Course:KIN366/ConceptLibrary/MusicTherapy

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Movement Experiences for Children
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KIN 366
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Instructor: Dr. Shannon S.D. Bredin
Email: shannon.bredin@ubc.ca
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Music therapy is an alternative solution compared to conventional behaviour therapy, which has shown many positive outcomes. With scientific evidence, this therapeutic method has been proven to help children with brain trauma and other cognitive disorders. Treatment on children with autism spectrum disorder has resulted in improvements in coordination, attention, speech, and creating movement patterns (Croke, 1989). It is also helpful at promoting memory for seniors with Alzheimer’s. There are many different techniques on administering this therapy. With this, most treatment programs are individualized and are created by an accredited professional music therapist. Music therapy is becoming more widespread as parents and clinical populations learn about the treatment results. The benefits of music can improve social, mental and emotional aspects of child development (LaGasse, 2014).

Music Therapy

Music therapy is defined as an evidence-based intervention provided by professionals from an accredited music therapy program. This therapeutic practice is classified under complementary and alternative health care. Music is the organization of sound and rhythm that forms recognizable auditory patterns (Morehouse, 2012). This mode of therapy is used to improve and maintain quality of life through many domains: motor skills, mental, social, and emotional health. The goal is to create a relationship with the client through music and promote emotional and physiological healing. This connection is based on verbal and non-verbal communication through music activities, both instrumental and vocal. Music therapists, similar to other health care clinicians, perform client assessments in order to develop treatment plans and monitor recovery and progress. With this, Music therapists can work alongside other health professional in an interdisciplinary teams in private sectors, the general public and as consultants for other professionals (Canadian Association for Music Therapy [CAMT], 2012)

Intervention Techniques

Singing

Singing is a method that develops articulation, rhythm and breathing. Singing with others can promote social skills for that child. It can also stimulate more oxygen intake and help with language centers in the brain (CAMT, 2012).

Playing

Playing musical instruments improves fine motor skills and can help regain coordination for children with a neurophysiological (brain and body) disability. It can also enhance cooperation, attention and build self-esteem, if it is their first time playing an instrument. It can give students a sense of accomplishment and pleasure (CAMT, 2012).

Rhythmic

Rhythmic activities can increase range of motion, agility, strength, balance, and gait consistency. The beats in music can activate motor areas in brain and synchronize with the autonomic nervous system; this system is responsible for breathing and heart rate (CAMT, 2012).

Improvising

Improvising allows the client to have the freedom to express themselves through music. This method is non-judgmental, easy and does not require previous music knowledge. Improvising usually occurs without verbal communication as the music therapist can interpret the art form of music. It is about creating a safe environment for the person or child while building a relationship. When words cannot express emotion, music can fulfill this role (CAMT, 2012).

Composing / Song writing

With hospitalized children, writing songs is another way of expressing their emotions. It is an opportunity talk about theirs fears with regards to life and death. The lyrics can be a medium for memories, stories, future aspirations or other topics of their choosing (CAMT, 2012).

Imagery

Patients envision positive scenarios while listening to music. It is also an opportunity to reflect upon unconscious and conscious thoughts that are emerging in throughout this experience. Painting, movement, and other forms of art can be combined with music to facilitate with imagery (CAMT, 2012).

Listening

Listening to music is universal and can be appreciated by all. It can help develop memory retention for children. An example would be learning nursery rhymes or other childhood songs. During pregnancy, listening to soothing music can help the mother relax during labor. Music has the ability to form many connections spiritually, emotionally, and physically (CAMT, 2012).

History

The healing properties of music can be traced back to its origins in 300-400 B.C. This was the time when philosophers, Plato and Aristotle, made reference to Apollo, the Greek god of music. The earliest known reference to the physiological effects of music was in 1789, in an article in the Columbian Magazine. During the 1800s, Edwin Atlee and Samuel Mathews were the first to create medical dissertations on the therapeutic effects of music. This was the beginning of the appearance of systematic experiments in the field of music therapy. Many of these studies included the effects of music therapy in a mental institutional setting, Blackwell’s Island, and the effect of music on altered dream states in psychotherapy (American Association for Music Therapy [AMTA], 2010).

In the 1940s, the conventional use of music therapy was widespread after World War II. Psychiatrist were adhering to a holistic model of treatment that considered physical, mental, and social health. As war veterans were recovering from the trauma of war, musicians volunteered to host music performances and programs to help them recover. With this, the effects of music on Post Traumatic Stress Disorder were studied. As the therapeutic evidence of music grew, organizations and educational institutions were developed. The National Association for Music Therapy in the United States was formed in 1950. The Canadian Association for Music Therapy was established in 1974. Lastly, the American Music Therapy Association was established in 1971 (AMTA, 2010).

