For the moderately involved child, music can serve as a carrier signal for verbal communication. One child, while having no functional communication, had a storehouse of holiday and children's songs in her head. I only found this out one day when I didn't play the last note of a song. Not only did she say the correct word, she sang it at the right pitch. My only wish is that I would have been able to continue working with her in order to move this verbal ability towards functional communication. With limited verbal children of this nature, it is often possible to get them to vocalize and supply the missing words to a song they know by suddenly stopping the song and accompaniment at points of maximal tension. These places of “maximal tension” (Miller & Eller-Miller, 1989, p. 65, 93) occur at the cadences during the last few notes before the final note of the music.

Music, for the child with high-functioning autism or Asperger Syndrome can serve to organize the verbal communication skills that already exist. All of my communications with one particular child with Asperger Syndrome are sung. If I mistakenly lapse into a typical conversational tone, he loses focus, engages in self-stimulatory activities, and drifts away. In addition, given sufficient interest on the child's part, the music sessions may transform into fairly typical music lessons.

During our first session I created a system where the child asked me for pieces of paper that had the letter names of the notes. Once this series of events was internalized I expanded the routine by having him place the notes on the appropriate place on the music staff. This system was expanded further by having him draw a circle on the staff where the note belonged and write in the letter of the note. Then he would give the note to his mother. Fine motor problems were present and drawing a circle first helped confine where the note should go. Asking him on which space or line the note should go on (as opposed to a generic "Where does the note go?") also helped. The system was expanded yet again by having the child guess which note I had in my hand. After guessing correctly he then had to write the note on the staff before receiving the piece of paper.

We then took turns with him holding the notes, with either his mother or I having to guess which note he had in his hand. When it came time for me to write the note in the staff I would ask him in a singing voice on which line or space it went.

Other parts of the session were spent in imitative drumming, and later, work on the recorder. I made certain that we took turns in leading the imitation. This was a good activity to do when he seemed to be fading away and losing focus. His mother quickly caught on to our activities; participated very well in the session and we all had a pleasurable experience. The child has a lot of musical ability and using the Miller Method approach, he was taught to play the recorder and later the piano which he now plays well.

Instruments and ensembles

With the child that already plays an instrument, I will introduce myself into his world by sharing the instrument via turn taking. When I play the instrument the child accompanies me on percussion. Then we will switch roles. The turns start out short and gradually lengthen to where I work on other issues such as verbal skills, writing, and motor control as needed. To establish equality between us, I must also take my turns doing anything I require of him or her. I too, for example, need to ask for permission to use the keyboard if the child is already using it.

For the child at the high-functioning end of the autism spectrum, the school band may represent or provide an important avenue for development. The trombone requires a good kinesthetic sense of where one's arm is in order to place the trombone slide in the right place for a note to be in tune. Other instruments, except for the stringed ones, require less ear-to-arm coordination as the pitches are obtained with the assistance of keys or valves. The French horn, however, demands much coordination of the embouchure. Percussion may be another avenue. If complex rhythms present a challenge the bass drum may be a good choice as the musical patterns are relatively simple. Additionally, the bass drum with its low and relatively simple sound waves is often easier for a person with sound sensitivities to handle. Finally, being at the rear of a potentially cacophonous musical ensemble may be of help as it is not as noisy there.

Location in the ensemble may have to take sensory sensitivities into account. If a student with autism insists on playing a certain instrument and it is clear that there will be problems with sound sensitivities, allowing the child to sit in a different location may be easier than rearranging the ensemble in a non-standard manner. I skipped many Jazz band rehearsals in high school because the director was unwilling to let me sit elsewhere than right in front of the blaring trumpets. In addition to the purely musical benefits, playing in an ensemble is good for working on concepts such as cooperation with others, coordination, and a sense of accomplishment.