The rationale for this is an attempt to develop

a population-based music therapy assessment and treatment intervention that focuses on

establishing and achieving musical goals in relation to social-emotional development in children

with neurodevelopmental disorders that affect relating and communicating, specifically autism

spectrum disorders. To that end, assessment and conceptualizing the child to determine

intervention planning includes both DIR® and NRMT.

Clinical setting

The DIR® model, developed by Drs. Greenspan and Weider (Greenspan & Weider,

2006b), provides a comprehensive framework for assessing and treating the child. It centers on

facilitating foundational components of child development in the areas of relating,

communicating, and thinking through the development of relationships via interactive play -

Floortime™

Developmental milestones include six levels of emotional development;

Regulation and shared attention

Engagement and relatedness

Two-way purposeful communication

Shared problem solving

Creative use of ideas

Building bridges between ideas

Floortime- is a systematic way of using play to help the child to develop.

In NRMT(Nordoff-Robbins Music Therapy) , the therapist (music maker) observes the child and follows
his/her lead using

music as the primary medium. The music being improvised attempts to create affective and

emotionally charged experiences intended to help the child regulate, musically engage and

interact in a joint musical relationship

Differences between Floortime and NRMT; Medium – NRMT primarily involves the use of live ineractive
musical experiences while floortime primarily involves the use of objects and symbolic and sensory toys.

Therapist’s primary concern is to develop and incorporate musical interventions that deepen the child’s
musical engagement and interaction in order to increase relatedness and communication

Music Therapy Assessment of the child

Seven areas of musical responsiveness ;

Musical Awareness: The child’s ability to respond or react in a reflexive or intentional

manner related to any of the musical elements being offered.

2) Musical Relatedness: The child’s ability to engage musically in an intentionally and

related manner to the therapist’s music.

3) Relationship within Musical Play: The child’s ability to display an emotional interest in

connecting with the music and therapist, based on his/her (child’s) own initiative.

4) Music Interresponsiveness: The child’s ability to imitate or copy a musical idea, and then

incorporate it into musical play with the therapist.

5) Musical Communicativeness: The child’s ability to open (initiate a musical idea) and

close circles of musical communication (end or complete a musical phrase) during

musical play, including the ability to engage in call-and-response interplay and causeand-effect based
play.

6) Musical Interrelatedness: The child’s ability to connect his/her musical idea with the

therapist’s idea, and then elaborate on it during musical play.

7) Musical Expressiveness: The child’s ability to play musically using range of musical

elements (e.g. dynamics, tempo, etc.).

25 sessions over a five month period. Subject passed through four separate stages
“ In the first stage, he exhibited self regulatory challenges which impeded his ability to enter and remain
in the music room and to

engage and relate during musical play. In the second stage, in providing Matthew with sensory

input to facilitate self-regulation, he began to increase his ability to engage and relate during

musical play. During stage three, a relationship (interpersonal and musical) began to develop as

Matthew began to open (initiate) and close circles of musical communication during musical

play. Finally, in stage four, Matthew’s ability to engage in intentional and reciprocal musical

interactions, while displaying causal thinking during musical play, began to develop.”

Stage Two: Integrating Matthew’s sensory and musical profiles

Incorporated a rolling chair in order to provide him with vestibular input.

Shut off rear room lights to cater to hypersensitivity to light

Play-Doh in case he required tactile input

Paid close attention to the register, dynamics, and chord voicing’s of music

“After 15 minutes of trying to coax Matthew into the room, Jean (intern) began to gently

spin him in the chair. As Matthew was slowly spinning outside the music room, I accompanied

him on the piano. In so doing, I created a repeated three-note melodic sequence (triplets) that

matched his circular movements. As the music continued to play, Matthew stood up from the

chair and began to pirouette into the room. This would be the first time that he entered the

room on his own initiative, exhibiting self-regulation, musical awareness, and engagement”

Musical communication:

Improvising on the guitar using the tempo of the child’s rocking motion in the chair.

Child acknowledged the connection between music and rocking

Several minutes of this back in forth musical interaction

Two-way musical communication

Integrating and synchronizing multiple sensory stimuli (Vestibular, tactile, proprioceptive, visual,
and auditory)

Music became the vehicle for communication, also the medium that converted his isolated sensory
motor play into joint musical interactions.