Using a Music Therapy Collaborative Consultative Approach - World ...

In spite of the short intervention phase (11 days), Andy made some progress in
learning parts of the toileting procedure as evidenced by the data. Andy learned and
performed all steps of the toileting routine, except step eight (assisting the teacher to re-dress
by holding his shirt up). During both conditions he performed a maximum of five steps of
the ten-step toileting routine at once. Overall, Andy learned 35.5% of the toileting
procedure. The lyric intervention produced a slightly greater independent performance
(M=38.2%) than the song intervention (M=32%). The complexity and novelty of both the
toileting procedure and the unique song might have been overwhelming for Andy. This
replicates earlier observations claiming that children with autism are often confused by the
sequencing actions involved in toileting (Dalrymple & Boarman, 1992; Wheeler, 1998), and
the novelty of songs (Brownell, 2002). The results of this study support the premise that
toilet training using the scheduled method and structured teaching approach might require
several months, particularly for children with autism (Boswell & Gray, 2003; Heffner, 2002;
Siegel, 1998, Wheeler, 1998).
In addition, the ATD used to evaluate whether the song intervention or lyric
intervention was more effective might have interfered with the child’s learning process. It
might have been confusing for Andy that the song was sung on one day and not on others.
Boswell and Gray (2003) strongly suggest using a predictable routine when toilet-training
children with autism. The predictable routine was only partly kept by following the same
sequence, but the presentation of the sequence (song-lyrics) alternated daily. An A-B-A-B
withdrawal design might have given clearer information on whether songs as a structural
prompt are more effective than the verbal presentation of this fairly novel routine and song.
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