According To The American Music
According to the American Music Therapy Association (AMTA), “Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals” (2018). A music therapist will begin music therapy by assessing the needs, skills, and abilities of an individual and create an individualized treatment by creating music, singing music, listening to music, and/or moving to music. Music therapy can be used to aid in communication for people who may struggle communicating verbally, “overall physical rehabilitation and facilitating movement, increasing people’s motivation to become engaged in their treatment, providing emotional support for clients and their families, and providing an outlet for expression of feelings” (American Music Therapy Association, 2018). Music therapy can be beneficial to students with physical disabilities, emotional disabilities, nonverbal students, and a variety of other students’ needs, particularly students with developmental disabilities such as autism spectrum disorder (ASD). Music therapy is beneficial for developing and improving communication, social skills, language, joint attention, and many other skills in children with ASD.
The earliest reference to music therapy was in Columbian Magazine, in the article “Music Physically Considered” in 1789. Dr. Benjamin Rush, a physician and psychiatrist originally began using music to treat medical diseases, and his students, Edwin Atlee and Samuel Mathews, published the first medical researched about music therapy 1804 and 1806 respectively. The first recorded music therapy intervention in an institution setting also occurred in the 1800’s at Blackwell’s Island in New York. Early organizations were the National Society of Musical Therapeutics founded by Eva Augusta Vescelius, the National Association for Music in Hospitals founded by Isa Maud Ilsen, and the National Foundation of Music Therapy founded by Harriet Ayer Seymour in 1903, 1926, and 1941 respectively. The National Association for Music Therapy (NAMT) was created in 1950 and the American Association for Music Therapy (AAMT) was established in 1971. The two groups merged to form the American Music Therapy Association in 1998 (AMTA, 2018).
Autism spectrum disorder is a developmental disability that is often characterized by social, communication, emotional and behavioral challenges. According to the CDC (2018), ASD is prevalent in one out of 59 children in the United States. Due to the prevalence of ASD increasing, professionals are developing more effective therapies for treatment, one of which being music therapy (Crane, 2016). Early research states that music therapy can improve communication and social skills for children with developmental disabilities by enhancing nonverbal and verbal communication and social engagement. Music therapy combined with other intervention strategies has been proven to positively alter social skills in children with a wide variety of developmental disabilities. Music is most directly linked to promoting social interaction and patterns in music may help children stay attentive and aid in language development (Mendelson et al., 2016). Additionally, music is a medium that children can access and utilize that may be more beneficial than other mediums (Kim, Wigram, Gold, 2008). Studies have shown that children with developmental disabilities, including autism spectrum disorder, process information differently, and people with ASD respond to music emotionally similar to neurotypical people (Mendelson et al., 2016). Sandiford, Mainess, and Daher (2013) discuss possible causes for music therapy being so successful and effective among children with ASD. One of the possible causes for children with ASD responding well to music therapy is the idea that individuals with ASD demonstrate often exhibit strengths in the right hemisphere of their brain. Individuals with autism have “relatively lower than normal activation of the left hemisphere” (Sandiford, Mainess, Daher, 2013 p. 1298). Melody, rhythm and music are linked to the right hemisphere of the brain, which may be why people with autism show positive results within music therapy (Sandiford, Mainess, Daher, 2013).
Music therapy is most traditionally used to promote social, communication, behavioral, and physical development. Early research on music therapy with children with ASD shows that children with ASD were more engaged by musical experiences that in other environments. Many of the areas that music therapy benefits are areas in which individuals with ASD need extra support, therefore music therapy is an excellent tool and form of therapy that can be extremely beneficial for students with autism. Music therapy for higher functioning students typically targets behavior, social or learning outcomes, and music therapy for severe and profound disabilities typically focuses on communication and physical domains. There are seven broad goals for music therapy with children with ASD: communication, social, behavior, emotional development, motor skills, activities of daily living, and pre-academic skills. In “Music Therapy for Autistic Spectrum Disorder” the authors discuss that “music therapy significantly improved the social interaction skills, social-emotional reciprocity and communication skills of children with ASD aged between two and nine years” (McFerran, Thompson, Bolger, 2016, p. 243).
