Blindness, Rex and Music Make Sense

This is an incredible story with many angles to explore about how music makes sense! This is one of the longer videos highlighting Rex's savant capabilities, but I like this particular clip because it gives a sense of where Rex started leading up to his current pursuits. There are shorter videos on youtube if you can't watch this one.

As a music therapist, I am generally trying to help people achieve non-musical goals through the use of specially designed music activities. Rex and the people around him have also been using this method, just without the music therapy label. I noticed several examples as I was watching his story:

1. Will music activities help Rex transfer some of his amazing fine motor skills to non-music tasks and settings? Rex has incredible dexterity in his fingers to play the piano like he does, but he still has difficulty strapping on Velcro shoes. He was also shown having trouble identifying basic shapes. I did not see his teachers trying to use music to help him learn shapes or strap on some shoes, but I think there is potential for his motor skill dexterity on the piano to be transferred to other tasks. This would be a good goal for music as therapy.

2. Will music help Rex to learn emotion? Rex's teacher was astute in realizing that like many savants, Rex can technically imitate, but he leaves out nuances in style, dynamics and tempo that help to convey emotion. I think his teacher is doing a great thing helping Rex to learn how to convey emotion musically; and hopefully Rex will transfer his learning to new pieces of music as he learns them.

3. Music is helping Rex with socialization. Autism is often characterized by a lack of awareness or inept handling of social protocols. In Rex's case, his participation in duets and group music ensembles is providing the perfect setting for learning how to interact with peers musically as well as socially. In the group music settings, he is practicing turn-taking skills, harmonizing, call and response patterns, aural balance and all kinds of other musical attributes that make for a successful ensemble. All of these skills can be transferred to social interaction in a non-musical setting. The contact with peers provides Rex with the opportunity to build friendships and carry on multi-part conversations.

4. Music helps Rex to overcome sensory defensiveness. The video mentioned that Rex has a history of tactile defensiveness for certain textures or objects. His interest in the piano has reportedly helped him overcome his aversion to touching certain things. I have found that many children with autism or visual impairments will often touch musical instruments despite their tactile defensiveness. The key is to find an instrument that the student likes and encourage exploration and music-making with that instrument. I like to use the guitar, an African shekere, the ocean drum, cabasa and piano as instruments to help push past the sensory defensiveness.

Read more about Rex:

Top Ten Behavior Management Strategies For a Successful Music Group

I work with several students who can have aggressive and inappropriate behaviors. These situations may include spitting, biting, pinching, throwing objects, yelling, bad language, jumping up and down, running, and any number of other undesirable behaviors. Sometimes these behaviors are inadvertent, but it always seems like they are done by students who are very large and strong. It can be dangerous and intimidating at times even if these students are not directly aggressive towards me. As a music therapist I usually don't see many of the undesirable behaviors that teachers deal with on a daily basis. I am seeing students for music therapy services who have been documented to respond with unique and significant behaviors towards music stimuli. They are usually motivated to have improved in-seat behavior and have a happier and more cooperative disposition during their preferred music activities. I have discovered that their positive reactions to specially designed music activities can also be facilitated by the following strategies, although they are not listed in any specific order of importance: 1. Keep "busy hands" busy! Many kids are much calmer when they have some object to hold or manipulate. The object does not necessarily distract their attention from the music activity, but simply engages that part of them that needs tactile input or something to fidget with. The Greek people have "worry" beads that many older men often have in their hands, working the beads around a chain. This unconscious activity can be a key factor in helping a student keep his hands to himself as well as providing a calming influence. During music activities, I am able to substitute the object with musical instruments or an object related to the song for the duration of a music activity and then return the original object in between music activities. 2. Make success the goal. Time is an important element to consider with kids who have trouble with behavior. When I am first starting out to work with these clients I usually run a very short music therapy session in order to see if we can make it through the entire session with as few behavior issues as possible. The goal is to make it to the end and then verbally praise the student for a job well done. Non-verbal rewards may also be used and worked into the student's regular work for reward routine. After a few successful sessions the length of the sessions can gradually be increased. 3. Picture it! Visual picture schedules can be a powerful tool in many different situations, but for children with behavior issues they can be crucial. The picture schedules should include a picture or icon to represent each song or music activity. Work towards having the students remove each picture from the schedule as the music session progresses. The schedule will provide a visual timeline to indicate how long they will be participating. The pictures will also indicate preferred songs or instruments that might be used as motivators or rewards after participating in a number of other activities. Since children learn in different ways it can be very important to have the visual cue provided by the picture schedule even if the music session follows a routine. 4. Structured space. Chairs and tables can add to a sense of personal space. Chairs are even more helpful if you need to add more structure by including armrests or even a tray that attaches to the chair. I have even had clients who seat belted themselves into a chair on their own just because they apparently liked the structure and security that provided. Tables are nice because they can be a symbolic as well as literal barrier between you and a child who may pose a danger. Sitting at a table is an appropriate activity, but it also provides more limited space for out of seat behavior, reaching, grabbing, etc. 5. Adapt! Music therapists pride themselves on being able to improvise on the fly by changing the style, tempo, lyrics or dynamics of any given music in order to influence behavior. If one song or music activity is not working, move on and try something else even if it is a song you have been practicing all week for a student or group. One of the most important parts of helping a student participate in a music group is the greeting song. The "hello" song introduces the music session and tries to elicit attention and participation from the target audience. If the regular "hello" song is not working don't be afraid to try something else. Try to find a song that the child really likes even if it has nothing to do with saying hello. Use this song or a song with instruments that they like to begin the music session. After you gain their attention sing the regular "hello" song. 6. Ignore attention seeking behaviors. Many times behaviors such as spitting, hitting, throwing things or bad language are inadvertently reinforced by the startled reactions of teachers and students on the receiving end. Sometimes these behaviors will fade if they are ignored. Unfortunately, I have learned from experience that this can be especially difficult for spitting behaviors, but it is worth it in the long run. I have seen many unwanted behaviors self-extinguish themselves after being ignored across multiple encounters. 7. Be moveable! This idea can often be paired with #5. If the student is not interested in regular activities, it may be necessary to start out in close proximity to the student's location. After you gain his or her attention you can try to move to a designated area or continue to do the music session in the location where you made a connection with the student. I remember one instance when I was seeing a client for the first time in her home. The parents had a room set up as a work room that the girl was used to being in, but she did not like new people and would not come down the stairs. I ended up going upstairs with guitar in hand and literally sang the client down the stairs one stair at a time with an improvised song and lyrics! 8. Social stories with a twist! Social stories have been used with great success in teaching appropriate behaviors, especially to children with autism. Putting a social story to song can sometimes augment the power of the story by increasing the student's attention and interest to the story. Social stories are often paired with pictures. Pairing a social story with a song helps to make the story moveable. For example, if you have forgotten to bring along the picture cards for a social story that you need but it has been paired with a song, you can sing the story and it should help the student pay attention and remember the instructions in the story. 9. Beware tambourines! I have seen a tambourine become a very dangerous weapon! Just imagine a flying disc with metal plates spinning on the sides! Use lightweight instruments without obvious pointed ends or other features that could turn dangerous if used as a throwing object or hitting tool. When using drums, try using a gathering drum that sits on the floor and can be held down easily or a paddle drum where the student uses the mallet and the teacher holds out the drum. 10. Choices, choices, choices... I like to establish a routine set of songs and activities across several sessions so that the students anticipate the songs and the length of the session. Once this routine and structure have been established the students will be presented with choices for songs and activities within the overall scheme of the established routine. Many of the children with behavior management issues thrive on sameness in their daily schedules. Songs and music activities are naturally structured by the music itself. If there is a student who is particularly sensitive to change, then allow for choices to be made within a routine and familiar song such as varying the tempo, dynamics or instrumentation. This strategy has often been successful in teaching about change without setting off a reaction of unwanted behaviors. One more thing! Jenny, one of my readers, recently suggested some great articles about traveling, starting at a new school, and moving homes when you have a child with ASD or sensory needs. Music can always be used in conjunction with other strategies, but there are some very good basics to keep in mind. I hope you find these posts useful as well! Thank you!

