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Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy

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Abstract

Through behavioural analysis, this study investigated the social-motivational aspects of musical interaction between the child and the therapist in improvisational music therapy by measuring emotional, motivational and interpersonal responsiveness in children with autism during joint engagement episodes. The randomized controlled study (n = 10) employed a single subject comparison design in two different conditions, improvisational music therapy and toy play sessions, and DVD analysis of sessions. Improvisational music therapy produced markedly more and longer events of 'joy', 'emotional synchronicity' and 'initiation of engagement' behaviours in the children than toy play sessions. In response to the therapist's interpersonal demands, 'compliant (positive) responses' were observed more in music therapy than in toy play sessions, and 'no responses' were twice as frequent in toy play sessions as in music therapy. The results of this exploratory study found significant evidence supporting the value of music therapy in promoting social, emotional and motivational development in children with autism.

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... Researchers have examined the effects of MT on individuals with ASD with regards to behaviour, psychosocial, intellectual, and interpersonal parameters. However, there is a need for a comprehensive review of the published benefits and potential side effects of the use of music in people with ASD [26][27][28]. This comprehensive overview is the aim of our systematic review. ...
... A large survey study showed that regular antenatal exposure to music and talking to the baby might prevent traits of ASD [94]. In small studies, MT was shown to be beneficial regarding the bond between ASD children and their parents [84], movement coordination [73], social communication, interaction and attention [21,26,28,70,71,75,82,90,92,93,96,98], and their overall ASD symptoms [71,75,92,93]. Listening to musical excerpts increased vocal recognition and ability to not hide emotions [91]. ...
... In the third category of articles, which focused on the effects of MT and musical training on people with ASD, MT was shown to be beneficial for the child-parent relationship [84], movement coordination [73], social communication, interaction, attention [15,21,28,74,78,82,87,97,100], and overall ASD symptoms [71,92,93]. However, these effects of MT could not be replicated in an RCT with 362 participants [70]. ...
Article
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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.
... Children with autism who underwent an music-based intervention using improvisational techniques, as well as a control play-based intervention (n = 10, repeated-measures design), displayed longer durations of both eye contact with their therapist while engaged in activities, and turn-taking episodes during MI (Kim, et al., 2008). Additional video analysis of sessions from this study (Kim, Wigram, & Gold, 2009) demonstrated that children spontaneously initiated engagement with the therapist more frequently during music-based than the control play-based intervention, as well as displayed more joyful affect and sharing of emotional affect with the therapist during music than the control play-based therapy. This study provided a critical first step in directly comparing music-based intervention to a control intervention with respect to joint engagement. ...
... This study provided a critical first step in directly comparing music-based intervention to a control intervention with respect to joint engagement. The primary coder in these studies (Kim et al., 2008(Kim et al., , 2009) was the first author who was aware of the study hypotheses. Given this evidence of the positive effect of music-based interventions, a larger sample size and independent raters blind to study hypotheses are called for to strengthen these findings. ...
... To investigate whether triadic joint engagement may serve as an "active ingredient" contributing to the positive outcomes of music-based intervention, we extended previous findings (Kim et al., 2008(Kim et al., , 2009 by including a larger sample size of children with autism obtained using RCT methodology and using objective raters. A modified version of Adamson et al.'s (2004) coding scheme was applied in Analysis 1 to evaluate whether music therapy elicits higher levels of joint engagement than does a control non-music play intervention. ...
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Background: The effectiveness of music-based interventions (MI) in autism has been attested for decades. Yet, there has been little empirical investigation of the active ingredients, or processes involved in music-based interventions that differentiate them from other approaches. Objectives: Here, we examined whether two processes, joint engagement and movement, which have previously been studied in isolation, contribute as important active ingredients for the efficacy of music-based interventions. Methods: In two separate analyses, we investigated whether (1) joint engagement with the therapist, measured using a coding scheme verified for reliability, and (2) movement elicited by music-making, measured using a computer-vision technique for quantifying motion, may drive the benefits previously observed in response to MI (but not a controlled non-MI) in children with autism. Results: Compared to a non-music control intervention, children and the therapist in MI spent more time in triadic engagement (between child, therapist, and activity) and produced greater movement, with amplitude of motion closely linked to the type of musical instrument. Conclusions: Taken together, these findings provide initial evidence of the active ingredients of music-based interventions in autism.
... Improvizacijska MT je upravo takva individualizirana intervencija koja facilitira spontane odgovore i interpersonalnu komunikaciju. 25 Improvizacijska MT se pokazala i učinkovitom intervencijom za poticanje spontanog samoizražavanja, emocionalne komunikacije i socijalnog uključivanja pojedinca, te se stoga široko upotrebljava u osoba s PSA, posebice nestrukturirani modeli poput slobodne improvizacije ili kreativne muzikoterapije. 13 U okviru improvizacijske MT postoji cijeli niz tehnika koje se mogu koristiti, a neke od najčešćih su: zrcaljenje, imitacija, uparivanje, reflektiranje, prizemljivanje, držanje, sadržavanje, empatička improvizacija, dijalog i pratnja. ...
... Ovaj pristup može se usporediti s odnosom majke i novorođenčeta, te predstavlja osnovnu neverbalnu razmjenu koja nadalje može inicirati složeniji odgovor klijenta, bilo vokalno, glazbom, pogledom ili pokretom tijela. 25 Također je važno voditi računa o jasnoj strukturi seanse, jer se na taj način pruža sigurnost i poticaj za sudjelovanjem. Predvidljiva struktura poznate glazbene fraze može potaknuti vokalizaciju klijenta i održati njegovu pažnju na nekoj aktivnosti. ...
... usporedili učinak improvizacijske MT i terapije igrom, na pozitivne emocionalne reakcije, emocionalni angažman, interpersonalnu inicijativu i responzivnost djece s PSA. 25 Također su se uspoređivale reakcije djece na direktivnu ulogu terapeuta u oba terapijska pristupa, korištenjem dva konteksta tijekom pojedine seanse (neusmjerenivodstvo djeteta, u odnosu na usmjerenivodstvo terapeuta). U okviru MT rezultati su pokazali veće vrijednost na varijablama "veselje", "emocionalni sinkronicitet" i "iniciranje angažmana" u neusmjerenom dijelu seanse. ...
Article
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Social communication disorder is one of the main characteristics of a person with autism spectrum disorder (ASD). Due to the fact, the attention of contemporary therapeutic approaches is increasingly focused on the conceptualisation of different methods aimed at initiating and supporting different aspects of communication in this population. In that sense, the use of music therapy (MT) has been considered as a complementary therapeutic method since music is based on universal language and requires interaction between two or more people. Also, certain scientific and empirical studies have shown that persons with ASD are interested in music, with often intact or even superior musical hearing, melody memory, and understanding of music, melody, and rhythm structure. Based on these findings, the aim of this study was to define the complex interaction between MT and social communication in persons with ASD. For this purpose, an overview of current researches in this area was carried out by using quotation databases like WoS, Scopus, EBSCO, Google Scholar etc. A review of the literature showed that most of MT interventions had a positive impact on the various elements of social communication such as: verbal and nonverbal communication, vocalization, joint attention, eye contact, concentration, cooperation and interactive behaviour in persons with ASD.
... Music therapy interventions can "facilitate motivation, communication skills and social interactions" [29] (p. 535), develop and sustain joint attention, increase selfesteem, lower anxiety, and improve attitudes towards peers among individuals with disabilities [30,31], help individuals "develop a tangible tool they can access when needed" [32] (p. 91) when working on developing personal care skills, social skills, and managing emotions, as well as develop new ways of processing and responding to external stimuli [32]. ...
... Music can be used to promote interpersonal relatedness and can guide individuals smoothly into new developmental stages [41]. Music therapy has also been seen to be effective in promoting social skills and the emotional and motivational development of children with disabilities [31]. Furthermore, a meta-analysis by Whipple [42] revealed an increase in appropriate social behaviors, increased attention to task, improved vocalizations, more expressive gestures and better vocabulary comprehension when music was used with children and adolescents with developmental disabilities. ...
... As described below, a significant three-way 29 interaction was found: The effects of sessions on conversation, 30 exchanges, and emotions were moderated by group and rater. 31 Results are summarized in Table 3 and presented below. Table 3 34 Initiating conversation. ...
