RUNNING HEAD: MBCT

Melodic Based Communication Therapy and Autism Spectrum Disorder

Tessa Swiger
Seton Hill University

ABSTRACT

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Autism is on the rise and is affecting millions of children and adults. It is a developmental
disorder that stems from the brain; affecting speech, cognitive functioning, social
interaction, motor skills, and interpersonal skills. Music therapy has been proven to
improve these skills in those with autism. In this research, melodic based communication
therapy will be studied on how its affects have an impact on verbalization. There will be
50 autistic children (15 female, 35 male, Mage=4.5 years, age range: 3-9 years ) varying in
severity but with emphasis on communication. Research will be conducted over the
course of one year, with data being collected every month using a pretest/posttest time
design series. It is anticipated that a statistically significant difference between the two
groups will occur, and include a positive correlation between the melodic based
communication therapy and verbalization in the participant. Either used by itself or
alongside of other music therapy techniques, melodic based communication therapy will
significantly increase ones language development.
Key words: music therapy, autism, melodic based communication therapy, language

Melodic Based Communication Therapy and Autism Spectrum Disorder

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Autism Spectrum Disorder affects every 1 in every 150 children (Rice, 2007).

Children that are diagnosed with autism struggle daily with socialization, cognition,
possibly physical, and communication skills. Little to no development of verbalization is
one of the most prominent signs of autism in a child. Speech becomes communication
when there is a desire or intent to convey a message to someone else (Stokes). Because
there is difficulty understand language, possible aggression can occur. There are many
different types of early interventions that are used for children on the Autism Spectrum.
Creative Arts therapies, more specifically Music Therapy, are non-invasive therapies that
aid in a childs development, and are also most effective.
Autism
Leo Kanner was a psychiatrist at John Hopkins University when he discovered
that autism was a distinct developmental disorder in 1943. He describes children as
being normal in physical appearance but exhibited severely disturbed behavior patterns
that included: extreme social aloofness or aloneness; lack of emotional responsiveness;
avoidance of eye contact; failure to respond to auditory or visual stimulation; lack of
language development or failure to use language adequately for communication;
excessive attachment to objects; and preoccupation with ritualistic, repetitive, and
obsessive behaviors (Davis, 2008). Autism today is defined as a neurological disorder
that affects someones ability to communicate and develop relationships. Autism
Spectrum Disorder (ASD) is just one sub category of Pervasive Developmental Disorders
(PDD). Also falling under PDD is Retts Syndrome and Aspergers Syndrome. PDD is
listed in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric
Association, 2000). Symptoms of autism begin before age 3 and continue on into

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adulthood. To make the diagnosis of autism, there must be qualitative impairment in

reciprocal social interaction, qualitative impairment in verbal and non-verbal
communication, and lastly restricted repertoire of interests and activities (Davis, 2008).
Qualitative impairment in reciprocal social interaction is based on what is considered
normal for that development level. Poor eye gaze, limited use of gestures, and the
inability to create relationships are examples of this. Qualitative impairment in verbal and
non-verbal communication includes lack of speech, language delay, lack of make
believe play, and echolalic language (repeating words or phrases). Restricted repertoire of
interests and activities include rocking type motions, repetitive movements or gestures,
hand flapping, or spinning, as well as limited or abnormally intense interests in areas
(Frith, 2003). No two autistic children are the same. This disorder manifests itself in
many different ways, in many different people. According to the Autism Society of
America (2008), the number of people with autism could reach 4 million within the next
decade. Although there is no known cause for autism, early researchers believed it was
from childhood trauma or lack of parenting. Because of the normal appearance, it was
widely believed that it had to be a result of emotional trauma early in life (Davis, 2008).
Since the 1960s, however, evidence suggests that it is a developmental disorder of the
brain.
It is suggested that the prefrontal cortex, cerebellum, and medial temporal lobe are
possible regions of abnormality in this disorder (Dawson, 1998). Studies have shown that
monkeys with lesions on the hippocampus and amygdala had severe cognitive and social
impairments.
Music Therapy

