Music Therapy with Children with Hearing Impairments

For our friends with hearing loss (mild-severe) there is often a misconception about their ability to experience music and to become musicians. Music Therapy is an effective mode of therapy for children with varying degrees of hearing impairments--especially in the areas of speech & language development, cognitive development, social/emotional development, and listening skills. Team Therabeat had the opportunity to present to the Georgia Bell Event at Atlanta Speech School about this topic, so we would like to share a little bit about our presentation here as well!

Research shows that children with hearing impairments share or surpass children without hearing impairments in rhythmic competency (Gfeller, 2016). This is due to the way we “hear” music. In the absence of normal hearing, people may experience music through vibrotactile input via percussive instruments. Children may also rely on visual cueing via therapist/educator demonstrating rhythmic patterns. A therapist or music educator should always be aware of how each individually child experiences music. Each child with hearing impairments has varying degrees of ability to perceive pitches, varying ways of hearing music, and has varying degrees of perception of music. Hearing aids and cochlear implants are formatted for speech sounds, not musical pitches. Therefore, a music therapist should be aware of each child’s preference for timbres and choose instruments accordingly.

Once a therapist knows what kind of musical interventions will work best for the child (or group of children), the following are goal areas that are addressed. These goal areas are based on clinical practice, and peer-review/evidence-based research for music therapy with children with. pre- or per- lingual hearing loss.

·      Language Development: increase of vocabulary, increase of spontaneous speech, increase of sophisticated language structures such as metaphors/figures of speech, and pragmatics

·      Speech Production: increase vocalizations, increase speech prosody,

·      Listening Skills: increase in sound detection, sound discrimination, sound comprehension, and sound identification

·      Social Development: improvement in turn-taking, increased self-expression, and working cooperatively with others

(Gfeller, 2016)

Music Therapists address the goals above through the following music interventions:

·      Lyric Analysis & Song Writing: music therapists engage individuals in discussion or rewriting of lyrics to address learning and comprehension of age appropriate vocabulary and syntax to facilitate language development

·      Movement to Music: rhythmic movement in a predictable tempo can reinforce language development by performing movement paired with action words.

·      Therapeutic Singing: singing at slow, sustained tempos to facilitate accurate phonation of sounds. Rhythmic repetitions of target sounds happen in controlled and predictable tempo.

·      Instrument Play: Listening skills may be improved by auditory training through the play of percussive instruments that create sounds that can be experienced through tactile vibrations, or through instruments that create different timbres.

·      Music Therapy Groups: creating music with others provides a structured and motivating space to learn how to attend with others, take turns, and work well with others to create an aesthetic that is pleasing to the group.

(Gfeller, 2016)

We are always honored and excited to share information about how beneficial music therapy is in our community! We were able to demonstrate first hand some interventions we might use in a  group with the children who attended the event. We enjoyed seeing seeing the concepts we discussed in action.

-Perry Wright, LPMT, MT-BC

Reference:

Gfeller, K.(2016). Music Therapy for Children and Adults who are Deaf or Hard of Hearing. In The Oxford Handbook

of Music Therapy: Oxford University Press. Retrieved from

www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199639755.001.0001/oxfordhb-9780199639755-e-31.
 

Senior Adult Fair Extravaganza

Music therapy advocacy, in all forms, is such an important and efficient way to express the effectiveness of music therapy. For that reason, Therabeat, Inc. continues to support and advocate for music therapy in many wonderful ways, and for many wonderful populations.

This past weekend, Jennifer, our music therapy intern Alaina, and I were pleased to be one of many vendors for the Cherokee Triad S.A.L.T. Senior Adult Fair Extravaganza at the First Baptist Church Woodstock Conference Center. We had the pleasure of spreading the joy of music to a wide variety of listeners with our display of instruments, music therapy fact sheets, and smiling faces! We also enjoyed walking around and meeting all of the other vendors in attendance. It was a phenomenal teaching and learning experience for us, and we look forward to continuing our mission to advocate for music therapy throughout the community!

-Morgan Minyard, LPMT, MT-BC

In the Community: Canton Optimist Club

                  The members of Therabeat, Inc. have been working hard to advocate for music therapy throughout the community. We were recently honored to be a part of a Canton Optimist Club meeting, where we had the opportunity to tell the members all about what we do. The Optimist Club is an incredible organization that serves the community in many ways. Adult volunteers join together with the slogan, “Bringing out the best in kids”. The Optimist club is dedicated to serving and empowering youth in any way possible. 

