Music Therapy and Autism in Winnipeg
What is Autism?
Autism is a complex developmental disability that typically appears during the first three years of life. The result of a neurological disorder that affects the functioning of the brain, Autism affects the normal development of the brain in the areas of social interaction and communication skills.
Autism is one of five disorders which fall under the umbrella of Pervasive Developmental Disorders (PDD). The five disorders are Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder (CDD), Rett Syndrome, and PDD-Not Otherwise Specified (PDD-NOS).
What is Music Therapy?
Music Therapy is a clinical and evidenced-based health care profession in which music is used within a therapeutic relationship by an accredited music therapist to address physical, cognitive, emotional and social needs of individuals.
Music therapists conduct client assessments, develop treatment plans, implement therapy processes and evaluate client progress, strengthening and transferring clients‘ abilities to other areas of their lives.
What is Neurologic Music Therapy and How Can It Help?
Neurologic Music Therapy is the therapeutic application of music to speech and language, cognitive, and sensorimotor dysfunctions and has been shown to be successful intervention for people with (but not limited to): Traumatic Brain Injury, Parkinson’s Disease, Developmental Disabilities, Autism Spectrum Disorder, Communication Disorders, Multiple Sclerosis, Cerebral Palsy, and Dementia.
Neurologic Music Therapy was one of the first models of Music Therapy to provide standardized clinical approaches. It emphasizes clinical research and the biomedical approach, rather than relying on philosophical theories. We know that music engages the whole brain with rhythm and musical patterns enhancing motor and cognitive responses. Because sensory inputs change the brain’s plasticity, Neurologic Music Therapy draws on the brains ability to learn from musical structure.
Research shows that individuals with Autism Spectrum Disorder respond positively to music and may show a heightened interest and response to music. Many people with Autism show an innate talent for music as demonstrated by a superior ability to identify and recall pitches (tonal memory) and enhanced music processing.
Autism is a spectrum disorder. The following characteristics and need areas of Autism can present themselves in a wide variety of combinations, ranging from mild to severe. Although Autism is defined by a certain set of behaviours, children and adults can exhibit any combination of the behaviours in any degree of severity. The following is a general guide, not a diagnostic checklist.
Individuals with Autism Spectrum Disorders (ASDs) represent the general population in that there is variety. Some have special talents, some are geniuses, some have intellectual limitations and some have average intelligence. However, most individuals display impairment in imaginative thought and play. In terms of learning, they process information in unique ways and have difficulty learning under ordinary teaching methods. Some learn to read and/or master math concepts at a very young age. Their abilities can fluctuate from day to day due to difficulties in concentration, processing, or anxiety. They may show evidence of learning one day, but not the next. Changes in external stimuli and anxiety can also affect learning.
Music therapy songs and techniques are effective in addressing academic skills. Some of these skills may include number identification, counting, and mathematical problem solving. Music therapy is motivating and can allow an individual to attend to a task for a longer period of time. Because music is processed in both hemispheres of the brain, music can stimulate cognitive functioning and may be used for remediation of some speech/language skills.
Individuals with Autism may have difficulty with expressive and receptive communication. They may show problems with initiating and/or maintaining a conversation. Communication is often described as talking at others (for example, monologue on a favorite subject that continues despite attempts by others to interject comments). Individuals may show difficulty in expressing needs, use gestures or point instead of using words. They may repeat words or phrases (echolalia). Peculiar voice characteristics may be present, such as a flat monotone or a high-pitched voice. These individuals may not respond to simple requests or verbal cues, acting as if they are deaf when their hearing tests are within normal ranges.
Music therapy can enable those without language to communicate, participate and express themselves non-verbally. Often music can assist in the development of verbal communication, speech and language skills. Singing is an effective technique used to increase sentence length, fluency, rate, and appropriate pitch and volume of the speaking voice. Rhythmic cueing can improve the rate of speech. Conversational skills can also be enhanced through “musical conversations” with instruments where the child takes turns “talking” with a peer.
Individuals with Autism show impairments in social skills, especially in building relationships with others. They may prefer to be alone, have an aloof manner and demonstrate difficulty mixing with others. As an infant, they may not want to cuddle or be touched. They may make little to no eye contact with others. They may display emotions such as laughing or crying at seemingly inappropriate times, and show distress for reasons that are not apparent to others. One theory explains that the reason for this is that persons with Autism cannot communicate or express feelings normally because they do not fully understand that others have thoughts, desires, interest, and intentions. They may be very insistent, rigid on sameness, and resistant to changes in the environment or schedule. In some cases, aggressive and/or self-injurious behaviour may be present. They might hit, or bite themselves and/or others and have temper tantrums for no apparent reason.
