Review Article

The Effectiveness of Music in Pediatric Healthcare: A Systematic Review of Randomized Controlled Trials

Table 2

Outcome measures and results of eligible studies.

StudyOutcomeFindings
TrialMeasureScaleAnalysisResult -value

Learning and developmental disorders

Change from baseline:Group A (MT) = 7.96Group B (no MT) = 4.60.045
Aldridge et al., 1995 [33]Developmental milestones (locomotor development; personal-social; hearing and speech; hand-eye coordination; performance tests; practical reasoning)Griffiths ScaleRepeated measures ANOVA
Change after crossover:Group A (no MT) = 3.92Group B (MT) = 5.83NS

Claussen and Thaut, 1997 [34]Recall accuracy of multiplication tablesTest of multiplication problemsANCOVAMean accurate responses (SE):PrePost
Music0.9 (.46)3.5 (.59).0001
Verbal1.6 (.48)2.1 (.62)

Buday, 1995 [35]Number of correctly imitated signed and spoken wordsScored by independent observerANOVAGroup means (SD) for correctly imitated words:MusicRhythm
Sign5.10 (2.89)4.00 (2.83) .05
Speech4.20 (3.36)3.20 (2.94) .02

Kim et al., 2008 [36]Joint attention skills and pro-social behaviors; nonverbal social communication skillsPervasive Developmental Disorder Behaviour Inventory-C (PDDBI); Early Social Communication Scales (ESCS); Video analysisRepeated measures ANOVA Effect size (95% CI) for music therapy vs. play session:
PDDBI: 0.79 ( to +1.71)NS
ESCS: 0.97 (+0.20 to +1.74) .05
Duration of behaviors:
Eye contact: MT > Play .0001
Turn taking: MT > Play .0001

Pratt et al., 1995 [37]EEG frequency band activity; severity of ADD/ADHD; adaptive and maladaptive behavioursEEG signal (A620 Assessment Software); McCarney Test (parents); Likert scale (parents)Wilcoxon signed-rank test Pre-post change in EEG power for ADD children :
Band ActivityMusicNo music
Beta band NS
Alpha band NS
Theta band NS
McCarney TestNS
Likert RatingsNS

Rickson and Watkins, 2003 [38]Aggressive behaviours: disruptive and antisocialDevelopmental Behaviour Checklist (DBC); Video analysisRepeated measures ANOVA Mean change for DBC Subscale :
TeacherParent
Group 1 (Control)
Group 2 (MT) NS
Group 3 (MTl)+2.83+1.00NS
Positive & negative events:
Group 1 vs Group 2 vs Group 3NS
Rickson, 2006 [39]Motor impulsivitySynchronised tapping task (STT); Conners' Rating Scales (teacher rated)Unpaired -tests and multi-way ANOVAGroup (Mean # of errors):PrePost
(1) NO music20.1322.43
(2) AB (Improv/Instruct)20.9111.56.02
(3) BA (Instruct/Improv)20.8912.18.02
Conner's DSM IV Total:
Group 1 > (Group 2 + Group 3).02
Conner’s Global Index Scale:
Group 1 > (Group 2 + Group 3).03

Stressful life events

Baker and Jones, 2006 [40]Classroom behaviours: externalising, internalising, school, Behavioral Symptom Index (BSI), adaptive skillsTeachers completed Behaviour Assessment System for Children (BASC)MANCOVAF-statistic (df = 21) for Treatment (music/no music) × time: Externalising: 2.21.01
Internalising: 0.32NS
Behavior Symptom Index: 2.57.07
School problems: 0.89NS
Adaptive skills: 0.53NS

DeLucia-Waack and Gellman, 2007 [41]Beliefs about divorce and affective measuresRevised Children's Manifest Anxiety Scale (RCMAS); Children's Depression Inventory (CDI); Children's Beliefs about Parental Divorce Scale (CBPDS)MANOVATreatment (music therapy/
psychoeducation) × time:
Anxiety Depression Irrational BeliefsF (6,127) = 0.487NS
F (10,123) = 1.416NS
F (12,111) = 0.988NS

Hilliard, 2007 [42]Grief symptoms and behavioural distressBehaviour Rating Index for Children (BRIC); Bereavement Group Questionnaire for Parents (BP)Within-group Wilcoxon signed-ranks testsChange in BRIC: ControlNS
Music therapy.01
Social work.04
Change in BP: ControlNS
Music therapy.01
Social workNS

Mood disorders and related psychopathology

Field et al., 1998 [43]Behaviour; mood; stress; left frontal activation1) Behaviour Observation Scale (BOS);
(2) Depression Adjective Checklist (DACL);
(3) Salivary Cortisol;
(4)EEG recording
Repeated measures MANOVA and post hoc tests Mean scores for music group (control group):
BeforeDuringAfter
(1) 14.0 (15.1)14.2 (14.9)14.7 (14.8)NS
(2) 9.5 (8.9)–- (–)9.7 (9.1)NS
(3) 1.3 (1.5)–- (–)0.5 (1.3).02
.05
Wooten, 1992 [44]Fluctuations in moodPositive and Negative Affect Scales (PANAS)Repeated measures ANOVANegative affect Treatment (none, rock or heavy metal) × time:
F (2, 204) = 0.25,
NS
Positive affect Treatment (none, rock or heavy metal) × time:
F (2, 204) = 1.28
NS

Acute and/or chronic physical illness

Colwell et al., 2005 [45]Self-conceptPiers-Harris Children's Self Concept Scale (PHCSS)*MANCOVAPre- to post-test mean differences:Music composition 2.08Art composition 2.00NS

Robb et al., 2008 [46]Frequency of coping related behaviorsTime sampling of observed behaviours:Repeated measures ANOVA and post hoc testsAMEMLASB
Positive facial affect18.63 (13.0)7.7 (7.5)2.0 (2.3)AME>ML, ASB; <.0001
Active engagement26.03 (4.1)15.65 (6.2)15.17 (4.9)AME>ML, ASB; <.0001
Active initiation14.19 (8.3)15.89 (11.2)7.43 (6.6)AME, ML>ASB; <.05

Froehlich, 1984 [47]Verbalization of hospital experiencesStandardized questionnaires and coding system to rate quality of responsesChi-Square% of responses coded:Music therapyPlay therapy
Answer90%62%<.10
No answer10%38%

Grasso et al., 2000 [48]Enjoyment and perception of time7-point bipolar Likert-type Child* & Parent Enjoyment scale (proxy) and Caregiver Perception of Time surveyKruskal-Wallis Median (range) group change for Child enjoyment:
Treatment music (TM)Familiar music (FM)No music (NM)
+1.25 ( to +4.0)+0.75 ( to +3.0) ( to +2.0)TM vs NM;.03
FM vs NM; NS
Oelkers-Ax et al., 2008 [49]Relative reduction in headache frequencyChild-adapted daily headache diary% reduction from baseline°: Butterbur, Placebo, Music
Repeated measuresPost-test ,   ,   M>P;.005 (at T1) and  .018 (at T2)
ANOVAFollow-up ,   ,   B>P; NS (at T1) and  .044 (at T2)

No significant effects reported for ADHD children.
Similar findings for Antisocial Subscale.
Only child-related outcome measure reported on.
Only data for treatment completers reported on.