Music therapy, sensory integration and the autistic child

Abstract

Berger, D. S. (2002). Music therapy, sensory integration and autistic child. London, England: Jessica Kingsley Publishers. 255 pages. ISBN 1-84310-700-7. $23.95 paper. In her foreword to book Music therapy, sensory integration and autistic child, Donna Williams, a renowned author with a diagnosis on autism spectrum, states that music has the convincing power to restore order in chaos. Author Dorita S. Berger expands upon this and other basic tenets of music therapy in an informative, conversationa manner. Her book is a very significant contribution to music therapy literature base, particularly in light of fact numbers of children diagnosed with autism spectrum disorders continue to escalate. Her linking of music therapy and sensory integration offers a very unique perspective in addressing needs of this growing clientele. The volume's eleven chapters flow in a logical order. In introduction Berger reminds reader that we may need to adjust our opinions about what is appropriate and functional. Unusual behaviors displayed by our clients may in fact be their systems' typical adaptive responses to incoming sensory information that they encode, decode or interpret in different ways. In Chapter 2 Berger clearly articulates what autism is and is not, and thoroughly reviews general characteristics of autism and Asperger Syndrome. I was pleased to note her reference to Dr. Stanley Greenspan's work discussing fundamental developmental skills and sensory misinformation's impact on one's ability to engage in interpersonal relationships. Berger begins third chapter by stating that all animal life adapts by coding a variety of forms of adequate sensory stimuli and converting them into sensory action potential traveling to brain and central nervous system to be processed. She draws from experience of Jean Ayres, a pioneer in development of sensory integration work in occupational therapy, in defining sensory integration as involving, sorting, logging and assigning priority order to sensory information so an efficient response to a problem can ensue. Berger clearly explains journey of perception from paleoencephalon, Reticular Activating System (RAS), thalamus and limbic system to neo-cortex. However, inclusion of diagrams in this description would have been beneficial. She delineates domains of right and left hemisphere of neo-cortex and further details functions of frontal, temporal, occipital and parietal lobes, as well as cerebellum, in promoting thought and cognition. In Chapter 4 Berger suggests that functional adaptation is way brain and body decide to register and resolve a situation physiologically to accommodate or satisfy some or all of fundamental prerequisites of human survival. She further outlines three basic levels of physiologic adaptation: (1) immediate, short-term, instinctive reflexive accommodation; (2) delayed, medium-term, conditioned adaptive accommodation; and (3) permanent, long-term, genetically encoded (inscriptive) accommodation. She slates that music therapists may effect changes in first two types of accommodation. At reflexive level, because individuals with autism often remain in a threatened state for longer periods and require extra time to make adjustments, music as a natural sedative may induce release of relaxants and reduce flow of stimulating chemicals. At medium-term accommodation level, music therapists play a major role by continuously, repetitively, and constantly applying music interventions (what Berger calls the continuous disturbance) to encourage brain to change its reference points and repattern its functions. Chapters 5 through 7 explain basic sensory systems. There are three sub-cortical sensory systems, vestibular, proprioceptive and tactile. Taste and smell are relatives of tactile system. The visual system supports vestibular and proprioceptive systems. …