Lecture 7 - Guest Lecture
Music Therapy and Autism
Music 2MT3 - Test 2
Brief History of Autism
● 1938 - Hans Aspergers - Asperger’s Syndrome
● 1943 - Dr. Leo Kanner - early infantile autism
● 1980 - DSM III - differentiates schizophrenia and autism
● 2013 - DSM V - grouping PDD-NOS, autism, Asperger’s, syndrome, Rett
syndrome, CDD
● Greek word ”Autos” = self
● American Psychiatric Association: Autism Spectrum Disorder (ASD) is a
complex neurodevelopmental disorder characterized by pronounced
difficulties in social and communication abilities
● CDC stat: 1 in 68 children are diagnosed
● Onset before age 3
● Boys diagnosed 4x more often than girls
● Neurological Disorder
● A spectrum disorder: severity and behaviours vary greatly
● Asperger’s: not have language delay, but have social
impairments and repetitive/restrictive behaviours
● ASD diagnosis is associated with substantial costs
● Unsure of which treatment is most effective
● School aged children with ASD are often unengaged in social settings
● Brain connectivity: overconnectivity in sensory networks and
underconnectivity in fronto-temporal networks
Diagnostic Criteria (DSM-V)
● Persistent difficulties in social communication and interaction across multiple
contexts
● Restricted, repetitive patterns of behaviour, interests, or activities
● Symptoms present in early development
● Symptoms cause significant impairment in functioning
● Symptoms are not better explained by another disability
Possible Co-Morbidities
Co-morbidity: the simultaneous presence of two chronic diseases or conditions in a
patient.
● ADHD
● OCD
● Depression
, ● Anxiety
● Low self-esteem
● Social isolation
● Learning Disabilities
Treatment Options
● Behavioural (ABA)
● Biomedical (Medication, Nutrition, etc.)
● Communication (PECS, Social Stories, Sign Language, Electronic Devices)
● Traditional Therapies (Speech, Occupational, Physical Therapy)
● Alternative/Complementary (ie. Son-Rise Program)
2 Current Theories
Theory of Mind:
● Attribute mental states to oneself and others
● Ability to understand that others’ point of view can be different
than one’s own Joint Attention:
● Two or more people coordinating attention towards an object or event of
mutual interest
● Share awareness
Music Therapy Approaches to Autism
Relationship-based Framework:
● Goal areas: musical, social, emotional
● Techniques: improvisational, re-creative,
compositional NMT:
● Goal Areas: cognition, communication, sensorimotor
● Techniques: auditory perception training, developmental speech &
language training, social competence training
Receptive Methods
Social Stories
● Enhance interest in concepts
● Preparing for social interactions
● Use 1st person (“I”)
● Add words “sometimes” or
“usually” Child-directed Singing
● Use of song to communicate and reflect moment
● Goal to absorb music, rather than expression
● When child disengages, change musical elements
Improvisation
● Arise from vocal and motor output by the child, MT then reflects and
expands...captures essence
, ● Mirroring, then shaping into melodic motifs, rhythms, or lyrics
● Joining the child in his/her experience
Note: Can still include structure, repetition, and familiarity
Recreative
Adaptive Music Lessons
● Typically voice, piano, guitar, drums
● Goals: motor control, coordination, self regulation, self- awareness,
sequencing, memory, and attention
● Higher functioning goals: leisure skills, self-esteem, frustration tolerance,
social skills
Compositional
● Lower-functioning: more basic pre- academic, behavioural, and life skills
○ Goals: develop vocabulary, expand behavioural repertoire,
understanding social cues
● Higher functioning: more psychological or emotional themes
○ Goals: more traditional; that is, expression, self-esteem, creativity
MT & Autism
● Those with ASD have strengths in the creative arts and demonstrate
enhanced musical abilities
● Emotion processing deficits in ASD are domain specific, may not impact
musical domain
● Greater song vs. speech response
● Music therapy has been suggested as a promising approach to
improve social communication in ASD (Simpson & Keen, 2011).
