Dancing For a Cause!

I saw this on ABC news and couldn't resist! Hospitals need more music! The glove company wanted to promote Breast Cancer awareness, so they made pink gloves and donated some of the profits from the sale of the gloves. The hospital employees took up the challenge to a whole new level!

I actually began my career in music therapy after working in a hospital and seeing the need for music. This video is great! It has already been seen by 1.7 million people!

Stem Cell Research, Therapy and Related Music Therapy

Stem cell research has been highly publicized and discussed in the last ten years. Much of this is due to the fact that useful human embryonic stem cell lines were only recently established in 1998 (International Society for Stem Cell Research, 2008). The existence of stem cells for use in experimentations led to ethical dilemmas with political implications. Notwithstanding political and ethical debates, the use of stem cells for treating many diseases and disabling conditions has continued to increase. The related literature regarding music therapy and patients being treated with stem cells is small, but music therapy has been shown to have promising potential.

In order to understand the possible ways music therapy may benefit patients receiving stem cell therapy, it is important to define stem cells and review the current state of research and treatment. Stem cells are building blocks of life since they are unspecialized cells that can turn into many different types of cells as they develop. Stem cells can turn into muscle cells, red blood cells, brain cells and any other cell in the body. The National Institutes of Health (2009) primer on the subject of stem cells further explains that stem cells can divide without limits into more unspecialized stem cells. Embryonic stem cells begin dividing into different types of cells as the embryo grows into a fetus. In adults, stem cells located in the gut and bone marrow produce a replenishing supply of specialized cells that replace and repair damaged tissue (National Institutes of Health, 2009).

Embryonic and somatic (adult) stem cells present important differences for researchers studying different ways to utilize them in experiments and therapy. Embryonic stem cells, discovered in 1981, are produced from embryos that have been created through in vitro fertilization (National Institutes of Health, 2009). Embryonic stem cells have been considered unique because they can proliferate for many years in the laboratory without changing into specialized cells. Adult stem cells, however, usually generate the same type of cells for the tissue where they reside. Researchers have also found it difficult to make adult stem cells proliferate in the lab, and even when they do, it is for only a short time (National Institutes of Health, 2009).

Researchers aim to establish pluripotent stem cells, which mean that the cells can produce any cell in the body (International Society for Stem Cell Research, 2008). Embryonic cells are cultured and then subcultured until the cells have proliferated for more than six months. This establishes a “stem cell line.” The first human embryonic stem cell lines were created in 1998 (International Society for Stem Cell Research, 2008). Stem cell lines are useful to scientists because they have an abundant supply of unspecialized stem cells that can be used for directed differentiation.

Embryonic stem cells that are allowed to clump together and form embryoid bodies can start differentiating spontaneously. Researchers can direct this differentiation by adjusting the chemical composition of the culture medium or inserting certain genes. The eyes, ears and heart are common destinations for these cells. Adult stem cells can be differentiated into cells that are common to their origin such as skin cells, neural cells and hematopoietic cells (National Institutes of Health, 2009). Sometimes adult skin cells have been able to transdifferentiate into cell types other than expected, but these occurrences have been isolated in non-human vertebrate. One exception to this is the induced fluripotent cells (iPSCs). These are adult stem cells that have been turned into embryonic stem cells by introducing embryonic genes. Although these stem cells offer great hope to researchers in expanding stem cell lines, scientists do not know if iPSCs and embryonic stem cells are exactly the same (International Society for Stem Cell Research, 2008).

Stem cells offer great hope for treatment of disease and use in the lab for drug trials. Embryonic stem cells can become any type of cell and can be produced with relative ease compared to adult stem cells. Adult stem cells, however, are thought to be less likely to cause rejection by the immune system in a patient because they can be created from the patient’s own cells. By overcoming the problems with rejection stem cell therapy has been used successfully to place new cells in the spinal cord, repair burns, and aid in fighting heart disease and arthritis (International Society for Stem Cell Research, 2008). Stem cells in the lab have been used to learn how cell division occurs in cancer and birth defects. Researchers have also been able to test drug effects on differentiated cells.

