Funded in part by American Music Therapy Association
Music therapy for people with autism spectrum disorder
Geretsegger M, Elefant C, Mössler KA, Gold C
The Cochrane database of systematic reviews · 101 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Industry funded
- Industry group
- American Music Therapy Association
- University or hospital
- Florida State University
- University or hospital
- Aalborg Universitet
Based on 3 listed funder(s).
Publication
- Published
- 2014-06-17 · Cochrane Database Syst Rev · vol. 2016 · issue 3 · p. CD004381
- Publisher
- Elsevier BV
- Cited
- 420 citations · more than 99% of similar papers · 8.8× the field average
- Impact
- Top 10% most cited in its field
- References
- 131 works
- Access
- Free to read
- Research areas
- Autism Spectrum Disorder Research · Music Therapy and Health · Pain Management and Placebo Effect
- Keywords
- Music therapy, MEDLINE, Autism spectrum disorder, PsycINFO, CINAHL, Medicine, Confidence interval, Randomized controlled trial, Study heterogeneity, Meta-analysis, Clinical psychology, Physical therapy, Psychology, Autism, Psychological intervention, Psychiatry, Internal medicine
- MeSH
- humans, music therapy, communication, child development disorders, pervasive, autistic disorder, time factors, child, randomized controlled trials as topic
4 authors
From NO, IL
- Monika GeretseggerUni Research (Norway)
- Cochavit ElefantUniversity of Haifa
- Karin Antonia MösslerUni Research (Norway)
- Christian GoldUni Research (Norway)
Abstract
Background
The central impairments of people with autism spectrum disorder (ASD) affect social interaction and communication. Music therapy uses musical experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of people with ASD. The present version of this review on music therapy for ASD is an update of the original Cochrane review published in 2006.
Objectives
To assess the effects of music therapy for individuals with ASD.
Search methods
We searched the following databases in July 2013: CENTRAL, Ovid MEDLINE, EMBASE, LILACS, PsycINFO, CINAHL, ERIC, ASSIA, Sociological Abstracts, and Dissertation Abstracts International. We also checked the reference lists of relevant studies and contacted investigators in person.
Selection criteria
All randomised controlled trials (RCTs) or controlled clinical trials comparing music therapy or music therapy added to standard care to 'placebo' therapy, no treatment, or standard care for individuals with ASD were considered for inclusion.
Data collection and analysis
Two authors independently selected studies, assessed risk of bias, and extracted data from all included studies. We calculated the pooled standardised mean difference (SMD) and corresponding 95% confidence interval (CI) for continuous outcomes to allow the combination data from different scales and to facilitate the interpretation of effect sizes. Heterogeneity was assessed using the I² statistic. In cases of statistical heterogeneity within outcome subgroups, we examined clients' age, intensity of therapy (number and frequency of therapy sessions), and treatment approach as possible sources of heterogeneity.
Main results
We included 10 studies (165 participants) that examined the short- and medium-term effect of music therapy interventions (one week to seven months) for children with ASD. Music was superior to 'placebo' therapy or standard care with respect to the primary outcomes social interaction within the therapy context (SMD 1.06, 95% CI 0.02 to 2.10, 1 RCT, n = 10); generalised social interaction outside of the therapy context (SMD 0.71, 95% CI 0.18 to 1.25, 3 RCTs, n = 57, moderate quality evidence), non-verbal communicative skills within the therapy context (SMD 0.57, 95% CI 0.29 to 0.85, 3 RCTs, n = 30), verbal communicative skills (SMD 0.33, 95% CI 0.16 to 0.49, 6 RCTs, n = 139), initiating behaviour (SMD 0.73, 95% CI 0.36 to 1.11, 3 RCTs, n = 22, moderate quality evidence), and social-emotional reciprocity (SMD 2.28, 95% CI 0.73 to 3.83, 1 RCT, n = 10, low quality evidence). There was no statistically significant difference in non-verbal communicative skills outside of the therapy context (SMD 0.48, 95% CI -0.02 to 0.98, 3 RCTs, n = 57, low quality evidence). Music therapy was also superior to 'placebo' therapy or standard care in secondary outcome areas, including social adaptation (SMD 0.41, 95% CI 0.21 to 0.60, 4 RCTs, n = 26), joy (SMD 0.96, 95% CI 0.04 to 1.88, 1 RCT, n = 10), and quality of parent-child relationships (SMD 0.82, 95% CI 0.13 to 1.52, 2 RCTs, n = 33, moderate quality evidence). None of the included studies reported any adverse effects. The small sample sizes of the studies limit the methodological strength of these findings.
Authors' conclusions
The findings of this updated review provide evidence that music therapy may help children with ASD to improve their skills in primary outcome areas that constitute the core of the condition including social interaction, verbal communication, initiating behaviour, and social-emotional reciprocity. Music therapy may also help to enhance non-verbal communication skills within the therapy context. Furthermore, in secondary outcome areas, music therapy may contribute to increasing social adaptation skills in children with ASD and to promoting the quality of parent-child relationships. In contrast to the studies included in an earlier version of this review published in 2006, the new studies included in this update enhanced the applicability of findings to clinical practice. More research using larger samples and generalised outcome measures is needed to corroborate these findings and to examine whether the effects of music therapy are enduring. When applying the results of this review to practice, it is important to note that the application of music therapy requires specialised academic and clinical training.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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