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Brief Report: The Effects of Tomatis Sound Therapy on Language in Children with Autism

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Due to the myriad of problems associated with autism, parents often consider alternative treatments. The investigation was undertaken to determine the effects of the Tomatis Method on language skills in children with autism utilizing a randomized, double-blind, placebo-controlled, crossover design. The results indicated that although the majority of the children demonstrated general improvement in language over the course of the study, it did not appear to be related to the treatment condition. The percent change for Group 1 (Placebo/Treatment) for treatment was 17.41%, and placebo was 24.84%. Group 2 (Treatment/Placebo) showed -3.98% change for treatment and 14.15% change for placebo. The results reflect a lack of improvement in language using the Tomatis Method for children with autism.
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BRIEF REPORT
Brief Report: The Effects of Tomatis Sound Therapy on Language
in Children with Autism
Blythe A. Corbett Æ Kathryn Shickman Æ
Emilio Ferrer
Published online: 3 July 2007
! Springer Science+Business Media, LLC 2007
Abstract Due to the myriad of problems associated with
autism, parents often consider alternative treatments. The
investigation was undertaken to determine the effects of the
Tomatis Method on language skills in children with autism
utilizing a randomized, double-blind, placebo-controlled,
crossover design. The results indicated that although the
majority of the children demonstrated general improve-
ment in language over the course of the study, it did not
appear to be related to the treatment condition. The percent
change for Group 1 (Placebo/Treatment) for treatment was
17.41%, and placebo was 24.84%. Group 2 (Treatment/
Placebo) showed –3.98% change for treatment and 14.15%
change for placebo. The results reflect a lac k of improve-
ment in lang uage using the Tomatis Method for children
with autism.
Keywords Autism ! Tomatis ! Alternative treatment
Introduction
Autism is a severe neurodevelopmental disorder charac-
terized by impairment in verbal and nonverbal communi-
cation, reciprocal social interaction, and a restricted
repertoire of activities and interests (American Psychiatric
Association 1994). Individuals with autism frequently have
concomitant auditory processing problems especially as
related to the processing of speech (Gervais et al. 2004;
Lepisto et al. 2005; Samson et al. 2005; Tecchio et al.
2003). It has been sugges ted that impaired auditory per-
ception skills may be associated with deficits in commu-
nication and recipr ocal social skills (Kellerman and
Gorman 2005).
Considerable empirical evidence has shown that early
intervention based on applied behavior analysis (ABA) can
result in significant, comprehensive and lasting improve-
ments in children with autism (e.g. Birnbrauer and Leach
1993; Eikeseth et al. 2002; Eldevik et al. 2006; Lovaas
1987; McEachin et al. 1993; Smith et al. 2000). Addi-
tionally, traditional interventions such as speech and lan-
guage therapy have been used to improve the language and
communication skills of children with autism. However,
parents looking for solutions may consider alternative
treatments most of which have not been subjected to
clinical research (American Academy of Pediatrics 2001).
This paper describes a study designed to determine the
effectiveness of one such alternative treatment, the Tomatis
Method of sound based therapy (Tomatis).
There has been growing interest in the United States in
Tomatis and other alternative treatments, which incorpor ate
forms of music therapy. However, there is a lack of research
to support or refute such interventions (Thompson and An-
drews 2000). To date, there have been no well-con trolled,
experimentally designed studies from peer-reviewed jour-
nals examining the efficacy of Tomatis in autism. This is
concerning due to the time and financial resources that could
be directed to more proven interv entions. Baranek warned
that ‘relying on non-harmful but potentially ineffective
B. A. Corbett (&)
Department of Psychiatry and Behavioral Sciences, University
of California, Davis, 2230 Stockton Boulevard, Sacramento, CA
95817, USA
e-mail: blythe.corbett@ucdmc.ucdavis.edu
B. A. Corbett ! K. Shickman
The M.I.N.D. Institute, University of California, Davis,
Sacramento, CA, USA
E. Ferrer
Department of Psychology, University of California, Davis,
Davis, CA, USA
123
J Autism Dev Disord (2008) 38:562–566
DOI 10.1007/s10803-007-0413-1
treatments can squander valuable time that could be used in
more productive educational or therapeutic ways’ (Baranek
2002) (p. 418). Herein lies the impetus for this carefully
controlled investigation of Tomatis.
