Examining the relationship between skilled music training and attention

Exploring the Intersection of ADHD and Music: A Systematic Review

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental disorder, affecting both children and adults, which often leads to significant difficulties with attention, impulsivity, and working memory. These challenges can impact various cognitive and perceptual domains, including music perception and performance. Despite these difficulties, individuals with ADHD frequently engage with music, and previous research has shown that music listening can serve as a means of increasing stimulation and self-regulation. Moreover, music therapy has been explored as a potential treatment option for individuals with ADHD. As there is a lack of integrative reviews on the interaction between ADHD and music, the present review aimed to fill the gap in research. Following PRISMA guidelines, a comprehensive literature search was conducted across PsychInfo (Ovid), PubMed, and Web of Science. A narrative synthesis was conducted on 20 eligible studies published between 1981 and 2023, involving 1170 participants, of whom 830 had ADHD or ADD. The review identified three main areas of research: (1) music performance and processing in individuals with ADHD, (2) the use of music listening as a source of stimulation for those with ADHD, and (3) music-based interventions aimed at mitigating ADHD symptoms. The analysis revealed that individuals with ADHD often experience unique challenges in musical tasks, particularly those related to timing, rhythm, and complex auditory stimuli perception, though these deficits did not extend to rhythmic improvisation and musical expression. Most studies indicated that music listening positively affects various domains for individuals with ADHD. Furthermore, most studies of music therapy found that it can generate significant benefits for individuals with ADHD. The strength of these findings, however, was limited by inconsistencies among the studies, such as variations in ADHD diagnosis, comorbidities, medication use, and gender. Despite these limitations, this review provides a valuable foundation for future research on the interaction between ADHD and music.

A Descriptive Study on the Effect of Music on Speech-in-Noise Perception in Binaural and Monaural Hearing Aid Users

Many auditory system functions improve under the influence of music. The binaural hearing also plays a critical role in speech-in-noise perception. The present study was done to investigate the effect of music on speech-in-noise perception in binaural and monaural hearing aid users. This study was conducted on 40 unilateral and bilateral hearing aid users aged 25 to 55, including 23 female and 17 male individuals. The Q-SIN test and SSQ questionnaire were used to investigate the effect of music on speech-in-noise perception before and after the treatment. Results of the Q-SIN test showed that music reduced SNR-50 and SNR LOSS, which was more evident in bilateral hearing aid users (p < 0.05). Results of the SSQ questionnaire also indicated that after the 3-month reevaluation, the questionnaire scores increased, and the increase was higher in the bilateral hearing aid users (p < 0.05). Regularly listening to music on a programmed basis improves speech-in-noise perception. Results of the present study showed that bilateral hearing aids had a higher effect on improving speech-in-noise perception than unilateral hearing aids.

Music training is associated with better audio-visual integration in Chinese language

In the present study, we aimed to investigate whether long-term music training could improve audio-visual speech integration in Chinese, using event-related brain potential (ERP) measurements. Specifically, we recruited musicians and non-musicians to participate in our experiment where visual Chinese characters were presented simultaneously with congruent or incongruent speech sounds. In order to maintain participants' focus on both auditory and visual modalities, they were instructed to perform a probe detection task. Our study revealed that for the musicians, audiovisual incongruent stimuli elicited larger N1 and N400 amplitudes compared to audiovisual congruent stimuli. Conversely, for the non-musicians, only a larger N400 amplitude was observed for incongruent stimuli relative to congruent stimuli, without a significant difference in N1 amplitude. Furthermore, correlation analyses indicated that more years of music training was associated with a larger N1 effect for the musicians. These results suggest that musicians were capable of detecting character-speech sound incongruence at an earlier time window compared to non-musicians. Overall, our findings provide compelling evidence that music training is associated with better integration of visual characters and auditory speech sounds in language processing.

