Rett syndrome is a rare neurodevelopmental disorder caused by mutations in the gene containing information for making the methyl-CpG binding protein 2 (MECP2). The disease severely affects body and limb movements, coordination, verbal and non-verbal communication, cognitive abilities, and daily living activities. It also causes epileptic seizures and breathing issues.

Music therapy refers to the use of music as a clinical intervention to develop, improve, or restore functional deficits.

How music therapy works

Research has shown that music has a direct effect on brain cells synchronizing their activity and promoting neuroplasticity, which is defined as the ability of the brain to reorganize itself by forming new connections between nerve cells in response to learning or external cues.

Music therapists use different forms of music and musical instruments to activate regions of the brain involved in functions such as learning, movement, behavior, social skills, and others.

Music therapy can be used in Rett syndrome patients for the following:

  • developing and improving expressive and receptive communication
  • improving choice-making
  • increasing vocalization and the ability to communicate information or knowledge as well as understanding patterns of language
  • teaching about colors, numbers, letters, and other factual information
  • teaching to follow directions by performing specific movements upon music cues such as clapping hands or stomping feet during a song
  • motivating patients to purposefully improve hand use and increase grasping or holding through the use of musical instruments, therefore decreasing stereotypical movements.
  • as a tool for physical and occupational therapy to achieve better control of head, limb, and body movements
  • maximizing hand use for various daily activities such as dressing, feeding, and grooming, and improving sensory input in school settings
  • increasing interactions and leadership, and enhancing social skills when used in group therapy sessions through eye contact upon specific musical cues, for example
  • facilitating communication and learning by incorporating eye gaze responses, letter and word boards, touch or switch-operated voice output devices, visual aids, pictures, sign language, and augmentative devices to musical activities

Studies on music therapy in Rett syndrome patients

A study published in the Journal of the Formosan Medical Association in January 2019 analyzed the effects of music therapy in individuals with Rett syndrome and their families. A total of 11 families were enrolled in a 120-minute music therapy program, twice weekly for 24 weeks. A control group included 12 families who did not receive any music therapy. The study assessed the behavior and motor skills of the patients as well as the levels of parental stress. Results showed that the music therapy program improved social interactions, communication skills, eye contact, and hand function, and reduced seizure frequency among patients. Music therapy was also effective in relieving parental stress.

Another study published in the journal Brain and Development analyzed the effects of music therapy through weekly 30-minute active music sessions in 4-, 5-, and 6-year-old children with Rett syndrome. Results showed improvements of 35% in listening to music, 33.3% in playing music, 13.3% in singing, 11.7% in minute motions, 11.7% in language, and 20% in personal relations and socialization. The study also showed significant improvements in hand grasp times and frequency.

A study published in the Nordic Journal of Music Therapy assessed the response of the autonomic nervous system to music and vibroacoustic therapy (the use of sound to produce vibrations that are directly applied to the body) in 21 Rett syndrome patients. The patients were stimulated with different forms of music and vibroacoustic therapy and the autonomic responses of the brain stem were recorded. The autonomic function of the patients at rest was used as a control. The study concluded that music and vibroacoustic therapy had measurable effects on autonomic functions in Rett syndrome patients, although the responses were unique to each patient.

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