Gustavo Gattino

Effects of relational music therapy on communication of children with autism: a randomized controlled study

The intent of this study (registration ACTRN12608000625370) was to investigate the effects of Relational Music Therapy (RMT) in verbal, nonverbal and social communication of children with autism spectrum disorders (ASDs). A randomized controlled trial (RCT) with 24 boys from the Programme for Invasive Developmental Disorders (Porto Alegre City, Brazil), was designed to compare individuals treated with music therapy (n = 12) and standard treatment (clinical routine activities including medical examinations and consultations, n = 12). The outcomes were assessed by two blind evaluators, before and after interventions, through the verbal, nonverbal and social communication scores of Brazilian version of the Childhood Autism Rating Scale (CARS-BR). The CARS-BR scores in T1 and T2 did not show a statistically significant difference in the three measured outcomes. However, the study found a positive statistically significant difference on subgroup analysis of nonverbal communication among patients with autistic disorder, p = 0.008 and standard mean difference of 2.22 (95% CI 1.90 to 2.53). The results observed in the investigation of the effects of relational music therapy on communication skills of ASD children are inconclusive. The next investigations need more rigorous designs leading to smaller effect size estimates and more accurate tools for the outcome assessment (including some specific instrument of music therapy). These modifications will increase the accuracy to observe the treatment effects in this population.

Effects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder: The TIME-A Randomized Clinical Trial

Importance Music therapy may facilitate skills in areas affected by autism spectrum disorder (ASD), such as social interaction and communication. Objective To evaluate effects of improvisational music therapy on generalized social communication skills of children with ASD. Design, Setting, and Participants Assessor-blinded, randomized clinical trial, conducted in 9 countries and enrolling children aged 4 to 7 years with ASD. Children were recruited from November 2011 to November 2015, with follow-up between January 2012 and November 2016. Interventions Enhanced standard care (nu2009=u2009182) vs enhanced standard care plus improvisational music therapy (nu2009=u2009182), allocated in a 1:1 ratio. Enhanced standard care consisted of usual care as locally available plus parent counseling to discuss parents’ concerns and provide information about ASD. In improvisational music therapy, trained music therapists sang or played music with each child, attuned and adapted to the child’s focus of attention, to help children develop affect sharing and joint attention. Main Outcomes and Measures The primary outcome was symptom severity over 5 months, based on the Autism Diagnostic Observation Schedule (ADOS), social affect domain (range, 0-27; higher scores indicate greater severity; minimal clinically important difference, 1). Prespecified secondary outcomes included parent-rated social responsiveness. All outcomes were also assessed at 2 and 12 months. Results Among 364 participants randomized (mean age, 5.4 years; 83% boys), 314 (86%) completed the primary end point and 290 (80%) completed the last end point. Over 5 months, participants assigned to music therapy received a median of 19 music therapy, 3 parent counseling, and 36 other therapy sessions, compared with 3 parent counseling and 45 other therapy sessions for those assigned to enhanced standard care. From baseline to 5 months, mean ADOS social affect scores estimated by linear mixed-effects models decreased from 14.08 to 13.23 in the music therapy group and from 13.49 to 12.58 in the standard care group (mean difference, 0.06 [95% CI, −0.70 to 0.81]; Pu2009=u2009.88), with no significant difference in improvement. Of 20 exploratory secondary outcomes, 17 showed no significant difference. Conclusions and Relevance Among children with autism spectrum disorder, improvisational music therapy, compared with enhanced standard care, resulted in no significant difference in symptom severity based on the ADOS social affect domain over 5 months. These findings do not support the use of improvisational music therapy for symptom reduction in children with autism spectrum disorder. Trial Registration isrctn.org Identifier: ISRCTN78923965

Inter-rater reliability on the Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) for autism spectrum disorder

ABSTRACT The Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) is an evaluation instrument made up of three criterion-referenced rating scales designed to examine how clients perceive, interpret, and make music with the therapist while participating in individual improvisational music therapy. The purposes of this study are to determine the inter-rater reliability of the IMCAP-ND’s Scale I: Musical Emotional Assessment Rating Scale (MEARS), Scale II: Musical Cognitive Perception Scale (MCPS), and Scale III: Musical Responsive Scale (MRS); and to examine the inter-rater reliabilities of the MEARS, MCPS, and MRS subscales scores. Two raters scored 30 music therapy video-recorded sessions (n = 30) featuring individuals diagnosed with autism spectrum disorder using the MEARS, MCPS, and MRS. Findings pertaining to the MEARS are that nearly all of the weighted kappas (98%) can be characterized as “almost perfect,” using Landis and Koch’s interpretive standard for assessing inter-rater reliability. In addition, all of the weighted kappas (100%) for the subscales of the MCPS as well as the subscales of the MRS can be characterized as “almost perfect,” i.e. the highest level of inter-rater reliability. The statistical evidence from this study strongly supports the inter-rater reliability of the IMCAP-ND’s MEARS, MCPS, and MRS.

Assessment in music therapy: Strategies and applications to clinical practice in an international perspective

Background: In music therapy field, assessment is aimed at understanding the client’s unique strengths and challenges determining whether the client may benefit from music therapy treatment. There are different perspectives to conduct this phase in music therapy process according to the use of distinct scales, questionnaires and musical experiences.Objective: Drawing from the experience of music therapists in three different countries (Argentina, Brazil and United States) this roundtable reflects upon and connects perspectives on how to implement distinct assessments in music therapy clinical practice.Content: The members of the roundtable reflect upon their experience as clinicians using assessments in different areas of clinical practice. Themes explored include strategies and applications of some music therapy assessments: Individual Music Therapy Assessment Profile (IMTAP), Intramusical Relationship Scale (IRS) and Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND...

AUDIOVISUALIDADE EM MÚSICA: PROCESSOS PERCEPTIVOS E COGNITIVOS

Tanto o sistema auditivo, como o sistema visual, ambos localizados em regioes bem proximas no cerebro, codificam frequencias (sonoras e luminosas) que entram em nosso sistema sensorial, no caso a visao e a audicao, em informacoes para o cerebro, dando-nos condicoes de saber com o que estamos nos relacionando. nA substituicao sensorial e empregada para suprir a perda de uma modalidade sensorial, convertendo a informacao do sentido prejudicado por outro sentido nao acometido. nA integracao audiovisual e um tema pouco abordado na literatura musical. Nos estudos sobre musica e neurociencias este tem sido um assunto constante. Os aportes destes estudos trazem diversas hipoteses que se referem a sinestesia audiovisual, percepcao de objetos pela audicao musical, manifestacao da linguagem e percepcao de emocoes pela visualizacao da performance musical. Dessa forma, o proposito deste artigo e apresentar algumas desses aportes e discutir de que forma elas podem auxiliar os musicos, professores de musica e musicoterapeutas na sua pratica de trabalho e na formulacao de novas hipoteses de pesquisa.