A powerpoint of the presentation given by Professor Tony Wigram at the ASC network meeting of the Association of Professional Music Therapists, October 2009.

2. “ YOU’RE GOING TO HAVE TO GIVE UP YOUR ASSUMPTIONS ABOUT SHARED MEANINGS” “…EACH OF US WHO LEARNS TO TALK TO YOU,… MANAGES TO FUNCTION AT ALL IN YOUR SOCIETY, …MANAGES TO REACH OUT AND MAKE A CONNECTION WITH YOU, IS OPERATING IN ALIEN TERRITORY, MAKING CONTACT WITH ALIEN BEINGS. WE SPEND OUR ENTIRE LIVES DOING THIS, AND THEN YOU TELL US WE CAN’T RELATE” JIM SINCLAIR

3. “ SOCIAL SKILLS MAY BE DEFINED AS THE ABILITY TO UNDERSTAND OTHERS BEHAVIOUR AND RELATE TO THEM ACCORDINGLY” (Pam Yates, 1992) “IT IS THE INTERPRETATIONS OF OTHERS BEHAVIOUR THAT GUIDE OUR ACTIONS, NOT THE BEHAVIOUR ITSELF” (Rita Jordan, 1998)

23. Results The two assessments showed 72 % agreement between diagnostic categories, indicating that the MTDA was providing similar information to a recognised and established diagnostic tool.

26. EXPECTATIONS OF THERAPY: In the area of Communication Activating intersubjective behaviours Spontaneous initiation of contact Development of meaningful gestures and signs Development of communicative vocalisation Emergence of language in songs

27. In the area of Social development: Motivated interaction Shared and understood experiences Relationship building skills Tolerance of change Entrained responses Flexibility

28. In the area of Emotional needs: Developed and Increased sense of self Empathic synchronicity – shared emotions Containment of emotional expression Emergence of insight and self-esteem In the area of Cognitive development : Development of awareness, attention and concentration Development of organisational skills Development of memory

29. EVIDENCE BASED PRACTICE Music Therapy in Autism Spectrum Disorder and Developmental Disability Type of Evidence Edgerton 1994 Evidence based Clinician Observed Oldfield 2005 Evidence based and Clinician Observed Kim 2006 Evidence based RCT Walworth 2007 Clinician observed Kern and Aldridge 2006 Case series Buday 1995 Case study randomised crossover Brownell 2001 Case studies quasi RCT Farmer 2003 RCT Hairston 1990 Clinician observed Thaut 1988 Experimental study Gold et al 2003 RCT Whipple 2004 Meta review)

30. Music Therapy for Autistic Spectrum Disorder: A Cochrane Review Christian Gold , PhD Bergen University, Norway Tony Wigram PhD, Aalborg University, Denmark Cochavit Elefant PhD, David Yellin College, Israel

32. Communicative skills - gestural

33. Communicative skills - verbal

36. Joint attention in improvisational music therapy with autistic children Jinah Kim Supervisor: Tony Wigram Aalborg University

42. ESCS – joint attention and social interaction

47. Selected session analysis findings; music therapy vs. free play Eye contact Duration a significant effect (p <.0001) was found comparing the music therapy condition with free play

48. Joy Duration (smiling & laughing during the interaction) A highly significant effect was found comparing the music therapy condition with free play (p <.0001) , session – 1st, 4th, 8th, 12th (p= .0007) and session part – unstructured and structured (p= .0034)

49. Initiation of engagement by child with autism condition (p <.0001) , session (p= .0010) and session part (p= .0292).

50. Turn-taking duration condition (p <.0001) and session part (p= .0370).

54. Hazard ratings Limited evidence of harmful effects. Any Grade D studies indicating adverse/harmful effects Strong evidence of harmful effects. Any Grade C studies indicating adverse/harmful effects Very strong evidence of harmful effects. Any Grade A or B studies indicating adverse/harmful effects