Shared Moments. The quality of the relationship as outcome predictor in music therapy with children with autism spectrum disorder

From infant research we know that the early attachment between infant and caregiver is characterized by a consistent modulation between attunement, mis-attunement and re-attunement of affective states and relational intentions. The experience of attunement develops through mutual regulation, synchronization, and coordination and facilitates social-emotional as well as cognitive development.

In therapy it is generally assumed that good relationships create good outcomes. Psychotherapy research suggests the quality of the therapeutic relationship as crucial mechanism of change. In the field of autism, some research underlines the importance of relational factors, however little evidence exists about how relational factors, especially attunement processes between therapist and client , contributes to generalized changes in autistic traits.

“Shared Moments” is a project looking at relational experiences of children with autism spectrum disorder (ASD) made in music therapy sessions and how these experiences might moderate the effect of therapy. The musical and emotional attunement and synchronization are essential and unique features of music therapy supporting the organization and regulation of relational experiences grounded in the body, similar to the development of interaction between infant and caregiver in early childhood. The particular involvement in music allows for experiencing various bodily qualities of being in relation which might help to facilitate the emotional attunement between child and therapist.

The project is designed as mixed method study. Based on predictor analyses examining whether the relationship between children with ASD and their music therapist predicts changes in social communication and interaction skills, further investigations will follow focusing on qualitative aspects of the relational dynamics between child and therapist. A focus will be on involving music therapists, researchers and practitioners from other fields, autistic people and parents of children with autism in different types of workshops (interviews, focus groups) to gain deeper insight in how processes of attunement are perceived, understood and applied to support relational experiences. All analyses are based on video data of music therapy sessions with children with autism and outcome data on their development collected during a large multicenter RCT (see TIME-A project, NORCE).

Findings of this study will provide evidence on the impact of relational factors on symptom change in children with autism, and broaden the knowledge on how bodily and emotional attunement can be used by caregivers and care providers to support relational experiences between children with autism and their interaction partners. Findings might be able to contribute to an integrated theory and understanding of autism that shifts the focus of attention on the human body, and its crucial role in cognition, emotion, and social interaction.