The Thoughtful House Center: A Holistic Approach to Treating Autism

Many of us are aware of the diverse and often controversial treatments for autism. My work across ten different counties and more than fifty public school districts has brought me in contact with kids receiving all kinds of interventions, from chelation therapy to special diets and ABA behavior therapy to potty training. The research behind the efficacy of these treatments is incomplete, but new studies are continually being presented for review. My attention was directed toward the Thoughtful House after reading about Dr. Bryan Jepson's book, Changing the Course of Autism. Dr. Jepson joined the team of therapists and care providers at the Thoughtful House after his child developed autism as a toddler. Dr. Jepson was dissatisfied with the medical research and treatment options for autism and decided to look into it himself.

The Thoughtful House website is full of information about their philosophy and opinions regarding current treatment options and research regarding autism. Their point of view directly confronts the current controversy surrounding autism and childhood immunizations. My understanding is that they assert that some children's inability to process heavy metals and toxins properly can place them at greater risk for an adverse reaction to the MMR vaccination or a contracted virus that leads to onset of regressive autism. I think the most exciting part of their conclusion is that this type of autism may also be medically linked to gastrointestinal problems. Treating these GI issues seems to help the adverse symptoms many children with autism experience. There will also be further opportunity for research into the link between the immune system relating to mercury and the gastrointestinal problems.

In addition to the new medical paradigm for looking at autism, the specialists at the Thoughtful House seem to have put together an exciting holistic model for treatment. In my experience, when children I have worked with go away for some kind of specialized treatment, the treatment is focused on one type of intervention. They may be put on a special diet or behavior therapy, but the treatments have seldom made much of a long term impact once the child has returned to school. I like the idea that the treatment should be medically based as well as taking into account environmental influences. The Thoughtful House Center begins treatment with a full medical history and analysis and then develops a therapy program suitable for each child. They can adapt the dietary and behavioral needs of a child as the medical situation is treated and hopefully improves.

I am glad that the Thoughtful House is taking the lead on performing new research related to immunizations and autism. This is a hot button topic that is often discussed without a good grasp of the current research findings. Dr. Jepson and his colleagues have taken the time to discuss current research findings and what we can and cannot conclude about autism and any links to immunizations. If we can establish concrete treatments for autism based on a medical model, then therapists like myself will have a much easier time complementing the treatment and expecting better results.

For further reference, I recommend a visit to their website: Thoughtful House Center

Side Notes! TAKS and Adequate Yearly Progress

I have learned much more about the relationship between TAKS and No Child Left Behind since my last post about how Sarah Palin might help bring some attention to the subject. Unfortunately, we will not have the advantage of having Governor Palin in the White House, so changes to the system will probably not occur as quickly!

My original argument has been substantiated by the superintendent of Fort Worth ISD. Melody Johnson was interviewed in the Fort Worth Star-Telegram for a story published on October 15, 2008, titled, "Fort Worth, 5 other area districts miss mark." Johnson said that the AYP conflicts with the IDEA (Individuals With Disabilities Act, 1975) which requires that each student in special education be provided an individualized plan for education. According to Johnson, only 3 percent of the student population can be exempted from TAKS testing in order to meet AYP requirements. Many of the school districts, including Fort Worth ISD, have more than 3 percent of their students enrolled in special education. This means that many students who have an individual education plan are being forced to take standardized tests and the school districts are being held accountable for the scores. School districts will risk losing federal money if they do not take actions to meet AYP each following year.

This is becoming a serious problem each year that the law is in place because more sanctions are placed on school districts for every year that they miss their AYP. At some point in the future, teachers and staff may lose their jobs as the districts try to comply with AYP requirements. I believe this situation is out of control and it sounds like many school district leaders feel the same way. I am surprised this ever got passed into law with this kind of conflict between the laws.

Beginning this year there will be several levels of standardized tests that a school can choose from for special education students to take. Each level of test has a corresponding number of points that can be awarded to the district if the student passes. The harder the test, the more points the district can get. I fear that schools will be motivated by points rather than the educational needs of the students. As a therapist, I continue to work with teachers to address the needs of the students even as we are distracted by trying to teach academic concepts that may not be useful to some of our students as they prepare for life after school.

Related Post: Side Notes! Sarah Palin: Overture for Special Education

Stayin' Alive: Sing it for CPR!

This is a great story about how music makes sense!

The American Heart Association has been using the original 1977 song from the Bee Gees as an aid people learning CPR. It turns out that the song has 103 beats per minute. The AHA recommends that chest compressions for CPR be given at 100 times per minute.

I usually have to maintain my CPR certification in order to work with certain populations. I have often wondered if I would be able to remember the instructions if the time ever came that I had to perform the life saving procedures. This song is the perfect combination of lyrics and rhythm being key factors for the therapeutic use of music. The AHA even tested their theory about the song by having a small group of medical professionals do CPR while listening to the song. They were reported to do the chest compressions at almost the perfect rate. This same group was then tested to see how they would do without the recorded music, but still singing the song in their heads as they did the chest compressions for CPR. Amazingly, they were able to maintain very similar rates of compression without the recorded music!

The story is here at Fox News.

...Somebody help me, yeah. Stayin' alive!

Side Notes! Sarah Palin: Overture for Special Education

The current presidential election has created a novel situation for those of us who work with kids with special needs. Governor Palin has promised that if she is elected to work with John McCain in the White House, she will be an advocate for families who have children with special needs. As I thought about the possibilities this might present for reform of the special education system, I inevitably considered the TAKS testing that goes on in Texas. This is the Texas Assessment of Skills and Knowledge test that is used to establish minimum standards for passing certain grade levels. The results of the exam are used to meet requirements for the federal guidelines in No Child Left Behind.

I am just an observer of how TAKS testing is implemented, but I may have an idea for Governor Palin and others to consider. I have watched the teachers I work with spend countless hours trying to figure out how to implement TAKS test alternatives for the children in the special education program. The way I understand things, every child has to be tested on subjects and knowledge areas according to their grade level. therefore, special education teachers have to take knowledge questions that would be on the regular TAKS test and break down the questions into fundamental skills that would be necessary to answer the target question. They do this until they get to a level of question that would be possible for a specific student with disabilities to answer with a reasonable degree of success. They do this for every child who has an Individual Education Plan in the grade levels that are testing. This means that every child with special needs ends up with a different test. This makes sense since we are talking about children with Individual Education Plans.

What does not make sense to me is why teachers are spending so much time on making up tests that will be different for every child and turning that in for use with standardized tests as a measure of a school's performance? In talking with professionals in the public education system it seems that before TAKS-alt became the rule, some schools were "hiding" poorly performing students under the special education label so that they did not have to take the test or at least did not have their scores counted toward the school's overall score. Since then, everyone has to take the test regardless of its educational value for the student.

