Music therapy: An effective approach in improving social skills of children with autism

Ghasemtabar, Seyyed Nabiollah; Hosseini, Mahbubeh; Fayyaz, Irandokht; Arab, Saeid; Naghashian, Hamed; Poudineh, Zahra

Music therapy: An effective approach in improving social skills of children with autism

Authors

¹ Department of Curriculum Studies, Kharazmi University, Tehran, Iran

² Department of Education, Allameh Tabatabai University, Tehran, Iran

³ Department of General Psychology, Kharazmi University, Tehran, Iran

⁴ Department of Education, Shahid Chamran University, Ahvaz, Iran

⁵ Department of Children Psychology, Islamic Azad University of Birjand, Birjand, Iran

Abstract

Background: The existing methodological weakness in conducted researches concerning music therapy (MT) for children with autism led to ambiguity and confusion in this scope of studies. The aim of the present research is to identify the effectiveness of MT method in improving social skills of children with autism and its stability, as well.
Materials and Methods: In the form of a clinical trial study with design of pretest/posttest/follow-up with control group, among the children with autism in community of Tehran city, on the basis of childhood autism rating scale, 27 children with mild to moderate autism were chosen and were divided into two groups of experiment (n = 13), and control (n = 14). Social skills' level of both groups was measured and recorded with the help of social skills rating system scale. The children of the experiment group participated in MT programs of Orff-Schulwerk for 45 days in 12 sessions (two sessions of 1-h/week), whereas the control group received no intervention. The data were analyzed with Statistic Package For Social Science (SPSS) software t-test and analysis of covariance was used to compare groups.
Results: In posttest, the results of covariance analysis showed a significant increase in social skills' scores of the experiment group (P < 0.001). Also, results of the paired-sample t-test showed that the effectiveness of MT has been persistent up to the follow-up phase.
Conclusions: The study showed that MT is an effective method with deep and consistent effects on improving social skills of children with autism.

