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Music Therapy Theses

All Music Therapy theses can be found here. They are also available in the Theses and Dissertations section.

Theses/Dissertations from 2024 2024

Comparing the Impact of Client-Led Music Therapy with Autistic Clients Enrolled in an Applied Behavior Analysis Program Versus Those in Standard Care , Annie Fitzgerald

Experiences in Vocal Psychotherapy of a Music Therapy Intern with Post-Covid Symptoms , Kyungwon Matilda Choi

Exploring Music Therapists' Experiences of Utilizing a Family-Based Approach with Children Receiving Palliative Care , Faith Anne Agolia

Music Therapy Perspectives in Popayan by Music Graduates From the Universidad Del Cauca , Laura Piedad Parra Acosta

The Experience of an Autistic and Neurotypical Sibling Dyad in Improvisational Music Therapy , Gianna DeRusso

The Experience of Home-Based Music Therapists Working with Individuals with Intellectual and Developmental Disabilities: A Thematic Analysis , Sarah Mayr

Theses/Dissertations from 2023 2023

An Exploration into Art Therapists' Experiences of Collaboration with Music Therapists to Treat People with Autistic Spectrum Disorder , Heejoon Park Jun

Early Childhood Educators' Understanding and Perspectives of Music Therapy , Sophia G. Woods

How Music Therapists Experience Improvising with Nonspeaking Clients: A Thematic Analysis , Alexandra Timoshenko

Music Therapists' Perspectives on the Use of Heavy Metal Music in Music Therapy , Jessie E. Davis

Nurses' Perceptions of Music Therapy in Skilled Nursing Facilities: A Survey , Teressa Sambolin

Theses/Dissertations from 2022 2022

A Thematic Analysis of the Clinician's Experience of Individual Music Therapy in Skilled Nursing Facilities with Older Adults , Jaycie Perretta

Music Therapist Experiences of Meaningful Moments in Short-term Medical Settings: A Thematic Analysis , Haojie Lyu

The Connections in Relationships Among Autistic and Neurotypical Adolescents Participating in a Virtual, Inclusive, Performative Music Therapy Group , Laura Silvestain

The Experience of Music Therapists Working with the Parents of Premature Infants in the Neonatal Intensive Care Unit (NICU) , Harria Kim

The Experiences of an Individual with Parkinson's Engaging in a Relationship-based, Improvisational Music Therapy Group , Daniel DeLucia

The Non-verbal Expressions and Experiences of an Autistic Adolescent in Improvisational, Relationship-based Music Therapy , Naoko Funahashi

The Role of Affinity Group Membership For Marginalized Music Therapy Students and Professionals , Fakoya A. Jack-Vilmar

Theses/Dissertations from 2021 2021

An Exploration of Music Therapists' Experience of Simultaneous Trauma During the COVID-19 Pandemic: A Phenomenological Inquiry , Nadia Mary Flutie

A Study on the Perception and Influence of Whiteness in White Music Therapists , Maria Abramovich

Deconstructing the Clinician: An Auto-Ethnographic Study , Nicole Moy and Natalia Alvarez-Figueroa

Puppets in Music Therapy: A Qualitative Study , Kaitlyn Lewis

Racial and Ethnic Representation in Music Therapy Education , Eden M. Medina

The Development of Therapeutic Alliance in Long-Term and Short-Term Music Therapy Treatment , Brooke Morris

The Influences of Language Barriers in Music Therapy , Kohei Mori

The Music Therapist’s Experience of Flow During the COVID-19 Pandemic: A Phenomenological Inquiry , Kaitlyn Upshaw

The Music Therapist's Experience of the Client-Therapist Relationship in Improvisational Voicework: An Interpretive Phenomenological Inquiry , Samantha Schick

The Prevalence of Hip Hop Music in Music Therapy Education & Practice , Dannyele C. Crawford

The Role of Telehealth in Music Therapy Practice During the COVID-19 Global Pandemic Through the Lens of the Music Therapist: A Survey , Brianne Brunick

Theses/Dissertations from 2020 2020

A Culturally Situated Perspective of Music Therapy in Hungary , Sylvia E. Foldes-Berman

A Phenomenological Study of the Therapeutic Relationship in Tele-Music Therapy in the US , Kiyomi Kamiya Glover

From Student to Practitioner: Formal Music Education’s Influence on The Practitioner’s Informed Music Therapy Practice , Daniel M. Salaway

