The Effect of Learning to Drum on Behaviour and Brain Function in Autistic Adolescents

M-S Cahart, Ali Amad, Steve Draper, Ruth G. Lowry, L. Marino, C. Carey, M. S. Smith, S. C. R. Williams

Research output: Contribution to conferenceAbstractpeer-review


There is an acknowledged need for improved service provision in the context of autism spectrum disorders (ASD). Previous studies have demonstrated the positive role drum training can play in improving behavioural outcomes for adolescents and children with emotional and behavioural difficulties, including ASD. Additionally, our proof-of-concept neuroimaging study in neurotypical adolescents revealed structural and functional connectivity changes following drum training, in brain areas related to sensorimotor integration and the mirror neuron system. This current study aimed to investigate the impact of drum training on behaviour and brain function in autistic adolescents. Thirty-six adolescents (mean (SD): 18 (1) yrs), with no prior drumming experience, and with an established clinical diagnosis of Autism Spectrum Disorder according to DSM-5 criteria, were age, gender and handedness matched before being randomly assigned to one of two groups. The drum group received individual drum tuition (two 45-minute lessons per week for an eight-week period) following an entry level drumming curriculum (Rockschool, 2018) while the control group did not and were instructed not to engage in any drum-related, music or new physical activities over that period. We explored behavioural outcomes related to drum practice in this clinical population and examined their association with changes in functional brain connectivity between the two groups. All participants attended a testing session pre and post drum training. Each session included a drumming assessment, a 45-minute MRI scan and a parent completing questionnaires (including the Social Skills Improvement System) relating to the participants’ socio-communication abilities and repetitive and restricted behaviours. Results showed that improvements in drumming, as seen in reduced timing errors (P=0.039), were associated with a significant reduction in hyperactivity and inattention difficulties in drummers compared to controls (P=0.004). The fMRI results demonstrated increased functional connectivity in brain areas responsible for inhibitory control, action outcomes monitoring and self-regulation. In particular, seed-to-voxel analyses revealed an increased functional connectivity in the right inferior frontal gyrus and the right dorsolateral prefrontal cortex, and a multivariate pattern analysis (a whole brain data driven approach using drumming performance as a regressor) demonstrated significant changes in the medial frontal cortex, the left and right paracingulate cortex, the subcallosal cortex, the left frontal pole, the caudate and the left nucleus accumbens. In conclusion, this is the first study to investigate the impact of a drum-based intervention on neural and behavioural outcomes in autistic adolescents. These results provide strong evidence that drumming not only reduces hyperactivity and inattention in autistic adolescents, but also strengthens functional integration in brain regions responsible for inhibitory control and action outcome monitoring. The results also highlight the central role of the prefrontal cortex in regulating motor impulsivity. We hope that these findings will inform further research trials into the potential use of drum-based interventions in benefitting clinical populations with inhibition-related disorders and emotional and behavioural difficulties.
Original languageEnglish
Publication statusPublished - Mar 2021
EventInternational Conference on Autism 2021 -
Duration: 25 Mar 202126 Mar 2021


ConferenceInternational Conference on Autism 2021
Abbreviated titleICA 2021


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