The Effect of Music Attention Control Training (MACT) on Attention Skills of Adolescents with Neurodevelopmental Delays: A Pilot Study
Varvara Pasiali, A. Blythe LaGasse, Saundra L. Penn
Reviewed by Florencia Rusinol, music therapy intern
The authors of this study began by providing support on how music-based experiences motivate children to with ASD and help gain and maintain engagement. They shared research of how music can be useful in the processes of attention and auditory processing, and how the sense of “reward and motivation to participate in music experiences may impact attention” (Pasiali, LaGasse, & Penn, 336). The authors also provided examples of how music-based experiences have improved joint-attention skills in children with ASD, and that music is adaptable enough for music therapists to individualize the attention training during sessions.
The purpose of the study was to determine the feasibility of Music Attention Control Training (MACT), a music therapy intervention developed by Michael Thaut, on attention in adolescents with neurodevelopmental delays. Additionally, the purpose was also to gather preliminary evidence on the effects of the intervention on attention.
Participants for this study included 9 adolescents (ages 13-20) with Autism Spectrum Disorder (ASD) that were recruited from a private school for high-functioning adolescents with neurodevelopmental disabilities. The participants ranged from minimal to severe symptoms. The study was designed as a single group pre- and post-test, meaning there was no control group. Previous to the sessions, participants were tested using the Test of Everyday Attention for Children (TEA-Ch) and the participants’ teachers completed the High Functioning Version of t the Childhood Autism Rating Scale (CARS2-HF) to indicate autism severity.
Students participated in eight 45-minute sessions over six weeks in which the board-certified music therapist and researcher used Music Attention Control Training as the primary music therapy technique. The author notes using a variety of interventions such as Orff-based musical tasks, structured drumming/rhythm experiences, and improvisation. She included a variety of songs and chants, body percussion, pitched/non-pitched percussion, and vocal or rhythmic ostinatos during the sessions. The author addressed sustained attention primarily by prompting the participants to respond to changes in the musical stimulus, such as but not limited to tempo, dynamics, or rhythmic patterns. To address selective attention, participants had to focus on specific musical cues while ignoring other stimuli. One particular intervention used was teaching the participants specific patterns and having them sustain that pattern while the researcher attempts to distract them from their task. Lastly, attentional control/switching attention was addressed during interventions that required participants to focus on two musical stimuli at the same time.
This research study showed that, in this case, it was indeed feasible to conduct this study, and use MACT as the primary technique. The school setting complicated study procedures because of special events and school holidays, which the authors note may have affected the study. One hundred percent of parents gave parental consent and teachers were cooperative, which also leant to the feasibility of this study. Overall, researchers stated that the data indicated positive trends in the outcomes related to selective and attentional control/switching attention, and found no trends in sustained attention. (The authors note that this was not surprising, as research shows that individuals with ASD do not have sustained attention deficits.) The authors conclude by cautioning result interpretation because of small sample size, lack of control group, and potential bias. I agree that the lack of a control group makes this study difficult to generalize across the ASD population. Perhaps future researchers can test this modality against a group receiving a different form or therapy or no therapy at all. Also, this study was done at a single school. In future research, a study involving several ASD groups at several schools may be more widely interpreted. The authors do suggest that the study serve as initial evidence that MACT may assist in developing attention skills in adolescents with ASD and that the pursuit of a larger controlled trial is warranted after this study.
While I do believe that joint attention is necessary to improve schooling for individuals with ASD, I question whether there are more important needs to be met before joint attention can be addressed. During my internship, I have witnessed a much larger focus on meeting sensory and emotional needs before working on tasks such as attention. I wonder how this research could have been more effective had the session started in a sensory-based intervention, or sensory breaks had been given throughout the session. Furthermore, providing an emotional check-in at the beginning of the group, especially because the teenage years can be a very emotional time, may have contributed to higher response rates in attention. In future research, I hope to see a more holistic approach to attention with individuals with autism, recognizing which needs are primary to the clients themselves.
Pasiali, V., LaGasse, A. B., & Penn, S. L. (2014). The effect of musical attention control training (MACT) on attention skills of adolescents with neurodevelopmental delays: A pilot study. Journal of Music Therapy 51(4), 333-354. doi: 10.1093/jmt/thu030