Background Information
● 1940s: Early MT pioneers likely worked in psychiatric hospitals, institutions,
schools
● Medical community in US begins shift to holistic treatment philosophy,
began to employ part-time music therapists as profession began to define
itself
● Autism diagnosis and music therapy profession simultaneously
emerging; no publications
● First article to address MT treatment for children with autism was
published in British Journal of Music Therapy in 1969
● Music therapists started delineating goals and objectives in their publications
and articles by the end of the 1960s and articles specific to this population
began accumulating
Nordoff Robbins
● Pioneers in improvisational music therapy
● Perceived music as a nonthreatening medium
, ● Creative Music Therapy technique for children with autism and other
developmental disabilities
● “The Musical Child”
Improvisational techniques used to:
● Establish rapport
● Encourage expressive language and social skills
● Medium for self expression
● Allowed sensory activities to be explored
● Addressed behaviour challenges
More structured techniques to address:
● Attention
● Body Awareness
● Communication
● Video Example
Evidence-Based Practice
● Music therapists and non-music therapists have been critical of the level
of evidence vouching for the effectiveness of their work with children with
autism
● Response: Task forces to explore and offer recommendations for future
directions for MT & autism
● Research! Clinical models and more rigorous assessment methods
○ Example: Rational-Scientific Mediating Model (R-SMM) developed
by Thaut (2000) – Neurologic Music Therapy
● Social Communication, Emotional Regulation, and Transactional Support
(SCERTS) curriculum model as intake and ongoing assessment tool in
music therapy for children with autism
Recent Research
Purpose
● To evaluate the effects of a music-based intervention (MT) on language and
social
communication in school-aged children with ASD, compared to a non-music
control intervention (nonMT) using a randomized control trial design.
● Investigating a direct link between effects of music interventions and
changes in the brain for children with ASD
Methods
● Fifty-one children aged 6–12 years with autism were randomized to receive
8–12 weeks of music (n = 26) or non-music intervention (n = 25)
Music Therapy and Autism
Music 2MT3 - Test 2
Brief History of Autism
● 1938 - Hans Aspergers - Asperger’s Syndrome
● 1943 - Dr. Leo Kanner - early infantile autism
● 1980 - DSM III - differentiates schizophrenia and autism
● 2013 - DSM V - grouping PDD-NOS, autism, Asperger’s, syndrome, Rett
syndrome, CDD
● Greek word ”Autos” = self
● American Psychiatric Association: Autism Spectrum Disorder (ASD) is a
complex neurodevelopmental disorder characterized by pronounced
difficulties in social and communication abilities
● CDC stat: 1 in 68 children are diagnosed
● Onset before age 3
● Boys diagnosed 4x more often than girls
● Neurological Disorder
● A spectrum disorder: severity and behaviours vary greatly
● Asperger’s: not have language delay, but have social
impairments and repetitive/restrictive behaviours
● ASD diagnosis is associated with substantial costs
● Unsure of which treatment is most effective
● School aged children with ASD are often unengaged in social settings
● Brain connectivity: overconnectivity in sensory networks and
underconnectivity in fronto-temporal networks
Diagnostic Criteria (DSM-V)
● Persistent difficulties in social communication and interaction across multiple
contexts
● Restricted, repetitive patterns of behaviour, interests, or activities
● Symptoms present in early development
● Symptoms cause significant impairment in functioning
● Symptoms are not better explained by another disability
Possible Co-Morbidities
Co-morbidity: the simultaneous presence of two chronic diseases or conditions in a
patient.
● ADHD
● OCD
● Depression
, ● Anxiety
● Low self-esteem
● Social isolation
● Learning Disabilities
Treatment Options
● Behavioural (ABA)
● Biomedical (Medication, Nutrition, etc.)
