Music Therapy With My Favorite Little People!

The Daily Muse

 Welcome to the Daily Muse feature of Music Makes Sense!  This daily update brings you up to the minute news about music and music therapy as it relates to our professions, events and individual lives.  You can follow the daily entries by subscribing to Music Makes Sense on Twitter or by "Liking" the Facebook page for Music Makes Sense.  Enjoy, and thanks for reading!

Some of you may have missed the new article by Ronna Kaplan in the Huffington Post last week.  I finally got a chance to read it and it was well worth the time!  


This article in the series by Ronna Kaplan was titled: Music Therapy in Early Childhood Classrooms.  Ronna has been doing an excellent job in her posts to Huffington by explaining music therapy with concrete examples and terms that everyone can understand. 


Her description of a typical music therapy session with an early childhood group was spot on!  I found myself missing some of my favorite little people and all the great experiences I had while doing music therapy in the early childhood setting!  


Please read the article and send it to people you know!  This would be a great way to promote music therapy during music therapy advocacy month!     

Down Under With Music Therapy and Down Syndrome

The Daily Muse     


Welcome to the Daily Muse feature of Music Makes Sense!  This daily update brings you up to the minute news about music and music therapy as it relates to our professions, events and individual lives.  You can follow the daily entries by subscribing to Music Makes Sense on Twitter or by "Liking" the Facebook page for Music Makes Sense.  Enjoy, and thanks for reading!

When I was working as a music therapist in the school system, one of my favorite groups was the Early Childhood classroom. These little guys always seemed to be enjoying life and they always treated the music therapist like a rock star! I guess they were like music therapy groupies! 


The following story out of Australia reminded me about my favorite little guys and especially my little clients who had Down Syndrome. In my experience, it was a rare case that a little one with Down Syndrome did not respond to music in very positive ways. The news story has a nice audio track with pictures that shares a little of the success and joy going on down under:

Down Syndrome and Music Therapy

Schoolhouse Stories: Making Sense Out of Music Therapy for Teachers and Parents

I gave a presentation this past week at the 2011 national conference for the American Music Therapy Association.  The focus of my conference session was to help other music therapists teach parents and teachers about why music works.  My initial interest in this topic grew from my work as a music therapist in the public school system.  There seemed to be many instances when I was asked to consult with teachers and parents on how they could use music more effectively with their child or students.  


As I had more opportunities to talk to teachers and parents, I started to notice that I was using stories and examples of successful music therapy interventions and experiences in my consultations.  This was actually the driving force behind the start of my blog!  I decided that I should write up the stories and post them on the web so that people could go back and look at them as a resource.   


After I realized that stories were so powerful as a teaching tool, I looked up some of the research and theories behind the use of stories in education.  The following prezi presentation is the outline that guided my conference presentation at the 2011 AMTA conference.  I post it here especially for the people that attended the session, but I think it may also be helpful to those who did not attend, even if it is in outline form.  


After I went through the outline, I had the attendees form up into groups.  Each group read through an example story and then discussed the effects of music intervention mentioned in the story.  The groups were instructed to try and find the fundamental musical structures and elements that drove the successful educational outcomes in each story.  I have included links to the stories after the Prezi presentation.  Although these links contain the stories as well as my analysis, the conference attendees only saw the main story so that they could practice evaluating the uses of music in each case.  I encourage you to find even more elements and uses of music than I pointed out in these stories!



 References:

Jackson, P. W. (1995).  On the place of narrative in teaching.  In H. McEwan & K. Egan (Eds.), Narrative in teaching, learning and research (p. 5).  New York: Teachers College Press.

Jalongo, M. R. (2011, November 15). Stories that teach life lessons.  Retrieved from http://www.scholastic.com/teachers/articles/stories-teach-life-lessons

McEwan, H., & Egan, K. (1995).  Narrative in teaching, learning, and research.  New York: Teachers College Press.

Roche, L., & Sadowsky, J. (2003). The power of stories: A discussion of why stories are powerful.              International Journal of Information Technology and Management, 2(4), 377 - 388.

Stories:


1. William Learns to Walk Like a Man
2. Bobby and the Ladybug
3. Scooby Doo Meets His Match
4. Wendy and the Power of Melody


I hope you will let me know what you think about this idea of using stories to help teach people about the power of using music.  Please send me your comments and even your own stories and how you have used them!  Thanks again for reading and stay tuned in for more great stuff from the 2011 conference!

The Wheels on the Bus!

