1. Introduction
Autism spectrum disorder (ASD) is a neurodevelopmental disorder which affects a significant number of people. There are numerous theories regarding the cause of autism, perhaps because it affects people of every race, every nation, and every socioeconomic class, without following a specific pattern. While the challenges associated with ASD can vary significantly in severity, individuals may experience comorbid conditions such as social anxiety and depression, which can impact daily functioning and adaptive skills.
Autism occurs in children at a very young age [1]. Children with autism spectrum disorder (ASD), as outlined in the DSM-5, face significant challenges regarding social–emotional reciprocity. These challenges can manifest as atypical social approaches or an inability to initiate or respond to social interactions. Additionally, these children may struggle with nonverbal communicative behaviors, which include inadequate integration of verbal and nonverbal communication, irregularities in eye contact and body language, and difficulties in both understanding and utilizing gestures. Furthermore, they may face obstacles in developing, maintaining, and comprehending relationships, which can include challenges in adapting behavior to different social situations, a lack of interest in peers, and difficulties engaging in imaginative play.
The term social skills is used to describe specific behaviors, used by an individual to properly conduct a social interaction. It is virtually a procedure which is based on the individuals themselves, on the information they wish to communicate and on their environment. Therefore, social skills include behaviors which help to have effective interaction with others and avoid undesirable answers [2]. Additionally, social skills are those behaviors that expose the individual to certain circumstances which lead to social interaction and require social ability.
Social ability is essentially the process through which the individual has formed a certain perspective about what social behavior is [3]. The fewer social skills the individual has, the fewer opportunities there are for social interaction. It should also be mentioned that a lot of children within the spectrum of autism demonstrate delayed language skills. Additionally, they face challenges in speech development, which deteriorates their social skills even further [4]. Additionally, school bullying tends to be more severe for children with special needs due to the challenges they face in social and emotional communication. [5].
Many different types of intervention have been applied to children within the autism spectrum, to develop their social skills. These types of interventions include social stories [6], peer-mediated strategies [7], video modeling [8], cognitive–behavioral training [9] and theory of mind [10].
One of the major traits of autism is the deficit in social and communication skills, including compensatory social interaction. Autism causes atypical communicative behavior as well as problems concerning the establishment and the retention of social relationships (American Psychiatric Association 2013). Children within the spectrum of autism are less likely to start any kind of social interaction. Specifically, when their turn to speak comes, during a conversation, they usually answer in one word and show little interest to continue the social interaction started by their interlocutor [3]. This is also corroborated by a study of Walton and Ingersol (2013) [11], which mentions that social skills seem to develop more slowly than other aspects of behavior, in which children with autism face deficits.
A more recent approach explores a possible connection pattern between social skills and cognitive and motor abilities, which could facilitate the learning of new social behaviors. Such studies focus on the kinetic aspect of social skills, through activities which children with ASD are asked to carry out [12,13]. This approach supports the idea that kinetic development and social skills development are strongly connected [14]. Many children within the autism spectrum face kinetic dysfunctions, such as inability to co-ordinate the movement of the upper or the lower limbs and problems with kinetic sequences. All these inconveniences can negatively affect their ability to participate with their peers in games that require physical motion, which is detrimental for their socialization [15].
In recent years, the use of rhythm has been proposed as an effective method for addressing the aforementioned challenges. The rhythm of clapping hands or percussive musical instruments can help children with ASD to improve their gross motor skills and their joint attention [16].
Music can have a particularly strong impact on humans, especially on children, significantly influencing their mood and emotions. Teaching music can help in creating and developing verbal and non-verbal social skills [17]. Individuals on the ASD spectrum can demonstrate enhanced abilities in various musical skills, such as recognizing pitch and perceiving melodies [18,19]. According to Thaut and Hoemberg (2014) [20], Neurologic Music Therapy is “the therapeutic application of music to cognitive, affective, sensory, language, and motor dysfunctions due to disease or injury to the human nervous system”. From this point of view, if people with ASD can process musical stimuli more efficiently, then music can help these individuals improve aspects of their lives where they face deficits. Specifically, structured musical activities give the participants the option to react and to respond to external stimuli as well as the time to rejoin. This condition leads to social interaction in much the same way as a conversation does [21]. The therapeutic attributes of music can be applied to children with severe autism to alleviate symptoms like difficulties with non-verbal communication and joint attention and little eye contact. Certain findings suggest that people with ASD respond to music in the same way as the neurotypical individuals [22]. For example, they tend to prefer listening to harmonic sounds rather than discordant ones.
Throughout time, researchers have shown a particular preference for therapeutic interventions with music as their main implement. According to Srinivasan et al. (2013) [23], at least 12% of all the treatments for people with ASD are based on interventions which include the use of music. This may be because many people with ASD are naturally drawn to music. Its use can be easy and costless, and it is a direct means of communication and interaction.
At the same time, recent studies recommend playing musical instruments as a particularly effective method of enhancing the social skills and linguistic competence of children with ASD. The mental and psychomotor development, as well as the cognitive growth of these children, were positively influenced by using musical instruments in certain intervention procedures. Their social life was improved, and stereotypies were reduced [24,25].
Those beneficial effects derive from the multimodal stimuli which are generated by the playing of a musical instrument as well as the mimicry and the synchronization which such a process includes [26].
The current review focuses on the use of tangible and intangible musical instruments as a method of intervention for enhancing the social skills of children with ASD. The aims of this review are (a) to present internationally acclaimed and peer-reviewed studies, describing the elements of interventions with the use of musical instruments by children with autism, (b) to assess and analyze the effects of interventions with the use of musical instruments on the children’s social skills and (c) to provide suggestions for future research and implementation.
Reviewing interventions which are based on the use of musical instruments is exceptionally important. These interventions could provide educators, parents and specialized institutions with a highly effective tool for enhancing the social skills of children with ASD.
2. Methodology
This review utilized a systematic search strategy, meticulously following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, which are widely recognized as essential for conducting high-quality systematic reviews [27]. The PRISMA checklist was also completed and is presented in Appendix B.
