Music therapy and parent counselling to enhance resilience in young children with autism spectrum disorder: a mixed methods study

Abstract

This study investigates the effects of music therapy and parent counselling on resilience in young children with autism spectrum disorder (ASD). As many children with ASD and their families face adversity due to the condition, effective interventions are needed. Commonly, interventions are considered effective if they reduce ASD symptoms. However, it is controversial whether symptom reduction is an appropriate treatment aim. Rather, treatment effectiveness might be better measured against improved resilience. Resilience refers to positive adaptation in the context of significant adversity. The potential of music therapy and parent counselling to promote resilience has not been sufficiently explored yet. A mixed methods design was used for this research. Thirteen children with ASD aged four to seven years received individual music therapy sessions over five months. In addition, all parents were offered three counselling sessions each. Video-recorded excerpts of music therapy sessions were analysed using a time-sampling method to detect occurrences of behaviours indicative of resilience. In addition, an assessment of the quality of the child-therapist relationship was carried out. Generalised linear mixed models were used for the statistical analysis. To extract relevant information from video-recorded counselling sessions, one session for each family was transcribed and analysed using thematic analysis. Quality of life of children in the treatment group and in a control group was measured with a parent-rated scale at different time points. The material analysed in this doctoral research was a subset of data which had been collected but not analysed in the international randomised controlled trial TIME-A. The time-sampling video analysis of music therapy sessions revealed that several child behaviours indicative of resilience significantly increased over the course of the intervention, including self-expression, engagement, eye-contact, reciprocal smiles and initiating behaviours. The relationship between child and therapist significantly improved for all children receiving music therapy. According to the thematic analysis of counselling sessions, parents felt empowered by the simultaneous treatment approach. They reported improved child wellbeing and an improved ability to recognise and celebrate their children’s strengths. The analysis of quality-of-life scales pre- and post-intervention indicated that mean changes in participants’ quality of life were significantly more positive in the music therapy group than in the control group. This study provides preliminary support for the use of music therapy and parent counselling to enhance resilience in young children with ASD. Implications for clinical practice and future research are discussed