The effect of music interventions in autism spectrum disorder: a systematic review and meta-analysis

The promise of precision medicine in autism

Autism spectrum disorder (ASD) is a set of heterogeneous neurodevelopmental conditions, characterized by early-onset difficulties in social communication as well as repetitive and unusually restricted behaviors and interests. The treatment of ASD is based primarily on psychoeducational and behavioral interventions. Since the effectiveness of available treatments for ASD is limited, many families search for alternative therapies, such as the gluten-free and casein-free (GFCF) diet. Despite the popularity of the GFCF diet as a supplementary treatment in children with ASD, several rigorous evaluations have failed to confirm its effectiveness. The majority of the available studies examining the efficacy of the GFCF diet are seriously flawed and allow no firm conclusions. The available evidence regarding the effectiveness of the GFCF diet in the treatment of childhood ASD is very weak and cannot be considered promising. The GFCF diet should be used only if an allergy or intolerance to nutritional gluten or casein has been established. The identification of a hypothetical diet-related ASD phenotype may help in selecting children who could benefit from a GFCF dietary intervention. An important consideration is that potentially ineffective therapies may imply considerable opportunity costs, with other possibly more effective treatment approaches remaining unutilized.

Oxytocin is a hormone that mediates interpersonal relationships through enhancing social recognition, social memory, and reducing stress. It is released centrally into the cerebrospinal fluid, as well as peripherally into the blood, where it can easily be measured. Some studies indicate that the oxytocin system with its social implications might be different in people with autism spectrum disorder. With summarizing evidence of 31 studies, this meta-analysis suggests that children with autism spectrum disorder have lower blood oxytocin levels compared to neurotypical individuals. This might not be the case for adults with autism spectrum disorder, where we could not find a difference. Our findings motivate further exploration of the oxytocin system in children with autism spectrum disorder. This could lead to therapeutic options in treating autism spectrum disorder in childhood.

Toward a Better Understanding of Depression, Schizophrenia, and Autism

Communication interventions for autism spectrum disorder in minimally verbal children.

Autistic individuals consistently experience long waitlists to access assessment and intervention. Additionally, they report difficulty obtaining integrated services for their co-occurring medical and mental health disorders. The current study seeks to explore the way that graduate school training may contribute to the specialized and siloed nature of autism spectrum disorder (ASD) assessment and intervention. Multiple sources of data were collected to understand training opportunities related to ASD, child mental health, and the integration of ASD and child mental health in American Psychological Association- (APA) accredited Clinical Psychology Ph.D. programs. Data were collected from information publicly available online, and from clinical psychology doctoral students and graduate program directors (GPD). Results indicate that most programs do not employ a faculty member whose work focuses on ASD. Additionally, ASD experience is encouraged, but not a required element of program curriculum. Therefore, most doctoral students do not obtain training in ASD assessment or intervention during graduate school. Even doctoral students who pursued ASD training experiences reported that they do not feel prepared to meet the mental health needs of autistic individuals. We discuss implications and provide recommendations for how doctoral programs can promote students’ proficiency and comfort diagnosing and supporting autistic individuals.

Piano with a twist: A pilot study exploring the preliminary effects of a piano therapy program for children with autism spectrum disorder

This review describes the effects of intervention for young children with autism spectrum disorder (ASD) on parents. Like all children, children with ASD bring both negative and positive experiences for parents and families-from increased resource needs, to higher levels of parenting-related stress, to positive personal growth for family members. It is increasingly recognized that, although children with ASD are the primary targets of early ASD intervention, ASD intervention also impacts parents. From the time emerging developmental concerns begin to be identified, through the process of obtaining a diagnosis and initiating services, parents play a central role in addressing the needs of young children with ASD, including implementing and supporting early intervention. Parents experience the impact of intervention directly, through interaction with providers within the health care and educational systems. Parents also experience indirect impacts of ASD intervention due to accelerated developmental progress of children who are benefitting from services and when children make slower progress than expected or have challenging behaviors. Parental stress and psychological well-being are legitimate targets of intervention and compelling research objectives, needing no additional justification. However, parents are also the major contributors to family adaptive functioning-the activities families employ to support positive outcomes for children with ASD (e.g., family-orchestrated child experiences, parent-child interaction, child health and safety functions; Guralnick, 1997). A parent's ability to carry out adaptive functions is, in part, related to their levels of stress and psychological well-being. Thus, there is a transactional process in which parents are both impacted by and have an impact on ASD interventions for their child. Evaluating the effect of ASD intervention on parents is needed to develop new strategies for helping parents and children with ASD reach their full potential. This review will provide an overview of research on the impact of early ASD intervention on parents. Evidence regarding the impact of three types of intervention (i.e., early intensive behavioral intervention, parent-implemented intervention, and programs directly targeting parent stress) on parent well-being and family adaptive functioning will be reviewed. Potential moderators of the impact of ASD intervention on parents and family adaptive functioning will be discussed. We conclude that research on the impact of ASD intervention on parents of young children with ASD is a promising avenue for improving the lives of children with ASD and their families.