Social song stories can be created specifically for the child to target specific social skills or behaviours such as turn-taking, shared play, joint attention, listening and responding to others and appropriate interaction with peers. In the music therapy setting, the individual has the opportunity to role-play different scenarios where this skill could be used which can lead to the generalization of skills to other settings. An individual may also learn these skills (such as eye contact) through cooperative instrument playing. For instance, if two people are taking turns playing the marimba (an xylophone-like instrument) they may make eye contact (without words) to signal that it’s the other person’s turn to play.
Music is predictable, structured and success-oriented. This brings a sense of security, encouraging the individual to take risks and be more spontaneous in interactions with others. Music therapy can provide additional opportunities for positive interaction and building relationships among family members and the person with Autism. Participation in music therapy often allows family members to see their loved one in a “different light,” to witness their relative’s areas of strength and aptitude, maybe for the first time. Music therapy highlights what an individual can do, enhancing self-esteem and positive self-image.
Music therapy can also allow individuals the opportunity to develop identification and appropriate expression of their emotions. For instance, individuals may listen to a “sad” (in a minor key) piece of music while singing about feeling sad and practicing making a sad face in a mirror.
Sample Goals From A Music Therapy Assessment
Speech and Language Training
Goal : To improve overall expressive articulation.
Objective : While singing along to preferred songs, Jaclyn will articulate each sylable of every word, benefiting from maximum lyrical cues, for the duration of each verse.
NMT Technique : Theraputic singing
Goal : To improve ability to adjust when events do not go according to original plan.
Objective : While playing a repetitive rhythmic pattern, group participants will tolerate the addition of a competing rhythmic pattern, benefiting from verbal encouragement and praise as well as imitative cues, for at least 1 complete musical phrase.
NMT Technique : Musical Executive Function Training
Jaclyn Sorenson is my 4 year olds son’s music therapist! Right now she comes weekly to the home and My husband and I cannot say enough good things about Jaclyn.
She is amazing with our son and we have witnessed undeniable progress and change. She has pulled more words out of our non-verbal son than any other therapist! Music Therapy has helped our son more than I can say.
Jaclyn is very passionate about her work and it shows. We call her our godsend!!! Congrats Jaclyn on your new adventure with Bang a Beat!!! And thank you for teaching and loving our son!!!The Orzech family
Bang A Beat Music Therapy Centre
Content provided by the Music Therapy Center of California
Applebaum, E., Egel, A.L., Koegel, R.L., & Imhoff, B. (1979). Measuring musical abilities of autistic children. Journal of Autism and Developmental Disorders, 9, 279-285.
Bettison, S. (1996). The long-term effects of auditory training on children with autism. Journal of Autism and Developmental Disorders, 26(3), 361-374.
Bonnel, A., Mottron, L., Peretz, I., Trudel, M., Gallun, E., & Bonnel, AM. (2003). Enhanced pitch sensitivity in individuals with autism: a signal detection analysis. Journal of Cognitive Neuroscience, 15(2), 226-35.
Brown, S. (1994). Autism and music therapy-is change possible, and why music? Journal of British Music Therapy, 8(1), 15-20.
Brown, W.A., Cammuso, K., Sachs, H., Winklosky, B., Mullane, J., Bernier, R., Svenson, S., Arin, D., Rosen-Sheidley, B., & Folstein, S.E. (2003). Autism-related language, personality, and cognition in people with absolute pitch: results of a preliminary study. Journal of Autism and Developmental Disorders, 33(2), 163-7.
Brownell, M. (2002). Musically adapted social stories to modify behaviors in students with autism: four case studies. Journal of Music Therapy, 39(2), 117-144.
Bruscia, K.E. (1982). Music in the assessment and treatment of echolalia. Music Therapy, 2(1), 25-41.
Buday, E.M. (1995). The effects of signed and spoken words taught with music on sign and speech imitation by children with autism. Journal of Music Therapy, 32(3), 189-202.
Bryan, A. (1989). Autistic group case study. British Journal of Music Therapy, 3(1), 16-21.
Ceponiene, R., Lepisto, T., Shestakova, A., Vanhala, R., Alku, P., Naatanen, R., & Yaguchi, K. (2003). Speech-sound-selective auditory impairment in children with autism: they can perceive but do not attend. Proceedings of the National Academy of Sciences of the United States of America, 100(9), 5567-72.
