sets of movements and scenarios designed to warm up the body and musicality, to incite creativity and imagination, and to encourage interactions among copresent participants.

3. Analysis and Results

Below, we present five multimodal transcripts that illustrate how participants, including resident older adults, PLWD, and carers (staff/facilitators), respond to the on-screen instruction (OSI) of the seated Sharing Dance program. In each of the settings shown, participants are seated in chairs facing a TV monitor, where the program plays. The OSI is prerecorded and streamed from a remote location, with her chair facing the camera and her gaze to the lens so that her instructions seem directed to the viewer. The facilitator (either the author/researcher or a staff member) is seated close to the screen. As the dance program plays on the screen for participants, the OSI first demonstrates the upcoming movements with verbal descriptions and then cues the music and participants to join with her as she repeats the dances, providing verbal directives with accompanying embodied demonstrations. Each of the dances below (other than the warm-up in the first example) is designed to depict scenarios (i.e., a Broadway chorus line; under the sea; a coffee break; and a trip to the art gallery). The first two examples show how participants’ responses to creative direction embody mimicable shapes as directed. In the first, an individual complies with the OSI in a classical (albeit embodied) adjacency pair completion. In the second, a series of adjacency pairs are coordinated in sequential order by a copresent facilitator. The third and fourth examples highlight how participants respond creatively in their instructed actions: one with embellishing flourishes in response to the OSI, and the other improvising according to ability in response to the copresent facilitator. In the fifth example, reciprocal cocreativity is highlighted in a sequence of contingent responses between a participant and a copresent facilitator, as initiated by the OSI. In all cases, instructed action comprises multimodal directives (verbal and embodied) in demonstrations for participants to follow.
In the transcript extracts that follow, multimodal transcription conventions are followed (see Appendix A). Symbols are used to delimit the embodied movements of each participant:
  • On-screen instructor (Osi): ¶.
  • Facilitator (Fac): +.
  • Participant dancers: Δ, ©, ø.
  • Gaze for all participants: gz.
  • Musical beats (mus) are marked up to eight counts: ♫1, ♫2, ♫3, etc.
  • Figures: #.
  • Video screen capture images have been anonymized as sketches.
  • Green arrows indicate gaze direction (in Figures 2, 3, 5–7 and 9).

3.1. Getting Warmed Up: Following the Leader with Matching Movements

In the first excerpt (1), we analyze how a participant follows the OSI on cue, with matching movements, bodily quoting the OSI (Keevallik 2010) in response to multimodal directives, in coordination with temporal rhythm of the music. As this excerpt begins, a previous sequence of dance movements has finished and is to be repeated. The participant, Anita, is seated among other participants in a side-by-side formation, with her chair facing the screen (shown in rectangular boundary box in Figure 1). Anita follows the directions and matches the knee-tapping movements of the OSI in time, joining together with the OSI as she continuously maintains the rhythm of the music.
(1) OSI: On-screen instructor (¶), Anita(ani): dancer PLWD (Δ), Music (mus) ♫
1 OSIone more time here we go ¶♫1Δtapping, (0.1)#
a mus>>piano plays             ♫1->>
b osi  >>gz camera             ¶taps hands on knees ((with music))->>
c ani  >>gz screen                Δtaps knees ((in same time)->>
d fig                          #Figure 1
Prior to the start of the transcript (1a), the music set the temporal, rhythmic structure for the activity in a predictable, recognizable pattern, made relevant by the OSI, who was oriented to the beat in how she timed her multimodal instruction. The OSI began with a verbal directive that indicated an upcoming action, “one more time,” involving “we,” with a cue of when to start (“go”) and what to do: “one more time, here we go tapping” (1a). The OSI’s embodied demonstration of knee-tapping began on the first beat immediately following the verbal directive “go” (1b) that projected the embodied response of the ongoing repeated action “one more time” (see Figure 1). Anita responded in turn, on the beat in the relevant place in the sequence (1c), tapping her knees at the same time as the OSI, with both continuing the tapping in keeping with the music to the end of the sequence.
Within the embodied conversation of the dance class, a bodily move can be equated to a verbal utterance (see Keevallik 2010). As the OSI directed an embodied response from the dancer, this can be seen as the first part of the classic adjacency pair in conversation analysis (Sacks et al. 1974). When Anita responded by following along with the instruction, in time, with matching movements bodily quoting the OSI (Keevallik 2010), the second part of the pair was in compliance with the initiated first part, and completion of the pair. The achievement of the instructed action was directed by the prerecorded OSI using verbal and embodied resources in coordination with the predictable external musical rhythm (see Albert 2015). Anita’s subsequent embodied response displayed her understanding of not only what was expected but also how to complete the action in time as the moment progressed, by tapping her knees as demonstrated, immediately upon the beat following the directive “go.”

