Research with the University of Birmingham

Our team worked with Dr Lila Kossyvaki, a lecturer in Severe, Profound and Multiple Learning Difficulties at the University of Birmingham, and Dr Sara Curran from Cambridge University. We conducted a research study with Cosmo and measured its impact on the engagement, emotional expression and social communication of children with Autism Spectrum Disorder.

The study lasted five weeks and examined the interaction of five children with Cosmo. The participants were students of Hamilton School in Birmingham and are diagnosed with severe learning difficulties (P levels 1-3).

The study has been peer-reviewed and published in the Journal of Intellectual Disabilities in spring 2018. It is titled “The role of technology-mediated music-making in enhancing engagement and social communication in children with autism and intellectual disabilities”. More on the paper found here.

Scroll down to read a summary of the study.

Increased engagement in learning

Significantly increased the engagement levels of all 5 children who participated in the study.

Increased frequency & quality of communication

Increased the frequency of initiating communication. Increased responsiveness to adult’s communication.

Improved emotional regulation

Decreased expression of negative emotions and increased expression of positive emotions.

The Cosmo project

University of Birmingham

February -March 2016

Dr Lila Kossyvaki, lecturer in Severe, Profound and Multiple Learning Difficulties at the University of Birmingham and Dr Sara Curran from Cambridge University researched further development of the Cosmo units and measured their impact on engagement, emotional expression and social communication of children on the Spectrum. After a round of pilot studies, we ran eight ten-minute sessions with children with Autism Spectrum Disorder (one female and four males between 5 and 7 years old) and Severe Learning Disabilities at their SEN school.


The primary study took place between February and March 2016. Five staff members (one teacher and four teaching assistants) participated in the sessions to support the children and the researcher. They also took part in five focus group interviews where they shared their views on potential changes in children’s behaviour as the intervention went along and strengths and areas for further development of Cosmo units. The study followed a participatory action research methodology in which researchers and practitioners work in close partnership to produce viable improvements to real-world problems (Reason and Bradbury, 2001). The researcher used the following Cosmo activities: Improvisation, Follow the Light, Orchestration, Turn-Taking and Exploration. The researcher used the units with the children following elements from Intensive Interaction (Nind and Hewett, 2001), Musical Interaction (Methley and Wimpory, 2010) and Reciprocal Imitation Training (RIT) (Ingersoll and Schreibman, 2006). In sum, the researcher kept a balance between modelling actions and following the child’s initiative. She imitated the children’s verbal and non-verbal behaviours, ran commentaries on their play using simple language, received their attention before modelling, prompted and praised them.

Combining music and technology

The strengths of the Cosmo units rely on two primary elements, which work very efficiently for the population that formed the sample of this study, people with ASD and other learning disabilities. The two elements are music and technology. Music is a fundamental communication channel for people with complex learning needs and is a medium of sharing emotions and intentions, even for non-verbal communication (MacDonald et al., 2002). Additionally, ‘music appreciation requires no verbal understanding; it goes beyond intellect and therefore is accessible to all levels of intelligence’ (Corke, 2002, p. 12). On the other hand, technology is predictable, with consistent responses. It does not require an understanding of social rules and conventions, and language skills, making it ideal for people with ASD (Murray, 1997).


A preliminary analysis of the findings showed that:

  1. engagement either increased or remained high for four out of five children,
  2. expression of positive emotions increased for most children,
  3. social communication, especially requesting and rejecting, as well as commenting, was higher than typically expected for this cohort.

Last but not least, there was some knowledge co-production between staff and researchers like the one described in Parsons et al. (2015), and the researcher came up with some valid advantages but also challenges as a result of working in a multidisciplinary team which confirmed existing literature (Lacey, 1998; Lacey, 2012).


Corke, M. (2002) Approaches to communication through music. London: David Fulton.

Ingersoll, B. and Schreibman, L. (2006) Teaching reciprocal imitation skills to young children with autism using a naturalistic behavioral approach: effects on language, pretend play and joint attention. Journal of Autism and Developmental Disorders, 36 (4): 487-505

Lacey, P. (1998) Interdisciplinary training for staff working with people with profound and multiple learning disabilities. Journal of Interprofessional Care 12(1): 43-52.

Lacey, P. (2012) ‘Meeting complex needs through collaborative multidisciplinary teamwork’. In P. Lacey and C. Ouvry (Eds.) People with profound and multiple learning disabilities: a collaborative approach to meeting complex needs. London: Routledge (pp. ix – xvii).

MacDonald, R. A. R., Hargreaves, D. J. and Miell, D. (eds.) (2002) Musical identities. Oxford: Oxford University Press.

Methley, A. and Wimpory, D. (2010) Music interaction therapy for children with autism. [DVD]. Bangor: Bangor University.

Murray, D. K. C. (1997) Autism and Information Technology: Therapy with Computers. In: Jordan, R. (ed.) and Powell, S. (ed.) Autism and Learning. London: David Fulton Publishers.


Nind, M. and Hewett, D. (2001) A Practical guide to intensive interaction. Kidderminster, Worcestershire: BILD Publications.

Parsons, S., Guldberg, K., Porayska-Pomsta, K. and Lee, R. (2015) Digital stories as a method for evidence-based practice and knowledge co-creation in technology-enhanced learning for children with autism. International Journal of Research & Method in Education, 38(3): 247-271.

Reason, P. and Bradbury, H. (2001) “Introduction: inquiry and participation in search of a world worthy of human aspiration”. In: Reason, P. and Bradbury, H. (eds.) Handbook of action research: participative enquiry and practice. London: SAGE Publications. pp. 1-14.