The Tomatis Method has often been compared to
Auditory Integration Th erapy (AIT) (Berard 1993), another
controversial treatment showing limited if any benefit for
children with autism (for a review see: Baranek 2002). The
Tomatis Method and AIT are similar in that they both are
considered sound therapy and use high and low frequency
filtered music. However, the techniques are distinguishable
in the application and intensity of the intervention.
Alfred Tomatis, MD proposed that listening to modified
music would stimulate connections between the ear and the
central nervous system (Thompson and Andrews 2000).
Anecdotal reports claim that Tomatis has improved the
communication, social and behavioral functioning of some
children with autism. Neysmith-Roy (Neysmith-Roy 2001)
conducted a study of six children with severe autism ages
4–11 years who were administered several blocks of
Tomatis treatment. The authors report improvement in
behavior and prelinguistic behaviors in some of the six
participants with the youngest subjects showing the most
improvement.
The Tomatis Method consists of the administration of
prepared auditory stimulation recordings through equip-
ment designed to modulate the acoustical signal. The
stimuli include specially created compact discs of Mozart
music and Gregorian chants. The acoustical signal modu-
lation equipment attenuates low frequency sounds and
amplifies higher frequencies (800–300 Hz). Proponents
hypothesize that this modulation allows the child to grad-
ually focus listening on language frequencies. During the
protocol the child listens through an ‘Electronic Ear’ (EE)
headphone with an attached oscillator permitting the sounds
to be perceived through bone conduction as well as air
conduction. The primary aim of this study was to determine
if Tomatis contributed to the improvement of receptive and
expressive vocabulary in children with autism.
Methods
Participants
Eleven children with autism between 3 years, 6 months
and 7 years, 2 months were enrolled in this study. Inclu-
sion required a diagnosis of Autistic Disorder based on the
DSM-IV criteria (American Psychiatric Association 1994)
corroborated by the Autism Diagnostic Observation Sche-
dule-Generic (ADOS-G); (Lord et al. 1999), and clinical
judgment (B.A.C.). Participants needed to speak at least 1–
3 words, have a pointing gesture, and tolerate wea ring
headphones. Participants who had previous exposure to
auditory stimulation treatments were excluded. Demo-
graphic information presented in Table 1.
Design
The study utilized a double-blind, placebo-controlled,
crossover design. Assessme nts were conducted at baseline,
midpoint, and conclusion of the study. The investigation
was approved by the University of California Institutional
Review Board (IRB) and written parental informed consent
was obtained prior to participa tion.
Measures
The Autism Diagnostic Observation Schedule-Generic
(ADOS-G); (Lord et al. 1999) provides observation of a
child’s communication, reciprocal social interaction, and
stereotyped behavior including an algorithm with cut-offs
for autism and autism spectrum disorders (Lord et al.
1999).
Table 1 Demographic information of study participants
Participant Treatment group Age Gender Ethnicity IQ Language
#10 Treatment/Placebo Group 1 3.50 Male Hispanic 83 Single words
#05 Treatment/Placebo Group 1 3.92 Male Caucasian/NatAm/Hispanic 63 Single words
#08 Placebo/Treatment Group 0 4.00 Male Caucasian/NativeAmerican 65 Single words
#04 Treatment/Placebo Group 1 4.67 Male Caucasian 52 Few words
#03 Treatment/Placebo Group 1 4.92 Female Caucasian/Hispanic 60 Single words
#01 Placebo/Treatment Group 0 5.33 Male Caucasian 63 Single words
#02 Placebo/Treatment Group 0 6.08 Male Hispanic 66 Phrase speech
#07 Treatment/Placebo Group 1 7.08 Male Pacific Islander 68 Phrase speech
#11 Placebo/Treatment Group 0 7.08 Female Caucasian 83 Some full sentences
#06 Placebo/Treatment Group 0 7.17 Male Caucasian 68 Phrase speech
#12 Treatment/Placebo Group 1 7.42 Male Caucasian/Hispanic 64 Some full sentences
J Autism Dev Disord (2008) 38:562–566 563
123
The Stanford-Binet Intelligence Scale-Fourth Edition
(SB4); (Thorndike et al. 1986) is a standardized measure of
cognitive functioning adm inistered to all participants to
provide a measure of overall intellectual ability (IQ).