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Music Therapy is an effective approach for addressing language and

communication skills (Bettison,1996). Music therapy is a motivating and fun medium for
children to use. Those with autism are more attentive and responsive to musical stimuli
(Davis, 2008). Since those with autism seem to have an affinity for music, this can really
be an effective, safe, and flexible intervention to use. The benefits that music therapy
interventions are but not limited too : increase of socialization, enhance self awareness,
developing coping and relaxing skills, adopt positive behaviors, having sense of control
over life.
An Analysis of Music Therapy Program Goals and Outcomes for Clients with
Diagnoses on the Autism Spectrum by Ronna S. Kaplan and Anita Louise Steele (2005)
explore how music therapy interventions were used in sessions with the client population
being Autistic. The primary goal areas that were studied were language/communication
at 41%, behavioral/psychosocial at 39%, cognitive at 8%, musical 7%, and finally
perceptual motor 5%. Commonly, music therapy sessions are either in groups or
individualized. They found that 100% of the clients reached their initial objectives in the
goal areas within a year or less (Kaplan, R.S. & Steele, A.L., 2005, 2). These researchers
chose to do their study with Autism due to its significant increase of cases over the years.
They investigated with types of music therapy interventions were frequently used, what
goal area and target objectives were most frequently addressed and/or met with those
interventions, an whether the skills attained in music therapy session were generalized to
other settings outside of music therapy (Kaplan, R.S. & Steele, A.L., 2005,4 ).
Researchers collected data over a two year period. During that time, 40 children and
adults that ranged on the autism spectrum (including autism, pervasive developmental

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disorder, and Aspergers syndrome). Session types that were used in the study were
individual (which was the most common), partner, small group, large groups, peer model
and a combination of two modes. In the study the largest goal area that was measured
was the language/communication skills. As stated previously, 100% of subjects reached
their first objectives within one year or less no matter the session type, level of difficulty
or goal area;77% of second objectives were reached within a year. 100% of cognitive and
musical intermediate objectives were achieved, 74% of both behavioral/psychosocial and
language/communication goals were attained (Kaplan, R.S. & Steele, A.L., 2005,7 ).
Parents reported that clients were able to take the skills they learned from therapy and
apply them to everyday life tasks.
Music Therapy and Autism
In Music therapy with autistic children, Thaut gives us some examples of
interventions used in music therapy sessions. These include music interaction to establish
communicative intent (facilitate desire or necessity to communicate); action songs to
promote interaction; oral motor exercises to strengthen awareness and functional use of
lips, tongue, jaws, and teeth; sequence imitation of gross motor, oral motor, and oral
vocal motor skills (after perceptual and imitative skills are established); and finally
shaping vocal inflection of children who have some speech sound (Thaut, 1999). From
Adamek and Darrow, we are given some example strategies used to reach the goal of
communication, these include making choices through instrumental and vocal activities,
echoing verbalizations of therapist through songs, and also following directions and being
the leader (Adamek &Darrow, 2005).
Mirror Neurons

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Mirror Neurons are neurons that fires off both when an animal acts and

when an animal observes the same action by another. These neurons are found in the
premotor cortex of the brain. This is similar to the Brocas area of the brain that is in
humans (Dawson, 1998). These neurons are responsible for a multitude of other human
behaviors and thought processes. It is believed that possibly damaged mirror neurons are
linked to autism. It has been proved by neuroscientists that the inability for autistic
children to relate to their environment and other people are linked to a poor functioning
of mirror neurons.
Melodic Intonation Therapy
Melodic Intonation Therapy is a treatment technique used for patients that have
been affected by aphasia (Albert, Sparks, Helm, 1974). It is believed that this technique is
successful because of MIT stimulates the language areas of the right hemisphere. Another
explanation is that singing supposedly increases brain activity in the right hemisphere in
the interhemispheric control of language (Albert, Spark, Helm 1974). Studies from
Boucher, Garcia, Fleurant, and Paradis (2001) suggest that involving rhythmic attributes
can improve repetition to a greater degree. Mixing different musical modes make the
brain more active, causing more reactions. Vocal intonation therapy addresses the
rehabilitation of abnormal pitch, loudness, timbre, breathing, and prosody of speech
(Davis 2008). Therapeutic singing shows positive effects on a variety of neurological and
developmental speech and language dysfunctions (Glover, Kalinowski, Rastatter, &
Stuart, 1996).
MIT is training verbal production by repeating melodically intoned
phrases while rhythmically tapping the clients hand (Muelen 2012). In this article,

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Melodic Intonation Therapy: Present Controversies and Future Opportunities, discusses

