Music therapy for children with disabilities and special needs

tour special needs family

All children can be helped to learn to enjoy and become involved in music to some extent.

Music therapy can be of inestimable value for children who have difficulties in hearing, seeing, moving, thinking or responding.

A single instrument can possess qualities of sound and tone irresistible enough to reach a child in a direct, uncomplicated manner.

Children who experience severe obstacles in forming relationships with other children, adults and their environment can achieve security and joy in making music.

By means of therapeutic music, we can assist these children to come to maturity in many ways. "Music confers non-musical benefits that have particular consequences for families with special needs.

A message from Mary - one of our website visitors: I am an adult with mild CP. I wanted to let you know that I've tried a LOT of things to make movement easier and one of the best has been music therapy. I am having good luck with a 2-CD set called Leave Your Sleep by Natalie Merchant. It is music about motherhood and childhood and it contains songs that are sad/introspective as well as ones that are upbeat and kind of whimsical. Because it's about childhood, it seems to be more emotionally moving than alot of other music. However it's not a " children's CD."

A lot of music performed specifically for children is too simplistic for many adults. You might want to check out her website,, which has samples of a lot of this music, to see if you think it would help other people with disabilities. I find that walking, etc. are a lot easier with music. I don't know Natalie Merchant or anyone related to or working for her; however I've been looking for effective music therapy resources for a long time.

Music contributes to: reasoning ability, reading skills, feelings and response, personal fulfillment, language development, the promotion of communication, motor control and physical well-being, positive attitudes to school, socializing and pleasurable experiences in a group

Therapeutic Characteristics of Music

•Music captivates and maintains attention
•Music stimulates and utilizes many parts of the brain
•Music is easily adapted to, and can be reflective of, a person's abilities
•Music structures time in a way that we can understand that's the last verse - my exercise session is almost over!)
•Music provides a meaningful, enjoyable context for repetition
•Music provides a social context -- it sets up a safe, structured setting for verbal and nonverbal communication
•Music is an effective memory aid
•Music supports and encourages movement
•Music taps into memories and emotions
•Music and the silences within it provide nonverbal, immediate feedback
•Music is success-oriented - people of all ability levels can participate

Music has been successful as a therapeutic intervention for children with disabilities. It has been used with persons, of all ages from preschool to late adulthood and with many types of disabilities whether congenital or adventitious. Music therapy may play an important role in developing, maintaining and/or restoring physical functioning.

Because music is reinforcing, it can be used to motivate movements or structure exercises which are prescribed in physical rehabilitation. Involvement in music may provide a distraction from the pain discomfort, and anxiety often associated with some physical disabilities.

Music therapy techniques

Music therapy techniques have been used to develop and maintain joint and muscle function or to increase fine and gross motor coordination and control, increase muscle strength, increase range of motion, improve cardiopulmonary and respiratory functioning, improve oral-motor skills, facilitate relaxation and controlled movement, as well as provide an outlet for emotional self-expression and provide opportunities for social interaction.

Musical experiences presented within a music therapy sessions can be effective in achieving a variety of physical, emotional and social goals relevant to the individuals needs capabilities and preferences.

Music therapy sessions incorporate the use of different musical media to achieve individualized treatment goals. Through movement to music and dance routines, movements may become more controlled, fluid and purposeful. Recorded or five background music may be used.

Live music offers increased flexibility and adaptability to match and guide physical movements elicited by the client. Musical instruments may be used to work on range of motion, handgrasp strength, and non-verbal self-expression. These instruments are often adapted to fit the specific physical capabilities of each client.

The use of computer-aided and electronic musical equipment also allows severely physically disabled clients to reach their fullest creative potential. The act of singing may assist in the maintenance and improvement of oral motor skills and pulmonary functioning. Singing provides opportunities to improve breath-control, rate of speech, articulation and pronunciation skills.

For some clients, listening to music may facilitate relaxation. Discussion of lyrics and songwriting may provide opportunities to discuss and share personal thoughts and experiences. Music therapy can increase an individual's level of independence, and enhance feelings of self-confidence, self-worth and self-esteem. Through participation in successful and enjoyable experiences, music therapy can assist these individuals in reaching their fullest potential.

For children with disabilities, music can:

1. Facilitate relaxation

Relaxation is an important component in achieving increased range of motion and flexibility. It is also important when working with persons who have difficulties with spasticity. Sedative music has been show to enhance EMG biofeedback relaxation training when compared to EMG biofeedback relaxation training alone for persons. with spastic cerebral palsy . Music experiences that can promote relaxation include listening to carefully chosen music, instrumental improvisation and music-assisted relaxation exercises. Improvised music can match and guide physiological responses (i.e., respiratory rhythm, pulmonary rhythms), toward achieving a more relaxed state. Although most people may find sedative music effective in achieving a relaxed state, this may not be true in all cases. The music therapist is able to recognize and monitor the effects of the presented music on the individual. and to adjust the music to ensure that the intended results are achieved.

