BACKGROUND: Social interaction and social communication are among the central areas of difficulty for autistic people. Music therapy uses music experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of autistic people. Music therapy has been applied in autism since the early 1950s, but its availability to autistic individuals varies across countries and settings. The application of music therapy requires specialised academic and clinical training which enables therapists to tailor the intervention to the specific needs of the individual. The present version of this review on music therapy for autistic people is an update of the previous Cochrane review update published in 2014 (following the original Cochrane review published in 2006).
OBJECTIVES: To review the effects of music therapy, or music therapy added to standard care, for autistic people.
SEARCH METHODS: In August 2021, we searched CENTRAL, MEDLINE, Embase, eleven other databases and two trials registers. We also ran citation searches, checked reference lists, and contacted study authors to identify additional studies.
SELECTION CRITERIA: All randomised controlled trials (RCTs), quasi-randomised trials and controlled clinical trials comparing music therapy (or music therapy alongside standard care) to 'placebo' therapy, no treatment, or standard care for people with a diagnosis of autism spectrum disorder were considered for inclusion.
DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. Four authors independently selected studies and extracted data from all included studies. We synthesised the results of included studies in meta-analyses. Four authors independently assessed risk of bias (RoB) of each included study using the original RoB tool as well as the certainty of evidence using GRADE. MAIN RESULTS: We included 16 new studies in this update which brought the total number of included studies to 26 (1165 participants). These studies examined the short- and medium-term effect of music therapy (intervention duration: three days to eight months) for autistic people in individual or group settings. More than half of the studies were conducted in North America or Asia. Twenty-one studies included children aged from two to 12 years. Five studies included children and adolescents, and/or young adults. Severity levels, language skills, and cognition were widely variable across studies. Measured immediately post-intervention, music therapy compared with 'placebo' therapy or standard care was more likely to positively effect global improvement (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.06 to 1.40; 8 studies, 583 participants; moderate-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) = 11 for low-risk population, 95% CI 6 to 39; NNTB = 6 for high-risk population, 95% CI 3 to 21) and to slightly increase quality of life (SMD 0.28, 95% CI 0.06 to 0.49; 3 RCTs, 340 participants; moderate-certainty evidence, small to medium effect size). In addition, music therapy probably results in a large reduction in total autism symptom severity (SMD -0.83, 95% CI -1.41 to -0.24; 9 studies, 575 participants; moderate-certainty evidence). No clear evidence of a difference between music therapy and comparison groups at immediately post-intervention was found for social interaction (SMD 0.26, 95% CI -0.05 to 0.57, 12 studies, 603 participants; low-certainty evidence); non-verbal communication (SMD 0.26, 95% CI -0.03 to 0.55; 7 RCTs, 192 participants; low-certainty evidence); and verbal communication (SMD 0.30, 95% CI -0.18 to 0.78; 8 studies, 276 participants; very low-certainty evidence). Two studies investigated adverse events with one (36 participants) reporting no adverse events; the other study found no differences between music therapy and standard care immediately post-intervention (RR 1.52, 95% CI 0.39 to 5.94; 1 study, 290 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: The findings of this updated review provide evidence that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. The certainty of the evidence was rated as 'moderate' for these four outcomes, meaning that we are moderately confident in the effect estimate. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-intervention. For these outcomes, the certainty of the evidence was rated as 'low' or 'very low', meaning that the true effect may be substantially different from these results. Compared with earlier versions of this review, the new studies included in this update helped to increase the certainty and applicability of this review's findings through larger sample sizes, extended age groups, longer periods of intervention and inclusion of follow-up assessments, and by predominantly using validated scales measuring generalised behaviour (i.e. behaviour outside of the therapy context). This new evidence is important for autistic individuals and their families as well as for policymakers, service providers and clinicians, to help in decisions around the types and amount of intervention that should be provided and in the planning of resources. The applicability of the findings is still limited to the age groups included in the studies, and no direct conclusions can be drawn about music therapy in autistic individuals above the young adult age. More research using rigorous designs, relevant outcome measures, and longer-term follow-up periods is needed to corroborate these findings and to examine whether the effects of music therapy are enduring.
