music therapy, music therapy for autism, special needs

Improvisational music therapy for ASD

There’s an extremely well written article recently published in the Journal of Music Therapy entitled Common Characteristics of Improvisational Approaches in Music Therapy for Children with Autism Spectrum Disorder.  The article defines the ways in which improvisational music therapy (IMT) can be used with ASD and explains many of the rationales and motives behind the actions of a music therapist. I strongly recommend that practitioners, families and caretakers read this article and wanted to highlight some of the key elements with which Music Therapy Services of Portland resonates and strives to implement these methodologies. Please see endnotes for the many resources used within this article.

IMT employs improvising as a primary therapeutic experience where the client and therapist spontaneously create music using singing, playing, and movement (Bruscia, 2014). IMT is described as a procedure of intervention that makes use of the potential for social engagement and expression of emotions occurring through improvisational music making (Geretsegger, Holck, & Gold, 2012). Improvised music can be made to be very predictable, containing repetitions at different levels while at the same time providing “controlled” flexibility in the form of variations in melody, harmony, rhythm, phrasing, or dynamics (Wigram, 2004; Wigram & Elefant, 2009).

Targeted areas of interventions for individuals with ASD include: 

  • imitation (e.g., Hobson & Hobson, 2008; Landa, 2007)
  • joint attention (Leekam, López, & Moore, 2000)
  • reciprocity (Landa, 2007)
  • affective sharing (Wetherby et al., 2004)
  • initiation of interaction (Landa, 2007; Landa, Holman, & Garrett-Mayer, 2007).

These interventions share characteristics such as:

  • following the child’s lead
  • encouraging initiations from the child
  • responding to all types of communicative behavior as if it was purposeful
  • focusing on emotional expression
  • adjusting any language and social input to the child’s developmental stage and attentional focus (Ingersoll et al., 2005).

Within this IMT framework, a child-centered approach is incorporated in which active, spontaneous music making enhances the relationship between the child and therapist. The therapist generally follows the child’s focus of attention, behaviors, and interests to facilitate growth in the child’s social communicative skills and promote development in other areas of need, such as awareness and attention, sense of self, or self-efficacy (Bruscia, 1998; Kim, 2006; Kim, Wigram, & Gold, 2008, 2009; Wigram, 2002).

Involving parents/caregivers in the process can support both children and parents in building interactions with one another and facilitating the generalization of therapy outcomes into the child’s and caregivers’ everyday life (Oldfield, 2006; Warwick, 1995). This involvement may include family members directly in therapy sessions (Thompson, McFerran, & Gold, 2013), describing the activities to parents upon completion of the sessions, or even recording the sessions and inviting the family to watch the sessions at home together. 

References

Geretsegger, M., Holck, U., Carpente, J., Elefant, C., Kim, J., Gold, C. (2015). Common Characteristics of Improvisational Approaches in Music Therapy for Children with Autism Spectrum Disorder: Developing Treatment Guidelines.  Journal of Music Therapy, 52(2), 258–281 doi:10.1093/jmt/thv005

Accordino, R., Comer, R. & Heller, W. B. (2007). Searching for music’s potential: A critical examination of research on music therapy with individuals with autism. Research in Autism Spectrum Disorders, 1, 101–115. doi:10.1016/j. rasd.2006.08.002

Bruscia, K. E. (1998). Defining music therapy (2nd ed.). Gilsum, NH: Barcelona Publishers.

Bruscia, K. E. (2014). Defining music therapy (3rd ed.). Gilsum, NH: Barcelona Publishers.

Geretsegger, M., Holck, U., & Gold, C. (2012). Randomised controlled trial of improvisational music therapy’s effectiveness for children with autism spectrum disorders (TIME-A): Study protocol. BMC Pediatrics, 12(2). doi:10.1186/1471-2431-12-2

Gold, C., Wigram, T., & Voracek, M. (2007). Predictors of change in music therapy with children and adolescents: The role of therapeutic techniques. Psychology and Psychotherapy: Theory, Research, and Practice, 80(4), 577–589.

Hobson, R. P., & Hobson, J. A. (2008). Dissociable aspects of imitation: A study in autism. Journal of Experimental Child Psychology, 101, 170–185. doi:10.1016/j. jecp.2008.04.007
Ingersoll, B., Dvortcsak, A., Whalen, C., & Sikora, D. (2005). The effects of a developmental, social-pragmatic language intervention on rate of expressive language production in young children with autistic spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20, 213–222. doi:10.1177/1088357605020004 0301

Kim, J. (2006). The effects of improvisational music therapy on joint attention behaviours in children with autistic spectrum disorder (PhD thesis, Aalborg University).

Kim, J., Wigram, T., & Gold, C. (2008). The effects of improvisational music therapy on joint attention behaviors in autistic children: A randomized controlled study. Journal of Autism and Developmental Disorders, 38, 1758–1766. doi:10.1007/ s10803-008-0566-6

Kim, J., Wigram, T., & Gold, C. (2009). Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy. Autism, 13, 389–409. doi:10.1177/1362361309105660

Landa, R. (2007). Early communication development and intervention for children with autism. Mental Retardation and Developmental Disabilities Research Reviews, 13, 16–25. doi:10.1002/mrdd.20134

Landa, R. J., Holman, K. C., & Garrett-Mayer, E. (2007). Social and communication development in toddlers with early and later diagnosis of autism spectrum disorders. Archives of General Psychiatry, 64, 853–864. doi:10.1001/ archpsyc.64.7.853

Leekam, S. R., López, B., & Moore, C. (2000). Attention and joint attention in preschool children with autism. Developmental Psychology, 36, 261–273. doi:10.1037/0012-1649.36.2.261
Oldfield, A. (2006). Interactive music therapy—A positive approach: Music therapy at a child development centre. London: Jessica Kingsley.

Thompson, G. A., McFerran, K. S., & Gold, C. (2013). Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: A randomized controlled study. Child: Care, Health, and Development, 40(6), 840–852.

Warwick, A. (1995). Music therapy in the education service: Research with autistic children and their mothers. In T. Wigram, B. Saperston, & R. West (Eds.), The art and science of music therapy: A handbook (pp. 209–225). Oxford: Routledge.

Wetherby, A. M., Woods, J., Allen, L., Cleary, J., Dickinson, H., & Lord, C. (2004). Early indicators of autism spectrum disorders in the second year of life. Journal of Autism and Developmental Disorders, 34, 473–493. doi:10.1007/s10803-004-2544-y

Wigram, T. (2002). Indications in music therapy: Evidence from assessment that can identify the expectations of music therapy as a treatment for autistic spectrum disorder (ASD): Meeting the challenge of evidence-based practice. British Journal of Music Therapy, 16, 11–28.

Wigram, T. (2004). Improvisation: Methods and techniques for music therapy clinicians, educators, and students. London: Jessica Kingsley.

Wigram, T., & Elefant, C. (2009). Therapeutic dialogues in music: Nurturing musi- cality of communication in children with autistic spectrum disorder and Rett syndrome. In S. Malloch & C. Trevarthen (Eds.), Communicative musicality (pp. 423–446). Oxford: Oxford University Press.

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