The great education bureaucracy in their wisdom has apparently decided to make everyone take the test so that nobody can hide. I think this is an abrogation of their duties in oversight and now an unfortunate waste of valuable time resource for many of the teachers and students who now have to participate in this TAKS-alt system. I have no idea how scores are reconciled or accounted for in the broad scheme of things or if the scores from TAKS-alt figure into achieving "Exemplary" or "Recognized" status for individual schools and districts. Maybe we can open up a discussion here and find out? My initial thought about the situation is why didn't the people in charge just fire people who were misusing the special education labels? How does it serve the children with special needs to take TAKS or TAKS-alt? I think this has come to pass to satisfy a bureaucratic need instead of an educational need.

The bottom line in my view, is that many of the children in special education are not in school to prepare for college or some kind of career. We are teaching them skills of daily living and preparing them with basic knowledge to live a quality life at whatever level they can attain. Many of the test questions developed for TAKS-alt are about skills and knowledge that would be taught regardless of the existence of the TAKS exam, but the time spent in developing TAKS-alt for every student is misplaced effort. I also must assume that scores from TAKS-alt testing will be statistically meaningless since every test is individualized. There is no way to create a standardized test for special education or compare scores across student results.

I don't know if Sarah Palin will have any way to help bring some sense to the realm of special education, but we can start a conversation and see where it leads. I welcome comments and feedback for this topic. I am not an expert on the law and implementation for No Child Left Behind, but I see its effect in the "trenches" so to speak. For the most part everyone is trying to help the children, but sometimes we can't see the forest for the trees!

**Please see related post: Side Notes! TAKS and Adequate Yearly Progress

Lyrics Mean Things!

We have all heard the phrase, "Words mean things!" This leads me to emphasize the importance of music as a carrier of information. One of the most powerful tools we have as therapists, teachers and parents, is using lyrics to provide directions and knowledge to our target audience. Advertisers have taken advantage of this phenomenon by using jingles to help people remember important information such as phone numbers and company mottoes.

I like to use songs to deliver one and two step directions such as passing objects, raising your hand or to indicate gross motor movements. Another useful way of using lyrics to convey ideas is with social stories. Social stories put to song can greatly augment its effectiveness by increasing a client's attention and promoting memory and portability of the intended instructions.

One example of this is how I used a song to help a student put on his shoes and sit up straight. I used a familiar melody from the song, Skip to My Lou, and imposed new lyrics, "Put on your shoes and sit up straight, time to get ready for music." The use of a "piggyback" song was intended to help teachers use the song when I was not there. I often stop singing the lyrics and allow my student to sing to himself as I provide accompaniment on the guitar, but because of the familiar tune, his teachers have also been able to start singing the song and then the student finishes it himself.

Here are some key ideas about using lyrics:

1. Provide multiple opportunities for the listener to comply with sung directions. In other words, use a song with a repeating lyric line and sing the song several times in order to provide enough time for the listener to process the information and respond.

2. Don't re-invent the wheel! If you can fit some lyrics to a familiar tune or song, then it will be easier to remember. This is what we call "piggybacking" new words on an old melody. One example is how the ABC song is traditionally sung to the melody for Twinkle, Twinkle, Little Star.

3. Keep it simple and direct. Try keeping the lyric instructions limited to one or two-step directions.

4. Be consistent. Many of the children that I work with respond well to structure and routine. One advantage to using music to convey instructions is that you do not always need accompaniment from a guitar or piano. If you have used the lyrics with a piggyback song, then the tune should be easy to remember. Sing the song with your student whenever the need arises. Music can be a great tool if you have gone off and forgotten the picture cards that go along with the needed social stories!

5. Follow through! In my example above about singing for my client to, "sit up straight and put on his shoes," I did not begin the music therapy session until he had complied with the instructions in the song. I sang the song together with him many times and kept singing it as he started to put on his shoes. One word of caution, however, since I know this client very well and realize the power music has with him. Just because you sing a song with instructions does not mean your listener will follow through, but it is important to make sure that they understand that the words mean something. In my example, perhaps the student reaches for his shoes and that is as far as he gets. Take that progress and build on it next time so that on the next occasion that it is necessary to sing the song, try to hold out for a higher level of compliance to the lyric directions.

Altogether now - "Put on your shoes and sit up straight, time to get ready for music!"

Adapted Song Series: Clap, Clap, Clap

The adapted song series features songs with simple chord progressions that have been useful in music therapy settings. These songs have memorable tunes and offer logical and predictable opportunities to substitute words, sounds and actions for lyrics and movements in the original song. These songs are especially useful for teachers and parents in between music therapy sessions.

Clap, Clap, Clap is from the Musik Garten album, Family Music: Clap With Me.

This song is so catchy that teachers and kids will never forget the tune. It is easily sung without accompaniment and the motions that go along with the song help to keep it lively and engaging. The original song asks for movements like: clapping, tapping toes, and clicking heels. There is an instrumental interlude between each movement request in the lyrics.

Adaptations:

1. Sing on “la” or other syllable sounds (i.e., “ma,” “za,” “ha,” “ho,” are very successful) during the instrumental interludes. This is perfect for working on speech and language objectives for beginning consonant sounds and vowel sounds.

2. Conduct the instrumental music with your hand or make a “music wand” with ribbons and streamers.

3. Encourage students to make choices about what motor movements can be done. I have used: blink your eyes, pat your knees, pat your head, stomp your feet, etc.

This song has been so successful for use with children who have disabilities because you can tailor the movements to be as simple as blinking your eyes. This allows children in a wheelchair or with severe physical disabilities to successfully be part of the group activity. Clap, Clap, Clap also uses very few chords and can easily be played in the key of D on the guitar or keyboard. The lyrics are very repetitive and therefore provide multiple opportunities for children to hear instructions. Finally, I like the structure of the song since it provides predictable sections of music without lyric accompaniment. Verbal prompts and instructions can be used at these times to reinforce what will happen in the song.

Amazon has the CD here:

Clap With Me

The Music Therapy Show

Janice Harris, one of our local therapists, has started a blog radio show on music therapy. I love this idea! Her intent is to spread information about music therapy as she provides a platform for discussion about different aspects of the profession and music therapy strategies. The show is broadcast every Saturday at 4:00 Central time, but there is a show archive so that you can go back and listen to previous shows.

The program has already presented very useful information about music therapy referrals, performance wellness, drum circles and other topics I actively discuss here at Music Makes Sense. Janice also highlights some interesting historical facts about music therapy and provides links to helpful information around the worldwide web. I encourage therapists, parents and teachers to call in or e-mail Janice with questions and comments so that we can support the show and expand the discussion about the power of music in therapy.

See you on Saturdays!

Music for Birth and Labor: Lessons From the Labor and Delivery Floor

There are music therapists who specialize in using music for childbirth and for babies in neonatal intensive care. Although I have extensive experience working in hospitals, I had not specifically used music strategies as part of a birthing plan. I have read that some women develop detailed descriptions of what they would like to happen as labor progresses and delivery occurs. Medical details are often highlighted, such as when and if they wish to receive an epidural block or whether or not certain drugs should be used. From my understanding of what some music therapists do as part of the birthing plan, music can be integrated as a motivator or relaxation cue for different parts of the laboring process. As I proceeded to develop ideas for my part in a birth, the idea of making a detailed plan was beyond my expertise since I had only watched two previous deliveries many years ago. I did, however, identify some key moments when I thought music therapy strategies might be effective.

