Music Therapy for Autism
Music Therapy for Autism
Music therapy is a controlled music experience that is used to facilitate positive change in human behavior. Each session of music therapy is carefully planned, carried out, and evaluated to suit the specific needs of each patient. Music therapy can include any of the following musical activities:
- Listening to music and/or musical creation.
- Playing musical instruments (any instrument can be used).
- Moving to music.
As was previously mentioned, music therapy is made specific to each individual. This is extremely important, because what may be positively received by one autistic may be negative to another. That being said, let's take a look at the positive influence music therapy has had on autistic individuals.
Improved socioemotional development: In the first steps of a relationship, autistics tend to physically ignore or reject the attempts of social contact made by others. Music therapy helps to stop this social withdrawal by an initial object relation with a musical instrument. Instead of seeing the instrument as threatening, autistic children are usually fascinated by the shape, feel and sound of it. Therefore, the musical instrument provides an initial point of contact between the autistic and the other individual by acting as an intermediary.
Assisted in both verbal and nonverbal communication: When music therapy is used to aid in communication, its goal is to improve the production of vocalization and speech, as well as stimulate the mental process of comprehending, conceptualizing and symbolizing. A music therapist will attempt to establish a communicative relationship between the behavior of a child with autism and a specific sound. An autistic person may have an easier time recognizing or being more open to these sounds than they would to a verbal approach. This musical awareness, and the relationship between the autistics' actions and the music, has potential to encourage communication.
Another form of music therapy that may help with communication is to play a wind instrument (IE flute). It is thought that by playing such an instrument, you become aware of the functioning of your teeth, jaws, lips and tongue. Thus, playing a wind instrument almost mirrors the functioning required in order to produce speech vocalizations.
Encouraged emotional fulfillment - Most autistics lack the ability to effectively respond to stimuli that would otherwise allow them to enjoy an appropriate emotional charge. Thus, since most autistics respond well to music stimuli, music therapy has been able to provide autistics with an environment that is free of fear, stimuli considered threatening, etc.
During a music therapy session, an autistic individual has the freedom to behave in specific ways that allow them to discover and express themselves when they want and choose. They can make noise, bang instruments, shout and express and experience the pleasure of emotional satisfaction.
Musical therapy has also helped autistic individuals by:
- Teaching social skills.
- Improving language comprehension.
- Encouraging the desire to communicate.
- Making creative-self expression possible.
- Reducing non-communicative speech.
- Decreasing echolalia (uncontrolled and instant repetition of the words spoken by another).
Autism Terms and Glossary
Abnormal Behavior - A general term referring to behavior that is unusual to the degree that it exceeds the boundaries of what society views as normal.
Abstract Intelligence/Reasoning - The intellectual ability to understand relationships and to react, not only to concrete objects, but also to concepts, ideas, images, and symbols that are more intangible objects. Abstraction is the process of selecting or isolating a certain aspect from a concrete whole, i.e. all ducks are birds, but not all birds are ducks.
Adaptive Behavior Scale (ABS) - Used as an assessment tool.
Advocacy - The process of actively speaking out, writing in favor of, supporting, and/or acting on behalf of oneself, another person, or a cause. Advocacy can be any action to assure the best possible services for or intervention in the service system on behalf of an individual or group.
Age Appropriate - Activities, materials, curriculum, and environment consistent with the chronological age of the child being served.
Anxiety - Apprehension, tension or uneasiness that stems from the anticipation of danger which may be internal or external. Some definitions of anxiety distinguish it from fear by limiting it to the anticipation of danger from a largely unknown source, whereas fear is the response to a consciously recognized and usually external threat or danger.
Applied Behaviour Analysis (ABA) - is a style of teaching which uses a series of trials to shape a desired behaviour or response. Skills are broken down to their simplest components and taught through a system of reinforcement. Prompts are given as needed when the child is learning a skill. As a skill is mastered the prompts are faded until the child can perform the task independently. It is a step-by step approach, complete with curriculum, that teaches: attention, language, self-help, play, motor and social skills. It is a data based program in which the child's progress is documented. This documentation is reviewed daily.
Asperger's Syndrome - People with Asperger's Syndrome appear to demonstrate normal cognitive and language development ( though the onset of speech may be slightly delayed). They are less obviously socially impaired than children with autism, and may develop relationships with parents and other family members. It is with peers that the qualitative impairments in reciprocal social interaction become most apparent. They may also have unusual or elaborate preoccupations with objects or topics.
Asperger's Syndrome Diagnostic Criteria - A) Qualitative impairment in social interaction; B) Restricted and repetitive and stereotyped patterns of behaviour, interests and activities; C) Causes clinically significant impairment in social, occupational, or other important areas of functioning; D) There is no clinically significant general delay in language; E) There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour and curiosity about the environment in childhood; F) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.