the effectiveness of MIT as well the neural processes the brain undergoes while
participating in MIT. This study was also conducted on those that suffer from aphasia, but
this is similar to those with struggling development of speech with autism. Studies
showed an increase of correct information units (CIUs) after completion of MIT. The
study showed positive effects.
Melodic Based Communication Therapy
Melodic Based Communication Therapy is similar in its aspects of MIT, yet this
intervention is designed to make use of the musical strengths of the child with autism in
order to increase verbal output. In a study done by Sandiford (2012), Melodic Based
Communication Therapy was used with children that had ASD, as opposed to services
done by speech therapy. Twelve children 5-7 years of age were randomly assigned to
groups. Studies found that the music group progressed most in verbal attempts in weeks
1-4. The speech therapy group stated to progress most after week 4-5 (Sandiford 2012). A
standard melody is used for each target word. Words are then pre recorded on a CD and
the participant is to clap while saying the word. This was also a pilot study, which is a
small-scale test of methods and procedures to be used on a larger scale.
Improvisation
In Improvisation in Music Therapy: Human Communication in Sound,
Mercedes Pavlicevic researches how improvisation in music therapy elicits responses in
music/jazz improvisation, mother-infant interaction in children, and emotional
expressions in childrens songs. The study found that when a song was played to a child,
they are able to understand that the song has an emotional value to it, it is more than just

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a song. Children were able to use nonverbal cues such as gestures and movements to
express emotion along with tempo rhythm, and melody. Young children appear to have an
intuitive, natural capacity for creating music spontaneously, through vocalizing
(Pavlicevic, 2000).
In this study, the purpose is to explore the techniques and methods of
Melodic Based Communications Therapy (including Melodic Intonation Therapy and
Rhythm Therapy) with children affected by autism. These methods aid in many goal
areas including communication, social, physical, neural and behavioral. We are going to
focus on language and communication in this study. Melodic Based Communication
Therapy increases verbalization in clients with Autism Spectrum Disorder

Methods
Participants
50 young children (15 female, 35 male, Mage=4.5 years, age range: 3-9
years) diagnosed with autism will be recruited by criterion sampling. All those that are
chosen must have little to no communication skills, or in the process of developing these
skills. Participants were recruited from local special needs schools. Participants will be
compensated with two free months music therapy session following the study. In this
study 20% of participants are of upper socio-economic class, 45% are middle class, and
the remaining 35% are of lower class. Participants of study are 40% Caucasian, 25%
African American, 20% Asian, and the remaining 15% are of Latino descent. It is
expected that subjects might have various other deficits such as social and cognitive
skills. Based on the DSM IV, participants must have qualitative impairments in

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communication as manifested by at least one of the following: Delay or total lack of

spoken language, individuals with impairment in the ability of initiating or sustaining a
conversation, the use of idiosyncratic language, or lack of varied, make believe play.
Procedure
Music therapy will be administered by qualitative interviews between
board certified music therapist and participants with autism. Informed consent will be
obtained. Parents/care givers may be present in the room. Sessions will be held in the
music room of the special needs school throughout the week, over a twelve month period.
Sessions will be one hour in length. Sessions will include a Hello Song involving the
childs name. Then the therapist will show pictures or actual objects to a child (everyday
items they would see/use on a daily basis). Using specific rhythmic and melodic patterns,
therapist will utilize a call and response intervention. Then therapist will choose a song
based on the themed items for that day to play and sing with the child. Therapist will then
return to the picture, while saying sentences with specific melodic patterns including the
words that are being focused on. Finally, the child will use headphones to listen to the
song throughout the week, until the next session. In the event that the primary music
therapist is unavailable, a secondary music therapist will fill in.
Measures
The Social Responsiveness Scale (SRS) and the Gilliam Autism rating
scale will be used to assess autism severity level. Parent or guardian will give consent.
The parent or guardian will complete the SRS (Constantino and Gruber, 2005); this will
assist in measuring the childs social impairments, social awareness, social information
processing, and capacity for reciprocal social communication. The test is a three-point

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likert scale, which is varied from 0 (not true), 1 (sometimes true), 2 (often true), and 3
(almost always true). Statements that will be rated will be shown as following:

0 (not true) 1 (sometimes true) 2 (often true) 3 ( almost always true)

1. Seems self- confident when interacting with others

____________

2. Is able to communicate their feelings to others in words/gestures ____________

3. Is able to understand the meaning of other peoples tone of
voice and facial expression

____________

T-scores that are 60 through 75 are considered severely autistic. The reliability is .
94 in males, .93 in females.
The Gilliam Autism rating scale (Gilliam, 2002) is measured using four
subscales; those include Stereotyped Behaviors, Communication, Social Interactions, and
a parent interview on Developmental Disturbances. This has a reliability coefficient of .
90. Parents will indicate how the child communicates, whether it is through sound, sign,
or nothing at all. Parents will rate each occurrence on a three point likert scales stating
whether behaviors are never observed, sometimes observed, or frequently
observed. Example of this research is shown as follows:
1 (never observed)

2 (sometimes observed)

3 (frequently observed)

1. Child echoes words verbally or with signs

_______

2. Does not ask for things that he/she wants

_______

3. Does not initiate conversation with peers/adults _______

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The Wechsler Intelligence Scale (WISC-IV) developed by Dr. David Wechsler

