Music Therapy Outcomes Research Articles

Music Therapy with Preterm Infants and Their Families after Hospital Discharge: An Integrative Review.

After discharge from a neonatal unit, families of preterm infants may require therapeutic support to address challenges related to their infant/s' development, changed family circumstances, and/or parent wellbeing. This integrative review (IR) sought to examine the impact of music therapy on preterm infants and their families post-hospital discharge. A systematic search encompassing seven databases resulted in 83 citations, with six studies initially meeting the inclusion criteria. A further six studies were evaluated and selected upon their publication during the review process. Each study was assessed using the Mixed Methods Appraisal Tool (MMAT), followed by the identification of major themes and sub-themes. Our results suggest that music therapy contributed to creating supportive physical and metaphorical environments for preterm infants and their families, in which they could acquire essential skills, tools, and resources for fostering communication and connection with one another. Preterm infants and toddlers may have also enhanced their developmental skills through music therapy sessions post-discharge. Further investigation into the impact of music therapy on preterm infants and their caregivers at different timepoints after hospital discharge is recommended, as well as a comparison of individual and group music therapy outcomes on infant development and parent health. Future research should include a broader spectrum of family members, along with caregivers from diverse family structures and gender identities, reflecting practices already established in some clinical settings.

Spanish Validation of the Music in Dementia Assessment Scales

Music therapy has been described as a beneficial intervention for people with dementia. To provide a music therapy outcome measure, McDermott et al. (2015) developed the Music in Dementia Assessment Scales (MiDAS). The preliminary original validation indicated that MiDAS had acceptable to good psychometric properties. This study aimed to present the translation and cross-cultural adaptation of the MIDAS to the Spanish language and to show some validity sources using the Spanish version of the scale. MiDAS was adapted following the guidelines of Beaton et al. (2000), Muñiz et al. (2013) and Ridder et al. (2015), A psychometric validation study was conducted with a sample of 80 care home residents with moderate-severe dementia. Acceptable reliability values according to Cronbach's alpha were obtained, as was good interobserver reliability at one rating time point, based on Kendall's W test. The concurrent criterion validity values were positive, particularly in terms of the correlation coefficients of the criterion measure (specifically, the QoL-AD measures) and the item analysis, as shown by the correlation matrices. A one-factor confirmatory factor analysis (CFA) did not indicate a good fit for the obtained models, but acceptable and optimal values were observed for various parameters. The results indicate the usefulness of this tool, with sources of evidence of validity and reliability, although it is necessary to note the limitations of some of the results, as in the construct validity analysis. The MiDAS-ESP is a useful tool in clinical practice that can be used for measuring the effect of music therapy.

Social outcomes in children with autism spectrum disorder: a review of music therapy outcomes.

Autism spectrum disorder (ASD) affects approximately one in 68 children, substantially affecting the child’s ability to acquire social skills. The application of effective interventions to facilitate and develop social skills is essential due to the lifelong impact that social skills may have on independence and functioning. Research indicates that music therapy can improve social outcomes in children with ASD. Outcome measures are primarily assessed using standardized nonmusical scales of social functioning from the parent or clinician perspective. Certified music therapists may also assess musical engagement and outcomes as a part of the individual’s profile. These measures provide an assessment of the individual’s social functioning within the music therapy session and generalizability to nonmusical settings.

Active music therapy approach in amyotrophic lateral sclerosis: a randomized-controlled trial.

This randomized controlled study assessed the efficacy of active music therapy (AMT) on anxiety, depression, and quality of life in amyotrophic lateral sclerosis (ALS). Communication and relationship during AMT treatment were also evaluated. Thirty patients were assigned randomly to experimental [AMT plus standard of care (SC)] or control (SC) groups. AMT consisted of 12 sessions (three times a week), whereas the SC treatment was based on physical and speech rehabilitation sessions, occupational therapy, and psychological support. ALS Functional Rating Scale-Revised, Hospital Anxiety and Depression Scale, McGill Quality of Life Questionnaire, and Music Therapy Rating Scale were administered to assess functional, psychological, and music therapy outcomes. The AMT group improved significantly in McGill Quality of Life Questionnaire global scores (P=0.035) and showed a positive trend in nonverbal and sonorous-music relationship during the treatment. Further studies involving larger samples in a longer AMT intervention are needed to confirm the effectiveness of this approach in ALS.

Music in Dementia Assessment Scales (MiDAS): clinical relevance, cultural adaptation and its contribution to psychosocial research in dementia

Background: Music in Dementia Assessment Scales (MiDAS) is a validated outcome measure for music therapy with people with dementia. In preparation for multi-centre studies, there was a need to develop a systematic procedure for translating and adapting music therapy outcome measures. Investigation of the clinical relevance of MiDAS and its value and limitations in the wider context of psychosocial research in dementia was also necessary.Methods: Cultural adaptation and translation procedures were developed through literature review, expert and peer consultations and field-testing. Feedback from music therapists in Denmark, Norway and the UK was obtained. Expert opinions on MiDAS were sought from INTERDEM researchers involved in recommendation of outcome measures for dementia psychosocial research across Europe.Results: Danish and Norwegian MiDAS were produced. A guideline on translation and adaptation procedures for music therapy outcome measures was published.Conclusions: MiDAS is a reliable tool to eval...