Assessment - A collecting and bringing together of information about a child's learning needs, which may include social, psychological, and educational evaluations used to determine assignment to special programs or services; a process using observation, testing and test analysis to determine an individual's strengths and weaknesses to plan, for example, his or her educational services.
Attention Deficit Disorder (ADD) - A condition characterized by when a person is easily distracted and has difficulty staying focused on an individual activity for any period of time. ADD affects 3-5% of all students.
Attention Deficit Hyperactivity Disorder (ADHD) - A condition in which a child exhibits signs of developmentally inappropriate hyperactivity, impulsivity, and inattention. These characteristics are usually present before the age of 7.
Auditory Training - About 40 percent of autistic children are reported to show very sensitive hearing. Auditory training is training to overcome the hypersensitivity. Use of electronic devices to modulate sounds in such a way that hypersensitive hearing and certain other hearing problems, can be remedied.
Augmentative Communication - Any approach designed to support, enhance, or supplement the communication of individuals who are not independent verbal communicators in all situations.
Autism - is a severely incapacitating life long 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 Spectrum Disorder (ASD) - is a congenital developmental disorder that is characterized by problems in three areas: social development, communication and stereotypic behaviours. It encompasses a number of disorders including Autism, Retts Syndrome, Childhood Disintegrative Disorder and Aspergers Syndrome.
Basic -Skills Approach - Pertaining to instruction that lays the ground work for further development and higher levels of functioning.
Behavior Checklist - Objective protocols that permit an observer to count or check for the existence or absence of a given behavior or set of behaviors through direct observation of the individual being evaluated.
Behaviour Management - To develop, strengthen, maintain, decrease or eliminate behaviors in a planned or systematic way.
Behavior Modification - A technique of changing human behavior based on the theory of operant behavior and conditioning. Careful observation of events preceding and following the behavior in question is required. The environment is manipulated to reinforce the desired responses, thereby bringing about the desired change in behavior.
Case Management - A service that assists persons to obtain and coordinate community resources such as income assistance, education, housing, medical care, treatment, vocational preparation, and recreation.
Checklist for Autism in Toddlers - diagnostic tool.
Childhood Autism Rating Scale - diagnostic tool.
Childhood Disintegrative Disorder - Development in persons with this disorder proceeds normally for several years, with age-appropriate verbal and non-verbal communication, social skills, play, etc. There is a subsequent ( after 2 years of age and before 10 years) marked regression in skills in multiple areas, and the development of various autistic-like features. This disorder is also sometimes referred to as Heller's Syndrome.
Child Psychiatrist - A physician (MD) specializing in mental, emotional, or behavior disorders in children and adolescents. Qualified to prescribe medications.
Child Psychologist - A mental health professional with a Ph.D. in psychology who administers tests, evaluates and treats children's emotional disorders. Cannot prescribe medication.
Clinical Social Worker - A mental health professional trained to provide services to individuals, families and groups.
Communicative Partner - One of the two trainers in PECS. This person sits across from the child and draws the child's attention to the initial training item.
Communication Skills - Consciously linking the meaning and the purpose of what (we say) is said to what is (we do) done.
Community Supports - Providing activities, services, supports, and other assistance to persons with developmental disabilities, and the families and communities of such persons, which are designed to a. assist neighbourhoods and communities to be more responsive to the needs of persons with developmental disabilities and their families, b) develop local networks which can provide informal support, and c) make communities accessible and enable communities to offer their resources and opportunities to persons with developmental disabilities and their families. Community supports includes community education, personal assistance services, vehicular and home modifications, support at work, and transportation.
Developmental Disability - When applied to infants and young children it means: Individuals from birth to age 5 who have substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disabilities if services are not provided. For persons 5 years of age or older it means: A sever, chronic disability which is attributable to a mental or physical impairment or combination of mental and physical impairments; and is manifested before the person attains age twenty-two and is likely to continue indefinitely and results in substantial functional limitations in three or more of the following areas of major life activity: self care, receptive and expressive language, learning, mobility. Self-direction, capacity for independent living and economic self-sufficiency; and reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment or other services which are of lifelong or extended duration and are individually planned and coordinated.
Developmental Tests - Standardized tests that measure a child's development as it compares to the development of all other children at that age.
Diagnostic Criteria for Autistic Disorder - 1. Qualitative impairment in social interaction; 2. Qualitative impairments in communication; 3. Restricted repetitive and stereotyped patterns of behaviour, interests, and activities; 4. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3: a) social interaction; b) language as used in social communication; c) symbolic or imaginative play; 5. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder; 6.The disturbance is not better accounted for by another specific Pervasive Developmental Disorder.