The Peabody Picture Vocabulary Test-Third Edition
(PPVT-III); (Dunn and Dunn 1997) is a measure of single-
word receptive vocabulary used as the primary dependent
measure
The Expressive One Word Vocabulary Test (EOWVT)
(Brownell 2000) is a measure of single word expressive
vocabulary also used as a dependent measure.
Treatment Procedures
The Tomatis Method was administered by two trained
assistants at The Listening Clinic in Sacramento, CA. Each
subject was randomly assigned to either treatment first,
Group 1, (Treatment/Placebo) or placebo first, Group 0
(Placebo/Treatment). The M.I.N.D. Institute researchers
and parents remained blind to the experimental conditions
until the conclusion of the study.
The experimental condition involved receiving the
Tomatis Method. Each subject listened to three different
pieces of professionally produced Mozart music and one of
Gregorian chant daily for a total of 2 h, passed through the
EE for attenuation and modu lation. Audio-vocal feedback
was included consisting of verbal activities, such as
repeating phrases into a microphone allowing feedback of
their own voices. According to proponents of Tomatis, the
combination of filtered music, the EE and auditory feed-
back results in enhanced auditory perception by stimulating
middle ear hair cells leading to alterations in the central
nervous system. Therefore, these three key components
were not included in the placebo condition. Specifically,
the placebo condition involved listening to commercially
produced Mozart and Gregorian chant CDs and not using
an active microphon e or the EE.
Consistent with a cross-over design, the experimental
phase of the study was divided into two equal rounds and
three assessment time periods. The Tomatis protocol was
divided into four blocks lasting 3 weeks each, followed by
a break for a total duration of 18 weeks.
Block 1 included 15 days of passive listening to music
for 2 h each day. Participants listened to non-filtered
sounds of Mozart music and Gregorian Chants with gating
(randomly alternating between high and low frequency
sounds). Block 2 consisted of 10 days of active listening
for 2 h each day alternating between filtered and non-fil-
tered music. The compact discs introduced sound fre-
quency at 1,000 Hz filtering up to 9,000 Hz. In Block 3,
participants experienced 10 days of mixed active and
passive listening for 2 h each day. Microphone work was
introduced and participants listened to their modulated
voices. Sound frequency filtering was up to 9,000 Hz.
Block 4 exposed participants to 10 days of mixed active
and passive listening for 2 h each day with filtering ranging
from 2,000 Hz up to 9,000 Hz.
After completion of this first round (treatment or pla-
cebo), participants completed the mid-point assessment.
The second round of the study followed using the same
schedule of blocks for an additional 18 weeks. Once the
second round was completed, participants returned for their
final assessments.
Statistical Analysis
Data analysis was designed to evaluat e the effects of
Tomatis treatment on the functioning of children with
autism compared to placebo condition. It was hypothesized
that a positive response to treatment would result in a
significant improvement in receptive and expressive lan-
guage. A repeated measures Analysis of Variance (ANO-
VA) was used to analyze the profile of scores across the
levels of treatment (experi mental versus placebo condition)
and across the three time periods. In this way we asked, if
the groups differ in the dependent measure, do the lan-
guage measures show changes across the different time
periods, and are such changes different across both groups?
Results
The means and standard deviations for the primary
dependent language measures, PPVT and EOWVT, are
presented in Table 2. Repeated measures ANOVA was
applied to compare the time period values and there were
no differences between the groups in the PPVT F
(1,9) = 1.34, p = 0.28. There was a time effect in the PPVT
F(2,8) 5.82 p = 0.03 that appears to be linear; there was a
constant increase in the PPVT scores over time. The
overall time by group interaction was not significant F
(2,8) = 3.5, p = 0.08 although the linear contrast of this
interaction was significant F (1,9) = 7.30, p = 0.02, but not
the quadratic F (1,9) = 0.84, p = 0.38. Although small, the
time by group interaction suggests that individuals in
Group 0 (placebo/treatment) show a steeper increase in
PPVT scores over time than in Group 1 (treatment/pla-
cebo).