WARNING! This is not your typical book review!

This semester I have been in Dr. C. Madsen's class on the Modification of Behavior. The textbook for the class is:

Teaching/Discipline: A Positive Approach for Educational Development

I could choose any book to review by taking ideas we learned in class and explaining how they applied to the book. I chose, The Wheels on the Bus, because I thought if I could apply the theories of behavior modification to a children's book, then I should have a good grasp of the concepts! (I also happen to love this book!) If you get lost with some of the behavior "mod" jargon, then go read Teaching/Discipline. That book is the basis for every successful behavior management program out there. Every therapist should have a thorough understanding of the ideas Dr. Madsen presents.

Zelinsky has created a wonderful book that I frequently use in therapy and with my own daughter, Darby. The book is colorful and has pop-ups and moving parts that are visually appealing to young children. Zelinsky has remained faithful to the song for his inspiration and kept the traditional lyrics as text for the book. On the surface, Zelinsky’s book tells a simple story, but it also contains many examples regarding the principles of behavior modification.

The story centers around a city bus opening its doors to a myriad of townspeople on their way to various destinations. Any city bus system is part of an overall strategy of government to promote mass transit as a preferred mode of transportation. In essence, the city is running a government sponsored behavior modification program. The pinpoint is that there are too many cars on the roads causing traffic and congestion. A city usually has several parts of a highly developed consequent in order to increase bus ridership. Taxes are levied on automobiles, gas and parking. Parking restrictions are enforced so that there are fewer spaces for cars and more room for bus stops. Positive reinforcement includes the city subsidizing payment for bus fare and creating special bus lanes to allow buses freedom of movement. Public awareness advertising emphasizes the value of using the bus system. Evaluation of these programs indicated that bus ridership increased, but only for people who did not also have a car.

The people on the bus often must contend with noisy distractions like the windows going up and down and the window wipers swishing back and forth. Another nuisance is the crying babies. In the story, the mamas on the bus just tell the babies, “Shush, shush, shush!” The babies do not necessarily respond to this plea because it is not a sufficiently powerful disapproval and there are not contingent consequences. One possible solution to the crying babies could be a program that includes rewards for quiet behavior. Pacifiers, food and toys would be good motivators. The mothers may also want to approach bus riding in steps of successive approximation by taking their babies on the bus for short rides at first and increasing the time on the bus as the babies increase their tolerance and time of quiet behavior. In extreme cases, some mothers may have to practice systematic desensitization by exposing their babies to progressively louder noises as they are relaxed and happy until they are able to be on the bus without crying. Evaluation of these strategies has indicated that babies on the bus were able to sleep, sleep, sleep.

Zelinsky tells the story of the bus as it makes several stops throughout the city. The bus maintains a schedule on a variable interval, so some people miss the bus and others have to wait. Each time the bus picks up a rider, the bus driver provides verbal reinforcement by saying, “Move on back!” Some of the riders accept this as verbal approval, while others feel that it is disapproval, but they all respond to the reinforcement by following through on the directions. The narrative also relates that there is sometimes traffic and bad weather. The driver on the bus frequently hits the horn, “Honk, honk, honk!” This behavior usually does not solve the traffic problem since the bus driver is unable to follow through with contingent rewards or punishments and must continue to drive the bus to the next stop.

Overall, Zelinsky offers a colorful tale of life in the city. The characters in the story lead a life of repetition and generally allow their environment to dictate their actions. In reality, who decides what kind of bus system a city will have and who decides who will decide? Children love to read this book over and over until they have developed conditioned responses to many different phrases such as, “The wheels on the bus,” go, “round and round!” This has been a favorite book in my house and for road trips as we travel all through the town.

Schoolhouse Story: Scooby Doo Meets His Match!

A story about the power of live music and singing to help a boy with autism do his work.

Ricki is eight years old and spends most of his day in a classroom set up for children who have autism. He had been observed spending much of his time singing to himself, but also paying attention to songs and music activities that were part of the regular classroom instruction. His teacher requested a music therapy assessment to evaluate the potential to help Ricki make better progress on his academic and communication objectives.

The music therapy assessment included time observing Ricki in his classroom working without music as a stimulus as well as time spent participating in specially developed music activities. After the music therapy assessment activities were completed, I observed Ricki working on a math exercise in which he was supposed to trace the numerals 1-5 on a worksheet. After he had traced only one number he began singing about Scooby Doo. He turned his paper over and started writing the words, "Scooby Doo," repeatedly on the back of the paper. Ricki's teacher said that this was a common occurrence and that it was very difficult to refocus his attention back to the assignment.