Digital rhythm training improves reading fluency in children

Musical instrument training has been linked to improved academic and cognitive abilities in children, but it remains unclear why this occurs. Moreover, access to instrument training is not always feasible, thereby leaving less fortunate children without opportunity to benefit from such training. Although music-based video games may be more accessible to a broader population, research is lacking regarding their benefits on academic and cognitive performance. To address this gap, we assessed a custom-designed, digital rhythm training game as a proxy for instrument training to evaluate its ability to engender benefits in math and reading abilities. Furthermore, we tested for changes in core cognitive functions related to math and reading to inform how rhythm training may facilitate improved academic abilities. Classrooms of 8-9 year old children were randomized to receive either 6 weeks of rhythm training (N = 32) or classroom instruction as usual (control; N = 21). Compared to the control group, results showed that rhythm training improved reading, but not math, fluency. Assessments of cognition showed that rhythm training also led to improved rhythmic timing and language-based executive function (Stroop task), but not sustained attention, inhibitory control, or working memory. Interestingly, only the improvements in rhythmic timing correlated with improvements in reading ability. Together, these results provide novel evidence that a digital platform may serve as a proxy for musical instrument training to facilitate reading fluency in children, and that such reading improvements are related to enhanced rhythmic timing ability and not other cognitive functions associated with reading performance. RESEARCH HIGHLIGHTS: Digital rhythm training in the classroom can improve reading fluency in 8-9 year old children Improvements in reading fluency were positively correlated with enhanced rhythmic timing ability Alterations in reading fluency were not predicted by changes in other executive functions that support reading A digital platform may be a convenient and cost-effective means to provide musical rhythm training, which in turn, can facilitate academic skills.

Successful learning of alpha up-regulation through neurofeedback training modulates sustained attention

As a fundamental attention function, sustained attention plays a critical role in general cognitive abilities and is closely linked to EEG alpha oscillations. Neurofeedback training (NFT) of alpha activity on different aspects of attention has been studied previously. However, it remains unclear how NFT with up- or down-regulation directions modulates sustained attention. Here we employed a counterbalanced single-blind sham-controlled crossover design, in which healthy young adults underwent one NFT session of alpha up-regulation, one NFT session of alpha down-regulation, and one sham-control NFT session over the posterior area. The session order was counterbalanced with a 7-day interval between each session. After each NFT session, the participants completed a visual continuous temporal expectancy task (vCTET) to assess their sustained attention performance. The results showed that compared to sham-control NFT, successful learning of alpha up-regulation resulted in increased reaction time at the beginning of the attention task but a slower increase over vCTET blocks. On the other hand, successful learning of alpha down-regulation had no impact on attention performance compared to sham-control NFT. These findings suggest that successful learning of alpha up-regulation through NFT could impair initial attention performance but slow down visual attention deterioration over time, i.e., alpha enhancement by NFT stabilizing visual attention.

Misjudgement of One's Own Performance? Exploring Attention Deficit (Hyperactivity) Disorder (ADHD) and Individual Difference in Complex Music and Foreign Language Perception

In previous research, we detected that children and adolescents who were diagnosed with ADHD showed deficits in both complex auditory processing of musical stimuli and in musical performance when compared to controls. In this study, we were interested in whether we could detect similar or distinct findings when we use foreign speech perception tasks. Therefore, we recruited musically naïve participants (n = 25), music-educated participants (n = 25) and participants diagnosed with ADHD (n = 25) who were assessed for their short-term memory (STM) capacity and the ability to discriminate music and speech stimuli and we collected self-ratings of the participants' music and language performances. As expected, we found that young adults with ADHD show deficits in the perception of complex music and difficult speech perception stimuli. We also found that STM capacity was not impaired in young adults with ADHD and may not persist into young adulthood. In addition, subjective self-estimation about the participants' language and music performances revealed that the ADHD group overestimated their performance competence relatively compared to both control groups. As a result, the findings of our study suggest that individuals diagnosed with ADHD require a special training program that not only focuses on improving performance in perceptual skills of music and language but also requires metacognitive training to develop realistic self-assessment skills.

