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Incorporating Music into Speech and Language Therapy for Kids with Autism Spectrum Disorders – An Interview with Dr. Hayoung Lim

Dr. Hayoung Lim is Assistant Professor of Music Therapy and Director of Graduate Studies in Music Therapy at Sam Houston State University, Texas, USA. She has worked as a music therapist in a number of hospitals, schools and organizations with a diverse range of clients including individuals with mental illnesses, developmental disorders, medical problems, neurologic impairments and dementia. Her research focuses on the effect of music on children with ASD and the effect of musical experiences on cognition, speech and language, and physical rehabilitation. She is also a concert cellist and lives in The Woodlands, Texas with her husband and son.

In this interview, Dr. Lim explains why music is so effective at developing communication skills in kids with Autism Spectrum Disorders (ASD) – the subject of her PhD research and new book, Developmental Speech-Language Training through Music for Children with Autism Spectrum Disorders: Theory and Clinical Application.


Why do children with ASD respond so well to music?

Children with ASD appear to have intact pattern perception and production ability. They also tend to follow the Gestalt style of language acquisition which is based on the pattern perception. In parallel, all of the musical behaviors require pattern perception and production; and these abilities are commonly found in children with ASD. It follows that patterns in music can facilitate the Gestalt style of language acquisition and the consequent speech- language development in children with ASD.

One child I worked with was a five year-old boy who could not speak a single word during our initial meeting. When I start singing one of my composed songs with pictures, he looked at the pictures and my mouth intensely. I then tried a couple well-known songs such as “Twinkle, Twinkle, Little Star” and “Old McDonald”, but he turned his head away from me. From this example we can see that a new speech pattern embedded in a song with the optimal perceptual level (one that is not too familiar and not too complex) can capture the best perceptual capacity in children with ASD. In addition, presentation of the corresponding visual materials (e.g., pictures, photos, and real objects) can facilitate the perceptual mechanisms.

How do you measure a child’s achievements?

When children with ASD start predicting the next verses in the presented songs or show a great level of anticipation in the session, I consider them making progress. I measure the number of spontaneous words or verses in a song and use the ‘post-test’ type of measurement after each set of Developmental Speech and Language Training Through Music (DSLM) protocol. The post-test consists of verbal questions (i.e., What is this? What is the pink pig doing?) and the children’s verbal responses.

What is timely and/or unique about the book?

This book provides both theoretical orientation and clinical application regarding use of music in speech-language training for enhancing speech production and functional communication in children with ASD. The most promising explanation for musical behaviors in autism may lie in the knowledge of brain function and perceptual processes of children with ASD. Unfortunately, books that provide the theoretical orientation for perception and production of music in children with autism, and that explore the mechanisms for the musical responsiveness of children with autism are limited. Therefore, empirical mechanisms of music perception and production in children with ASD, as well as the theoretical foundations for the use of music in treating autism presented in this book, have a great value. This book may augment the understanding of the perception and production of both music and speech. The link between music and speech may be verified as a result of thorough research review and the author’s investigation, and the common principles and the mechanisms of both music and speech production might be explained in the book.

Furthermore, the contents of the book might support the previous studies that have suggested the significance of integrating the two domains, music and speech, in early childhood development. The book demonstrates the theories supporting a developmental speech and language training tool through music and validating the functions of musical elements in enhancing speech. The chapters of clinical implications in this book might be useful for music therapists who specialize in treating children with ASD to implement interventions for enhancing social communicative functions of their patients.

In addition, clinical suggestions in this book will enhance the collaborative efforts of speech/language therapists and pathologists (SLTs/SLPs), special education teachers, and music therapists who practice speech-language training for children with ASD. For example, a few chapters of the book inform the a selection of materials and interventions based on scientific evidence, and suggest a more systematic implementation of a speech/language training tool through music. Therefore, the therapists or teachers can produce more consistent outcomes and follow procedures indicated by the best practice.

Why was it important to include Applied Behavior Analysis (ABA) as a particular topic?

ABA has often utilized music, especially songs, in its language assessments and training; however, the theoretical justification for the use of music in the approach is lacking. Previous studies in ABA approaches did not provide the scientific mechanisms for how songs impact speech/language of children with autism. As a result, those programs or interventions depended on very limited use of music, and children with autism could not experience the benefits of using a broad range of musical interventions and various musical activities. A thorough discussion is needed to develop the mechanism and strategy of using music in an ABA verbal behavior approach, and to explore systematic interventions with music for enhancing communication skills for children with ASD. My book establishes the protocols of music therapy language training in autism within a Applied Behavior Analysis (ABA)/Verbal Behavior (VB) approach, and explores the incorporated use of music within the common training approach.

What would you say to SLTs/SLPs who feel they are not ‘musical’ enough to use this approach effectively?

One of the greatest benefits of a music therapist led DSLM intervention is the quality of music; If the music is not presented in a good quality, it is hard to anticipate the therapeutic effects of music in the clients. Because of these concerns and others, many SLTs/SLPs who are not musically inclined tend to avoid using music in their practices. However, recorded music with the same quality can be used in speech-language training for children with ASD.  One suggestion might be to consult a music therapist or professional singer, and ask them to record the musical materials that you can use in therapy. Take it from me: We’d love to sing for you!!

Copyright © Jessica Kingsley Publishers 2011.


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