Friday, June 25, 2010

Try to Remember: The Rhythmic Mind

The Spring 2010 issue of the Journal of Music Therapy has an interesting article about memory. Dr. Silverman, from the University of Minnesota, was interested in looking at how different combinations of pitch, rhythm and familiarity of a music selection affected working memory and anxiety.

Sixty undergraduate students were asked to recall six nine-digit sequences using the numbers one through ten, but not the number seven. The nine-digit sequences were recorded under different treatment conditions such as the digits paired with pitch only from a familiar melody (e.g., Old MacDonald) or the digits recorded with the rhythm only from a familiar melody, (e.g., Mary Had a Little Lamb.) The other four treatment conditions were: a familiar melody with both pitch and rhythm, an unfamiliar melody with pitch only, an unfamiliar melody with rhythm only and an unfamiliar melody with both pitch and rhythm. Although Dr. Silverman also investigated the anxiety levels of the participants before and after taking the memory tests, he did not find a significant difference in anxiety levels.

The results indicated that recall of the nine-digit sequences was best for the rhythm only condition. Participants actually remembered the least when the digit sequences were paired with only pitch or with pitch and rhythm. Dr. Silverman hypothesizes that working memory can become overloaded with information and does not function as well when more than one stimuli at a time is streaming in. The "rhythm only" treatment condition may have helped the participants to better "chunk" the digits into meaningful and more memorable groups of information, whereas the number sequences paired with pitch or pitch and rhythm together caused an "information overload" in the working memory.

This research may prove highly useful in a variety of settings. I think that when a music therapist does an assessment, for example, it might be a good idea to try a variety of interventions including the "rhythm only" method rather than only trying to use pitch, preference and rhythm together at the same time. Songs may become a memory aid over time after information is committed to long term memory, but using rhythm to aid in short term memory may provide a good evaluation of a client's response to music. Sometimes music therapists only get one chance to do an assessment with a client, so every successful response to music regarding non-musical goals is an important part of the assessment's conclusion and determination of recommendation.

I also think that this new information about rhythm and memory can be a powerful tool to use during behavior modification. There are many times when a client with autism or cognitive delays will benefit from performing something successful in a short amount of time in order to benefit from positive reinforcement. Perhaps using simple and familiar rhythms to teach key information would be the best approach to helping the client use working memory to respond appropriately and then receive a reward.

Just don't let advertisers get a hold of this new research or we might see a lot more impulse buying!

Silverman, M. J. (2010). The effect of pitch, rhythm, and familiarity on working memory and anxiety as measured by digit recall performance. Journal of Music Therapy, 47, (1), 70-83.

Sunday, June 20, 2010

Gentlemen, Start Your iPods!

The UK Telegraph reported on a recent research study out of France that looked at the effect of a romantic song versus a "neutral" song on the likelihood of a woman to give out her phone number. Interestingly enough, the study found that a woman gave away her phone number 52% of the time after listening to a romantic song playing in the background but only 28% of the women hearing the non-romantic song in the background gave out their phone numbers.

As a music therapist I often advocate for the power and influence of music on behavior, but I am not sure that this particular research proves anything. Although many of us would argue that romantic music "sets the mood," the results of this French research study probably should not be generalized too far.

First of all, the setting for the research does not transfer well to real world situations. The investigators had each lady sit in a room for five minutes and played one of the two songs. They were then told to go in and talk to the man about the advantages and disadvantages between organic and non-organic cookies! Maybe you could equate this situation with a blind date or the first date through a dating service, but otherwise I don't see how useful the findings of the research will be in real world situations.

The researchers also used a man with "average" looks as selected by a panel of women. I don't know about you, but when was the last time you really knew "what women want?!" We could cut Barnes & Noble to half its size if we had information like that!

Another problem with the study was that the researchers only used two different songs. I think it would be important to test a variety of "romantic" songs and then try to categorize and isolate the common elements of the songs that might characterize "romantic" songs with the power to influence behavior.

And for the American guys, this study is no help at all since the "romantic" song used in the research was a French song by Francis Cabrel. On second thought, my wifes loves Francis Cabrel!...I wonder if I can get her to give me her phone number?...

(Image by: Graeme Weatherston /

Monday, June 14, 2010

The Other MMS: Multimodal Stimulation with Premature Infants

Music Makes Sense meets Multimodal Stimulation

Multimodal stimulation (MMS) is one of the coolest music therapy applications to come out of the research in the last decade! Dr. Jayne Standley at Florida State University has spearheaded the multimodal stimulation research in the NICU (Neonatal Intensive Care Unit) at TMH (Tallahassee Memorial Hospital). Before I tell you about my experience with MMS, however, it is important to understand some basic ideas supported by the research literature regarding premature babies.

