JHSticky Notes

RESEARCH | PROSE | POETRY: The Intersection of Autism & Music

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The role of anxiety in modulating temporal processing and sensory hyperresponsiveness in autism spectrum disorder (Atsumi et al. 2025))

One common symptom of autism spectrum disorder, occurring in approximately 90% of individuals with the condition, is heightened responsiveness to sensory stimuli. ASD also has a high comorbidity with anxiety disorders, which increase the response of one’s autonomic nervous system in response to threatening stimuli. With around 20% of adults and 60% of children on the spectrum experiencing some form of anxiety disorder, researchers suspect that these features may be correlated with each other. Specifically, the authors of this study proposed that elevated levels of anxiety could cause increased activation of neural circuits, which could in turn lead to sensory hyperresponsiveness in individuals on the spectrum. 

This study used fMRI data to compare the neuronal activation of 25 participants with ASD versus a control group of 25 typically developing individuals. While inside the fMRI, subjects were presented with pictures of two faces, one with a fearful expression and the other with a neutral expression. Next, they were given a simple, unrelated task in which they had to choose which of two shapes appeared on the screen first. Their accuracy and response time was measured and compared across three conditions: no face shown, neutral face shown, or fearful face shown.

No overall correlation was found between the type of face shown and the accuracy of the participants on the simple task. However, participants with lower anxiety scores had faster reaction times on tasks following the “fearful face” condition. Subjects with high anxiety levels did not display this benefit, suggesting that when already in an anxious state, the brain responds less to fearful stimuli. These results were also backed up by fMRI imaging of the anterior insula, a region of the brain involved in processing emotion. Seeing the fearful face stimulus increased activity within the anterior insula, but this effect was dampened in subjects with high anxiety levels.

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Identifying understudied correlations between autism & phenotypic attributes in a large family dataset (McNealis 2025)

By: Tucker Park

Diagnosis of autism spectrum disorder can be complicated with the differences in how the condition presents itself across different factors such as gender and culture. The authors of this paper have compiled a registry of diverse families of children with autism to better understand the phenotypic presentation of this condition. This registry included a sample of 6,951 kids from 4,120 families from the KidsFirst registry. The goals of this project were to test the feasibility of using crowd-sourced, parent-reported data for a sufficiently representative dataset, and to determine which attributes are significantly associated with autism. In addition to administering the Social Communication Questionnaire, the researchers also gathered data on hearing issues, noise sensitivity, vision impairment, irregular sleep, impaired motor skills, metabolic disorders, gastrointestinal problems, infections, seizures, and premature birth. 

The results found that noise sensitivity, impaired motor skills, irregular sleep, gastrointestinal problems, and seizures were significantly associated with autism diagnoses. Specifically, children with autism were more likely to experience noise sensitivity and difficulty with motor skills, more so than an age-matched control. They also had a higher prevalence of irregular sleep patterns and gastrointestinal problems. The researchers also found that certain attributes correlate with each other, which opens the door to there being definable subtypes of autism. 

Overall, this database is beneficial to both clinicians and families as it could help identify more targeted approaches to an individual’s intervention needs.

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A Social Timing Model of Autism (Wimpory 2015)

By: Tucker Park

Timing is critical for human language; altering the timing of words in a conversation can influence the semantics of a sentence. Previous autism studies have hypothesized that those with autism may experience temporal impairment, although it is unclear whether this is a symptom of the disorder or a causal effect. 

Typically developing infants are able to perceive time and estimate the duration of events. At 10 to 16 weeks, they also show preference for synchronized communication over asynchronous communication (the audio in the asynchronous video was misaligned by half a second). Around 5 to 7 years, children are able to achieve temporal synchrony in conversation, meaning that each participant pauses for a similar duration before taking their turn to speak.