BACKGROUND: This is an update of the review published on the Cochrane Library in 2016, Issue 8. Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in people with cancer. This review includes music interventions defined as music therapy offered by trained music therapists, as well as music medicine, which was defined as listening to pre-recorded music offered by medical staff.
OBJECTIVES: To assess and compare the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer.
SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 3) in the Cochrane Library, MEDLINE via Ovid, Embase via Ovid, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the RILM Abstracts of Music Literature, http://www.wfmt.info/Musictherapyworld/ and the National Research Register. We searched all databases, except for the last two, from their inception to April 2020; the other two are no longer functional, so we searched them until their termination date. We handsearched music therapy journals, reviewed reference lists and contacted experts. There was no language restriction.
SELECTION CRITERIA: We included all randomized and quasi-randomized controlled trials of music interventions for improving psychological and physical outcomes in adults and pediatric patients with cancer. We excluded patients undergoing biopsy and aspiration for diagnostic purposes.
DATA COLLECTION AND ANALYSIS: Two review authors independently extracted the data and assessed the risk of bias. Where possible, we presented results in meta-analyses using mean differences and standardized mean differences. We used post-test scores. In cases of significant baseline difference, we used change scores. We conducted separate meta-analyses for studies with adult participants and those with pediatric participants. Primary outcomes of interest included psychological outcomes and physical symptoms and secondary outcomes included physiological responses, physical functioning, anesthetic and analgesic intake, length of hospitalization, social and spiritual support, communication, and quality of life (QoL) . We used GRADE to assess the certainty of the evidence.
MAIN RESULTS: We identified 29 new trials for inclusion in this update. In total, the evidence of this review rests on 81 trials with a total of 5576 participants. Of the 81 trials, 74 trials included adult (N = 5306) and seven trials included pediatric (N = 270) oncology patients. We categorized 38 trials as music therapy trials and 43 as music medicine trials. The interventions were compared to standard care. Psychological outcomes The results suggest that music interventions may have a large anxiety-reducing effect in adults with cancer, with a reported average anxiety reduction of 7.73 units (17 studies, 1381 participants; 95% confidence interval (CI) -10.02 to -5.44; very low-certainty evidence) on the Spielberger State Anxiety Inventory scale (range 20 to 80; lower values reflect lower anxiety). Results also suggested a moderately strong, positive impact of music interventions on depression in adults (12 studies, 1021 participants; standardized mean difference (SMD): -0.41, 95% CI -0.67 to -0.15; very low-certainty evidence). We found no support for an effect of music interventions on mood (SMD 0.47, 95% CI -0.02 to 0.97; 5 studies, 236 participants; very low-certainty evidence). Music interventions may increase hope in adults with cancer, with a reported average increase of 3.19 units (95% CI 0.12 to 6.25) on the Herth Hope Index (range 12 to 48; higher scores reflect greater hope), but this finding was based on only two studies (N = 53 participants; very low-certainty evidence). Physical outcomes We found a moderate pain-reducing effect of music interventions (SMD -0.67, 95% CI -1.07 to -0.26; 12 studies, 632 adult participants; very low-certainty evidence). In addition, music interventions had a small treatment effect on fatigue (SMD -0.28, 95% CI -0.46 to -0.10; 10 studies, 498 adult participants; low-certainty evidence). The results suggest a large effect of music interventions on adult participants' QoL, but the results were highly inconsistent across studies, and the pooled effect size was accompanied by a large confidence interval (SMD 0.88, 95% CI -0.31 to 2.08; 7 studies, 573 participants; evidence is very uncertain). Removal of studies that used improper randomization methods resulted in a moderate effect size that was less heterogeneous (SMD 0.47, 95% CI 0.06 to 0.88, P = 0.02, I2 = 56%). A small number of trials included pediatric oncology participants. The findings suggest that music interventions may reduce anxiety but this finding was based on only two studies (SMD -0.94, 95% CI -1.9 to 0.03; very low-certainty evidence). Due to the small number of studies, we could not draw conclusions regarding the effects of music interventions on mood, depression, QoL, fatigue or pain in pediatric participants with cancer. The majority of studies included in this review update presented a high risk of bias, and therefore the overall certainty of the evidence is low. For several outcomes (i.e. anxiety, depression, pain, fatigue, and QoL) the beneficial treatment effects were consistent across studies for music therapy interventions delivered by music therapists. In contrast, music medicine interventions resulted in inconsistent treatment effects across studies for these outcomes.
