Using the Musical Multimedia Tool ACMUS with People with Severe Mental Disorders: A Pilot Study
Mikel Ostiz-Blanco, Alfredo Pina, Miriam Lizaso, Jose Javier Astraín, Gonzalo Arrondo · 2018 · Proceedings of the 20th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS 2018) · doi:10.1145/3234695.3241016
Summary
This demo paper from the University of Navarra presents a pilot study evaluating ACMUS (Accessible Music), a multimedia tool that adds visual and interactive dimensions to music therapy for people with severe mental disorders. Music therapy has shown preliminary benefits for psychiatric conditions including anxiety, depression, stress, anger control, and social abilities, but the use of multimedia technology in psychiatric music therapy remains uncommon. ACMUS provides four activities covering different musical areas: the Composition Workshop (creating music while drawing, where line colour and thickness map to timbre and volume), the Musical Scene (improvising melodies on a nine-key piano across various musical styles), the Conductor (recognizing musical instruments by sound, alone or in groups), and the Mixing Studio (mixing real songs by adjusting volume and panorama of different instrument tracks represented by draggable icons). The system uses an interactive whiteboard setup based on the Wiimote Whiteboard project, with a projector, Bluetooth Wii remote controller, and infrared pen, enabling group participation in a shared physical space.
Key findings
The pilot study involved 12 participants (8 men, 4 women, mean age 58.8) from residential services for people with severe mental disorders, with 9 diagnosed with schizophrenia or related disorders and a mean time since diagnosis of 33.6 years. Participants were divided into four subgroups and received nine 30-minute sessions over one month. Using the COTE (Comprehensive Occupational Therapy Evaluation) scale — which assesses cognitive, social, and manipulative skills, with lower scores indicating better performance — there was a statistically significant improvement between the first session (mean 9, SD 6.2) and last session (mean 0.83, SD 0.99) with p=0.002. Satisfaction questionnaire results were positive, with sessions rated 4.64 out of 5. Most participants found ACMUS easy (45%) or of average difficulty (45%), and the majority wanted to continue using it (55% said "yes," 45% said "probably"). Therapists also assessed the tool positively, noting that ACMUS combines active techniques (composition and improvisation) with passive techniques (listening), giving participants room for initiative and creativity.
Relevance
This study contributes to an underrepresented area in accessibility research: technology-supported interventions for people with severe psychiatric conditions. While most accessibility research focuses on sensory or physical disabilities, people with schizophrenia and related disorders face significant cognitive, social, and motivational barriers that technology could help address. ACMUS demonstrates that multimedia music tools can be feasibly used in clinical psychiatric settings, and the significant COTE score improvement — though preliminary and lacking a control group — suggests therapeutic potential. For accessibility practitioners, the study highlights that accessible design extends beyond accommodating sensory impairments to supporting cognitive and social functioning. The interactive whiteboard approach enables group participation, which is particularly valuable for psychiatric populations where social skill development is a therapeutic goal. The combination of creative expression through multiple modalities (visual drawing mapped to sound, instrument recognition, mixing) provides accessible entry points for users with varying abilities.
Tags: mental health · schizophrenia · music therapy · music accessibility · serious games · occupational therapy · multimedia · cognitive accessibility