2.1. Research Process
To search for suitable studies, four databases were used: (a) PsycINFO, (b) Education Resources Information Center (ERIC), (c) Scopus and (d) Web of Science and the “gray” literature identified from citations. We have chosen these databases because they focus on educational settings and we had access to them, through our university account. The titles and abstracts of each article were considered. The search terms entered were: “autism” and “musical instruments” and “social skills” and/or “social dexterities”. The accepted studies were conducted between 2013 and January 2024, reflecting updated knowledge in the field of autism. The review was meticulously developed and critically peer-reviewed by both authors, without the use of any automation tools.
2.2. Inclusion and Exclusion Criteria
This specific study examines the effects of using musical instruments on the social skills of children with ASD. The basic criteria for acceptance defined for each study were as follows: (a) participants must have been diagnosed with autism, (b) participants must not have any other kind of disorder or disability such as Tourette syndrome, visual impairments, hearing loss, etc., (c) studies must have been published in scientific reviews or conference proceedings, (d) participants must have taken part in an intervention that included at least one musical instrument, whether tangible or electronic, (e) the intervention must have been planned to focus on social skills, (f) studies must have been published between 2013 and January 2024 and (g) the ages of the children participating in the interventions must be between 3 and 12 years. Studies that (a) are not written in English, (b) used various music therapy implements but not musical instruments, (c) included at least one participant who was not within the age range of 3 to 12. Lastly, books and literature reviews were not included either. We were interested in recent publications that were written in English and were all peer-reviewed. Furthermore, in May 2013, changes in the DSM-5 criteria were introduced. For this reason, we have decided to include papers written from this year onwards. As far as the sample age range is concerned, we wanted to include preschoolers and elementary school children until their early adolescence. We believe that middle and late adolescent children need interventions with a different approach, which can be the subject of another literature review.
The initial search provided 181 results in total (Figure 1). After the duplicates were excluded, this number was reduced to 175. As a result, 6 results were included through databases, while the remaining 6 results were included through citations from other papers during the process. Ultimately, the review included 12 results, 11 studies and 1 conference proceeding, which presents the study conducted by the researchers prior to the conference.
Both authors independently reviewed the results from all four databases to determine whether they met the predefined inclusion criteria. The risk of bias in the included studies was assessed by independently evaluating the database results against these criteria. To address potential bias due to missing outcome data, we thoroughly examined the citations of each paper that fulfilled all or most of the inclusion criteria. This process identified six additional studies that met the inclusion criteria and were subsequently included in the review.
To mitigate bias arising from the randomization process and the selection of reported results, strict criteria were collaboratively established by the authors. These criteria encompassed all previously defined inclusion and exclusion parameters. This rigorous approach ensured consistency and minimized disagreements between authors, as any paper failing to meet the criteria was not considered for inclusion in the review.
3. Results
The 12 studies included in this review were checked and analyzed according to the following categories: (a) age range (years), (b) sample (number and age), (c) duration of the intervention, (d) research design, (e) assessment methods, (f) effects of the intervention, and (g) limitations and suggestions for future research. The thematic analysis was predetermined and conducted by both reviewers. It was created manually, and its purpose was to capture the main elements of the methodology, the results as well as the main limitations of each paper.
3.1. Participant’s Characteristics
The total number of children who participated in interventions with the use of musical instruments, as a part of the 12 studies included in this review, is 208. The ages of the children range from 3 to 12 years. The sex of the children is mentioned only in some of the 12 studies. In the studies where the participants’ sex is known, out of a total of 132 individuals, 94 of them are boys and 38 are girls. All the participant children were diagnosed with autism, without any additional disorders.
3.2. Duration of the Intervention
The number of interventions in each of the studies included in this review varies. In only three studies did this number exceed 20. The study with the largest number of interventions was that of Geetha Bharathi et al. (2019) [24], where it is mentioned that the researchers made 36 visits. On the other hand, the study by Nonnis and Kinns (2021) [28] reports only five visits. As for the duration of these interventions, in three studies they lasted from 50 to 60 min each [3,21,25]. In another three of the studies the interventions lasted from 35 to 45 min per time [24,29,30], while in other three, from 15 to 24 min per time [28,31,32]. The remaining three studies do not mention any duration for the interventions.
It is also important to note the duration of each intervention, as there are great differences between the studies included in this review. The shortest reported intervention lasted 5 weeks [28], while the longest was 20 weeks [31].
3.3. Research Planning
The studies included in this review (Table 1) vary significantly in their research design. In four studies, a Randomized Control Trial (RCT) was adopted [21,24,30,33]. Two studies were designed according to the single-subject method, including baseline, pre-tests, post-tests and follow-up tests [31,32]. Another study was based on pre-tests, post-tests and follow-up tests with a control group [3]. There were also researches in which only pre-tests and post-tests were used [16,25] for assessing the results. The research conducted by Pater et al. (2021) [29] was based on multiple case studies. Lastly, two more studies used follow-up interviews [28,34].
3.4. Quality Appraisal
For appraising study quality, the MMAT (Mixed Methods Appraisal Tool) was used. It is developed by Pierre Pluye and his team at McGill University in Canada. This specific instrument is suitable for covering and assessing manifold studies. As far as the qualitative studies go, all were evaluated, and all of them were evaluated as having clear research questions. These questions are addressed by the collected data in all four qualitative studies. Likewise, the qualitative approach was deemed appropriate to answer the research questions in each study. However, in one of the four studies [29] the qualitative data collection methods were somewhat inadequate for addressing the research question, since the first questionnaire was short and non-validated, and the observations of this study were only performed by the mothers of the children. Nevertheless, in all four studies the findings were adequately derived from the data. The interpretation of results is sufficiently substantiated by the data presented in the studies, except for one [30], in which there were no follow-up tests, and the sample size was considerably small. Lastly, in all four studies there was coherence between qualitative data sources, collection, analysis and interpretation.
