Article

Effects of vibroacoustic music on challenging behaviors in individuals with autism and developmental disabilities

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Abstract

Vibroacoustic music has been proposed to be an effective treatment for individuals with developmental disorders and challenging behaviors. The present study experimentally tested the effects of vibroacoustic music on self-injurious, stereotypical, and aggressive destructive behaviors in 20 individuals with autism spectrum disorders and developmental disabilities. The participants were randomized into two groups in a randomized controlled trial evaluation. The first group received 10–20 min sessions with vibroacoustic music treatment for 5 weeks. Then the second group received the same treatment during the next 5 weeks. Behavior was assessed using the Behavior Problems Inventory in all participants before the treatment, after the first group had completed their treatment, and again after the second group had completed their treatment. In order to evaluate each session, the accompanying assistants assessed behavior on different scales after each session. In addition, the sessions were videotaped and analyzed minute by minute for challenging behaviors. The results revealed that vibroacoustic music reduced self-injurious, stereotypic, and aggressive destructive behaviors in the participants. In addition, the results indicated that the effect of vibroacoustic music was to some extent dependent on the participants’ diagnosis. Implications for vibroacoustic music theory and practice are discussed.

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... Other ethical and logistical considerations associated with this population -including, but not limited to, obtaining consent for participation, transportation to and from sessions, and compensation for participation-make this population relatively challenging to recruit. Nevertheless, we did identify four randomized controlled trials containing both a treatment group and a control group García-Villamisar and Dattilo, 2010;Lundqvist et al, 2009;Van Bourgondien et al, 2003). However, the process of randomization was clearly described in only three of these Lundqvist et al, 2009;Van Bourgondien et al, 2003), and all four studies provided inadequate descriptions of the inclusion and exclusion criteria as well as limited information on other potential neurodevelopmental factors that may have influenced participant performance. ...
... Nevertheless, we did identify four randomized controlled trials containing both a treatment group and a control group García-Villamisar and Dattilo, 2010;Lundqvist et al, 2009;Van Bourgondien et al, 2003). However, the process of randomization was clearly described in only three of these Lundqvist et al, 2009;Van Bourgondien et al, 2003), and all four studies provided inadequate descriptions of the inclusion and exclusion criteria as well as limited information on other potential neurodevelopmental factors that may have influenced participant performance. Thus, it is difficult to tell how representative the participants in the four studies were of the population as a whole (which, as mentioned, is heterogeneous in itself). ...
... Due to a very low proportion of studies that showed a significant effect of the intervention yet showed a high risk of bias, the quality of the evidence supporting the effectiveness of interventions to reduce aggressive/destructive behaviors in adults with ASD-3 was low. This outcome was investigated in 12 studies: Adelinis and Hagopian (1999), Boso et al (2007), Carminati et al (2007), Elliott et al (1994), Fava and Strauss (2010), Kaplan et al (2006), , Lundqvist et al (2009, McKee et al (2007, and Reese et al (1998). Two studies used recreational therapies as the intervention (Boso et al, 2007;Lundqvist et al, 2009), seven used behavioral techniques Carminati et al, 2007;Elliott et al, 1994;McClean et al, 2007;McNally et al, 1988;Reese et al, 1998), and three used multisensory rooms (Fava and Strauss, 2010;Kaplan et al, 2006;McKee et al, 2007). ...
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Article
There is face validity to the expectation that adults with level 3 autism spectrum disorder (ASD-3) will benefit from a range of psychoeducational interventions. This paper reviews the empirical evidence supporting the effectiveness of these interventions, many of which are currently used in clinical settings. We reviewed 56 peer-reviewed studies of psychoeducational interventions for adults with ASD-3, written in English and since 1968, that met our criteria. The reviewing team included educators, clinicians, researchers, and a biostatistician. The available literature was limited, and most, if not all, of the studies presented some significant methodological limitations. When using Cochrane's criteria to assess seven key outcome domains-activities of daily living, aggressive/destructive behaviors, emotional functioning, language/communication skills, self-injurious behaviors, stereotypy/mannerisms, and vocational skills-we found only moderately reliable evidence to support the effectiveness of interventions designed to improve emotional functioning in adults with ASD-3. The reliability of evidence relevant to the six other outcome domains was rated as low or very low. Based on this review, we suggest directions for future study of interventions for adults with ASD-3, including topics, subpopulations, and approaches that should be explored. We also propose some crucial changes in how future studies regarding this population should be designed, analyzed, and documented, while balancing clinical considerations with scientific/educational utility.
... The following preventative programs incorporate various low frequency programmes into their recommendations i.e.: Physioacoustic chairs (Hairo, 2002;Punkanen, 2004;Kärkkäinen, & Mitsui, 2006;King, Almeida, & Ahonen, 2009;Zheng, Sakari, Cheng, Hietikko, Moilanen, Timonen, Fagerlund, Kärkkäinen, Alèn, & Cheng, 2009), vibroacoustic programme also known as Vibroacoustic Therapy (VAT) (Skille, Weekes, & Wigram, 1989;Rüütel, 2002;Rüütel, Ratnik, Tamm, & Zilensk, 2004;Bergström-Isacsson, Julu, & Witt-Engerström, 2007;Lundqvist, Andersson, & Viding, 2008), Somatron (Brodsky, 2000). Another treatment program is the Whole-body-vibration (Fontana, Richardson, & Stanton, 2005;Haas, Turbanski, Kessler, & Schmidtbleicher, 2006). ...
... These then became the beginning threads of the thematic analysis (Borkan, 1999). When the descriptive categories began to emerge, it became obvious that some of them have similarities with mindfulness theory (Langer, 1989). ...
... It is concerned with discerning what constitutes the phenomenon" (Bruscia, 2005, p. 89). For the purpose of this article, they have been linked to mindfulness theory (Langer, 1989) and the findings that the cultivation of mindfulness can have a positive effect on well-being (Shapiro, Oman, Thoresen, Plante and Flinders, 2008). One of the main studies regarding the effects of mindfulness cultivation on well-being was done in 2008 at Santa Clara University in California. ...
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Article
Low frequency sound has many applications to medicine but the efficacy and effectiveness of low frequency sound treatment in health prevention remains unclear. The purpose of this study was to explore the perspectives and potentials of physioacoustic chair's low frequency sound treatment when applied to daily activities among a sample of music students, faculty and/or staff, and to examine how participants view the benefits of the intervention for their well-being, health and health-related activities. The results show that the physioacoustic low frequency treatment added to participants' subjective well-being by increasing their physical and emotional relaxation level, decreasing pain and stress, and increasing emotional enrichment and concentration. The study served as a pilot, to confirm stakeholder interest and to inform the feasibility of a larger study.
... The following preventative programs incorporate various low frequency programmes into their recommendations i.e.: Physioacoustic chairs (Hairo, 2002;Punkanen, 2004;Kärkkäinen, & Mitsui, 2006;King, Almeida, & Ahonen, 2009;Zheng, Sakari, Cheng, Hietikko, Moilanen, Timonen, Fagerlund, Kärkkäinen, Alèn, & Cheng, 2009), vibroacoustic programme also known as Vibroacoustic Therapy (VAT) (Skille, Weekes, & Wigram, 1989;Rüütel, 2002;Rüütel, Ratnik, Tamm, & Zilensk, 2004;Bergström-Isacsson, Julu, & Witt-Engerström, 2007;Lundqvist, Andersson, & Viding, 2008), Somatron (Brodsky, 2000). Another treatment program is the Whole-body-vibration (Fontana, Richardson, & Stanton, 2005;Haas, Turbanski, Kessler, & Schmidtbleicher, 2006). ...
... These then became the beginning threads of the thematic analysis (Borkan, 1999). When the descriptive categories began to emerge, it became obvious that some of them have similarities with mindfulness theory (Langer, 1989). ...
... It is concerned with discerning what constitutes the phenomenon" (Bruscia, 2005, p. 89). For the purpose of this article, they have been linked to mindfulness theory (Langer, 1989) and the findings that the cultivation of mindfulness can have a positive effect on well-being (Shapiro, Oman, Thoresen, Plante and Flinders, 2008). One of the main studies regarding the effects of mindfulness cultivation on well-being was done in 2008 at Santa Clara University in California. ...
Full-text available
Article
Low frequency sound has many applications to medicine but the efficacy and effectiveness of low frequency sound treatment in health prevention remains unclear. The purpose of this study was to explore the perspectives and potentials of physioacoustic chair’s low frequency sound treatment when applied to daily activities among a sample of music students, faculty and/or staff, and to examine how participants view the benefits of the intervention for their well-being, health and health-related activities. The results show that the physioacoustic low frequency treatment added to participants’ subjective well-being by increasing their physical and emotional relaxation level, decreasing pain and stress, and increasing emotional enrichment and concentration. The study served as a pilot, to confirm stakeholder interest and to inform the feasibility of a larger study.
... However, there was a significant interaction effect with the age group, and the authors interpreted their findings with caution. Lundqvist et al. (2009) found that vibroacoustic music reduced challenging behaviours, in children with ASD, as well as reduced the frequency of self-injurious behaviours [60]. A study conducted by Portnova et al. (2018) found that children with ASD perceive most pieces of music similarly to neurotypical children except in one musical fragment, where children with ASD found the musical fragment to be "angry and frightening", whereas neurotypical children perceived the fragment as "sad" [61]. ...
... However, there was a significant interaction effect with the age group, and the authors interpreted their findings with caution. Lundqvist et al. (2009) found that vibroacoustic music reduced challenging behaviours, in children with ASD, as well as reduced the frequency of self-injurious behaviours [60]. A study conducted by Portnova et al. (2018) found that children with ASD perceive most pieces of music similarly to neurotypical children except in one musical fragment, where children with ASD found the musical fragment to be "angry and frightening", whereas neurotypical children perceived the fragment as "sad" [61]. ...
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Article
The prevalence of autism spectrum disorders (ASD) is globally increasing, and the current available interventions show variable success. Thus, there is a growing interest in additional interventions such as music therapy (MT). Therefore, we aimed to provide a comprehensive and systematic review of music and people with, or at risk of, ASD. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and used PubMed, PsycINFO, and Web of Science as databases, with “music”, “music therapy”, “autism spectrum disorder”, and “ASD” as search terms. Among the identified and screened articles, 81 out of 621 qualified as scientific studies involving a total of 43,353 participants. These studies investigated the peculiarities of music perception in people with ASD, as well as the effects of music and MT in this patient group. Most of the music-based interventions were beneficial in improving social, emotional, and behavioural problems. However, the availability of studies utilizing a rigorous randomized controlled trial (RCT) design was scarce. Most of the studies had a small sample size, and the applied therapeutic and scientific research methods were heterogeneous.