The Relationship between Formal Music Training and Conflict Control: An ERP Study

Music training involves manifolds of sensorimotor processes that tie closely with executive functions, including conflict control. Past studies have found consistent evidence in children of the link between music learning and executive functions. However, the same relationship has not been found in adult populations, and conflict control has yet to be studied in a focused manner. Via the Stroop task and event-related potentials (ERPs), the present study examined the association between musical training and conflict control ability among Chinese college students. The findings exhibited that individuals with music training outperformed individuals without music training by demonstrating higher accuracy and faster reaction times on the Stroop task and exhibiting greater N2 and smaller P3 amplitudes compared to the control group. The results support our hypothesis that people who received music training demonstrate advantages in their capacity for conflict control. The findings also provide scope for future research.

Can musical ability be tested online?

We sought to determine whether an objective test of musical ability could be successfully administered online. A sample of 754 participants was tested with an online version of the Musical Ear Test (MET), which had Melody and Rhythm subtests. Both subtests had 52 trials, each of which required participants to determine whether standard and comparison auditory sequences were identical. The testing session also included the Goldsmiths Musical Sophistication Index (Gold-MSI), a test of general cognitive ability, and self-report questionnaires that measured basic demographics (age, education, gender), mind-wandering, and personality. Approximately 20% of the participants were excluded for incomplete responding or failing to finish the testing session. For the final sample (N = 608), findings were similar to those from in-person testing in many respects: (1) the internal reliability of the MET was maintained, (2) construct validity was confirmed by strong associations with Gold-MSI scores, (3) correlations with other measures (e.g., openness to experience, cognitive ability, mind-wandering) were as predicted, (4) mean levels of performance were similar for individuals with no music training, and (5) musical sophistication was a better predictor of performance on the Melody than on the Rhythm subtest. In sum, online administration of the MET proved to be a reliable and valid way to measure musical ability.

Effects of Amateur Musical Experience on Categorical Perception of Lexical Tones by Native Chinese Adults: An ERP Study

Music impacting on speech processing is vividly evidenced in most reports involving professional musicians, while the question of whether the facilitative effects of music are limited to experts or may extend to amateurs remains to be resolved. Previous research has suggested that analogous to language experience, musicianship also modulates lexical tone perception but the influence of amateur musical experience in adulthood is poorly understood. Furthermore, little is known about how acoustic information and phonological information of lexical tones are processed by amateur musicians. This study aimed to provide neural evidence of cortical plasticity by examining categorical perception of lexical tones in Chinese adults with amateur musical experience relative to the non-musician counterparts. Fifteen adult Chinese amateur musicians and an equal number of non-musicians participated in an event-related potential (ERP) experiment. Their mismatch negativities (MMNs) to lexical tones from Mandarin Tone 2–Tone 4 continuum and non-speech tone analogs were measured. It was hypothesized that amateur musicians would exhibit different MMNs to their non-musician counterparts in processing two aspects of information in lexical tones. Results showed that the MMN mean amplitude evoked by within-category deviants was significantly larger for amateur musicians than non-musicians regardless of speech or non-speech condition. This implies the strengthened processing of acoustic information by adult amateur musicians without the need of focused attention, as the detection of subtle acoustic nuances of pitch was measurably improved. In addition, the MMN peak latency elicited by across-category deviants was significantly shorter than that by within-category deviants for both groups, indicative of the earlier processing of phonological information than acoustic information of lexical tones at the pre-attentive stage. The results mentioned above suggest that cortical plasticity can still be induced in adulthood, hence non-musicians should be defined more strictly than before. Besides, the current study enlarges the population demonstrating the beneficial effects of musical experience on perceptual and cognitive functions, namely, the effects of enhanced speech processing from music are not confined to a small group of experts but extend to a large population of amateurs.

