The effect of music interventions in autism spectrum disorder: a systematic review and meta-analysis.

INTRODUCTION: Several disciplines have explored the relationship between autism spectrum disorder (ASD) and music, though most insights derive from cognitive sciences. This systematic review and meta-analysis synthesize evidence on the therapeutic effects of music-based interventions (MI) on communication, behavior, social engagement, attention, and quality of life in autistic individuals. It also examines how participants perceive and process music, situating therapeutic findings within this perceptual framework. METHODS: From a total of 346 publications screened in PubMed, Cochrane Library, and WILEY Online Library databases, 120 were included, of which 15 met the criteria for quantitative evaluation and meta-analysis, to assess the state- of-the-art of research on music and autism in the fields of neuropsychology and cognitive sciences. The reviewed studies span a range of methodologies, including randomized controlled trials and qualitative research, and incorporate diverse MI strategies, such as active music-making, structured listening, and improvisational techniques. RESULTS: Despite methodological heterogeneity, the findings suggest a moderate overall beneficial effect of MI, particularly in enhancing social interaction (z = 1.89, p-value = 0.06), verbal communication-especially vowel articulation (z = 2.93, p-value = 0.01), behavior (z = 1.92, p-value = 0.06; after outlier removal), and quality of life (z = 1.67, p-value = 0.09). DISCUSSION: This study highlights music's potential as a non-invasive, engaging therapeutic medium that elicits emotional, cognitive, and social responses in individuals on the spectrum. Given evidence of context-sensitive and domain-specific strengths in musical abilities, music emerges as a promising therapeutic approach. Future studies should investigate individual variability in response to MI, aim to standardize outcome measures, and assess long-term effects. Such efforts will support more personalized, neurodiversity-affirming therapeutic models in autism care.