Keywords

References

1.	American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5 ^th ed. Washington DC: American Psychiatric Association; 2013.
2.	Centers for Disease Control and Prevention. Autism Spectrum Disorders (ASDs2012). Retrieved August 7, 2013, from: http://www.cdc.gov/ncbddd/autism/index.html.
3.	Reynolds CF 3 ^rd , Lewis DA, Detre T, Schatzberg AF, Kupfer DJ. The future of psychiatry as clinical neuroscience. Acad Med 2009;84:446-50.
4.	Carter AS, Davis NO, Klin A, Volkmar FR. Social development in autism. In: Volkmar FR, Paul R, Klin A, Cohen D, editors. Handbook of Autism and Pervasive Developmental Disorders. Diagnosis, Development, Neurobiology, and Behavior. Hoboken, NJ: John Wiley and Sons; 2005. p. 211-221.
5.	Gresham FM, Sugai G, Horner RH. Interpreting outcomes of social skills training for students with high-incidence disabilities. Except Child 2001;67:331-44.
6.	DeMatteo FJ, Arter P, Sworen-Parise C, Fasciana M, Paulhamus M. Social skills training for young adults with autism spectrum disorder: Overview and implications for practice. Natl Teach Educ J 2012;5:21-7.
7.	Bellon-Harn ML, Harn WE. Profiles and social communicative competence in middle school children with Asperger's syndrome: Two case studies. Child Lang Teach Ther 2006;22:1-26.
8.	Whalen C, Schreibman L, Ingersoll B. The collateral effects of joint attention training on social initiations, positive affect, imitation, and spontaneous speech for young children with autism. J Autism Dev Disord 2006;36:655-64.
9.	Williams White S, Keonig K, Scahill L. Social skills development in children with autism spectrum disorders: A review of the intervention research. J Autism Dev Disord 2007;37:1858-68.
10.	Jones CD, Schwartz IS. When asking questions is not enough: An observational study of social communication differences in high functioning children with autism. J Autism Dev Disord 2009;39:432-43.
11.	Schopler E, Mesibov GB. Autism in Adolescents and Adults. New York: Plenum Press; 1983.
12.	Tantam D. The challenge of adolescents and adults with Asperger syndrome. Child Adolesc Psychiatr Clin N Am 2003;12:143-63, vii.
13.	Strain PS, Schwartz I. ABA and the development of meaningful social relations for young; 2001. Focus of Autism and Other Developmental Disabilities, 16, 120-128
14.	Caltabiano A. The Impact of Music Therapy on the Social Behaviours of Children with Autism in a Structured Outdoor Inclusive Setting. Vol. 4. Unpublished Thesis, University of Sydney; 2010. p. 43-52.
15.	Delano ME, Snell ME. The effects of social stories on the social engagement of children; 2006. Journal of Positive Behavior Intervention, 8, 29-42.
16.	Laushey KM, Heflin LJ. Enhancing social skills of kindergarten children with autism through the training of multiple peers as tutors. J Autism Dev Disord 2000;30:183-93.
17.	Paterson CR, Arco L. Using video modeling for generalizing toy play in children with autism. Behav Modif 2007;31:660-81.
18.	Bock MA. The impact of social-behavioral learning strategy on the social interaction skills of four students with asperger syndrome. Focus Autism Dev Disord 2007;22:88-95.
19.	Jones EA, Feeley KM. Parent implemented joint attention intervention for preschoolers with autism. J Speech Lang Pathol Appl Behav Anal 2007;2:252-68.
20.	Chin HY, Bernard-Opitz V. Teaching conversational skills to children with autism: Effect on the development of a theory of mind. J Autism Dev Disord 2000;30:569-83.
21.	American Music Therapy Association. What is music therapy? 2014. Retrieved september13, 2013, from: http://www.musictherapy.org/.
22.	Meadowes T. Music therapy for children with severe and profound multiple disabilities: A review of the literature. Aust J Music Ther 1997;8:3-17.
23.	Vaiouli P, Schertz H. Promoting Social Engagement for Young Children with Autism: A Music Therapy Approach. Paper Delivered at 12 ^th International Conference on Music Perception and Cognition (ICMPC); 2012. Retrieved August 14, 2013, from: http://www.icmpcescom2012.web.auth.gr/sites/default/files/papers/1044_Proc.pdf.
24.	Caltabiano A. The Impact of Music Therapy on the Social Behaviours of Children with Autism in a Structured Outdoor Inclusive Setting. Unpublished Thesis, University of Sydney; 2010.
25.	Katagiri J. The effect of background music and song texts on the emotional understanding of children with autism. J Music Ther 2009;46:15-31.
26.	Walworth DD. The use of music therapy within the SCERTS model for children with Autism Spectrum Disorder. J Music Ther 2007;44:2-22.
27.	Stephens CE. Spontaneous imitation by children with autism during a repetitive musical play routine. Autism 2008;12:645-71.
28.	Kern P, Wolery M, Aldridge D. Use of songs to promote independence in morning greeting routines for young children with autism. J Autism Dev Disord 2007;37:1264-71.
29.	Kern P, Aldridge D. Using embedded music therapy interventions to support outdoor play of young children with autism in an inclusive community-based child care program. J Music Ther 2006;43:270-94.
30.	Reitman MR. Effectiveness of Music Therapy Interventions on Joint Attention in Children Diagnosed with Autism: A Pilot Study. Retrieved August 23, 2013, from: Doctoral Dissertation, Carlos Albizu University; 2005.
31.	Woodward A. Music therapy for autistic children and their families: A creative spectrum. Br J Music Ther 2004;18:8-14.
32.	Holck U. Turn-taking in music therapy with children with communication disorders. Br J Music Ther 2004;18:45-54.
33.	Ulfarsdottir L, Erwin P. The influence of music on social cognitive skills. Arts Psychol 1999;26:81-4.
34.	Wimpory D, Chadwick P, Nash S. Brief report: Musical interaction therapy for children with autism: An evaluative case study with two-year follow-up. J Autism Dev Disord 1995;25:541-52.
35.	Buday EM. The effect of signed and spoken words taught with music on sign and speech imitation by children with autism. J Music Ther 1995;32:189-202.
