Contributors: Sabiqunnahar Shampa, Nusrat Fatima, Masum Billah, Naeem Imtiaz
Paper Details
Paper Title: Nonverbal Communication, Music Therapy, and Autism: A Review of Literature and Case Example
Author: Michael J. Silverman
Journal Information
Journal of Creativity in Mental Health
ISSN: 1540-1383 (Print) 1540-1391 Online Journal homepage
Title Analysis
Nonverbal Communication, Music Therapy, and Autism: A Review of Literature and Case Example
A review and selective compilation of prior research-based literature about interconnection among Nonverbal Communication, Music Therapy, and Autism with a Case Study. It was written based on archival research and personal experience of the writer Michael J. Silverman.
Abstract
This article presents a review of nonverbal literature relating to therapy, music, autism, and music therapy. Included is a case study of a woman with autism who was nonverbal. The case highlights and analyzes behaviors contextually. Interpretations of communication through music therapy, musical interactions, and the rapport that developed through the music therapy treatment process are provided.
Keywords
Autism, counseling, creativity, music therapy, nonverbal communication
Introduction
Humans are always eager and depend on communication. Communication has two aspects: these are Verbal and Nonverbal means. Listeners automatically and unconsciously process nonverbal cues, and nonverbal communication often takes place whether the sender believes the message is important or not (Kang, 2000).
Nonverbal Communication
Nonverbal communication has not any linguistic limitations such as gestures, facial expressions, eye contact, pupil dilation, distance, attire, vocal features, movements, posturing, smell, and use of space. NVC also includes Body language, Object language, and metacommunication
Nonverbal communication typically gets exquisite and it is culture-specific.
- Nonverbal communication typically occurs and may be culturally specific Specifically, the facial expression is noted as one of the most universal types of nonverbal communication.
- Before making postulations or assuming, clinicians should be fully aware of the client’s individual perception of body language.
Nonverbal communication works as compensation for verbal communication. It clarifies the speech and transmits effective communication.
- It enhances spoken language
- Unintentional physical gestures can clarify the meaning of speech, just as speech can clarify the meaning of gestures (Kelly, Barr, Church, & Lynch, 1999).
Nonverbal behavior is so important. Early language acquisition in children is improved when verbal requests are accompanied by nonverbal pointing behaviors. (Kelly, 2001) Body language is an aspect of nonverbal communication that affects interaction. For example, maintaining eye contact conveys interest and has been related to higher ratings of counselor respect and genuineness. A slight tilt of the head can indicate receptiveness; a nod can be associated with a sense of support and accomplishment.
Proxemics (The use of space) relating to therapy, body position has been related to more favorable ratings of counselors and therapists. The use of space between client and therapist decides the relation between them.
Nonverbal Communication In Therapy
- Nonverbal means of communication can be used to establish rapport which is the key element in therapy. Nonverbal cues appear to be more important than speech in judgments of rapport. Rapport is the mutual understanding between client and therapist which they share.
- Therapists refrain from listening to the words of their patients. Rather, therapists should listen to their voices while carefully observing their posture, body-picture, and facial expressions.
- Failing to smile or even keeping yourself in a seated position can adversely affect patient progress.
- It is important for therapists not only to take note of their client’s nonverbal behavior but to be equally aware of their own nonverbal communication and messages. Indeed, nonverbal messages were the most important predictors of patient satisfaction.
- Verbal communication has its own difficulties and limitations.
- The same words convey different meanings.
- Speaker’s inability to express
- Listener’s inability in comprehension.
- Dialect
Miscommunication can result in confusion or frustration especially comes when working with clients with various types of developmental disabilities, neurological problems, or speech delays (Harrigan & Rosenthal, 1986).
Music As Communication
- Music can be used as a bridge across communicative restrictions and may function as a powerful treatment modality in treating clients with communication deficits.
- By using music a client with communication deficits transmit information, emotional messages, needs, and values.
- Music is a means of communication and has spoken for people when words are inadequate.
- “Music is nonverbal communication”.
- The greatest power of music as a healing agent (Hodges and Haack (1996))
- Music can also express the inexplicable and can support individual feelings.
- Establish personal relationships (Hodges and Haack (1996))
- Clients may respond better to music therapy than to other modalities because some clients have difficulty with therapeutic modalities that include verbal communication. Bruscia (1991), a prominent music therapy educator.
- Music therapists possess the ability to utilize a medium that provides clients the opportunity to explore themselves in unique ways they had previously been unaware of, thus minimizing communication deficiencies
- If therapists and clients do not share a common verbal language then music can be the one.
- Mode of expression for clients who have limited or no verbal communication skills.
- Music can increase nonverbal social behavior with patients diagnosed with Alzheimer’s Disease.
Music therapy led to an increase in verbal and nonverbal communication in a withdrawn, depressed, older adult female (Redinbaugh,1988). - nonverbal communication progressed faster than verbal communication.
- The use of music can also be used to encourage speech and vocalization.
- During the assessment, nonverbal communication techniques can be used.
Music originated because early humans needed to more effectively communicate over long distances.
