Symposium Follow-up

Thank you for attending the Symposium at Berklee last year!  Here is some feedback from an attendee http://missingpiecesproject.wordpress.com/2013/02/

Symposium Music Therapy and Autism

Perspectives on Music Therapy and Autism

Free One-Day Symposium

February 12, 2013

9:00am-3:30pm

Berklee College of Music

David Friend Recital Hall

921 Boylston Street

Boston, MA 01915

Adult family member, allies, and professionals are invited to attend this free one day symposium on music therapy and autism.  Local and international music therapists and researchers will share perspectives on how music therapy plays a role in the lives of individuals with autism.   Key speakers will include Dr. Pamela Heaton, PhD from Goldsmiths College, University of London; Dr. Catherine Wan, PhD from Beth Israel Deaconess Medical Center, Harvard Medical School; and Dr. Krystal Demaine, PhD, MT-BC from Lesley University.   The day will include lunch, roundtable discussions, and a concert by the Boston Higashi School Jazz Band.  The New England Chapter of Autism Speaks and the Music Therapy Department at Berklee College of Music sponsor this free event. 

Research Collaborations in Music Therapy

I was invited to give a talk to the Massachusetts Music Therapy Alliance (MMTA) in Weston MA on December 8, 2012.  The theme of all MMTA talks this year is Collaboration.  In my talk, I spoke about collaboration in music therapy research. 

I large point I made in my talk was on the importance of recognizing expertise in music therapy and in other fields of practice.  As individuals (music therapists), we cannot be expected to  excel at all that we do.  To be able to reach out to others and collaborate in our work is a unique and valid element for good practice.  When it comes to research, there are multiple layers involved in producing meaningful outcomes.  There is a need for a team of people who can work together to produce the best possible research related to the work at hand. As music therapists we have special skills in understanding musical concepts, individual (participants) needs, behavioral / psychological normality, use of space/ time, and session structure.  With all of these areas of skill in music therapy, the potential for great contributions to research is unbounding.  Music therapists do however rely on other experts (non-music therapists) to contribute to the analysis, writing, testing measures, involved in the research process.

When reviewing the literature in the field I have found that, the majority of music therapists work with other music therapists in order to produce research.  Furthermore, much of that research is anecdotal and includes small samples and case studies.  I think that with collaborations with experts outside of the field of music therapy more expansive and meaningful contributions can be made to the literature.  I don't mean to say that research produced solely by music therapists isn't meaningful, however I would like to indicate the potential of reaching broader audiences and scientific communities through collaborative research. 

From conversations with other music therapists, it seems that many clinicians are interested in participating in research, but don't know where to begin.  I think that if music therapists reached beyond music therapy lines that research could be produced more quickly and scientifically.  Someitmes we work better when we are encouraged and supported by others in our process.  We all have so much to contribute to the world and we don't need to do it all alone.

A link to my presentation has been posted on the MMTA page  http://massmusictherapy.org/?page_id=843

Please feel free to take a peek at the presentation. Perhaps I will further develop this presentation for other forums.

Enjoy!

Conference Report

I recently wrote a report on my the Northeast Music Cognition Group Meeting held at Boston University on November 17, 2012.  The report has been posted on the Music Therapy Research Blog "bringing current research to music therapy clinicians". 

Here is the link to the report:  http://www.musictherapyresearchblog.com/?p=1399

AMTA and NEMCOG (applied science and research)

I recently presented my research on Musical Echolalia and Non-Verbal Children with Autism at two different venues.  On October 13, 2012 I presented a poster of my topic at the American Music Therapy Association National (AMTA) Conference in St. Charles, Illinois.  On November 17, 2012 I presented an eight-minute talk of the same topic at the North East Music Cognition Group (NEMCOG) at Boston University in Boston, Massachusetts.  Just to note, I am writing a guest article on the NEMCOG meeting for the “Music Therapy Research Blog,” and will provide a link to my article here once it is published.

