Simpson's confidence in music therapy is based on her own experience and that of other parents of children with autism who are eager to find ways to increase their children's ability to function. But exactly how and to what extent music therapy works is not well understood. Just over a year ago, a session titled "The Autism Agenda" at the American Music Therapy Association conference stressed the need for more research and for practice to be based on evidence.
Despite the limited data about its effectiveness, making music has become an integral part of many programs for children with autism. Leanne Belasco, a music therapist at the Kennedy Krieger School's Montgomery County campus in Rockville, says music gives structure and a predictable rhythm to verbal directions. When Belasco strums her autoharp to her students, she sings encouraging, instructive lyrics such as, "I know I have what it takes; I am a good listener" and "Be flexible."
At the school, where all 37 full-time students are enrolled in music therapy, Belasco begins her 30- to 45-minute sessions by singing a refrain: "Hello, everybody, it's time for music today." She wheels around the group seated in a horseshoe formation, addressing each student in song as she does so. A 16-year-old, who regularly wears headphones in class because of his auditory sensitivities, responds with apparent enjoyment, as does a younger boy, who strums the autoharp with seeming pleasure as he rocks back and forth in his chair. When Belasco asks her students to shake the blue plastic maracas she has passed out, classroom assistants help. When one student seems pained by the exercise, the assistants physically settle him in his chair.
Despite the benefits associated with music, there are special challenges for children with autism. "Some students are sensitive to sirens and vacuums; some are sensitive to music, to specific instruments or the frequency of the instrument," says Linda Brandenburg, director of school autism services at Kennedy Krieger, which is based in Baltimore. The music therapist gradually eases students with such auditory sensitivities into the group.
For higher-functioning students on the autism spectrum, music can be a creative outlet in addition to helping regulate behavior, therapists say. At Rockville's Frost School, for children with emotional disorders including those on the autism spectrum, ninth-grader Donny Toker has enjoyed music from a young age and now composes jazz and rock pieces, which he has performed at family gatherings and at school. His mother, Nancy Toker, says music helps him focus and relieves anxiety and frustration. "When he is in a musical environment, he is able to interact with his peers, and his conversational skills are appropriate, " Toker says.