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1.
J Music Ther ; 55(2): 133-155, 2018 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-29800316

RESUMO

BACKGROUND: For young children on the autism spectrum, the inclusion of shared parent-child music activities in everyday life may provide additional opportunities for social interactions in the home. However, no psychometrically validated assessment exists to measure the extent of shared music activity within family or community contexts. OBJECTIVE: This study aimed to develop and test the reliability of a self-report assessment to measure the use of Music in Everyday Life (MEL) by parents with young children on the autism spectrum. METHODS: A total of 45 mothers of children with autism aged between 4 and 7 years completed the MEL questionnaire. Internal consistency and item-total correlation were examined. RESULTS: Analysis confirmed the reliability of two predetermined subscales: Music in Everyday Life-Joint Activities using Music (MEL-JAM) and Music in Everyday Life-Routine Activities using Music (MEL-RAM). Internal consistency (Cronbach's alpha 0.63 and 0.75) and positive item-total correlation (Pearson's r between .23 to .62 for MEL-JAM and between .30 to .67 for MEL-RAM) were demonstrated. CONCLUSIONS: The reliability of the MEL assessment to measure the use of music in everyday life by parents with their children with autism was confirmed, filling an important gap in the availability of assessment tools.


Assuntos
Transtorno Autístico/terapia , Musicoterapia , Música , Pais/psicologia , Psicometria/instrumentação , Inquéritos e Questionários/normas , Adulto , Transtorno Autístico/psicologia , Criança , Transtornos Globais do Desenvolvimento Infantil , Pré-Escolar , Feminino , Humanos , Relações Interpessoais , Masculino , Psicometria/estatística & dados numéricos , Qualidade de Vida/psicologia , Reprodutibilidade dos Testes
2.
JAMA ; 318(6): 525-535, 2017 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-28787504

RESUMO

Importance: Music therapy may facilitate skills in areas affected by autism spectrum disorder (ASD), such as social interaction and communication. Objective: To evaluate effects of improvisational music therapy on generalized social communication skills of children with ASD. Design, Setting, and Participants: Assessor-blinded, randomized clinical trial, conducted in 9 countries and enrolling children aged 4 to 7 years with ASD. Children were recruited from November 2011 to November 2015, with follow-up between January 2012 and November 2016. Interventions: Enhanced standard care (n = 182) vs enhanced standard care plus improvisational music therapy (n = 182), allocated in a 1:1 ratio. Enhanced standard care consisted of usual care as locally available plus parent counseling to discuss parents' concerns and provide information about ASD. In improvisational music therapy, trained music therapists sang or played music with each child, attuned and adapted to the child's focus of attention, to help children develop affect sharing and joint attention. Main Outcomes and Measures: The primary outcome was symptom severity over 5 months, based on the Autism Diagnostic Observation Schedule (ADOS), social affect domain (range, 0-27; higher scores indicate greater severity; minimal clinically important difference, 1). Prespecified secondary outcomes included parent-rated social responsiveness. All outcomes were also assessed at 2 and 12 months. Results: Among 364 participants randomized (mean age, 5.4 years; 83% boys), 314 (86%) completed the primary end point and 290 (80%) completed the last end point. Over 5 months, participants assigned to music therapy received a median of 19 music therapy, 3 parent counseling, and 36 other therapy sessions, compared with 3 parent counseling and 45 other therapy sessions for those assigned to enhanced standard care. From baseline to 5 months, mean ADOS social affect scores estimated by linear mixed-effects models decreased from 14.08 to 13.23 in the music therapy group and from 13.49 to 12.58 in the standard care group (mean difference, 0.06 [95% CI, -0.70 to 0.81]; P = .88), with no significant difference in improvement. Of 20 exploratory secondary outcomes, 17 showed no significant difference. Conclusions and Relevance: Among children with autism spectrum disorder, improvisational music therapy, compared with enhanced standard care, resulted in no significant difference in symptom severity based on the ADOS social affect domain over 5 months. These findings do not support the use of improvisational music therapy for symptom reduction in children with autism spectrum disorder. Trial Registration: isrctn.org Identifier: ISRCTN78923965.


Assuntos
Transtorno do Espectro Autista/terapia , Musicoterapia , Habilidades Sociais , Atenção , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Método Simples-Cego , Resultado do Tratamento
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