Benefits of Co-Treating with Music Therapy & Speech Therapy

            Speech and Language therapists focus on communication disorders in individuals who struggle in areas such as improving coordination and strength in speech muscles, improving fluency of speech, articulation of speech, auditory processing, methods of eating, and a plethora of other speech related goals. While speech therapists have been trained to assess and create treatment plans for these specific goals, other therapies have been beneficial towards addressing these goals as well. A research study by Geist, McCarthy, et al., discusses the benefits of MT and ST services practiced together in a co-treatment model. Music therapists are trained to use the therapeutic functions of music such as tempo, rhythm, key, texture, etcetera, to assist with communication skills in individuals with those particular needs. For example, using methods such as OMREX (oral, motor, and respiratory exercises) can be beneficial for the promotion of deep breathing, muscle control, and vocal suspension. Music can also assist with articulation by using songs with specific and repeated words, phrases, or sounds.

            In Geist’s (et al.) study, she created the requirements of one client who needed to be between the ages of two and twelve, had a communication impairment, and had parental consent to participate in the study. The client selected was four years of age and had participated in speech therapy services prior to the experiment. The speech therapist had been working on transitioning from bottle feeding, as well as expressing wants and needs. The client’s biggest need, which was assessed by both therapist’s after an initial assessment, was the need to communicate with other children and participate in the classroom. Before co-treatment with music therapy and speech therapy, the client had the comprehension and expression of a 9-to-12 month old child according to the Rossetti Infant Toddler Scale.

            The two therapists selected specific co-treatment interventions to address the client’s needs. For example, working on greetings through songs, using a voice output device to select instruments that he wanted to play, or using sound cues to work on sign language. After treatment, ten teachers watched a video of the client's pretreatment and post-treatment. Each agreed that the client had better class participation after treatment concluded.

            While speech and music therapy have different domains, they can be beneficial when used together to create faster and more long-term results in areas such as pitch, timbre, rhythm, duration, etcetera. By combining and adapting two types of therapy together, there is a better chance of improving client’s quality of life in an efficient and productive manner.

- Mallory McDonald, Music Therapy Intern

Resources

Geist, McCarthy, et al., (2008) Integrating music therapy services and speech-language therapy services for children with severe communication impairments: A co-treatment model. Journal of Instructional Psychology. 35(4), 311-316.

Tam, L. (2018, April 11). Music Therapy & Co-treatment: What does it look like?. Music Therapy Connections. https://musictherapyconnections.org/2018/04/music-therapy-co-treatment/

Speech-language therapy and music therapy collaboration: The DOS, the ... (n.d.). https://leader.pubs.asha.org/do/10.1044/speech-language-therapy-and-music-therapy-collaboration-the-dos-the-donts-and-the-why-nots/full/

Welcome Mallory!

Hi! My name is Mallory McDonald, and I am one of the new music therapy interns at Therabeat, Inc. For the next six months, I have been offered the privilege of working alongside exceptional therapists as well as clients, and I could not be more excited to begin this journey. This week consisted of a lot of observation of sessions, note taking, and friend making! I have had the time of my life thus far, and I am so thrilled to be able to finish my degree with In Harmony Pediatric Therapy.

Music therapy is an extremely special form of healthcare that utilizes the therapeutic functions of music to improve quality of life. I have always enjoyed music and have been involved in activities such as choir, musical theater, and singing lessons for as long as I can remember. I felt a little disheartened before attending college because I thought that I would have to set aside my passion for music to pursue a career. It was such a pleasant surprise when music therapy was introduced to me as an option. I had not heard of music therapy until my brother and sister were diagnosed with autism. Watching my sister receive treatment and meet goals was so special, and opened a door to discovering how the therapeutic functions of music can be used to meet an individual’s needs. I knew that I wanted to do the same for others and promote positive change in people’s lives.