Special Report: Autism Spectrum Disorder and Inflexible Thinking—Affecting Patients Across the Lifespan

Background: Individuals with Autism Spectrum Disorder (ASD) frequently experiencechallenges with sensory processing, emotional regulation, communication, and focus, oftenleading to significant distress or "meltdowns." Existing market solutions for sensory supportare typically single-functional, often stigmatizing, and lack the discreet, portable designnecessary for continuous use across diverse environments. Objective: This paper introducesthe Sereni smart bracelet, a novel, multi-functional, and discreet wearable deviceconceptualized to provide personalized sensory stimuli (vibration, ASMR/binaural sounds, andlight) to support autoregulation, improve focus, and aid in crisis prevention for neurodivergentindividuals, particularly those with ASD across all support levels. Methods: We employed auser-centered design (UCD) approach informed by identified needs of autistic individuals andtheir families, as well as established principles of sensory intervention. The Sereni braceletintegrates three core sensory modalities: a central button for customizable vibrations (targetingtherapeutic frequencies between 40-120 Hz), a lateral output for user-selected ASMR andbinaural sounds, and integrated lights around the main button for visual distraction. The designprioritizes discreetness, personalization through interchangeable bands, and user comfort(hypoallergenic silicone). Results: The Sereni bracelet is positioned as an innovative "blueocean" solution, addressing a significant market gap for a comprehensive, multi-functional, andnon-stigmatizing sensory aid. Its design directly tackles the critical need for a tool that offerscontinuous support without drawing unwanted attention. The multimodal stimuli are groundedin established evidence for sensory interventions in ASD, including specific vibrationfrequencies for calming, the benefits of music therapy and light therapy. The integration of userselectable functions caters to individual sensory profiles, promoting self-management andindependence. Conclusions: The Sereni smart bracelet offers a promising, user-centeredapproach to sensory support for individuals with ASD. By empowering self-regulation throughdiscreet, customizable sensory input, it has the potential to reduce crisis severity, improve focus,and enhance overall quality of life for both autistic individuals and their families. This projectaims to bridge the gap between therapeutic needs and practical, socially acceptable wearabletechnology.

IntroductionBehavioral interventions for autism spectrum disorder show variable outcomes, highlighting the need for complementary therapies. Music-based interventions are promising, yet their molecular mechanisms remain unclear. Saliva-based RNA sequencing (RNA-seq) provides a non-invasive framework to monitor neuroimmune and metabolic dynamics, but its application in autism remains underexplored.MethodsWe explored the buccal transcriptional effects of music exposure in five individuals with autism (8–37 years; 60% female). To overcome saliva-specific limitations, we combined Poly-A selection and Human-Enriched protocols preparation methods to enhance human transcript detection and reproducibility while capturing microbial signals.ResultsIndividually, each dataset revealed a few differentially expressed genes, but integrated analysis improved biological resolution. Consistently modulated genes included HERC6, TSPAN5, and REM2, involved in neurodevelopmental and immune functions. Enrichment analyses highlighted pathways associated with immune regulation, oxidative phosphorylation, and epithelial differentiation, hallmarks of autism, such as immune dysregulation and mitochondrial dysfunction. Co-expression network analysis identified modules correlated with music exposure. The AKNA module, previously linked to autism, was downregulated and enriched for Ras-related GTPase and immune pathways, suggesting modulation of intracellular signaling and inflammation. Conversely, upregulation of the UBE2D3 module indicated activation of endoplasmic reticulum stress responses, a contributor to autism. Exploratory metagenomics identified 15 microbial species responsive to music exposure, including Acidipropionibacterium acidipropionici and Propionibacterium freudenreichii, producers of propionic acid, a metabolite associated with autism-like behaviors and neuroinflammation.ConclusionSaliva-based RNA-seq can stably capture transcriptomic and microbial responses to behavioral stimuli. Music exposure modulates neuroimmune pathways relevant to autism, supporting the biological plausibility of music therapy and demonstrating saliva-based RNA-seq as a viable, non-invasive tool for monitoring intervention outcomes.

