Guest Work: Research and ASD Techniques

This is an article by my colleague and fellow music therapist, Denise Coovert.  She works with many populations, but specializes in children with Autism Spectrum Disorders.  This is a review of a recent research article out of the Journal of Music Therapy.  She reminds us of the importance of staying up to date on research-based techniques and applying them in our practice.  Thanks for the summary!

“Effect of ‘Developmental Speech and Language Training Through Music’ on Speech Production in Children with Autism Spectrum Disorders” by Hayoung A. Lim, PhD, MT-BC, NMT: A Summary and Review

Review by: Denise Coovert, MT-BC

Getting the Journal of Music Therapy each season reminds me of the strong, motivated network of music therapists in the world breaking new ground in music therapy research. Working in a small community in the Midwest, I sometimes feel isolated from the abundance of quality experiments, techniques and tools available to me as a music therapist. The more I practice, the more I realize how vital it is to read, understand and implement the research music therapists present in the Journal of Music Therapy and other publications. This article caught my attention for two reasons. I have the privilege of working with children with ASD and desire to know about new, research-supported techniques used with this population.  It is relevant because I am currently developing interventions to address speech production, vocabulary expansion and language comprehension with my clients.

The study experimented with music and language using a Neurologic Music Therapy technique known as developmental speech and language training through music (DSLM). This technique, among many others, was developed in part by Dr. Michael Thaut, and provides a framework of music therapy known as Neurologic Music Therapy (NMT). This theory uses knowledge of music, the brain and how they interact to encourage desired behavior through music.  The use of technique is explained in the article and opens with some very helpful background on ASD and the use of language with this population.

50 participants, ages 3-5, who had been previously diagnosed with ASD were included in the study. A scale was used to determine the children’s functioning level for use in data analysis after the study was complete. This data did not influence which group the participant was placed in or how they were tested in the study. 36 age appropriate, target vocabulary words were selected for the participants to learn. The testing materials included pre and posttests with fill-in-the-blank phrases with the target word at the end of each phrase. Six sets of phrases or songs were composed to include six different target words, and each of these sets was video recorded for use in the study. Each target word was also paired with a PECS symbol to aid in comprehension for the participants. The participants were randomly divided into three groups: control, speech and music. The control group only took the pre and posttests and did not watch any videos. The speech group watched a recording of a person speaking the phrases with the target words (with PECS) and each child watched the video two times consecutively and watched the video two times per day for three days (24 viewings total). The music group watched a video of the same phrases, this time sung with guitar accompaniment, and again watched the video two times per day for three days (24 viewings total).

The pre and posttests consisted of an investigator stating each phrase while leaving out the target word. Each child was instructed to state the target word left out of the phrase. Investigators were looking at the following aspects of speech: semantics (meaning), phonology (pronunciation), pragmatics (language and context), prosody (tone), vocal stress (syllable stress), and vowel sounds. All together, each participant could earn between 0-6 points for each word for a total of 216 points. The article describes in detail the protocol for determining each participant’s effectiveness of stating the word and therefore earning more points.

Results showed that both music training and speech training significantly increased the participant’s scores when compared with the control group. There was no significant difference between the music and speech group on the participants. The high functioning level participants more greatly improved their score when compared with participants with a lower functioning level, though the analysis showed the lower function participants produced positive score changes in the music training and not the speech training. The higher functioning group showed positive score changes in both variables.

Music and speech training are both effective in improving vocabulary in children with ASD. It should be noted that lower functioning children were more affected by the music training. Also, children who participated in the music training produced speech sounds, rather than musical imitation, during the posttest showing the development of a functional behavior rather than a memorization of song. The study also monitors the participant’s with echolalia and how is effective their results. The data shows that participants with echolalia and their level of functioning are positively related and therefore affected their posttest outcome.

This article goes on to address and discuss the possibilities and explanations for the outcomes of the study. The study is an excellent resource to music therapists looking for documentation to present to school districts to explain music therapy’s effectiveness and reliability. More research is needed to test the video music sessions versus live music sessions on the speech production variable and to answer how this technique can be applied in other areas of music therapy. Many clients with goals of increasing vocabulary and speech production can benefit from this technique and I am looking forward to using this strategy with my clients.