An investigation of the effects of music therapy on profoundly mentally handicapped adults is reported. The therapy was directed at achieving specific objectives for individuals and the study compared the efficacy of music therapy and play activities in achieving these objectives. Four subjects out of the 12 included in the therapy groups were studied intensively. All subjects received both treatments in a reversal design with 20 weekly sessions of each treatment. Videotapes of the treatment sessions were analysed using a time-sampling method to record the occurrence of behaviour indicating the achievement of the individual treatment objectives. Staff behaviour in the treatment sessions was also observed to investigate the role of staff attention in mediating the treatment effects. The observations of staff behaviour showed that, overall, there was less individual attention given during music therapy than in play sessions, that there was a much greater role differentiation among the staff present in the music therapy groups and that individual clients in the groups received markedly unequal amounts of staff attention. For all four subjects studied in detail, some differences in behaviour were shown between the treatments and most, but not all, of these differences indicated greater effectiveness of music therapy. For one subject showing higher performance in play sessions than in music therapy, this could be attributed to a higher level of staff attention for this subject. The differences in favour of music therapy could not be accounted for in this way. It is concluded that music therapy is a useful treatment approach with profoundly handicapped people.
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