Music Therapy In Transitional Academies

Transitional academies are placed in the some school systems for young adults ages 18-21 in order to give these individuals a launching pad before going into the real world. In these programs, they acquire skills necessary for living and working in the community. Additionally, they learn effective social skills as they are placed in a group classroom setting. Transitional programs and music therapy can go hand-in-hand, because one overarching goal we have for our clients at Therabeat is using musical interventions in order to help our clients in their daily lives. Two primary ways music therapy can help these clients is facilitating growth in social and attentional skills.

Social skills are crucial in development, and especially for clients getting prepared to start a career. There is a connection between behavioral and social difficulties as children mature into young adults. Lower social competence can lead to an increase in depression, conduct issues, and anxiety (Gooding, 2011, p. 441). Luckily, there are multiple social aspects that play into the music making process! Cooperation, verbal and non-verbal communication, peer collaboration, impulse control, delayed gratification, and recognizing and supporting the rights of others are all areas that can be addressed through music therapy (Gooding, 2011, p. 442). For example, an intervention requiring each client to play a separate instrument can be used in addressing these social skills. Clients can exercise these skills by waiting their turn before they are allowed to play their instrument, actively listen to their peers as they are playing their instruments, and cooperate by playing in-sync with the group to the best of their ability. Due to the non-threatening nature of music, it can allow for successful participation regardless of ability level, and teach social and leisure skills simultaneously (Gooding, 2011, p. 442).

Along with social skills, attentional skills are also important in social development. Music Attention Control Training (MACT) is a technique that is used to target specific attentional skills. Attententional skills addressed include sustained attention, selective attention, and switching attention.  One particular study used MACT and measured how attentional skills improved in a group music therapy setting. The participants in the study showed positive outcomes in both selective and switching attention. In general, individuals with Autism Spectrum Disorder have typical sustained attention skills, and this is shown in their ability to attend to preferred objects or activities for an extended amount of time (Pasiali, 2014, p. 335). Because of this, MACT can specifically help these individuals with selective and switching attention. With selective attention, music can be used in groups through interventions requiring them to focus on single musical cues while opposing auditory stimuli is present (Pasiali, 2014, p. 334). As previously mentioned, group instrument play can improve social skills, but it can also target selective attention skills! The therapist can give a variety of instruments to the clients (drums, xylophone, maracas, etc) and instruct the clients to play a similar or different part on their selected instrument. Through this, clients are required to concentrate on their specific part, rather than becoming distracted by the other instruments being played. Additionally, interventions aiding clients in switching attention include chanting while doing body percussion, playing an instrument and singing simultaneously, and playing assigned parts in a musical arrangement (Pasiali, 2014, p. 334).

The primary goal of transition academies is to prepare students for their next phase of life, no matter what it is. And regardless of age and ability level, social and attentional skills are vital and can always be improved upon, as well as addressed through music therapy! At Therabeat, we are always seeking out new opportunities for our clients to grow in these areas. In doing so, they can be equipped for the exciting opportunities ahead of them!

Until next time,

Mia Cellino, Music Therapy Intern

Gooding, L.F. (2011). The effect of a music therapy social skills training program on improving social competence in children and adolescents with social skills deficits. Journal of Music Therapy, 48, 440-462. https://doi.org/10.1093/jmt/48.4.440

Pasiali, V., LaGasse, A. B., & Penn, S. L. (2014). The effect of musical attention control training (MACT) on attention skills of adolescents with neurodevelopmental delays: a pilot study. Journal of Music Therapy, 51, 333-354. https://doi.org/10.1093/jmt/thu030

Screen Time: The Good, The Bad, and How Music Serves As A Replacement

In today’s day and age, an important topic of discussion is the use of “screen time” with children and adolescents. In the past decade, electronic devices have been used more than ever before in education and entertainment. Although technology aids in teaching, too much screen time can be harmful for individuals with autism and other varying disabilities. In writing this post, I hope to briefly share research and open the discussion on how to use technology to our advantage in guiding our friends at Therabeat!

One main concern with screen time overuse is that it has been shown to delay social development. With any child, watching television or playing video games for too long can negatively affect development of reading facial expressions and body language, and impair eye contact and communication (Yalda, 2012, p. 388). When children are developing, it is important for them to have plenty of time to explore their likes/dislikes, hobbies, and friendships outside of their time spent on screens. Additionally, the term “addiction” has been used increasingly by physicians in terms of screen use. Abusing screen time releases dopamine in the brain, which results in the addictive nature of technology. This can even result in “neuropathologic damage to the dopaminergic neural system caused by internet addiction disorder” (Sigman, 2014, 611). By spending less time on screens, children have more of an opportunity to fully develop appropriate social skills and regulate emotions more effectively.

Even though dopamine is released as a result of excessive technology use, dopamine release is not a negative concept as a whole. “Dopamine is a neurotransmitter that is involved in motivation and reward-seeking behavior, working memory, and reinforcement learning” (Stegemoller, 2014, 216). In regards to music therapy, this dopamine release is important to our sessions with each of our clients, because listening to music stimulates dopaminergic regions. This is the same neural network that is involved in learning and rewards (Stegemoller, 2014, 217). Although video games and binge-watching television can give a sense of satisfaction or reward, music is scientifically proven to give the same reward!

