Children with developmental coordination disorder display atypical interhemispheric connectivity during conscious and subconscious rhythmic auditory-motor synchronization.

Children with developmental coordination disorder (DCD) display difficulties in perception-action coupling when engaging in tasks requiring predictive timing. We investigated the influence of awareness on auditory-motor adjustments to small and large rhythmic perturbations in the auditory sequence to examine whether children synchronize their movements automatically or through planning and whether those adjustments occur consciously or subconsciously. Electroencephalography (EEG) was used to assess functional connectivity patterns underlying different adjustment strategies. Thirty-two children aged 7-11 participated, including children with DCD and their typically developing (TD) peers with and without musical training. All children automatically adjusted their motor responses to small rhythmic perturbations by employing the anticipatory mode, even when those changes were consciously undetectable. Planned adjustments occurred only when children consciously detected large fluctuations (Δ 20%), which required a shift from predictive to reactive strategies. Compared to TD peers, children with DCD showed reduced interhemispheric connectivity during planned adjustments and displayed similar neural patterns regardless of task constraints. Notably, they benefited from rhythmic entrainment despite having increased variability and lower perceptual acuity. Musical training was associated with enhanced auditory-perceptual timing, reduced variability, and increased interhemispheric coherence. These insights are important for the therapeutic application of auditory/rhythm-based interventions in children with DCD.

Can Music Enhance Working Memory and Speech in Noise Perception in Cochlear Implant Users? Design Protocol for a Randomized Controlled Behavioral and Electrophysiological Study.

BACKGROUND: A cochlear implant (CI) enables deaf people to understand speech but due to technical restrictions, users face great limitations in noisy conditions. Music training has been shown to augment shared auditory and cognitive neural networks for processing speech and music and to improve auditory-motor coupling, which benefits speech perception in noisy listening conditions. These are promising prerequisites for studying multi-modal neurologic music training (NMT) for speech-in-noise (SIN) perception in adult cochlear implant (CI) users. Furthermore, a better understanding of the neurophysiological correlates when performing working memory (WM) and SIN tasks after multi-modal music training with CI users may provide clinicians with a better understanding of optimal rehabilitation. METHODS: Within 3 months, 81 post-lingual deafened adult CI recipients will undergo electrophysiological recordings and a four-week neurologic music therapy multi-modal training randomly assigned to one of three training focusses (pitch, rhythm, and timbre). Pre- and post-tests will analyze behavioral outcomes and apply a novel electrophysiological measurement approach that includes neural tracking to speech and alpha oscillation modulations to the sentence-final-word-identification-and-recall test (SWIR-EEG). Expected outcome: Short-term multi-modal music training will enhance WM and SIN performance in post-lingual deafened adult CI recipients and will be reflected in greater neural tracking and alpha oscillation modulations in prefrontal areas. Prospectively, outcomes could contribute to understanding the relationship between cognitive functioning and SIN besides the technical deficits of the CI. Targeted clinical application of music training for post-lingual deafened adult CI carriers to significantly improve SIN and positively impact the quality of life can be realized.

Auditory feedback decreases timing variability for discontinuous and continuous motor tasks in autistic adults.

Introduction: Autistic individuals demonstrate greater variability and timing error in their motor performance than neurotypical individuals, likely due at least in part to atypical cerebellar characteristics and connectivity. These motor difficulties may differentially affect discrete as opposed to continuous movements in autistic individuals. Augmented auditory feedback has the potential to aid motor timing and variability due to intact auditory-motor pathways in autism and high sensitivity in autistic individuals to auditory stimuli. Methods: This experiment investigated whether there were differences in timing accuracy and variability in autistic adults as a function of task (discontinuous vs. continuous movements) and condition (augmented auditory feedback vs. no auditory feedback) in a synchronization-continuation paradigm. Ten autistic young adults aged 17-27 years of age completed the within-subjects study that involved drawing circles at 800 milliseconds intervals on a touch screen. In the discontinuous task, participants traced a series of discrete circles and paused at the top of each circle for at least 60 milliseconds. In the continuous task, participants traced the circles without pausing. Participants traced circles in either a non-auditory condition, or an auditory condition in which they heard a tone each time that they completed a circle drawing. Results: Participants had significantly better timing accuracy on the continuous timing task as opposed to the discontinuous task. Timing consistency was significantly higher for tasks performed with auditory feedback. Discussion: This research reveals that motor difficulties in autistic individuals affect discrete timing tasks more than continuous tasks, and provides evidence that augmented auditory feedback may be able to mitigate some of the timing variability present in autistic persons' movements. These results provide support for future investigation on the use of music-based therapies involving auditory feedback to address motor dysfunction in autistic individuals.

