The synchrony study: a randomized controlled trial of music training for children

The National Institute on Alcohol Abuse and Alcoholism awarded Lovelace Biomedical Research Institute $1.705 million on September 25, 2025, under the Alcohol Research Programs grant (CFDA 93.273) to conduct a randomized controlled trial of music training for children with Fetal Alcohol Spectrum Disorder.

The research examines whether music training improves brain function and targeted cognitive skills in children with FASD through enhancement of predictive coding—the brain's capacity to predict environmental conditions and correct errors. The intervention involves a 12-week music training period compared against a music listening control condition. Music training targets auditory and visual perception, multisensory integration, attention, and working memory, deficits commonly experienced by children with FASD. Prior pilot data demonstrated acceptance of the intervention by participants and parents, along with pre- and post-training changes in neural and behavioral measures.

The award funds work performed in Albuquerque, New Mexico, with a period of performance ending August 31, 2028. The Alcohol Research Programs supports research to develop fundamental knowledge applicable to improved treatment methods and prevention strategies for alcoholism and alcohol-related problems across biomedical, genetic, psychological, environmental, and health services domains.

Abstract

Recent estimates indicate that, conservatively, up to 5% of children in the united states have sufficient behavioral and cognitive effects due to prenatal alcohol exposure that they qualify for a fetal alcohol spectrum disorder (FASD). Children with an FASD experience a range of effects, including deficits in sensory, motor, and executive functions, which are in turn related to poor long-term outcomes. However, few evidence-based interventions are available for children with an FASD and, of these, only two target academic or cognitive skills. Music training (MT) targets a complex array of skills including AUDITORY and visual perception, multisensory integration, attention, and working memory. These MT targets align well with the deficits experienced by children with FASD and, therefore, MT may be well-suited for improving outcomes for these children. In this project, we hypothesize that MT improves brain function and targeted skills via improvement in predictive coding. The predictive coding framework posits that a primary role of the brain is to predict the ENVIRONMENT and optimize outcomes through identifying and correcting prediction errors. MT provides direct practice of predictive coding when participants regularly produce sounds (ENVIRONMENT) and adjust their behavior to correct any errors (fix incorrect notes/timing). We further posit that this bottom-up training will help optimize sensory, motor, and cognitive function relative to top-down strategies, leading to better outcomes. Our pilot MT intervention in children with an FASD provided exciting evidence for acceptance of MT by children and parents and for the occurrence of pre-/post-MT changes at the neural and behavioral level in children with MT VS. Those without MT. In the R61 phase, we will conduct a randomized cross-over study of a 12-week MT intervention relative to a music listening (ML) control period in a larger sample to examine neurophysiological changes in predictive coding and behavioral effects due to MT in FASD in children 8-16 years of age. We will assess changes in 1) brain function using magnetoencephalography and electroencephalography, 2) brain structure using structural magnetic resonance imaging and diffusion tensor imaging, and 3) cognition and behavior using neuropsychological assessment and questionnaires at three time points (pre-trial (week 1), cross-over (week 13), and post-trial (week 28)). In the R33 phase, we will again implement a randomized cross-over design in 8-16 year-olds with an FASD to: a) compare MT effects relative to a cognitive training (CT) control and B) evaluate dose effects by comparing 12- VS. 24-weeks of intervention. We hypothesize that the bottom-up approach of MT, which improves sensory (AUDITORY) and motor functioning, will lead to changes in brain connectivity, which in turn will improve cognitive functioning relative to the top- down approach of CT. We have assembled a strong multidisciplinary team to implement a music training intervention and assess the outcomes using objective neuroimaging, cognitive, and behavioral measures. Future studies will explore how MT can contribute to a strengths-based intervention approach for FASD.