Tuning in and sharing affects: Fostering social motivation in young autistic children in improvisational music therapy – an embedded mixed-methods study

Previous studies explored the short- and medium-term benefits of improvisational music therapy (IMT) for autistic children from both objectivist and interpretivist perspectives. The present embedded mixed-methods study integrated these approaches to examine factors influencing the process and outcomes of year-long IMT with non-speaking and minimally speaking young autistic children. Fifteen children participated in the study. Quantitative assessments measured changes in social affect, developmental levels of the children, and parent-reported quality of life. Qualitative data were gathered through post-program interviews with parents (n = 15) and therapists (n = 4) , analysed using a modified grounded theory to explore key factors shaping the therapeutic process and its outcomes. Exploratory analyses further examined trends related to attunement quality and subsequent outcomes, corroborating the qualitative findings. The results indicated significant improvement in children's social-affect and developmental levels and parents' quality of life (p < 0.05) following the year-long IMT program. Key findings highlighted the critical role of ' musical-emotional attunement' in enhancing social motivation, with higher attunement linked to more positive experiences reported by parents and therapists and better outcomes across all measures. These preliminary findings suggest that the mutually influential nature of therapeutic relationships and affect sharing between the child and therapist are integral to the processes and outcomes of IMT. These findings demonstrated IMT's potential to enhance the social-emotional development of young autistic children through a relationship-driven, attuned approach, providing valuable insights for both practice and education in music therapy. • Attunement is key to fostering social motivation in autistic children. • Differences in vitality affects challenge therapist-child attunement. • Therapists regulate energy and affects to attune to the child’s needs. • Interaffectivity builds therapeutic bonds and boosts child motivation. • Collaborating with parents enhances the therapeutic process and outcomes.