AUTHORS' CONCLUSIONS: This systematic review indicates that music interventions compared to standard care may have beneficial effects on anxiety, depression, hope, pain, and fatigue in adults with cancer. The results of two trials suggest that music interventions may have a beneficial effect on anxiety in children with cancer. Too few trials with pediatric participants were included to draw conclusions about the treatment benefits of music for other outcomes. For several outcomes, music therapy interventions delivered by a trained music therapist led to consistent results across studies and this was not the case for music medicine interventions. Moreover, evidence of effect was found for music therapy interventions for QoL and fatigue but not for music medicine interventions. Most trials were at high risk of bias and low or very low certainty of evidence; therefore, these results need to be interpreted with caution.
BACKGROUND: Existing systematic reviews provide evidence that music therapy is an effective intervention in the treatment of children and adolescents with psychopathology. The objective of the present review was to systematically review and quantify the effects of music-based interventions in reducing internalizing symptoms (i.e., depression and anxiety) in children and adolescents using a meta-analytical approach. METHODS: Databases and journals were systematically screened for studies eligible for inclusion in meta-analysis on the effects of music-based interventions in reducing internalizing symptoms. A random-effect meta-analysis using standardized mean differences (SMD) was conducted. RESULTS: Five studies were included. Analysis of data from (randomized) controlled trials, yielded a significant main effect (Hedge's g = -0.73; 95%CI [-1.42;-0.04], Z = 2.08, p = 0.04, k = 5), indicating a greater reduction of internalizing symptoms in youth receiving music-based interventions (n = 100) compared to different control group interventions (n = 95). LIMITATIONS: The existing evidence is limited to studies of low power and methodological quality. Included studies were highly heterogeneous with respect to the nature of the intervention, the measurements applied, the samples studied, and the study design. CONCLUSIONS: Findings indicate that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents. While these results are encouraging with respect to the application of music-based intervention, rigorous research is necessary to replicate existing findings and provide a broader base of evidence. More research adopting well controlled study designs of high methodological quality is needed.
BACKGROUND: Depression is a highly prevalent mood disorder that is characterised by persistent low mood, diminished interest, and loss of pleasure. Music therapy may be helpful in modulating moods and emotions. An update of the 2008 Cochrane review was needed to improve knowledge on effects of music therapy for depression.
OBJECTIVES: 1. To assess effects of music therapy for depression in people of any age compared with treatment as usual (TAU) and psychological, pharmacological, and/or other therapies.2. To compare effects of different forms of music therapy for people of any age with a diagnosis of depression.
SEARCH METHODS: We searched the following databases: the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR; from inception to 6 May 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; to 17 June 2016); Thomson Reuters/Web of Science (to 21 June 2016); Ebsco/PsycInfo, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed (to 5 July 2016); the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, the National Guideline Clearing House, and OpenGrey (to 6 September 2016); and the Digital Access to Research Theses (DART)-Europe E-theses Portal, Open Access Theses and Dissertations, and ProQuest Dissertations and Theses Database (to 7 September 2016). We checked reference lists of retrieved articles and relevant systematic reviews and contacted trialists and subject experts for additional information when needed. We updated this search in August 2017 and placed potentially relevant studies in the "Awaiting classification" section; we will incorporate these into the next version of this review as appropriate.
SELECTION CRITERIA: All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing music therapy versus treatment as usual (TAU), psychological therapies, pharmacological therapies, other therapies, or different forms of music therapy for reducing depression.
DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias, and extracted data from all included studies. We calculated standardised mean difference (SMD) for continuous data and odds ratio (OR) for dichotomous data with 95% confidence intervals (CIs). We assessed heterogeneity using the I2 statistic.
