Music Therapy and Children

Kathryn M. Medina DLSU Dasmarinas SPED 109

Objectives

To Identify Children Served by Music Therapy To Identify Uses of Music Therapy with Children in Medical and Educational Settings in the USA

Children Who Receive Music Therapy

Premature Infants Developmental Disabilities Learning Disabilities Behavior Disorders Communication Disorders Sensory Impairment Physical and Health Impairments Abused Children

Work Settings Demonstrating Growth in Employment for Music Therapists In the USA (2003)

Self Employment or Private Practice (Includes Services to Children) School (K - 12) Early Childhood Intervention Child and Adolescent Treatment Centers

Music Therapy

Use of music by a trained music therapist to: restore physical

maintain
improve

mental
health

Role of Music Therapy in the Cycle of Illness

Music therapy promotes coping skills and diminishes psychological symptoms to client ability.

Cycle of Illness - Hans Selye (1956)

Stress

Distress

Disease

Disorder

Disability

Clinical Research in Music Therapy (Standley, 2000)

Results of a meta-analysis of clinical studies in music therapy in English (l980 - 1999) 92 Studies 232 Variables - Effect Size ( r=3. 28 to - 1.53) Music condition sometimes more than 3 standard deviations greater in effect than the control condition (Standley, 2000, p. 9)

Music Effects

Live music by trained music therapist (ES = 1.13, n = 16) has a greater effect than recorded music Preferred music has the greatest effect (ES = 1.40, n = 30)
(Standley, 2000, p. 15)

Research in Music Therapy with Children

Children & adolescents (ES = .95, n = 26) respond to music with slightly greater effect than do adults (ES = .87, n = 158) The smallest effects for music were with newborns (ES, .48, n = 34)

(Standley, 2000, p. 9)

Music Therapy Approaches

Improvisational Music Stimulation & Enrichment Medical Medical Objectives

Educational Skill Development: in Nonmusic Domains

Improvisational Model

Paul Nordoff & Clive Robbins

Music Therapy Environments

Medical

Educational

Medical Music Therapy Newborns & Pediatrics

Jayne M. Standley, Ph.D Florida State University

Medical Music Therapy Hospitalized Newborns

Treatment by Physician Referral Established Music Therapy Practices and Hospital Protocol Observed Clinical Effects

Research in Music with Premature Infants Hospitalized in the Neonatal Intensive Care Unit (NICU)

11 studies 21 variables Music generally has a positive and significant effect in NICU: initial results were inconsistent (Standley, 2000, p. 19)

Music Therapy Objectives Hospitalized Newborns

Pacification for Growth & Development Enhanced Respiration (Reduced Oxygen Support) Non-Nutritive Sucking (Promotes Feeding) Parent Training & Counseling Promotion of Development (awareness, tracking & social reciprocity)

Music Therapy Intervention I

Sustained music, live or recorded, is provided to individual infants to: Facilitate growth, development, and learning Promote enhanced respiratory strength and reduction of stress
(Standley, 2003, p. 76-77)

Music Therapy Intervention II

Music to reinforce non-nutritive and nutritive sucking endurance and effectiveness (Standley, 2003, p.79-89)

Music Therapy Intervention III

Music and multimodal stimulation to facilitate neurological growth and development using a (prescribed) auditory, tactile, visual and vestibular stimulation sequence
(Standley, 2003, p. 89-94)

Music Therapy Intervention IV

Live, slightly stimulating music (sung) to the swaddled infant to facilitate alertness and response to people and the environment
(Standley, 2003, p. 94)

Music Therapy Intervention V

Parent counseling to: Facilitate parents comfort and relationship with their infant and his or her condition Promote parent trust of medical personnel and procedures
(Standley, 2003, p. 95)

Medical Music Therapy in Pediatrics

Pain Reduction
Communication of Distress Normalization of Environment Therapy Enhancement Family Counseling Stimulation
(Standley, 2003)

Music as a Focus of Attention During Distraction Conditions: A Study with Young Children Wolfe & Naguchi (2003)

75 Kindergarten Students: Public School Multicultural Sample Aged 5 to 5.5 years Randomly Assigned to 4 Groups

Music as a Focus of Attention During Distraction Conditions

4 Groups:

Spoken Story with No Distraction Spoken Story with Distraction Musical Story with No Distraction Musical Story with Distraction

(n = 17) (n = 18) (n = 17) (n = 20)

Treatment
Musical story/song was Little Squirrel CD recording of male voice with instrumental accompaniment (116 sec., 77-88 dB with headphones)

Spoken version of the story was recited at the same tempo as the musical verses and by male voice

Treatment

Visual aids for song and story were pictures of the actions and animals in the story

3 Distracter sounds presented were: Ambulance Siren People Talking Telephone Ringing

Treatment
Each child was told he would listen to a story about a squirrel that did many things The child was instructed to listen to the story and to point to pictures on a board illustrating what the squirrel did during the story Experimenter tabulated correct responses in at correct times in the story

Results (Wolfe & Naguchi 2003)

Children were more focused, engaged, and attentive during the musical story conditions, whether with or without distraction, compared to the spoken story conditions, whether with or without distraction Significant Results: Music was an effective focus of attention with or without distraction (F = 4.52, df = 3, p = .006)

Music Therapy in Education

School or Home Inclusion: Public School Special School Home Care Group or Individual Setting

Goals of Music Therapy in Education

Prevention & Early Intervention Remediation Compensation for Disability

Research in Music Children & Adolescents with Disabilities

(Jellison, 2000)

148 data based studies (1975 - 1999) Age range = 14 to 22 months Children & youth with disabilities Children & youth with disabilities Non-disabled children Compared or combined children:
Disabled and typical peers

(n = 101) (n = 101) (n = 14) (n = 33)

Disabilities in by Frequency in Research Literature

The most prevalent populations were developmental delay, learning disability, severe hearing impairment & emotional disorder The least prevalent populations were brain injury, severe visual impairment, attention deficit disorder, speech & language impairment & Rett Syndrome (Jellison, 2000, p. 231)

Nonmusic Outcomes

Music as a stimulus, cue or prompt for academic, motor, social & verbal behavior (n = 34) Music as a structured activity for academic, motor, social & verbal behavior & assessment (n = 51) Music as a behavioral contingency for academic, motor, social & verbal behavior (n = 25)

Music Outcomes

Music Discrimination Singing Listening & Music Preference General Participation Playing Instruments & Instrument Preference Movement Verbalizing (Jellison, 2000, p. 237)

(n = 17) (n = 15) (n = 18) (n = 16) (n = 17) (n = 4) (n = 4) (n = 4)

Trends in Music Research (Jellison, 2000)

Increase in Music Research with . . .

Very Young Children

Children with Attention Deficit Disorder and/or Hyperactivity

Children with Autism (Jellison, 2000 p. 243)

Remediation in Older Children

Child referral and music therapy assessment Goal is to minimize the effects of disability

Music used to engage child playfully and to teach skills

Helping Older Children to Live as Normally as Possible

Child referral and music therapy assessment Child participates in music, individually or with others, to promote independence and community

Music Therapy is a Viable Therapy for Children as It Is. . .

Cost effective An integrative treatment modality Protocol is grounded in research Treatment based on clinical assessment Play-like: Engaging for children Structured and flexible Adaptable to patients music preferences & experience Accountable for change in nonmusic skills Useful in group or individual settings

In Conclusion
Music therapy is an effective clinical intervention useful in the treatment for hospitalized infants and children with special medical and education needs.