The Use of Prescriptive Therapeutic Songs in a Home-Based Environment to Promote Social Skills Acquisition by Children with Autism: Three Case Studies

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ABSTRACT: The researcher investigated the effect of prescriptive therapeutic songs on promoting social skills acquisition by children who have autism. Participants were three children with autism. The researcher created an individualized song for each participant, the purpose of which was to decrease an undesirable behavior identified by the parents. The researcher developed the lyrics of each song by following the current guidelines for writing the text of social stories. "Social stories" is a strategy developed by special educators for modifying problematic behaviors of children with autism. The adapted lyrics were then set to the tune of a favorite song of the child. The song intervention was implemented during the treatment phases of the ABAB reversal design. Even though the results are not conclusive, there is some indication that prescriptive songs are a viable intervention with children who have autism.

Autism is a complex developmental disorder originating in infancy. Children with autism vary widely in ability and personality, and often demonstrate challenging cognitive, social and linguistic behaviors (American Psychiatric Association [APA], 1994). There is no cure for autism; however, appropriate treatment methods and educational programs can significantly improve children's social, cognitive and communication skills while enhancing their quality of life (Simpson & Myles, 1998a).

The society indicates that music therapy used in a structured setting may improve motor, cognitive and daily living skills. In addition, the American Music Therapy Association [AMTA] outlines the therapeutic benefits of music therapy for individuals with autism spectrum disorders (AMTA, 2003). Therefore, music therapy may be a helpful addition to comprehensive treatment programs for children with autism.

Reports regarding the responses of children with autism to music stimuli exist early in the autism literature. Both Kanner (1943a, 1 943b, 1951 ), the psychiatrist who first offered a scientific account of autism, and Sherwin (1953), a psychiatrist with musical training, noted the unusual musical capacity of children with autism including their ability to retain and sing many songs. Noteworthy, Rimland (1964) included unusual musical capabilities as one of the diagnostic criteria for autism and as a method to differentiate between autism and other disorders. Empirical evidence supports observations regarding the musical abilities of children with autism. Studies have indicated that children with autism produced as complex tone sequences on a xylophone as typical peers (Frith, 1972;Thaut, 1988) and matched individual tones and tone sequences as accurately as typical children (Applebaum, Egel, Koegel, & lmhoff, 1979). While children with autism may reject other auditory features of their environment, they usually accept music. Children with autism preferred the sung version rather than the spoken version of songs (Blackstock, 1978) and a musical auditory stimulus over a visual stimulus (Kolko, Anderson, & Campell, 1980; Thaut, 1987). The findings in these studies support the statement that music is a preferred stimulus for this population.

The first case study describing the benefits of music therapy for an eight-year-old girl who had autism appeared in 1964 (Goldstein, 1964). Further case studies indicated that music therapy increased attentiveness, attention span (Mahlberg, 1973), established non-verbal communication (Mahlberg, 1973; Saperston, 1973), increased eye contact (Saperston, 1973), improved music abilities while at the same time reducing inappropriate behaviors at school (O'Connell, 1974), reduced echolalia (Bruscia, 1982), improved reciprocal relationships and increased body awareness (Bryan, 1989; Levinge, 1990; Wimpory, Chadwick, & Nash, 1995). Snell (2002) discusses several case studies derived from her clinical experience in a public school setting. Participation in music therapy sessions taught students how to observe social cues and cooperate with group boundaries, how to wait, how to transition from one activity to the other, and also established trust, reduced frequency of crying fits, increased consistency of responses during a session, and exposed hidden skills. …