How Music Therapists and Psychologists Treat Autism (the Similarities and Differences)
Autism spectrum disorder presents within the first two years of life and involves repetitive and restrictive behavior or interests and impairments in socializing and communicating verbally and nonverbally1. There is no known cure, and there is little evidence for effective treatments2. One problem with the research, though, is that both the music therapy3,4 and psychological literature5 have historically used single-case study designs, which limit the overall generalizability and efficacy of the tested intervention.
Both psychologists and music therapists will go through a standard treatment procedure, which starts with assessing the client. In a survey on treating autism, 88% of the responding music therapists stated that they assessed the client to determine how functioning the client is. They also assessed to monitor progress (69%) and to determine what interventions to use and how intense they should be (62%)6. Music therapists will still work on the same goals as the psychologists. For example, the respondents also stated their goals for autism were in communication (98%), social (91%), and emotional (42%) skills6, and 80% of the goals in another study were on communication and behavior/psychosocial skills7. Psychologists and music therapists will also then create interventions and track data on the client’s progress. Applying interventions, however, will differ between psychologists and music therapists.
Psychology classifies autism treatments in two ways: focused intervention practice and comprehensive treatment models. Focused intervention practices have the child with autism obtain specific behavioral or developmental outcomes8. Comprehensive treatment models are a set of interventions designed to work on the core learning and developmental deficits9. In treating the social impairment of autism, psychologists will often use social stories. A social story explains situations, skills, or concepts as part of social cues and common responses to situations in a story-like fashion, and the goal is to put the information in a context that the child can understand10. In psychology, these social stories can be read or presented through audio-visual equipment. A review of the literature found that these social stories improve social deficits in children with autism between eight and 11 years old. Benefits included improvements in playing games, understanding stories, generalized social comprehension, labeling emotions, aggressive behavior, and communication11.
The music therapist, however, will center the intervention around music with improvised and composed songs being the most common12. Music therapists will implant music into social interactions13 and will create lyrics to provide social routines to engage reciprocal behavior14 and create morning routines15 . The most frequently used interventions with autism are singing and vocalization (98.6% of therapists who treat this population), instrument play (98.6%), movement and dance (84%), music improvisation (75%), and songwriting and composition (56%)6. A good example would be taking the social story described above and setting it to music so that the child can sing the directions while doing the task (see Kern & Aldridge, 2006 for an example13).
Despite the differences in approach, music therapists still use the same principles as psychologists. In fact, starting in the 1990s, interventions “were based on therapeutic approaches from psychology and special education” (p. 179)16. For example, in the survey from music therapists who treat autism, the therapists use prompting (90%), reinforcement (84%), joint attention intervention (81%), and picture schedules (81%)6.
The way I personally view music therapy is the application of psychological principles through music. Music Therapy appears to be fundamentally based on Psychology, as they both follow similar procedures and use the same reinforcing techniques. The biggest difference between the two disciplines is how they are implemented. Where psychologists will talk with their clients and put them in situations to improve a condition, music therapists will focus the talking and situations around music.
1.NIH, (n. d.); 2. Bolte, 2014; 3. Srinivasan & Bhat, (2013); 4. Reschke-Hernandez, 2011); 5. Granspeesheh, Tarbox, & Dixon (2009); 6. Kern, Rivera, Chandler, & Humpal (2013); 7. Kaplan & Steele (2005); 8. Odom et al., (2010); 9. National Research Council (2001); 10. Gray, (1994); 11. Karkhaneh, Clark, Ospina, Seida, Smith, & Hartling (2010); 12. Simpson, & Keen (2011); 13. Kern & Aldridge (2006); 14. Stephens (2008); 15. Kern et al., 2007); 16. Reschke-Hernandez (2011)