I tried verbal encouragement and reinforced my verbal requests with visual gestures and even gentle physical elbow and shoulder prompts to try and gain Ricki's attention. Ricki provided some eye contact, but continued his self-made Scooby Doo activity instead of returning to his work assignment. In addition, Ricki began pacing the room.

During the music therapy activities that were conducted before Ricki's work assignment, I had observed that he quickly learned new songs and seemed to enjoy singing. He was also very interested in strumming the guitar and playing other instruments such as shakers and drums. Based on these observations, I felt that I could use music to help Ricki refocus his attention.

I began by singing an improvised song about sitting back down and counting pictures. Unfortunately, Ricki just continued singing and verbalizing about Scooby Doo and ignored my singing. I picked up my guitar and added guitar accompaniment to my improvised song and started walking to match Ricki's pacing around the room. I immediately seemed to gain his attention and sang about Ricki sitting back down in his chair. Ricki followed the instructions of the song and continued by counting the pictures and tracing the numbers as the song directed.

I found it significant that Ricki only responded to singing that included instrumental accompaniment. I believe that it was also important that I was able to move around the room with Ricki while playing the guitar and singing. The power of music and this specific intervention are clearly evident, but this example also provides some reminders about why music as therapy is so powerful when a trained music therapist is involved in the process.

Most of the teachers I work with do not consider themselves singers and definitely don't play the guitar. They can use some recorded music and simple instruments like drums or even small keyboards to help them employ songs in the classroom, but there are limitations to what they can do. Improvisation in music is a skill and a talent that is often a key strategy in using music to help children with autism make progress on goals and objectives. I encourage the teachers I work with to explore different options and help them practice using music in their classrooms, but I am glad that I am also there to meet the needs of clients who require specially developed music strategies on the spot!

Scooby Doo, we've got some work to do now!

Henry Sings For Success: 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 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. For the purpose of this article, I will refer to these behaviors by the more official term, stereotypy, since "stimming" is not a word currently listed in the dictionary.

Henry has been observed to sing to himself almost all the time. He is a very good singer with excellent pitch accuracy and the ability to remember many lyric phrases. His teachers have been working with Henry to have him sing more quietly outside of the classroom or at times when he should be quiet. His teachers have noticed that when Henry is working with his hands on tasks that involve objects with significant tactile stimulation, he stops singing. He will stop singing, for example, when he is putting his hands in shaving cream or trying to button a sweater. He also decreases his stereotypic singing when he is on a therapy ball during physical therapy or adapted PE.

I have worked with Henry during music therapy sessions and observed his eager participation in the activities. He seems to crave the sensory input provided by the music stimuli. Fortunately, Henry is able to participate in music activities in more significant ways than only absorbing it as sensory stimulation. Henry has demonstrated that he can follow sung directions during movement to music activities and can start and stop singing or playing instruments as part of group activities and highly structured musical activities. In general, Henry stops his stereotypic singing for the duration of music therapy groups, approximately thirty minutes. He has also been observed to be less restless and stay in his seat better during the music therapy sessions. His teacher said that Henry has the best waiting skills during music therapy than any other time or activity of the day.

Recently, I observed Henry working in the classroom in order to obtain data about his behavior and skills outside of music therapy. I was able to see how Henry worked on writing skills, matching words and quantities and following directions. Henry was guided by picture schedules to help him stay on task, but also to allow choices and provide rewards for work completed. One of his work tasks was to match word strips to pictures. He seemed to know how to match correctly, but he took a long time because he was singing to himself throughout the entire work activity.

I had noticed that Henry preferred familiar children's songs with attractive melodies rather than chants or repetitive melodies with little variance in pitch. I composed an original melody, ad lib, that was reminiscent of songs like, "The Itsy, Bitsy Spider," or "Oh Where, Oh Where Has My Little Doggie Gone." I wanted to use this song to help him with his word to picture matching activity. Henry quickly began singing the song with me after only one example and we began matching his words to pictures. Henry stopped singing to himself and immediately switched to the song I had composed and sang along with me. I sang with Henry for several word matches and then gradually stopped singing with him. He was able to continue singing the new melody with each new word and finished the matching exercise with amazing speed. Before I introduced the song, he had been sitting with his work folder for five minutes just moving the word strips around without actively matching. In Henry's case, I was able to combine his need for sensory input with active learning. His singing stopped being an impediment to his productive use of time, and instead, accelerated his work.

