Music therapy is not one of the main stream therapy options thought of when treating a patient or caring for a child with autism spectrum disorders (ASDs), even though there is obvious benefit from this non-invasive therapy. Patients, families, and health care providers alike are largely unaware of its past and current uses for intervention in this population of children.
Music therapy has been found by numerous studies to be an effective and beneficial intervention for communication, socialization, and aberrant behavior in children with ASDs (Buday, 1995; Edgerton, 1994; Kern & Aldridge, 2006; Lim, 2010; Orr, Myles, & Carlson, 1998; Simpson & Keen, 2010); though research has been scrutinized because of the small number of study participants and the lack of defining the technique of therapy to be used as clinical application. In an article published in the Journal of Music Therapy, Reschke-Hernandez talks about the pressure felt by music therapists “to improve the level of evidence to justify the effectiveness of their work with children with autism” (2011, p.189). This priority has geared current and future research in this topic towards generalizing music therapy techniques and its clinical application to children with ASDs as a more main stream therapy option. The American Music Therapy Association provides up-to-date research and results regarding music therapy with autistic children on their website, however, without the awareness of the option, this patient population is unlikely to come across such information.
Alaine E. Reschke-Hernandez discusses the history of the use of music therapy in autistic children in a review published in the Journal of Music Therapy (2011). Music therapy has been used for this purpose since the 1940s, though studies of efficacy and publications on the matter were limited. As the profession grew, more literature emerged about autistic children and “their apparent unusual musical ability and attraction to music” (as cited in Reschke-Hernandez, 2011, p. 173). Nordoff and Robbins, leading the way in music therapy for autistic children, suggested that they experienced music as a “nonthreatening medium” which encouraged their engagement in the therapy. This concept was the basis of their development of the “Creative Music Therapy” technique used for children with autism or other developmental disabilities, a concept used today (as cited in Rescheke-Hernandez, 2011, p. 173). Throughout the years, music therapists have implemented techniques such as singing, music games, and the Music Hut, which is a musical playground that encourages socialization (Reschke-Hernandez, 2011, p. 192).
Research has been done looking at the effects of music therapy as communication, socialization, and behavioral interventions. A number of studies suggest that music interventions are beneficial to those with autism with respect to communication development (Buday, 1995; Edgerton, 1994; Kim, Wigram & Gold, 2009; Lim, 2010; Simpson & Keen, 2010; Wigram, 1999, 2000). In the most recent of the studies, Lim (2010) looked at 50 children with ASD ranging in age from 3-5 years and randomly assigned them to music training, speech training, or no treatment/control group. The results of his study showed that those who participated in the music or speech training groups had a significant increase between their pretest and posttest in verbal production. It also showed that high and low functioning participants (determined prior to the study by evaluation on standard tests of level of functioning) had significant improvement with music or speech training, but the low functioning participants showed larger development after music training. These results were measured after 3 days of training.
Music therapy has also been studied as treatment for development of social skills in autistic children. One study by Kim, Wigram, and Gold (2008) compared music therapy to play session in order to determine which would be more effective in developing “joint attention and positive emotional communication.” The results showed significance in the efficacy of the music condition compared to the play condition. Other studies suggest that the use of music encourages more social engagement when compared to other kinds of therapy (Kern & Aldridge, 2006; Wimpory, Chadwick, & Nash, 1995).
Music has been found to be an effective intervention for abnormal behavior in children with ASDs (Gunter & Fox, 1993; Lanovaz, Fletcher & Rapp, 2009; Orr, Myles, & Carlson, 1998; Rapp, 2007). In the study by Orr, Myles, & Carlson (1998), it was found that metered music reduced abnormal behavior in one 11 year-old girl when she was stressed. One study by Devlin, Healy, Leader, and Reed (2008) found that music can also be a deterrent to aberrant behavior. It was discovered that the 6 year-old boy in their study increased aberrant behavior when he heard a certain type of music. They used that type of music as a “differential negative reinforcement” for other behavior, resulting in increased tolerance to that music.
