音乐治疗与自闭症

8455 Colesville Road, Suite 1000, Silver Spring, MD 20910 (301) 589-3300 fax (301) 589-5175 email: amta@musictherapy.org website: www.musictherapy.org American Music Therapy Association, Inc. MUSIC THERAPY AND INDIVIDUALS WITH DIAGNOSES ON THE AUTISM SPECTRUM What is Music Therapy? Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. It is a well-established allied health profession that uses music therapeutically to address behavioral, social, psychological, communicative, physical, sensory-motor, and/or cognitive functioning. Because music therapy is a powerful and non-threatening medium, unique outcomes are possible. For individuals with diagnoses on the autism spectrum, music therapy provides a unique variety of music experiences in an intentional and developmentally appropriate manner to effect changes in behavior and facilitate development of skills. Music therapy may include the use of behavioral, biomedical, developmental, educational, humanistic, adaptive music instruction, and/or other models. Music therapy enhances one’s quality of life, involving relationships between a qualified music therapist and individual; between one individual and another; between the individual and his/her family; and between the music and the participants. These relationships are structured and adapted through the elements of music to create a positive environment and set the occasion for successful growth. Why Music Therapy for Individuals with Diagnoses on the Autism Spectrum? The literature reports that most individuals with autism respond positively to music (DeMyer, 1974; Edgerton, 1994; Euper, 1968; Snell, 1996; Thaut, 1992). People with diagnoses on the autism spectrum often show a heightened interest and response to music, making it an excellent therapeutic tool to work with them. Music is a very basic human response, spanning all degrees of ability/disability. Music therapists are able to meet clients at their own levels and allow them to grow from there. The malleability of music makes it a medium that can be adapted to meet the needs of each individual. Music is motivating and enjoyable. Music can promote relatedness, relaxation, learning, and self-expression. Music therapy addresses multiple developmental issues simultaneously. Music therapy can provide success-oriented opportunities for achievement and mastery. The structure and sensory input inherent in music help to establish response and role expectations, positive interactions, and organization. How Does Music Therapy Make a Difference for Individuals with Diagnoses on the Autism Spectrum? Individuals with diagnoses on the autism spectrum may display “qualitative impairments in social interaction and communication” and often manifest “restricted repetitive and stereotyped patterns of behavior, interests and activities.” Delays and/or abnormal functioning usually occur before age 3 • • • • • • • and may be marked by a lack of symbolic or imaginative play as well. (Diagnostic Statistical Manual- IV, pp. 70-71). Music therapy can be effective in addressing the typical characteristics of autism listed above in the following ways: Music is considered a “universal language” which provides bridges in a non-threatening setting between people and/or between individuals and their environment, facilitating relationships, learning, self-expression, and communication. Music captures and helps maintain attention. It is highly motivating and engaging and may be used as a natural “reinforcer” for desired responses. Music therapy can stimulate clients to reduce negative and/or self-stimulatory responses and increase participation in more appropriate and socially acceptable ways. Music therapy can enable those without language to communicate, participate and express themselves non-verbally. Very often music therapy also assists in the development of verbal communication, speech, and language skills. The interpersonal timing and reciprocity in shared play, turn-taking, listening and responding to another person are augmented in music therapy with children and adults with autism to accommodate and address their styles of communication. Music therapy allows individuals with diagnoses on the autism spectrum the opportunity to develop identification and appropriate expression of their emotions. Because music is processed in both hemispheres of the brain, music can stimulate cognitive functioning and may be used for remediation of some speech/language skills. Music provides concrete, multi-sensory stimulation (auditory, visual, and tactile). The rhythmic component of music is very organizing for the sensory systems of individuals diagnosed with autism. As a result, auditory processing and other sensory-motor, perceptual/ motor, gross and fine motor skills can be enhanced through music therapy. Musical elements and structures provide a sense of security and familiarity in the music therapy setting, encouraging clients to attempt new tasks within this predictable but malleable framework. Many people with diagnoses on the autism spectrum have innate musical talents; thus, music therapy provides an opportunity for successful experiences. Emphasis is placed on strengths, which in turn may be utilized to address each individual’s areas of need. What Do Music Therapists Do? Music therapists provide direct or consultative services. They work individually or in small groups, using a variety of music and techniques to engage children and adults with diagnoses on the autism spectrum. They involve clients in singing, listening, moving, playing instruments, and creative activities in a systematic, prescribed manner to influence change in targeted responses or behaviors and help clients meet individual goals and objectives. They create a musical, familiar environment that encourages positive interpersonal interaction and allows clients freedom to explore and express themselves. They utilize music that is preferred by and reinforcing to clients and is appropriate for ages, cultures, and environments in which the clients interact. Music therapists are trained professionals who accept referrals, observe clients’ behavior and interactions, and assess their behavioral/psycho-social/emotional, communication/language, perceptual/ and sensory/motor, cognitive/academic, and musical skills. After designing realistic goals and target objectives to address identified needs, music therapists plan and implement individualized