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Reaching Children Through Music

Reaching Children Through Music: Addressing developmental disorders through music therapy

Katrina Todd, MT-BC, BCABA

Treating children with developmental disabilities has been, and continues to be, a challenging journey through a maze of theories, techniques and strategies. Families face a myriad services and programs that claim their effectiveness, but time is a precious commodity for a child who is already falling behind. The agenda for any child’s program is to strengthen his ability to relate, communicate and adapt to his environment, but the program should not stop there. It should also include educating and supporting families in their ability to relate and communicate with their child to promote healthy relationships and develop motivating learning environments.

Our society has identified “learning” as an academic driven curriculum of socially acceptable behavioral responses. We often forget the motivation and interest necessary for learning to occur. When a child focuses on his inability to adapt to the environment, he gives little attention to the social cues and complex forms of communication (e.g. words) needed to interact successfully with the general population. Because children’s deficits and strengths can vary, it is important to understand the underlying reasons for a child’s behaviors and the lacking requisite skills inhibiting that child’s success. Once therapists identify the child and family dynamics affecting behavior, they can begin an action plan.

The use of music in a multi-dimensional therapeutic program can incite positive change. As a social and communicative experience spanning millennia, people also find music motivating and relational. Children with developmental disabilities struggle relating to others and adapting to their environment, but therapist have found music reaches these children in ways no other therapy has.  The non-verbal cues and organization naturally occurring in music provides structure and safety, helping the child learn and grow.

As a music therapist, developing a program for the unpredictable nature of a child remains challenging. The music selection, instrument, or completion of activities does not matter. Instead, the therapist targets activities that develop skills for independence, communication, relating, problem-solving and accessing the environment functionally. To address a child’s individual needs effectively, it is important to be familiar with the different therapeutic disciplines and how collaborating with professionals within these disciplines is vital when forming an individualized and apt program.

Understanding the biological, neurological, behavioral and developmental strengths and deficits of the child is not a destination, but a journey. Each child comes in with a distinctive individual and family profile that determines and affects his skills. On assessment, it is important to identify not only what is developmentally suitable, but also family priorities. If the family does not internalize the goals or the targeted skills do not reflect their culture and beliefs, they seldom gain significant progress.

During the assessment period, the music therapist observes the child’s behaviors and analytically addresses the reason these behaviors occur. A child who screams and tantrums when presented with a puzzle may be expressing more than non-compliance; he may have praxis or regulatory deficits that inhibit his ability to remain seated, motor-planning the sequence and visually identifying where a piece goes. Teaching and providing opportunities to practice skills necessary for larger tasks, the child is more likely to feel naturally reinforced by his successful attempts.

Co-treatment plays a key part in successful therapy. If limited speech or motor skills are causing deficits in the child’s functional ability, it is important to seek out the right professional to ensure proper treatment. Working in a multidisciplinary clinic, I have found co-treatment essential when working with children and their families. A music therapist is trained to use and adapt music with therapeutic strategies, but consulting with speech, occupational, behavioral and psychological therapists provides increased effectiveness in developing the family’s program by identifying the core deficits that need to be addressed. Educating caregivers on how to relate to and teach their child will create a new way of life for the family rather than isolated experiences.

Once therapists develop skills, identify needs and understand a child and family’s strengths, treatment can begin. In a session, therapists use music as a motivator, prompt, communicator and regulatory tool. The therapist chooses and adapts live or recorded music to motivate, identifying music the child can relate to and in which he feels naturally inclined to participate. Therapists can harness novel music experiences to expand the child’s repertoire and provide further opportunities to practice functional skills, with the goal of using the selection to teach a non-musical skill. Music can then be used to prompt responses by incorporating exercises within the selection.

Throughout the session, the therapist observes the child’s affect and body language and validates stressful situations by creating music with an intensity that matches the child’s emotional state. This effectively engages the child in a meaningful interaction and can drive his ability to recognize emotions and ways to express appropriately (e.g. yelling “I’m mad!” versus hitting and scratching others). A child who feels understood is more likely to listen when provided suitable ways to express emotional states.

Music also supports regulation during moments of heightened emotion and conflict. Families often feel stressed seeing their child’s inability to cope, but music can prompt respiration and provide structure, masking the “loss of control” feeling. Having the family understand the normalcy of stress – especially in a learning environment – helps them remain calm and support their child during challenges. The goal of therapy is to engage positive experiences for the child while challenging with the right amount of intensity. This develops functional skills, which ultimately lead to anxiety provoking situations.

Anxiety is a physiological and psychological state that accompanies new experiences. Heightened arousal states are important for learning and if we constantly avoid anxiety (i.e. sticking with the same routine each day), we may never learn the skills needed to adapt successfully to changes in the environment. Using the example of driving: if each day you travel the same route with minimal variance in traffic, you drive unconsciously. Taking a new, less familiar route, you are more likely to experience a heightened, alert state to ensure you reach your destination. Children with developmental disabilities may feel safe engaging in repetitive routines or behaviors, but lack the skills necessary to cope when changes occur in the environment. If children avoid anxiety and do not join in new activities, learning constricts and they continuously face an overwhelmingly, changing world in which they cannot function.

Music can ease the anxiety of learning a new skill. Its non-verbal capacities provide validation as well as a means to communicate. Children with developmental disabilities typically have a harder time communicating verbally or through gestures at a speed appropriate to the moment. For example, when cut off in traffic, your immediate reaction may be to honk your horn and yell at the other driver. A child, who needs time to motor plan the act of pushing a button and lacks the oral motor capabilities to express frustration, may engage in aggressive hitting to express himself. Using instruments, the child can learn how to express with 1-step actions and non-verbal means.

Music is a flexible, encompassing, social medium created by humans to cope and communicate with the world and the people they meet. It provides structure, motivation, comfort, expression, art and an inter-personal experience across cultures. Music’s versatility naturally adapts to human development. It changes and relates as we continue to expose ourselves to new experiences. Children with developmental disabilities pose difficulties in relating and experiencing the world with ease as others do. Learning behaviors that may be maladaptive to the child’s environment address these challenges. This then decreases the child’s chances of experiencing success, learning new strategies, and developing pertinent cognitive skills. It eventually throws the child into a cycle: no success; no reinforcement from their environment, family and peers; limited development of new skills; poor self-esteem; limited risk taking; no success.

By understanding that children with disabilities have potential wholly contingent on the energy we use to understand their difficulties, we provide them the opportunity to flourish. It is when we fail to understand the child’s intentions that we begin to hinder natural development. Music therapy is a motivating therapeutic experience that uses the child’s strengths to develop skills needed to benefit from challenges. These challenges are what support the child’s development and ability to grow into an independent, functional human being.

Katrina is a board certified Music Therapist and Associate Behavior Analyst.

Published by TherapyTimes.com on 4/04/10: http://www.therapytimes.com/content=0602J84C487EB884408040441