My first week at Therabeat has just come and gone, and I am so giddy to wake up and come into the clinic every morning. Having the opportunity to observe successful music therapists treat clients has been incredible. I have met some of the most spectacular individuals, and have enjoyed every minute of making music with them. Some of my favorite moments of the week were observing other therapies including speech, physical, and occupational. It was so intriguing to see the different forms of treatment. Along with that, observing a co-treatment session with physical therapy was insightful, and allowed me to view how much progress can be made when therapists work together on a treatment plan. I have also enjoyed listening to the clients prepare for the recital in adaptive lessons. I can tell how hard these kiddos have worked on their songs, and can hardly wait to hear the finished product. I also had the opportunity to observe an evaluation/assessment using IMTAP.

Being at Therabeat this past week has already educated me on so much and has made me extremely excited to become a board certified music therapist. I am honored to be working with these individuals and making music with them for the next six months. I am so thrilled to be here and so excited to contribute to sessions in the weeks to come!

-Mallory McDonald, Music Therapy Intern

Welcome Lila!

Hello! My name is Lila Finke, and I just started my music therapy internship with Therabeat Inc. I am so honored and excited to work alongside the incredible staff of music therapists and other allied health professionals. I am from Roswell, Georgia, and am currently taking the final step to complete my Bachelor’s Degree in Music Therapy. My primary instrument is my voice, but I also play guitar, piano, ukulele, and percussion. My other hobbies consist of pickleball, art, hiking, yoga, being in nature, and spending time with friends and family.

When looking for a career, I knew that I was interested in music and serving others. Singing has always been a passion of mine, and I have been in choir and have taken music lessons from a young age. Before I knew about music therapy, I was considering pursuing a career as a child psychologist and minoring in music. When I was introduced to music therapy for the first time, I was blown away to hear that music interventions have the ability to do things such as help individuals relearn how to walk or talk. After observing a music therapist at a local hospital, I learned about the therapeutic functions of music and how music is used to treat the needs of the individual. I was so happy to discover that there was a career path that combined my interests and was able to help so many people.

I just finished my first week of internship, and I already feel that I have learned so much. The therapists have been so kind and helpful this past week as I have been observing their music therapy sessions with their clients. It has been so wonderful meeting clients, seeing their unique strengths, and building rapport with them this week. I was also able to observe some allied health professionals from In Harmony Pediatrics, such as several physical therapists and a speech and language therapist. Working at a clinic with other allied health professionals is such a great opportunity to work as a multidisciplinary team to benefit a client’s specific needs. I was able to observe a co-treatment session with a music and physical therapist. Even in one session, it was obvious that the combination of the therapies was extremely beneficial for this client.

This first week has been so educational and exciting! I am looking forward to continuing my education and growth as a music therapist at Therabeat Inc. for the next six months!

-Lila Finke, Music Therapy Intern

Music Therapy Impacting Patients with Alzheimer’s Disease & Dementia

Famous jazz vocalist Tony Bennett’s experience with Alzheimer’s disease while actively performing the lyrics and melodies of a multitude of songs is a glimpse into the impact of music on brain function throughout cognitive decline. Dementia and Alzheimer’s disease affect a large number of older adults every year globally. In 2022, approximately 6.5 million people 65 years and older in America will be diagnosed with Alzheimer’s dementia (Alzheimer’s Association, 2022). While memory impairment and cognitive decline are the primary symptoms, agitation, anxiety, depression, and paranoia are among some of the other symptoms that affect people with Alzheimer’s disease (Brotons & Pickett-Cooper, 1996). Music therapists can address various behavioral, emotional, and cognitive goals with these patients.

Many types of music therapy interventions have been found to be successful in treating different behaviors and symptoms present within this population. One important goal is improving cognition. Movement and instrument playing interventions were found to be effective in improving next-day cognition and were greatly preferred by clients over other types of music interventions (Bruer, et. al., 2007). When facilitated by a board-certified music therapist, these interventions are accessible and adaptable to all clients regardless of their prior musical training or lack thereof. The goal of improving cognition can be achieved through more specific Neurologic Music Therapy (NMT) techniques. NMT techniques are a subset of music therapy interventions requiring special training and qualifications, which are used primarily in rehabilitative goals and settings. Techniques such as Associative Music and Memory training and Musical Executive Function training engage the patients and assist them in reaching orientation and cognitive goals through music (Álvarez, 2022). These focused interventions utilize music improvisation, singing, discussion, and other methods to provide cognitive stimulation.