● Communication (PECS, Social Stories, Sign Language, Electronic Devices)
● Traditional Therapies (Speech, Occupational, Physical Therapy)
● Alternative/Complementary (ie. Son-Rise Program)
2 Current Theories
Theory of Mind:
● Attribute mental states to oneself and others
● Ability to understand that others’ point of view can be different
than one’s own Joint Attention:
● Two or more people coordinating attention towards an object or event of
mutual interest
● Share awareness
Music Therapy Approaches to Autism
Relationship-based Framework:
● Goal areas: musical, social, emotional
● Techniques: improvisational, re-creative,
compositional NMT:
● Goal Areas: cognition, communication, sensorimotor
● Techniques: auditory perception training, developmental speech &
language training, social competence training
Receptive Methods
Social Stories
● Enhance interest in concepts
● Preparing for social interactions
● Use 1st person (“I”)
● Add words “sometimes” or
“usually” Child-directed Singing
● Use of song to communicate and reflect moment
● Goal to absorb music, rather than expression
● When child disengages, change musical elements
Improvisation
● Arise from vocal and motor output by the child, MT then reflects and
expands...captures essence
, ● Mirroring, then shaping into melodic motifs, rhythms, or lyrics
● Joining the child in his/her experience
Note: Can still include structure, repetition, and familiarity
Recreative
Adaptive Music Lessons
● Typically voice, piano, guitar, drums
● Goals: motor control, coordination, self regulation, self- awareness,
sequencing, memory, and attention
● Higher functioning goals: leisure skills, self-esteem, frustration tolerance,
social skills
Compositional
● Lower-functioning: more basic pre- academic, behavioural, and life skills
○ Goals: develop vocabulary, expand behavioural repertoire,
understanding social cues
● Higher functioning: more psychological or emotional themes
○ Goals: more traditional; that is, expression, self-esteem, creativity
MT & Autism
● Those with ASD have strengths in the creative arts and demonstrate
enhanced musical abilities
● Emotion processing deficits in ASD are domain specific, may not impact
musical domain
● Greater song vs. speech response
● Music therapy has been suggested as a promising approach to
improve social communication in ASD (Simpson & Keen, 2011).
Background Information
● 1940s: Early MT pioneers likely worked in psychiatric hospitals, institutions,
schools
● Medical community in US begins shift to holistic treatment philosophy,
began to employ part-time music therapists as profession began to define
itself
● Autism diagnosis and music therapy profession simultaneously
emerging; no publications
● First article to address MT treatment for children with autism was
published in British Journal of Music Therapy in 1969
● Music therapists started delineating goals and objectives in their publications
and articles by the end of the 1960s and articles specific to this population
began accumulating
Nordoff Robbins
● Pioneers in improvisational music therapy
● Perceived music as a nonthreatening medium
, ● Creative Music Therapy technique for children with autism and other
developmental disabilities
● “The Musical Child”
Improvisational techniques used to:
● Establish rapport
● Encourage expressive language and social skills
● Medium for self expression
● Allowed sensory activities to be explored
● Addressed behaviour challenges
More structured techniques to address:
● Attention
● Body Awareness
● Communication
● Video Example
Evidence-Based Practice
● Music therapists and non-music therapists have been critical of the level
of evidence vouching for the effectiveness of their work with children with
autism
● Response: Task forces to explore and offer recommendations for future
directions for MT & autism
● Research! Clinical models and more rigorous assessment methods
○ Example: Rational-Scientific Mediating Model (R-SMM) developed
by Thaut (2000) – Neurologic Music Therapy
● Social Communication, Emotional Regulation, and Transactional Support
(SCERTS) curriculum model as intake and ongoing assessment tool in
music therapy for children with autism
Recent Research
Purpose
● To evaluate the effects of a music-based intervention (MT) on language and
social
communication in school-aged children with ASD, compared to a non-music
control intervention (nonMT) using a randomized control trial design.
● Investigating a direct link between effects of music interventions and
changes in the brain for children with ASD
Methods
● Fifty-one children aged 6–12 years with autism were randomized to receive
8–12 weeks of music (n = 26) or non-music intervention (n = 25)