Is there a bilingual advantage in auditory attention among children? A systematic review and meta-analysis of standardized auditory attention tests.

A wealth of research has investigated the associations between bilingualism and cognition, especially in regards to executive function. Some developmental studies reveal different cognitive profiles between monolinguals and bilinguals in visual or audio-visual attention tasks, which might stem from their attention allocation differences. Yet, whether such distinction exists in the auditory domain alone is unknown. In this study, we compared differences in auditory attention, measured by standardized tests, between monolingual and bilingual children. A comprehensive literature search was conducted in three electronic databases: OVID Medline, OVID PsycInfo, and EBSCO CINAHL. Twenty studies using standardized tests to assess auditory attention in monolingual and bilingual participants aged less than 18 years were identified. We assessed the quality of these studies using a scoring tool for evaluating primary research. For statistical analysis, we pooled the effect size in a random-effects meta-analytic model, where between-study heterogeneity was quantified using the I2 statistic. No substantial publication bias was observed based on the funnel plot. Further, meta-regression modelling suggests that test measure (accuracy vs. response times) significantly affected the studies' effect sizes whereas other factors (e.g., participant age, stimulus type) did not. Specifically, studies reporting accuracy observed marginally greater accuracy in bilinguals (g = 0.10), whereas those reporting response times indicated faster latency in monolinguals (g = -0.34). There was little difference between monolingual and bilingual children's performance on standardized auditory attention tests. We also found that studies tend to include a wide variety of bilingual children but report limited language background information of the participants. This, unfortunately, limits the potential theoretical contributions of the reviewed studies. Recommendations to improve the quality of future research are discussed.

Improved motor skills in autistic children after three weeks of neurologic music therapy via telehealth: a pilot study.

Background: Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)® sessions via telehealth would improve motor and attention skills in autistic children. Methods: Five autistic children between five and 10 years of age participated in the study, with support from their caregivers. Motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency second edition, short form (BOT-2 SF), and a selective attention and sustained attention task were taken from the Test of Everyday Attention for Children, Second Edition (TEA-Ch2). Caregivers and the two neurologic music therapists involved in the study provided qualitative input about the perceived effectiveness of telehealth NMT for the children involved. Their responses were analyzed using qualitative content analysis. Caregivers also filled out a Sensory Profile 2 assessment prior to the onset of sessions so that each child's sensory profile could be compared to their motor and attention results. Results: Statistically significant improvements in motor skills were observed between pre-test assessment and a two-week follow-up assessment. Results from attention test scores were not significant. Caregivers and neurologic music therapists generally perceived sessions positively and noted the importance of having caregivers actively involved. When compared with individual progress on the BOT-2 SF assessment, sensory profile results revealed that children with fewer sensory sensitivities tended to improve the most on motor skills. The improvements in motor skills and positive caregiver and therapist views of telehealth indicate that NMT motor interventions administered via telehealth are a promising avenue of therapeutic support for movement skill development in autistic children.

Please unmute your microphone: Comparing the effectiveness of remote versus in-person percussion training.