The first concept is that premature babies need sleep in order for their brains to develop. When they are sleeping, they form up to 250,000 neurons per minute. As you can imagine, any interruption to sleep can cause the baby to lose a lot of brain development! In fact, any startle response sends cortisol (a stress hormone) to the brain and stops the brain development until the baby can return to a relaxed state. The environment of a NICU is naturally startling no matter what we do to decrease the noise and intrusions. The medical staff is there to save the baby by whatever means necessary and survival takes precedence over development. The beeping of equipment, people talking, alarms, machinery and routine hands-on medical care are all startling to these babies.

The second concept to understand is that as the baby's brain is developing, it sends out new brain cells from the center outward to other parts of the brain. It is necessary for these brain cells to quickly find a job to do in that area of the brain or else they simply die off, never to be "re-born." A premature baby under all the necessary sedation and medication does not have the opportunity for normal environmental sensory input in order for all of these brain cells to find a "job" and establish themselves permanently in the brain.

These competing ideas of needing to provide appropriate stimulation without startling the baby led Dr. Standley to develop MMS for premature babies primarily 34 adjusted gestational weeks and older. The technique involves gradually layering different types of stimulation in a way that the baby tolerates the input without startling. The protocol works best with two people so that one can hold the baby while the other therapist plays guitar and sings. The music is gradually introduced so that only soft arpeggiated finger picking at a slow tempo and major key are used at first. If the baby does not startle, then the therapist can start humming and eventually begin singing. Most common children's songs are okay and there are even ways to adapt adult folk and easy listening songs to be appropriate for use as accompaniment. A trained music therapist is important for this aspect of the protocol.

The therapist holding the baby proceeds by gently stroking the baby on the face, back, arms, legs, etc., in a set pattern. The therapist is constantly observing positive and negative responses from the baby. Smiles, coos and snuggling are good signs, but any jerking movements, grimaces or cries indicate that the touching protocol immediately must stop until the baby is again relaxed. If the baby is able to tolerate the entire sequence of touch, then the therapist goes through the sequence again while adding gentle rocking. At this point the baby will be listening to music, feeling motion and touch. MMS continues for 15 minutes and is great before feeding time since it prepares the baby to appropriately accept physical handling and environmental input.

The music is a key factor for MMS because it helps to mask the sounds of medical equipment and other startling aural sensations. Sedative music has also proven to be very powerful in stabilizing the respiration rates of premature babies. In addition, the rhythmic music is essential in providing structure and timing for the touch/stroking and rocking.

It is very important to emphasize that MMS should only be done by a board certified music therapist with the NICU-MT certification. Parents of premature infants may also participate in the protocol under the supervision of the music therapist in order to increase parent child bonding.

I was able to participate in MMS during my training to become NICU-MT certified. I am used to holding a baby, since we just had a baby two years ago, but premature babies are so fragile! They are truly precious little miracles and I am always impressed by the parents of these little ones and how well they handle the stress and emotional duress of being separated from their babies so much while they are in NICU. One of the babies I was able to do some MMS with was not very cooperative, but he certainly wanted to communicate! If you remember the saying and gesture, "Talk to the hand!", this little guy had obviously been practicing! I was only able to do a few different touch strokes during the entire 15 minutes because he kept giving me the halt sign. Still, babies have good and bad days just like us and it is really the cumulative effect over multiple interventions that will hopefully show his progress in appropriately tolerating stimuli.

Another baby I worked with allowed me to do almost the entire protocol, including the rocking. This was great! I do have to admit, however, that my arm was rather tired after the 15 minutes. I guess it has been long enough since our own little one was small enough to be cradled that my baby holding muscles have already atrophied!

My description is only meant to be an introduction to one of the evidence-based music therapy interventions currently in use with premature infants. The definitive guide to music therapy in neonatal care can be found in Dr. Standley's book, "Music Therapy with Premature Infants."

Monday, June 7, 2010

An Insider's View of the Fight Against Autism Spectrum Disorder

Five Things You Should Consider When You Find Out Your Child Has Autism

I often talk about Autism because so many of my clients with ASD respond so well to music therapy strategies. I have mentioned The Thoughtful House in Austin, TX as one of the places that tries to take a holistic approach to treating the symptoms of the disorder. Specialists at The Thoughtful House believe that some autism disorders may sometimes be related to the inability of the body to correctly process toxins and metals. New research is starting to corroborate this theory and establish a link between problems in the gut with processes in brain functioning. In my review of the research, work with clients and examination of practice treating the issues of diet and toxicity in children with autism, I have found that treatment can be helpful for some children, although it does not seem to be a cure-all for Autism.

