Music therapy for autistic people

This review assessed the effects of music therapy, or music therapy added to standard care, for autistic people.

The review authors included 26 studies (16 new to this update) with 1165 participants. More than half of the studies were conducted in North America or Asia and most (21 studies) included children aged two to 12 years old. The studies examined the short- and medium-term effect of music therapy (intervention duration: three days to eight months) for autistic people in individual or group settings.

The results were as follows.

Compared with 'placebo' therapy or standard care at immediately post-intervention, music therapy:

  • was more likely to positively effect global improvement (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.06 to 1.40; 8 studies, 583 participants; moderate-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) = 11 for low-risk population, 95% CI 6 to 39; NNTB = 6 for high-risk population, 95% CI 3 to 21);

  • was more likely to slightly increase quality of life (SMD 0.28, 95% CI 0.06 to 0.49; 3 RCTs, 340 participants; moderate-certainty evidence, small to medium effect size); and

  • probably results in a large reduction in total autism symptom severity (SMD −0.83, 95% CI −1.41 to −0.24; 9 studies, 575 participants; moderate-certainty evidence). 

There was no clear evidence of a difference between music therapy and comparison groups at immediately post-intervention for:

  • social interaction (SMD 0.26, 95% CI −0.05 to 0.57, 12 studies, 603 participants; low-certainty evidence);

  • non-verbal communication (SMD 0.26, 95% CI −0.03 to 0.55; 7 RCTs, 192 participants; low-certainty evidence); and

  • verbal communication (SMD 0.30, 95% CI −0.18 to 0.78; 8 studies, 276 participants; very low-certainty evidence).

One study (36 participants) reported no adverse events. Another study (290 participants) found no differences between music therapy and standard care immediately post-intervention (RR 1.52, 95% CI 0.39 to 5.94; moderate-certainty evidence). 

The review authors concluded that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-intervention. The findings are limited to the age groups included in the studies, and no direct conclusions can be drawn about music therapy in autistic individuals above the young adult age. More research using rigorous designs, relevant outcome measures, and longer-term follow-up periods is needed to corroborate these findings and to examine whether the effects of music therapy are enduring.

The search is current to 2021.

Read the full review here on the Cochrane Library.