36.	Edgerton CL. The effect of improvisational music therapy on the communicative behaviors of autistic children. J Music Ther 1994;31:31-62.
37.	Hairston MJ. Analyses of responses of mentally regarded autistic and mentally retarded non autistic children to art therapy and music therapy. J Music Ther 1990;27:137-50.
38.	Staum M, Flowers P. The use of stimulated training and music lessons in teaching appropriate shopping skills to an autistic child. Music Ther Perspect 1984;1:14-7.
39.	Thaut MH. A music therapy treatment model for autistic children. Music Ther Perspect 1984;1:7-13.
40.	Hurt-Thaut C. Clinical practice in music therapy. In: Hallam S, Cross I, Thaut M, editors. The Oxford Handbook of Music Psychology Oxford University Press: 2009. p. 503-14.
41.	Bunt L. Music therapy for children. In: McPherson GE, editor. The Child as Musician: A Handbook of Musical Development. Oxford: Oxford University Press: 2006. p. 273-85.
42.	Srinivasan SM, Bhat AN. A review of "music and movement" therapies for children with autism: Embodied interventions for multisystem development. Front Integr Neurosci 2013;7:22.
43.	Heaton P, Hermelin B, Pring L. Can children with autistic spectrum disorders perceive affect in music? An experimental investigation. Psychol Med 1999;29:1405-10.
44.	Heaton P. Pitch memory, labelling and disembedding in autism. J Child Psychol Psychiatry 2003;44:543-51.
45.	Pasiali V. The use of prescriptive therapeutic songs in a home-based environment to promote social skills acquisition by children with autism: Three case studies. Music Ther Perspect 2004;22:11-22.
46.	National Autism Center. National Standards Project findings and conclusions: Addressing the need for evidence-based practice guidelines for Autism Spectrum Disorders. Randolph, MA: NAC; 2009.
47.	Hollander FM, Juhrs PD. Orff-Schulwerk, an effective treatment tool with autistic children. J Music Ther 1974;4:1-12.
48.	Lofthouse N, Hendren R, Hurt EL, Arnold E, Butter E. A review of complementary and alternative treatments for autism spectrum disorders. Autism Res Treat 2012;2010;21. Retrieved August 7, 2013, from: http://www.hindawi.com/journals/aurt/2012/870391/ref/.
49.	Schopler E, Reichler RJ, Renner BR. The Childhood Autism Rating Scale (CARS). Los Angeles, CA: Western Psychological Services; 1988.
50.	Mick KA. Diagnosing autism: Comparison of the childhood autism rating scale (CARS) and the autism diagnostic observation schedule (ADOS). Unpublished Doctoral dissertation, Wichita State University; 2005. Retrieved August 26, 2013, from: http://www.soar.wichita.edu/bitstream/handle/10057/439/d05001.pdf?sequence=3.
51.	Garfin DG, McCallon D, Cox R. Validity and reliability of the Childhood Autism Rating Scale with autistic adolescents. J Autism Dev Disord 1988;18:367-78.
52.	Geier DA, Kern JK, Geier MR. A Comparison of the Autism Treatment Evaluation Checklist (ATEC) and the Childhood Autism Rating Scale (CARS) for the Quantitative Evaluation of Autism. J Ment Health Res Intellect Disabil 2013;6:255-67.
53.	Eaves RC, Milner B. The criterion-related validity of the Childhood Autism Rating Scale and the Autism Behavior Checklist. J Abnorm Child Psychol 1993;21:481-91.
54.	Pereira A, Riesgo RS, Wagner MB. Childhood autism: Translation and validation of the Childhood Autism Rating Scale for use in Brazil. J Pediatr (Rio J) 2008;84:487-94.
55.	Rellini E, Tortolani D, Trillo S, Carbone S, Montecchi F. Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) correspondence and conflicts with DSM-IV criteria in diagnosis of autism. J Autism Dev Disord 2004;34:703-8.
56.	Ahmadi J, Safari T, Hemmatian M, Khalili Z. Study of psychometric indices of the diognostic test for autism. Q Behav Sci Res 2012;1:87-104.
57.	van der Oord S, van der Meulen EM, Prins PJ, Oosterlaan J, Buitelaar JK, Emmelkamp PM. A psychometric evaluation of the social skills rating system in children with attention deficit hyperactivity disorder. Behav Res Ther 2005;43:733-46.
58.	Shahim S. Correlations between parents' and teachers' ratings of social skills for a group of developmentally disabled children in Iran. Psychol Rep 1999;85:863-6.
59.	Gresham FM, Elliot SN. Social Skills Rating System Manual. Circle Pines, MN: American Guidance Service; 1990.
60.	Chou Y. The Effect of Music Therapy and Peer-mediated Interventions on Social-communicative Responses of Children with Autism Spectrum Disorders. Unpublished Thesis, Georgia University; 2008 Retrieved September 3, 2013, from: http://www.kuscholarworks.ku.edu/dspace/bitstream/1808/.../1/umi-ku-2707_1.pdf.
61.	Bakan MB, Koen B, Kobylarz F, Morgan L, Goff R, Kahn S, et al. Following frank: Response-ability and the co-creation of culture in a medical ethnomusicology program for children on the autism spectrum. Ethnomusicology 2008;12:163-202.
62.	Klein SB. Music Therapy for School-Aged Individuals with Varying Exceptionalities: A Content Analysis (1975-2009). Unpublished Thesis, Florida State University; 2010. Retrieved September 8, 2013, from: http://www.diginole.lib.fsu.edu/etd/2823/.
63.	Koegel RL, Koegel LK, ediotrs. Teaching Children with Autism: Strategies for Initiating Positive Interactions and Improving Learning Opportunities. Baltimore, MA: Paul H. Brookes; 1995.
64.	Overy K, Molnar-Szakacs I. Being together in time: Musical experience and the mirror neuron system. Music Percept 2009;26:489-504.
65.	Trevarthen C. Musicality and the intrinsic motive pulse: Evidence from human psychobiology and infant communication. Musi Sci 1999, 6:155-215.
66.	Wigram T. Indications in music therapy: Evidence from assessment that can identify the expectation of music therapy as a treatment for Autistic Spectrum Disorder (ASD): Meeting the challenge of evidence based practice. Br J Music Ther 2002;16:11-28.

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