Today’s guest blog post is from Gottfried Schlaug, MD, PhD, director of the Music and Neuroimaging Laboratory and associate professor of neurology at Beth Israel Deaconess Medical Center and Harvard Medical School, in Boston. He is a recent recipient of an Autism Speaks Treatment Research Grant.
As many as three in ten children with autism are nonverbal. Yet many children with autism have superior auditory skills and a particular attraction to music. Based on these observations, I and my colleagues have been using forms of music-making that encourage vocalization as a pathway to developing language.
We call our therapy Auditory-Motor Mapping Training (AMMT), and our approach is built on two findings.
First research has shown that music-making creates clear changes in the human brain. In particular we know that it engages and strengthens connections between the auditory and motor regions and improves mapping of sounds to actions. Second, here at our Music and Neuroimaging Lab, we have successfully used a form of singing (i.e., Melodic Intonation Therapy) to help stroke patients regain speech lost after a stroke (aphasia). In essence, our therapies involve having the patient sing words and phrases while using a coordinated movement of the hand not affected by the stroke. This helps their brains map sounds to actions.
In recent years, we’ve adapted our music-motor therapy for stroke victims in ways that allow us to use it with children who have autism and little or no speech. In simplified terms: Our team members sing words and phrases with social connotations (for example, “more please,” “mommy,” “all done”) to the children and with the children, while showing them pictures of the action, person or object. At the same time, we guide each child’s hand to play two drum pads tuned to different pitches.
We believe that intensive, repetitive training—pairing sound with actions–can engage and strengthen the brain pathways needed to speak. In our recently published “proof of concept” study, each participant received 40 treatment sessions, conducted 5 days per week over an 8 week period, with each session lasting 45 minutes. Further analysis revealed that the therapy’s benefits probably occur in the first 25 sessions.
We have seen very encouraging results in our pilot and proof-of-concept studies and are now excited to expand our research and therapy program with a 2011 treatment grant from Autism Speaks. In other words, this funding and this study are being made possible by you—Autism Speaks’ community of supporters. Thank you. We look forward to reporting back our results! Meanwhile, please visit our lab’s website: http://www.musicianbrain.com.
I still remember the day in 2009 when I was sitting in the committee hearing room of our state capitol. We were waiting for the next parent to testify in favor of our Autism Insurance Reform bill—in its second year of battle here in Missouri. Many moms and dads sat in the back with me, clutching their note cards, printed testimonials and handwritten pages. Though we were all nervous, we were eager to tell our stories to the legislators whose decision could make such a huge difference in our children’s lives.
Megan was a local volunteer, autism advocate and parent of two children, one of whom (Henry) has autism. Her hands were shaking a little, but she delivered her message in a calm and confident voice. She was confident the legislators would respond to her personal testimony. Megan explained that she was in extreme debt, had declared bankruptcy and had to sell her home—all to pay for Henry’s autism behavioral treatment. But Megan was not there to complain. She wanted to share Henry’s progress and positive outcomes. Thanks to more than 20 hours a week of early behavioral intervention, Henry had uttered his first words. She told the legislators that her financial sacrifices were well worth that precious reward. But she asked that other families not have to sell their homes and declare bankruptcy for their children to receive treatment for autism. I was not the only one wiping tears at the end of her story.
But the next individual who testified opposed our Autism Insurance Bill. He represented an insurance provider, and he used the same argument that insurance lobbyists were feeding the legislators across the country. “Although we empathize with Megan’s struggle,” he said, “the simple fact is that behavioral therapy is an experimental treatment for autism.” He said it was reckless for insurance providers to pay for experimental therapies and that despite Henry’s improvement, there was no predicting whether other children would benefit.
His words produced gasps around the room. My heart sank.
But wait, this is where the story gets good. Next, Lorri Unumb, Autism Speaks vice president for state government affairs, took the stand. She too shared the progress of her son from intensive applied behavioral analysis (ABA). But it was the next part of her testimonial that every legislator in the room heard loud and clear.
Countering the insurance industry testimony head-on, Lorri stated unequivocally, “ABA is not experimental!” And she had the published research studies to back up her statement.
It didn’t matter whether the studies were done in Missouri or another state. Each study had been vetted and published by a leading scientific journal. The evidence made clear that ABA is far from experimental, and it demonstrated the importance of early intervention in producing the most successful outcomes.
The Missouri House of Representatives voted our bill out of committee that day. It went on to our governor’s desk to be signed into law—all because we had the scientific research to back up our efforts.
Never before had the importance of funding research become so clear to me!
Currently Autism Speaks is funding additional studies that can provide a firm foundation for our advocating that insurers cover additional types of behavioral therapy–such as social skills training, infant-toddler interventions and cognitive behavioral therapies focused on social and communication skills.
And that’s crucial because the downside to our story was that the Missouri bill mandated coverage for some but not all autism treatments. Many more treatment options need to be further investigated to ensure they are safe and produce tangible benefits for those who struggle with autism.
The great news is that Autism Speaks just funded $1.8 million in treatment grants that will further our understanding of the most promising new interventions—not only for children but for all those on the spectrum—from early intervention therapies in underserved communities to job interview training for adults.
We look to these studies to give us the ammunition we’ll need the next time we are sitting in front of a room full of government decision makers. And they would not be possible without your support at our Walks and other fundraisers.
When it comes to helping our children and all those with autism, scientific evidence of benefit puts us on the road to affordable access to therapy. And that means better outcomes. This is what our families deserve and our mission supports.
Autism Speaks continues to work for state-mandated medical coverage for autism interventions. To date, its advocacy efforts have helped secure autism insurance reform laws in 29 states. To learn more about Autism Speaks advocacy efforts, please visit http://www.autismvotes.org.
For more news and perspective, please visit the Autism Speaks science page.