Using Body Orientation Exercises in a Music Therapy Session

What is Spatial Awareness?

Spatial awareness is the awareness of your body in space and the ability to organize knowledge of objects in relation to your body. When a child is developing spatial awareness they will become more aware of where objects are in relation to their body. Developing spatial awareness can be difficult for children with developmental coordination disorder; this is common in autism, cerebral palsy, and other conditions.

Signs of poor Spatial Awareness

1. Visual perception difficulties

2. Stand too close or too far from objects

3. Reproducing patterns, sequencing, and shapes

Strengths of poor Spatial Awareness

1. Strong in practical and concrete subjects

2. Excel at multi sensory learning

3. Good auditory memory skills

Technique of Body Orientation Exercises

Body Orientation Exercises use the same pattern as when a fetus develops in utero. In month two the baby begins to develop the brain and pelvis connections.  In month three the baby develops all four limbs. In month five the baby begins to move; the first movement is folding horizontally, then left and right, and lastly crossing the midline. Throughout these exercises the therapist will apply light to deep pressure (depending on the needs of the client) when moving over the limbs.  

1. The therapist starts at the center of the body and extends pressure out to the brain and to the pelvis.

2. The next part of the body that develops are the limbs individually; this means the therapist starts at the center and radiates out to each limb individually squeezing the end of the limb (hands and feet) always coming back to the center.

3. The body develops the ability to fold horizontally at five months in utero; the therapist will start at the center and extend to the upper extremities and then lower extremities squeezing the end of the limb (hands and feet) always coming back to the center.

4. Then the body develops the ability to identify left and right sides of the body after learning to fold horizontally; the therapist will start at the center and extend to the right side and then the left side squeezing the end of the limb (hands and feet) always coming back to the center.

5. Lastly the body develops the ability to cross over the midline after identifying left and right sides of the body; the therapist will start at the center and extend to opposite hand and foot (right hand, left foot, vise versa) squeezing the end of the limb (hands and feet) always coming back to the center.

This process allows the brain to become aware of where the limbs start and stop. For children with developmental coordination disorder this is important to facilitate development.

I start my session with these orientation exercises; it helps the client’s spatial awareness and allows them to make more progress in the session. I have used Body Orientation Exercises with a client who has Cerebral Palsy; after these exercises the client showed a noticeable increase in reaching for the instruments and playing them throughout the session.

-Dana LaValley, Music Therapy Intern

Cleveland Clinic (2017, April 26). Fetal development- stages of growth. Cleveland

Clinic. Retrieved from: https://my.clevelandclinic.org/health/articles/fetal-develo

      pment-stages-of-growth

Eckersley, S. (2012, August 4).  Spacial Awareness- Occupational Therapy [Web log  

       comment]. Retrieved from: http://occupationaltherapyforchildren.over-blog.com/

       Article-spatial-awareness-108726104.html

Use of Music Therapy for Enhancing Self-Esteem Among Academically Stressed Adolescents

As everyone gets back in the swing of a school year schedule, it is important to have tools to help manage academic stress. Academic stress can be defined as a product of a combination of academic related demands that exceed the adaptive resources available to an individual. Sharma and Jagdey did a study to measure how effective music therapy was on enhancing self-esteem among academically stressed adolescents. Self-esteem has been found to have a direct effect on an individual’s proneness to stress.

In this study, they took students age 15-18 years old and split them into two groups. One group received the musical treatment and the other one just received tips on how to manage stress. In this study, the music was delivered through a pre-recorded method where the participants were just listening. The music therapy sessions we provide at Therabeat are all with a trained music therapist, so the benefits are most likely to be increased when live patient-preferred music is utilized. Even with just the use of recorded music though, they found positive results in this study.

The group that received music therapy had a significant increase in self-esteem. The self-reported posttest did not however show significant results for the non-musical group in the study. The authors of the study hypothesize that music had such a positive effect because it can meet psychological, social and emotional needs that very few other interventions can address.

-Lauren Booke, Music Therapy Intern

Sharma, Mamta, & Jagdev, Tanmeet. (2012). Use of music therapy for enhancing self-esteem among academically stressed adolescents.(Report). Pakistan Journal of Psychological Research, 27(1), 53-64.

“Why that instrument? A bibliographic study of the reasons instruments are chosen by music therapy clients”

“Each instrument posses a character, a musical personality of its own that is created by its sound, its physical construction, and the way it is played. This individual quality gives each instrument its special musical value. Children quickly feel and respond to the character of an instrument we set before them…”

-Nordoff and Robbins (1971)

            As music therapists, we often give our patients a choice in which instrument we play or which instrument they play during our sessions. Avi Golboa and Yael Almog surveyed four music therapy journals and leading music therapy textbooks to examine examples of clients choosing specific instruments. They ended up choosing 53 examples and analyzed them in order to determine why each client made those choices. They determined there were two main dimensions that the choices were made by. Firstly, how the instrument is used sensorially or symbolically. And second, the attributes of the instrument including its sound, shape, or bodily action required to interact with the instrument.

