Effects of music therapy vs. play session with toys on social behaviors in young children with autism: Sub-group analyses based on differences in age, symptom severity and language skills

Background: Music therapy is gaining growing recognition as an effective intervention addressing fundamental levels of emotional communication and social engagement for young children with autism.

Objectives: Considering both toys and musical instruments involve some form of playing together, this explorative study set out to investigate and compare the effects of music therapy and play session with toys on social behaviors in young children with autism. As children with autism display huge variety and individuality across all ages and abilities, it would be clinical relevant to find out what type of interventions are most suited to the different developmental needs of these children. This study takes a further step into addressing these more specific and fundamental issues.

Methods: A randomized controlled study was undertaken employing a repeated measures comparison design, both between conditions and within subjects. Children were randomly assigned to two groups; Group 1 had music therapy first, and then play sessions later. Group 2 had play first, then music therapy. The responsiveness in children was assessed with the Pervasive Developmental Disorder Behavior Inventory (PDDBI), and the Early Social Communication Scales (ESCS). Analyses of sub-groups were also undertaken as follows: 1) verbal vs. non-verbal children; 2) the younger vs. older children; 3) mild to moderate vs. severe autism.

Results: Overall results from the PDDBI and the ESCS indicated that music therapy was more effective at improving pro-social behaviors in children with autism. Younger, less autistic and more verbal children gained more from these trials in both conditions than ‘low functioning non-verbal, severely autistic and older children’. Session analysis revealed significant differences between conditions in target behaviours.

Conclusions: Clinical implications are further discussed. One should not, however, overlook the small improvement in low functioning and severely autistic children in comparison to larger changes in the ‘more able’ group of children.