Autism Spectrum Disorders: Music Therapy Research and Evidence-Based

evidence is growing and music therapy interventions were reviewed for quality of evidence by the Cochrane Collaborative with favorable results. STANDARDIZATION: Music therapy sessions are documented in a treatment plan and delivered in accordance with standards of practice.<br><br> Music selections and certain active music- making activities are modified for client preferences and individualized needs (i.e., song selection and music may vary). Toolkits are available via AMTA and publications. REPLICATION: Yes; has also been used with different providers and populations.<br><br> OUTCOMES: Increased attention Improved behavior Decreased self-stimulation Enhanced auditory processing Improved cognitive functioning Decreased agitation Increased socialization Improved verbal skills Successful and safe self-expression Enhanced sensory-motor skills * The Individuals with Disabilities Education Act (IDEA) 20 U.S.C. §1400, provides that eligible children and youth with disabilities shall receive special education and related services. The law includes a definition of related services that the U.S.<br><br> Department of Education notes is not exhaustive. In addition, in June 2000, the U.S. Department of Education issued a letter of policy clarification related to the use of music therapy.<br><br> The letter reiterated the Department 9s continuing policy that c[i]f the IEP team determines that music therapy is an appropriate related service for a child, the team 9s determination must be reflected in the child 9s IEP, and the service must be provided at public expense . . . d [This interpretation stands with the 2006 regulations.] American Music Therapy Association 1 030208 OVERVIEW OF RESEARCH Trends regarding evidence-based review and recommendations regarding assessment and referral criteria based on current research and clinical evidence are emerging.<br><br> Music therapy is a particularly important intervention for children with autism spectrum disorders to engage and foster their capacity for flexibility, creativity, variability, and tolerance of change, in order to balance the more structured and behaviorally driven education required in school settings. One review protocol published in the Cochrane Collaborative of Systematic Reviews concluded music therapy was superior to cplacebo d therapy with respect to verbal and gestural communicative skills (verbal: 2 RCTs, n = 20, SMD 0.36 CI 0.15 to 0.57; gestural: 2 RCTs, n = 20, SMD 0.50 CI 0.22 to 0.79). The addition of music therapy intervention to a child 9s treatment program can have positive outcomes and may be an effective method for increasing joint attention skills in some children with autism.<br><br> The Council for Exceptional Children (CEC) published an article examining the effectiveness and efficacy of various intervention and music therapy was one of the few professions listed as promising based upon the systematic reviews of research complied and listed herein. " Gold, C., & Wigram, T. (2006).<br><br> Music therapy for autistic spectrum disorder. Cochrane Database of Systematic Reviews, 1. " Reitman, M.<br><br> R. (2005). Effectiveness of music therapy interventions on joint attention in children diagnosed with autism: A pilot study (Doctoral dissertation, Carlos Albizu University, 2005).<br><br> Dissertation Abstracts International, B66 (11). (AAT 3195248) " Umbarger, G.T. (2007).<br><br> State of the evidence regarding complementary and alternative medical treatments for autism spectrum disorders. Education and Training in Developmental Disabilities , 42(4): 437-447. " Wigram, T.<br><br> (2002). Indications in music therapy. British Journal of Music Therapy, 16 (1),11 328.<br><br> An overall positive direction is noted in meta-analytic reviews of the literature on the subject of music therapy and autism in terms of an array of outcomes related to both therapeutic and specific educational goals. Variations for effect size occur within the broad category of the autism spectrum disorders and tend to reflect the idiosyncratic nature of the disorders between individuals. This is typical across disciplines.<br><br> " Standley, J. M. (1996).<br><br> A meta-analysis on the effects of music as reinforcement for education/therapy objectives. Journal of Research in Music Education, 44 (2), 105 3133. " Whipple, J.<br><br> (2004). Music in intervention for children and adolescents with autism: A meta-analysis. Journal of Music Therapy, 41 (2), 90 3106.<br><br> (Listed in Database of Abstracts of Reviews of Effects produced by the Centre for Reviews and Dissemination, 2007.) Survey research indicates goal areas typically addressed by music therapists among persons with autism include language/communication, behavioral/psychosocial, cognitive, and musical, to perceptual/motor. Goal attainment was found to be high within one year, and parents and caregivers surveyed indicated subjects generalized skills/responses acquired in music therapy to non-music therapy environments. American Music Therapy Association 2 030208 " Kaplan, R.