... They found that chills coupled with EDRs are relatively rare events, supporting previous findings from [12], [13], and that the musical event that triggered most chills was the entrance of a singing voice. Lundqvist and Juslin [14] measured EDL among other signals from a group of 32 musically untrained university students. ...
... The authors found that positive music was associated with higher self-reported arousal. They also found a significant increase in EDL from baseline measures for both the positive and negative inductions, contrasting with [14], [16], [18]. Interestingly, they reported that during the recovery period, self-reported affect returned to baseline levels within two minutes, but EDL remained above the baseline for the entire six-minute period. ...
... Οι έρευνες που εστιάζουν πιο συγκεκριµένα στον αυτοτραυµατισµό είναι αρκετά περιορισµένες. Μέσα από την ανασκόπηση της υπάρχουσας βιβλιογραφίας και αρθρογραφίας εντοπίστηκαν τρεις έρευνες που επικεντρώνονται στη µείωση του αυτοτραυµατισµού µε τη χρήση µουσικής (Ford 1999; Lundqvist, Andersson & Viding 2009; Wigram 1992) και µόνο µια από αυτές επικεντρώνεται στα άτοµα µε αυτισµό (Lundqvist, Andersson & Viding 2009). Στην έρευνα του Ford (1999) γίνεται συγκριτική µελέτη µεταξύ µουσικής και άλλων τρόπων αντιµετώπισης της αυτοτραυµατικής συµπεριφοράς µιας εικοσιτριάχρονης κοπέλας µε αναπτυξιακές δυσκολίες, αναπηρία, µειωµένες ικανότητες επικοινωνίας καθώς και προβλήµατα όρασης. ...
... Οι έρευνες που εστιάζουν πιο συγκεκριµένα στον αυτοτραυµατισµό είναι αρκετά περιορισµένες. Μέσα από την ανασκόπηση της υπάρχουσας βιβλιογραφίας και αρθρογραφίας εντοπίστηκαν τρεις έρευνες που επικεντρώνονται στη µείωση του αυτοτραυµατισµού µε τη χρήση µουσικής (Ford 1999; Lundqvist, Andersson & Viding 2009; Wigram 1992) και µόνο µια από αυτές επικεντρώνεται στα άτοµα µε αυτισµό (Lundqvist, Andersson & Viding 2009). Στην έρευνα του Ford (1999) γίνεται συγκριτική µελέτη µεταξύ µουσικής και άλλων τρόπων αντιµετώπισης της αυτοτραυµατικής συµπεριφοράς µιας εικοσιτριάχρονης κοπέλας µε αναπτυξιακές δυσκολίες, αναπηρία, µειωµένες ικανότητες επικοινωνίας καθώς και προβλήµατα όρασης. ...
... More recent studies of VAT have also been focused on the effects of low-frequency sound on challenging behavior, 28 functional capacity, blood circulation, and bone metabolism in frail older adults, 8 and on the control functions of the autonomic system in people with Rett syndrome (RTT). 29 In randomized controlled trial of Lundqvist et al, 28 experimental tests were carried out to investigate whether VAM had an effect on self-injurious, stereotypical, and aggressive destructive behavior in participants with autism spectrum disorders (ASDs) and developmental disabilities. ...
... More recent studies of VAT have also been focused on the effects of low-frequency sound on challenging behavior, 28 functional capacity, blood circulation, and bone metabolism in frail older adults, 8 and on the control functions of the autonomic system in people with Rett syndrome (RTT). 29 In randomized controlled trial of Lundqvist et al, 28 experimental tests were carried out to investigate whether VAM had an effect on self-injurious, stereotypical, and aggressive destructive behavior in participants with autism spectrum disorders (ASDs) and developmental disabilities. Twenty participants were randomly assigned to 1 of 2 groups. ...
Full-text available
Article
Vibroacoustic therapy (VAT), traditionally considered to be a physical and receptive type of music therapy intervention, uses pulsed, sinusoidal, low-frequency sound on a specially designed bed or chair. Today VAT is viewed as a multimodal approach, whereby the therapist works with the client’s physiological and psychological experiences, incorporating a mind–body approach. This article provides current knowledge in clinical practice emphasizing the systematic and documented implementations of VAT. This includes presentation and explication of the key elements of VAT, assessments, treatment plans and procedures, documentation, and evaluation of the treatment with recommendations for follow-up care in health and rehabilitation. Recent research is presented, and directions for future research are considered. Applicable views on clinical training and required competencies are outlined.
... In some contemporary cultures, there is little conceptual differentiation between dance, music and movement. It is widely accepted that we are emotionally touched by both dance and music [14,18,19]. Researchers have argued that it is the feeling of rhythm in a dance movement that is the basis for the experience of music ("music is movement"). ...
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Article
Transition to sustainability is a process that requires change on all levels of society from the physical to the psychological. This review takes an interdisciplinary view of the landscapes of research that contribute to the development of pro-social behaviors that align with sustainability goals, or what we call 'inner sustainability'. Engaging in musical and dance activities can make people feel trust and connectedness, promote prosocial behavior within a group, and also reduce prejudices between groups. Sustained engagement in these art forms brings change in a matter of seconds (such as hormonal changes and associated stress relief), months (such as improved emotional wellbeing and learning outcomes), and decades (such as structural changes to the brains of musicians and dancers and superior skills in expressing and understanding emotion). In this review, we bridge the often-separate domains of the arts and sciences by presenting evidence that suggests music and dance promote self-awareness, learning, care for others and wellbeing at individual and group levels. In doing so, we argue that artistic practices have a key role to play in leading the transformations necessary for a sustainable society. We require a movement of action that provides dance and music within a constructive framework for stimulating social sustainability.
... Music-as-therapy is an established intervention used to address communicative, emotional, cognitive, and motor impairments in individuals with ASD. In a recent review of music and movement therapy interventions for children with autism, Srinivasan and Bhat (2013) found that music-based therapies accounted for 12% of all autism interventions and for 45% of alternative treatment approaches occurring in school settings (Hess et al., 2008;Simpson et al., 2005); however, except for three randomized control trials (Gattino et al., 2011;Lim, 2010;Lundqvist et al., 2009), the reviewers found the overarching quality of the studies to be quite weak. Most utilized a pre-post comparison design using single subjects or small sample sizes and did not include a control group. ...
... For instance, another study supports the efficacy of VAT to reduce chronic pain, muscle tension, anxiety and sleep disorders [3]. Additionally, in a pilot study, conducted in subjects with autism, the results revealed that VAT reduced self-injurious, stereotypic movements, and aggressive-destructive behaviors in the participants [4]. Koike et al. [5] showed that VAT led to relaxation in the elderly people Nursing Home residents, decreasing depression and improving quality of sleep. ...
Conference Paper
Over the last decade Vibro-Acoustic Therapy (VAT) was used for several clinical applications. This paper investigates the use of AcusticA ® , an innovative VAT solution represented by a wooden chaise longue that follows the construction principles of a "musical instrument that stimulates the whole body" in relation to the sound frequencies produced by the music tracks. Ten healthy young subjects were enrolled for this study. Wearable sensors were used to monitor the human physiological response during the VAT session but also during a traditional acoustic therapy (AT) to highlight similarity and differences of those stimulations. Signals from heart activity, brain activity and electrodermal activity were analyzed to investigate the response during the non-stimulated and the stimulated phases. Additionally, two supervised classification algorithms were used to investigate whether the extracted instances could be grouped into two different groups. The results identify a trend of the attention and meditation features extracted from brain activity, which pointed out the relax efficacy of the VAT. Clinical Relevance-There are not significant differences (p<0.05) in the physiological response between the VAT and the AT stimulation, but during the VAT the alpha coefficients were significant different during the stimulated phase. Finally, the classification algorithms were able to classify the groups with an accuracy equal to 100% in the best case.
... In Sweden, a study called "The Impact of Vibro-Acoustic Music on the Behaviour of People with Autism and Developmental Disorders." The results of this study showed that vibroacoustic therapy reduced the aggressive behaviour of patients, improved well-being, participants were able to rest while receiving therapy [10]. Music has a positive effect on a baby who has not yet been born. ...
... The music vibrations harmoniously combine to produce a new type of relaxation for patients. Lundqvist and colleagues reported that vibroacoustic sound waves reduce anxiety and aggression in some patients, thus reducing the need for medical treatment [29]. Koike and colleagues reported that VAST improved the psychological symptoms of 15 nursing home residents with symptoms of depression [30]. ...
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Article
Background and objective: This study investigated the therapeutic effect of applying local body vibration (LBV) with built-in vibroacoustic sound on patients who had an anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Twenty-four participants were randomly classified into a LBV group (LBVG; n = 11) or a non-LBV group (nLBVG; n = 13). Both groups received the same program; however, the LBVG received LBV. Psychological measures included pain, anxiety, and symptoms; physiological measures included systolic blood pressure (SBP), diastolic blood pressure, heart rate (HR), breathing rate (BR), sympathetic activation (SA), parasympathetic activation (PSA), range of motion (ROM), and isokinetic muscle strength at Weeks 0, 4, and 8. Results: Among the psychophysiological variables, pain, anxiety, symptoms, SBP, BR, and SA were significantly reduced in both groups, whereas HR, PSA, isokinetic peak torque (PT) of the knee joint, and ROM were significantly improved only in the LBVG. Comparing both groups, a significant difference appeared in pain, symptom, SA, PSA, isokinetic PT, and ROM at Weeks 4 and 8. Conclusions: The results indicate that the LBV intervention mitigated the participants’ pain and symptoms and improved their leg strength and ROM, thus highlighting its effectiveness.
... Therefore, it can be concluded that the combination of music therapy with game therapy should be one of the main pillars for professionals and educators in the education and treatment of children with autism disorder (99). The emotional evacuation instigated by listening to music decreases the frequency and severity of stereotypical behaviors in autistic individuals (100). Many of the behavioral problems of children with autism disorder are due to the dysfunction in mirror neurons, and music therapy by activating these neurons in the brain can improve and reduce the problems of these children (101). ...