“Sundown Syndrome” is an even more specific phenomenon that can be addressed by music therapists working with geriatric populations. Sundown syndrome, or sundowning, is the colloquial term for a set of negative behaviors that arise for dementia patients in the late afternoon or evening. These behaviors can include “confusion, disorientation, anxiety, agitation, aggression, pacing, wandering, resistance to redirection, screaming, yelling and so forth” (Khachiyants, 2011, p. 275). Agitation reduction is an important emotional and behavioral goal addressed by music therapists. Interventions such as therapeutic singing, instrument playing, movement with music, musical games, and improvisation have all been found to be effective in reducing agitation (Brotons & Pickett-Cooper, 1996). One study noted comments from caregivers that claimed patients were “more cooperative and responsive” following music therapy sessions (Brotons & Pickett-Cooper, 1996, p. 14). This implies that strategically timed music therapy sessions facilitated by a board-certified music therapist can be beneficial to improving the patient’s symptoms while aiding the jobs of the caregivers of patients actively experiencing sundowning. 

In addition to agitation and anxiety, music therapists can address depression symptoms in patients with Alzheimer’s disease and dementia. Reminiscence-based music therapy interventions use strategic familiar song choices and focused questions to facilitate discussion about certain topics. These types of interventions provide patients “a safe place to interact socially, to share their memories with other residents, and to improve self-image” (Ashida, 2000, p. 180). This positive social interaction and discussion leads to a decrease of depression symptoms among patients. Music therapists have the ability to positively impact many goal areas with patients with Alzheimer’s disease and dementia. The use of research-based interventions can improve the overall quality of life for patients in a rapidly growing geriatric population.

-Tess Vreeland, Music Therapy Intern

References

Álvarez, L. (2022). Neurologic music therapy with a habilitative approach for older adults with dementia: A feasibility study. Music Therapy Perspectives, 40(1), 76–83. https://doi.org/10.1093/mtp/miab021 

Alzheimer's disease facts and figures. Alzheimer's Disease and Dementia. (2022). Retrieved October 17, 2022, from https://www.alz.org/alzheimers-dementia/facts-figures 

Ashida, S. (2000). The effect of reminiscence music therapy sessions on changes in depressive symptoms in elderly persons with dementia. Journal of Music Therapy, 37(3), 170–182. https://doi.org/10.1093/jmt/37.3.170 

Brotons, M., & Pickett-Cooper, P. K. (1996). The effects of music therapy intervention on agitation behaviors of alzheimer's disease patients. Journal of Music Therapy, 33(1), 2–18. https://doi.org/10.1093/jmt/33.1.2 

Bruer, R. A., Spitznagel, E., & Cloninger, C. R. (2007). The temporal limits of cognitive change from music therapy in elderly persons with dementia or dementia-like cognitive impairment: A randomized controlled trial. Journal of Music Therapy, 44(4), 308–328. https://doi.org/10.1093/jmt/44.4.308 

Khachiyants, N., Trinkle, D., Son, S. J., & Kim, K. Y. (2011). Sundown Syndrome in persons with dementia: An update. Psychiatry Investigation, 8(4), 275. https://doi.org/10.4306/pi.2011.8.4.275

The Benefits of Music Therapy for Children with Hearing Impairment

During human evolution, the auditory system was important for those who would gather or hunt for food in order to be aware of their surroundings, especially with the looming threat of predators (Posner, 1980). It was imperative that the hearing of these hunters and gatherers were perfectly balanced. With under-sensitive hearing they would not be aware of their surroundings, and over-sensitive hearing would create an improper response to auditory stimuli (Näätänen, 1992), such as a branch falling and the hunter thinking that they were being hunted by a predator. In addition to hearing being a warning system, the auditory system is important for verbal and gestural communication. While some sounds and gestures made by humans evolved into languages, others suggest that variations of these sounds created music and dance (Mithen et al., 2006). As researched by Patel (2010), the more one delves and explores language and music, the more we can exhibit the greater capabilities of the auditory system.