The problem seems to be that many of the studies looking at the efficacy of music therapy for children with autism in regards to their communication, socialization, and behavioral skills have a small number of participants and do not look at long-term effects. Many of the published literary reviews point out these flaws (Gold, Wigram, & Elefant, 2010; Simpson & Keen, 2011; Whipple, 2004). The number of participants in each study is not large enough to be applied to the general targeted patient population and there is no follow-up for long term effects of the therapy. In addition, the methods or techniques used for music therapy treatment are not always defined as the therapy can be improvisational, catering to each patient’s specific needs. Therefore, the results reflect the use of music as treatment, but the technique per study participant cannot be carried across the board; which may be the reason why the study sizes are so small, using participants with similar therapeutic needs. Whipple’s meta-analysis (2004) concluded that music therapy was indeed effective in treating those with ASDs, but the studies included in the analysis were “too heterogenous to allow clinically meaningful and methologically strong conclusions” (as cited in Gold, Wigram, & Elefant, 2010, p. 3).
Music therapy has been found by numerous studies to be an effective and beneficial intervention for communication, socialization, and aberrant behavior in children with ASDs (Buday, 1995; Edgerton, 1994; Kern & Aldridge, 2006; Lim, 2010; Orr, Myles, & Carlson, 1998; Simpson & Keen, 2010); though research has been scrutinized because of the small number of study participants and the lack of defining the technique of therapy to be used as clinical application. In an article published in the Journal of Music Therapy, Reschke-Hernandez talks about the pressure felt by music therapists “to improve the level of evidence to justify the effectiveness of their work with children with autism” (2011, p.189). This priority has geared current and future research in this topic towards generalizing music therapy techniques and its clinical application to children with ASDs as a more main stream therapy option. The American Music Therapy Association provides up-to-date research and results regarding music therapy with autistic children on their website, however, without the awareness of the option, this patient population is unlikely to come across such information.
Alaine E. Reschke-Hernandez discusses the history of the use of music therapy in autistic children in a review published in the Journal of Music Therapy (2011). Music therapy has been used for this purpose since the 1940s, though studies of efficacy and publications on the matter were limited. As the profession grew, more literature emerged about autistic children and “their apparent unusual musical ability and attraction to music” (as cited in Reschke-Hernandez, 2011, p. 173). Nordoff and Robbins, leading the way in music therapy for autistic children, suggested that they experienced music as a “nonthreatening medium” which encouraged their engagement in the therapy. This concept was the basis of their development of the “Creative Music Therapy” technique used for children with autism or other developmental disabilities, a concept used today (as cited in Rescheke-Hernandez, 2011, p. 173). Throughout the years, music therapists have implemented techniques such as singing, music games, and the Music Hut, which is a musical playground that encourages socialization (Reschke-Hernandez, 2011, p. 192).
Research has been done looking at the effects of music therapy as communication, socialization, and behavioral interventions. A number of studies suggest that music interventions are beneficial to those with autism with respect to communication development (Buday, 1995; Edgerton, 1994; Kim, Wigram & Gold, 2009; Lim, 2010; Simpson & Keen, 2010; Wigram, 1999, 2000). In the most recent of the studies, Lim (2010) looked at 50 children with ASD ranging in age from 3-5 years and randomly assigned them to music training, speech training, or no treatment/control group. The results of his study showed that those who participated in the music or speech training groups had a significant increase between their pretest and posttest in verbal production. It also showed that high and low functioning participants (determined prior to the study by evaluation on standard tests of level of functioning) had significant improvement with music or speech training, but the low functioning participants showed larger development after music training. These results were measured after 3 days of training.
Music therapy has also been studied as treatment for development of social skills in autistic children. One study by Kim, Wigram, and Gold (2008) compared music therapy to play session in order to determine which would be more effective in developing “joint attention and positive emotional communication.” The results showed significance in the efficacy of the music condition compared to the play condition. Other studies suggest that the use of music encourages more social engagement when compared to other kinds of therapy (Kern & Aldridge, 2006; Wimpory, Chadwick, & Nash, 1995).
Music has been found to be an effective intervention for abnormal behavior in children with ASDs (Gunter & Fox, 1993; Lanovaz, Fletcher & Rapp, 2009; Orr, Myles, & Carlson, 1998; Rapp, 2007). In the study by Orr, Myles, & Carlson (1998), it was found that metered music reduced abnormal behavior in one 11 year-old girl when she was stressed. One study by Devlin, Healy, Leader, and Reed (2008) found that music can also be a deterrent to aberrant behavior. It was discovered that the 6 year-old boy in their study increased aberrant behavior when he heard a certain type of music. They used that type of music as a “differential negative reinforcement” for other behavior, resulting in increased tolerance to that music.
