Common characteristics of improvisational approaches in music therapy for children with autism spectrum disorder:Developing treatment guidelines

Background: Improvisational methods of music therapy have beenincreasingly applied in the treatment of individuals with autism spectrumdisorder (ASD) over the past decades in many countries worldwide.Objective: This study aimed at developing treatment guidelines basedon the most important common characteristics of improvisational musictherapy (IMT) with children affected by ASD as applied across variouscountries and theoretical backgrounds.Methods: After initial development of treatment principle items, a surveyamong music therapy professionals in 10 countries and focus groupworkshops with experienced clinicians in three countries were conductedto evaluate the items and formulate revised treatment guidelines.To check usability, a treatment fidelity assessment tool was subsequentlyused to rate therapy excerpts.Results: Survey findings and feedback from the focus groups corroboratedmost of the initial principles for IMT in the context of children withASD. Unique and essential principles include facilitating musical andemotional attunement, musically scaffolding the flow of interaction, andtapping into the shared history of musical interaction between child andtherapist. Raters successfully used the tool to evaluate treatment adherenceand competence.Conclusions: Summarizing an international consensus about core principlesof improvisational approaches in music therapy for children withASD, these treatment guidelines may be applied in diverse theoreticalmodels of music therapy. They can be used to assess treatment fidelity,and may be applied to facilitate future research, clinical practice, andtraining