Autism, Communication, And Music
- The essential features or clues of Autistic Disorder are the presence of markedly abnormal or impaired development in social interaction and communication and a markedly repetitive, restricted repertoire of activity and interests. Exposition of the disorder varies greatly depending on the developmental level and chronological age of the individual. (p. 70) APA DSM-4
- One of the first indicators of autism is difficulty in communication.
- The functional communication difficulties with autism result from the inability to manipulate symbols or symbolic representations.
- The communication problems of autism may vary, depending on the intellectual and social development of the individual (APA, 2000)
- Although people with autism typically have little or no problem with pronunciation, most have difficulty using language effectively. They experience difficulties in word and sentence meaning, intonation, and rhythm, not in pronunciation. Additionally, as many as 50% of people with autism never speak (APA,2000; Volkmar & Klin, 2000).
- Music has long been considered especially effective in communicating with persons diagnosed with autism because it is a nonverbal form of communication and is usually enjoyed by clients.
- For children with autism, music can be “innately pleasurable, perhaps because it is an absolutely predictable phenomenon in an unpredictable world”.
- when the auditory stimulus is musical, most of the children with autism are more likely to attend to an auditory stimulus than a visual one.
- Music appears to be such a powerful tool with this population that regardless of its purpose or how it is used for a particular client, it achieves positive effects.
- Music therapy has long been recorded to be an effective and creative modality for children.
- Music actually facilitates or supports the desire to communicate.
- Music improves social skills, increases developmental abilities, and increases language comprehension in children with autism.
- Increase communicative responsiveness in children with autism.
- Musical techniques to meet objectives concerning attention span, educational deficits, eye contact, appropriate behavior, self-care tasks, and self-expression.
Case Example
Client Information table
| Name | Michelle (pseudonym) |
| Age | 29-years |
| Gender | Female |
| Communication Modality | Nonverbal, Did not use Sign Language or any Augmentative Communication Modalities. |
| Demography | American Rural area |
Therapy objective
Manage and remove the deficiency areas of eye contact and vocalization.
Special Interest Of Client
Music, especially the electronic keyboard.
Behavior Analysis
Michelle approached and grabbed the therapist’s hand, and pulled into the music therapy room.
Interpretation
- Interest in music
- By initiating physical contact and physically leading to the activity room. Michelle was able to use tactile and motor prompts to communicate her needs nonverbally.
Pushing hand away while the therapist accompanied her on the keyboard. She then went to the closet and pointed at a keyboard in the closet. The therapist plugged in the new keyboard and she played.
Interpretation
- Michelle was not happy with the present situation
- Michelle used gestural communication (pointing) to show me what she wanted (the other keyboard)
- By plugging in the new keyboard, she displayed her emotion with a smile.
Michelle played the keyboard, appearing quite excited about the music, then stopped playing and looked at the therapist. She then motioned toward the keyboard with her head but did not play.
Interpretation
- It appeared that Michelle was waiting for something to happen on the keyboard when she stopped playing and began her head motion. I interpreted this as a prompt of turn-taking.
- Her eyes widened. It interprets the widening of Michelle’s eyes as nonverbal communication of acceptance and reinforcement.
Michelle sighed and softly vocalized. The therapist reinforced Michelle heavily for the vocalization, verbally and musically encouraged her by repeating the same melody on the keyboard and asking her to vocalize again.
Interpretation
- Michelle was happy due to her pride after vocalizing. It may have been my praise and reinforcement that prompted the smile
Michelle put her hands on the therapist’s knees and leaned forward, gently touching her forehead to the therapist ‘s chest. So he asked Michelle to “show me what you want” and she sighed. Again asked Michelle if she wanted a hug and Michelle sighed again. The therapist gently patted her back, giving her a soft hug while Michelle sighed.
Interpretation
- By initiating physical contact and had never done so by putting her head to my chest, I interpreted this nonverbal behavior as a significant means of communication. Michelle wanted something and was determined to show this to me. Her physical communication (touching knees and chest) and vocal communication (sighing) cued me that she may want to be hugged.
Michelle stopped playing the keyboard and looked down, towards the floor. She started shaking her hand in front of her face but continued to look at the therapist’s face. Michelle was unresponsive to continuous prompts.
Interpretation
- providing disapproval by ignoring prompts, avoiding eye contact, and not responding nonverbally
- Indicates that Michelle wanted to play the keyboard independently without any accompaniment.
- This handshaking meant “pay attention—I’m going to show you what I want.”
Outcome
- Able to better understand and interpret others’ behavior.
- Quickly learned to be conscious of proxemics and the spatial relationship.
- Michelle was able to use basic behavioral principles of approval and disapproval to increase nonverbal communication.
Michael J. Silverman Quotes the result of this particular case-
Unfortunately, Michelle was unable to continue music therapy treatment due to funding difficulties. However, Michelle was making considerable progress: She was beginning to vocalize in sessions (two times per session), her eye contact was improving (she was making eye contact for five second intervals on three of five attempts), and she was able to express herself through the keyboard improvisation and therapist interaction. It seemed that music therapy contributed to Michelle’s quality of life and social development. Michelle’s enjoyment of music therapy was evidenced by her smiling, her leading me into the therapy room, the number of prompts required for her to leave the room at the end of the session, and reports of her family and caretaker. Michelle was an absolute pleasure to have in music therapy.
