Assessment & Research

Listening to music is associated with reduced physiological and subjective stress in people with mild intellectual disabilities: A biofeedback study.

van Swieten et al. (2025) · Research in developmental disabilities 2025
★ The Verdict

A wristband that cues self-selected music can shave off mild stress for adults with intellectual disability just as well as algorithm-chosen songs.

✓ Read this if BCBAs running adult day programs or group homes for people with mild ID.
✗ Skip if Clinicians working solely with young children or severe behavior cases.

01Research in Context

01

What this study did

Adults with mild intellectual disability wore a smartwatch that watched their heart rate. When the watch saw stress rising, it pinged the wearer to play music.

Each person tried two playlists: songs they picked themselves and songs chosen by an AI system. The team tracked heart rate and asked how stressed the person felt.

02

What they found

Both playlists lowered heart rate a little and made people feel less stressed. The AI list worked no better than the self-picked list.

Letting the user choose the songs was just as good as high-tech personalization.

03

How this fits with other research

Rojahn et al. (2012) showed that high-preference music cuts vocal stereotypy in autism. Marlieke et al. now stretch the same idea to stress control in adults with ID.

Park et al. (2026) used live music sessions to help autistic youth regulate emotions. Both studies land on positive feelings, but Marlieke’s biofeedback method is hands-off and portable.

ter Harmsel et al. (2023) also used a wrist sensor to cue forensic outpatients when anger rose. Their app prompts worked for only a few people, matching the small gains Marlieke saw with music.

04

Why it matters

You can give adults with ID a cheap smartwatch and a simple rule: when it buzzes, play a favorite song. No need to build AI playlists. The tiny drop in stress may keep escalation at bay during day programs or group homes. Try it as a low-risk self-management tool next week.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Program a smartwatch alarm at the first heart-rate spike and teach the client to hit play on their own playlist.

02At a glance

Intervention
other
Design
single case other
Sample size
11
Population
intellectual disability
Finding
positive
Magnitude
small

03Original abstract

BACKGROUND: Many people with mild intellectual disabilities are at increased risk to experience stress. Reducing stress is important because experiencing prolonged and elevated stress can have detrimental effects on mental and physical health and it is associated with aggressive behaviour and self-harm. AIMS: This preliminary study investigated whether an intervention combining biofeedback with listening to music is effective and whether a personalized music playlist is more effective than self-selected music in reducing physiological and subjective stress in participants with mild intellectual disabilities. METHODS: We collected 103 music listening sessions over a period of 2-4 weeks for 11 participants throughout their daily routines. They listened to music when they received biofeedback on their increased stress level (as measured by wearable biosensor Nowatch) or when they themselves felt stressed. Participants listened either to self-selected music or to a personalised playlist compiled with X-system, music technology that predicts the effect of a song on levels of autonomic arousal. Pulse rate (PR) and skin conductance level (SCL) were measured with the EmbracePlus and subjective feelings of stress and mood were measured with two scale questions. After the intervention phase, participants and their caregivers completed a short questionnaire to evaluate their experiences with using the X-system playlist. RESULTS: Mixed regression analyses showed reductions in PR and SCL during listening to music, and indications were found for reductions in subjective stress and improvement of mood after intervention. Listening to music compiled with X-system was not more effective than listening to self-selected music. However, lower combined arousal values (a feature of X-system) from self-selected and X-system music predicted lower PR and SCL, indicating that these indices can be used to select songs that have a relaxing or energizing effect. CONCLUSIONS AND IMPLICATIONS: The present study suggests that music listening is associated with both subjective and physiological stress reduction. Listening to music might be an accessible, inexpensive and empowering strategy for stress reduction and improving emotion regulation, which could also benefit mental and physical health. Several challenges were encountered while implementing the intervention and suggestions for future research are given.

Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.104976