Musicoterapia e Hipersensibilidade Auditiva no Transtorno do Espectro Autista
Revisão de Literatura e Proposição de Protocolo Clínico
Palavras-chave:
Transtorno do Espectro Autista, Musicoterapia, Música, hipersensibilidade, protocolos clinicosResumo
Este estudo investiga o manejo musical e musicoterapêutico da hipersensibilidade auditiva no Transtorno do Espectro Autista (TEA), condição com impacto crítico na regulação emocional e na participação social. O objetivo consistiu em realizar uma revisão integrativa da literatura para subsidiar a proposição do Protocolo Musicoterapêutico para Redução da Hipersensibilidade (PMRH). Metodologicamente, as buscas em bases indexadas e estratégias complementares resultaram na seleção de 20 artigos. A fundamentação teórica articula os achados da literatura com a práxis da musicoterapia clínica, compreendendo a reatividade sonora como resposta emocional mediada pela necessidade de segurança autonômica e regulação límbica. Os resultados da revisão evidenciam uma lacuna de intervenções estruturadas que priorizem a agência do paciente em detrimento de métodos passivos de estimulação. Como desfecho principal, o estudo apresenta o PMRH, organizado em 12 sessões distribuídas em cinco fases procedimentais: Avaliação de Base, Sintonização, Integração Narrativa, Autonomia e Reavaliação. Conclui-se que a transição de modelos diretivos para abordagens fundamentadas no protagonismo da criança e na improvisação musical é determinante para o delineamento de intervenções musicoterapêuticas voltadas à modulação sensorial no TEA
Downloads
Referências
AAZH, H. Cognitive behavioural therapy (CBT) for managing tinnitus, hyperacusis, and misophonia: the 2025 Tonndorf lecture. Brain Sciences, v. 15, n. 5, p. 526, 2025. DOI: https://doi.org/10.3390/brainsci15050526.
ABIDIN, R. R. Parenting Stress Index: Professional Manual. 3. ed. Odessa: Psychological Assessment Resources, 1995.
ADAMS, B. et al. A Delphi survey to determine a definition and description of hyperacusis by clinician consensus. International Journal of Audiology, v. 60, n. 8, p. 607-613, dez. 2020.
AMERICAN PSYCHIATRIC ASSOCIATION. Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5. ed. Porto Alegre: Artmed, 2014.
ANARI, M. et al. Hypersensitivity to sound: questionnaire data, audiometry and classification. Scandinavian Audiology, v. 28, n. 4, p. 219-230, out. 2009.
ARAÚJO, P. E. T. G.; FREIRE, M. H. Musicoterapia e autismo: revisando experiências musicais e perspectivas musicoterapêuticas. Brazilian Journal of Music Therapy, v. 25, n. 36, 2023. DOI: https://doi.org/10.51914/brjmt.36.2023.436.
BARCELLOS, L. R. M.; SANTOS, M. A. C. A musicoterapia no Brasil. Revista Brasileira de Musicoterapia, v. 23, n. 32, 378, 2021. DOI: https://doi.org/10.51914/brjmt.32.2021.378.
BETTISON, S. The long-term effects of auditory training on children with autism. Journal of Autism and Developmental Disorders, v. 26, n. 3, p. 361-374, 1996. DOI: https://doi.org/10.1007/BF02172480.
BERGER, Dorita S. Music Therapy, Sensory Integration and the Autistic Child. London: Jessica Kingsley Publishers, 2002.
BRUSCIA, Kenneth. Definindo Musicoterapia. 3. ed. Dallas: Barcelona Publishers, 2016.
CARSON, T. B.; GUERRERO, L. A.; NIEBLES, M.; GAYLE, C. G. F. Modified cognitive behavioral therapy approach reduces loudness discomfort levels for an autistic child with hyperacusis: case report. Frontiers in Psychiatry, v. 15, p. 1440624, 2024. DOI: https://doi.org/10.3389/fpsyt.2024.1440624.
DANESH, A. A. et al. Hyperacusis in autism spectrum disorders. Audiology Research, v. 11, n. 4, p. 547-556, out. 2021.
