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Music for maladies

by  /  31 May 2013

Music-based therapies are often provided to children diagnosed with autism spectrum disorders. Many parents report that their children with autism enjoy musical activities, and show more positive interactions with others through greater eye contact, smiling and speaking.

Autism is a multisystem disorder and music-based therapies have the potential to improve social communication and motor skills in these children, as well as nurture a lifelong interest in music.

As we reported in our paper, published 9 April in Frontiers of Integrative Neuroscience, about 12 percent of autism interventions in schools involve music-based activities1. However, the lack of substantial evidence to support the use of music therapies limits their further implementation within schools and clinics.

We are conducting a pilot randomized, controlled trial to examine the effects of music- and movement-based interventions in children with autism. This is a two-year study that will compare eight weeks of active music therapy with stationary play using conventional academic activities such as reading, and arts and crafts.

Music therapies can be passive or active. Passive music therapies such as auditory integration therapy involve listening to white noise or relaxing music to promote attentional focus. Active music therapies such as the Auditory-Motor Mapping Technique2 or improvisational music therapy3 involve singing, rhythmic motor synchronization, music-making and social turn-taking to promote social communication skills.

Most of the evidence for music therapy is based on studies with small sample sizes and low-quality designs. However, there are a few randomized clinical trials and some meta-analyses suggesting that music improves communication skills in children with autism. There is also preliminary evidence for its effects on promoting social skills and reducing negative behaviors. However, there are no studies examining the effects of music therapy on the motor skills of children with the disorder.

Clinical researchers need to objectively investigate the effects of active music therapies on social communication and affective, motor and behavioral skills in children with autism. Specifically, the studies should include standardized assessments, better study designs involving control groups, prolonged interventions and long-term follow-up.

Children with autism who enjoy music-based activities should have access to these experiences two to three days each week for about 30 to 45 minutes. Music-based activities should include humming or singing, keeping a beat, playing an instrument and whole-body movements within group settings.

The music sessions themselves should be based on principles from contemporary autism interventions, such as Applied Behavior Analysis, Picture Exchange Communication System, and Training and Education of Autistic and Related Communication Handicapped Children.

Specifically, they should incorporate structured environments, brief instructions, visual modeling — for example, asking children to repeat the action after showing it to them — graded prompting involving visual, verbal and hand-on-hand prompts, repetition, reinforcement and spontaneous child-directed activities.

We hope that with more research evidence for its multisystem effects, clinicians may incorporate music-based activities into mainstream interventions for children with autism.

Anjana Bhat isassistant professor of kinesiology at the University of Connecticut’s Neag School of Education.

References:

1. Srinivasan S.M. and A.N. Bhat Front. Integr. Neurosci. 7, 22 (2013) PubMed

2. Wan C.Y. et al. PLoS One 6, e25505 (2011) PubMed

3. Kim J. et al. Autism 13, 389-409 (2009) PubMed