The National Standards Report Panel Sings Off Key
04/09/11 18:13
This is the first in a series of posts on the various findings of the autism treatment guidelines from the National Standards Report (NSR). Some of you may be thinking, “What does this dry, boring group of Ph.D.s have to do with me, or my kid?” Well..., the NSR panel is a very influential group whose recommendations on autism treatments can carry a huge amount of weight with public policy wonks and health insurance folks. The NSR recommendation I’d like to delve into today is a particular favorite of mine, Music Therapy.
The NSR panel actually considers Music Therapy as an emerging treatment (page 64). My analysis of Music Therapy arrives at a very different conclusion -- it’s nonsense. The NSR based their findings on six studies. The only study that met minimally acceptable standards relied on four children. That one study, Kern et al (2006) looked at children during music sessions and found that when teachers used music to mediate an activity, the typically developing kids stuck around longer! Big surprise! Kids hang around longer when it’s fun. For the ASD kids, the teachers created specialized songs for each child to teach social skills. The researchers describe the shortcomings of their own study when they state:
“... a clear limitation imposed by the application of a single-case experimental design is the small number of participants. Another limitation is that no maintenance and generalization measures have been applied. It is not known whether the teachers' and peers' accurate implementation of the interventions would maintain once the intervention (including ongoing collaborative consultation) is no longer in place. Nor do we know if the child's skill acquisition would generalize across settings.”
In other words, they have no idea whether their efforts are going to work once they stop orchestrating the interaction! Based on these thoroughly inadequate results, it is hard to understand how the NSR panel actually deems Music Therapy as an emerging treatment for ASD!
Here’s the main point: music can be extremely repetitive and reinforcing for many children, but it has not been shown to ameliorate the condition of autism. If every repetitive, reinforcing activity is going to be recognized as a treatment, the potential list of contenders can grow without limit or merit, to include:
As an aside, I find it hard to believe that out of the approximately twenty behavioral experts (BCBA’s) involved in the report, not one of them raised his/her hand to state the obvious: “Excuse me, but perhaps music is simply reinforcing, rather than therapeutic.”
If caregivers would like to use music as a mainstreaming activity or reward for skill acquisition, that’s fine. Also, music is an excellent way to memorize a sequence. We have been doing this for generations (“now I know my A,B,Cs, won’t you come & sing with me”).
Music may accomplish all these things, but it is certainly not an emerging therapy for autism.
The NSR panel actually considers Music Therapy as an emerging treatment (page 64). My analysis of Music Therapy arrives at a very different conclusion -- it’s nonsense. The NSR based their findings on six studies. The only study that met minimally acceptable standards relied on four children. That one study, Kern et al (2006) looked at children during music sessions and found that when teachers used music to mediate an activity, the typically developing kids stuck around longer! Big surprise! Kids hang around longer when it’s fun. For the ASD kids, the teachers created specialized songs for each child to teach social skills. The researchers describe the shortcomings of their own study when they state:
“... a clear limitation imposed by the application of a single-case experimental design is the small number of participants. Another limitation is that no maintenance and generalization measures have been applied. It is not known whether the teachers' and peers' accurate implementation of the interventions would maintain once the intervention (including ongoing collaborative consultation) is no longer in place. Nor do we know if the child's skill acquisition would generalize across settings.”
In other words, they have no idea whether their efforts are going to work once they stop orchestrating the interaction! Based on these thoroughly inadequate results, it is hard to understand how the NSR panel actually deems Music Therapy as an emerging treatment for ASD!
Here’s the main point: music can be extremely repetitive and reinforcing for many children, but it has not been shown to ameliorate the condition of autism. If every repetitive, reinforcing activity is going to be recognized as a treatment, the potential list of contenders can grow without limit or merit, to include:
- Chocolate Therapy
- Movie Therapy
- Bubble Therapy
- Lip Smacker Therapy
- Sticker Therapy
- Guitar Hero Therapy
- Computer Time Therapy
As an aside, I find it hard to believe that out of the approximately twenty behavioral experts (BCBA’s) involved in the report, not one of them raised his/her hand to state the obvious: “Excuse me, but perhaps music is simply reinforcing, rather than therapeutic.”
If caregivers would like to use music as a mainstreaming activity or reward for skill acquisition, that’s fine. Also, music is an excellent way to memorize a sequence. We have been doing this for generations (“now I know my A,B,Cs, won’t you come & sing with me”).
Music may accomplish all these things, but it is certainly not an emerging therapy for autism.