3.2. A Sequence of Depictive Gestures in Turn: Coordinating a Pretend Coffee Break

In the next excerpt (2), we illustrate how coparticipants orient to each other sequentially within a timed musical structure in response to on-screen instructions (OSIs) and as they are repeated by a copresent facilitator. Three participants, Dancer 1, Dancer 2, and Dancer 3, are seated with their chairs facing the screen, and a facilitator sits beneath the screen, facing the participants (see Figure 2). The OSI provides an embodied demonstration of a coffee-pouring and -sharing scenario within a musical structure of eight beats. The coffee pouring takes four beats, and the sharing takes four beats (two beats to reach toward a participant (to hand them a cup) and two beats to return to home position). The eight beats are shown in the transcript as numbered musical notes (♫1, ♫2, etc.). Example (2), below, begins as music playing leads up to the first measure (counted and shown as ♫5, ♫6, ♫7, and ♫8). During the musical lead in, the OSI cues the timing of the projected instructed action, “pour yourself some coffee.” The facilitator then “takes the lead” and pours coffee for the three dancers, who each respond in turn.
(2) OSI: On-screen instructor ¶, Fac: Facilitator (staff) +, Dancers 1–3, Da1 Δ (PLWD), Da2©, Da3 (PLWD) ø
1 OSI¶  ♫5 Pour yourself♫6 some coffee,♫7
a Osi¶ ((mimes pouring))->
P Mus>>♫piano plays 4/4time ((5,6,7,))♫->>
2 Fac♫8¶(0.2)♫1+Coffee,# (0.3)            ♫2
p Mus     ♫ piano plays 2 beats ((1,2))♫
a Osi->¶
a Fac         +((mimes pouring acc to demo))->
b Fac       ->gz own hands
c Da1       ->gz Fac hands
d Da2       ->gz Fac hands
e Da3       ->gz Fac hands
f fig            #Figure 2
In compliance with the OSI’s directive (1), the facilitator depicts with her hands the matching shape of pouring a coffee (2a) and verbalizes “coffee” (2) within the timed structure of four beats (2P—3b). Her gaze is on the shape as she creates it with her own hands (2b) (see Figure 2). The dancers each orient to her movements with his or her gaze, focused on her hands (2d–f).
3 OSIGive¶♫3 it to a friend,                   +¶♫4
P mus     ♫piano plays 2 beats ((3,4)) ----------♫
a Osi    ¶♫ reaches to camera, flicks wrist     ¶♫ ((to place coffee))
b Fac----------------------------------------->+
4 FAC(0.2)+for you,♫5 (0.1)+(0.6)♫6Δ      + #♫7 (0.6)+(0.6)    +♫8
P Mus              ♫ piano plays 4 beats ((5,6,7,8))------------♫
a Fac     +reaches ♫to Da1 +puts ♫cup btwn+ #♫,,,,,,,+reachback+♫
b Da1                              Δ turns head, opens hands
                                             gz cup spot->
c fig                                       #Figure 3
Continuing with the sequence in time to the music, the OSI initiates the next directive, “give it to a friend,” just in time to finish on the fourth beat (3), when the F completes the pouring gesture (3b). Next, on beat five (4), the facilitator reaches toward and “hands” the imaginary coffee to Dancer 1 with a verbal offer, “for you” (4). With a wrist motion, she “places the coffee” (4a) in the space between them on beat seven, reaching back by beat eight. Dancer 1′s gaze follows the facilitator’s hand and remains focused on the spot where the cup was placed (4b) (see Figure 3).
5(0.1)+♫1Δ     ♫2     ♫3    (1.6)     ♫4+
P Mus      ♫piano plays 4beats ((1,2,3,4))♫
a Fac     +mimes pouring--------------------+
b Da1         Δgz Fac hands->
6 FACFor +♫5you, hehehe©#+  (0.6) ©      +♫6 +(0.6)Δ (0.1)
P mus     ♫ piano plays 2 beats((1,2))----♫
a Fac    + reaches to Da2+puts cup btwn  +,,,+reaches back->
b Da2                   ©#nods head©
c Da1                                              Δgz coffee
d fig           #Figure 4
Starting again on beat one of the next musical measure and over the course of four beats, (5) the facilitator repeats the coffee-pouring motion (5a) and verbalization “for you” (6) that she did in her first turn (2,2a); again, similarly to her previous turn (4a), the OSI reaches with the coffee on beat five, but this time to Dancer 2, (6a) who sits next to Dancer 1. Dancer 1 shifts his gaze to the spot where the coffee was placed for Dancer 2. Dancer 2 acknowledges receipt of the coffee with a head nod (6b) toward where the coffee was placed (see Figure 4).
On beat seven, Dancer 2 looks down at his hands (7a) and shapes them as if around an imaginary cup (7b) (see Figure 5). Then, within the next and eighth beat, Dancer 2 breaks his hands apart (making the cup disappear) and looks up (8a) with an eye roll, smiling (8b) (see Figure 5), making visible to coparticipants his stance on the creative practice, within the structure of the musical measure.
9 FAC♫1+hehehe©(0.6)Δ (0.6)         ♫4
P Mus♫piano plays 4beats ((1,2,3,4) ♫
a Fac  +mimes pouring coffee->
b Da2         ©gz Fac, smiles->