1) How the instrument is used:

·      Clients can choose the instrument to serve a sensory need. Whether that is auditory, visual, and/or tactile, it can help stimulate them, calm them down, or establish isolation with the environment through it.

·      Clients can also choose the instrument symbolically according to one or more of the instrument’s attributes. This is when a client chooses an instrument based on the sound or shape and how that symbolically relates to what they are thinking.

2) Physical attributes of the instrument:

·      How the instrument sounds.

·      What shape the instrument is.

·      The bodily interaction with the instrument required to play it.

The instrument’s sound was the most frequent attribute found to dictate the choice in this study. This study reinforces how important it is to present our clients with a variety of instruments and let them have a say in which are used during their session.

-Lauren Booke, Music Therapy Intern

Source: Avi Gilboa & Yael Almog (2017): Why that instrument? A bibliographic study of the reasons instruments are chosen by music therapy clients, Nordic Journal of Music Therapy, DOI: 10.1080/08098131.2016.1272625

“Is Music Therapy an Effective Intervention for Dementia? A Meta-Analytic Review of Literature”

         What is the purpose of a review of literature? Here it is to draw together peer-reviewed studies to see if there are overarching trends. This review points to a robust body of evidence-based research that shows the efficacy of music therapy interventions with patients with dementia.

          “Is Music Therapy an Effective Intervention for Dementia?” is the question researchers Koger, Chapin, & Brotons ask in this review of literature. This is a fitting question as the researchers point out that dementia is steadily rising with the average life expectancy. This creates a need in the healthcare field to find out what modes of care are most effective with this population to best fit their needs. The purpose of this study was to “update and statistically cumulate the findings of clinical-empirical investigations” identified by earlier researchers in the field of music therapy. The studies selected in this meta-analysis are empirical rather than theoretical/philosophical in nature, or case studies. Researchers rather selected studies that allowed for repeated measures and comparison of pre/post intervention performance. Dependent variables (or symptoms/behaviors displayed by patients with Alzheimer’s or dementia) present across studies selected included: agitation, face-name recognition, wandering, reality orientation, depression, interaction, participating, disruptive vocalizing, and more. Therapeutic techniques included to address these symptoms included: singing, instrument play, dancing/moving, musical games, improvising, music listening, group singing, and listening to music while receiving tactile stimulation. A reduction of behaviors such as wandering, restlessness, and agitation was observed in the analysis. The overall results of the study suggest that music therapy is an effective intervention for patients with dementia. Researchers found that improvement in social behaviors included participation in group singing, socializing, and vocalizing were significantly increased. The researchers suggest that music therapists continue to conduct research with this population to better identify the most effective techniques to utilize with patients with dementia.                   

Source: Koger, S.M., Chapin, K., & Brotons, M. (1999). “Is Music Therapy an

Effective Intervention for Dementia? A Meta-analytic Review of  

Literature” Journal of Music Therapy, 36(1), 2-15. https://doi.org/

10.1093/jmt/36.1.2

To read the full study, click here:

https://academic.oup.com/jmt/article-lookup/doi/10.1093/jmt/36.1.2

The Benefits of Group Music Therapy with Children with Autism

As part of my internship, I have the opportunity to work individually with kids as well as in groups. For a lot of our kids working on social goals, doing so in a group of peers has huge benefits.

A. Blythe LaGasse did a research study looking at the benefits of group music therapy sessions specifically for kids with Autism. She wanted to observe the impact of these group sessions on eye gaze, joint attention, and communication. The children ranged from ages 6 years old to 9 years old and attended 50-minute music therapy sessions for ten weeks. The two domains that were most successfully improved with the intervention were joint attention with peers and eye gaze. For joint attention, this means the children could more successfully track where a peer was devoting attention as well as share attention on one object with another person. With eye gaze, this was directed at peers as well as the facilitators. Overall, more successful peer-to-peer interactions were developed in the music therapy setting as opposed to a non-musical social skills group.

As we gear up for our fall semester and new classes are forming, I look forward to helping encourage these same results for our patients. I also am excited to witness other benefits and see how else these music therapy groups can foster growth.

Source: LaGasse, A. Blythe. (2014). Effects of a Music Therapy Group Intervention on Enhancing Social Skills in Children with Autism. Journal of Music Therapy 51(3), 250-275.

Thanks for reading,

Lauren