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Article
Abstract Introduction: Side effects of most synthetic drugs used in the treatment of various diseases have led researchers around the world to conduct studies on the identification of alternative therapies. In this vein, the present study aims to review the research carried out in association with the therapeutic effects of music used in the treatment of relatively common diseases. Methods: To develop this review article, researchers conducted some computer search using keywords in databases including Google scholar, SID, Iranmedex, Medline, PubMed, Springer, Science Direct, ProQuest, and ISC, and collected and probed the results of over 100 published articles from 2000 to 2018 dealing with the effect of music therapy in the treatment of 12 relatively common diseases. Results: The findings show that music therapy has a positive effect on the treatment of the diseases studied. Conclusion: Music can have positive effects on pain, sleep disorders, learning, memory, IQ, depression, anxiety and special diseases such as schizophrenia and autism.Hosseini SE, Hosseini SA. Therapeutic effects of music: a review. Rep Health Care. 2018; 4 (4): 1- 13.
... Vibration is the most direct bodily aspect of music, for example, the felt physical experience of rhythm and beat with the whole body develops the client's sense of structure and internal order (Pellitteri, 2000). Research has shown that vibroacoustic music therapy can reduce self-injurious, stereotypic, and aggressive destructive behaviors (Lundqvist, Andersson & Viding, 2009;Wigram, 1997). Vibroacoustic therapy uses the physical vibration of sound for the deepest, cellular level of body stimulation with specially designed devices. ...
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Book
From the perspective of music and wellbeing in people with severe disabilities, this is a valuable and interesting textbook. The author L. Tiszai has integrated well-established traditional approaches to infant research and innate human musicality with new work in the expanding fields of music and wellbeing and embodied music interaction. The book is intended for learners who may have little or no experience reading professional international journals, but would benefit from a substantial research base in understanding how these emerging areas can contribute to working with nonverbal children and adults with severe disabilities. The book is organized into eight chapters. The first half of the book focuses on the theoretical background; the second half is dedicated to practice. The subject matter is accurate and has an appropriate reading level for the students who will be using the material. The book has been written in a style that will hold the student’s attention; the end-of-chapter questions will be interesting for the learners. To conclude her textbook on musical interventions for nonverbal children and adults with severe disabilities, L. Tiszai pleads for a fair and unbiased treatment of various groups in society. In doing so she motivates learners to acknowledge the importance of inclusive communities, where the needs and talents of the most vulnerable members of society are taken in consideration.
... Therefore, it can be concluded that the combination of music therapy with game therapy should be one of the main pillars for professionals and educators in the education and treatment of children with autism disorder (99). The emotional evacuation instigated by listening to music decreases the frequency and severity of stereotypical behaviors in autistic individuals (100). Many of the behavioral problems of children with autism disorder are due to the dysfunction in mirror neurons, and music therapy by activating these neurons in the brain can improve and reduce the problems of these children (101). ...
Full-text available
Article
Introduction: Side effects of most synthetic drugs used in the treatment of various diseases have led researchers around the world to conduct studies on the identification of alternative therapies. In this vein, the present study aims to review the research carried out in association with the therapeutic effects of music used in the treatment of relatively common diseases. Methods: To develop this review article, researchers conducted some computer search using keywords in databases including Google scholar, SID, Iranmedex, Medline, PubMed, Springer, Science Direct, ProQuest, and ISC, and collected and probed the results of over 100 published articles from 2000 to 2018 dealing with the effect of music therapy in the treatment of 12 relatively common diseases. Results: The findings show that music therapy has a positive effect on the treatment of the diseases studied. Conclusion: Music can have positive effects on pain, sleep disorders, learning, memory, IQ, depression, anxiety and special diseases such as schizophrenia and autism.
... This discussion will be based on findings from randomized controlled trials and controlled clinical trials published in peerreviewed journals from 2000 to 2016. For systematic and narrative reviews of recent clinical studies in music therapy for autism, including case studies and single-group studies, see Accordino, Comer, and Heller (2007) It is important to clarify that music therapy interventions exclude sound therapies (Corbett, Shickman, & Ferrer, 2008;Lundqvist, Andersson, & Viding, 2009;Sinha et al., 2006), background music (Carnahan, Basham, & Musti-Rao, 2009), robotic interventions (Srinivasan et al., 2016), or Melodic Based Communication Therapy (MBCT) (Sandiford, Mainess, & Daher, 2013). ...
Chapter
From neuroimaging and behavioral research investigating the unique relation between music and preserved cognitive skills to the clinical use of music to mediate the developmental and therapeutic processes, music has played a prominent role in clinical and research literature on autism spectrum disorder. In this chapter, we discuss the current state of clinical research in the area of music-based intervention for autism. We start outlining recent neuroimaging and behavioral research investigating the unique relation between music and preserved cognitive skills in autism. The next sections discuss key concepts underlying Neurologic Music Therapy and the impact of the neuroscience model for clinical and research practices. The discussion of the current state of clinical research is centered on results from controlled clinical studies investigating the effects of music-based interventions to address core features of autism, such as communication, social, and emotional skills. To conclude, we discuss new directions to expand the clinical scope of music-based interventions, including under-researched functions such as motor and attention control. ** This publication is available online at https://link.springer.com/chapter/10.1007/978-3-030-13027-5_20 and https://nmtacademy.files.wordpress.com/2019/05/thaut-braunjanzen2019_chapter_neurologicmusictherapy.pdf?fbclid=IwAR1cUOcS5lMRPlFvSHDM_djbKnf2Rw9jzEYr8weVqH6lrKmjdJUVKmOUSt8
... Music training led to improvements in social engagement skills including eye contact and reciprocal interactions with caregivers and peers in children with ASDs (Kern & Aldridge, 2006;Kim et al., 2008;Wimpory et al., 1995). Similarly, children with autism reduced the frequencies of problem behaviors following active and passive musical therapies involving listening, singing, and instrument playing (Boso et al., 2007;Brownell, 2002;Lundqvist, Andersson, & Viding, 2009;Orr, Myles, & Carlson, 1998;Pasiali, 2004;Rapp, 2007). In fact, music sessions led to greater joy and compliance with therapy compared to toy play in children with ASDs . ...
Article
The current randomized controlled trial compared the effects of novel, embodied, rhythm interventions - music and robotic - with those of a standard-of-care, stationary, academic intervention on the social communication, behavioral, and motor skills of 36 children with Autism Spectrum Disorders (ASDs) between 5 and 12 years of age. Children were matched on age, level of functioning, and services received prior to randomization. The study lasted for 10 weeks with the pretest and posttest sessions conducted during the first and last weeks of the study. Training was provided in the intermediate 8 weeks, with 2 sessions provided each week. Between-group differences and within-group changes in social attention and social verbalization skills, repetitive/problem behaviors, and motor performance were assessed using task-specific tests within the training context and standardized tests outside the training context. The music-based context afforded greater social monitoring and spontaneous initiation of engagement compared to the robotic and academic contexts. The robotic context promoted fixation on robots and greater scripting and self-directed vocalizations, limiting opportunities for interactions with social partners. Due to the novelty of the training activities, the movement groups initially demonstrated greater negative behaviors compared to the academic group. Although the academic group afforded responsive verbalization, children spent a majority of time in non-social object-based engagement. In terms of task-specific training effects, the music group showed an increase in duration of social verbalization and reductions in imitation error scores and frequency of negative behaviors across weeks. Although the robot group demonstrated small improvements in imitation scores, children demonstrated a decrease in engagement with the context across training sessions. The academic group improved their fine motor imitation scores, but did not demonstrate any changes in social attention, social verbalization, and repetitive behaviors across sessions. In terms of generalized changes in skills, the music and academic groups demonstrated improvements in responsive joint attention following training. Consistent with training demands, the movement groups improved gross motor skills, whereas the academic group improved fine motor skills, on a standardized test of motor performance. Overall, movement-based music contexts hold promise in remediating the impairments associated with autism and warrant future investigation.
... Moreover, children reduced levels of negative affect with a concurrent increase in interested affect from the early to the late session. Our findings fit with other studies that found a reduction in problem behaviors as well as an increase in enjoyment, positive affect, and compliance following active and passive music therapies involving listening, singing, and instrument playing (Boso et al., 2007;Brownell, 2002;Kim et al., 2009;Lundqvist, Andersson, & Viding, 2009;Orr, Myles, & Carlson, 1998;Pasiali, 2004;Rapp, 2007). The non-intimidating yet enjoyable nature of musical experiences could induce positive affective states, improve compliance, and reduce negative and problem behaviors in children with ASD (Srinivasan [ 1 6 8 _ T D $ D I F F ] and Bhat, 2013a). ...
Article
Repetitive behaviors and poor affect regulation are commonly seen in children with Autism Spectrum Disorder (ASD). We compared the effects of two novel interventions - rhythm and robotic therapies, with those of a standard-of-care intervention, on the repetitive behaviors and affective states of 36 children with ASD between 5 and 12 years using a randomized controlled trial design. We coded for frequencies of sensory, negative, and stereotyped behaviors and the duration of positive, negative, and interested affective states in children during early, mid, and late training sessions. In terms of repetitive behaviors, in the early session, the rhythm and robot groups engaged in greater negative behaviors, whereas the comparison group engaged in greater sensory behaviors. With training, the rhythm group reduced negative behaviors whereas there were no training-related changes in the other groups. In terms of affective states, the rhythm and robot groups showed greater negative affect, whereas the comparison group demonstrated greater interested affect across all sessions. With training, the rhythm group showed a reduction in negative affect and an increase in interested affect whereas the robot group showed a reduction in positive affect. Overall, it appears that rhythm-based interventions are socially engaging treatment tools to target core impairments in autism.
... The main flaw of this study was the lack of a standardized outcome measure. Vibroacoustic music has been investigated in individuals with mental retardation and also in a small sample of patients affected by autism [64]. The randomized study was focused on self-injuring, aggressive and stereotypical behavior and demonstrated that vibroacoustic music may be useful in reducing these aspects. ...
