Group Music Practice Enhances Development

Study Overview
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Brief Summary
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This randomized controlled trial shows for the first time that focused musical instrumental practice as compared to traditional sensitization to music provokes multiple transfer effects in the cognitive and sensorimotor domain. Over the last two years of primary school (10-12-year-old children), sixty-nine children received biweekly musical instruction in a group setting by professional musicians within the regular school curriculum. The intervention group learned to play string instruments, whereas the control group, peers in parallel classes, was sensitized to music via listening, theory, and some practice. Broad benefits manifested in the intervention group as compared to the control group for working memory, attention, processing speed, cognitive flexibility, matrix reasoning, sensorimotor hand function and bimanual coordination Apparently, learning to play a complex instrument in a dynamic group setting impacts development much stronger than classical sensitization to music. Our results therefore highlight the added value of intensive musical instrumental training in a group setting, encouraging general implementation in public primary schools, better preparing children for secondary school and for daily living activities.

Detailed Description
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This 2-year longitudinal study compared cognitive and sensorimotor development of two groups of children. Both groups received two music courses of 45 minutes per week in a class setting (maximum 20 children per class), given by professional musicians. The intervention groups (n=34) learned to play string instruments Orchestra in Class, the control groups (n=35) followed the standard Swiss school curriculum, with sensitization to music lessons, lacking focused instrumental practice. Children who received protocolled extracurricular music lessons before or during the study, were excluded from the analyses. The groups were compared at baseline (T0) after one year (T1) and after two years (T2) using standardized psychometric tests, evaluating cognitive and sensorimotor functions as well as tests on musicality. Music practice, covering a wide and diverse field of skills and abilities, from sensorimotor to cognitive activities at the highest level, is a real driving force for development. Widely distributed regions in the brain, which support all these functions, are trained and better coordinated as a result of this practice. This provokes changes in the morphology and function of the brain. Consequently, practicing music regularly brings benefits that go far beyond musicality. The results of various studies indicate that children who practice music show increased verbal memory, verbal intelligence, reading, visual-spatial processing, executive functions, attention, logical reasoning, and according to some authors even better mathematics or even IQ and social skills. Available evidence of beneficial musical practice effects on cognitive child development predominantly concerns children of parents with a high socioeconomic and educational background [10] and typically results from private lessons. Additionally, most of the time, the child is interested to learn a musical instrument, inducing a motivational bias. Evaluation of beneficial transfer effects restrains in general to a limited number of capacities or skills and randomized controlled trials (RCTs) with active control groups are scarce. Here, the investigators compared children who intensively practiced different string instruments in a class setting within a specific Orchestra in Class (OC) program, to peers in parallel classes that received the same amount of musical instruction, also within an entire class, but lacking focused training on a complex musical instrument. Entire existing classes were assigned randomly to the OC and the Control programs (cluster randomization). The study took place in public primary schools in popular neighborhoods in the Geneva area, avoiding confounding music effects with effects of socioeconomic background. The investigators anticipated that cognitive functions strongly involved in musical practice like working memory, attention, information processing, cognitive flexibility and abstract reasoning, as well as fine sensorimotor function would provoke enhanced positive transfer effects in the OC group as compared to the control group.

Official Title
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Formal String Instrument Training in a Class Setting Enhances Cognitive and Sensorimotor Development of Primary School Children

Conditions
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Cognitive Change, Motor Activity

Intervention / Treatment
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* Behavioral: musical instrumental training
* Behavioral: sensitization to music


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The experimental group will include students from 2 classes 7P HarmoS (1st year of research) and 8P HarmoS (2nd year of research) who participate in the Orchestre en classe program in a public primary school in the vicinity of Geneva. The Control group will include students from 2 classes 7P (1st year of research) and 8P (2nd year of research) who do NOT participate in the Orchestre en classe program, in the same and a nearby public primary school in the vicinity of Geneva. HarmoS: primary school education system in French-speaking Switzerland Exclusion Criteria (both groups) hearing deficits; development disorders epilepsy other severe health or neurological problems non-consent of the parents or the child children who have taken music lessons outside the school curriculum before or during the study will be excluded from the study

Ages Eligible for Study
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Minimum Age: 9 Years
Maximum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Longitudinal cluster RCT (randomized controlled trial) with an intervention group and an active control group
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: musical instrumental training<br>Bi-weekly musical string instrument training in a group setting, over 24 months, provided by professional string instrument teachers | Behavioral: musical instrumental training<br>* Learning to play a string instrument in a group setting (school class)<br>* Other names: Orchestre en Classe;|
| Active Comparator: sensitization to music<br>Bi-weekly sensitization to music in a group setting, over 24 months, involving listening, playing small percussive instruments and choir singing, provided by professional school music teachers | Behavioral: sensitization to music<br>* sensitization to music via listening, theory, moderate practice on small percussive instruments and choir singing in a group setting (school class)<br>* Other names: Classical school music lessons according to the Swiss school system;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Working memory change | Changed scores at a backward digit span task (WISC-R; Wechsler, 2005). | 24 months | 
| Executive function change | Changed scores at attention tasks, cognitive flexibility tasks and speed of information processing tasks (D2 Test of Attention; Brickenkamp and Zillmer, 1998);Children's Color Trails Test (CCTT; Llorente, 2003) Higher scores at attention tasks, cognitive flexibility tasks and speed of information tasks processing (D2 Test of Attention; Brickenkamp and Zillmer, 1998); Children's Color Trails Test (CCTT; Llorente, 2003) . | 24 months | 
| Change in abstract thinking (Matrices subtest of the WISC-IV (Wechsler, 2003)) | Changed scores at a matrix reasoning task | 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changed sensorimotor functioning | Changed scores atall 4 subtests of the Purdue Pegboard task (Lafayette, 1999), involving manual dexterity and bimanual coordination | 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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music-practice, group-setting, randomized-controlled-trial, multiple-transfer-effects, cognitive, sensorimotor, matrix-reasoning, string-instruments