It's hard to believe it is September, and the kids are back in school. That means it is my yearly reminder to educate the public on music therapy in a school setting! I am going to talk about two ways I use music therapy in schools: as a related service and as an enhancement.
For music therapy to be used a related service, a student must first be referred for services. This student is probably not making adequate progress on their IEP goals and/or is resistant to other therapies/modalities of education. Insert music therapy! As the board-certified music therapist, I come in and observe the student in the classroom. How are they performing on the IEP goal? How many prompts does it take them to complete the task? Are they completing the task in a sufficient number of opportunities? After the observation, I complete the exact same classroom tasks but with music. I may sing a song about money if they have a money goal, I may have a series of instruments to sequence if they have a reading goal, etc. Finally I compare the performance between the two settings. If the student has a significantly higher difference of performance in the MT session than in the classroom, then that student qualifies for music therapy as a related service. One school district in which I work also has me come in to provide music therapy as an enhancement service. I currently provide a social skills group to five students in a classroom. I use their pre-existing IEP goals to work on appropriate peer socialization, impulse control, communication, and more. It also provides them an opportunity to make music at their own level. We also do songwriting for them to work on communicating with their iPads. Music Moves currently provides music therapy services in the Albia and Moravia school districts.
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Today we’re going to talk about another population that benefits from music therapy – individuals with intellectual and developmental disabilities (IDDs). As has been mentioned in previous blogs, music itself is inherently motivational and people are more willing to participate when music is involved.
Music therapy offers them the ability to improve skills that are necessary for their daily lives, having fun while doing so. These skills can be cognitive, physical/motor, emotional, or behavioral in nature. Some examples include: appropriately following directions, providing an on-topic response, grasping an object for a certain period of time, filling a leadership role, and more. Music therapy also provides them with autonomy – the ability to choose for oneself. For example, they get to choose which color shaker they’d like to use, they get to choose which dance move will be incorporated into the movement intervention. These individuals have a lot of their autonomy stripped away daily, whether it be due to the support needs and assistance they require for day-to-day living, their living situation itself, or by support needed due to their cognition levels. Music therapy offers them these concrete, easy choices that they can make to have some control over their lives. Since music therapy uses live music during the sessions, the music is able to be manipulated in order to best work for the participant. Everybody has different abilities and also has different support needs – we are all unique in our talents. Individuals with IDDs may need more support and assistance when it comes to motor tasks, such as improving upper body movement skills to make dressing themselves easier. They may need more support when it comes to behavioral skills, such as creating coping mechanisms for when their emotions feel out of control or following directions even when they don’t feel like doing so. These may seem like simple things for somebody to learn as they grow up, but for somebody with an IDD it could be much more difficult due to their disability. While Morgan and I were in college we learned not only the therapeutic techniques to help these individuals achieve their goals and improve their skills, but we also learned how to apply instruments and adapt the music. We then learned how to combine the musical techniques and the therapeutic techniques to provide the best environment for success for different populations we work with. For individuals with IDDs, music therapy creates that structured environment which allows them to make independent choices, utilizes interventions that are easy for them to understand yet difficult enough to challenge them, and provides a safe and welcoming atmosphere that makes them comfortable enough to participate in the session. -B Let’s talk about Alzheimer’s/related dementia and music therapy this week.
You know when you haven’t heard a song in many years but despite this, when it starts playing you suddenly know most, if not all of the words? That’s what music does for individuals with dementia as well. Did you know that music is one of the very few things that activates and uses both sides of the brain at once? For individuals with dementia/Alzheimer’s, brain cells begin to degenerate and brain functioning is impacted. Since music uses both sides of the brain, all areas of brain tissue are activated. This allows the entirety of the brain to be used, reaching any functioning regions that the individual still has. Now, music therapy cannot improve the brain’s abilities, as dementia causes death of neurons and tissues in the brain. However, it helps to maximize the usage and can be used to help maintain what skills are still there for as long as possible. What are some goals that the music therapists work towards to help these individuals? Unfortunately, dementia is a progressive disease, meaning that no matter what you do, you cannot stop it from happening or take medicine to make it better. As this is the case, music therapy’s primary purpose for these individuals is to improve their quality of life to its maximum potential. Music therapists can help clients with: mood elevation, decreasing agitation and anxiety, increasing alertness levels, decreasing feelings of isolation, helping to orient the patient back to the current reality, promote relaxation, and help pain management and decreasing the feeling of pain. On top of all of those, music therapy also provides the individual with an additional opportunity for stimulation. Stimulation for individuals with Alzheimer’s/dementia is a very important part of the therapy session. Whether tactile, vibrotactile, or auditory, additional stimulation provides further interpersonal engagement between the therapist and the client, as it helps to capture and attract the client’s attention to the session. Now, why does this require a music therapist? Why can’t little Suzie down the road come and sing with her guitar with them, wouldn’t it be the same? Unfortunately for Suzie, no it is not. As a board-certified music therapist, we have learned what stimulation is most effective for which diagnoses, how to notice and adjust for overstimulation in the client, what instruments are most effective for the scenario the session is in, and more. To make a long story short: music therapy is immensely successful with individuals who have Alzheimer’s/dementia. The music unlocks the client from their own mind, and even if it just for five minutes or an hour, it’s worth it. There are times, regardless of how much we explain our profession, the general public views us as "the entertainment." While it is great that residents find us entertaining and enjoy our visits, it is important for staff, administrators, and whomever else to know the actual purpose for our sessions. Residents having regular access to music is WONDERFUL! However, here is what differentiates us from them.