c Da1               Δgz dancer3->
10♫5+(0.6)©Δ#      +ø (0.3)     ♫6+ (0.3)ø+ (0.3)      ø+♫7
P mus♫piano plays 3 beats ((1,2,3)) ------------------------♫->>
a Fac  +reaches#to Da3+ places cup   +,,,,,,,+reaches back +
b Da3                  øreaches coffee,,,,,,øcloses thumb ø
c Da2      ->©gz Da3 hand->
d Da1       ->Δgz Da3 hand->
e fig          #Figure 5
On the first beat of the next musical measure, the facilitator laughed (9) in response to Dancer 2′s stance display. Dancer 2 shifted his gaze to the facilitator (9b) and smiled. At the same time, within the four-count measure, the facilitator repeated the mimed pouring of coffee (9a). Halfway through this measure, before the facilitator was finished pouring, Dancer 1 oriented his gaze to Dancer 3, displaying understanding of whose turn was projected to receive the next cup. In the same pattern as the previous two turns, on the fifth beat (10), the facilitator reached toward the next seated participant, Dancer 3 (10a). Dancer 3 reached toward the placement of the imaginary coffee and then closed his thumb as if around an invisible handle on the seventh beat (10b). Dancers 2 and 1 were both focused with their gaze at the space where the cup was being shaped (10c,d). At this point, all four of the coparticipants were oriented toward the imaginary cup (see Figure 6).
Over the course of the coffee-time scenario, the coparticipants shared a joint focus of attention on the facilitator, and each displayed an understanding of being handed something in their turn, as well as an understanding of the next participant’s upcoming turn. The facilitator repeated the pattern of the movement sequences in time with the rhythm established by the OSI for a total of three times. In each iteration, the OSI poured the coffee from beats one to four, and then on beats five to six, she handed it to each participant in turn. On beat seven, in all three instances, the dancers embodied receipt of the facilitator’s offered object within the timed structure of the musical rhythm. Each dancer’s embodied response was individually enacted. Dancer 1 opened his hands (4b), Dancer 2 brought his hands together in a shape around the invisible object, and Dancer 3 reached and closed his thumb. Each performed their receipt on the same seventh beat in the musical structure in a coordinated, taking turns. While the OSI initiated the embodied directive to “pour yourself some coffee” (1) and “give it to a friend” (3), each participant, in coordination with the facilitator, was given his moment in a measured musical beat to create a signature move in response. By the eighth count of each iteration of the coffee-pouring and -sharing sequence, the group focus of the movement shifted in orientation to the next dancer in turn. While initiated by the OSI, then led by the facilitator, the rhythm of the music provided an external interactional resource in a predictable structure (Albert 2015) with which each individual aligned in sequence. By the end of the sequence, each dancer had contributed a unique movement to the creation of a shared dance, which was led by the facilitator, in alignment with the ongoing instructed action (Stivers 2008). Coparticipants, in turn, each displayed alignment with the musical beat as the facilitator-initiated responses in a chain of sequentially contingent actions (Schegloff 2007). The creativity afforded to each individual was structured yet improvised according to individual interpretation and ability. Their responses were compliant in aligning with the predictable structure of the turns in sequence and creative in their individual expressions of receiving their “coffees” in turn.
In the two examples above, participants used bodily quoting in alignment with sequential and musical structures to achieve instructed actions. Participants’ responses to creative direction were achieved in interactional compliance with matching movements. In the first, Anita complied with the OSI in a classical (albeit embodied) adjacency pair completion. In the second, a series of embodied adjacency pairs were coordinated in sequential order by a copresent facilitator. In both examples, the temporal structure of the music provided a resource to cue participants as to when to move. In the second example, the facilitator responded to the OSI’s multimodal directive on cue to the beat, and repetitively, in quoting the OSI’s bodily movements (Keevallik 2010). In sustaining the rhythm of the OSI choreography, the facilitator used the music as a resource to organize the turn-taking sequence that projected a visible predictability of upcoming action for her coparticipants. The inherent artistic creativity of the dance was realized in both cases through participants’ compliant turn-taking responses to the instructions.

