Influence of MT and Music-Based Interventions on Dementia: A Pilot Study

Article Summary by Kathryn Trujillo 

According to the authors, and the World Health Organization (WHO), more than 55 million people live with dementia worldwide. Dementia causes deterioration in cognitive functioning, and “negatively affects memory, thinking, orientation, understanding, calculation, ability to learn, language, and judgment” (Dahms, p.13). There are three stages of dementia: early, middle, and late. Depending on the characteristics and symptoms expressed by individuals living with dementia,  Common symptoms of dementia, from early to late progression, are forgetfulness, losing track of time, becoming lost in familiar places, forgetful of recent events or people’s names, behavioral changes, repeating questions, an increasing need for assisted self-care, and behavior changes that can escalate to include aggression (WHO, 2021, p. 1). The study by Dahms, Eicher, and colleagues titled “Influence of Music Therapy and Music-Based Interventions on Dementia: A Pilot Study,” though conducted in Germany, has results which should be considered in the care of those living with dementia here in the United States. Dahms and colleagues implemented music by following guidelines set by the National Dementia Plan. According to Dahms, nursing homes in “other countries of the world (such as Australia and the United States)” also act according to the National Dementia Plan (p.14). This study provides evidence that when Music Therapy (MT) and technology music-based interventions (TMBI) that are a part of a patient’s daily routine, decrease agitation and apathy of those living with dementia in nursing homes.

Dahms and colleagues focused on the influence of individual MT, group MT, listening to background music, group music with movement, and presence of a music program in the common room on disruptive behaviors of those living with dementia in 3 separate nursing homes across Germany. Terms used synonymously to describe behavioral symptoms being observed were “disruptive behavior” (e.g agitation) and “social behavior” (e.g. apathy) (Dahms, p. 18). The primary research question was, “what was the frequency of use and acceptance of the different music interventions (MT and TBMI) offered to people with dementia in nursing homes” (Dahms, p.15)? The purpose of the study was to evaluate the use, acceptance, and interaction of music on people with dementia living in nursing homes across Germany (Dahms, 2021). Three nursing homes, two in Berlin and one in Stuttgart, Germany were included in the study. 30 people between the ages of 65 and 97 years, and diagnosed with dementia, were included in the study. Considering that those with dementia were dependent on full time caregivers, the related caregivers (RPs) answered questionnaires on behalf of the included residents before, during, and after the study took place. All questionnaires “included questions on the following topics: instrumental activities of daily life that influence the behavior of people with dementia (e.g disruptive behavior), depression, quality of life...and about expectations of MT and TBMI” (Dahms, 2021, p. 17). 

The goal of each MT and TMBI intervention was to investigate their usage by people with dementia over time. MT is unique, in that board-certified music therapists (MT-BCs) individualize each intervention to the preferences and likings of each study participant. The use of music is purposeful and intentional. Interventions were presented under 6 different conditions: group MT, individual MT, background music during meals, background music during exercise, CD in the common room, and individual listening time with a radio. Group MT was conducted once a week for 45-minutes, with 5 study participants, but when other nursing home residents stepped in, the group size varied (Dahms, p.19). The interventions presented were live, improvised, facilitated by an MT-BC on guitar or accordion, and singing bowls and percussion instruments were given to participating group members. Individual MT was provided bi-weekly for 30-minutes, and facilitated by an MT-BC on guitar. Background technology based music (TBMI), was played by caregivers on a daily basis during meals for all study participants for 4-minutes with a CD player (Dahms, p. 19). Music was played on a television (TV) for a group music class with movements. Group music with movement was provided every two weeks for 60-minutes with a certified fitness trainer for physical activation. A music program in the common room was available to each participant for 6 hours through a TV and accompanied by lyrics and visuals, daily. Individual radio time was provided twice a day for 30 minutes in each resident’s room and individualized to meet their personal needs (e.g volume, playing speed, genre). 

Data was primarily collected through physical questionnaires filled out by the related caregivers, and then turned into digital data using Microsoft Excel. Researchers used IBM’s SPSS Statistics 27 program to evaluate data from the questionnaires. The study was separated into four test phases and questionnaires were filled out at each phase. Data was then analyzed at timepoints “T2 and T3, using bivariate and multivariable analysis. For example, one variable, the “frequency of use on MT and TBMI” was split into two sub variables to distinguish the sample between “residents with high usage” and “residents with low usage” (Dahms, p20). Researchers used nonparametric Mann-Whitney U-tests on scores for agitation, apathy, and depression,  independent sample t-tests were used for quality of life, and a Friedman test was used to further evaluate the influence of MT and TBMI on agitation (Dahms, p.21). 

