3/3/2017 Examining the Evidence Examining the Evidence for Music Therapy with for Music Therapy with Disclosures: None Disclosures: None Individuals with ASD & DD Individuals with ASD & DD Pierre Brennan, MM, MT-BC, BCBA Pierre Brennan, MM, MT-BC, BCBA Kidjaboun Togo 1
3/3/2017 AUDITORY INTEGRATION THERAPY (AIT) “Despite approximately one decade of practice in this country, this method has not met scientific standards for efficacy and Music Therapy is the clinical and evidence- Music Therapy is the clinical and evidence- safety that would justify its inclusion as a mainstream treatment for these disorders.” (ASHA, 2004) based use of musical interventions to based use of musical interventions to accomplish individualized goals within a accomplish individualized goals within a therapeutic relationship by a credentialed therapeutic relationship by a credentialed American Academy of Audiology (1993) American Academy of Pediatrics (1998) professional who has completed an professional who has completed an Educational Audiology Association (1997) approved music therapy program. approved music therapy program. New York State Department of Health (1999) concluded that AIT not be used as an intervention for young children with autism. 2
3/3/2017 Melodic Intonation Therapy MUSIC THERAPY GOAL AREAS MUSIC THERAPY GOAL AREAS Social Communication Social Communication Used in rehabilitation Emotional Regulation Emotional Regulation of expressive aphasia Motor Motor Pre-academic Pre-academic Academic Academic Cognitive Cognitive Musical Musical Gabrielle “Gabby” Giffords ENHANCED PERCEPTUAL FUNCTIONING ENHANCED PERCEPTUAL FUNCTIONING MUSIC AS AN INTRINSICALLY Enhanced low-level processing with Enhanced low-level processing with REWARDING EXPERIENCE or without intact global processing or without intact global processing 3
3/3/2017 JOINT ATTENTION JOINT ATTENTION Pivotal in language, play, and social Pivotal in language, play, and social development development VISUAL SUPPORT U sing photographs, picture symbols, or written words to enhance the child’s active participation and understanding. 4
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3/3/2017 MUSIC AS A REINFORCER ABA ABA ABA ABA Applied Behavior Analysis is a Applied Behavior Analysis is a B. F. Skinner’s Operant Conditioning B. F. Skinner’s Operant Conditioning systematic process of studying and systematic process of studying and modifying observable behavior through a modifying observable behavior through a A B C manipulation of the environment. manipulation of the environment. ANTECEDENT BEHAVIOR CONSEQUENCE 6
3/3/2017 RHYTHM AS A TEMPORAL CUE SHARED NEURAL SYSTEMS SHARED NEURAL SYSTEMS Rhythm and timing are important in motor learning. 7
3/3/2017 GAIT REHABILITATION GAIT REHABILITATION Impelling and anticipatory nature of rhythm promotes STEP CADENCE STRIDE LENGTH speech SYMMETRY VELOCITY MUSIC FACILITATES NON-PROPOSITIONAL SPEECH 32 8
3/3/2017 The structure and patterning in music The structure and patterning in music can direct attention toward language can direct attention toward language concepts and social behavior. concepts and social behavior. 35 9
3/3/2017 RAPID TEMPORAL PROCESSING HYPOTHESIS RAPID TEMPORAL PROCESSING HYPOTHESIS Speech perception relies on higher Speech perception relies on higher temporal resolution of complex stimuli, temporal resolution of complex stimuli, making the deficit in ASD a timing problem, making the deficit in ASD a timing problem, where slower, repetitive sounds, where slower, repetitive sounds, like in music, remain intact. like in music, remain intact. Training on a musical SIMILAR ACOUSTIC CUES instrument changes subcortical encoding Both music and speech use of speech patterns pitch, timing, and timbre. can improve how speech and noice is heard (Kraus & Chandrarasekaran, 2010) 10
3/3/2017 LANGUAGE Music and language share underlying Words as discrete elements are cognitive and neural mechanisms combined to form sentences. MUSIC Auditory processing structures in the brain Individual and simultaneous tones in respond in similar ways to both speech and the form of intervals and chords music. combine to form meaningful musical phrases. (Zatorre, Evans, Meyer, & Gjedde, 1992) SYNTAX SYNTAX Similarities in music and language The set of principles that governs the combination of discrete elements into meaningful structural sequences � Phonemes: basic sound units (Jackendoff, 2002) � Syntax: how sound units are organized � Semantics: meaning that is assigned to sound sequences THE COGNITIVE PROCESSING OF � Pragmatics: rules that define effective communicative interactions STRUCTURAL RELATIONS BETWEEN EVENTS 11
3/3/2017 When given a choice between listening to their mothers’ voice and the unintelligible noise of superimposed voices generated by a noisy crowd, children with autism showed CULTURE INFLUENCES either no preference for either auditory stimulus, or a preference for the noise of a crowd, whereas typically SYNTACTIC DEVELOPMENT developing children and children with intellectual disability preferred their mother’s voice (Klin, 1991, 1992). AUTISM TYPICALLY DEVELOPING HYPOTHESIS HYPOTHESIS When given When given a choice between a choice between listening to listening to American children’s music and music from American children’s music and music from Africa of similar tempo, orchestration, and form, Africa of similar tempo, orchestration, and form, INTELLECTUAL DISABILITY children with autism will not show a bias for children with autism will not show a bias for American children’s music when compared to American children’s music when compared to the results of typically developing children and the results of typically developing children and children with intellectual disability matched for children with intellectual disability matched for chronological age. chronological age. Pie graphs for percentages of average individual listening times for each type of music selected: American children’s music and African music. 12
3/3/2017 Shared Syntactic Integration Resource Hypothesis The processing of music and linguistic Although the processing of musical and linguistic syntax use different cognitive operations, these two domains share syntax interact overlapping neural networks for processing structural in Broca’s area information in working memory. These shared syntactic processes in frontal brain areas and domain-specific syntactic representations in more posterior brain regions are implicated Kunert, Willems, Casasanto, Patel & Hagoort, 2015 in the accessing and processing of rule-governed information (Patel, 1998). MUSIC AS A MNEMONIC DEVICE Listening to music recruits attention and working memory circuits (Janata, Tillmann & Bhurucha, 2002) Syntactic deficits in this study appeared Syntactic deficits in this study appeared Music training improves verbal memory to be domain-specific, implicating to be domain-specific, implicating (Chan, Ho & Cheung, 1998) linguistic syntactic representations rather linguistic syntactic representations rather Verbal learning with a musical template increases neuronal synchronization and approves verbal memory (McInotsh, Peterson, Thaut, 2006) than shared syntactic processes. than shared syntactic processes. 13
3/3/2017 MUSIC AS SYMBIOLIC MUSIC AS A COMMUNICATION SOCIAL EXPERIENCE 55 14
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