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Article
Background. Complementary and alternative medicine (CAM) represents a popular therapeutic option for patients with autism spectrum disorder (ASD). Unfortunately, there is a paucity of data regarding the efficacy of CAM in ASD. The aim of the present systematic review is to investigate trials of CAM in ASD. Material and Methods. We searched the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, Psychology and Behavioral Sciences Collection, Agricola, and Food Science Source. Results. Our literature search identified 2687 clinical publications. After the title/abstract screening, 139 publications were obtained for detailed evaluation. After detailed evaluation 67 studies were included, from hand search of references we retrieved 13 additional studies for a total of 80. Conclusion. There is no conclusive evidence supporting the efficacy of CAM therapies in ASD. Promising results are reported for music therapy, sensory integration therapy, acupuncture, and massage.
... Moreover, children reduced levels of negative affect with a concurrent increase in interested affect from the early to the late session. Our findings fit with other studies that found a reduction in problem behaviors as well as an increase in enjoyment, positive affect, and compliance following active and passive music therapies involving listening, singing, and instrument playing (Boso et al., 2007;Brownell, 2002;Kim et al., 2009;Lundqvist, Andersson, & Viding, 2009;Orr, Myles, & Carlson, 1998;Pasiali, 2004;Rapp, 2007). The non-intimidating yet enjoyable nature of musical experiences could induce positive affective states, improve compliance, and reduce negative and problem behaviors in children with ASD (Srinivasan [ 1 6 8 _ T D $ D I F F ] and Bhat, 2013a). ...
... Improvisational music therapy (the specific use of music by a credentialed music therapist; Certification Board of Music Therapists, 2009) was found to be an effective intervention for facilitating joint attention behaviors and nonverbal social communication skills for preschool children diagnosed with autism (Kim, Wigram, & Gold, 2008). Similarly, music therapy was used as an intervention in reducing self-injurious behaviors and aggressive and destructive behaviors in children diagnosed with autism spectrum disorders and developmental disabilities (Lundqvist, Andersson, & Viding, 2009). Music was demonstrated as a therapeutic intervention with blind children to help develop sensorimotor skills, social and communication skills, cognitive skills, and emotional skills (Kern & Wolery, 2002) and similarly as an intervention for children with hearing impairments (Jahns, 2001). ...
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The creative and expressive use of music can be a powerful therapeutic intervention with children and adolescents who have experienced trauma. In this article, a model for increasing self-awareness and self-understanding including materials, facilitation, and processing of musical activities in group format is presented. Creative activities such as the “feelings ensemble” and “feelings symphony” are illustrated in a case application with children transitioning back to school following a tornado. Implications for the role of expressive arts activities in the aftermath of a natural disaster are discussed.
... Moreover, these studies involved a pre-post comparison of outcomes in the treatment group and did not include a control group. The overall quality of studies was poor except for three published randomized controlled trials (Lundqvist et al., 2009;Lim, 2010;Gattino et al., 2011). The majority of the studies focused on addressing the communication impairments in autism. ...
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The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of ASDs, explain why music and movement therapies are a powerful clinical tool, as well as describe mechanisms and offer evidence in support of music therapies for children with ASDs. We will support our claims by reviewing results from brain imaging studies reporting on music therapy effects in children with autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research.
... Habit reversal and differential reinforcement of other behavior improve stereotypic behaviors in non‐autistic children [68] . Vibroacoustic music decreases stereotypic behaviors in individuals with autism and developmental disabilities [69] . The peer‐ mediated intervention and social engagement and educating social interaction decrease stereotypic behavior of children with autism [70,71] . ...
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This is an overview of stereotypic behavior in autistic spectrum disorder (ASD). This repetitive, nonfunctional, fixed pattern of behavior is associated with autism severity but it is not specific for ASD. There are a wide range of behaviors mentioned as stereotypies. It usually starts in early childhood and its severity is associated with outcomes and severity of autism in adolescence and adulthood. It is usually co-morbid with other psychiatric problems and its pathophysiology is not exactly known. Management is most likely behavioral. There are some reports regarding efficacy of antipsychotics for its management. Further studies should be conducted to improve our knowledge about it and our ability to differentiate it from tics.
... A study in [19] detailed the recovery of a pianist from stroke. Such findings motivated us to investigate the potential of BCI in music for composition encompassing the topics of gaming [20], entertainment and possibly rehabilitation (for e.g., in the treatment of autism [21][22]). We believe that there was a need to link BCI systems with music 1) to investigate other communication channel than spelling words, 2) to explore new BCI applications which could also provide novel ways of entertainment, and finally, 3) to stimulate brain-storming on future BCI research avenues while reviewing the limitations of the current state-of-the-art. ...
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In this paper we present, for the first time in Brain-Computer Interface (BCI) research, a novel application for music composition. We developed, based on the I<sup>2</sup>R NeuroComm BCI platform, a novel Graphical User Interface (GUI) to allow composition of short melodies by selecting individual musical notes. The user can select any individual musical key (quarter note with Do, Ré, Mi, Fa, Sol, La, Si, Do, etc.), insert a silence (quarter rest), delete (Del) the last note to correct the composition, or listen (Play) to the final melody, shown in text form and as a musical partition. Our BCI system for music composition has been successfully demonstrated and shown to be, with very short training time, effective and easy to use. This work is the first step towards a more intelligent BCI system that will extend current BCI-based Virtual Reality (VR) navigation for e.g. exploring a Virtual Synthesizer Museum/shop, in which the user would first move around within the virtual museum/shop and at the point of interest would try the synthesizer by composing music. More advanced modes (e.g. musical puzzle) with various levels of difficulty will be added in future developments as well as using the Open Vibe environment and mobile platforms such as the Apple's iPAD.
... The therapy is based on practical experience as well as research, both illustrating that low-frequency acoustic vibrations (27-113 Hz) can have positive effects on several symptoms. For instance, in an intervention period of five weeks, PAS therapy has led to a decrease in self-wounding, stereotype, and aggressive self-destructive behavior in patients with autism and development disorders [11]. Furthermore, a PAS therapy programme for the elderly has proven to improve their general wellbeing and functional capacity: bone formation and mobility improved, cholesterol levels were lower, and blood circulation was stimulated [12]. ...
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Many older people with neuropsychiatric disorders such as Alzheimer's disease and frontotemporal dementia suffer from sleeping problems and often show nocturnal restlessness. Professionals and informal carers face considerable problems in solving these problems. Attempts to diminish these problems with medication in a safe and responsible manner have proven hardly effective or not effective at all. Therefore, nowadays the focus lies more on non-pharmacological solutions, for example by influencing environmental factors. There are indications that treatment with low-frequency acoustic vibrations, that is Physio Acoustic Sound (PAS) therapy, has a positive effect on sleeping problems. Therefore we study the effectiveness of PAS therapy in demented patients with nocturnal restlessness. In a randomized clinical trial, 66 nursing home patients will be divided into two groups: an intervention group and a control group. For both groups nocturnal restlessness will be measured with actiwatches during a period of six weeks. In addition, a sleep diary will be filled in.For the intervention group the baseline will be assessed, in the first two weeks, reflecting the existing situation regarding nocturnal restlessness. In the next two weeks, this group will sleep on a bed identical to their own, but with a mattress containing an in-built PAS device. As soon as the patient is lying in bed, the computer programme inducing the vibrations will be switched on for the duration of 30 min. In the last two weeks, the wash-out period, the measurements of the intervention group are continued, without the PAS intervention.During the total study period, other relevant data of all the implied patients will be recorded systematically and continuously, for example patient characteristics (data from patient files), the type and seriousness of the dementia, occurrence of neuropsychiatric symptoms during the research period, and the occurrence of intermittent co-morbidity. If PAS therapy turns out to be effective, it can be of added value to the treatment of nocturnal restlessness in demented patients. Non-pharmacological PAS therapy is not only safe and patient-friendly, but it can also be widely used in a simple and relatively inexpensive way, both in institutions such as nursing homes and residential homes for the elderly, and at home. Ultimately, this may lead to a decrease in the frequent and still common use of psychotropic drugs. In addition, care needs of demented patients also may decrease as well as the number of preventable admissions to care institutions. Netherlands Trial Register (NTR): NTR3242.
... In addition, the psychometric quality of the BPI-01 has been demonstrated in other languages, such as Dutch (Lambrechts et al., 2009) and Romanian (Mircea et al., 2010). The BPI-01 has also been translated into Swedish and has been used to assess effects of interventions to reduce self-injurious behaviors (Lundqvist, Andersson, & Viding, 2009). The results indicate that the BPI-01 is sufficiently sensitive to detect changes and is therefore usable for intervention evaluation. ...
Article
The aim of the present study was to evaluate the psychometric properties and factor structure of the Behavior Problems Inventory (BPI-01) in a community population. The Swedish version of the BPI-01 was administered by interviewing care staff of all adults (n = 915) with administratively defined intellectual disabilities (IDs) living in Örebro County, Sweden. Sixty-two percent of the participants had at least one behavior problem. Altogether, 30.9% showed self-injurious behavior, 41.3% stereotyped behavior, and 34.8% aggressive/destructive behavior. All but the self-injurious behavior scale reached acceptable levels of internal consistency. Confirmatory factor analysis supported the unidimensionality of the subscales as well as the proposed three factor structure of the original BPI-01. The present study demonstrates that the three subscales are highly similar constructs across different language and cultural settings, and that the BPI-01 is applicable in research on populations with varying mental functioning, diagnoses, ages, and living arrangements.
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This study explored the effect of music on the driving performance of experienced young adult drivers with and without autism spectrum disorder (ASD) using an interactive driving simulator with two types of scenarios. A 2 (Group: autism/neurotypical) × 2 (Music: music/no music) × 2 (Scenario: hazards/wayfinding) factorial design was used with the order of scenarios and music conditions counterbalanced. Participants were 34 neurotypical drivers and 5 drivers with ASD, all with at least 3 years of driving experience. Paired sample t-tests demonstrated no effect of music for any condition. Overall, the drivers with ASD had higher performance means than the neurotypical group with significant differences in the wayfinding scenario and the category for following regulations. Neurotypical drivers had better performance on the wayfinding scenario than the hazard scenario in maneuvers and being attentive to the environment. Although this study had a low number of drivers with ASD, it suggests drivers with ASD can perform better than neurotypical drivers, possibly because they follow road rule guidelines more consistently than neurotypical peers. In addition, this is the first study to examine wayfinding skills in teens/young adults with and without ASD.
