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Fall 2012 l Vol. 3, No.1


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imagine Fall 2012 l Vol.3 No.1

EDITOR Petra Kern, Ph.D. MT-DMtG, MT-BC, MTA EDITORIAL ASSISTANCE Marcia Humpal, M.Ed., MT-BC Lisa Jacobs, MM, MA, MT-BC Rose Fienman, MT-BC Gretchen Chardos Benner, LSW, MT-BC BUSINESS MANAGER Andrea Farbman, Ed.D. AMTA National Office DESIGN Petra Kern, Ph.D. MT-DMtG, MT-BC, MTA PUBLICATION Annual Online Magazine PURPOSE to improve access to and distribute knowledge and information about early childhood music therapy in clinical terms. SPONSOR American Music Therapy Association WEBSITE Hosted by Music Therapy Consulting

imagine: Early Childhood Music Therapy Online Magazine ISSN 2153-7879

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DISCLAIMER The opinions and information contained in this publication are those of the authors of the respective articles and not necessarily those of the editorial team, the Early Childhood Network co-chairs, or the American Music Therapy Association (AMTA). Accordingly, the editorial team, the Early Childhood Network co-chairs, and AMTA assume no liability or risk that may be incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this publication.

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editorial Strong Foundations and Innovations Welcome to the third volume of imagine, AMTA’s annual early childhood online magazine. This issue includes 39 informative articles grounded in evidence-based practice, nine resourceful audio/video podcasts, and four creative photo stories highlighting the work of our pioneers in early childhood music therapy and young professionals from the U.S. and other parts of the world. We also expanded our imagine website by adding a new “teaching episode,” our favorite apps for children, and by listing latest early childhood events. Since the inauguration of imagine 2010, the online magazine has grown exponentially in range of topics, number of contributing authors and readers, inclusion of multimedia and use of technology. Our imagine editorial team also has expanded; we welcome aboard Rose Fienman and Gretchen Chardos Benner, both former AMTAS Presidents. This issue reflects our strong foundation of music therapy practice and research, which shape our innovations and lead us into the future.

Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA Editor, imagine

As a tribute to Dr. Clive Robbins, I am delighted to present a beautiful multimedia article featuring his work with young children with special needs. Nina Guerrero, Dr. David Marcus, and Dr. Alan Turry at the Nordoff-Robbins Center for Music Therapy in New York put together this depiction of Clive’s pioneering and innovative contributions to the field from the early 60s to his passing in December, 2011. Starting with his work with composer Paul Nordoff at the Sunfield Children’s Home in Worcestershire, England to the foundation of the NordoffRobbins Center in New York, this article captures Dr. Clive Robbins incredible journey that touched the lives of many children and families. The embedded video clips highlight his work. All case examples demonstrate Dr. Clive Robbins presence, playfulness, and belief in these children's potential. As the authors say, “In his teaching, no less than in his clinical work, Clive was a motivator, a visionary whose passion was contagious.” Inspired by his humanity, creativity, and vision, his work will continue and reach many more children around the globe. We are forever grateful for the legacy he leaves behind. Strong foundations and innovations can also be found in our research and clinical practice section. In the 2012 Early Childhood Research Snapshot, Dr. Blythe LaGasse summarizes scientific outcomes featuring the link between music and speech-language development in young

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children. Along those lines, Linda Robbins looks into Music as a Preventive Intervention for Language Delay in Toddlers of Low Socioeconomic Status, and Dr. Satoko Mori-Inoue and Dr. Lori Gooding present an innovative way of Tackling Children‘s Weight Issues through Music Therapy. Dr. Kamile Geist wraps up the research section with Keep the Beat (KAB) Music Enrichment Program, a pilot project currently implemented in Ohio. The 2012 practice articles encompass ongoing topics such as effective strategies for dealing with challenging behaviors and utilizing augmentative and alternative communication (AAC) in music therapy sessions. Also included are examples of innovative topics such as addressing music preferences in young children, the Music Indicator of Early Childhood Development (MIECD) assessment tool, combining young children’s yoga practice with music, using creative movement to engage boys in learning, and sharing family stories in the Northern Territory of Australia. The ideas and resources section brings together contributions from seasoned practitioners and newcomers in the field. This year, we invited students and young professionals to share their works in writing to expand our pool of authors and give first time writers publishing experience. All of our featured one-page intervention ideas include a purpose statement, address goals and behaviors to observe, list materials, give direction for implementation, and discuss adaptations for different skill levels. Our authors also included music scores of original songs along with audio recordings, which can be easily downloaded (making the intervention ideas also accessible to parents and practitioners from related fields). The 2012 imagine resources review early childhood music blogs, what it takes to be a blogger, and YouTube videos spotlighting self-broadcastings and outstanding news broadcasts on early childhood music therapy. These articles validate that the increasing use of social media and online resources has great potential for educating the general public about the benefits of music therapy for young children and their families. We are especially grateful for Dr. Jayne Standley’s sharing of decades of knowledge and insights related to Infant Stimulation and Development under the imagine Wisdom section. AMTA staff member and long-term advocate Judy Simpson keeps us abreast with the latest news about state

