A pilot and feasibility study of music therapy for attentional functioning in children with autism spectrum disorder

Background Children with autism spectrum disorder (ASD) commonly experience attention difficulties, yet evidence on music therapy targeting attentional functioning remains limited. This pilot and feasibility study examined intervention and assessment feasibility and explored immediate pre–post changes across attentional domains. Methods Twenty children, aged 6–9 years, with ASD participated in a single-session, 30-minute feasibility trial of an active music therapy intervention involving interactive instrumental activities with the therapist. Four subtests of the Test of Everyday Attention for Children (TEA-Ch) were administered immediately pre- and post-intervention while participants wore near-infrared spectroscopy (NIRS) headgear (analysis not reported). Exploratory linear mixed-effects models used available observations for each subtest, with additional adjustment for intellectual ability and ADHD-related traits. Results All 20 participants completed the music therapy intervention, with no intervention-related adverse events reported. Fifteen participants (75%) completed all four TEA-Ch subtests at both assessments, and three (15%) experienced temporary discomfort from the NIRS headgear. Primary analyses indicated pre–post improvements in selective attention (Sky Search: β = −1.60, 95% CI [− 2.68, − 0.52], p = 0.004) and less precisely estimated improvements in attention control/switching (Creature Counting: β = −1.26, 95% CI [− 2.46, − 0.07], p = 0.039); the estimates were similar after covariate adjustment. The 95% CI for Creature Counting included zero in the covariate-adjusted complete-case sensitivity analysis ( n = 15). No clear changes were observed in sustained or sustained-divided attention. Conclusions Delivery of the single-session music therapy protocol was feasible in this sample, although assessment completion and NIRS headgear tolerability require further attention. The exploratory findings warrant controlled studies to establish whether music therapy improves attention and whether any benefits persist or extend to everyday functioning.