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Symposium Topic

 

Michelle-Hardy-Music-Therapist

Michelle Hardy, MM, MT-BC

Michelle Hardy is a Board-Certified Music Therapist with a master’s degree in Music Therapy from Colorado State University, having received her bachelor’s degree in music therapy from Loyola University in New Orleans in 1995. Michelle has worked with children and adults with various neurological impairments and developmental delays, but her focus is with individuals with autism and sensory processing difficulties. 

MTCCA staff and interns were given the opportunity to speak with Michelle Hardy, MM, MT-BC in our weekly symposium. My personal learnings taken from this meeting include the follwing;

What are the main diagnostic criteria of autism?

  1. Social deficits
  2. Deficits in communication

Did you know that motor movement is also a prominent diagnostic characteristic of autism? Michelle Hardy brought to our attention that motor movement is not included in the leading diagnostic criteria of autism in the DSM-IV not the DSM-V. However, motor movement deficit is a prominent characteristic in individuals with autism. This makes perfect sense because if you take a look at the parts of the brain that are affected by autism you will see that included are the cerebellum and the frontal lobe. These are the areas of the brain that help us with movement planning, grading, and executing. Before any deficits in attention, behavior, higher learning, or social skills can be improved in a child, their brain’s ability to integrate sensory information and program proper motor signals must be re-calibrated through brain activation modalities.

As a music therapist, treatment may include:

  • Rhythm Training
  • Use of a metronome
  • Proprioceptive stimulation

By using rhythm in a purposeful way, we can access the frontal lobe and mend long distance connections within the brain. Rhythm also creates a sense of predictability and strengthens pathways in the brain.

A specific intervention to include all of the above treatment ideas, would be Bilateral Drumming. Here is an example of bilateral drumming with Michelle Hardy.

*Notice the use of rhythm, a metronome and the proprioceptive feedback given from hitting the drums and walking.

-Kristin

We have all seen that wiggly, fidgety child who climbs, touches, bumps into, and jumps onto just about almost anything and everything. The common conclusion that we often come to is that the child is misbehaving and has a surplus of energy. But the truth is that these children may have poor propriocetive sense which adversely effects their awareness of where there bodies are in space and effects their awareness of how fast or slow their bodies are moving. Our sensory processing abilities are supposed to tell us where our bodies are, allowing us to sit up straight and still and to tell us how fast or slow we are moving our bodies so that we can manipulate objects and move around in space without bumping into things. However, children with Sensory Processing Disorder are not being given the sensory information and/or are not able to integrate, modulate, organize and discriminate sensory messages efficiently causing them bounce, wiggle, rock, slide to the floor, and fidget.

There are ways to help these children establish awareness of their bodies which may allow them to listen better, retain information and focus. If you are working with a child who isn’t comfortable in their chair, are sliding off of it or is rocking it on two legs, try giving them an exercise ball to sit on and allow them to bounce while you teach your lesson or facilitate your intervention.  It may seem like they still are unable to pay attention due to their bouncing bodies but check in with them and you may see that they really are paying attention and are able to retain content. This is made possible because the sensory input received from the bouncing tells their bodies where they are, which then clears up the neuro pathways for them to focus on something else other than trying to figure out where their bodies are in space.

A music therapists approach for children in need of sensory input may include creating interventions that involve ample amounts of movement such as rocking, spinning, jumping or pushing.

The Hard Facts:

“Proprioceptive dysfunction is the inefficient processing of sensations perceived through the muscles and skin, as well as the joints.”

The functions of our proprioceptive sense include:

  • Body awareness
  • Motor control
  • Motor planning
  • Regulation of arousal level (aroused or calm)
  • Discrimination of movement in time and space (tells us where our bodies are)

I leave you with this video which provides insight from the perspective of children with SPD and poor proprioception. I share this with hopes that others will think again when they see a wiggly little one.

https://youtu.be/uhsQhGcI0-8?list=PL3opm2WogRKUyk9vStTggyiZQgS26Z0NL

-Kristin

Our team recently had the pleasure of doing a workshop on piano accompaniment techniques with JayJay Lim, a wonderful music therapist based in the San Diego area.

