Gold C, Wigram T, Elefant C
Sogn og Fjordane University College, Faculty of Health Studies, Study Centre Sandane, Sandane, Norway, 6823.
Cochrane Database Syst Rev. 2006 Apr 19(2):CD004381. doi: 10.1002/14651858.CD004381.pub2.
The central impairments of people with autistic spectrum disorder (ASD) include social interaction and communication. Music therapy uses music and its elements to enable communication and expression, thus attempting to address some of the core problems of people with ASD.
To review the effects of music therapy for individuals with autistic spectrum disorders.
The following databases were searched: CENTRAL, 2005, (Issue 3); Medline, (1966 to July 2004); Embase, (1980 to July 2004); LILACS, (1982 to July 2004); PsycINFO, (1872 to July 2004); CINAHL, (1982 to July 2004); ERIC, (1966 to July 2004); ASSIA, (1987 to July 2004); Sociofile, (1963 to July 2004); Dissertation Abstracts International, (late 1960's to July 2004). These searches were supplemented by searching specific sources for music therapy literature and manual searches of reference lists. Personal contacts to some investigators were made.
All randomised controlled trials or controlled clinical trials comparing music therapy or music therapy added to standard care to "placebo" therapy, no treatment or standard care.
Studies were independently selected, quality assessed and data extracted by two authors. Continuous outcomes were synthesised using a standardised mean difference (SMD) in order to enable a meta-analysis combining different scales, and to facilitate the interpretation of effect sizes. Heterogeneity was assessed using the I(2) statistic.
Three small studies were included (total n = 24). These examined the short-term effect of brief music therapy interventions (daily sessions over one week) for autistic children. Music therapy was superior to "placebo" therapy with respect to verbal and gestural communicative skills (verbal: 2 RCTs, n = 20, SMD 0.36 CI 0.15 to 0.57; gestural: 2 RCTs, n = 20, SMD 0.50 CI 0.22 to 0.79). Effects on behavioural problems were not significant.
AUTHORS' CONCLUSIONS: The included studies were of limited applicability to clinical practice. However, the findings indicate that music therapy may help children with autistic spectrum disorder to improve their communicative skills. More research is needed to examine whether the effects of music therapy are enduring, and to investigate the effects of music therapy in typical clinical practice.
自闭症谱系障碍（ASD）患者的核心障碍包括社交互动和沟通。音乐疗法利用音乐及其元素来促进沟通和表达，从而试图解决ASD患者的一些核心问题。
综述音乐疗法对自闭症谱系障碍个体的影响。
检索了以下数据库：Cochrane系统评价数据库（CENTRAL），2005年第3期；医学索引数据库（Medline，1966年至2004年7月）；荷兰医学文摘数据库（Embase，1980年至2004年7月）；拉丁美洲和加勒比卫生科学数据库（LILACS，1982年至2004年7月）；心理学文摘数据库（PsycINFO，1872年至2004年7月）；护理学与健康领域数据库（CINAHL，1982年至2004年7月）；教育资源信息中心数据库（ERIC，1966年至2004年7月）；应用社会科学索引和摘要数据库（ASSIA，1987年至2004年7月）；社会科学数据库（Sociofile，1963年至2004年7月）；国际学位论文摘要数据库（Dissertation Abstracts International，20世纪60年代末至2004年7月）。通过检索音乐疗法文献的特定来源和手动检索参考文献列表对这些检索进行补充。还与一些研究者进行了个人联系。
所有比较音乐疗法或在标准治疗基础上加用音乐疗法与“安慰剂”疗法、无治疗或标准治疗的随机对照试验或对照临床试验。
由两位作者独立选择研究、评估质量并提取数据。连续结局采用标准化均数差（SMD）进行综合分析，以便能够对不同量表进行荟萃分析，并便于解释效应大小。使用I²统计量评估异质性。
纳入了三项小型研究（共24例）。这些研究考察了针对自闭症儿童的简短音乐疗法干预（为期一周的每日治疗）的短期效果。在言语和手势沟通技能方面，音乐疗法优于“安慰剂”疗法（言语：2项随机对照试验，n = 20，SMD 0.36，95%置信区间0.15至0.57；手势：2项随机对照试验，n = 20，SMD 0.50，95%置信区间0.22至0.79）。对行为问题的影响不显著。
纳入的研究在临床实践中的适用性有限。然而，研究结果表明音乐疗法可能有助于自闭症谱系障碍儿童提高其沟通技能。需要更多研究来检验音乐疗法的效果是否持久，并调查音乐疗法在典型临床实践中的效果。