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Objective: In this study, we aimed to investigate the effect of Music Therapy (MT) along with Play Therapy (PT) on increasing appropriate Social Behaviors (SBs) and decreasing inappropriate stereotyped behaviors of children with autism. Methods: This is an experimental study, and we used pre-test and post-test control group design to analyze the data. The study sample included 30 children with autism between the ages of 6 and 12 years who were randomly selected and assigned into experimental and control groups. To collect data, the Autism Assessment Quotient, Teacher Assessment of Social Behavior Questionnaire, and Gilliam’s Autism Rating Subscale were used. In this study, the experimental group underwent a total of 15 sessions of training with MT along with PT for a period of 7 weeks, whereas the control group did not receive such training. Results: Analysis of covariance (ANCOVA) showed that training with MT along with PT increased pro-social subscales (P=0.001) and decreased shyness/withdrawal subscales (P=0.001) and that stereotyped behaviors in children with autism decreased (P=0.01). Conclusion: MT along with PT increased appropriate SBs and decreased inappropriate stereotyped behaviors of children with autism. Therefore, we can conclude that strengthening MT and PT skills should be considered one of the basic axes for professionals and educators in training and curing children with autism
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Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by markedly impaired social interaction, impaired communication, and restricted/repetitive patterns of behavior, interests, and activities. In addition to challenges caused by core symptoms, maladaptive behaviors such as aggression can be associated with ASD and can further disrupt functioning and quality of life. For adults with ASD, these behaviors can portend adverse outcomes (e.g., harm to others or to the individual with ASD, hindering of employment opportunities, criminal justice system involvement). This article reviews the scientific literature to provide an update on evidence-based interventions for aggression in adults with ASD. Method: A search of the electronic databases CINAHL, EMBASE, and PsycINFO was conducted using relevant search terms. After reviewing titles, abstracts, full-length articles, and reference lists, 70 articles were identified and reviewed. Results: The strongest (controlled trial) evidence suggests beneficial effects of risperidone, propranolol, fluvoxamine, vigorous aerobic exercise, and dextromethorphan/quinidine for treating aggression in adults with ASD, with lower levels of evidence supporting behavioral interventions, multisensory environments, yokukansan, and other treatments. Conclusions: Additional randomized, controlled trials using consistent methodology that adequately addresses sources of bias are needed to determine which treatments are reliably effective in addressing aggression in adults with ASD. In the meantime, considering efficacy and adverse effect/long-term risk profiles, a practical approach could start with functional assessment-informed behavioral interventions along with encouragement of regular, vigorous aerobic exercise to target aggression in adults with ASD, with pharmacotherapy employed if these interventions are unavailable or inadequate based on symptom acuity.
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Background Non‐pharmacological interventions are recommended for the treatment of challenging behaviours in individuals with intellectual disabilities by clinical guidelines. However, evidence for their effectiveness is ambiguous. The aim of the current meta‐analysis is to update the existing evidence, to investigate long‐term outcome, and to examine whether intervention type, delivery mode, and study design were associated with differences in effectiveness. Method An electronic search was conducted using the databases Medline, Eric, PsychINFO and Cinahl. Studies with experimental or quasi‐experimental designs were included. We performed an overall random‐effect meta‐analysis and subgroup analyses. Results We found a significant moderate overall effect of non‐pharmacological interventions on challenging behaviours (d = 0.573, 95% CI [0.352–0.795]), and this effect appears to be longlasting. Interventions combining mindfulness and behavioural techniques showed to be more effective than other interventions. However, this result should be interpreted with care due to possible overestimation of the subgroup analysis. No differences in effectiveness were found across assessment times, delivery modes or study designs. Conclusions Non‐pharmacological interventions appear to be moderately effective on the short and long term in reducing challenging behaviours in adults with intellectual disabilities.
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Research
Musiikkiterapia tukee kehitysvammaisen kuntoutujan toimintakykyä ja osallistumista Musiikkiterapia on avuksi erityisesti silloin, kun kuntoutujan on vaikeaa kommunikoida sanallisesti. Musiikkiterapian avulla voidaan edistää eri-ikäisten ja eriasteisesti kehitysvammaisten kuntoutujien toimintakykyä usealla osa-alueella. Terapiamuoto tukee kuntoutujien fyysistä, psyykkistä, kognitiivista ja sosiaalista toimintakykyä, osoittaa tuore tutkimus. ­– Musiikki on motivoiva kuntoutuksen väline. Musiikillinen ilmaisu, vuorovaikutus ja toiminta onnistuvat, vaikka kuntoutujalla olisi vaikeuksia sanallisessa kommunikoinnissa, sanoo tutkija, musiikkiterapeutti, psykologi Päivi Saukko. – Sekä terapiassa että arkielämässä musiikki tarjoaa yhteisen kiinnostuksen kohteen, johon jokainen ihminen voi osallistua omalla tavallaan, hän pohtii. Toimintarajoitteet lieventyvät, vuorovaikutustaidot kehittyvät Kehitysvammaisilla lapsilla musiikkiterapia tukee varhaisen vuorovaikutuksen ja kommunikoinnin valmiuksia sekä lapsen ja vanhemman suhteen kehittymistä. Kouluikäisillä lapsilla se edistää oppimisvalmiuksia, tunne-elämän toimintoja sekä vuorovaikutustaitoja. Tutkimuksen perusteella arjen suoriutumista ja osallistumista haittaavat toimintarajoitteet lieventyivät niin nuorilla, aikuisilla kuin ikääntyneilläkin kehitysvammaisilla. – Lisäksi musiikkiterapia mahdollistaa psykoterapian sellaisten kuntoutujien kanssa, jotka kommunikoivat puheella vain rajallisesti tai eivät lainkaan, sanoo tutkija, musiikkiterapeutti, perhe- ja paripsykoterapeutti Hanna Hakomäki. Vaikeasti kehitysvammaisilla, monivammaisilla lapsilla ja aikuisilla musiikkiterapia tukee orientoitumista omaan itseen, omaan kehoon, toisiin ihmisiin ja ympäristöön. Vaikutukset näkyvät myös käsien käytön aktivoitumisena ja monipuolistumisena. Musiikkiterapia perustuu tutkimusnäyttöön Musiikkiterapia on tavoitteellinen, suunnitelmallinen ja tieteelliseen tutkimukseen perustuva kuntoutusmuoto, jota toteuttaa musiikkiterapeutin koulutuksen suorittanut terapeutti. Monet asiakkaista ovat kehitysvammaisia kuntoutujia. Musiikkiterapia on yksi Kelan lääkinnällisen kuntoutuksen muodoista. Kelan rahoittama tutkimus perustuu kirjallisuuskatsaukseen. Katsaus selvitti musiikkiterapian vaikutusta kehitysvammaisten lasten, nuorten ja aikuisten toimintakykyyn. Julkaisu Saukko P, Hakomäki H. Musiikkiterapian vaikutus kehitysvammaisten lasten, nuorten ja aikuisten toimintakykyyn. Kirjallisuuskatsaus. Helsinki: Kela, Sosiaali- ja terveysturvan raportteja 18, 2019. ISBN 978-952-284-070-7 (pdf).
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The goal of present study is to determine the effect of instrumental and relaxing music on spiritual health of teenage girls. This research is a quasi-experimental study with a pretest-posttest theme and a control group. The statistical community included all High school girl students in Shiraz city. A high school was selected by available sampling. 30 students were randomly divided into two groups of control and experimental (each contained 15 persons). Passive music therapies for the subjects were held during 8 sessions for 30 minutes to form a kind of listening of relaxing and nonverbal songs. Before and after music therapy intervention the spiritual health of teenage girls was measured with using spiritual health questionnaire (Palutzian and Ellison). The results of covariance analysis showed an effective increase in the spiritual health of teenage girls. However, the result of the study indicated that the relaxing and nonverbal music would increase the teenage girls ' spiritual health significantly and effectively. volume & Issue: Volume 7, Issue 25, Spring 2016
Chapter
Music treatments addressed to individuals with autism are usually aimed at enhancing social skills. To do so, musical activities are paired with a series of underlying competencies to be acquired. This chapter focuses on some of these basic competencies, such as the detection of the congruence between the emotional valence of music and the mood states it elicits, the identification of the relationships between the sounds (hearing) and the motor acts (vision) which produced them, the ability to mirror the partner’s mental state through the production of musical acts. Experimental findings supporting the notion that these basic competencies can be acquired or refined by people with autism, as well as the outcomes of music treatments focused on those skills, are reported and discussed in the chapter.
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Objective: In this study, we aimed to investigate the effect of Music Therapy (MT) along with Play Therapy (PT) on increasing appropriate Social Behaviors (SBs) and decreasing inappropriate stereotyped behaviors of children with autism. Methods: This is an experimental study, and we used pre-test and post-test control group design to analyze the data. The study sample included 30 children with autism between the ages of 6 and 12 years who were randomly selected and assigned into experimental and control groups. To collect data, the Autism Assessment Quotient, Teacher Assessment of Social Behavior Questionnaire, and Gilliam’s Autism Rating Subscale were used. In this study, the experimental group underwent a total of 15 sessions of training with MT along with PT for a period of 7 weeks, whereas the control group did not receive such training. Results: Analysis of covariance (ANCOVA) showed that training with MT along with PT increased pro-social subscales (P=0.001) and decreased shyness/withdrawal subscales (P=0.001) and that stereotyped behaviors in children with autism decreased (P=0.01). Conclusion: MT along with PT increased appropriate SBs and decreased inappropriate stereotyped behaviors of children with autism. Therefore, we can conclude that strengthening MT and PT skills should be considered one of the basic axes for professionals and educators in training and curing children with autism.
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Technical Report
A systematic review of educational autism interventions and international provision case studies
Article
Purpose In 2014, National Institute for Health and Care Excellence (NICE) announced it was going to develop its first set of guidelines on learning disabilities. The topic was “behaviour that challenges” and in May 2015 NICE published a full set of guidance (371 pages) covering service user and carer experiences, assessment, risk factors and interventions for behaviour that challenges (NICE, 2015). The linked quality standards were published later in 2015. The paper aims to discuss these issues. Design/methodology/approach This paper explains the process of developing the guidance. Findings The final guidance is described in summary form, together with the quality standards. Originality/value This paper provides a brief summary of the NICE guidelines on people with learning disabilities and behaviour that challenges.