The usefulness of stem cells is sometimes overshadowed by ethical questions surrounding the use of embryos and their destruction to create embryonic stem cells. Many people have asked whether embryos should be considered people or property. Even if embryos are considered property concerns have been raised that women could become commercially exploited for their eggs (Hollowell, Coelho, Weldon, & Moffit, 2005). Cord blood stem cells may offer an alternative to embryonic stem cells since they do not require an embryo to be destroyed and offer some potential for undifferentiated cells. The current dependence on embryonic stem cell lines for most of the research and therapy will continue to cause ethical debate, but has also been a catalyst for political battles.

The political debate over stem cells has centered around the use of federal money for research on embryonic stem cells. George W. Bush established an executive order allowing for funding of ongoing research on embryonic stem cell lines that had already been established, but did not allow for additional funding to destroy new embryos and create new stem cell lines (The White House, 2001). In March of 2009, President Barack Obama issued an executive order to allow embryonic stem cell research to be funded by the National Institutes of Health (Stout & Harris, 2009). His order makes it possible for federal spending on new embryonic stem cell lines.

Ethical and political debates may continue until consistent methods are found to produce pluripotent stem cells without destroying human embryos. Although private research was not directly affected by the political debate and continued producing stem cells for medical use, President Obama’s new executive order will surely spur more federal help. Stem cell transplants and therapies that have been successful over the last decade have presented patients with challenges in healing and coping with the invasive procedures. The American Cancer Society (2009) cites high fever, infection, cramps, diarrhea, mouth sores and pain from needle sticks as only a few of the adverse symptoms and side effects from stem cell transplant. Health care workers will have to put effort into treating the physical and psychological side effects of stem cell therapy and transplant.

Music therapy has already been involved with some of the patients in this new frontier of medicine. Music therapists have been using music to help with pain and nausea (Sahler, Hunter, & Liesveld, 2003), improving mood (Cassileth, Vickers, & Magill, 2003), and decreasing anxiety (Robb & Ebberts, 2003). The research conducted by Cassileth, Vickers and Magill (2003) looked at the effect of music therapy on mood disturbance during autologous stem cell transplant for 69 patients divided into two groups. Music therapy interventions were determined by trained music therapists according to the needs of each patient and the interventions ranged from music assisted relaxation to active music making with instruments and song-writing. The researchers found that patients in the group receiving music therapy indicated a 28% lower score on an anxiety/depression scale and a 37% lower score on a total mood disturbance score when compared to the group that did not receive music therapy. The score for total mood disturbance for the group receiving music therapy was significantly lower than the total mood disturbance score for the control group. Music therapy was helpful in this instance where drug therapy might be less effective or contraindicated due to medical circumstances.

More research will need to be conducted with regard to music therapy and the therapeutic use of stem cells. The research literature about music therapy to help with relaxation (Sahler, Hunter, & Liesveld, 2003) and reducing anxiety (Robb & Ebberts, 2003) were pilot studies with very small numbers of subjects. These studies are important in establishing the feasibility for future research using music therapy with patients undergoing stem cell transplant and therapy, but the experimental results cannot yet be generalized to larger populations.

Opportunities for music therapy will increase as more options for stem cell transplant become available. One exciting new development is the discovery of stem cells that can turn into hair cells in the inner ear (International Society for Stem Cell Research, 2005). Successful transplants of stem cells for hearing loss would be a huge step forward and could benefit from specially developed music interventions during hearing rehabilitation. Overall, music therapy is well positioned to help patients before, during and after stem cell therapy. There already exists a large research base describing music therapy for pain management, relaxation and psychosocial support for patients undergoing similar procedures. Transfers can be made between existing practice and work with patients who are meeting the challenge of stem cell therapy.

References

American Cancer Society. (2009). Detailed guide: Multiple myeloma stem cell transplantation. Retrieved October 30, 2009, from http://www.cancer.org/docroot/CRI/ content/CRI_2_4_4X_ Stem_Cell_Transplantation_30.asp

Cassileth, B. R., Vickers, A. J., & Magill, L. A. (2003). Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation: A randomized controlled trial. Cancer , 98, 2723-2729.

