The current randomized controlled trial compared the effects of novel, embodied, rhythm interventions - music and robotic - with those of a standard-of-care, stationary, academic intervention on the social communication, behavioral, and motor skills of 36 children with Autism Spectrum Disorders (ASDs) between 5 and 12 years of age. Children were matched on age, level of functioning, and services received prior to randomization. The study lasted for 10 weeks with the pretest and posttest sessions conducted during the first and last weeks of the study. Training was provided in the intermediate 8 weeks, with 2 sessions provided each week. Between-group differences and within-group changes in social attention and social verbalization skills, repetitive/problem behaviors, and motor performance were assessed using task-specific tests within the training context and standardized tests outside the training context. The music-based context afforded greater social monitoring and spontaneous initiation of engagement compared to the robotic and academic contexts. The robotic context promoted fixation on robots and greater scripting and self-directed vocalizations, limiting opportunities for interactions with social partners. Due to the novelty of the training activities, the movement groups initially demonstrated greater negative behaviors compared to the academic group. Although the academic group afforded responsive verbalization, children spent a majority of time in non-social object-based engagement. In terms of task-specific training effects, the music group showed an increase in duration of social verbalization and reductions in imitation error scores and frequency of negative behaviors across weeks. Although the robot group demonstrated small improvements in imitation scores, children demonstrated a decrease in engagement with the context across training sessions. The academic group improved their fine motor imitation scores, but did not demonstrate any changes in social attention, social verbalization, and repetitive behaviors across sessions. In terms of generalized changes in skills, the music and academic groups demonstrated improvements in responsive joint attention following training. Consistent with training demands, the movement groups improved gross motor skills, whereas the academic group improved fine motor skills, on a standardized test of motor performance. Overall, movement-based music contexts hold promise in remediating the impairments associated with autism and warrant future investigation.