The following guest post is from the perspective of a mother who has a son with autism. She has found the combined treatment of ABA therapy and bio-medical treatment for her son to be highly successful. I am very excited to introduce her as my first guest blogger! Anne Marie White has a Bachelor of Arts in Communications from BYU-Idaho. She is currently working on a Master's degree in Speech and Language Pathology. Anne Marie lives in Texas with her husband and two boys, the oldest of which was diagnosed with PDD-NOS (Pervasive Developmental Delay - Not Otherwise Specified) two years ago. She has implemented intensive ABA (Applied Behavior Analysis) and bio-medical therapy for her son ever since that time. In her own words, "I work hard to be the best mother I can be to my children by learning everything I can about Autism."

I asked Anne Marie to write a post from the perspective of someone who had to learn quickly about what she could do to help her son with Autism. Since I have mentioned the Thoughtful House before, I asked her to provide some insight for parents and others who might be just starting out finding what to do in the case of a child with ASD (Autism Spectrum Disorder). As I read her thoughts, I could not help but feel her fierce determination and great love for her son. Here she is in her own words:

On December 15, 2008, my world as a mother changed forever. On that cold day, in a small room, I was told that my son had Pervasive Developmental Delay—Not Otherwise Specified (PDD-NOS). I was told that there was no hope that he would ever lead a normal life. They said that there was no cure and no one knew why 1 out of every 91 kids was being diagnosed with some form of Autism Spectrum Disorder (ASD). They told me the best I could do was to start some Occupational Therapy (OT), Speech Language Pathology (SLP), and try any other therapies I might hear about. In their opinion, I would be wasting my money, and I should expect to have to take care of my son for the rest of his life.

Well, after that day I felt very alone, like I had no hope. I had no idea what I was going to do. So for the next 4 months I did nothing but grovel in self-pity. Then one day it felt like God woke me up with a slap in the face. I was sitting at home and I got a phone call telling me to turn on the TV and watch the show “The Doctors” on NBC. That day they were talking about Autism. They said that there are kids recovering and living a normal life. These kids were recovering through bio-medical treatment and Applied Behavioral Analysis (ABA) and other forms of therapy. Ever since that day, I have never stopped looking for the thing that will cure my son. My son is now making great eye contact, he plays with other kids, he now has many words, and he has almost completely recovered. I would like to share five things that I wish someone had told me at the start of this journey my family has been on:

1. DO NOT blame yourself or your spouse.
I blamed myself for four months and didn’t want to do anything. I kept asking myself what I had done wrong. Let me be clear, you have done NOTHING wrong; it is what it is. We all have trials in this life. It’s what we do with them that makes us who we are. Give yourself permission to wallow in self-pity for some time and then pick yourself up and get started healing your child. I lost four precious months that could have been used more effectively!

2. Take action while your child is young. Do not wait.
A mother knows deep down that there is something not right with her child. Do not block out those feelings. You have them for a reason. As much as you don’t want to hear it, you need to get your child diagnosed so you can move on and recover your child. It is important to know where your child stands on the autism spectrum so that you can learn how to help him or her. Every child is different and what works for one may not work for another. You must be your own detective and find out what works with your child. Young children are amazing and can overcome things that seem impossible. And believe me, some days it does seem impossible! Just keep going! Find out early, and then get started quickly, helping your child to recover.

3. Go to a “Defeat Autism Now” (DAN) Conference.
This was a life changing event in my life and now I go every year. You will meet leaders in the field of autism and you will learn how bio-medicals may change your child’s life. You will learn about the newest research in autism and meet other parents who know how you feel and can give you ideas. My first DAN conference not only gave me the hope I needed to go on, it gave me a direction to go in.

4. Find a DAN Doctor.
There are DAN doctors all over the country that are doing bio-medical treatment with children who have autism and some of these kids are recovering. When you find the doctor that works for you, listen to him and follow what he says. Do the diets and the vitamins because it is worth the hassle. My son has improved so much from our diet change and by adding the vitamins to help him get what he needs. Do not let anything stop you from finding the right doctor. We have to drive 7 hours to get to Austin to go to “Thoughtful House”, but it is worth every hour and penny spent. I am changing my son’s life and he is changing mine.

5. Start therapy NOW.
My son does speech therapy, OT, ABA, and many other forms of therapy. Do as many hours as you can. I know therapy is very expensive, but if you do it now, hopefully you will not have to do it forever. ABA has done amazing things for my son. Find out what works for your child and run with it. Bio-medicals can only do so much. We must also find a way to teach our children what they have missed while they were in the fog caused by the pollutants in their brains.
Finally, learn as much as you can about autism. I am not saying every child will recover, but children do recover. We, as parents, have to fight for our kids and give them the best chance at a normal life. I hope this helps someone else to begin or continue on this journey with Autism.

~Anne Marie Tague White

In full disclosure, I should say that Anne Marie is my sister. Thanks, Anne Marie for sharing your story and being passionate about helping your son! I know your words will add to the community and strengthen others in their fight!

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