Article
This pilot study investigated the use of music therapy to increase three specific prosocial behaviors in adults with disabilities attending a day habilitation program. The social skills addressed were (a) initiating conversation, (b) participating in reciprocal exchanges, and (c) expressing emotions. Fifteen participants between 21 and 46 years of age were selected through purposive sampling. Participants attended biweekly music therapy sessions for 30-45 minutes over a 6-week period. Sessions included interventions that encouraged learning about and using socially appropriate prosocial behaviors. These interventions consisted of musical interplay between therapist and participants, as well as interactive play among the participants. The parents and/or legal guardians of the participants were asked to assess the participants’ social behaviors prior to and following music therapy, using the Home and Community Social Behavior Scales (HCSBS). Data were collected from the participants using pre- and post-HCSBS assessments, and from the researcher and day program staff using a Likert scale designed specifically for this study. Participants who engaged in music therapy demonstrated an increase in prosocial behaviors, suggesting that participation in music therapy increased social skill development in adults with disabilities.Spanish Los efectos de la Musicoterapia en las conductas prosociales de adultos con discapacidad.Este estudio piloto investiga el uso de la musicoterapia para incrementar tres conductas prosociales específicas en adultos con discapacidad que asisten a programas diarios de habilitación. Las habilidades sociales abordadas fueron : (a) inicio de conversación , (d) participación en intercambios recíprocos y (c) expresión de emociones. Se seleccionaron quince participantes de entre 21 y 46 años a través de un muestreo intencional. Los participantes asistieron a sesiones de musicoterapia de 30 a 45 minutos dos veces por semana por un periodo de 6 semanas. Las sesiones incluyeron intervenciones que incentivaban el aprendizaje y el uso social de conductas prosociales apropiadas. Estas intervenciones consistían en interacciones musicales entre terapeuta y participantes, así como también juegos interactivos entre los participantes. Los padres y/o tutores legales de los participantes fueron consultados para evaluar las conductas sociales de los participantes previas y posteriores a musicoterapia, utilizando la Escala Home and Community Social Behavior Scale (HCSBS). Los datos fueron obtenidos: de los participantes usando las evaluaciones HCSBS pre y post musicoterapia y de los investigadores y personal del programa diario utilizando la escala Likert diseñada específicamente para este estudio. Aquellos participantes que se comprometieron con musicoterapia demostraron un incremento en sus conductas prosociales, lo que sugiere que la participación en musicoterapia incremento el desarrollo de habilidades sociales en adultos con discapacidades. Palabras Clave: Musicoterapia , adultos con discapacidad , conductas prosociales , habilidades sociales.GermanDie Auswirkungen von Musiktherapie auf das prosoziale Verhalten von Erwachsenen mit BehinderungAbstract: Diese Pilotstudie untersuchte, wie der Einsatz von Musiktherapie drei spezifische prosoziale Verhaltensweisen behinderter Erwachsener in einer Tageseinrichtung verbessern kann. Die untersuchten sozialen Fähigkeiten waren (a) eine Unterhaltung zu beginnen, (b) an gegenseitigem Austausch teilzunehmen, (c) und Emotionen auszudrücken. 15 Teilnehmer im Alter zwischen 21 und 46 Jahren wurden durch gezieltes Sampling ausgewählt. Die Teilnehmer nahmen zweimal pro Woche über einen Zeitraum von 6 Wochen an Musiktherapiesitzungen von 30-45 Minuten teil. Die Sitzungen beinhalteten Interventionen, die Lernen über und mithilfe sozial angemessener prosozialer Verhaltensweisen. Dies Interventionen bestanden aus musikalischem Spielen zwischen Therapeut und Teilnehmern, und interaktives Spielen unter den Teilnehmern. Die Eltern u/o gesetzliche Betreuer der Teilnehmer wurden gebeten, das soziale Verhalten der Teilnehmer vor und nach der Musiktherapie mit der Home and Community Social Behavior Scales (HCSBS) zu bewerten. Die gesammelten Daten stammten von den pre- and post-HCSBS Assessments der Teilnehmer, vom Forscher und dem Tagespersonal, die eine speziell für diese Studie entwickelte Likert -Skala benutzten. Die Teilnehmer an dem Musiktherapie-Programm zeigten eine Verbesserung ihres prosozialen Verhaltens, was vermuten lässt, das die Teilnahme an Musiktherapie die Entwicklung sozialer Fähigkeiten bei Erwachsenen mit Behinderung erhöht. Keywords: Musiktherapie, Erwachsene mit Behinderung, prosoziales Verhalten, soziale FähigkeitenItalian GLI EFFETTI DELLA MUSICOTERAPIA NEI COMPORTAMENTI PRO-SOCIALI DI ADULTI CON DISABILITA` Questo studio pilota ha studiato l’uso della musicoterapia per aumentare tre specifici comportamenti pro-sociali negli adulti con disabilità che frequentano un programma giornaliero di abilitazione. Le competenze sociali affrontate erano (a) l’avvio di una conversazone, (b) la partecipazione in scambi reciproci, (c) esprimere emozioni. Quindici partecipanti tra i 21 e i 46 anni di età sono stati selezionati attraverso un campionamento intenzionale. I partecipanti hanno partecipato a sessioni di musicoterapia bisettimanali per 30-45 minuti in un periodo di 6 settimane. Le sessioni includevano interventi che incoraggiavano ad apprendere l’uso di comportamenti pro-sociali socialmente appropriati. Questi interventi consistevano nell’interazione musicale tra terapeuta e partecipanti, cosi come il gioco interattivo tra i partecipanti. Ai parenti e/o i tutori legali dei partecipanti è stato chiesto di valutare il comportamento sociale dei partecipanti prima e dopo il trattamento musicoterapeutico, usando la Home and Community Social Behavior Scale (HCSBS). I dati dei partecipanti sono stati raccolti utilizzando assestamenti pre- e post-HCSBS, e dal personale di ricerca e dallo staff del programma giornaliero usando una scala Likert progettata specificatamente per questo studio. I partecipanti che si sono lasciati prendere dalla musicoterapia hanno dimostrato un aumento dei comportamenti pro-sociali, implicando che la partecipazione ai trattamenti di musicoterapia abbia aumentato lo sviluppo di abilita` sociali negli adulti con disabilità. Parole Chiave: musicoterapia, adulti con disabilità, comportamenti prosociali, competenze socialiJapanese 障害者の向社会的行動における音楽療法の効果この予備研究では、デイプログラムに参加している障害者に対して、3つの向社会的行動を向上させた音楽療法の活用について検証する。取り組まれた社会的スキルは、(a) 発話、 (b)相互的なやり取りへの参加、 (c)感情表現の3つである。21歳から46歳の15名が被験者として、有意サンプリングで選択された。被験者は、6週間にわたって隔週30分から45分の音楽療法セッションに参加した。セッションプログラムでは、向社会的行動を学び活用することを促進する介入を行った。これらの介入は、音楽療法士と対象者および対象者間との音楽的相互行為を含んでいる。被験者の親または法的介護者が、HCSBS (Home and Community Social Behavior Scales =家庭とコミュニティにおける社会行動評価尺度)を使って、音楽療法前後の社会行動を評価する。音楽療法前と後のHCSBSスコアと、 本研究のために特別に作成されたリッカート尺度を研究者とデイケアスタッフが付けた評価とを総合して、データが収集された。音楽療法活動への参加度が高かった被験者の方が、向社会的行動の増加を呈しており、障害者対象の音楽療法への参加が社会スキルを向上させることがわかった。 キーワード:音楽療法、障害者、向社会的行動、社会的スキル
... The child is also encouraged to practice imitation, joint attention, turntaking and affect sharing, with the aim of improving language skills and social competency (Crawford et al. 2017). Studies implementing IMT have shown positive impact on individuals with ASD including improvements in joint attention, actions of social engagement (Vaiouli et al. 2015;Kim et al. 2008), more and longer events of "joy," "emotional synchronicity," and "initiation of engagement: behaviors (Kim et al. 2009). Studies using IMT also show decreased stress levels, (Poquérusse et al. 2018), increased self-esteem, reduced anxiety, more positive attitudes toward peers (Hillier et al. 2012), and improvements in verbal (Ghasemtabar et al. 2015) and non-verbal social communication skills (Kim et al. 2008). ...
... In the category of IMT that includes FCMT and MTG, we included 21 articles (Table 3). In this group, we found one study that includes a large sample size with 364 subjects (Bieleninik et al. 2017& Crawford et al. 2017; nine articles with sample sizes below ten (Carpente 2017;Dezfoolian et al. 2013;Eren et al. 2013;Kim et al. 2008;Kim et al. 2009;Pasiali et al. 2014;Spiro and Himberg 2016;Thompson 2017;Vaiouli et al. 2015); and ten articles with a moderate sample that ranges between 11 and 51 subjects (Ghasemtabar et Thompson et al. 2014;Yoo and Kim 2018). The study with a large sample size found no significant improvements in the patients with ASD. ...
Article
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Individuals with autism spectrum disorder (ASD) can experience difficulties functioning in society due to social communication deficits and restrictive and repetitive behaviors. Music therapy has been suggested as a potential intervention used to improve these deficits in ASD. The current systematic literature review focuses on two methods of music therapy: improvisational music therapy (IMT) and singing/listening to songs. We review the extant literature and the associated methodological limitations, and we propose a framework to assess the effectiveness of music therapy as an intervention in ASD. We suggest the creation of a standardized framework that should utilize neuroimaging tools as an objective marker of changes induced by music therapy as well as a combination of functional and behaviourial outputs, rather than assessment methods addressing a broad range of functional and behavioural outputs, rather than only the main symptoms. The methodological limitations found in the current literature prevent us from making a strong statement about the effects of music therapy in autism. We consider treatment fidelity assessments as the key to successful future attempts to truly understand music therapy effects in ASD.
... NDD is a chronic state, but early and focused interventions are thought to mitigate its effects [22]. Traditional therapy involves different approaches for assessing NDD symptoms and helping persons with NDD develop solid social skills [7,50], learn receptive and expressive language [29], improve adaptive behavior, and promote autonomy in self-care and everyday life tasks. ...
... Still, the ideal treatment includes regular interventions that meet a person's specific needs and objectives and monitor their development [67]. Objectives encompass strengthening adaptive behaviors, developing association skills and abstract concepts (e.g., time and money), expanding emotional and relational skills [7,50], learning receptive and expressive language [29], enhancing communicative and speech skills, and improving self-care and autonomy. From literature we know that Standard therapeutic interventions for people with NDD include different approaches such as play therapy [7,39], music therapy [84], speech therapy [41], occupational therapy [85], Cognitive Behavior Therapy (CBT) [21,43], and practices based on Applied Behavior Analysis (ABA) [8,33]. ...
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Neurodevelopmental Disorders (NDD) are a group of conditions with onset in the developmental period characterized by deficits in the cognitive and social areas. Conversational agents have been increasingly explored to support therapeutic interventions for people with NDD. This survey provides a structured view of the crucial design features of these systems, the types of therapeutic goals they address, and the empirical methods adopted for their evaluation. From this analysis, we elaborate a set of recommendations and highlight the gaps left unsolved in the state of the art, upon which we ground a research agenda on conversational agents for NDD.
... To analyze the video recordings, we used techniques inspired by structured observation [54]. The coding scheme contains behaviors used in previous works that observed similar tasks for children with autism [34,55,56] (Table 4). We focused on the following factors when observing each video: the amount of time the children spent focused on the task [55], whether they exhibited positive or negative emotions [56], how many movements each child performed, and if the movements had an aim or not [34], and the kind of help they needed to execute the movement. ...