Twin studies involving one neurotypical twin and one twin with autism have studied the difference in the childrens’ behavior in a one on one child to adult conversation. In these studies, the typically developing twin was able to demonstrate temporal synchrony as well as reciprocation of facial expressions. However, the twin with autism did not display any well-timed reactions. This difference was not present in child to mother interactions, implying that socialization over a long period of time can improve these deficits. Interventions for this include Music Interaction Therapy, which has been shown to improve synchrony and social attentiveness. Researchers hypothesize that these timing deficits arise from abnormalities in the cerebellum, although this is difficult to confirm due to the variations in the degree of autism, age, intelligence, and comorbid disorders. 

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An Exploratory Study of Imagining Sounds and “Hearing” Music in Autism (Bacon et al. 2020)

Written by: Tucker Park

This study examined the phenomenon of “earworms” (also known as songs that get “stuck in your head”) and how they may affect individuals with ASD and typically developing individuals differently. 

The manner in which music affects people with autism is poorly understood; however, studies have suggested that music processing abilities are preserved even with delays with spoken language. For example, a 1999 study found that children with autism were able to accurately match the tone of music with pictures of faces expressing different emotions, suggesting that their ability to associate music with emotions is unimpaired.

This study utilized the Bucknell Auditory Imagery Scale (BAIS), which involves the participant imagining a sound and rating its vividness in their head from a scale of 1 to 7. The sample consisted of 34 participants, 17 neurotypical and 17 with ASD, each matched with controls by gender. The results found that the ASD group experienced slightly higher instances of earworms, although the difference was not significant enough to generalize to the entire ASD population. However, the survey revealed that individuals with autism tended to self-report less vivid imagery and less control over their auditory imagery. This disproves the claim that the frequency of earworms is correlated with one’s level of auditory imagery. Another interesting finding from this study was that the participants’ scores on the BAIS were able to predict the density of gray matter in the auditory and sensorimotor regions of the brain, as well as how well the individual was able to replicate a pitch that was played for them. Overall, this study was a valuable insight into the auditory imagery in the ASD population, although it was limited by its small sample size and lack of relevant supporting research.

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The autistic brain can process local but not global emotion regularities in facial and musical sequences (Xu et al. 2022)

By: Tucker Park

Autism has long been associated with difficulties in information processing, but experts disagree whether this deficit is global or local. Local processes deal with a short timescale, extracting specific details of the stimulus. Global integration occurs on a longer timescale and involves integrating those details into one’s existing knowledge to understand a coherent whole. The leading theories in this debate are the Weak Central Coherence theory, which hypothesizes that global information processing difficulties inhibits local processing, and the Enhanced Perceptual Functioning theory, which argues that local processing can occur without a global processing deficit.

This study used electroencephalography to measure event-related potentials (ERPs) to test whether individuals with autism have different neurological responses to within-trial (local) or across-trial (global) experimental tasks. The participants for this study were 20 people with ASD and 21 neurotypical participants, all matched by age and IQ. During the experiment. participants were shown either five faces expressing the same emotion (standard sequence), or four faces expressing the same emotion and a fifth face displaying a different one (deviant sequence). To test local processes, standard sequences were presented 84% of the time, and deviant sequences were presented 16% of the time. When testing global processes, standard sequences were presented 16% of the time, while deviant sequences were presented 84% of the time. 

The study found that participants with ASD did not show differences in neural responses to deviant and standard images the same way the neurotypical control did. Specifically when viewing faces ASD participants exhibited an MMN, which is the first component of an ERP, but not any subsequent components. This means that people with autism can determine facial expressions on an automatic level. However, neurotypical subjects exhibited all of the features of an ERP. These findings suggest that autistic brain responses to emotional stimuli are dependent on the timeframe in which they are viewed.

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Should teaching strategies emphasize emotion or competence? (Gu et al. 2025)

Enhancing public acceptance of people with autism is a pressing issue which, if left unaddressed, leads to stigmatization of this condition. This study investigated how musical performance by a person with autism can change an outside observer’s perception of that person. A survey of the audience members was conducted before and after the performance in order to analyze their levels of immersion in the music and opinions of the musician.

Music is a strong means of conveying emotion for both autistic and neurotypical people. The researchers proposed that music is fundamentally intertwined with emotions and has the power to guide how people feel. They hypothesized that music encodes specific emotions, which are then decoded and absorbed by the audience. 

In order to maximise immersion, participants listened to a binaural audio which was edited in order to replicate the acoustics of a room. After comparing survey results from before and after the performance, researchers found that when the music evoked an emotional response in the observer, their acceptance of the performer with autism increased. This has implications for autism interventions, since social acceptance can increase the confidence of an autistic person while decreasing stereotypes and bullying. It also highlights the importance of music education and how it can create environments that accept and include neurodiverse groups.

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Rhythm and music for promoting sensorimotor organization in autism (LaGasse et al. 2024)

Written by: Tucker Park

This article provides an updated perspective on the author’s 2013 study on how music and rhythm-based interventions can improve social and motor skills in individuals with autism. Although the DSM-5’s diagnostic criteria for autism only describes communication difficulties and restrictive behaviors, a survey of parents of autistic children indicated that 88% of those children also experience some motor impairment. Research has also supported the claim that people with autism show differences in motor planning, motor coordination, movement timing, and balance. Thus, even though it is not a diagnostic criteria, many individuals with autism would benefit from these kinds of interventions.

Rhythm, such as that of music tempo, stimulates numerous brain areas correlated with motor movement. Rhythmic synchronization, also known as entrainment, occurs in all individuals regardless of their level of musical training, and even persists despite movement disorders such as Parkinson’s disease. Using rhythm for sensorimotor development has already shown great promise in rehabilitation, and the authors propose that similar applications may be helpful for people with autism. For example, the study Cibrian et al. (2021) used musical tones that would change in response to the child’s arm movements. They found that this increased the child’s engagement in the exercise and allowed them to execute more precise movements. Other studies have also concluded that providing stable and predictable timing cues can improve motor coordination.

Rhythm synchronization can also have an effect on the temporal dimension of social behavior (aka. interpersonal synchronization), which involves engaging with social stimuli in a timely fashion. Research has determined that individuals with autism engage in this interpersonal synchronization less frequently than their neurotypical peers. Therefore, when accompanied by clear goals and directions, rhythm can serve as a guide to help autistic people meet their sensorimotor and social goals. 

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The effectiveness of music therapy in improving behavioral symptoms among children with autism spectrum disorders: a systematic review and meta-analys

Written by: Tucker Park

This article is a meta-analysis of thirteen different experiments, all examining the effectiveness of music therapy on individuals with autism. Despite autism having a proven negative impact on financial, physical, and mental health, effective treatments are few and often untested. Music therapy shows promise as an impactful treatment, since it stimulates the cortical and subcortical brain areas, which are linked to emotions are rewards, which in turn could improve social motivation and emotional resonance. Engagement in musical activities can also strengthen the mirror neuron system in the brain, which enhances social imitation behavior. However, these benefits are still under scrutiny since a recent study found no significant differences between a music therapy group and a standard treatment control group.

Researchers began by screening and choosing literature to analyze. 43 studies were reviewed, but most were eliminated due to unclear study data, text inavailability, or unsuitable study topic. The thirteen remaining papers were then examined for bias, which was accounted for in the analysis. The authors concluded that music therapy indeed improved behavior symptoms of ASD. Children with autism view music as a safe and controlled stimulus, which allows them to partake in musical experiences and thereby train their communicative skills. Music also stimulates the brain’s sensory system with rhythm and melody, which creates a pleasant sensory experience which lessens the occurrence of maladaptive behaviors.

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Enhanced memory for vocal melodies in autism spectrum disorder and Williams syndrome (Weiss et al. 2021)

Written by: Tucker Park

In contrast to instrumental melodies, verbal or sung melodies have biological, communicative consequences. As a result, typically-developing adults and children exhibit a memory bias towards the vocal melodies, making them easier to remember than instrumental ones. This study examines whether people with Autism Spectrum Disorder (ASD) or with William’s Syndrome (WS), two conditions which are marked by abnormalities in processing communicative signals, experience the same memory bias. For the study, researchers recruited 26 subjects with ASD and 26 subjects with WS. The task was presented as two games; during the first game, participants listened to 12 musical excerpts, which were all western folk melodies sung by a female vocalist without lyrics. Participants were then asked to rate their enjoyment of each melody. For the second game, the subjects listened to the same 12 melodies intermixed with 12 new, unfamiliar melodies, and were asked to indicate whether they had heard that melody before or not. The study found that both groups were able to successfully separate the original 12 melodies from the new ones, showing a memory advantage for the vocal melodies. This has implications for the care and treatment of people with these conditions. In particular, the researchers recommend the use of vocal music in therapeutic interventions.

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Neural systems for speech and song in autism (Schneider et al. 2012)

Written by: Tucker Park

Neuroimaging on the brains of patients with autism has revealed decreased activity in Broca’s area, which is crucial for the production of language. At first glance this appears paradoxical since this does not explain the preservation of related functions, such as the understanding and creation of music. To investigate this discrepancy, this study utilized functional MRI and diffusor tensor imaging to compare the brain structures in autistic minds compared to an age-matched, neurotypical control. 36 people with autism and 21 non-autistic controls participated in this study. The parents of these children were also asked to rate how receptive their child was to music on a ten-point scale. The study found that all participants in the autistic test group were well above the minimum diagnostic criteria in the language and communication for autism. During speech, the control group exhibited activation in the left inferior frontal gyrus, while the test group did not. Furthermore, the fMRI results showed that the activation in posterior brain regions was also reduced in participants with autism. No regions in the test group were any more active in response to a speech stimulus than in the control group. In contrast to the differences in language impairment, there were no significant differences between the parent-reported musical affinity between the two groups. After compositing the data, researchers found that the reduced activation of the left inferior frontal gyrus in subjects with autism does not sufficiently account for language impairment in autism. A more likely theory, which is supported by data from related studies, is that this reduced activation might actually be a failure to receive information from lower-processing regions, not a disconnection of the system as a whole. This would indicate that impairments in these brain regions are the result of a speech-specific attention deficit, rather than towards social stimuli as a whole.

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Music, autism, and emotion (Zangwill 2013)

Written by: Tucker Park

This article examines the differences between how autistic and non-autistic people experience music by drawing on experimental data collected by Rory Allen and his colleagues. While those with autism spectrum disorder possess the regular scope of human emotion, they exhibit marked difficulties in their abilities to attribute emotions to others, imagine emotions when not having them, and describe emotions in words. For this reason, questionnaires of other self-report methods are ineffective for studying the experiences of people with autism. Instead, arousal in response to music is measured by capturing galvanic skin responses (GSRs), which measures the activation of sweat glands in the skin in response to a stimulus. Random, non-musical noise did not provoke a GSR in either sample group. However when participants were instructed to listen to a set of musical stimuli, both groups displayed a GSR, and there was no significant difference in the GSRs of the autistic and non-autistic sample groups. The study concludes that people with and without autism do not differ in their physiological arousal in response to music. One interpretation of this is that music uniquely triggers normal emotional cognition in people with autism. However, there is no evidence that listening to music is some kind of “cure” for autism. A more plausible conclusion is that listening to music does not involve an understanding of or the ability to imagine emotion. This position is supported by evidence on the efficacy of music therapy on people with autism. The reason music works so well as a therapeutic tool is because it does not involve having to think about things in terms of psychological states. While people with and without autism may still have different artistic experiences, this experience is independent of their understanding and imagining of emotions.

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Teaching Students with Autism (Link 2023)

Written by: Tucker Park

Individuals with autism spectrum disorder present with a variety of symptoms, including challenges with communication, social interaction, and learning. Consequently, teaching students with autism requires patience and flexibility to adapt to an individual’s educational needs. 

Since autism is categorized as a socio-communicative disorder, students with autism face a unique set of challenges in the school environment, which is dependent upon social communication between peers and teachers. Additionally, children with autism may face significantly higher rates of behavioral or emotional disturbance, highlighting the importance of autism advocacy and the need for accessibility in the classroom.

General education teachers can accommodate autism in their classrooms by using guided reading, formulated writing strategies, and well-planned transitions between stations or topics. In addition, it can be highly beneficial to relate the lesson to other subjects the student may be more interested in, as it encourages participation and self-confidence. 

Children with autism also frequently experience stress and anxiety in social settings, as well as sensory disorders related to light and sound. It is important to develop a behavior management plan to help identify stressors and de-escalate emotional or behavioral problems when they arise. 

Finally, aside from the student’s behavior, it is important to recognize the effects of having a child with autism on the family system. In order to serve a child’s educational needs, the parents must first acknowledge the problem, which can prove difficult for some to accept. Parents of a child with autism also face increased responsibility and stress, which negatively impacts family cohesion. To overcome these barriers, teachers, parents, and administrators must work together to best meet the needs of the student.

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Common Characteristics of Improvisational Approaches in Music Therapy for Children with Autism Spectrum Disorder (Geretsegger et al, 2015)

By: Tucker Park

Improvisational music therapy has seen increasing popularity as a treatment for ASD. This study evaluates the common practices in music therapy for people with autism, with the goal of using this data to refine treatment guidelines. While music therapy is a very diverse and individualized practice, there is still a need to operationalize in order to ensure the replicability of research findings and to improve transparency and training for incoming professionals. 

In order to gather this data, focus group workshops were held in three different countries by music therapy professionals from ten different countries. To measure treatment fidelity, a six-point scale was devised. The therapists would be filmed while administering their treatment, and then these video clips were reviewed by independent raters of various skill levels (undergraduate students, masters students, and certified music therapists). Following this, researchers compiled an initial list of treatment guidelines, which was then reviewed by established professionals from around the world. Based on the feedback from these music therapy professionals, a finalized version of the treatment guidelines was presented. It sorts music therapy techniques into three categories: compatible (tools, toys, or media that are not inherently related to music), essential (but not unique to improvisational music theory), and unique and essential. One critical point in the “unique and essential” category is “scaffolding the flow of interaction musically.” This involves the therapist reacting to the child’s behavior as communicatively intended, even if the child’s signals are scarce or poorly timed. The therapist then uses musical means such as matching the volume or rhythm of the patient’s expressions through musical interactions. This reinforces the child’s communication skills while acting as a scaffolding to enable the child to engage in the interaction. 

The study concludes that there is an international consensus on the characteristics of improvisational music therapy for autism, and that the compiled guidelines will enable music therapists to further develop and reflect on their clinical practices.

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Music Therapy

Written by: Tucker Park

Music therapy is a clinical practice recognized for over 200 years that utilizes music as a therapeutic tool. It can be used to address a variety of issues such as aggression, dementia, autism, traumatic brain injury, and stress. In this summary, I will be focusing specifically on the section of this paper regarding autism. 

During music therapy, the therapist and patient engage in creating music through instruments or singing. There are five main types of music therapy, which can be used either alone or in combination. These are receptive (listening to music), compositional (writing original music), improvisational (spontaneously creating music), re-creative (learning how to play an instrument), and activity (playing musical games).

The left hemisphere of our brains controls language functions, which may be underdeveloped in children with autism spectrum disorder. A type of music therapy called melodic intonation therapy can be used to help children on the spectrum develop their language skills. Melodic intonation therapy initially combines music and singing, then removes the music component once speech improves, with the goal that speech will continue to develop. These techniques have proven to be highly beneficial in aiding people recovering from strokes or traumatic brain injuries in relearning speech. However, one downside of this method is that empirical evidence for its effectiveness is limited, since it is unclear whether the development of language skills comes from the therapy itself or from the maturation of the child. Various ongoing studies are aimed at exploring modified forms of melodic intonation therapy, which may include additions such as phonetic placement or tapping.

