Music Therapy

 Music Therapy for Children with Special Needs

Music therapists use musical interactions and interventions to help children and adults with special needs learn both functional and academic skills necessary to lead independent, fulfilling lives. Music therapists work with individuals at all levels of abilities and challenges, including disorders such as cerebral palsy, autism spectrum disorder, pervasive developmental disorders, and attention deficit/hyperactivity disorder. Music therapy services can take place in school and/or in the home. Many times children with special needs are first included in general music education classrooms prior to integrating into math or reading classrooms.


Common music therapy goal areas include improving motor skills, communication, academic skills, and addressing pre-academic skills such as attention span, following directions, and eye contact. Playing instruments and singing songs can incorporate both academic concepts within the songs themselves and encourage positive group participation.


Music therapy services can be covered through an Individual Education Plan (IEP) and delivered by a qualified music therapist within a school system. Music therapists work on several levels within school systems, such as consultants to regular classroom teachers or music educators. Sometimes music therapists work in tandem with other special education teachers and therapists to maximize the benefits of special education services. Services can also sometimes be covered through home-based Medicaid waiver programs.

Music Therapy and Autism (ASD)
Individuals diagnosed along the Autism Spectrum often show a keen interest for music, which makes music therapy a useful modality for most individuals. Autism spectrum disorder is characterized by disturbances in four areas: development rates and/or sequences; responses to visual, auditory, and tactile stimuli; speech, language cognition; and social relationships.

Developmental Delays:
There are several behaviors that the Autism Society of America recommends watching for: lack of spoken language, repetitive behaviors, limited or no eye contact, few to no friends, and failing to engage in imaginative play like typically developing children. Parents and caregivers may observe isolated abilities in such areas as math, music, or art.

Speech/Language/Cognitive Delays:
Children with autism spectrum disorder experience major difficulties with social interaction and communication. Commonly, there are severe disturbances in both verbal and nonverbal communication skills. An example of this is echolalic speech, where the child repeats a sound, word or phrase that has little to do with the surrounding environment. There are characteristics speech patterns of children who have autism, such as lack of verbal imitation, a failure to use verbs in sentences, and pronoun reversal. Cognitively, seventy percent of autistic individuals are mentally handicapped, with 40% with an IQ less than 50 (Average IQ scores are around 100 points). However, there are a small percentage of individuals who are highly intelligent.

Social Relationships:
Individuals with autism experience a major difficulties relating to other people. They may have very little eye contact and/or flat facial expressions. Social relationships are further hampered by prolonged emotional outbursts (both temper tantrums and laughing) for no apparent reason.

Primary goals of therapy:
Not surprisingly, social-behavioral goals such as decreasing attention-interrupting behaviors and encouraging cooperative play are major foci for individuals with autism. Additional goals areas include independent living and self help skills such as activities of daily living, fine and gross motor skills, educational skills, and language development (receptive and expressive language skills).

Many if not all of these goal areas can be addressed within a music therapy treatment plan. There is promising research evidence that music therapy is useful in addressing some of the communication and social problems that children with ASD demonstrate. 1 Many autistic children respond more often and aptly to music than to other auditory stimuli. 2 Since music is a common language, especially for children, it creates a non-threatening environment that encourages social interaction, learning, and expression. 3
Music therapy interventions for individuals with autism can include vocalization exercises, singing and chanting, moving to music, musical games, instrumental performances and music listening. Research suggests that music therapy is especially beneficial in improving communication and social relationships. The following are examples of specific goals areas and corresponding music therapy interventions.

Communication:

Music is sometimes called a universal language. Music therapists take advantage of this characteristic by encouraging patients to engage in a musical question and answer session, providing a musical example of how verbal communication takes place. This often helps individuals imitate the prosody or natural melodic contour of speech.
Action-Songs are songs that have lyrics that provide directions for movement. These types of active interventions provide an opportunity to integrate rhythm, body percussion and vocalization. This helps individual become more aware of their environment and how to interact with others.

Playing wind instruments, such as harmonica or kazoo can help strengthen the muscles needed for speech. Vocal improvisation and breathing exercises also help strengthen muscles and prepare for speech exercises.
Social and Emotional Development:

Some of the primary, initial goals for music therapy may include minimizing sensory overload, rituals, and destructive behavior. This then allows the music therapist and patient to build relationships through live musical interactions. Imitation, eye contact, and taking turns can all be social responses within a musical environment. Individuals with autism can also learn to be more social through singing, moving, dancing and instrument playing. They can also learn to associate different types of music with feelings.

Cognitive Development:
Music, specifically lyrics, can be a carrier of nonmusical information than reinforces learning academic, social, and emotional concepts. How did you learn your ABCs, maybe a little Twinkle, Twinkle Little Star? This is a prime example of how to incorporate academic concepts into song to enhance learning. There are many songs that a music therapist may use or, she may compose her own for a specific individual that reinforces specific concepts.

Children on the autism spectrum can benefit from music therapy by increasing communication through development of speech and language skills. Music therapists may sing or have children sing songs that contain words or sounds that are a focus for improvement. The children may engage in active music making to help develop social skills. Active music making in groups gives a child the opportunity to practice taking turns, sharing, and interacting with other children, all of which encourage developmentally appropriate symbolic and imaginative play. Successful music experiences can reinforce and encourage additional positive changes in behavior.

1 Gold C, Wigram T, Elefant C. Music therapy for autistic spectrum disorder. Cochrane Database Syst Rev. 2006(2):CD004381.

2 Thaut MH. Music Therapy with Autistic Children. In: Davis WB, Gfeller KE, Thaut MH. An introduction to music therapy: theory and practice. 2nd ed. Boston, Mass: McGraw-Hill; 1999.

3 AMTA. Music therapy and individuals with diagnoses on the autism spectrum. American Music Therapy Association