... The coding scheme contains behaviors used in previous works that observed similar tasks for children with autism [34,55,56] (Table 4). We focused on the following factors when observing each video: the amount of time the children spent focused on the task [55], whether they exhibited positive or negative emotions [56], how many movements each child performed, and if the movements had an aim or not [34], and the kind of help they needed to execute the movement. For instance, help could be verbal (e.g., the psychologist says "move your arm"), physical (e.g., the psychologist moves the arm of the child), or gestural (e.g., the psychologist moves his/ her arm to show the children how to do the movement) [55]. ...
Article
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Interactive sonification is an effective tool used to guide individuals when practicing movements. Little research has shown the use of interactive sonification in supporting motor therapeutic interventions for children with autism who exhibit motor impairments. The goal of this research is to study if children with autism understand the use of interactive sonification during motor therapeutic interventions, its potential impact of interactive sonification in the development of motor skills in children with autism, and the feasibility of using it in specialized schools for children with autism. We conducted two deployment studies in Mexico using Go-with-the-Flow, a framework to sonify movements previously developed for chronic pain rehabilitation. In the first study, six children with autism were asked to perform the forward reach and lateral upper-limb exercises while listening to three different sound structures (i.e., one discrete and two continuous sounds). Results showed that children with autism exhibit awareness about the sonification of their movements and engage with the sonification. We then adapted the sonifications based on the results of the first study, for motor therapy of children with autism. In the next study, nine children with autism were asked to perform upper-limb lateral, cross-lateral, and push movements while listening to five different sound structures (i.e., three discrete and two continues) designed to sonify the movements. Results showed that discrete sound structures engage the children in the performance of upper-limb movements and increase their ability to perform the movements correctly. We finally propose design considerations that could guide the design of projects related to interactive sonification
... These conditions involve numerous pathological perspectives such as specific autism-related anxieties (White et al., 2014). Governing neural processes, music therapy provides clinical means of emotion regulation (Moore, 2013), hence its relevance to the treatment of autism spectrum disorders (Kim, Wigram & Gold, 2009). ...
... From literature, we know that standard therapeutic interventions for children with NDD explore diferent approaches, such as play therapy [7], [34], cognitive behavior therapy [24,36], and music therapy [58]. They aim to help children strengthen adaptive behaviors, develop stronger emotional and relational skills [7,39], learn receptive and expressive language [27], and improve their self-care. In particular, the therapeutic tasks usually focus on developing: i) association skills; ii) emotional skills; iii) relational skills; iv) communicative and speech skills; v) abstract concepts (e.g., time and money). ...
... Research concerning music and autism generally focuses on treating the "symptoms" of autism through musical interventions (e.g. music therapy) which are designed to improve an individual's functioning in several areas, including communication (Edgerton, 1994;Wan et al., 2010), emotional responsiveness (Kim et al., 2009), and social skills (LaGasse, 2017). While these studies may be helpful in some contexts (e.g. in healthcare and therapeutic settings), they do not account for the functions of music that occur naturally in the majority of people's lives and the impact that these functions may have on autistic people. ...
Article
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Current research investigating the functions of music in everyday life has identified cognitive, emotional, and social functions of music. However, previous research focuses almost exclusively on neurotypical people and rarely considers the musical experiences of autistic people. In addition, there is limited research which focuses explicitly on the musical experiences of young people on the autism spectrum. Current research exploring the functions of music may therefore not accurately represent the experiences of the autistic community. This article aims to explore the function of music in the lives of young people on the autism spectrum through a series of interviews. Eleven young people on the autism spectrum age 12 to 25 (M = 19.4) were interviewed about the function of music in their lives. An adaptive interview technique, utilizing multiple methods of communication, was employed to account for the participants’ broad communicative and personal needs. Interpretative phenomenological analysis revealed four key functions of music in the participants’ lives: Cognitive, Emotional, Social, and Identity. Collectively, these results provide a unique insight into the musical experiences of young people on the autism spectrum.
... Neuropsychologist Damasio describes core consciousness experience as non-verbal and noncognitive, arguing that communicating through the use of sound is more effective for music therapists working with people with ASC than language-based interventions [114]. Kim et al. suggest the process of musical attunement relies heavily upon the non-verbal and multi-modal components of music, including vocal and instrument exchanges, facial expressions, eye contact, and synchronous movement and gestures [115]. It could be argued that CymaSense augments that non-verbal communication through its visual modality. ...
Article
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The present research evaluates the effectiveness of CymaSense, a real-time 3D visualisation application developed by the authors, as a means of improving the communicative behaviours of autistic participants through the addition of a visual modality within therapeutic music sessions. Autism spectrum condition (ASC) is a lifelong neurodevelopmental disorder that can affect people in a number of ways, commonly through difficulties in communication. A multi-sensory approach within music sessions encourages people with ASC to engage more with the act of creating music, and with the therapists, increasing their level of communication and social interaction beyond the sessions. This article presents a study evaluating the use of CymaSense within a series of therapeutic music sessions, and a follow-up series of semi-structured interviews. Eight adults with ASC participated in 12 sessions using a single case experimental design approach over a total period of 19 weeks. Using qualitative and quantitative data, the results show an increase in communicative behaviour, for both verbal and non-verbal participants, resulting from the use of CymaSense. Qualitative feedback from interviews provided insight into the factors that contribute to the successful use of the application, as well as aspects that could be improved.
... The study also found that the IMT group with a low IQ (below 70) performed better in the area of social affect than standard care. Similarly, an existing meta-analysis reported music therapy to be more effective than standard care for promoting social interaction and communication (Geretsegger et al., 2014;Simpson & Keen, 2011), and a handful of small randomized controlled trials have also supported the effectiveness of IMT for improving joint attention (a triadic situation in which two people are attending to the same object or event and are aware of each other's focus of attention on the shared object or event), communication, emotional joy, parent-child relationships, synchrony and initiation of engagement, a term used to describe states of joint attention (Gattino et al., 2011;Kim et al., 2008Kim et al., , 2009Thompson et al., 2014). ...
Article
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Introduction: Previous evidence suggests that improvisational music therapy (IMT) can be effective at improving social skills of children on the autism spectrum (CoS). To date, no published research exists regarding the effectiveness of specific IMT techniques. Given the improvised nature of IMT such research is important to understand the effective ingredients of the method. The purpose of this study is to examine the effectiveness of three IMT techniques with minimally verbal CoS: (1) exact imitation, (2) imitation with elaboration, and (3) contingent response. Method: Seven children aged 40 to 56 months (M = 50.1) participated in the study.Inclusion criteria included minimally verbal children (producing fewer than 10 spontaneous words or phrases) between three and five years of age diagnosed with autism spectrum disorder. Each child participated in nine 30-minute sessions designed toinclude one of the three treatment techniques. Hence, three therapy sessions targeted each therapy technique. Sessions were video-recorded, analyzed and coded for treatment fidelity and child engagement. Results: Analysis revealed that there was a significant overall effect of therapist technique on engagement state of a child, Hotelling’s Trace = 4.061, F(10, 14) = 2.843, p = 0.037. The overall pattern suggests that exact imitation and imitation with elaboration may result in better overall engagement than contingent response. Discussion: Results suggest that using IMT imitation techniques may improve engagement. Since engagement is often a clinical goal, and is important in the process of social learning, music therapists are encouraged to consider employing imitation techniques during IMT sessions with CoS.
... Music therapy is based on the assumption that certain processes in musical improvisation and coordination with other music players may help autistic individuals develop social interaction and communicative skills. Music therapy may help in the emotional and motivational responses of the involved individuals, though conclusive results are still lacking (92). ...
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The diagnostic criteria and treatment approaches of autism spectrum disorders (ASD) have changed greatly over the years. Currently, diagnosis is conducted mainly by observational screening tools that measure a child' s social and cognitive abilities. The two main tools used in the diagnosis of ASD are DSM-5 and M-CHAT, which examine persistent deficits in interaction and social communication , and analyze responses to "yes/no" items that cover different developmental domains to formulate a diagnosis. Treatment depends on severity and comorbidities, which can include behavioral training, pharmacological use, and dietary supplement. Behavior-oriented treatments include a series of programs that aim to recondition target behaviors, and develop vocational, social, cogni-tive, and living skills. However, to date, no single or combination treatments have been able to reverse ASD completely. This chapter provides an overview of the current diagnostic and treatment strategies of ASD.
... 2007; Oldfield, 2006), randomised controlled trials (Kim et al., 2008(Kim et al., , 2009, and qualitative studies (Smeijsters & Cleven, 2006). Karkou and Sanderson (2005) describe the need to locate arts therapies work within theoretical frameworks that support, explain and guide practice. ...
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Survey research using questionnaire-based methods is a common and very relevant form of enquiry used in music therapy. This article presents the survey results from three countries (Greece, UK and the Netherlands), aiming at comparing the views of music therapists on the importance of theory and research in the current music therapy practice.
... Moreover, research has indicated that music therapy is not only an effective way to engage children with ASD in non-verbal and rhythmic communications but is also a well-known method in the education/rehabilitation of these children (Kim et al. 2009). In the literature, music teaching/therapy has been demonstrated as an effective means to acquire social/cognitive skills and to improve communicative behaviors in children with ASD (Edgerton 1994;Kim et al. 2008). ...
Article
Virtual Reality (VR) technology is a growing technology that has been used in various fields of psychology, education, and therapy. One group of potential users of VR are children with autism who need education and have poor social interactions; this technology could help them improve their social skills through real-world simulation. In this study, we evaluated the feasibility of conducting virtual music education programs with automatic assessment system for children with autism at treatment/research centers without the need to purchase a robot, resulting in the possibility of offering schedules on a larger scale and at a lower cost. Intervention sessions were conducted for five children with high-functioning autism ranging in age from 6 to 8 years old during 20 weeks which includes a baseline session, a pre-test, training sessions, a post-test, and a follow-up test. Each music education sessions involved teaching different notes and pieces of music according to the child’s cooperation, accuracy, and skill level utilizing virtual reality robots and virtual musical instruments. Actually, by analysis of psychological tests, and questionnaires conducted by a psychologist, we observe slight improvements in cognitive skills because of the ceiling effect. Nevertheless, the effectiveness of the proposed method was proved by conducting statistical analysis on the child’s performance data during the music education sessions which were obtained by using both video coding and the proposed automatic assessment system. Consequently, a general upward trend in the musical ability of participants was shown to occur in these sessions, which warrants future studies in this field.