3.3. Being Dramatic on Broadway: Embellishing Flourishes

In the next example, we analyze how a participant creatively embellished the instructed movements in response to directives. In the transcript (3) below, Dan is seated facing the screen. The OSI demonstrates the Broadway chorus line choreography in which she depicts that she is clasping a top hat in her hands, held at the torso. The OSI directs participants to depict and present their own imaginary hats by pushing them out (reaching) and bringing them back in. Dan complies by following the instructions and adding his own embellishments.
(3) OSI: On-screen instructor (¶), Dan: dancer PLWD (Δ)
1 OSIand ¶re:ach, (0.3)Δ and (0.2)    ¶in,(0.3)Δ      ¶     Δ
a Osi    ¶pushes hands out            ¶pulls hands in ¶
b Dan>>gz screen       Δpushes hands right---Δpulls hands inΔ
2 OSIand then can you (0.3) ¶↑throw it away ¶
a Osi                       ¶flicks wrist up¶
3 (0.3)Δ(0.3)              # Δ
a Dan      Δflicks hand to side  Δ
b Dan        ->gz imaginary hat#
c fig                          #Figure 7
4 OSI↑nice and dramatic Δ like on Broadway#
a Dan                   Δ suspends raised arm, turns torso->
b Dan                ->gz follows hat above arm and R->
c fig                                     #Figure 7
From the beginning of the sequence, a compliant embodied response was projected by multimodal instructions composed of verbal directives—“and reach” (1), followed by “and then can you throw it away” (2)—accompanied by an embodied demonstration of reaching (1a) and then flicking wrists (2a) movements by the OSI. Dan showed his understanding of what was expected by matching his arm movements to those of the OSI (1b). When Dan responded with the compliant embodied flick, he additionally moved his gaze to where the hat would be thrown away (3a). This extension of his gaze was not an instructed action but an embellishment of his own. Next, the OSI verbally directed the movement to be “nice and dramatic” (4). In response, Dan extended his arm and gaze, twisting his body to watch the hat fly away. Within the sequence, Dan complied with the directed action, created his own flourish, and embellished it on cue according to what was directed, “to be dramatic.” Within the sequence, Dan displayed his unique expression of individual creativity. His emphasized embodiment made relevant the OSI’s directive to be dramatic and displayed his understanding of what was expected of him in his individual performance of throwing the hat (4b) (see Figure 7). He was compliant in his response to the instruction and creative in his individual interpretation. As Kontos et al. (2020a) pointed out, the creative flourish is often associated with the accomplished artist; this example showcases a person living with dementia performing an artistic embellishment with his own signature. Our analysis illustrated how this was achieved in response to multimodal directives in the creative instruction.