Chapter
The risk for the development of challenging behavior among individuals with an intellectual disability (ID) is high. Aggressive behavior is often cited as the most prevalent of such problem behaviors seen in this population. This chapter reviews interventions to reduce or eliminate aggression in individuals with ID. It examines their evidence base as empirically supported treatments in this population. First, the chapter defines aggression and then describes its prevalence among persons with ID. Next, it examines the factors that may contribute to its development and its impact and implications for both the persons themselves and the wider community. Some of the methodological issues that arise in the assessment and treatment of this problem behavior are analyzed. The chapter examines studies that employed behavioral interventions to decrease or eliminate aggression in ID including studies that used antecedent-based and reinforcement-based strategies and mixed-treatment packages.
Article
[Purpose] The objective of this study was to investigate whether vibroacoustic therapy (VAT) could improve the psychological symptoms of 15 elderly nursing home (NH) residents with symptoms of depression. [Methods] Fifteen subjects received VAT for 30 minutes per day for 10 days. Depression was evaluated using the Dementia Mood Assessment Scale (DMAS). Tympanic temperature, pulse, blood pressure, and SpO2 were measured as physiological indexes of relaxation. In addition, sleep-wake rhythms of the 15 subjects were evaluated using actigraphy. [Results] Based on DMAS scores, mitigation of depression was observed in NH residents after receiving VAT. Moreover, significant decreases in tympanic temperature and pulse were observed after treatment. Total sleeping hours per day showed a significant decrease when mean sleeping hours in the first week were compared with the mean sleeping hours in the second week. [Conclusion] VAT provided relaxation effects for elderly NH residents, and improved depressive symptoms.
Article
Aggression is one of the most frequent and debilitating problems observed among persons with autism spectrum disorders (ASD). It is common and can be more problematic than many core symptoms of ASD. Thus, treating the behavior is a high priority. A surprisingly limited number of studies have addressed treatment when taken in the context of the vast ASD literature. This paper reviews many of these papers and describes the types of interventions that have been used and the characteristics of the people who have been studied.
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The haptic sense is one of the five human senses that deeply affects cognitive development and everyday lives of children and adults. Recently, researchers and developers have started active discussions and research on haptic technologies. The purpose of this paper is to explain the role of haptics in learning, review studies that have attempted to use haptic technologies to teach students, and discuss how these technologies can be applied in special education context. National and international databases were searched and analyzed using meta-analysis methods. The few studies that have been completed so far are heavily focused on math and science learning. However, haptic technology has great potentials for children with disabilities who can benefit from extra assistance from these devices in wide areas of curriculum including math, science, music, art, history, and so on.
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Background: The central impairments of people with autism spectrum disorder (ASD) affect social interaction and communication. Music therapy uses musical experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of people with ASD. The present version of this review on music therapy for ASD is an update of the original Cochrane review published in 2006. Objectives: To assess the effects of music therapy for individuals with ASD. Search methods: We searched the following databases in July 2013: CENTRAL, Ovid MEDLINE, EMBASE, LILACS, PsycINFO, CINAHL, ERIC, ASSIA, Sociological Abstracts, and Dissertation Abstracts International. We also checked the reference lists of relevant studies and contacted investigators in person. Selection criteria: All randomised controlled trials (RCTs) or controlled clinical trials comparing music therapy or music therapy added to standard care to 'placebo' therapy, no treatment, or standard care for individuals with ASD were considered for inclusion. Data collection and analysis: Two authors independently selected studies, assessed risk of bias, and extracted data from all included studies. We calculated the pooled standardised mean difference (SMD) and corresponding 95% confidence interval (CI) for continuous outcomes to allow the combination data from different scales and to facilitate the interpretation of effect sizes. Heterogeneity was assessed using the I² statistic. In cases of statistical heterogeneity within outcome subgroups, we examined clients' age, intensity of therapy (number and frequency of therapy sessions), and treatment approach as possible sources of heterogeneity. Main results: We included 10 studies (165 participants) that examined the short- and medium-term effect of music therapy interventions (one week to seven months) for children with ASD. Music was superior to 'placebo' therapy or standard care with respect to the primary outcomes social interaction within the therapy context (SMD 1.06, 95% CI 0.02 to 2.10, 1 RCT, n = 10); generalised social interaction outside of the therapy context (SMD 0.71, 95% CI 0.18 to 1.25, 3 RCTs, n = 57, moderate quality evidence), non-verbal communicative skills within the therapy context (SMD 0.57, 95% CI 0.29 to 0.85, 3 RCTs, n = 30), verbal communicative skills (SMD 0.33, 95% CI 0.16 to 0.49, 6 RCTs, n = 139), initiating behaviour (SMD 0.73, 95% CI 0.36 to 1.11, 3 RCTs, n = 22, moderate quality evidence), and social-emotional reciprocity (SMD 2.28, 95% CI 0.73 to 3.83, 1 RCT, n = 10, low quality evidence). There was no statistically significant difference in non-verbal communicative skills outside of the therapy context (SMD 0.48, 95% CI -0.02 to 0.98, 3 RCTs, n = 57, low quality evidence). Music therapy was also superior to 'placebo' therapy or standard care in secondary outcome areas, including social adaptation (SMD 0.41, 95% CI 0.21 to 0.60, 4 RCTs, n = 26), joy (SMD 0.96, 95% CI 0.04 to 1.88, 1 RCT, n = 10), and quality of parent-child relationships (SMD 0.82, 95% CI 0.13 to 1.52, 2 RCTs, n = 33, moderate quality evidence). None of the included studies reported any adverse effects. The small sample sizes of the studies limit the methodological strength of these findings. Authors' conclusions: The findings of this updated review provide evidence that music therapy may help children with ASD to improve their skills in primary outcome areas that constitute the core of the condition including social interaction, verbal communication, initiating behaviour, and social-emotional reciprocity. Music therapy may also help to enhance non-verbal communication skills within the therapy context. Furthermore, in secondary outcome areas, music therapy may contribute to increasing social adaptation skills in children with ASD and to promoting the quality of parent-child relationships. In contrast to the studies included in an earlier version of this review published in 2006, the new studies included in this update enhanced the applicability of findings to clinical practice. More research using larger samples and generalised outcome measures is needed to corroborate these findings and to examine whether the effects of music therapy are enduring. When applying the results of this review to practice, it is important to note that the application of music therapy requires specialised academic and clinical training.
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Article
To provide a critical evaluation of a broad range of peer-reviewed published studies of relevance to self-injurious behaviour in people with intellectual disability and autism spectrum disorders. The review covers the prevalence of self-injurious behaviour, the characteristics of those showing the behaviour, self-injury in autism spectrum disorders, biological influences on self-injurious behaviour, behavioural assessment and psychological and pharmacological interventions. The recent literature describes systematic evaluation of the efficacy of aripiprazole, and parent training combined with risperidone. Meta-analyses of behavioural interventions provide evidence of their efficacy and related research describes beneficial modification to behavioural assessment procedures. The prevalence literature provides data on individual characteristics that are associated with persistence and presence of self-injury and that might be considered as risk markers. Pain behaviour appears to be associated with self-injury, with implications for theories of the involvement of endorphins, and as a causal factor. In combination, these research findings demonstrate the multiple influences on self-injurious behaviour that must be taken into account in the assessment, formulation, intervention process.
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Self-injury is a frequent and serious problem for individuals with autism and developmental disabilities. This paper summarizes the clinical and empirical evidence pertaining to self-injury, and highlights valid theories and treatment options. Unlike most reviews of self-injury, the present one pays particular attention to the impact that research has made within the field of autism treatment. The importance of prospective large-scale research is stressed to support the development of treatments that should alleviate or even prevent the primary causes of self-injurious behaviour. This review aims to impart readers with an unambiguous conceptualization of self-injury and hopes to stimulate further research within the field.
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A crucial issue in research on music and emotion is whether music evokes genuine emotional responses in listeners (the emotivist position) or whether listeners merely perceive emotions expressed by the music (the cognitivist position). To investigate this issue, we measured self-reported emotion, facial muscle activity, and autonomic activity in 32 participants while they listened to popular music composed with either a happy or a sad emotional expression. Results revealed a coherent manifestation in the experiential, expressive, and physiological components of the emotional response system, which supports the emotivist position. Happy music generated more zygomatic facial muscle activity, greater skin conductance, lower finger temperature, more happiness and less sadness than sad music. The finding that the emotion induced in the listener was the same as the emotion expressed in the music is consistent with the notion that music may induce emotions through a process of emotional contagion.
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In people with learning disability one of the most frequent reasons for psychiatric referral is challenging behaviour. To determine what proportion of people with challenging behaviour actually have psychiatric symptoms. Using an instrument specifically designed for use by informants, a sample of 320 people with administratively defined learning disability, with and without challenging behaviour, was surveyed for the presence of psychiatric symptoms. Increasing severity of challenging behaviour was associated with increased prevalence of psychiatric symptoms, depression showing the most marked association. Anxiety symptoms were associated with the presence of self-injurious behaviour. There is clearly the potential for reducing challenging behaviour by improved identification and treatment of coexisting psychiatric disorders. The possibility of modifying diagnostic criteria for depression in people with learning disability, by including aspects of challenging behaviour, merits attention.
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Several recent lines of inquiry have pointed to the amygdala as a potential lesion site in autism. Because one function of the amygdala may be to produce autonomic arousal at the sight of a significant face, we compared the responses of autistic children to their mothers' face and to a plain paper cup. Unlike normals, the autistic children as a whole did not show a larger response to the person than to the cup. We also monitored sympathetic activity in autistic children as they engaged in a wide range of everyday behaviours. The children tended to use self-stimulation activities in order to calm hyper-responsive activity of the sympathetic ('fight or flight') branch of the autonomic nervous system. A small percentage of our autistic subjects had hyporesponsive sympathetic activity, with essentially no electrodermal responses except to self-injurious behaviour. We sketch a hypothesis about autism according to which autistic children use overt behaviour in order to control a malfunctioning autonomic nervous system and suggest that they have learned to avoid using certain processing areas in the temporal lobes.