MAIN RESULTS: We included in this review nine studies involving a total of 421 participants, 411 of whom were included in the meta-analysis examining short-term effects of music therapy for depression. Concerning primary outcomes, we found moderate-quality evidence of large effects favouring music therapy and TAU over TAU alone for both clinician-rated depressive symptoms (SMD -0.98, 95% CI -1.69 to -0.27, 3 RCTs, 1 CCT, n = 219) and patient-reported depressive symptoms (SMD -0.85, 95% CI -1.37 to -0.34, 3 RCTs, 1 CCT, n = 142). Music therapy was not associated with more or fewer adverse events than TAU. Regarding secondary outcomes, music therapy plus TAU was superior to TAU alone for anxiety and functioning. Music therapy and TAU was not more effective than TAU alone for improved quality of life (SMD 0.32, 95% CI -0.17 to 0.80, P = 0.20, n = 67, low-quality evidence). We found no significant discrepancies in the numbers of participants who left the study early (OR 0.49, 95% CI 0.14 to 1.70, P = 0.26, 5 RCTs, 1 CCT, n = 293, moderate-quality evidence). Findings of the present meta-analysis indicate that music therapy added to TAU provides short-term beneficial effects for people with depression if compared to TAU alone. Additionally, we are uncertain about the effects of music therapy versus psychological therapies on clinician-rated depression (SMD -0.78, 95% CI -2.36 to 0.81, 1 RCT, n = 11, very low-quality evidence), patient-reported depressive symptoms (SMD -1.28, 95% CI -3.75 to 1.02, 4 RCTs, n = 131, low-quality evidence), quality of life (SMD -1.31, 95% CI - 0.36 to 2.99, 1 RCT, n = 11, very low-quality evidence), and leaving the study early (OR 0.17, 95% CI 0.02 to 1.49, 4 RCTs, n = 157, moderate-quality evidence). We found no eligible evidence addressing adverse events, functioning, and anxiety. We do not know whether one form of music therapy is better than another for clinician-rated depressive symptoms (SMD -0.52, 95% CI -1.87 to 0.83, 1 RCT, n = 9, very low-quality evidence), patient-reported depressive symptoms (SMD -0.01, 95% CI -1.33 to 1.30, 1 RCT, n = 9, very low-quality evidence), quality of life (SMD -0.24, 95% CI -1.57 to 1.08, 1 RCT, n = 9, very low-quality evidence), or leaving the study early (OR 0.27, 95% CI 0.01 to 8.46, 1 RCT, n = 10). We found no eligible evidence addressing adverse events, functioning, or anxiety.
AUTHORS' CONCLUSIONS: Findings of the present meta-analysis indicate that music therapy provides short-term beneficial effects for people with depression. Music therapy added to treatment as usual (TAU) seems to improve depressive symptoms compared with TAU alone. Additionally, music therapy plus TAU is not associated with more or fewer adverse events than TAU alone. Music therapy also shows efficacy in decreasing anxiety levels and improving functioning of depressed individuals.Future trials based on adequate design and larger samples of children and adolescents are needed to consolidate our findings. Researchers should consider investigating mechanisms of music therapy for depression. It is important to clearly describe music therapy, TAU, the comparator condition, and the profession of the person who delivers the intervention, for reproducibility and comparison purposes.