3.4. Individual Expression: Improvising Seaweed Movements

In the next example (4), we focus our analysis on how one participant improvises an unplanned movement of his own, within the structure of the activity, in response to the copresent facilitator’s encouragement. The participant, George, is part of a group of seated dancers facing the screen. A facilitator (staff) sits below the screen facing the dancers and demonstrates the movements in copresence. The sequence begins as a dance session is in progress and the on-screen instructor (OSI) has directed participants to move their arms and upper body like seaweed. The facilitator encourages George to comply with the instructed movements and provides an embodied demonstration similar to the OSI. George complies with the instructed movement by copying the facilitator’s movements at first. Then, he deviates from the demonstration and moves his hands his own way.
(4) OSI: On-screen instructor ¶, FAC: facilitator +, Dancer George (Geo) ø (PLWD)
1 OSI Now ¶we have our seaweed,
a Osi    ¶sways torso, twists arms upward->>
2 FAC(0.2) O:ohh+seaweed (1.0) C’mon George be some seaweed
a >>gz screen+gz George
b            +sways torso, twists arms upward->
3 FAC(1.0)øSome seawee=ø =thats# it(.)good one George(.)good one(.)
a Geo     øgz Fac      ø sways#torso, swings arms to sides->
b fig                          #Figure 8
4 GEO (1.0) ø(0.3)+(I can say I’m just doing this)# ( )follow yours
a Geo    ->øwrings hands together->>             #
a Geo  gz hands
b fig                                            #Figure 8
c Fac             +stands, leans into George->
5 FAC You just can’t do it +well you do what +your body can do, right,
a                    ->+sits back in seat+
Continuing an ongoing instruction sequence, the OSI gave the verbal directive, “now we have our seaweed” (1), with an embodied demonstration, twisting her arms in upward motions (1a), comprising the multimodal instruction. This projected a relevant next in the dance sequence. “Now” provided the cue in the timing, along with the embodied demonstration of what “we” the participants following were to be doing in this moment, “our seaweed.” Neither did the depictive gesture nor the verbal directive alone represent a recognizable instruction; together, they constituted the formation of the action (Lilja and Piirainen-Marsh 2022). The response of the facilitator produced the instructed action (Garfinkel 2002) in her compliant embodied replication of moving and swaying her arms similarly to the OSI (2a). Her verbal “o:ooh” (2) produced an affiliative stance display that positively endorsed the movement, while her embodiment of seaweed aligned with the structure of the ongoing activity (Stivers 2008). The facilitator reformulated the OSI directive as an invitation with a summons, “C’mon George, be some seaweed,” as she quoted the OSI depictive gesture of seaweed (2). When George responded to the summons with shifting gaze, matching the facilitator’s movements (3a), he made the facilitator’s reformulated instruction understandable and aligned with her directive in compliance (see Figure 8). After a beat, George changed his hand movements to his own unique wringing movements, not demonstrated by the OSI or the facilitator (4a) (see Figure 8). He accounted for this verbally, with a deictic reference, “I’m just going like this,” and his gaze pointed toward his hands (4a). The facilitator responded to George with an affirmation of his approach, “well you do what you can, right,” (5) showing agreement with George’s change of movement and affiliation that his action was right based on his physical ability.
In breaking away from following the lead of the facilitator and improvising his own movement, George initiated a response from the facilitator (5), who complied with affiliating agreement to his approach. As Kontos et al. (2020b) highlighted, creative action can emerge from practical involvement in a task, not only as an individual cognitive trait. This example illustrated George’s improvisation in response to the facilitator’s creative direction to “be some seaweed” in relation to what he had to work with using his own hands. George’s verbal turn reformulated his ongoing action as self-motivated rather than according to the facilitator’s multimodal directive. In this way, his accounting for his incipient compliance (see Kent 2012 allowed him to maintain autonomy of his own conduct according to his ability. George’s account of his interpretation can be analyzed as a prosocial action in explaining his potentially misaligning move (Schegloff 2007), afforded in interaction by the copresence of the facilitator. In this example, the copresent facilitator’s affiliating stance afforded the opportunity for George’s improvised movement to be sanctioned as allowable within the parameters of the activity.

