Use of bone conduction music to increase relaxation in children with ASD

Cynthia Lau, PhD, OTR/L, BCP, Megan Meengs, Natalie Noss, Johnny Rider, and Nicole Sellers
Touro University Nevada, School of Occupational Therapy, Henderson, NV

Background:
The purpose of this pilot study was to evaluate the
effectiveness of the Dream Pad pillow at promoting
relaxation and sleep in children with autism. Studies estimate
sleep problems in children with autism spectrum disorders
(ASD) to be between 41 to 86% (Liu, Hubbard, Fabes, & Adam,
2006). Commonly reported problems are sleep onset,
maintenance, night waking, short night sleep duration, and
early morning waking (Krakowiak et al., 2008). Sleep problems
and associated decreased function of daily activities in families
with ASD indicate a critical need for occupational therapists to
establish effective sleep intervention for this population.
Occupational therapists (OT) use a wide range of behavioral
and sensory based strategies to improve sensory modulation
for children with sleep difficulties (Kuhaneck & Watling, 2010).
Listening to music has been recommended to calm children
with ASD and over-arousal at bedtime (LaVesser & Hilton,
2010). The Integrated Listening Systems (iLs) bone conduction
music is proposed to affect the reticular activating system and
parasympathetic nervous system, therefore, increasing a calm
and relaxed state (iLs, 2013). The bone conduction music is
available in the Dream Pad pillow to promote rest and sleep.
Bone conducted music is provided in the pillow by dual bone
conductors built into the pillow that transduces sound to
vibration and vibrates in response to low frequency sounds,
which may promote the feeling of being grounded in the body
(iLs, 2013).

Methodology:
The design of this pilot was quasiexperimental using a
convenient group of eleven children diagnosed with ASD
attending outpatient OT at one facility. Heart rate variability
(HRV) is typically higher in sleep (Vanoli, 1995) and during
relaxation (Sangthoung & Pickler, 2004). HRV was measured
from an ECG provided by the Sleepimage device. The
participants HVR was measured for 15 minutes on six separate
days. Phase 1-consisted of baseline, phase 2- two days with air
conduction music, phase 3- two days with the Dream Pad
Pillow and phase 4- return to baseline . The 11 participants
HRV data were analyzed by using nonparametric statistical
analyses and then single subject analyses.

Case 2-ambient music

Results:
Statistical analyses of the data specified that the participants had
increased HRV, indicating improved parasympathetic activity, in
the ambient music condition only. HF Power reached statistical
significance, Fr(3) = 8.45, p = .03, Cliffs = 0.741.
Visual analyses of each participants results via graphs indicated
that 3 of the individual cases showed most change in HF HRV
with the Dream Pad TM, 5 participants showed most change with
the ambient music, and 3 had upward trend of HRV through the
6 days. The below 3 graphs demonstrate one of each of the
different scenarios respectively.

Case 10-habituation

Conclusions:
Children with ASD showed increased HRV with the
introduction of music indicating increased relaxation
with this sensory input.
Healthcare professionals may consider recommending
music to help clients with ASD with sleep difficulties.
Health care professionals should recommend bone
conduction music judiciously.
Limitations of the study were the small sample size,
the short interval of the time HRV was measured, and
habituation to the experimental environment. The
small sample size limits generalizability to all children
with ASD and HRV taken throughout the night would
have provided more validity to the results.

Case 4-bone conduction music

This work was supported by a TOURO University Nevada Research Grant Award.