Autism and Music Therapy
This is the second in a series about autism. The first post, which talks about what autism is, can be found here. Today's post will discuss how music therapy can be used to treat autism. Future posts will list resources for individuals with autism online and in the Salt Lake Area.
There might not be an aspect of music therapy more thoroughly researched than music therapy with individuals who have Autism Spectrum Disorders. There's a good reason for this; ask the parent of any child with autism and 9 times out of 10 they'll have something to say about how much their kid loves music. Sometimes music can reach people on the spectrum when nothing else can.
If you remember from our previous post on autism, some of the main issues I talked about were communication skills and social skills. Another area of need for individuals who have more severe ASD is daily living skills. Something I haven't discussed yet is hypersensitivity to sensory stimuli (ie sights, sounds, textures, touching) because I'm saving that for when I talk about Sensory Processing Disorder later on. But let's break down the three areas we are going to cover.
Daily Living Skills
Daily living skills are something most of us take for granted once we reach a certain age--getting dressed, preparing a meal, brushing teeth, making a phone call, even using the bathroom. But for individuals with Autism Spectrum Disorders, this can be more difficult. (You might remember the 'Mirror Neuron' theory from before: that might be why it is such a struggle.) Remembering the steps to do something, sequencing tasks in the correct order, and even understanding instructions when they are given can all be challenges depending on what an individual's strengths and deficits are. But one technique has been found to help: Singing the instructions.
A 2012 research study shows that individuals with ASD show more brain activity when listening to singing than speech. This may explain why individuals with autism also show better reading comprehension when they can hear the text set to music.
Part of this is true for everyone: we process music and singing with a different part of the brain than we process speech, which is a principal used in music therapy with individuals who have lost the ability to speak in a stroke-- it's actually possible to teach someone how to sing what they want to say, and sometimes even re-teach someone how to speak using the parts of the brain meant for singing. (This is called Melodic Intonation Therapy, and the research is fascinating! Some studies have shown new neural pathways growing to bridge the damaged portions of the brain.)
Something a music therapist can do is help break down a daily living skill into small steps, and compose a song which goes through all of these steps. For some individuals with autism, memorizing the song is enough to help them remember how to do a task. For others, providing a recording to be played while doing the task, or teaching family members the song, may be more helpful.
A lot of the same behaviors we use in interacting with people outside of music show up when we make music with other people. Think about it this way: you probably know someone who tends to dominate conversations, talking over other people and not leaving room for a word in edgewise. Imagine what happens if they are in a group of people improvising on some drums? You probably guessed it-- they play the loudest and don't listen to what other people are playing.
Because making music together works as a sort of microcosm of our social behavior, music therapy is a great way to address social skills. Basic social skills like following directions, sitting still, listening to others, and taking turns are addressed very naturally. For individuals with better social skills, music can be used to develop more complex abilities like watching for nonverbal cues, imitation, and supportive listening. And one of the really neat things about this approach is that you can do all of this without speaking at all; in music, it is possible to practice all of the skills of a conversation without using language at all. This means that music therapy is ideal for teaching social skills to individuals who are nonverbal-- it naturally starts at their level.
I did my music therapy internship at a school for students with a variety of disabilities, including autism. The main goals that the school asked us to focus on were literacy and communication.
Above, I talked about how individuals with autism understand words better if they are sung than if they are sang. Many of these individuals also use language more easily in singing than in speaking as well; I've worked with several adults with autism who are more or less nonverbal--generally only saying a handful of words or repeating back the last thing they heard-- but who could sing all of the words to a favorite Disney song. This is a great starting point for developing language skills; from there I usually try to work on helping them learn how to say what songs they want to sing and what instruments they want to play, and build up from there.
This also works with individuals who cannot speak at all but are using alternative forms of communication, such as PECS pictures, ASL, or an Augmented Communication Device such as a laptop. Because music is very motivating, individuals who sometimes resist learning to communicate will learn how to request a favorite song or instrument. In this way, music therapy can be used to support speech therapy in increasing the abilities of individuals to communicate their needs and wants.
We'll stop there for now, but look forward to some upcoming posts on resources for individuals with autism.
It sure has been a wet spring in Utah this year, hasn't it? I couldn't resist closing today with one of my favorite classical pieces for piano: Chopin's "Raindrop Prelude". But wherever you are, stay dry, and see you soon!