There were three primary limitations to Dahms’ and colleagues’ study. The first limitation was that all participants relied on caregivers due to late stage dementia, and their declining health made it impossible for participants to provide self-assessments on the questionnaires. The second limitation was that acceptance of the use of technology was not assessed. Participants relied on related caregivers to physically set up and start the music using technology. The third limitation was that the study’s “eight-week intervention phase was not sufficient enough to detect long-term effects in people with dementia with respect to the parameters studied” (Dahms, p.32). Though there were limitations to this study, the design, implementation, and results are supported by previous research. 

Results of Dahms’ and colleagues' study stated that 83% of participants with dementia did listen to music regularly, that some residents still handled this activity independently, while the majority of people with dementia were dependent on the support of their caregivers for it (Dahms, p.e21). According to the responses from RPs on the questionnaires, the reasons for nonuse of MT or TBMI was due to health problems of the residents, loss of memory about the existence of the music interventions, their tendency to retreat, and motor restlessness. On p.22 it states that “the frequency of use of the TBMI, for example, karaoke and biography-specific favorite music, was lower than the frequency of use of the personnel-guided music interventions.” A majority of the residents with dementia preferred the individualized active music therapy sessions with an MT-BC. Group MT was rated the best, followed by group music with movements, and individual MT. Overall, this study suggests that individualized MT and group MT, provided by an MT-BC, can reduce agitation and apathy of inpatient nursing home residents living with dementia. 

-Kathryn Trujillo, Music Therapy Intern

Reference: 

Dahms, R., Eicher, C., Haesner, M., & Mueller-Werden, U. (2021). Influence of music therapy and music-based interventions on dementia: A pilot study. Journal of Music Therapy, 58(3), e12-e36. doi:10.1093/jmt/thab005

World Health Organization. (2021, September 2). https://www.who.int/news-room/fact-sheets/detail/dementia

MT & Approaches to Behavior

Rationale and Support for 3 Behavioral Approaches within Music Therapy

Music therapists (MT-BCs) who work with children, youth, and young adults use music-based interventions to address specific behaviors. Behavior, as defined by the American Psychological Association (2020), is “an organism’s activities in response to external or internal stimuli, including objectively observable activities, introspectively observable activities, and nonconscious processes” (2020). Below is rationale and support for three different MT philosophical approaches and their corresponding strategies that address behavior of children and youth. 

The Cognitive Behavioral Theory (CBT) approach is centered around the belief that how we think, how we feel, and how we act are all interrelated. Our thoughts and feelings determine our behavior, which in turn, determines our thoughts and feelings. The CBT model looks like this: 

(McLeod, 2019).

Practicing MT-BCs who are trained and influenced by CBT help clients realize that their positive, uplifting thoughts can bring about more positive outcomes, while their negative, self-destructive thought patterns bring about more upsetting outcomes. Negative interpretations of events influence behavioral patterns which reinforce distorted thinking (McLeod, 2019).. In turn, positive interpretations of events influence behavioral patterns which reinforce healthy thinking. Cognitive-behavioral therapy helps people to develop alternative ways of thinking and behaving which aim to reduce their psychological distress. One strategy often used by cognitive behavioral therapists is assigning “homework” for clients, such as keeping a journal of thoughts, or noting how many times a particular negative thought enters their minds each day. Through increased self awareness, behavior can begin to change. MT-BCs use music, which is reality-based and structured, to increase self-awareness of thoughts, bring attention to emotional content, and more. MT-BCs can also assign “homework,” such as journaling about thoughts which can be used in song-writing during the next session, assigned listening to preferred music and bringing specific lines or full songs to discuss in a lyric analysis intervention. Music-based interventions and intentional verbal processing, related to the music intervention, are used to guide the client to a state of self awareness or identification of emotion and its corresponding behavior. 