Although remote music training has its limitations, the use of technology can lower barriers to its accessibility. This exploratory study compared the effects of remote and in-person percussion training on motor performance, performance quality, and students' enjoyment. The training involved the motor aspects of playing legato on percussion instruments. Twenty percussionists received the training either remotely from an instructor using videoconferencing technology or in person from the same instructor who was in the training room. Motor behavior, legato expressivity, performance quality, and participants' self-rated enjoyment were compared to determine potential advantages and disadvantages of training in the two formats. Furthermore, participants rated their interest in continuing to receive training in the same way they had experienced it, remote or in person. Regardless of whether the instructor was remote or in person, participants lifted their mallets to a greater height above the drums post-training, perhaps because there was more spatial and velocity variability in the movements of their elbows and wrists. Changes in their patterns of post-training movements were paralleled by higher ratings for expressivity of legato and performance quality. Critically, participants who received training from the remote instructor expressed greater interest in continuing training than those who received training from the instructor who was physically present, in both the short and long term. These findings may suggest that remote and in-person instruction yielded comparable changes on motor behavior, as demonstrated by the altered speed at which movements of the elbow and wrist were executed, which in turn may influence the perception of expressivity in legato playing. The results may support the use of remote training as an adjunct to physical practice to lower some barriers to music education.

Factors Influencing Music Therapists' Retention of Clinical Hours with Autistic Clients over Telehealth During the COVID-19 Pandemic.

The 2019 coronavirus disease pandemic influenced music therapists to migrate services to online platforms, though some lost clinical hours during the pandemic when telehealth was not a viable option. This survey study aimed to ascertain factors that helped music-based therapists to continue serving autistic clients over telehealth during the pandemic. We surveyed 193 accredited music therapists located mainly in Canada and the US. In addition to gathering data on general perceptions of telehealth music therapy and Neurologic Music Therapy (NMT), one-way ANOVAs were applied to determine differences in percent-change loss of clinical hours for music therapists: (1) working in different employment settings; (2) serving children, youth, adults, or a mixture of ages; and (3) practicing NMT or not. The general perception of telehealth music therapy was positive, and NMTs believed that the clear protocols and transformation design model were helpful to them in adapting services to telehealth. There were no significant differences in percent-change of clinical hours among music therapists in different employment settings or serving different client age groups. Music therapists who said they practiced within the NMT treatment model lost a significantly lower percentage of clinical hours with autistic clients than those who did not practice NMT. Possible reasons for this result and the need for further research are discussed.

The neural bases of familiar music listening in healthy individuals: An activation likelihood estimation meta-analysis.

Accumulating evidence suggests that the neural activations during music listening differs as a function of familiarity with the excerpts. However, the implicated brain areas are unclear. After an extensive literature search, we conducted an Activation Likelihood Estimation analysis on 23 neuroimaging studies (232 foci, 364 participants) to identify consistently activated brain regions when healthy adults listen to familiar music, compared to unfamiliar music or an equivalent condition. The results revealed a left cortical-subcortical co-activation pattern comprising three significant clusters localized to the supplementary motor areas (BA 6), inferior frontal gyrus (IFG, BA 44), and the claustrum/insula. Our results are discussed in a predictive coding framework, whereby temporal expectancies and familiarity may drive motor activations, despite any overt movement. Though conventionally associated with syntactic violation, our observed activation in the IFG may support a recent proposal of its involvement in a network that subserves both violation and prediction. Finally, the claustrum/insula plays an integral role in auditory processing, functioning as a hub that integrates sensory and limbic information to (sub)cortical structures.

Rhythmic auditory stimulation as a potential neuromodulator for Parkinson's disease.

Auditory rhythm-based therapeutic interventions such as rhythmic auditory stimulation (RAS) are effective in improving gait and balance and preventing falls in idiopathic Parkinson's disease (PD). Research showing associated neuromodulatory effects of RAS on brain oscillations is also emerging. The neuromodulation may be induced by neural entrainment and cross-frequency oscillatory coupling. Auditory rhythm and RAS based interventions are potentially effective in improving other PD symptoms and can be extended to atypical parkinsonism.

Electroencephalographic interbrain synchronization in children with disabilities, their parents, and neurologic music therapists.