Schoolhouse Story: 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.

William is a student in second grade who I have often observed demonstrating defiant and oppositional behavior in the classroom. William has a rare brain disorder that affects his gross motor skills, but he is fully capable of walking. His teacher reported, however, that William was having great difficulty walking to the bus. William frequently decided to practice the safety protocol for when you are on fire and, "stop, drop and roll," in the hallway on the way to the bus!

William did not respond to music activities immediately when school started in the Fall, but he seemed to be listening and demonstrating good eye gaze toward the music therapist and the activities. Approximately half way through the school-year, William suddenly began performing all the movement to music activities that were part of the general music therapy session routine. He did not require prompts and seemed excited to participate. In light of this behavior, I adapted the lyrics to the song by Frankie Valli, "Walk Like a Man," in an effort to teach him more appropriate behavior. The song went something like, "Walk like a man, fast as you can, walk like a man my friend... stand straight and tall, walk never fall, walk like a man, William!"

I began using this song as one of the movement to music activities during the weekly music therapy sessions. William was very excited to practice walking around the room and did not demonstrate any inappropriate behaviors. I recorded the song with guitar accompaniment onto a tape so that the teachers could use the recording for William after school. The tape worked beautifully and William seemed to forget that he had ever had any problem going to the bus. This strategy continued to be successful more often than not for the remainder of the school year.

One of the advantages of using music is that it is "moveable." In the case with William, the sound of the guitar and upbeat accompaniment was a key to the successful result. Sometimes, simply singing a song and clapping along is all that is necessary to use music successfully as a therapuetic strategy. Many children will respond in a unique and significant ways to music stimuli and familiar songs with corresponding actions can effectively be used across settings. Social stories are often used with children who have autism, for example, to help them practice appropriate social skills. Sometimes adding a melody to a social story can be even more effective. This social story can then be sung anywhere, at any time to help encourage desired behaviors.

Schoolhouse Story: Wendy and the Power of Melody

I am often called upon to conduct assessments to see if a student will qualify for music therapy as a related service. "Wendy" was referred for a music therapy assessment after her teacher observed that Wendy significantly increased her focus of attention during songs at circle time activities. Wendy has mild to moderate mental retardation and speech impairments. As part of the music therapy assessment process I observed Wendy working in the classroom during various group activities as well as some individual work.

Wendy was observed to provide very short attention to her teacher unless given direct verbal prompts. When she was prompted, she was able to maintain her eye gaze focus to the teacher or task for less than one minute for most tasks. I watched Wendy become very focused, however, during familiar songs that employed accompanying gross motor movements. Wendy began singing the songs and performing all the motions without prompts. Wendy had not verbalized any other words throughout the activities until the singing activity except for saying some numbers during a counting exercise. One of the songs the group sang used the melody from Skip to my Lou. Wendy performed motions in the air as if she was drawing each number from one through four. The lyrics to the song described the motions for the number four as, "down, across, one more down...that is the numeral four."

After the group activities, Wendy was tracing the numeral 4 with a pencil for one of her assignments. Her teacher used hand over hand prompts to help Wendy focus her attention and trace the numbers. Wendy's teacher was verbalizing the same instructions as repeated in the lyrics of the song, but Wendy was not paying attention to the verbal instructions. I suggested that the teacher try to sing the melody along with the instructions. The teacher tried this and immediately gained Wendy's attention to the task, although she was still required to provide hand over hand guidance for Wendy's tracing.

I wanted to build on the progress that the teacher made simply by adding the melody back to the instructions for writing the number four. I had observed that Wendy was successful with larger gross motor movements and so suggested that we use a white board to write the number as we sang the song. Wendy was able to sing and draw the number 4 several times on the white board as I sang along with her. Her numbers were messy since she did not have reference points to trace over, but she clearly drew the number 4 without assistance and was fully engaged in the activity.

In Wendy's case, melody and scale were the key elements to enabling her success. She had been observed to respond to some elements of rhythm during chanting and counting activities in group activities, but she was unable to resist singing and moving to music when the melody was added during songs. I believe that by starting out with her drawing large numbers and gradually decreasing the size of her motions to write smaller characters that she will be successful in writing numbers with her pencil on paper. Singing may further enhance this process if the singing is louder for the large drawing on the white board and gradually softer for writing smaller characters.

Sing...sing...sing for success!