Navigating the Experience of Burnout of Immigrant Music Therapists in the United States , Naeun Lee

The Role of Music in Personal Therapy in Advanced Music Therapy Training: A Self-Inquiry , Jan Mark Casco

The Role of Personal Therapy for Chinese-Speaking Music Therapy Students: A Survey , Xinrui Liu

The Role of Verbal Skills in Analytical Music Therapy, the Bonny Method of Guided Imagery and Music, and Nordoff-Robbins Music Therapy , Elizabeth Ingram

Theses/Dissertations from 2019 2019

Exploring the Use of Marimba in Nordoff Robbins Music Therapy with Children with Autism Spectrum Disorder , Lucas McCarren

The Experience of Songwriting in Music Therapy for Adults with Intellectual Disability , Jasper Lewis

The Roles of Absorption in Music Therapy , Michael John Russo

Understanding Group Dynamics in DIR-Based Improvisational Music Therapy with Autistic Children , Anne Therese Crean

Theses/Dissertations from 2018 2018

A Phenomenological Inquiry into an Autistic Adolescent's Experience in Relationship-based Music Therapy from the Perspectives of the Adolescent and Parent , Diana N. Abourafeh

A Survey of Music Therapists Working in Acute Care, Adult Psychiatric Facilities in the United States: Theoretical Orientations and Practices , Jon Reichert

Clinical Intuition in Improvisational Music Therapy: A Phenomenological Study of the Relationship between Intuition and Music , Nick Farr

The Role of Entrainment on an Older Adult’s Stress and Anxiety: A Mixed Methods Study , Francesca Brennan

Theses/Dissertations from 2017 2017

A Closer Exploration of Therapeutic Relationship through a Musical Mediuem: An Arts-Based Research Study , Michael Kelliher

An Analysis of Burnout and Music Therapy Methodologies , Samara Berry

An Exploration of Creative Arts-Based Self-Care Practices among Music Therapy Students , Marion Kaiser

A Teacher's Experience in Improvisational Music Therapy with her Students with Autism Spectrum Disorder: A Phenomenological Inquiry , Inbar A. Kaplan

The Impact of a Degree in Music Education on Music Therapy Professional Practice: A Qualitative Interview Study , Katherine Glathar

Theses/Dissertations from 2016 2016

An Exploration of Music Therapists' Perspectives on Preventing and Treating Postpartum Depression , Chengcheng Du

Exploring the use of the bass guitar as a clinical instrument within music-centered practice , Matthew J. Brady

Music Therapy with Adolescents in Crisis in America and Korea : A Cross-Cultural Analysis , Seulgi Kim

Parents’ Experiences of Music Therapy in the Neonatal Intensive Care Unit (NICU) , Naoko Mizutani

The Experience of Countertransference for Music Therapists when Working with Children with Developmental Disabilities , Carly Caprioli

The Function of Improvised Song Creation for Individuals with ASD in Formation of Identity: A Grounded Theory Investigation , Jesse Asch

Theses/Dissertations from 2015 2015

Clinical Supervisors' Experience with Conflict with Music Therapy Interns , Joanna M. Kelly

Exploring the Implications of Resource-Oriented Music Therapy for Medical Practice , Jacqueline M. Christen

The Experiences of Music Therapists Developing Music Therapy Programs in New York State Public Schools , Michelle Kovacs

The Role of Personal Therapy for Music Therapists: A Survey , Carla D. Chikhani

The Role of Songs in Music Therapy with Adults who have Developmental Disabilities , Gregory Razzano

Theses/Dissertations from 2014 2014

A Phenomenological Investigation of the Experience of Music Therapists with Vocal Health Issues , Liisa Hill Murray

Exploring Empathy In Music Therapy , Jessica Haviland

Theses/Dissertations from 2013 2013

A Historical Review of Music Therapy and the Department of Veterans Affairs , Jenna Spencer

A Phenomenological investigation of Nordoff-Robbins trainees' personal and musical growth during certification training , Matsuri Imura

Boundary Issues in Music Therapy Internship Supervision , Michelle Lasco

Exploring spiritual experiences of Nordoff-Robbins music therapists , Hyun Jin Hong

Exploring the Impact of Personal bereavement on Music Therapists' Work in End-of-Life Care , Kaitlyn Leann Weeks

