Tuesday, December 3, 2013

In Neuroscience in Music Pedagogy.  Editors:  W. Gruhn and F. Fauscher. pp. 233-266.  2008. Nova Science Publishers, Inc. ISBN: 978-1-60021-834-7

In his chapter entitled Musical Learning in Individuals with Disabilities, Eckart Altenmueller discusses how music can be shared with children with disabilities.  He addresses a range of physical and intellectual disabilities. 

Altenmueller begins by celebrating the “richness of musical experience”, recognizing that music engages us at the emotional, sensorimotor and cognitive levels.   He describes the extensiveness of the brain’s neural response to music and notes music’s impact on the brain, demonstrated by plasticity and the brain’s adaptation as a result of musical performance. He suggested that this plasticity, evidenced in a musician’s brain, may also have benefit for disabled children, potentially “helping to improve various sensory, motor, coordinative or emotional disabilities.” In acknowledging that a child’s disabilities will at some level interfere with the music experience, Altenmueller makes the important statement that there are yet several abilities with which the disabled child can participate in and enjoy the musical experience.

Altenmueller addresses music learning with four categories of disability:  physical disabilities, localized brain lesions, developmental disabilities, and chromosomal disorders.

Within physical disability he addresses physical, visual, and hearing impairments.
In localized brain lesions he addresses receptive and expressive amusia, congenital amusia, and focal dystonia. Developmental disabilities included are Attention Deficit Hyperactivity Disorder, dyslexia, Autism Spectrum Disorder, and Savants.  Chromosomal disorders include Down Syndrome and Williams Syndrome.

Altenmueller recognizes that the above list of disabilities contains a range of levels of severity of disability and that music activities need to be modified and adjusted to each individual’s need.  He also acknowledges that it will take time to achieve a plastic response or to observe development with children with special needs.  His chapter is primarily addressed to educators, so he reminds them to be realistic about time-lines and to encourage parents to be the same. 

He concludes by commenting on the social experience that music provides and the value for children with special needs to participate in the group sharing of music.


Altenmueller covers a lot of information in his chapter, describing various disabilities in a range of categories and provides suggestions on how music educators might engage these children in music learning.  Of importance to me was his underlying philosophy that music is a powerful experience at several levels: emotional, physical, and cognitive, and that children with disabilities can benefit from music and should participant in musical experience.  He focuses on what the child can do, and how to use this ability in music. 

I facilitate a weekly 45-minute music therapy session with a group of six profoundly disabled high-school students.  None of these students have the ability to learn music.  They cannot respond with speech or singing, nor can they hold any instrument without hand-over-hand support.  Yet, we share a beautiful musical experience together.  Songs that have become familiar bring out smiles, and in some cases laughter.  Recognizing their name in a song often results in eye contact. 
In spite of fine and gross motor challenges, great effort is exerted (with the hand-over-hand support from an aid) to move an arm towards an instrument to produce a sound in the space provided for them in a song.  We are making and sharing music together and it matters.  Sounds of my instruments crashing together as I arrive in the room causes some students to begin rocking and others to vocalize in anticipation of “music time”.  The students know that I have arrived and are getting excited.  Music matters to them.  As Altenmueller noted, we celebrate what the child can do, and use that ability to engage in music, at whatever level that is for that individual. 

Of interest to me is the response of the students when we are united in rhythm.  Some songs are what are considered “action songs” where the student, with hand-over-hand support, clap hands, stamp feet, or lift arms to a strong beat.  I often vary a rhythmic pattern for these actions.  The support workers imitate my rhythmic pattern with the students’ clapping or foot stamping.  As we begin to go though a number of these rhythmic variations, the students begin to recognize the imitation that is taking place.  As they do, smiles and laughter break out. I often ponder, what is it about the experience of sharing rhythm that results in such strong responses from the students?

 In another song I play a long descending glissando at which time the students drop their arms from a raised position.  This song has become a favourite.  Again, matching the music with their body brings a strong response.

As I reflect on this group of students, another music therapy client I worked with 3 years ago comes to mind.  He was a nine-year-old boy with profound disabilities.  He had minimal motor-control, was blind and completely deaf.  I had 4 sessions with him at his home.  Initially I was at a loss of what I could do with a child with this level of disability.  Uneasiness crept over me as I tried to think of what to do to give this young boy an opportunity to engage with me, somehow with my music.  Then I realized that he could feel, that he could have a tactile experience.  I took the cabassa to him, placed his hand on top, and began to move his hand with mine, in a strong rhythmic pulse.  I then moved it to the top of his leg and repeated the rhythm.  He began to laugh when he recognized the same rhythm being played on his leg.  As he laughed, I imitated the rhythm of his laughter with the cabassa on his leg.  He laughed again as he realized I was imitating him. We had connected.  For the remaining 3 sessions, we shared rhythm with a variety of percussion instruments.  Sometimes a buffalo drum was laid against his cheek to feel the vibrations, other times we struck rhythm patterns on the rough leather top of the bongo drums with our hands, the cabassa was always a favourite.  It is of interest to me that, as in the class mentioned above, sharing rhythmic patterns had such an impact on the child. 

Without the ability to sing together, to play an instrument unaided, to dance, or to move to the music, sharing the strong beat of the rhythm, even though the movement is supported by another, allowed the children to be part of the music, to connect to me, and to experience a social activity. 

The responses of these children reflect what Altenmueller described as the richness of music experience, impacting at the levels of emotion, sensorimotor, and cognition.  The children responded on all of these levels: emotion-joy; sensorimotor-the motor sensation of rhythm; and cognition-the recognition of this.

What they could not do did not matter.  What they could do brought smiles and laughter.  Why? Because they recognized and enjoyed what they could do, in music.


Autism Cafe said...

Cheryl - Do you facilitate the music therapy sessions in Toronto? I developed a piano teaching method using the principles of ABA to teach my low-verbal son with autism how to play the piano. Is is currently being beta tested with non/low verbal children with autism. I'd be interested in getting a better understanding the learning strengths and weaknesses of other disabilities to see if it might have a broader application. I am blogging about the testing at adaptedmusic.blogspot.ca.


Will Snodgrass said...

Hi Cheryl,

Thanks for a very heart-warming post. I love that you have been able to find ways to connect with people through music - however small these ways may seem. Often we approach situations with a very narrow definition of what music is. Your work is helping to expand that definition.

I can relate to your stories of working with people with a variety of special needs. Sometimes we can't truly understand or appreciate the extent of the impact that we do in fact have. Keep up the good work!


Danielle said...

Hi Cheryl,

Thank you for your posting. I greatly enjoy hearing about your experiences as a music therapist.

My first thought upon reading this was to ask what kind of effect the music therapy was having on plasticity. Learning cues from music such as raising and dropping your arms, or recognizing rhythmic patterns might stimulate plasticity in related tasks. I wonder if you or your colleagues noticed an improvement in any other areas in your high school student group after extensive music therapy