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Music Therapy is More than Sharing Instruments and Singing Songs – the Relationship is at the Heart of the Work

In 1991, the first year of JB Music Therapy,  AUTISM was still spoken about as a rare, life long, institutionalized disorder.

Autistic disorder is rare, occurring in fewer than five children per ten thousand births, but with few exceptions, it leads to a life of marginal adjustment, often within an institution.” – Lovaas, 1987

By the late 90’s Autism was becoming more ‘popular’ being identified in 1 in 300 children.  It feels so recently that the stat again changed to 1 in 100 – and then shockingly in 2014 the U.S. government increased its autism estimate to 1 in 68 children. Fortunately in this short period of time teams of caring individuals and innovative thinkers have propelled the development of many useful resources for caregivers, professionals, families and the 1 percent of the world population who have been diagnosed with autism.  We still have more work to do.

My first encounter with children with autism, early in my career, was often quite perplexing.  Each child was being given the same diagnosis however the display of that diagnosis was so different I remember thinking,  ‘this must be something else – not autism – how can it be?’

I have worked with highly social children with autism, those strongly affected by their sensory environment using high pitched screams to convey their discomfort and displeasure, others who would quietly stare at a seemingly far off place, some who incessantly talked (often at a more advanced level than myself), and those who rarely if ever spoke a word.  How could all these children have the same diagnosis?

Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences. We now know that there is not one autism but many types, caused by different combinations of genetic and environmental influences. –

It wasn’t until the word ‘spectrum’ began to be used that I began to understand the breadth and depth of autism – the way it would be exhibited and the array of resources required to care for every individual need.  However like all disorders, diagnosis, conditions, and illness….Music Therapy sessions continued to bypass many of the symptoms and reveal the child beyond the behaviours and the words – finding the very core of the child- the best bits and pieces that were only momentarily hidden.

As you have read time and time again, individuals of all ages and all abilities benefit from Music Therapy. At one time, Music Therapy was documented as a ‘technique’ used by many professions – but the complex nature of music coupled with the therapeutic relationship with a  Music Therapist required Music Therapy to become a specialized discipline – requiring its own standards of practice and code of ethics. As with all human service professions, research has revealed the reasons behind many of the clinical stories being experienced – some include:

  • A 2004 study from the Journal of Music Therapy found that music in interventions used with children and teens with ASD can improve social behaviours, increase focus and attention, increase communication attempts (vocalizations, verbalizations, gestures, and vocabulary), reduce anxiety, and improve body awareness and coordination.
  • A 2009 study by Kim, Wigram, & Gold found that children with autism showed more emotional expression and social engagement during music therapy sessions than in play sessions without music. These children also responded to the therapist’s requests more frequently during music therapy than in play sessions without music.
  • In a 2012 study of 41 children with autism over a ten-month period, See found that weekly music therapy sessions seemed to improve overall behavior, with the most improvement seen in inattentive behaviors. 

To be clear, Music Therapy is more than the passing and sharing of instruments and singing new songs – the heart of the work is in the relationship between the Music Therapist and Client.  It is this relationship that maximizes the music and in particular fosters opportunities for confidence building and social interactions – and provides the individual with autism the opportunity to practice skills in a safe environment.

There is no question that music is an effective communication tool – for many the relationship created between Music Therapist, the Client, and Music, can be life-changing and for some….a lifeline. 


Kim, J., Wigram, T., & Gold, C. (2009). Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy. Autism, 13(4), 389-409. PMID: 19535468

See, C. M. (2012) The Use of Music and Movement Therapy to Modify Behaviour of Children with Autism. Pertanika J. Soc. Sci. & Hum., 20 ( 4): 1103 – 1116

Whipple J. (2004). Music in intervention for children and adolescents with autism: a meta-analysis. Journal of Music Therapy. 41(2):90-106. PubMed PMID: 15307805.