Measures
Researchers measured parent-child interactions in four areas by parent report. Areas
included parental responsiveness, irritable parenting, parental self-efficacy, and play activities
that incidentally were teaching activities. Parental responsiveness was measured using the Child
Rearing Questionnaire and irritable parenting was assessed with the Parental Perceptions and
Behaviors Scale. Items from the Early Childhood Longitudinal Study-Birth Cohort Parenting
scale evaluated levels of the parents self-efficacy. Lastly, play and incidental teaching activities,
using a 4-point scale to measure five items (Nicholson et al., 2008).
Intervention
A 10-week intervention was designed using traditional childrens music to meet specific
learning objectives for each session. Each session typically focused on one or more
developmental skill and encouraged parent-child social interaction. Also, parents who were
observed to have specific skills deficits were given verbal encouragement to try new things
(Nicholson et al., 2008, p. 230). Parents were given suggestions, skills were modeled, materials
were provided, and they were able to practice activities that would help develop skills.
Statistical Analyses
The mean and standard deviation were obtained for each of group, including both pre and
post intervention scores for parent-report and observer-rated measures. According to Nicolson et
al., (2008), Comparisons for time and group effects were undertaken using repeated measures
analysis of variance (ANOVA) (p. 232). From this ANOVA a significant time-by-group
interaction was obtained for parenting self-efficacy.
Findings: Hypothesis Supported
The hypothesis of this study was supported. Through improvement in post-test scores
compared to pre-test scores, it was found that using music during therapy intervention can help
improve a childs behavior, social skills, and communication skills (Nicholson et al., 2008). The
post test scores showed that 79.8 percent of the parents were pleased with the intervention, with
97.2 percent saying they would attend another program of the same or similar design and 98
percent reporting that they would recommend the program to others.
The 10-week group intervention showed that incorporating music into a therapy session
can help increase a childs ability to communicate, their social skills, and their overall
behavior. During post-test evaluation, improved parenting behaviors and improved mental
health amongst these parents were also reported (Nicholson et al., 2008). Overall, including
music into therapy and play groups was shown to be very beneficial.
Previous Literature
The findings from this studied coincided with the findings from previous studies,
confirming that it is beneficial to include music and singing within a play group or therapy
session to increase social skills. It also showed a high rate of positive feelings amongst the
parent participants just as previous similar studies had. Lastly, along with other studies, this
study found an increase in parents confidence level in regards to effective parenting (Nicholson
et al., 2008).
Clinical Implications for Practice
By evaluating the effect that songs, music, and singing have on a childs development, it
has been found that including these things into an intervention program is beneficial. During
intervention, specifically group intervention, music should be included to promote positive
parent-child and peer relationships. Knowing that children with autism nearly always suffer
from poor communication and social skills, this would be a great modality to include in
intervention with this population.
Limitations
A major limitation of this study was that it did not utilize a comparison
group. Measurements from a comparison group would have increased the efficacy of the study
by providing quantitative data to compare to the measurements from the control group that
completed the 10-week intervention program. They were unable to have a control group due to
decreased funds. Another limitation of the study was that it primarily relied on reports from
clinicians who may or may not have been biased by their close ties to the study design and
purpose. A third limitation of this study is that they encountered a similar problem as most other
early intervention programs: a low retention rate. All of these factors could have altered the
studys results.
Implications for Future Research
This study opened the door for more research of its kind. Future research studies should
further look at the benefits of music within therapy by ensuring consistency with the group sizes
and potentially provide an incentive for program completion. They should also include a more
specific program design within the study to confirm that all participants are receiving the exact
same intervention. Future studies should incorporate music into individual therapy sessions
rather than just group therapy to see if the benefits are still evident. Lastly, including a control
group in a future study will increase the validity of the study.
Sample Size
Although it would be beneficial for the sample size to be larger, the number of
participants used for this study is adequate for a baseline measurement. Consistent results from
358 participants, with 37 different groups, shows a fairly high level of generalizability.
Including parent-child pairs from different countries, different ethnicities, and different economic
backgrounds would be favorable.
Control Group Significance and Type II Error
No control group existed for this study, which was a major limitation. With no control
group there was not a possibility of a type II error. Regardless of the fact that there was no
control group, researchers reported that the hypothesis was supported from the pre to post test
results.
Group Assignment and Outcome Measures
While no group assignments were made, data was reported by clinicians who were
conducting the programs. This observational measurement approach (Nicholson et al., 2008,
p. 234) could have led to biased reporting of data. Despite this possibility, researchers remained
confident in the validity of the observed data. In addition to this, participants were not blind to
group assignment.
Drop-outs and Influence to Outcomes
Researchers did not require participants to specify any intentions to continue throughout
the program, so exact drop-out rates are unknown. Data was collected for only the first two and
last two sessions, and according to Nicholson et al. (2008) if failure to attend the last two
sessions is taken as evidence of drop-out, then the current program is comparable with other
early childhood interventions (p. 235). The drop-outs, or individuals not continuing throughout
the program, raise concern about recommending the program based on the amount of
intervention participants received.
Reliability and Validity
program, which too could have altered the studys results. The overall average of session
completion was 5.6 sessions. According to Nicholson et al., approximately only half of the
participants attended enough sessions for their data to be included in the results.
Application of the Article
As a future therapist, we would consider including music and/or singing within an
intervention program due to the findings of this research study. We first witnessed the calming
effect that music has on children during the time spent at Family to Family Connection for my
first Level I Fieldwork. It gives the children a chance to interact with their parents and peers
through various dance related motions. There are many ways that music can be incorporated into
a therapy session, either at the beginning, the end, or somewhere in the middle. There are also
numerous songs that can be included including hello songs, clean-up songs, and good-bye
songs.
Support for OT
This article supports participation in occupation in several ways. First, it encourages
social participation with peers and parents through the multiple dance movements associated
with the music and songs. As a childs social skills improve, their play participation
increases. Children are better able to fulfill their roles when they actively engage in play and
social situations. Lastly, positive parent-child interactions and increased confidence for parents
also allows these parents to better fulfill their roles within the family dynamic.
10
References
Nicholson, J. M., Berthelsen, D., Abad, V., Williams, K., & Bradley, J. (2008). Impact of music
therapy to promote positive parenting and child development. Journal of Health
Psychology, 13(2), 226-238.