Articles for April 2014

Rhythmic Entrainment in Music Therapy to Assist With Social Awareness part 4 of 4

Meghan is a 12 year old girl with Autism Spectrum Disorder (ASD), She has words, but uses them to repeat lines from TV or movies, she plays with her stuffed animals and often times appears to be unaware of the world around her. Meghan didn’t participate in the music therapy groups when they first started in her facility. I would always greet her and ask her to join us but the teacher told me that she doesn’t participate in any group activities and it was one of her goals.

Group drumming supports neurological and physiological growthIn March I wrote a blog series called “Sensory Integration, Not Just for Autism Spectrum Disorders” in which I discussed the importance of using a multi-sensory approach in the music therapy group so that individual goals can be achieved in the group setting. This month I have written about the importance of “Rhythmic Entrainment, What is it and Why is it Important in Music Therapy?” “Rhythmic Entrainment for Motor Planning“,  and “Rhythmic Entrainment in Music Therapy to Assist in Language Development”. I discussed that I focus on the rhythmic aspects of the music to support neurological and physiological growth. These were the techniques I was using in Meghan’s class.

As the weeks went on, Meghan began to move closer to the group but still held onto her dolls and seemed to be unaware of her surroundings. I continued to observe her while leading the group and interacting with the other kids and I noticed that after about several weeks her dolls started dancing to the music and then each week, I noticed more and more involvement. One day, a staff member brought 2 chairs up and sat them behind the circle, she sat in one and had Meghan and her dolls sit in the other. At first she could only stay for the “Hello” song, but then she would leave the group and come back multiple times, participating in background but not as a part of the group. Finally Meghan began to feel more comfortable and stayed in the group longer and we began to move her closer to the group as well. She didn’t show interest in the books, visuals or movement activities, but she was interested in the instruments and would repeat the names, and began to request them but didn’t actually play them herself.  So the assistant would sit next to her and play the instruments and sing to model appropriate behavior. The assistant began to fade her assistance and Meghan stayed in the group with the instrument beside her and would sing to her dolls.  One day I looked over and Meghan was playing the guiro, she was holding correctly and playing it rhythmically with the group.  This story isn’t over as I still work with Meghan and have for the past two years. But now she is able to sit for most of the session, she still has her stuffed dolls and they play instruments with her. She is able to trade and share instruments with other kids in the group and she will even request songs if asked.

I have mentioned the multi-sensory approach that I use in my music therapy groups in many of my blogs. I provide a wide variety of sensory interventions using visuals, tactile objects (instruments) and movement so that each child can receive a variety of sensory input. In Meghan’s case it was the instrument playing that was the motivator for her, and when she did start to play, she was able to play rhythmically with the group. This was a signal to me that even though Meghan appeared disconnected and unaware at the beginning, she was still receiving the input on a neurological basis.

An adult may seem lost in their own world, but when I hand them an instrument and start singing a familiar song, they are able to come out for a while and be in the moment with the group.

An adult may seem lost in their own world, but when I hand them an instrument and start singing a familiar song, they are able to come out for a while and be in the moment with the group.

I have also seen this same phenomenon on the Memory Care units that I serve. An adult may seem lost in their own world, but when I hand them an instrument and start singing a familiar song, they are able to come out for a while and be in the moment with the group. Marilyn is one such client. She is very musical and hums to herself all day. During the sing-along activities she is able to sing most of the songs and can play the instruments appropriately. Marilyn is in the late stages of Alzheimer’s disease and she cannot answer simple questions most of the time. In February, we were singing love songs for Valentine’s Day (of course) and Marilyn had been happily singing and playing so I looked at her and asked her what she did for Valentine’s Day as a child. She looked me in the eye and said “We made valentines out of paper and glue and lace doilies.” It was so great to be in that moment with her. Sadly, Marilyn hasn’t been able to respond appropriately since then, but she is still singing and playing instruments and I know that the music is working in her brain and in her body.

