Autism – What It Really Is… and How Rhythm is the Key

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Article Review #2: Autism – What It Really Is… and How Rhythm is the Key

Since beginning at The George Center, I have come to realize that autism spectrum disorder (ASD) is so much more than what appears on the surface. From my undergraduate studies and interactions, I was familiar with some of the common symptoms: hypersensitivity, echolalia, repetitive movements and behaviors, but that was barely the tip of the iceberg. In the past month and a half, I have learned more about ASD than I have in the past 3 years at university. I am realizing how much scientists, parents, and the public know – and don’t know – about autism. For example, many think that people with autism are generally emotionally detached and have little interest in social interactions. However, if you read some of our clients’ blogs, it is very clear the answer is no. Any apparent lack of emotion is more likely due to a difficulty in planning the motor movements to show emotion: to smile, to frown, to speak, to touch gently. Try telling your loved ones how you felt about them if you couldn’t move a muscle with intentionality. Chances are you would smack them in the face or not move at all. If this is news to you, you might be wondering, “It’s a motor disorder? How?”

Lagasse and Hardy present an extensive amount of research into the neurological phenomena in the brains of people with autism. Although they report that the findings are not always consistent, they discuss some common areas of neurological difference in people with autism. (I am about to use some neurological terms, but please don’t run… I’ll explain).

Firstly, the cerebellum is significantly smaller in persons with autism. The cerebellum is the “general purpose device” that communicates with other neural systems and prepares for movement (Lagasse & Hardy, 2013, p. 68). Thus, deficits in the cerebellum impede a person’s ability to plan their movements – to smoothly and quickly target an object with the appropriate force and direction or to calculate the path of a stimulus. Also, Lagasse and Hardy highlight that  researchers have noted larger brain volume in the early childhood of people with autism (p. 68). This could indicate inefficient pruning of unneeded synapses. Lastly, connectivity within the brain is often different in people with autism. Both underconnectivity and overconnectivity have been reported, one of the complicated results of ASD being a spectrum disorder. Underconnectivity between parts of the brain that are far away from each other can cause motor delays or deficits, difficulties with motor sequencing, planning, motor inhibition, and motor execution (p. 69). Overconnectivity creates clutter and static that make communication between various brain structures inefficient. A frequently traversed and stronger pathway may “hijack” a signal travelling along a weaker connection. Because of this mixture of underconnectivity and overconnectivity,  a person with ASD may be hyposensitive to some stimuli and hypersensitive to others. Similarly, some movements may be very easy to execute, whereas other are very difficult.

Thus, the neurologic research suggests that autism is a deficit in processing sensory information from the environment and a difficulty in planning movements in response. This information significantly affects the treatment approach that therapists should take to effectively help clients progress. It is not that clients do not understand or care about the world around them. They are just trapped in their own bodies, trying to get the words out!

Music therapy is a unique tool to help my clients with motor planning. Entrainment – the phenomenon of your brain and body instinctively synchronizing to a given beat – has already been extensively explored in the gait regulation of clients with stroke (p. 71). Rhythm provides a framework for planning motor movements. It tells a person exactly how long it should take for them to move their limb from point A to point B, and most importantly how to pace the movement that comes in between.

Other musical elements may also facilitate motor planning (p. 72). For example, dynamics – the loudness or softness of sound – can cue the force of a movement. The range of pitches – how high or low – can cue the size of the movement. And of course, the style of the song itself can increase the client’s motivation to execute the movement.

Now that I understand that autism is a motor planning disorder, I can use the same principle of rhythm for organizing movement to help people with autism to plan their movement as well. Only with this essential foundation can we begin to address their ability to communicate and socialize!

At one time, I might have seen a person with ASD and assumed they were just clumsy and uncoordinated. Yet now, when I think about what really is happening within their brains, I realize it must be a scary experience to navigate their surroundings. Just as it is difficult to move around in your attic when it is full of junk from the past ten years, it can be difficult for signals in the brain to navigate amidst a clutter of synapses. I cannot begin to imagine the feeling of dreading every movement I made, not knowing whether I would hit the person next to me or grab a pencil too hard. For every object that approached,  I would just be hoping it would pass me by and not knock me to the ground.