... Music therapy studies with young autistic children have shown enhanced social verbal and communication skills and emotional development (Dezfoolian et al., 2013;Hillier et al., 2012;Kim et al., 2009;Oldfield, 2006). One project exploring the impact of musical engagement on 35 young people with special educational needs following a summer residential programme found statistically significant increases with a large effect size for self-esteem, emotional well-being, resilience and life satisfaction. ...
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There is accruing evidence which indicates that actively making music can contribute to the enhancement of a range of non-musical skills and lead to other beneficial outcomes.
... Using engaging and evidence-informed musical interventions could lead to improved outcomes and earlier discharge from therapy. However, locating and developing effective evidenceinformed, appealing, and engaging strategies that use music for adolescents to help them meet their goals can be difficult (Adamek & Darrow, 2017;Kim et al., 2009). Furthermore, Gadberry and Sweeney (2017) found that music therapists' training on integrating AAC into music therapy sessions was inconsistent. ...
Article
Adolescents on the autism spectrum may experience challenges with multiple domains of communication that impact their quality of life. Both music therapists and speech-language pathologists (SLPs) implement activities to address these challenges. Empirical evidence suggests that incorporating music into treatment can be an effective way to improve communication. The purpose of this article is to provide suggestions for music therapists assisting adolescents on the autism spectrum to improve their communication skills and ways to collaborate with SLPs in doing so. In this paper, we discuss interprofessional collaborative models (e.g., interdisciplinary, transdisciplinary) and competencies (e.g., coordination, adaptability), as well as music-based clinical experiences that appeal to adolescents, and target improvement of communication skills for learners with complex communication needs.
... These conditions involve numerous pathological properties such as speci c autism-related anxieties (White et al., 2014). Governing neural processes, music therapy provides clinical means of emotion regulation (Moore, 2013), hence its relevance to the treatment of autism spectrum disorders (Kim, Wigram & Gold, 2009). With regard to the Neurodiversity movement, which addresses autistic and other neurodiverse people, Shiloh and LaGasse (2014) present Sensory Friendly Concerts as 'a music enjoyment and making venue that promotes the social acceptance of each individual, speci cally of those who identify as "autistic" and seek to develop an autistic culture and community.' ...
... In education, the group setting prevails; in this context, music and movement interventions are mostly components of superordinate, exercise-based concepts. In terms of method, active improvisational music therapy (IMT) dominates, which is based on active, spontaneous music-making, with the therapist generally following the client's focus of attention, behaviors, and interests (Carpente 2011;Green et al. 2010;Kim et al. 2008Kim et al. , 2009Schumacher 1999;Wigram 2002). This also includes receptive interventions, such as singing and improvising for the client or listening to recorded music. ...
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Music as a non-verbal form of communication and play addresses the core features of autism, such as social impairments, limited speech, stereotyped behaviors, sensory-perceptual impairments, and emotional dysregulation; thus music-based interventions are well established in therapy and education. Music therapy approaches are underpinned by behavioral, creative, sensory-perceptional, developmental, and educational theory and research. The effectiveness of music therapy in the treatment of children with autism spectrum disorder (ASD) is reflected by a huge number of studies and case reports; current empirical studies aim to support evidence-based practice. A treatment guide for improvisational music therapy provides unique interventions to foster social skills, emotionality, and flexibility; in developmental approaches, the formation of interpersonal relationships is key. Since ASD is a lifelong neurodevelopmental condition, music therapy is also appropriate in the treatment of adults with intellectual disability. Diagnostic approaches using musical-interactional settings to assess ASD symptomatology are promising, especially in non-speakers.
... These conditions involve numerous pathological perspectives such as specific autism-related anxieties (White et al., 2014). Governing neural processes, music therapy provides clinical means of emotion regulation (Moore, 2013), hence its relevance to the treatment of autism spectrum disorders (Kim, Wigram & Gold, 2009). ...
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Since the early period of modern music therapy, autism spectrum disorder (ASD) has been considered a main indication for creative and artistic modes of treatment. The seminal work of Juliette Alvin and Gertrud Orff, two pioneers of music therapy, has considerably influenced the methodology and theoretical frameworks for ASD-specific music interventions. The paper gives a survey about the roots of music therapy for people with ASD. Highlighting music therapeutic aims such as the enhancement of social communication, responsiveness and readiness for social inclusion, language and verbal communication skills etc., it presents clinical benefits and how neurosciences explain the therapeutic potential of music for patients with ASD. Scientific research underscores that individuals with ASD exhibit different modes of music processing and tend to construct sound worlds that serve as multifaceted living spaces. This also elucidates why particularly children with ASD show different behavioural features when being involved in musical activities. With regard to different schools and concepts of music therapy, the paper points out that we cannot just speak about only one notion of music therapy, but have to take into account that different music therapeutic approaches are also based on different theoretical frameworks and involve different methods such as communication-based improvisation, outdoor singing, and creative experiences with sounds, words, and body-movements. In this context, our short review particularly explores characteristics of music therapy for children with autism spectrum disorders in China. Many concepts and approaches are a mere import from the West and do not thoroughly explore relevant cultural conditions. Not least due to the fact that music therapy is a culturally sensitive intervention and that music played an important role in Traditional Chinese Medicine and health care, there are strong and high-ranking trends to establish a genuine Chinese music therapy for individuals with ASD in China. As the view of ASD-symptoms goes hand in hand with socio-cultural traditions and norms, cross-cultural and ethnological perspectives have to be taken into account, hence the crucial importance of cultural sensitivity in ASD-related music therapy.
... Child-centred play therapy (CCPT), a mental health intervention between a counsellor and a child facing many types of challenges, is another solution for the social development of children with ASD even though it might not yield immediate results. CCPT has proven its effectiveness across a broad spectrum with social, emotional, and behavioural challenges [10,46,49,80,95]. According to a result reported by Josefi and Ryan [46], children's independence and empathy were increased after nondirective play for sixteen sessions. ...
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It is very challenging for children with autism to express their emotions to others as well as to recognise others’ feelings accurately. As social difficulties of autistic people might aggravate their loneliness and social isolation, a holistic development is required from an early age. This study aimed to suggest a digital intervention for supporting autistic children’s empathy development by using design thinking. This study developed a mobile-interface design on the basis of the human-centred design approach, and a prototype was evaluated by stakeholders with respect to acceptability and usability. Usability was measured by twelve statements of a combination of design guidelines and the system usability scale, and subsequently, open-end interview questions were offered to collect data regarding acceptability. The separate interviews were recorded and transcribed verbatim, and thus, meaningful data were selected and clustered by themes. The result of the qualitative data analysis is represented by eighteen themes in five categories. Altogether, this research suggests a phased (bit-by-bit) strategy for teaching empathy of children with ASD through a digital intervention.
... These conditions involve numerous pathological properties such as speci c autism-related anxieties (White et al., 2014). Governing neural processes, music therapy provides clinical means of emotion regulation (Moore, 2013), hence its relevance to the treatment of autism spectrum disorders (Kim, Wigram & Gold, 2009). With regard to the Neurodiversity movement, which addresses autistic and other neurodiverse people, Shiloh and LaGasse (2014) present Sensory Friendly Concerts as 'a music enjoyment and making venue that promotes the social acceptance of each individual, speci cally of those who identify as "autistic" and seek to develop an autistic culture and community.' ...
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Today, there is strong evidence that music therapy is beneficial to individuals with autism spectrum disorder (ASD). A short review gives insights into the therapeutic outcomes of various approaches and conflicting positions and sheds light on CoMT-relevant aspects. To harmonise contradictions , a Chinese CoMT model in which the individual plays the crucial role is proposed. ASD symptoms encompass serious difficulties with communication and social inclusion and involve various issues of acculturation, hence the cross-cultural characteristics of contemporary curative approaches. Although both music and community-based activities play an important role in the therapy and education of children with ASD, there is a lack of related models of community music therapy (CoMT). The paper presents CoMT for children with ASD in the Chinese harbour town Ning Bo, introduces the Ning Bo Xing Bao Autism Family Support Centre and discusses the multifaceted role of professional music therapists involved.
Conference Paper
Neurodiversity, a term, associated with a rights-based disability agenda (Silverman, 2015), proposes that people's neurologically-based differences are no different to other social classifications such as gender and race (Singer, 2017). The Neurodiversity movement challenges systems and interventions with “normalization” as the core agenda (Bascom, 2012). Instead, “maximization” of strengths and resources is encouraged, with advocates seeking to influence all levels of society, from policy to interpersonal, everyday practices. The deep humanistic inheritance of the music therapy profession (Abrams 2015), along with ecological and community paradigms that have become more prevalent in recent times are perhaps well aligned with the principles of neurodiversity. However, disability scholars have critiqued music therapy as supporting the medical model of disability and therefore risk contributing to oppression (Cameron, 2014; Straus, 2011). During a roundtable at the European Congress of Music therapy, 2019, we are planning to discuss the possible contributions of the neurodiversity movement to music therapy. Important questions will be raised about definitions and ethics in music therapy, and on the personhood of less advocated individuals. In the present roundtable we will further discuss these topics as well as the role of music and the music therapist as viewed through the neurodiversity perspective. References Abrams, B. (2015). Humanistic approaches. In B. L. Wheeler (Ed.) Music therapy handbook (p148-160). NY: The Guilford Press. Ansdell, G. (2002). Community Music Therapy & the Winds of Change. A Discussion Paper Voices 2(2), July 1. Retrieved from: http://www.voices.no/mainissues/Voices2(2)ansdell.html Bascom, J. (2012). Loud hands: Autistic people, speaking. Washington DC: Autism Self-Advocacy Network Press. Cameron, C. (2014). Does Disability Studies have Anything to Say to Music Therapy? And Would Music Therapy Listen if it Did?. Voices: A World Forum for Music Therapy, 14(3). https://doi.org/10.15845/voices.v14i3.794 Silberman, S. (2015). Neurotribes: The legacy of autism and how to think smarter about people who think differently. Atlantic Books. Singer, J. (2017). Neurodiversity: The Birth of an idea. (Kindle Edition). Retrieved from Amazon.com Straus, J. (2011). Extraordinary Measures: Disability in Music. Oxford: Oxford University Press.