            While I presented the same topic at each venue, the remarks and inquires I received from the conference attendees were both divergent and unique.  It was interesting for me to reflect upon the two experiences and realize the different lenses in which researchers at NEMCOG and clinicians at the AMTA conference viewed the research.  Attendees of the AMTA conference is mainly comprised of music therapy professionals and students while the NEMCOG meeting is primarily researchers.  Personally, I consider myself as a researcher and clinician with greater depth of history as a clinician. 

            The main differences that I noticed among the comments from music therapists  at the AMTA conference were that they hoped to see stronger clinical outcomes in my current research.  I explained that my initial findings were lead to the need for a protocol that tests the clinical implications of musical echolalia.  While I explained that my findings indicated social outcomes the music therapists wanted to see how the findings could be used in a traditional clinical setting. 

            On the other side of the coin, the researchers at the NEMCOG meeting commented positively at the novelty of my findings and said that the outcomes spoke clearly to the uniqueness of imitation and music among children with autism, and in a way presented a strong case against the mirror neuron theory.  Many of the comments of the researchers were steeped in topic specific answers and related to the current findings in the field.   The questions that the researchers asked me were specific in their relation to the definition of imitation and how I defined it specific to my work.

            It seemed that the main differences among the response of my two presentations were that the music therapists were looking for more clinical depth and had a canvas of questions related to the breadth of the work, while the researchers at NEMCOG were impressed with the novel findings and asked questions that were very scientific in nature.  Philosophically speaking, these questions presented at the two meetings could all be the same with just a different dialect to express the inquiry.  In a way I believe that music therapists are researchers, while researches also delve into applied work; ultimately, I believe there is a common mission between the two roles.   One common thread between both meetings asked when and where the work would be published.  I am glad that this question was raised because it encourages me to move forward and produce this work more widely to the public.

American Chinese Medical Exchange: Autism

Conference Proceedings

Biomedical Advances of Autism 2012

American Chinese Medical Exchange Society

On August 26, 2012 the American Chinese Medical Exchange Society www.acmes.net in collaboration with McLean Hospital, Harvard Medical School hosted a one-day forum entitled Biomedical Advances of Autism 2012.  This event introduced a rich agenda of speakers, comprised mainly of researchers and medical doctors who practice traditional western and traditional Chinese medicine with individuals who have autism. 

I found this conference to be both thought provoking and inspiring.  I attended the conference with friend Dr. Jane Richardson, ART-BC, who is an art therapist and colleague at Lesley University.  Jane and I traveled to Beijing, China with in 2009, where we were invited to both present our work at the International Creative Arts Therapy Conference.  In result of our experience in China, we have a co-written book chapter, which will appear in an edited book to arrive later this year.

The current conference, Biomedical Advances of Autism 2012, allowed the opportunity for the audience and its speakers to consider scientific and real basis for working with children with autism, through the very ancient and very holistic lense of traditional Chinese medicine.  The book Chapter that mentioned that Jane and I have collaborated on exemplifies this view in its relation to the expressive / creative arts therapies – a multi-sensory whole body engagement for the child with autism. 

The keynote speaker at the current conference was Dr. Martha Herbert who shared her new book, “Autism Revolution.”  In her keynote talk Herbert spoke of the timeliness of the conference and the importance of listening / working with / examining the whole child – a view that Traditional Chinese Medicine has long employed.  With respect to traditional Chinese medicine – considering the meridians and the five element theory in relation to the many aspects of life – and how the child with autism operates may seem foreign to many, however, it is an ancient practice that has been used for centuries.  Herbert’s talk seemed to consider the treatemetn of autism with a  holistic view – Herbert considered neurology while also looking at the impact of stress, biology, and the environment upon the child.

What stood out the most to me was when Herbert began to note the sharp rise in the autism diagnosis. She suggested that individuals with autism may be trying to tell the work something – like “the canary in the cole mine,” she said…. “should autism be the world telling us about the human race?”