"The best-laid plans of mice and men..."
~John Steinbeck

I had diligently worked with the expectant mother to make two different play-lists on an ipod. One play list included her preferred songs for relaxing. Another play list titled, "Push it!", contained motivating music with fast tempos and an invigorating beat. I had envisioned that the relaxing music could be used with deep breathing and muscle relaxation techniques during needle sticks and the introduction of an epidural. The motivating music would be available for late in the labor process in the event that physical or mental fatigue presented itself. I should have heeded Steinbeck and thrown most of this limited birthing plan out the window!

The bright spot in the plan was that the relaxation music for needle sticks worked very well. Key elements for this success were that the patient did not need to listen to instructions given by the medical professional during the procedure. I was able to hold the patient's hand and encourage her to close her eyes and breathe in and out in slow, regular breaths that fell into her own comfortable rhythm. The patient listened to music through headphones to help mask environmental sounds and encourage mental visualization of a relaxing, comfortable scene. I further guided the patient in slightly tensing and releasing various muscle groups to help her feel the difference between tense and relaxed. She squeezed my hand and relaxed, tightened her face muscles and then let them feel loose, and released her jaw muscles so that her jaw and tongue were relaxed. Relaxing the jaw is a very good way to force the body to relax since it signals many other muscle groups in the body to either tense or relax.

There were many instances where shots, blood draws and an I.V. placement were necessary. In all these cases the patient was visibly more relaxed during the procedures and has not talked as much about the incidents afterwards as she had for previous needle sticks given without music and relaxation.

The epidural procedure involves introducing a long needle near the base of the spine and then placing a flexible tube over the needle. The anesthesiologist must use touch to guide the needle and catheter into the correct position since every person has slightly different anatomy. My client was highly anxious about potential pain and concern over complications that could occur during the procedure. She began by wearing headphones and listening to her selected relaxing music, but soon had to remove one earbud in order to listen to instructions from the nurse and anesthetist. My client lost the masking effect of the music by having to remove one ear piece, but also lost a strong focal point to help her focus her attention on something else besides the needle stick. The procedure requires a patient to arch her back and drop her head and arms forward and allow them to hang. Progressive muscle relaxation was therefore contraindicated since the patient must not move and should stay in a loose and relaxed state. The anesthetist continually provided instructions and asked questions, while requiring the patient to stay alert and verbally respond to the questions when appropriate. This arrangement precluded me from being able to provide verbal coaching or instructions to the patient in hopes of establishing relaxed breathing or facilitating relaxing visualization.

During this labor, the patient did not require motivating music. Although it was a long labor (34 hours), she did not lose energy to push at the request of the nurse or doctor. I believe that music would have been problematic since it was necessary for the nurse to count out loud and provide verbal instructions throughout the birthing process. The patient also had a spouse acting as verbal coach so there were already competing focal points.

There was one point during labor when the patient was instructed to breathe through the contractions and not push. In retrospect, this may have been another opportunity for the relaxation music and protocols. The main thing to remember is that assistance through music can be available as a strategy when needed, but it should not be forced into situations just because it is part of a "birthing plan."

The result of my short foray into music assisted childbirth was holding a beautiful newborn baby.

Related Posts:

Relaxation Strategies for Pre-operative Settings
A Guide to Sedative Music

Music Therapy: Examples of the Power of Live Music

Music therapy in the public school setting is usually provided to clients on a weekly basis. Depending on the student, the therapist may see the client one to one or in a small group setting with peers. Music therapists are trained to provide specially developed music activities in a variety of different musical styles and have knowledge of a wide range of disabilities and health issues. Sometimes music therapy services will be provided as a consult service instead of direct service so that other educational staff may be trained in using music strategies. These strategies can help clients across settings and more frequently throughout the week when the music therapist is not present. I have seen many clients through a consult role with some success, but there are limitations to what teachers and other staff can accomplish when using music activities. I would like to provide some specific examples about how live music can be the key to successful intervention with music therapy. The following case studies are based on occurrences at schools, but live music is also important in working with adults in medical treatment and older adults in rehabilitation and assisted living settings. (Although these are stories about real students, names have been changed for confidentiality.)

1. Clint is an elementary student who has autism. He functions higher than average on the spectrum of autism disorders closer to Asperger's. Clint does well with established routines, picture schedules and a structured environment, but he is often lost in his own imagination, making sounds and repeatedly talking about a topic. In the classroom, Clint requires picture prompts and sometimes physical prompts combined with verbal instructions in order to remain in a designated work area.

Music therapy group time for Clint is very structured, following a similar routine of songs and providing movement to music activities and instrument playing to help Clint remain focused. Although Clint is more focused during music therapy activities than during work without music, he often leaves his chair or starts talking to himself off the subject. I generally have my guitar as my accompanying instrument and have used improvised singing to help Clint return to his chair or follow simple directions. Clint is very focused on predictable melodies that have an obvious musical conclusion. He would definitely be able to finish the happy birthday song if it was incomplete! Clint almost always looks up to me as I sing instructions and usually finishes singing the lyrics himself as he sits back down, raises his hand or follows through with the physical directions in the song. My ability to obtain Clint's immediate and unprompted compliance has always impressed his teachers. They generally remark that they wish they had the ability to sing and play the guitar. I have been able to provide them with some easy songs to sing and remember, but Clint is very sensitive to musicality and will not respond to music stimuli that is out of tune or incorrect. This is a great challenge for teachers who are not musically trained.

2. Travis, another student with autism, is in junior high school. His teachers have been having problems with him not wanting to wear his shoes at school. Travis did not usually have his shoes off in music therapy, but one day he came without his shoes on. I immediately made up a song with a lively beat that said, "Put on your shoes and sit up straight, Travis is getting ready for music!" The song had a repeating lyric structure and very simple melody so that Travis started singing the song with me. He was able to sing the lyric by himself after two times singing through the song and proceeded to follow the directions in the song as he sang them to himself while I played the accompaniment on the guitar. I have recorded the song for his teachers to use, leaving the last phrase blank so that he can, "get ready for ______," whatever class he is in.

3. Scott has autism and is a student in elementary school. He has been sitting and listening in the music therapy groups, but not participating with verbalizations or eye contact. In a recent session, I noticed that Scott was tapping his foot during an upbeat song. I quickly matched the tempo of my guitar playing to his foot tapping. Scott immediately looked up and provided meaningful eye contact. He changed his foot tapping faster and slower and began smiling when the rhythm of the guitar accompaniment followed the tempo he set. In subsequent sessions, Scott has seemed more aware of the music when it encourages body movements or playing instruments.

4. Lisa is a student with multiple disabilities. She is a high schooler who uses a four button communication device to make choices or indicate her wants and needs. Lisa is much more active in using her communication device during preferred music activities with one exception. She does not seem to like music in a minor key. Lisa participates in choir class with her peers, but has cried and become emotionally upset when the choir is singing songs in a minor key. Her teachers are careful to monitor recorded music used in class to make sure that songs will not play that are in a minor key. During music activities designed to address Lisa's educational objectives, I have been very careful to use songs arranged around major chords.

Music should be encouraged as a stimulus and structuring force for many different learning and therapy situations even if a music therapist is not involved. Try to recognize the unique power of live music and take advantage of music therapists when they are available.

