The effects of music therapy incorporated with applied behavior analysis verbal behavior approach for children with autism spectrum disorders


By: Stephanie H. Morris, MM, MT-BC, NMT

As I stated last month, reading research is an art and takes practice. My goal for discussing this particular article is to help you understand the significance of this research for the music therapy community and for parents and caregivers of children with a diagnosis of Autism Spectrum Disorder (ASD).

This research was a joint effort by Dr. Lim and Ms. Draper, who at the time were at Sam Houston State University. For those who have been around others who live and work with individuals on the Autism Spectrum, the term “Applied Behavior Analysis” (ABA) is commonplace. It is often the way we determine the why someone is reacting to a stimulus or their environment. Lim and Draper (2011) wanted to compare ABA Verbal Behavior (VB) with ABA VB paired with music to see how that affected the speech development of children on the Autism Spectrum. This qualitative study included twenty-two children, ranging in age from 3 – 5, “who were verbal or pre-verbal with presence of immediate echolalia” (p. 532).

Lim and Draper (2011) state, “The effect of music on speech production in children with ASD might be explained by the inherent structure of music stimuli and the intact capacity of pattern perception and production in children with ASD” (p. 533). Dr. Lim has done other studies with children diagnosed with ASD and validating the positive effects of music on their speech production. Therefore, the researchers for this study wanted to examine specifically how music paired with ABA VB compared to ABA VB without music. Their examination of this training would take into account that language is a behavior yet also look at the language of the child and ask the why they are using that particular language.

If you recall, I stated in my September 20 blog that researchers go to great lengths to make sure their research is sound and valid. Last month’s research divided their participants into two groups, but this study has the children divided into three groups. They wanted to examine three scenarios, 1) music with ABA VB, 2) speech ABA VB and 3) no training at all. They developed a set of “target words or phrases [which were] categorized by four verbal operants: mand, tact, echoic, and intraverbal” (Lim & Draper, 2011, p. 536). The table on page 537 breaks down these categories and identifies the target word or phrase dependent on the type of training.

I feel at this point that I need to provide an explanation of the different types of training.

  • Mand training is where someone identifies what they want to do or how they want something to go. An example might be “What instrument would you like to play? The mand response may be “drum” or “guitar”.
  • Tact training is the act of someone labels what he or she sees. An example may be to show the child a picture and they tell you it is a “black dog”.
  • Echoic involves the child repeating what they have just heard. If you tell the child to say “hello” to someone and they in turn, say “hello.”
  • Intraverbal training relates to having a conversation. For example, you say “Playing the instruments is _________” and the child fills in the blank with an answer such as “fun.”

Now that we have a clearer understanding of what the researchers were testing, we now focus on the results. Not all research is going to have “significant” results. In some instances, that may be what the researchers are seeking. The results for this study indicated that there was not a significant difference between ABA VB with music and ABA VB with speech. However, “music incorporated ABA VB was most effective in echoic production, and speech trainings were effective for production of the four ABA verbal operants” (p. 532).

Lim and Draper (2011) stated in their discussion that, “Participating in music training might be a positive reinforcement for continuing production of the verbal operants in children with autism” (p. 543). For parents, caregivers and music therapists, this is a significant statement. While music paired with ABA VB was not significantly better than ABA VB with speech, music can still be beneficial. A music stimulus provides prompts, reinforcements and an antecedent that you cannot find in speech alone.

Their discussion highlights specific issues surrounding the research as it was conducted. For instance, we do not want to overlook are the “negative (non-functional) verbal production” that occurred when the therapist was working with two specific participants. They imitated or echoed the mand operant instead of giving the answer. The example given in the research report stated that these participants said “Drum or Guitar” when asked what instrument they wanted to play. While these types of responses change the statistics for the researchers, it is the responsibility of the researchers to report and calculate them to provide the reader with an accurate report of what exactly happened during the testing.

Twenty-two children was not a large number of students in comparison to the number of children currently diagnosed with ASD (Autism Spectrum Disorder). This limitation and other variables such as different formats for the pre and post-tests cast restrict the generalization of this study, but future studies with different classifications, more music stimuli or other verbal operants could provide more information about this important look at language development for children with ASD.

All research has its place. While this specific research did not provide significant results between the three different groups, it remains a valuable part of the body of research for music therapy and the role it plays in language development training for children with ASD.

Lim, H. A., Draper, E. (2011). The effects of music therapy incorporated with applied behavior analysis verbal behavior approach for children with autism spectrum disorders. Journal of Music Therapy, 48(4), 532-550.