BACKGROUND: In pediatric health care, non-pharmacological interventions such as music therapy have promising potential to complement traditional medical treatment options in order to facilitate recovery and well-being. Music therapy and other music-based interventions are increasingly applied in the clinical treatment of children and adolescents in many countries world-wide. The purpose of this overview is to examine the evidence regarding the effectiveness of music therapy and other music-based interventions as applied in pediatric health care. METHODS: Surveying recent literature and summarizing findings from systematic reviews, this overview covers selected fields of application in pediatric health care (autism spectrum disorder; disability; epilepsy; mental health; neonatal care; neurorehabilitation; pain, anxiety and stress in medical procedures; pediatric oncology and palliative care) and discusses the effectiveness of music interventions in these areas. RESULTS: Findings show that there is a growing body of evidence regarding the beneficial effects of music therapy, music medicine, and other music-based interventions for children and adolescents, although more rigorous research is still needed. The highest quality of evidence for the positive effects of music therapy is available in the fields of autism spectrum disorder and neonatal care. CONCLUSIONS: Music therapy can be considered a safe and generally well-accepted intervention in pediatric health care to alleviate symptoms and improve quality of life. As an individualized intervention that is typically provided in a person-centered way, music therapy is usually easy to implement into clinical practices. However, it is important to note that to exploit the potential of music therapy in an optimal way, specialized academic and clinical training and careful selection of intervention techniques to fit the needs of the client are essential.
Síntesis amplia/ Revisión panorámica de revisiones sistemáticas
ABSTRACT CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs) include autistic disorder, Asperger’s disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.
Síntesis amplia/ Revisión panorámica de revisiones sistemáticas
AIM: Una amplia variedad de intervenciones psicosociales para el tratamiento de personas con trastornos del espectro autista (TEA) se ha evaluado en las revisiones sistemáticas. Hemos llevado a cabo una revisión del paraguas de las revisiones sistemáticas de la efectividad de las intervenciones psicosociales para el ASD.
MÉTODO: Se realizaron búsquedas exhaustivas en 25 bases de datos bibliográficas, revistas relevantes y las listas de referencias hasta mayo de 2007. Los estudios incluidos eran revisiones sistemáticas sobre la intervención psicosocial para las personas con trastornos del espectro autista. Dos revisores de forma independiente evaluaron la pertinencia y calidad del estudio.
RESULTADOS: Treinta revisiones sistemáticas fueron incluidos. La mayoría de las críticas evaluó las intervenciones basadas en la teoría del comportamiento (n = 9) o comunicación centradas (n = 7) terapias. Se informaron los resultados de intervención positiva en la mayoría de los comentarios. La calidad metodológica de las revisiones fue deficiente.
INTERPRETACIÓN: Los comentarios informaron resultados positivos para muchas de las intervenciones, lo que sugiere que alguna forma de tratamiento es favorable en ausencia de tratamiento. Sin embargo, hay poca evidencia de la eficacia relativa de estas opciones de tratamiento. Muchas de las revisiones sistemáticas tenían defectos metodológicos que los hacen vulnerables al sesgo. Hay una necesidad de más revisiones sistemáticas que se adhieren a estrictos métodos científicos y para estudios primarios que hacen comparaciones directas entre diferentes opciones de tratamiento.
In pediatric health care, non-pharmacological interventions such as music therapy have promising potential to complement traditional medical treatment options in order to facilitate recovery and well-being. Music therapy and other music-based interventions are increasingly applied in the clinical treatment of children and adolescents in many countries world-wide. The purpose of this overview is to examine the evidence regarding the effectiveness of music therapy and other music-based interventions as applied in pediatric health care.
METHODS:
Surveying recent literature and summarizing findings from systematic reviews, this overview covers selected fields of application in pediatric health care (autism spectrum disorder; disability; epilepsy; mental health; neonatal care; neurorehabilitation; pain, anxiety and stress in medical procedures; pediatric oncology and palliative care) and discusses the effectiveness of music interventions in these areas.
RESULTS:
Findings show that there is a growing body of evidence regarding the beneficial effects of music therapy, music medicine, and other music-based interventions for children and adolescents, although more rigorous research is still needed. The highest quality of evidence for the positive effects of music therapy is available in the fields of autism spectrum disorder and neonatal care.
CONCLUSIONS:
Music therapy can be considered a safe and generally well-accepted intervention in pediatric health care to alleviate symptoms and improve quality of life. As an individualized intervention that is typically provided in a person-centered way, music therapy is usually easy to implement into clinical practices. However, it is important to note that to exploit the potential of music therapy in an optimal way, specialized academic and clinical training and careful selection of intervention techniques to fit the needs of the client are essential.
Síntesis amplia»Revisión panorámica de revisiones sistemáticas
