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What is the Research Project about?

M4A is a research project evaluating the effects of music therapy compared to a play-based intervention to improve social communication, participation, mental health, and brain functioning in autistic children aged 6 to 12 years. It is designed to provide strong evidence of clinical effects and working mechanisms of music therapy, and will contribute to a better understanding of autism and neuroplasticity.

See more on why we do what we do below.

Who is involved?

M4A is a randomised controlled trial conducted in Norway and Austria. It is led by NORCE Norwegian Research Centre (PI Christian Gold) and conducted in collaboration with the University of Bergen (Co-PI Karsten Specht) and the University of Vienna (Co-PI Giorgia Silani).

M4A – why we do what we do

Some people are neurotypical – some are not. Autism spectrum disorder is a developmental condition, meaning it starts manifesting during childhood, and it affects the way people communicate and interact with other people. Even though it is safe to assume that people on the autism spectrum have always existed, any formal characterization of the condition is relatively recent (Kanner, 1943). 

The last decades of research into autism spectrum have enhanced our understanding of the condition, and also changed how we characterize it. This in turn influences how we diagnose it and how we can care for people diagnosed with it. Roughly one in 100 children around the world have an autism diagnosis (Zeidan et al., 2022). However, the condition and symptoms are very variable; each person is unique in how they perceive their condition, and how they are able to live their lives. 

Today, many different forms of therapy have become health care standards for individuals with autism. From pharmacological interventions, i.e. the prescription of pills or other substances, to psychotherapy, the variance is large, and the efficacy of interventions or its acceptance by autistic individuals are often hotly debated topics. In health care, developing and honing new therapy avenues to ultimately improve the quality of life of autistic people as well as their families, is of utmost importance. To achieve this, we need to perform research. 

One understudied therapeutical avenue is music. A recent theory trying to explain what mechanisms of social cognition may be working differently in autism suggests that individuals on the spectrum may struggle to form expectations about their social environment (Amoruso et al., 2019). Neurotypicals use the context and their past experience to form expectations on what will happen next, in a social setting. Autistic people may fail to rely on their past experiences. When they interact with someone, they may constantly experience surprise at what other people do or say. 

Music is a stimulus that constantly plays with our expectations (of what to hear next), often fulfilling our expectations and providing us with enjoyment, and reward, both when we are correct, but also sometimes when we are not (Gold et al., 2019). In this study project, we are trying to leverage this aspect of music, to see if music therapy helps improve the ability of autistic children to make predictions in different settings. 

In our study, autistic children take part in a 6-month long program. For 12 weeks, they get one-on-one music therapy sessions, performed by a licensed music therapist. Then, they get play-based therapy interventions, also performed by a licensed therapist. Some children start out with the music therapy block, others start with the play-based intervention and get the music therapy second. Importantly, before and after the interventions, we collect data on the children´s general wellbeing and neurological health, as well as how they perform on certain key tasks (see our first publication from the project, Ruiz et al., 2023). With this procedure, we make sure that all children benefit from both types of therapy, and we can also directly compare the effects of play-based therapy with those of music therapy, which we think will be more effective. 

Alexandrina Guran, on behalf of M4A 

  • Amoruso, L., Narzisi, A., Pinzino, M., Finisguerra, A., Billeci, L., Calderoni, S., Fabbro, F., Muratori, F., Volzone, A., & Urgesi, C. (2019). Contextual priors do not modulate action prediction in children with autism. Proceedings of the Royal Society B, 286(1908), 20191319.
  • Gold, B. P., Mas-Herrero, E., Zeighami, Y., Benovoy, M., Dagher, A., & Zatorre, R. J. (2019). Musical reward prediction errors engage the nucleus accumbens and motivate learning. Proceedings of the National Academy of Sciences, 116(8), 3310–3315.
  • Gold, B. P., Pearce, M. T., Mas-Herrero, E., Dagher, A., & Zatorre, R. J. (2019). Predictability and Uncertainty in the Pleasure of Music: A Reward for Learning? The Journal of Neuroscience, 39(47), 9397–9409. 
  • Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2(3), 217–250.
  • Ruiz, M., Groessing, A., Guran, A., Koçan, A. U., Mikus, N., Nater, U. M., Kouwer, K., Posserud, M.-B., Salomon-Gimmon, M., & Todorova, B. (2023). Music for autism: A protocol for an international randomized crossover trial on music therapy for children with autism. Frontiers in Psychiatry, 14.
  • Zeidan, J., Fombonne, E., Scorah, J., Ibrahim, A., Durkin, M. S., Saxena, S., Yusuf, A., Shih, A., & Elsabbagh, M. (2022). Global prevalence of autism: A systematic review update. Autism Research, 15(5), 778–790.