Learning Through Play: The Greenspan Floortime Method

           Mark Greenspan developed a specific method of floortime therapy to interact with children with autism and developmental disabilities. It is all about meeting the child where they are and letting them guide the interaction between adult and child. There are six stages that Greenspan developed in order to aid development.

·      Stage 1: Self-regulation and Shared Attention

o   The child must be able to regulate in the environment in order to enter the world of shared attention with the adult.

o   The adult engages the child using hearing, touching, looking and movement.

·      Stage 2: Engagement and Relating

o   The adult interacts with the child and engages emotionally with them while they play encouraging pleasure they receive from the interaction.

o   Establishing relationships with the adult is important for the child to help support the development of motor planning, language, and positive attitudes towards learning.

·      Stage 3: Two-way Intentional Communication

o   This stage is where the child takes the lead and communicates wants, interests, and needs through exchanges with the adult.

·      Stage 4: Purposeful Complex Problem Solving Communication

o   The adult continues the communication from the child by going with the ideas they are presenting and following through on them (going to the door when the child leads you there and asking what they will go get).

·      Stage 5: Creating and Elaborating Symbols (ideas)

o   This stage focuses on playing with the child in a way that they can transfer later into the real world. Establishing relationships and fixing problems in play will later help them connect that to their life.

·      Stage 6: Building Bridges Between Symbols (ideas)

o   This is when the child is challenged to differentiate between different feelings, thoughts and actions. Creating play or a drama that has a beginning, middle, and end will help the child make sense of themes or ideas that may be fragmented.

In our music therapy sessions, we think about the levels of play in order to ensure the session has a good flow. Incorporating the floortime stages into our sessions can be beneficial to help guide our interactions with our clients to encourage success.

Source: Greenspan, S, & Wieder, S. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. The National Autistic Society: 7(4), pgs. 425-435. 

--Lauren Booke, Music Therapy Intern

Rhythm, Music, and The Brain

         I have been working my way through Dr. Michael Thaut’s book, “Rhythm, Music and The Brain.” While the book is quite academic in nature and focuses a lot on complex scientific findings, there are also universal music therapy concepts that can directly apply to everyday practice.

         Dr. Thaut has dedicated his research and music therapy practice to putting science behind the success of what music therapists’ witness with their patients every day. He has created the field of Neurologic Music Therapy and continues to train others in these science-based music therapy techniques. While a lot of his research is with patients who have suffered a stroke or have been diagnosed with Parkinson’s Disease, his findings can be applied across the board.

         Here are a couple of quotes from his book that really have stood out for me. I think it is so important as advocates for music therapy to learn from as many sources as possible about the field and research that is available to us.

        “Rhythm may be one of the central processors to optimize our gestalt formation in the basic processes of learning and perception.” (pg. 17)

o   A gestalt is a completed unit of human experience. So basically he is saying that rhythm can help our brain develop the tools we need to gain the processes of learning and perception.

·      “Artistic expression may exercise fundamental brain functions and may create unique patterns of perceptual input that the brain needs and cannot generate through other means in order to keep its sensory, motor, and cognitive operations at optimal levels of functioning.” (pg. 25)

o   One of the many reasons music therapy is such a beneficial treatment modality is because it has that unique artistic expression component that triggers the brain totally different than anything else.

·      “Music must be viewed as a biological fact, not just as a cultural phenomenon.” (pg. 57)

o   Human beings are innately musical and learning more how to utilize that to achieve growth is what music therapy is all about.

Through his research, Dr. Thaut has proven time and time again that there are unique benefits to using music in engaging, developing, and growing the potential of the human brain. These are just a few of many of his findings and the music therapy community is blessed to have him continuing to learn more about what we do each and every day. 

-Lauren Booke, Music Therapy Intern

North Fulton Family Life Magazine-Music Therapy & Literacy

Ms. Perry Wright's article on Music Therapy & Literacy was published in the North Fulton Family Life Magazine this month.

Click here to read the article!

Incorporating Sensory Input into Music Therapy Sessions

            We have five senses to taste, to touch, to see, to hear, and to smell. When we incorporate these senses into a session we are incorporating sensory techniques. The use of sensory-based therapies has become more common throughout therapies when treating developmental and behavioral disorders. 

           There are four main sensory processing systems: vestibular, proprioceptive, tactile, and auditory. Children with sensory issues can have either hypersensitivity (over-responsiveness to senses) or hyposensitivity (under-responsiveness to senses). The sensory issue I will be discussing is hyposensitivity; these techniques should not be used for those children with hypersensitivity because this will over-stimulate them.

