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How does Music Therapy apply to individuals with
ASD?
“Music is effective because it is a nonverbal form
of communication, it is a natural reinforcer, it is immediate in time
and provides motivation for practicing nonmusical skills. Most importantly,
it is a successful medium because almost everyone responds positively
to at least some kind of music.” (Staum, 2003)
Children and youth with ASD have difficulty making sense
of the world. Often children who have autism have difficulty assessing
and interpreting sensory stimuli resulting in unusual behaviors that
interfere with functional behavior and learning (Cook, & Dunn 1998).
Their behavior suggests that they do not receive accurate information
from their senses or cannot use the information in the same way typically
developing children do. They do not readily learn incidentally through
play and interactions with others. It is common for individuals with
ASD to be highly anxious, nervous or stressed by thoughts and events
that might not affect others. This makes perfect sense! If you are confused,
can’t make sense of your environment, don’t know what’s
wrong and don’t know what you are supposed to do, chances are
you will feel anxious. When a person feels confused and anxious, it
is very easy to make mistakes and just about impossible to learn. Often
the behaviors we see exhibited by individuals with ASD seem odd or unusual.
It can be hard to determine why they are responding the way they are.
It is important to remember, that the child with ASD is doing the best
they can with the resources they have available to them at the time.
It is helpful for parents and educators to keep in mind that learning
new, adaptive responses might feel uncomfortable for the individual
with ASD, especially in the beginning. A primary goal for the music
therapist when working with a child with ASD is to use music to help
the individual become relaxed yet alert so they are able to learn.
Having the ability to focus attention on what is important
is a critical first step in learning. Many children with ASD have great
difficulty paying attention to what other people want them to. They
may have difficulty shifting attention and maintaining their attention.
Music is a powerful tool for getting and maintaining attention. An important
part of the music therapy evaluation involves the use of a variety of
music to determine what types of music grabs the individual’s
attention. The use of simple repetitive songs using the child’s
name might be incorporated in the session. The therapist might incorporate
periods of silence during a therapy session. The stopping and starting
of music or a long pause during a familiar song might be one way to
build initial awareness of the presence and absence of music and regain
attention.
Impairment in joint attention is typical of individuals
with ASD. Responding jointly means to focus your attention on an object
indicated by another person. One initiates joint attention by directing
another person to focus their attention on something. At an elementary
level, an example of joint attention may be simply looking towards and
object their partner is looking at, then looking back to the partner
for the purpose of gaining information about the object of interest.
At a more sophisticated level, the “object” may be an experience
or idea introduced by the partner in conversation and the learner responds
verbally to acknowledge, ask a question or add more information. Reciprocal
social interaction is based on joint attention. One must understand
that another person’s actions, where they are looking, and the
language they use is meaningful. Because music is a pleasurable, non-threatening
medium it can be used effectively as a focus for joint attention. Music
becomes the point of mutual contact between therapist and child (Thaut,
1999; p.173).
Joint attention is also the basis of shared enjoyment.
Shared enjoyment is not just having fun but the understanding that having
another person participating in the activity with you makes the experience
better than doing it alone. A critical part of shared enjoyment is that
both partners are having fun and they let each other know it through
their gaze, smiles and laughter. Both partners contribute to the experience,
modifying as necessary so that their partner maintains interest and
enjoyment. Individuals with ASD may take great delight in a particular
activity or interest but sometimes those who live and work with them
are baffled at the reason for their delight. This is an example of difficulty
with joint attention or the inability to initiate a mutual topic of
interest and share that enjoyment with a partner. Shared enjoyment is
central to a music therapy session. The music therapist uses music the
child likes as the focus of the session. The therapist might begin a
session by playing a percussion instrument matching the rhythm of the
child’s movements. The recognition that the music is keeping pace
with their movements is often empowering. The child finds they are able
to affect the music with the speed and intensity of their own movements,
often to the delight of both child and therapist. This moment of shared
enjoyment is the beginning of making a connection with another person
through music.
Individuals with ASD often have impairments in reciprocal
social interaction. Social interaction is an increasingly complex process
that involves understanding and responding to the actions and intentions
of others. It also involves seeking clarification of your partners’
intention and the repairing of breakdowns or misunderstandings. Even
those of us who are very good at reading other people occasionally misunderstand
our partner’s intention and inadvertently say the wrong thing.
The ability to ask for clarification and repair the relationship when
misunderstandings occur is a critical skill needed to develop friendships.
In addition, for most of us, social interaction is one of the contexts
in which we learn. We learn new information through others and it is
our interaction with others that enables us to clarify small misconceptions
so they do not develop into major misunderstandings. Skillful use of
the pace, including stopping and starting of the music during the session
might be used to guide the child to begin to understand the pace of
social interaction. Incorporating the use of musical instruments might
facilitate active participation in the session. Alternately acting on
musical instruments, the therapist and child each taking a turn is one
way to begin to establish reciprocity, which is the basis of all social
interaction.
Individuals with ASD may have difficulty understanding
language, reading non-verbal cues and using both verbal and non-verbal
communication to express their thoughts. Sometimes they may learn to
communicate to get their needs met but communicating for social purposes,
to greet, call for attention, ask questions, and share information is
a challenge. Music therapy may address specific communication goals
for the child, either directly or indirectly. Verbal and non-verbal
communication skills develop through reciprocal social interaction.
As you know by now, the format of music therapy sessions builds on the
child’s developing reciprocal social interaction through establishing
and maintaining joint attention on the music. The therapist uses music
to frame “conversations” with the child. The therapist may
also use songs that teach specific communication skills such as greetings,
when to say, “excuse me” or listening and responding to
a partner’s topic.
No studies reviewed for this lecture identify a particular
musical genre as effective and beneficial to all students with autism.
Since each child is different, conducting a functional assessment of
music preference is needed to determine preferences and identify possible
adverse affects. (Brownell, 2000) The nature of music therapy techniques
allows for capitalizing on strengths as well as addressing the needs
of the child with ASD.
7 Reasons why Music Therapy might be an intervention
to consider for individuals with ASD:
- Music is positive, pleasurable and motivating
- Music has structure that provides a framework for
learning
- Music is predictable
- Music uses repetition and patterns
- Music is a form of non verbal communication
- Music is a dynamic process, adaptations can be made
based on the responses from the individual
- Music can amplify the salient features of what is
to be learned
The
Autism Society of America supports the use of music therapy as a treatment
option for individuals with autism (ASA, 2000). Music therapy used
in a structured setting may improve motor, cognitive and daily living
skills. Music therapy interventions provide a supportive context for
establishing skills of attending, initiating and interacting with others,
and their surrounding environment.
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