Music improves social communication and brain connectivity outcomes in children with autism: A randomized controlled trial

Abstract

Music has been identified as a strength in people with Autism Spectrum Disorder, however, there is currently no neuroscientific evidence supporting its benefits. Given its universal appeal, intrinsic reward value and ability to modify brain and behaviour, music may be a potential therapeutic aid in autism. Here, we evaluated the neurobehavioral outcomes of a music intervention, compared to a non-music control intervention, on social communication and brain connectivity in school-age children (ISRCTN26821793). Fifty-one 6-12 year olds with autism were randomized to receive 8-12 weeks of music (n=26) or non-music intervention (n=25). The music intervention involved use of improvisational approaches through song and rhythm to target social communication. The non-music control was a structurally-matched behavioural intervention implemented in a non-musical context. Groups were assessed before and after intervention on social communication and resting-state functional connectivity of fronto-temporal brain networks. Communication scores were higher in the music group post-intervention (difference score=4.84, P=.01). Associated post-intervention resting-state brain functional connectivity was greater in music versus non-music groups between auditory and subcortical regions (z=3.94, P<.0001) and auditory and fronto-motor regions (z=3.16, P<.0001). Post-intervention brain connectivity was lower between auditory and visual regions in music compared to non-music groups, known to be over-connected in autism (z=4.01, P<.00001). Post-intervention brain connectivity in the music group was related to communication improvement (z=3.57, P<.0001). This study provides the first evidence that 8-12 weeks of individual music intervention can indeed improve social communication and functional brain connectivity, lending support to further investigations of neurobiologically-motivated models of music interventions in autism.

Features of the application of art-therapeutic and gaming technology based on folk music in rehabilitation and socialization of children with health limitations

“…However, in addition to the regulatory function, music performs the important function of activating the child's brain. Our hypothesis is partly similar to the findings of Canadian scientists who "evaluated the neurobehavioral outcomes of a music intervention on social communication and brain connectivity in school-age children," and their study "provides the first evidence that 8-12 weeks of individual music intervention can indeed improve social communication and functional brain connectivity" [24]. However, unlike previous practices of music therapy, the present experiment proves the possibility of forming not only the key capabilities for the development of communicative and cognitive abilities in children with DPVD and early autism, such as the time of productive activity; the ability to concentrate; attentional set-shifting; speech development; and understanding of oral speech but also complex creative abilities such as musical ear, sense of rhythm, and the ability to play instruments, which are acquired in the course of special training.…”

PRESS-Play: Musical Engagement as a Motivating Platform for Social Interaction and Social Play in Young Children with ASD

“…In a separate, randomized controlled trial, school-aged children with autism participated in music therapy sessions that used music (musical instruments, songs, and rhythmic cues) to target communication, turn-taking, sensorimotor integration, and social appropriateness or a parallel non-music play therapy (Sharda et al, 2018). Children in the music therapy condition exhibited increased auditory-motor functional connectivity post-intervention compared to children in a parallel non-music play therapy (Sharda et al, 2018). Functional connectivity levels between multiple auditory and subcortical areas (thalamus, striatum) post-music therapy was associated with parent-reported communication skills (Sharda et al, 2018).…”

“…In preliminary investigations, school-aged children participating in Auditory-Motor Mapping Training increased consonant and vowel speech production skills versus children in a control Speech Repetition therapy (Chenausky et al, 2016; Chenausky et al, 2017). In a separate, randomized controlled trial, school-aged children with autism participated in music therapy sessions that used music (musical instruments, songs, and rhythmic cues) to target communication, turn-taking, sensorimotor integration, and social appropriateness or a parallel non-music play therapy (Sharda et al, 2018). Children in the music therapy condition exhibited increased auditory-motor functional connectivity post-intervention compared to children in a parallel non-music play therapy (Sharda et al, 2018).…”

“…Music perception and production engages multiple areas and networks of the brain involving sensory, motor, emotional, attentional, and social processes leading to hypotheses that musical experiences may transfer to non-musical skills due to shared neural resources (e.g., Patel, 2011; Wan & Schlaug, 2010). These hypotheses have been applied to music therapy approaches for children with ASD, particularly through the lens of musical experiences impacting neural pathways involved in attention, sensory, motor, and emotional processes that support social communication (Janzen & Thaut, 2018; Overy & Molnar-Szakacs, 2009; Sharda et al, 2018; Trevarthen, 2002; Wan et al, 2011; see Janzen & Thaut (2018), Geretsegger et al (2014) or Srinivasan & Bhat (2013) for reviews of music therapy approaches and findings). There are credible, albeit limited, studies supporting musical engagement for non-musical social and communicative goals for children with ASD, including those drawn from music therapy (Geretsegger et al, 2014; Kim et al, 2008; Sharda et al, 2018) and music education (Cook et al, 2018; Kern et al, 2007; McFerran et al, 2016) literatures.…”

“…These hypotheses have been applied to music therapy approaches for children with ASD, particularly through the lens of musical experiences impacting neural pathways involved in attention, sensory, motor, and emotional processes that support social communication (Janzen & Thaut, 2018; Overy & Molnar-Szakacs, 2009; Sharda et al, 2018; Trevarthen, 2002; Wan et al, 2011; see Janzen & Thaut (2018), Geretsegger et al (2014) or Srinivasan & Bhat (2013) for reviews of music therapy approaches and findings). There are credible, albeit limited, studies supporting musical engagement for non-musical social and communicative goals for children with ASD, including those drawn from music therapy (Geretsegger et al, 2014; Kim et al, 2008; Sharda et al, 2018) and music education (Cook et al, 2018; Kern et al, 2007; McFerran et al, 2016) literatures. At the same time, a large-scale improvisational music therapy trial did not yield effects on autism symptoms relative to a non-music treatment (e.g., Bieleninik et al, 2017; though note concerns with intervention fidelity and outcome measures) and debates continue over the effectiveness of specific therapeutic approaches (Accordino et al, 2007; Sharda et al, 2019; Sreewichian, 2019).…”