Labeling: Stepping Into a Minefield In Special Education

I recently held a brainstorming session with a teacher regarding how to approach a parent about a child who is showing significant delays across many educational areas. This teacher had just experienced the fury of the parent after remarking to the parent that the child was exhibiting some behaviors consistent with those in some autism spectrum disorders. My teacher friend walked right into the "lion's den" of controversy. Currently, autism is a highly charged topic among parent networking groups, researchers and the media. It is not, however, the only word or disability that sparks instant debate or carries with it certain connotations, myths, and mental images. I have worked with many cases where parents are also concerned about using language like "mental retardation," or "Down Syndrome." The discussion I had with the teacher made me reflect on several strategies and conversational protocols that I use to help facilitate exploration of the educational issues in the world of special education.

1. Take vocabulary cues from your conversation partner ~ Defer all references to labels, disabilities, diseases, syndromes, etc. to the parent until he or she has mentioned one. If the parent names a disability first, then you can feel free to discuss the behaviors and attributes that might be common for that condition.

2. Use specific examples of behavior ~ Instead of comparing the actions and abilities of a student to those of a child with a disability, simply express your remarks as quantifiable measures of progress. One example of this could be that a student frequently echoes words or phrases but does not initiate appropriate verbal interaction. Describe this behavior through a numerical comparison between how many times, on average, the other children in class initiate conversations and how many times the child in question initiates verbal interaction. In this way, a teacher should use many specific examples to express concern to a parent without generating emotions that may be triggered by key words like Autism or Attention Deficit Disorder.

3. Talk to an administrator ~ The appropriate time to speak about a student and use labels referring to disabilities is when discussing a child's progress with the principal, educational diagnostician or school psychologist. I have often had conversations with teachers and other professionals on the educational team about my clients and explored possible disabilities that should by looked at through an assessment process. The administrators should listen to these observations and proceed to contact the parent about assessing for specifically named disabilities.

4. Check the student files ~ I am called upon to evaluate some students to find out if they will benefit educationally from specially developed music strategies. The assessment process includes speaking with parents about their child's reactions to music stimuli outside of school. I routinely audit the student's files for information about what assessments have previously been completed and for the official reasons the student is already receiving special services through an Individual Education Plan. The IEP will list things like, MR for mental retardation, AU for autism, SI for speech impaired and so on. When I speak to the parent about the music therapy assessment and/or progress of their child, I only use the labels that have already been assigned in the student's record unless the parent uses another label.

As a music therapist who travels around to different classrooms and schools everyday, I have observed many different children with a wide range of disabilities. It is often easy for me to quickly come to a conclusion about the nature of a child's disability after only a short time of observation and interaction. I am trained to find out if music activities can benefit a student in achieving educational objectives, but I am not trained to assess and determine disabilities or disease. This limitation is the guiding factor when discussing a student and using specific labels too freely. There are many cases where a child exhibits classic behaviors from the autism spectrum, for example, but the origin of the behaviors is actually traced directly back to a seizure disorder or mental retardation due to trauma at birth. The child will technically be labeled with speech impairment, mental retardation or as other health impaired. Therefore, it is understandable how a parent can be quite upset if an educator is talking about autism and using terminology associated with that spectrum of disorders.

Educators must find a way to address the needs of every child regardless of parents who are understandably wary of believing that anything is wrong with their child. By using care in speaking with labels, educators can keep the dialogue open without creating an adversarial relationship with parents. Most teachers care a great deal about the welfare of their students. Let's all work together and take care of those kids!

Schoolhouse Rock: Five Exciting Ideas for Using an Ocean Drum!

The ocean drum is one of the most unique, yet versatile instruments I usually keep in my "bag of tricks." When it is tilted gently back and forth, the small ball bearings inside create a sound very much like that of waves on the beach. The drum comes in a variety of different sizes including a very large 22 inch drum. I generally use the 16 inch drum because it is easier to carry around but still provides a nice, rich wave sound. I have found that the smaller 12 inch drum does not provide enough surface area to make good ocean sounds, but if portability is an issue, this may be the better choice. The larger 22 inch drum sounds incredible and works well when used by a pair of children to teach sharing and team-work! If you have a closet or classroom close to the area where you are working, this is the drum to get! All of the sizes come in either a fish print graphic design or a plain white/tan. I use the fish print drum, but children who may be over-stimulated may respond more appropriately to the plain fabric.





1. Relaxation ~ The ocean drum works great for creating a background sound for relaxation. Play the drum by gently tilting it from side to side or in a motion that sends the ball bearings around in a circle. If you keep the clear side of the drum facing up, the ocean sound will be softer. I like to get a volunteer to play the ocean drum as I facilitate relaxation to music. Try some appropriate music from Enya or Kevin Kern and slowly describe some imagery of sitting on a warm beach or resting by a babbling brook.



2. Fishing ~ One of my favorite activities is to go fishing for songs. Turn a gathering drum upside down and use it as a "pond" for paper fish cutouts. Place paper clips on the mouth of each fish and use a magnet as the fishing lure to go fishing for songs written on the fish. As each child takes turns fishing, have another child play the ocean drum and sing the song, "You get a line, I'll get a pole..." In between fishing, sing the songs indicated on the fish that are caught. This is a great activity to give multiple kids something to do as they take turns using the fishing pole. The activity also provides a good structure for transitioning between songs and activities that can target specific learning objectives.



3. Portable gathering drum ~ An ocean drum has a great sound when played as a regular drum with your hands or soft headed mallets. This can be very useful if you want to share a drum with another person when sitting in chairs. A gathering drum, for example, is best played sitting around it on the floor. When sitting on the floor is not appropriate due to age or disability, the ocean drum provides a good substitute. The ocean drum can also be placed on a tray-table attached to a wheelchair. It maintains a good resonant sound even when it is placed on a table.



4. Focus of attention ~ The ocean drum is visually attractive and aurally unique. The drum with the fish graphic is colorful and full of a variety of sea creatures that stimulates discussion. The drum without the graphic still has the movement of the small ball bearings that have the ability to mesmerize! I have found that children with autism will often respond to the sound of the ocean drum by looking for the source of the sound. When they see the movement inside the drum they may respond to instructions to wait their turn or follow specific directions in order to gain the opportunity to play the ocean drum. This is a very strong motivator/reward for children with many different disabilities!



5. Surfing ~ This is an obvious choice of activity for use with the ocean drum. Get out your old Beach Boys recordings and turn on, "Surfing USA!" While two people make the waves on the ocean drum, get out those surfboards and catch a wave! This is a great movement to music activity for any age. Use pictures or a short video to set the stage if necessary.



Grab your ocean drum and I'll meet you down by the fishin' hole!

Patient Resource Page: Music Strategies for Relaxation and Wellness

*This page is actively updated*

Music Therapy:

• American Music Therapy Association - The official site for music therapy as a profession. This site includes a very informative FAQ section describing music therapy and its applications.
• Music as Part of Rehab - How music as therapy fits into the lifestyle changes that must happen after a major cardiac event or surgery. Improving your mood and reducing stress are key elements in maintaining a healthy future.
• How Music Works to Help Relaxation - Breaking down the elements of music to find out why music can be so powerful as an aid to relaxation.
  
• Abstract: The Effect of Preferred Sedative Music on Anxiety - The purpose of this study was to examine the effect of patient preferred, sedative music on the state anxiety level of patients undergoing heart catheterization or pacemaker implant.

Music Strategies:

• Using Music Effectively to Manage Pain - Theories and strategies for pain management and distraction from pain.
  