Hollowell, K., Coelho, P. H., Weldon, D., & Moffit, R. E. (2005). Federal stem cell research: What taxpayers should know. The Heritage Foundation, Washington, D. C.

International Society for Stem Cell Research. (2008). Stem cell facts: The next frontier? Retrieved October 31, 2009, from http://isscr.org/public/ISSCR08_PubEdBroch.pdf

International Society for Stem Cell Research. (2005). Stem cells and the inner ear. Retrieved October 28, 2009, from http://www.isscr.org/public/ear.htm

National Institutes of Health. (2009, April 28). Stem cell basics. Retrieved October 27, 2009, from http://stemcells.nih.gov/info/basics/defaultpage

Robb, S. L., & Ebberts, A. G. (2003). Songwriting and digital video production interventions for pediatric patients undergoing bone marrow transplantation, part I: An analysis of depression and anxiety levels according to phase of treatment. Journal of Pediatric Oncology Nursing , 20, 2-15.

Sahler, O. J., Hunter, B. C., & Liesveld, J. L. (2003). The effect of using music therapy with relaxation imagery in the management of patients undergoing bone marrow transplantation: A pilot feasibility study. Alternative Therapies in Health Medicine , 9, 70-74.

Stout, D, & Harris, G. (2009, March 7). Obama reversing stem cell limits Bush proposed. The New York Times, p. A1.

The White House (2001, August 9). President discusses stem cell research. Retrieved November 1, 2009, from http://georgewbush-hitehouse.archives.govw/news/releases/2001/08/ 20010809-2.html.

Top 5 Books about Drumming for Therapy

Drum circles and group drumming have experienced huge growth over the last decade. There are many music therapists who use the power of drumming to help their individual clients or different kinds of groups from corporate employees to kids in special education. There are so many different ways to use drums and drumming in therapy that it has been hard to find one authoritative book on the subject. Here are my top 5 favorite handbooks on using drums in therapy. Each book has its strengths and adds to the knowledge base. All of them are well written, easy to read and have many great pictures and illustrations:

Tataku: The Use of Percussion in Music Therapy

Bill Matney has put together a great book that brings together instruction about how to play instruments and a guide about facilitating drum circles. He has included specific references for working with different types of populations.







The Healing Power of the Drum.
Robert Lawrence uses his book to explore many case examples of using drums in therapeutic situations. He also provides some history and foundation for the use of drums in wellness.

The Art and Heart of Drum Circles.
Christine Stevens is one of the pioneers of synthesizing music therapy and group drumming. Her book is an indispensable tool for the drum circle facilitator. She has years of insight into what can make or break a drum circle.

Together in Rhythm : A Facilitator's Guide to Drum Circle Music.
Kalani is not a music therapist, but he has been doing community drum circles for a very long time. His book comes with a DVD that is very useful in visualizing the leadership/facilitator skills for group drum circles. He also includes transfers for using various techniques with people and children with disabilities or in special situations.

Any of these books will help you to keep the rhythm going!

Delicious

Delicious

(Leo Sevush)

D______________D7
Pick out a pumpkin, a pumpkin that fits.
G_______________Gm
Put it on the table and scoop out the pits.
D
Put it in the oven and bake that pie.
A7_______________________D
Put it on the table and listen to the sighs.
D___________________A7_____D
Delicious, delicious, delicious pumpkin pie!
D_________________________________A_____D
(rub your tummy...) Mmmm, mmmm, delicious pumpkin pie!

Cranberries look, red, round and small.

Put them in your mouth, you won’t like them at all!

Put them in a pot and cook them long

Put them on the table and you’ll hear this song!

Potatoes and gravy are part of our fare,

Cut up the potatoes and cook them in a pot.

Mash the potatoes, and pour the gravy on,

Put them on the table and you’ll hear the cheers!

Turkey and stuffing are the dish for today,

Mom’s been cooking since early in the day.

Turkey’s in the oven and the dressing is on the stove,

Put them on the table, and you’ll see the smiles!

