Using Music Therapy to Treat Autism — Diving into the Research

Can you use music as an intervention to help people on the Autism spectrum improve their lives? A recent study found that Autism Spectrum Disorder in children increased five fold1. So, in this article, we’ll delve into what the research has to say about using music to address their needs.

You will find studies that music therapy helps people with autism improve their communication 2,3,4,5, including both verbal 6,7 and nonverbal communication 7,8,9, but larger scale studies have not shown a reduction in symptoms3. In 2007, an article reported disappointment in the lack of articles with statistical analyses10. However, a more recent Cochrane Review meta-analysis of 10 studies found that there was sufficient evidence showing improvements in core symptoms of Autism Spectrum Disorder with moderate to large effects on social skills, nonverbal communication, emotional cues, and the parent-child relationship. The music therapists used interactive techniques, structured and receptive techniques, and relational techniques8. Another meta-analysis of 11 studies found similar medium-to-large effects11.

However, you’ll also find meta-analyses and an overview showing improvements in mood and social skills4,5, sensory perception, prosocial behaviors4 and quality of life5 . You may also see a decrease in repetitive behaviors 6,7, anxiety, and even echolalia 7. Overall, music therapy helps people with autism improve their sensory and motor skills, communication, social skills, and self-expression. We can do this through melodic intonation therapy, auditory integration training, rhythmic entrainment, improvisation, synchronization, interaction with music, and passive and active music therapy10, In fact, most music therapists use singing and vocalization (98.6%), playing instruments (98.6%), moving and dancing (84%), improvising to music (75.3%), and composing songs (55.7%) 12.

A systematic review even looked at different interventions on children with Autism Spectrum Disorder and found that music therapy was the most effective because it was able to achieve improvements in social skills and communication in the lowest amount of time and with the lowest intensity of interventions13. For example, in just 10 weeks, music therapy helped kids (ages 6 to 9) improve communication through improvised musical play2. Both standard care and improvised music therapy helped children with autism improve their social skills but neither did better than the other14.

In one study, 100% of the people with autism met their initial goals within one year or less of music therapy, and it didn’t matter what type of sessions they received. In these sessions the patients would interactively play musical instruments to promote social skills or communication, learn how to play instruments or musical concepts like rhythm and dynamics, sing to promote social skills or communication, and make specific choices between which instruments to play or songs to hear. More importantly, the parents often say that what they’re doing in the music therapy sessions translates outside the session15:

“He uses music to express his feelings and interests.”
“He tries to interact with brothers and sisters more.”

Client’s with autism most often get individual sessions (one-on-one with the music therapist), but they can also receive sessions with a partner, in a small group of 3–5 people, large groups of 6 or more people, a peer model, and a combination of these15.

Neurologically, areas of the brain that tend to be overconnected in children with Autism are less connected when given a musical intervention, but they’ll also have increased resting state connectivity in other areas that need the stimulation. So, music therapy is helping the brain adjust as needed, and the neurological data are suggesting that music therapy is beneficial for children on the Autism spectrum16.

To sum, music therapy does help people with autism improve their life and especially helps with communication if they are nonverbal. Improvement in nonverbal communication skills comes up a lot9. Most clients with autism will work on language and communication goals, but they will also work a lot on psychosocial goals 12,15 and emotional skills12. To a lesser degree, they also tend to work on motor, cognitive, and musical skills15.

The studies are not reporting adverse effects5, but it is dangerous to assume that music therapy can’t bring about negative side effects10. Even so, there’s research suggesting that there’s higher acceptance of music therapy compared to other disciplines17. Music interventions definitely help children and adolescents who have autism, and music is such a powerful tool that all music regardless of its purpose is beneficial7. More important with music therapy, they feel more joy and initiate more behaviors with music therapy18.

1. Shenouda et al. (2023). Prevalence and Disparities in the Detection of Autism Without Intellectual Disability https://publications.aap.org/pediatrics/article-abstract/151/2/e2022056594/190525/Prevalence-and-Disparities-in-the-Detection-of?redirectedFrom=fulltext

2. Edgerton (1994). The effect of improvisational music therapy on the communicative behaviors of autistic Children https://psycnet.apa.org/record/1994-30859-001

3. Marquez-Garcia et al. (2021). Music Therapy in Autism Spectrum Disorder: a Systematic Review https://link.springer.com/article/10.1007/s40489-021-00246-x

4. Shi, Lin, & Xie (2016). Effects of music therapy on mood, language, behavior, and social skills in children with autism: a meta-analysis https://www.sciencedirect.com/science/article/pii/S2095771816300822

5. Stegemann et al. (2019). Music Therapy and Other Music-Based Interventions in Pediatric Health Care: An Overview https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473587/

6. Dezfoolian et al. (2013). A pilot study on the effects of Orff-based therapeutic music in children with autism spectrum disorder https://mmd.iammonline.com/index.php/musmed/article/view/MMD-2013-5-3-5

7. Whipple (2004). Music in Intervention for Children and Adolescents with Autism: A Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/15307805/

8. Geretsegger et al. (2014). Music therapy for people with autism spectrum disorder https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956617/

9. Gattino et al. (2011). Effects of relational music therapy on communication of children with autism: a randomized controlled study https://www.tandfonline.com/doi/abs/10.1080/08098131.2011.566933

10. Accordino, Comer, & Heller (2007)). Searching for music’s potential: A critical examination of research on music therapy with individuals with autism https://www.sciencedirect.com/science/article/abs/pii/S1750946706000109

11. Li (2016) The Effectiveness of Music Therapy for Children with Autism Spectrum Disorder: A Meta-analysis https://core.ac.uk/download/pdf/79584364.pdf

12. Kern et al. (2013). Music therapy services for individuals with autism spectrum disorder: a survey of clinical practices and training needs. https://pubmed.ncbi.nlm.nih.gov/25014668/

13. Maw & Haga (2018). Effectiveness of cognitive, developmental, and behavioural interventions for Autism Spectrum Disorder in preschool-aged children: A systematic review and meta-analysis https://pubmed.ncbi.nlm.nih.gov/30211331/

14. Bieleninik et al. (2017). Effects of improvisational music therapy vs enhanced standard care on symptom severity among children with autism spectrum disorder: the TIME-A randomized clinical trial https://pubmed.ncbi.nlm.nih.gov/28787504/

15. Kaplan & Steele (2005). An Analysis of Music Therapy Program Goals and Outcomes for Clients with Diagnoses on the Autism Spectrum https://pubmed.ncbi.nlm.nih.gov/15839730/

16. Sharda et al. (2018). Music improves social communication and auditory–motor connectivity in children with autism https://pubmed.ncbi.nlm.nih.gov/30352997/

17. Tripha et al. (2018). Caregivers’ knowledge and acceptance of complementary and alternative medicine in a tertiary care pediatric hospital https://pubmed.ncbi.nlm.nih.gov/29535550/

18. Kim et al. (2009). Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy https://pubmed.ncbi.nlm.nih.gov/19535468/