          In the case study, Music and On-Task Behaviors, the authors mention five off-task behaviors: running away, refusing, hand/arm movements, jumping and spinning, and verbal repetitions. Dieringer, Porretta, and Sainato used two different techniques: music and no verbal prompts and music plus verbal prompts. All of the participants engaged in more on-task behaviors during music plus verbal instructions.

         In our group, Little Beats, we are using music and verbal prompting (which stimulates the auditory system) but we are also adding other sensory components:

●      Vestibular: addressed by swinging

●      Proprioceptive: addressed by jumping

●      Tactile: addressed by actual objects in songs (if a book talks about leaves bring in leaves)

When adding the other senses into a session the therapist is helping address the needs of the clients. Clients with hyposensitivity actively crave and seek sensory input; the off-task behaviors that were described in Music and On-Task Behaviors, were behaviors that the children are using to attempt to gain sensory input. For example spinning can show a need for vestibular input; when we address these needs in the session, the client is able to gain more from the session. Over the past three sessions we have found that the clients have increased their on-task participation in the session from 20% to 80% of the clients participating.

First the therapist must understand the off-task behaviors and then the therapist can address the needs of the clients. The incorporation of sensory input into music therapy sessions can greatly benefit any client who is diagnosed with hyposensitivity.         

                        -Dana LaValley, Music Therapy Intern

Samayan, K., Dhanavendan, K., and Nachiketa, R. (2005). Allied health professionals’

           perceptions of the role of sensory integration therapy in managing challenging behaviours.

           International Journal of Therapy and Rehabilitation, 22(4), 167-172.

Dieringer, S., Porretta, D., and Sainato, D. (2017) Music and on-task behaviors in preschool

        children with autism spectrum disorder. Adapted Physical Activity Quarterly, 34, 217-234.

        https://doi.org/10.1123/apaq.2015-0033

3 Mindfulness Apps for Kids and Teens

          A lot of our patients benefit from mindfulness or relaxation based activities during their sessions. We pair music with guided breathing and stretching in order to help them achieve a relaxed state. It is a great way to help them focus in on the present moment or de-stress from an event that has happened in their day. Since we can’t be there every time they need to reach that state, here are some apps that can be used at home. Completing a relaxation/meditation exercise can also help kids wind down and fall asleep faster at the end of the day. Below, I have reviewed three different apps and highlighted what I believe to be the strengths of each one so you may choose which might work best for your child.

1) Head Space: This is one of the original mindfulness apps out there. It can guide you through the basics of mindfulness and begins with short sessions of 3 minutes. This app is definitely a little more mature and mainly geared towards teens and adults, but does have a kids tab as well with categories by age. It does however require a subscription to unlock a lot of the content though.

·      Strengths: This app provides a great variety of categories and an entire series devoted to “The Basics” to help you ease into the exercises. Even if you just get this one for the Basic series and then transition to another app, it is a great place to start.

2) Smiling Mind: This app has a cool feature that will track your meditation data for you throughout the week. They offer a variety of programs that have multiple nodules in each program and are sorted into categories based on age and length of time.

·      Strengths: I really like the dashboard component so you can track your data and see what is up next in the programs you are participating in. They also offer all of their sessions for free and have varying active and meditative themed meditations. Their themes for the kid and teen programs are also very relevant and applicable for kids in there every day life.

3) Stop, Breathe, and Think/ Stop, Breathe, and Think Kids:  Both of these apps are developed by the same people and are free. They have a check-in component, information on how to begin meditating, and a data tracker.

·      Strengths: I absolutely love the check-in offered with this app. It will ask you how you are feeling physically, mentally, and emotionally and then recommend specific meditations based on your response. You can also just explore the activities they offer and pick for yourself if you would like. While there is some that require an additional fee, there are a lot of free activities. In the kid’s version, a screen with emojis comes up for the check-in. This also helps promote emotional awareness and give the kids a chance to assess how they are feeling in the present moment. The meditations recommended for kids are accompanied with a visual to help keep them engaged.

Overall, the Stop, Breathe, and Think apps are the most appealing to me with the check-in. I think a large part of learning to incorporate mindfulness into your life is self-awareness and the check-in helps develop that ability to examine your current state in order to know what is going to be most beneficial for you in the present moment. After using one of these apps at home, it also can be beneficial to play some relaxing white noise or background music to continue that relaxed state or help promote sleep!

Happy meditating,

Lauren Booke