<br><br> S., & Steele, A. L. (2005).<br><br> An analysis of music therapy program goals and outcomes for clients with diagnoses on the autism spectrum. Journal of Music Therapy, 42 (1), 2 319. Survey research examining therapy trends of inpatient and habilitation care of autistic children revealed the most common therapies were physical therapy, speech, occupational, and music therapy.<br><br> One hundred and seventy-eight subjects out of 187 showed some improvement on the Childhood Autism Rating Scale (CARS). All modes of therapy were found to be useful. " Kielinen, M., Linna, S.<br><br> L., & Moilanen, I. (2002). Some aspects of treatment and habilitation of children and adolescents with autistic disorder in Northern-Finland.<br><br> International Journal of Circumpolar Health, 61 (Suppl. 2), 69 379. Observational study of the effect of music therapy on communication skills revealed significant gains in autistic children 9s communication behaviors as measured by Checklist of Communicative Responses/Acts Score Sheet (CRASS).<br><br> Commensurate decreases in scores were noted when music therapy intervention was removed. " Edgerton, C. (1994).<br><br> The effect of improvisational music therapy on the communicative behaviors of autistic children. Journal of Music Therapy, 21 (1), 31 362. Preschool children in an early intervention music therapy program show high on-task behavior during sessions and a high success rate in language development, social skills, cognitive concepts, motor skills, and music knowledge.<br><br> " Standley, J. M., & J. E.<br><br> Hughes (1996). Documenting developmentally appropriate objectives and benefits of a music therapy program for early intervention: A behavioral analysis. Music Therapy Perspectives, 14 (2), 87 394.<br><br> Research demonstrates the efficacy of music used in the curriculum to enhance literacy skills. Musical cueing is effective to improve word recognition, logo identification, print concepts and prewriting skills of children in early intervention programs. Shared reading paired with song rehearsal of text facilitates greater text accuracy than spoken rehearsal with kindergarten students.<br><br> " Colwell, C. M. (1994).<br><br> Therapeutic applications of music in the whole language kindergarten. Journal of Music Therapy, 31 (4), 238 3247. " Register, D.<br><br> (2001). The effects of an early intervention music curriculum on pre-reading/ writing. Journal of Music Therapy, 38 (3), 239 3248.<br><br> " Standley, J., & Hughes, J. (1997). Evaluation of an early intervention music curriculum for enhancing pre-reading/writing skills.<br><br> Music Therapy Perspectives, 15, 79 386. Selected verbal language and speech skills are enhanced through music activities in special education populations. Musical presentation of new vocabulary words results in an increased number of words learned and transferred in elementary school-age American Music Therapy Association 3 030208 children.<br><br> Music is effective as a prompt and reinforcer to increase verbal response in preschool-age children with limited verbal communication. " Braithwaite, M., & Sigafoos, J. (1998).<br><br> Effects of social versus musical antecedents on communication responsiveness in five children with developmental disabilities. Journal of Music Therapy, 35 (2), 88 3104. " Buday, E.<br><br> M. (1995). The effects of signed and spoken words taught with music on sign and speech imitation by children with autism.<br><br> Journal of Music Therapy, 32 (3), 189 3202. Research supports the use of music to structure and organize information in order to increase learning and retention of number concepts. Sequential verbal information, such as telephone numbers and multiplication tables, set to melodic and rhythmic patterns are more effectively memorized and recalled than through non-music presentation.<br><br> " Claussen, D., & Thaut, M. (1997). Music as a mnemonic device for children with learning disabilities.<br><br> Canadian Journal of Music Therapy, 5, 55 366. " Wolfe, D., & Hom, C. (1993).<br><br> Use of melodies as structural prompts for learning and retention of sequential verbal information by preschool students. Journal of Music Therapy, 30 (2), 100 3118. Music-facilitated interactions and structured instrument playing are effective to improve social skills in school-age populations.<br><br> Social problem solving skills in 5-year- old students are increased on a long-term basis through creative musical activities. Positive affect induced by music helps to improve social problem solving skills in middle school students. " Bryan, T., Sullivan-Burstein, K., & Mathur, S.<br><br> (1998). The influence of affect on social- information processing. Journal of Learning Disabilities, 31 (5), 418 3426.<br><br> " Ulfarsdottir, L., & Erwin, P. (1999). The influence of music on social cognitive skills.<br><br> The Arts in Psychotherapy, 26 (2), 81 384. American Music Therapy Association 4 030208

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