(2003) will measure skill level of verbalization, depending on the age in question. The
WISC-IV will measure crystalized ability, visual processing, reasoning, short-term
memory, and processing speed. Prompts that will be evaluated are repeats words
verbally or with signs, repeats word or phrases over and over, and repeats
unintelligible sounds (babbles) over and over. Child participants will go through a
guided interview, based on needs and abilities.
RESULTS
Research Design
Pretest-posttest time series design will be utilized for this research. Pretest will be
administered a month before group sessions will begin. Results from the pretest will
determine the sessions music experience for each participant. After the pretest, random
assignment of participants will spilt into Group 1 and Group 2. Group 2 will receive the
melodic based communication therapy. Group 1 will participate in standard play therapy.
Assessments will be recorded monthly. After a year, an official post test will be
administered to both groups.
Data Analysis
A Pearson Product-Moment Correlation Coefficient analysis will used to analyze
data from both groups. It is expected that a positive statistically significant correlation
will be shown as the amount of times the melodic based communication therapy is used,
the higher the improvement of communication will occur in the participant.
Discussion
Implications

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It is suggested that melodic based communication therapy will improve

communication skills with those that have autism. While melodic based communication
is not the only technique to use, when combined other music therapy interventions it can
be very beneficial to someone with autism.
Limitations
Limitations of this study include ethical limitations, and because of personalized
session plans based on clients needs and abilities, certain session might not be applicable
to all subjects.
Further Investigations
This research can be used to further investigate neural processes while engaging
in melodic based communication therapy along with other music experiences. In
everyday life, autistic individuals might avoid communication or socialization with others
due to inability to verbalize. After this research, participants will have improved
vocabulary, speech, and understand of language. This method can also be used to
research how it may help increase self expression, self awareness or socialization within a
group with those with autism.

REFERENCES

Adamek, M. & Darrow, A.A. (2005). Music in special education. Silver Springs, MD:
American Music Therapy Association

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Albert, M.L., Sparks, R. W. & Helm, N.A. (1974). Melodic intonation therapy for
aphasia. Archives of Neurology, 29, 130-131.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental
disorders (4th ed.,text revision). Washington, DC: Author.
Autism Society of America. (2008). About autism. Retrieved from www.autismsociety.org.
Bettison, S. (1996). The long-term effects of auditory training on children with autism.
Journal of Autism and Developmental Disorders, 26, 361-375.
Boucher, V., Garcia, L.J., Fleurant, J. & Paradis, J. (2001).Variable efficiacy of rhythm
and tone in melody-based interventions:Implications for the assumption of a right
hemisphere facilitation in non fluent aphasia. Aphasiology, 15, 131-149.
Dawson,G. (1998). Neuropsychological correlates of early symptoms of autism. Child
Development, 69 (5), 1276-1285.
Davis, W.B. (2008) The introduction to music therapy: theory and practice. Book. Silver
Springs, MD: The American Music Therapy Association, Inc.
Frith, U. (2003) Autism: Explaining the enigma. Book. Malden, MA :Blackwell
Glover, H., Kalinowski, J. Rastratter, M. & Stuart, A. (1996). Efffect of instruction to sing
on stuttering frequency at normal and fast rates. Perceptual and Motor Skills, 83,
511-522.
Kaplan, R. S. & Steele, A. L. (2005). An analysis of music therapy program goals and
outcomes for clients with diagnoses on the autism spectrum. Journal of Music
Therapy, 42 (1), 2-19.

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Meulen, I. (2012) Melodic intonation therapy: Present controversies and future

opportunities. Arch Phys Med Rehabil, 93 (1), 46-52. Retrieved from
http://download.journals.elsevierhealth.com/pdfs/journals/00039993/PIIS0003999311008100.pdf
Pavlicevic, M. (2000). Improvisation in music therapy: Human communication on sound.
Journal of Music Therapy, 42 (2), 269-285. Retrieved from
http://www.chinamusictherapy.org/file/doc/Improvisation%20in%20Music
%20Therapy_%20Human%20Communication%20in%20Sound.pdf
Rice, C. (2007). Prevelance of autism spectrum disorders-Autism and developmental
disabilities. Centers for Disease Control and Prevention. Retrieved from www.
Cdc.gov/mmwr/preview/mmwrhtml/ss5601a1.htm
Sandiford, G. A., Mainess, K. J., & Daher, N. S. (2013). A pilot study on the efficacy of
melodic based communication therapy for eliciting speech in nonverbal children
with autism. Journal of Autism and Developmental Disorders, 43(6), 1298-1307.
Stokes, S. (n.d.)."Written by Susan Stokes under a contract with CESA 7 and funded by
a discretionary grant from the Wisconsin Department of Public Instruction.
Retrieved from http://www.specialed.us/autism/verbal/verbal11.html
Thaut, M.H. (1999). Music therapy with autistic children. In W.B. Davis, K. E. Gfeller, &
M. H. Thait (Eds.), An intro to music therapy: Theory and practice 2nd edition
(pp163-178). Dubuque, IA: McGraw-Hill College.

