I recently read a fascinating research paper about music therapy for children with ASD. There have been a few papers about the effects of music intervention in ASD, and most report positive changes in emotional engagement and social communication. However, this paper is the first to report how the brain might be affected by music intervention.
How the study was designed
Sharda and colleagues compared a music intervention to a non-music control intervention in school-aged (6-12) children with ASD. Twenty-six children participated in the music intervention, and 25 different children participated in the non-music intervention. Both interventions met weekly for 45 minutes and were conducted for 8-12 weeks. Before and after both interventions, researchers measured behaviors (such as social communication, verbal communication, and family quality of life/parental stress), and brain activity using rsfMRI. fMRI allows researchers to measure levels of brain activity in various parts of the brain. In this study, researchers measured the connection and communication between different areas of the brain. The "rs" in rsfMRI stands for "resting state," and means that brain activity was measured while children laid in the scanner passively (e.g. while "resting").
Why the interest in communication/connection between brain areas? Because there is a long history of neuroscience findings to suggest that differences in connections between areas of the brain are a hallmark of ASD. Some findings suggest that brain areas are overly connected in ASD, while others suggest that the connection between different brain areas aren't strong enough in ASD. These differences in connectivity are thought to be partially responsible for the difficulties in verbal and social communication observed in ASD, and may also play a role in sensory sensitivity.
Behaviorally, improvements were seen in communication, social responsiveness, and family quality of life for children in the music intervention vs. the control intervention. Neuroscience results were equally promising. For children in the music intervention, there were increased connections between brain areas responsible for auditory processing and subcortical motor areas. For children in the music intervention, there were also decreased connections between auditory and visual processing areas.
Brain and Behavior
The most exciting part of the neuroscience findings is that differences in brain activity were related to improvements in behavioral measures. For example, the strength of the connection between auditory and motor areas after was significantly related to improvements in social communication. That is, children who had the biggest increases in brain connection between auditory and motor areas also had the biggest behavioral improvements in response intervention. Similarly, children who had decreased connections between auditory and visual brain areas showed more improvements in social communication.
What does this mean?
I think there are a few important messages here:
1. Music interventions can improve social communication in school-age children with ASD. Music interventions and music therapy have long been seen as an "alternative" therapy, and have not been readily accepted by the scientific community. This research supports music intervention as a promising way to improve social communication in ASD. Hopefully, this type of work leads to increased availability of music intervention providers, insurance coverage, and more funding for research.
2. Music intervention doesn't only improve behavior; it also affects the strength of connections between brain areas, and those connection changes are related to behavioral improvements in social communication. This is exciting because it points to why music intervention might be working. For example, decreases in connections between auditory and visual brain areas might be helping with sensory sensitivity in ASD, which may lead to improvements in social skills. It is possible that sensory sensitivity gets in the way of social communication in ASD.
Imagine that you are trying to speak to someone, but their voice is loud, high pitched, and grating. On top of that, the lights in the room are hurting your eyes, and there is a constant ambulance-type wailing outside. How strong would your social communication skills be in that situation? My guess is that they would decrease due to the sensory over-stimulation. This might also be the case in ASD. It is possible that if we can help with sensory symptoms, social skills will improve.
I am enthusiastic about music intervention as a new avenue to help children with ASD, and I look forward to reading more about it and contributing to future research efforts.
Sharda, M., Tuerk, C., Chowdhury, R., Jamey, K., Foster, N., Custo-Blanch, M., Tan, M., Nadig, A., & Hyde, K. (2018). Translational Psychiatry. DOI: 10.1038/s41398-018-0287-3