Di Franco, G. (1999). Music and autism. Vocal improvisation as containment of stereotypes. In T. Wigram. & J. De Backer (Eds.), Music therapy applications in developmental disability, pediatrics and neurology. London: Jessica Kingsley Publishers.
Edgerton, C.L. (1994). The effect of improvisational music therapy on the communicative behaviors of autistic children. Journal of Music Therapy, 31(1), 31-62.
Gold, C., & Wigram, T. (2003). Music therapy for autistic spectrum disorder (Protocol for a Cochrane Review), The Cochrane Library, 4. Hairston, M.J. 91990). Analyses of responses of mentally retarded autistic children and mentally retarded nonautistic children to art therapy and music therapy. Journal of Music Therapy, 27, 137-150.
Heaton, P., Hermelin, B., & Pring, L. (1998). Autism and pitch processing: a precursor for savant musical ability? Music Perception, 15(3), 291-305.
Heaton, P., Hermelin, B., & Pring, L. (1999). Can children with autistic spectrum disorders perceive affect in music? An experimental investigation.Psychological Medicine, 29(6), 1405-10.
Heaton, P., Pring, L., & Hermelin, B. (2001). Musical processing in high functioning children with autism. Annals of the New York Academy of Sciences, 930, 443-444.
Heaton, P. (2003). Pitch memory, labeling and disembedding in autism. Journal of Child Psychiatry and Psychology, 44(4), 543-51.
Hoelzley, P. (1991). Reciprocal inhibition in music therapy: A case study involving wind instrument usage to attenuate fear, anxiety, and avoidance reactivity in a child with pervasive developmental disorder. Music Therapy, 10(1), 58-76.
Kaplan, R.S. & Stelle, A.L. (2003). An analysis of music therapy program goals and outcomes for clients with diagnoses on the autism spectrum. In publication. Ma, Y., Nagler, J., Lee, M., & Cabrera, I. (2001). Impact of music therapy on the communication skills of toddlers with pervasive developmental disorder. Annals of the New York Academy of Sciences, 930, 445-7.
Mottron, L., Peretz, I., & Menard, E. (2000). Local and global processing of music in high-functioning persons with autism: beyond central coherence?Journal of Child Psychology and Psychiatry, 41(8), 1057-1065.
Nelson, D.L., Anderson, V.G. & Gonzales, A.D. (1984). Music activities as therapy for children with autism and other pervasive developmental disorders. Journal of Music Therapy, 21, 100-116.
Pasiasli, V. (2004). The use of prescriptive therapeutic songs in a home-based environment to promote social skills acquisition by children with autism: Three case studies. Music Therapy Perspectives, 22(1), 11-20.
Robarts, J. (1996). Music therapy for children with autism. In C. Trevarthen, K. Aitken, D. Papoudi, & J. Robarts (Eds.), Children with autism: Diagnosis and interventions to meet their needs (pp. 134-169).
Bristol, PA: Jessica Kingsley Publishers. Staum, M.J. & Flowers, P.J. (1984). The use of simulated training and music lessons teaching appropriate shopping skills to an autistic child. Music Therapy Perspectives, 1(3), 14-17.
Stewart, R. (2002). Combined efforts: Increasing social-emotional communication with children with autistic spectrum disorder using psychodynamic music therapy and division TEACCH communication programme. In A. Davies & E. Richards (Eds.), Music therapy and group work: Sound company (pp. 164-187).
London: Jessica Kingsley Publishers. Thaut, M. (1987). Visual versus auditory (musical) stimulus preferences in autistic children: a pilot study. Journal of Autism and Developmental Disorders, 17(3), 425-432.
Thaut, M. (1988). Measuring musical responsiveness in autistic children: a comparative analysis of improvised musical tone sequences of autistic, normal, and mentally retarded individuals. Journal of Autism and Developmental Disorders, 18(4), 561-571.
Watson, D. (1979). Music as reinforcement in increasing spontaneous speech among autistic children. Missouri Journal of Research in Music Education, 4(3), 8-20.
Simpory, D., Chadwick, P., & Nash, S. (1995). Brief report: Musical interaction therapy for children with autism: An evaluative case study with two-year follow-up. Journal of Autism and Developmental Disorders, 25(5), 541-552.
Young, R.L, & Nettelbeck, T. (1995). The abilities of a musical savant and his family. Journal of Autism and Developmental Disorders, 25(3), 231-247.