Inhibition Control Outcomes of a Music Intervention for Autism

Background: Music is a complex, multimodal activity which depends on and may in turn enhance inhibition control (IC) during cognitive development (Holochwost et al., 2017; Jaschke, 2018). IC is an executive function important for regulating appropriate and inappropriate responses and for adapting behavior to shifting situational demands. Individuals with autism spectrum disorder (ASD) have shown impairments on standard IC tasks such as the Go-NoGo (Geurts et al., 2014) and Eriksen Flanker tasks (Christ et al., 2011). However, no study has yet examined the effects of a music-based intervention for children with ASD using IC measures.

Objectives: The object of this study was to evaluate changes in IC measures in children with ASD after 8-12 weeks of a music or non-music intervention, using the Go-NoGo and Eriksen Flanker tasks.

Methods: Data were collected as part of a larger 8-12 week randomized controlled trial of music for school-age children with autism (Sharda et al, 2018). Both the music and non-music therapies targeted social and communication outcomes. Music sessions were individual, semi-improvisational and participants could choose from several instruments. The Go-NoGo task consisted of 160 Go and 40 NoGo trials, and the Flanker task consisted of 100 congruent and 100 incongruent trials. Both tasks were adapted for children. The IC analysis was run on 32 participants who had pre- and post-intervention data for the Go-NoGo task (MT, n=18; NM, n=14) and 29 for the Flanker task (MT, n=15; NM, n=14). Groups had average IQ and were matched on age, sex, IQ and socioeconomic status in both analyses (p≥.274). Mixed-effects analyses tested changes in IC performance in the NoGo and incongruent conditions of the Go-NoGo and Flanker tasks respectively. Main effects of time-point and treatment by time-point interactions were examined for both accuracy and reaction time.

Results: On the Go-NoGo task, 8-12 weeks of therapy showed no significant treatment by time-point interaction on NoGo accuracy (p=.393; Figure 1). On the Flanker task, there were no significant treatment by time-point interactions for incongruent condition reaction times (p=.519) or accuracy (p=.869; Figure 2). There were also no overall main effects of time-point for the NoGo trials or for the Flanker task conditions on either reaction time or accuracy (p≥.260).

Conclusions: IC performance was not significantly greater in children with ASD who participated in 8-12 weeks of music intervention compared to those in the non-musical intervention, and overall no changes in IC performance were found in either intervention. In the larger RCT, positive effects were previously found on communication scores for the music group compared to the non-music group (Sharda et al., 2018). Although the intervention may simply have been too short to observe IC improvements, previous work on music and IC suggests that a greater focus on rhythmic activities and rhythm-based interaction may be beneficial in music-based interventions where IC is a targeted outcome (Holochwost et al., 2017; Vuust et al., 2011). As such, these results may help guide the effectiveness of future music-based interventions in ASD.