• Relaxation Strategies for Pre-Operative Settings - Three suggestions about how to relax before surgery.
• A Guide to Sedative Music - Tips for choosing the right kinds of music to aid in relaxation.
  
• Self-Guided Relaxation to Music - A relaxation script and guide for relaxing on your own.
  

Tools on the Web:

• Music for the Heart - A website that will present strategies to address the specific stress-inducing events that surround cardiovascular health problems. Recent research has emphasized the need for a holistic approach to health after heart attacks and cardiovascular surgery. This site will present tools and guidance to help patients elevate their mood, learn to relax and introduce music as a leisure-time tool to help them make the post-cardiac event lifestyle change.
• The Mind-Body Wellness Center - This center features cutting edge research about wellness by Dr. Barry Bittman.
  
• Music Makes Sense store at Amazon - A collection of books, music and instruments that I use in music therapy.
  

Memory Booster! Using Music to Memorize Lists and Facts.

The popularity of shows on television, like Fox's "Don't Forget the Lyrics," and party games such as "Encore" emphasize the power of music to help us remember words and numbers. If I write the phone number 867-5309, you may naturally start singing the hit song by Tommy Tutone! I often use music to help my clients remember phone numbers, addresses and lists of information like the months of the year or counting by twos, fives or tens. The children I work with have a range of disabilities from autism to mental retardation, but the principles of music that facilitate memorization remain the same for helping anyone remember key items of information.

1. Use "chunking" - Telephone numbers, as they are written in the United States, (###) ###-####, are good examples of dividing up information into manageable pieces of information. One way I have used this idea is by dividing up lists like the twelve months of the year into two groups before making up a song to help children memorize them. In addition, I use two different songs for each set of months in order to differentiate the "chunks" and make them more memorable.

2. "Piggyback" songs - These are songs where new words are used with an old melody. A great example of this is the Alphabet Song which is set to the tune of Twinkle, Twinkle, Little Star. Piggyback songs are easily overused, but very helpful for teachers and parents who are not musically trained. I usually make up original melodies for use in memorizing material, but it is possible to find appropriate popular tunes that appropriately fit the text to be memorized. I suggest not to use the same tune for all of the different "chunks" of information. Folk songs or songs from the 50's and 60's are usually very good sources for trying out piggyback tunes. These songs are usually very simple in structure, easily sung and very familiar. The melody for (Oh my darling) Clementine, for example, works well to sing about the days of the week:

There are seven days,
There are seven days,
There are seven days of the week.
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday.

3. Add body movements - Kinesthetic memory can be a cue for cognitive recall and kids love to move their bodies to music. A perfect example for this is when kids are chanting, "Hip, hip, hurray!" and naturally pump their arms and fists high up into the air. Adding body percussion such as clapping, stomping or patting your knees at times in the songs can help to emphasize certain lyric information. Strategically placed claps or stomps can also "chunk" the song into smaller parts and allow the singers to refocus and get back on track with the group if they were behind or forgot some of the lyrics. These actions can be very useful for children who have mental retardation or Down Syndrome. Sometimes it takes many repetitions of the song, but in my experience, they eventually learn the action and prefer songs with movement over songs that only use singing.

4. Sign language - Add sign language for key words or even for the whole song. Signing is both kinesthetic and visual! When using sign language for a song pay special attention to keeping the signs in tempo with the rhythm of the music and making the signing motions larger or smaller according to the dynamics and lyrics.

5. Use melody and harmony effectively - Most songs have obvious lyric and melodic phrases that sound incomplete if not finished. One example of this could be singing, "This little light of mine, I'm gonna let it ______," and just leaving the word and the melody blank. This space can be used for important information since it is the most likely place in the song that a word will be remembered when the melody is sung as a cue. An added advantage to this song is that the lyric phrase is repeated many times, providing even more emphasis for important information.

6. Try a Bigmak! - Ablenet has a step by step Bigmak or Littlemak that can be programmed with multiple words or phrases so that the recordings are played sequentially as the button is pushed. This is a great feature for lists and allows non-verbal children to participate in the songs.

Beeping Easter Egg Hunt! The Creative Use of Sound to Facilitate Children Who Have Disabilities.

This story was featured in the Fort Worth Star Telegram. Click here for the full story: Blind, Deaf Can Play These Easter Games.

I love this idea! I immediately started thinking about how small music chips could be placed into eggs instead of just "beeping" sounds. This is the first I have heard of this organized event and my kudos go out to the folks at AT&T. Keep an eye out in your own community for similar events

Hey Mr. DJ! Dancing Activity for the Special Education Classroom.

I learned this activity in my music therapy internship, but I do not know where the original idea came from. We called it, "Disco Nerf!" This group activity can be done in a variety of special education settings or even at home as a family. I think it works especially well for junior high and high school groups. Dancing is an age appropriate activity, but these kids don't usually get to attend the regular school dances and parties.




Equipment:

- Nerf Ball
- CD player (remote control makes things easier)

Rules:

- Whoever has the ball when the music stops has to make up a dance move.
- Whenever you get the ball you have to do your dance move if you have made one up.
- If you get the ball a third time when the music stops, then you become the DJ!
- Everyone starts over with no dance moves when there is a new DJ.

Activity:

Form a circle making sure that there are teachers or peer facilitators at strategic locations in the circle to assist students with disabilities. (Remain sitting in chairs to add more structure to the activity if there are students who get too excited or lack focus of attention skills.) Select a person to be the first DJ and have them control the pause button on the CD player. The DJ should be facing away from the group so that he or she cannot see where the ball is. The DJ starts the music and the group quickly passes the ball in a circle like it is a "hot potato." The DJ randomly stops the music and waits for the person with the ball to make up a dance move. The dance moves should be kept simple and the dancer should be able to do the move while holding the ball. Request the DJ to restart the music and continue passing the ball. If a person who has made up a dance move gets the ball while the music is going, he or she should do their dance move before passing the ball to the next person. Prior to starting, you should determine if dancers will have to make up two different dance moves if the music stops while they have the ball on two different occasions. (Sometimes I just have them do one dance move depending on how well they can remember.) Once a person has the ball a third time when the music stops, they become the DJ and everyone starts over without any dance moves. The ball just moves quickly as a "hot potato!"

Applications, goals and objectives:

This activity can easily be used to collect data on objectives. It is also an easy way to have peer assistants partner with students who have disabilities. Many students with cerebral palsy or other disabilities will need help to hold and pass the ball, but in my experience they always love the activity!

Here are some suggested goals to observe:

- Following one and two-step directions.
- Gross motor movement.
- Peer interaction.
- Focus of attention.
- Sequencing skills.

Now go and, "Shake your booty!"

Parent Resource Page: Using Music To Help Your Child With Disabilities

*This page is actively updated*

Music Therapy:

• American Music Therapy Association - The official site for music therapy as a profession. This site includes a very informative FAQ section describing music therapy and its applications.
• Prelude Music Therapy - Kathleen Coleman and Betsey King have developed many useful materials for use in music therapy. Kathleen is a pioneer in music therapy in the Dallas/Fort Worth area and offers helpful information about music therapy in the public school setting.
  
• What Happens in a Music Therapy Assessment - This article answers many questions that I regularly receive from teachers as I prepare to evaluate a student in their classes.
  