Rolls with butter are an extra treat,

Fluffy, white and tasty – you’ll eat and eat and eat!

Bake them in the oven until they’re nice and golden!

Put them on the table and you’ll hear us say,

Please see my post: Thanksgiving Tunes! Delicious! for a description of activities that go with this song.

Thanksgiving Tunes! Delicious!

I use a number of different songs around the holidays, but one of them that has been a huge success is a song called, "Delicious." It is written by Leo Sevush according to the sheet of music I have, but I have never been able to find the original source. If anyone out there knows what book or collection it comes from, please let me know!

I usually play the song on guitar, but I have also recorded it for some of the clients and teachers I used to work with. You can listen to the recorded version by clicking on the record:

02 Track 2.wma

This song is great for many reasons, but especially for the repeating line, "Delicious, delicious..." This is an obviously difficult word for many young children or kids with speech impairments to say, but they absolutely love trying to say it all twenty times in this song! This very clear repeating line also lends itself nicely to the use of a Bigmak button for anyone who does not speak or needs an alternate way to participate.

I have made up a file folder with pictures of all the things in the song with a picture of a table so that the children can set the table as the song goes along:


Like so many file folder activities, you can make this one fit the ability level of your students or clients. You may want to let each participant choose what they want to eat for thanksgiving and just see if they can get the food on the table. Sometimes, I sing about a specific food and see if they can find the correct picture from a field of however many choices I feel will be appropriate. I made up pictures for all the foods in the song, but feel free to add more pictures and verses for foods your kids like.

I have transcribed a song sheet for guitar that you can see here. The tune will get stuck in your head for at least a day or two! Enjoy!

Oxytocin: Implications for Autism and Music

Someone asked me recently about the use of Oxytocin to help people with autism improve their social skills. I had not heard much about using this drug, so I did some investigating. I think some of the recent "buzz" about using Oxytocin may be from some new research that was published about genes in people with autism. Dr. Simon Gregory at Duke University used a controlled study to establish that in 20 cases of autism there was a problem with the OXTR gene that processes Oxytocin in the brain. Another study by L. A. Green et al also found problems with Oxytocin processing in children with autism. This is important because previous research has shown some indications that oxytocin can decrease obsessive compulsive behaviors, repetitive behaviors and increase the desire for social attachment. One study by Eric Hollander in 2003 compared giving Oxytocin or a placebo to individuals with autism and found that there was a significant decrease in the number of repetitive behaviors for the group receiving Oxytocin infusions.

The research seems to be showing that there is some relationship between autism and the genes that process Oxytocin. So far, the number of research studies are few. The studies also have small sample populations and have not been replicated. I think we are just at the beginning of understanding how Oxytocin might play a part in autism. Some people are theorizing that giving Oxytocin to people with autism might be helpful, but the research has only been able to demonstrate short-lived improvements from extra Oxytocin. These studies also used injected Oxytocin and giving the drug through nasal mist did not seem to have the same effect. Since the research is not clear about the possible problems with the brain processing Oxytocin, perhaps giving extra Oxytocin is not recommended since it may have negative side effects in other areas. Oxytocin, after all, is a powerful drug (Pitocin) sometimes used during labor to increase the strength of contractions.

So if injecting Oxytocin may create a temporary positive effect in some people with autism who may have a deficient processing mechanism, perhaps we can find a better way to supply Oxytocin or increase its uptake. Please bring in Dr. Hill of Arizona State University....

Dr. Hill started a research project last year to test Oxytocin levels in band students before and after playing in ensembles. These students do not have autism, but if there is evidence that music may increase natural Oxytocin levels, this may be an interesting basis for more research into why music has been so effective in helping many people with autism.

My initial thought is that it may explain why after about 5-10 minutes of a familiar music therapy session, children with autism usually settle down and increase their focus of attention. I have also noticed that many children with autism have a very positive association with music and the music therapist. Would music induced increases in Oxytocin account for the increased verbalization and social interactions that often occur during music therapy? I have not seen published results of Dr. Hill's study, but I anxiously await his findings.