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Music Therapy and Children

Music Therapy and Children. Peggy A. Codding Berklee College of Music Boston, Massachusetts. 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.

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Music Therapy and Children

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  1. Music Therapyand Children Peggy A. Codding Berklee College of Music Boston, Massachusetts

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

  3. Children Who Receive Music Therapy • Premature Infants • Developmental Disabilities • Learning Disabilities • Behavior Disorders • Communication Disorders • Sensory Impairment • Physical and Health Impairments • Abused Children

  4. 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

  5. Music Therapy Use of music by a trained music therapist to: restore physical maintain mental improve health

  6. Role of Music Therapy in the Cycle of Illness Music therapy promotes coping skills and diminishes psychological symptoms to client ability.

  7. Cycle of Illness - Hans Selye (1956) Stress Distress Disease Disorder Disability

  8. 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)

  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)

  10. 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)

  11. Music Therapy Approaches • Improvisational • Music Stimulation & Enrichment • Medical • Medical Objectives • Educational • Skill Development: in Nonmusic Domains

  12. Improvisational Model Paul Nordoff & Clive Robbins

  13. Music Therapy Environments • Medical • Educational

  14. Medical Music TherapyNewborns & Pediatrics Jayne M. Standley, Ph.D Florida State University

  15. Medical Music Therapy Hospitalized Newborns • Treatment by Physician Referral • Established Music Therapy Practices and Hospital Protocol • Observed Clinical Effects

  16. 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)

  17. 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)

  18. 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)

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

  20. 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)

  21. 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)

  22. 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)

  23. Medical Music Therapy in Pediatrics • Pain Reduction • Communication of Distress • Normalization of Environment • Therapy Enhancement • Family Counseling • Stimulation (Standley, 2003)

  24. Music as a Focus of Attention During Distraction Conditions: A Study with Young ChildrenWolfe & Naguchi (2003) • 75 Kindergarten Students: Public School • Multicultural Sample • Aged 5 to 5.5 years • Randomly Assigned to 4 Groups

  25. Music as a Focus of Attention During Distraction Conditions 4 Groups: • Spoken Story with No Distraction (n = 17) • Spoken Story with Distraction (n = 18) • Musical Story with No Distraction (n = 17) • Musical Story with Distraction (n = 20)

  26. 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

  27. 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

  28. 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

  29. 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)

  30. Music Therapy in Education School or Home • Inclusion: Public School • Special School • Home Care Group or Individual Setting

  31. Goals of Music Therapy in Education Prevention & Early Intervention Remediation Compensation for Disability

  32. 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 (n = 101) • Children & youth with disabilities (n = 101) • Non-disabled children (n = 14) • Compared or combined children: (n = 33) Disabled and typical peers

  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)

  34. 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)

  35. Music Outcomes • Music Discrimination (n = 17) • Singing (n = 15) • Listening & Music Preference (n = 18) • General Participation (n = 16) • Playing Instruments & (n = 17) • Instrument Preference (n = 4) • Movement (n = 4) • Verbalizing (n = 4) (Jellison, 2000, p. 237)

  36. 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)

  37. 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

  38. 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

  39. 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 patient’s music preferences & experience • Accountable for change in nonmusic skills • Useful in group or individual settings

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

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