Having grown up in what he calls “a musical household,” Robert Accordino first learned about the benefits of music participation for people with autism while an undergrad studying psychology and music. Before heading to medical school, he did graduate work at Oxford University where he first encountered the UK version of Music for Autism, founded by musician-parents who had a son with autism. The idea stayed with Accordino upon returning to the States, and from his med school dorm room, he launched a U.S. version of the program in 2007 with four sensory-friendly concerts in the New York area. Today Music for Autism—which received an FY16 Art Works grant—hosts sensory-friendly concerts in several locations across the country including Washington, DC, Los Angeles, and Houston. Presented in a range of styles from jazz to musical theater to classical, concerts feature a diverse roster of artists, Tony and Grammy winners among them. In his own words, here’s Dr. Accordino on what exactly it means for a concert to be sensory-friendly and what success looks like for the project. Identifying the Need When parents learn that they have a son or daughter with a developmental condition like autism, it's one thing to accept the condition, it's another thing to realize the impact that it will have on families. What winds up happening is that doing things spontaneously without thorough preparation becomes a really big deal. If you need to pick up a quart of milk at the grocery store or if you want to as a family to go out to a meal or go to a shopping mall or go to a baseball game or a musical concert or a movie, these things that we take for granted become a huge deal when there's a family member with autism. So these families with a family member with autism retreat. They stay in more and more because they feel they'll be embarrassed due to behaviors exhibited by their family member with autism that may be misunderstood. It just makes their family too vulnerable to step outside into the public square because of passersby who may be quite judgmental. The “A-ha” Moment I grew up with parents and grandparents who were very musical, and I was exposed to a ton of music. I was struck by the fact at a very young age that there were families who would not be able to have these experiences. As a college student, I was studying psychology and music, and I was reading about potential connections between music and autism, that sometimes kids with autism sing before they speak or they respond to sung and not spoken language, that music somehow potentially makes language more interesting. My undergraduate thesis was a music therapy study with several families with autism and I got to know those families and the things they talked about the most were the number of activities that they were shut out from because of their family member with autism. It immediately occurred to me that this is something that's so important. This is something that's not focused on enough in terms of quality of life for these families. Before [I went] to medical school, I was lucky enough to do some graduate work with music and autism at Oxford University. I got to know more families complaining of similar things and got to know a charity in the UK called Music for Autism. Inspired by that organization, as a first-year medical student, I started Music for Autism out of my med school dorm room. “As long as no one or no instrument gets hurt, anything goes…” When we step into a concert hall we sign an implicit social contract that we're not going to get up and dance during "The Farmer and the Cowman Should be Friends" in Oklahoma! or we can't get up and hug characters on the stage during a romantic ballad. We have to stay in our seats, applaud when it's appropriate, and keep our mouths shut other than laughter and crying [in response] to what's on stage. Anything else is considered disruptive . As long as no one or no instrument gets hurt, anything goes at [Music for Autism] concerts. We're cautious about the volume of sound and we prepare families with a social story so they know what sorts of things will occur during the concert. The social story is a picture book that allows families to rehearse for new experiences. It starts with, "We're going to the Music for Autism concert. We'll walk into this building on 51st Street and in this building, there will be friendly people to greet us. When they greet us they'll show us where the bathroom is and we'll walk through the building. We take our seats and when we take our seats we can have some healthy snacks before the concert starts…” and so on. We also have on our website a “musical zoo” that allows concert participants to get used to some of the sounds they might hear so they can rehearse for that as well. When families arrive at the concert our goal is for the spirit of acceptance to commence from the moment they enter the building. We have volunteers who we train to greet and orient families to the physical space. One volunteer is assigned to every two to three families so it's very intimate and the volunteer can ask, "How can I make this experience as helpful and accommodating to you and your family?" to tailor the experience to the individual's needs. We have parts of the concert where we teach everyone how to conduct the ensemble; we have parts of the concert where we play along with percussion instruments. We soft clap by patting our legs to make the experience most sensory friendly. [We think] about the sensory experience of the concert. In other words, it’s making sure that there are no dynamic shifts that are very dramatic. There can be crescendos and decrescendos but [they are] a bit muted so that there are not sudden changes in the environment. We leave the lights on. There's also no wall between audience members and performers so audience members are free to move throughout the venue to participate in the music making in any way they feel comfortable. Some of the time a child may sit quietly while others may leave their seats and dance in the aisle. We've had kids and adults with autism sit next to pianists during performances. We obviously train the artists just as we train volunteers to be prepared for this. Everyone’s Welcome Our concerts are fully subsidized community events so no one has to pay to attend. We believe we are the most socioeconomically diverse autism-friendly program in the country because of this. We also have bilingual concerts responding to the fact that there were certain programs in Brooklyn where up to 30 percent of our participants were non-native English speakers. Some of them did not speak any English at all. We translated all of our materials and signage and social stories and everything that gets sent to families ahead of time and during the concerts into Spanish. We have live Spanish translation, too. So we've really adapted the model to support our families as best we can. The feedback that we have from families really fuels our endeavor. One mother said, "The Music for Autism concert was the first time I can say that we've felt truly welcome at a musical concert or anywhere for that matter, not once did I have to explain my nine-year-old son's behavior, how relaxing." That [kind of feedback] really propels us forward. The Importance of NEA Funding to Music for Autism We are completely supported through grants and private donations, grants from governmental organizations like the National Endowment for the Arts, and grants from private foundations that support us, as well as the support of individuals. That is our life blood. We don't charge admission to come to the concerts so we have no revenue generation except in the form of grants and charitable donations. [Our NEA grant] makes a world of difference in terms of our ability to continue doing the programs, to continue having these concerts in the cities where we have programs, and expanding strategically our geographic footprint to not only serve individuals with autism and their families but also to increase awareness that programs like this really expand the bounds of disability friendly programming for music and beyond. What Success Looks Like I think success for us would be having a broad enough geographic footprint such that we are directly serving as many families as we can and responding to their individual needs and that just by being present in a broad array of places that we are able to inspire more work, more programs like ours that are broadly accessible. There are now sensory-friendly museum visits across the country. There are orchestras that are doing sensory-friendly concerts. There are movie nights and matinees that are sensory friendly, Broadway shows, baseball games. I'm not claiming we're directly responsible for all of this, but we feel that we have pushed the agenda forward of what the needs of these families are and we imagine a world where we wouldn't really be necessary and we become obsolete.