Chapter
In an effort to improve the quality of life for individuals with Autism Spectrum Disorders (ASD) by harnessing the therapeutic power of music, the Terpsichore software interface constitutes a proposal to center music-oriented activities around the development of compositional skills instead of the passive appreciation of music through the reproduction of existing content. This interface aims to assist learners with ASD in composing original tonal music and soundscapes, with a view of additionally contributing to the accomplishment of non-musical goals. To assess the software’s effectiveness, a pilot study was conducted in which twenty-eight adolescents and adults diagnosed with ASD, participated in a series of software instruction sessions administered at four institutions in the Attica region of Greece. The study attested that participants generally responded to Terpsichore in a positive manner, with regards to their comfort in completing required tasks and their shifts in behavior, communication and emotional state.
Chapter
Over the last decade, vast research has been conducted on assistive technology devices and the potential implementation of these devices in the daily lives of individuals with disabilities. Many devices are new to the public and may require further development, but it is important to disseminate information about these useful technologies, which often afford users more independence with their activities of daily living. Unfortunately individuals with disabilities often encounter stigma; research suggests that assistive technology devices may at times contribute to this ostracism. This chapter reviews a variety of technologies that have been used to improve the quality of life of individuals with varying disabilities. These devices are presented in the context of introducing a new children's television show, Realabilities, a pro-social and stop-bullying children's television program that seeks to enhance the social interaction and initiation of typical children towards children with disabilities. Directions for future research and implementation of these devices are also discussed. Full Text Preview Legislation Supporting Assistive Technology Devices And Services During the Civil Rights Movement of the early 1950s, it was mandated that assistive technology be provided to children with special needs. The Education for All Handicapped Children Act (P.L. 94-142) stems from the decision made in the Brown vs. Board of Education case (1954) where separate education was declared not to be equal education under the 14th Amendment of the Constitution (Behrmann, 1998). With this legislation, a “free appropriate public education in the least restrictive environment” for children with disabilities was to be established. This legislation implied that they may be placed in the same classrooms as their typical peers. Inclusion continues to be debated today, and although it is encouraged in many schools, it remains a controversial issue. Continue Reading
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زمینه و هدف: اختلالات طیف اتیسم شامل گروهی از اختلالات رشدی – عصبی هستند که در آن ها تخریب در تعاملات و مهارت های اجتماعی، تاخیردررشد زبان و گستره رفتاری وجود دارد. افزایش شیوع اتیسم و آثار مخرب روانی، اجتماعی، اقتصادی ،این اختلال بسیار چشمگیر و برای جامعه و خانواده ها هزینه بر است. ازاین رو درمانهای متفاوتی در جهت توانبخشی این کودکان وجود دارد،این درمان ها عبارتند از: یکپارچگی حسی، درمان های خانوادگی، تئاتردرمانی،بازی درمانی ،دارو درمانی، آموزش های رفتاری، آموزش های شناختی، موسیقی درمانی و...دردهه های اخیر موسیقی درمانی در درمان بسیاری از بیماری های روانشناختی استفاده میشودو دربسیاری از موارد، تنها ابزار و وسیله ارتباط فعال در کودکان اتیسم با محیط موسیقی میباشد، وموسیقی درمانی روشی است که برای بهبود سازگاری اجتماعی،ثبات عاطفی،کنترل شخصی، افزایش تمرکز و انگیزش کودکان اتیسم استفاده میشود. نتیجه گیری: مرور پژوهش های موجود پیرامون کاربرد موسیقی درمانی درمهارت های اجتماعی کودکان با اختلال طیف اتیسم نشان داد که موسیقی درمانی تاثیر مناسبی برمهارت های اجتماعی کودکان اتیسم، از قبیل مهارتهای کلامی و غیر کلامی، مهارت های شناختی و عاطفی و رشد مهارت های گفتار و زبان آنها دارد. واژگان کليدي: موسیقی درمانی، مهارت اجتماعی، اختلالات طیف اتیسم
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Objectives: This study aims to investigate the effects of prenatal music therapy on fetal and neonatal status. Design and setting: A systematic review and meta-analysis of randomized controlled trials. Interventions: Ovid MEDLINE, Embase, Web of Science, Cochrane Library, and Chinese Biomedical Literature Database were searched for studies investigating the effects of prenatal music therapy. Two independent investigators carried out the literature selection, data analysis, and evidence quality assessment. Eligible studies were qualitatively described and synthesized using meta-analyses. Main outcome measures: The outcomes included fetal or neonatal status. Results: After screening the 821 records yielded by the systematic search, we identified nine eligible studies involving 1,419 pregnant women. Eight studies were included in the meta-analysis, and three outcomes were synthesized. Compared with no music therapy, prenatal music therapy did not change fetal heart rate (mean difference [95% CI]: -0.28 [-3.75-3.20] beat/min, P = 0.88, moderate quality), number of fetal movements (mean difference [95% CI]: 0.50 [-0.79-1.78] time/min, P = 0.45, low quality), or number of accelerations (mean difference [95% CI]: 0.16 [-0.87-1.19] time/min, P = 0.76, low quality). This result did not change when two studies with a high risk of bias were excluded. Subgroup analysis showed that prenatal music therapy did not change fetal heart rate, number of fetal movements, or number of accelerations in different intervention phases. Conclusions: Prenatal music therapy might not change fetal and neonatal status. However, more systematic strategies of prenatal music therapy deserve further exploration.
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Background and Aims Autism has many characteristics and dimensions that make it very difficult to treat. Music therapy promises to overcome some of these challenges by creating an enjoyable healing process. However, studies on its effectiveness in Iran are scarce and the acceptance of treatment by children and mothers has not yet been studied. The main purpose of the preset study is to examine acceptance, effectiveness, as well as challenges in the treatment process. Methods The present study has a concurrent mixed-method design that was conducted in the form of a multiple-case study. Thus, participants included five children with autism (without severe cognitive and learning disorders) who were in the second age of childhood (between 7 and 12 years old). They were selected through purposeful sampling. Finally, one of them was excluded from the study process. Music therapy was performed individually for an average of eight one-hour sessions. Its effectiveness was studied through the Matson Evaluation of Social Skills Scale and the Stirman Theory of Mind Scale, interviews with mothers and therapist, and observation of therapy sessions. Results Observing the participants’ reactions in sessions and interviews with the mothers showed good compliance of treatment and even their enthusiasm. Mothers also showed overall satisfaction with the treatment. The effect of treatment was significant on social and cognitive skills, the theory of mind, but anxiety and repetitive behaviors did not appear to be reduced. Also, two challenges in the treatment process were significant: high anxiety and lack of concentration of children in the initial sessions, as well as a lack of passion and interest to practice at home. Conclusion Music therapy seems a potentially effective approach for children with autism, especially as the affected ones showed good acceptance and enthusiasm. Comparing this approach with a variety of psychological interventions for children with autism can be helpful.
Chapter
This chapter begins with an overview of music therapy research with autistic children (tamariki takiwātanga). The predominance of positivist research, which has been produced to meet the traditional demands of evidence-based practice (EPB), is highlighted. This is followed by an outline of music therapy practice, beginning with an indication of the range of theoretical frames that underpin practice internationally, the goals that are being addressed, and the music therapy methods that are employed.
