Music in diagnostics: using musical interactional settings for diagnosing autism in adults with intellectual developmental disabilities

Music therapy and Sanfilippo syndrome: an analysis of psychological and physiological variables of three case studies

Introduction

Mucopolysaccharidosis type III (MPS III) or Sanfilippo syndrome is a neurodegenerative disease caused by the accumulation of mucopolysaccharides in the body. As the symptoms are wide ranging, it is a challenge to provide a diagnosis and psychological treatment for affected children.

Method

The main objective of this study was to describe a form of music therapy treatment applied to three children diagnosed with MPS III. The psychological variables were evaluated by an ad hoc observation recording template, and the physiological variables were measured with a digital meter before and after each session. The perception of the parents was also considered through a semi-structured interview.

Results

An improvement in the psychological variables was shown in all cases. Changes in the physiological variables were also noted, although they varied according to each child. The parents report some benefit of music therapy and they share difficulty in assessing the extent of benefits of the music therapy.

Discussion

Findings indicate that music therapy can be a useful form of treatment with multiple benefits for children with conditions such as MPS III or similar conditions. However, further research is needed in this area and in the development of specific ways of evaluating music therapy.

Beneficios de la musicoterapia como opción integrativa en el tratamiento oncológico

Objetivo: Identificar la eficacia de los tratamientos musicoterapéuticos que aborden la sintomatología en pacientes con cáncer y que constaten algún tipo de beneficio psicológico, fisiológico, espiritual, social o intelectual. Método: Se realizó un análisis documental que supuso un estudio comparativo de evidencias científicas. Resultados: La musicoterapia minimiza los efectos fisiológicos de tratamientos específicos oncológicos como la quimioterapia, se usa como complemento de la morfina o el sufentanilo disminuyendo el dolor e influye en la vida emocional del paciente. Conclusiones: Es una disciplina que demuestra evidencias positivas en situaciones de tipo emocional reduciendo la depresión, la ansiedad y el estrés, ayudando en la relajación y mejorando el umbral del dolor, postulándose como una opción no-farmacológica que debiera conducir a una implantación cada vez más normalizada en los centros hospitalarios.

Developing a Diagnostic Algorithm for the Music-Based Scale for Autism Diagnostics (MUSAD) Assessing Adults with Intellectual Disability

Initial studies have presented the Music-based Scale for Autism Diagnostics (MUSAD) as a promising DSM-5-based observational tool to identify autism spectrum disorder (ASD) in adults with intellectual disability (ID). The current study is the first to address its clinical utility in a new sample of 124 adults with ID (60.5% diagnosed with ASD). The derived diagnostic algorithm differentiated well between individuals with and without ASD (sensitivity 79%, specificity 74%, area under the curve = 0.81). Inter-rater reliability, assessed by the scorings of four independent experts in 22 consensus cases, was excellent (ICC = 0.92). Substantial correlations with scores from other ASD-specific measures indicated convergent validity. The MUSAD yields accurate and reliable scores, supporting comprehensive ASD diagnostics in adults with ID.

Music-Evoked Reward and Emotion: Relative Strengths and Response to Intervention of People With ASD

This review presents research findings showing that music is a unique domain to assess perception, reward, emotion, and associated physiological reactions and neural circuitry of people with autism spectrum disorder (ASD). There is growing evidence, reported in several studies in this review article, indicating that music is a relative strength of people with ASD including musical pitch perception, musical memory, and identification of music-evoked emotions. Listening to music activates neural circuits of reward and emotion response, which are described. Research presented shows adults with ASD also activate these systems when listening to music, although there may be developmental differences in the physiological and neural response to music in childhood and adolescence alongside typical behavioral response. Nonetheless, studies reviewed lend support to the use of music therapy and education for people with ASD, specifically to improve social skills and communication. Neural correlates of response to music therapy and education are also discussed. Taken together, findings reviewed provide evidence for music as a strength-based approach for ASD to assess reward and emotion response and as a powerful tool for intervention.

KAMUTHE video microanalysis system for use in Brazil: translation, cross-cultural adaptation and evidence of validity and reliability

<b>Background</b><br /> KAMUTHE is a video microanalysis system which observes preverbal communication within the music therapy setting. This system is indicated for children with autism spectrum disorder (ASD) or multiple disabilities. The purpose of this study was to translate, adapt to Brazilian Portuguese language and analyze some psychometric properties (reliability and validity evidence) of KAMUTHE administration in Brazil for individuals with ASD.<br /> <br /> <b>Participants and procedure</b><br /> Translation, back translation, analysis by judges, and pilot application were performed to obtain evidence of content and face validity. The second part of this study was to administer KAMUTHE in 39 consecutive children with ASD. An individual session of improvisational music therapy was applied to assess the different behaviors included in KAMUTHE. The intra-rater reliability, concurrent validity and convergent validity were analyzed.<br /> <br /> <b>Results</b><br /> Translation and cross-cultural adaptation were followed and some cultural adaptations were needed. Inter-rater reliability was very good (ICCs 0.95-0.99) for the three child’s behaviors analyzed. Criteria validity with a moderate negative association was found (r = –.38, p = .017) comparing the behavior “Gazes at therapist” and the level of ASD along with the Childhood Autism Rating Scale (CARS). Convergent validity was established between the behavior “Gazes at therapist” and the two nonlinguistic communication scales (social interaction and interests) of the Children’s Communication Checklist (CCC) with a moderate correlation (r = –.43, p = .005).<br /> <br /> <b>Conclusions</b><br /> The administration of the KAMUTHE video microanalysis system showed positive results in children with ASD. Further studies are needed to improve the reliability and validity of the instrument in Brazil.

Music-based Autism Diagnostics (MUSAD) - A newly developed diagnostic measure for adults with intellectual developmental disabilities suspected of autism

The MUSAD was developed as a diagnostic observational instrument in an interactional music framework. It is based on the ICD-10/DSM-5 criteria for autism spectrum disorder (ASD) and was designed to assess adults on a lower level of functioning, including individuals with severe language impairments. This study aimed to evaluate the psychometric properties of the newly developed instrument.

METHODS

Calculations were based on a consecutive clinical sample of N=76 adults with intellectual and developmental disabilities (IDD) suspected of ASD. Objectivity, test-retest reliability, and construct validity were calculated and a confirmatory factor analysis was applied to verify a reduced and optimized test version.

RESULTS

The structural model showed a good fit, while internal consistency of the subscales was excellent (ω>.92). Item difficulties ranged between .04≤pi≤.82 and item-total correlation from .21 to .85. Objectivity was assessed by comparing the scorings of two external raters based on a subsample of n=12; interrater agreement was .71 (ICC 2, 1). Reliability was calculated for four test repetitions: the average ICC (3, 1) was .69. Convergent ASD measures correlated significantly with the MUSAD, while the discriminant Modified Overt Aggression Scale (MOAS) showed no significant overlap.

CONCLUSION

Confirmation of factorial structure and acceptable psychometric properties suggest that the MUSAD is a promising new instrument for diagnosing ASD in adults with IDD.