In the Groove: An Evaluation to Explore a Joint Music Therapy and Occupational Therapy Intervention for Children with Acquired Brain Injury

An acquired brain injury in children disrupts brain development and neural pathways, which may have serious implications on occupational role performance. Assessment and management of children with neurological disorders is complex and treatment requires the engagement of a multidisciplinary team. Increasing evidence indicates that both occupational therapists and music therapists work effectively towards similar goals with children with acquired brain injury. This evaluation investigated the effectiveness of a joint music therapy and occupational therapy group in promoting the development of self-regulation skills in children with an acquired brain injury or neurological condition, as part of a pilot project at a regional paediatric hospital in Australia. Six participants, aged five and half to ten years, were recruited through the acquired brain injury and neurology outpatient service at a regional paediatric hospital. Children underwent occupational therapy assessment and were identified to have sensory processing difficulties that negatively impacted on the child’s occupational roles of "friend" and "student." The intervention group, In the Groove, received seven, weekly, one-hour sessions, held for one hour on a weekly basis. Each session involved a variety of joint music therapy and occupational therapy activities, specifically planned to achieve intervention goals. A range of standardised occupational therapy and music therapy outcome measures were used, as well as non-standardised measures. All children received positive outcomes following intervention for at least one outcome measure. The findings indicate that joint music therapy and occupational therapy intervention may provide children with acquired brain injury and neurological impairment opportunities to develop self-regulation skills.

Translation and adaptation procedures for music therapy outcome instruments

ABSTRACTWith increasing occurrence of international multicentre studies, there is a need for music therapy outcome measures to become more widely available across countries. For countries where English is not the first language, translation and cross-cultural adaptation of outcome measures may be necessary. A literature review identified a knowledge gap regarding translation procedures of outcome measures used in music therapy research. However, a large body of translation guidelines is available in other health professions. We used the guidelines from these related fields to identify guidelines and outline procedural steps for the translation and adaptation of music therapy outcome instruments.

The development of Music in Dementia Assessment Scales (MiDAS)

There is a need to develop an outcome measure specific to music therapy in dementia that reflects a holistic picture of the therapy process and outcome. This study aimed to develop a clinically relevant and scientifically robust music therapy outcome measure incorporating the values and views of people with dementia. Focus groups and interviews were conducted to obtain qualitative data on what music meant to people with dementia and the observed effects of music. Expert and peer consultations were conducted at each stage of the measure development to maximise its content validity. The new measure was field-tested by clinicians in a care home. Feedback from the clinicians and music therapy experts were incorporated during the review and refinement process of the measure. A review of the existing literature, the experiential results and the consensus process enabled the development of the new outcome measure “Music in Dementia Assessment Scales (MiDAS)”. Analysis of the qualitative data identified five key areas of the impact of music on people with dementia and they were transformed as the five Visual Analogue Scale (VAS) items: levels of Interest, Response, Initiation, Involvement and Enjoyment. MiDAS comprises the five VAS items and a supplementary checklist of notable positive and negative reactions from the individual. This study demonstrates that it is possible to design and develop an easy to apply and rigorous quantitative outcome measure which has a high level of clinical relevance for people with dementia, care home staff and music therapists.

Patient-reported outcomes on integrative therapies for pain, tension, and level of comfort.

58 Background: The 2007 National Health Interview Survey (NHIS) reported more than one-third of adults used some form of complementary and alternative medicine (CAM). An analysis of 2002 NHIS data found CAM use to be more prevalent among people with a prior diagnosis of cancer. In 1999, St. Luke’s Mountain States Tumor Institute (MSTI) began an integrative therapies program to meet this growing interest and provide evidence-based, safe CAM modalities for patients. The program continues to grow and offers programs such as massage, acupuncture, and pediatric music therapy. Methods: Patient reported outcomes are collected from patients using pre/post treatment assessments. Outpatient massage and acupuncture programs measure comfort levels pre/post treatment using a 0-10 scale (0 = very comfortable; 10 = worst discomfort). The inpatient massage program measures pre/post treatment pain and tension using a 0-10 scale (0 = no pain/tension; 10 = worst pain/tension). Finally, the MSTI pediatric music therapy program collects pre/post treatment pain outcomes using a FLACC scale, where each of the five categories Face (F), Legs (L), Activity (A), Cry (C) and Consolability (C) are scored from 0-2, which results in a total score 0-10. Results: Assessments from outpatient acupuncture and massage collected between July 1, 2011 to July 1, 2012 showed that patients had an average comfort score of 3.6 before acupuncture and 2.0 after acupuncture and an average comfort score of 3.4 before massage and 0.77 after massage (n=1300 estimate). Inpatient massage outcomes collected between Dec. 2011 – June 2012 showed an average pain score of 2.53 before massage and 0.41 after massage and an average tension score of 4.73 before massage and 0.52 after massage (n=52). MSTI pediatric music therapy outcomes collected from January-April 2012 showed an average FLACC score of 3.0 before music therapy and 0.72 after music therapy (n=68). Conclusions: Integrative therapies such as massage, acupuncture and pediatric music therapy show significant benefits in providing comfort and decreasing pain and tension in MSTI cancer patients. Opportunities remain to conduct research and set a standard of practice with integrative therapies.