Music Therapy, Pain, and Anxiety in Short-Term Adult Inpatient Orthopedic Rehabilitation: a randomized controlled trial , John Marino

The Call for Bravery: The Use of Improvised Story Songs with a Preschooler with Developmental Delays , Emily McClure

The Experience of Music Therapists Who Balance the Dual Professions of Music Therapist and Professional Musician , Colin Turner

The Experience of Teamwork in Nordoff-Robbins Music Therapy: a phenomenological investigation , John Mulcahy

The role of the musical - self in promoting career longevity among music therapists , Peter Davis

Theses/Dissertations from 2012 2012

An Exploration of Perceived Stress Among Music Therapy Interns , Ayelet Walker

Exploring the Musical Culture of an African American Child with Developmental Disabilities in Group Music Therapy , Meghan Cork

I Am Surrounded by Love: an inquiry into the use of songs with a woman with traumatic brain injury, 11 years post-injury , Pamela J. Carlton

Parallel Process in Music Therapy Supervision , Gabriela S. Ortiz

Theses/Dissertations from 2011 2011

An exploration of mindfulness in my music therapy sessions with a child with suggest autism spectrum disorder , Kimberly Lau

Listening, Improvisation, and the Therapeutic Relationship in Music Therapy: A Self-Inquiry , Jill Lucente

Music for quality of life: Huntington Grant Proposal , Lauren A. Klimek

Music Therapy and Culture: Exploring my Culture and its Influences , Midori Tsujimoto

The Development and Establishment of a Pre-School Music Therapy Program , Tracey Lee Rosen

Theoretical orientations applied by music therapists working in adult psychiatric inpatient settings , Angel A. Park

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Hayes School of Music Graduate Studies

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• Handbook for Graduate Students in Music

The Master of Music Therapy candidate has two options for the culminating project within the degree requirements. These are the thesis and the creative project in music therapy.

Thesis:  The thesis entails proposal, design, implementation, and scholarly documentation of an original research investigation. Students interested in completing a thesis are advised to begin the process early in consultation with their thesis advisor and to make use of the Thesis Handbook available from the Office of Graduate Studies. Note that the Thesis prospectus must be approved by the student's graduate committee prior to the semester in which the student intends to undertake the research. The prospectus plus Thesis Committee Form must be on file in the Office of the Graduate School before the student is permitted to register for MUS 5999 Thesis.

Clinical Paper in Music Therapy:  The Clinical Paper is designed to provide an appropriate alternative to the traditional thesis as the culminating experience for student whose focus is clinical music therapy. While similar to the thesis in scope, it differs in its design and emphasis. Although both the Thesis and Clinical Paper are based upon a critical review of the relevant literature, the Clinical Paper will document either music therapy for a specific population or clinical application of an approach in music therapy rather than a traditional research study. In either case the paper is based on both a review of the literature and clinical experience. Those completing the Clinical Paper are required to enroll in one additional approved music therapy elective course related to the topic of the paper.

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Home > Graduate School of Arts and Social Sciences > Expressive Therapies Capstone Theses > 388

Expressive Therapiehttps://digitalcommons.lesley.edu/cgi/myaccount.cgis Capstone Theses

Neuro-informed music therapy for the treatment of anxiety and depression: a literature review.

Sarah E. Sullivan Follow

Date of Award

Spring 5-22-2021

Document Type

Degree name.

MA - Master of Arts

Expressive Therapies

Dr. Vivien Marcow-Speiser

This capstone thesis project is a literature review of research specifically regarding the neuroscience and neurochemistry of music and how it can inform music therapy treatment of mental health. Mental health is a large, overarching term that includes many disorders that refer to one’s psychological and/or emotional condition(s), which further includes an individual’s social well-being. This can include, but is not limited to, depression, anxiety, schizophrenia, and obsessive-compulsive disorder (OCD). This paper will focus in on a research-based, neuro-informed music therapy treatment of anxiety and depression. The goal of this paper was to provide research toward a future method in music therapy where therapists can take a research based and neuro-informed approach to treating anxiety and depression. With the current available research, it can be suggested that a neuro-informed music therapy approach can be used to treat mood disorders, specifically anxiety and depression, however, further research will be needed to support this method.