I think that regardless of what happens with individuals with autism, that it is important to listen with heart, hands, voice, and ears – engage the whole body and listen with the whole body – as we may not all speak or understand the same language, we might as well be open to exploring other options if we want to learn form one another… 

There is something to be said for exploring traditional Chinese medicine for children whit autism.  There is published literature on the use of acupuncture,  traditional Chinese herbs, and traditional Chinese movement practices (tai chi, qi gong) in helping children with autism manage some difficulties - yet more needs to be explored.  As a music therapist and expressive arts therapist - I see that there is a correlation between Chinese medicine and the arts - and can quickly identify helping properties for the child with autism.  I look forward to reading new literature on this topic and writing and exploring such applications in my own work.

Thank you for the American Chinese Medical Exchange Society for hosting such a wonderful event!

Conference Preceedings: Perspectives from the Jouney / The Autism Forum at the Boston Higashi School

On April 26^th, 2012 the Higashi School of Boston held a one day Autism Forum at the Hilton Boston / Dedham entitled “Perspectives from the Journey.”  The forum hosted four presenters who each shared an hour-long talk on their perspective of either being a person with autism, of researching autism, and / or researching “hot” topics on or related to autism.  Each talk at this conference, presented itself a master class of thought provoking information from leading experts.

 The presenters included: Dr. Temple Grandin, Dr. Margaret Bauman, Dr. Stephen Shore, and Mr. Seth Mnookin.

After the morning registration, a welcoming breakfast buffet, and opening remarks from the principle of the Higashi School, the first speaker Dr. Temple Grandin was graciously introduced. 

Dr. Grandin’s talk was entitled, “Autism in My Sensory Based World.”  According to the introduction by the principle of the Higashi School, Temple Grandin, PhD, is known as “the most famous person with autism.”  Grandin has published several books, been a strong advocate for autism, has been portrayed in film, and has been called upon to consult on many occasions.  In her talk Grandin shared several stories of her life as a person with autism, the schools she attended (Beaver Country Day School), her sensory processes (the famed Squeeze Machine), her ability to shift attention, and tune into specific stimuli.  She referenced current literature in the field, shared images of her young life, shared images of her current MRI, and research images on the brains of others with autism.

In the talk Grandin focused on information processing –that information is often “coming in to fast” for the person with autism to process, causing sensory abnormalities and difficulty with processing information.   Grandin also spoke to the many uniquie talents for individuals wit autism, and that it is important to allow these talents to be contributed to society.  She spoke primarily of individuals with Aspergers syndrome, mainily the verbal folks.  She spoke of the importance of getting “these folks / kids” involved in social activities - music groups, drama groups – to encourage socialization with others while doing a pleasurable activity.   She noted the heterogeneity of autism, which reminded me that TAKING A SENSORY PROFILE IS SOOOO IMPORTANT!

For readers interested in Grandin’s perspective, I highly recommend Grandin’s Ted Talk http://www.ted.com/talks/temple_grandin_the_world_needs_all_kinds_of_minds.html

The second speaker to be introduced was pediatric neurologist Dr. Margaret Bauman.  Dr. Bauman is a leading researcher in the investigation of the neurobiology of autism.  In her talk Dr. Bauman spoke to the forthcoming DSM-V diagnostic criteria for autism changes (slated for May 2013).  These proposed changes will include Asperger’s as part of ASD and narrow the three criteria to two criteria (1. Communication and social limitations and 2. Restrictive and repetitive behaviors).  There has been a lot of two-sided discussion on these proposed changes on how it might impact the autistic community.  Bauman spoke to genetic phenotypes and subtypes  - the role of assessing subtypes, and the need to develop an assessment tool for such criteria to occur.  Because of the heterogeneity of the disorder, Bauman explained, “subtypes are important to consider.”

After a lovely lunch and a performance by the Boston Higashi School Jazz Band, the third speaker was announced.