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Background: Autism is a neurodevelopment disorder that usually appears in early years and its main characteristics are repeated problems in social interaction, abnormal verbal and nonverbal communication, and stereotyped patterns of behavior and interests. Two of the therapies that are currently being discussed are music therapy and play therapy. Music with play is one of the skills necessary for communication in children with autism who do not use language to communicate. As a result the experience of music and play and the interaction between them ends in improving communication which is one of the main problems in these children. Through the process of integrating music and plays, patients will move to reach some predetermined goals by the help of some specialists who are trained in such courses. These goals may include improving motor, social and interpersonal development, reduced stereotypical behaviors, achieving self-awareness, but they are not limited to these. Conclusion: In this article, the importance of music education and play and the effect of training and playing music in children with autism is discussed. It is concluded that music therapy should be useful in conjunction with play therapy
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Background: Social interaction and social communication are among the central areas of difficulty for autistic people. Music therapy uses music experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of autistic people. Music therapy has been applied in autism since the early 1950s, but its availability to autistic individuals varies across countries and settings. The application of music therapy requires specialised academic and clinical training which enables therapists to tailor the intervention to the specific needs of the individual. The present version of this review on music therapy for autistic people is an update of the previous Cochrane review update published in 2014 (following the original Cochrane review published in 2006). Objectives: To review the effects of music therapy, or music therapy added to standard care, for autistic people. Search methods: In August 2021, we searched CENTRAL, MEDLINE, Embase, eleven other databases and two trials registers. We also ran citation searches, checked reference lists, and contacted study authors to identify additional studies. Selection criteria: All randomised controlled trials (RCTs), quasi-randomised trials and controlled clinical trials comparing music therapy (or music therapy alongside standard care) to 'placebo' therapy, no treatment, or standard care for people with a diagnosis of autism spectrum disorder were considered for inclusion. Data collection and analysis: We used standard Cochrane methodological procedures. Four authors independently selected studies and extracted data from all included studies. We synthesised the results of included studies in meta-analyses. Four authors independently assessed risk of bias (RoB) of each included study using the original RoB tool as well as the certainty of evidence using GRADE. MAIN RESULTS: We included 16 new studies in this update which brought the total number of included studies to 26 (1165 participants). These studies examined the short- and medium-term effect of music therapy (intervention duration: three days to eight months) for autistic people in individual or group settings. More than half of the studies were conducted in North America or Asia. Twenty-one studies included children aged from two to 12 years. Five studies included children and adolescents, and/or young adults. Severity levels, language skills, and cognition were widely variable across studies. Measured immediately post-intervention, music therapy compared with 'placebo' therapy or standard care was more likely to positively effect global improvement (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.06 to 1.40; 8 studies, 583 participants; moderate-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) = 11 for low-risk population, 95% CI 6 to 39; NNTB = 6 for high-risk population, 95% CI 3 to 21) and to slightly increase quality of life (SMD 0.28, 95% CI 0.06 to 0.49; 3 RCTs, 340 participants; moderate-certainty evidence, small to medium effect size). In addition, music therapy probably results in a large reduction in total autism symptom severity (SMD -0.83, 95% CI -1.41 to -0.24; 9 studies, 575 participants; moderate-certainty evidence). No clear evidence of a difference between music therapy and comparison groups at immediately post-intervention was found for social interaction (SMD 0.26, 95% CI -0.05 to 0.57, 12 studies, 603 participants; low-certainty evidence); non-verbal communication (SMD 0.26, 95% CI -0.03 to 0.55; 7 RCTs, 192 participants; low-certainty evidence); and verbal communication (SMD 0.30, 95% CI -0.18 to 0.78; 8 studies, 276 participants; very low-certainty evidence). Two studies investigated adverse events with one (36 participants) reporting no adverse events; the other study found no differences between music therapy and standard care immediately post-intervention (RR 1.52, 95% CI 0.39 to 5.94; 1 study, 290 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: The findings of this updated review provide evidence that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. The certainty of the evidence was rated as 'moderate' for these four outcomes, meaning that we are moderately confident in the effect estimate. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-intervention. For these outcomes, the certainty of the evidence was rated as 'low' or 'very low', meaning that the true effect may be substantially different from these results. Compared with earlier versions of this review, the new studies included in this update helped to increase the certainty and applicability of this review's findings through larger sample sizes, extended age groups, longer periods of intervention and inclusion of follow-up assessments, and by predominantly using validated scales measuring generalised behaviour (i.e. behaviour outside of the therapy context). This new evidence is important for autistic individuals and their families as well as for policymakers, service providers and clinicians, to help in decisions around the types and amount of intervention that should be provided and in the planning of resources. The applicability of the findings is still limited to the age groups included in the studies, and no direct conclusions can be drawn about music therapy in autistic individuals above the young adult age. More research using rigorous designs, relevant outcome measures, and longer-term follow-up periods is needed to corroborate these findings and to examine whether the effects of music therapy are enduring.
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Music-based speech language interventions have shown promise to support young children with autism, other speech and language deficits, and Dual Language Learners (also known as DLL, English Language Learners, or ELL). Online edtech learning programs may produce greater positive outcomes for children by including parents as mediators of the intervention. This study measured the preliminary effectiveness of Sing and Speak 4 Kids (SS4Kids), a music-based online speech and language development game, administered to 26 children ages 2–6 years old with or at risk for a diagnosis of autism, other speech and language deficits or DLL. The children were trained in early intervention settings across 4–6 sessions over a 2-week period in one of three group conditions: (a) teacher only in clinic; (b) parent only at home; (c) both teacher + parent. Measurement of verbal production of target words in pre- and post-training sessions showed that trained words significantly improved from pre-test to post-test Additionally, there was no effect of different group conditions (teacher only vs. parent only vs. both teacher + parent) on children's performance. Results suggest that the SS4Kids program is an effective music-based speech and language training method for supporting target word production in young children across a two week timespan. Importantly, the results also found that group conditions did not influence the improvement, confirming effectiveness of both clinic and home-based parent mediation. During a time when traditional in-person intervention services may be restricted, the current work provides cautious but emerging evidence of the effectiveness of an online edtech evidence-based practice to support the speech and language outcomes for a variety of children in early intervention.
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Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies ( N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.
Research
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Muitos estudos que mostram benefícios na comunicação e interação social em musicoterapia para pessoas com esquizofrenia, como os de GERETSEGGER et al (2017) e SILVERMAN (2015), não se referem ao construto de Cognição Social (SC), Neurocognição ( NC) e / ou seus subdomínios, que são visivelmente classificados como déficits na esquizofrenia, avaliados em outros contextos (GREEN, 2007). Recentemente, a metanálise de Jochum van't Hooft et al (2021) identificou que o processamento de um dos subdomínios da SC classificado como Teoria da Mente, e a percepção musical, podem compartilhar os mesmos circuitos neurobiológicos, porém não exploram a prática musical interativa, muito recorrente nas sessões de musicoterapia no Brasil. A partir da prática musical interativa realizada com pacientes atendidos no CERSAM (Centro de Referência em Saúde Mental) em Belo Horizonte - MG, foi necessário investigar e analisar de modo sistematizado os vestígios que emergem da relação entre musicoterapeuta e paciente no processo conjunto do fazer musical, e o possível impacto da Musicoterapia no atendimento dessa população, abarcando a atenção psicossocial e ideais da reforma psiquiátrica com aspectos neurocientíficos. Para o desenvolvimento das questões de pesquisa foram desenvolvidos três artigos que incluem uma revisão integrativa de literatura, uma descrição do atendimento musicoterapêutico no CERSAM e em serviços de saúde mental e uma microanálise relacionando tais vestígios com a cognição social, neurocognição e sintomas negativos da esquizofrenia. Esta dissertação contribui para o desenvolvimento de uma possível escala de avaliação sobre os domínios da cognição social e neurocognição em Musicoterapia. Foi possível estabelecer uma ponte entre determinadas situações musicais com estes domínios, e se faz necessário um maior aprofundamento teórico e científico para consolidar estas relações. Palavras-chave: Musicoterapia. Saúde Mental. Esquizofrenia. Cognição Social. Memória de Trabalho. Avaliação Musicoterapêutica. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Many studies that show benefits in communication and social interaction in music therapy for people with schizophrenia, such as those by GERETSEGGER et al (2017) and SILVERMAN (2015), do not refer to the construct of Social Cognition (SC), Neurocognition (NC) and / or its subdomains, which are visibly classified as deficits in schizophrenia, evaluated in other contexts (GREEN, 2007). Recently, the meta-analysis by Jochum van't Hooft et al (2021) identified that the processing of one of the SC subdomains classified as Theory of Mind, and musical perception, may share the same neurobiological circuits, but they do not explore interactive musical practice. , very recurrent in music therapy sessions in Brazil. From the interactive musical practice carried out with patients treated at CERSAM (Reference Center for Mental Health) in Belo Horizonte - MG, it was necessary to investigate and systematically analyze the traces that emerge from the relationship between music therapist and patient in the joint process of music making , and the possible impact of Music Therapy in the care of this population, encompassing psychosocial care and ideals of psychiatric reform with neuroscientific aspects. To develop the research questions, three articles were developed that include an integrative literature review, a description of music therapy care at CERSAM and in mental health services, and a microanalysis relating these traces to social cognition, neurocognition and negative symptoms of schizophrenia. This dissertation contributes to the development of a possible assessment scale on the domains of social cognition and neurocognition in Music Therapy. It was possible to establish a bridge between certain musical situations with these domains, and further theoretical and scientific research is needed to consolidate these relationships. Keywords Music Therapy, Mental Health, Schizophrenia, Social Cognition, Working Memory, Music Therapy Evaluation.
Article
The mixed-method study evaluated the effectiveness of the 6-week long Creative Arts-based Parent Training program for parents with children with Autism Spectrum Disorder (ASD). Korean Parenting Stress Index-Short Form and Korean Parenting Efficacy Test were used to examine parental stress and sense of competence. Qualitative data were collected for the experimental group (EG) (n = 17) using a 30 min focus group interview, art journaling, and questionnaires. There was no difference in age (t(25) = 1.38, p = .19) and gender (p = .86) between the experimental and control groups (n = 15). The program was a positive experience. Qualitative data on parental experience and quantitative data on parental stress showed significant change, favoring the EG, t(17)=−2.72, p = .014 after controlling for inequality of variances. The EG highlighted the program as: (a) a social connection; (b) new opportunities to be child-focused, and (c) the learning of importance of emotion for child development. More, implementation promoted changes in both parents and children as the fundamental parenting style and the view on the child and disability changed. Therefore, although the study had some limitations, the program showed the promise of group-based supplementary parent training in parent-mediated, creative arts–based intervention as an early intervention treatment for children with ASD.
Article
Persons with Autism Spectrum Disorder (ASD) may have strengths in musical skills and music perception. Some children with ASD may also have better social engagement in music activities, making music a potential strength for interacting with others. Although children with ASD may be mainstreamed into music education classes, there is little known research on the impact of peer support. The purpose of this project was to examine the impact of peer-assisted learning (PAL) on musical creatiFvity and pro-social skills, between neurotypical (NT) and students with ASD. The following questions were investigated: (a) does music making with a peer impact music creativity differently in NT children and children with ASD, (b) does music making with a peer promote pro-social skills differently in NT children and in children with ASD. The sample included eighteen children with ASD and twenty-eight children with no known disability, between the ages of 9–14. Results of this study provide initial evidence that PAL experiences may be mutually beneficial for children with ASD and NT peers. In particular, an increase in pro-social skills were observed for some children grouped with NT peers, while the amount of time in creative music-making was similar between NT and NT/ASD peer groups.
Article
Music therapists have argued that people who witness music therapy can develop good understandings of processes and potential outcomes. Family members and other experts were invited to critically examine clinical materials, generated from ten new cases of music therapy with children on the autism spectrum and presented in Narrative Assessment form, and to share their perceptions of the work. Narrative assessments include descriptive text and audio and/or video examples which capture and document children’s learning in authentic contexts; and are designed to make learning ‘visible’. Each case was interpreted by two-four people who knew the child, and six other autism experts who did not know the children. These commentators provided rich feedback regarding the personal resources that children and their therapists brought to the music therapy encounter; music therapy processes; and their perceptions of outcomes. Their observations, and their articulation of feelings and beliefs about music therapy, suggest that they developed good understanding and strong appreciation for music therapy as it is practiced in New Zealand. Narrative Assessment and qualitative case studies are highlighted as valuable ways to share professional knowledge and enable families and other stakeholders to understand what happens in music therapy programmes.