La lesión cerebral adquirida (ABI) puede resultar en alteraciones en la función motora, lenguaje, cognición y procesamiento sensorial, y en trastornos emocionales, que pueden reducir gravemente la calidad de vida de un sobreviviente. Las intervenciones musicales se han utilizado en la rehabilitación para estimular las funciones cerebrales involucradas en el movimiento, la cognición, el habla, las emociones y las percepciones sensoriales. Se necesitó una actualización de la revisión sistemática publicada en 2010 para medir la eficacia de las intervenciones musicales en la rehabilitación de las personas con ABI. OBJETIVOS: Evaluar los efectos de las intervenciones musicales en los resultados funcionales en las personas con ABI. Ampliamos los criterios de nuestra revisión actual para: 1) examinar la eficacia de las intervenciones musicales para abordar la recuperación en las personas con ABI incluyendo la marcha, la función de las extremidades superiores, la comunicación, el estado de ánimo y las emociones, el funcionamiento cognitivo, las habilidades sociales, el dolor, los resultados del comportamiento y las actividades De la vida diaria y eventos adversos; 2) comparar la eficacia de las intervenciones musicales y la atención estándar con a) la atención estándar sola, b) la atención estándar y los tratamientos con placebo, o c) la atención estándar y otras terapias; 3) comparar la eficacia de los diferentes tipos de intervenciones musicales (musicoterapia impartida por musicoterapeutas entrenados versus intervenciones musicales impartidas por otros profesionales). Métodos de búsqueda Se realizaron búsquedas en el Registro de ensayos del Grupo Cochrane de Accidentes Cerebrovasculares (Cochrane Stroke Group) (enero de 2016), en el Registro Central Cochrane de Ensayos Controlados (CENTRAL) (2015, número 6), MEDLINE (1946 a junio 2015), Embase (1980 a junio 2015) (1982 a junio de 2015), PsycINFO (1806 a junio de 2015), LILACS (1982 a enero de 2016) y AMED (1985 a junio de 2015). Buscamos manualmente revistas de musicoterapia y actas de congresos, búsquedas de disertaciones y bases de datos musicales especializadas, registros de ensayos e investigaciones, listas de referencias y contacto con expertos y asociaciones de musicoterapia para identificar investigaciones no publicadas. No impusimos ninguna restricción de idioma. Se realizó la búsqueda original en 2009. CRITERIOS DE SELECCIÓN: Se incluyeron todos los ensayos controlados aleatorios y ensayos clínicos controlados que compararon las intervenciones musicales y la atención estándar con la atención estándar sola o combinada con otras terapias. Se examinaron los estudios que incluyeron a personas mayores de 16 años de edad que tenían ABI de naturaleza no degenerativa y que participaban en programas de tratamiento ofrecidos en el hospital, ambulatorio, o la comunidad. Se incluyeron estudios en cualquier idioma, publicados e inéditos. Dos revisores extrajeron los datos de forma independiente y evaluaron el riesgo de sesgo de los estudios incluidos. Nos pusimos en contacto con investigadores del ensayo para obtener datos faltantes o para obtener información adicional cuando era necesario. En la medida de lo posible, presentamos resultados para resultados continuos en metanálisis usando diferencias de medias (MDs) y diferencias de medias estandarizadas (SMDs). Se utilizaron las puntuaciones post-prueba. En los casos de diferencia significativa basal, se utilizaron las puntuaciones de cambio. Se realizó un análisis de sensibilidad para evaluar el impacto del método de asignación al azar. PRINCIPALES RESULTADOS: Se identificaron 22 nuevos estudios para esta actualización. La evidencia para esta actualización se basa en 29 ensayos con 775 participantes. Una intervención musical conocida como estimulación auditiva rítmica puede ser beneficiosa para mejorar los siguientes parámetros de la marcha después del accidente cerebrovascular. Se encontró un aumento de la velocidad de la marcha de 11,34 metros por minuto (intervalo de confianza del 95% (IC) 8,40 a 14,28, 9 ensayos, 268 participantes, P <0,00001). La longitud de la zancada del lado afectado también puede beneficiarse, con un promedio de 0,12 metros (IC del 95%: 0,04 a 0,20, 5 ensayos, 129 participantes, P = 0,003, evidencia de calidad moderada). Se encontró una mejoría promedio de la marcha general de 7,67 unidades en el índice de marcha dinámica (95% IC 5,67 a 9,67, 2 ensayos, 48 participantes, P <0,00001). También puede haber una mejoría en la cadencia de la marcha, con un incremento promedio de 10,77 pasos por minuto (IC del 95%: 4,36 a 17,18, 7 ensayos, 223 participantes, P = 0,001, evidencia de baja calidad). Mejorando el tiempo de la función de la extremidad superior después del accidente cerebrovascular, como se registró por una reducción de 1,08 segundos en la Prueba de Función Motora de Lobo (IC del 95%: -1,69 a -0,47; 2 ensayos; 122 participantes: evidencia de muy baja calidad). Beneficiosos para los resultados de la comunicación en personas con afasia después del accidente cerebrovascular. En