Music Therapists are not the only ones looking at the phenomenon of rhythmic entrainment in the brain. Scientists have found that rhythm and speech are so tied together that they have identified similar behavior in animals that have some speech capabilities such as parrots and dolphins. Check out the links below and come back to www.mindfullmusic.com for my next blog. Until then, embrace your musical mind.

http://www.world-science.net/othernews/090430_rhythm.htm

http://www.sciencedaily.com/releases/2012/02/120224152753.htm

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Rhythmic Entrainment in Music Therapy to Assist in Language Development part 3 of 4

In March I wrote a blog series called Sensory Integration Not Just for Autism Spectrum Disorders, in which I discussed a multi-sensory approach that includes visual, auditory and tactile interventions to provide support for individuals with sensory needs. This month I have been blogging about the importance of rhythmic entrainment techniques in music therapy as an integral part of the multi-sensory approach. In the first post, “What is Rhythmic Entrainment and Why is it Important in Music Therapy?”  I stated that Rhythmic Entrainment in music therapy is a specialized practice used to assist in helping people become more “in tune” to their own rhythm and the rhythms of the world around them.  Last week in the blog about the importance of “Rhythmic Entrainment for Motor PlanningI briefly mentioned that even those individuals that can’t move their bodies can still benefit from rhythmic entrainment techniques because the brain can still receive and respond to rhythmic stimulus even when the body cannot.

Become actively involved in the music making!The thing about the music therapy session is that you can address multiple goals and objectives at the same time! So while I am singing or chanting and playing or moving rhythmically with my clients, I am addressing motor development (or rehabilitation), cognition, language development and social skills simultaneously. The how and why of this comes back to how the brain responds to music; “All music therapy goal-directed activity is aimed first and foremost at enhancing the functioning capacity of each client’s brain” (Taylor, 1997 p. 14). So when my clients are actively involved in the music making process, the entire brain is working. We cannot tell one part of the brain to wait because we only want to activate the language centers right now, and then tell the language centers to stop while we address motor ability. Even if that were possible it would defeat the purpose of a holistic approach to therapy that is inherent in music therapy.

There are many different languages, spoken, signed and body language are used throughout the world. We need an effective method of communication or our needs may not be met. Babies cry when they are hungry, sick or need to be changed. Communication develops as the child develops so language development becomes a very important goal in music therapy.  Also language has rhythm already built into the way we speak and our emphasis and inflections.

I use many techniques for language development in my music therapy groups. Last week I described the way I use the “HiDa” song with maracas as a basic beginning rhythmic entrainment technique. This song is also great for early language learners because the words, while they don’t really mean anything, have 4 syllables that are easy to pronounce. With older kids and adults that are in rehab, I use similar techniques but the music is age appropriate and the presentation is different.

Singing books to support language and literacy goals

The multi-sensory approach that I use in my music therapy sessions includes not only singing, dancing and instrument play, but also includes singing books. (click here to reathe blog “The importance of pictures in music therapy”) There are many children’s books out there in the big world and I have an extensive bibliography of books that I use in my music therapy practice. I choose books based on subject content but also based on rhythm and rhyme. Some of the books are as simple as the “Brown Bear” series by Bill Martin, Jr., which I sing with a simple 3 note melody. Others I may chant while having the kids pat to the beat. I have 6 books that I created music sound tracks, a repetitive chorus and sign language. The children love these activities and request them every week. I will be sharing more about these books and how I use them in upcoming blogs. 

Next week I will be posting about how rhythmic entrainment techniques can lead to social awareness.

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Rhythmic Entrainment for Motor Planning part 2 of 4

In the last post “What is Rhythmic Entrainment ? And Why is it Important in Music Therapy?” I stated that “Rhythmic Entrainment in music therapy is a specialized practice used to assist in helping people become more “in tune” to their own rhythm and the rhythms of the world around them.”

Some children have an innate rhythmic sense

Some children have an innate rhythmic sense

Babies hear their first rhythm in utero from the beating of the mother’s heart. So a natural way to soothe a restless infant is to pat their back rhythmically while rocking or swaying, and singing, of course.  I have spent many years working in early intervention pre-schools, the experience has been fun and I have learned so much through the years. Some children have an innate rhythmic sense and are able to move their bodies gracefully and can grasp simple concepts such as “this is how we keep the beat” while other children are not able to keep a steady beat. Some children are just “out of step with the world” this is seen in children that don’t have strong core balance or rhythmic awareness.  

some people cannot move their bodies rhythmically but can still benefit from this sensory input on the physiological level.

some people cannot move their bodies rhythmically but can still benefit from this sensory input on the physiological level.