Evidence for Enhanced Long-term Memory in Professional Musicians and Its Contribution to Novel Word Learning

Previous studies evidenced transfer effects from professional music training to novel word learning. However, it is unclear whether such an advantage is driven by cascading, bottom-up effects from better auditory perception to semantic processing or by top-down influences from cognitive functions on perception. Moreover, the long-term effects of novel word learning remain an open issue. To address these questions, we used a word learning design, with four different sets of novel words, and we neutralized the potential perceptive and associative learning advantages in musicians. Under such conditions, we did not observe any advantage in musicians on the day of learning (Day 1 [D1]), at neither a behavioral nor an electrophysiological level; this suggests that the previously reported advantages in musicians are likely to be related to bottom-up processes. Nevertheless, 1 month later (Day 30 [D30]) and for all types of novel words, the error increase from D1 to D30 was lower in musicians compared to nonmusicians. In addition, for the set of words that were perceptually difficult to discriminate, only musicians showed typical N400 effects over parietal sites on D30. These results demonstrate that music training improved long-term memory and that transfer effects from music training to word learning (i.e., semantic levels of speech processing) benefit from reinforced (long-term) memory functions. Finally, these findings highlight the positive impact of music training on the acquisition of foreign languages.

Musical Training for Auditory Rehabilitation in Hearing Loss

Despite the overall success of cochlear implantation, language outcomes remain suboptimal and subject to large inter-individual variability. Early auditory rehabilitation techniques have mostly focused on low-level sensory abilities. However, a new body of literature suggests that cognitive operations are critical for auditory perception remediation. We argue in this paper that musical training is a particularly appealing candidate for such therapies, as it involves highly relevant cognitive abilities, such as temporal predictions, hierarchical processing, and auditory-motor interactions. We review recent studies demonstrating that music can enhance both language perception and production at multiple levels, from syllable processing to turn-taking in natural conversation.

Attentional networks functioning and vigilance in expert musicians and non-musicians

Previous literature has shown cognitive improvements related to musical training. Attention is one cognitive aspect in which musicians exhibit improvements compared to non-musicians. However, previous studies show inconsistent results regarding certain attentional processes, suggesting that benefits associated with musical training appear only in some processes. The present study aimed to investigate the attentional and vigilance abilities in expert musicians with a fine-grained measure: the ANTI-Vea (ANT for Interactions and Vigilance-executive and arousal components; Luna et al. in J Neurosci Methods 306:77-87, https://doi.org/10.1016/j.jneumeth.2018.05.011 , 2018). This task allows measuring the functioning of the three Posner and Petersen's networks (alerting, orienting, and executive control) along with two different components of vigilance (executive and arousal vigilance). Using propensity-score matching, 49 adult musicians (18-35 years old) were matched in an extensive set of confounding variables with a control group of 49 non-musicians. Musicians showed advantages in processing speed and in the two components of vigilance, with some specific aspects of musicianship such as years of practice or years of lessons correlating with these measures. Although these results should be taken with caution, given its correlational nature, one possible explanation is that musical training can specifically enhance some aspects of attention. Nevertheless, our correlational design does not allow us to rule out other possibilities such as the presence of cognitive differences prior to the onset of training. Moreover, the advantages were observed in an extra-musical context, which suggests that musical training could transfer its benefits to cognitive processes loosely related to musical skills. The absence of effects in executive control, frequently reported in previous literature, is discussed based on our extensive control of confounds.

Music and Teaching-Learning in Nursing: Harmony and Rhythm in Co-Constructing New Knowings

Drawing on a passion for music and teaching-learning, the author explored possibilities in using music creatively in the teaching-learning of nursing. Considering what was found in the literature, further insights were gleaned from interviewing two professional musicians and considering two relevant movies. From these insights, implications are offered for nurse teachers seeking innovative ways to engage students in teaching-learning on their journey of becoming nurses.

DEVELOPMENT AND VALIDATION OF A METHOD TO ENHANCE AUDITORY ATTENTION DURING CONTINUOUS SPEECH-SHAPED NOISE ENVIRONMENT

Auditory training (AT) may strengthen auditory skills that help human not only in on-task auditory perception performance but in continuous speech-shaped noise (SSN) environment. AT based on musical material has provided some evidence for an “auditory advantage” in understanding speech-in-noise (SIN), but with a long period training and complex procedure. Experimental research is essential to develop a simplified method named auditory target tracking training (ATT) which refined from musical material is necessary to determine the benefits of training. We developed two kinds of refined AT method: basic auditory target tracking (BAT) training and enhanced auditory target tracking (EAT) training to adult participants ([Formula: see text]) separately for 20 units, assessing performance to perceive speech in noise environment after training. The EAT group presented better speech perception performance than the other groups and no significant differences between BAT group and control group. The training effect of EAT is the most significant when uni-gender SSN and [Formula: see text] dB. Outcomes suggest that efficacy of trained EAT can improve speech perception performance and selective attention during SSN environment. These findings provide an important link between musical-based training and auditory selective attention in real-world, and extended to special vocational training.