Music is incorporated in therapy and intervention for children with ASD in as many as 12% of classroom-based interventions. There have been multiple studies on the effects of music therapy for students with ASD in the classroom. One study conducted by Mendelson et al., looks at how a new classroom-based music therapy program, Voices Together, effects social and communication skills particularly in students with developmental disabilities. Voices Together is a “specialized music therapy model that integrates music and multisensory experiences to teach communication and social/emotional skills to people with intellectual and developmental disabilities” (Mendelson et al., 2016, p. 2). Voices Together uses VOICSS: Vocal Interactive Communication and Social Strategies as one of the core methods. VOICSS uses “structured music-based interactions to help participants develop their skills in domains of communication and social/emotional learning” (Mendelson et al., 2016, p. 2). This study was conducted in Durham, North Carolina including thirty-three children, 5 with autism spectrum disorder, and thirty-two children with intellectual disabilities without ASD. These students were divided into groups based off of the length of intervention; The long-term level lasted 15 weeks starting in January of 2015, and the short-term lasted seven weeks starting seven weeks after the long-term in February of 2015. There were significant improvements in level of communicative response found in the long-term group. However children in the short-term group did not display as significant of results which suggests that music therapy may be more beneficial over a longer period of time (Mendelson et al., 2016).
Another study on music therapy took place in The Northern School for Autism in Melbourne, Australia. The study was designed to identify what aspects of music therapy practices could be used beyond the classroom and incorporated throughout the entire school. This study revealed that the most useful and feasible part of music therapy was relationship building. Relationships between teachers and students with ASD improved, and relationships between other staff around the school and students with ASD began to grow. Even non-verbal students with autism spectrum disorder can communicate through music by physical movement, body percussion, etc. Providing non-verbal students with a way to express themselves and communicate can drastically alter their relationships with those around them. Additionally, music therapy fosters relationships by allowing for a sharing of power within the classroom between the students and teachers. Students were no longer feelings dominated and controlled by a teacher in their classroom and began to feel like their voice, opinion, and participation matters in class (McFerran, Thompson, Bolger, 2016).
One type of music therapy that can be beneficial to students with autism spectrum disorder is improvisational music therapy. Improvisational music therapy is when the therapist and student use music to relate to each other. Improvisational music therapy is known for its effectiveness in engaging children with autism, and helping them develop self-expression, emotional communication and social interaction. Therapists use music attunement, or “a moment-by-moment, responsive use of improvised music which is sensitive and attentive to the child’s music and non-musical expression” during sessions (Kim, Wigram, Gold, 2008, p. 1759). This strategy allows the therapist to make a musical connection between him/herself and the student which fosters an emotional relationship. Students also will begin to perceive that the music the therapist is creating has to do with themselves, and therefore can relate to the music and begin to use it for themselves. This can promote student’s interaction and engagement during therapy and can be utilized with non-verbal children. In a randomized control study, students with ASD who completed 12 weekly 30-minute improvisational music therapy session showed a significant increase in eye contact and turn-taking duration. Overall results from the study showed that music therapy was beneficial in increasing join attention in students with ASD. Join attention skills are crucial for children to develop because they lead to higher level functioning skills such as communication, social interaction, and language (Kim, Wigram, Gold, 2008).
Music therapy has developed into a field with a wide variety of uses since its beginning in the late 18th century. However, there is still a lot that can be accomplished using music therapy. Music therapy has proven to be extremely beneficial for students with developmental disabilities, especially students with autism spectrum disorder. Studies have shown that aspects of music therapy are not only effective in school settings but feasible as well. Components of music therapy can be incorporated into the classroom, into a student’s interventions and therapy in IEP’s, and throughout the school in special subject classes, such as physical education or art, and in places like the lunch room. Since the beginning of music therapy it is crucial for those employing music therapy to adapt the therapy and activities to the individual and their musical abilities. Dr. Stephen Shore, who identifies himself as an autistic professor of special education, once said “If you’ve met one person with autism, you’ve met one person with autism,” exemplifying how every student is different. In order to incorporate music therapy into schools, the music therapist/teacher/etc. must be able to adapt musical strategies to the learning style of each student. This can be very difficult, however without adapting the material to the student it loses its engaging effectiveness. There are many different feasible and effective strategies that can be used throughout the school such as: singing the names of students, body percussion, microphone songs, call and responses, vocal imitation, drum sensory activities, changing the words of songs, making up songs, etc. Music therapy is engaging, effective, and beneficial for all students, especially those with autism spectrum disorder, and should be implemented throughout classrooms.