I introduce body percussion with the “keep the beat” chant on the very first day and we march around the classroom to reinforce the concept in the whole body. I have small maracas that I give to the kids and I model ways to keep the beat with the maraca, first just shaking it, then touching each knee and then in the palm of the hand while the beat gets faster.  We also do dance and movement activities that reinforce this concept. In the last blog series Sensory Integration Not Just for Autism Spectrum DisordersI explained how I use rhythm instruments as part of the multi-sensory approach. As I introduce each instrument, I explain how to play it correctly and rhythmically. The children are assisted using a least to most approach in which I start with eye contact as a subtle reminder to keep the beat and stay with me, if that doesn’t work one of the other adults may start patting the beat on the child’s shoulder, knee or back. As a last resort the child will receive hand over hand assistance. As stated in last week’s post “What is Rhythmic Entrainment? And Why is it Important in Music Therapy” some people cannot move their bodies rhythmically but can still benefit from this sensory input on the physiological level.

For individuals with traumatic brain injury, stroke and Parkinson’s disease, motor abilities may need to be relearned and practiced. Many of the techniques would be modified by using age appropriate music and instruments.

What’s your favorite way to keep the beat? Please post in the comments below.

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What is Rhythmic Entrainment? and Why is it Important in Music Therapy? Part 1 of 4

What is Rhythmic Entrainment? and Why is it Important in Music Therapy? This is the first of a four part series about rhythmic entrainment in music therapy.

I have been a music therapist for nearly 20 years and I have seen a lot and learned a lot. I have seen children and adults that appear to be unaware or disconnected from the world around them start to connect to music and through the music be able to connect with the world around them.

It was a typical physical therapy session; the PT was supporting the elderly stroke rehab patient and trying to explain to her that he wanted her to shift her weight by crossing one leg over the other. The move he wanted from her is a common dance step called the grapevine and is used in a lot of traditional country dances. I was observing the session and I could see that no matter how many times he demonstrated or explained, she couldn’t understand what he wanted her to do. I had already been working with the patient and it was the PT’s first time with her so I knew her background and I asked him if I could help and when he agreed, I started slowly  singing “Hava Nagila” a traditional Israeli song that is used to dance the “Hora.” It was as if a light bulb had gone off in her brain, she was able to move, with assistance and over time was able to walk and move independently. This is an example of rhythmic entrainment. Through the music she was able to make connections in her brain which then helped her ability to walk, to talk and to think more clearly.

We are surrounded by rhythm, from the movement of the earth through space, to the clicking of the clock there is rhythm. As humans, we are rhythmic beings and this is the area that I want to focus on in this post.  I use rhythmic entrainment techniques as an important part of the multi-sensory approach that I discussed in the last blog series (read Sensory Integration, Not Just for Autism Spectrum Disorders).

Rhythmic Entrainment in music therapy is a specialized practice used to assist in helping people become more “in tune” to their own rhythm and the rhythms of the world around them. keeping the beat

Entrainment is a physics term that is used to explain that two objects moving together use less energy than two objects moving in opposite directions, so even when they are moving differently, if they are placed next to each other will, over time, begin to move together in synchronicity.  This is often seen in a drum circle, when one person starts the rhythm and the others are able to match the pattern and either duplicate it or augment it. Music therapists often work with individuals that are “out of sync” with the rest of the world, this may be due to a genetic condition such as developmental delays, cerebral palsy and autism, or traumatic brain injury, stroke, Alzheimer’s and Parkinson’s disease. In these circumstances music therapists take this physics phenomenon and use it as an intervention to help people become more aware of their personal rhythms and those of the world around them.

The lub dub of a heart beat is the primary rhythm in our bodies and it controls the circulatory system which runs throughout the body and oxygenates the blood. The oxygenated blood travels to the brain which controls the central nervous system and tells the body how and when to move. When we are excited or nervous our respiration and circulation rate increase and when we are quiet or sleeping they slow down. This is an automatic response of our bodies.

Most of us are born with the ability to sense rhythm and even move our bodies to match that rhythm. For example when I want to exercise I listen to fast music and when I want to relax, I listen to slow music. My brain hears the different tempos and my heart rate begins to match those tempos.

Rhythmic Entrainment for all agesFor individuals with sensory processing differences, rhythmic entrainment in music therapy can help organize thought patterns, speech development, and motor planning issues. Many of these people appear to be withdrawn or self-absorbed, but, through rhythmic entrainment techniques we can help them to connect to their own body rhythms and gives them a non-verbal way to connect with other group members.

People with Cerebral Palsy may be very rigid and not be able to move their bodies to the rhythm due to physical limitations, but they still benefit from rhythmic entrainment techniques because their bodies are still functioning rhythmically at the circulatory and cellular level.  Studies in Neurologic Music Therapy have shown that the brain can still perceive rhythmic stimulus even below the threshold of consciousness.

Click here to continue to the next post.

 

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