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Application for Initial Review

Institutional Review Board (IRB)
Seton Hill University
Principal Investigator: Tessa Swiger
Department: Psychology
Department Address: 1 Seton Hill Drive
Email Address: t.swiger@setonhill.edu
Phone Number: 724.420.7702
SHU Extension: N/A
Study Coordinator/Additional Contact Person: Dr. Alonzo DeCarlo
Study Coordinator/Additional Contact Phone: N/A
Project Title: Melodic Based Communication Therapy

I am requesting (please check one):

Exempt / X Expedited Review or Full Committee Review

Total Number of Subjects to be Enrolled: 50

(Please check all that apply)
If your study proposes to include any of the
following study subjects, indicate in the box
below and include the proposed number of
each: N/A
X Minors (under age 18) 50
Pregnant Women / Fetuses
Prisoners
X Cognitively Impaired 50
Other

Gender Breakdown:
(if known)
35
Males
15
Females
If your study proposes to include any of the
following
items, indicate in the box below: N/A
Human Tissue Sample
Other

Assurance:
The undersigned assures that protocols involving human subjects described in this application are complete and
accurate, and are consistent with applicable protocols submitted to any external funding agencies. All protocol
activities will be performed in accordance with Seton Hill University institutional guidelines and any applicable
State and Federal regulations. Research conducted by SHU researchers falls under the purview of the University
even when conducted elsewhere. Research at international sites must receive approval by the local equivalent of
the IRB. The SHU IRB requires documentation of this local approval before they can receive IRB approval. No
activities involving the use of human subjects can be initiated without prior review and approval by the University
Institutional Review Board.
Tessa Swiger
Signature of Principal Investigator
Signature of Department Chair(s)

December 2, 2013
Date
Date

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If this is a Student Project: Signature of Supervising Faculty / Date:

_____________________________________
_____________________________________________________________________________________________
_________________________________
FOR SHU IRB USE ONLY:
Primary Reviewer: __________________________ Date Received:
_______________
Approved by IRB Chair: __________________________ Date: _______________ IRB #:
_________________

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Application for Initial Review

Institutional Review Board (IRB)
Seton Hill University
Page (2)
Research Plan:
1) Research Plan: The research plan should contain a brief explanation
in lay language (non-technical terminology) sufficient information
needed for the evaluation of the project independent of any other
document. The research plan should explain the purpose and
relevance of the study, design of the study, expected outcomes,
inclusion and exclusion criteria for the recruitment of research
subjects, and plans to monitor the safety and privacy of the
subjects. If deception is used, please justify its use.
Many children across the world are struggling everyday with autism. Autism is on a very rapid
rise in todays society. Those affected by autism have a hard time developing social, cognitive,
motor, language, and interpersonal skills. Music therapy has been proven to be affective in these
areas. This study will investigate how a certain technique, melodic based communication therapy,
can significantly improve the communication development in children with autism. This research
will give us a better understanding of how we can approach these developmental delays in a safe,
non invasive and enjoyable way for children. Only children with autism will be eligible to
participate. The safety and confidentiality of the subjects will be monitored, as well as all records,
session plans, and test results will be stored in a locked filing cabinet as well as being password
protected privet hard drive.

2) Recruiting and Consent Process: The process for obtaining informed

consent must be considered by the IRB. This includes who, when,
where, how, and any special circumstances pertinent to the process.
The Principle Investigator is responsible for all aspects of the
consent process regardless of any delegation of duty. Please provide
detailed information regarding how subjects will be identified, who
will approach them regarding potential participation in the study,
and in cases of subjects lacking decisional capacity, when and how
informed assent will be obtained. Please explain how the
participants anonymity will be preserved (if applicable) and/or how
confidentiality will be maintained. If your research involves a nonEnglish speaking population, please submit copies of the
appropriate consent forms in both languages.
The subjects selected for this research will have been recommended for this study by local
special needs facilities and schools. Parent/Guardians of the children will be notified by

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email and phone call. The music therapy session will be administered by a MT-BC, using a
session plan that the principle investigator has deemed appropriate per subject.
Subjects in sessions and session plans will be identified by names, but in administered tests
initials will be used to refer to them (example being Subject TS showed..). Parents or
legal guardians will be asked to read and signed the informed consent. Sessions plans and
documented results will be stored in a locked cabinet as well as on a password protected
hard drive.

