By Emma Schaeffer
Music Therapy With The Developmentally Handicapped (Folkways)
Conversation and music-making have a number of things in common—the rhythm of the words, the rise and fall of tone, the changing of pitch, the back and forth turn-taking. Despite this, most of us would not choose to communicate with each other through singing and playing instruments rather than speaking. Spoken conversation is what is most natural to us. But for those suffering from autistic spectrum disorder, ordinary communication, or even verbal communication, may not be an option.
People suffering from autism are essentially characterized as being “shut-in” from the rest of the world. They have difficulties with social communication and interaction, restrictions of imagination and social repertoire, and behavioral problems. Lower functioning autistics may be speech impaired, or incapable of verbal communication. Higher functioning autistics may have normal development aside from social issues, and even show advanced skill in an area such as mathematics or art. However, in either of these cases, communication with others poses an issue. This is where music therapy may prove useful (Graham, 2001).
Music therapy is designed to be very personalized, in order to promote one-on-one interaction and demonstrate a functioning two-person relationship. It tends to focus on spontaneous improvisation—the idea is not to enhance musical ability; any musical talent that is acquired is merely a side effect (Bell, 2008). The basic intent is to create an environment in which the client feels comfortable making their own contributions, mixing those contributions with those of the therapist (taking turns), and exploring. This environment provides the client with a place in which they can connect and communicate on a more advanced level than they usually would, and works to improves their communication issues in everyday life. Music is effective as a communication device on multiple levels. Not only does it imitate social interactions, its patterned nature also appeals to the autistic mind, which tends to form patterns and gravitate towards patterns and structure in the external world. For this reason, even patients with sound sensitivities may benefit from and enjoy music therapy (Gold, Wigram, & Elefant, 2006).
The issue with determining the value of music in treating autism is that it is very difficult to research how or why music therapy is effective on a greater scale. One problem is that in cases like this, there will always be subject variations and observer bias (Gold, Wigram, et al., 2006). The studies are entirely dependent on the people involved, making it difficult to have full control. This effect is aggravated by the fact that cases of autism can vary greatly from person to person, and so treatment must be very specific. For instance, examine a study conducted by Mike Brownell on students from an Iowan elementary school. The study set out to see whether putting “social stories” (stories meant to reinforce a specific positive behavior) to a sung melody was more effective than simply reading or showing the stories. Participants were selected based on previous positive reactions to music and/or music therapy (Brownell, 2002). While this avoids upsetting those with adverse reactions to aural stimuli, it also creates a group that may be biased towards favorable results. However, since other treatments for autism must be equally personalized, this is perhaps a better method in terms of benefit to the patient. While results may not offer an understanding of how effective music therapy is on the entire spectrum of autism, they will offer a way to help patients already exhibiting certain tendencies. On a more technical level, it can be difficult to separate the music from the therapy, so to speak. It is hard to know whether patients are actually responding to the music, or simply to the attention of the therapist. In order to counteract this, researchers try to create placebo scenarios, in which participants experience all aspects of music therapy except the music itself (Gold, Wigram, et al., 2006). Still, though, separating two such intertwined things can be a tedious process. For instance, should the back and forth turn-taking be taken out, because it is a part of the music making, or can it remain, since it does not involve any actual sound?
Despite this, the fact remains the music therapy has developed many loyal followers among autistic patients and their caregivers. Parents like Judy Simpson, who regularly sings things like “take a bath, take a bath” to her daughter Janna, firmly believe that music therapy is a good method. They see a change in their child’s behavior, communication skills, and level of functioning after sessions of music therapy (Hwang, 2009). Whether it is the attention or the music that is making a difference, something positive is resulting from this type of treatment, and that is always a good thing. In the study mentioned above, although the data was significant in only one of four cases (though nearly significant in a second case), singing was still as least as effective as reading in all four cases (Brownell, 2002). So, while melody with social stories may not always be more helpful than simply reading, it definitely does not do any harm. As research continues and becomes more precise, perhaps scientists will be able to understand further what it is that makes music therapy effective, and expand upon this to offer an even greater advantage to autistic patients.
Editor’s note: Readers may also enjoy these posts:
Healing the brain through music
The sweet sound of brain development
Alternatives for cerebral palsy patients
References
Bell, E. (2008). Music Therapy. The National Autistic Society. Retrieved March 6, 2009, from http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=10.