The results for the EOWVT are similar in showing no
differences between groups F (1,9) = 0.72, p = 0.42. The
time effect was also significant F (2,8) = 4.83 p = 0.04
indicating a linear increase in EOWVT over time with no
quadratic component. Further, there was no time by group
interaction F (2,8) = 0.50, p = 0.63. The means and stan-
dard deviations for the ADOS and IQ are presented in
Table 3.
564 J Autism Dev Disord (2008) 38:562–566
123
Discussion
The primary purpose of this study was to determine if
Tomatis contributed to the improvement of the receptive
and expressive language in children with autism. The re-
sults show ed no significant differences on the language
measures across the groups attributed to the treatment
condition. In regards to receptive language, there was an
overall trend for the participants to progress or develop in a
linear way. All subjects showed improvement in their
language skills over time; however, the change did not
appear related to the treatment condition. It is unclear if the
improvement is associated with general developmental
progress or some other factor.
Although the participants were randomly assigned to the
groups, the developmental level appeared to be differ ent
for each in that the placebo/treatment group was higher
functioning than the treatment/placebo group. It has been
suggested that variables such as age and level of func-
tioning at the start of treatment need to be carefully con-
sidered when evaluating outcome (Rogers 1998). As is
evident in Tables 1 and 2, the participants in this sample
are heterogeneous. There is notable variability in terms of
IQ and language skills at baseline. However, since we
employed a randomized design we were unable to control
for these possible effects.
In summary, our results did not demonstrate treatment-
specific improvement in receptive and expressive language
in children with autism. Due to the fact that this is the only
known experimental study investigating the Tomatis
Method, we are unable to unequivocally state that Tomatis
does not show some benefit for children with autism.
However, our results do not provide evidence for the pre-
sumed benefit of the treatment compared with music alone,
a finding similar to studies of AIT indicating a lack of
empirical support or unconvincing findings for the use in
autism (Dawson and Watling 2000).
Despite our design and experimental control, there are
limitations to report. The study may be underpowered due
to the small sample size and the heterogeneous sample
makes it difficult to determine if certain factors such as age
or level of functi oning make a child more responsive to
treatment. Future investigations will need to consider
contributing factors for general improvement including the
treatment intensity, and placebo effects. Other forms of
placebo such as ‘white noise’ or comparing music treat-
ment to consistent interactive play with a therapist on a
regular basis may be informative. Explorations into the
broader beneficial aspects of intervention and participation
in research may be valuable and warrant our expanded
study.
Acknowledgments We would like to acknowledge the families of
those children who participated in our research who committed to
nearly 1 year of assessments and treatments. Funding was provided
by the University of California, Davis M.I.N.D. Institute.
References
American Academy of Pediatrics. (2001). Counseling families who
choose complementary and alternative medicine for their child
with chronic illness or disability. Committee on Children with
Disabilities. Pediatrics, 107(3), 598–601.
Table 2 Means, Standard Deviations, % change for the PPVT and EOWVT
Treatment Group Pre Mid Post % Change
PPVT EOWVT PPVT EOWVT PPVT EOWVT PPVT EOWVT
Placebo/Tomatis Group 0 32.20 25.20 40.20 29.40 47.20 34.40 P = 24.84 P = 16..67
(25.21) (19.82) (26.69) (22.65) (24.45) (25.00) T = 17.41 T = 17.00
Tomatis/Placebo Group 1 20.83 16.50 20.00 18.00 22.83 21.50 P = 14.15 P = 19.44
(28.52) (21.11) (25.76) (18.73) (29.36) (23.30) T = –3.98 T = 9.10
Total Sample 26.00 20.45 29.18 23.18 33.91 27.36
(26.38) (20.01) (26.98) (20.40) (28.85) (23.81)
Note: T = Treatment, P = Placebo
Table 3 Diagnostic and psychological variables pre and post treat-
ment
Participant Treatment
Group
ADOS
Pre
ADOS
Post
IQ
Pre
IQ
Post
#01 Group 0 16 14 63 62
#02 Group 0 9 8 66 69
#03 Group 1 18 23 60 71
#04 Group 1 18 20 52 59
#05 Group 1 16 16 63 53
#06 Group 0 13 16 68 49
#07 Group 1 13 17 68 44
#08 Group 0 15 17 65 61
#10 Group 1 10 12 83 70
#11 Group 0 13 14 83 84
#12 Group 1 12 11 64 65
J Autism Dev Disord (2008) 38:562–566 565
123
American Psychiatric Association. (1994). Diagnostic and statistical
manual of mental disorders (4th ed.). Washington, DC, USA:
American Psychiatric Publishing, Inc.