The third speaker was Mr. Seth Mnookin, who presented a talk entitled “Panic Virus: A True Story of Medicine, Science and Fear.”  Mr. Mnookin is an author who has written a book on vaccines and autism called, The Panic Virus: The True Story Behind the Vaccine-Autism Controversy.   Mr. Mnookin, was very well spoken and well researched in his topic.  He had attended conferences, spoken to parents, and reviewed literature on the topic of autism and vaccines.   Mnooken noted in his talk that “biggest impact of the autism – vaccine debate has been how it has divided the autism community.”

The fourth and final speaker was Dr. Stephen Shore, who gave a talk entitled “Life on and Slightly to the Right of the Autism Spectrum.”  Like Grandin, Shore is also an adult person with ASD, and also considered high functioning.  Shore told stories of his experiences with perceptual processing, managing relationships, the role of his parents in his early treatment, and his current life.  He referenced such work as the Miller Method, Lovaas ABA therapy, Floortime (Greenspan), Daily Life Therapy (Higashi), and curriculum for Universal Design.   Shore in particular spoke about his experience with music.  Please see my previous post on Shore’s book http://musicalecholalia.blogspot.com/2012/07/beyond-wall-by-stephen-shore.html

Shore noted that “music is good for every body” and that “what is good for people with autism is good for everyone.”

All in all, the Higashi School hosted an incredible one-day event that surely stirred interest in students, educators, therapists, administrators, parents, and researchers alike.  It was a true gathering of pioneers in the field in a real master class like forum.

Beyond the Wall by Stephen Shore

In my opinion Beyond the Wall: Personal Experiences with Autism and Asperger Syndrome (2003) by Dr. Stephen Shore is an incredibly informative read for professionals, parents, persons with autism, and the general community alike.  Shore is a professor of special education at Adelphi University and is an expert on the field of autism and music. 

In this autobiographical book, Shore shared his personal experiences as a person with autism spectrum disorder navigating through school, career, relationships, and the many adventures that life has to offer.  In particular interest to this blog, Shore discussed how music and imitation shaped much of his development and interests.  Shore commented that when he was a child his parents engaged him in "music, movement, imitation..." and this helped in his development of communication and socialization.

Shore has a bachelors and masters degree in music and a PhD in special education.  Shore originally had attempted to fulfill a PhD in music, yet ran into some complication in his understanding of some aspects in music therapy.   Music has always been important to Shore - in particular he discussed how music listening was able to "unlock" emotions.  When it comes to individuals with autism, music can be key to unlocking such emotions - at this juncture I recommend reading Allen, Hill, and Heaton's (2009) paper where the authors interviewed 12 high functioning adults and their subjective experiences when listening to music (see reference below).  Allen also has much emerging research on Alexythymia - which I will disseminate in future blogs.

In addition to Shore's personal experience with music, he is a skilled music teacher for children with ASD who are both verbal and non-verbal.  He described a teaching session, "parts of the session were spent in imitative drumming...I made certain that we took turns leading the imitation...this was a good activity to do when he [the child] seemed to be fading away and losing focus" (p. 69).  While Shore's goals in his music lessons were educationally based - his training and personal experience naturally inclines him to meet the child in the music - much like what occurs in music therapy.  In the following pages - Shore writes about the importance of narrating the child's word as they engaged in particular actions - and to speak in a musical tone.  For more information on intoned singing and autism, please read From music Making to Speaking, written by me and my colleagues (2010).

Shore speaks to the importance of imitation in understanding his world.  As an adult he explained how he learned social skills - such as smiling in response through imitation, and that one of his co-workers a previous employer used to engage in imitation with him - which was both fun and educational.  Shore noted that while not all persons with autism speak - and are considered non-verbal, music may provide a different outlet for communication.  In an interview with Dr. Rossen, at the end of his book Shore wrote, "music works better than words in communication for people on the autism spectrum because music lights up or accesses a different part of the brain than does oral communication"  As far as communication is concerned, I feel that for some people at the more severe end of the spectrum, music can be a way to communicate" (p. 188). 