Brownell, M. D. (2002). Musically adapted social stories to modify behaviors in students with autism: Four case studies. [Electronic version]. Journal of Music Therapy, 39, 117–144.
Gold C., Wigram T., & Elefant C. (2006). Music therapy for autistic spectrum disorder. [Electronic version]. Cochrane Database of Systematic Reviews , Issue 2. Art. No.: CD004381. DOI: 10.1002/14651858.CD004381.pub2.
Graham, G. (2001). Music and Autism. [Electronic version]. Journal of Aesthetic Education 35(2), 39-47
Hwang, Jean. (2009, March 3). Music Wins Applause for Addressing Autism. [Electronic version]. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2009/03/02/AR2009030201759.html
I have also found that music therapy is also being used to treat patients suffering from depression. They believe that the same characteristics that make it effective for autistic patients make it an effective treatment for those with clinical depression. Most studies that involved music therapy required that the patient and their therapist interact musically.
Although it does not seem music therapy is a viable treatment on its own, it seems to have benefits in conjunction with traditional medicines. Patients that were undergoing music therapy treatments showed an increased participation and compliance with their overall treatment program (Center for the Advancement of Health).
It seems amazing that music has such an effect on our mental wellbeing. It is integral to our daily life (just try and imagine a day without music), and apparently to our health as well!
Reference
Music therapy may offer hope for people with depression. (2008, January 23).
Science Daily. Retrieved from http://www.sciencedaily.com/releases/2008/
01/080122203158.htm
Comment by Arianna Gass — October 5, 2009 @ 7:07 pm
It is true that the level of effectivity of music therapy with autistic patients will vary due to the variability of autism in patients. This is why the National Autistic Society hesitates to recommend it. While the NAS does not discount it as a successful methods in certain cases, they maintain that every patient is so different that it would be hard to recommend it as a universal therapy form.
Despite its lack of universality, music therapy certainly provides great benefits for many patients. It can offer people with autism the chance to communicate with others if verbal communication is unavailable to them. According to Krystal Demaine, a practicing Music Therapist, much of the therapy’s success lies in the stimulation of many senses at once It requires sense of touch, hearing, and often sight.
An interesting read for anyone who would like to learn about the amazing potential of music in helping autistic patients is Rex by Cathleen Lewis. This is a true story about an autistic child, Rex, and how playing the piano opened up a world of possibilities for him despite his great physical and mental challenges.
Sources:
http://www.healingmusic.org/Library/Newsroom/LearningCommunicationThroughMusicTherapy.asp
http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=528&a=3348
Comment by Jesse Greenberg — October 9, 2009 @ 3:23 pm
People with autism tend to be very good with patterns and mathematics. Psychologist Simon Baron-Cohen particularly expounds on this idea in his theory of autism as representing an “extreme male brain,” which thrives on systematic, mechanical perspectives as opposed to the emotional intelligence attributed to females. (Myers, 2007) On this premise it makes sense, then, that an autistic brain would respond well to music. Music is very patterned and mathematical, and thus could make an accessible form of communication for someone whose brain is wired to better understand things systematically than on a more abstract, emotional level.
References
Baron-Cohen, Simon (1999). The extreme-male-brain theory of autism. Neurodevelopmental Disorder. Retrieved from http://www.autismresearchcentre.com/docs/papers/1999_BC_extrememalebrain.pdf
Hwang, Jean. (2009, March 3). Music Wins Applause for Addressing Autism. [Electronic version]. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2009/03/02/AR2009030201759.html
Meyers, D. G. (2007). Psychology (8th ed., in modules). New York: Worth.
Comment by Sandy Wood — October 12, 2009 @ 1:52 am
It seems that music has several benefits on the brain and physiological processes. When we listen to music, our brain waves actually mimic the beat we are hearing. Therefore, listening to fast-paced music with many beats stimulates brain activity and can improve concentration and alertness. Listening to slower music can have a calming, meditative effect. Modification of our brain waves also brings about changes in the body. Music can decrease the effects of chronic stress, for example, because the slower brain waves can slow down breathing and heart rate (functions of the autonomic nervous system), and stimulate the parasympathetic nervous system’s actions to relax the body.
Reference
Scott, Elizabeth. “Music and Your Body: How Music Affects Us and Why Music Therapy Promotes Health.” Retrieved from stress.about.com
Comment by Christine Marisco — October 14, 2009 @ 2:03 pm