Baranek, G. T. (2002). Efficacy of sensory and motor interventions
for children with autism. Journal of Autism and Developmental
Disorders, 32(5), 397–422.
Berard, G. (1993). Hearing equals behavior. New Canaan, CT: Keats.
Birnbrauer, J. S., & Leach, D. J. (1993). The murdoch early
intervention program after 2 years. Behaviour Change, 10(2),
63–74.
Brownell, R. (2000). Expressive one-word picture vocabulary test
(3rd ed.) Novato, CA: Academic Therapy Publications.
Dawson, G., & W atling, R. (2000). Interventions to facilitate
auditory, visual, and motor integration in autism: a review of
the evidence. Journal of Autism and Developmental Disorders,
30(5), 415–421.
Dunn, L. M., & Dunn, L. M. (1997). The peabody picture vocabulary
test (3rd ed.) Circle Pines, MN: American Guidance Service
Publishing.
Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2002). Intensive
behavioral treatment at school for 4- to 7-year-old children with
autism. A 1-year comparison controlled study. Behavior Mod-
ification, 26(1), 49–68.
Eldevik, S., Eikeseth, S., Jahr, E., & Smith, T. (2006). Effects of low-
intensity behavioral treatment for children with autism and
mental retardation. Journal of Autism and Developm ental
Disorders, 36(2), 211–224.
Gervais, H., Belin, P., Boddaert, N., Leboyer, M., Coez, A., &
Sfaello, I., et al. (2004). Abnormal cortical voice processing in
autism. Nature Neuroscience, 7(8), 801–802.
Kellerman, G. R., & Gorman, J. M. (2005). Auditory abnormalities in
autism: Toward functional distinctions among findings. CNS
Spectrums, 10(9), 748–756.
Lepisto, T., Kujala, T., Vanhala, R., Alku, P., Huotilainen, M., &
Naatanen, R. (2005). The discrimination of and orienting to
speech and non-speech sounds in children with autism. Brain
Research, 1066(1–2), 147–157.
Lord, C., Rutter, M., DiLavore, P., & Rissi, S. (1999). Autism
diagnostic observation schedule-WPS.LosAngeles,CA:
Western Psychological Services.
Lovaas, O. I. (1987). Behavioral treatment and normal educational
and intellectual functioning in young autistic children. Journal of
Consulting and Clinical Psychology, 55(1), 3–9.
McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term
outcome for children with autism who received early intensive
behavioral treatment. American Journal of Mental Retardation,
97(4), 359–372, discussion 373–391.
Neysmith-Roy, J. M. (2001). The Tomatis Method with severely
autistic boys: Individual case studies of behavioural changes.
South African Journal of Psychology, 31(1), 19–28.
Rogers, S. J. (1998). Empirically supported comprehensive treatments
for young children with autism. Journal of Clinical Child
Psychology, 27(2), 168–179.
Samson, F., Mottron, L., Jemel, B., Belin, P., & Ciocca, V. (2006).
Can spectro-temporal complexity explain the autistic pattern of
performance on auditory tasks? Journal of Autism and Devel-
opmental Disorders, 36(1), 65–76.
Smith, T., Groen, A. D., & Wynn, J. W. (2000). Randomized trial of
intensive early intervention for children with pervasive devel-
opmental disorder. American Journal of Mental Retardation,
105(4), 269–285.
Tecchio, F., Benassi, F., Zappasodi, F., Gialloreti, L. E., Palermo, M.,
Seri, S., et al. (2003). Auditory sensory processing in autism: A
magnetoencephalographic study. Biological Psychiatry, 54(6),
647–654.
Thompson, B. M., & Andrews, S. R. (2000). An historical commen-
tary on the physiological effects of music: Tomatis, Mozart and
neuropsychology. Integrative P hysiological and Behavioral
Science, 35
(3), 174–188.