Chapter
Lucas was a 6-year-old boy who had good cognitive skills, and was competent with speech and language, reading, and maths. Lucas experienced proprioceptive dysregulationProprioception and would sometimes express himself loudly and forcefully which in turn led him to be viewed as oppositionalAutismsensory differences. His music therapy sessions involved a variety of musical and sensory activities, in response to his interests, and expressions at the moment. Rachael, his music therapist, also engaged him inMethodsverbal interaction verbal discussions which helped him to understand and articulate what he was feeling and “to understand that his actions can also affect other people’s emotions and reactions” (Lucas’ mother).
Chapter
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Empathy, reciprocity and turn-taking are critical therapeutic targets in conditions of social impairment such as Autism Spectrum Disorder (ASD). These aspects are related to each other, converging into the construct of synchrony, which includes emotional, behavioural and, possibly, physiological components. Therefore, being able to quantify the synchrony could impact the way therapists adapt and maximise the efficacy of the interventions. However, current methods are based on the observational coding of behavior, which is time-consuming and usually only performed after the interaction is over. In this study we propose to apply Artificial Intelligence (AI) methods on physiological data in order to obtain a real time and objective quantification of synchrony. In particular, we introduce the Multi-Modal Synchrony dataset (M-MS), which includes 3 sources of information—electrocardiographic signals, video recordings and behavioral coding—to support the study of synchrony in ASD. As a first AI application, we are currently developing an unsupervised model to extract a multivariate embedding of the physiological data. The multivariate embedding has to be compared with the behavioral synchrony label to create a map of physiological and behavioural synchrony. The application of AI in the treatment of ASD may become a new asset for the clinical practice, especially if the possibility of providing real time feedback to the therapist is exploited.
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In the context of the development of prototypic assessment instruments in the areas of cognition, personality, and adaptive functioning, the issues of standardization, norming procedures, and the important psychometrics of test reliability and validity are evaluated critically. Criteria, guidelines, and simple rules of thumb are provided to assist the clinician faced with the challenge of choosing an appropriate test instrument for a given psychological assessment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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The authors have previously described less activation of left speech-related temporal areas in adults with autism when listening to speech-like sounds than in normal adults. Here, they investigated whether this abnormal cortical processing was also present in children with primary autism. Regional cerebral blood flow was measured with positron emission tomography after premedication in 11 autistic children and six nonautistic mentally retarded children during rest and while they were listening to speech-like sounds. As with autistic adults, direct comparison between the two groups revealed significantly less activation in the autistic group localized in left speech-related areas. For the first time to their knowledge, an activation study was performed in children with autism and has confirmed previous results obtained in adults. The abnormal cortical auditory processing observed in both children and adults with autism could be involved in inadequate behavioral responses to sounds and in language impairments characteristic of autism.
Article
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Disturbances in the development of joint attention behaviors and the ability to share affect with others are two important components of the social deficits of young autistic children. We examined the association of shared positive affect during two different communicative contexts, joint attention and requesting. The pattern for the normal children was one of frequent positive affect displayed toward the adult during joint attention situations. Compared to the normal children, the autistic children failed to display high levels of positive affect during joint attention whereas the mentally retarded children displayed high levels of positive affect during requesting as well as joint attention situations. These results lend support to the hypothesis that the joint attention deficits in autistic children also are associated with a disturbance in affective sharing.
Article
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This study examined autistic children's social behavior, affect, and use of gaze during naturalistic interactions with their mothers. Sixteen autistic children, 30 to 70 months of age, and 16 normal children, matched on receptive language, participated. Children and their mothers were videotaped during three situations: a free-play period, a more structured period during which communicative demand was made on the child, and a face-to-face interaction. In all three situations, autistic and normal children did not differ in the frequency or duration of gaze at mother's face. In the one condition (face-to-face interaction) during which affective expressions were coded, autistic and normal children also were not found to differ significantly in the frequency or duration of smiles displayed, and neither group displayed frowns. However, autistic children were much less likely than normal children to combine their smiles with eye contact in a single act that conveyed communicative intent. Autistic and normal children were not found to differ in the percentages of smiles they displayed to social versus nonsocial events. However, when autistic children's responses to mother's smiles specifically were examined, it was found that they were much less likely to smile in response to mother's smiles than were normal children. Finally, it was found that mothers of autistic children displayed fewer smiles and were less likely to smile in response to their children's smiles, when compared with mothers of normal children. These findings suggest that the autistic child's unusual affective behavior may negatively affect the behavior of others.
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We review research evidence on the emergence and development of active “ self-and-other ” awareness in infancy, and examine the importance of its motives and emotions to mental health practice with children. This relates to how communication begins and develops in infancy, how it influences the individual subject's movement, perception, and learning, and how the infant's biologically grounded self-regulation of internal state and self-conscious purposefulness is sustained through active engagement with sympathetic others. Mutual selfother- consciousness is found to play the lead role in developing a child's cooperative intelligence for cultural learning and language. A variety of preconceptions have animated rival research traditions investigating infant communication and cognition. We distinguish the concept of “ intersubjectivity ”, and outline the history of its use in developmental research.
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Sustained interactions and responses to social bids made by children with autism and verbal-age-matched children with mental retardation were recorded in two naturalistic settings. Children with autism produced fewer positive responses and more "no responses" than children with mental retardation; both groups were more likely to make positive responses to adults and not to respond to other children. Furthermore, although the frequency of conversations was not different for the two groups, children with autism were significantly less likely to engage in sustained play compared to children with mental retardation. Results suggest that children with autism are able to master the more rote and need-oriented social skills, such as simple conversation, but may not develop other forms of social interactions, like play.
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The purpose of the present study was to investigate the unconditional and conditional relations between amount of intervention and language development in children with autism. Joint attention skills were proposed as child characteristics that might moderate this relation. The results replicated previous findings that better joint attention skills were associated with greater language development. The results further indicated that the relation between amount of intervention and gain in language age was conditional; it depended upon the child's ability to respond to bids for joint attention from others and initial language skills. The current study demonstrated the utility of employing characteristics of children as moderators of relations between interventions and developmental outcomes.
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We interpret early age-related developments in intentions and socially responsive behaviour with data from home videos of infants who later develop autism or Rett syndrome. Detailed evidence is given from a micro-analytic study of videos of monozygotic twin girls at 11 months, one of whom became autistic in the second year. Changes in this twin's attention, motor tonus, initiative and emotion reduce her prospective control of movements and her anticipations in awareness compared to her sister. These changes were reflected in the child's asynchronous social behaviour, which frustrated the father's attempts to support her attempts to walk, share toys, or play a game, confusing his anticipations, and this further reduced mutual attention and joint activity. Observations of the development of girls with Rett syndrome in the first year reveal changes in motor coordination, attention and communicative initiative, indicative of a failure of intrinsic core brain regulations of neural development and conscious activity. Notwithstanding that the two conditions show clear differences in both brain growth and early development of skills and sociability, the first signs of autism and Rett syndrome have important similarities. We conclude with recommendations for an approach to early diagnosis and treatment, applicable for the whole range of developmental brain disorders, including Rett syndrome and autism, that attempts to identify residual capacities for sympathetic motivation and collaborative learning-an approach that deliberately tries to support weakened rhythmic impulses for motor, perceptual and communicative functions in the growing infant brain.
Book
A guide to using S environments to perform statistical analyses providing both an introduction to the use of S and a course in modern statistical methods. The emphasis is on presenting practical problems and full analyses of real data sets.
Article
When children with Autistic Spectrum Disorder (ASD) are assessed in music therapy, significant strengths, potentials and resources emerge that may remain hidden in other, more formalised assessments. Therefore, it is becoming more necessary to develop a systematic method of describing this responsiveness, in order to define the expectations of therapy. Music therapy is a particularly important intervention for children with ASD to engage and nurture their capacity for flexibility, creativity, variability and tolerance of change, in order to balance the more structured and behaviourally driven education that is currently popular. The potential of treatment can be defined within the context of meeting healthcare needs. A case study will illustrate a model for defining ‘expectations of therapy’, by drawing on one child's awakened capacity for interaction through shared, improvised music-making. This article includes a long appendix providing an evidence-based review and recommendations regarding assessment and referral criteria based on current research and clinical evidence.
Chapter
In the ethnographically informed approach to observational research one studies everyday settings, and seeks to understand actions and meanings in their social context (Silverman 1993; Wolcott 1990). This approach is a strong tool for investigating interactions of a more or less implicit character. Combined with video micro analysis, the ethnographic approach is, furthermore, very useful in recognising small indicators of communication and social interaction in music therapy with clients with severe communicative limitations. Especially with this client group, the method can be used to confirm or reject interpretations of the child’s actions as being social attempts to take part in the interaction, even though these actions may seem vague, arbitrary or even ambivalent. Because the method is suitable for describing what actually happens between client and therapist, it can also be used when the therapist, student or trainer wants to be aware of interactions taking place partly or fully outside of the therapist’s awareness, either because they are taken for granted or because of “blind spots” in the way they are perceived. The following describes some selected relevant steps of analysis, illustrated by a case from my doctoral study on music therapy interactions with children with severe functional limitations, including children with autism (Holck 2002).
Article
This study documents the rate, mean duration, and mode of infants' affective displays. Using a cross-sequential design, infants were observed in their homes from 6 to 18 months playing with their mothers, with peers, and alone. Affect rates were higher with mothers than peers. With increasing age, affect rates as well as the vocal mode increased, while mean durations and facial and motoric modes decreased. Affect was most likely when infants were engaged with mothers or peers in person play. It also occurred often when infants first became engaged with the same object their partner was manipulating; with mothers (but not peers) affect continued to be expressed throughout these periods of shared object play. Rates were elevated when mothers moved objects repetitively. Discussion focuses on how infants' earlier-developing affective communication skills may continue to be used as they begin to explore the world of objects and on how adults may support this integration of expressive and referential communication.