general, la comunicación mejoró en 0,75 desviaciones estándar en el grupo de intervención, un efecto moderado (IC del 95%: 0,11 a 1,39, 3 ensayos, 67 participantes, P = 0,02, evidencia de muy baja calidad). Se indicó que la denominación se había mejorado en 9.79 unidades en el Aquisgrán Aphasia Test (IC del 95%: 1.37 a 18.21, 2 ensayos, 35 participantes, P = 0.02). Las intervenciones musicales pueden tener un efecto beneficioso sobre la repetición del habla, reportado como un aumento promedio de 8,90 puntos en el Aquisgrán Aphasia Test (IC del 95%: 3,25 a 14).55; 2 ensayos; 35 participantes; P = 0,002). Puede haber una mejoría en la calidad de vida después de un accidente cerebrovascular usando estimulación auditiva rítmica, reportada con una mejora de 0,89 desviaciones estándar en la Escala de Calidad de Vida Específica del Stroke, que se considera un gran efecto (IC del 95%: 0,32 a 1,46, 2 ensayos, 53 participantes, P = 0,002, evidencia de baja calidad). No encontramos ninguna evidencia fuerte de los efectos sobre la memoria y la atención. Los datos fueron insuficientes para examinar el efecto de las intervenciones musicales en otros resultados. La mayoría de los estudios incluidos en esta revisión actualizada presentaron un alto riesgo de sesgo, por lo tanto la calidad de la evidencia es baja. Las intervenciones musicales pueden ser beneficiosas para la marcha, el momento de la función de las extremidades superiores, los resultados de la comunicación y la calidad de vida después del accidente cerebrovascular. Estos resultados son alentadores, pero se necesitan ensayos controlados aleatorios de mayor calidad en todos los resultados antes de que se puedan hacer recomendaciones para la práctica clínica.
BACKGROUND: The hospital environment leaves preterm infants (PTIs) exposed to various stressors that can disrupt their growth and development. Developmental interventions such as music may be an important strategy to mitigate PTI's stress. This brief evaluates current evidence regarding the impact of music therapy on outcomes for PTIs.
PURPOSE: The question guiding this brief is "Do various types of music therapy positively affect physiologic indicators, feeding behaviors/length of stay (LOS) and pain management outcomes for PTIs?"
SEARCH STRATEGY: CINAHL/MEDLINE Complete and PubMed databases were searched using keywords preterm infants, premature infants, preterm baby, premature baby, NICU baby, music, and music therapy. The search was limited to 5 years for English studies evaluating the effects of music therapy on physiological indicators, feeding, pain outcomes, and length of stay. The search yielded 12 studies addressing these concerns.
FINDINGS: Music therapy was shown to positively affect physiologic indicators, feeding, length of stay, and pain outcomes for PTIs. In addition, music decreased parental stress.
IMPLICATIONS FOR PRACTICE: Thoughtful consideration should be given regarding the value of diverse types of music and parental involvement when incorporating music into an individualized plan of care. Furthermore, the development of guidelines with a focus on ambient sound reduction is an important strategy when adding music as an intervention.
IMPLICATIONS FOR RESEARCH: Further research is needed to investigate ambient sound levels in conjunction with musical interventions. In addition, the impact of various types of music, differences in gender, reduction of stress, pain for infants, and parental role in music requires further evaluation.
This systematic review investigated the use and efficacy of music listening as an intervention for children and adolescents in clinical and non-clinical settings. Database search was carried out via EMBASE, MEDLINE, PsycARTICLES Full Text, PsycINFO, PubMed together with hand-search in related journals using an age restriction of 0–18 years and the following keywords: music (therapy) AND receptive OR passive. Only original studies that were peer-reviewed were included. The searched publication period was between 1980 and up until March, 2015. In summary, 36 studies were identified as satisfying inclusion criteria, 28 being randomized controlled trials. One half of included studies (n = 18) focused on music listening in pediatrics, indicating a significant reduction of pain, anxiety, and distress. One quarter of studies were set in mental health contexts (n = 9), and the remaining nine studies were varied in focus and contents, also supporting the beneficial effects of music listening for specific symptom reduction and enhancement of specific skills. Included studies varied with respect to diagnosis, sample size, design, choice and delivery of music and duration of interventions. Results show that music listening in health care contexts is a feasible, easily applicable, and cost effective intervention for children and adolescents. As expected with such diversity, there was a marked variability in results. Careful consideration in interpreting the results and also in designing future studies is needed. Clinical and research implications are discussed further.