The problem seems to be that many of the studies looking at the efficacy of music therapy for children with autism in regards to their communication, socialization, and behavioral skills have a small number of participants and do not look at long-term effects. Many of the published literary reviews point out these flaws (Gold, Wigram, & Elefant, 2010; Simpson & Keen, 2011; Whipple, 2004). The number of participants in each study is not large enough to be applied to the general targeted patient population and there is no follow-up for long term effects of the therapy. In addition, the methods or techniques used for music therapy treatment are not always defined as the therapy can be improvisational, catering to each patient’s specific needs. Therefore, the results reflect the use of music as treatment, but the technique per study participant cannot be carried across the board; which may be the reason why the study sizes are so small, using participants with similar therapeutic needs. Whipple’s meta-analysis (2004) concluded that music therapy was indeed effective in treating those with ASDs, but the studies included in the analysis were “too heterogenous to allow clinically meaningful and methologically strong conclusions” (as cited in Gold, Wigram, & Elefant, 2010, p. 3).
Published studies and
articles:
- Buday, E. M. (1995). The effects of signed and spoken words taught with music on sign and speech imitation by children with autism. Journal of Music Therapy, 32, 189–202.
- Devlin, S., Healy, O., Leader, G., & Reed, P. (2008). The analysis and treatment of problem behaviour evoked by auditory stimulation. Research in Autism Spectrum Disorders, 2, 671–680.
- Edgerton, C. L. (1994). The effect of improvisational music therapy on the communicative behaviours of autistic children. Journal of Music Therapy, 31, 31–62.
- Gold, C., Wigram, T., Elefant, C. (2010). Music therapy for autistic spectrum disorder (Review). The Cochrane Library, 1. John Wiley & Sons, Ltd.
- Gunter, P., & Fox, J. (1993). A case study of the reduction of aberrant, repetitive responses of an adolescent with autism. Education and Treatment of Children, 16, 187–197.
- Kern, P., Aldridge, D. (2006). Using embedded music therapy interventions to support outdoor play of young children with autism in an inclusive community-based child care program. Journal of Music Therapy, 43, 270-294.
- Kim, J., Wigram, T., & Gold, C. (2008). The effects of improvisational music therapy on joint attention behaviours in autistic children: A randomized controlled study. Journal of Autism and Developmental Disorders, 38, 1758–1766.
- Kim, J., Wigram, T., Gold, C. (2009). Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy. SAGE Publications and The National Autistic Society, 13(4), 389-409.
- Lanovaz, M., Fletcher, S., & Rapp, J. (2009). Identifying stimuli that alter immediate and subsequent levels of vocial stereotypy: A further analysis of functionally matched stimulation. Behaviour Modification, 33, 682–704.
- Lim, H.A. (2010). Effect of “Developmental Speech and Language Training Through Music” on Speech Production in Children with Autism Spectrum Disorders. Journal of Music Therapy, 47(1), 2-26.
- Orr, T., Myles, B. S., & Carlson, J. K. (1998). The impact of rhythmic entrainment of a person with autism. Focus on Autism and other Developmental Disabilities, 13, 163–166.
- Rapp, J. (2007). Further evaluation of methods to identify matched stimulation. Journal of Applied Behaviour Analysis, 40, 73–88.
- Reschke-Hernandez, A.E. (2011). History of Music Therapy Treatment Interventions for Children with Autism. Journal of Music Therapy. 48(2), 169-207.
- Simpson, K., & Keen, D. (2010). Teaching young children with autism graphic symbols embedded within an interactive song. Journal of Developmental and Physical Disabilities, 20, 165–177.
- Simpson, K., Keen, D. (2011). Music Interventions for Children with Autism: Narrative Review of the Literature. Journal of Autism and other Developmental Disorders, 41, 1507-1514. doi: 10.1007/sl0803-010-1172-y.
- Whipple, J. (2004). Music in intervention for children and adolescents with autism: A meta-analysis. Journal of Music Therapy, 41(2), 90-106.
- Wigram, T. (1999) Assessment methods in music therapy: a humanistic or natural science framework? Nordic Journal of Music Therapy, 8, 6–24.
- Wigram, T. (2000) A method of music therapy assessment for the diagnosis of autistic and communication disordered children. Music Therapy Perspectives, 18, 13-22.
- Wimpory, D., Chadwick, P., Nash, S. (1995). Brief report: Musical interaction therapy for children with autism: An evaluative case study with two-year follow-up. Journal of Autism and Development Disorders, 25, 541-552.