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Despite the difficulty of defining behaviour disorder, most previous studies have reported a high rate of behaviour disorders in people with intellectual disability (ID). The aim of the present study was to establish the overall rate and types of behaviour disorders in a population-based sample of adults with ID. The other aim was to explore the possible risk factors that are associated with the overall rate as well as different types of behaviour disorders. One hundred and one adults with ID aged between 16 and 64 years were randomly selected from a sample of 246 such adults, i.e. those who were known to the Vale of Glamorgan Social Services Department in South Wales, UK. Thirteen behaviour disorders were rated according to the Disability Assessment Schedule. Background data on subjects were also collected, and were subsequently analysed to assess the relationship between different risk factors and behaviour disorders. Sixty-one subjects (60.4%) had at least one behaviour disorder of any severity or frequency. Twenty-three per cent of subjects showed aggression, 24% self-injurious behaviour, 36% temper tantrum, 26% overactivity, 29% screaming, 38% attention-seeking behaviour, 20% objectionable habits, 18% night-time disturbance and 12% of subjects showed destructiveness. Statistically significant associations were seen between the rate of overall behaviour disorder and the use of psychotropic medication, and between family and group home residence. The rate of aggression was significantly associated with the use of psychotropic medication. The rate of self-injurious behaviour was significantly associated with the severity of ID, female gender and poor communication abilities. The rate of temper tantrum was significantly associated with the use of psychotropic medication. Twenty-four subjects showed severe or frequent aggression, destructiveness, self-injury or temper tantrum, and 11 individuals showed real challenging behaviours. Severe behaviour problems were significantly associated with female gender, severity of ID, the presence of a history of epilepsy and attendance at day activities.
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The Behavior Problems Inventory (BPI-01) is a 52-item respondent-based behavior rating instrument for self-injurious, stereotypic, and aggressive/destructive behavior in mental retardation and other developmental disabilities. Items are rated on a frequency scale and a severity scale. The BPI-01 was administered by interviewing direct care staff of 432 randomly selected residents from a developmental center between the ages of 14 to 91 years. For 73% of those selected, at least one problem was endorsed on the BPI-01. A total of 43% showed self-injury, 54% stereotyped behavior, and 38% aggressive/destructive behavior. Confirmatory factor analysis and item-total correlations supported the three a priori factors. Analyses of variance (ANOVA) showed that of the variables age, sex, and level of mental retardation, only the latter had a significant effect on the BPI-01 total score, the SIB subscale score, and the Stereotyped Behavior subscale score. Aggression/destruction was not significantly related to any of the three variables. Individuals with a diagnosis of pervasive developmental disorder had higher scores on all three subscales than those without, whereas residents with a diagnosis of stereotyped movement disorder had higher Stereotyped Behavior scale scores than those without. The BPI-01 was found to be a reliable (retest reliability, internal consistency, and between-interviewer-agreement) and valid (factor and criterion validity) behavior rating instrument for problem behaviors in mental retardation and developmental disabilities with a variety of potentially useful applications. Strengths and limitations of the instrument are discussed.
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There have been very few population-based studies of the prevalence of psychiatric disorders among children and adolescents with and without intellectual disability (ID). Secondary analysis of the 1999 Office for National Statistics survey of the Mental Health of Children and Adolescents in Great Britain was performed. This survey collected information on a multistage, stratified, random sample of 10 438 children between 5 and 15 years of age across 475 postcode sectors in England, Scotland and Wales. The prevalence of any diagnosed ICD-10 disorder, conduct disorder, anxiety disorder, hyperkinesis and pervasive developmental disorders were significantly greater among children with ID than among their non-ID peers. There were no statistically significant differences between children with and without ID with regard to the prevalence of depressive disorders, eating disorders or psychosis. Factors associated with an increased risk of psychopathology among children and adolescents with ID included age, gender, social deprivation, family composition, number of potentially stressful life events, the mental health of the child's primary carer, family functioning and child management practices. Children and adolescents with ID are at significantly increased risk of certain forms of psychiatric disorder. Careful consideration of the social and economic adversity facing such families will be necessary to ensure that support services are responsive to both the needs of child as well as the needs of the family in which they are living.
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Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects an individual throughout life. It is often associated with impairment in social interaction with others as well as in language skills. Music therapy is thought to utilize a “pre-verbal” form of communication that occurs between mothers and infants that includes tones, gestures, and mirroring. Given that many individuals with autism have difficulty with verbal interaction, music therapy has emerged as a potential vehicle for communication with and treatment of individuals with autism. Conclusion: Music therapy for autistic spectrum disorder may carry the potential to improve social interaction and join attention skills in children with autism and may also facilitate communication with them. Music therapy may also improve the parent-child relationship when parents are included in the therapy. Larger studies will clarify the potential benefits of this treatment. Furthermore, research is necessary to understand the long term effects of treatment, effects in older individuals with autism, and the neurological basis for improvement.
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This article presents the field of VibroAcoustic therapy as a form of treatment that uses patented equipment and music software devised by Olay Skille in 1968. Out of his extensive investigation of human musical behavior, Skille designed and tested a Musical Behavior Scale (MUBS)—a nonverbal screening test for observing signs of language difficulties, personality disorders, motor functions, and learning capacity in children and adults. He sub-sequently conceived of VibroAcoustic (VA) therapy as a means of using the energy of musical sound waves applied directly to the body to produce relaxing physiological as well as psychological effects. Skille suggests that, in addition to its potential for music therapists, VA therapy has possibilities for use by other professionals, such as physiotherapists, psychologists, psychiatrists, physicians, chemotherapists, and chiropractors. Since its inception in Norway, this therapy has been conducted in Finland and Germany, expanding to England, Denmark, and Estonia. Skille's initial paper on this subject, submitted in 1987, gave information about and descriptions of the application and results of VA therapy from its earliest stages of development. In an updated paper submitted, Skille added an overall view of the ongoing practice in the above-mentioned European countries. At the request of the author, the Editor has assembled the following article which combines the two papers, thus giving a portrait—in broad strokes—of a facet of therapy that may be of interest and practical use for the music therapy practitioner and educator. This article represents the Editor's intention to bring a cohesive account of the material to a wider readership, and she invites queries about areas that may need clarification or more informative details, such queries to be communicated to Mr. Skille in Norway.
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The purpose of this study was to ascertain the effect of music vs. the sound of a dental drill, paired with or without the vibrotactile stimulation of a Somatron™, on continuous, computerized recording of subject comfort and heart rate and intermittent recording of peripheral finger temperature. Subjects were 130 music majors divided into five auditory stimuli conditions ( N =26) with 13 males and 13 females in each group: (a) vibrotactile stimulation with music followed by dental drill; (b) vibrotactile stimulation with dental drill followed by music; (c) free field music then dental drill (no vibrarion); (d) free field dental drill then music (no vibration); and (e) no auditory or vibrotactile stimuli. Each condition lasted 6.5 minutes. Results showed that the vibrotactile stimulation blunted perception, thereby reducing levels both of comfort and discomfort; this stimulation also reversed the effects of the two auditory stimuli on heart rate from those caused by free field presentation, and raised significantly finger temperature for both auditory strimuli. Overall, music preceding the dental drill generally reduced the drill's aversive effects while the drill preceding music generally enhanced music's positive effects. Heart rate responses to music were varied. The initiation of all stimuli created an arousal response with acclimation occurring in approximately 30 seconds. Neither music nor the dental drill, alone or in combination with vibrotactile stimulation, produced a consistent heart rate response. Changes in heart rate seemed to be affected most by the sequence of stimuli across time. When music followed the drill, music decreased heart rate; however, when used in combination with the Somatron™, heart rate was increased. These results were identical to the effects of the drill following music when presented via the Somatron™, i.e., the same heart rate effects were found for opposite auditory stimuli and with opposite levels of perceived comfort.
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A qualitative approach was used to study the therapeutic intervention based on vibroacoustic therapy (treatment method based on the combined effect of music and low frequency sound vibrations), to which other methods (mood assessment, drawing) had been added according to the therapy plan. The participants were ten girls aged 15-18 with heightened anxiety combined with low self-esteem and/or body image problems. The principles of grounded theory were used to study the experience of the girls and the outcome of the intervention. Three categories describing the meaning of the therapy process emerged in the girls' interviews: “balancing self-discovery,” “tension release,” and “interesting and beneficial experience.” Vibroacoustic therapy can be considered as an important therapy component useful for enhancing coping ability through fulfilling the bodily needs for relaxation, improving self-knowledge through physical selfawareness, and giving peaceful time for reflection.
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The objective of this study was to report on the prevalence and correlates of anxiety and mood problems among 9- to 14- year-old children with Asperger syndrome (AS) and high-functioning autism. Children who received a diagnosis of autism (n 40) or AS (n 19) on a diagnostic interview when they were 4 to 6 years of age were administered a battery of cognitive and behavioural measures. Families were contacted roughly 6 years later (at mean age of 12 years) and assessed for evidence of psychiatric problems including mood and anxiety disorders. Compared with a sample of 1751 community children, AS and autistic children demonstrated a greater rate of anxiety and depression problems. These problems had a significant impact on their overall adaptation. There were, however, no differences in the number of anxiety and mood problems between the AS and autistic children within this high-functioning cohort. The number of psychiatric problems was not correlated with early autistic symptoms but was predicted to a small extent by early verbal/non-verbal IQ discrepancy scores. These data indicate that high-functioning PDD children are at greater risk for mood and anxiety problems than the general population but the correlates and risk factors for these comorbid problems remain unclear.
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The present study examined the prevalence and types of anxiety exhibited by high-functioning adolescents With autism spectrum disorders and factors related to this anxiety. Results suggest that adolescents With autism spectrum disorders exhibit anxiety levels that are significantly higher than those of the general population. The study found a loW negative correlation betWeen assertive social skills and social anxiety. In addition, a moderate curvilinear relationship Was found betWeen empathic skills and the various social anxiety measures. Results of the study support an emerging body of research demonstrating elevated anxiety levels in high-functioning individuals With autism spectrum disorders.
