Effects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder

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Bieleninik, Ł., Geretsegger, M., Mössler, K., Aßmus, J., Thompson, G., Gattino, G., Elefant, C., Gottfried, T., Igliozzi, R., Muratori, F., Suvini, F., Kim, J., Crawford, M., Odell‐Miller, H., Oldfield, A., Casey, Ó., Finnemann, J., Carpente, J., Park, A.,..., & Team, f. t. T. A. S. (2017). Effects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder. JAMA, 318(6), 525. https://doi.org/10.1001/jama.2017.9478

Publication date: 8 Aug 2017 Added to AutiHub: 6 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
22
Publication authors identified as autistic
1 / 22 (4.5%)
  1. Łucja Bieleninik
  2. Monika Geretsegger
  3. Karin Mössler
  4. Jörg Aßmus
  5. Grace Thompson *
  6. Gustavo Gattino
  7. Cochavit Elefant
  8. Tali Gottfried
  1. Roberta Igliozzi
  2. Filippo Muratori
  3. Ferdinando Suvini
  4. Jinah Kim
  5. Mike Crawford
  6. Helen Odell‐Miller
  7. Amelia Oldfield
  8. Órla Casey
  1. Johanna Finnemann
  2. John Carpente
  3. A‐La Park
  4. Enzo Grossi
  5. Christian Gold
  6. for the TIME-A Study Team

Abstract

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 (n = 182) vs enhanced standard care plus improvisational music therapy (n = 182), 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]; P =.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.

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Cited references
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1 / 31 (3.2%)
Cited author occurrences identified as autistic
1 / 128 (0.8%)
Among occurrences linked to AutiHub author records: 1 / 50 (2.0%). Distinct cited authors identified as autistic: 1 / 98 (1.0%).
Cited author occurrences linked to AutiHub author records
50 / 128 (39.1%)
Distinct linked cited authors: 27 / 98 (27.6%)
Linked cited-author occurrences not identified as autistic
49 / 50 (98.0%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 49 / 128 (38.3%). Distinct linked cited authors not identified as autistic: 26 / 27 (96.3%).
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