Thorndike, R., Hagen, E., & Sattler, J. (1986). The Stanford-Binet
intelligence scale (4th ed., SB4). Itasca, IL: The Riverside
Publishing Company.
566 J Autism Dev Disord (2008) 38:562–566
123
... Some studies have found positive effects of HBOT in children with ASD (Rossignol, et al., 2009). Speech therapy has an important role in language improvement and enhancing the communication skills of patients with ASD (Neysmith-Roy 2001; Corbett, et al., 2008). Alfred Tomatis developed TST, which utilizes electronically modified human voice and music delivered via the "Electronic Ear". ...
... To ameliorate the ASD symptoms, several complementary or alternative treatments have been widely used, such as modified diets, supplementation with vitamins, especially vitamin D and polyunsaturated fatty acids, immune therapy, and recently HBOT and TST (Corbett, et al., 2008;Rossignol, et al., 2009;El-Rashidy , et al., 2017). The new trend is to adopt more than one therapeutic approach that might synergize for the best outcomes depending on the stage of intervention and severity of the ASD. ...
... As regards the use of TST in ASD, the studies are inadequate, and the interpretation of findings has been somewhat confusing among the scientific community. Some studies have found positive effects of TST for ASD (Neysmith-Roy 2001;Vervoort, et al., 2007;AbediKoupaeia, et al., 2013), whereas others have found no significant effect (Corbett, et al., 2008). In line with our findings, Neysmith-Roy 2001 showed that TST had positive effects in five out of six males with severe ASD. ...
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Children with Autism Spectrum Disorder (ASD) experience deficits in verbal and nonverbal communication skills including motor control, turn-taking, and emotion recognition. Innovative technology, such as socially assistive robots, has shown to be a viable method for Autism therapy. This paper presents a novel robot-based music-therapy platform for modeling and improving the social responses and behaviors of children with ASD. Our autonomous social interactive system consists of three modules. Module one provides an autonomous initiative positioning system for the robot, NAO, to properly localize and play the instrument (Xylophone) using the robot’s arms. Module two allows NAO to play customized songs composed by individuals. Module three provides a real-life music therapy experience to the users. We adopted Short-time Fourier Transform and Levenshtein distance to fulfill the design requirements: 1) “music detection” and 2) “smart scoring and feedback”, which allows NAO to understand music and provide additional practice and oral feedback to the users as applicable. We designed and implemented six Human-Robot-Interaction (HRI) sessions including four intervention sessions. Nine children with ASD and seven Typically Developing participated in a total of fifty HRI experimental sessions. Using our platform, we collected and analyzed data on social behavioral changes and emotion recognition using Electrodermal Activity (EDA) signals. The results of our experiments demonstrate most of the participants were able to complete motor control tasks with 70% accuracy. Six out of the nine ASD participants showed stable turn-taking behavior when playing music. The results of automated emotion classification using Support Vector Machines illustrates that emotional arousal in the ASD group can be detected and well recognized via EDA bio-signals. In summary, the results of our data analyses, including emotion classification using EDA signals, indicate that the proposed robot-music based therapy platform is an attractive and promising assistive tool to facilitate the improvement of fine motor control and turn-taking skills in children with ASD.
... Specifically, playing music to children with ASD in therapy sessions has shown a positive impact on improving social communication skills LaGasse et al. (2019); Lim and Draper (2011). Many studies have utilized both recorded and live music in interventional sessions for single and multiple participants Dvir et al. (2020); Bhat and Srinivasan (2013); Corbett et al. (2008). Different social skills have been targeted and reported (i.e., eye-gaze attention, joint attention and turn-taking activities) in music-based therapy sessions Stephens (2008); Kim et al. (2008). ...
... As shown by others LaGasse et al. (2019); Lim and Draper (2011) as well as this study, playing music to children with ASD in therapy sessions has a positive impact on improving their social communication skills. Compared to the state of the art Dvir et al. (2020); Bhat and Srinivasan (2013); Corbett et al. (2008), where they utilized both recorded and live music in interventional sessions for single and multiple participants, our proposed robot-based music-therapy platform is a promising intervention tool in improving social behaviors, such as motor control and turn-taking skills. As our human robot interaction studies (over 200 sessions were conducted with children), most of the participants were able to complete motor control tasks with 70% accuracy and 6 out of 9 participants demonstrated stable turn-taking behavior when playing music. ...