Similar to Cognitive-Behavioral Theory is Dialectical Behavior Therapy, or DBT. “Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others” (Schimelpfening, 2021, paragraph 1). DBT strategies are used in group therapy and individual therapy sessions. Common strategies used by DBT therapists are core mindfulness skill development, distress tolerance skill development, interpersonal effectiveness, and emotional regulation strategies. DBT provides clients with the opportunity to develop skills to improve their quality of life. In 2015, Chwalek and colleagues interviewed MT-BCs who were using DBT and concluded that, though few, MT-BCs valued and saw the benefit of DBT strategies within therapy. MT-BCs provide music-based interventions that in their nature address self-esteem, mindfulness, improving social skills, increasing self-confidence, building stress tolerance, improving communication skills, and learning positive peer interactions (Chwalek, 2015, p.297). 

Person-centered therapy, or humanistic therapy, was developed by Carl Rogers in the 1940s. A person-centered therapist is authentic, provides the client with genuine empathy, and unconditional positive regard (Unknown, 2018, paragraph 3). Music can be uniquely used in a person-centered fashion when the therapist is working from a person-centered approach. For example, a person-centered intervention may include allowing the patient to write their own lyrics, discuss lyrics, or improvise melodies in a way that affirms and accepts their experience with no attempt to correct or judge the client. Music is a non-threatening and non-verbal form of building relationships, communication, and interpersonal connection, so it has inherent qualities appropriate for the person-centered approach. In 2015, McCaffrey and Edwards interviewed six psychiatric patients, all who had participated in MT sessions, about their experience. The most common theme that appeared in the interviews was that in its nature, MT is person-centered. According to participant L, one-on-one MT sessions provided “a space in which he feels acknowledged as a unique and individual person” (McCaffrey, p.129). Within MT sessions there is often opportunity for autonomy, choice, and expression of individual wants or needs. In many cases, expressing wants and responding to opportunities of binary choices, is an objective or goal set by the treating MT-BC. In their interview, participant L stated that “in the music therapy environment, choice, direction, and leadership were encouraged by his therapist” (McCaffrey, p.130), which was similar to the experience of other participants in the study. 

MT-BCs can use music to address behaviors, improve behaviors, increase self-efficacy, improve self-esteem, and more by presenting interventions with additional background in CBT, DBT, and person-centered psychological approaches. Those who specialize in and work with children or youth may be influenced by one or more than one of the psychological orientations and strategies discussed above. 

-Kathryn Trujillo, Music Therapy Intern

References:

APA Dictionary of Psychology. (2020). American Psychological Association. https://dictionary.apa.org/behavior 

Chwalek, C., & McKinney, C. (2015). The use of dialectical behavior therapy in music therapy: A sequential explanatory study. Journal of Music Therapy, 52(2), p.282-318, https://doi.org/10.1093/jmt/thv002

McCaffrey, T., & Edwards, J. (2016). Music therapy helped me get back doing: Perspectives of music therapy participants in mental health services. Journal of Music Therapy, 53(2), p.121–148, doi:10.1093/jmt/thw002 

McLeod, S. A. (2019). Cognitive behavioral therapy. Simply Psychology. https://www.simplypsychology.org/cognitive-therapy.html

Schimelpfening, N. (2021, July 9). What is dialectical behavior therapy (DBT)? Verywell Mind. https://www.verywellmind.com/dialectical-behavior-therapy-1067402

Unknown. (2018). Person-centered therapy (Rogerian therapy). Good Therapy. https://www.goodtherapy.org/learn-about-therapy/types/person-centered

Music Therapy and the Hearing Impaired

Deficits in auditory perception and hearing loss affect all individuals regardless of age, race, gender, socioeconomic class, and more. According to the National Institute of Deafness and Other Communication Disorders, “2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears” (2021, line 1). Traditional verbally expressed and auditorily processed communication may not be easily accessible to individuals with auditory deficits or an extreme degree of hearing loss. Therefore it is important to use alternate forms of communication such as sign language, visual supports, augmentative and alternative communication devices, vibrations, and other elements of music. Music therapy (MT) provides those who live with impaired hearing and deficits in auditory perception the opportunity to build a positive self-image, improve self-esteem, improve communication, and more through uniquely designed music-based interventions. MT is an effective mode of treatment because trained and board certified music therapists (MT-BCs) provide music-based stimulation through tactile touch, vestibular stimulation, and visuals. All of which are unique to each individual and their degree of hearing loss. 

