Music as Autistic Sense-making: Toward an Enactive Framework of Neuro-affirming Music Therapy

Music therapy for autism has historically been guided by a “pathology paradigm” that aims to normalize autistic people in line with neuronormativity. The neurodiversity movement has initiated a paradigm shift towards more neuro-affirming practices. However, music therapy would benefit from a more robust theoretical grounding to guide this neuro-affirming transition. We address this gap by putting forward an enactive account of autistic musical engagement—grounded in the neurodiversity paradigm—that avoids pathological framing. Drawing on first-person reports from recent qualitative studies, we discuss how autistic people use music in everyday life for emotional regulation, identity construction, and social connection, while also noting how music can sometimes clash with autistic sensory sensitivities and agency. From this enactive perspective, autistic styles of musical engagement are revealed not as a set of symptoms to be managed but as vital dimensions of sense-making. We conclude by deriving some core principles to guide the development of neuro-affirming music therapies and inclusive live music events, creating spaces for autistic flourishing.