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Recommended Citation

Sullivan, Sarah E., "Neuro-informed Music Therapy for the Treatment of Anxiety and Depression: A Literature Review" (2021). Expressive Therapiehttps://digitalcommons.lesley.edu/cgi/myaccount.cgis Capstone Theses . 388. https://digitalcommons.lesley.edu/expressive_theses/388

Since April 24, 2021

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Effectiveness of music therapy in children with autism spectrum disorder: A systematic review and meta-analysis

1 College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China

2 Department of Rehabilitation Medicine, Shanghai Fourth People’s Hospital Affiliated to Tongji University, Shanghai, China

3 Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China

Minguang Yang

Jianhong li, associated data.

The original contributions presented in this study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.

This study was to investigated the efficacy of music therapy (MT) in children with autism spectrum disorder (ASD) via a meta-analysis that comprehensively evaluated data from all eligible research in this field.

Systematic review and meta-analysis.

A systematic search of the PubMed, Embase, and Cochrane Library databases from inception to October 2021 to identify studies that administered MT to children with ASD.

Eight randomized controlled trials (RCTs) including 608 participants met the inclusion criteria. The meta-analysis showed that MT was associated with a significant increase in social reactions among children with ASD (standardized mean difference (SMD) = 0.24, 95% confidence interval (CI) [0.03, 0.46], I 2 = 0%, P = 0.03). However, MT did not elicit a significant increase in symptom severity (SMD = 0.17, 95% CI [−0.04,0.38], I 2 = 0%, P = 0.12), social adaptive behavior (SMD = 0.02, 95% CI [−0.44,0.48], I 2 = 0%, P = 0.93) or speech (SMD = 0.04, 95% CI [−0.39, 0.47], I 2 = 0%, P = 0.86) in children with ASD.

MT can improve social skills in children with ASD; however, there does not seem to be a consensus on the persistence of its effects. These findings can inform clinical practice. Promoting the use of MT in children with ASD and improving its symptoms are the ultimate goals.

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder of children, characterized by a behavioral phenotype of impaired social communication and stereotypic behavior ( 1 ). One percent of the worldwide population has ASD ( 1 ). Extensive genetic and early developmental environmental factors play an important role in the etiological heterogeneity of ASD. Functional neuroimaging is essential to highlight the presence of altered activation patterns in specific brain regions of patients with ASD, such as those involved in emotion regulation and social interaction ( 2 ), Frontal and cingulate cortices have been associated with persistently impaired social skills in ASD ( 3 ). Furthermore, inadequate local connectivity of the dorsal posterior cingulate cortex and the right medial paracentral lobule has been observed in ASD ( 4 ).

Music can trigger engagement in social functions, and musical activity is directly related to the fulfillment of basic human needs, such as communication, cooperation and social attachment ( 5 ). Supporting social functions was probably an important adaptive function of music in human evolution of humans ( 5 ). Despite their socioemotional impairment in everyday life, individuals with ASD have nearly normal abilities to recognize, experience and process emotional aspects of music ( 6 ). While listening to happy or sad music, individuals with ASD show activations in cortical and subcortical brain regions that are known to be deficient in this patient group with regard to nonmusical emotional stimuli ( 6 ).

As a cost effective, noninvasive adjunct to standard therapy, music therapy(MT) can be beneficial in the treatment of psychiatric disorders, in a variety of settings and patient groups, yet more validated scientific research is still required to establish MT as a quantified therapy ( 7 ). MT is usually easy to implement in practice ( 8 ). MT is a systematic intervention process in which the therapist helps the client to promote health, using musical experiences and the relationships that develop through them as dynamic forces of change ( 9 ). In terms of interventions, MT has been performed with child-centered or therapist-led approaches, using songs, improvisation, music listening, or combinations thereof ( 10 ). Some research has found that MT is an effective method with profound and consistent effects on improving the social skills of children with ASD ( 11 ).

Early social communication skills are theorized to be important for later more complex social behaviors ( 12 ). Social intervention from childhood onward is essential for individuals with autism. The neuropeptide oxytocin has been used as a potential therapy to reduce social impairment in ASD, but this hypothesis remains controversial and inconclusive ( 13 ). A placebo-controlled trial of intranasal oxytocin therapy in children and adolescents with ASD showed no significant between-group differences in the least-squares mean change from baseline on social functioning measures of over 24 weeks ( 14 ). Promising MT effects for autism have been shown in many domains ( 10 ), and MT may be a better option than some other treatments for improving the social skills of children with ASD.

