The Dual Effects of Structured and Relational Interventions in Piano Lessons: An Interdisciplinary Case Study of a Preschool-Aged Child with Autism Spectrum Disorder (ASD)

This practice-based, single-case study followed a six-year-old child with autism spectrum disorder (ASD) over two years of piano instruction in a naturalistic lesson setting, testing a teaching framework that combines structured scaffolding with relationship-based engagement. Data sources included the teacher’s post-lesson reflective journals, a repertoire and technique log, and brief parent communications. Sustained attention increased from approximately 10 minutes to 45 minutes per session, and by the end of the study the child could complete 90-minute lessons with one break. On-task behavior rose from about 60% to 85–90%. Repertoire and technique milestones included completion of Czerny’s Op. 599 and Op. 849, major and minor scales in keys with up to five sharps and five flats, and selected movements from Mozart and Beethoven piano sonatas. Relational strategies--such as adopting a peer-like tone, offering choices, using exchange-based reinforcement, and leveraging the child’s interest in cats-promoted active communication and participation while reducing anticipatory anxiety at lesson onset. The findings suggest that combining structured and relational strategies can concurrently support lesson organization, technical progress, and emotion regulation. Replication with additional students and instructors is needed to assess generalizability.