Remembering how rhythm, dynamics, range, and style can affect motor coordination will be essential in helping me to treat my clients. An important part of my role as a therapist when working with my clients with autism will be to provide steady rhythmic support during activities that require some motor response from them – which is essentially the whole session. Additionally, using live music will enable me to adapt musically to the client’s needs in the moment. Just as I try to help my clients execute intentional movements, every element of my music-making and facilitation will require intentionality.

A touching expression from Peyton Goddard, an autism activist with autism himself, recorded in Lagasse and Hardy’s article captures the need for we therapists to give attention to the motor system before all else: “Trying to be the real me, rhythm helps the motor frenzy madness to stop. You are all too musically gifted to ignore the importance of rhythm. Please know my body  utmost lacks rhythm. In music therapy I’m benefitted by pairing to your upping rhythmic beats to motor my body. Trying to be me in harmony!’’

Reference

Lagasse, A. B. & Hardy, M.W.. (2013). Considering Rhythm for Sensorimotor Regulation in

Children with Autism Spectrum Disorders. Music Therapy Perspectives, 31, 67-77.



Songs, Sensory, and Social Skills: Group Music Therapy for Children with Autism

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The possibilities that music brings to the therapeutic process are endless. Communication, motor movement, processing, stimulation, sensory elements, and so much more are easily accessed through the use of music alone. As a new intern, my first weeks at the George Center have been full of observing all of this in action.  My mind seems to be more full than ever of examples of how music therapy is used to benefit the lives of individuals everyday. Considering all of this, as I chose my first journal article, I decided to pick something that addresses one of many populations that I am passionate about: children with autism.

In my experience, Autism Spectrum Disorder (ASD) presents itself differently in every child. There is beauty in this, but it definitely does NOT make an easy job for science. This diagnosis can still be a highly controversial in many settings and even homes. The history of therapy for this population can be both inspiring and heartbreaking to those who know how far the world of healthcare has come in regards to individuals with ASD. All of this is exciting as we see research lead to successes being documented, especially with music therapy.

According to the  article Effects of a Music Therapy Group Intervention on Enhancing Social Skills in Children with Autism, statistics show that 1 in 88 children in the United States are diagnosed with ASD (LaGasse, 2014). Since this study statistics have changed. According to the Center of Disease Control and Prevention 1 in 68 children now meet the criteria for ASD. Autism is defined in short, as a neurodevelopmental disorder. Current research suggests that neurological aspects influence specific features of ASD. Some of these directly relate to motor deficits and difficulties with sensory processing. However, research also confirms that individuals with ASD demonstrate different musical processing skills, in that the activation of their brain surpasses that of neurotypical or normally developing individuals (LaGasse, 2014). So, good news: music is a multisensory medium!  

You may ask, “What is one of the biggest challenges for children with ASD?” I would venture to say that one of the largest areas of focus in general is socialization and communication. Although this is a large focus, to achieve goals in this area the regulation of the sensory system is what current research has shown to be most important. Therefore, it may be language development we are trying to foster; other times it is socialization skills and interactions that are required on a daily basis that we are trying to build on or make more tolerable through music therapy. The areas of expressive, receptive, verbal, and nonverbal language all fall under social and communicative areas of development. One way music therapy can help children that battle issues like this is through group interventions. This article by LaGasse exemplifies recent successes in this area, so let’s jump into the details!

Studies show that music therapy can improve social behaviors and joint attention in children with ASD. LaGasse delves into what impact music therapy has in a group setting along with areas of focus within the groups relating to social skills, which included eye gaze, joint attention, and communication. To examine this in the study children ages 6-9 with ASD were assigned a music therapy group or a non-music therapy group. The children participated in two 50-minute sessions per week for 5 weeks, for a total of ten sessions during the study. Each group was designed to target social skills.