3.5. When Pointillism Becomes Pointing at Each Other: Cocreating Embodied Reciprocity

Our final example showcases how a facilitator and participant reciprocate and build upon each other’s movements and affective stances in the cocreation of their own dance in response to instructions. In the excerpt (5) below, the copresent facilitator is seated in a circle, along with residents and staff, oriented toward the screen, where the prerecorded dance is in progress. The scenario is a trip to the art gallery, and the movements represent different techniques of painting. Where the transcript begins below (5), the OSI directs dancers through the pointillism technique, depicting repetitive pointing gestures into the air. The facilitator is pointing into the air, as instructed by the OSI, while monitoring participants. One of the dancers, Joe, watches the facilitator before joining in with matching his movements to the facilitator’s. The facilitator sees Joe watching her and points toward him. What follows is a reciprocal exchange of movements that lead to the dyadic dance cocreated by Joe and the facilitator.
(5) OSI: On-screen instructor ¶, Fac: Facilitator (researcher) +, Joe: Dancer (PLWD) Δ
1 OSI  and now we ¶make our fine details+
a Osi        ¶points fingers repeatedly->>
b Fac                   +points fingers repeatedly->>
2   (1.0)+ (0.3) +       Δ  (1.3) +
a Fac    +gz Joe +raises eyebrows +gz own fingers->
b Joegz Fac->>            Δlifts hands->
3 (1.0)Δ(0.6)+*(1.0)                          +
a Joe   ->Δ pokes fingers into air repeatedly toward Fac->>
b Fac      ->+gz Joe’s fingers, raises eyebrows+
c Fac       *nods, turns torso and pointing toward Joe->>
4 Fac  + (1.8) Δ(1.0) hehehe#              +
a Fac  +gz Joe, shrugs shoulders toward Joe+
b Joe      Δsmiles at Fac, shakes shoulder in silent laugh->>
c fig             #Figure 9
From the beginning of the sequence, an instructed action was projected in response to the OSI. Following the OSI’s verbal directive, “now we make our fine details,” accompanied by embodied demonstration of pointing fingers (1,1a), the facilitator made repeated pointing gestures (1b), demonstrating the OSI’s embodied directive (1,1a) as Joe watched (1b). The facilitator raised her eyebrows at Joe and, using her gaze, shifted her focus to her pointing fingers (2a). When Joe started to join the action with his own pointing fingers, (3a) the facilitator returned her gaze to Joe and raised her eyebrows in his direction (3b), turning her movements toward him in alignment with his joining the activity. The facilitator’s shrug and laughter directed toward Joe (4) displayed an affective stance to which Joe’s contingent response was an affiliative smile. The result was a collaborative achievement of joining together in a cocreated response to instructions in a shared moment of laughter. Their shared moment of pointing at each other was collaboratively achieved in a sequencing chain, in reciprocity. The resulting escalation unfolded as the two oriented to each other’s movements and responded in turn to their affiliative stance displays, in the service of experience sharing (Stevanovic and Peräkylä 2015). In their compliance within a chain of sequentially and reciprocally contingent actions, as initially directed by the OSI, they cocreated their own shared work of art—in an intercorporeality that neither could have accomplished without the other.
In summarizing the five excerpts we presented above, each of the examples illustrated sequences initiated by an onscreen instructor, followed by variably compliant responses and different types of creativity. We organize these below on axes of compliance and creativity to demonstrate how they are related to the dance instruction.
Anita’s warm-up was a precise following in the matching movements of instructed action, demonstrating a prosocial second pair part embodied by the participant in response to the OSI. The coffee break was similarly prosocial, with the facilitator taking the lead and participants coordinating their matching, yet individual movements in a turn-taking structure (Schegloff 2007). Both of these examples were in alignment with the activity structure as instructed by the OSI and facilitated by copresent staff. The first was compliant with the OSI, and the second was compliant with the copresent facilitator, increasing the complexity and cooperative nature of the social interaction.
The next two examples highlight the nature of the creativity in relation to the dance activity. Dan complied with OSI directions, embellishing flourishes—as instructed and of his own accord, given space in the sequence to do so. Dan was compliant similarly to Anita in response to the OSI and added a level of creativity in his embodied self-embellishments, exaggerating dramatically “in the Broadway chorus line.” George went even further in his artistic expression in improvising his seaweed movements, adding a creative touch and an interactional turn to the sequence in response to the facilitator.
In the final example of the pointillism dance, a facilitator and participant each responded to each other in reciprocated instructed movements in what became a pointing at each other in their own shared creation of a pointing dance. Both creative and compliant, this example illustrated how the dance instructions were achieved in a sequential chain and built reciprocally, as each contingently responded to each other in alignment with the structure of the activity and in affiliation with each others’ stance displays (Stivers 2008).
We organized each of the examples in a figure (Figure 10) below that illustrates the different types of creativity (in the activity of the dance) and compliance (in the instructed actions). Along the axis of creativity are the actions of embellishments that built upon the dance instruction, first in embellishing and then in improvising. Along the axis of compliance are the actions that increase in complexity of coordination with coparticipants, from following OSI movements as an individual to following in sequential turn-taking. Somewhere in between the intersections of artistic creativity and interactional compliance, cocreativity is realized, as indicated in our final example (see Figure 10).

