Family-centered music therapy in the home environment: Promoting interpersonal engagement between children with autism spectrum disorder and their parents

Autism Spectrum Disorder (ASD) is a group of neurological disorders with lifelong implications. It is diagnosed based on impairments in social interaction, communicative behavior, and repetitive and stereotyped patterns of behavior or interests (American Psychiatric Association, 2000). These three core features, sometimes described as the "triad of impairments of social interactions" (Wing, 1988, p. 92), highlight the defining feature for every age, stage and level of functioning of people with an ASD as being the "lack of reciprocal social interaction" (Prior & Ozonoff, 1998, p. 83). While there are many different programs to support children with ASD to develop early social communication skills, there is evidence to suggest that early, intensive, family-based programs that are responsive to the individual differences amongst children and families are particularly beneficial in supporting these skills (Roberts & Prior, 2006). Family-Centered PracticeSince the 1980s, therapists and educators working in the field of early childhood intervention (ECI) were expected to be family, rather than child-focused, practitioners (Dunst, Trivette, & Deal, 1988). Informed by Bronfenbrenner's (1975) systems model, American researchers in the field of ECI, Dunst et al. (1988) wrote their ground-breaking book "Enabling and Empowering Families: Principles and Guidelines for Practice. " They compelled ECI practitioners to turn away from an expertmodel and toward an approach based on family participation and collaboration. This shift occurred due to the emerging understanding of family systems theory, which deems that events affecting the family will ultimately affect the child (Dunstetal., 1988). Since then, ECI teams in Australian government and nongovernment organizations have implemented a broadly based family systems approach to support pre-school aged children with special needs. The Australian Early Child Intervention Association's Code of Ethics directs ECI practitioners to: develop collaborative partnerships with families; work to engage in shared decision making with families in regards to the support given to their child; work to support and complement the skills of the family by recognizing their existing strengths; and respect the family's right to choose the way they wish to be involved in the services provided to their child (ECIA, 2011). ECI services in Australia and elsewhere additionally acknowledge that young children are actively engaged and learn best when their learning is part of their daily routine, emphasizing the need to embed learning strategies into natural environments such as the home, childcare and preschool (Rantala, Uotinen, & McWilliam, 2009; Roper & Dunst, 2003). A central tenet of family-centered practice is practitioners and families striving to work together in partnership (Davis, Day, & Bidmead, 2002) with an emphasis on building the capacity of the family (Dunst & Trivette, 2009). Respect, empathy and emotional responsiveness are required from practitioners as they attempt to support parents in the highly private and personal responsibility of parenting their child. Practitioners therefore aim to enhance parents' self-esteem (in this context, their feelings of self-worth as a parent) and their self-efficacy (their belief in their own ability to influence the care of their child). The way parents think about themselves in general, including their skills in parenting, is believed to be influenced by the subtle ways that practitioners interact with them (Davis et al., 2002). The quality of the relationship between the parent and the practitioner is therefore of great importance, requiring the practitioner to focus consciously on recognizing and supporting the strengths of the parent (Dunst & Trivette, 2009). However, ECI practitioners also need to acknowledge and respect the challenging circumstances in which parents of young children with special needs find themselves. …