In order to provide individualized MT interventions to children and adolescents, MTs strive to understand human auditory processing and how best to provide additional stimulation for those who are hard of hearing. Music reaches these individuals in many creative and effective ways. Research suggests that in order for MT-BCs to communicate effectively with other professionals and parents, they must have technical knowledge in regards to hearing aids and cochlear implants (CIs), how young children develop auditory perception, and typical communication goals established by speech-language pathologists and audiologists (Gfeller et. al, p.39). The human experience of music does not simply occur through aural vibrations and auditory perception. Humans experience music through other senses, such as tactile touch, vestibular stimulation, and sight. In order to treat clients with a wide range of hearing deficits, MT-BCs must understand equipment, how sound is processed for individuals with hearing impairments, and assess how this affects their presentation during MT treatment. 

While discussing the mechanics of hearing aids and CIs, which have helped those with hearing loss significantly, it is important to understand how music is perceived through these devices and by the individuals using them. It is important to note that hearing aids and CIs were originally developed to assist those who had difficulty identifying speech, not music. Kirchberger (2016, p.1) defines dynamic range and compression in music as “the level difference between the highest and lowest-level passages of an audio signal. Dynamic range compression (or dynamic compression) is a method to reduce the dynamic range by amplifying passages that are low in intensity more than passages that are high in intensity.” This informs the MT-BC which musical passages are effective for clients with varying levels of hearing loss. Dynamic compression is controlled primarily by recorded musical passages, however, with this knowledge, an MT-BC can select and adjust specific musical elements if presenting live musical interventions. If using recorded music, hearing aid listeners will receive a dual dose of compression which is not always beneficial or aesthetically pleasing. As an MT-BC, it is important to understand how hearing aids work, and to anticipate how recorded music may be experienced by young clients. MT-BCs should adjust session plans and interventions to meet the preference of the client and find the appropriately compressed music that is aesthetically comfortable for them, if not performing and accommodating while presenting live. 

The experience of hearing impaired and CI users varies considerably. Each individual’s experience needs to be considered carefully by the treating MT-BC. This information would be gathered during the assessment phase and clinically influences the techniques and interventions presented to the client. In an MT session, hard-of-hearing children may rely on visual cueing from the therapist demonstrating different rhythmic patterns, tempo, dynamics, and other musical elements for a full musical experience. Each child with hearing impairments has varying degrees of ability to perceive pitches, varying ways of hearing music, and varying degrees of perception of music. Again, hearing aids and CIs are formatted for speech sounds, not musical pitches. Therefore, an MT-BC should be aware of each child’s preference for timbres and choose instruments accordingly. MT-BCs provide interventions using a variety of instruments, sounds, and rhythms during all stages of the therapy process. MT-BCs provide tactile rhythmic stimulation, tonal interventions, and instrumental variety. 

Early intervention, especially through MT, can improve the quality of life for both the hearing-impaired child and the family as a whole. According to research, MT “is an attractive method through which children’s attention is enhanced, abolishes the shyness and social withdrawal of children, enhances children’s expressive abilities towards the uncommon vocabularies, and it doesn’t only enhance the segmental aspect of phonological development, but also the supra-segmental level of development; as it helps in recognition and discrimination of different pitch direction, proper timing of utterance and tonicity” (Bassiouny, et. al, p.109-110). This means that any child or adolescent with hearing impairments, speech and language deficits, or in need of additional support, speech-specific elements of music can provide opportunity for support. Pitch direction, timing, and melodic flow can be used to teach clients how to ask, “how are you?” to say, “my name is ___,” and more. Not only do music-based interventions address many logistical aspects of speech, as stated above, but music can also encourage and improve other forms of communication for the child. MT is indicated for children with hearing impairments provided the MT-BC appropriately assesses how the client is processing music through assistive devices, and chooses music stimuli accordingly. 

-Kathryn Trujillo

References

Quick statistics about hearing. (2021, March 25th). National Institute of Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing

Adamek, M., Darrow, A. (2018). Music in special education. The American Music Therapy Association. (3rd ed., pp. 319-351). The American Music Therapy Association.  

Bassiouny, S., Saleh, M., Elrefaie, D., & Girgis, M. (2017). Using music therapy in (Re)habilitation of prelingual cochlear implant children. Journal of Scientific and Technical Research, p.1-6. DOI: 10.26717/BJSTR.2017.01.000127

Du, M., Jun, J., Li, Z., Man, D., & Jiang, C. (2020). The effects of background music on neural responses during reading comprehension. Scientific Reports, 10, p. 1-11.

Gfeller, K., Driscoll, V., Kenworthy, M., & Voorst, T. (2011). Music therapy for preschool cochlear implant recipients. Music Therapy Perspectives, 29, p.1-11.