3)

Risks: The IRB must review and find that research risks are
reasonable in relation to the anticipated benefits to subjects or
others. Explicit consideration must be given to all risks. For
example, physical, psychological, emotional, legal, social or
financial risks of the participants. Risks related to privacy and
confidentiality should be considered as well. Please explain
any and all procedures taken to minimize risk.
There are no anticipated risks for individuals participating in this protocol.
The probability and magnitude of harm or discomfort anticipated in this
research are not greater in and of themselves than those ordinarily
encountered in daily life or the performance of routine physical, psychological
examinations or tests. To protect from risks to confidentiality, the research
materials will be stored in secure files, by lock and key, as well as password
only. Results of the study will be published in a manner that maintains the
anonymity of the individual study participants.
4) Benefits: Describe potential benefits to study participants and/or
humanity that may result from participation in the study.
Compensation for participation is not a benefit.
Potential benefits to study participants are higher cognitive and language
functioning,
appropriate self expression is displayed, fewer stimming episodes, as well as
improvement
of quality of life. Potential benefits for humanity include greater knowledge of
autism as well as music therapy and treatment modalities that enable client to
function greater in society.
5) Alternatives to Participation: Describe any alternatives to
participation including currently accepted practices or treatments.
Non-participation is a reasonable alternative.
Non-participation is a reasonable alternative.
6) Other Issues: Please describe any potential conflict of interest or
financial benefit that the investigator might benefit from or any other
relevant information deemed relevant to IRB consideration.
There are no foreseeable conflicts of interest or financial gains that the
investigator might benefit from as a result of conducting this study.

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Application for Initial Review

Institutional Review Board (IRB)
Seton Hill University
Page (3)
Investigator Agreement
Please read and initial each of the following items in the space provided:
_X_I agree to conduct the study in accordance with the relevant, current protocol and will
only make changes in a protocol after notifying the sponsor and the SHU IRB, except
when necessary to protect the safety, rights, or welfare of the research participants.
_X_I agree to personally conduct or supervise the described investigation.
_X_I agree to ensure that all of the requirements relating to the recruitment and consent
process are met.
_X_I agree to report to the sponsor and the SHU IRB any adverse experiences and/or
events that occur during the course of the experiment.
_X_I agree to ensure that all associates, colleagues, and employees assisting in the
conduct of the study are informed about their obligations consistent with and in
meeting the above commitments.
_X_I agree to maintain adequate and accurate records in accordance with IRB regulations
and to make those records available for inspection in accordance with those
regulations.
_X_I ensure that I will submit a request for initial and continuing review and approval to the
SHU IRB within the appropriate period of review.
_X_I agree to report promptly to the IRB any and all changes in the research activity and all
unanticipated problems involving risk to the participants and/or others.
_X_I agree to comply with all other requirements regarding the ethical and legal obligations
of clinical investigators and all other pertinent requirements found in the IRB
regulations.
_X_I agree to submit a copy of the final report of the results and a summary of those results
upon completion of the study.

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_X_I agree to attach a Certificate of Completion from the NIH Human Participant
Protection website dated during the previous two years to the completed application
materials. A link to this website is accessible at the SHU IRB webpage.
The SHU IRB reserves the right to audit any/all IRB approved protocols to inquire about the
progress of the study, inspect accrued consent documents, inspect accrued data, and/or
observe the consent and recruitment process utilized. The Principal Investigator must
cooperate fully with the IRB staff in making such visits.
Tessa Swiger
Signature of Principal Investigator
Tessa Swiger
Print Name
Date Dec 2, 2013

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SETON HILL UNIVERSITY

INFORMED CONSTENT FORM
Dear Potential Participant,
My name is Tessa Swiger, an undergraduate student studying music therapy and
psychology at Seton Hill University (SHU). I am conducting research in which I intend to
gather information about how melodic based communication therapy increases
verbalization in children with autism. You have been asked to participate in this study
because you have been identified as an individual who would provide valuable
information on this subject, as well as fitting specific criteria. This form asks for your
consent for participation in this study. If you agree, you will be asked to participate in
weekly music therapy session, along with assessments (including IQ, various autism
rating scales, and behavior intervention assessments) taking place monthly. The entire
study will take place over the course of one year. There are no hazards in participating in
this study. Individual benefits include increased cognitive functioning, few stimming
episodes, and increased communication, verbalization, and self expression skills. Those
who chose to participate will be compensated with two months of free music therapy
services.
Data will be collected anonymously. Names will be used during the sessions and on
session plans, but data will be filed under initials. In the official report, initials will
become numbers for case studies ( for example Patient 20 in the study). Consent
forms will be kept separate from the data locked up in the undergraduate psychology
office. Consent forms will be terminated after three years.
As a participant, you have the right to withdraw from the study at any
time for any reason without penalty. You will also have the right to a
written summary of the study once it has completed. If you so wish to
obtain a summary, please submit a written request to the address
below. Any questions or concerns about the research or about your
rights as a participant, please contact Dr. Alonzo DeCarlo, Head of
Undergraduate Psychology at SHU. He may be reached at (724)-552-1084

