Providing music therapy for children with autism can be a rewarding career. “What is exciting is that music is often ‘the thing’ that reaches a child with autism, and connects him or her to others,” states Dr. Tracy Richardson. “It is not just a way to shape or control ‘behaviors’ but it is a way to reach in to the essence of that child and say ‘Here I am! Let’s be together in the music!'”

According to Richardson, professor and director of Music Therapy at Saint Mary-of-the-Woods College, “Children with autism often have an affinity for music. A child might have a song that he sings to calm himself or perhaps he has a type of music (such as Disney songs) that he is drawn to. Because of this, music therapists have a natural and often non-threatening avenue for communication with that child. A child may sing words that she will not speak, which then is the start of communication between the child and music therapist. If I sing ‘Old MacDonald had a farm….E I E I…’ the child may respond with ‘O’ (if this is a song she is familiar with). It takes little effort for her to respond, and the structure of the music makes it easy to do so.”

Dr. Blythe LaGasse has worked with children on the autism spectrum (ASD) for many years and also coordinates the Music Therapy program at Colorado State University. “Many persons on the autism spectrum show increased interest in musical stimuli, making music therapy an excellent tool to facilitate achieving their cognitive, social, communication, or motor goals,” she says.

Benefits of Music Therapy for Children with ASD

Music therapy is useful for:

• facilitating relationships, learning, self-expression, and communication.
• improving attention span, including gaining and maintaining attention.
• helping children learn to follow directions.
• helping children learn to express feelings appropriately, including instances where verbal language isn’t used.
• facilitating social skills including sharing, interacting appropriately with other children, taking turns, and responding in an acceptable manner.
• encouraging motivation.
• improving verbal skills including rate, volume, and pacing of speech.
• facilitating limit-setting.
• helping individuals process sensory information.
• building frustration tolerance including the ability to adjust to changes in routine.
• developing and improving gross motor skills such as directionality, balance, coordination, and walking.
• developing and improving fine motor skills including grasping, use of the wrist and fingers, and facial movements such as winking.

How long does it take to observe change? According to Brittany Neuser, a music therapist who graduated from Western Michigan University, “In some cases, benefits are immediately evident and in others, observable benefits may not emerge until after more long-term exposure to music therapy treatment.”

Assessment and Techniques

“Each child is assessed carefully by the music therapist before and during the sessions,” says Tracy Richardson. “The assessment will help determine if this is an appropriate therapy for the particular child. Some children with a severe sensitivity to sound may not benefit from music therapy. However, even if a child cries or seems to be upset in the presence of music, it does not necessarily mean that music therapy is contraindicated. The music therapist can determine this through ongoing assessment. Sometimes a child’s cries can be echoed melodically in the music, and may make her feel ‘heard.’ She may start responding differently because of this.”

Rhythmic elements help organize the sensory system and are commonly used with children on the autism spectrum. “For example,” says Brittany Neuser, “some individuals with autism may experience difficulty initiating, sustaining, or stopping movement (walking is a common example). In these cases, a steady rhythmic pulse provided by something as simple as patting your hand on your leg, often helps to activate sensorimotor pathways and facilitate movement. This technique requires no special equipment or materials and can easily be used across many different environments.” Other techniques, according to Neuser, include “songs or rhythmic chants that help to teach or cue specific behaviors or skills. These songs may help people with autism learn to sequence and complete activities of daily living such as brushing teeth and identifying emotional or physical states. They may also help to teach academic or social skills.”

Working with Parents and Family Members

Music therapists communicate with parents and other significant support people about the work they’re doing with children. “There may be techniques which can be replicated at home and school to give the child consistency in feedback and expectations,” says Dr. Lalene Kay, director of the Cleveland Music Therapy Consortium (consisting of Baldwin Wallace Conservatory, The College of Wooster, and Cleveland State University). “At other times, it is just a matter of these professionals and the family sharing observations to confirm acquisition and generalization of certain behaviors and knowledge through demonstration in a variety of settings (home, school, church, other therapies, etc.).”

Linda Sanders, co-director of Creative Therapies Enterprises and adjunct professor of Music Therapy at Duquesne University’s Mary Pappert School of Music, offers additional ideas for working with parents of children on the autism spectrum. “I have worked with parents to assist them in using their singing voice to label objects or actions, give directions, and give information such as scheduling, as in ‘We’re going to go to the grocery store this morning.’ I’ve also helped parents learn songs that apply to daily living and self-help skills, as well as to improvise songs on the spot. I’ve recommended recorded music for various uses, and encouraged parents to share with their child the music that they enjoy.”

Training

“Each college student studying music therapy has points along their education journey where they evaluate and reevaluate their interests, talents, strengths and challenges in terms of specific areas of practice,” says Lalene Kay. “As students have opportunities to experience working with different populations, they are able to make more realistic decisions regarding populations and their own inclinations and talents for working with specific age groups, diagnoses, and with specific models and approaches.

“Even if one is exclusively interested in working with children living with autism,” Kay continues, “the incoming college music therapy major needs to be aware that colleges and universities offering MT degrees are obliged to require students to complete clinical hours with 3 – 5 different populations. Specialization would be pursued on a Masters level or at least in a Post-Bac certificate.”

Blythe LaGasse adds, “One of the best ways to gain skills is to collaborate. I would suggest that persons interested in working in this area gain experience with other music therapists or professionals who work with individuals with ASD.” Brittany Neuser concurs. She encourages students to “actively pursue interaction with people from other disciplines (including speech, occupational, physical, recreational, and art therapy) and to learn about autism from all therapeutic perspectives, as most music therapists working with people with ASD function as part of an interdisciplinary team.”

Employment Opportunities

Settings where music therapists work with children include:

• Schools
• Pediatric hospitals
• Outpatient mental and behavioral health clinics
• Private practices specializing in work with ASD
• Local autism resource centers

Jennifer Gravish, a music therapist who trained at Temple University Boyer College of Music and Dance, adds that music therapy can also take place in the homes of families with children on the autism spectrum and in after school programs. According to Tracy Richardson, another employment option is through Medicaid waiver provider companies. “Companies that serve families with a child on the waiver may offer music therapy as a service that is then paid for by Medicaid,” she says. “However, not every state includes music therapy on its list of waiver services.”

Sometimes a child’s cries can be echoed melodically in the music, and may make her feel ‘heard.’ She may start responding differently because of this.”

– Dr. Tracy Richardson