Mental Health

Impact of Drum Training on Neural Function of Autistic Adolescents

A team of researchers explored the impact of drum training on the brain function and behavior of adolescents with autism spectrum disorder (ASD). The study findings have been published in the PNAS journal.

A total of 36 adolescents with ASD diagnosis based on the diagnostic and statistical manual, fifth edition-based were enrolled for the study and divided into two groups i.e., the drum group comprising 19 autistic adolescents and the control group, comprising 17 individuals. The drug group received drum lessons twice weekly for 8 weeks, whereas the control group did not.

Each training session comprised drumming assessments of 20 minutes duration, functional magnetic resonance imaging (fMRI) scans of 45 minutes duration, neuropsychological tests, and parent-completed questionnaires which were related to the participants’ behaviors. The drumming assessments comprised nine exercises performed at 60, 90, and 120 beats per minute (bpm).

Drumming improvements were assessed quantitatively as the reduction in onset errors post drumming sessions. The absolute and non-absolute differences between the actual drumming note by the drummer and the expected note, for the nine exercises performed at the three tempi were referred to as the timing error and the relative timing error, respectively.

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The team assessed the behavioral outcomes related to drum practice among participants and comparatively assessed the functional connectivity (FC) changes between the drummers and controls and the FC changes prior to and post drumming. Scales such as the Social Skills Improvement System (SSIS) rating scale and the Repetitive Behavior Scale-Revised (RBS) were used for the assessments. Seed-to-voxel and voxel-to-voxel/ multivariate pattern analyses (MVPA) were performed.

Despite the enrollment of 36 autistic adolescents, the drumming performance was analyzed for only 32 participants (17 drummers and 15 controls) since one participant couldn’t attend the assessment session post-drumming (n=1) or misunderstood the drumming assessment instructions (n=3).

Results of the study

Significant time-group interactions were observed for the hyperactivity/inattention subscale with substantially decreased attention difficulties, and hyperactivity among drummers compared to controls. Drummers also showed significant improvements in timing errors and anticipation errors over time whereas the controls did not.

Significant reductions in externalizing and behavioral issues (stereotyped behaviors, repetitive behaviors, and sameness behaviors) were noted post-drumming in comparison to before drumming lessons. The findings indicated improvements in cognitive flexibility, social relationship management ability, reductions in physical and verbal aggression, the release of physical tensions, and overall improved mental and social well-being post-drumming.

The fMRI scans showed higher FC values for brain sites of self-regulation, action outcomes monitoring, and inhibitory control. Drumming improvements were associated closely with enhanced anticipation measures reflective of increased ability to delay motor responses.

The seed-to-voxel analyses showed higher FC values for the right dorsolateral prefrontal cortex (rDLPFC), the right inferior frontal gyrus (rIFG), precuneus, the posterior cingulate gyrus of the brain. The findings indicated that drumming improved observation and imitation of actions and integration of body-based senses.

Significant changes were also noted for the left and right paracingulate cortex, left nucleus accumbens, frontal medial cortex, left frontal pole, caudate, and the subcallosal cortex post-drumming. FC values were also higher for the intracalcarine cortex, cuneal cortex, superior parietal lobule, supracalcarine cortex, and the superior lateral occipital cortex of the left side of the brain. The findings indicated enhanced motor learning, visualization, object exploration, spatial orientation, and verbal and non-verbal communication skills including language development, face perception, and mentalizing post-drumming. There were no significant FC changes among controls.

The voxel-to-voxel analysis demonstrated four clusters of improved FC connectivity overlapping with the dorsal attention network among drummers. Cluster 1 consisted of the medial frontal cortex and the right and left paracingulate gyrus; cluster 2 consisted of the frontal medial cortex and subcallosal cortex; cluster 3 comprised the frontal medial cortex and frontal pole of the left side; cluster 4 consisted of the caudate, left nucleus accumbens and the subcallosal cortex.

Overall, the study findings demonstrated that drumming lessons improved several outcomes in adolescents with ASD such as reduced hyperactivity, and improved attention, behavior, inhibitory control, self-regulation, and functional connectivity across different brain regions. Additionally, the study findings highlighted the potential use of drum-based techniques for individuals with emotional and behavioral disorders and inhibition-related dysfunction.


The effect of learning to drum on behavior and brain function in autistic adolescents. Marie-Stephanie Cahart, Ali Amad Stephen B. Draper, Ruth G. Lowry, Luigi Marino, Cornelia Carey, Cedric E. Ginestet, Marcus S. Smith, and Steven C. R. Williams. PNAS 2022 Vol. 119 No. 23 e2106244119



Pooja Toshniwal Paharia

Dr. Pooja Toshniwal Paharia is a Consultant Oral and Maxillofacial Physician and Radiologist, M.DS (Oral Medicine and Radiology) from Mumbai. She strongly believes in evidence-based radiodiagnosis and therapeutic regimens for benign, potentially malignant, or malignant lesions and conditions either arising from the oral and maxillofacial structures or manifesting in the associated regions.

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