We started off with a simple warm up; playing V7 chords in a circle of fifths pattern. Using a metronome to keep us all in time, we played 2 measures of C7, 2 measure of F7, 2 mesaures of Bb7 and so on. If this workout is comfortable, the next step is to play through the circle of fifths playing V7 inversions. JayJay also suggested playing through this same exercise playing min7 chords. Again, if it’s easy, play inversions! Of course this warm up is good for your muscles, but doing it without sheet music is good for warming up that cognitive functioning too!

Next, we reviewed some important tips for effective accompaniment. If you’re leading a singing intervention in a group, it’s important to give your clients some kind of introduction so they get a feel for the key, the tempo, and when to join in. JayJay suggests introducing the song by playing the melody line of the last 4 measures of the song, then giving a strong cue with their starting pitch or with the first few notes of the melody.

JayJay encouraged us to practice a few easy folk songs, including Home on the Range and You Are My Sunshine, with the left hand playing a pattern or just a bass rhythm, and to only play chords in the right hand on the first beat of each measure.  

One of the most beneficial tips I took from the workshop; put two colored stickers an octave apart on the keyboard and only play right hand chords between those two stickers, including V7 chords. You can play on the stickers, but you can’t go past them! This forces you to get more comfortable with inversions so you’re not always playing everything in root position.

I’ve been incorporating these into my daily practice time and I have already seen a huge improvement! It’s easy to fall into the same playing patterns or accompaniment styles, especially if you’re not a pianist (like myself). Simple, functional practice techniques like these can go a long way in increasing your flexibility and familiarity on the keyboard. The less you have to think about which keys to play for which inverted chords, the better off you’ll be in not only accompaniment, but improvisation and performance as well.

 

Best of luck in your practice time!

 

Toby

 

We reviewed this book this week in our symposium and had an interesting discussion about what it means to each of us.  It basically comes down to how well a person deals with changes in his or her life, whatever those changes may be.  Each person may relate it to a different personal challenge in his or her life at the time.  Here is the basic outlines of the characters and what each of them represents:

  • Sniff: sniffs out change early
  • Scurry: scurries into action
  • Hem: denies and resists change, fears it will lead to something worse than what he currently has
  • Haw: Learns in time to adapt to change when he sees it leads to something better

We may not have the ability in our lives to decide what changes, but we each have the ability to choose how we will react when things change in our lives.  We can choose to be one of these characters.

Mary Jane

MTCCA shared an acronym with me for how to write great goals for your clients.  It is simply this–be SMART.

  1. Specific: The action must be very specific in order for it to be measurable.  In order to do this, you must first determine their functioning level before therapy is begun so there is something to compare
  2. Measurable: This is the way to tell if clients are making progress
  3. Achievable: They must be able to achieve the goals or there is no point in setting goals at all
  4. Relevant: There is no point in working on something that is not relevant to the client
  5. Time Limited: You should set a specific date for when they should have a goal achieved, for example “by July 2015…”

Mary Jane

Eleven percent of children in the United States have been diagnosed with ADHD and 1 in 88 children have been identified with having autism.  People who have these diagnoses exhibit trouble with cognition, specifically with attention and inhibitory control.  So why use music therapy to help with attention?

  • Rhythm creates a temporal structure for neurons to fire
  • Rhythm creates an organized time frame, helps with learning and perception
  • Rhythm can create the right amount of predictability
  • Pleasant music increases blood flow to the basal ganglia and prefrontal cortex and decreases blood flow to the flight or fight response area in the amygdala

Below is an example of an ABA therapist working on joint attention with a child with autism.  Music therapists use similar techniques, but using musical instruments and songs.

Here is an example of a music therapist working on joint attention with a child.  You can also see how well the child’s attention is sustained while playing an instrument.  Playing an instrument is a great way for someone to practice and develop sustaining attention to a task as well as other types of attention and cognitive skills.

Mary Jane

Hello!

This is my first post as an intern at MTCCA and I’m excited to share with others the amazing things I’m learning about music therapy and the work that we do!