OBJECTIVE: To investigate the effects of music therapy on mood, language, behavior, and social skills in children with autism.
METHODS: A literature search was conducted using the following Chinese databases: the China National Knowledge Infrastructure (CNKI), Wanfang Data, the Chinese Biomedical Literature (CBM) Database, and the VIP Chinese Science and Technology Periodicals Database. The search terms were “autistic children” or “children with autism” and “music therapy” or “music treatment.” Studies of randomized controlled trials (RCTs) were included, and each publication included was assessed for quality. A meta-analysis was conducted using RevMan 5.1.
RESULTS: Publications were selected based on the inclusion and exclusion criteria. Six research articles describing RCTs were included; the total sample size was 300 patients. The results of meta-analysis showed that music therapy improved mood [Risk ratio (RR) = 3.02, 95% confidence interval (CI) = 1.93–4.11, Z = 5.45, P < 0.000 01] and behavior (RR = 7.36, 95% CI = 4.28–10.44, Z = 4.69, P = 0.000 01) in children with autism. Additionally, music therapy improved language (RR = 4.05, 95% CI = 3.38–4.73, Z = 11.71, P = 0.000 01), sensory perception (RR = 4.62, 95% CI = 1.55–7.69, Z = 2.95, P = 0.003), and social skills (RR = 4.66, 95% CI = 1.90–7.42, Z = 3.31, P = 0.000 9) in children with autism.
CONCLUSIONS: Music therapy can improve mood, language, sensory perception, behavior, and social skills in children with autism.
OBJETIVO: Las unidades de cuidados intensivos neonatales (NICU) de todo el mundo usan cada vez más intervenciones musicales. La revisión sistemática más reciente de ensayos controlados aleatorios (ECA) data de 2009. Desde entonces, se han publicado 15 nuevos ECA. Proporcionamos una revisión sistemática actualizada sobre los posibles beneficios de las intervenciones musicales en el bienestar de los bebés prematuros. MÉTODOS: Se realizaron búsquedas en 13 bases de datos electrónicas y 12 revistas desde su primera fecha disponible hasta agosto de 2016. Se incluyeron todos los ECA publicados en inglés con al menos 10 participantes por grupo, incluyendo niños nacidos prematuramente y ingresados en la UCIN. Las intervenciones fueron intervenciones de música grabada o intervenciones de musicoterapia en vivo. Todas las condiciones de control fueron aceptadas siempre y cuando los efectos de la intervención musical pudieran ser analizados por separado. Un metanálisis no fue posible debido a la incompletitud y la heterogeneidad de los datos. RESULTADOS: Tras la eliminación de los duplicados, las búsquedas recuperaron 4893 citas, 20 de las cuales cumplieron los criterios de inclusión / exclusión. Los 20 estudios incluidos abarcaron 1128 participantes que recibieron grabaciones o intervenciones de música en vivo en la NICU entre 24 y 40 semanas de edad gestacional. Se informaron 26 resultados diferentes que se clasificaron en tres categorías: parámetros fisiológicos; Crecimiento y alimentación; Estado de conducta, resultados de relajación y dolor. Las intervenciones de música en vivo demostraron mejorar el sueño en tres de los cuatro estudios y la frecuencia cardíaca en dos de los cuatro estudios. La música grabada mejoró la frecuencia cardíaca en dos de seis estudios. Se informaron mejores resultados de alimentación y succión en un estudio utilizando música en vivo y en dos estudios utilizando música grabada. Aunque las intervenciones musicales muestran resultados prometedores en algunos estudios, la variación en la calidad de los estudios, los grupos de edad, las medidas de resultado y el momento de las intervenciones a través de los estudios hace difícil sacar conclusiones sólidas sobre los efectos de la música en los prematuros.