When speaking of the term non-verbal (individuals who are non-verbal and have challenging behaviors are often considered more severe), Shore wrote that generally speaking "non-verbal communication includes tone of voice, facial expressions, and body language...however, the non-verbal component can be so difficult to decode that it interferes with getting the meaning from the verbal channel" (p. 143).  This thought if very interesting - and also an important topic to researchers - that is, how much language is understood, or do individuals with autism care for language --- at this point I recommend reading the work of French researcher Nadel.  I will write more about her later.  Infact, I will have to broach this entire topic more deeply in a later blog.  It is as vast and important topic!

At the end of the book, Shore expressed his political involvement in spreading the autism word -- educating others, and creating opportunities for individuals with ASD to receive appropriate education and services.  Shore who knows ASD first hand, and his autobiography will serve as an important handbook for parents, teachers, persons with autism and the general community to gain a better understanding of ASD.

In closing, I hope, just as Shore does, that people do find and read this book!  It is insightful, thought provoking, and educational.  Enjoy!

References

Allen, R. Hill, E. Heaton, P. (2009).  The subjective experience of music and autism spectrum disorder.  The neurosciences and music III: Disorders and plasticity.  Annals of the NY Academy of Arts and Sciences, 1169, 326-331.

Shore, S. (2003).  Beyond the wall: Personal experiences with autism and Asperger syndrome, 2nd Edition.  Shawnee Mission, KS: Autism and Asperger Publishing Company.

Wan, C., Demaine, K., Zipse, L., Norton, A., & Schlaug,G. (2010). From music making to speaking: Engaging the mirror neuron system in autism.  Brain Research Bulletin, 82, 161-168. 

Podcast from the WCOM Radio Show Interview

Here is the link to my interview with Dr. Sangeeta Swamy, MT-BC that occured on the Sound Effect hour with the WCOM Radio Station in North Carolina on June 18, 2012. Many thanks to Dr. Swamy for her excellent hosting and for creating such a wonderful forum to discuss "the art and science of music and healing" (Swamy, 2012). http://thesoundeffect.wordpress.com/2012/06/18/musical-echolalia-in-non-verbal-children-with-autism-an-interview-with-dr-krystal-demaine-2/

Film recommendation: Wretches and Jaberrers (2011)

A couple of months ago one of my students recommended that I watch the film Wretches and Jaberrers, "It is streaming on Netflix right now," she said, "you have to check it out!" I ended up watching the film that same evening and I really, really enjoyed it.

This film Wretches and Jaberrers is about two adult men who are diagnosed with autism and are non-verbal. These two men, Larry and Tracy are friends who travel the world with a mission to "change the public's thinking about intellectual abilities of people with autism" (Wurzburg & Geradine, 2011).   Each man is accompanied by a person with out autism and a film crew.

The film was actually directed by one of the same individuals who directed the film Autism is a World.   If you haven't seen Autism is a World then you should.

Wretches and Jaberrers not only shares the traveling story of Larry and Tracy, but also of thier personal lives, in addition to some of the history that surrounds autism.   Until the 1980's most adults with autism were institutionalized.  Larry and Tracy remind the viewer that people with autism "want to communicate" and that they are "more like non-autistic persons than not."   This eludes to the concept of using the arts as a language for autism.  For example Larry, an established artist, said "listen to my artistic voice not my autistic voice."  In another example when the men were in Japan they commented during a musical drumming experience that a person with autism will "use their body to hear the sound."

Though both Larry and Tracy are non-verbal they are able to communicate in spoken English language though typing - this skill exemplifies the intellectual ability and desire to communicate that is commonly stressed through out the film.  Through out the story the men travel to Sri Lanka, Japan, and Finland.    In one of the final statements of the film the men talk about the noted limitations in social abilities among individuals with autism and commented that, "poor social behavior is because of lack of social interaction."  We often hear the quote that people with autism are "in their own world". ..but if we give opportunities (alternative opportunities such as music making with others which allows for an inherent social engagement) then we can create more opportunities for developing that much needed social relationship.

This film fully supports many of the concerns I discuss in my research - that of the need for and understanding of 1. neurodiversity, 2. exploring alternative ways to socialize and communicate with people with autism, and 3. recognizing the intellectual abilities of all individuals. 

