Summarizing an international consensus about core principles of improvisational approaches in music therapy for children with ASD, these treatment guidelines may be applied in diverse theoretical models of music therapy. They can be used to assess treatment fidelity, and may be applied to facilitate future research, clinical practice, and training.
BackgroundPrevious research has suggested that music therapy may facilitate skills in areas typically affected by autism spectrum disorders such as social interaction and communication. However, generalisability of previous findings has been restricted, as studies were limited in either methodological accuracy or the clinical relevance of their approach. The aim of this study is to determine effects of improvisational music therapy on social communication skills of children with autism spectrum disorders. An additional aim of the study is to examine if variation in dose of treatment (i.e., number of music therapy sessions per week) affects outcome of therapy, and to determine cost-effectiveness.Methods/DesignChildren aged between 4;0 and 6;11 years who are diagnosed with autism spectrum disorder will be randomly assigned to one of three conditions. Parents of all participants will receive three sessions of parent counselling (at 0, 2, and 5 months). In addition, children randomised to the two intervention groups will be offered individual, improvisational music therapy over a period of five months, either one session (low-intensity) or three sessions (high-intensity) per week. Generalised effects of music therapy will be measured using standardised scales completed by blinded assessors (Autism Diagnostic Observation Schedule, ADOS) and parents (Social Responsiveness Scale, SRS) before and 2, 5, and 12 months after randomisation. Cost effectiveness will be calculated as man years. A group sequential design with first interim look at N = 235 will ensure both power and efficiency.DiscussionResponding to the need for more rigorously designed trials examining the effectiveness of music therapy in autism spectrum disorders, this pragmatic trial sets out to generate findings that will be well generalisable to clinical practice. Addressing the issue of dose variation, this study's results will also provide information on the relevance of session frequency for therapy outcome.Trial RegistrationCurrent Controlled Trials ISRCTN78923965.
In a well-functioning dialogue, the nonverbal and often implicit visual and auditory cues ensure good continuation without interruptions or overlapping speak. In mutual interplay, both partners participate in turn-organisation, and therefore an analysis of cues indicating turn-taking and turn-yielding can provide information about the participants' social skills, whether or not the dialogue is verbal.
This article presents relevant concepts from conversation analysis literature in order to analyse music therapy interplay aimed at promoting preverbal and social skills. As the character of the turn-organisation is dependent on the developmental age of the participants, the described cues are compared to research in early mother–child interplay, as well as studies of turn-organisation in dialogues with disabled children.
The theoretical part of the article is illustrated by a turn-analysis of case material from music therapy with a 2½-year-old boy with communication disorders. The analysis was a part of the author's doctoral research and focuses on the boy's participation in turn-organisation as well as the therapist's use of turn-yielding and turn-overlapping.
The article concludes with a discussion of the applied theoretical concepts in relation to music therapy practice. It will be suggested that the turn-yielding cues can be compared to response-evoking techniques, while the management of simultaneousness (overlaps) naturally is very different in verbal than in musical dialogues.
The dyadic music therapy intervention examined in this study improved emotional communication between parent and child and interaction after 6 to 10 sessions and can be considered as a viable treatment alternative or supplement for families at risk and families with emotionally neglected children.
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