music therapy treatment programs with strategies, procedures, and interventions to develop skills necessary to achieve an optimum level of success or quality of life for individuals with diagnoses on • • • • • • • • • the autism spectrum. Music therapists document client responses, conduct ongoing evaluations of progress and performance, and make recommendations for future consideration. They often work as team members in conjunction with families and professionals to best address each individual’s needs. Music therapists may also make recommendations to team members and families regarding ways to include successful music therapy techniques in other aspects of clients’ lives. What Can One Expect from a Music Therapist? A music therapist is… Professionally trained to utilize clinical musical interventions to address behavioral/ psycho-social/emotional, communication/language, sensory-motor, & cognitive needs of individuals. A competent musician who is both creative and resourceful. An understanding, caring, ethical therapist, with a broad range of skills. Well-versed in a variety of music therapy applications and pertinent research. Informed regarding individuals with diagnoses on the autism spectrum and able to provide adaptations to address unique processing styles. Able to create a therapeutic environment and engage in the therapeutic process. An effective communicator, with clients, other team members, and the public. Who is Qualified as a Music Therapist? Graduates of colleges or universities from more than 70 approved music therapy programs are eligible to take a national examination administered by the Certification Board for Music Therapists (CBMT), an independent, non-profit certifying agency fully accredited by the National Commission for Certifying Agencies. After successful completion of the CBMT examination, graduates are issued the credential necessary for professional practice, Music Therapist-Board Certified (MT-BC). In addition to the MT-BC credential, other recognized professional designations are Registered Music Therapists (RMT), Certified Music Therapists (CMT), and Advanced Certified Music Therapist (ACMT) listed with the National Music Therapy Registry. Any individual who does not have proper training and credentials is not qualified to provide music therapy services. Where Do Music Therapists Work? Music therapists may work in public school systems, where, in accordance with the Individuals with Disabilities Education Act (IDEA), music therapy is recognized as a related service that provides a “significant motivation and/or assist” in the achievement of Individual Education Plan (IEP) goals and objectives. In addition, music therapists may provide service in the following settings: early intervention centers, Head Start programs, day care centers, preschools through high schools, day treatment centers, hospitals, hospices, clinics, rehabilitation centers, substance abuse facilities, mental health centers, group homes, sheltered workshops, long-term care facilities, correctional institutions, private homes, camps, community schools of the arts, music retailers, wellness centers, holistic treatment centers, private practice, and more. How Does Music Therapy Help Families of Individuals with Diagnoses on the Autism Spectrum? Families of those with diagnoses on the autism spectrum may reap many benefits from music therapy: An individual’s growth through music therapy may improve the quality of life for the whole family. If the client’s behavior is improved, there may be less stress or strain on • • • • • • • • other family members. In addition, with an increase in skills, the client may become more independent and aware and more able to interact and communicate with others. Music therapy can provide additional opportunities for positive interaction and building relationships among family members and the client. New music-related leisure options among family members may be explored, while providing an acceptable emotional outlet. Greater family cohesiveness, support, and coping skills may be achieved through shared, equal music making during sessions or in the home environment. Music therapy interventions can teach family members alternative ways to interact, socialize, and communicate with their loved ones. Music therapy can help promote generalization/transfer of skills in sessions to the home environment. Participation in music therapy often allows family members to see their loved one in a “different light,” to witness their relative’s areas of strength and aptitude, perhaps seeing or hearing novel responses in this setting that they have not noted elsewhere. Music therapy may provide hope for the future and belief in the individual’s abilities. Is There Research to Support Music Therapy for Individuals with Diagnoses on the Autism Spectrum? Through peer-reviewed journals inside the profession such as Music Therapy, the Journal of Music Therapy, Music Therapy Perspectives, and extensive articles in journals outside the profession, AMTA has promoted much research exploring the benefits of music therapy with individuals with diagnoses on the autism spectrum. A research bibliography of select articles and publications is available from AMTA for those interested in specific research examples. What is AMTA? The American Music Therapy Association (AMTA) represents over 5,000 music therapists, corporate members, and related associations worldwide. AMTA’s roots date back to organizations founded in 1950 and 1971. Those two organizations merged in 1998 to ensure the progressive development of the therapeutic use of music in rehabilitation, special education, and medical and community settings. AMTA is committed to the advancement of education, training, professional standards, and research in support of the music therapy profession. The mission of the organization is to advance public knowledge of music therapy benefits and increase access to quality music therapy services. Currently, AMTA establishes criteria for the education and clinical training of music therapists. Members of AMTA adhere to a Code of Ethics and Standards of Practice in their delivery of music therapy services. How Can You Find a Music Therapist or Get More Information? American Music Therapy Association 8455 Colesville Road, Suite 1000 Silver Spring, MD 20910 Phone (301) 589-3300 Fax (301) 589-5175 Web: www.musictherapy.org Email: info@musictherapy.org • • • • •