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The Effects of Improvisational Music Therapy on Joint Attention Behaviors in Autistic Children: A Randomized Controlled Study

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Abstract

The purpose of this study was to investigate the effects of improvisational music therapy on joint attention behaviors in pre-school children with autism. It was a randomized controlled study employing a single subject comparison design in two different conditions, improvisational music therapy and play sessions with toys, and using standardized tools and DVD analysis of sessions to evaluate behavioral changes in children with autism. The overall results indicated that improvisational music therapy was more effective at facilitating joint attention behaviors and non-verbal social communication skills in children than play. Session analysis showed significantly more and lengthier events of eye contact and turn-taking in improvisational music therapy than play sessions. The implications of these findings are discussed further.

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References

  • Alvin, J. (1978). Music therapy for the autistic child. London, UK: Oxford University Press.

    Google Scholar 

  • Bakeman, R., & Adamson, L. (1984). Coordinating attention to people and objects in mother infant and peer-infant interaction. Child Development, 55, 1278–1289.

    Article  PubMed  Google Scholar 

  • Bono, M., Daley, T., & Sigman, M. (2004). Relations among joint attention, amount of intervention and language gain in early autism. Journal of Autism and Developmental Disorders, 34, 495–505.

    Article  PubMed  Google Scholar 

  • Brown, S. (1994). Autism and music therapy; is change possible and why music? British Journal of Music Therapy, 8(1), 15–25.

    Google Scholar 

  • Bruner, J. (1995). From joint attention to meeting of minds: An introduction. In C. Moore, & P. Dunham (Eds.), Joint attention: Its origins and role in development (pp. 1–14). Hillsdale, NJ: Nawrence Erlbaum Associates.

    Google Scholar 

  • Bunt, L. (1994). Music therapy, an art beyond words. London: Routledge.

    Google Scholar 

  • Cicchetti, D. V. (1994) Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6(4), 284–290.

    Article  Google Scholar 

  • Cicchetti, D. V., & Sparrow, S. S. (1981). Developing criteria for establishing interrater reliability of specific items: Applications to assessment of adaptive behavior. American Journal of Mental Deficiency, 86, 127–137.

    PubMed  Google Scholar 

  • Cohen, J. (1990). Things I have learned (so far). American Psychologist, 45(12), 1304–1312.

    Article  Google Scholar 

  • Cohen, I. L., & Sudhalter, V. (1999). Pervasive Developmental Disorder Behavior Inventory (PDDBI-C). NYS Institute for Basic Research in Developmental Disabilities.

  • Cohen, I. L., Schmidt-Lackner, S., Romanczyk, R., & Sudhalter, V. (2003). The PDD behavior inventory: A rating scale for assessing response to intervention in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 33(1), 31–45.

    Article  PubMed  Google Scholar 

  • DeMyer, M. K., Alpern, G. D., Barton, S., DeMyer, W. E., Churchil, D. W., & Hingtgen, J. N. (1972). Imitation in autistic, early schizophrenic, and non psychotic subnormal children. Journal of Autism and Childhood Schizophrenia, 2, 264–87.

    Article  PubMed  Google Scholar 

  • Edgerton, C. L. (1994). The effect of improvisational music therapy on the communication behaviors of autistic children. Journal of Music Therapy, 31(1), 31–61.

    Google Scholar 

  • Escalona, A., Field, T., Nadel, J., & Lundy, B. (2002). Brief report: Imitation effects on children with autism. Journal of Autism and Developmental Disorders, 32(2), 141–144.

    Article  PubMed  Google Scholar 

  • Gold, C., Wigram, T., & Elefant, C. (2006). Music therapy for autistic spectrum disorder (Cochrane Review), The Cochrane Library, Issue 2, 2006. Chichester, UK: John Wiley & Sons, Ltd.

  • Heal Hughes, M. (1995). A comparison of mother–infant interactions and the client–therapist relationship in music therapy sessions. In T. Wigram, B. Saperston, R. West (Eds.), The art & science of music therapy: A handbook (pp. 296–308). Harwood Academic Publishers.

  • Holck, U. (2002). Music therapy for children with communication disorders. In T. Wigram, I. N. Pedersen, & L. Bonde (Eds.), A comprehensive guide to music therapy (pp. 183–187). London: Jessica Kingsley Publishers.

    Google Scholar 

  • Holck, U. (2004a). Interaction themes in music therapy—definition and delimitation. Nordic Journal of Music Therapy, 13(1): 3–9.

    Google Scholar 

  • Holck, U. (2004b). Turn-taking in music therapy with children with communication disorders. British Journal of Music Therapy, 18(2), 45–54.

    Google Scholar 

  • Kasari, C., Sigman, M., Mundy, P., & Yirmiya, N. (1990). Affective sharing in the context of joint attention interaction of normal, autistic and mentally retarded children. Journal of Autism and Developmental Disorders, 20, 87–100.

    Article  PubMed  Google Scholar 

  • Kim, T. (1995). Ewha—psycho educational profile. Ewha Women’s University Press.

  • Kim, T. & Park, L. (1995). Korean version of childhood autism rating scale. Seoul. Special Education.

  • Kim, J (2006). The effects of improvisational music therapy on joint attention behaviors in children with autistic spectrum disorder. Unpubl. Ph.D thesis. Denmark: Aalborg University.

  • Lewy, A. L., & Dawson, G. (1992). Social stimulation and joint attention in young autistic children. Journal of Abnormal Child Psychology, 20(6), 555–566.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). The ADOS-G (Autism Diagnostic Observation Schedule-Generic). Los Angeles: Western Psychological Services.