2. Increase motor coordination

Motor coordination can be improved through many musical experiences. The use of selected instruments can improve range of motion as well as fine and gross motor skills through strategically, placing instruments around the individual or using instruments that require the use of specific muscle groups or, body parts. Eye hand coordination can also be improved through the use of instruments that require increased precision in physical motion. The use of rhythmic auditory stimuli has been shown to increase independent, even control of ambulation in individuals with uneven or arrhythmic gait patterns and to facilate temporal and quantitative muscular control in children with gross motor dysfunction.

3. Reinforce and provide motivation for physical exercise

The use of music in therapy provides a positive and enjoyable atmosphere for persons with physical disabilities to experience success. Carefully chosen background music can enhance regular physical exercise. Through providing live background music, adaptability and flexibility is maintained so that the music therapist can more easily match the individual's motions in tempo, style and rhythm. Music can help provide distraction and diversion from exercises that may be difficult for the individual, provide motivation to maintain participation and make a regular exercise routine seem less tedious.

4. Foster independence, self-confidence- and self-esteem

As physical abilities improve, and persons have increased opportunities to practice and acquire new skills and abilities, independence can be fostered and self-confidence and self-esteem enhanced. A positive self-image and self-concept can be developed through music therapy interventions and music therapy activities can be adapted according to the individual's needs and capabilities. This may involve adapting instruments or songs to make them more accessible and to ensure that the musical experience can be successful while continuing to provide challenges to the individual. Music therapy can help these individuals to develop positive attitudes toward their disabilities and provide opportunities for personal growth.

5. Develop functional speech and communication abilities

Singing and speech have many commonalities. The use of vocal exercises used in singing can enhance oral motor skills such as articulation, breath control, and vocal intensity. Through manipulating tempo and rhythm, clarity of speech can be enhanced and the rate of speech can be modified to provide increased communication abilities for the individual. Rhythmic training has also been shown to be effective in the treatment of aphasia. Melodic intonation therapy involves the sung intonation of propositional sentences in such a way that the intoned pattern is similar to the natural prosodic pattern of a sentence when it is spoken. This technique has been shown to be effective in improving word-morpheme performance levels, sentence lengths, articulation skills and intelligibility for language delayed apraxic children and has been an effective treatment for some persons with severe aphasia . Music has also been effective as a stimulus to promote spontaneous speech with physically challenged children and to promote non-verbal communication through bliss symbols or sign language.

6. Motivate interaction with others

Persons with physical disabilities may encounter decreased opportunities and motivation for social interaction. Music therapy can provide opportunities to interact with peers through a shared experience. Group ensembles provide opportunities to develop peer relationships, develop social interaction skills and provide opportunities for cooperation and working together as a group toward a common goal. Group music therapy sessions can also provide opportunities to share personal experiences with others and provide a means and an outlet for appropriate self-expression.

Music therapy and children with autism

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 often noted 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.

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.

The profession of Music Therapy

Music Therapy is an allied health profession and is the prescribed use, by a qualified music therapist, of music, music-related activities, and the relationships that develop through shared musical experiences to support positive changes in a person's physical, cognitive, communication, social, or emotional state.

Music therapists work towards a number of non-musical goals including improving communication skills, decreasing inappropriate behavior, improving academic and motor skills, increasing attention span, strengthening social and leisure skills, pain management and stress reduction.

Music therapy can also help individuals on their journey of self-growth and understanding. Music is effective because it is a nonverbal form of communication, it is a natural reinforcer, it is immediate in time, provides motivation for practicing nonmusical skills, and is successful because almost everyone responds positively to at least some kind of music. Music therapists work in a variety of settings, including medicine, rehabilitation, psychiatric care, special education, correctional facilities, state schools, community-based health care, and private practice. Music therapists draw from an extensive array of music activities and interventions. For example, the therapist and client might compose songs for the purpose of expression of feelings; one client might learn to play the piano for the purpose of improving fine motor skills, while another client might use instruments to improvise unspoken emotions. Music therapists may also use music and movement activities, singing, lyric discussion or music and imagery (including the Bonny Method of Guided Imagery and Music) to help the client reach their goals.

Music therapists work with a wide variety of people including the mentally ill, the physically handicapped, those who have been abused, the elderly including those suffering from Alzheimer's and dementia, the terminally ill, the mentally retarded and the developmentally delayed, the traumatically brain injured, those with learning disabilities, the exceptional child, adolescent and adult, as well as those persons who do not suffer from a clinical diagnosis.

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.

For more information: An Introduction To Music Therapy: Theory and Practice by William B. Davis, Kate E. Gfeller, and Michael H. Thaut, music therapist

For more information about music therapy, Reach the
American Music Therapy Association
8455 Colesville Road, Suite 1000
Silver Spring, Maryland 20910, USA
Phone: (301) 589-3300
Fax: (301) 589-5175
References: Myra J. Staum, Ph.D., RMT-BC
Director and Professor of Music Therapy
Willamette University, Salem, Oregon

We encourage you to visit Instruments and Products for Music Education and Therapy at A Day's Work

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