Temporal predictions provided by musical rhythm influence visual memory encoding

Selective attention plays a key role in determining what aspects of our environment are encoded into long-term memory. Auditory rhythms with a regular beat provide temporal expectations that entrain attention and facilitate perception of visual stimuli aligned with the beat. The current study investigated whether entrainment to background auditory rhythms also facilitates higher-level cognitive functions such as episodic memory. In a series of experiments, we manipulated temporal attention through the use of rhythmic, instrumental music. In Experiment 1A and 1B, we found that background musical rhythm influenced the encoding of visual targets into memory, evident in enhanced subsequent memory for targets that appeared in-synchrony compared to out-of-synchrony with the background beat. Response times at encoding did not differ for in-synchrony compared to out-of-synchrony stimuli, suggesting that the rhythmic modulation of memory does not simply reflect rhythmic effects on perception and action. Experiment 2 investigated whether rhythmic effects on response times emerge when task procedures more closely match prior studies that have demonstrated significant auditory entrainment effects. Responses were faster for in-synchrony compared to out-of-synchrony stimuli when participants performed a more perceptually-oriented task that did not contain intervening recognition memory tests, suggesting that rhythmic effects on perception and action depend on the nature of the task demands. Together, these results support the hypothesis that rhythmic temporal regularities provided by background music can entrain attention and influence the encoding of visual stimuli into memory.

Cognitive Benefits From a Musical Activity in Older Adults

The aging population is growing rapidly. Proposing interventions that enhance the cognitive functions or strategies that delay the onset of disabilities associated with age is a topic of capital interest for the biopsychosocial health of our species. In this work, we employed musical improvisation as a focal environmental activity to explore its ability to improve memory in older adults. We present two studies: the first one evaluated neutral memory using the Rey Complex Figure (RCF) and the second one evaluated emotional memory using International Affective Picture System (IAPS). A group of 132 volunteers, between the ages of 60 and 90, participated in this investigation. Fifty-one of them were musicians with more than 5 years of formal musical training. After acquisition of neutral (Study 1) or emotional (Study 2) information, the groups of older adults were exposed to music improvisation (experimental intervention) or music imitation (control intervention) for 3 min. We then evaluated memory through two tasks (free recall and recognition), by means of immediate and deferred measures (after a week). We found a significant improvement in memory among participants involved in music improvisation, who remembered more items of the RCF and images from IAPS than the imitation group, both in the immediate and deferred evaluation. On the other hand, participants who had musical knowledge had a better performance in neutral visual memory than non-musicians. Our results suggest that a focal musical activity can be a useful intervention in older adults to promote an enhancement in memory.

Pitch and Time Processing in Speech and Tones: The Effects of Musical Training and Attention

PURPOSE

Musical training is often linked to enhanced auditory discrimination, but the relative roles of pitch and time in music and speech are unclear. Moreover, it is unclear whether pitch and time processing are correlated across individuals and how they may be affected by attention. This study aimed to examine pitch and time processing in speech and tone sequences, taking musical training and attention into account.

METHOD

Musicians (16) and nonmusicians (16) were asked to detect pitch or timing changes in speech and tone sequences and make a binary response. In some conditions, the participants were focused on 1 aspect of the stimulus (directed attention), and in others, they had to pay attention to all aspects at once (divided attention).

RESULTS

As expected, musicians performed better overall. Performance scores on pitch and time tasks were correlated, as were performance scores for speech and tonal stimuli, but most markedly in musicians. All participants performed better on the directed versus divided attention task, but again, musicians performed better than nonmusicians.