Today we were talking about speech and language development through music. Music is an amazing tool to help develop and enhance language skills of kids and adults of all backgrounds. Because of the inherent structural qualities in music, like tempo & rhythm, melody, and repetitions of sections or verses, our brains and bodies can quickly connect with what we are hearing, oftentimes without even thinking about it! One of the reasons the brain work so well in the context of music is because once we connect with a rhythm and structure of a song we can anticipate what is coming next and we want there to be a resolution to our anticipation.

Here is a cool example of anticipation in music lead by the multi-talented speaker and musician, Bobby McFerrin. Watch for what happens at the 38 second mark!

http://worldsciencefestival.com/videos/the_power_of_the_pentatonic_scale

Now, this example does not have to do specifically with speech and language, but it is a good example of how we respond to music when we are anticipating what should be next. Because music is fun and engaging for so many individuals, they are motivated to work to keep the music or the singing going. So for a child who is engaged in music making, but has difficulties with speech or language, we will often sing a line or phrase they know well except for the last word and pause the music until they verbalize that target word, then the music continues. For example, “Up above the world so_____, like a diamond in the _____,” and so on. This prompt is very basic, but it can work as a foundation for children who are learning how and when to give appropriate responses, producing accurate articulation, making eye contact and watching for cues, and so much more!

That’s my realization of the day! Stay tuned for more interesting thoughts and information about music therapy in our next post!

-Michelle “Toby” Tobias

When teaching music lessons to those with special needs, it is important to be able to adapt to each of their individual needs and to be understanding of the ways they learn best.  Here are some tips for teaching adapted music lessons:

  • Put yourself in their shoes, learn as much as you can about their diagnosis so that you can think like they do
  • Be precise and detailed in your instructions, some students can take things very literally and do not generalize, so be careful of idioms or terms that could be confusing
  • Use a routine with order and repetition, you can list out what you are going to do in the session
  • Be consistent, with the way they do things at home, with what is in their IEPs, etc and if you are preparing for a recital then you may need to help prepare them for several weeks in advance.  The more they feel comfortable, the less you will have acting out behaviors
  • Adapt and be flexible, you may need to work on left and right hand with them first on a drum or by throwing balls, they may need breaks if they are having a melt down
  • Set expectations, make sure you are setting high enough expectations, have them perform in the same recital as typical students
  • Have patience
  • Have compassion
  • Have a sense of humor, find ways to make lessons fun for them

Mary Jane

What is the Transformational Design Model?
Also known as the TDM, the Transformational Design Model is an assessment procedure that is used by many music therapists. There are a series of steps that the therapist goes through as they are assessing the client that ends in determining goals and interventions that are best for that client. It is a system that basically translates scientific methods into real-life functional use. It helps music therapists take non-musical therapeutic exercises and turn them into musical exercises, and then take those exercises and turn them into real-life every day skills that are functional.
Why is it important in the practice of music therapy?
-Helps plan goals that are relevant to the clients’ needs
-Helps make sure the goals and objectives are musical
-Helps generalize interventions into everyday functional application
-Allows music therapists to work with and share with other therapists
-Ensures patient centered instead of discipline centered programs
-Give clients quality service

Mary Jane

 

As my music therapy internship is coming to an end I have been establishing closure with more and more of my clients. Many families of clients have expressed gratitude, appreciation, and even sadness to see me go. I hadn’t actually realized how much of a partnership I had established with some of these families, which is a large part of the therapist/client relationship.

That’s something we weren’t exactly taught in music school. They teach us how to work effectively with many different populations, but they don’t teach us very much about interacting and connecting with the families of clients. In early childhood education, when a teacher establishes relationships and partnerships with families, the child’s learning is enhanced. This goes the same for music therapy. When there is a strong connection between the family and therapist, the child’s experience is enhanced, and this internship has certainly taught me that.

Well, it’s been a wild ride. I’ve learned many things about music therapy and life in general. I’ve experienced many things, a lot of which I never thought I would experience. And I can now say with certainty: I am ready for the professional world. Here I come!