The increasing prevalence of autism spectrum disorder (ASD) makes early recognition, evaluation and management an important task for pediatricians, physicians and other professionals caring for children. Educational interventions form the mainstay of management for children with autism spectrum disorder. Such interventions focus on improving social interaction, communication and challenging behaviors, thereby promoting learning and independence in children. This article provides an overview of educational and behavioral interventions in autism spectrum disorder, with special reference to challenges and feasible solutions in the Indian context. Articles were retrieved from various databases including Google Scholar, Medscape, Cochrane, PubMed using the search terms 'autism spectrum disorder OR autism AND educational interventions'; 'autism spectrum disorder OR autism, educational interventions AND India' and 'autism spectrum disorder OR autism AND India'. Reference lists from retrieved articles as well as websites of organizations working in this space in India were also searched. Extracted manuscripts were analysed for content related to various aspects of educational and behavioral interventions in autism spectrum disorder. Intervention models for autism spectrum disorder are based on various theoretical orientations and target specific deficits associated with the disorder. In addition, evidence-based principles for effective intervention are highlighted. In developing countries like India, access to interventions is a challenge and resources are limited. In such settings, the pediatrician's or physician's role is vital in supporting families choose programs that are evidence-based, target individual needs and result in improved outcomes.

Using neuroscience as an outcome measure for behavioral interventions in Autism spectrum disorders (ASD): A review

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social impairment, restricted interests, and repetitive stereotyped behaviors. At present, its pathogenesis has not been fully understood. Various methods are used for clinical treatment and intervention, among which physical activity (PA) intervention also has an obvious effect. This study has used bibliometric methods and visual analysis methods to analyze 885 studies of PA intervention in ASD from 2003 to 2022 in the Web of Science (WoS) database in order to provide theoretical support for the follow-up research on the effect of PA with ASD. The main findings of this study are as follows. First, the literature on PA interventions in ASD research showed a growing trend. The leading institution in this field is the University of Delaware, forming a core group of authors represented by authors such as Sean Healy and Carol Curtin et al. Second, the research focus of this research area mainly includes PA interventions for children and adolescents with ASD. PA can improve symptoms such as stereotyped behaviors and motor function in patients with ASD as well as can reduce childhood obesity rates and improve quality of life. Third, skill, youth, prevalence, and meta-analysis systematic reviews were found. It is the long-term concern and focus of researchers. In conclusion, the current research is only a short-term analysis, and it is not possible to verify the long-term effect; thus, future data analysis should evaluate and explore the long-term effects of PA interventions on ASD including cohort and longitudinal study types focused on the rehabilitation of patients with ASD. Moreover, testing the sustainability of benefits for children with ASD and constructing a multidimensional exercise integrated intervention model are the main directions for future research in this field.

In 1998 secretin, a gastrointestinal hormone, was suggested as an effective treatment for autism spectrum disorders (ASD) based on anecdotal evidence. To assess whether intravenous secretin improves the core features of ASD, other aspects of behaviour or function such as self-injurious behaviour, and the quality of life of affected individuals and their carers. We also assessed whether secretin causes harm. This is an updated version of our review of this topic originally published in 2005. We searched CENTRAL (2010 Issue 1), MEDLINE (1950 to January 2010) , EMBASE (1980 to 2010 Week 2), PsycINFO (1806 to 2010 Week 2), CINAHL (1938 to January 2010), ERIC (1966 to January 2010), Sociological Abstracts (1952 to January 2010). Sociofile and HealthStar were searched in March 2005 when this review was first published, but were not available for this update. Records were limited to studies published since 1998 as this is when secretin was first proposed as a possible treatment for ASD. We searched reference lists of trials and reviews; we also contacted experts and trialists to find unpublished studies. Randomised controlled trials of intravenous secretin compared to a placebo treatment in children or adults diagnosed with ASD, where at least one standardised outcome measure was reported. Sixteen studies met the inclusion criteria but for two of these, conducted by Repligen, the only available multisite data were reported in press releases. All outcome data from the other 14 trials were continuous. Where trials used cross-over designs, we conducted analysis on results from the first treatment phase. Where mean change from baseline was reported, we used this in preference to post-treatment scores for meta-analyses or forest plots. Meta-analysis was able to be attempted for only one outcome (Childhood Autism Rating Scale). Insufficient data were available to conduct sensitivity or subgroup analyses to assess the impact of study quality, clinical differences in the intervention or clinically relevant differences between groups, such as age or presence of gastrointestinal symptoms. Over 900 children were recruited for the secretin trials. Twenty-five established standardised outcome measures were reported to assess core features of ASD, communication, behaviour, visuospatial skills, affect and adverse events. One standardised measure of global impression was also used. No more than four studies used any one outcome measure similarly. When duration from the start of the intervention to outcome assessment was known, outcomes were reported at between three and six weeks. Meta-analysis of data was not possible but there is now consistency of findings, with RCTs of the efficacy of secretin in autism not showing improvements for core features of ASD. There is no evidence that single or multiple dose intravenous secretin is effective and as such currently it should not be recommended or administered as a treatment for ASD. Further experimental assessment of secretin's effectiveness for ASD can only be justified if there is new high-quality and replicated scientific evidence that either finds that secretin has a role in neurotransmission in a way that could benefit all children with ASD or identifies important subgroups of children with ASD who could benefit from secretin because of a proven link between the action of secretin and the known cause of their ASD, or the type of problems they are experiencing.