This meta-analysis investigated the effects of MT on children with ASD. The primary outcome was the Social Reaction Scale (SRS) score, Gresham and Elliot created the SRS, which includes forms for parents, instructors, and students and is meant for three periods: preschool, elementary, and guidance school ( 11 ). The SRS mainly evaluates social functions; Phuong found that it exhibited good reliability with high internal consistency and test retest reliability, sensitivity, and specificity for identifying children with ASD ( 15 ). The secondary outcomes were the Vineland Adaptive Behavior Scales (VABS) and Verbal Production Evaluation Scale (VPES) socres. The VABS produces standardized scores in four domains: communication, social skills, daily living skills, and motor skills ( 16 ). Additionally, Hayoung designed the VPES to measure the participant production of target words according to the four speech components ( 17 ). The Autism Diagnostic Observation Schedule (ADOS) is a semistructured, standardized assessment of communication, social interaction, gaming, and restricted and repetitive behaviors ( 18 ). The Childhood Autism Rating Scale(CARS) is a useful tool for diagnosing children over 2 years old, and it has strong psychological measurement characteristics ( 19 ). The ADOS and CARS are measures of autism symptom severity, higher assessment result scores indicate greater symptom severity.

Materials and methods

Search strategy.

The Preferred Reporting Items for System Reviews and Meta-Analyses (PRISMA) Statement Guide was reviewed. We searched the electronic databases that met the requirements and manually searched the reference list from the existing review. We searched PubMed, Embase, Cochrane Data, and Web of Science from database inception through October 4, 2021, using medical subject headings or a combination of free text words and concepts related to children with ASD and MT; the search was not limited by geography or publication type. Additional relevant publications were found by scanning the reference lists of the retrieved research.

Inclusion criteria

The inclusion criteria were pre-specified according to the PICOS (participants, interventions, comparisons, outcomes, and study design) framework (see Table 1 ). Studies investigating children who had a definite diagnosis of autism were included. The interventions had to be delivered by a trained therapist to meet the definition of MT. Both active and receptive interventions were included. To attain a complete set of the variables tested in this context, no outcomes were indicated in the search syntax. Randomized controlled trials (RCTs) and controlled clinical trials were accepted.

Eligibity criteria.

Study selection and data extraction

All searched records were loaded into reference management software (Note Express V9.0) during the preliminary screening to minimize duplicates and discover probable acceptability by scanning titles and abstracts. The detailed strategy for each database is shown in the supplementary files as an online resource. After that, a full-text review was carried out. A reviewer was tasked with resolving all discrepancies. One reviewer used a prepared form to extract data, which was then confirmed by another reviewer. The details of the extracted data included: the first author name, study and participant characteristics, intervention(s) for the experimental and control groups, and outcomes.

Assessment of the risk of bias in the included studies

The risk of bias in the included studies was evaluated by two independent reviewers (XK and WS) using the Cochrane Collaboration’s tool ( 20 ). This tool includes scores on six domains: (1) selective deviation (random sequence generation and allocation concealment), (2) performance deviation (participant and personnel blinding), (3) detection deviation (outcome assessor blinding), (4) attrition bias (incomplete outcome data), (5) reporting bias (selective reporting), and (6) other bias. Each item in each study was evaluated, and each domain was categorized as “low,” “high,” or “unclear” based on whether it matched the evaluation criteria for the feature conveyed by the items. Any discrepancies were resolved by a third reviewer.

Data analysis

The statistical analyses were conducted using Review Manager 5.3 software (RevMan 5.3). When several scales were employed in each experiment, the combined statistics were the mean and standardized deviation (SD), standardized mean difference (SMD), and 95% confidence interval (CI). When the same scales were used in each trial, the combined statistics were the weighted mean difference and 95% CI. A random effect model was used to examine the data if the results had heterogeneity; otherwise, a fixed effect model was utilized. I 2 reflects the study diversity. We contacted the author to request the original data if a study merely provided the value change in the evaluation scores. When two or more studies measured the same outcome and supplied data in a format suitable for pooling, the data were pooled for the meta-analysis. The χ 2 test and Higgins’s I 2 value were used to analyze the heterogeneity of the collected studies. P < 0.05 was considered significant when using the χ 2 test. When data were available, the pooled effect was computed using the fixed-effect model, and no significant heterogeneity was found. In addition, the random-effect model was used.