1. Music is used to work on therapeutic goals and objectives When we sing, play instruments, or move we are observing every.single.resident in that group to see if they're engaged, how they're engaged, etc. Let's say Sally doesn't typically participate in activities at her skilled-nursing facility but attends music therapy. We make note if Sally sings, plays a drum, taps her toes, anything that shows she is engaging. Why? Socialization and engagement can contribute to her overall quality of life. What if Bill is sleeping during the session? I would tell Bill hello and might provide sensory stimulation such as sing gently to him or pat his hand to the beat of the music. Why? Because sensory stimulation contributes to brain activity which, again, can contribute to his overall quality of life. 2. Music therapists know how music affects people We went to school for this, did ya know that? Bailey and I both have degrees in music therapy. During our time in school we learned about many populations with whom we could work as music therapists. We know what their diagnosis might look like and how music might benefit them. We know how to manipulate the music to assist with relaxation or we utilize songwriting techniques to assist with emotional expression. We also do not take things personally: if someone does not wish to receive music therapy that day, we respect their wishes. 3. Music is about the clients, not us When we lead sessions, we focus on the music of our clients, not ourselves. We change the key so it's easier for the clients to sing. We slow the tempo so a resident with dementia can sing as many words as they can. If we are in a group, we can adapt the song or instruments to make sure every person can participate at their own level. If we planned to sing "Hey Good Lookin" and the client starts singing "Hound Dog," we switch to "Hound Dog." The point is, we want the music, not our showmanship, to empower each individual in the best way they can. In summation, we make music with people, not for people. If you're interested to see how music therapy differs from entertainers, contact us today! Hello! Welcome to Music Moves’ first blog post. For the next couple of weeks, I’m going to discuss music therapy with different populations, how it works, what we do, etc. For week one, I’m covering music therapy with children on the autism spectrum. A quick overview: as reported by the CDC, 1 in 44 children are diagnosed with autism spectrum disorder (ASD). ASD is a developmental disability that impairs an individual’s social, emotional, and communication skills. Some examples of common behaviors in autistic children are: -Lack of interest in playing with other children -Avoid eye contact and are uncomfortable with physical touch -Prefer to be alone -Not play “pretend” games (ex: “feeding” a baby doll) -Difficulties adapting to routine changes, potentially lashing out Not all autistic children demonstrate the same behaviors or have the same deficits. Autism is a spectrum, meaning each child has their own strengths and weaknesses in the disability. When I was growing up, autism didn’t seem to be as prevalent as it is now, however I did go to a school in a town of 3,200 people. Throughout the past 10-15 years, research has grown, and awareness of the disability has grown, leading to more (well deserved) diagnoses. More children are able to receive the supports they need in order to thrive and succeed. You may be asking, “How does music therapy fit into this? Does it even help autistic children?” I have a short and sweet answer for you: yes, it does. Music therapy is one of the most effective ways to work on goals for these children. There is one MAJOR benefit that music provides autistic children that other therapies cannot: it is a form of non-verbal communication. There are no words that need to be spoken. Simply, music made. Many children with ASD struggle with communication. They don’t understand social cues, speech and language can develop improperly or not fully; they tend to avoid eye contact. Since autistic children have difficulties recognizing the presence of others, they also have difficulties recognizing what others are saying and can sometimes contribute completely unrelated topics to the discussion. As the children get older, they can begin to recognize and comprehend that they aren’t the same, and it can make them feel bad about themselves. Using music, a medium that is based around nonverbal expression, gives the child the opportunity to convey what they’re thinking/feeling without their deficits interfering with their success and their enjoyment. Music is also inherently motivational. It’s an immersive experience that is fun and engaging, resulting in the child not even realizing that they’re working on their individualized goals. There are multiple ways that music can be used to work on social, communication, or emotional goals. Remember, each autistic child is different and has different needs, therefore all of our goals are individualized for them and what skills they need to work on. I’ll give you two interventions that I’ve used in the past when working with autistic kiddos. 1) The goal: following directions I piggybacked (used new words over a known melody) the song Baby Beluga and turned it into a song about sea creatures that we saw underwater, and what we heard them doing. There were three creatures that had correlating instruments to imitate the sounds made: castanets for crabs clicking their claws, a stir xylophone for bubbles blown from fish, and a frog rasp for a frog croaking. The child would have the instruments on the ground in front of them and would have to listen to my song in order to know which instrument to play. While the main objective of this intervention was for the child to follow directions, it also worked on other skills. They had to wait to play the instrument, working on improving self-control and waiting, actively listen to hear which animal I sang in the song, and attend to the current task by listening to the whole song before I prompted which animal. This intervention was also an interpersonal intervention, meaning that we had to work together in order for him to get to play the fun instrument. The child had to recognize that I was present and actively interact with me. 2) The goal: learn how to cross the street Another learning technique that is very common to use with autistic children is a social story. A social story is a story centered around a character who has to complete a task or how to appropriately behave in a situation (ex. brushing teeth in the morning, when they become angry at a peer or parent). The child I was working with had absolutely no concept of safety skills, especially when it came to crossing the street, so I created a song where the lyrics were a social story. The melody had to be repetitive and simple, and the lyrics had to be simple, so the child would be able to remember it when they were needing to cross the road. I broke down the process of crossing the road into four steps: stopping at the [crosswalk] light, looking both ways twice, waiting for traffic to stop, then crossing the road with their parent. I also paired it with a PowerPoint that had visual representations of the process with animations for the child in the slideshow. The child in the slideshow looked like the child who was learning the song, that way he could try to relate it to himself. Now, social stories aren’t exclusive to music therapy. Special education teachers and parents use them all the time for autistic individuals, typically just spoken instead of sung. However, pairing the social story with a melody makes it much easier for the child to learn and to remember it when it comes time for the task. Additional resources on music therapy with autistic children can be found on the American Music Therapy Association’s website at this link: https://www.musictherapy.org/assets/1/7/Fact_Sheet_ASD_and_MT__8-26-15.pdf. |
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