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Music Therapy with
 Autism Spectrum Disorders:
     Review of Research
Southwest Ohio Regional Autism Advisory Council
            2009 Summer Institute
Mimi Sinclair,
           MM, MT-BC
• Director, Music Therapy Services
• 513-474-6064
• msinclair@cinci.rr.com
• www.music-therapy-cincinnati.com
Music therapy is:


• a behavioral science and
• an aesthetic experience
• which uses music as a tool
• to make positive changes in behavior.
Uses of music


• As a reinforcer, contingent on desired behavior
• As a physical structure for the learning activity
 primarily though its components of rhythm,
 melody, and tempo
Uses of music


• As a background for learning, a complimentary
 stimulus



• As a carrier of information: skills, concepts,
 and general information
Uses of music

• As a reflection of skills or processes to be
 learned, pairing nonmusical concepts within
 the structure of the music



• As a music learning experience for leisure and
 aesthetic experience
An Analysis of Music Therapy
Program Goals and Outcomes
for Clients with Diagnoses on
the Autism Spectrum.

• Ronna Kaplan and A. Louise Steele
•   Journal of Music Therapy, 2005
Subjects


• 40 music therapy clients receiving services over
 two years in community music school or group
 home setting

• Age range 2-49 years
Session types

• Individual
• Partner
• Small Group
• Large Group
• Peer Model
• Combination
Goal Areas

• Behavioral/psychosocial
• Language/communication
• Perceptual/motor
• Cognitive
• Musical
Interventions

• Interactive instrument play
• Musical instrument instruction
• Interactive singing
• Instrument choice-making
• Song choice-making
Session format


• Activity-based
• Client-led/Shadow
• Ensemble/Combo
• Lesson-based
Outcomes



• Initial goals set at 25% change from baseline.
• 100% clients attained goal in one year or less
Outcomes



• Intermediate goals set at 25% change from
 level achieved in initial phase.

• 77% met goal within 1 year or less
Generalization


• Parents and caregivers surveyed at end of year
• 100% subjects generalized targeted behaviors
 outside of music setting occasionally or
 frequently
Music in Intervention for
Children and Adolescents
      with Autism:
    A Meta-Analysis

•   Jennifer Whipple

•   Journal of Music Therapy, 2004
Meta-analysis allows for greater
  confidence in conclusions
about the efficacy of treatment.
10 studies met criteria for
          inclusion


• Only 3 are published. Others are dissertations
 and theses

• Skill areas addressed: social behaviors,
 communication skills, cognitive skills
Uses of music


• Sung instructions
• Background music
• Music as reinforcer
• Music as structure
Target Behaviors

• Challenging behaviors
• Task completion/accuracy
• Self-stimulatory behavior
• Eye contact
• Vocabulary comprehension
Target Behaviors

• Shape identification
• Verbalization
• Out-of-seat
• Social acknowledgement
• Spontaneous speech
Results



• “All music intervention has been effective.”
• All reviewed use has a relatively high effect.
The Effects of Signed and
Spoken Words Taught with
    Music on Sign and
   Speech Imitation by
  Children with Autism

• Evelyn M. Buday
•   Journal of Music Therapy, 1995
Subjects


• 10 children from Chicago Public Schools
• Mild-severe autism
• Ages 4-9 years
Treatment Conditions


• Signs taught in conjunction with music and
 speech

• Signs taught in conjunction with rhythm and
 speech
Design


• Seen individually 4 consecutive days, 5 trials
 each day, for two weeks

• Music condition one week, rhythm condition
 the next
Dependent variables


• Correct signing
• Correct speaking
• 14 words
Results


• Average number of signs correctly imitated
 during music condition was significantly higher

• Average number of words spoken correctly
 during music condition was significantly higher
Musically Adapted Social
Stories to Modify Behaviors
 in Students with Autism:
     Four Case Studies

• Mike D. Brownell
•   Journal of Music Therapy, 2002
Subjects



• 4 elementary school students in Iowa
• Ages 6-9 years
Conditions


• Baseline
• Reading social story
• Singing social story
Target behaviors


• TV talk
• Following directions
• Using a quiet voice
Results


• Both conditions significantly improved target
 behaviors in a all 4 cases

• Frequency of negative behavior occurred least
 often during music, but not significant
The Effect of Background
Music and Song Texts on the
Emotional Understanding of
  Children with Autism

•   June Katagari

•   Journal of Music Therapy, 2009
Subjects


• 12 students attending school in Japan
• Primary diagnosis of autism
• Ages 9-15 years
Treatment conditions


• No teaching of emotions
• Teaching emotions with verbal instruction only
• Verbal teaching with background music
• Singing songs about emotion
Emotions taught


• Happiness
• Sadness
• Anger
• Fear
Dependent variables



• Recognition of facial expression from photos
• Recognition of facial expression from drawings
Dependent variables



• Identification of situation-based emotions
 suggested in a set of pictures

• Facial expression of emotions by participants
Results


• All conditions resulted in gains
• Background music was most effective
• Singing songs was next
• Verbal instruction was lowest