Social interaction and social communication are among the central areas of difficulty for autistic people. Music therapy uses music experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of autistic people. Music therapy has been applied in autism since the early 1950s, but its availability to autistic individuals varies across countries and settings. The application of music therapy requires specialised academic and clinical training which enables therapists to tailor the intervention to the specific needs of the individual. The present version of this review on music therapy for autistic people is an update of the previous Cochrane review update published in 2014 (following the original Cochrane review published in 2006).
OBJECTIVES:
To review the effects of music therapy, or music therapy added to standard care, for autistic people.
SEARCH METHODS:
In August 2021, we searched CENTRAL, MEDLINE, Embase, eleven other databases and two trials registers. We also ran citation searches, checked reference lists, and contacted study authors to identify additional studies.
SELECTION CRITERIA:
All randomised controlled trials (RCTs), quasi-randomised trials and controlled clinical trials comparing music therapy (or music therapy alongside standard care) to 'placebo' therapy, no treatment, or standard care for people with a diagnosis of autism spectrum disorder were considered for inclusion.
DATA COLLECTION AND ANALYSIS:
We used standard Cochrane methodological procedures. Four authors independently selected studies and extracted data from all included studies. We synthesised the results of included studies in meta-analyses. Four authors independently assessed risk of bias (RoB) of each included study using the original RoB tool as well as the certainty of evidence using GRADE.
MAIN RESULTS:
We included 16 new studies in this update which brought the total number of included studies to 26 (1165 participants). These studies examined the short- and medium-term effect of music therapy (intervention duration: three days to eight months) for autistic people in individual or group settings. More than half of the studies were conducted in North America or Asia. Twenty-one studies included children aged from two to 12 years. Five studies included children and adolescents, and/or young adults. Severity levels, language skills, and cognition were widely variable across studies. Measured immediately post-intervention, music therapy compared with 'placebo' therapy or standard care was more likely to positively effect global improvement (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.06 to 1.40; 8 studies, 583 participants; moderate-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) = 11 for low-risk population, 95% CI 6 to 39; NNTB = 6 for high-risk population, 95% CI 3 to 21) and to slightly increase quality of life (SMD 0.28, 95% CI 0.06 to 0.49; 3 RCTs, 340 participants; moderate-certainty evidence, small to medium effect size). In addition, music therapy probably results in a large reduction in total autism symptom severity (SMD -0.83, 95% CI -1.41 to -0.24; 9 studies, 575 participants; moderate-certainty evidence). No clear evidence of a difference between music therapy and comparison groups at immediately post-intervention was found for social interaction (SMD 0.26, 95% CI -0.05 to 0.57, 12 studies, 603 participants; low-certainty evidence); non-verbal communication (SMD 0.26, 95% CI -0.03 to 0.55; 7 RCTs, 192 participants; low-certainty evidence); and verbal communication (SMD 0.30, 95% CI -0.18 to 0.78; 8 studies, 276 participants; very low-certainty evidence). Two studies investigated adverse events with one (36 participants) reporting no adverse events; the other study found no differences between music therapy and standard care immediately post-intervention (RR 1.52, 95% CI 0.39 to 5.94; 1 study, 290 participants; moderate-certainty evidence).
AUTHORS' CONCLUSIONS:
The findings of this updated review provide evidence that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. The certainty of the evidence was rated as 'moderate' for these four outcomes, meaning that we are moderately confident in the effect estimate. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-intervention. For these outcomes, the certainty of the evidence was rated as 'low' or 'very low', meaning that the true effect may be substantially different from these results. Compared with earlier versions of this review, the new studies included in this update helped to increase the certainty and applicability of this review's findings through larger sample sizes, extended age groups, longer periods of intervention and inclusion of follow-up assessments, and by predominantly using validated scales measuring generalised behaviour (i.e. behaviour outside of the therapy context). This new evidence is important for autistic individuals and their families as well as for policymakers, service providers and clinicians, to help in decisions around the types and amount of intervention that should be provided and in the planning of resources. The applicability of the findings is still limited to the age groups included in the studies, and no direct conclusions can be drawn about music therapy in autistic individuals above the young adult age. More research using rigorous designs, relevant outcome measures, and longer-term follow-up periods is needed to corroborate these findings and to examine whether the effects of music therapy are enduring.