Kirchberger, M. & Russo, F. (2016). Dynamic range across music genres and the perception of dynamic compression in hearing-impaired listeners. Sage, 20, p.1-16. 10.1177/2331216516630549

Improvisational Music Therapy for Young Adults

The United States of America is experiencing a mental health crisis. There have been many mass shootings and acts of violence in the country. According to Everytown Research & Policy, “between 2009 and 2020, 1,363 people in the United States were killed and 947 more were wounded in 240 mass shootings, an average of 20 shootings each year. Among the casualties were at least 362 children and teens killed as well as 21 law enforcement officers killed and 35 wounded” (paragraph 5). Because mental health disorders are so often present by the time someone is in their mid-20s, it is important for a person to receive appropriate intervention as soon as possible. In addition to other therapies, Music Therapy (MT) is indicated in the treatment of mental health disorders. Researchers Clements-Cortes and Yu (2021) conducted a literature review concerning the benefits of improvisational music therapy with university and college age students experiencing mental health issues. The body of literature suggests that improvisation plays an integral role when it is difficult for clients to verbally express their emotions ( Clements-Cortes et al., p1). Hans Christian Anderson is well known for once saying, “where words fail, music speaks.” 

Clements-Cortes and Yu explore clinical improvisation and improvisational MT research outcomes. First a general explanation of mental health issues and MT is offered. The purpose of Clements-Cortes and Yu’s article is to explore the mental health benefits of improvisational music therapy for young adults through literature review of fourteen articles and research studies. The literature review provides hope for those living with mental health issues and provides evidence for the use of MT as a non-invasive treatment of mental health concerns. Musical improvisation in MT sessions, as studied by Erkkilia, et al. (p. 32 as cited by Clements-Cortes and Yu) resulted in positive outcomes for those with depression and increased their personal well-being compared to the control group. Maraos’ study found that active music making provided clients with novel aesthetic, relational, and physical experiences thus ameliorating mental health challenges (p. 32 as cited by Clements-Cortes and Yu). General findings confirm that MT benefits those with mental health disorders such as depression, anxiety, autism, trauma, and schizophrenia.

Musical improvisation can be active playing or receptive listening. According to Bruscia, “active improvisation involves spontaneous exploration of one's own character, while receptive improvisation involves listening to improvisations to build support, openness, and provoke physical responses from those who might otherwise be reluctant to participate” (p. 31, as cited by Clements-Cortes and Yu). It is not the therapist, or other group members, but the music that is the medium for regulating and processing client emotions and mood states. MTs facilitate structured or free-flowing sessions in which they provide prescriptive support, such as written prompts for the clients, or in which they support the direction set by the client(s). Improvisation of voice, instruments, and body is important because musical improvisation becomes an emotional coping mechanism for clients. 

Below is a case study for how MTs use improvisational music to address mental health concerns: 

Client A: 16-year old female with depression and anxiety 

Therapy Goals: to grow in self-confidence, self-esteem, create a positive sense of self, and gain more creative coping skills

Procedure: Treating MT first provides instrument choice for Client A to manipulate during improvisation intervention. MT then offers pre-determined prompts for Client A to choose from. For example “relaxing on the sand sounds like…” or “crying while it rains sounds like…” If appropriate, after improvisation finds a natural end, both Client A and MT discuss the experience.   

Here are two visual examples of how music improvisation can be used with adults participating in MT sessions: can this be listed after the case study as more examples? It belongs there, not as a conclusion. And then maybe just conclude by listing where people can get MT services for mental health--I’m sure this in the AMTa website 

Music Improvisation - Loneliness https://youtu.be/5ALShMMbJ-k (Nordoff-Robbins Music Therapy Australia, 2011)

Music Improvisation - Anger https://youtu.be/GS5EX1EhPHc (Nordoff-Robbins Music Therapy Australia, 2011). 

It is important that professionals invest their time and resources in mental health research, treatment planning, and advocacy efforts in order to reduce the stigma around mental health. MT has been recognized as a non-invasive treatment for mental health diagnoses and many MTs continue to advocate for continuing MT services in settings such as hospitals, psychiatric facilities, hospices, assisted living homes, schools, private practices, and more. If you, or someone you know, is experiencing mental health issues, contact your healthcare provider or seek referrals for a MT assessment. 

