Music and Speech

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Music and Speech

Music as an effective tool for improving speech in children with ASD

One of the things that I have really enjoyed about my internship thus far, is having the opportunity to observe other therapies as well. I love that clients and families can come into one building for a convenient one-stop shop and receive occupational, physical, speech and music therapy. It has been really special to witness co-treatments where there are multiple therapists with varying skills working together to help each client make improvements. It also makes me excited for my friends who are also pursuing careers in related therapies and the possibility of us being able to learn from each other in the future. 

During my internship, I have noticed that a lot of our clients have difficulties with speech. Speech problems are common in many of our clients’ diagnoses, but are regarded as one of the most significant deficits in autism spectrum disorder. Atypical speech features that are prevalent in children with autism are unusual word choice, pronoun reversal, echolalia, incoherent discourse, unresponsiveness to questions, aberrant prosody and lack of drive to communicate. Not only is this frustrating to family members and friends, but it can be particularly irritating for the client, especially when they want something but cannot express exactly what it is that they want verbally. 

This particular research study examined the use of DLSM (Developmental Speech and Language Training Through Music) to address the acquisition of target words in 50 children (ages 3-5) with ASD. There were 3 groups involved: speech training group, music training group and a no training group. For the speech training group, a female student was videotaped reading a story that included the 36 target words and pictures for each word. For the music training group, the same female student was videotaped singing 6 songs that included the same 36 target words and pictures for each word. The same posttest was administered individually to participants in all conditions and all of the posttests were videotaped. 

In the results of this study, low functioning participants showed a greater improvement after the music training than the speech training and high functioning participants produced positive changes in verbal production in response to both music and speech training conditions equally. These findings suggest that music provides more predictable temporal patterns than speech does, making it easier to perceive by low-functioning children with ASD. This result indicates that children with ASD are able to transform the information perceived within musical patterns into speech patterns. This suggests that children with ASD have a certain degree of intact perceptual association between music and speech and supports that there is a close integrating relationship between music and language in early childhood development. 

“Children with ASD perceive important linguistic information embedded in music stimuli organized by principles of pattern perception and produce the functional speech.”

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Enjoying the Journey as an Intern

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Enjoying the Journey as an Intern

It’s incredible to think that I am already three weeks into my internship here at Therabeat Inc! I know without a doubt, I could not do it without the constant encouragement and support from all of the music therapists at In Harmony Pediatrics. Even though it has only been three weeks, I am overwhelmed with learning new techniques, reading new material, and ideas that can make music therapy sessions the best they can be. I am encouraged to branch out of my comfort zone to meet the needs and the variety of abilities that come to Therabeat. I am so thankful that I have had the opportunity to get to know clients and their families as well. As I talked to one parent earlier this week about how much fun we had today in music therapy, she remarked,

        “This is truly the happiest place on earth.                                                   Everyone here has so much joy.”

I am blessed to say that I thoroughly enjoy every minute of meeting the needs of these wonderful children and watching them grow. I am excited to learn and grow as well here at Therabeat. I cannot wait to see what is in store in the months to come!

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Hope with a dash of faith...

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Hope with a dash of faith...

Hope Is a belief in a positive outcome related to events and circumstances in one's life. Hope is the feeling that what is wanted can be had or that events will turn out for the best. Faith Is seeing light with your heart when all your eyes see is darkness.

Can you have hope without faith? I would image it all depends on who you ask, but I know for me personally they work in tandem. I have faith, therefore I have hope. I have faith my boys will live up to their fullest potential, whatever that may be... it is God's plan. While I don't have a crystal ball to see into the future,  I can envision what I want for them in the days to come.  So I choose to have hope and faith it will happen. I just have to trust that my faith will guide me on the right path, keep my hope alive, and make the conscience choice to believe everyday that we will get there. 
One day at a time......

THERE WAS A TIME WHEN THE WORDS HOPE AND FAITH WERE NOT USED WITH ANY FREQUENCY IN MY HOME.  BEFORE KIDS, SURE....OH THE GRAND PLANS. HOWEVER OUR HOUSE OF CARDS QUICKLY CAME FALLING DOWN AND LIFE AS WE KNEW IT CAME TO AN ABRUPT HEART WRENCHING HALT. OUR BEAUTIFUL,  PERFECT LITTLE BOY WAS DIAGNOSED WITH AUTISM JUST SHY OF HIS SECOND BIRTHDAY.  IT WAS A SWIFT KICK IN THE GUT THAT LITERALLY TOOK MY BREATH AWAY. 

