A systematic review of the effect of music therapy compared to speech therapy on social communication skills in preschool children with autism spectrum disorder

Background: Autism spectrum disorder (ASD) is defined by impairment in social communication and the presence of restricted interests and repetitive behaviors. Individuals with ASD receive a variety of interventions tailored to their specific needs, enhancing their social, communication, and adaptive skills. Speech therapy (ST) aims to promote speech and language development and further improve social and communication skills in children diagnosed with ASD. Music therapy (MT) has been recognized as an intervention for individuals with ASD to facilitate social and communication skills. At present, there is no systematic review (SR) of MT compared to ST on social communication skills in preschool children with ASD. Objective: This SR aimed to (a) investigate the effectiveness of MT compared to ST on social communication skills for preschool children with ASD and (b) investigate which type of MT, compared to ST, affects the social communication skills of preschool children with ASD. Materials and methods: This SR was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using five databases: the CINAHL Complete, PubMed, Scopus, ERIC, and Cochrance. The researchers also conducted a hand search for reference lists of identified articles and pertinent reviews for additional studies. We assessed the risk of bias using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool and the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2). Results: The initial literature search yielded 63 articles. Following the exclusion of non-relevant studies, 2 studies met the inclusion criteria for this review. The results indicated that the differences in overall efficacy between MT and ST were not statistically significant. Both therapies are effective for speech production, including semantics, phonology, pragmatics, and prosody in preschool children with ASD. MT, specifically developmental speech and language training through music (DSLM), is equally successful as ST in enhancing speech production. Behavioral intervention, applied behavior analysis verbal behavior (ABA-VB), is also effective in improving core symptoms of autism, such as social and communication deficits. Conclusion: MT has comparable efficacy in enhancing speech production compared to ST, which impacts social communication in preschool children with ASD. Nevertheless, ST remains a cornerstone in addressing communication deficits in children with ASD, focusing on structured speech and language development. MT provides a complementary approach that can enhance speech production and bring more enjoyment to these young children, who frequently struggle with social communication. Therefore, MT could be viewed as a complementary approach to traditional ST. Limitations included research on the use of DSLM and ABA-VB by music therapists has been sparse, and the number of studies has been small. Further study would allow for more precise conclusions regarding the effect of MT compared to ST on social communication skills in preschool children with ASD.