Pediatric Musical Play as Therapy
Musical Play is used as therapy with young children and their caregivers.​
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"When I was a child my cousin would play Debussy, Ravel, and music by other composers and I would create dances with my sister. And then, when I had my own three children, I found that music was a vital pathway for them. Especially so for their daily routines and for bedtimes, winding them up to a certain point through dance, song and stories and then winding them down through lullaby when they would go off to sleep. It all seemed so logical and natural.
As a high school teacher I taught a class of boys who were struggling academically. I invited them to tell me how they wanted to learn. They said they wished to understand more about music but, understandably, it was their music they were referring to. So, we had a whole weekend when we made instruments including tubular bells, for instance, and explored popular music. Then, gradually, they started to become interested in classical music and the music of Beethoven. One of them said wouldn’t it be great if Beethoven came back for a day and we could interview him. So, I said OK let’s do it - who’s going to be Beethoven? We had one of them interviewing Beethoven and they dressed up. It was one of the most moving interviews, quite profound, in fact. We all learnt a lot about Beethoven.
Not long after that, music advisers came to see what was happening with these boys. They’d seen them at the beginning of the year and they could not believe how they had responded to the music and progressed; moreover, this growth was apparent in other areas of their learning." Julie Wylie
Music Therapy Training
Soon after that, I did a music therapy training weekend and then, in the following year, Clive and Carol Robbins came to New Zealand so I enrolled on their course. I loved every moment of it. They gave me a task which was to play in the Locrian mode (notes B to B, without using any black notes on the piano) to create music for a simulated case study involving a teenage girl in a wheel chair with cerebral palsy. I enjoyed this and they liked what I did so they invited me to write more music of the kind I had created.
That was the beginning of my involvement in music therapy but I decided I was not going to become a registered music therapist, but rather, develop therapeutic musical play following the child and empowering the parent. Carol Robbins suggested to me that I should continue what I was doing, working at the Champion Centre with other therapists, extending the music so that it could be used to underpin all learning and enhance the holistic nature of the Champion Centre programme. My whole philosophy was community based and collaborating with a voluntary association I’d set up called Musical Parenting.
Drawing on my understanding of music therapy, I developed my approach and this included building a clearer picture of what other therapists based at the Centre were doing. One child I saw had Down Syndrome and , was very musical , but he had no spoken language. I began by matching his pace, matching his expression and helping his parents, initially his mother, to understand how she could play alongside him.
Music in Early Intervention
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The instruments used include a wooden alto xylophone, a large gathering drum, a sound cradle, and other such instruments chosen because of the resonance of these instruments which is felt by parent and child through their whole body. If I was playing on the piano, I would play in the key of C having showed the parent how to play a repeated pattern on the xylophone in the same key on C and G. The child might be dancing, singing playing, doing whatever he wanted.The parent and I were together in the moment, supporting the child musically. If I was playing on the sound cradle, with strings tuned to the notes, A and E, the parent played notes A-A the Aeolian scale on the alto xylophone in the same key as me, thus providing support, structure and meaning to whatever the child played, This helped to develop his sense of self and immense pride in his own musical offerings.
The very first thing I had to do with him was to help him feel confident about the music room. I worked with his parents to enable them to understand the five -notes scale style’ in relation to the body. (A lot of the children really cottoned on to this because it was fun but also calming and regulating.) He would take my hand and I would sing: ‘Feet, feet, feet.’ Then he would guide me up to his knees and I would sing: ‘Knees, knees, knees.’ Then he might go back to his feet or up further to his tummy and finally his head. Each time I would sing where he decided to take me on his body. In this way, he led me.
I would then write down his music for his mother to take home and she would play the same musical game with him. It’s a wonderful vocal exercise for tuning your voice up. But then he started to sing himself, not responding to the words but to pictures. I had children who were very low tone who had Down Syndrome and also other children on the autistic spectrum who were often in a constant state of high arousal.
I developed greater understanding of how music works and why it works in relation to the brain and brain/body connections., calming and regulation. Bruce Perry’s work (e.g. Perry, 2014) helped me with his idea of a ‘neuro-sequential’ model and also Daniel Levitin (e.g. Levitin, 2012), a musician himself. There were others who enabled me to better understand what I was doing and what I might do further.
One instrument that helps children to grasp where musical notes are is the ‘chime bar box’ of notes C-C octave, colour coded notes. Because they can change the order of the notes children start to compose their own tunes. They play something and I play an answer. This is a non-verbal musical question and answer. This call and response is an essential feature of our musical communication and I regularly share this technique with parents. What I seek to do is to help a parent and child to play musically together and in synch. However, the child is the conductor who leads both the parent and myself. There is no right or wrong way to play.
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So What is Music Therapy?
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I can answer this by referring to the seminal work of Clive and Carol Robbins and others, of course. However, it’s usual for the therapist to pose the music question and for the child to answer it. In my practice, I turn this around. I believe it’s important to follow the child in whatever they choose to do and thus to wait, listen and watch. It might take some time because you need to wait for a child to give the first music question. It might come about through gesture or some kind of rhythmic patterning or the tempo and pace that they’re enjoying. By hooking into what they give me, and building around it little by little, the most amazing things can happen. Out of these, I have recorded a number of music CDs for parents. My musical play philosophy is about empowering parents through relationship-based musical play, thus building for the child a strong sense of self in relation to others and the musical community. I therefore aim to the child and empowering the parent, and bringing them parent and child into synchrony so they can play musically together at home in their daily routines.
As I have indicated, play and playfulness are an essential component of a music therapy approach. A specific example is a little girl who came into the music room with her mother. The child was carrying a tin which she wanted to play. My task was to follow her. She beat her tin very rhythmically and then led me out into the playroom. I was intrigued at the many things that she was able to with this tin – calling into it, tapping it, rolling it backwards and forwards to her mother and so on. This established a wonderful tempo between mother and child. She started to use her voice, but not her chest (speaking) voice. I would sing into the tin when she held it out to me and I would use my singing voice, which she picked up on. So, by the end of the half hour session she was using her beautiful singing voice. The tin also served to give amplification to that voice.
It is over 20 years since I set up the music therapy programme at the Champion Centre and we have seen some very delightful and profound things happen. As I have said, the educational and therapeutic approach that we use with children and parents requires that adults learn to watch, to wait and to listen - some people find this a challenge at first.
I think, in our work, it’s so important to know how to play and, moreover, what it is to be a child, and to never forget that.
Looking back to my early childhood, this is where I was so fortunate with my first musical experiences and the way my concert pianist cousin accepted that my sister and I wished to dance when she played.
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References
Levitin, D. J. (2012) What does it mean to be musical? Neuron, 73, 633-637. On-line:
http://daniellevitin.com/levitinlab/articles/2012-Neuron-Levitin.pdf (Accessed June 6th 2016)
Barfield, S., Dobson, C., Gaskill, R. and Perry, B. D. (2014) Neurosequential model of therapeutics in a preschool: implications for work with children with complex neuropsychotic problems, The Advanced Generalist: Social Work Research Journal, 1 (2), pp. 64-80.
Training