Autism, Music and Music Therapy | Part 2

by Ritu Gopal

Part Two: From the music therapy room

Having spent several months observing children with autism responding to music in a therapeutic setting, what stands out is that the simple act of being given exposure to musical sounds is met with utmost attention and fascination. One of the first music interventions for a child on the autism spectrum is that of gaining attention, and creating an atmosphere that comforts them to be in a new place with a new person. Once this initial challenge is addressed, the child reveals a deep attraction towards the variety of musical sounds, the feel of new instruments, and the calmness of the entire setting. They begin to respond in subtle or flamboyant ways by paying attention to a specific object, making contact with the therapist, or uttering a sound or a note. Therefore many weeks and even months are spent by a therapist playing various instruments, singing songs, and performing for the child to elicit a response or reaction of any kind. This also builds trust, which is important in gaining the acceptance of the child. This in turn sparks the therapist-child relationship and marks the onset of a long journey, for music therapy is a slow process, but also a rewarding and lasting one.

Here is the case study of a young girl with autism from the archives of Sampoorna Music Therapy Centre of Latika and her journey with music.

Latika was diagnosed with autism at the age of 10 months and began undergoing various therapies from the age of one year. She was associated with the music therapy centre from its inception in 2012. At this time, she was 8 years old. At home, her parents recognised an interest in music and in performing and decided to foster a space for this strength of hers. They attended live music performances that were arranged by the founding members of the centre and noticed its effect on her, and also on the other children frequenting these events. Latika was always humming to herself, and looking for music to listen to on the phone or computer. Her response time to a musical stimulus or any sensory stimulus increased over time, and this was noticed through her humming, singing, or speaking the lyrics as an effort to explore what the music meant. Essentially, she was grasping rhythm and melody very fast. Her family chose Sampoorna in order to combine music, which she loved, along with therapy, which would enable development of speech, behaviour and social skills in a peaceful environment; this was in the endeavour to give her the time to relax and enjoy what she was doing while also learning the nuances of music in the process of doing so. However, she did take time to settle into a new place and setting, and would be very uncomfortable and disturbed in the session, sometimes throwing serious tantrums. Since her therapists changed at regular intervals, she took time to adjust to new people but eventually settled and calmed down. From feeling uncomfortable with all the changes in a new place, to vocally saying “no” or stating her preference for something, the progress in her communication abilities was evident. She also showed a lot of excitement when in the group sessions and began to understand how to express social interaction more amicably. She continued to express her feelings of joy, happiness and excitement through screaming or shouting, but also became more verbally eloquent. Music helped her to become more positive and calm around people, and also to her own self.

Latika was always intrinsically musical and very talented with extremely high grasping abilities to pick up new music quickly and perform it in the session. She enjoyed Carnatic music, Western music on the piano, pop songs that she often danced to, and also liked trying out the instruments in the room. She also loved dancing and performing to showcase her understanding of the emotion behind the music. She was good at imitating movements and this only developed over time, which in turn made it possible for the therapist to teach her new music more frequently. She particularly enjoyed the piano and djembe, and sang the notes from the piano vocally, and also the songs taught by the therapist. Latika’s successes at Sampoorna were not only musical but also behavioural. She grew as a person, as a daughter, and as an eager learner. She became more reciprocal, more reactionary and more aware of her environment. Her narration skills improved from self-talk about her family or random observations of incidents on the streets, to detailed descriptions of an event or of a story she had recently read. She is now able to communicated effectively and sequence the order of events, which has also led her to be meticulous at scheduling her daily routine with the help of her mother. Latika goes to a mainstream school with a special education wing. She sits in the same class as other children but has a “shadow” appointed by her parents, from groups of special educators, to assist her where she needs assistance. Her parents and the special educator together form a course plan that works well for Latika. This succeeded in helping her enjoy school, and reading and writing, which she does when not coerced to do but when intrinsically motivated. Latika progressed in communication, confidence, awareness of her surroundings, narration, coherence in speech and action, and in being open to trying new songs and activities. Her peer relationships improved through the social skills that she practiced in the music therapy setting. This, along with her attending a mainstream school with a special education wing, and understanding the concept of rules and regulations, has made her more prepared to deal with the world as a growing independent individual.

Latika grew up to be an even more graceful girl whose ability to concentrate improved to where her performance and behaviour in school became more relaxed and focused. She is also an enthusiastic participant in school events, public autism events, and also expresses her zest for life. She has a better understanding of her emotions, how to express them, and how to state her perceptions. This was observed among several other students who experienced music therapy, all of whom have grown to be deeply confident and expressive individuals. For the parents to, it has added not only much joy, but also a lot of structure in the daily schedule. Additionally, some children have gone on to learn music in formal educational settings, therefore showing the impact that it has had on their lives. Her mother has been a major strength, and reflects the support of a patient parent in allowing time to take its natural course during the various educational interventions that she was a part of.

The takeaway from Latika’s case is that music proved to be instrumental in initiating her into the creative arts. More importantly, it gave her a means to express her uniqueness, which is a basic human desire regardless of what our backgrounds might be and what we choose to do with our abilities. For those of us who have had the opportunity to attend a violin lesson, to play with a band, or to write a song, we know how these chances have made us grow and grapple human existence despite our own challenges. Music has that ability and one should be able to access it in the manner that they want to regardless of being born or perceived as different.

Children with autism find regular tasks to be difficult. To express how they feel, what is going on in their inner world, and to state a simple want to a caregiver, is an everyday challenge. In music therapy, all of these basic challenges are given an opportunity to be expressed in the weekly hour that the child spends surrounded by a piano, a xylophone, a singing voice, and by anything musical. At the same time, what is astounding is that music which can be complex for a person in general, is absolutely appealing to a child with autism and the look of wonder says that best. Latika, mentioned in the case study above, would be able to talk about the happenings of a simple day at school and put it into the tune of a song that she had heard earlier, matching each word with the appropriate rhythm, and telling the therapist how she felt in the process of doing so. It comes almost naturally, and becomes an excellent way of connecting with the personality of the student sitting across the room.

There is increasing awareness of the importance of music education, with the next part of the article series exploring the Indian context of Western music. More and more music enthusiasts are enrolling in music lessons and examinations, while also taking up performance opportunities through school activities, local music festivals, and in upcoming Indian orchestras. However, if one were to observe the student diversity attending music lessons in an inclusive setting, one would find that there are very few students with disabilities. Orienting teachers towards understanding disabilities and adapting teaching methods and the music syllabus to specific needs could go a long way in nurturing a student’s inclination towards music itself. These are some approaches towards ensuring that a child is given access to music education despite challenges that are both intrinsic and in the competitive system.

As a violinist, music therapist and a curious observer, what I wonder most is what a teacher would plan for a child like Latika if she were to learn music in a formal, non-therapeutic setting. The more pertinent implication of this question is whether being trained in a musical art to achieve the nuances and technical demands of that art form is something that could be successfully conducted by a teacher while also acknowledging her individual need for autism-specific interventions. Simultaneously, should we be restricting a musical enthusiast with a disability only to therapy, or should we throw the doors of music and the arts open to a fuller approach. Could this then be an approach that follows the interest and personality of the child, and equips them to reach a level of performance with adequate time and support? The transformative power of music is undoubtedly stunning, and there is so much that we can achieve by making this available to students with special needs through equal opportunities.

Drawing from this case study, the next article will touch upon a few other experiences of children with autism in musical settings. It will then discuss at length how existing settings in the Indian context can be made more open and accessible to special needs through simple interventions.

Special thanks to Priya Kannan, Latika’s mother, who proudly raises two children on the autism spectrum. She also requested that her daughter’s identity be shared in the article because she is so grateful for the therapists’ work in bringing music to her life. She is also proud of Latika’s motivation to seize every opportunity, particularly presented through music therapy. Latika continues to abound in energy and continues enjoying music in her day-to-day life.