The Autism-CHIME (CHildren’s Improvisational Music Therapy Evaluation) study tests whether improvisational music therapy is helpful for autistic children aged 7-11 years old. Music therapy is an evidence-based approach conducted by a registered music therapist, to accomplish individualised goals such as reducing stress, improving mood and strengthening communication. Improvisational music therapy is one style of music therapy, in which a therapist and a child spontaneously co-create music together using singing, playing and movement, and assumes no prior experience with playing an instrument. This can create engaging opportunities for interactions and for children to express themselves. Previous research suggests that this kind of music therapy may be particularly useful for autistic children. We will test scientifically if improvisational music therapy helps autistic children to improve their social and communication skills, and their emotional wellbeing.
Music enables non-verbal communication through the production and interaction of rhythm, melody, and harmony. The timing and anticipation of musical rhythm, and the sounds of a musical instrument, can be predictable and create enjoyable patterns that can be easily followed by many autistic children, who sometimes have enhanced pattern recognition and rhythm perception skills. During music therapy, the music interaction provides a fun opportunity for social interaction in a predictable context, and this non-verbal social interaction with the music therapist may support autistic children’s social and communication skill development. An additional benefit of improvisational music therapy is that the interactions are ‘child-led’ which gives the child control over how each session unfolds. Giving autistic children a greater sense of control may help build their confidence and self-esteem, which in turn may improve their wellbeing.
These potential benefits mean that improvisational music therapy could be an effective support for autistic children. However, there is currently not enough evidence to say that improvisational music therapy is effective in supporting autistic people’s social communication development, or whether any positive effects are retained after the end of the therapy. Our study will address this pivotal gap in the research literature.
We will invite 200 autistic children and their parents to take part in our study. We will assess each child’s social and communication skills, and psychosocial development, at the start of the study. Within the clinical trial, children will be recruited through their schools and allocated at random so that half of the children receive 12 weeks of improvisational music therapy from a registered music therapist in addition to their usual support, while the others will receive their usual support only. We will follow up with both groups at 13 weeks (after the end of the music therapy sessions) to test whether improvisational music therapy plus usual support leads to improvements in social communication skills or wellbeing. We will follow up with the children again at 39 weeks, to see if any improvements are maintained.
We will measure 4 different outcomes to see if music therapy can:
- Improve social skills
- Improve communication skills
- Improve wellbeing
- Reduce psychosocial distress
We will also evaluate the quality of the relationship between therapist and child, and test whether this can predict how social, communication and language skills will develop.
This will tell us whether skills improve as a result of improvisational music therapy, whether improvements are retained in the long term and whether improvisational music therapy has a positive impact on autistic children’s wellbeing.
Without evidence, we cannot be certain that a therapy will provide a benefit, and it would be unethical to put children through an ineffective or even potentially harmful therapy. It is therefore important to find out whether improvisational music therapy is helpful for autistic children, so that all children can benefit from an evidenced based support. If our study shows that improvisational music therapy is beneficial for autistic children, this could help educators and parents feel confident in offering it to them.
We consulted with six members of the autism community with relevant expertise to this study, including an autistic representative and the parent of an autistic child, about the design of the study and the study materials, including the information sheet, consent form and flyers used to advertise the study to parents. Changes were made as a result of the engagement process. We have formed a study Steering Committee, comprising of four independent experts. The purpose of the Steering Committee is to advise us throughout the course of the 3-year project. One of the committee members is both autistic and a music therapist.
Autism Centre of Excellence at Cambridge (ACE)