The effect of music therapy on autistic people

In regard to preset primary outcomes, music therapy has shown itself to improve social interaction within and outside of the therapy context. Within the music therapy context, it has additionally been seen to positively impact non-verbal communication within the therapy context, although there has not been significant statistical evidence of its improvement outside of the therapy context. It also improved the preset primary outcomes of initiating behavior and social-emotional reciprocity (Geretsegger et al., 2014). When it came to social adaptability and the quality of parent-child connections, music therapy also outperformed the effects of ‘placebo’ therapy or standard care for autistic people (Geretsegger et al., 2014). It is important to note that this meta-analysis reviewed the short- and long-term effects of autism, which leaves the question of the continuation of intervention effects. The quality of the evidence leading to these conclusions was low for nonverbal communicative skills outside of the therapy context, verbal communicative skills outside of the therapy context, and social-emotional reciprocity, but moderate for initiating behavior, social adaptation, and the quality of the parent-child relationship. This highlights the underlying limitations due to issues with research design and a small number of patients who participated in the studies (Geretsegger et al., 2014).

Additionally, since there are a variety of different music therapy approaches throughout the world, it can be difficult to clearly assign a certain range of outcomes to a specific approach when a meta-analysis is conducted. While the finding may stand that music therapy has positive effects on the above-mentioned outcomes, it is important to also analyze specific approaches individually, which, on the other hand, can lead to smaller participant numbers depending on the prevalence of an approach. In this regard, more research needs to be conducted to also give parents and caretakers of autistic children more evidence-based guidance in choosing the individually right approach.

Another meta-analysis found that MT was significantly linked to an increase in social reactions in children with ASD under the age of twelve. However, MT did not result in a statistically significant improvement in the severity of ASD-related symptoms, socially appropriate conduct, or speech (Ke X et al., 2022). Since autism is a spectrum and can lead to a varying severity of symptoms, there is no uniform procedure like with medical drugs that would make it easier to gain clear results on the effect of music therapy due to different approaches, ages, solo or group therapy settings, different intervention periods, or the presence or absence of parents. Therefore, the aforementioned meta-analysis reviewed studies where the intervention period lasted under a year, which leaves the question of whether long-term music therapy would show improvement in the categories in which this study did not find any improvement (Ke X et al., 2022).

Under the condition of actively playing an instrument or singing, neuroimaging outcomes were intrinsic functional brain connectivity of fronto-temporal brain networks (Nawaz et al., 2018), which are engaged in executive function and goal-oriented, cognitively demanding tasks (Uddin et al., 2019). This indicates, despite the potential for further research in MT, that actively engaging in music by playing an instrument or singing can be beneficial for autistic children.

The aforementioned studies can be found through the links in the following reference list:

Geretsegger, M., Elefant, C., Mössler, K., & Gold, C. (2014). Music therapy for people with autism spectrum disorder. The Cochrane Library, 2016(3). https://doi.org/10.1002/14651858.cd004381.pub3

Hiller, J. K. (2009). Use Of and Instruction In Clinical Improvisation. Music Therapy Perspectives. https://doi.org/10.1093/mtp/27.1.25

Hodges, H., Fealko, C. & Soares, N. (2020). Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics, 9(S1), S55–S65. https://doi.org/10.21037/tp.2019.09.09

Ke, X., Song, W., Yang, M., Li, J., & Liu, W. (2022). Effectiveness of music therapy in children with autism spectrum disorder: A systematic review and meta-analysis. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.905113

Nawaz, R., Nisar, H., & Voon, Y. V. (2018). The Effect of Music on Human Brain; Frequency Domain and Time Series Analysis Using Electroencephalogram. IEEE Access, 6, 45191–45205. https://doi.org/10.1109/access.2018.2855194

Uddin, L. Q., Yeo, B. T., & Spreng, R. N. (2019). Towards a Universal Taxonomy of Macro-scale Functional Human Brain Networks. Brain Topography, 32(6), 926–942.

https://doi.org/10.1007/s10548-019-00744-6