    Google Scholar 

  • Malloch, S. (1999). Mother and infants and communicative musicality. In “Rhythms, musical narrative, and the origins of human communication”. Musicae Scientiae, Special Issue, 1999–2000 (pp. 29–57). Liège: European Society for the Cognitive Sciences of Music.

  • McArthur, D., & Adamson, L. B. (1996). Joint attention in preverbal children: Autism and developmental language disorder. Journal of Autism and Developmental Disorders, 26(5), 481–496.

    Article  PubMed  Google Scholar 

  • Mundy, P. & Sigman, M. (2006). Joint attention, social competence and developmental psychopathology. In D. Cicchetti & D. Cohen (Eds.), Developmental Psychopathology (2nd ed., pp. 293–332), Volume one: Theory and methods, Hoboken, NJ: Wiley.

  • Mundy, P., Sigman, M., & Kasari, C. (1994). Joint attention, developmental level, and symptom presentation in autism. Development and Psychopathology, 6, 389–401.

    Article  Google Scholar 

  • Mundy, P., Delgado, C., Block, J., Venezia, M., Hogan, A. & Seibert, J. (2003). A manual for the abridged Early Social Communication Scales (ESCS). University of Miami.

  • Mundy, P., Sigman, M., Ungerer, J. A., & Sherman, T. (1986). Defining the social deficits in autism: The contribution of nonverbal communication measures. Journal of Child Psychology and Psychiatry, 27, 657–669.

    Article  PubMed  Google Scholar 

  • Nadel, J., Guérini, C., Pezé, A., & Rivet, C. (1999). The evolving nature of imitation as a format for communication. In J. Nadel, & G. Butterworth (Eds.), Imitation in Infancy. Cambridge: Cambridge University Press.

    Google Scholar 

  • Nordoff, P., & Robbins, C. (1977). Creative music therapy. New York: John Day Company.

    Google Scholar 

  • Oldfield, A. (2006). Interactive music therapy in child and family psychiatry. London: Jessica Kingsley Publishers.

    Google Scholar 

  • Pavlicevic, M. (1997). Music therapy in context; music, meaning and relationship. London: Jessica Kingsley Publishers.

    Google Scholar 

  • Plahl, C. (2000). Entwicklung Fördern durch Musik. Evaluation Musiktherapeutischer Behandlung (Development through Music. Assessment of Music Therapy Treatment) Unpublished. PhD thesis, 1999. Münster: Waxman.

  • Robarts, J. Z. (1996). Music therapy for autistic children. In C. Trevarthen, et al. Children with Autism: Diagnosis and interventions to meet their needs (pp. 132–160). London: Jessica Kingsley Publishers.

  • Saperston, B. (1973). The use of music in establishing communication with an autistic mentally retarded child. Journal of Music Therapy, 10(4), 184–188.

    Google Scholar 

  • Siller, M., & Sigman, M. (2002). The behaviors of parents of children with autism predict the subsequent development of their children’s communication. Journal of Autism and Developmental Disorders, 32(2), 77–89.

    Article  PubMed  Google Scholar 

  • Stern, D. N. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. Basic Books.

  • Trevarthen, C. (2001). Intrinsic motives for companionship in understanding: Their origin, development, and significance for infant mental health. In A. Schore (Ed.), Infant Mental Health Journal (Vol. 22(1–2), pp. 95–131). (Special issue—Contributions from the Decade of the Brain to Infant Mental Health).

  • Trevarthen, C. (2002). Autism, sympathy of motives and music therapy. Enfance, France. (1/2001), 86–99.

  • Trolldalen, G. (2005). Sharing through affects: The role of ‘affect attunement’ in musical improvisation. Unpublished paper presented at the 11th World Congress of Music Therapy, Brisbane, Australia.

  • Upton, G., & Cook, I. (2002). Oxford dictionary of statistics. Oxford University Press.

  • Venables, W. N., & Ripley, B. D. (2002). Modern applied statistics with S. New York: Springer.

    Google Scholar 

  • Watson, L.R. (1998). Following the child’s lead: Mothers’ interaction with children with autism. Journal of Autism and Developmental Disorders, 28(1), 51–59.

    Article  PubMed  Google Scholar 

  • Wigram, T. (1995). A model assessment and differential diagnosis of handicap in children through the medium of music therapy. In T. Wigram, B. Saperston, & R. West (Eds.), The art & science of music therapy: A handbook (pp. 181–193). Harwood Academic Publishers.

  • 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(1), 11–28.

    Google Scholar 

  • Wigram, T. & Elefant, C. (2008). Therapeutic dialogues in music: Nurturing musicality of communication in children with Autistic Spectrum Disorder and Rett Syndrome. In C. Trevarthern, & S. Malloch (Eds.), Communicative Musicality. Oxford University Press, in press.

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Acknowledgments

This study was a part of the first author’s PhD study and was supported by a PhD scholarship, the Graduate School of Music Therapy, Institute for Communication and Psychology, Aalborg University, Denmark. We wish to thank the children and families who participated in the study, and also the clinical research team (Yenok Song, Eunyoung Lee, Kyungsook Kim, Jiyen Jang, Mijung Kwon) for their contribution over the period of the trials (2004–2005) at Jinah Kim Music Therapy Clinic, Seoul, Korea. We are also grateful to Soochurl Cho, Minsup Shin and Sejin Joo, Ira Cohen, Peter Mundy, Michael Siller variously for their expert help.

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Correspondence to Jinah Kim.

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Kim, J., Wigram, T. & Gold, C. The Effects of Improvisational Music Therapy on Joint Attention Behaviors in Autistic Children: A Randomized Controlled Study. J Autism Dev Disord 38, 1758–1766 (2008). https://doi.org/10.1007/s10803-008-0566-6

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  • DOI: https://doi.org/10.1007/s10803-008-0566-6

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