Each year, approximately 8.5 million children in the U.S. walk into a therapist’s office to talk about their difficulties and find a path to better health. Freud called this the “talking cure”. But not all people believe there’s a cure and talking doesn’t always work. This becomes more evident when we realize that approximately 6 million children in the U.S. receive medication to try to manage their conditions [1].

Kids have difficulty verbalizing and putting words to their emotions — they simply haven’t learned the tools yet to talk about their feelings. And autistic and neurodiverse people can find social situations, including sitting in a room across from a therapist, intimidating, unpredictable, and unsettling.

Not only do children struggle to adjust to the classical therapeutic environment, but also, when parents seek help, it’s often not readily available. Nearly half of children with mental health disorders don’t get the treatment they need.[2]. Why? Several reasons: professionals are scarce (especially in rural or underserved communities), parents don’t have enough time to take their children to treatment, and costs are too high (no insurance coverage).

So how do you deal with this situation, especially among autistic and neurodiverse kids?

Healthcare at the tip of your fingers

You go virtual. With the use of a smartphone or computer, neurodiverse children can handle social situations more easily. These online health services allow kids to work on their issues from their home environment. It feels more comfortable and less intimidating for them. When they feel safe, healing can take its course.

But telehealth also addresses other barriers to therapy that usually discourage parents from seeking treatment:

• Virtual services increase access to care, especially when there’s a serious logistical challenge to have in-person sessions.

• Diagnosis happens earlier and treatment can be more consistent, and seamlessly integrated into the child’s daily routine.

• It’s more cost-effective than in-home therapies, making it a more viable option for a wider range of families.

And for those skeptical about virtual treatments, studies show a telehealth approach is a reliable and effective method to work with children with autism, even as a primary service model[3]. But, not all treatments meet their needs.

Music therapy is an exciting, validated, and reliable alternative. The research has shown again and again that music therapy improves their social skills, communication (nonverbal and verbal), overall mood, decreases undesirable behaviors (e.g. repetitive actions, aggressions, tantrums, etc.), and boosts sensory perceptions, among other positive outcomes[4]. Music allows kids to engage with others in a structured yet flexible way. It feels like a calming anchor in a sea of sensory overload.

Let’s take the case of Ryan[5], a six-year-old boy living in a historic town in northern California with his family who was diagnosed with autism at 18 months. Ryan’s sensory sensitivities made everyday experiences overwhelming. Loud noises, like church bells, would cause him distress, and unexpected contact, like hugs, could trigger tantrums. He didn’t understand how to interact with other children and this led to isolation and confusion in the playground or class. Instead of using words to express his needs or emotions he would go into meaningless repetition of words and would become agitated when misunderstood.

Music therapy helped him make a transformative leap. The rhythm and structure of the music allowed Ryan to explore and express his emotions in a comfortable framework. Songs about feelings taught him to identify and articulate his emotions, like using specific tunes to express happiness or sadness. By singing along with his mother, he improved his social skills, encouraging turn-taking and eye contact. Music allowed him to engage more with his environment and peers and feel more connected with a world that was once scary and menacing.

The power of music

Like Ryan’s case, using music as the primary tool for change instead of talking is an attractive and effective alternative for many kids and their families.

There are over 9,000 board-certified music therapists in the U.S. and abroad[6] but only 6% reside internationally[7]. Considering that there are around 1.5 million autistic children in the U.S. and over 40,000 in Canada, there are not enough music therapists to meet these demands if it’s in person. However, teletherapy significantly mitigates this shortage and reduces the challenges posed by families living in underserved or remote areas.

One innovative approach in online music therapy is CHIME Therapy. This next-generation platform merges telehealth with music therapy as its core tool, effectively addressing numerous challenges in the field.

• Access: it’s the first platform to bring together music therapists with clients to increase access to care.

• Evidence-based approach: the health center ensures that the treatment is provided by board-certified music therapists and rooted in scientific research.

• Ease of use: scheduling is easy and clients can message their therapist at any time.

• Widespread coverage: music therapists on CHIME can practice in most US states, all of Canada, and most countries in Europe.

• Data privacy: the platform is HIPAA-compliant which ensures that personal health information is kept private and secure according to strict government rules.

CHIME also takes on another major issue, especially in the field of music therapy: reimbursement. In 2016, 28% of all children in the U.S. didn’t have access to essential healthcare services. One of the main reasons is cost. High copays, deductibles, and the cost of prescription drugs can make it hard for families to afford the necessary healthcare for their children. It’s both disheartening and difficult to accept that this is the case in one of the wealthiest nations in the world.

CHIME vouches for its clients. Several programs are reimbursing clients for their services including the Ontario Autism Program in Canada and the Music Movement in the U.S. And for those clients who don’t receive reimbursement, CHIME ensures that if clients don’t experience improvements in what they call core domains (e.g. emotional, social, etc.) within 12 weeks, CHIME will give the client’s money back.

CHIME’s ins and outs

Their evidence-based approach to care involves twelve weeks of therapy with 1:1 video visits with certified music therapists. The treatment is tailored to each individual, and goals and progress are tracked across five areas of health including the emotional, mental, social/communication, physical, and spiritual domains.

Sessions are usually held once a week or even twice a week. Additionally, the direct line to their music therapist offers an extra layer of convenience for parents, who will value the flexibility in scheduling. This fits the unpredictable nature of a child’s day, from sudden changes in plans to illnesses.

One common misconception is that clients should have music knowledge to be part of this treatment. This is especially important to clarify with parents to ensure they feel encouraged to explore this therapy option for their children. Kids don’t need to know anything about music or play any instrument. Rather than working on developing the child’s music skills, music is used as a tool to help them understand themselves and the environment and learn to cope better with both the inner and outer worlds. Even without musical instruments at home, music therapists creatively employ tools like singing, vocabulary cards, rhythmic exercises, tapping hands to beats with each syllable for speech imitation, among many other innovative methods.

Music is the framework for healing, not the outcome.

Where next?

Before March 2020, telehealth in the U.S. was rarely used. It was difficult to coordinate doctors with patients, the reimbursement was inconsistent, regulations were unclear and people were concerned with privacy[8]. Telemedicine changed drastically afterward and it became more integrated into healthcare, but it still has a long way to go.

One of the main issues preventing mainstream adoption of telehealth is reimbursement for remote healthcare services[9]. Although virtual autism therapy was still covered by Medicare until the end of 2023, the future remains uncertain. Reimbursement rates are different for in-person services compared to remote services and telehealth reimbursement for autism treatment could be reduced post-COVID emergency due to the expiration of temporary coverage expansions.

Thus, the next step for CHIME is to get coverage by private insurance plans. They already started doing this in Canada with the Ontario Autism Program which already provides funding for 30,000 families with autistic children and implements their own result-based policy of reimbursement if therapy fails after 12 weeks of treatment.

The field of music therapy shows great promise with its market expected to grow from $2.62 billion in 2022 to $5.73 billion by 2030 at a 9.1% annual rate. As research continues and its benefits become more widely recognized, music therapy is set to become a key part of personalized care, particularly for young clients, including those who are autistic and neurodiverse. CHIME’s founder, Dr. David M. Greenberg, a world-renowned American-Israel psychologist and neuroscientist, shares his personal connection:

“Music therapy helped me as a child and my mission is to make evidence-based music therapy accessible to everyone, everywhere. So we created a platform to make that happen”.

Let music be the voice your child finds when words are out of reach- their growth will be your greatest gratitude.

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