Music Therapy Protocol Development to Enhance Swallowing Training for Stroke Patients with Dysphagia

Considering the devastating condition of dysphagia, it is necessary to provide intensive therapeutic regimen based on interdisciplinary approach. In this aspect, music-enhanced swallowing protocol was developed through a pilot study. Then, the modified protocol from a pilot study was examined with 8 stroke patients in a local hospital. The protocol was designed to improve oral motor control, laryngeal elevation, breathing, and swallowing functions. The dependent variables measured included reflex, respiration, and laryngeal functions using the Frenchay Dysarthria assessment. Results from the initial to the midevaluation showed that pitch in the laryngeal category were statistically significant after 6th sessions. After the 12th session, when the final evaluation was compared with the initial assessment, additional categories revealed statistically significant changes. It is recommended that this study should be replicated with a control group and a larger sample using either FEES or video fluoroscopy for scientific data to further substantiate music therapy outcomes in stroke rehabilitation.

The study of variables leading to music therapy outcomes perceived by music therapy practitioners.

The study of variables leading to music therapy outcomes perceived by music therapy practitioners.

The Use of Effect Sizes in Music Therapy Research

ABSTRACT: Music therapy outcome research frequently involves comparisons between groups on continuous scales of psychological constructs. Describing such differences only through statistical tests reduces the existing complexity and creates an artificial and potentially misleading dichotomy. The interpretation of the magnitude of a difference found on a psychological scale is often not straightforward, but can be greatly facilitated and improved by using effect sizes. Cohen's (1988) benchmarks allow for intuitive judgements and enable comparisons between different scales. An example of a study of the effects of music therapy on self-esteem shows how the use of effect sizes can change the interpretation of a research result. Effect sizes have important applications in many fields of music therapy research, including primary studies as well as meta-analyses, and planning of research as well as reporting of research results. Because of their intuitiveness, they may help to bridge the gap between research and clinical practice. There are many different types of research designs and strategies which are applied in music therapy research, including experimental to descriptive forms of research. Experimental and quasi-experimental research on music therapy outcomes frequently involves a comparison between two groups, such as an experimental group and a control group. Different characteristics can be chosen to represent the outcomes of the groups, including, for example, frequency counts of behaviors and psychological constructs. The latter type of outcome is most commonly measured on a continuous scale. Examples of such scales include severity of psychiatric symptoms, degree of social functioning, and level of self-esteem, among others. The purpose of outcome research that involves comparisons between groups is to draw conclusions about the clinical effects of a treatment procedure (e.g., a music therapy program), when compared with a different procedure (e.g., no treatment, standard care, verbal therapy, or another music therapy program). Whenever the means of two groups are compared, there are various ways of describing the difference. The first question that can be addressed is the size of the difference between these two groups. This question is related to the clinical relevance of the difference (or the effect of treatment) and can be answered using an effect size (ES) calculation. If the two groups represent random samples drawn from larger populations, the second question that can be asked is whether one can be sure that there is a difference between the populations from which our sample was drawn. This question refers to inferences that can be made of the generalizability of the results from a representative sample to a larger population, and can only be answered indirectly with a test of statistical significance, which tells how likely-or unlikely-the sample would be drawn in the absence of a difference between the populations. Researchers in the social sciences have often addressed differences between groups only in terms of inferential statistics, without undertaking a descriptive analysis of the differences in their sample, possibly because they were not aware of the potential for calculating the size of an effect (Cohen, 1988). Problems with Statistical Tests There are several problems with the exclusive use of inferential statistics. First, since tests of significance are designed to accept or reject a null hypothesis, they lead to a dichotomous decision, such as between yes and no, or between and white, suggesting that there is either an effect or no effect. This is inappropriate for research questions where it is relevant to what degree a null hypothesis may be wrong. To stay with this scenario, deciding between black and white ignores the many shades of gray that may exist in between. second, the statistical indices that a test of significance provides are, by nature, not useful (and not intended) as descriptive statistics because they depend on effect size and sample size. …