Preprint
Full-text available
Children with Autism Spectrum Disorder (ASD) experience deficits in verbal and nonverbal communication skills including motor control, turn-taking, and emotion recognition. Innovative technology, such as socially assistive robots, has shown to be a viable method for Autism therapy. This paper presents a novel robot-based music-therapy platform for modeling and improving the social responses and behaviors of children with ASD. Our autonomous social interactive system consists of three modules. We adopted Short-time Fourier Transform and Levenshtein distance to fulfill the design requirements: a) "music detection" and b) "smart scoring and feedback", which allows NAO to understand music and provide additional practice and oral feedback to the users as applicable. We designed and implemented six Human-Robot-Interaction (HRI) sessions including four intervention sessions. Nine children with ASD and seven Typically Developing participated in a total of fifty HRI experimental sessions. Using our platform, we collected and analyzed data on social behavioral changes and emotion recognition using Electrodermal Activity (EDA) signals. The results of our experiments demonstrate most of the participants were able to complete motor control tasks with ~70% accuracy. Six out of the 9 ASD participants showed stable turn-taking behavior when playing music. The results of automated emotion classification using Support Vector Machines illustrate that emotional arousal in the ASD group can be detected and well recognized via EDA bio-signals. In summary, the results of our data analyses, including emotion classification using EDA signals, indicate that the proposed robot-music based therapy platform is an attractive and promising assistive tool to facilitate the improvement of fine motor control and turn-taking skills in children with ASD.
... Certain previous studies have inspired other scientists to facilitate the multi-system development of individuals with special needs by using an embodied music-based method/approach [2]. Music-based tasks involved in these intervention sessions included playing pre-recorded files and/or teachers/therapists playing musical instruments [2,5]. Kalas [6] and Kim et al. [7] reported that the eyecontact, turn taking, and Joint Attention (JA) skills of the participants with ASD improved through their active music-based sessions. ...
... Secondly, four Questionnaires, including the Autism Social Skills Profile (ASSP) [39], Gilliam Autism Rating Scale (GARS) [40], Autism Checklist [5], and Parenting Stress Index-Short Form (PSI-SF) [41], were filled in by the parents four times during the Baseline, Pre-Test, Post-Test, and Follow-up Test sessions. The assessment sessions (i.e. the Baseline, Pre-Test, Post-Test, and Followup Test) were conducted without the presence of the Nima robot. ...
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This article endeavors to present the impact of conducting robot-assisted music-based intervention sessions for children with low-functioning (LF) autism. To this end, a drum/xylophone playing robot is used to teach basic concepts of how to play the instruments to four participants with LF autism during nine educational sessions. The main findings of this study are compared to similar studies conducted with children with high-functioning autism. Our main findings indicated that the stereotyped behaviors of all the subjects decreased during the course of the program with an approximate large Cohen’s d effect size. Moreover, the children showed some improvement in imitation, joint attention, and social skills from the Pre-Test to Post-Test. In addition, regarding music education, we indicated that while the children could not pass a test on the music notes or reading music phrases items because of their cognitive deficits, they showed acceptable improvements (with a large Cohen’s d effect size) in the Stambak Rhythm Reproduction Test, which means that some rhythm learning occurred for the LF participants. In addition, we indicated that parenting stress levels decreased during the program. This study presents some potential possibilities of performing robot-assisted interventions for children with LF autism.
... Tomatis has explained these improvements by saying that the ear plays a crucial role in information processing and is seen as a single sensorimotor organ that opens up access to the entire nervous system. The success of the Tomatis method has been proven by numerous studies in various countries [3][4][5]. Ayres also emphasized that good integration of auditory sensations contributed to speech development. ...
... In Russia, there are practically no studies concerning the Tomatis neurosensory technique for improving listening skills in preschool children [15], while in global practice, this method is successfully used, including working with children with autism [3][4][5]. These circumstances impose significant restrictions on the popularization of these methods in Russia. ...
