Music Therapy with Mentally Challenged Persons
Reprinted with permission from CAMT, Wilfrid Laurier University
Because most people experience positive responses to music, music therapy has demonstrated its effectiveness with developmentally handicapped persons. The inherent qualities of music–melody, harmony, rhythm, timbre etc.–provide foundations, upon which tasks may be developed that support and foster improvements within a variety of goal areas. These areas might include social awareness and interaction, language and communication, attention span and following directions, academic and self-help skills, motor development and coordination, as well as visual and auditory perception skills. Persons with developmental handicaps can benefit from an musical experiences including learning to play various instruments, singing and/or vocalizing, improvising, songwriting, moving to music and music listening. Music therapy experiences can be adapted according to the capabilities and needs of the individual. Music therapy has also been used to help decrease maladaptive behaviours and reinforce positive behaviours. Studies have shown contingent music to be effective in reducing disruptive behaviours such as rumination and out-of-seat behaviours (Davis et al., 1983) and disruptive screaming and crying (Strawbridge et al., 1987), and in encouraging adaptive behaviours such as improving arithmetic performance (Miller, 1974) and increasing manual production tasks (Cotter, 1971). Background music has also been effective in ameliorating difficulties during therapeutic feedings (Ayres, 1987) and improving work production in a vocational/training environment (Groeneweg et al., 1988). Music therapy has been used with developmentally delayed persons of all ages from preschool to late adulthood. With young children, music therapy is often used to reinforce the child’s strengths and to improve areas that need development. During adolescence, music provides an outlet for self-expression, encourages self-awareness, fosters self-esteem and provides opportunities to further develop social interaction skills. In adulthood, music therapy continues to provide opportunities for the development of new skills and maintenance of previously acquired ones. Musical and instrumental considerations should reflect the client’s age, preference, capabilities and needs.
Music therapy sessions can be conducted individually, in small group settings, or in the classroom. Music therapy can provide an alternative approach when other therapies have been unsuccessful. When used therapeutically, music provides motivation for achievement and success within an atmosphere that is positive and rewarding to the individual.
For persons with developmental handicaps, music therapy can:
Increase language and communication skills
Music therapy can provide an avenue for the development of receptive and expressive, language and communication skills (Price, 1978). This can take place on both a verbal and non-verbal level. Instrumental improvisation can be used to stimulate and encourage pre-verbal language development by musically mirroring, supporting, guiding and extending any vocal sounds of the client. Selected listening experiences can enhance auditory discrimination and memory skills, important for the acquisition of language. Singing encourages breath control, development of inflection, and improved rate and clarity of speech. Vocabulary can be increased through providing opportunities within songs to learn and use new words. Non-verbally, music can be used as a means of communication within itself. Music therapy sessions can also encourage the acquisition and use of sign language and bliss symbolics by incorporating them into song material and into the entire session.
Help identify and appropriately express emotions
Music has the ability to represent emotions through sound. Anger and aggression, sadness and solitude, joyfulness, playfulness, and fear can all be embodied within music through the endless combinations of melody, harmony, consonance, dissonance, timbre, mode, and rhythm. Songs offer opportunities which can facilitate the identification of emotions. For example, an individual may be able to identify with specific lyrics, or with a mood portrayed through a song, which may provide a catalyst for discussion. The music therapist may also compose a song for the client to reflect how he or she may be feeling. The composition may reflect the client’s verbal responses or facial expressions and body movements. Alternatively, songwriting can also give the client an opportunity for verbal self-expression that is appropriate, structured and supported by the music. Instrumental improvisation can facilitate emotional expression non-verbally. The use of a variety of percussion instruments such as the bass drum, xylophone, bells, and maracas or wind instruments such as the harmonica, melodica, reed horn, and recorder may provide an outlet for feelings that clients may not be able to express in any other way. The therapist’s accompaniment can musically support and guide the client’s emotional expression.
Encourage adaptive responses and self-control
The diverse qualities inherent in music and the many ways it can be used make music therapy an excellent tool to promote increased flexibility and adaptability to new situations. Through providing a variety of experiences within the session, an individual’s repertoire of responses relating to self-expression, social interaction, and awareness of the environment can be expanded. By gradually adding new challenges within presented tasks, self-control and tolerance can be developed through a medium which is both enjoyable and rewarding to the individual.
Increase focused attention and attention span
The pleasurable and reinforcing qualities of music, as well as its orientation in time, make it an ideal tool for developing and maintaining focused attention and attention span. Tasks such as starting and stopping playing an instrument in response to the starting and stopping of the accompaniment, identifying sounds and instruments when listening, imitating rhythm patterns or movement sequences and following directions all encourage focused attention. Tasks can be gradually lengthened by bar, phrase, or song according to the person’s progress and capabilities.
Improve motor coordination skills
Eye-hand coordination, range of motion, and fine and gross motor skills can all be improved through the use of various music experiences (Burnett,1983). The use of varying sizes and shapes of instruments such as large, medium and small drums, single xylophone bars, or tiny wind chimes can encourage the acquisition of eye-hand coordination skills, especially when they are played with a mallet. Instruments can also be placed in strategic positions around the client to increase range of motion through purposeful reaching and beating movements. Other instruments, such as a keyboard, require fine motor dexterity and offer an enjoyable way in which to exercise this skill. Movement to the beat of the music, performing actions described in a song, dance and movement games can all encourage improved locomotor and non-locomotor movements. The provision of live music to accompany movements allows for increased flexibility and adaptability within the session. Live music is able to match the needs and capabilities of the client and encourage progress from that point.
Improve social awareness and social interaction skills
Because music has a universal appeal, it has a unique ability to bring people together within a shared positive, experience. In this manner, social awareness and social interaction skills can be developed and maintained. Awareness can be stimulated through encouraging eye contact, singing songs that require clients to name themselves or other group members, as well as through group singing and instrumental activities. Awareness can also be encouraged through watching and listening to other group members who may demonstrate movements, or perform on a solo instrument Social interaction can be encouraged through providing opportunities to- shake hands during greeting/parting songs and to initiate conversation. Cooperation can be encouraged through waiting and turn-taking opportunities, passing and sharing instruments and dual dependent activities.