Music has been seen and proven to be a beneficial tool for brain development. Some benefits include an increase in auditory skills and neural structures (Hyde et al. 2009), sound perception, sound discrimination, attention allocation (Dittinger et al. 2017), verbal intelligence, phonological awareness (Tierney et al. 2015), and faster neuronal timing (White-Schwoch et al., 2013), to name a few. But what happens when a child develops a hearing impairment? Are they stripped of these benefits due to their reduced ability to hear the music that they are being treated with?

According to The Diagnostic Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013), hearing impairments can be one of many causes of language disorders, speech disorders, stuttering, Attention-Deficit/Hyperactivity Disorder, and Specific Learning Disorder, to name a few. Without speech therapy, music therapy, or the use of a cochlear implant, a child with a hearing impairment may not be able to acquire all the benefits otherwise attained by those with therapy and/or assistive devices. According to a collection of research compiled by Dr. Ritva Torppa and Dr. Minna Huotilainen (2019) of Helsinki University, 80% of studies in their article published in Hearing Research concluded that musical skills and perception, linked to speech patterns and sentence emphasis, have been further developed with musical interventions in children with hearing impairments. Other benefits of musical interventions include an increase in speech perception, language acquisition and skills, perception of sounds, auditory attention, and auditory working memory, which are important for learning and educational success. 

In addition to the compiled research, Torppa and Huotilainen (2019) created the following list of recommendations for those caring for individuals treating those with hearing impairments to make sure that they receive as many benefits from music as they can:

“1. Start using music systematically at an early age, before implantation or the application of hearing aids. Continue musical activities for more than one year, to improve speech perception.

2. Use bodily movements in the rhythm of the music. Use orientations.

3. Use singing as your main instrument, especially with a young child.

4. Engage children in musical activities in small groups; use several musical instruments and pictures/toys presenting lyrics.

5. Use plenty of repetition.

6. Use plenty of turn-taking.

7. Give advice to families on how to use music with their child.

8. Use computer games and apps to help the child perceive and produce sounds.

9. Give advice to school music teachers.

10. Support musical hobbies of teenagers with hearing impairments.”

-Jackson Arnold, Music Therapy Intern

Works Cited

Dittinger E, Chobert J, Ziegler JC and Besson M (2017) Fast Brain Plasticity during Word Learning in Musically-Trained Children. Front. Hum. Neurosci. 11:233. doi: 10.3389/fnhum.2017.00233

Hyde, K.L., Lerch, J., Norton, A., Forgeard, M., Winner, E., Evans, A.C., Schlaug, G., 2009. Musical training shapes structural brain development. J. Neurosci. 29, 3019-3025. https://doi.org/10.1523/JNEUROSCI.5118-08.2009.

Mithen, S., Morley, I., Wray, A., Tallerman, M., Gamble, C., 2006. The Singing Neanderthals: the Origins of Music, Language, Mind and Body, by Steven Mithen. Weidenfeld & Nicholson, London, 2005.

Näätänen, R. (2018). Attention and brain function. (Psychology library edition. Neuropsychology; Vol. 8). Routledge. https://doi.org/10.4324/9780429487354.

Patel, A.D., 2010. Music, Language, and the Brain. Oxford university press.

Posner, M.I., 1980. Orienting of attention. Q. J. Exp. Psychol. 32 (1), 3-25. https://doi.org/10.1080/00335558008248231.

Tierney, A., Krizman, J., Kraus, N., 2015. Music training alters the course of adolescent auditory development. Proc. Natl. Acad. Sci. U. S. A. 112, 10062-10067. https://doi.org/10.1073/pnas.1505114112.

Torppa, R., & Huotilainen, M. (2019). Why and how music can be used to rehabilitate and develop speech and language skills in hearing-impaired children. Hearing Research, 308, 108–122. https://doi.org/https://doi.org/10.1016/j.heares.2019.06.003

White-Schwoch, T., Carr, K.W., Anderson, S., Strait, D.L., Kraus, N., 2013. Older adults benefit from music training early in life: biological evidence for long-term training-driven plasticity. Journal of Neuroscience. 33 (45), 17667-17674. https://doi.org/ 10.1523/JNEUROSCI.2560-13.2013.