April is National Autism Awareness Month and I’d be amiss if I did not take the opportunity to write about it since I serve so many clients who are on the autism spectrum and consider myself a specialist in the area.

According to the CDC, about 1 percent of the world population has autism spectrum disorder.  The prevalence of autism in U.S. children increased by 119.4% from 2000 (1 in 150) to 2010 (1 in 68) making Autism is the fastest-growing developmental disability.

With so many people diagnosed every day there is much responsibility on practitioners to keep up with the demand and offer high-quality, innovative, and of course fun services.  Most people diagnosed with autism spectrum disorders often show heightened interest and response to music, making them ideal candidates for music therapy!

Music therapy is scientifically proven to help with communication, cognition, stereotypic and/or repetitive behaviors, social skills and interaction, emotional regulation, motor, academics, sensory, and musical skills.  Below is a wealth of research on music therapy and autism compiled by Coast Music Therapy.  I hope that you’ll take the time to read a few of the articles and see just how amazing the power of music can be in the life of an individual with autism.

For more information or to schedule a music therapy assessment for your family member/friend on the autism spectrum leave a comment below or contact Musical Bridges here.

2015 Research:

“Bill is now singing”: Joint engagement and the emergence of social communication of three young children with autism.

A child-centered improvisational music therapy intervention model was implemented to promote engagement in three children with autism in a kindergarten classroom.  Using a multiple baseline design, all children showed improvement in joint attention and actions of social engagement.
Autism 2015; 19(1), 73-83.
Vaiouli, P., Grimmet, K., & Ruich, L.J.

2014 Research:

Intact brain processing of musical emotions in autism spectrum disorder, but more cognitive load and arousal in happy vs. sad music.

Using functional magnetic resonance imaging, this study investigated neural correlates of emotion recognition in music in high-functioning adults with ASD and neurotypical adults. Both groups engaged similar neural networks during processing of emotional music, and individuals with ASD rated emotional music comparable to the group of neurotypical individuals. However, in the ASD group, increased activity in response to happy compared to sad music was observed in dorsolateral prefrontal regions and in the rolandic operculum/insula, and we propose that this reflects increased cognitive processing and physiological arousal in response to emotional musical stimuli in this group. Read the entire article for free through PubMed.
Frontiers in Neuroscience 2014; 15(8), 192.
Gebauer, L., Skewes, J., Westphael, G., Heaton, P., & Vuust, P.

Music therapy for people with autism spectrum disorder.

This review of research examined randomised controlled trials (RCTs) or controlled clinical trials comparing music therapy or music therapy added to standard care to ‘placebo’ therapy, no treatment, or standard care for individuals with ASD. The findings of this review provide evidence that music therapy may help children with ASD to improve their skills in primary outcome areas that constitute the core of the condition including social interaction, verbal communication, initiating behaviour, and social-emotional reciprocity. Music therapy may also help to enhance non-verbal communication skills within the therapy context. Furthermore, in secondary outcome areas, music therapy may contribute to increasing social adaptation skills in children with ASD and to promoting the quality of parent-child relationships.
Cochrane Database of Systematic Reviews 2014 Jun 17;6:CD004381
Geretsegger, M., Elefant, C., Mossler, K.A., & Gold, C.

Effects of a music therapy group intervention on enhancing social skills in children with autism.

Seventeen children, ages 6 to 9, with a diagnosis of ASD were randomly assigned to the music therapy group (MTG) or the no-music social skills group (SSG). All group sessions were designed to target social skills. The Social Responsiveness Scale (SRS), the Autism Treatment Evaluation Checklist (ATEC), and video analysis of sessions were used to evaluate changes in social behavior. Statistical results demonstrate initial support for the use of music therapy social groups to develop joint attention.
Journal of Music Therapy 2014; 51(3), 250-75.
LaGasse, A.B.

The effect of musical attention control training (MACT) on attention skills of adolescents with neurodevelopmental delays: a pilot study.

This single group pretest/posttest study included 9 adolescents with neurodevelopmental delays including autism. Researchers assessed feasibility of implementing a 45-min Musical Attention Control Training (MACT) intervention delivered by a board-certified music therapist eight times over 6 weeks in a school setting. The preliminary efficacy of the MACT to improve attention skills using the Test of Everyday Attention for Children (TEA-Ch) was also examined.  Data analysis demonstrated positive trends indicating that more research on the use of music therapy attention training in high-functioning adolescents with neurodevelopmental disabilities/autism is warranted.
Journal of Music Therapy 2014; 51(4), 333-54.
Pasiali, V., LaGasse, A.B., & Penn, S.L.

Fronto-temporal connectivity is preserved during sung but not spoken word listening, across the autism spectrum.