For the quantitative randomized controlled trials, two studies were utilized. The research questions were assessed clearly in all of them. Additionally, the collected data allows us to address the research questions in each one of those studies. Likewise, the randomization is appropriately performed, and the groups are comparable at the baseline. As for the outcome, data were complete in one of the two studies. The other one [33] does not include follow up tests, and so we can not say whether the outcome of the data is complete or not. Lastly, in the two studies the outcome assessors are blinded to the intervention provided and the participants adhere to the assigned intervention. As for the quantitative non-randomized studies, clear research questions were present in all six included studies, and those questions were addressed by the collected data. However, the degree of representativeness was different in each of these studies. In two of them [31,32] the sample size of male/female participants in the subject group was unbalanced since all the participants were male. In two other studies, it is unclear whether the participants were representative of the target population, because of the small sample size [3,16]. In another of the six included studies [24] the participants were selected from a single city, thus compromising the representativeness of the sample. In only one study, the participants were adequately representative of the target population [25]. In all six studies, the measurements were appropriate regarding both the outcome and intervention (or exposure). On the other hand, only two of them [24,31], had complete outcome data. As for the other four, in one of them [32] the number of the autistic participants was too small, and scientific statistical analysis could not be applied on the data. In another one there were participants who did not contribute to all measurements. Lastly, one of these six studies [25] did not include follow-up tests while the last study [3] lacked follow-up tests and a control group, evidence-based assessment and standardized protocols. In all these studies, confounders were accounted for in the design and analysis. Lastly, during the study period, the intervention was administered as intended in all six studies.
3.5. Effects of the Intervention
In all the twelve papers included in this review, there was an improvement observed in a wide range of skills of the participating children. The interventions were particularly beneficial for the social skills of the children [3,24,25,35]. Their joint attention [29] and social interaction [32] were significantly enhanced. Their negative behavior was reduced [35] while there was an improvement in their relationships with their parents and their peers [16]. Children also demonstrated greater efficiency in non-verbal communication [28] and became sufficiently familiar with eye contact [21,28]. However, there was not any improvement regarding the mimicry procedure [16], nor were there significant differences in social cognition [31].
According to a recent approach, there is a strong link between social and motor skills. Many children with ASD demonstrate kinetic dysfunctions which affect their ability to participate in motion games, hinder their communication with their peers and, as a result, impede their socialization process [15]. The interventions of this review presented encouraging results in the field of the participating children’s motor skills. Under the influence of the intervention, children were able to co-ordinate their movements and control their physical strength more easily [33]. Their rhythmic perception [32] and rhythmology [31] were improved, as well as their gross and small motor skills [32,34].
Finally, there was a significant improvement in the cognitive skills of the children who participated in the interventions included in this review. The children demonstrated greater willingness to take initiatives [29], their concentration skill was improved [16] and there was progress in their language skills [25] which are essential components of the broader social skills
It should also be noted that apart from the aforementioned skills, which have a utilitarian function in the children’s everyday life, some of the interventions in this review indicated a beneficial relationship between the participants and the art of music [31].
4. Discussion
This literature review encompasses twelve distinct papers, examining the effects of the use of tangible and electronic musical instruments on the social skills of children with autism. Our findings suggest that all the twelve studies reported positive and promising results, indicating that this type of intervention could help some children with ASD. However, there were a significant number of limitations in these studies, which must be discussed. According to most of the studies included in this review, to generalize the results and apply them to other groups of the population requires a larger sample of participating children [25,30,31,33,34]. There are also many other factors that should be considered, such as the degree of functionality of the participating children with ASD, their music preferences, their sex, age and their demographic characteristics. All these are crucial factors in determining the type of the intervention that will be applied and its potential outcomes [3,24].
It is also very important to mention that if an intervention focusing on kinetic coordination occurs at a very young age, it can increase the chances of interaction with other individuals, as it is directly related to the socio-emotional development of the child [36,37]. Most of the social skills developed in children are based on motion, giving the ability to understand social stimuli [38]. It is suggested that kinetic abilities may assist in learning new social behaviors, as they are connected directly with social skills [12,13,14]. As it is mentioned by Srinivasan and Bhat (2013) [23], only a few of the interventions there was an improvement in gross and small motor skills, possibly because of the fact that there have not been many studies in this specific field [32].
It is also worth mentioning that the result assessment tools of each study also play an important role in drawing conclusions. To determine whether an intervention had long-lasting positive results, it is necessary to conduct follow-up tests and confirm that the progress achieved has been maintained. In several of the studies included in this review, there were no such assessments [25,29,30,33,34]. The assortment of assessment tools plays also an important role in drawing conclusions, since different types of tools can lead to different or even contrary results in the same study [21]. Therefore, it is suggested that different types of assessment tools should be used, to have more solid conclusions [33], including different groups in the study as much as possible, like parents, teaching staff and scientists [29].
Lastly, the use of musical instruments can take different forms. In rhythmic exercises, for example, we can use easy-to-play tunes, songs and reproduction of rhythmic patterns. It is also worth mentioning that most studies conducted do not provide a detailed description of the applied intervention [29] and this is why it is difficult to ascertain the precise manner in which the musical instruments were used during the intervention and what led to the recorded results. Furthermore, there are no studies which employed musical instruments for the composition of musical pieces [25].
5. Conclusions
The studies featured in this review include interventions involving the use of tangible musical instruments, as well as interventions with musical instruments and the simultaneous use of technological applications. Both types of interventions yield notably encouraging results. More specifically, the studies included in this bibliography display improvements in various areas such as communication, social skills, rhythmic perception, fine motor skills, concentration levels, and eye contact, through interventions based on the use of music.
However, it is crucial to highlight that the examination of these studies raises two major questions. Firstly, can the results be generalized, and to what extent? Secondly, could the positive effects of the interventions be maintained in the long term and to what extent?
The review of the existing literature indicates that both the use of musical instruments and their integration with technological applications could improve the social skills of children with ASD. However, to draw additional and more robust conclusions, further research studies on this specific field are needed, involving a larger sample of children in each study. The findings of this review will further provide a foundation for future research on interventions that employ technology and music as primary tools to enhance social skills.
Not applicable.
Not applicable.
No new data were created or analyzed in this study.
The authors declare no conflicts of interest.
Footnotes
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
Enlarge this image.Figure 1. PRISMA flowchart. * No automation tools were used, all records were excluded by humans (see the tables in Appendix A).
This table presents the year of publication, age range, sample, duration of intervention, methodology, measurement system, findings and future work.
| Article | Year | Age | Sample | Duration | Methodology | Measurement System | Findings | Future Work |
|---|---|---|---|---|---|---|---|---|
| A. Blythe LaGasse | 2014 | 6–9 | 17 (13 boys–4 girls) | 10 meetings of 50′ | Randomized Control Trial (RCT) | Social Responsiveness Scale, Autism Treatment Evaluation Checklist and Video Analysis | Improvements in joint attention and eye gaze towards other persons | Limited sample size, no improvements showed on ATEC and only instances of eye gaze toward another individual were counted |
| Seyyed Nabiollah Ghasemtabar et al. | 2015 | 7–12 | 27 (14 boys–13 girls) | 24 meetings of 60′ | Pre-test, Post-test and Follow-up tests with control group | Social Skills Rating System Scale (for parents) | Positive effects on social skills | Limited sample size and only the Orff–Shulwerk method was used |
| Shabani Minaabad M. | 2020 | 10–12 | 30 (unclear) | 16 meetings of 60′ | Pre-test and Post-test | Vineland Social maturity Scale and Test of Language Development | Improvements in the development of social activities and language skills | Limited sample size and lack of follow-up measurement |
| Geetha Bharathi et al. | 2019 | 6–12 | 26 (13 boys–13 girls) | 36 meetings of 35′ for 3 months | Randomized Control Trial (RCT) | TRIAD Special Skills Assessment | Improvements in social skills, development in their ability to understand, respond and maintain interaction with peers | Participants were selected only from Coimbatore City and social skill domain was the only aspect studied |
| Alireza Taheri et al. | 2016 | 6 | 4 (boys) | 11 meetings of 20′–30′ | Single-Subject Design Method (baseline, pre-test, post-test, follow-up test) | Stambak’s Rhythmic Structures Reproduction test and Gilliam Autism Rating Scale (GARS) | The robot does have the ability to teach the fundamentals of music to children with ASD, improvement in fine hands imitation and rhythm identification | Limited sample size, unbalanced sample size of male/female participants, and no scientific statistical analysis applied |
| Ying-Hua Peng et al. | 2014 | 8 | 2 (1 boy–1 girl) | 7 weeks | Test papers | Observation | Concentration of children improved significantly, their relationship with others became better but they did not do any kind of imitation | The children did not do any kind of imitation, and the time of each intervention session was too short |
| Mojtaba Shahab et al. | 2021 | 6–8 | 5 (boys) | 8–10 meetings of 15′–20′ | Single-Subject Design Method (baseline, pre-test, post-test, follow-up test) | Stambak’s Rhythmic Structures Reproduction test, Early Social Communication Scales (ESCS), Autism Social Skills Profile (ASSP), Gilliam Autism Rating Scale (GARS), Autism Checklist, Parenting Stress Index-Short Form (PSI-SF), Video Analysis and Kinematic data from headsets and controllers in VA | Improvements in musical abilities and in performance of difficult tasks but there was no improvement in the cognitive skills | Only children with high-functioning autism participated, unbalanced sample size of male/female participants and short time of each intervention session |
| Mathieu Pater et al. | 2021 | 4–10 | 10 (8 boys–2 girls) | 20 meetings of 40′ | Multiple Case Study | Questionnaire for the Inventory of Social Behavior for Children (VISK) and Social Behavior Questionnaire (SBQ) | Positive effects on social behavior | There was no definite conclusion that it was the music therapy that had a positive effect on social behavior, the observations were done only by the mothers of the children, short questionnaire was developed, no unbiased baseline measurement was conducted and there was no follow-up measurement |
| Franceli L. Cibrian et al. | 2017 | 3–11 | 24 (unclear) | 10 meetings | Semi-structured interviews and observation | System Usability Scale (SUS), User Experience Questionnaire (UEQ), Semi-Structured Interviews, Video Analysis and Wilcoxon Signed Rank-test | Maintenance of attention, beneficial effects on motor development and control of motor skills | Limited sample size, the research was conducted in only one school-clinic and short time of intervention |
| Sudha Srinivasan et al. | 2015 | 5–12 | 36 (32 boys–1 girl) | 32 meetings of 45′ for 10 weeks | Randomized Control Trial (RCT) | Vinland Adaptive Behavior Scale 2nd edition (VABS), Repetitive Behavior Scale-Revised (RBS-R) and video analysis | The “rhythm group” decreased negative behaviors, no training-related changes in the other groups. In the “rhythm group” there was an increase in interest affect whereas the “robot group” showed a decrease in positive affect | Limited sample size, limited variability in the level of functioning of children, short training duration and lack of follow-up measurement |
| Antonella Nonnis et al. | 2021 | 5–10 | 5 (4 boys–1 girl) | 5 meetings of 24′ for 5 weeks | Pre- and post-study interviews and video analysis | Social Communication Emotional Regulation Transactional Support (SCERTS), observation and interviews | Amplification of spontaneous play, enhancement of eye contact and non-verbal communication | Limited sample size, all children had preference to music, the study was conducted in an almost ideal environment and some adults became a hindrance to the children’s participation |
| Franceli L. Cibrian et al. | 2020 | 4–8 | 22 (unclear) | 8 meetings for 2 months | Pilot Randomized Control Trial (RCT) | Developmental Coordination Disorder Questionnaire (DCDQ) and Playing in Touch questionnaire (PiT) | “BendableSound” improves strength control and coordination whereas tambourines improve reaction time | Limited sample size, more measurement tools are required, the cognitive function of participants was not controlled and lack of follow-up measurement |
Appendix A
| Title: ERIC | Status * |
| (1) Utilizing social virtual reality robot (V2R) for music education to children with high-functioning autism | YES |
| (2) Social Emotional Effects of Drumtastic®: A Dyadic Within-Group Drumming Pilot Program for Children with Autism Spectrum Disorder | NO |
| (3) Rock drumming enhances motor and psychosocial skills of children with emotional and behavioral difficulties | NO |
| (4) Mental Health Benefits of a Service-Learning Group Drumming Between College Students and Children with Autism Spectrum Disorder | NO |
| (5) Piano Lessons: Fostering Theory of Mind in ASD through Imitation | NO |
| (6) Musical Creativity in Autism: Exploring Growth through collaborative peer interaction | NO |
| (7) Using music to encourage joint attention for students with autism spectrum disorder: attention as a reciprocal relationship | NO |
| (8) Teaching the Skill of Reading Facial Expressions to a Child with Autism Using Musical Activities: A Case Study | NO |
| (9) Attunement in Music Therapy for Young Children with Autism: Revisiting Qualities of Relationship as Mechanisms of Change | NO |
| (10) Brief Report: Discrimination of Foreign Speech Pitch and Autistic Traits in Non-Clinical Population | NO |
| (11) Stakeholder Perceptions of the Effects of a Public School-Based Theatre Program for Children with ASD | NO |
| (12) Music Strategies to Promote Engagement and Academic Growth of Young Children with ASD in the Inclusive Classroom | NO |
| Title: PsycINFO | Status * |
| (1) Piano with a twist: A pilot study exploring the preliminary effects of a piano therapy program for children with autism spectrum disorder | NO |
| (2) Discriminating autism and language impairment and specific language impairment through acuity of musical imagery | NO |
| (3) Effects of music therapy on mood, language, behavior, and social skills in children with autism: A meta-analysis | NO |
| (4) Circumscribed interests in autism: Can animals potentially re-engage social attention? | NO |
| (5) Dance, rhythm, and autism spectrum disorder: An explorative study | NO |
| (6) The Use of Music Interventions to Improve Social Skills in Adolescents with Autism Spectrum Disorders in Integrated Group Music Therapy Sessions | NO |
| (7) Tensions in designing tablet-based musical instruments for students with disabilities | NO |
| (8) Parental responsiveness during musical and non-musical engagement in preschoolers with ASD | NO |
| (9) MUSAD-Short—A music-based screening tool to assess autism spectrum disorder in people with intellectual disability | NO |
| (10) Autism Spectrum Disorder and Complementary-Integrative Medicine | NO |
| (11) Dramatherapy for children and adolescents with autism spectrum disorder: A systematic integrative review | NO |
| (12) The developmental progress in social behavior of children with Autism Spectrum Disorder getting music therapy. A multiple case study | YES |
| (13) Filmmaking and video as therapeutic tools: Case studies on autism spectrum disorder | NO |
| (14) Family members’ and other experts’ perceptions of music therapy with children on the autism spectrum in New Zealand: Findings from multiple case studies OK | NO |
| (15) Early social communication through music: State of the art and future perspectives | NO |
| (16) An evaluation of a developmental individual differences relationship-based (DIR®)-creative arts therapies program for children with autism | NO |
| (17) The effects of embodied rhythm and robotic interventions on the spontaneous and responsive social attention patterns of children with autism spectrum disorder (ASD): A pilot randomized controlled trial | NO |
| (18) Behavioral and emotional problems of toddlers with autism spectrum disorder: Effects of parents’ sociocultural level and individual factors | NO |
| (19) Autism and tablet computers in Turkey: Teaching picture sequencing skills via a web-based iPad application | NO |
| (20) BendableSound: An elastic multisensory surface using touch-based interactions to assist children with severe autism during music therapy | YES |
| (21) Musical friends and foes: The social cognition of affiliation and control in improvised interactions | NO |
| (22) Early prediction of Autism Spectrum Disorders through interaction analysis in home videos and explainable artificial intelligence | NO |
| (23) A randomized controlled trial of 25 sessions comparing music therapy and music listening for children with autism spectrum disorder | NO |
| (24) Comparing sensory processing in children with Down syndrome to a mental age matched sample of children with autism, other developmental disabilities, and typically developing children | NO |
| (25) Correlations between features of event-related potentials and Autism Spectrum Quotient scores | NO |
| (26) Music-based Autism Diagnostics (MUSAD)—A newly developed diagnostic measure for adults with intellectual developmental disabilities suspected of autism | NO |
| (27) Reframing Autism: Young Adults With Autism Share Their Strengths Through Photo-Stories | NO |
| (28) Structuring collaboration: Multi-user full-body interaction environments for children with Autism Spectrum Disorder | NO |
| (29) Vision, concretism, repetitism. Typical artistic design features in drawings of adults with autism and intellectual disability | NO |
| (30) Research Report How do typically developing children and children with autism perceive different social robots? | NO |
| (31) Musical Attention Control Training (MACT) in secure residential youth care: A randomised controlled pilot study | NO |
| (32) A comparison of the effects of rhythm and robotic interventions on repetitive behaviors and affective states of children with Autism Spectrum Disorder (ASD) | YES |
| (33) An inclusive design approach for developing video games for children with Autism Spectrum Disorder | NO |
| (34) Music intervention as system: Reversing hyper systemising in autism spectrum disorders to the comprehension of music as intervention | NO |
| (35) Survey of the home music environment of children with various developmental profiles | NO |
| (36) Parent-child interaction during the first year of life in infants at elevated likelihood of autism spectrum disorder | NO |
| (37) Role of parental occupation in autism spectrum disorder diagnosis and severity | NO |
| (38) Effects of a music-based short story on short- and long-term reading comprehension of individuals with Autism Spectrum Disorder: A cluster randomized study | NO |
| (39) Evaluation of the Barnet Early Autism Model (BEAM) teaching intervention programme in a ‘real world’ setting | NO |
| (40) Intentions vs. resemblance: Understanding pictures in typical development and autism | NO |
| (41) What evidence? Designing a mixed methods study to investigate music therapy with children who have autism spectrum disorder (ASD), in New Zealand contexts | NO |
| (42) The impact of esports participation on the development of 21st century skills in youth: A systematic review | NO |
| (43) Music therapy song repertoire for children with autism spectrum disorder: A descriptive analysis by treatment areas, song types, and presentation styles | NO |
| (44) The Differential Diagnosis of Anxiety Disorders in Cognitively-Able Youth With Autism | NO |
| (45) Exploring the influence of ownership history on object valuation in typical development and autism | NO |
| (46) Behavioral and neural markers of visual configural processing in social scene perception | NO |
| (47) Olly: A tangible for togetherness | YES |
| (48) The Impact of LCSMA Based Therapy on the Overall Development Profile of Autistic Children | NO |
| (49) Supporting coordination of children with ASD using neurological music therapy: A pilot randomized control trial comparing an elastic touch-display with tambourines | YES |
| (50) Using an inclusive therapeutic theatre production to teach self-advocacy skills in young people with disabilities | NO |
| (51) Our restless minds | NO |
| (52) Do children with specific language impairment and autism spectrum disorders benefit from the presence of orthography when learning new spoken words? | NO |
| (53) Art activities with Kinect to students with cognitive disabilities: Improving all motor skills | NO |
| (54) Variability in infant social responsiveness: Age and situational differences in attention-following | NO |
| (55) Music in the practice of dance/movement therapy | NO |
| (56) Use of Music in Special Education and Application Examples from Turkey | NO |
| (57) Conducting Exposure-Based Groups via Telehealth for Adolescents and Young Adults With Social Anxiety Disorder | NO |
| (58) Six adolescents’ lived experiences of resource-oriented music therapy assessment in a community-based mental health day program | NO |
| (59) When the cost has sunk: Measuring and comparing the sunk-cost bias in autistic and neurotypical persons | NO |
| (60) On the use of a multimedia platform for music education with handicapped children: A case study | NO |
| (61) Co-learning facilitates memory in mice: A new avenue in social neuroscience | NO |
| (62) Predicting multiscan MRI outcomes in children with neurodevelopmental conditions following MRI simulator training | NO |
| (63) Participation and enjoyment of leisure activities in adolescents born at ≤29 week gestation | NO |
| (64) Influence of music training on language development. A longitudinal study | NO |
| (65) Relations between social-perceptual ability in multi- and unisensory contexts, autonomic reactivity, and social functioning in individuals with Williams syndrome | NO |
| (66) Domain specific traits predict achievement in music and multipotentiality | NO |
| (67) The Role of Art and Music Therapy Techniques in the Educational System of Children with Special Problems | NO |
| (68) Mentalising music in frontotemporal dementia | NO |
| (69) Autonomic response to approachability characteristics, approach behavior, and social functioning in Williams syndrome | NO |
| (70) Kindergarten Social Assistive Robot (KindSAR) for children’s geometric thinking and metacognitive development in preschool education: A pilot study | NO |
| (71) The effects of a music enrichment program on parent-infant interactions during mealtime: A randomized controlled trial | NO |
| (72) The effectiveness of music therapy for individuals with Rett syndrome and their families | NO |
| (73) An adaptive cognitive-social model for mirroring and social bonding during synchronous joint action | NO |
| (74) Future plans and social/recreational activities of youth with special health care needs: The implications of parental help in completing surveys | NO |
| (75) Betwixt and between: Considering liminality and rites of passage in the context of music therapy in a specialist further education college | NO |
| (76) Pediatric staff and their perceptions of music therapy services | NO |
| (77) Creative music therapy to promote brain function and brain structure in preterm infants: A randomized controlled pilot study | NO |
| (78) Activity and participation in children with neurofibromatosis type 1 | NO |
| (79) Situating computational empowerment in formal education: A multi-perspective view | NO |
| (80) Participation in group music therapy: A preliminary study of the experiences and perceptions of adolescents who stammer | NO |
| (81) Breaking the ice: Use of music improvisation to facilitate interprofessional communication | NO |
| (82) Generic versus disorder specific cognitive behavior therapy for social anxiety disorder in youth: A randomized controlled trial using internet delivery | NO |
| (83) Music listening for children and adolescents in health care contexts: A systematic review | NO |
| (84) The adult developmental coordination disorders/dyspraxia checklist—German: adapted factor structure for the differentiation of DCD and ADHD | NO |
| (85) The development of functional connectivity within the dorsal striatum from early childhood to adulthood | NO |
| (86) Short-term music therapy treatment for adolescents with depression—A pilot study | NO |
| (87) The Effects of the Establishment of Adult Faces and/or Voices as Conditioned Reinforcers for Children with ASD and Related Disorders | NO |
| (88) Differentiated instruction for special needs in inclusive schools: A preliminary study | NO |
| (89) Effects of group singing versus group music listening on hospitalized children and adolescents with mental disorders: A pilot study | NO |
| (90) Learning maths with a tangible user interface: Lessons learned through participatory design with children with visual impairments and their educators | NO |
| (91) Maternal and child factors associated with the health-promoting behaviours of mothers of children with a developmental disability | NO |
| (92) Auditory brainstem’s sensitivity to human voices | NO |
| (93) Pilot randomized controlled trial of Tuning Relationships with Music: Intervention for parents with a trauma history and their adolescent | NO |
| (94) Does early object exploration support gesture and language development in extremely preterm infants and full-term infants? | NO |
| (95) The Influence of Students’ Cultural Music and Classroom Music Activities on their Attitudes towards their Multiethnic Peers | NO |
| (96) Understanding the robotization landscape transformation: A centering resonance analysis | NO |
| (97) Intertrial auditory neural stability supports beat synchronization in preschoolers | NO |
| (98) The speech-language pathologist’s role in supporting the development of self-regulation: A review and tutorial | NO |
| (99) When home becomes classroom: The shifting roles of Korean immigrant mothers in the management of children’s education during COVID-19 in the US | NO |
| (100) Differences in patterns of physical participation in recreational activities between children with and without intellectual and developmental disability | NO |
| (101) Development and evaluation of the psychometric properties of the Adolescent Motor Competence Questionnaire (AMCQ) for Adolescents | NO |
| (102) A grounded theory of music therapists’ approach to goal processes within their clinical practice | NO |
| (103) An exploratory factor analysis of visual performance in a large population | NO |
| (104) Development of a movement questionnaire adapted for Japanese culture for elementary school children | NO |
| (105) Gracefully yours: Would snap judgments of one’s subtle graceful movements lead to inferences about their emotional intelligence? | NO |
| (106) Creative children in a robust learning environment: Perceptions of special education teacher candidates | NO |
| (107) The New DSM-5 and Its Impact on the Mental Health Care of Children | NO |
| (108) Measuring individual and group flow in collaborative improvisational dance | NO |
| (109) Βeyond technical learning: Internship as a liminal zone on the way to become a psychologist | NO |
| (110) Domain-general auditory processing as an anchor of post-pubertal second language pronunciation learning: Behavioural and neurophysiological investigations of perceptual acuity, age, experience, development, and attainment | NO |
| (111) Usability and user experience of an individualized and adaptive game-based therapy for children with cerebral visual impairment | NO |
| (112) Loss, adaptation and growth: The experiences of creative arts therapists during the COVID-19 pandemic | NO |
| (113) The Use of Music Therapy as a Factor of Sustainable Development | NO |
| (114) Psychological effects of gamified didactics with exergames in Physical Education at primary schools: Results from a natural experiment | NO |
| (115) Sequence learning in the human brain: A functional neuroanatomical meta-analysis of serial reaction time studies | NO |
| (116) A synthetic theory to integrate and explain the causes of the Flynn effect: The Parental Executive Model | NO |
| (117) Designing for appropriation: A DIY kit as an educator’s tool in special education schools | NO |
| (118) Eight wonders of the human brain | NO |
| (119) Critical aspects of neurodevelopment | NO |
| (120) Clinical features of Tourette syndrome and tic disorders | NO |
| (121) Preschoolers’ word learning and story comprehension during shared book reading | NO |
| (122) Vocal emotion adaptation aftereffects within and across speaker genders: Roles of timbre and fundamental frequency | NO |
| (123) Are scalar implicatures automatically processed and different for each individual? A mismatch negativity (MMN) study | NO |
| (124) Effects of classroom-based creative expression programmes on children’s well-being | NO |
| (125) Cultivating interest in art: Causal effects of arts exposure during early childhood | NO |
| (126) Recognition of facial emotions and identity in patients with mesial temporal lobe and idiopathic generalized epilepsy: An eye-tracking study | NO |
| (127) Brain responses to biological motion predict treatment outcome in young adults with autism receiving Virtual Reality Social Cognition Training: Preliminary findings | NO |
| (128) Calming effects of repetition in music for children with sensory sensitivities: Findings from two experimental studies | NO |
| (129) Active music making and leisure activities for people with intellectual disabilities: A cluster randomized pilot study | NO |
| (130) Effects of music therapy in children and adolescents with neurodevelopmental disorders—A literature review | NO |
| (131) Art therapy as a treatment for adults with learning disabilities who are experiencing mental distress: A configurative systematic review with narrative synthesis | NO |
| (132) Barriers to inclusive education under occupation: An evaluative approach using Nussbaum’s capabilities approach | NO |
| (133) Effect of Audio-Visual-Based Art and Music Therapy in Reducing Adolescents Post Traumatic Stress Disorder | NO |
| (134) Teacher experiences under COVID-19 pandemic school reopening periods: A window of opportunity for adapted education | NO |
| (135) Embedding immersive virtual reality in classrooms: Ethical, organisational and educational lessons in bridging research and practice | NO |
| (136) Development of a gaze contingent method for auditory threshold evaluation in non-verbal ASD children | NO |
| (137) Learning Styles and Visual Literacy for Learning and Performance | NO |
| (138) Executive function and verbal self-regulation in childhood: Developmental linkages between partially internalized private speech and cognitive flexibility | NO |
| (139) Personality and cognitive profiles of a general synesthetic trait | NO |
| (140) Introduction of Active Video Gaming Into the Middle School Curriculum as a School-Based Childhood Obesity Intervention | NO |
| (141) Examining the participation patterns of an ageing population with disabilities in Australia | NO |
| (142) Auditory object perception: A neurobiological model and prospective review | NO |
| (143) Brain mapping of emotional prosody in patients with drug-resistant temporal epilepsy: An indicator of plasticity | NO |
| (144) Millennial generation preservice teachers’ intrinsic motivation to become a teacher, professional learning and professional competence | NO |
| (145) Loss of central mineralocorticoid or glucocorticoid receptors impacts auditory nerve processing in the cochlea | NO |
| (146) Understanding the mechanisms of familiar voice-identity recognition in the human brain | NO |
| (147) Abstracts | NO |
| (148) E-Poster Viewing | NO |
| (149) Fuzzy controlled humanoid robots: A literature review | NO |
| (150) Auditory event-related potentials index faster processing of natural speech but not synthetic speech over nonspeech analogs in children | NO |
| (151) Gait profiles as indicators of domain-specific impairments in executive control across neurodevelopmental disorders | NO |
| (152) Getting to know you: The development of mechanisms underlying face learning | NO |
| (153) Friday Abstracts | NO |
| (154) E-Poster Walk | NO |
| (155) Teaching as dance: A case-study for teacher practice analysis | NO |
| Title: Scopus | Status |
| (1) Piano with a twist: A pilot study exploring the preliminary effects of a piano therapy program for children with autism spectrum disorder | NO |
| (2) Exploring the Possibilities of Music Therapy in Virtual Reality: Social Skills Training for Adolescents with Autism Spectrum Disorder | NO |
| (3) Utilizing social virtual reality robot (V2R) for music education to children with high-functioning autism | YES |
| (4) Development of emotional skills through videomodeling: A case study with a non-verbal participant | NO |
| (5) A casestudy on the use of an innovative, technical, musical instrument, skoog, in a special needs education setting with a child with autism and its effects on social skills | NO |
| (6) Inter-rater reliability on the Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) for autism spectrum disorder | NO |
| (7) Innovative computer technology in music-based interventions for individuals with autism moving beyond traditional interactive music therapy techniques | NO |
| (8) Musical interaction with children and young people with severe or profound intellectual and multiple disabilities: a scoping review | NO |
| Title: Web of science | Status * |
| (1) A casestudy on the use o f an innovative, technical, musical instrument, Skoog, in a special needs education setting with a child with autism and its effects on social skills | NO |
| (2) Utilizing social virtual reality robot (V2R) for music education to children with high-functioning autism | YES |
| (3) Piano with a twist: A pilot study exploring the preliminary effects of a piano therapy program for children with autism spectrum disorder | NO |
| (4) From music making to speaking: Engaging the mirror neuron system in autism | NO |
| (5) Innovative computer technology in music-based interventions for individuals with autism moving beyond traditional interactive music therapy techniques | NO |
| (6) Inter-rater reliability on the Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND) for autism spectrum disorder | NO |
| Status YES *: This paper integrates all the inclusion criteria of our review. (a) Participants must have been diagnosed with autism; (b) participants must not have any other kind of disorder or disability; (c) studies must have been published in scientific reviews or conference proceedings; (d) participants must have taken part in an intervention that included at least one musical instrument, whether tangible or electronic; (e) the intervention must have been planned to focus on social skills; (f) studies must have been published between 2013 and January 2024 and (g) the ages of the children participating in the interventions must be between 3 and 12 years. Status NO *: Does not integrate one or more inclusion criteria. | |
Appendix B
