This article is evidence-based, verified by Ashleigh Willis, a Neuroscience Ph.D. candidate.
Music is a powerful expressive medium that all cultures and societies engage with. Music resonates with us all and can elicit profound emotional and behavioral responses. Listening to or playing music can connect us with ourselves and others around us.
A common challenge for people with autism spectrum disorder is communicating with others. These challenges can make interacting with others during daily life difficult. It can also cause distress for families and carers.
A growing body of research has revealed that the expressive art of music may be able to aid these issues. Music therapy can provide many benefits for people with autism and those who care for them.
What is music therapy?
Music therapy is a clinical, evidence-based treatment facilitated by a certified music therapist. The therapy uses the expressive qualities of music to support communication and well-being. In music therapy, patients and therapists interact using music instead of speech.
Patients and therapists use a range of musical activities to communicate. These activities include singing, playing instruments, musical improvisation, and listening to melodies together.
There are no pre-requisites to music therapy. The beauty of the treatment is the ability it has to reach everyone. Almost everyone can connect with music in some way. Whether someone is a musical virtuoso or hasn’t played a note in their life, there are activities for everyone.
For people with autism, communicating through the rhythm of music can help them to express their thoughts and emotions. Music therapy can also allow patients to explore their inner feelings naturally and safely.
What does a music therapy session look like?
The types of music therapy available are diverse, but they all involve engaging with music in a therapeutic environment. The treatment is also able to be personalized for each person, depending on their needs. This can help patients reach their personal goals.
All therapies will involve some standard stages, including:
Initial assessment
Before starting a music therapy intervention, music therapists will conduct an initial assessment. This helps the therapist to understand the unique needs of a person. This assessment involves interacting with a person with autism. The therapist may also discuss their needs with families and carers. On occasion, they may also consult the person’s doctor or other therapists. This process allows the therapist to predict which activities may be most beneficial.
Goal setting
Following the assessment, therapists will develop an individualized therapeutic program. They will also set goals, suggest new goals, and desired outcomes. Therapists will collaborate with individuals and families on these goals. This ensures all parties’ needs and desires are met.
Session activities
Music therapy sessions are practical and interactive. Each session includes a variety of activities that best fit the needs of the patients. The sessions are designed with the abilities and desires of patients in mind. The program will also target specific outcomes. Furthermore, music therapy sessions are generally intended to be accessible and enjoyable. This avoids unnecessary stress or anxiety for individuals or families.
Ongoing evaluation
Music therapy is often so effective due to its adaptable nature. A session is pre-planned, but there is a constant on-going evaluation conducted by the therapist. Therapists evaluate how well patients engage with various activities to assess how well these are working. Therapists have a broad tool-box of activities, so programs are often adapted over time.
What types of music therapy help those with autism?
One to one therapy
Given the individualized nature of music therapy, most sessions are usually one-on-one. In this case, therapists work exclusively with one patient. The needs of the individual dictate session length and frequency. Most sessions will last between 30-50 minutes and are usually held every week.
One-on-one sessions provide the most significant amount of individualization. They are also often the best at fostering a strong bond between patient and therapist. Each session has a defined structure and plan of activities. This structure works well for people with autism who can become overwhelmed by disorganization.
Activities will primarily aim to promote communication and social skills—for example, collaborative songwriting and musical improvisation. Research has shown that these activities can improve social skills, such as eye contact and taking turns.
Therapists may use musical activities to improve specific skills. This works particularly well for children with autism. Sometimes therapists will pair a new skill (for example, eye contact) to a musical cue. The patient and therapist will then practice this skill. Once the person has learned the new skill, musical cues are phased out until the skills happen without musical prompts.
To foster a sense of self-expression, therapists may use sing-along songs. Sometimes patients and therapists write lyrics together to sing. These types of activities work well for high-functioning adults or children with autism who have verbal skills. Sometimes these patients find it easier to express themselves to a familiar tune.