Music Strategies and Inspirational Stories:

• Scooby Doo Meets His Match! - A story about the power of live music and singing to help a boy with autism do his work.
• Using Music With Children Who Have Visual Impairments - Children who have visual impairments or blindness combined with disabilities such as mental retardation, autism, Down and other syndromes present unique challenges for using music therapeutically. These children also tend to have more acute sensory defensive behaviors towards objects in the environment. Therefore, I often employ music strategies to address non-musical objectives instead of trying to teach music as a skill.
• A Schoolhouse Story About Singing and Stimming Behaviors - Henry is a delightful boy in the second grade. He has recently been labeled as having an an autism spectrum disorder and his behaviors are consistent with many of the common characteristics of autism. One of these characteristics is his desire for self-stimulation through hand flapping, visual and verbal perseveration, muscle flexing and in Henry's case, singing.
• William Learns To Walk Like A Man - I am fortunate that many behavior problems disappear during music therapy activities. The teachers I work with often joke that I remain around longer so that their students continue to pay attention and remain sitting appropriately. These students do not have bad teachers, but the power of the music activities is often strong enough to maintain order during the music therapy session without many of the behavioral interventions that are necessary during regular classroom activities.

Tools on the Web:

• Songs for Teaching - This very useful site has educational songs grouped by category and subject. Visitors to the website can listen to music samples and view song lyrics.
  
• Music Makes Sense store at Amazon - A collection of books, music and instruments that I use in music therapy activities or that I recommend for use by teachers and parents.
• West Music - West music is a full-line music store with a very nice catalog and internet website. They have most of the musical instruments that would be used in a classroom setting. I have met many of the West music employees while working at conventions and highly recommend their services and products.
• Disaboom - A community on the web developed by a doctor with quadriplegia. Here you may find ways to connect with other people with disabilities, hear their stories and benefit from their knowledge.
  
• Go Fish Guys - Music written for kids that is safe to listen to and nice enough that it won't drive parents crazy!
  

Teacher Resource Page: Music Strategies for the Classroom

*This page is actively updated*

Music Therapy:

• American Music Therapy Association - The official site for music therapy as a profession. This site includes a very informative FAQ section describing music therapy and its applications.
• Prelude Music Therapy - Kathleen Coleman and Betsey King have developed many useful materials for use in music therapy. Kathleen is a pioneer in music therapy in the Dallas/Fort Worth area and offers helpful information about music therapy in the public school setting.
  
• What Happens in a Music Therapy Assessment - This article answers many questions that I regularly receive from teachers as I prepare to evaluate a student in their classes.
  
• BEFORE Asking for a Music Therapy Assessment - A guide to screening your students before presenting a case at the ARD meeting. Much time will be saved by paying attention to the right kinds of reactions a student has to music before proceeding with a full music therapy evaluation.
  

Music Strategies:

• Using a Gathering Drum - The children's gathering drum is a great way to gain a lot of "bang for your buck!" This is a list of 10 ways to use the drum in music activities.
• Drum Circles - Tips and guidance for doing drum circles in a special education setting. Drum circles are very fun and motivating for students and can be very successful with the right planning!
• Music Activities for Children with Visual Impairments - Children with visual impairments have special awareness of musical sounds. This article is a guide for using music more effectively with this population.
• Try Out the Suzuki Q-Chord! - The Q-chord is an amazingly versatile instrument that many teachers find easy enough to learn how to play. You don't have to play the piano or guitar to facilitate music with your students!
• Stress Management and Relaxation - Take some time to benefit from music assisted relaxation. Both you and your students can benefit from these useful strategies.
• Parachute Activities - Useful ideas for incorporating goals and objectives into parachute activities using music.
• Tuned in to Learning - This music and learning curriculum was developed by a music therapist and an autism specialist.
  

Tools on the Web:

• Teacherxpress.com - An amazing collection of links to reference sites that are useful of teachers. Check it out and don't forget to bookmark it!
• Songs for Teaching - This very useful site has educational songs grouped by category and subject. Visitors to the website can listen to music samples and view song lyrics.
  
• Music Makes Sense store at Amazon - A collection of books, music and instruments that I use in music therapy activities or that I recommend for use by teachers and parents.
• West Music - West music is a full-line music store with a very nice catalog and internet website. They have most of the musical instruments that would be used in a classroom setting. I have met many of the West music employees while working at conventions and highly recommend their services and products.
  
• Ablenet - The home of the Bigmak! A site full of switches, adaptive communication devices, and functional skills curriculum helps.
• LifeSounds - Chris Brewer is a musician with advanced training in Guided Imagery and Music. She also specializes in integrating music into the classroom. Here is a link to a great book about how to use music more effectively in the classroom!
• Kangarooboo - I love the musical instruments available here! Many of them are designed as animals or characters and are great for stories and songs with themes!
  

Up, Up, and Away! Music Activities With a Parachute.

Small parachutes are a fun and unique way to complement music activities. Parachutes are common in P.E. classes, but I enjoy using them for my clients in the special education setting to target a variety of learning objectives. Unlike the huge one pictured here which can be used for large groups, I suggest using an 8' - 10' parachute in small group activities. Parachutes that are smaller than this do not catch as much air nor achieve the same effect of suspension in the air and subsequent slow, floating down.

When to use a parachute:

1. Gross motor movement.

-Children who are in wheelchairs benefit greatly from using a parachute because it is easy for them to participate with a group in a movement activity that does not require lower extremity motor skills. There are also many applications for students to practice grasping and raising their arms up in the air. (Make sure that the parachute has handles or loops attached to it to facilitate the activity.) I like the song, "Reach Up High," by the group Parachute Express for this activity.

-Children can participate in dancing with or without wheelchairs by taking turns running in and out from under the parachute and dancing underneath before it drops down. The students in wheelchairs can be pushed in and out or allowed to dance as the parachute goes up and down over the top of them. Popular music is the best choice for this activity. Currently, Hannah Montana and the Jonas Brothers are favorites in the classes I go to.

2. Academic/Social skill development.

-I like to use a very light blow up ball about 10" in diameter for these activities. (Nerf balls seem to be too heavy and bouncy.) Most of the parachutes come with different colored sections so take turns calling out colors on the parachute and see if you can move the ball to the requested color. There is a fun song by Aaron Carter called, "Bounce," that works well for this activity.

-Another option for using a ball is to see if the students can roll the ball on the parachute to one of their peers. This requires that they work together and also that they recognize their peers. Try this activity at the beginning of the school year when there are new students in the class.

3. Relaxation.

-The parachute provides refreshing bursts of air as it is thrown up high and floats back down. The key to successfully gaining this effect is that the group must stretch up high to place the parachute and then slowly allow it to return to the ground.

-Stretching and breathing are important components to relaxation. The motion of the parachute up and down are good physical cues to help students breathe in and out slowly in preparation for music assisted relaxation. One good song to use for this is Enya's song, "Watermark." This song repeats a series of up and down melodic lines that evoke the feeling of raising and lowering the parachute.

The Role of Music:

1. Lyric instruction. Songs that sing about reaching up or going "high" or "low" are perfect for the parachute activities. There are also songs that talk about fast and slow or moving left or right. Songs about colors such as Hap Palmer's, "All the Colors of the Rainbow," can be used as a way to discuss colors and to guide the bouncing ball around the parachute.

2. Setting the mood. Songs are a powerful way to set the mood for the activity. Relaxing music will evoke slow motions up and down, while fast music with a lively beat is good for trying to keep a ball bouncing on the parachute without letting it fall off.

3. Melodic cues. Music like Enya's, "Watermark," guides the participants in moving up and down like the melody. Other motions such as swaying or spinning may also be tied to the melodic line.