Using a passive-listening functional magnetic resonance imaging paradigm with spoken words, sung words and piano tones, we found that 22 children with ASD, with varying levels of functioning, activated bilateral temporal brain networks during sung-word perception, similarly to an age and gender-matched control group. In contrast, spoken-word perception was right-lateralized in ASD and elicited reduced inferior frontal gyrus (IFG) activity which varied as a function of language ability.  Results demonstrate the ability of song to overcome the structural deficit for speech across the autism spectrum and provide a mechanistic basis for efficacy of song-based interventions in ASD.
Autism Research 2014 Nov [ePub ahead of print] Sharda, M., Midha, R., Malik, S., Mukerji, S., & Singh, N.C.

2013 Research:

Rhythm, movement, and autism: using rhythmic rehabilitation research as a model for autism.

The purpose of this paper is to illustrate the potential impact of auditory rhythmic cueing for motor functioning in individuals with autism and proposes a rationale for how rhythmic input can support cognitive, behavioral, social, and communication outcomes.  Read the entire article for free through PubMed.
Frontiers in Integrative Neuroscience 2013; 7:19.
Hardy, M., LaGasse, B.

A review of “music and movement” therapies for children with autism: embodied interventions for multisystem development.

This article explains why music and movement therapies are a powerful clinical tool and reviews the results from brain imaging studies reporting on music therapy effects with autism.  Read the entire article for free through PubMed.
Frontiers in Integrative Neuroscience 2013; 7:22.
Srinivasan, S., Bhat, A.

Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: a randomized controlled study.

In this study, 23 children with autism between the ages of 36 and 60 months either received 16 weeks of parent-child music therapy in addition to their early intervention program, or their early intervention program without the addition of music therapy. Results utilizing the Vineland Social Emotional Early Childhood Scale indicated a significant effect on social interaction and the parent-child relationship in the group receiving music therapy.
Child: Care, Health and Development; Nov 2013 ePub ahead of print
Thompson, G.A., McFerran, K.S., & Gold. C.

2012 Research:

Is talent in autism spectrum disorders associated with a specific cognitive and behavioural phenotype?

Parents of 125 youth and young adults with autism were surveyed. Special skills such as in music, art, and mathematics were associated with individuals who had superior working memory and highly focused attention that was not associated with increased obsessesionality.
Journal of Autism and Developmental Disorders 2012; 42(12), 2739-53
Bennett, E., Heaton, P.

Pilot study investigating the efficacy of tempo-specific rhythm interventions in music-based treatment addressing hyper-arousal, anxiety, system pacing, and redirection of fight-or-flight fear behaviors in children with autism spectrum disorder.

This eight week pilot study with six children with ASD employed rhythm interventions at 60-beats per minute and tracked heart-rate data for participants. Results suggest that highly structured rhythmic interventions at a slow tempo were effective in providing ‘controlled arousal’ levels.
Journal of Biomusical Engineering 2012; 2(1-15)
Berger, D.

An embodied approach to testing musical empathy in participants with an autism spectrum disorder.

Results suggest that people with ASD have an understanding of the affective features of music although this physical understanding does not give them clear access to the emotional content of the music.
Music and Medicine 2012; 4(1), 28-36
De Bruyn, L., Moelants, D., Leman, M.

Positive outcomes following participation in a music intervention for adolescents and young adults on the autism spectrum.

Pre- and post-outcome measures for a pilot music program geared to students with ASD showed a significant increase in self-esteem, reduced self-reported anxiety, and more positive attitudes towards peers.
Psychology of Music 2012; 40(2), 201-15
Hillier, A., Greher, G., Poto, N., Dougherty, M.

Joint attention responses of children with autism spectrum disorder to simple versus complex music.

Music that is simple with clear and predictable patterns was found most effective in eliciting responses to bids for joint attention in children with autism in the severe range of functioning. On the contrary, more complex and variable music was most effective with children in the mild/moderate range.
Journal of Music Therapy 2012; 49(4), 430-52.
Kalas, A.

Neural systems for speech and song in autism.

Findings indicate that in low functioning individuals with autism, functional systems that process speech and song were more effectively engaged for song than for speech and neural pathways associated with these functions were not distinguishable from controls.
Brain 2012; 135(Pt 3), 961-75
Lai, G., Pantazatos, S., Schneider, H., Hirsch, J.

The utility of assessing musical preference before implementation of noncontingent music to reduce vocal stereotypy.

This study emphasizes the potential importance of assessing musical preference prior to using music in the reduction of vocal stereotypy. Results found that music was effective to reduce stereotypy compared to a no-interaction condition and high-preference music was most successful. Read the entire article for free through PubMed.
Journal of Applied Behavior Analysis 2012; 45(4), 845-51.
Lanovaz, M., Rapp, J., Ferguson, S.

Music: a unique window into the world of autism.