Social skills are important to be addressed in children with autism because the lack of development in these skills will have lifelong implications (LaGasse, 2014). It is stressed that social skills are needed in every relationship and activity. Noting this, another important piece of research is referenced in this article, stating that, “ The notion that persons with ASD do not want to be involved in their environment is being challenged as self-advocates with autism indicate that it is not a matter of wanting to interact; rather, they have an inability to follow through or tolerate the desired interaction” (Goddard & Goddard, 2012). Key words there are inability and desired.  As research like this advances, it is becoming more apparent that by helping develop these skills in children with ASD, we are also giving them tools to enhance their overall quality of life.

The outcome of this study was very interesting. Through the use of uniform scales to measure the changes in social behaviors, the results found over this brief period of time that the music therapy group showed more improvements. Positive differences primarily showed up in attention with peers and eye gaze towards individuals (LaGasse, 2014). After 10 sessions the mean for eye gaze variable in the final calculations increased by 3.73 for the music therapy group. The mean decreased 14.75 for the non music social skills group. The explanation of these results pointed toward musical structure being able to maintain children’s attention to their peers more than the prompts and visuals used in the nonmusical group.

These results are important because they validate techniques being used in music therapy and highlight an issue that has a lasting impact on the ASD population. In the music therapy group of this study, some intervention tools used were rhythmic cueing, rhythmic deep pressure exercises with songs, instrument playing, as well as music and movement. For both groups the goals were the same, however, outcomes for the music therapy group were different. Both groups had interventions revolving around group interactions, cooperative play, and sensory experiences. The rhythmic and structural components of music can provide a cue or foundation externally that assists individuals with ASD in organizing their responses to their surroundings (LaGasse, 2014). This fact only supports why the music therapy group had higher positive outcomes.

This article is one of many that scientifically support the use of music therapy for children with ASD. This type of research impacts my work as a future music therapist and as an advocate for individuals I serve because it supports the use of music as a therapeutic tool to reach nonusical goals. Going forward, I will continue to observe and participate in ASD groups with the mindset that this type of research gives of hope and a solid foundation to what possible benefits music therapy services can bring. There are opportunities everyday to observe success happening at the George Center. I appreciate the proactiveness, integrity, and assumed competence I have observed each therapist treat ASD clients with at this facility.

The importance of early intervention and consistent complimentary treatments like music therapy cannot be advised enough by professionals.  It is my hope that through being able to share small pieces of this, that parents, teachers, and current therapists will continue to take initiative and stay updated on ASD research. For this relates to our professions, our caregivers, our community, and most importantly our loved ones impacted by this diagnosis everyday. It is our job to advocate and support these children that cannot always access the ability to do so for themselves.   

 

 

A. Blythe LaGasse (2014). Effects of a Music Therapy Group Intervention on             Enhancing  Social Skills in Children with Autism, Journal of Music Therapy,         51,(3). 250–275.     


Goddard, P., & Goddard, D. (2012). I am intelligent: From heartbreak to healing- A         mother and daughter’s journey through autism. Guilford, CT: Skirt!

Round Up, November 18th

It's going to be a quiet week around the clinic, but your George Center therapists will be busier than ever! We'll be down in Jacksonville for our annual national music therapy conference! We'll post updates here on the blog and over on Facebook periodically to let you know what we're up to!

Autistic boy finds voice with Katy Perry's 'Roar' (Today)

 

Cool testament to the power of music here! This young boy has autism and is non-verbal. Previously, he had only been able to use one word at a time to make requests, yet is able to sing full lines of Katy Perry's "Roar." Music uses different neural pathways than speaking, which is one of the reasons individuals with brain damage who lose their ability to speak can sometimes still sing.

If I were this child's music therapist, I would put functional phrases ("I want water, please") to the tune of the song then slowly fade the music until he is able to speak the phrase. Great way to use music to attain a non-music goal!

 

Music as Medicine (Worcester Magazine)

 

Pretty extensive and well written write-up on a music therapy practice! Good information.

Can changes in the eyes help diagnose Alzheimer’s disease? (Fox News)

 

Alzheimer's patients' brains boosted by belting out Sound of Music (The Guardian)

More great research backing for music and Alzheimer's and dementia! This study found increased brain function for individuals with moderate to severe dementia who participated in sing-along groups compared to those who just listened to music across a four month period. Longer term studies like this are a very positive sign for the future of music therapy!

