Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: a randomized controlled study

Interventions Targeting Sensory Challenges in Autism Spectrum Disorder: A Systematic Review

CONTEXT

Sensory challenges are common among children with autism spectrum disorder (ASD).

OBJECTIVE

To evaluate the effectiveness and safety of interventions targeting sensory challenges in ASD.

DATA SOURCES

Databases, including Medline and PsycINFO.

STUDY SELECTION

Two investigators independently screened studies against predetermined criteria.

DATA EXTRACTION

One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE), or confidence in the estimate of effects.

RESULTS

Twenty-four studies, including 20 randomized controlled trials (RCTs), were included. Only 3 studies had low risk of bias. Populations, interventions, and outcomes varied. Limited, short-term studies reported potential positive effects of several approaches in discrete skill domains. Specifically, sensory integration-based approaches improved sensory and motor skills-related measures (low SOE). Environmental enrichment improved nonverbal cognitive skills (low SOE). Studies of auditory integration-based approaches did not improve language (low SOE). Massage improved symptom severity and sensory challenges in studies with likely overlapping participants (low SOE). Music therapy studies evaluated different protocols and outcomes, precluding synthesis (insufficient SOE). Some positive effects were reported for other approaches, but findings were inconsistent (insufficient SOE).

LIMITATIONS

Studies were small and short-term, and few fully categorized populations.

CONCLUSIONS

Some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear. Although some therapies may hold promise, substantial needs exist for continuing improvements in methodologic rigor.

Social outcomes in children with autism spectrum disorder: a review of music therapy outcomes

Autism spectrum disorder (ASD) affects approximately one in 68 children, substantially affecting the child's ability to acquire social skills. The application of effective interventions to facilitate and develop social skills is essential due to the lifelong impact that social skills may have on independence and functioning. Research indicates that music therapy can improve social outcomes in children with ASD. Outcome measures are primarily assessed using standardized nonmusical scales of social functioning from the parent or clinician perspective. Certified music therapists may also assess musical engagement and outcomes as a part of the individual's profile. These measures provide an assessment of the individual's social functioning within the music therapy session and generalizability to nonmusical settings.

Music therapy in the neonatal intensive care unit: Putting the families at the centre of care

In this article, the core concepts of family-centred care will be discussed in relation to family-centred Music Therapy with preterm babies and their parents in the neonatal intensive care unit. Then, the basic pillars of a family-centred Music Therapy programme at the neonatal intensive care unit of the Hospital Centro Policlínico del Olaya in Bogotá, Colombia, will be illustrated by selected case vignettes. Parents are considered to be an important ally in caring for their baby in the neonatal intensive care unit and family-centred Music Therapy actively seeks to provide early relational and communicative experiences between parents and their babies. However, family-centred Music Therapy goes beyond the integration of parents and needs to carefully balance out the fluctuating needs of the babies, parents and the emerging relationship between them.

Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder

A number of studies of parent-mediated interventions in autism spectrum disorder have been published in the last 15 years. We reviewed 19 randomized clinical trials of parent-mediated interventions for children with autism spectrum disorder between the ages of 1 and 6 years and conducted a meta-analysis on their efficacy. Meta-analysis outcomes were autism spectrum disorder symptom severity, socialization, communication-language, and cognition. Quality of evidence was rated as moderate for autism spectrum disorder symptom severity, communication-language, and cognition, and very low for socialization. Weighted Hedges' g varied from 0.18 (communication-language) to 0.27 (socialization) and averaged 0.23 across domains. We also examined the relationship between outcome and dose of parent training, type of control group, and type of informant (parent and clinician). Outcomes were not significantly different based on dose of treatment. Comparing parent training to treatment-as-usual did not result in significantly different treatment effects than when parent training was compared to an active comparison group. Based on parent report only, treatment effects were significant for communication-language and non-significant for socialization, yet the opposite was found based on clinician-rated tools. This meta-analysis suggests that while most outcome domains of parent-delivered intervention are associated with small effects, the quality of research is improving.