Wednesday, 11 March 2015

Wombles and Music Therapy for Autism

Instead of giving you my rather heavy post about epigenetics and autism, today’s post is much more down to earth.

Medical opinion in North America has long been very much in favour of ABA (Applied Behavioural Analysis) as the only “scientifically proven” therapy for the core symptoms of autism.

This evidence is actually quite flaky, so much so that in the very "evidence driven" United Kingdom, their highly regarded National Institute for Health and Care Excellence (NICE) does not even mention ABA, let alone endorse it, in their guidance note in how to manage autism.

ABA is a potent tool to manage autism and provides a flexible framework to teach people who do not respond to traditional teaching methods.  However, it is no cure for autism and the old studies suggesting that almost 50% of kids going to an intensive ABA program will lose their autism diagnosis after two years are nonsense.  They just serve to over-extend the expectations of parents entering ABA therapy and increase guilt among those not able to afford it.

All of our ABA consultants to date have agreed with this view.  In highly intelligent kids with mild autism, maybe 50% can improve so far to lose their diagnosis; but maybe they would have done so after two years without ABA?

Selective interpretation of evidence

A therapy that is sometimes included alongside swimming with the dolphins, as being non-evidence based, is music therapy.

Music and dance is used extensively with many typical kids of kindergarten age, mainly as a fun activity.

I myself would have previously thought that was all there was to it.  But after several years of observing the effect of lots of music on Monty, aged 11 with ASD, there really is much more to it.  

Monty’s original assistant was (and remains) really into music, and so he had lots of music and dance from a very young age.  A few years later we bought a piano and he started piano lessons.

It appears that for some people, singing is easier than talking, or perhaps it is that music encourages communication.  We saw in a post long ago that singing lowers your level of cortisol, the stress hormone. 

Music (and dance) appear to unlock something deep within. (Perhaps the music gene)

Who are the Wombles

The Wombles are furry inhabitants of a burrow on Wimbledon Common in London, England.  They live by collecting up and reusing all the rubbish humans leave behind.

The Wombles were created by British author Elisabeth Beresford, and originally appeared in a series of children's novels from 1968. A stop motion animated series of five minute episodes was made between 1973 and 1975.  A new TV series, with CGI animation, is in production, along with a movie.

Wombles on Sunday Morning

Last Sunday morning, when half the house was sleeping, Monty was sitting in the kitchen with his iPad; then he selected his Wombling song on Youtube.  He then started singing his own mixture of the original lyrics and his creation, at full volume.  Listen a bit harder and he was singing in two languages.

Given most kids with classic autism really struggle to communicate, this is quite remarkable and light years ahead of where he used to be.

I am a convert to both ABA and music therapy, but I do not think you can prove the effectiveness of either.  Anecdotal evidence, but lots of it, is as good as it can realistically get.

The moral of the story is that if you set the bar too high, you will reject valid therapies alongside all the quack therapies. 

Also, you may have to persevere for a long time to kindle that interest in music; but as our ABA consultant commented recently, the biggest problem her older clients have, is that they have nothing to do – no hobbies, no interests.  Keep up with those lessons.



  1. I believe any therapy that actually "engages" a child for extended period of time will likely have efficacy whether ABA, Floortime, Son Rise, RDI, PVT, music therapy, regular classroom, or just playing with other kids. The only question is that of relative efficacy and that hasn't been studied (and likely won't) but certainly using rewards to buy "engagement" is one way to do it. I do believe music is a a great one as most kids seem to enjoy it and naturally attracted to it. Our son could sing entire nursery rhymes before he learned to use even single words to communicate (presumably, different part of the brain?) and he continues to love music/singing. We bought a piano as well and hopefully he can master that in a few years.

    1. I agree that engagement is they key. It also takes someone fun to engage with. The therapist is as important as the therapy.

      Good luck with piano lessons. Here again getting a nice, but firm, teacher with experience of teaching kids with special needs is key.

  2. Music Therapy
    is not a direct cure to autism. But kids who undergoes music therapies show better state of mind to those who do not. Thanks for this great article Peter!

  3. Hi Peter, your post reminded me of something I read earlier today. There have been a few studies in the past showing influence of music on brain function, but this recent one is probably the most in-depth one so far
    "According to a latest study, music performance by professional musicians enhanced the activity of genes involved in dopaminergic neurotransmission, motor behavior, learning and memory."

    Yes our kids are not 'professional musicians' but isn't it interesting that they are talking here about dopaminergic neurotransmission and cellular calcium handling!

  4. Interesting, there is also a study about gene expression after listening to classic music, by the same group from Finland

  5. This is quite good, came out in July 2015:

    "... 27 children with mild to moderate autism were chosen and were divided into two groups of experiment (n = 13), and control (n = 14). Social skills’ level of both groups was measured and recorded with the help of social skills rating system scale. The children of the experiment group participated in MT programs of Orff–Schulwerk for 45 days in 12 sessions (two sessions of 1-h/week), whereas the control group received no intervention. ..

    ... In posttest, the results of covariance analysis showed a significant increase in social skills’ scores of the experiment group (P < 0.001). Also, results of the paired-sample t-test showed that the effectiveness of MT has been persistent up to the follow-up phase..."

    1. There is a post I never finished that looked at two studies that showed how playing music and listening to music changed gene expression. There was some overlap, but it was playing music that triggered the biggest changes.


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