As with typically developing children, children with cerebral palsy and autism spectrum disorder develop important socio-emotional rapport with their parents and healthcare providers. However, the neural mechanisms underlying these relationships have been less studied. By simultaneously measuring the brain activity of multiple individuals, interbrain synchronization could serve as a neurophysiological marker of social-emotional responses. Music evokes emotional and physiological responses and enhances social cohesion. These characteristics of music have fostered its deployment as a therapeutic medium in clinical settings. Therefore, this study investigated two aspects of interbrain synchronization, namely, its phase and directionality, in child-parent (CP) and child-therapist (CT) dyads during music and storytelling sessions (as a comparison). A total of 17 participants (seven cerebral palsy or autism spectrum disorder children [aged 12-18 years], their parents, and three neurologic music therapists) completed this study, comprising seven CP and seven CT dyads. Each music therapist worked with two or three children. We found that session type, dyadic relationship, frequency band, and brain region were significantly related to the degree of interbrain synchronization and its directionality. Particularly, music sessions and CP dyads were associated with higher interbrain synchronization and stronger directionality. Delta (.5-4 Hz) range showed the highest phase locking value in both CP and CT dyads in frontal brain regions. It appears that synchronization is directed predominantly from parent to child, that is, parents and music therapists' brain activity tended to influence a child's. Our findings encourage further research into neural synchrony in children with disabilities, especially in musical contexts, and its implications for social and emotional development.

Auditory-Perceptual and Auditory-Motor Timing Abilities in Children with Developmental Coordination Disorder: A Scoping Review.

Developmental coordination disorder (DCD) remains largely underdiagnosed and masked by other co-occurring conditions. The aim of this study was to (1) provide the first review of research regarding auditory-motor timing and synchronization abilities in children with DCD and (2) examine whether reduced motor performance may be associated with difficulties in auditory perceptual timing. The scoping review was carried out across five major databases (MEDLINE, Embase, PsycINFO, CINAHL, and Scopus) in accordance with the PRISMA-ScR guidelines. Studies were screened by two independent reviewers against the inclusion criteria, without publication date restrictions. From an initial return of 1673 records, 16 articles were included in the final review and synthesized based on the timing modality studied (i.e., auditory-perceptual, motor, or auditory-motor). Results suggest that children with DCD have difficulties with rhythmic movements both with and without external auditory cues and further indicate that variability in and slowness of motor response are key characteristics of DCD, regardless of the experimental task. Importantly, our review highlights a significant gap in the literature regarding auditory perceptual abilities in DCD. In addition to testing auditory perception, future studies should compare the performance of children with DCD on paced and unpaced tasks to determine whether auditory stimuli contribute to a more or less stable performance. This knowledge may inform future therapeutic interventions.

Substituting some unassisted practice with robotic guidance: Assessing the feasibility of auditory-cued mixed practice for music-based interventions.

BACKGROUND: There is equivocal evidence regarding the effectiveness of robotic guidance on the (re)learning of voluntary motor skills. Robotic guidance can improve the performance of continuous/ tracking skills, although being seldom more effective than unassisted practice alone. However, most of the previous studies employed robotic guidance on all intervention trials. Recently, we showed that mixing robotic guidance with unassisted practice (i.e., mixed practice) can significantly improve the learning of a golf putting task. Yet, these mixed practice studies involved self-paced movements in a standing posture, thus less applicable to rehabilitation contexts. OBJECTIVE: The current study aimed to investigate the influence of mixed practice on the timing accuracy of an upper-limb, rhythmic, sequential task. The goal was to assess the feasibility of integrating mixed practice with music-based interventions. METHODS: Two groups of participants performed circle-drawing sequences in synchrony with rhythmic auditory signals. They completed a pre-test and an acquisition phase, followed by immediate retention and transfer tests. One group received robotic guidance on 50% of the acquisition trials (i.e., mixed practice), whereas another group always practiced unassisted. The pre-test, retention, and transfer tests were performed unassisted. RESULTS: Both groups significantly improved their timing accuracy and precision between the pre-test and the retention test. CONCLUSION: This study provides further evidence that mixed practice can facilitate the (re)learning of voluntary actions, especially with the type of externally paced upper-limb movements employed in music-based interventions.

Auditory cueing facilitates temporospatial accuracy of sequential movements.

