音樂的力量: 溝通無界限

音樂跨越語言及種族界限,可作為語言及社交障礙人士的一種溝通橋樑。專研幼兒心理的科學家發現,人與生俱來可以音樂作為互相溝通的媒介 (Trevarthen, 2000),音樂亦可作為自閉症人士進行非語言社交溝通的有效渠道。

 

自閉症人士擁有正常或超凡的音樂能力

縱然自閉症人士呈現廣泛的認知功能障礙,科研實證多翻驗證了他們於辦認音準或其他音樂元素(Sharda et al., 2015),理解或命名音樂所表達的情感(De Bruyn et al., 2012; Gebauer et al., 2014; Molnar-Szakacs & Heaton, 2012; Quintin et al., 2011),及對音樂的偏好(Lanovaz et al., 2012; Molnar-Szakacs & Heaton, 2012)皆與發展正常的孩子無異,有些甚至擁有超凡的表現。

一些有趣的研究結果揭示了自閉症的音樂專長,這強項更表現於不同程度的自閉症患者中。例如,Stanutz教授與同僚(2014)發現自閉症孩子與發展正常的孩子相比,呈現較強的音準分辨能力及較好的旋律記憶力。最近一項磁力共振研究(Gebauer et al., 2014)更發現自閉症人士的大腦於處理富情感之音樂時所運用的大腦網絡跟發展正常人士相若,但當他們聽到開心音樂時的腦部活躍度比聽傷心音樂時的活躍度為高。這表示自閉症人士的大腦於處理富情感的音樂時呈現比發展正常人士更高的生理反應。另一研究(Sharda et al., 2015)亦指出自閉症孩子在聆聽以歌曲模式唱頌出來的詞語時,他們的兩側顳葉腦區活躍度與發展正常孩子相若。相反,當聆聽誦讀的詞語時,其大腦的活躍度較遜於發展正常孩子。這結果顯示歌曲唱誦方式或許能補償自閉症孩子於接收話語訊息的不足,同時亦為音樂治療對自閉症的效用提供了大腦運作機制的基礎。類似的研究結果也被發現於智障的自閉症患者中(Lai et al., 2012)。



音樂對自閉症的正面影響

有關音樂與自閉症的研究驗證了自閉症患者處理音樂的優勢及個人與小組音樂治療對自閉症的正面影響。音樂的益處不只限於高智能的自閉症患者,即使是有智力障礙或較嚴重病徵,甚至沒有語言能力的自閉症患者也能受益。最具說服力的音樂效益就是在於改善自閉症人士的社交情感反應及溝通能力(Geretsegger et al., 2014)。具體的療效包括增加了與人交往時相互注意的協調(Carnahan et al., 2009; Kim et al., 2008; LaGasse, 2014; Vaiouli et al., 2015),增強了社交溝通的能力及投入度(Finnigan & Starr, 2010; Gooding, 2011; Kern et al., 2007; Kim et al., 2008; Vaiouli et al., 2015),增多了自發的模仿行為(Stephens, 2008),更好的情感理解(Katagiri, 2009),減少了焦慮感(Berger, 2012; Hillier et al., 2012),提升了自信心(Hillier et al., 2012),減少了核板的發聲(Lanovaz, et al., 2012)及增加了語言表達(Lim, 2010; Wan et al., 2011)。

音樂的效用因應音樂的複雜程度,自閉症人士的能力水平及對音樂的偏好而有所不同。例如,對較嚴重的自閉症患者而言,簡單、清晰及能預計的音樂最能有效地誘發他們與人交往時的相互注意行為,而較複雜、多變的音樂則對輕度至中度的自閉症患者最為有效(Kalas, 2012)。此外,採用自閉症患者所偏好的音樂最能有效地減少其核板式發聲的頻率(Lanovaz, et al., 2012)。更有趣的是,當早期訓練配合以家庭為中心的音樂治療時,受惠的不只是自閉症患者,而且還改善了他們與父母的關係(Thompson et al., 2014)。

除社交層面的益處外,初步研究結果亦支持音樂有助自閉症人士提升專注力(Pasiali et al., 2014),減少自殘性、刻板式及暴力行為(Boso et al., 2007; Lundqvist et al., 2008),以及協助他們學習如自理(Kern et al., 2007a)、早上打招呼(Kern et al., 2007b)等日常生活習慣。



科研文獻:

Berger, D. (2012). Pilot study investigating the efficacy of tempo-specific rhythm interventions in music-based treatment addressing hyper-arousal, anxiety, system pacing, and redirection of fight-or-flight fear behaviors in children with autism spectrum disorder. Journal of Biomusical Engineering, 2, 1-15.

Boso, M., Emanuele, E., Minazzi, V., Abbamonte, M., &Politi, P. (2007).Effect of long-term interactive music therapy on behavior profile and musical skills in young adults with severe autism. The Journal of Alternative and Complementary Medicine, 13(7), 709-712.

Carnahan, C., Musti-Rao, S., & Bailey, J. (2009). Promoting active engagement in small group learning experiences for students with autism and significant learning needs. Education and Treatment of Children, 32(1), 37-61.