I hope that people will watch this film to gain an opportunity to widen their perspective on the life of the person with autism.

Radio Show June 18, 2012

Today, from 9:00-10:00am I will be on the radio program "The Sound Effect" hosted by Sangeeta Swamy. I will talk about my work with Musical Echolalia. Here is the Link to the live stream http://www.wcomfm.org/ I will post the link to the recording once it is ready.

Dissertation

On April 13, 2012 I passed the oral defense for my doctoral dissertation. My dissertation, "Musical Echolalia and Non-Verbal Children with Autism" has been published on ProQuest. The dissertation is available for purchase through ProQuest or can be accessed through the Lesley University library repository.

Autism research at MIT

MIT in Cambridge, MA has developed a research center for autism. Here is the link to an article in the metro http://bostonglobe.com/metro/2011/12/14/new-mit-center-fund-autism-research/SHMAXDLp2cqSAGyRLF23CN/story.html

The center will focus on identifying better diagnosis and treatment of ASD by examinng the neurology of the disorder. $26.5 million was given as a gift from the Simons family to begin this project. See MIT News http://web.mit.edu/newsoffice/2011/simons-center-founded.html

AMTA Conference Poster Session

Here is my poster from the AMTA National Conference in Atlanta, GA (November, 2011)

National Conference AMTA 2011

Just returned from the National Conference of the American Music Therapy Association in Atlanta, GA. Here I presented my poster entitled “Musical Imitation and Non-Verbal Children with Autism”. I got some nice feedback concerning inter-rater reliability and additional inquiries as to weather girls imitated better than boys or if performances were better with pitch versus rhythm. This poster presented a pilot study that looked at 4 children (aged 4-11, three boys and one girl); a larger sample size would be needed to be more conclusive to broach some of these questions, however my initial findings in terms of ability to imitate musical sounds with voice and a musical instruments, when imitation is otherwise impaired, shows that these children with autism have the ability to imitate through music. Next would come larger sample followed by a comparative study looking at the role of imitation with other forms stimuli (non-musical of course). There is a lot more to consider!

I do plan to publish this pilot study – the manuscript is set to be finished sometime in the Spring 2012.

Reference:
Demaine, K. (2011). Musical imitation and non-verbal children with autism. Poster Presentation, American Music Therapy Association National Conference, Atlanta, GA

Film: Loving Lampposts

Last night I watched the film “Loving Lampposts” (Drezner, 2010), it is streaming on Netflix. This film is directed by a parent of a child with autism, whom has a special interest in lampposts – the child names them, hugs them, spends time with them - and his parents support his fascination with them. The film explores etiology, treatment, and history through interviews with parents, adults with autism, therapists, advocates, and both medical and philosophical experts in the field.

What I found most engaging was to hear form adults who were diagnosed with autism and are able to talk about it either through verbal language or AAC. Three adults shared their stories – two using AAC (text to speech) and the other, Stephen Shore, who as a child was non-verbal, but now was able to talk about how music, movement, and imitation helped him to engage in society and share his special skills interest. In Stephen’s case this was music, and his parent’s support / ability to help him allowing him to show them how he related to others.

Additionally I appreciated how experts and parents in the film highlighted neuro-diversity, and the need for accepting autism as something akin to how we except ones sexual orientation or religious beliefs. While humankind is still on the track toward the acceptance of many of these things I believe that Neuro-diverisity might be on the fast track – and is something that we could consider has been in development since the 1970’s when many of the educational acts and support for persons with disabilities came into more of an active light.

Reference:
Drezner, T. & Silver, L (Directors) (2010). Loving Lampposts.

Imitation in Young Children

Nielsen, M. & Blank, C. (2011). Imitation in young children: When who gets copied is more important than what gets copied. Developmental Psychology 47(4), 1050-1053.

