Autism Crises: Music Therapeutic Practice & Research at the Social Care Centre Tloskov, Czech Republic. A Short Report

摘要

CSS Tloskov is a social pediatric care center and a leading institution in the Czech Republic. Sixty-five percent of its clients are diagnosed with autism spectrum disorder (ASD) and receive usually music therapy as a main constituent of individually designed pedagogical and therapeutic programs. In contrast to numerous music therapeutic concepts that are based on musical improvisation, the Tloskov model advocates a complex approach involving favorite songs, instrumental improvisation, and body-oriented modalities such as muscle relaxation and breathing techniques. Clinical analyses allow us to distinguish typical psychiatric exacerbations in our ASD-clients. These "autistic crises" comprise an "onset phase," a "gradation phase," a "culmination phase," and a "subsiding phase," which can be partly controlled by music therapeutic interventions. On the basis of Grounded Theory we used qualitative methods to examine system compatibility between clinical data and the 4-phase autism crisis theory and to generate hypotheses about mechanisms of successful music therapy. Outcomes involve five main principles: identification and avoidance of specific stimuli and cues that trigger autism crises; direct musical "sedation "; acquisition of music-behavioral skills to "auto-regulate" pathological developments; and a sort of music therapeutic emotional re-balancing and consolidation of an inner equilibrium. The "right moment" of intervention and adjustment of musical experiences within a narrow range of the client's aesthetic-emotional intensity tolerance are critical to therapeutic outcomes. Possible music therapeutic contra-indications have to be taken into consideration.