De Bruyn, L., Moelants, D., & Leman, M. (2012). An embodied approach to testing musical empathy in participants with an autism spectrum disorder. Music and Medicine, 4, 28-36.

Finnigan, E., & Starr, E. (2010). Increasing social responsiveness in a child with autism. A comparison of music and non-music interventions. Autism, 14, 321-348.

Gebauer, L., Skewes, J., Westphael, G., Heaton, P., & Vuust, P. (2014). Intact brain processing of musical emotions in autism spectrum disorder, but more cognitive load and arousal in happy vs. sad music. Frontiers in Neuroscience, 15, 192.

Geretsegger, M., Elefant, C., Mossier, K. A., & Gold, C. (2014). Music therapy for people with autism spectrum disorder. Cochrane Database of Systematic Reviews, 17, CD004381.

Gooding, L. (2011). The effect of a music therapy social skills training program on improving social competence in children and adolescents with social skills deficits. Journal of Music Therapy, 48, 440-462.

Hillier, A., Greher, G., Poto, N., & Dougherty, M. (2012). Positive outcomes following participation in a music intervention for adolescents and young adults on the autism spectrum. Psychology of Music, 40, 201-215.

Kalas, A. (2012). Joint attention responses of children with autism spectrum disorder to simple versus complex music. Journal of Music Therapy, 49, 430-452.

Katagiri, J. (2009). The effect of background music and song texts on the emotional understanding of children with autism. Journal of Music Therapy, 46(1), 15-31.

Kern, P., Wakeford, L., Aldridge, D. (2007a). Improving the performance of a young child with autism during self-care tasks using embedded song interventions: A case study. Music Therapy Perspectives, 25, 43-51.

Kern, P., Wolery, M., & Aldridge, D. (2007b).Use of songs to promote independence in morning greeting routines for young children with autism. Journal of autism and developmental disorders, 37(7), 1264-1271.

Kim, J., Wigram, T., & Gold, C. (2008). The effects of improvisational music therapy on joint attention behaviors in autistic children: a randomized controlled study. Journal of autism and developmental disorders, 38(9), 1758-1766.

LaGasse, A. B. (2014). Effects of a music therapy group intervention on enhancing social skills in children with autism. Journal of Music Therapy, 51, 250-275.

Lai, G., Pantazatos, S., Schneider, H., & Hirsch, J. (2012). Neural systems for speech and song in autism. Brain, 135, 961-975.

Lanovaz, M., Rapp, J., & Ferguson, S. (2012). The utility of assessing musical preference before implementation of noncontingent music to reduce vocal stereotypy. Journal of Applied Behavior Analysis, 45, 845-851.

Lim, A. H. (2010). Effect of “developmental speech and language training through music” on speech production in children with autism spectrum disorders. Journal of Music Therapy, 47, 2-26.

Lundqvis, L., Andersson, G., & Viding, J. (2008). Effects of vibroacoustic music on challenging behaviors in individuals with autism and developmental disabilities. Research in Autism Spectrum Disorders, 3, 390-400.

Molnar-Szakacs, I., & Heaton, P. (2012). Music: A unique window into the world of autism. Annals of the New York Academy of Sciences, 1252, 318-324.

Quintin, E., Bhatara, A., Poissant, H., Fombonne, E., & Levitin, D. (2011). Emotion perception in music in high-functioning adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 41, 1240-1255.

Pasiali, V., LaGasse, A. B., & Penn, S. L. (2014). The effect of musical attention control training (MACT) on attention skills of adolescents with neurodevelopmental delays: A pilot study. Journal of Music Therapy, 51, 333-354.

Sharda, M., Midha, R., Malik, S., Mukerji, S., & Singh, N. C. (2015). Fronto-temporal connectivity is preserved during sung but not spoken word listening, across the autism spectrum. Autism Research, 8, 174-186.

Stanutz, S., Wapnick, J., & Burack, J. (2014). Pitch discrimination and melodic memory in children with autism spectrum disorder. Autism, 18, 137-147.

Stephens, C. E. (2008). Spontaneous imitation by children with autism during a repetitive musical play routine. Autism, 12, 645-671.

Thompson, G. A., McFerran, K. S., & Gold, C. (2014). Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: A randomized controlled study. Child: Care, Health and Development, 40, 840-852.

Trevarthen, C. (2000). Musicality and the intrinsic motive pulse: evidence from human psychobiology and infant communication. Musicae scientiae, 3(1 suppl), 155-215.

Vaiouli, P., Grimmet, K., & Ruich, L. J. (2015). “Bill is now singing”: Joint engagement and the emergence of social communication of three young children with autism. Autism, 19, 73-83.

Wan, C., Bazen, L., Baars, R., Libenson, A., Zipse, L., Zuk, J., Norton, A., & Schlaug, G. (2011). Auditory-motor mapping training (AMMT) as an intervention to facilitate speech output in non-verbal children with autism: A proof of concept study. PLoS One, 6, e25505.
 

 


 

 

 

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