In this brief report Nielsen and Blank (2011) observed how 36 children (19 boys and 17 girls) aged 4-5 years old imitated a task when independently performed by two adults, one who completed the task with “efficiency” and the other with extra “irrelevant” actions. The task was to open a small box, that had a metal latch, and take a toy out of it. In the trials the adults demonstrated the task each three times, in three different ways, two ways involved some irrelevant actions, and one way simply moved the metal latch and opened the box to reveal the toy. Prior to opening the box the adult demonstrator began with the directive “watch me”. The child sat in front of the demonstrator with their parent by their side. After the first demonstrator performed the task they left the room, and the second demonstrator stayed to perform their form of the task. At the end of the demonstration the adult announced “now it is your turn” (p. 1051) and handed the box to the child. Only one demonstrator was in the room to watch the child open the box and take out the toy.

In result the child imitated the actions that were modeled by the demonstrator that stayed in the room, even if the demonstrator was the one that performed the “irrelevant” acts to open the box. Some of the irrelevant acts included rotating the box, or tapping the box with an object. The authors use the term overimitation in relationship to the imitation of acts with no purposeful or function, modeled after an adults actions. They point out how children learn through imitation, and that young children or novices may learn behaviors that may not be relevant to completing a task.

While the stimuli in this research study was “a box” that could have been opened by swinging a small latch and lifting up the top, the children continued to complete a series of irrelevant acts when in the presence of the adult who performed these same acts. This may speak to the human desire for social approval and human connection. The authors note that imitation or copying is “likely to prove a hallmark of what it means to be human” (p. 1052).

The role of imitation seems to play a clear role in the development of human interactions, learning of language, and the passing along of traditions. This leads me to support the investigation of the neural mechanisms involved in imitation and the role that this may play among the social and communicative development of children with autism.

An examination of the state of imitation research in children with autism: Issues of definition and methodology.

Sevlever, M. & Gillis, J. (2010). An examination of the state of imitation research in children with autism: Issues of definition and methodology. Research in Developmental Disabilities, 31, 976-984doi: 10.1016/j.ridd.2010.04.014.

Sevlever and Gillis (2010) have written a lovely review on imitation research. The authors highlight the “conflicting theoretical explanations of imitative difficulties” among individuals with autism (p. 976), and reported that the “extent of imitative difficulties in children with autism remains largely unknown” due to “inconsistent operational findings” (p. 977). The author comments on the work of Tomasello (1990) who noted differences using describing terms of imitation and mimicry, and comments that “autism research adheres to amore colloquial definition of imitation” (p. 977). The author suggested that more objective approaches toward evaluating imitation through a standardized methodology may offer generalization and greater impact across studies.

The author did mention that many variables such as the a host of sensory impairments may play a role in offering a generalized protocol as each child with autism is so different in nature. So questions remain in terms of how imitation is measured, and what stimuli is used. Why do children with autism consistently perform worse than neuro-typical children when it comes to imitation? Are imitation tasks boring or not of interest to children with autism? Do children with autism see no point in imitating others? Is there a disruption in the visual motor system that may inhibit functional imitation?

As a music therapist I find that children with autism are able to imitate musical sounds in various ways. While motor imitation in general may be impaired – the ability to imitate a motor act on a drum per se is completed within the first trial. If I simply moved my arms as if playing the drum, such imitation would not occur. The trick is finding a way to measure such imitative abilities – with a clear definition of terminology, methodology, and analysis procedure.

Article Review: Slowing down the presentation of facial and body movements enhances imitation performance in children with severe autism.

Laine, F., Rauzy, S., Tardif, C., Gepner, B. (2010). Slowing down the presentation of facial and body movements enhances imitation performance in children with severe autism. Journal of Autism and Developmental Disorders, 41, 983-996.

The authors of this article comment that documented observations from the past 40 years according to DeMeyere and colleagues (1972) have noted imitation difficulties of gestures and actions among individuals with autism. Laine and collegues cite the work of Nadel (2006) who suggested that impaired imitation might contribute to poor imitation and social skills among children with autism. The authors hypothesize that decreasing the speed of movements presented might increase performance of imitative acts.