Effectively executing goal-directed behaviours requires both temporal and spatial accuracy. Previous work has shown that providing auditory cues enhances the timing of upper-limb movements. Interestingly, alternate work has shown beneficial effects of multisensory cueing (i.e., combined audiovisual) on temporospatial motor control. As a result, it is not clear whether adding visual to auditory cues can enhance the temporospatial control of sequential upper-limb movements specifically. The present study utilized a sequential pointing task to investigate the effects of auditory, visual, and audiovisual cueing on temporospatial errors. Eighteen participants performed pointing movements to five targets representing short, intermediate, and large movement amplitudes. Five isochronous auditory, visual, or audiovisual priming cues were provided to specify an equal movement duration for all amplitudes prior to movement onset. Movement time errors were then computed as the difference between actual and predicted movement times specified by the sensory cues, yielding delta movement time errors (ΔMTE). It was hypothesized that auditory-based (i.e., auditory and audiovisual) cueing would yield lower movement time errors compared to visual cueing. The results showed that providing auditory relative to visual priming cues alone reduced ΔMTE particularly for intermediate amplitude movements. The results further highlighted the beneficial impact of unimodal auditory cueing for improving visuomotor control in the absence of significant effects for the multisensory audiovisual condition.

Absolute pitch: neurophysiological evidence for early brain activity in prefrontal cortex.

Absolute pitch (AP) is the ability to rapidly label pitch without an external reference. The speed of AP labeling may be related to faster sensory processing. We compared time needed for auditory processing in AP musicians, non-AP musicians, and nonmusicians (NM) using high-density electroencephalographic recording. Participants responded to pure tones and sung voice. Stimuli evoked a negative deflection peaking at ~100 ms (N1) post-stimulus onset, followed by a positive deflection peaking at ~200 ms (P2). N1 latency was shortest in AP, intermediate in non-AP musicians, and longest in NM. Source analyses showed decreased auditory cortex and increased frontal cortex contributions to N1 for complex tones compared with pure tones. Compared with NM, AP musicians had weaker source currents in left auditory cortex but stronger currents in left inferior frontal gyrus (IFG) during N1, and stronger currents in left IFG during P2. Compared with non-AP musicians, AP musicians exhibited stronger source currents in right insula and left IFG during N1, and stronger currents in left IFG during P2. Non-AP musicians had stronger N1 currents in right auditory cortex than nonmusicians. Currents in left IFG and left auditory cortex were correlated to response times exclusively in AP. Findings suggest a left frontotemporal network supports rapid pitch labeling in AP.

Music-based intervention drives paretic limb acceleration into intentional movement frequencies in chronic stroke rehabilitation.

This study presented a novel kinematic assessment of paretic limb function "online" during the actual therapeutic exercisers rooted within the acceleration domain. Twenty-eight patients at chronic stroke stages participated in an auditory-motor intervention mapping reaching movements of the paretic arm unto surfaces of large digital musical instruments and sound tablets that provided rhythmic entrainment cues and augmented auditory feedback. Patients also wore a tri-axial accelerometer on the paretic limb during the nine-session intervention. The resulting acceleration profiles were extracted and quantified within the frequency domain. Measures of peak power and peak width were leveraged to estimate volitional control and temporal consistency of paretic limb movements, respectively. Clinical assessments included the Wolf Motor Function Test and Fugl-Meyer - Upper Extremity subtest. The results showed that peak power increased significantly from Session 1 to Session 9 within oscillatory frequency ranges associated with intentional movement execution (i.e., 4.5 Hz). Decreases in peak width over time provided additional evidence for improved paretic arm control from a temporal perspective. In addition, Peak width values obtained in Session 1 was significantly correlated with pre-test Fugl-Meyer - Upper Extremity scores. These results highlighted improvements in paretic limb acceleration as an underlying mechanism in stroke motor recovery and shed further light on the utility of accelerometry-based measures of paretic limb control in stroke rehabilitation. The data reported here was obtained from a larger clinical trial: https://clinicaltrials.gov/ct2/show/NCT03246217 ClinicalTrials.gov Identifier: NCT03246217.