Article
Vibroacoustic therapy is a treatment method based on the combined effects of music and low frequency sound vibration. The aim of this study was to find out about possible differences between the effects of music alone and vibroacoustic therapy on healthy people. The study was carried out in two series of trials performed according to a repeated measure, within-group design counterbalancing three main conditions — music, vibroacoustic therapy (the same music combined with pulsed low frequency sound), and silence (no stimulation). Following analysis of physiological measurements the results showed significant decreases in blood pressure, pulse rate, muscle oscillation frequency (m. tibialis anterior and m. trapezius) independent of the conditions and sound intensity levels. Clear differences occurred in the case of subjective feeling of health and comfort, measured by bipolar scales of adjectives constructed for the current experiment according to a semantic differential method, when conditions with music and vibroacoustics were compared to silence. There is also some evidence that vibroacoustics may have a wider influence on feelings of health and comfort when compared with music alone. The current study also demonstrated that women can perceive a wider spectrum of change in their subjective status of health and comfort than men in the vibroacoustic therapy condition. Keywords: Music, Vibroacoustic Therapy, Low frequency sound vibration, Blood pressure, Pulse rate, Muscle tone. Perceived health and comfort, Therapy.
Article
Reviews a variety of hypotheses that researchers have developed over the years to understand self-injurious behavior (SIB). It is noted that initial hypotheses focused on underlying causes related to psychopathology, social deprivation, homeostasis, and arousal. Researchers have more recently focused on learning, social communicative functions of SIB, and specific neurochemical pathological conditions or behavioral phenotypes and their relationship to certain genetic syndromes such as Lesch-Nyhan syndrome and Prader-Willi syndrome. It is maintained that no single factor causes SIB. The authors conclude that a comprehensive approach to treatment based on the etiology, underlying social and neurochemical mechanisms, and exacerbating medical conditions is required to treat SIB and obtain lasting results. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Surveyed music therapists' (MTs') use of music for pain relief (PR) with elderly and medically, neurologically, and physically disabled populations. 136 Ss responded to a survey about their use of music and music vibration in pain management. The results indicated that 41% of Ss used music specifically for PR and suggested a growing interest in the use of music for PR. Research in pain management is reviewed and it is stated that most of the music-and-pain studies do not specifically state what musical stimuli were used to provide PR, preventing future replication. Suggestions for future research are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
A summer music therapy program providing music listening opportunities to patients undergoing chemotherapy was initiated. Multiple data collection procedures were devised to determine the long-term effects of music on the frequency and degree of nausea and vomiting during chemotherapy, occurring posttreatment, and developing prior to treatment as anticipatory symptoms; the level of anxiety during chemotherapy administration as observed by peripheral finger temperature, verbal interaction, movement, and skin pallor; and attitudes about cancer and its treatment. Data were collected on 15 people who completed four or more chemotherapy treatments under one of several conditions isolating the influence of music. One group ( n = 5) listened to music during treatments one through four, while another ( n = 5) listened to music during treatments two through five. There were two comparable no-music groups ( n = 2, 3). Throughout the project, patients and staff reacted very favorably to the benefits of music listening during chemotherapy. Data analysis showed that both music groups reported less nausea than the no-music groups Data also demonstrated that the length of time before nausea began war much longer far the music groups than for the no-music groups. Other physiological and observed responses did not appear to be differentiated by music condition.
Article
Spontaneous electrodermal activity as well as electrodermal orienting responses to auditive stimuli of moderate intensity were recorded in a group of 35 autistic children and in three control groups. Mean number of spontaneous fluctuations in skin conductance did not differentiate the groups. Autistic children, as compared with the children from the control groups, were significantly more often nonresponsive to the first trial. When responding, autistic children showed electrodermal orienting responses characterized by large amplitudes and fast recovery. The functional significance of nonresponding is discussed, and it is concluded that the response pattern of the autistic child shows a striking resemblance to that of the electrodermal response of schizophrenic persons.
Article
This present study describes the outcome of a recreation therapy program of vibroacoustic music (VAM) offered to hospitalized patients. In order to provide patients with assistance in achieving the relaxation response, recreation therapists at a major federal research hospital created several relaxation opportunities for patients and family members. The present results suggest the value of using VAM to induce the relaxation response in order to reduce the symptom burden of hospitalized patients. These findings point to an avenue of future research using careful patient selection, assignment, controls, variable dosage, and longer follow-up periods to test the durability of VAM interventions.
Article
A total population study was undertaken in two areas of England to identify the situation and characteristics of people reported to exhibit challenging behaviors. We found that: (1) challenging behaviors are shown by 10-15% of people with mental retardation who are in contact with educational, health or social care services for people with mental retardation; (2) the most common forms of challenging behaviors reported were 'other' behavior (shown by 9%-12% of all people screened), aggression (7%), destructive behavior (4%-5%) and self-injury (4%); (3) the majority of people identified showed two or more of these four general forms of challenging behavior; (4) approximately two-thirds of the people identified were boys/men; (5) close to two-thirds of the people identified were adolescents or young adults; (6) approximately 50% of the people identified as showing more demanding challenging behavior were living with their families; (7) people who showed more demanding challenging behavior were more likely to need greater levels of assistance in eating, dressing and washing, be incontinent and have more restricted expressive and receptive communication.
Article
The reported prevalence of psychiatric illness among adults with intellectual disability (ID) varies widely between 10 and 39%; however, many methodological problems exist. The aims of the present study were to establish the prevalence of functional psychiatric illness among adults with ID who live in the community, in order to compare the overall rate and types of psychiatric illness between the population with ID and the general population without ID, and to establish the risk factors associated with psychiatric illness in adults with ID. The study was done in two stages. In the first part, a trained psychiatrist interviewed 101 randomly selected adults with ID and their carers using the Mini Psychiatric Assessment Schedule for adults with Developmental Disability (Mini PAS-ADD) to screen for psychiatric caseness. Out of these 101 adults, 90 had sufficient communicative abilities that made the administration of Mini PAS-ADD possible. A second trained psychiatrist interviewed 19 out of the 20 adults who were diagnosed as psychiatric cases according to the initial Mini PAS-ADD interview. This psychiatrist interviewed patients and their carers in line with the full PAS-ADD interview. The second psychiatrist was blind to the initial diagnoses made according to the Mini PAS-ADD questionnaire. A final psychiatric diagnosis was made according to International Classification of Diseases - 10th Revision (ICD-10) criteria. Some 14.4% (95% confidence interval = 7.4-21.4%) of the cohort had a psychiatric diagnosis according to ICD-10 criteria: 4.4% had schizophrenia, 2.2% depressive disorder, 2.2% generalized anxiety disorder, 4.4% phobic disorder and 1% delusional disorder. The overall rate of functional psychiatric illness (point prevalence) was similar to that found in the general population (16%). However, the rates of schizophrenic illness and phobic disorder were significantly higher in the study cohort compared with those in the general population (0.4% and 1.1%, respectively). Increasing age and the presence of physical disability were significantly associated with the occurrence of psychiatric illness. Out of the 11 remaining adults with severe ID, two (18%) had a diagnosis of a psychiatric illness (one mania and one anxiety disorder) according to the Diagnostic Assessment for the Severely Handicapped (DASH) questionnaire.
Article
Music, like language, is a universal and specific trait to humans. Similarly, music appreciation, like language comprehension, appears to be the product of a dedicated brain organization. Support for the existence of music-specific neural networks is found in various pathological conditions that isolate musical abilities from the rest of the cognitive system. Cerebrovascular accidents, traumatic brain damage, and congenital brain anomalies can lead to selective disorders of music processing. Conversely, autism and epilepsy can reveal the autonomous functioning and the selectivity, respectively, of the neural networks that subserve music. However, brain specialization for music should not be equated with the presence of a singular "musical center" in the brain. Rather, multiple interconnected neural networks are engaged, of which some may capture the essence of brain specialization for music. The encoding of pitch along musical scales is likely such an essential component. The implications of the existence of such special-purpose cortical processes are that the human brain might be hardwired for music.
Article
Studies in Britain and the US indicate that 10-15% of people with mental retardation show challenging behaviour, like attacking others (aggression), self-injurious behaviour, destruction, and other difficult, disruptive or socially unacceptable acts. Most researchers indicate that challenging behaviour is more common among adolescents and young adults, among males, is associated with autism, and increases with lack of communication skills and severity of mental retardation. These factors can be understood as risk markers, and some of them can be decreased by preventive and treatment interventions, at least in principle. The present study confirmed most of the previous findings, with some exceptions: the prevalence of more demanding challenging behaviour was somewhat lower in the present study, and no association between gender and challenging behaviour was found. We also concluded that declining prevalence of challenging behaviour at older ages is not a result of a young age structure of the population.
Article
People with autism spectrum disorders (ASD) have difficulties with communication, behaviour and/or social interaction. Music therapy uses music and its elements to enable people to communicate and to express their feelings. In this way music therapy addresses some of the core problems of people with ASD. This review set out to assess the evidence for the effectiveness of music therapy for individuals with ASD. Three small studies were included which examined the short-term effect of brief music therapy interventions for autistic children. Music therapy was superior to "placebo" therapy with respect to verbal and gestural communicative skills, but it was uncertain whether there was an effect on behavioural outcomes. The included studies were encouraging, but of limited applicability to clinical practice. More research with better design, using larger samples, in more typical clinical settings is needed to strengthen the clinical applicability of the results and to examine how enduring the effects of music therapy are. When applying the results of this review to practice, it is important to note that the application of music therapy requires specialised academic and clinical training.
Article
Background Children and adolescents with autistic spectrum disorder (ASD) presenting with significant limitations in conventional forms of verbal and non-verbal communication are found to respond positively to music therapy intervention involving both active, improvizational methods and receptive music therapy approaches. Improvizational musical activity with therapeutic objectives and outcomes has been found to facilitate motivation, communication skills and social interaction, as well as sustaining and developing attention. The structure and predictability found in music assist in reciprocal interaction, from which tolerance, flexibility and social engagement to build relationships emerge, relying on a systematic approach to promote appropriate and meaningful interpersonal responses. Results Published reports of the value and effectiveness of music therapy as an intervention for children with ASD range from controlled studies to clinical case reports. Further documentation has emphasized the role music therapy plays in diagnostic and clinical assessment. Music therapy assessment can identify limitations and weaknesses in children, as well as strengths and potentials. Research evidence from a systematic review found two randomized controlled trials that examined short-term effects of structured music therapy intervention. Significant effects were found in these studies even with extremely small samples, and the findings are important because they demonstrate the potential of the medium of music for autistic children. Case series studies were identified that examined the effects of improvizational music therapy where communicative behaviour, language development, emotional responsiveness, attention span and behavioural control improved over the course of an intervention of improvizational music therapy.
The disease entities of autism
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