4. Discussion

In each of the examples above, the instruction was designed to be mimicable remotely with verbal and embodied directives (Due et al. 2019). These, together within the temporal structure of the music, allowed the inherent artistic creativity of the dance to be realized through participants’ compliant responses to the instructions both in copresent and mediated interactions. Participants’ compliance in response to the multimodal directives of the OSI and then the facilitator displayed alignment with the ongoing structure of the activity (Schegloff 2007; Stivers 2008) regarding when and how they were accomplished, resulting in their compliant and creative contributions to the progressivity of the instructed activity. Actions were not separable from instructions and, as such, were examples of instructed action (Garfinkel 2002).
As pointed out by Lilja and Piirainen-Marsh (2022), a multimodal instruction comprises a directive and depicted gesture to demonstrate how something should be performed to achieve a desired result in a second-language cooking class. In the cases of our data, verbal directives contributed to a multimodal instruction of a creative goal in how an embodied depictive gesture can be embellished. In a second-language (L2) context, this raises questions about the understandability of verbal directives, drawing attention to the order of priority of various modes in multimodal instructions toward different types of goals (i.e., cooking vs. aesthetic objectives). The dance program, in this case, was not intended for an L2 audience or purpose. In terms of second language, the verbal directives as “creative cues” to induce the narrative scenario or imagery of the art gallery or being under the sea are necessarily understood through the talk. In our one example of a foreign-language setting, the focus was on the embodied exchange in turn-taking between the facilitator and the participant. While the OSI may have led the movements of the group in an imaginary narrative of a trip to the art gallery, the pointillism technique shared between the two participants became pointing at each other in a dance of their own making.
Not surprisingly, our results illustrate how the complexity of the interactions increased with the copresence of the facilitator who initiated and encouraged responses of PLWD. The role of the facilitator was implicated in both creative and interactional compliance in the progressing activity. Notably, the opportunities for affiliation with affective stance displays (Lee and Tanaka 2016). (Stivers 2008) were afforded by the copresence of the facilitator, but not the OSI in our examples. Further exploration is warranted into the participation framework and the role of the copresent facilitator (as staff, family, or volunteer), as well as the interactional space in the material environment. As our results show how facilitators were instrumental in initiating copresent interactions, it would be interesting to study further in what circumstances PLWD initiate the same and with each other.
There are many contributions that dance makes to health and well-being, including embodiment, affective responses, and creativity, among others (Chappell et al. 2021). The authentic presence of being with a person, the moment of connection and holding on to it, acceptance of fictional truths, and spontaneous interactions have each been identified as qualities of social communion through art (Balfour 2019). By looking closely at the interactional mechanisms of how these social actions are accomplished, we can identify practices and methods to incorporate these artful processes increasingly into everyday lives in the context of long-term residential care for PLWD. With the overarching directive to “be creative” or to “do what you can,” individuals are allowed to bring their own ideas to play in alignment with the structured activity in which they agree to participate.
Importantly, while this research involves a sample demographic of PLWD in institutional settings, our findings are not only relevant for applied conversation analysis (see Antaki 2011), atypical interaction, or ageing studies. These findings contribute to ongoing discussions in the literature regarding compliance and creativity in interaction, multimodal instructed actions, and directive–response sequences in multimodality, embodiment, and intercorporeality in conversation analysis. Contributing to discussions concerning response relevance and recipiency relevance (Schegloff 2010; Stivers and Rossano 2010), we do not assert creativity or compliance in scalar terms but that complexity and diverse combinations of multimodal resources may be drawn upon in instructed actions in consideration of diverse participant abilities and contingencies. The recognition of embodied pair parts as drivers of action as much as utterances (Keevallik 2010) is an important contribution that our work builds upon. Arts-based practices offer environmental contexts within which variably compliant responses are afforded—beyond utterances. How these elements of conduct are shaped in interaction speaks to the artistic and social inclusion practices developing in institutions of health, care, and arts-based research. Including older adults and PLWD in ongoing research in everyday practices for everyone will also be an important consideration for future research on health, well-being, and social inclusion.

5. Conclusions

This article explored the artistic mechanisms at play in an online dance program and how compliance was implicated at a social interactional level. The institutional context of long-term residential care for PLWD was an important setting in which to analyze how arts-based practices contribute to social inclusion, health, and well-being when delivered remotely via technology. Our findings revealed how creativity was achieved in instructed actions that were variably compliant with multimodal directives, from individual following to coparticipants’ coordinating. Creativity resulted as participants embellished and improvised in response to directives, building upon dance instruction. At intersections of artistic creativity and interactional compliance, participants’ reciprocating actions became cocreative. By demonstrating the sequences of interactions and how they unfolded temporally in the context of the dance, we were able to show how copresent facilitators played an important role in the coordination of compliant and creative instructed actions. Understanding how to support facilitators in institutional contexts will be an important next step in the continued development of remote arts-based programs and practices. Our contribution is about revealing the “how” of the practice mechanisms in bringing arts-based research to dementia care remotely, with a focus on creativity in artistic dance and compliance in interaction.

Author Contributions

Conceptualization, A.K. and M.S.; methodology, A.K.; formal analysis, A.K. and M.S.; investigation, A.K.; resources; A.K. and M.S. data curation, A.K. and M.S.; writing—original draft preparation, A.K.; writing—review and editing, A.K.; visualization, A.K.; supervision, M.S.; project administration, A.K.; funding acquisition, A.K. All authors have read and agreed to the published version of the manuscript.


As part of “Improving Social Inclusion for Canadians with Dementia and Carers through Sharing Dance” this study was funded by a Canadian Institutes of Health Research/Alzheimer Society of Canada Operating Grant: Social Inclusion for Individuals with Dementia and Carers (CIHR/ASC grant no. 150702). The study also funded, in part, by the Canada Research Chairs program (M. W. Skinner, Trent University; R. V. Herron, Brandon University).

