Music, Arousal and Self-Injurious Behaviour: A 3-Stage Mediating Model For Children With Low Functioning Autism - Study 3

INTERVENTION: Research suggests that music can reduce arousal and that reducing arousal can reduce Self‐Injurious Behaviour. The intention of this research is to conduct three studies designed to test whether arousal mediates the relationship between music and SIB, hence defining the 3‐Stage Mediating Model. Study 1, the first stage of the 3 ‐Stage Mediating Model, involves the selection, performance and provision of music performed in Rondo, Theme and Variations and Sonata forms rated by primary carers of males with autism from most to least sedate. The first 2 minutes of 6 musical performances, two from each Rondo, Theme and Variations and Sonata forms (appearing in a randomised order) will be rated by primary carers of males with Low Functioning Autism from 1 = least calming to 6 = most calming or that none were calming. Ratings from at least 30 primary carers will then be analysed to reveal the single muscial performance that is agreed to be most calming. This piece of music will be applied to Study 2, the second stage of the 3 ‐Stage Mediating Model, and Study 3, the third stage of the 3 ‐Stage Mediating Model. Study 2 (ACTRN12611001063909)the second stage of the 3 ‐Stage Mediating Model: A laboratory based randomised control trial will test if Receptive Music Therapy (listening to music selected in Study 1 as most calming) can reduce salivary cortisol levels and Self Injurious Behaviour frequencies for children with Low Functioning Autism when exposed to 13 minutes video footage of a school bus ride (a Trier Social Stress Test). This study is designed to assess the trial within a laboratory setting prior to its application within a naturalistic setting; an actual school bus. Frequency: the participant will attend Curtin University Laboratory once per week for 2 weeks. Duration: 13 minutes watching a TV playing video footage of a school bus ride. The total time of preparation and collection of saliva for anaylsis will be less than 45 minutes. Study 3 A single case design will test if Receptive Music Therapy (listening to music rated as most calming from Study 1, then applied in Study 2) can reduce salivary cortisol levels and Self Injurious Behaviour frequencies for children with Low Functioning Autism when travelling to school by bus (an applied version of the Trier Social Stress Test). Frequency: one day per week over 4 consecutive weeks Duration: 1 hour per week CONDITION: Arousal (Cortisol) Low Functioning Autism Self‐Injurious Behaviours PRIMARY OUTCOME: Self‐Injurious Behaviour ; Study 3: Self Injurious Behaviour frequency will be recorded as a rate per minute measurement during the first 10 minutes of pre and post‐test periods when the participant is exposed to a school bus ride. SECONDARY OUTCOME: Salivary Cortisol ; Study 3: ; Firstly, to capture the behaviour of each participants cortisol, a Cortisol Awakening Response (CAR) profile will be created by assessing cortisol levels in saliva from samples taken during one morning at awakening (AW), 15 minutes (AW15), 30 minutes (AW30), 45 minutes (AW45) and 60 minutes (AW60) after awakening. ; Through the 4 week trial, saliva samples will be collected via oral swabs and analysed during Phase 1, 2,3 and 4 to assess the effect of the music in reducing arousal. INCLUSION CRITERIA: Males aged between 6 to 11 years, Diagnosis of Autism and Intellectual Disability defined by a Full Scale Intelligence Quotient of 70 or below, the presence of Self‐Injurious Behaviour, travel to school by bus, maintain ongoing treatment for the duration of the trial, no aversion to wearing earphones or having swabs taken for saliva collection as endorsed by primary carer(s).