FREIRE, M. H. Efeitos da Musicoterapia Improvisacional no tratamento de crianças com Transtorno do Espectro do Autismo. 2014. Dissertação (Mestrado em Neurociências) – Universidade Federal de Minas Gerais, Belo Horizonte, 2014.
FU, Y. et al. Improvement of symptoms in children with autism by TOMATIS training: a cross-sectional and longitudinal study. Frontiers in Behavioral Neuroscience, v. 18, 1357453, 2024. DOI: https://doi.org/10.3389/fnbeh.2024.1357453.
GASSNER, L.; GERETSEGGER, M.; MAYER-FERBAS, J. Effectiveness of music therapy for autism spectrum disorder, dementia, depression, insomnia and schizophrenia: update of systematic reviews. European Journal of Public Health, v. 32, n. 1, p. 27-34, fev. 2022. DOI: https://doi.org/10.1093/eurpub/ckab042.
GERETSEGGER, M. et al. Music therapy for autistic people. Cochrane Database of Systematic Reviews, n. 5, 2022. Art. No.: CD004381.
HOOPER, J.; MCMANUS, A.; MCINTYRE, A. Exploring the link between music therapy and sensory integration: an individual case study. British Journal of Music Therapy, v. 18, n. 1, p. 15-23, 2004.
JACQUEMIN, L.; SCHECKLMANN, M.; BAGULEY, D. M. Hypersensitivity to sounds. In: SCHLEE, W. et al. (org.). Textbook of tinnitus. Cham: Springer, 2024.
KATIKAR, M. S.; DEVI, A.; PRABHU, P. Sensory processing in Autism Spectrum Disorder: insights into misophonia, and hyperacusis in a pediatric population. International Journal of Pediatric Otorhinolaryngology, v. 189, n. 112241, p. 1-3, jan. 2025.
KHALFA, S. et al. Psychometric normalization of a hyperacusis questionnaire. Audiology and Neurotology, v. 7, n. 6, p. 453–462, 2002. DOI: 10.1159/000067570.
KOEGEL, R. L.; OPENDEN, D.; KOEGEL, L. K. A systematic desensitization paradigm to treat hypersensitivity to auditory stimuli in children with autism in family contexts. Research and Practice for Persons with Severe Disabilities, v. 29, n. 2, p. 122-134, 2004.
LAGASSE, A. B. et al. Assessing the impact of music therapy on sensory gating and attention in children with autism: a pilot and feasibility study. Journal of Music Therapy, v. 56, n. 3, p. 287-314, 2019. DOI: https://doi.org/10.1093/jmt/thz008.
LAGASSE, B.; YOO, G. E.; HARDY, M. W. Rhythm and music for promoting sensorimotor organization in autism: broader implications for outcomes. Frontiers in Integrative Neuroscience, v. 18, 1403876, 2024. DOI: https://doi.org/10.3389/fnint.2024.1403876.
LEE, L.; HO, H.-J. Technology-enhanced multisensory music education for children with autism: effects on sensory integration and learning behaviors. Eurasia Journal of Mathematics, Science and Technology Education, v. 21, n. 7, em2664, 2025. DOI: https://doi.org/10.29333/ejmste/16566.
LI, Ning; LI, Ling; LI, Guimei; GAI, Zhongtao. The association of auditory integration training in children with autism spectrum disorders among Chinese: a meta-analysis. Bioscience Reports, v. 38, n. 4, p. BSR20181412, 2018. DOI: https://doi.org/10.1042/BSR20181412.
LINK, Hanna M. Auditory Integration Training (AIT): Sound Therapy? Case Studies of Three Boys with Autism who Received AIT. British Journal of Learning Disabilities, v. 25, n. 3, p. 106-111, 1997. DOI: https://doi.org/10.1111/j.1468-3156.1997.tb00021.x.
LIUZZI, T. et al. Euterpe music therapy methodology and procedure algorithms. Frontiers in Neurology, v. 15, 1443329, 2024. DOI: https://doi.org/10.3389/fneur.2024.1443329.
LIU, Yuqing; TAN, Jie. Music and Sensory Integration. Lecture Notes in Education Psychology and Public Media, v. 89, n. 1, p. 106–111, maio 2025. DOI: 10.54254/2753-7048/2025.22826.
