The Therapeutic Relationship as Predictor of Change in Music Therapy with Young Children with Autism Spectrum Disorder

Abstract

This study examined whether the therapeutic relationship in music therapy with children with Autism Spectrum Disorder predicts generalized changes in social skills. Participants (4-7 years, N = 48) were assessed at baseline, 5 and 12 months. The therapeutic relationship, as observed from session videos, and the generalized change in social skills, as judged by independent blinded assessors and parents, were evaluated using standardized tools (Assessment of the Quality of Relationship; ADOS; SRS). Linear mixed effect models showed significant interaction effects between the therapeutic relationship and several outcomes at 5 and 12 months. We found the music therapeutic relationship to be an important predictor of the development of social skills, as well as communication and language specifically.

The case for treatment fidelity in active music interventions: why and how

“…There is increasing interest in the use of music training and interventions to promote language outcomes in populations of children who have disabilities and who are typically developing. Music therapy approaches in which treatment is implemented by a board‐certified music therapist have been explored with the goal of improving language in children with disabilities . Researchers in the field of music therapy argue that music affects language as a result of the client–therapist relationship and that music can be understood as an adaptive means of communication .…”

“…Provider training, the second element of treatment fidelity, is also critical to report in music intervention studies. The provider's credential or degree and a statement that they have sufficient clinical experience is frequently reported, and it is also often mentioned that they have been trained for the specific intervention protocol . Yet, for provider training to be fully addressed, training needs to be described in greater detail, such as in the following two interventions.…”

“…They also addressed quality of administration by calculating the outcome effect across therapists to control for possible differences in administration. Mössler et al . utilized videotapes to code behavior using a standardized assessment of the therapeutic relationship.…”

“…[1][2][3] Researchers in the field of music therapy argue that music affects language as a result of the client-therapist relationship and that music can be understood as an adaptive means of communication. 1,3 This approach has a certain degree of contrast with approaches from cognitive neuroscience, in which neural plasticity and transfer effects of musical skills directly to language through shared neural resources are theorized to drive transfer from music training to language skill. These studies include several pseudo-randomized control trials in children with typical development, where greater improvement in speech/language-related outcomes was demonstrated among children who received musical training (from a music instructor) than among children who received an alternate training, such as art classes or sports.…”

“…The provider's credential or degree and a statement that they have sufficient clinical experience is frequently reported, 1,4,6,[18][19][20] and it is also often mentioned that they have been trained for the specific intervention protocol. 3,5 Yet, for provider training to be fully addressed, training needs to be described in greater detail, such as in the following two interventions. In a study on the effects of music therapy on depression, Erkkilä and colleagues 21 reported that the therapists had 15 months of training and rehearsal sessions and reported the quantity of supervision and feedback that the providers received throughout the study.…”