Studies have shown that music therapy can also promote improvement in other skills. This includes a cognitive ability and perceptual-motor skills. Throughout the sessions, practical music skills may also be built upon. For example, if a child or adult with autism likes a particular instrument, therapists can help them focus on these skills.
Over time, patients can improve their abilities with this instrument. This process provides a wealth of benefits. Learning an instrument helps cognitive ability, collaborative learning, listening, self-regulation, and perceptual-motor skills.
Group therapy sessions
Music therapy can also be offered in a group format. The basis of these sessions is similar to one-on-one meetings. However, group sessions can help individuals improve their abilities in a social environment. For example, patients can practice interacting with others and self-regulation.
Group therapy sessions are especially helpful to adolescents and adults with autism. Teenagers with autism often report a desire for social interaction and can experience loneliness. Group sessions can help with these feelings. Repeated positive social interactions are also an essential way of reinforcing social skills.
Group therapy sessions allow for productive social interactions in a non-threatening environment. The calming nature of music helps to keep anxiety levels low while therapists can work on improving social skills.
Group therapies are sometimes available in a family setting. In this case, the person with autism and their families take part in sessions together. Parents included in these sessions report overwhelmingly positive outcomes. They often say that the meetings provide new insights about themselves and their children.
What does the science say?
There’s no lack of positive reports and testimonials from individuals and families. This highlights the multidimensional benefits of music therapy for those with autism.
Personal accounts are precious. However, scientific data can help us understand which patients may benefit most from specific interventions. Luckily, since its invention 1950’s, music therapy has been the subject of many scientific studies. The results are impressive! Here’s what the science says:
Improvisational music therapy is effective in children with autism.
Improvisational music therapy promotes social, emotional, and motivational development in children with autism. Studies show that improvisational music therapy sessions foster joyful emotions and emotional ‘synchrony.’ It also promotes understanding and encourages children to initiate social behaviors. Improvisational therapy improves eye-contact and turn-taking in children with autism. Music therapy can be more effective at this than the traditional ‘toy plays’ treatment.
Music therapy produces positive neurobiological changes.
A biological hallmark of autism is a reduction in the connectivity and communication of various brain regions. Scientists believe this contributes to the perceptual and social difficulties of autism. Brain scan studies have shown that music therapy improves the connectivity between brain regions. In parallel, researchers have found an improvement in social behaviors.
Interactive music therapy improves autism symptoms in young adults.
A considerable amount of autism research focusses on children. However, music therapy can benefit adults too. A 2007 study showed that sessions that involved learning musical skills improved many symptoms of autism in adults.
Lesson-based formats are most effective in reaching immediate objectives quickly.
Studies have shown that lesson-based formats may be most effective in obtaining immediate goals. Lesson-based formats help patients to work on one chosen skill. This format can be useful in helping both children and adults with autism. However, these studies have also highlighted that all other types of intervention were also valuable. Moreover, 100% of parents and caregivers report that the skills learned in therapy are generalized to other aspects of life.
Where else is music therapy helpful?
Music therapy in a hospital setting
Music therapy can work in a wide variety of clinical settings. While sessions are usually ‘outpatient’ and take place in specialized facilities, music therapy is often used in hospitals.
Music therapy is used across a variety of medical fields, from pediatrics to pain management. Patients undergoing treatment in all kinds of medical settings can benefit from music therapy. Research has shown that playing or listening to music can help to ease chronic pain. It can also alleviate stress before and after surgery and during pregnancy and childbirth.
Music therapy, stress relief, and health benefits
Reports suggest this is due to the significant stress and anxiety reduction music therapy can produce. Excessive stress and anxiety can trigger physiological changes that impair immune system function. This can lead to inflammation and can impact healing ability.
Easing stress improves physical health. This includes reductions in muscle tension, blood pressure, chest pain, fatigue. Furthermore, studies have shown that music therapy can result in improved respiration and heart health. It’s clear – the benefits of music therapy across the physical body are extensive!