Tessa Swiger
Undergraduate Studies
Music Therapy
Seton Hill University
1 Seton Hill Drive
Greensburg, PA 15601
t.swiger@setonhill.edu

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Documentation of Informed Consent

I, __________________________ (print name), agree to participate in a study to investigate the

relationship between melodic based communication therapy and autism by Tessa Swiger at SHU. My
signature below indicates that I have read this consent form (or had it read to me) and have discussed any
questions I have with the researcher, understand the conditions of my participation, and agree to
participate in this study.
____________________________
______________
Participant
Date
___________________________
Legal Guardian (if under age 18)
__________________________

Researcher/Witness

______________
Date
______________

Date

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Gilliam Autism Rating Scale Second Edition (GARS 2)

(SAMPLE)
The Gilliam Autism Rating Scale - 2 (GARS - 2) is a checklist developed for
use with students who display characteristics typical of autism. This
instrument is comprised of three subtests including Stereotyped Behaviors,
Communication, Social Interaction, and a parent interview section on
Developmental Disturbances. In the current circumstance, the GARS-2 was
utilized to achieve further information regarding STUDENTs behaviors as
perceived by the home and school staff and was only used to identify
concerns and to target goals for change and intervention on the students
individual education plan. Some of the items NOT observed by either rater
included: (LIST SOME ITEMS IN EACH SUBSCALE THAT HOME AND SCHOOL
RATED AS NEVER OBSERVED OR (0). However, the following items were
noted by one or both sets of raters as sometimes observed (person
behaves in this manner 3-4 times per 6-hour period) or frequently observed
(person behaves in this manner at least 5-6 times per 6-hour period.) P =
parents; T = teachers; B = both:
Stereotyped Behaviors:
1. Avoids establishing eye contact (i.e. looks away when eye contact is
made.)
2. Stares at hands, objects, or items in the environment for at least 5
seconds.
3. Flicks fingers rapidly in front of eyes for periods of 5 seconds or more.
4. Eats specific foods and refuses to eat what most people will usually eat.
5. Licks, tastes, or attempts to eat inedible objects (e.g., persons hand, toys,
books).
6. Smells or sniffs objects (e.g., toys, persons hand, hair).
7. Whirls, turns in circles.
8. Spins objects not designed for spinning (e.g., saucers, cups, glasses).
9. Rocks back and forth while seated or standing.
10. Makes rapid lunging, darting movement when moving from place to
place.
11. Prances (i.e., walks on tiptoes).
12. Flaps hands or fingers in front of face or at sides.
13. Makes high-pitched sounds (e.g., eee-eee-eee-eee) or other vocalizations
for self-stimulation.
14. Slaps, hits, or bites self or attempts to injure self in other ways.
Communication:
How does this individual communicate. Talks ____Signs ____ Doesnt Talk or
Sign _____
If the individual does not talk, sign, or use any other form of communication,
omit this subscale.

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15. Repeats (echoes) words verbally or with signs.

