Study on the influence of trauma-informed music intervention on emotional adjustment and social adaptability of children exposed to pediatric trauma

Background Children exposed to traumatic events frequently develop emotion dysregulation and impaired social adaptation, which severely impairs their psychosocial development. As a non-invasive, well-tolerated psychological intervention, trauma-informed music intervention yields promising therapeutic gains for traumatized children's emotional and social functioning. Nevertheless, high-quality quantitative clinical trials remain lacking to corroborate its clinical efficacy. Methods This randomized controlled trial recruited 120 trauma-exposed children hospitalized in our institution between January 2024 and June 2025, randomly allocated to an intervention group ( n = 60) and a control group ( n = 60). The control group received standard psychological care only. The intervention group received an additional 8-week trauma-informed music intervention (twice weekly, 45 min per session), consisting of structured modules including musical improvisation, rhythmic training and emotion-oriented song creation. Outcome assessments were conducted at three time points (pre-intervention, post-intervention, 3-months follow-up) using the Children's Emotion Regulation Questionnaire (ERQ-C), Social Skills Improvement System (SSIS), and Screen for Child Anxiety Related Emotional Disorders (SCARED). Respiratory sinus arrhythmia (RSA) was measured as a physiological biomarker of autonomic regulatory function. Results At post-intervention, the intervention group demonstrated substantially higher ERQ-C total scores (48.72 ± 6.35 vs. 35.18 ± 7.24) and SSIS total social skills scores (52.41 ± 7.03 vs. 39.27 ± 6.89) relative to the control group ( P < 0.001), alongside marked reductions in SCARED anxiety-depression scores (22.36 ± 5.17 vs. 38.65, P < 0.001). The cooperation, empathy and social initiative subscales of the SSIS reflected the largest improvements. The intervention group displayed significant elevations in RSA magnitude ( P < 0.01), signifying upregulated parasympathetic nervous system activity. All intervention-related gains persisted stably at the 3-months follow-up, with Cohen's d ranging from 0.78 to 0.92. No severe adverse events were recorded during the entire trial period. Conclusion Trauma-informed music intervention improves emotion regulation and social functioning, and mitigates internalizing symptoms among children with pediatric trauma exposure. The intervention delivers durable therapeutic effects with satisfactory safety profiles, and can serve as a valid non-pharmacological adjunct for psychological rehabilitation of traumatized children.