The Impact of Limb Velocity Variability on Mallet Accuracy in Marimba Performance.

The present study examined spatial accuracy of mallet endpoints in a marimba performance context. Trained percussionists performed two- (i.e., Experiment 1) and four-mallet (i.e., Experiment 2) excerpts in three tempo conditions including slow, intermediate, and fast. Motion capture was utilized to gather data of upper-limb and mallet movements, as well as to compute velocities of the upper-limb joints. Mallet spatial accuracy was assessed by comparing mallet endpoints to a visual target positioned on the marimba. It was hypothesized that mallet spatial accuracy would be reduced as tempo condition increased, with effects on joint kinematics potentially revealing sensorimotor mechanisms underlying optimal sound production in marimba. Across both experiments, mallet accuracy was reduced as tempo condition increased. Interestingly, velocity variability in the elbows, wrists, and hands increased as mallet accuracy decreased. Such a pattern of effects suggested that sound production in marimba is suboptimal at fast relative to slow tempi. In addition, the velocity variability effects highlight the impact of motor planning mechanisms on sound production. Overall, the results shed new light on sensorimotor control in percussion which can be leveraged to enhance the training of percussionists.

Does music induce interbrain synchronization between a non-speaking youth with cerebral palsy (CP), a parent, and a neurologic music therapist? A brief report.

Shared emotional experiences during musical activities among musicians can be coupled with brainwave synchronization. For non-speaking individuals with CP, verbal communication may be limited in expressing mutual empathy. Therefore, this case study explored interbrain synchronization among a non-speaking CP (female, 18 yrs), her parent, and a music therapist by measuring their brainwaves simultaneously during four music and four storytelling sessions. In only the youth-parent dyad, we observed a significantly higher level of interbrain synchronization during music rather than story-telling condition. However, in both the youth-parent and youth-therapist dyad, regardless of condition type, significant interbrain synchronization emerged in frontal and temporal lobes in the low-frequency bands, which are associated with socio-emotional responses. Although interbrain synchronization may have been induced by multiple factors (e.g., external stimuli, shared empathetic experiences, and internal physiological rhythms), the music activity setting deserves further study as a potential facilitator of neurophysiological synchrony between youth with CP and caregivers/healthcare providers.

Temporospatial Alterations in Upper-Limb and Mallet Control Underlie Motor Learning in Marimba Performance.

Sound-producing movements in percussion performance require a high degree of fine motor control. However, there remains a relatively limited empirical understanding of how performance level abilities develop in percussion performance in general, and marimba performance specifically. To address this issue, nine percussionists performed individualised excerpts on marimba within three testing sessions spaced 29 days apart to assess early, intermediate, and late stages of motor learning. Motor learning was quantified via analyses of both the temporal control of mallet movements, and the spatial variability of upper-limb movements. The results showed that temporal control of mallet movements was greater in the intermediate compared to the early learning session, with no significant additional improvements revealed in the late learning session. In addition, spatial variability in the left and right elbows decreased within the intermediate compared to the early learning session. The results suggest that temporal control of mallet movements may be driven by reductions in spatial variability of elbow movements specifically. As a result, this study provides novel evidence for kinematic mechanisms underlying motor learning in percussion which can be applied towards enhancing musical training.

Novel Screening Tool and Considerations for Music Therapists Serving Autistic Individuals via Telehealth: Qualitative Results from a Survey of Clinicians' Experiences.

During the COVID-19 pandemic, music therapists transitioned services from in-person to telehealth due to health and safety concerns. Though online delivery of music therapy services for autistic individuals occurred prior to 2020, the number of North American music therapists using telehealth with autistic clients rose substantially during the pandemic. The current paper's objective was to delineate music therapists' perceptions regarding factors that helped or hindered autistic persons' engagement in online music therapy sessions. In total, 192 participants completed the survey. Qualitative content analysis of an open-ended question identified seven overarching themes regarding the benefits and challenges of telehealth music therapy for autistic clients. Findings were used to create a screening tool to help music therapists evaluate autistic persons' suitability for telehealth and meet the needs of those who can benefit from telehealth music therapy.