NEXT CAME THE PARALYZING FEAR. NOT THE KIND OF FEAR THAT PASSES QUICKLY AFTER GATHERING YOUR WITS, BUT THE KIND THAT TAKES HOLD SO DEEP, IT PULLS YOU UNDER LIKE A TIDAL WAVE. THE UNMITIGATED FEAR AND PANIC THAT SET IN, NOT ONLY SHOOK MY FAITH BUT IT HAD ME WONDERING HOW I COULD EVER RECOVER ENOUGH TO EVER GET BACK TO THE SURFACE TO EVEN CATCH ONE SINGLE DEEP, LUNG FILLING BREATH. YET THE HARDER MY ARMS FLAILED, AND THE STRONGER I FOUGHT AGAINST IT, THE AUTISM TIDAL WAVE PUSHED ME BACK DOWN WITH A MIGHTY, MIGHTY FORCE. ENTER THE UGLY CRY.....

SO I HAD A CHOICE TO MAKE. DO I KEEP FIGHTING AGAINST IT, OR DO I LEAN INTO IT AND EMBRACE THE AMAZING? I HAD TO ACT FAST OR I WOULD WITHOUT A DOUBT DROWN IN A SEA OF "WHY ME'S" AND FLOAT AWAY ON THE RIVER OF SELF PITY. SINCE THAT WAS NOT AN OPTION IT WAS TIME TO FIGURE OUT  HOW TO OVERCOME THE FEAR, ADJUST MY LENS OF LIFE AND LEARN HOW TO LEAN INTO IT.  ONCE I CAME TO THE REALIZATION I WAS NOT CONCEDING , I WAS ABLE TO CATCH MY FIRST REAL BREATH IN A STAGGERINGLY LONG TIME. I WAS OPENING THE DOOR TO SOME AMAZING OPPORTUNITIES AND EXPERIENCES THAT I  MIGHT NOT EVER EVEN HAVE KNOWN WERE POSSIBLE.  SO I CHOSE TO NOT LET FEAR RULE MY LIFE.  EVERY PARENT WORRIES ABOUT THE FUTURE OF THEIR CHILD. THAT IS A CENTRAL STRUGGLE WE ALL FACE AS PARENTS, AND MUST LEARN TO BALANCE SO THAT OUR FEARS DO NOT OVERSHADOW OUR HOPES FOR THEM TO BE AMAZING HUMANS.

JUST WHEN YOU THINK YOU HAVE IT ALL UNDER CONTROL, AS WE OFTEN DO...YOU ARE THROWN ANOTHER CURVE BALL. IT WAS NOT WITHOUT WARNING THOUGH. I HAD MY EYES ON THE FEET OF AUTISM AND WAS NOT GOING TO BE FOOLED BY A LAZY NO-LOOK FAKE PASS. WE WERE FACING IT HEAD-ON, EYES WIDE OPEN. YET, EVEN THOUGH I SAW IT COMING NOT SIX MONTHS AFTER OUR SECOND ONE WAS BORN, THE BLOW WAS JUST AS FURIOUS, AND IT STILL TOOK MY BREATH AWAY. AUTISM....THERE IT WAS AGAIN. REARING ITS UGLY, STIMMY, NOISE FEARING, PERSONALITY STEALING SELF AGAIN. LEAVING BOTH OF MY CHILDREN WITHOUT VOICES AND TRAPPING THEM IN A ROOM WITH SHATTERPROOF WALLS THAT I COULD NOT BREAK. I FELT HELPLESS, BUT WAS I REALLY? 