| Section and Topic | Item # | Checklist Item | Location Where Item Is Reported |
| TITLE | |||
| Title | 1 | Identify the report as a systematic review. | 1 |
| ABSTRACT | |||
| Abstract | 2 | See the PRISMA 2020 for Abstracts checklist. | 1 |
| INTRODUCTION | |||
| Rationale | 3 | Describe the rationale for the review in the context of existing knowledge. | 1 |
| Objectives | 4 | Provide an explicit statement of the objective(s) or question(s) the review addresses. | 1 |
| METHODS | |||
| Eligibility criteria | 5 | Specify the inclusion and exclusion criteria for the review and how studies were grouped for the syntheses. | 3–4 |
| Information sources | 6 | Specify all databases, registers, websites, organisations, reference lists and other sources searched or consulted to identify studies. Specify the date when each source was last searched or consulted. | 3 |
| Search strategy | 7 | Present the full search strategies for all databases, registers and websites, including any filters and limits used. | 3 |
| Selection process | 8 | Specify the methods used to decide whether a study met the inclusion criteria of the review, including how many reviewers screened each record and each report retrieved, whether they worked independently, and if applicable, details of automation tools used in the process. | 3–4 |
| Data collection process | 9 | Specify the methods used to collect data from reports, including how many reviewers collected data from each report, whether they worked independently, any processes for obtaining or confirming data from study investigators, and if applicable, details of automation tools used in the process. | 4 |
| Data items | 10a | List and define all outcomes for which data were sought. Specify whether all results that were compatible with each outcome domain in each study were sought (e.g., for all measures, time points, analyses), and if not, the methods used to decide which results to collect. | 4 |
| 10b | List and define all other variables for which data were sought (e.g., participant and intervention characteristics, funding sources). Describe any assumptions made about any missing or unclear information. | 4 | |
| Study risk of bias assessment | 11 | Specify the methods used to assess risk of bias in the included studies, including details of the tool(s) used, how many reviewers assessed each study and whether they worked independently, and if applicable, details of automation tools used in the process. | 4 |
| Effect measures | 12 | Specify for each outcome the effect measure(s) (e.g., risk ratio, mean difference) used in the synthesis or presentation of results. | |
| Synthesis methods | 13a | Describe the processes used to decide which studies were eligible for each synthesis (e.g., tabulating the study intervention characteristics and comparing against the planned groups for each synthesis (item #5)). | 3–4, 7–9 |
| 13b | Describe any methods required to prepare the data for presentation or synthesis, such as handling of missing summary statistics, or data conversions. | ||
| 13c | Describe any methods used to tabulate or visually display results of individual studies and syntheses. | 5–9 | |
| 13d | Describe any methods used to synthesize results and provide a rationale for the choice(s). If meta-analysis was performed, describe the model(s), method(s) to identify the presence and extent of statistical heterogeneity, and software package(s) used. | ||
| 13e | Describe any methods used to explore possible causes of heterogeneity among study results (e.g., subgroup analysis, meta-regression). | 10 | |
| 13f | Describe any sensitivity analyses conducted to assess robustness of the synthesized results. | 4 | |
| Reporting bias assessment | 14 | Describe any methods used to assess risk of bias due to missing results in a synthesis (arising from reporting biases). | 3–4 |
| Certainty assessment | 15 | Describe any methods used to assess certainty (or confidence) in the body of evidence for an outcome. | 3–4 |
| RESULTS | |||
| Study selection | 16a | Describe the results of the search and selection process, from the number of records identified in the search to the number of studies included in the review, ideally using a flow diagram. | 5 |
| 16b | Cite studies that might appear to meet the inclusion criteria, but which were excluded, and explain why they were excluded. | ||
| Study characteristics | 17 | Cite each included study and present its characteristics. | 7–9 |
| Risk of bias in studies | 18 | Present assessments of risk of bias for each included study. | 10–11 |
| Results of individual studies | 19 | For all outcomes, present, for each study: (a) summary statistics for each group (where appropriate) and (b) an effect estimate and its precision (e.g., confidence/credible interval), ideally using structured tables or plots. | 10–12 |
| Results of syntheses | 20a | For each synthesis, briefly summarise the characteristics and risk of bias among contributing studies. | 10–11 |
| 20b | Present results of all statistical syntheses conducted. If meta-analysis was done, present for each the summary estimate and its precision (e.g., confidence/credible interval) and measures of statistical heterogeneity. If comparing groups, describe the direction of the effect. | ||
| 20c | Present results of all investigations of possible causes of heterogeneity among study results. | 3–12 | |
| 20d | Present results of all sensitivity analyses conducted to assess the robustness of the synthesized results. | ||
| Reporting biases | 21 | Present assessments of risk of bias due to missing results (arising from reporting biases) for each synthesis assessed. | |
| Certainty of evidence | 22 | Present assessments of certainty (or confidence) in the body of evidence for each outcome assessed. | |
| DISCUSSION | |||
| Discussion | 23a | Provide a general interpretation of the results in the context of other evidence. | 11–12 |
| 23b | Discuss any limitations of the evidence included in the review. | 11–12 | |
| 23c | Discuss any limitations of the review processes used. | 11–12 | |
| 23d | Discuss implications of the results for practice, policy, and future research. | 11–12 | |
| OTHER INFORMATION | |||
| Registration and protocol | 24a | Provide registration information for the review, including register name and registration number, or state that the review was not registered. | |
| 24b | Indicate where the review protocol can be accessed, or state that a protocol was not prepared. | ||
| 24c | Describe and explain any amendments to information provided at registration or in the protocol. | ||
| Support | 25 | Describe sources of financial or non-financial support for the review, and the role of the funders or sponsors in the review. | 13 |
| Competing interests | 26 | Declare any competing interests of review authors. | 13 |
| Availability of data, code and other materials | 27 | Report which of the following are publicly available and where they can be found: template data collection forms; data extracted from included studies; data used for all analyses; analytic code; any other materials used in the review. | 13 |
| [ | |||
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