Melanie's frequency of inappropriate behavior was not consistent; she experienced unpredictable increases and decreases in hair pulling, screaming, scratching, and tantrum behavior.
The study occurred in a self-contained classroom for children and youth with autism, which was housed within the special education department of a large state medical center. The classroom included four students, one certified classroom teacher, and three paraprofessionals. Students received one-on-one instruction; group instruction; speech-language, music, art, and adaptive physical education; and occupational therapy
An ABAB design was used to evaluate the effectiveness of rhythmic entrainment as a calming technique. The first and third phases of the study were baseline conditions during which Melanie interacted in her structured classroom environment as was typical for her schedule. This included walking into the classroom, hang'rag up her backpack, reviewing her daily schedule, eating breakfast, checking her schedule, going to the rest-room, rechecking her schedule, and participating in calendar time. During the intervention phases, Melanie's schedule remained the same, while the entrainment music played on the tape recorder for 20 minutes. The volume was set on 3, with the loudest setting of 10 and the quietest setting of 0. Data collection stopped when Melanie left the classroom (i.e., to use the bathroom) and resumed when she returned. Music ceased to play after 20 minutes of data collection. Data were collected by both the first author and the classroom paraprofessional on the frequency of head jerking and screaming each morning for 20 consecutive minutes during the class opening session. Before data collection on head jerking and screaming began, the behaviors were operationally defined and interrater reliability was achieved between the first author and the classroom paraprofessional with 100% accuracy over five sessions.
Interobserver reliability was calculated with each interaction component as an individual data point using the following formula: agreements/agreements plus disagreements times 100. Interobserver reliability was calculated as 100%.
Melanie's head-jerking behavior was stable during the first 7-day baseline condition, with a mean occurrence of 49 and a range of 48 to 50. During the first intervention phase, head jerking appeared to decrease, with only one incident above the mean of the first intervention phase. The mean occurrence of head jerking across the 7-day intervention phase was 29, with a range of 6 to 93. The second baseline appeared erratic. During the 7-day span of the second baseline, the mean occurrence of Melanie's head jerking was 57, with a range of 7 to 94. The second intervention phase showed that all data points were below the mean of the first and second baselines, with a mean occurrence of 13 and a range of 3 to 43.
Melanie's screams appeared stable during the first 7-day baseline condition (with a mean occurrence of 5 and a range of 3 to 10). The screams decreased overall during the first intervention phase. Six of the seven data points were below the mean of the first baseline condition. One data point revealed a much higher number of screams. Melanie's mean occurrence of screams was 3, with a range of 2 to 14. The second baseline showed a similarly erratic pattern to the second head-jerking baseline. The mean occurrence of screams was 10, with a range of 4 to 17. During the second baseline phase, six of the seven data points were below the means of the first and second baseline phases, with a mean of 3 and a range of 0 to 15. Figure 2 shows the complete results of the screaming intervention.
Another study involving the observation of autistic and Ausberger's syndrome children between the ages of 5 and 12 concluded that music provides an alternative means of communication for those who are nonverbal, and for others it can help to organize verbal communication. Music can improve self-esteem, as the child is given an activity he or she can potentially excel in. Finally, playing a musical instrument gives persons with autism a typical means for engaging in social interaction in school and in the community, centered on their strength. (Shore, 2002)
In conclusion, researchers agree that there needs to be more research done on the effect of music therapy on autistic children. The case studies revealed tentatively established a link between music therapy and the reduction of disruptive behavior -- head-jerking and screaming; for example -- however, more research is needed to established positively the effects of music therapy on autism in children.
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