LUCKER, J. R. Auditory hypersensitivity in children with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, v. 28, n. 3, p. 184-191, 2013.
PORGES, S. W. et al. Reducing auditory hypersensitivities in autistic spectrum disorder: preliminary findings evaluating the Listening Project Protocol. Frontiers in Pediatrics, v. 2, 80, 2014. DOI: https://doi.org/10.3389/fped.2014.00080.
RAIPURE, P. A.; HARDIKAR, S. Effectiveness of sensory integration therapy with music therapy on sensory processing and reciprocal activities in children with autism spectrum disorder. International Journal of Health Sciences and Research, v. 13, n. 11, p. 22-28, 2023. DOI: https://doi.org/10.52403/ijhsr.20231105.
SALVI, Richard; CHEN, Guang-Di; MANOHAR, Senthilvelan. Hyperacusis: Loudness intolerance, fear, annoyance and pain. Hearing Research, v. 426, p. 108648, Nov. 2022. DOI: https://doi.org/10.1016/j.heares.2022.108648.
SAMPAIO, R. T.; LOUREIRO, C. M. V.; GOMES, C. M. A. A Musicoterapia e o Transtorno do Espectro do Autismo: uma abordagem informada pelas neurociências para a prática clínica. Per Musi, n. 32, p. 1-34, nov. 2015. Disponível em: https://periodicos.ufmg.br/index.php/permusi/article/view/38415.
SANTOS, V. M. M. F. et al. Prevalência de hipersensibilidade auditiva em pessoas com transtornos do Espectro Autista. 2023. Trabalho de Conclusão de Curso (Graduação em Fonoaudiologia) – Universidade Federal da Paraíba, João Pessoa, 2023.
SCHEERER, N. E. et al. Family experiences of decreased sound tolerance in ASD. Journal of Autism and Developmental Disorders, v. 52, n. 1, p. 4007-4021, set. 2021.
SINHA, Y.; SILOVE, N.; HAYEN, A.; WILLIAMS, K. Auditory integration training and other sound therapies for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, n. 12, art. no. CD003681, 2011. DOI: https://doi.org/10.1002/14651858.CD003681.pub3.
SHAHRUDIN, Fatin Amira; DZULKARNAIN, Ahmad Aidil Arafat; HANAFI, Ayu Madiha; JAMAL, Fatin Nabilah; BASRI, Nadzirah Ahmad; SIDEK, Shahrul Na’im; YUSOF, Hazlina Md; KHALID, Madihah. Music and Sound-Based Intervention in Autism Spectrum Disorder: A Scoping Review. Psychiatry Investigation, v. 19, n. 8, p. 626-636, 2022. DOI: https://doi.org/10.30773/pi.2021.0382.
VARNI, J. W. Pediatric Quality of Life Inventory. 1998. Disponível em: https://www.pedsql.org/pedsql12.html. Acesso em: 21 jun. 2025.
VINCENT, V. et al. Effectiveness of sound-based interventions for improving functional outcomes in children: a systematic review of the evidence. Occupational Therapy International, v. 2025, 1693722, 2025. DOI: https://doi.org/10.1155/oti/1693722.
WEITLAUF, A. S. et al. Interventions targeting sensory challenges in autism spectrum disorder: a systematic review. Pediatrics, v. 139, n. 6, e20170347, jun. 2017. DOI: https://doi.org/10.1542/peds.2017-0347.
WIGRAM, Tony. Improvisation: methods and techniques for music therapy clinicians, educators and students. London: Jessica Kingsley Publishers, 2004.
WILLIAMS, K. L.; TOMCHEK, S. D.; SIDERIS, J. Prevalence of decreased sound tolerance (hyperacusis) in individuals with autism spectrum disorder: a meta-analysis. Ear and Hearing, v. 42, n. 5, p. 1137-1150, set. 2021.
ZHAO, L.; WANG, Y.; ZHANG, Z. Music in intervention for children with autism: a review of the literature and discussion of implications. Current Psychology, v. 44, p. 4411-4421, 2025. DOI: https://doi.org/10.1007/s12144-025-07449-z.
