The Effects of Rhythm Interventions on Social Attention and Verbalization Skills of Children with Autism Spectrum Disorders

Background: Social communication delays are primary impairments in children with Autism Spectrum Disorders (ASDs). Applied Behavioral Analysis (ABA) approaches are the standard of care to promote social communication in children with ASDs; However, music therapies are often used in home or school settings (Hess et al., 2008), There is limited evidence to support the efficacy of music therapies in facilitating social communication skills of children with ASDs (Srinivasan & Bhat, 2013)  

Objectives: Therefore, in the present study, we systematically evaluated the efficacy of embodied rhythm therapies involving music and movement activities in promoting social communication skills in children with ASDs between 5 and 12 years of age using a randomized controlled trial  

Methods: 24 children with ASDs between 5 and 12 years of age were included. The study lasted for 10 weeks with the pretest and the posttest conducted in the first and the last weeks of the study. Children were matched on age and level of functioning and then randomly assigned to either the “rhythm” or the “academic” intervention group. Each child received 8 weeks of training with 2 sessions provided per week. The rhythm group engaged in music-based whole-body activities involving imitation and rhythmic synchrony with an expert trainer and an adult model. The academic group engaged in tabletop, academic and fine motor activities including reading, building, and arts and crafts with the expert trainer and the adult model. We coded for social attention patterns as well as vocalization/verbalization patterns of children during an early, mid, and late training session.  Attention and verbal communication were also categorized as spontaneous or responsive.  

Results:   Children in the rhythm group engaged in higher levels of socially directed attention compared to the academic group across all sessions (Mean (SD): Rhythm - Early: 45.14 (10.00), Mid: 44.81 (9.09), Late: 46.74 (13.75); Academic - Early: 7.62 (6.84), Mid: 6.86 (5.34), Late: 6.95 (7.70)). In contrast, the academic group engaged in greater object directed non-social attention episodes across all sessions (Rhythm - Early: 31.74 (7.77), Mid: 29.56 (8.62), Late: 29.06 (10.48); Academic - Early: 83.46 (13.12), Mid: 83.30 (8.65), Late: 82.87 (10.76)). In terms of verbalization patterns, the academic context promoted greater socially directed verbalization compared to the rhythm context in the early session (Rhythm: 8.18 (7.05), Academic: 14.11 (2.90)). However, with training, children in the rhythm group demonstrated a significant increase in the amount of social verbalization from the early to the late session (Early: 8.18 (7.05), Late: 17.08 (15.34)). Lastly, music and movement-based activities afforded greater spontaneous social attention and verbalization, whereas academic activities promoted predominantly responsive attention and verbalization episodes.

Conclusions:   We found significant improvements in social communication skills across weeks of training in the rhythm group. We believe that these findings support the notion that socially embedded motor activities have the potential to facilitate social communication development. Lastly, these data also support the inclusion of embodied music and movement interventions within the standard of care for children with autism.