Music therapy as social skill intervention for children with comorbid ASD and ID: study protocol for a randomized controlled trial

Yen Na Yum, Way Kwok-Wai Lau, Kean Poon, Fuk Chuen Ho, Yen Na Yum, Way Kwok-Wai Lau, Kean Poon, Fuk Chuen Ho

Abstract

Background: Autism spectrum disorder (ASD) is a developmental impairment characterized by persistent deficits in social communication and interactions, and over half of children with ASD possess below average intellectual ability (IQ < 85). The social development and response to social skill interventions among children with ASD and comorbid intellectual disability (ID) is not well understood. Music therapy is a systematic process of intervention, wherein a therapist may help clients promote their social skills by using musical experience. The proposed study will address limited research evidence on music therapy as an intervention for social functioning in children with ASD with mild to borderline ID.

Method: A randomized controlled trial (RCT) with two parallel groups of 40 children each (1:1 allocation ratio) is planned. Participants will receive 45 min of music therapy or non-musical intervention targeting social skills once a week for 12 weeks. Primary outcome measures will be independent ratings on the Childhood Autism Rating Scale and parent ratings on the Social Responsiveness Scale-2. Linear mixed-effects models for these two outcome measures will be created for data collected at 2-week pre-intervention, 2-week post-intervention, and 4-month post-intervention sessions. In-session behaviors at the first and last intervention will be videotaped and coded offline and compared. Pretreatment neural response of quantitative electroencephalograms (qEEG) to social scenes will be used to predict the outcomes of musical and non-musical social skill interventions, whereas qEEG responses to music will be used to predict the effectiveness of musical social skill intervention.

Discussion: If neural markers of social skill development are found, then the long-term goal is to develop individualized intervention based on pre-treatment markers to maximize treatment efficacy. The proposed study's results may also suggest directions to development and provision of music therapy services in Hong Kong.

Trial registration: ClinicalTrials.gov ( NCT04557488 ). Registered September 21, 2020.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study design and participant enrolment

References

    1. Sun X, Allison C, Matthews FE, Sharp SJ, Auyeung B, Baron-Cohen S, Brayne C. Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis. Molecular Autism. 2013;4(1):7. doi: 10.1186/2040-2392-4-7.
    1. White SW, Keonig K, Scahill L. Social skills development in children with autism spectrum disorders: a review of the intervention research. J Autism Dev Disord. 2007;37(10):1858–1868. doi: 10.1007/s10803-006-0320-x.
    1. Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, Kurzius-Spencer M, Zahorodny W, Rosenberg CR, White T, Durkin MS. Prevalence of autism spectrum disorder among children aged 8 years-Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States. 2014. MMWR Surveillance Summaries. 2018;67(6):1. doi: 10.15585/mmwr.ss6706a1.
    1. O'Kelly J, Fachner JC, Tervaniemi M. Dialogues in music therapy and music neuroscience: collaborative understanding driving clinical advances. Front Hum Neurosci. 2016;10:585. doi: 10.3389/fnhum.2016.00585.
    1. Bruscia KE: Defining music therapy. Second. Gilsum NH. Barcelona Publishers; 1998.
    1. Thaut MH, Hoemberg V, editors. Handbook of Neurologic Music Therapy. New York: Oxford University Press; 2014.
    1. Geretsegger M, Elefant C, Mössler KA, Gold C. Music therapy for people with autism spectrum disorder. Cochrane Database Syst Rev. 2014;6 10.1002/14651858.CD004381.pub3.
    1. Crawford MJ, Gold C, Odell-Miller H, Thana L, Faber S, Assmus J, Bieleninik L, Geretsegger M, Grant C, Maratos A, Sandford S. International multicentre randomised controlled trial of improvisational music therapy for children with autism spectrum disorder: TIME-A study. Health Technol Assess. 2017;21(59):1–40. doi: 10.3310/hta21590.
    1. Pietto ML, Gatti M, Raimondo F, Lipina SJ, Kamienkowski JE. Electrophysiological approaches in the study of cognitive development outside the lab. PLoS One. 2018;13(11):e0206983. doi: 10.1371/journal.pone.0206983.
    1. Li JH, Zhong JM, Cai LY, Chen Y, Zhou MZ. Clinical application of childhood autism assessment scale. Chinese J Child Health. 2005;13:267–268.
    1. Wang J, Barstein J, Ethridge LE, Mosconi MW, Takarae Y, Sweeney JA. Resting state EEG abnormalities in autism spectrum disorders. J Neurodev Disord. 2013;5(1):24. doi: 10.1186/1866-1955-5-24.
    1. Allen JJ, Keune PM, Schönenberg M, Nusslock R. Frontal EEG alpha asymmetry and emotion: from neural underpinnings and methodological considerations to psychopathology and social cognition. Psychophysiology. 2018;55(1):e13028. doi: 10.1111/psyp.13028.
    1. Pineda JA, Brang D, Hecht E, Edwards L, Carey S, Bacon M, Futagaki C, Suk D, Tom J, Birnbaum C, Rork A. Positive behavioral and electrophysiological changes following neurofeedback training in children with autism. Res Autism Spectrum Disord. 2008;2:557–581. doi: 10.1016/j.rasd.2007.12.003.
    1. Quaedflieg CW, Smulders FT, Meyer T, Peeters FP, Merckelbach HL, Smeets T. The validity of individual frontal alpha asymmetry EEG neurofeedback. Soc Cogn Affect Neurosci. 2015;11(1):33–43. doi: 10.1093/scan/nsv090.
    1. Schopler E, Reichler R, Renner RB. The childhood autism rating scale (CARS) Los Angeles: Western Psychological Services; 1988.
    1. Gebauer L, Skewes J, Westphael G, Heaton P, Vuust P. Intact brain processing of musical emotions in autism spectrum disorder, but more cognitive load and arousal in happy vs. sad music. Front Neurosci. 2014;8:192. doi: 10.3389/fnins.2014.00192.
    1. Constantino JN, Gruber CP. Social responsiveness scale (SRS) Torrance: Western Psychological Services; 2012.
    1. Gau SS, Liu LT, Wu YY, Chiu YN, Tsai WC. Psychometric properties of the Chinese version of the social responsiveness scale. Res Autism Spectr Disord. 2013;7(2):349–360. doi: 10.1016/j.rasd.2012.10.004.
    1. Kim J, Wigram T, Gold C. The effects of improvisational music therapy on joint attention behaviors in autistic children: a randomized controlled study. J Autism Dev Disord. 2008;38(9):1758. doi: 10.1007/s10803-008-0566-6.
    1. Greenberg DM, Baron-Cohen S, Stillwell DJ, Kosinski M, Rentfrow PJ. Musical preferences are linked to cognitive styles. PLoS One. 2015;10(7):e0131151. doi: 10.1371/journal.pone.0131151.
    1. Baayen RH, Davidson DJ, Bates DM. Mixed-effects modeling with crossed random effects for subjects and items. J Mem Lang. 2008;59(4):390–412. doi: 10.1016/j.jml.2007.12.005.
    1. Hong Kong Education Bureau. How to support children with autism spectrum disorders. 2015. . Accessed 1 Nov 2020.
    1. Autism parternership Hong Kong. Specialized treatment fee 2020. 2020. . Accessed 1 Nov 2020.
    1. Autism parternership Hong Kong. Service fee 2020. 2020. .
    1. Census and Statistics Department Hong Kong Special Administrative Region. Quarterly report on general household survey. 2020. . Accessed 1 Nov 2020.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere