Effect of Rhythmic-Musical Movements on the Theory of Mind in Children with Autism Spectrum Disorder

 Children with autism spectrum disorder (ASD) cannot easily communicate their feelings and thoughts, and experience difficulty with imagining what others think and feel. Studies have indicated that autistic children fail to use theory of mind (TOM). They are unable to understand the mind or otherschr('39') mental states. As a complementary therapy, music therapy could enhance cognitive, social, perceptual, educational, motor, verbal, and emotional skills of children with ASD. Therefore, the present study aimed to evaluate the effect of rhythmic–musical movements on the ToM in children with ASD.

 This was a quasi–experimental study with a pretest–posttest and a control group design. The study participants were 20 7– to 9–year–old children with ASD selected from the Autistic Children Center of Isfahan City, Iran. Moreover, they were randomly divided into an experimental (24 exercise sessions, three 60–min weekly sessions), and a non–intervention control group (n=10). The Gilliam Autism Rating Scale–Second Edition (GARS–2) was used to detect the severity of autism disorder in the studied individuals. This scale has 4 subscales that assess stereotypical behaviors, communication, social interaction, and developmental disorders. Each subscale includes 14 items, i.e., scored from 0 (never) to 3 (always). Finally, the sum of raw scores is converted into standard scores. The reliability of GARS is in the acceptable range. Children obtaining a score of 53–84 in this test were included in this study, as a high functioning autism class. Additionally, the TOM test was used to measure the TOM level in the study subjects. This test has been designed to measure the TOM in healthy children and those with Pervasive Developmental Disorders (PDDs) at the age of 5–12 years. Subscale 1 (social understanding range), subscale 2 (sensitivity & insight), and subscale 3 (emotions & thoughts acceptance) are scored as 0–20, 0–13, and 0–5, respectively. Besides, the total score of the test ranges between 0 and 38. Of the sum–scores of the three subscales, a total score is obtained for the TOM. The greater this score, the higher levels of the TOM the child will achieve. This test has proper reliability and validity. To analyze the collected data, one–way Analysis of Covariance (ANCOVA) with pretest effect control was implemented. Data analysis was performed using SPSS at a significance level of p<0.05.

 The present study results suggested a significant difference between two groups of posttest scores in the TOM score after adjusting the pretest scores [p<0.002, F=13.07, Eta–squared (η2) =0.43]. Therefore, the implemented exercise program had a positive and significant effect on the TOM in the study participants.

 The rhythm and music–based activities applied in this study could be a provocative and entertaining method for children with ASD. Additionally, they could be an effective measure to facilitate and accept the transition to a new learning environment or to expand their social group, leading to increased social communication and awareness. These interventions should be considered by families, the Welfare Organization, exceptional schools, and rehabilitation centers.