Tuesday, April 29, 2008

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.

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