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Round Up, November 11th

Happy Monday, and a special Happy Veteran's Day to all those who have served! Your service is greatly appreciated by all.

Let's get to some links.

Using music therapy to strike a chord (Duluth News Tribune)

 

Great write up from up north on a local music therapist! These articles go a long way in increasing awareness amongst individual communities.

 

Pele Visits Nordoff Robbins Music Therapy (Look to the Stars)

 

Whoa! How cool is that?! One of the most famous athletes in the world visited a music therapy provider in England and talked about the impact of music therapy!

Childhood Music Lessons Could Benefit Your Brain Later On (Huffington Post)

 

How's this for a strong argument for music? Adults who took music lessons as children showed boosts in brain speed even decades after stopping their music lessons!

Study: Signs of Autism May Show Up As Early As First Month (CNN)

Eye contact as a sign of autism is nothing new, but the fact that it may be possible to detect in the first month of life certainly is. Great study from the Marcus Autism Center here in Atlanta.

'Saxophone Lung' Developed by Man Who Didn't Clean His Clarinet for More Than 30 Years (Huffington Post)

Note: despite what some believe, this is NOT what a music therapist does.

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Your Child Isn’t Special: Music Is The Thing

I am a music therapist. Music therapy is the use of music to attain non-musical goals. Yes, it is a real job and yes, I get paid to do it. So do several thousand other music therapists across the United States and even more across the globe. We are nationally board certified, licensed in some states, and many insurance companies even reimburse for our services. I may be partial, but I think I have the best job in the world.

Having said this, I do have a pet peeve when it comes to my profession. Many music therapists will tell you that they are annoyed when people assume that we are “just volunteer musicians” or that we play our “iPods for sick people”, or that we “provide therapy to musicians”. I was even once asked if I would play music for someone’s cat.

While those misconceptions about our profession are certainly less than savory, I want to tell you about my real pet peeve. It’s when a parent or family member of a potential client calls and says “I think music therapy would be good for my child or loved one because they really LOVE music”. Now you might be asking yourself, “what’s wrong with that?!” Let me tell you….

Who doesn’t love music? Seriously, I want you to think about this. Do you know any one that says, “Man, I really hate music! It’s so melodic, motivating, relaxing, inspiring, and joyous. It’s so annoying.”

So, when a parent or caregiver calls and says “Here is a child who can’t see. Music must be THE THING!” I say “Ugh.” It’s the same thing I hear everyday. Here is a child who can’t walk. Music must be the thing! Here is a child who can’t speak. Music must be the thing! Here is a child with emotion/behavior disorder. Music must be the thing! I’ll let you in on a little secret. Music IS the thing!

Every culture since the beginning of time has used music in healing, as a way to communicate, and as a way of bringing people together. Humans use music to celebrate life and death. We use music in politics, war, religion, sports and recreation, love and heartache (you know you have your go to break up song or your feel good summer jam). We sing lullabies to our newborn babies and we celebrate the lives of those passed on by playing music at their memorials. We memorize lyrics and post them to our Facebook pages because no words we could ever write ourselves could possibly encompass our feelings so completely. The songwriter must have known my story!

The fact is research has shown that music has a profound effect on the human body and psyche. Music is one of the ONLY activities that activates, stimulates, and uses the ENTIRE brain. Biomedical researchers have found that music is a highly structured auditory language involving complex perception, cognition, and motor control in the brain and therefore it can effectively be used to retrain and reeducate the injured brain. Brain imaging techniques have revealed brain plasticity (its ability to change) and research clearly shows that music learning causes the auditory and motor areas in the brain grow larger and interact more efficiently.

Stroke patients are able to walk faster and with better control over their bodies by following rhythmic cues. Adults with from Alzheimer’s are able to recall memories and feelings through the use of familiar and preferred music. Children with Apraxia of speech are able to recall and complete phrases when given a melodic cue. Premature infants increase their sucking rates 2.5 times when exposed to music, helping to improve nutritive sucking and increase their weight. Studies show that music-making improves test scores in standardized tests, as well as in reading proficiency exams.High school music students score higher on the math and verbal portion of SAT, compared to their peers. Yet we wonder why our students math and science grades continue to decline after we have removed music programs from our schools. An education in the arts promotes abstract and creative thinking, but we don’t really need to be able to extrapolate information to form new and innovative ideas, do we? Let’s cut it.