SO I WAS FACED WITH THE CHOICE AGAIN...FIGHT IT OR LEAN INTO IT?  I CHOSE FAITH AND HOPE. THE CHOICE WAS CLEAR, NOT EASIER BY ANY STRETCH,  JUST OVERWHELMINGLY CRYSTAL CLEAR. IN MY 40 PLUS YEARS OF LIFE I HAVE MADE AN ABUNDANCE OF  MISTAKES, AND STILL DO EVERY DAY. TO ERR IS HUMAN, TO LEARN AND GROW FROM THE MISTAKES IS WHAT MAKES US STRONGER. WITH THAT SAID I CAN WITHOUT A DOUBT STATE THAT WHEN FACED WITH THE SOME OF THE DARKEST DAYS IN MY LIFE, I AM SO THANKFUL THAT I DID NOT MAKE THE MISTAKE OF FIGHTING THE TIDAL WAVE, BUT CHOSE TO LEAN INTO IT AND EMBRACE THE AMAZING.  MY LIFE IS PROFOUNDLY RICHER, THREADED WITH BEAUTIFUL COLOR, AND AN APPRECIATION FOR THINGS THAT I MIGHT OTHERWISE HAVE TAKEN FOR GRANTED. ALL BECAUSE OF TWO LITTLE BOYS THAT FORCED ME TO ADJUST MY LENS OF LIFE AND SEE THE AMAZING!

THERE WAS A DAY I WONDERED IF I WOULD EVER HEAR THEM SAY "I LOVE YOU MOMMY," OR ENGAGE WITH ME IN ANY RECIPROCAL MANNER. AUTISM OFTEN STEALS THAT FROM THEIR PARENTS AND LOVED ONES. SO IT IS REASONABLE TO FEAR THE WORST AND LET YOUR LENS OF LIFE FOG UP SO MUCH YOU ARE TRULY UNABLE TO SEE WHERE THEY WILL BE IN 6 MONTHS, 2 YEARS, 5 YEARS AND SO ON. FEAR IS BLINDING AND PARALYZING. YET IT IS A COMMON THREAD THAT WE AS PARENTS SHARE AND EXPERIENCE ON DIFFERENT LEVELS AS OUR CHILDREN GROW.

FAST FORWARD 12 YEARS, COUNTLESS HOURS OF THERAPY (WHICH THEY ARE STILL IN NOW), LOSS OF SLEEP ON MY PART AND A FEW FRIENDS WHO FADED AWAY BECAUSE THEY NEVER REALLY UNDERSTOOD (FEAR OF THE UNKNOWN WILL DO THAT) WE ARE HERE. WHERE IS HERE, YOU ASK?  WELL FOR NOW MY OLDER SON IS PERFORMING IN PLAYS, SINGING IN CHURCH IN FRONT OF LARGE AUDIENCES, AND PARTICIPATING IN TALENT SHOWS AT SCHOOL WITHOUT FEAR. I DON'T KNOW MANY ADULTS THAT COULD MANAGE ALL THAT WITHOUT HEART-RACING TREPIDATION. HE ON OTHER HAND DOES NOT SEE THAT AS A LIMITATION, BECAUSE WE CHOSE TO NEVER SET LIMITS EVEN THOUGH BY AND LARGE THE COLLECTIVE SOCIETY FEELS OTHERWISE. THEY EXPECT LESS, THEREFORE BY DEFAULT ASSUME THERE IS A CEILING. HOWEVER, WE TAKE THE TACT THAT "THE SKY IS THE LIMIT" AND IMAGINATION SHOULD NOT BE STIFLED BY BOUNDARIES. HIS HEART IS PURE AND HIS LIGHT IS INFECTIOUS. MY YOUNGER ONE WHILE STILL MORE PROFOUNDLY AFFECTED BY AUTISM, IS CONTINUALLY SURPASSING ALL OF OUR EXPECTATIONS. HE IS LOVING, CARING AND SMARTER THAN MEETS THE EYE.  HE TAKES ON LIFE NINJA STYLE, AT HIS OWN PACE, ON HIS OWN TIMELINE.  SLOW AND STEADY IS JUST AS AMAZING. HE CONSTANTLY BLOWS US AWAY AT ALL THE KNOWLEDGE HE HAS STORED AWAY.  IN TRUE NINJA FASHION WHEN HE UNLEASHES HIS KNOWLEDGE NUGGETS ON THE UNSUSPECTING, THEY ARE LITERALLY BLOWN AWAY.  AS MUCH AS WE THINK HE KNOWS, WE STILL NEVER SEE IT COMING......EVER!   

