| Music Therapy is the unique application of music to enhance personal
lives by creating positive changes in human behavior. It is an allied
health profession utilizing music as a tool to encourage development
in social/ emotional, cognitive/learning, and perceptual-motor areas.
Music Therapy has a wide variety of functions with the exceptional
child, adolescent and adult in medical, institutional and educational
settings. Music is effective because it is a nonverbal form of communication,
it is a natural reinforcer, it is immediate in time and provides motivation
for practicing nonmusical skills. Most importantly, it is a successful
medium because almost everyone responds positively to at least some
kind of music. The training of a music therapist involves a full curriculum
of music classes, along with selected courses in psychology, special
education, and anatomy with specific core courses and field experiences
in music therapy. Following coursework, students complete a six-month
full time clinical internship and a written board certification exam.
Registered, board certified professionals must then maintain continuing
education credits or retake the exam to remain current in their practice.
Music Therapy is particularly useful with autistic children owing
in part to the nonverbal, non threatening nature of the medium.
Parallel music activities are designed to support the objectives
of the child as observed by the therapist or as indicated by a parent,
teacher or other professional. A music therapist might observe,
for instance, the child's need to socially interact with others.
Musical games like passing a ball back and forth to music or playing
sticks and cymbals with another person might be used to foster this
interaction. Eye contact might be encouraged with imitative clapping
games near the eyes or with activities which focus attention on
an instrument played near the face. Preferred music may be used
contingently for a wide variety of cooperative social behaviors
like sitting in a chair or staying with a group of other children
in a circle.
Music Therapy is particularly effective in the development and
remediation of speech. The severe deficit in communication observed
among autistic children includes expressive speech which may be
nonexistent or impersonal. Speech can range from complete mutism
to grunts, cries, explosive shrieks, guttural sounds, and humming.
There may be musically intoned vocalizations with some consonant-vowel
combinations, a sophisticated babbling interspersed with vaguely
recognizable word-like sounds, or a seemingly foreign sounding jargon.
Higher level autistic speech may involve echolalia, delayed echolalia
or pronominal reversal, while some children may progress to appropriate
phrases, sentences, and longer sentences with non expressive or
monotonic speech. Since autistic children are often mainstreamed
into music classes in the public schools, a music teacher may experience
the rewards of having an autistic child involved in music activities
while assisting with language.
It has been noted time and again that autistic children evidence
unusual sensitivities to music. Some have perfect pitch, while many
have been noted to play instruments with exceptional musicality.
Music therapists traditionally work with autistic children because
of this unusual responsiveness which is adaptable to non-music goals
Some children have unusual sensitivities only to certain sounds.
One boy, after playing a xylophone bar, would spontaneously sing
up the harmonic series from the fundamental pitch. Through careful
structuring, syllable sounds were paired with his singing of the
harmonics and the boy began incorporating consonant-vowel sounds
into his vocal play. Soon simple 2-3 note tunes were played on the
xylophone by the therapist who modeled more complex verbalizations,
and the child gradually began imitating them.
Since autistic children sometimes sing when they may not speak,
music therapists and music educators can work systematically on
speech through vocal music activities. In the music classroom, songs
with simple words, repetitive phrases, and even repetitive nonsense
syllables can assist the autistic child's language. Meaningful word
phrases and songs presented with visual and tactile cues can facilitate
this process even further. One six-year old echolalic child was
taught speech by having the therapist/teacher sing simple question/answer
phrases set to a familiar melody with full rhythmic and harmonic
accompaniment The child held the objects while singing:
Do you eat an apple? Yes, yes.
Do you eat an apple? Yes, yes.
Do you eat an apple? Yes, yes.
Yes, yes, yes.
and
Do you eat a pencil? No, no.
Do you eat a pencil? No, no.
Do you eat a pencil? No, no.
No, no, no.
Another autistic child learned noun and action verb phrases . A
large doll was manipulated by the therapist/teacher and a song presented:
This is a doll.
This is a doll.
The doll is jumping.
The doll is jumping.
This is a doll.
This is a doll.
Later, words were substituted for walking, sitting, sleeping, etc.
In these songs, the bold words were faded out gradually by the therapist/teacher.
Since each phrase was repeated, the child could use his echolalic
imitation to respond accurately. When the music was eliminated completely,
the child was able to verbalize the entire sentence in response
to the questions, "What is this?" and "What is the
doll doing?"
Other autistic children have learned entire meaningful responses
when both questions and answers were incorporated into a song. The
following phrases were sung with one child to the approximate tune
of Twinkle, Twinkle, Little Star and words were faded out gradually
in backward progression. While attention to environmental sounds
was the primary focus for this child, the song structure assisted
her in responding in a full, grammatically correct sentence:
Listen, listen, what do you hear? (sound played on tape)
I hear an ambulance.
(I hear a baby cry.)
(I hear my mother calling, etc.)
Autistic children have also made enormous strides in eliminating
their monotonic speech by singing songs composed to match the rhythm,
stress, flow and inflection of the sentence followed by a gradual
fading of the musical cues. Parents and teachers alike can assist
the child in remembering these prosodic features of speech by prompting
the child with the song. While composing specialized songs is time
consuming for the teacher with a classroom full of other children,
it should be remembered that the repertoire of elementary songs
are generally repetitive in nature. Even in higher level elementary
vocal method books, repetition of simple phrases is common. While
the words in such books may not seem critical for the autistic child's
survival at the moment, simply increasing the capacity to put words
together is a vitally important beginning for these children.
For those teachers whose time is limited to large groups, almost
all singing experiences are invaluable to the autistic child when
songs are presented slowly, clearly, and with careful focusing of
the child's attention to the ongoing activity. To hear an autistic
child leave a class quietly singing a song with all the words is
a pleasant occurrence. To hear the same child attempt to use these
words in conversation outside of the music class is to have made
a very special contribution to the language potential of this child.
For more information about music therapy, contact the National
Association for Music Therapy, 8455 Colesville Road, Suite 930,
Silver Spring, MD 20910, U.S.A.
Author
Myra J. Staum, Ph.D., RMT-BC
Director and Professor of Music Therapy
Willamette University, Salem, Oregon
Copyright Autism.org
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