CONCLUSION

In general, this experiment shows that individuals with a better sense of pitch discrimination also have a better sense of timing discrimination in the auditory domain. In addition, although musicians perform better overall, these results do not support the idea that musicians have an added advantage for divided attention tasks. These findings serve to better understand how musical training and attention affect pitch and time processing in the context of speech and tones and may have applications in special populations.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.5895997.

Increased functional connectivity in the ventral and dorsal streams during retrieval of novel words in professional musicians

Current models of speech and language processing postulate the involvement of two parallel processing streams (the dual stream model): a ventral stream involved in mapping sensory and phonological representations onto lexical and conceptual representations and a dorsal stream contributing to sound-to-motor mapping, articulation, and to how verbal information is encoded and manipulated in memory. Based on previous evidence showing that music training has an influence on language processing, cognitive functions, and word learning, we examined EEG-based intracranial functional connectivity in the ventral and dorsal streams while musicians and nonmusicians learned the meaning of novel words through picture-word associations. In accordance with the dual stream model, word learning was generally associated with increased beta functional connectivity in the ventral stream compared to the dorsal stream. In addition, in the linguistically most demanding "semantic task," musicians outperformed nonmusicians, and this behavioral advantage was accompanied by increased left-hemispheric theta connectivity in both streams. Moreover, theta coherence in the left dorsal pathway was positively correlated with the number of years of music training. These results provide evidence for a complex interplay within a network of brain regions involved in semantic processing and verbal memory functions, and suggest that intensive music training can modify its functional architecture leading to advantages in novel word learning.

The shared neural basis of music and language

Human musical ability is proposed to play a key phylogenetical role in the evolution of language, and the similarity of hierarchical structure in music and language has led to considerable speculation about their shared mechanisms. While behavioral and electrophysioglocial studies have revealed associations between music and linguistic abilities, results from functional magnetic resonance imaging (fMRI) studies on their relations are contradictory, possibly because these studies usually treat music or language as single entities without breaking down to their components. Here, we examined the relations between different components of music (i.e., melodic and rhythmic analysis) and language (i.e., semantic and phonological processing) using both behavioral tests and resting-state fMRI. Behaviorally, we found that individuals with music training experiences were better at semantic processing, but not at phonological processing, than those without training. Further correlation analyses showed that semantic processing of language was related to melodic, but not rhythmic, analysis of music. Neurally, we found that performances in both semantic processing and melodic analysis were correlated with spontaneous brain activities in the bilateral precentral gyrus (PCG) and superior temporal plane at the regional level, and with the resting-state functional connectivity of the left PCG with the left supramarginal gyrus and left superior temporal gyrus at the network level. Together, our study revealed the shared spontaneous neural basis of music and language based on the behavioral link between melodic analysis and semantic processing, which possibly relied on a common mechanism of automatic auditory-motor integration.

Professional Music Training and Novel Word Learning: From Faster Semantic Encoding to Longer-lasting Word Representations

On the basis of previous results showing that music training positively influences different aspects of speech perception and cognition, the aim of this series of experiments was to test the hypothesis that adult professional musicians would learn the meaning of novel words through picture–word associations more efficiently than controls without music training (i.e., fewer errors and faster RTs). We also expected musicians to show faster changes in brain electrical activity than controls, in particular regarding the N400 component that develops with word learning. In line with these hypotheses, musicians outperformed controls in the most difficult semantic task. Moreover, although a frontally distributed N400 component developed in both groups of participants after only a few minutes of novel word learning, in musicians this frontal distribution rapidly shifted to parietal scalp sites, as typically found for the N400 elicited by known words. Finally, musicians showed evidence for better long-term memory for novel words 5 months after the main experimental session. Results are discussed in terms of cascading effects from enhanced perception to memory as well as in terms of multifaceted improvements of cognitive processing due to music training. To our knowledge, this is the first report showing that music training influences semantic aspects of language processing in adults. These results open new perspectives for education in showing that early music training can facilitate later foreign language learning. Moreover, the design used in the present experiment can help to specify the stages of word learning that are impaired in children and adults with word learning difficulties.