While many goals are addressed and specific to the individual person in a music therapy session, social skills are one of the primary goal domains for people with Autism Spectrum Disorder. The Diagnostic Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013) lists the first diagnostic criteria as deficits in social-emotional reciprocity “ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.” Within this social skills goal domain, emotional perception and expression are more specific goals that assist with socialization with peers. Research shows that music therapy is beneficial in addressing nonverbal emotional skills, appropriate expression, and other skills within this social-emotional domain (Reschke-Hernandez, 2011).
The types of interventions to address the emotional aspect of social skills with people with ASD has shifted and expanded throughout the years with more research and practical application. Music is often used as a carrier of nonmusical information that is more engaging than spoken word. Because individuals with autism “respond more frequently and appropriately to music than to other auditory stimuli,” important social cues are more easily perceived through this mode of communication (Bownell, 2002, p. 123). This increased responsivity supports the use of music accompanying social stories to directly teach appropriate perception of emotions in relatable scenarios. Social stories have also been found to be effective in shifting behavior to prompt appropriate responses. A social story is a short, individualized text that describes an event or social situation in detail using images, printed words, and verbal explanations to provide instructions on how to appropriately respond to that situation (Brownell, 2002). The use of music to accompany these stories aids in retention of the concepts discussed because “the ability for musical recall may provide another avenue by which these students may remember and incorporate vital information” (Brownell, 2002, p. 141).
Nonverbal communication, whether it is in the timing, facial expressions, or body language, can be an area of difficulty for people with ASD (Katagiri, 2009). Interventions that emphasize these nonverbal aspects of communication can improve the overall perception of emotions in a reciprocal conversation. The use of visual aids, flash cards of moods and facial expressions, and photographs has been found to assist with this direct explanation of the more indirect nuances of communication (Reschke-Hernandez, 2011). Drawing attention to and discussing the images and facial features associated with specific emotions can create connections and help recognize patterns for social interaction.
Researchers have also seen improvements in emotional perception through the use of correlated background music when discussing emotions or social stories attached (Katagiri, 2009). The auditory cues in the music such as tempo, dynamics, and instrumentation contribute to the understanding of the emotion being discussed. The musical delivery of the lyrics also improves the perception of the emotional meaning due to the engaging and multisensory qualities. Specifically negatively associated emotions such as anger and sadness were found to be perceived the most strongly through the use of background music interventions (Brown, 2016).
Music has proven to be a successful method of improving emotional perception and expression in people with Autism Spectrum Disorder. Having this emotional reciprocity is important to daily living and interactions with others. Whether this is in casual social interactions with family or friends, or it is in a more formal educational or employment setting, fostering connections with others and being able to more easily express oneself benefits all people involved. Music therapists are integrating different interventions into their sessions with people working on these specific goals, and the research is growing to expand on the possibilities for finding more effective methods of connection through the medium of music.
References
American Psychiatric Association. (2013). Autism Spectrum Disorder. In Diagnostic and statistical manual of mental disorders (5th ed.).
Brown, L. S. (2016). The influence of music on facial emotion recognition in children with autism spectrum disorder and neurotypical children. Journal of Music Therapy, 54(1), 55-79. https://doi.org/10.1093/jmt/thw017
Brownell, M. D. (2002). Musically adapted social stories to modify behaviors in students with autism: Four case studies. Journal of Music Therapy, 39(2), 117–144. https://doi.org/10.1093/jmt/39.2.117
Katagiri, J. (2009). The effect of background music and song texts on the emotional understanding of children with autism. Journal of Music Therapy, 46(1), 15–31. https://doi.org/10.1093/jmt/46.1.15
Reschke-Hernandez, A. E. (2011). History of music therapy treatment interventions for children with autism. Journal of Music Therapy, 48(2), 169–207. https://doi.org/10.1093/jmt/48.2.169