SO TO ALL THE MOMS AND DADS JUST TOSSED ON THE MERRY-GO-ROUND, ATTEMPTING TO NAVIGATE THE UNEXPECTED JOURNEY WITHOUT A MAP AND COMPASS, I URGE YOU TO HAVE HOPE.  HOPE PUTS OUR FEET ON THE PATH WHEN OUR EYES CANNOT SEE IT AND WITH A DASH OF FAITH YOU HAVE THE COURAGE TO CONTINUE MOVING TOWARDS THE UNKNOWN.  I PROMISE YOU THIS, YOU WILL MEET SOME AMAZING PEOPLE ALONG THE WAY. TEACH YOUR KIDDOS TO DREAM BIG AND DO NOT LET FEAR RULE YOUR JOURNEY.  RATHER ADJUST YOUR LENS ON LIFE,  NEVER SET LIMITS ON WHAT YOU THINK THEY CAN ACHIEVE,  AND WITHOUT A SHRED OF DOUBT, I PROMISE YOU WILL BE AMAZED AT THE PROGRESS THEY MAKE. WHERE YOUR "HERE" IS TWO, THREE, FIVE YEARS FROM NOW WILL NOT RESEMBLE YOUR NOW.

HOPE WITH A DASH OF FAITH.....BRINGS ENDLESS POSSIBILITY.  

 

 

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Internship Reflections: Intervention Implementation Week

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Internship Reflections: Intervention Implementation Week

I am in the middle of Week 3 of my internship and I feel like I have already learned so much! These past few weeks have been very enlightening for me. I have really enjoyed getting to meet the clients and families here, along with the entire team at In Harmony Pediatrics. Everyone is so welcoming and it is evident that there is a spirit of joy and determination in this facility.

As I look back on my first few weeks as an intern, I feel so blessed and thankful to have been chosen to be a small part of what is happening here at Therabeat, Inc. Each therapist inspires me with their creativity and resourcefulness. It is such a positive and fun environment that I don’t ever feel like I am actually working when I am planning, creating visuals, and doing interventions.

This week, I began implementing interventions with each client that I see during the week. One of the clients that I see has difficulty creating a complete sentence. When she wants something, she typically just points to an object and vocalizes using a non-specific word approximation. I decided to make it an objective for her to say in a full sentence what she wants in each session. I created a song called, “What do you want?” where she has to put images of the things that she wants on a poster and then sing it in a complete sentence. During the session, whenever she wanted something, I would have her sing it to me like we did in the song. I am hoping that she will be able to demonstrate generalization of this goal by saying what she wants in a complete sentence each time. I

love these kids already and cannot wait to watch them grow and develop for the next six months. I am so happy to be on this journey to becoming a board certified music therapist and can’t wait to see what the rest of my internship holds!

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Musically Adapted Social Stories Modify Behaviors in Students with Autism

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     One of the first things that I noticed when I began my internship last week is that many of these children have specific behavioral goals that they are working on. In one of the sessions last week, I learned that one client is getting ready to go to a new school. In order to prepare him for new social situations, one of the therapists helped him create a social story on an app called “Story Creator”. I was so intrigued by this technological tool that I decided to do some research on the effectiveness of musical social stories. Although this research does not specifically study the effectiveness of iPad apps, it focuses on how creating social stories and singing them with children who have autism can assist in reinforcing positive behavior so that they will be prepared for every social situation.

Research

Brownell, Mike D. (2002). Musically adapted social stories to modify behaviors in students with      autism: four case studies. Journal Of Music Therapy, 39 (2), 117-144.

     Social stories are a means of incorporating an individual with autism’s propensity toward visual learning with educationally necessary behavior modifications. In this study, a unique social story that addressed a current behavioral goal was created for 4 first- and second-grade students with autism. Original music was composed using the text of the social story as lyrics. The independent variable included three treatment conditions: baseline (A); reading the story (B); and singing the story (C). The dependent variable was the frequency with which the target behavior occurred under each condition of the independent variable. Data were collected as frequency tallies of the targeted behavior exhibited by the student, or responses to these behaviors made by teachers. The conclusion was that both the reading (B) and singing (C) of the created social story were significantly more effective in reducing the target behavior than the no-contact control condition (A). The singing condition was significantly more effective than the reading condition in Case Study III. The results of this study suggest that the use of a musically adapted version of social stories is an effective and viable treatment option for modifying behaviors with this population.

Here are some apps that you can use with your child to create stories that focus on specific behavioral goals.

Apps:

Social Stories

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