General results of the included studies

From the four electronic databases, 608 records were found using the search method. After the duplicates were deleted, two reviewers evaluated the titles and abstracts and removed irrelevant entries. Finally, 22 full-text papers were reviewed for eligibility, with 8 studies meeting the requirements ( 11 , 17 , 21 – 26 ). Figure 1 shows the research selection flowchart for discovering eligible papers.

PRISMA flow chart. Showing the article selection process. Eight chosen articles.

Characteristics of the included studies

The major goal of this study was to investigate the overall effectiveness of MT for children with ASD across numerous outcomes and modifiers. In 8 trials, 608 persons met the inclusion criteria. Figure 1 shows the overall search strategy and article-screening procedure, whereas Table 2 shows the coded methodological, participant, and study features as well as the total treatment impact for each study.

Study characteristics meeting inclusion criteria.

CGI, the Clinical Global Impression; CARS, Childhood Autism Rating Scale; ABC, the Aberrant Behavior Checklist; VPES, A verbal production evaluation scale; ADOS, Autism Diagnostic Observation Schedule; SRS, the Social Responsiveness Scale; VABS, Vineland Adaptive Behavior Scales; VSEEC, Vineland Social-Emotional Early Childhood Scales; ABA, Applied Behavior Analysis; ST, Speech Training.

The styles of music utilized in the intervention groups were diverse, involving commercial music ( 26 ), original music created by the therapist with speech training words ( 17 ), Orff-Schulwerk music ( 27 ), and other kinds of music styles. MT lasted anywhere from 3 days to 8 months in the studies that were included.

Risk of bias in the included studies

The assessment of evidence quality was performed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process. Figure 2 provides a summary of the risk of bias results for each included study. Six trials ( 17 , 21 – 24 , 28 ) randomized their group assignments by using a computer-generated randomization list. One trial ( 11 ) matched the children by both age and sex to eliminate possible intervening variables. Three ( 11 , 21 , 22 ) of those studies reported allocation concealment. Three studies ( 10 , 21 , 22 ) described participant and personnel. Two studies ( 22 , 24 ) clearly described the blind assessment of the outcome measures. The included studies were randomized controlled trials with high quality of evidence. Quality downgraded by one grade because of possible publication bias.

Risk of bias in the included studies.

Mean difference effect on symptoms severity in children with autism spectrum disorder

In 8 studies, means and SD, or means and 95% CI were used to report the results before and after the interventions. The influence of MT on the overall level of functioning in children with ASD was assessed. The included literature used the ADOS and CARS to assess symptom severity in children with ASD. Two studies with 353 participants reported the relevant data. Compared with the control group, the level of intervention in the MT group did not significantly improve in either of the two studies. The pooled SMD did not show a statistically significant improving symptoms severity in children with ASD ( P >0.05; Figure 3 ). MT did not improve symptom severity in children with ASD.

Forest plots of the effect of MT on symptoms severity compared with no MT; SD, standard deviation; 95% CI: 95% confidence interval; IV: inverse variance method.

Effect on the social reactions of children with autism spectrum disorder

The MT effect on the social reactions of children with ASD was assessed in four studies. Three studies ( 21 , 24 , 28 ) with 330 participants reported the relevant data. Four studies used the SRS to measure the MT effect on children with ASD. One study ( 21 ) demonstrated a significantly lower post-intervention level of social interaction in the MT vs. the control group. The pooled mean difference (MD) showed a statistically significant increase in the SRS score ( P < 0.05; Figure 4 ). MT improved the social reactions of children with ASD.

Forest plots of of MT (vs. no-MT) effect on the SRS score; SD: standard deviation; 95% CI: 95% confidence interval; IV: inverse variance method.

Effect on the adaptive social behaviors of children with autism spectrum disorder

Two studies with 34 participants reported the relevant data. Both used the VABS to measure the MT effect on children with ASD. The difference was significant between music and other training types ( P <0.05). The pooled MD did not show a statistically significant increase in adaptive social behaviors. ( P >0.05; Figure 5 ). MT did not improve social adaptive behavior.

Forest plots of the MT (vs. no-MT) effect on social adaptation. SD: standard deviation; 95% CI: 95% confidence interval; IV: inverse variance method.