                  Team leader Jennifer Puckett and I were the guest speakers at one of the club’s weekly meetings. We opened our meeting with a “hello song”, giving the members a taste of what a typical music therapy session looks like. We then talked about what music therapy is, why it’s effective, and who we serve. The members were an extremely receptive audience and seemed eager to learn more. We were grateful for yet another great advocacy opportunity! 

-Alaina Brommer, Music Therapy Intern

In the Community: Knox Elementary

                  The members of Therabeat, Inc. were honored to be highlighted as “community helpers” at Knox Elementary School. Jennifer Puckett and I made our way to the school to speak to over 100 kindergartners about music therapy! We were thrilled to have the opportunity to advocate to such a young audience, since even many adults do not know what music therapy is. We explained the basics of music therapy to the students and showed them a video of our amazing kiddos making music at the clinic. After sharing our presentation, Jennifer and I conducted a sample music therapy session with the whole group of students. We did music and movement, instrument play, and sing alongs with body percussion among other interventions. The kids were such an eager audience, and we loved getting them engaged. What a unique advocacy opportunity, and what an honor it was for us to be recognized for the work we do in the community. 

-Alaina Brommer, Music Therapy Intern

Structure in Music

            This week, I will explore the last of the 3 foundational principles of music therapy: “the utilization of the unique potential of rhythm to energize and bring order”. Many people who suffer from physical, mental, or emotional impairments struggle to perceive or understand their internal and external environments, which may result in the inability to control behaviors or respond to stimuli in appropriate ways. Music, being an extremely structured and organized form of expression, can be an effective tool for helping individuals establish the order that is so necessary to their well-being. According to Peters (2000), music can help “attract and sustain attention, elicit and organize response, and provide an example of ways to make beauty and order out of chaos” (pp.59). Music therapists have the opportunity to carefully choose, manipulate, and organize musical elements in a way that encourages clients to move from a state of chaos to a state of order.

Firstly, music is a multisensory experience. From the sound waves to the physical vibrations, music can be experienced through numerous sensory channels. Because of the multisensory nature of music, it attracts the attention of individuals rather easily. Furthermore, it can sustain that attention due to the fact that music is a real-time experience that requires “moment to moment commitment” from participants (Stevens, 2000, pp.60). For example, the sound of a xylophone being played by a music therapist may draw the attention of a child. Once the child decides to pick up a mallet and play the xylophone herself, she must continue playing in order to continue receiving that auditory input; if she stops playing, the music stops. As summarized by Stevens (2000), “after the rhythms, sounds, and melodies attract and individuals attention, the time-ordered structure and experience of music help hold that attention, providing an environment or structure in which growth and learning can occur” (pp.60).

Furthermore, the multisensory nature of music gives clients many opportunities to become involved in the experience. Individuals can respond to music through “auditory, visual, tactile, and kinesthetic channels” (Stevens, 2000, pp.60).  These responses can include anything from turning a head towards the source of music, picking up a mallet and hitting a drum, vocalizing with music, to dancing or moving to a steady beat. There are countless opportunities not only for music to reach clients but for clients of all abilities to respond. A client who may struggle with one particular sensory mode may be able to receive stimulation or respond through a different sensory mode offered by music. Music is versatile, accessible, and adaptable, which makes it an efficient therapeutic tool.

For many of the children I work with, flexibility and creativity are two major goal areas. Musical improvisation is a great way to encourage spontaneity and exploration within the confines of a provided musical structure. For example, the music therapist may play a chord progression on the guitar as the child engages in improvised play on the xylophone. The music therapist is providing structure both melodically and rhythmically with the guitar which makes the child feel more comfortable with exploration. Although the child is creating music in the moment, he or she still feels contained by the therapist’s musical accompaniment.

The structured and orderly nature of music makes it a natural and efficient choice in therapy. There is so much opportunity for growth and development within the confines of music, and that is what makes music therapy such a beautiful and effective experience! In the words of Stevens (2000), “for the child whose world is often a confusing chaos, the order of music is a welcome structured experience in which the child may feel free from confusion and safe in the ability to predict the activity and the person associated with the music” (pp.60).

-Alaina Brommer, Music Therapy Intern

References

Peters, J.S. (2000). Music therapy: an introduction (pp. 59-60). Springfield, IL: Charles C. Thomas.