Beyond Words: How Autistic Children Communicate

Trisha Van Berkel described her disorder in the following way: "Autism is about having a pure heart and being very sensitive....It is about finding a way to survive in an overwhelming, confusing world...It is about developing differently, in a different pace and with different leaps." This week, I hope to dwell further into the question of how music therapy helps autistic individuals make sense of the world. Although some researchers remain skeptical about the healing power of music, therapists are thoroughly convinced that music serves as a unique channel of communication for autistic children who lack the ability to express their emotions through words or actions. In my exploration of the blogosphere, I encountered a touching account of the success of music therapy in an article by Jean Hwang, a writer for the Miami Herald. The blog entry, titled “Music Gets Backing for Addressing Autism,” details the dramatic impact of this treatment on young patients' lives. As an avid proponent for the use of music therapy, I also decided to share about this topic on a prominent autism blog in response to an entry titled “Expressive Communication in Children with Severe Autism” in which Nestor L. Lopez-Duran discusses recent findings that children with severe autism respond best to simple verbal commands in a classroom. My comments could be viewed on the authors’ respective blogs as well as in the following paragraphs.

“Music Gets Backing for Addressing Autism”
Comment

Thank you for your insightful entry on the topic of music therapy for autistic children. In a recent post on my own blog, I explored the benefits of music on emotional health through the unique perspective of how music benefits autistic patients. After considering several scientific publications about the merits of this treatment, it is refreshing and convincing to read a real-life testimony about the impact of music therapy on patients' lives. I particularly enjoyed the narrative about how Janna’s mother succeeded in teaching basic survival skills to her autistic daughter by singing instructions. In your entry, you explained that “music gives structure and a predictable rhythm to verbal directions.” As a violinist myself, I often perceive music as a constantly changing and morphing set of sounds, but your idea helped me realize that music is made up of elementary building blocks in the same way that a logical story is written with hundreds of words. I am delighted that musical therapists recognized this structural property of music and applied it to non-music-related fields such as medicine.

In your description of a typical session of music therapy, I noticed two instances when students responded negatively to sound. In the first instance, a 16-year-old had to wear headphones because of his auditory sensitivities. Although you did not specify the reason for why the second student "seemed pained by the therapy session," I assume that he/she was also unable to tolerate music. According to John Foley, who has been working as a music therapist for over ten years, "the world is a chaotic place, full of overwhelming levels of sensory input [, for people with autism]." Hypersensitivity to sound is a very common symptom of Autism, therefore I wonder how many children are unable to benefit from music therapy for this reason. Since some children are only sensitive to certain types of sound (pictured right), personalized music therapy may be an option for them. Do you think educational institutions and child development centers should be responsible for providing individual sessions to children who do not benefit from group therapy? I worry that clients with more severe autism and hypersensitivity to sound fail to benefit from, and perhaps suffer unnecessarily as a result of participation in music therapy.

““Expressive Communication in Children with Severe Autism”
Comment

Thank you for drawing attention to the issue that “children with severe autism are underrepresented in today’s published research.” As I scoured the internet for information on music therapy and autism while writing a recent post on my own blog, I also noticed that most published research articles involve participants with mild or high functioning autism. I applaud your decision to present studies of low functioning autism on your blog. I especially enjoyed reading your summary of Hsu-Min Chiang’s naturalistic observation of expressive communication among kids with severe autism. I think your blog is powerful because it conveys the main ideas from scientific experiments in a way that does not intimidate the general population. In response to Chaing's findings, I was surprised that teachers’ physical prompts did not seem to be as effective as verbal prompts. His results contradicted an earlier study which indicated that autistic children prefer signing to speaking because they are able to reproduce movements accurately. The study explained that instructors often prefer to teach signs (pictured below) because "signs are promptable - they can be physically guided - whereas it is not really possible to force a child to speak even with sophisticated speech therapy." What are your thoughts about the discrepancy between the two research studies? Do you support Chiang's suggestion that speech, or verbal prompts, are more effective than physical prompts? Do you have a theory as to why physical prompts are not as effective? I think part of the answer is that autistic children may be oversensitive to touch and therefore they may discourage this form of communication by not responding to it. Alternatively, perhaps their hypersensitivity to touch simply prevents them from responding rationally to physical prompts.

Have you ever heard of music therapy for autistic children? As I mentioned earlier, I did some research on this topic and gathered strong evidence that supports the efficacy of this type of treatment. Music therapists often provide instructions to patients in the form of singing. Research suggests that music therapy may help children with autistic spectrum disorder improve their communicative skills. Do you think this type of communication is more potent than verbal prompts in the Chiang study? I think verbal instructions should be presented in musical forms to maximize response from autistic children. I admire your decision to disseminate the latest scientific findings related to autism spectrum disorders to parents, teachers, and clinicians through your blog. I would like to refer you to a recently published article that discusses the benefits of music for autistic patients as well as the general population. I hope you will consider sharing it with your blog readers.