Effect on the speech of children with autism spectrum disorder

Three studies ( 17 , 22 , 23 ) with 82 participants reported relevant data. Three studies used the VPES or the CARS–BR (Brazilian–Portuguese version) scale to measure the MT effect on children with ASD. The CARS–BR aspects assessed in this study included verbal, nonverbal and social communication ( 22 ). We analyzed the results of the verbal subscale of the CARS-BR, which showed that the difference was not significant between music and other training types. The pooled SMD did not show a statistically significant increase in speech ( P >0.05; Figure 6 ). MT did not improve the speech of children with ASD.

Forest plots of the MT (vs. no-MT) effect on speech. SD: standard deviation; 95% CI: 95% confidence interval; IV: inverse variance method.

Unlike previous meta-analysis, our subjects were children younger than 12 years old. Some limitations continued through to the meta-analysis and should be considered. First, the study design, methodological quality, and types and forms of music contributed to increasing the heterogeneity of the meta-analyses. The goal of this meta-analysis was to determine how MT affected children with ASD. This meta-analysis included eight RCTs with 608 individuals who compared MT groups to no-MT control groups. MT had a positive impact on social skills in children with ASD.

Social skills were examined in three studies. The subjects were of different ages, including preschoolers and school-aged children. Two of them explicitly used improvisational MT, and both required parental involvement. One was solo therapy by a professional therapist, without specifying musical form. The intervention frequency was weekly, with no significant differences in duration. The Intervention periods were different, ranging from 8 weeks to 5 months. Because differences in the age at intervention and the presence or absence of parents can have an effect on children’s MT outcomes; although I 2 was 0%, we believe this result is likely to be heterogeneous. With a growing body of research pointing to the potential benefits of parent-mediated interventions for supporting development in children with ASD, there is both a need, and increasing capacity, to examine influencing factors ( 29 ).

Karin found the MT relationship to be an important predictor of the development of social skills ( 30 ). Regarding the effect on the social reactions in children with ASD, the MT group showed a significant difference from the no MT group. Music is known to regulate arousal and attention in the brain and can engage different areas in the brains of individuals with neurological conditions ( 31 ). MT may increase the socioemotional motivation of children with ASD. Deficits in socioemotional reciprocity; nonverbal communicative actions utilized for social engagement; and the formation, maintenance, and comprehension of relationships are all examples of social communication impairments in children with ASD ( 32 ). Children with such impairments are unlikely to engage in social interactions. In addition, their social problems will not gradually improve as the children develop. Because their environments become more complicated, the children increase their understanding of their social discomfort, and may experience increased damage and pain during adolescence. The MT group did not show a significant difference from the no-MT group. A social adaptive function is required for children to adapt to their environments and interact adequately with others. Defects in social skills may result in limited relationships with peers and family members. Early social and communication skills are essential for a better developmental trajectory and the acquisition of more complicated abilities later in life ( 33 ).

People with ASD usually have a unique attraction to music and may have enhanced musical ability. This attraction to music can be used to allow children with ASD to participate in musical experiences, thereby promoting social skills ( 34 ). The musical strengths of children on the autism spectrum not only compensate for their social difficulties but also provide the potential for lifelong engagement in and enjoyment of musical activity ( 35 ). Many children with ASD respond favorably to music, finding it a safe and controlled stimulus for social interaction and social skill development. Musical stimuli may aid in the development of social interactions for a variety of reasons. Music has been shown to engage brain networks that are involved in similar musical and nonmusical tasks, and to maximize target behaviors through synchronized neuronal firings. MT interventions have a positive impact on social skills, including increasing participation ( 36 ), improving social connection and increasing emotional involvement ( 25 ). MT has also been shown to improve social greeting rituals and joint attention ( 37 ) as well as communication skills, peer interactions, and cognitive social skills ( 27 ). These studies show that MT can lead to measurable improvements in the social relationships of children with ASD.

Mean difference did not significantly decrease symptoms in children with autism. The ADOS is the medical standard for diagnosing autism and has been effective for classifying autism, but it is less specific and sometimes less sensitive for distinguishing children with mild autism ( 38 ). The CARS is widely used to detect and diagnose autism, and it has shown a strong concordance with the DSM–IV criteria for autism ( 39 ). However, the CARS is subjective. Moreover, the treatment durations included in the studies were relatively short, with none lasting more than 1 year. More research time and objective assessment methods may be needed to determine whether MT can improve symptom severity in children with autism. Although I 2 was 0%, we believe this result was likely to be heterogeneous. Social impairment is the core symptom of children with autism. The improvement of social ability should improve its severity, which requires larger samples and more studies to prove. Adaptive behavior was measured using reports from the parent/caregiver and teacher forms on the VABS, A total of two articles were analyzed. The children in the two studies were of different ages. One with parental involvement and one without although I 2 was 0%, we believe this is likely to be heterogeneous. Parents not only play an important role in the early diagnosis of the child, but also occupy an irreplaceable position in the later intervention treatment. Parental involvement contributes to the development of parent-child relationships and the development of children’s early social interaction skills.

