Autism - Children's Improvisational Music Therapy Evaluation (CHIME)

March 24, 2025 updated by: Prof Simon Baron-Cohen

A Randomised Controlled Trial on the Effectiveness of Improvisational Music Therapy for Autistic Children Aged 7 - 11 [Autism-CHIME Trial].

The goal of this clinical trial is to evaluate the effectiveness of individual sessions of improvisational music therapy for autistic children aged 7 - 11.

Researchers will compare the impact of adding improvisational music therapy to usual care alone for autistic children over a 12-week period.

Participants will be randomly assigned to one of the following two conditions: the Improvisational Music Therapy (intervention) Group or the support as usual (control) Group.

The aim is to achieve seven overarching objectives:

  1. To determine whether 12 weeks of individual sessions of improvisational music therapy in addition to support as usual is superior to support as usual alone in improving social communication in autistic children.
  2. To examine whether 12 weeks of individual sessions of improvisational music therapy in addition to support as usual is superior to support as usual alone in improving communication skills in autistic children.
  3. To examine whether 12 weeks of individual sessions of improvisational music therapy in addition to support as usual is superior to support as usual alone in reducing psychosocial problems in autistic children.
  4. To examine whether 12 weeks of individual sessions of improvisational music therapy in addition to support as usual is superior to support as usual alone in improving wellbeing of autistic children.
  5. To examine whether 12 weeks of individual sessions of improvisational music therapy in addition to support as usual is superior to support as usual alone in improving adaptive functioning in autistic children.
  6. To examine whether 12 weeks of individual sessions of improvisational music therapy in addition to support as usual is superior to support as usual alone in improving anxiety in autistic children.
  7. To examine whether the therapeutic relationship predicts the development of social, communication and language skills among autistic children.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Co-Chief Investigators Professor Simon Baron-Cohen Dr Carrie Allison Dr David M. Greenberg Dr. Jonathan Pool

Co-Investigators Dr Artur Jaschke

Advisor Emeritus Professor Helen Odell-Miller Dr. Claire Howlin

The Autism-CHIME trial is designed as a rigorous Randomised Controlled Trial (RCT) of individual sessions of improvisational music therapy with autistic children. The trial will be conducted in mainstream and special schools located in Cambridgeshire, Peterborough, London, and the South and East of England. The number of schools involved will depend on the number of eligible children willing to participate, with a minimum of 5-10 children per school.

Enrolled participants will undergo 1:1 block randomisation, to either support as usual plus improvisational music therapy sessions (intervention arm) or support as usual (control arm). Randomisation will occur after the baseline assessments have been completed. Participants will be stratified based on the version of the Brief Observation of Social Communication Change (BOSCC) that they are allocated (primary outcome measure): (1) Minimally Verbal, (2) Phrase Speakers, or (3) Fluent Speakers, so that there are equal numbers in each group, and that the control group and experimental group are balanced.

Data will be collected at different time points during the trial:

The first data collection point (T1) will be collected prior to randomisation (to establish eligibility to participate and assess baseline functioning), and at the primary endpoint T2 (13 weeks after randomisation; end of intervention) and the secondary endpoint T3 will be 39 weeks post-randomisation (i.e. 6 months after the end of music therapy).

The trial will finish after the final follow-up data collection from the participants is completed.

Study Type

Interventional

Enrollment (Estimated)

240

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Simon Baron-Cohen, Professor
  • Phone Number: 01223 465215
  • Email: sb205@cam.ac.uk

Study Contact Backup

Study Locations

  • United Kingdom
      • Cambridge, United Kingdom, CB1 1PT
        • Recruiting
        • Anglia Ruskin University
        • Contact:
          • Jonathan Pool, PhD
      • Cambridge, United Kingdom, CB2 8AH
        • Recruiting
        • Autism Research Centre
        • Contact:
          • Artur Jaschke, PhD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Aged 7 to 11 years.
  • A clinical diagnosis of autism made by a qualified professional according to the International Classification of Diseases (ICD) 10th Revision criteria. Confirmed by a copy of the clinical report detailing the diagnosis (if available) or verified verbally by the child's parents.
  • Parents/guardians must give informed consent for their children to be enrolled in the trial.
  • Parents/guardians must be willing for the music therapy sessions and BOSCC assessments to be video recorded for monitoring and research purpose
  • Participants must be willing to attend two music therapy sessions per week for the duration of the trial.
  • Non-verbal children may be included

Exclusion Criteria:

  • Received regular individual music therapy in the preceding year as this would be likely to have a strong influence on the course of therapy.
  • Severe hearing deficit as this would alter the aim, course, and implementation of therapy.
  • Caregivers that are unable to attend for the psychological assessments with their child.
  • Caregivers without a basic understanding of English.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Support as usual control Group
Participants allocated to 'support as usual' will receive routine support from their general practitioners (GPs), mental health and education/allied health professionals. Support as usual is defined as normal practice for each school in addition to the usual support from the specialist teaching teams for autism in the area, or any other additional therapies intended to support communication skills or wellbeing for autistic children. They will not receive the individual music therapy intervention or any extra support services from the research team. Any concomitant treatment or therapeutic interventions that participating children might receive will be recorded during assessment sessions before randomisation, and following the primary endpoint, specifying the kind and amount or frequency of intervention.
Experimental: Improvisational Music Therapy
Participating children randomised to the Improvisational Music Therapy (intervention) Group will receive 30-minute individual music therapy sessions two times per week over a 12-week period. These will be delivered by academically trained Health and Care Professions Council (HCPC)-registered music therapists in the United Kingdom (master's level or equivalent) with clinical experience of working with autistic children. Each child in the intervention arm will receive 24 sessions of music therapy over a 12-week period. A music therapy training manual will be used to guide music therapists.
Behavioral: Improvisational Music Therapy
The therapist engages with the child by playing and sharing musical instruments, and/or sings while being attuned to the child's behaviour and expression. Various improvisational techniques are employed to engage the child. There are opportunities for pulse, rhythmic, dynamic or melodic patterns, and timbre to be mirrored, reinforced, or complemented, which allows for moments of synchronization between the therapist and the child, giving the child's musical expressions a pragmatic meaning within this context. The therapist may also gently provoke the child by violating expectations or patterns that have been jointly developed in order to elicit specific social communication behaviours. Further, there are opportunities for the child to develop and enhance social communication skills such as joint attention, sharing affect, reciprocity, shared history, scaffolding, imitation and turn-taking. These have been shown to develop social competency and also resilience.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Absolute change of the total score of the Brief Observation of Social Communication Change (BOSCC). One of three versions of the BOSCC will be used depending on the child's level of verbal communication.
Time Frame: Baseline and at the end of intervention (13 weeks after randomisation).
The BOSCC consists of specific items that were developed to identify changes in social-communication behaviours over relatively short periods of time by quantifying subtleties in both the frequency and the quality of specific behaviours. There are three forms of the BOSCC: one for individuals who are minimally verbal (MV), one for those with phrase speech/young fluent speakers (PS/YF up to age 6 - 8) and one for fluent speakers (F1/F2 with two sets of materials, one for children and one for adolescents and adults). Scores are based on the observation of social communicative behaviour during naturalistic interactions between a child and an adult.
Baseline and at the end of intervention (13 weeks after randomisation).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Absolute change of the total score of the BOSCC.
Time Frame: Baseline and 39 weeks after randomisation.
The BOSCC consists of specific items that were developed to identify changes in social-communication behaviours.
Baseline and 39 weeks after randomisation.
Absolute change of the total score of the Children's Communication Checklist-2 to test improvement in communication skills.
Time Frame: Baseline, 13 and 39 weeks after randomisation.
Measure designed to assess the communication skills of children 4 to 16. It includes two domains: Language (Speech, Syntax, Semantics, Coherence) and Pragmatics (Initiation, Scripted Language, Context, Nonverbal Communication, Social Relations, Interests).
Baseline, 13 and 39 weeks after randomisation.
Association between the therapeutic relationship and the development of social, communication and language skills.
Time Frame: Weeks 1 and 12
The therapeutic relationship will be measured using the Assessment of the Quality of Relationship (AQR), based on video recordings of the first and last of music therapy to evaluate the association between the therapeutic relationship and the development of social, communication and language skills in children allocated to the music therapy intervention.
Weeks 1 and 12
Absolute change of the total score of the Strengths and Difficulties Questionnaire to test improvement in psychosocial difficulties
Time Frame: Baseline, 13 and 39 weeks after randomisation.
Questionnaire of behavioural and emotional difficulties suitable for children aged 3-16 years old. It addresses different dimensions: emotional problems, conduct problems, hyperactivity/inattention problems, peer problems and prosocial behaviour.
Baseline, 13 and 39 weeks after randomisation.
Absolute change of the total score of the Young Child Outcome Rating Scale (YCORS) as a measure of wellbeing.
Time Frame: Baseline, 13 and 39 weeks after randomisation.
Engaging young children regarding their assessment of how they are doing using child friendly language (faces).
Baseline, 13 and 39 weeks after randomisation.
Absolute change of the total score of the Parent-Rated Anxiety Scale (PRAS) for Youth with Autism Spectrum Disorder (ASD) as a measure of anxiety.
Time Frame: Baseline, 13 and 39 weeks after randomisation.
The PRAS-ASD is a 25-item, parent-reported measure of anxiety symptoms in youth with ASD (age 5-17 years).
Baseline, 13 and 39 weeks after randomisation.
Absolute change of the total score of the Music Therapy Communication and Social Interaction Scale (MTCSI) (or Music Engagement Scale, MES) based on video recordings.
Time Frame: Weeks 1 and 12.
Measured based on video recordings of the first and last weeks of music therapy in all of the children allocated to the music therapy intervention) to evaluate communicative and socially interactive responses that are elicited during music therapy sessions.
Weeks 1 and 12.
Absolute change of the total score of the Vineland-3 Domain level parent/caregiver form to test improvement in adaptive functioning.
Time Frame: Baseline, 13 and 39 weeks after randomisation.
Measure of adaptive functioning including Communication domain, Daily living skills domain and Socialization domain.
Baseline, 13 and 39 weeks after randomisation.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Prof Simon Baron-Cohen

Collaborators

Anglia Ruskin University
Rosetrees Trust
Musical Universe
Stoneygate Trust
Autism Centre of Excellence

Investigators

  • Principal Investigator: Jonathan Pool, PhD, Cambridge Institute for Music Therapy Research. Anglia Ruskin University, Cambridge
  • Principal Investigator: David M. David M. Greenberg, PhD, Musical Universe Inc. USA

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 13, 2023

Primary Completion (Estimated)

December 1, 2025

Study Completion (Estimated)

December 1, 2025

Study Registration Dates

First Submitted

August 19, 2023

First Submitted That Met QC Criteria

August 19, 2023

First Posted (Actual)

August 29, 2023

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 24, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PRE.2022.077
  • ETH2223-3184 (Other Identifier: Anglia Ruskin University Research Ethics Panel)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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