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The present article deals with the organization and implementation of correctional care for younger children with autism spectrum disorders. The authors reveal key aspects of the problems underlying the speech and nonspeech difficulties of this category of children, as well as consider the topic of the only generally accepted method (applied behavior analysis) that is widely used when working with these children, and prove the expediency of a different approach to the complex correction of speech problems in children with communication disorders. The approach is based on the identified peculiarities of the speech and nonspeech problems of children with autism. The authors justify the choice of contemporary foreign methods (Tomatis, Floortime, and Sensory Integration) in the correction of speech and behavior of children with communication disorders based on the results of the conducted ascertaining experiment. Based on a comparative analysis of the results of ascertaining and forming experiments in the control and experimental groups, it has been proved experimentally that establishing an emotional and communicative component of the mental development of the child, as well as improving the processing of auditory, tactile, vestibular, and proprioceptive sensation speed up the corrective process that plays a crucial role in speech development and the development of nonlanguage functions. The significance of this study concerns the evidence-based use of a comprehensive approach to the correction of children with autism in the sensitive period of their development (from two to four years). Early comprehensive care provides a chance to achieve success in the social and speech development of these children by the beginning of school education (from seven to eight years), which will significantly improve the quality of their lives and contribute to the best integration into society.
... On the other hand, in a more recent study conducted by Bieleninik et al. (2017) with large sample size and a group experimental research design, music therapy did not demonstrate benefit to participants with ASD when compared to a control group. Similarly, several single-subject research design studies were not able to show significant improvements in social and language skills in individuals with ASD upon implementation of music therapies (Corbett et al., 2008;Lim, 2010;Schwartzberg and Silverman, 2013). These inconsistent findings regarding the effects of music therapy on individuals with ASD highlight the need for further assessment of this type of treatment. ...
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The specific aims of this research study were to (a) examine the differential effect of three different music interventions, namely the interactive music playing therapy (“music and singing”), interaction music singing therapy (“singing”), and receptive music therapy (“listening”) studying the varying latency periods in the response time it took 3-year-old children diagnosed with autism spectrum disorder (ASD) to elicit the target word vocally; and (b) assess the index of happiness of children with ASD after the implementation of the three music interventions, which can, in turn, be used to influence their overall quality of life through this specific intervention. This study used a combined single-subject research design consisting of delayed multiple baseline across the participants and a multielement design to compare the effects of each music intervention technique targeting the child’s verbal response during playback of a practiced song. Findings demonstrated “singing” to be associated with the lowest latency compared to the other two interventions (“listening” and “singing and music”) across participants. Additionally, happiness levels varied from neutral to happy, signifying an overall positive experience during participation in the music applied behavior analysis (ABA) intervention.
... Some of the parents indicated that they have been using Tomatis Method as a treatment modality for their children. Several authors examined the effectiveness of the Tomatis Method on certain aspects of ASD related symptoms, but the results showed that there is a lack of improvement (Corbett et al., 2008) and even though some articles showed some improvement, they are considered to be using an inappropriate test design (Gerritsen, 2008). ...
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There is a large number of treatment types offered to parents of children diagnosed with autism spectrum disorders (ASD), but they are particularly vulnerable to the promoters of pseudoscience, which can lead to the use of ineffective types of treatment. This study represents an attempt to document the types of treatments used by parents of children with ASD in the Republic of Serbia. Secondary aim was to determine if certain parent or child characteristics influenced the types of treatments used. Modified version of survey constructed and conducted by Green, et al. (2006) was used. Nearly all (n=85) of the 86 treatments listed in our survey were being currently used or used in the past by at least one parent and the most commonly used treatment is speech and language therapy. The treatments were grouped into ten categories and the most commonly used is other treatments (80.6%), followed by standard therapies (79.2%) and vitamin supplements (65.3%). It is also of great importance to educate the parents of children with ASD about evidence-based treatments and on how to distinguish them from treatments that do not have empirical basis. Suggestions for this were given, limitations and future research implications were discussed.
... Schwartzberg and Silverman (2013) found music-based social stories to be ineffective for comprehension and generalization of targeted social skills in children with ASD. In addition, Corbett et al. (2008) were not able to prove the effectiveness of Tomatis sound therapy (a therapy that utilizes high-and low-frequency-filtered music) for expressive and receptive language. When melodic based communication therapy (MBCT), a music-based therapy that utilizes a standard melody for each target word, was compared with traditional speech and language therapy for eliciting speech, the main differences between group outcomes were the timing of progress. ...
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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.
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