16. Repeats words out of context (i.e., repeats words heard at an earlier
time; e.g., repeats words heard more than 1 minute earlier).
17. Repeats words or phrases over and over.
18. Speaks or signs with flat tone, affect or with dysrhythmic patterns.
19. Responds inappropriately to simple commands (e.g., sit down, stand
up).
20. Looks away or avoids looking at speaker when name is called.
21. Does not ask for things he or she wants.
22. Does not initiate conversations with peers or adults.
23. Uses yes and no inappropriately. Says yes when asked if he or she
wants an aversive stimulus or says no when asked if he or she wants a
favorite toy or treat.
24. Uses pronouns inappropriately (e.g., refers to self as he, you, she).
25. Uses the word I inappropriately (e.g., does not say I to refer to self).
26. Repeats unintelligible sounds (babbles) over and over.
27. Uses gestures instead of speech or signs to obtain objects.
28. Inappropriately answers questions about a statement or brief story.
Social Interaction:
29. Avoids eye contact; looks away when someone looks at him or her.
30. Stares or looks unhappy or unexcited when praised, humored, or
entertained.
31. Resists physical contact from others (e.g., hugs, pats, being held
affectionately).
32. Does not imitate other people when imitation is required or desirable,
such as in games or learning activities.
33. Withdraws, remains aloof, or acts standoffish in group situations.
34. Behaves in an unreasonably fearful, frightened manner.
35. Is unaffectionate; does not give affectionate responses (e.g., hugs and
kisses).
36. Shows no recognition that a person is present (i.e., looks through
people).
37. Laughs, giggles, cries inappropriately.
38. Uses toys or objects inappropriately (e.g., spins toy cars, takes action
toys apart).
39. Does certain things repetitively, ritualistically.
40. Becomes upset when routines are changed.
41. Responds negatively or with temper tantrums when given commands,
requests, or directions.
42. Lines up objects in precise, orderly fashion and becomes upset when the
order is disturbed.
Parent Interview:
Delays in:
Social Interaction

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During the childs first 3 years of life:

a. Child reached out or prepared to be picked up when the parent
attempted to lift the child.
b. Child cried or became upset when left unattended in his or her crib,
playpen, or other are.
c. Child cried or became upset when picked up or held.
d. Child cried ore became upset when handed from one adult to another.
e. Child attempted to join family members in group activities (e.g.,
watching TV).
Language Used in Social Communication
During the childs first 3 years of life:
a. Child used single words by 16 months of age.
b. Child used meaningful, communicative phrases by age 2.
c. Child developed normally in terms of language (i.e., cooing, babbling
and speaking without any interruption or regression).
d. Child followed directions (i.e., appears to understand what to do when
told to do something).
e. Child appeared to have normal hearing.
Abnormal Functioning in:
Social Interaction
During the childs first 3 years of life:
a. Child smiled at parents or siblings when smiled at or played with.
b. Child cried when approached by unfamiliar persons during the first
year.
c. Child engaged in imitative play before age 3 (e.g., played pat-a-cake,
peekaboo).
d. Child seemed to be involved and responsive to people.
e. Child preferred to spend time in the company of others.
Language Used in Social Communication
During the childs first 3 years of life:
a. Child responded to his or her name when called (e.g., turns and looks
at the person).
b. Child asked for things or used gestures to communicate what he or she
wanted.
c. Child followed simple directions (e.g., come here, give me a hug,
wave bye-bye).
d. Child appeared to understand what to do when told to do something.
e. Child indicated (showed facial concern) when a parent or sibling cried
or was distressed.
Symbolic or Imaginative Play
During the childs first 3 years of life:
a. Child engaged in pretend play (e.g., played with dolls, action heroes,
toy animals) appropriately.
b. Child pretended he or she was someone else (e.g., Mommy or Daddy,
action hero).

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c. Child pretended that an object was something else. For example, did
the child pretend that a broomstick was a horse and place the
broomstick between his or her legs and pretend to be riding a horse.
d. Child pretended that he or she had an imaginary friend or animal.
e. Child played with dolls pretending that they were real people.

SOCIAL RESPONSIVENESS SCALE (SAMPLE)

STATMENT

Seemsmuchmorefidgetyin
socialsituationsthanwhen
alone.
Expressionsonhis/herfacedont
matchwhathe/sheissaying
Seemsselfconfidentwhen
interactingwithothers.
Whenunderstress,childseems
togoonautopilot(for
example,showsrigidor
inflexiblepatternsofbehavior
whichseemodd)
Doesntrecognizewhenothers
aretryingtotakeadvantageof

NOT
TRUE

SOMETIM
ES
TRUE

OFTE
N
TRUE

ALMOS
T
ALWAY
S TRUE

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him/her
Wouldratherbealonethanwith
others
Isawareofwhatothersare
thinkingorfeeling.
Behavesinwayswhichseem
strangeorbizarre
Clingstoadults,seemstoo
dependentonthem.

Unabletopickuponanyofthe
meaningofconversationsof
olderchildrenoradults
Wechsler Intelligence Questionnaire Test (SAMPLE)

1.Lookatthese2rowsofpictures.Pickonepicturefromthefirstrowthat
goeswithapictureonthesecondrow.

2.Lookatthepicturesintheseboxes.Theshapesinthetoprowgotogether
insomeway.Nowlookatthebottomrow.Whichshapedoyouthinkgoes
withthebluecircleinthesameway?

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3.Nickstartsoutwith72rideticketsatthefair.Bytheendofthefirstday,
Nickhasused21ridetickets.HowmanyticketsdoesNickhaveleft?

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