So, I apologize if I sound like a smarta**. But no, your child is not special. We ALL love music. Music therapy is not good for them because they love music, it is good for them because music is the thing. And while there are those who are much more gifted at music than others, we as humans can always share our love of music with the world. You know why? Say it with me now… “Because music is the thing.”

See just what music can do! Sign up for a free consultation to learn more about music therapy!

 

 

Image credit: Flickr user basykes

Round Up, October 7th

Welcome to a new week! Every Monday, we bring you a collection of the best stories and links on music therapy, autism, Alzheimer's, healthcare, and more! Let's get to 'em!

Playing musical instrument 'sharpens mind' says St Andrews study (BBC)

Good news for those of us who enjoy picking out a tune! This study found that musicians (amateurs, no less!) are better at recognizing and correcting their mistakes. Study music, folks!

Saving the sight of preterm babies (Science Alert)

Vision loss is a very common and very significant side effect of necessary medical treatments in the NICU. This study found that treatment with near infared (NIR) light can reduce some of this damage and help prevent the leading cause of blindness in developed countries.

Studies have shown that certain music therapy techniques can increase oxygen saturation levels, thus decreasing the need for supplemental oxygen and reducing the risk of vision damage.

Enrollment grows in Drury's music therapy program (News-Leader.com)

Always good to see music therapy degree programs growing! Doesn't hurt that the faculty at Drury is top notch.

Missing Genes More Likely in Those With Autism (Psych Central)

Interesting read here from Psych Central that discusses some of the genetic components of autism.

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Round Up, September 30th

Happy new week! There were some stories on how music affects the brain in some big name publications this week that we're excited to share with you, but we're going to lead things off with a very special article to our crew here at The George Center. Check it out!

Sweet music to their ears (Atlanta Journal Constitution)

 

Our very own Jamie George was featured in an interview for the Atlanta Journal Constitution! If you follow us on Facebook, you've already seen this one. The article is mainly about the music therapy licensure bill that Jamie was integral in getting passed. #2 on my prediction list has been fulfilled with 3 months to spare.

The Power of Music to Affect the Brain (NPR)

 

You can click the link or listen to the story right here! This is a cool story from NPR all about how music effects the brain, and even details some specific music therapy techniques.

How Music Makes Us Feel Better (The New Yorker)

While not specifically about music therapy, this is a neat long form write up in the New Yorker about some research being done in Japan about how music effects our emotions.

Actress Daryl Hannah is an Autistic Woman (Forbes)

Daryl Hannah is an actress who has appeared in films such as "Wall Street" and "Kill Bill." She also revealed this week that she has autism. Autism is far more common in males than females, and this article discusses some of the details behind that. However, it can be very encouraging for parents and for individuals with autism to see highly successful public figures. It also can help change negative public perceptions of autism. I think that why this story has gained so much attention.

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Round Up, September 23rd

Welcome to the new week! This week's Round Up is short on music therapy news, but we've got some very interesting Alzheimer's and autism links to share today! Check 'em out.

 

New Brain Scans For Alzheimer's May Mean Earlier Diagnosis (Forbes)

Very interesting study here. Alzheimer's is notoriously difficult to diagnose, with no single clinical test existing that can identify the disease. If doctors were able to diagnose Alzheimer's through a brain scan, it could mean earlier diagnoses and better results for patients.

 

Georgia autism partnership looks to training opportunities, early detection, support for families (Washington Post)

 

Great local story here about a partnership between the Marcus Autism Center and the Georgia Department of Early Care and Learning to train day care operators to recognize early signs of autism and support parents.

 

Music Therapists Bring Healing Through Tunes and Beats (Houston Press) 

Check out this write up on music therapy featuring our colleague Bill Matney!

Music Therapy Ride raises $65,000 (Pique)

 

This annual motorcycle fundraiser brought in $65,000 for music therapy in Canada this year! How awesome is that?!

Interested in seeing music therapy first hand? Sign up for a free consultation!