Our approach and process

Humour and clowning are powerful tools for connecting with people who might experience feelings of social isolation.
Our participatory interventions, developed and implemented during this project, aim to foster creative self-expression and social connection, positively impacting emotional well-being.
We developed these artistic approaches collaboratively, involving international artists, artists from different fields, participants, caregivers, and experts in dementia and autism.

Working alongside family members, caregivers, social experts, and artists from various disciplines, clown artists sought innovative and tailored approaches for engaging with children with autism and individuals with dementia.


© Saulius Aliukonis

Artistic working groups and laboratories

To accommodate two distinct project audiences, we established two initial artistic working groups.

One focused on innovative approaches for engaging people with dementia, while the other centred on artistic interactions with children with autism.

During the three years of the project, each working group met in three transnational artistic laboratories, meaning a total of six artistic laboratories were held in six different EU member states.

The laboratories brought together healthcare clown duos, experts, individuals with lived experiences, and artistic coordinators.

These gatherings facilitated experiential learning and knowledge sharing, supporting the creative and learning processes of healthcare clowns.

The first round of laboratories focused on the artists getting to know each other, exchanging current practices and learning more about the experiences of the target audiences (people with dementia and children with autism) to gain a better understanding of local contexts, needs, and participant preferences.

Healthcare clowns & children with autism – a joint expedition has begun!

Red-nosed characters peek out from behind the trees. One climbs a tree and another admires the warmth of the autumn sun on her cheeks. What’s going on? The very first artistic laboratory of ClowNexus with healthcare clowns from several European countries has begun in Nuuksio, Espoo. The goal of the lab was to initiate the development of participatory clowning approaches for children with autism spectrum disorder.

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Second Artistic laboratories (LT&ES)

During the second laboratories, exchanges with experts continued and the artists were able to draw conclusions from their first encounters with the audiences.

Common topics and artistic approaches were collected and discussed for piloting in the next phase of the project.

ClowNexus Artistic Laboratory in Lithuania: clowns are creating a “tool box” that unlocks senses

In the first week of April, the second artistic laboratory on Autism of ClowNexus took place in Lithuania. Project partners from Lithuania, Austria, Croatia, Hungary, Finland and Spain gathered in Vilnius, the capital city. The participating clown artists continued to deepen their knowledge and explore the world of the senses in order to find the best tools to interact with autistic children.

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Video about the Laboratory in Barcelona:


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Third Artistic laboratories (AT&HR)

In the final laboratories, artists consolidated their project insights about the tested and implemented new approaches. They also strategised how to continue engaging with the project’s audiences in the future and explored ways to disseminate their learnings to local peers, fellow artists, and cultural or care professionals.

Healthcare clown organizations are creating new artistic approaches for children on the autism spectrum

Healthcare clowns from seven different European countries gathered from 29th January until 3rd of March in Zagreb, Croatia, as part of the ClowNexus project in order to share their previous experiences and artistic learnings in working with children on the autism spectrum. As part of the five-day laboratory, the international working group of clowns interacted with the children of the Zagreb Autism Center.

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Picture frames, foot choreographies and subtle movements:
The ClowNexus Artistic Laboratory in Austria

Wednesday morning, 9 am at the Grillhof educational institute in Innsbruck, Austria. It is the third day of the “Clownexus” Artistic Laboratory.

ClowNexus is a three-year project (November 2020-October 2023) in which eight European healthcare clown organisations explore how clowns and humor can build and facilitate social connections and better communication with people with dementia and children on the autism spectrum.

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© Red Noses International

Project Kick-off and Closing Meetings

Kick-off and closing meetings established a shared understanding of project goals and insights.

The project fostered strong bonds among approximately 30 artists and 15 cultural professionals, enriching it with diverse perspectives. This international collaboration enhanced inspiration and validated results across cultural contexts, increasing their international relevance.

Video of the kick-off meeting:


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© Mindaugas Drigotas, Berta Tilmantaitė – NARA

On-going participatory activities in six countries

Before and after each artistic laboratory, clown artists engaged in local participatory activities with project audiences.

Weekly sessions occurred in numerous medical, care, and educational facilities across Austria, Croatia, Finland, Hungary, Lithuania, and Spain.

The artists interacted, learned, explored, and shared emotions and special moments with children with autism, people with dementia, and their caregivers. Being tailored to their needs, talents, and wishes, fostering numerous, the activities fostered numerous moments of joy and connection.

Video by Pallapupas on their work in a retirement home:


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Interview with Finnish nurse Anna Reenkola by Sairaalaklovnit on the work with children with Autism:


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© Sairaalaklovnit


To ensure the artistic quality of the ClowNexus project, knowledge exchange and artistic trainings were an essential part of our process.

Artists had the opportunity to engage in various training sessions at the International School of Humour in Vienna and during the artistic laboratories.

These sessions covered a wide range of topics, including solo and duo clowning, physical comedy, improvisation, and innovative techniques such as the Instant Ageing Workshops (to enhance empathy for the elderly) and the creation of theatre pieces tailored for children with disabilities.

© Sairaalaklovnit

Conference “Healthcare Clowning International Meeting”

The Healthcare Clowning International Meeting, hosted by Cliniclowns in The Hague, Netherlands April 20-22, 2022, served as the project’s main networking and dissemination event.

With over 320 participants daily from around the world, including both cultural and medical sectors, the conference featured a keynote by Christopher Bailey, WHO’s Lead of Arts and Health.

It covered various clowning areas, including palliative care, medical procedures, children with disabilities, education, online clowning, and more. Numerous parallel sessions aligned with the project’s goals, focusing on clowning for children with autism and people with dementia.

Read more about the conference here: Home (hcim2021.com) and here Healthcare Clowning International Meeting in The Hague Connecting Worlds. Connecting people. Changing spaces. – ClowNexus.

© Iris Haidau Photography

Awareness raising, Advocacy and Communication

Through ClowNexus, we aimed to promote the positive impact of artistic and humorous activities on health and well-being. There’s growing recognition that art can support health and care work, covering treatment, management, prevention, and mental health.

Some EU countries are pioneering these approaches, and we collaborated with organisations like CultureForHealth, Arts for Health Austria, and the Northern Dimension Partnership on Culture to advocate for arts and health in European and local decision-making forums.

We presented ClowNexus as a best practice at an event by the European Commission and the European Parliament on “Culture as a driver for health and well-being in the EU.

We also organizsd an event with Culture Action Europe in Brussels, showcasing a documentary on ClowNexus and hosting discussions with WHO, European Parliament, and European Commission representatives.

To further raise awareness, we created a short documentary and eight video portraits produced by multimedia journalists NARA from Lithuania. These are being screened at various events and hopefully also at film festivals in the future.

Arts and health will continue to be a crucial topic, and our project partners will persist in advocating for the integration of arts and humour into healthcare systems.

List of interesting Publications on Arts and Health:

© Pallapupas

Learning activities

By embedding the following learning activities, ClowNexus had learning at its very core.

Evaluation: At the beginning of the project a baseline study to assess perceptions of clowning and healthcare clowning awareness. An endline evaluation measured ClowNexus’s effectiveness and offered sustainability recommendations.

Learning Questions: A set of learning questions guided the project. The learning questions revolved around understanding target groups, effective artistic techniques, successful co-creation with stakeholders, the impact of clowning on target groups, monitoring and evaluation methods, and ways to advocate for the use of humour and the arts for vulnerable groups.

Learning Tools: Various learning tools, initially developed during the baseline study, were piloted and shared with project partners. The endline evaluation focused on consolidating the most promising tools with examples and guidance for use.