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Prolonged Auditory Brainstem Response in Universal Hearing Screening of Newborns with Autism Spectrum Disorder (Miron et al. 2020)

Written by: Tucker Park

A prolonged auditory response (ABR) is defined as a delayed brain response to sound, and is observed in children and adults with ASD. It shows potential as a diagnostic tool for autism, but it was previously unclear whether newborns who are later diagnosed with autism showed these ABR abnormalities. In this study, 139,154 newborns were tested with the Universal Newborn Hearing Screening (UNHS) exam, which uses surface electrodes to measure the brainstem’s response to sounds. The experiments found that newborns who were later diagnosed with ASD exhibited prolonged ABRs, especially in the right ear. These differences could be the result of anatomical abnormalities in the brainstems of those with ASD. From these findings, it was determined that ABRs are an accurate prediction of whether the child will be later diagnosed with ASD (although other causes, such as hearing loss, must be ruled out first). This has possible implications for the development of an early screening system, which could be greatly beneficial since previous studies have revealed that earlier autism intervention is correlated with better overall outcomes. Currently, diagnoses are typically made after 3 to 4 years of age, but testing ABRs may be an untapped opportunity for even earlier intervention.

  Prolonged Auditory Brainstem Response in Universal Hearing Screening of Newborns with Autism Spectrum Disorder

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Celebrating the Artmaking of Children with Autism

Written by: Tucker Park

Artmaking may be uniquely meaningful and pleasurable both for children with autism and neurotypical children. Since visual art provides evidence of the artist’s thought process, often childrens’ drawings are visual representations of their obsessions with a particular narrow interest. This article shines a spotlight on Jessica Park, an artist with autism, and her mother Clara Park, who wrote various articles on autism and was one of the founding members of the Autism Society of America. Clara Park explains that children with autism will not learn how to make art by simply observing others; they must be explicitly taught. With the support of family, teachers, and classmates, Jessica was able to create “complex, intricately ordered systems” that beautifully illustrated the inner workings of her world, as well as showcased her natural talent for sensing colors, patterns, and composition.

Researchers have also been studying the question of whether there is such a thing as “distinctive autistic art,” pointing to common features such as perceptual accuracy, spontaneity, and oddity. For example, the book Nadia: A Case of Extraordinary Drawing Ability in an Autistic Child tells the story of a young British girl who was able to draw animals with a sense of space, motion, profile, and shadows that psychologists previously thought impossible for children of her age. In fact, many children with autism demonstrate these high levels of visual-spatial skills, with some describing it as “thinking in pictures.” 

Art education is critical to all children, but especially those who are developing atypically, such as children on the spectrum. It is important for art educators to acknowledge and appreciate the unique artistic abilities of children with autism, and design their lessons in a way that enables them to use their preferred mediums and express their special interests.

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Performance-Based Measures and Methods to Assess Emotional Dysregulation

Written by: Tucker Park

This chapter discusses why student performance data is a valuable complement to self-reported data about mood and behavior. Challenges with emotional regulation are rooted neurologically in the student’s prefrontal cortex, and are also linked to difficulties with attention, executive functioning, working memory, and verbal fluency. 

Although performance-based assessments are often not a high priority for students presenting with dysregulation, they can be useful in informing us about the student’s learning style, which has implications in optimizing their engagement in other forms of treatment. Furthermore, varying or unexpected patterns of scores can raise flags about previously unknown learning difficulties that may exacerbate emotional dysregulation. For example, an adolescent who struggles with verbal memory may also face difficulties listening and note-taking, and the resulting frustration may escalate into meltdowns or angry outbursts.

Two valuable performance-based measurement methods are the Rorschach and narrative techniques. Rorschach assessments involve tracking how a person experiences and manages their emotions throughout a series of tasks. For example, we may look for patterns about which conditions trigger different emotions, how intense the experiences are, and to what extent other psychological capacities are affected. Narrative methods, such as the TAT, CAT, and TEMAS, involve the instructor telling stories that include what the characters are thinking and feeling in order to sample the patient’s emotional vocabulary. For example, if a patient labels characters’ feelings with somatic states (e.g. tired, hungry, sick), this may indicate that they require more help in expanding their awareness of their internal experiences.