Although there are many other downsides to screen time, it is important to mention the ways technology can benefit children. Quality, age-appropropriate television can serve as an additional educational experience for children as young as two years old. With television, they can be exposed to topics such as positive racial attitudes, imaginative play, anti-violence attitudes, empathy and respect (Canadian Pediatric Society, 2017, p. 463). With these educational benefits, it is possible to use technology in a safe way, as it is only going to become more dominant in our world.

With this being said, there are practical ways to teach children how to safely utilize technology. An important step is to intentionally minimize screen time, and replace this time with face-to-face interactions. Co-viewing content can also reap the most educational benefits. While children are on their preferred screens, parents can use the opportunity to watch whatever their children are watching, as well as control what they watch. After viewing, parents can facilitate a discussion on what was viewed, and guide their children on practical ways to incorporate information learned into their daily lives (Canadian Paediatric Society 2017, p. 462). This practice can turn screen time into a more intentional learning experience, and decrease mindlessly turning on the television or iPad during important family times, such as during mealtimes or weekends.

In general, it is imperative for children with and without specific disabilities to have clear boundaries for screen time. Children are fully able to develop physically, emotionally, and socially when they are engaging with the people and events in their lives. Additionally, music can be used as an effective tool in replacing screen time with something more productive and rewarding. In doing so, they will become more self-aware of their personalities and the important role they play in the world!

-Mia Cellino, Music Therapy Intern

Canadian Paediatric Society (2017). Screen time and young children: Promoting health and development in a digital world, Paediatrics & Child Health, 22(8), 461–468. https://doi.org/10.1093/pch/pxx123

Sigman, A. (2014). Virtually addicted: why general practice must now confront screen dependency. The British Journal of General Practice, 64(629), 610–611. http://doi.org/10.3399/bjgp14X682597

Stegemoller, E.L. (2014). Exploring a Neuroplasticity Model of Music Therapy. Journal of Music Therapy, 51(3), 211-227.

Uhls, Y.T. (2012). Five Days at Outdoor Education Camp without Screens Improves Preteen Skills with Nonverbal Emotion Cues, Computers in Human Behavior, 39(0), 387-392. https://doi.org/10.1016/j.chb.2014.05.036

The Use of Melodic Intonation Therapy to Improve Communication Skills

The ability to effectively communicate is a need for all humans. There are many modes of communication, but the ability to speak and be understood is a goal for many individuals. Music therapy is beneficial for the improvement of speech, and can have a profound impact on an individual’s sense of well-being and social functioning. Melodic Intonation Therapy (MIT) was developed in the early 1970’s, and is a useful technique used for speech development. MIT greatly benefits patients with traumatic brain injury, adults in rehabilitation settings, patients with evidence of apraxia, and those who are verbal, yet non-fluent. MIT targets the damaged, dominant left-hemisphere of the brain (which primarily controls language) by “exaggerating the intonation (rhythm, stress, and melodic contours) of speech in the undamaged right hemisphere” (Norton, 2009). As the right hemisphere of the brain recognizes language in melodic and rhythmic structure, it essentially learns language along with the left hemisphere.

In practice, MIT assigns a simple rhythm and melody to a short word or phrase. MIT is designed to take patients through a series of steps, and each step is slightly more complex than the one preceding it. Each syllable of every word is assigned a beat and a specific amount of stress. The higher stressed syllables have higher pitches, and the lower stressed syllables have lower pitches. Here is a visual example of a useful phrase for MIT:

With this phrase, the syllables how, do, and to are the most stressed, and are assigned to higher pitches.

There are approximately five steps to take in each word (or phrase) of MIT. Once these steps are completed with 90% accuracy, the therapist can transition the patient to a phrase that is longer and more difficult to enunciate (such as the phrase above). In beginning MIT, an ideal first phase would be the use of a single word. The steps of each phase are listed below:

Step 1: Humming. The therapist will tap the patient’s left hand (triggering the undamaged right hemisphere of the brain, and the sensorimotor cortex of the right hemisphere) and simply hum each syllable with their assigned pitches. The patient will then hum with the therapist.

Step 2: Unison Intoning. The therapist will say the word/phrase along with the patient.

Step 3: Unison with Fading. The therapist will say the first half of the word/phrase with the patient, and then stop speaking halfway through. This allows the patient to complete the rest alone.

Step 4: Immediate Repetition. The patient will immediately say the complete phrase alone.

Step 5: Response to Probe. The therapist will ask a question prompting the patient to say the word/phrase being practiced. For example, if my patient is named Mia and I ask for her name, she will respond with “Mia.” Here is a video putting each of these steps into action.

Whether our friends at Therabeat are learning language, reganing language, or learning to use language more effectively, MIT is indicated for all cases. The use of MIT allows for both sides of the brain to work on the apprehension of language. Results from MIT include improvement in articulation, fluency, and prosody of speech. This gives our patients the tools to be confident in communicating with others. As therapists, furthering our knowledge in these research-based techniques can better our efforts in aiding our patients in successful speech and enunciation!