Benefits

Music can be used to manage chronic health conditions and prevent of long-term cognitive defects. In children with autism spectrum disorder, music therapy in group interventions can be used to increase eye gaze, joint attention and communication (LaGasse, 2014). With older populations, music therapy has been shown to manage behavioural and psychological symptoms of dementia (Ueda, Suzukamo, Sato, & Izumi, 2013). Nurses have commonly integrated music treatment to reduce pain, anxiety, and aggressive behaviours in patients (Snyder & Chlan, 1999). This treatment targets a wide range of conditions, and the targeted demographic includes children, adolescents, elderly patients and people of all cultural backgrounds. Music therapy is used to treat or manage many conditions: acquired brain injuries, autism, language impairments, Alzheimer’s disease, substance abuse, developmental, intellectual, and physical disabilities, and depression (CAMT, 2012).

Research

A German cross-sectional questionnaire, for all hospitals with child and adolescent psychiatry, gathered data on the structure and content of music therapy treatment (Stegemann, 2008). The reports showed that 63.4% of hospitals provided music therapy as a mode of inpatient psychotherapy, with a 77.7% response rate (Stegemann, 2008). In 2006, reviewers analyzed 51 studies, 3663 participants, which involved using music to reduce pain in symptomatic cancer patients (Cepeda, Carr, Lau, & Alvarez, 2006). In 31 studies, patients undergoing music therapy had lower pain intensity, 0.5 units lower on a 10 point scale, compared to unexposed patients (Cepeda et al., 2006). The remaining studies showed at least 50% decrease in pain and a 70% higher likelihood of decreased pain levels in music-exposed groups compared to control groups (Cepeda et al., 2006). Lastly, there has been research that reviewed the effects of music therapy for ‘end-of-life’ clinical patients (Bradt & Dileo, 2010). The hypothesis was that music therapy can help relieve symptoms, address psychological needs, facilitate communication and ultimately help patients cope (Bradt & Dileo, 2010). Five studies looked at 175 patients and found insufficient evidence to support the effect of music therapy on the quality of life of end-of-life patients (Bradt & Dileo, 2010).

Trends

In the United States, 21% of music therapists have reported working in the field of mental disabilities as the incidence of mental illnesses continues to rise (Silverman, 2011). Being in the 21st century, emerging technology has created virtual forms of treatment known as e-music therapy. With that, there are more online resources, available therapists, clinics and post-secondary education programs. In the United States, all 50 states officially recognize music therapy as a health profession. Another trend is that more exercise specialists are integrating individualized music into workout programs (Holmes. 2012).

Children

Movement Experiences

Music therapy is effective at treating cognitive disorders and can also be used to support overall child development. As a component aside from treatment, music paired with learning experiences is beneficial for children (Webster, 1998). Music as a psychiatric treatment enhances the social cognition, emotional processing, anxiety and stress of developing youth (AMTA, 2010). With regards to the neurophysiology, music engages many areas of the brain at once. Using neuroimaging, neuroplasticity (changes in neuron activity) is shown in subcortical regions (brain centers responsible for emotion and stress) and cortical regions (responsible for thought processing, memory, and attention) of most people (Yinger & Gooding, 2014). Adding on, the integration of music activates the cerebellum, basal ganglia and cortical motor area. These areas of the brain are responsible for coordination, balance, speech, and planning or creating movement patterns. Most of the research findings have been from testing the effects of music on children living with disabilities. More specifically with children with autism, music therapy has the significant effect of improving memory, attention, self-confidence and movement (Croke, 1989). The mechanism behind these benefits is explained by the chemical changes that occur in the brain when being exposed to music. Listening to music results in a dopamine release and a peak in an emotional arousal, this can be correlated to heart rate and respiration (Salimpoor & Benovoy, 2011).

Toys

Children learn many movement and thinking skills by playing with objects in their environment. Many classic toys have been associated with sounds and music to appeal to the auditory senses. Instruments (xylophone) and mats that light up or play sounds when touched are used to promote skills such as pointing, reaching, and coordination. Devices that play music or “speak” upon pressing a button can help children with language, attention, and memory (Francis, 2010). In this case, the music from toys serves as positive reinforcement for a child’s action. Based on the operant conditioning theory, the sounds are a positive stimulus that can be used to condition a child’s behaviour (Stark, 1972). Children are learning through play and are being rewarded for their actions automatically by the responses on the toy (Francis, 2010).

Rehabilitation

Music therapy can be applied to facilitate sensorimotor skills for children with developmental limitations. Children are motivated to express themselves and increase range of motion in movements with music that is integrated in training programs (Rice & Johnson, 2013). Combining music with other physical interventions can increase comfort and reduce the stress of the client. Listening to music can reduce fatigue during physical activities (Fahey, Insel, Roth, & Wong, 2010). Moreover, there is a connection between motor activation and cueing musical rhythm. Music patterns and tempo can help a child, with ataxia from a brain injury, regain coordination by synchronizing rhythms with motor movement (Stanley & Ramsey, 2012). Another example would be helping a child with symptoms of apraxia, which is an impairment of speech. Through music, singing and melody training is able to improve speech clarity and the coordination of speech muscles (Stanley & Ramsey, 2012).

