Music interventions are evidence-based with positive results — so why don’t we use them more often?

A version of this commentary appeared in the Seattle Times, Montreal Gazette and the Vancouver Sun.

My son is practicing the piano as I write this and it’s the sweetest sound. He’s spent two years working slowly through the same level, but it doesn’t matter; he’s improving and the benefits of both music therapy and music lessons have been clear and measurable. My only wish is that I had started sooner.

My son has autism, a neurodevelopmental disability that’s frequently highlighted in the media as a communication disorder or a behavioural problem, but the reality is more complex. Autism, I’ve come to learn, is a “whole body disorder” that may also affect fine and gross motor skills, impair sensory function, cause sleep and gut issues, along with the more commonly discussed social and verbal communication and rigid and repetitive behavioural challenges.

At age 10, my son still has difficulty using a fork properly, doing up buttons or tying a shoelace. It’s not intellectual delay that makes these tasks difficult – he could read maps from age three and memorize complex bus schedules or patterns by age four -- but fingers that lack typical muscle and dexterity.

No one talks much about this side of autism.

He spent years in Occupational Therapy using play-based strategies to improve his fine motor and muscle development, with much success. But as he aged, it was music that brought significant improvement.

First we tried music therapy, where our son worked with a trained therapist to achieve clinical (and not musical) goals, such as improved communication. Then we turned to more formal piano lessons intended for kids on the autism spectrum.

When he first started, his hands lay flat on the keys, with several unable to move individually without significant effort. It took weeks to have the fingers splay and bend and push the keys at will. And months to start to curve the fingers to create a rounded claw to give each finger more power to depress the individual note.

But it came, week by week, along with his sense of accomplishment at learning to read music and mastering new songs – and now, his ability to play both hands at the same time.

Other parents remember their child’s first steps with welled up tears. For me, it’s simple piano scales played without struggle – fluid fingers working their way up and down the keyboard.

We’ve seen music pay dividends in other significant ways. We noticed his attention span started lengthening – not just while at the piano, but in other settings too. His general confidence improved and his stress levels decreased. And he became proud he was doing something other than therapy – something that other kids do too.

So why hadn’t we done this sooner? The truth is, out of all the autism experts we consulted in the early days – and there were many – no one mentioned music as a way to help. It never came up.

Which is surprising, because it turns out there’s science to back it up.

A Cochrane meta-analysis of studies addressing the power of music interventions on autism found that music therapy specifically improved social interaction, verbal and non-verbal communicative skills, imitating behaviour, emotional reciprocity, social skills, quality of child-parent relationships — and joy. The researchers actually studied the frequency and duration of joy.

Joy! No other autism therapy I’ve ever read about includes “joy” as a measurable outcome.

Another earlier review flags the potential for musical training in kids with autism to improve joint attention, multi-sensory perception, motor development and the ability to foster social connections. Learning music also engages multiple areas of the brain, the authors note, and could possibly promote connectivity between different regions of the brain.

The review ends with a call for health and education practitioners to “diversify autism interventions” and to promote the use of music-based approaches. I couldn’t agree more.

Some studies show kids with autism may already have enhanced pitch memory and perception. So it’s about building on potential strengths too.

Other studies not specific to autism show music training improves what researchers call auditory and rhythm discrimination. Music can also increase dopamine levels and improve moods. Music therapy has also been linked to improving mental health, reducing anxiety, improving sleep and even improving gait in a range of other disorders.

And the best part? Music interventions demonstrate no negative side-effects whatsoever.

Importantly, music interventions also don’t try to “cure” or “fix” the individual with autism. Music offers instead a means for expression, growth and development – in their own time and voice.

February 2018