Today’s post
is about music and music therapy.
A new study
reports that music therapy does not improve autism symptoms.
In an earlier
post we saw that singing reduces the level of your stress hormone cortisol;
this was based on testing adults in a choir, so not music novices.
Music has
actually been shown to do much more than just reduce your level of stress, it
can actually affect the expression of your genes, but only in those who are
“musically experienced”; in people with little experience of music it does
nothing.
Although brain imaging studies have demonstrated that
listening to music alters human brain structure and function, the molecular
mechanisms mediating those effects remain unknown. With the advent of
genomics and bioinformatics approaches, these effects of music can now be
studied in a more detailed fashion. To verify whether listening to classical
music has any effect on human transcriptome, we performed genome-wide
transcriptional profiling from the peripheral blood of participants after
listening to classical music (n = 48), and after a control study without
music exposure (n = 15). As musical experience is known to influence the responses to music, we
compared the transcriptional responses of musically experienced and
inexperienced participants separately with those of the controls.
Comparisons were made based on two subphenotypes of musical experience: musical
aptitude and music education. In musically experienced participants, we observed the differential
expression of 45 genes (27 up- and 18 down-regulated) and 97 genes (75 up- and
22 down-regulated) respectively based on subphenotype comparisons (rank product
non-parametric statistics, pfp 0.05, >1.2-fold change over time across
conditions). Gene ontological overrepresentation analysis
(hypergeometric test, FDR < 0.05) revealed that the up-regulated genes are
primarily known to be involved in the secretion and transport of dopamine,
neuron projection, protein sumoylation, long-term potentiation and
dephosphorylation. Down-regulated genes are known to be involved in ATP
synthase-coupled proton transport, cytolysis, and positive regulation of
caspase, peptidase and endopeptidase activities. One of the most up-regulated
genes, alpha-synuclein (SNCA), is located in the best linkage
region of musical aptitude on chromosome 4q22.1 and is regulated by GATA2,
which is known to be associated with musical aptitude. Several genes reported
to regulate song perception and production in songbirds displayed altered
activities, suggesting a possible evolutionary conservation of sound perception
between species. We observed
no significant findings in musically inexperienced participants.
Apparently there are about 7,000 music therapists in the United States and
about 6,000 in Europe. One of the target
groups for these therapists is children with autism.
So should parents pay out their cash for music therapy classes? Well a very recent large study carried out in
nine countries by a team from Norway suggests you might not want to open your
wallet.
I must say that I hold a different view and that this simplistic kind of
research is rather unhelpful.
From the research in this blog we know
that people who develop a love of music express a measurable biological effect,
which does indeed look beneficial.
How do you develop a love of music, or
indeed dance? Well you have to be exposed to it and engage in it.
Music therapy is all about engaging in
music.
Monty, now aged 14 with ASD, has been
dancing almost since he was walking, in great part because his then assistant
loved music. Later on you can start to
make your own simple music, later you can sing and eventually play an
instrument. This process takes
years.
Music therapy is just a start, years
later you can be trampolining to Abba, lying in bed listing to classical music,
or just playing the piano. But it is a
long road.
In
the recent research they gave 5 months of music therapy to 364 children aged 4 to 7 and then tested their social skills using the
Autism Diagnostic Observation Schedule (ADOS).
Their social skill score did not improve. I am not sure why they picked
this variable to measure.
This is yet more flawed research, which
will then be quoted as fact by others.
You could make a study on teaching
judo to kids with autism. I think you would find after 5 months it did not
improve their social skills, but those who continue for 5 years might benefit
considerably, versus those sat on the sofa watching videos on their iPads.
Clearly not everyone likes music, or
indeed judo. Many kids with more severe autism have little interest in anything
and so they need a lot more encouragement than typical kids.
The only way to find out if children
can develop an interest in music, sport or anything else is to expose them to
it at a young age. This is all music therapy is supposed to be, it is not meant
to be a cure for anything.
Researchers found that children with ASD in nine countries scored similarly on a test of
their social skills whether or not they had received the music therapy.
"Music therapy - like many other interventions that have been
suggested - does not improve autism symptoms," said senior author
Christian Gold, of the Grieg Academy Music Therapy Research Center and Uni
Research Health in Bergen, Norway.
ASDs are developmental disorders that can lead to social, communication and
behavioral challenges. The U.S. Centers for Disease Control and Prevention
estimates that one in 68 children in the U.S. has been diagnosed with an ASD.
The anecdotal link between music and ASD goes back many years, Gold and
colleagues write in JAMA. During music therapy, a person helps a child
spontaneously make music through singing, playing and movement.
There are about 7,000 music therapists in the United States and about 6,000
in Europe, the researchers write.
For the new study, the researchers recruited 364 children ages 4 to 7 years
from 10 treatment centers between 2011 and 2015. The centers were in Australia,
Austria, Brazil, Israel, Italy, Korea, Norway, the UK and the U.S.
All of the children received the usual care a child with ASD would receive
in their region, but half of the children were randomly assigned to also get
music therapy.
Usual care could range from early intensive behavioral interventions, to
speech and language therapy, to sensory-motor therapies and medications, Gold
told Reuters Health by email.
"Music therapy is also among the interventions that have been
recommended when it is available," he said. "Some parents who are
frustrated with behavioral interventions may experience it as bringing back the
joy of being with their child in a natural way."
After five months of therapy, the researchers did not find a difference
between the two groups of children on a measure of social skills.
Gold said parents should
continue to pursue music therapy if they feel it's a good match for their
children, but don't expect it to be a so-called treatment.
The article below is quite a good one:
The study itself:
In this issue of JAMA,
Bieleninik and colleagues1 present the results of a large,
well-designed, multicenter randomized clinical trial (RCT) of improvisational
music therapy for young children with autism spectrum disorder (ASD). Music
therapy is “a systematic process of intervention wherein the therapist helps
the client to promote health, using musical experiences and the relationships
that develop through them.”2 Among 364 children aged 4 to 7
years, over 5 months, the mean scores on the Autism Diagnostic Observation
Schedule (ADOS), social affect domain, decreased from 14.08 to 13.23 among
children randomized to improvisational music therapy and from 13.49 to 12.58
among those randomized to enhanced standard care, a mean difference in change
scores of 0.06 (95% CI, −0.70 to 0.81), with no significant differences between
groups.
How Much Music?
I think you need music lessons twice
a week to have a meaningful impact and, as with all therapies, you need more practice
at home. Most kindergartens have music
and dance as part of their activities. Taken together it is not so hard to get quite
a lot of exposure to music at a young age. Then, if the child really likes
music, you just keep going.
Conclusion
Is music therapy a quick fix for
autism? Definitely not.
Is music therapy a fun way to engage
many young children with autism? The recent research does not say so, but it is
clear that many people, with all levels of autism severity, can enjoy music and
participate in it.
I think we should put music
alongside sport, as a useful activity that young children should be encouraged
to engage in. It can be a struggle to
get some people with autism to engage in anything, which is where a music
therapist comes in.
Is it worth the investment in time
and money? That all depends on the child and the therapist. Buying a piano, 7
years ago, was certainly one of my better investments; but you do also need a
lot of lessons. The end result is
someone with a genuine love of many kinds of music and I expect he is now in
the cortisol lowering, gene expression modifying category of the musically
experienced.
Five months of unspecified music
therapy may not be enough to see results and quite possible those results are
not increased sociability anyway.