Effects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder
| Autor: | Amelia Oldfield, Tali Gottfried, Lucja Bieleninik, A-La Park, Karin Mössler, Grace Thompson, Johanna Finnemann, Christian Gold, John A. Carpente, Gustavo Gattino, Jinah Kim, Ferdinando Suvini, Filippo Muratori, Jörg Assmus, Monika Geretsegger, Mike J. Crawford, Roberta Igliozzi, Cochavit Elefant, Enzo Grossi, Órla Casey, Helen Odell-Miller |
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| Přispěvatelé: | National Institute for Health Research |
| Rok vydání: | 2017 |
| Předmět: |
Male
030506 rehabilitation medicine.medical_specialty Music therapy Joint attention Autism Spectrum Disorder behavioral disciplines and activities law.invention Autism Diagnostic Observation Schedule Social Skills 03 medical and health sciences Medicine General & Internal Social skills Randomized controlled trial law General & Internal Medicine RA0421 Public health. Hygiene. Preventive Medicine medicine Clinical endpoint Humans Attention Single-Blind Method 0501 psychology and cognitive sciences Preschool Child Psychiatry Music Therapy 11 Medical and Health Sciences Science & Technology business.industry Medicine (all) Minimal clinically important difference 05 social sciences M Music General Medicine medicine.disease Treatment Outcome Autism spectrum disorder Child Preschool Physical therapy Female TIME-A Study Team 0305 other medical science business Life Sciences & Biomedicine INTERVENTION 050104 developmental & child psychology |
| Zdroj: | Bieleninik, Ł, Geretsegger, M, Mössler, K, Assmus, J, Thompson, G, Gattino, G, Elefant, C, Gottfried, T, Igliozzi, R, Muratori, F, Suvini, F, Kim, J, Crawford, M J, Odell-Miller, H, Oldfield, A, Casey, Ó, Finnemann, J, Carpente, J, Park, A L, Grossi, E, Gold, C & TIME-A Study Team 2017, ' Effects of improvisational music therapy vs enhanced standard care on symptom severity among children with autism spectrum disorder : The TIME-A randomized clinical trial ', JAMA: The Journal of the American Medical Association, vol. 318, no. 6, pp. 525-535 . https://doi.org/10.1001/jama.2017.9478 |
| ISSN: | 0098-7484 |
| Popis: | IMPORTANCE: Music therapy may facilitate skills in areas affected by autism spectrum disorder (ASD), such as social interaction and communication. OBJECTIVE: To evaluate effects of improvisational music therapy on generalized social communication skills of children with ASD. DESIGN, SETTING, AND PARTICIPANTS: Assessor-blinded, randomized clinical trial, conducted in 9 countries and enrolling children aged 4 to 7 years with ASD. Children were recruited from November 2011 to November 2015, with follow-up between January 2012 and November 2016. INTERVENTIONS: Enhanced standard care (n = 182) vs enhanced standard care plus improvisational music therapy (n = 182), allocated in a 1:1 ratio. Enhanced standard care consisted of usual care as locally available plus parent counseling to discuss parents’ concerns and provide information about ASD. In improvisational music therapy, trained music therapists sang or played music with each child, attuned and adapted to the child’s focus of attention, to help children develop affect sharing and joint attention. MAIN OUTCOMES AND MEASURES: The primary outcome was symptom severity over 5 months, based on the Autism Diagnostic Observation Schedule (ADOS), social affect domain (range, 0-27; higher scores indicate greater severity; minimal clinically important difference, 1). Prespecified secondary outcomes included parent-rated social responsiveness. All outcomes were also assessed at 2 and 12 months. RESULTS: Among 364 participants randomized (mean age, 5.4 years; 83% boys), 314 (86%) completed the primary end point and 290 (80%) completed the last end point. Over 5 months, participants assigned to music therapy received a median of 19 music therapy, 3 parent counseling, and 36 other therapy sessions, compared with 3 parent counseling and 45 other therapy sessions for those assigned to enhanced standard care. From baseline to 5 months, mean ADOS social affect scores estimated by linear mixed-effects models decreased from 14.08 to 13.23 in the music therapy group and from 13.49 to 12.58 in the standard care group (mean difference, 0.06 [95% CI, −0.70 to 0.81]; P = .88), with no significant difference in improvement. Of 20 exploratory secondary outcomes, 17 showed no significant difference. CONCLUSIONS AND RELEVANCE: Among children with autism spectrum disorder, improvisational music therapy, compared with enhanced standard care, resulted in no significant difference in symptom severity based on the ADOS social affect domain over 5 months. These findings do not support the use of improvisational music therapy for symptom reduction in children with autism spectrum disorder. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN78923965. |
| Databáze: | OpenAIRE |
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