Practical Application and Recommendations

Before a child undergoes music therapy for their condition, it is advised to gather more information on the treatment and get an opinion from a family physician. After consulting with a healthcare professional, the child must get a referral to see a music therapist. Next, the child will receive an initial assessment and screening by the music therapist. By observing education and medical records and interviewing other family members, the therapist can create an individualized treatment plan. Music therapy programs are tailored to clients as it considers their preference in music and instrumental sounds (Holmes. 2012). With the plan, it is important to set timely and realistic goals for the treatment outcome. There also needs to be the presence of social support for the child as they may be coping with additional stress. Children need to be consistent with their music rehabilitation training. It is recommended to practice not only in a clinical setting, but in a home setting as well. As music therapy alone, may not be sufficient for most mental and physical conditions. Children living with disabilities are encouraged to continue their other methods of therapy while being treated with music therapy (CAMT, 2012).

References

American Music Therapy Association. (2010). History of Music Therapy. Retrieved from http://www.musictherapy.org/about/history/

Bradt J., & Dileo C. (2010). Music therapy for end-of-life care. Cochrane Database of Systematic Reviews, 2, 157-169. doi: 10.1002/14651858.CD007169.pub2.

Canadian Association for Music Therapy. (2012). Music Therapy. Retrieved from http://www.musictherapy.ca/en/information/music-therapy.html

Cepeda M. S., Carr D. B., Lau J., & Alvarez H. (2006). Music for pain relief. Cochrane Database of Systematic Reviews, 2, 43-48. doi: 10.1002/14651858.CD004843.pub2.

Croke, K. (1989). Music motivates handicapped children. The Ottawa Citizen, Retrieved from http://search.proquest.com.ezproxy.library.ubc.ca/docview/239372211?accountid=14656

Fahey, T.D., Insel, P.M., Roth, W.T., & Wong, I. (2010). Fit and well: core concepts and labs in physical fitness and wellness. North Vancouver, BC: McGraw-Hill Ryerson Ltd.

Francis, B. (2010). Gender, toys and learning. Oxford Review of Education, 36(3), 325-344. doi:10.1080/03054981003732278

Holmes, D. (2012). Music therapy's breakthrough act. The Lancet Journal of Neurology, 11(6), 480-486. doi:10.1016/S1474-4422(12)70126-6

LaGasse, A. B. (2014). Effects of a music therapy group intervention on enhancing social skills in children with autism. Journal of Music Therapy, 51(3), 250-275. doi:10.1093/jmt/thu012

Morehouse, P. (2013). The Importance of Music Making in Child Development. YC: Young Children, 68(4), 82-87. Retrieved from: http://web.a.ebscohost.com.ezproxy.library.ubc.ca/ehost/pdfviewer/pdfviewer?sid=05a22f63-c319-4848-99f0-59b15e6505a4%40sessionmgr4002&vid=3&hid=4101

Rice, R. R., & Johnson, S. B. (2013). A collaborative approach to music therapy practice in sensorimotor rehabilitation. Music Therapy Perspectives, 31(1), 58-66. doi:10.1093/mtp/31.1.58

Salimpoor, V. N., & Benovoy, M. (2011). Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature Neuroscience, 14(2), 257-262. doi:10.1038/nn.2726

Silverman, M. J. (2011). Evaluating current trends in psychiatric music therapy: A descriptive analysis. Journal of Music Therapy, 44(4), 388-414. Retrieved from http://search.proquest.com.ezproxy.library.ubc.ca/docview/1097654?accountid=14656

Snyder, M., & Chlan, L. (1999). Music therapy. Annual Review of Nursing Research, 17, 3. doi: 10.1016/S0147-9563(98)90004-8

Stanley, P., & Ramsey, D. (2012). Music therapy in physical medicine and rehabilitation. Australian Occupational Therapy Journal: 2, 111–118. doi:10.1046/j.1440-1630.2000.00215.x

Stark, J. (1972). Language training for the autistic child using operant conditioning procedures. Journal of Communication Disorders, 5(2), 183-194. doi:10.1016/0021-9924(72)90015-9

Ueda, T., Suzukamo, Y., Sato, M., & Izumi, S. (2013). Effects of music therapy on behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Ageing Research Reviews, 12(2), 628. doi:10.1016/j.arr.2013.02.003

Webster, P. R. (1998). Young children and music technology. Research Studies in Music Education, 11(1), 61-76. doi:10.1177/1321103X9801100107

Yinger, O. S., & Gooding, L. (2014). Music therapy and music medicine for children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 23(3), 535. doi: 10.1016/j.chc.2013.03.003