Data Availability Statement

Data is unavailable due to privacy and ethical restrictions.


The authors would like to thank the special edition editors as well as reviewers for their comments as well as colleagues who contributed to analysis in data sessions. We would like to give special thanks to Saul Albert for his helpful insights and advice. We also gratefully acknowledge the research sites in Canada and Finland, participants, volunteers, and facilitators, and Canada’s National Ballet School for use of the Sharing Dance Older Adults program and research support.

Conflicts of Interest

The authors declare no conflict of interest.

Appendix A

Transcript Conventions
Talk was transcribed according to conventions developed by Gail Jefferson (2004) (see, e.g., Schegloff 2007 for a full description).
( )unheard or unclear utterance
[ ]overlapping speech
↑ /↓ sharp rising/falling intonation
(.)just noticeable pause
(1.0)timed pauses
,slight rise of intonation in the last syllable
(( ))transcriber’s comments or descriptions.
wor—a dash shows a sharp cutoff
wo:rdcolons show that the speaker has stretched the preceding sound
wordunderlined sounds are louder, capitals louder still
=no discernible pause between two speakers’ turns
Embodied and multimodal actions were transcribed according to the following conventions developed by Lorenza Mondada: accessed on 1 January 2021.
* *Descriptions of embodied actions are delimited between
+ +two identical symbols (one symbol per participant and per type of action)
Δ Δthat are synchronized with correspondent stretches of talk or time.
*--->The action described continues across subsequent lines
---->*until the same symbol is reached.
>> The action described begins before the excerpts beginning.
--->>The action described continues after the excerpts end.
…..action’s preparation
----action’s apex is reached and maintained
,,,,,actions retraction
ricparticipant doing the embodied action is identified in small caps in the margin.
figThe exact moment at which a screen shot has been taken
#is indicated with a sign (#) showing its position within the turn/a time measure.
¶ ¶On-screen instructor’s actions
+ +Facilitator actions
Δ ΔDancer actions (Anita, George, Dancer 1, Joe)
©©Dancer 2′s actions
ø øDancer 3′s actions
♫♫Within this framework, we added musical beats that count to eight ♫1, ♫2, ♫3, etc.


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Figure 1. Anita (left) matches her movements to the on-screen instructor’s (right).
Figure 1. Anita (left) matches her movements to the on-screen instructor’s (right).
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Figure 2. From L to R, Dancers 3, 2, and 1 watch facilitator (R) mime pouring “coffee”.
Figure 2. From L to R, Dancers 3, 2, and 1 watch facilitator (R) mime pouring “coffee”.
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Figure 3. Dancer 2 looks at space where facilitator puts imaginary coffee.
Figure 3. Dancer 2 looks at space where facilitator puts imaginary coffee.
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Figure 4. Dancer 2 nods head as facilitator hands him imaginary coffee.
Figure 4. Dancer 2 nods head as facilitator hands him imaginary coffee.
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Figure 5. Dancer 2 looks at hands shaping, then looks up with a smile.
Figure 5. Dancer 2 looks at hands shaping, then looks up with a smile.
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Figure 6. Group focuses on Dancer 3′s hand as he reaches for “imaginary coffee cup”.
Figure 6. Group focuses on Dancer 3′s hand as he reaches for “imaginary coffee cup”.
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Figure 7. Dancer reaches for imaginary hat.
Figure 7. Dancer reaches for imaginary hat.
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Figure 8. Dancer complies with directive and improvises his hand moves.
Figure 8. Dancer complies with directive and improvises his hand moves.
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Figure 9. Dancer and facilitator reciprocate pointing movements and smiles.
Figure 9. Dancer and facilitator reciprocate pointing movements and smiles.
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Figure 10. Participant’s creative and compliant actions in response to dance instruction.
Figure 10. Participant’s creative and compliant actions in response to dance instruction.
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Kosurko, A.; Stevanovic, M. Beyond Utterances: Embodied Creativity and Compliance in Dance and Dementia. Soc. Sci. 2023, 12, 304.

AMA Style

Kosurko A, Stevanovic M. Beyond Utterances: Embodied Creativity and Compliance in Dance and Dementia. Social Sciences. 2023; 12(5):304.

Chicago/Turabian Style

Kosurko, An, and Melisa Stevanovic. 2023. "Beyond Utterances: Embodied Creativity and Compliance in Dance and Dementia" Social Sciences 12, no. 5: 304.

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