Jump in the fun -- and don't forget your parachute!

Relax! How to Use Music and Relaxation to Help Your Students With Disabilities.

I have had the opportunity to lead several music assisted relaxation groups in public school special education classrooms. These groups have included a range of ages and types of disabilities including Down Syndrome, autism, mental retardation and Cerebral Palsy. One of the key points I like to emphasize with my clients and their instructors is that learning to relax can become a conditioned response. This means that relaxing can be practiced so that it is more effective and useful in the future.

Generally the clients that I work with in the special education classrooms do not have typical life stressors that would induce anxiety and require relaxation, but there are other reasons that relaxation can be an important tool for them and their teachers. I have found that many of the special education students are easily overwhelmed with environmental stimuli in their daily environment. Most teachers recognize this situation and have created quiet areas of their room that have been somewhat sectioned off and made comfortable for students to experience some quiet time without so much of the distractions of the classroom.

In other situations, students sometimes become agitated or emotionally upset without apparent cause. When this happens, it has been helpful to have a familiar music relaxation or music listening strategy already in place as part of the behavior intervention plan. In addition, the students may also benefit from social interaction, gross motor movement, stretching and opportunities to become peer models or leaders as they participate in small group relaxation activities.

I have used various music assisted relaxation activities with school-age students. There is not a specific protocol that must be followed, but rather some general suggestions and ideas to reference as you implement relaxation activities into your classroom:

1. Music choice - Music for relaxation should be chosen according to several criteria. The most important quality of the music is a slow tempo with a predictable underlying rhythmic pulse. I recommend a tempo of about 60 - 80 beats per minute. Music without lyrics is recommended, but there may be some singing if it does not distract too much attention from the experience. The melody should be pleasant and part of traditional music and not atonal or experimental. Try to use songs that do not have sudden changes in tempo, dynamics or unexpected starts or stops. The melody should also stay in the mid-range and not sound extremely low or high. There are some very good songs by Enya, Kevin Kern and Daniel Kobialka that I have used in my groups.

2. Facilitator - The person doing the relaxation facilitating, either a teacher or student, should use a calm, steady voice. Practice speaking slowly and clearly, pausing often to listen to the music. The music should be loud enough to mask unwanted environmental sounds, but not so loud that the facilitator has to speak any louder than he or she would in a normal conversation. The facilitator should sit in a chair and demonstrate the breathing or stretching movements.

3. Breathing - Breathing is the foundation for these relaxation groups. Start out the group with several deep cleansing breaths by breathing in through the nose and out through the mouth. Continue the relaxation by practicing some deep breathing in and out using slow eight or ten count intervals. Breathing can be verbally reinforced by describing the "revitalizing," "fresh," "relaxing," air going in and the "discomfort," "anxiety," and "stress," leaving the body. After a few minutes of breathing, the facilitator should encourage the group to get more comfortable in their chairs, close their eyes if desired, and breathe normally. Breathing should fall into a steady, relaxed rhythm.

4. Stretching - I encourage breathing and "stretching" as the main components of the relaxation sessions for these groups with students who have disabilities. Simple gross motor movements demonstrated by the facilitator provide "concrete" actions for the group to follow. I usually do shoulder rolls forward and backward, reaching for the ceiling and the floor and slowly tilting the head from side to side and forward as the basic movements. Other stretches can be done by reaching forward or sweeping the arms up and down as if doing very slow jumping jacks. Combine some breathing in and out on selected motions for added effect.

5. Imagery - For groups that do not have people with disabilities it is very effective to use some kind of imagery to facilitate the relaxation. Suggestions include imagining a warm light that slowly warms and relaxes each part of the body or being guided to a restful place in nature where comforting sounds and worry free relaxation can take place. Most of my clients in special education do not respond well to abstract imaginations and descriptions, but music that has environmental sounds or large pictures with client preferred settings may be possible applications after a relaxation routine is familiar and established.

The relaxation experience should begin and end with similar breathing and gross motor movements. Between these times the facilitator is free to try different stretches or breathing as they wish. This allows for leadership and choice-making opportunities for the students. Picture cards that illustrate the gross motor movements can be made so that students can make a choice between pictures and then present their choice to the group. The facilitator may also pass out supportive instruments such as an ocean drum to add to the atmosphere of the experience. An 6'-10' parachute shared by the group is a wonderful way to practice slow breathing and movements!

The relaxation session should last about 5-10 minutes depending on the attention span of the participants. If this group relaxation is practiced on a regular basis, you will notice that the students will tone down their activity simply in anticipation of the experience and even more when the music begins playing. Teachers will find that just by playing the music that they regularly use for relaxation they may be able to aid a student who is upset or agitated and help them regain some self-control. The relaxation protocol may also be helpful to use on days when an unplanned change of the school schedule has disrupted the regular routine and the students are unusually off-task.

There are many applications for the use of music assisted relaxation activity in relation to objectives in a student's Individual Education Plan. Following directions, making choices, gross motor movement, counting skills, focus of attention, gesturing and verbalizing are all specific objectives that can be tracked for progress during music facilitated group relaxation.

Now...take a deep breath....exhale.....

(For teachers after a long day, take a look at this article: Instructions For Self-Guided Relaxation
)

Bigger is Better! The Unique Powers of Drums, Guitars, Rainsticks and Other Large Musical Instruments In Therapy.

This week I made the observation that one of my clients responds more significantly to large instruments. He seems to prefer a large gathering drum, the guitar and a Q-chord placed in his lap. He is not the only client that enjoys these instruments, but it prompted me to detail the specific qualities that large instruments have that make them so powerful for some clients. Teachers and parents can benefit from understanding the qualities that make these instruments unique. Here are three ways large instruments can sometimes be so effective:

1. They are cool! Many large instruments are visually attractive. My large gathering drums and African drums have tropical patterns and colors that are appealing to children. The larger ocean drums come with colorful fish panoramas and provide focus of attention on the moving beads inside. There also seems to be something fun about getting to play the biggest instrument out of a group when given a choice.

2. Accessibility. Large instruments offer height and large playing surfaces that are often easier for children to approach. They do not require children to hold on to them in order to make a musical sound. This is especially true for children who do not have fine motor skills and have difficulty holding on to small shakers or handles. A large drum head, for example, is a perfect place for these children to play without worrying about hand strength and grasping. I also love that a Tubano drum is just the right height for younger children to stand next to and play. When they get older, the Tubano is easily played from a sitting position and can stand up straight on the floor - no tilting necessary! The Q-chord is the king of accessibility since it can sit on a tray table for wheelchair access or on a lap. The strum-plate on the Q-chord is also very easy to manipulate and does not require fine motor skill to activate.

3. Vibration. Large acoustic instruments provide much more in the way of sensory feedback. The gathering drum provides wonderfully low and rich vibrations. The drum can be placed on the floor or shared between two people on their laps so that the vibrations can permeate through the legs. The guitar is similar, but also provides the melodic elements so that the vibrations change with the high and low pitch. Many of my clients who are sensory defensive will reach out and strum the guitar as one of the few objects they seek out in their environment.

There are many other kinds of large instruments that can be effective during music activities when working with children who have disabilities. Pianos and keyboards are not as easily transported, but they offer all three aspects in that they are very unique, accessible and full of aural and tactile stimuli. I have also used large rain-sticks. For the best effect, try to find a rain-stick that sounds for as long as possible.

Sometimes it just makes sense to use a BIG instrument!