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Music Therapy with Autism Spectrum Disorders: Review of Research

  • 1. Music Therapy with Autism Spectrum Disorders: Review of Research Southwest Ohio Regional Autism Advisory Council 2009 Summer Institute
  • 2. Mimi Sinclair, MM, MT-BC • Director, Music Therapy Services • 513-474-6064 • msinclair@cinci.rr.com • www.music-therapy-cincinnati.com
  • 3. Music therapy is: • a behavioral science and • an aesthetic experience • which uses music as a tool • to make positive changes in behavior.
  • 4. Uses of music • As a reinforcer, contingent on desired behavior • As a physical structure for the learning activity primarily though its components of rhythm, melody, and tempo
  • 5. Uses of music • As a background for learning, a complimentary stimulus • As a carrier of information: skills, concepts, and general information
  • 6. Uses of music • As a reflection of skills or processes to be learned, pairing nonmusical concepts within the structure of the music • As a music learning experience for leisure and aesthetic experience
  • 7. An Analysis of Music Therapy Program Goals and Outcomes for Clients with Diagnoses on the Autism Spectrum. • Ronna Kaplan and A. Louise Steele • Journal of Music Therapy, 2005
  • 8. Subjects • 40 music therapy clients receiving services over two years in community music school or group home setting • Age range 2-49 years
  • 9. Session types • Individual • Partner • Small Group • Large Group • Peer Model • Combination
  • 10. Goal Areas • Behavioral/psychosocial • Language/communication • Perceptual/motor • Cognitive • Musical
  • 11. Interventions • Interactive instrument play • Musical instrument instruction • Interactive singing • Instrument choice-making • Song choice-making
  • 12. Session format • Activity-based • Client-led/Shadow • Ensemble/Combo • Lesson-based
  • 13. Outcomes • Initial goals set at 25% change from baseline. • 100% clients attained goal in one year or less
  • 14. Outcomes • Intermediate goals set at 25% change from level achieved in initial phase. • 77% met goal within 1 year or less
  • 15. Generalization • Parents and caregivers surveyed at end of year • 100% subjects generalized targeted behaviors outside of music setting occasionally or frequently
  • 16. Music in Intervention for Children and Adolescents with Autism: A Meta-Analysis • Jennifer Whipple • Journal of Music Therapy, 2004
  • 17. Meta-analysis allows for greater confidence in conclusions about the efficacy of treatment.
  • 18. 10 studies met criteria for inclusion • Only 3 are published. Others are dissertations and theses • Skill areas addressed: social behaviors, communication skills, cognitive skills
  • 19. Uses of music • Sung instructions • Background music • Music as reinforcer • Music as structure
  • 20. Target Behaviors • Challenging behaviors • Task completion/accuracy • Self-stimulatory behavior • Eye contact • Vocabulary comprehension
  • 21. Target Behaviors • Shape identification • Verbalization • Out-of-seat • Social acknowledgement • Spontaneous speech
  • 22. Results • “All music intervention has been effective.” • All reviewed use has a relatively high effect.
  • 23. The Effects of Signed and Spoken Words Taught with Music on Sign and Speech Imitation by Children with Autism • Evelyn M. Buday • Journal of Music Therapy, 1995
  • 24. Subjects • 10 children from Chicago Public Schools • Mild-severe autism • Ages 4-9 years
  • 25. Treatment Conditions • Signs taught in conjunction with music and speech • Signs taught in conjunction with rhythm and speech
  • 26. Design • Seen individually 4 consecutive days, 5 trials each day, for two weeks • Music condition one week, rhythm condition the next
  • 27. Dependent variables • Correct signing • Correct speaking • 14 words
  • 28. Results • Average number of signs correctly imitated during music condition was significantly higher • Average number of words spoken correctly during music condition was significantly higher
  • 29. Musically Adapted Social Stories to Modify Behaviors in Students with Autism: Four Case Studies • Mike D. Brownell • Journal of Music Therapy, 2002
  • 30. Subjects • 4 elementary school students in Iowa • Ages 6-9 years
  • 31. Conditions • Baseline • Reading social story • Singing social story
  • 32. Target behaviors • TV talk • Following directions • Using a quiet voice
  • 33. Results • Both conditions significantly improved target behaviors in a all 4 cases • Frequency of negative behavior occurred least often during music, but not significant
  • 34. The Effect of Background Music and Song Texts on the Emotional Understanding of Children with Autism • June Katagari • Journal of Music Therapy, 2009
  • 35. Subjects • 12 students attending school in Japan • Primary diagnosis of autism • Ages 9-15 years
  • 36. Treatment conditions • No teaching of emotions • Teaching emotions with verbal instruction only • Verbal teaching with background music • Singing songs about emotion
  • 37. Emotions taught • Happiness • Sadness • Anger • Fear
  • 38. Dependent variables • Recognition of facial expression from photos • Recognition of facial expression from drawings
  • 39. Dependent variables • Identification of situation-based emotions suggested in a set of pictures • Facial expression of emotions by participants
  • 40. Results • All conditions resulted in gains • Background music was most effective • Singing songs was next • Verbal instruction was lowest