A randomised controlled feasibility trial of music-assisted language telehealth intervention for minimally verbal autistic children—the MAP study protocol

Abstract

Background About 30% of children with autism spectrum disorder (ASD) do not develop functional speech and remain non-verbal or minimally verbal even after years of speech, language and educational interventions. A wide range of interventions have been developed for improving communication in ASD, but none have proved effective in eliciting functional language in ASD children. Research has found that people with ASD are more likely to have perfect pitch and prefer music to language. Further, it seems that language delay tends to co-occur with better musical skills. Brain imaging research has found that music alongside words increases the attention that people with ASD pay to spoken words. Methods In this protocol, we describe our music-assisted programmes (MAP) that will use music to attract the attention of people with ASD to speech. MAP may open the brain pathways to language and therefore help improve communication skills for people with ASD more than standard communication protocols. In particular, we aim to develop and test whether individualised, easily used MAP would increase spoken language in 24–60-month-old, nonverbal or minimally verbal children with ASD. We will develop a structured training method, delivered through naturalistic, interactive activities (e.g. songs) to teach language to ASD children. We will test this by comparing two groups: one undertaking music-assisted programmes, and the other receiving speech and language therapy in the way that is recommended in NHS clinics. Participants will be allocated to groups randomly. The feasibility of MAP will be assessed through estimations of recruitment and retention rates, the sensitivity and reliability of the outcome measures, the intensity and frequency of the trial, the usability of the MAP app (beta version), and the burden of the assessments for the children and parents. Discussion This feasibility randomised controlled trial will establish the acceptability and estimate the power of the MAP intervention to improve early word learning in children with ASD. In the longer term, this research will help us develop an app for parents or carers of children with ASD to design their own songs and implement their own individualised MAP. Trial registration ISRCTN, ISRCTN12536062. Registered on 26 June 2019.

Developing an Attention Assessment Tool for Individuals With Autism Spectrum Disorder Using Timbre, Rhythm, and Pitch

“…Many studies on music therapy have highlighted the correlations between musical factors and attention in individuals with typical development and communication difficulties. 15 43 44 45 46 Musical aptitude is associated with working memory and selective attention. 46 Pasiali and colleagues 15 reasoned that musical attention control training would improve attentional control and selective attention in individuals with ASD.…”

“… 15 43 44 45 46 Musical aptitude is associated with working memory and selective attention. 46 Pasiali and colleagues 15 reasoned that musical attention control training would improve attentional control and selective attention in individuals with ASD. Wigram and Gold 45 discovered that music therapy could progress emotional responsiveness, attention span, and behavioral control.…”

Mental representations of speech and musical pitch contours reveal a diversity of profiles in autism spectrum disorder

“…Also, a recent systematic review investigated the benefits of music in rehabilitation of communication disorders and revealed that in addition to improving joint attention and group participation, music-based therapy enhanced social communication skills, including an increased frequency of verbal and non-verbal responses, initiating vocalizations and taking conversational turns ( Boster et al, 2021 ). However, more research is needed to explore whether and how song-based interventions could improve language production and comprehension in ASD ( Williams et al, 2021 ).…”

“…Others have suggested that there are shared or domain-general mechanisms underlying the processing of information across both domains ( Koelsch, 2011 ; Koelsch & Siebel, 2005 ; Patel, 2008 ; Sammler et al, 2009 ). Given that there may be differences in specialized representations and commonalities in basic processing mechanisms between music and speech ( Patel, 2008 ), the investigation of top–down comparisons of internal mental representations of speech and music in ASD will not only help better understand the underlying processing systems across domains ( Ouimet et al, 2012 ), but also offer theoretical implications for using alternative options to remediate possible difficulties in either domain, such as using music-related activities to improve language production and comprehension in ASD ( Williams et al, 2021 ).…”

Musicoterapia y telehealth: Una revisión sistemática

“…Así, se advierte un incremento del uso terapéutico de la música en telehealth, definida por Glover (2020) como el uso de información electrónica y de tecnologías de telecomunicación en atención en salud a distancia, y en la relación entre terapeuta y paciente. Por un lado, hay aplicaciones de musicoterapia en telehealth con niños y adolescentes, por las que se han obtenido resultados similares a los de la musicoterapia presencial (Ahessy, 2021;Bompard et al, 2021;Cancer et al, 2021;Goicoechea & Lahue, 2021;Williams et al, 2021). También se crean programas grupales en línea para personas con demencia y sus cuidadores familiares, y programas comunitarios de apoyo social (Lee et al, 2021).…”