Article
Disturbances in the development of joint attention behaviors and the ability to share affect with others are two important components of the social deficits of young autistic children. We examined the association of shared positive affect during two different communicative contexts, joint attention and requesting. The pattern for the normal children was one of frequent positive affect displayed toward the adult during joint attention situations. Compared to the normal children, the autistic children failed to display high levels of positive affect during joint attention whereas the mentally retarded children displayed high levels of positive affect during requesting as well as joint attention situations. These results lend support to the hypothesis that the joint attention deficits in autistic children also are associated with a disturbance in affective sharing.
Article
2nd Ed, Repr Bibliogr. s. 149-150
Article
The present study was designed to examine the effects of social stimulation on the joint attention behavior of 20 autistic children under 6 years of age, 20 receptive language-matched Down syndrome children, and 20 receptive language matched-normally-developing infants. Children's social and non-social engagement states were measured during two experimental play sessions and during free play with parent. For all groups, joint attention was increased when adult play behavior closely followed and was contingent on the behavior of the children; however, the autistic children were significantly less responsive to the experimental manipulation than control subjects. In contrast, the autistic children were no less responsive in terms of other forms of social engagement. Results are interpreted as supporting a model of joint attention deficits in autism that involves factors inherent to the disorder in transaction with social context.
Article
Expression of emotion was examined in a group of 10 preschool‐aged autistic children and a control group of 10 developmentally delayed children matched for chronological and mental age. Each child was videotaped for 15 minutes of interaction with the mother, a child psychiatrist, and the nursery school teacher. Affective expression was recorded using a behavior checklist. The autistic children were found to display less positive affect that the delayed children (p < 0.01). In addition, the positive affect displayed by the autistic children was less likely to be partner‐related and more likely to be related to self‐absorbed activity than was the case with the delayed children (p < 0.001). The groups were not found to differ in the frequency of negative affect.
Article
This study provided a systematic analysis of improvised tone sequences of autistic children, as compared to musical improvisations by normal and mentally retarded control subjects. The data indicate that autistic children's tone patterns, analyzed and scored for rhythm, restriction, complexity, rule adherence, and originality, almost reached the scores of normal children. The highest individual total score in the study was achieved by an autistic child. Autistic children scored significantly higher than a control group of mentally retarded individuals. The autistic children's tone sequences showed high scores on the rhythm, restriction, and originality scales which support the notion of unusual musical responsiveness and abilities when compared to results in other performance and behavioral areas. In terms of complexity and rule adherence, autistic children's tone sequences resembled those of the mentally retarded by being rather short and repetitive.
Article
The Pre-Linguistic Autism Diagnostic Observation Schedule (PL-ADOS) is a semistructured observation scale designed for use as a diagnostic tool for children less than 6 years old who are not yet using phrase speech and are suspected of having autism. The PL-ADOS takes approximately 30 minutes to administer and is appropriate for use with this population because of its emphasis on playful interactions and the use of toys designed for young children. Reliability studies indicated that both individual activity ratings and summary ratings could be reliably scored from videotaped assessments by naive raters. Additionally, PL-ADOS scores of nonverbal preschool-aged children referred for clinical diagnosis and classified on the basis of a diagnostic team's clinical judgment, clearly discriminated between autistic and nonautistic developmentally disabled children. The resulting diagnostic algorithm is theoretically linked to diagnostic constructs associated with ICD-10 and DSM-IV criteria for autism.
Article
Longitudinal videotape recordings of six young children with autism and six age- and language-matched children with Down syndrome in structured play with their mothers at home were coded for the focus of the child's visual attention for four bimonthly visits and for facial affect for two of the four visits. The main finding was that the children with autism showed reduced expression of positive affect in a familiar social context. The autistic group attended to the mother's face and the researchers only about half as much as the Down syndrome group, but these differences did not reach statistical significance. Compared to the Down syndrome group, the autistic group displayed a smaller proportion of their total positive affect toward the mother's face and toward the researcher, but only the latter group difference reached statistical significance. Although limited by the small sample size, these findings suggest that autistic children's known deficits in attention and affective responsiveness to others persist even in structured interactions with a familiar partner in the home.
Article
This study examined the extent to which mothers of preschool children with autism use language that is related to the child's focus of attention. Fourteen mother-child dyads involving preschool children with autism participated in this study, along with 14 matched dyads involving typically developing preschool children. Both groups were observed during 15 minutes of free play. Results revealed that the mothers of children with autism directed verbalizations to something within the child's focus of attention as frequently as the mothers of typically developing children. Thus, children with autism had as many opportunities to benefit from verbal input related to their focus of attention as did typically developing children. However, mothers of children with autism directed verbalizations to something not within the child's focus of attention more frequently than mothers of typically developing children. This nonrelated input may have reflected the mothers' attempts to adapt to their children's difficulties in attention and interaction.
Article
The purpose of this study was to identify the specific aspects of social engagement that distinguish infants with autism from infants of similar age and developmental level who do not have autism. Ten parents of preschoolers with autism and 10 parents of matched children without autism were given a semistructured interview, the Detection of Autism by Infant Sociability Interview (DAISI), which elicits reports on whether 19 aspects of social engagement characteristic of typically developing infants were present at some time during the child's first 24 months. The reports of infants with autism differed from those of the control group on 16 items. Findings suggest that infants with autism have marked limitation in both person-to-person and person-person-object social engagement, in keeping with the theory that autism involves impairments in primary as well as secondary intersubjectivity (Hobson, 1993a).
Article
The present study focused on behaviors that caregivers of children with autism show during play interactions, particularly the extent to which the caregiver's behavior is synchronized with the child's focus of attention and ongoing activity. The study had two major findings. First, caregivers of children with autism synchronized their behaviors to their children's attention and activities as much as did caregivers of children with developmental delay and caregivers of typically developing children, matched on language capacities. Second, caregivers of children with autism who showed higher levels of synchronization during initial play interactions had children who developed superior joint attention and language over a period of 1, 10, and 16 years than did children of caregivers who showed lower levels of synchronization initially. These findings suggest a developmental link between parental sensitivity and the child's subsequent development of communication skills in children with autism. Implications for parent training interventions are discussed.
Article
Reviews the Vineland Social Maturity Scale by A. Edgar Doll (see record 1947-03773-000). An instrument that has been in use for thirty years is hardly news. The first article about the Vineland Social Maturity Scale by Edgar Doll appeared in 1935, after almost ten years of use and development at the Vineland Training School; the last revision was made in 1936, and the manual accompanying the current form of the scale was published in 1947. The Vineland Social Maturity Scale is a well known measure of the social and adaptational skills, habits, traits, coping behaviors, and interpersonal reactions of subjects between the ages of 0-1 and 25 plus. The Vineland Social Maturity Scale has its greatest usefulness in distinguishing between real and pseudo-feeblemindedness. The main purpose of this summary is neither to describe the Vineland Social Maturity Scale nor to present a survey of the published research on it; it is rather to discuss some aspects of its implied rationale, and some cautions in its application. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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
We studied the association between an adult's behavior and episodes of social engagement (ESEs) in young children with autism during play-based assessment. ESEs were defined as events in which a child looked toward the adult's face and simultaneously showed an additional form of communicative behavior. The adult's behavior before each ESE, and before time-sampled control periods, was rated using Coding Active Sociability in Preschoolers with Autism (CASPA). As predicted, adult musical/motoric activity, communications that followed the child's focus of attention, scaffolding through social routines, imitations of the child, and adult repetitions were significantly more prevalent before ESEs, but cognitive assessment activities, adult inactivity, and "ignoring" were significantly less prevalent. We consider the implications for understanding the developmental psychopathology of autism.
Article
Twenty six children with autism, 24 children with developmental disabilities, and 15 typically developing children participated in tasks in which an adult displayed emotions. Child focus of attention, change in facial tone (i.e., hedonic tone), and latency to changes in tone were measured and summary scores of emotional contagion were created. Group differences existed in the ratio of episodes that resulted in emotional contagion. Correlations existed between measures of emotional contagion, measures of joint attention, and indices of severity of autism. Children with autism demonstrated muted changes in affect, but these responses occurred much less frequently than in comparison groups. The findings suggest directions for early identification and early treatment of autism.
Article
Synchrony, a construct used across multiple fields to denote the temporal relationship between events, is applied to the study of parent-infant interactions and suggested as a model for intersubjectivity. Three types of timed relationships between the parent and child's affective behavior are assessed: concurrent, sequential, and organized in an ongoing patterned format, and the development of each is charted across the first year. Viewed as a formative experience for the maturation of the social brain, synchrony impacts the development of self-regulation, symbol use, and empathy across childhood and adolescence. Different patterns of synchrony with mother, father, and the family and across cultures describe relationship-specific modes of coordination. The capacity to engage in temporally-matched interactions is based on physiological mechanisms, in particular oscillator systems, such as the biological clock and cardiac pacemaker, and attachment-related hormones, such as oxytocin. Specific patterns of synchrony are described in a range of child-, parent- and context-related risk conditions, pointing to its ecological relevance and usefulness for the study of developmental psychopathology. A perspective that underscores the organization of discrete relational behaviors into emergent patterns and considers time a central parameter of emotion and communication systems may be useful to the study of interpersonal intimacy and its potential for personal transformation across the lifespan.
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Boddaert, N., Chabane, N., Belin, P., Bourgeois, N., Royer,V., Barthelémy, C., Mouren-Simeoni, M., Phillippe, A., Brunelle, F., Samson,Y. & Zilbovicius, M. (2004) 'Perception of Complex Sounds in Autism: Abnormal Auditory Cortical Processing in Children', American Journal of Psychiatry 161: 2117-20.