As a result of this, music therapy is particularly useful in the treatment of chronic pain. In fact, music therapy can reduce the need for invasive therapies and pharmaceuticals.
Music therapy’s stress-relieving abilities can also improve mental health. This includes helping with low mood and depression. This lift in emotions and mood can encourage more active participation in therapies by patients. Ultimately, this makes the work of healthcare professionals more fulfilling.
Music therapy can help foster intimacy between patients and their healthcare professionals. A better patient-therapist bond allows for a much more relaxed treatment environment. A more positive mood often improves communication. This can also reduce stress within families, where illness or hospital stays have been a source of stress.
Who can deliver music therapy?
Music therapists are registered healthcare professionals. Therapists have formal training in psychology, counseling, education, and social work. All music therapists hold an undergraduate degree (often in music!) and an accredited postgraduate Master’s degree in music therapy.
Of course, therapists are usually talented musicians too!
The credentials of music therapists will vary from country to country. All therapists will usually be part of an official body that ensures high standards of practice and care.
In the UK, music therapists must have their qualifications accredited by the Health and Care Professions Council. They must also register with this professional body.
In the US, all music therapists are American Music Therapy Association accredited.
Research shows that the most successful outcomes are achieved through personalized programs. A good patient-therapist bond is also crucial. Therefore, finding a therapist who understands the needs of someone with autism is vital. It’s a good idea to explore a variety of therapist options to find out which one is right for your loved one.
If you care for someone with autism, it’s a good idea to look for a therapist who specializes in working with autism. Music therapy is a popular intervention for autism, so it’s likely these types of therapists should be available in most regions.
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Ashleigh Willis is a final year Ph.D. candidate in Neuroscience at the University of Glasgow. Her research investigates the genetic and environmental contributors to mental health and neurodevelopmental conditions. Ashleigh has built research collaborations with McGill University and received specialist training at the Centre for Neuroscience at Montreal General Hospital, McGill University Health Centre. She is also an active member of the Society for Neuroscience. Ashleigh holds an Honours in Psychology, an MRes in Neuroscience, and is fascinated by the neuronal circuits which make us who we are. Ashleigh is passionate about providing a deeper understanding of mental health conditions and sharing an accurate and de-stigmatizing message through talks for organizations such as TEDx, Pint of Science, and the Scottish Funding Council.
You can follow Ashleigh on her Youtube channel here
References
- Parents’ Perceptions of Family-based Group Music Therapy for Children with Autism Spectrum Disorders: https://academic.oup.com/mtp/article-abstract/23/2/92/1134302
- Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy: https://journals.sagepub.com/doi/abs/10.1177/1362361309105660
- The Effects of Improvisational Music Therapy on Joint Attention Behaviors in Autistic Children: A Randomized Controlled Study: https://link.springer.com/article/10.1007/s10803-008-0566-6
- The Effect of Improvisational Music Therapy on the Communicative Behaviors of Autistic Children: https://academic.oup.com/jmt/article-abstract/31/1/31/889169
- Music therapy for people with an autism spectrum disorder, Cochrane Library: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004381.pub3/abstract
- Music improves social communication and auditory-motor connectivity in children with autism: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199253/
- Group therapy adolescents: https://core.ac.uk/download/pdf/82727306.pdf , https://www.researchgate.net/publication/282599606_The_Use_of_Music_Interventions_to_Improve_Social_Skills_in_Adolescents_with_Autism_Spectrum_Disorders_in_Integrated_Group_Music_Therapy_Sessions
- https://petersonfamilyfoundation.org/news/health-benefits-of-music-therapy/
- https://www.verywellmind.com/benefits-of-music-therapy-89829
- https://www.mtabc.com/what-is-music-therapy/how-does-music-therapy-work/pain/
- https://www.musictherapy.org/assets/1/7/MT_Medicine_2006.pdf