Speech function in children with autism was assessed in two papers by the same authors using scales created by the authors themselves. The two studies had different ages of children and different interventions, and one used behavior analytic therapy. Although I 2 was 0%, we believe this is likely to be heterogeneous. Social communication difficulties are a key feature of ASD and must be present to receive a behavioral diagnosis. Speech is one aspect of social communication that encompasses a wide range of abilities. Children with ASD are more likely to show developmental impairments in speech and communication ( 40 ). They struggle with maintaining a conversation, extending welcomes and farewells, taking turns appropriately, and applying conversational repair procedures. These shortcomings are linked to difficulties with perspective-taking and the theory of mind. Because pragmatic speech problems are very common in ASD, this area has received much attention. When compared to peers with usual development, intellectual disabilities, or other disorders, children with ASD have reduced pragmatic skills.

Mean difference is thought to be an excellent way to help children with ASD improve their speech and communication abilities ( 17 ). Music instruction was found to be useful in improving the speech production of 50 children with ASD, including semantics, phonology, pragmatics, and prosody ( 17 ). Therefore, music, especially music suitable for a child’s age and developmental level, has been used as a consistent and reliable strategy to improve speech and language and to cultivate communication skills in almost all treatment methods. However, the results of another study indicated ( 23 ) that both music and speech training are effective for language for ASD children, and the differences between music and language training were not statistically significant.

Music is an auditory stimulus that interests and motivates many children with ASD ( 41 ). MT improves movement synchrony in children with ASD ( 42 ). Children with high levels of adaptive behavior or low levels of maladaptive behavior displayed greater exercise intensity during a fast music condition ( 43 ). MT for motor function training in children with ASD has been less studied, but the impact of MT is broad, and more difficult to quantify. Targeted assessment tools are required to evaluate the impact and long-term effects of MT.

A second music-based assessment for children with ASD is the Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) ( 44 ). This assessment is part of the development framework based on the relationship between MT and ASD. In this framework, the ability to perform, and interpret creative music is evaluated. This assessment is based on music-centric treatment, which provides information about how people play a role in music, which helps with non-music interaction and understanding.

Failure to pre-register the protocol for this review is a problem because it introduces a potential bias to the evaluation. Fewer articles were included in this paper and only those published in English were covered, which may be subject to publication bias. Relatively little research has been conducted on the effects of MT on children with ASD and much of what has been published lacks scientific rigor. Fewer articles have been published in recent years, so selective publication can’t be ruled out.

In summary, our findings suggest that MT is effective in improving the social interaction of children with ASD. This convenient, short-term music program may help children with ASD learn social skills and integrate into society. Because of the small number of eligible studies, the conclusions should be applied with caution, and there appears to be no consensus on the continuation of the intervention effects. More assessor-blinded, international, parallel-group, pragmatic RCTs are needed to prove the effectiveness of MT in improving social interaction.

As an effective early intervention, MT, through auditory action on the cerebral system and other brain regions, adjusts the cerebral cortex, enhances emotions and arousal levels, and has a unique treatment effect on autistic children’s cognition, emotions and behaviors. To make MT truly beneficial for the majority of children with ASD, several changes should be implemented—including reductions in the required physical and mental effort, increases in the number of randomized controlled trials on the topic, and further exploration of the mechanism underlying MT—to elucidate its psychological mechanism. These suggestions can enhance the use of MT with children with ASD.

Data availability statement

Author contributions.

WL contributed to conceiving and designing the study. XK and WS drafted the manuscript. MY and JL conducted the literature search and extracted the data. All authors carried out with the direct participation of the study.

This work was supported by the Youth Top Talent Project of Fujian Province, China: “Young Eagle Project” (No. 2901-750102003).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Music Therapy as an Intervention for Pain Perception

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The History of Music Therapy and Its Applications

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