Music therapy is a systematic intervention that can benefit individuals with neurobehavioral disorders. The use of musical instruments is a central component of many clinical music therapy practices, and recent technological modifications to instruments have enhanced their accessibility and versatility as a therapeutic medium. A novel case example of a modified piano and examples from literature are presented to illustrate the potential applications of technological advances in musical instruments. These advances include the integration of computers, communication technology, and Internet connectivity in the creation of a more powerful and flexible platform for therapy. Sound amplification and surround sound systems, voice recognition software, eye-tracking and gesture-tracking command technology, magnifying lens technology, and Braille keyboards can aid individuals with sensory (eg, hearing or vision) or motor deficits. Such modifications have the potential to transform music therapy and education for children with neurodevelopmental disabilities including autism.