Diagnostic Criteria for Asperger's Disorder
1. Qualitative impairment in social interactions.
2. Restricted repetitive and stereotyped patterns of behaviour, interests and activities.
3. The disturbance causes clinically significant impairment in social, occupational or other important areas of functioning.
4. There is no clinically significant general delay in language.
5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour.
6. Criteria are not met for another specific Pervasive Developmental Disorder or schizophrenia.
Diagnostic and Statistical Manual (DSM-IV) - is published by the American Psychiatric Association. The DSM is the diagnostic system most often used by North American clinicians.
Echolalia - The repetition or parroting of words or phrases.
Facilitated Communication - is a method whereby a person with autism is able to point to letters or type out letters on a keyboard or electronic device or computer - provided the person with autism receives the support of the touch of another person or "facilitator" on wrist, elbow or shoulder. The elements of facilitated communication are: physical support; progressing from initial training to practice and finally to fluency; maintaining focus; emotional support; and fading physical support.
Family Centered/Focus Model - Providing intervention services for children with special needs within the context of the family for the purpose of enhancing the child's developmental outcomes. It recognizes that the family is the constant in a child's life and that service systems and personnel must support, respect, encourage, and enhance the strength and competence of the family. Staff members and service providers must have the ability to concentrate or center on the needs of the family and those of the chid, rather than the needs of an agency, program or service system.
Family Support Program/Services - Services, supports, and other assistance to families in providing care for their children or adult members with developmental disabilities so they can remain in the home. These services are designed to strengthen the family's role as primary caregiver, prevent inappropriate out of the home placement and maintain family unity, and reunite families with members who have been placed out of the home. The services include respite care, assistive, technology, personal assistance, parent training and counselling, support for elderly parents, vehicular and home modifications, and assistance with extraordinary expenses associated with the needs of the person with a developmental disability.
Fenfluramine - is an anorexigenic agent (appetite suppressant) that markedly decreases brain serotonin. Studies have shown 30-40 percent of autistic people have high levels of serotonin, one of the substances which help transmit impulses between brain cells. One case study in 1982 suggested that Fenfluramine significantly improved behaviour (Geller, Ritvo, Freeman, & Yuweiler, 1982). Further studies are conflicting, and most do not support this theory.
Fine Motor - The use of small muscle groups for controlled movements, particularly in object manipulation.
Geneva Centre - a centre in Toronto which offers resource and consultation services regarding autism and related disorders. They offer public information on treatment approaches, services, literature and current research. They also have a computerized resource library of current information.
Gentle Teaching - This is a totally non-aversive therapy emphasizing bonding between teacher and student. Developed by John McGee, he contends that persons who persistently hit, bite , kick, scratch, self-stimulate, or withdraw have not bonded with their caregivers and that teachers must help move behaviourally-involved persons from a state of emotional distancing to one of meaningful human engagement so that they will find it unnecessary to express their needs through primitive or harmful responses.
Gross Motor - Movement that involves balance, coordination and large muscle activity.
Inclusion - The process of taking children out of segregated settings and placing them in regular education classrooms with supports.
Individualized Educational Program (IEP) - A written education plan for a school aged child with disabilities developed by a team of professionals and the child's parents. IEP's are based on a multidisciplinary evaluation of the child, describes how the child is presently doing, what the child's learning needs are, and what services the child will need. They are reviewed and updated yearly.
Infant/developmental Stimulation - Early intervention procedures that emphasize providing an infant with an array of visual, auditory, and physical stimuli to promote development.
Interdisciplinary Team - A team whose members come from multiple disciplines, who interact and rely on the others for information and suggestions.
Landau-Kleffner Syndrome (LKS) - A rare disorder marked by sudden loss of language between the ages of 3-7, after a period of normal development. Individuals with LKS are also characterized by an abnormal EEG.
Mainstreaming - Placement of a child in a class room with non-disabled peers versus a separate classroom.
Manipulatives - Toys that children use their hands to play with.
Naltrexone - This drug blocks brain cell receptors for opioids, natural opium-like substances produced by the body which may be abnormally high in autism. In a series of studies on this drug, the self-injury and social withdrawal of autistic persons was reduced significantly (Walters, Barrett, Feinstein, Mercurio, & Hole, 1990). Some investigators have found children on naltrexone had better eye contact and social behaviour as well as less aggression and stereotypical behaviours. Also see opioid related theories.
Occupational Therapy - A therapy, treatment, or instructional support provided by an occupational therapist to the child, family, and/or pertinent members of the child's environment. Occupational therapy helps develop adaptive or physical skills that will aid in daily living and improve interactions with pa person's physical and social world.