Until next time,

Mia Cellino, Music Therapy Intern

References:

C, Cait. (2013, November 21). Melodic Intonation Therapy clip [Video File]. Retrieved from https://youtu.be/zr69bmqBU14

Norton, A., Zipse, L., Marchina, S., & Schlaug, G. (2009). “Melodic intonation therapy: shared insights on how it is done and why it might help.” Ann N Y Acad Sci, 1169(1), 431-436. Doi: 10.1111/j.1749-6632.2009.04859.x

Welcome, Ms. Mia!

If you have been to In Harmony sometime these past two weeks and have seen a new, curly headed Italian silently observing various therapy sessions, that would be me! My name is Mia Cellino, and I am so thrilled to be the music therapy intern at Therabeat. I’m coming from the University of Georgia, and I am completing the homestretch of my education here at Therabeat. During my time at UGA, I worked with a wide variety of populations, but I was most drawn to working with children after having a clinical at a local elementary school.

Throughout the past two weeks, I have observed a wide variety of music therapy sessions, as well as occupational, speech, and physical therapy. I also had the opportunity to begin forming relationships with the kids and adults that I will get to spend the next six months working with. I am already learning so much through osmosis and soaking in all I have seen and heard in these sessions! For example, I am learning about the various types of sensory processing disorder, both from observing sessions and reading The Out-Of-Sync Child by Carol Kranowitz. In a session, a child may show difficulty integrating various inputs of the room--the sound of my voice, the feel of an instrument, the lights in the room, or even a specific song selection. I am learning that it is important to identify each child’s sensory needs and address those through positive multi-sensory interventions. By planning music interventions that cater to a child’s sensory needs, we create an environment that is most beneficial for the child.

A unique aspect of starting my internship at Therabeat at this time is that I am coming in as soon as the staff became settled into the new clinic. We had a ribbon cutting ceremony a couple of weeks ago to celebrate the new clinic opening and all of the hard work that went into making the building fit for therapy. I feel as though I am the new kid on the block coming into a community full of therapists who are passionate about giving the best care possible. I cannot express how grateful I am to be here, because I am privileged enough to arrive after the challenges of moving, and I can reap all the benefits of interning somewhere so well-established and full of love. I am eager to start putting everything I have learned through observation into practice, because I want to contribute to the music therapy sessions in any way that I am able!

Until next time,

Mia Cellino, Music Therapy Intern

Reference:

Kranowitz, C. S. (2005). The out-of-sync child. New York, NY: The Penguin Group.

Reaching Beyond Pediatrics

            It has probably been awhile since you have read a blog post from a non-intern at Therabeat Inc. That is because we have been a little busy around here! Each of us at Therabeat Inc. has been working hard to turn our new clinic space into an environment where each child and parent who walks in will feel welcomed and loved. We are so blessed to have this new space, and if you haven’t checked it out yet, you definitely should! We had our ribbon cutting last Friday and it was such a wonderful day. Friends, family and members of our community came out to celebrate with us. We feel so blessed to work in such an inviting and beautiful place. 

            With our new clinic has come new opportunities, new experiences and new clientele. Ms. Chelsea Kinsler & I have especially enjoyed working with a group of 15-20 adults with intellectual and developmental disabilities from the Marietta Enrichment Center. These friends join us for a music class in our group room each Monday and Thursday morning. We have been working with this group for about 4 months now, and Ms. Chelsea and I both agree that we have developed a special bond with these precious people, and their caregivers also.

            We have had so much fun with this group. They cheer each other on so well, and I am convinced that if we were all encouraging and supportive like these friends, this world would be a much better place. One of the individuals did a special rap for the group one week while the rest cheered and hollered for him as if he had just performed at the Grammy’s. Another voluntarily got up out of his seat to assist another group member with the rhythm sticks while we were playing instruments and said to me, “I just need to help my friend.”  

            The sweetest moment happened this past week when I introduced a new instrument to the group-the ukulele. One of the precious men in the group said it reminded him of a song that was played at his father’s graveside-it was one of his father’s favorite songs. He told me a little bit about the song but couldn’t remember the name of it. I quickly searched it on the internet & figured it out! He wanted me to play “Somewhere Over the Rainbow” the version by Israel Kamakawiwo’ole. As soon as I began playing & singing the song, my sweet friend began to cry & tell us how wonderful his father was. At first, I was worried that I had used poor judgment by playing this song & bringing up negative emotions, but then I asked him if he wanted me to stop and he said “No, I love it.” with tears falling down his face. I kept singing along as we gathered around this sweet man & allowed him to cope and find peace in the midst of his grief. I can’t even explain how special this moment was. 

            This is what music does. It connects us. It allows us to share in the celebrations & hardships in life. It brings us together in good & bad times. I am so thankful for the gift of music. I am also thankful that because of our new facility at 9880 Hickory Flat Highway, Woodstock GA 30075, we are able to reach beyond just the pediatric population and also bring in adults who are just as much in need.

-Hayley Echols, LPMT, MT-BC