Effect of long-term interactive music therapy on behavior profile and musical skills in young adults with severe autism.

BACKGROUND: Data on the potential behavioral effects of music therapy in autism are scarce. OBJECTIVE: The aim of this study was to investigate whether a musical training program based on interactive music therapy sessions could enhance the behavioral profile and the musical skills of young adults affected by severe autism. METHODOLOGY: Young adults (N = 8) with severe (Childhood Autism Rating Scale >30) autism took part in a total of 52 weekly active music therapy sessions lasting 60 minutes. Each session consisted of a wide range of different musical activities including singing, piano playing, and drumming. Clinical rating scales included the Clinical Global Impression (CGI) scale and the Brief Psychiatric Rating Scale (BPRS). Musical skills-including singing a short or long melody, playing the C scale on a keyboard, music absorption, rhythm reproduction, and execution of complex rhythmic patterns-were rated on a 5-point Likert-type scale ranging from "completely/entirely absent" to "completely/entirely present." RESULTS: At the end of the 52-week training period, significant improvements were found on both the CGI and BPRS scales. Similarly, the patients' musical skills significantly ameliorated as compared to baseline ratings. CONCLUSIONS: Our pilot data seem to suggest that active music therapy sessions could be of aid in improving autistic symptoms, as well as personal musical skills in young adults with severe autism.

Neurophysiology and neurobiology of the musical experience.

Music, a universal art form that exists in every culture around the world, is integral to a number of social and courtship activities, and is closely associated with other creative behaviours such as dancing. Recently, neuroimaging studies have allowed researchers to investigate the neural correlates of music processing and perception in the brain. Notably, musical stimuli have been shown to activate specific pathways in several brain areas associated with emotional behaviours, such as the insular and cingulate cortex, hypothalamus, hippocampus, amygdala, and prefrontal cortex. In addition, neurochemical studies have suggested that several biochemical mediators, such as endorphins, endocannabinoids, dopamine and nitric oxide, may play a role in the musical experience. A growing body of evidence also indicates that music therapy could be useful in the clinical management of numerous neurological and psychiatric disorders. Indeed, music therapy could be effective in patients with neurodegenerative disorders, such as Alzheimer's dementia and Parkinson?s disease, as well as in psychiatric illnesses, such as schizophrenia, depression, anxiety and autism spectrum disorders. Unfortunately, there is still a shortage of rigorous scientific data supporting the clinical application of music therapy, and there is thus a need to confirm and expand the preliminary findings regarding the potential and actual effectiveness of music therapy. This need should be addressed through prospective, randomized, controlled, single-blinded investigations of the short- and long-term effects of music therapy in diverse clinical conditions.