Despite difficulties in the areas of socialization and communication, there is evidence to suggest many individuals with ASD show a strong and early preference for music and are able to understand simple and complex musical emotions.  New brain studies in the area of musical abilities with ASD is also reviewed.
Annals of the New York Academy of Sciences 2012; 1252, 318-24
Molnar-Szakacs, I., Heaton, P.

Effects of three types of noncontingent auditory stimulation on vocal stereotypy in children with autism.

Music, white noise, and recordings of vocal stereotypy were utilized on two children with autism who showed high rates of vocal stereotypy. For both participants, the music condition was most effective to reduce vocal stereotypy to near-zero levels and also resulted in the highest parent social validity rating and was selected as most preferred of the treatments.
Journal of Applied Behavior Analysis 2012; 45(1), 185-90
Saylor, S., Sidener, T., Reeve, S., Fetherston, A., Progar, P.

Pitch discrimination and melodic memory in children with autism spectrum disorder.

Compared to age and IQ-matched typically developing children, participants with autism demonstrated elevated pitch discrimination ability as well as superior long-term memory for melody.
Autism- Nov 13 [Epub ahead of print] Stanutz, S., Wapnick, J., Burack, J.

2011 Research:

Functional and dysfunctional brain circuits underlying emotional processing of music in autism spectrum disorders.

Individuals with ASD and neurotypical controls underwent an fMRI study while processing happy and sad music excerpts. Individuals with ASD did show activated regions known to be involved in emotion processing and reward but showed decreased brain activity in specific areas compared to the control group.
Cerebral Cortex 2011; 21(12), 2838-49
Caria, A., Venuti, P., de Falco, S

The effect of a music therapy social skills training program on improving social competence in children and adolescents with social skills deficits.

A total of 45 children aged 6-17 with social skills deficits including autism participated in a group-based five session intervention program involving music therapy. Results indicated that significant improvements in social functioning were found in pre and post test ratings and behavioral observations.
Journal of Music Therapy 2011; 48(4), 440-62
Gooding, L.

Effects of music on vocal stereotypy in children with autism.

Noncontingent access to music decreased immediate engagement in vocal stereotypy for 2 children with autism, but only produced marginal effects on subsequent engagement in the behavior after withdrawal.
Journal of Applied Behavior Analysis 2011; 44(3), 647-651
Lanovaz, M., Sladeczek, I., Rapp, J.

The use of auditory prompting systems for increasing independent performance of students with autism in employment training.

Self-operated tape recordings of music interspersed with prompts related to job self-evaluation and encouragement were utilized for two students with autism in an employment training program. Results indicated a potential positive relationship between the use of this auditory prompting system and the on-task behavior of the participants as well as a positive relationship between the decreased amounts of prompts used by support staff.
International Journal of Rehabilitation Research 2011; 34(4), 330-5
Montgomery, J., Storey, K., Post, M., Lemley, J.

Emotion perception in music in high-functioning adolescents with autism spectrum disorders.

Adolescents with ASD rate the intensity of musical emotions similarly to typically-developing individuals and reported greater confidence in their responses when they had correctly recognized the emotions.
Journal of Autism and Developmental Disorders 2011; 41(9), 1240-55
Quintin, E., Bhatara, A., Poissant, H., Fombonne, E., Levitin, D.

History of music therapy treatment interventions for children with autism.

This paper provides a systematic review of the history of music therapy research, treatment of children with autism, and reviews strengths and limitations of music therapy practice with children with autism from 1940-2009.
Journal of Music Therapy 2011; 48(2),169-207
Reschke-Hernandez, A.E.

Music interventions for children with autism: narrative review of the literature.

There is preliminary evidence that children with autism may benefit from music interventions within naturalistic settings and further investigation into these types of interventions and the training required to implement them is required.  While it appears that some individuals with autism may respond to elements of music, more research is needed to support the efficacy of specific applications of music stimuli.
Journal of Autism and Developmental Disorders 2011; 41(11). 1507-1514
Simpson, K., Keen, D.

Auditory-motor mapping training (AMMT) as an intervention to facilitate speech output in non-verbal children with autism: a proof of concept study.

AMMT aims to promote speech production directly by trainings the association between sounds and articulatory actions using intonation and bimanual motor activities, capitalizing on the inherent musical strengths of children with autism. Six non-verbal children with autism had no intelligible words prior to treatment. After 40 individual sessions of AAMT over eight weeks, all children showed significant improvements in their ability to articulate words and phrases with generalization to items that were not practiced during therapy sessions. Read the entire article for free through PubMed.
PLoS One 2011; 6(9), e25505
Wan, C., Bazen, L., Baars, R., Libenson, A., Zipse, L., Zuk, J., Norton, A., Schlaug, G.