By Ruhana Mahmud
Published 4:06 EST, Mon November 16th, 2021
The use of music for children diagnosed with Autism Spectrum Disorders (ASD) dates back to the 1940s and over time has been adopted by clinicians. This article discusses the condition and its causes and analyses the potential of music therapy to improve the cognitive and social abilities of ASD patients through a neurological lens.
By Ruhana Mahmud
Autism Spectrum Disorder: A brief introduction
Autism Spectrum Disorders (ASD) is a neurodevelopmental condition. Impaired social and communication skills and repetitive, restricted motor activities characterize ASD. The term Autism Spectrum disorders refer to a “spectrum” of disorders including autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS). Hypo or hyperactivity to sensory stimuli and unconventional interests are found in at least 70% of people diagnosed with ASD which may be linked to defective development of brainstem or cerebellum in utero. Generally, autism is classified into three levels: (i) requiring support, (ii) requiring substantial support and (iii) requiring very substantial support. Children with ASD face difficulties with social reciprocation and interaction. It affects 1 in 68 children.
What causes autism?
ASD is a neurobiological condition in which brain development is affected by both genetic and environmental factors although no single primary cause has yet been identified.
Genetic Factors
Siblings of ASD patients are at a much higher risk, and the risk is significantly higher in monozygotic twins. Genes coding for proteins required at synapses or activity-dependent neuronal changes, or those involved in neuronal neurotransmission and inflammation have been linked to autism. Genetically, ASD is one of the most heterogeneous disorders.
Environmental Factors
The phenotypic expression of the genes linked to autism is very variable. Higher parental age increases the risk. Children of mothers suffering from autoimmune diseases, diabetes, infections while pregnant, or taking thalidomide and valproic acid are at a higher risk of ASD. In addition premature delivery, low birth weight and cesarean delivery are also speculated to be related to ASD.
Autism Spectrum Disorder and The Brain
People with ASD have been found to have differences in their cerebellar connectivity, abnormal limbic systems, changes in frontal and temporal lobe modifications, and reduced long-range and local connectivity. Increased cortical size and extra-axial fluid alongside defective neuronal differentiation and cortical formation is linked to ASD. Structural and functional changes in sensorimotor networks in cerebellum or cerebro-cerebellar regions in ASD patients have been linked to their repetitive behavioral patterns.
What is Music Therapy? Let’s learn.
Music therapy, as defined by the American Music Therapy Association, is the “clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” It is the application of musical stimuli to achieve non-musical outcomes: such as improvements in social, communication, cognitive and motor skills.
How Music affects the ASD brain
Music activates a large network of brain regions. Cortical and subcortical networks including the auditory complex, SMA, cerebellum etc. are associated with auditory perception and are involved in auditory perception. The right temporal lobe that controls speech; also processes the pitch of the music and so music can potentially also improve verbal communication. The experience-dependent nature of neuroplasticity can be used to “rewire” the structural changes in long range and local connectivity in ASD patients using music along with appropriate treatment. Music also evokes emotions and arousal. In short, music stimulates multiple cortical regions and develops cortical plasticity and functional connectivity.
Rhythms and the ASD brain
Rhythm is a core structural and organizational feature in music that divides time in a distinct order. Timing is also associated with natural and voluntary movements of the body. Synchronization of sensory and motor systems is important for higher cognitive functions. Primary speech production is also linked to brain rhythms. Entrainment to music requires attention, motor synchronization, and non-verbal coordination; thus stimulating an extensive brain network controlling vision, auditory and vestibular perception, and kinaesthesia. Speech, language and motor improvements have also been linked to rhythmic entrainment to music. Musical rhythm can be used to synchronize the otherwise disrupted central rhythm in ASD through cortical plasticity, thus improving stimulation and coordination.
Music Therapy and Autism Spectrum Disorder: An endocrinological perspective
Current research has shown that the ASD population has higher dopamine DRD3 receptors in the peripheral blood lymphocytes in response to molecular stimuli. This may provide a molecular basis for greater reward dimensions to a musical experience in people diagnosed with Autism Spectrum Disorder (ASD), although further research is needed to solidify this claim.
Ruhana Mahmud, Youth Medical Journal 2021
References:
Music Therapy in Autism Spectrum Disorder: a Systematic Review, Amparo V. Marquez-Garcia1 & Justine Magnuson1 & James Morris2 & Grace Iarocci3 & Sam Doesburg1 & Sylvain Moreno, https://www.researchgate.net/profile/Amparo-Marquez-Garcia/publication/349571737_Music_Therapy_in_Autism_Spectrum_Disorder_a_Systematic_Review/links/60b64f2992851cde884a3b56/Music-Therapy-in-Autism-Spectrum-Disorder-a-Systematic-Review.pdf
Local and long-range functional connectivity is reduced in concert in autism spectrum disorders, Sheraz Khan 1, Alexandre Gramfort, Nandita R Shetty, Manfred G Kitzbichler, Santosh Ganesan, Joseph M Moran, Su Mei Lee, John D E Gabrieli, Helen B Tager-Flusberg, Robert M Joseph, Martha R Herbert, Matti S Hämäläinen, Tal Kenet, https://pubmed.ncbi.nlm.nih.gov/23319621/
Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation, Holly Hodges,1 Casey Fealko,2 and Neelkamal Soares, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082249/
Exploring the brain network: A review on resting-state fMRI functional connectivity,https://www.sciencedirect.com/science/article/pii/S0924977X10000684
Centers for Disease Control and Prevention (CDC) [webpage on the Internet] Data & Statistics. 2015. [Accessed January 16, 2017]. Available from: https://www.cdc.gov/ncbddd/autism/data.html.]
Youth Medical Journal 