Can Music Therapy Be a Valuable Suggestion for Promoting Joint Attention Skills in Preschoolers with Autism Spectrum Disorder?

The main goal of the above clinical question is to critically examine how music therapy affects joint attention skills in children with Autism Spectrum Disorder aged three to five years (ASD). Randomized clinical trials, ABC design, single "n-of-1" subject, and a mixed composition containing a single subject series "n-of-1" AB design and a separate group pre-post-test were all part of the recent study. Three of the four studies suggested that music therapy improves joint attention skills (Oldfield, 2007). However, one study found a mixed bag of consequences. According to the fourth edition of the Diagnostic and Arithmetical Manual of Mental Syndromes, ASD is a core symptom of unavoidable developmental disorders. This neuron-developmental syndrome is accompanied by impairments in social interactions, communication, restricted and repetitive interest patterns (Strock & National Institute of Mental Health, 2008). Researchers are particularly interested in how social relations and communication shortfalls of ASD are apparent in young kids with the diagnosis. Functional communication in ASD children of five years and below is associated with more constructive lasting communication outcomes. Consequently, timely communication intervention for ASD pre-schoolers is essential.

Therefore, joint attention skills are a depiction of a rational target for timely intervention in kids with ASD. Joint attention denotes a behaviour cluster, which helps a person in nonverbal communication with the other individual. Researchers use diversified measures to evaluate joint attention skills in infants with ASD. These encompass behaviour frequency counts relating to joint attention, for example, turn taking, engagement initiation, and eye contact. Other interventions also include the Social Method subscale of the Pervasive Developmental Disorder Behaviour Inventory (PDDBI) and Early Social Communication Scales (ESCS). Therefore, any intervention methodology that aims at the infants’ joint attention skills can eventually enhance their communication.

Music Therapy might address the problem of joint attention deficit in youngsters with ASD. According to Bruscia, music therapy also known as musical interactional therapy or improvisational music therapy is a systematic intervention process whereby the therapist assists the child to encourage health. The therapist ensures this by using relationships and musical experiences, which develop through the child as vital forces of change. The procedures encompass engaging the kid in free and organised creativeness, listening to songs and music. Music therapy based on the musical attunement process, which captures moment-to-moment receptive use of music to fit the kid’s rhythmic actions and pattern movements (Oldfield, 2007). Through tuning in to the youngster, music therapy provides a pre-verbal mutual setting between the child and the therapist, regularly creating a perfect communicative environment, which might enhance joint attention skills. Therefore, if it can promote joint attention skills, could be a pertinent approach that parents can take for the sake of their kids with ASD that have skill deficiencies.

However, according to the results of the following studies: randomised clinical trials, ABC design, PDDBI, single “n-of-1” subject, AB design, ESCS and a distinct group pre-post-test, they have provided no compelling validity outcomes that music therapy can influence the joint attention skills of ASD children. In fact, one of the researchers proposes that music therapy can lower joint attention (Oldfield, 2007). Joint attention skills are a predecessor to deliberate communication and need to be targeted for the timely intervention of infants with ASD. Therefore, the purpose of this clinical question is to find out if there is a research, which has a compelling validity that music therapy can affect joint attention skills. However, most researchers contribute to a convincing preliminary evidence that can guide future information. In general, music may offer a pre-verbal interaction environment for kids with ASD. Clinicians may scientifically include music into their practice and report their discoveries to contribute to the knowledge base of literature.


Oldfield, A. (2007). Interactive music therapy: A positive approach: music therapy at a child development centre. Palo Alto, Calif: Library

Strock, M., & National Institute of Mental Health (U.S.). (2008). Autism spectrum disorders: Pervasive developmental disorders. Bethesda, Md.: Dept. of Health and Human Services, National Institutes of Health [National Institute of Mental Health

Part A, Section 2: PICO Formulation


Autism Spectrum Disorder, Joint Attention Skills Deficit


Musical Therapy, Musical Interactional Therapy, Improvisational Music Therapy




Joint attention skills,

Part A, Section 3: Advance Search in CINAHL

Computerised database search in CINAHL was done using the search strategy below:

((autism spectrum disorder) OR (asd) or (asperger) or (aspergers)) AND ((musical interactional therapy) OR (music therapy) OR (improvisational music therapy)) AND ((joint attention) OR (interaction) OR (shared attention)) AND ((abc) OR (PDDPI) OR (ESCS))

Search Results

Van Antwerp, L. L., & Houston, K. T. (2013). Auditory-Verbal Therapy in Telepractice: A Practical, Philosophical and Musical Perspective. Volta Voices, 20(2), 24-31.

Boso, M., Emanuele, E., Minazzi, V., Abbamonte, M., & Politi, P. (2007). Effect of long-term interactive music therapy on behavior profile and musical skills in young adults with severe autism. Journal Of Alternative & Complementary Medicine, 13(7), 709-712. doi:10.1089/acm.2006.6334

Dee Adams, N., & Jennifer J., L. (2012). Influence of Music Training on Pre-Attentive Auditory-Neural Processing Across the Lifespan. Perspectives On Hearing & Hearing Disorders: Research & Diagnostics, 16(2), 47-54.

Chermak, G. (2010). Music and auditory training. Hearing Journal, 63(4), 57-58.

Mari, G., Scorpecci, A., Reali, L., & D'Alatri, L. (2016). Music identification skills of children with specific language impairment. International Journal Of Language & Communication Disorders, 51(2), 203-211. doi:10.1111/1460-6984.12200

Porter, S., Holmes, V., McLaughlin, K., Lynn, F., Cardwell, C., Braiden, H., & ... Rogan, S. (2012). Music in mind, a randomized controlled trial of music therapy for young people with behavioural and emotional problems: study protocol. Journal Of Advanced Nursing, 68(10), 2349-2358. doi:10.1111/j.1365-2648.2011.05936.x

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Honorato Franzoi, M. A., Guedes do Santos, J. L., Schubert Backes, V. M., & Souza Ramos, F. R. (2016). MUSICAL INTERVENTION AS A NURSING CARE STRATEGY FOR CHILDREN WITH AUTISM SPECTRUM DISORDER AT A PSYCHOSOCIAL CARE CENTER. Texto & Contexto Enfermagem, 25(1), 1-8. doi:10.1590/0104-070720160001020015

Buino, S., & Simon, S. R. (2011). Musical Interventions in Group Work with Chemically Dependent Populations. Social Work With Groups, 34(3-4), 283-295. doi:10.1080/01609513.2011.558825

Schauer, M., & Mauritz, K. (2003). Musical motor feedback (MMF) in walking hemiparetic stroke patients: randomized trials of gait improvement. Clinical Rehabilitation, 17(7), 713-722.

A. Blythe, L., & Andrew, K. (2011). Rhythm and Music in Rehabilitation: A Critical Review of Current Research. Critical Reviews In Physical & Rehabilitation Medicine, 23(1-4), 49-67.

Dankovicova, J., House, J., Crooks, A., & Jones, K. (2007). The relationship between musical skills, music training, and intonation analysis skills. Language & Speech, 50(2), 177-225.

Kennelly, J. (2000). The specialist role of the music therapist in developmental programs for hospitalized children. Journal Of Pediatric Healthcare, 14(2), 56-59.

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