Opioid Related Theories - There are several opioid related theories: a) that high opioid levels prevent self-injury from being painful to the individual with autism; b) that, when an autistic person becomes upset or aroused, self-injury causes the release of opioids which calm the individual; and c) that individuals with autism may actually be addicted to their own opioids, and injure themselves in order to raise their bodies' levels of these substances. Also, high opioid levels may make hugging and other physical contact less rewarding to autistic person than to normal persons.
Pervasive Developmental Disorder (PDD) - is used as a non-specific, generic term referring to a group of related disorders which share certain essential features: qualitative impairments in both verbal and non-verbal communication, difficulty with reciprocal social interaction and a restricted stereotypic pattern of behaviours. The most well known example of PDD is autism.
Pervasive Developmental Disorder Not Otherwise Specified (PDD NOS) - This category is used when there are impairments across all three areas of characteristics for autism, but the number of characteristics needed to meet criteria for other types of PDD are not met. In some children it is very difficult to distinguish the subtle differences between Autism and PDD NOS.
Physical Prompter - One of the two trainers used in PECS. This person physically assists the child to engage in communicative behavior.
Physical Therapy - Instructional support and treatment of physical disabilities provided by a trained physical therapist, under a doctor's prescription, that helps a person improve the use of bones, muscles, joints, and nerves.
Picture Exchange Communication System (PECS) - was developed at the Delaware Autistic Program. Training in PECS Begins by finding out what things a child is attracted to. After the adult knows what a child wants by having watched the child, a picture is made of the object. The picture is then paired with the real item. Physical help is given to pick up the picture and is slowly dropped over time. The process is then expanded to make sentences with the pictures. PECS has six phases: 1) requesting items or routines by physically assisting the picture exchange; 2) expanding spontaneous use of the picture exchange; 3) Discriminating between pictures; 4) Building Sentence Structure; 5)Responding to verbal questions/prompts such as " What do you want?"; 6) Commenting about a question. Two trainers are used to develop spontaneous communication: communicative partner and a physical prompter.
Rage Behaviour - is a violently explosive, episodic, often target less outburst, usually without adequate antecedent triggering factors (causes).
Rett Disorder - Rett is a condition found only in females who have apparently normal pre and perinatal development, with onset of symptoms after 5 months of age. These include decelerated head growth, loss of purposeful hand movements, and development of psychomotor retardation.
Scotopic Sensitivity Syndrome (Irlen Syndrome) - is a perceptual dysfunction affecting principally reading and writing based activities. It is caused by a sensitivity to light rather than visual problems.
Secretin - a gut hormone that has been used in controversial treatment of autism. There is no scientific proof that it works for Autism. Dr. Wendy Roberts at the Hospital for Sick Children in Toronto is starting a study on the drug.
Sensory Integration - is a theory of therapeutic intervention developed by Dr. A. Jean Ayres, Ph.D., an occupational therapist from the University of Southern California.
Sensory Integration Theory - The sensory integration theory of the relationship of brain function and behaviour is based on consideration of three important postulates: a) Learning is dependent on the ability of the child to take in sensory information from the environment and from his body movements, to process and integrate this sensory input within his central nervous system and to use this sensory information to plan and organize behaviour; 2) If the child has deficits in processing and integrating sensory input, conceptual and motor learning suffer from loss of the ability to plan and act on productive behaviour; 3) Conceptual and motor learning will be enhanced by providing repeated opportunities for expanded sensory intake. Meaningful activities promote planning and organizing of adaptive behaviour by improving the planning and organizing of adaptive behaviour by improving the ability of the child's central nervous system to process and integrate sensory input.
Speech/Language Therapy - A planned program to improve and correct speech and/or language or communication problems in people who are not thought to be able to improve without such help.
Stimming - The informal term for self-stimulation.
Structured Methods in Language Education (SMILE) - is divided into five modules which progress from attending, imitation of motor skills, production of single sounds, and combining sounds to using a series of sounds which are associated with a word. Vocabulary is expanded to where the student can independently read and write a short story. In this method, skills of listening, sound production, reading and writing are taught in combination.
Tactile Defensiveness (hypersensitivity to touch) - An individual with tactile defensiveness appears to overreact to sensation that most people do not particularly notice, or at least not bothered by. Common signs of tactile defensiveness include: sensitivity to certain types of clothes or fabrics; preference or aversion to foods which seems texture related; avoidance of touching substances such as finger paint or mud, or of getting one's hands messy; avoidance of walking barefoot on particular surfaces such as sand or grass; a greater than normal resistance to having teeth brushed, hair combed or face washed; and a tendency to prefer to touch rather than be touched, especially when the touching is unexpected.
Task Demonstration Model (TDM) - In this model trainers present many examples of both correct and incorrect items while gradually increasing their similarity thus forcing the student to make finer and finer discriminations.
Transition - The process of bridging the time and environments between two settings, programs, or life situations.