-Kathryn Trujillo, Music Therapy Intern

Reference(s):

Mass shootings in America 2009-2020. 2021, June 4th. Everytown for Gun Safety. https://everytownresearch.org/maps/mass-shootings-in-america-2009-2019/

Clements-Cortes, A., & Yu, M. T. (2021). The mental health benefits of improvisational music therapy for young adults. Canadian Music Educator, 62 (3), 30-33. http://0-search.ebscohost.com.pacificatclassic.pacific.edu/login.aspx?direct=true&db=ehh&AN=149346483&site=eds-live&scope=site&CUSTID=s8968023

Nordoff-Robbins Music Therapy Australia. (2011, July 5th). Music improvisation - loneliness [Video]. Youtube. https://youtu.be/5ALShMMbJ-k

Nordoff-Robbins Music Therapy Australia. (2011, July 5th). Music improvisation - anger [Video]. Youtube. https://youtu.be/GS5EX1EhPHc

Music Therapy Improves Social Skills in Children and Adolescents with Autism Spectrum Disorder

Music therapy (MT) professionals are often searching for new, music-based, creative interventions and approaches to support children and adolescents with a myriad of diagnoses. Those who conduct research in the MT field have provided many approaches, interventions, and case studies which demonstrate the success of MT to improve social skills of children and adolescents with Neurological Developmental Disorders (NDDs) such as Autism Spectrum Disorder (ASD). Below is further support as to why MT services for children and adolescents with NDD is important and often successful in improving social competence. 

Music, a multi-modal approach, facilitates many developmental skills. When children experience joy and play, they are more willing to participate in activities. Music is motivating and uplifting, but can also calm and relax clients. MT interventions are designed to set clients up for success and therefore help children feel better about themselves and others. Music often encourages socialization, self-expression, communication and motor development. Through music, those with NDD or ASD are able to self-manage pain and stressful situations. Elements of music are malleable, making it an appropriate therapeutic tool for many diagnoses as it can be tailored to each individual. 

According to the American Music Therapy Association (AMTA), those with ASD have a heightened interest in music and often display positive responses to music, making it an integral therapeutic tool while working with them (2012, p. 1). Social skill deficits are addressed through music performance, movement to music, and improvisation. According to Gooding, MT interventions “improve social skills and specific deficits within the social skills areas of peer relations and self-management skills” (2011, p. 440). MT interventions with children often address cooperation, communication, positive peer interactions, focus of attention, impulse control, delayed gratification and accepting consequences. 

As a result of MT intervention, children and adolescents with NDDs may have less outbursts at school, less behavioral reports from school, and improved social interactions. Below is a case study: 

Client: Client A  is a teenage male who is a sophomore in high school. Client A struggles with impulse control and often throws items for attention. This occurs within his home and while at school. 

Session: The treating MT, and MT intern (MTI), addressed impulse control and social-emotional development skills through turn-taking interventions, start and stop interventions, and emotional-regulation interventions. To facilitate movement to music and positive social interaction, the MTI used a Sony speaker to project the pt’s preferred song “Count on Me” by Bruno Mars. The MTI then stood in close proximity with Client A, began to dance with them, smiled, and used positive verbal affirmations to further encourage Client A’s positive social behaviors. When the MTI affirmed Client A’s positive reactions to the music, Client A made eye contact with the MTI and reached for their hand in order to dance together. This intervention used music as motivation, close proximity and bright affect to encourage social interaction, and was in the safety of the client’s own home. As the MTI and Client A sang along together, Client A experienced positive music-making AEB smiling, dancing, and vigilance to stimuli throughout intervention. After 3 weeks of treatment plan, Client A decreased frequency of throwing household items from 3 to 1x per session. The treating MT and MT intern will continue to add to Client A’s social skills toolbox as they continue his plan of care. 

In a safe therapeutic learning environment, children and adolescents with NDDs can explore, practice, and equip themselves with social skill tools for more successful experiences with their peers. As the picture above states, MT can facilitate the exploration of sharing, cooperation, listening, following directions, respecting personal space, making eye contact, and using culturally appropriate manners, among many other skills.  

-Kathryn Trujillo, Music Therapy Intern

References

Gooding, L. (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(4), 440-462

American Music Therapy Association. (2012, June). Music therapy as a treatment modality for Autism Spectrum Disorders. American Music Therapy Association. http://www.musictherapy.org/assets/1/7/MT_Autism_2012.pdf