The focus of the study was “on the physical aspect of imitation rather than on its meaning or familiarity” of the action performed (p. 984). The authors point out the role of perception as indicated by emerging data performed with functional imaging, which has suggested problems of on-line neurologic processing.

Participants in this study included 19 children with classic autism (4 girls and 15 boys, and excluded Asperger’s syndrome or PDD-NOS) aged 6.4-17.6, and two comparison groups that included 27 neuro-typical children (which were split in to additional groups based on assessment scores), and 17 children with Down syndrome. Assessment batteries allowed for the children with autism to be individual matched with the noted counterparts.

The children with autism were assessed for severity with the Childhood Autism Rating Scale scores (CARS), and additional batteries included a Verbal Mental Age Assessment (VMA), a non-verbal Mental Age Assessment (NVMA), The Progressive Matrix Coloured-Test (PMC-T), and the Kaufman-Assessment Battery for Children (K-ABC). Ultimately the participatns were split into the following groups, children with autism (n = 19), neuro-typical children VMA scores (n = 19), neuro-typical children NVMA scores (n = 18), and children with Down syndrome (n = 17).

The participants were tested individual in a private room where they sat in front of a computer screen with a model displaying 20 different facial and body gestures with no-meaning. The gestures were recorded and quantized to play at two different slower speeds, “slow” and “very slow” (p. 988). An experimenter scored the imitations of the gestures based on completeness of imitation – from beginning to end of a sequence. The score was based on a 0-2 point system for each gesture, with a total score of 0-120.

The results compared the three groups of autism according to the CARS scores and revealed that participants with mild autism performed better than participants with both moderate and severe forms of autism. The main findings indicated that children with autism performed almost just as well as those with Down syndrome, but significantly worse than neuro-typical children. The children with autism did not show a difference in imitation performance when the gestures were slowed, yet the children with severe forms of autism performed slightly better when the stimuli was slowed.

An interesting thought that the researchers present in the discussion is the question as to whether the children would have performed differently if the stimuli did not involve a person – as the perceptual experience may have been disrupted by its social underpinnings. In conclusion the authors note that slowing down visual information may assist some children and adolescents with imitation abilities.

In my personal experience as a music therapist – children with autism who are presented with auditory stimuli are able to imitate readily, however since this study focuses on visual stimuli one may consider the role of visual-motor versus auditory-motor relationships in the brain of the individual with autism.

In my conclusion I believe that article has a strong literature review; it is concise, well written, and informs the reader of the brief history of impairment imitation among individuals with autism. The methodology in my opinion in quite complex, there were many comparison groups, which leads me to many questions, and yielded data for possible additional investigations. I am mainly interested in seeing a comparison of the three sub-groups of children with autism and how they perform with the imitation of acts produced at two different speeds only. Additionally, I would also like a greater description of the testing room and the model on the computer. For example were there lights in the room… did the video that represented the model have sound…did the children have a history with the model? I would also be curious to know what gestures the children responded best to, facial or body? The appendix offers a list of the actions that were performed, and the sources of the gestures with references included.

All in all, I thought this was a thorough investigation – and I look forward to seeing more work on this topic, particularly in comparison to visual and auditory imitation among this population.

Music Therapy Reseacrh Blog: Music and Neurosciences Report and Podcast

I have written a brief report on the Neurosciencs and Music IV in Edinburgh, June 2011. It is posted on the Music Therapy Research Blog hosted by Dr. Blythe Lagasse from Colorado State University, and Andrew Knight from the University of North Dokota.
Here is the link to the report:
Part 1. http://www.musictherapyresearchblog.com/?p=1004
Part 2. http://www.musictherapyresearchblog.com/?p=1021
I also recorded a podcast with Blythe and Andrew.
Here is the link:
http://www.musictherapyresearchblog.com/?p=1043

I am very grateful to both Blythe and Andrew for allowing me the opportunity to share my conference experience. They are very supportive of evidence based research in music therapy and in cultivating relationships between music and scientific communities.