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recognition of music therapy in early intervention. Finally, Ilene Berger Morris’s reflection on the Sesame Workshop’s Music Works Wonders reminds us of the “sunny days” of making music with young children in the past and future. The strong foundation that has been built by the members of our outstanding Early Childhood Network Group (as also reflected in a podcast by Ronna Kaplan), allows us to reach for the stars and implement innovation. For example, Dr. Lori Gooding proposed adding audio bookmarks to traditional book reviews this year. You will hear her, Dr. Nicole Rivera’s and Beth McLaughlin’s practical applications of recently published books. Please also note the increasing number of multimedia submissions by our contributing authors. In summary, imagine has disseminated 192 contributions including 80 audio and video clips over the past three years. All of these can be found on the imagine website. We constantly look for innovative technology allowing our readers to experience imagine through an interactive digital viewing mode or using an QR code to access imagine on digital devices. Due to the open online access, we reach about 10,000 annual readers worldwide and also draw international authors as reflected in our color of us series, which by now has included 33 countries. This issue concludes our three-year imagine pilot project as supported by AMTA. A huge “THANK YOU” must be extended to the editorial team, authors, readers, and to AMTA. You have made imagine become a cutting-edge reality. The imagine editorial team is dedicated to continuing imagine as a service to the music therapy and early childhood community and hopes to “Make a dent in the universe” (Steve Jobs) for the young children and families we serve. Yours,

Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA Editor, imagine


contents Inside this issue: editorial ‣

‣ ‣




‣ ‣

“Sunny Days” for Music Therapy: Sesame Street and AMTA Share the Value of Making Music with Young Children Ilene Berger Morris................................................ 16


Coming into Being in Music: Clive Robbins’ Work with Young Children Alan Turry, Nina Guerrero, and David Marcus........ 25


2012 Early Childhood Research Snapshot Blythe LaGasse....................................................... 26 Music as a Preventive Intervention for Language Delay in Toddlers of Low Socioeconomic Status Linda Robbins...................................................... 30

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Tackling Children’s Weight Issues through Music Therapy Satoko Mori-Inoue and Lori Gooding...................... 33 Transforming the Early Childhood Classroom: The Keep a Beat (KaB) Music Enrichment Program Kamile Geist.......................................................... 36 Our Photo Stories 2011........................................... 38


research ‣ ‣


featured ‣


2011 Early Childhood Music Therapy Special Target Population Network: Meeting Report from 11-18-2011 Angela M. Snell..................................................... 10 Changing Winds: Innovation in Music Therapy Sandi Curtis........................................................... 12 State Recognition of Music Therapy in Early Intervention Judy Simpson......................................................... 13

reflection ‣

Infant Stimulation and Development Jayne M. Standley................................................... 8

reports ‣

Solid Foundation and Innovation Petra Kern.............................................................

wisdom ‣

‣ ‣ ‣


Because I Said So: Effective Strategies for Dealing with Challenging Behaviors Dana Bolton........................................................... Utilizing Augmentative and Alternative Communication in Music Therapy Sessions Anita L. Gadberry.................................................. Music Preferences of Young Children Darcy D. Walworth................................................. Assessing Early Childhood Development through Music Responses Elizabeth K. Schwartz............................................. Ancient Wisdoms for Current Times: Yoga, Music, and Young Children Dorothy S. Denton.................................................. Storybook Dance: A Multiart Approach Using Creative Movement to Engage Boys in Learning Karen R. Davidson................................................. Families Sharing Stories Anja Tait and Koulla Giannikouris...........................

ideas ‣

If I Had a Hammer: Engaging in Creative Movement with Rhythm Sticks Bill Matney............................................................. My Puppy: Teaching Appropriate Interaction with a Family Pet Beth McLaughlin..................................................... Thank You Song: Learning Appropriate Social Skills Anna Piper............................................................. Shaky Eggs: Following Directions and Body Awareness Meryl Brown.......................................................... Left and Right: Enhancing Differentiation and Motor


44 46



55 56

58 58 59 60



Planning Ruthlee Figlure Adler.............................................. 62 The Colors of Communication: Listening and Responding to Cues Kathryn A. Quattlebaum and Nicole D. Ribet........... 63 Ocean Adventures: Exploring Music and Creative Play Gretchen Chardos Benner....................................... 64

color of us ‣ ‣ ‣ ‣ ‣ ‣ ‣ ‣

‣ ‣

66 68 70

74 77 78 80


Reflections on Music Therapy with Young Children Ronna Kaplan........................................................ 86 Putting the Evidence into Practice: Designing a Plan for Student Success for Children with ASD

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‣ ‣ ‣ ‣ ‣

Beth McLaughlin.................................................... The Final Movement: Music Therapy and Pediatric Palliative Care Debbie Benkovitz................................................... The Role of Music in Developing Infant Attachment: An Interview with Cynthia Briggs Matt Logan........................................................... Resounding Joy: Music Therapy in India Laura Rose Anderson and Rebecca Vaudreuil........... A Little Tune with a Big Boom! Jennifer Pucket....................................................... Acoustic Instruments Accessible for Young Children Cathy Knoll............................................................ Yes, I Can Learn! Incorporating Music Instruction into Therapy to Help Children with ASD Kana Kamitsubo...................................................... The Magic of Sing-Play Cathy Fink and Marcy Marxer................................




86 86 87 87

87 87


Standley, J. M., & Walworth, D. (2010) (2nd Ed). Music Therapy with Premature Infants: Research and Developmental Interventions. Silver Spring, MD: American Music Therapy Association. Lori Gooding.......................................................... 88 Lim, H, A. (2012). Developmental Speech-Language ‣ Training through Music for Children with Autism Spectrum Disorders. London and Philadelphia: Jessica Kingsley Publishers. Nicole R. Rivera..................................................... 90 Schwartz, Elizabeth. (2012). You and Me ‣ Makes...We: A Growing Together Songbook. Melrose, MA. Center for Early Childhood Music Therapy, LLC. Beth McLaughlin..................................................... 91 ‣



Blog All About It: Early Childhood Music Blogs Rebecca Wellman................................................... 82 Making a Meaningful Mark in the Blogosphere Rachel Rambach...................................................... 84 Broadcast Yourself: Music Therapy and Early Childhood on YouTube Rose Fienman.......................................................... 85

podcasts ‣ ‣


Germany Lutz Neugebauer.................................................... Ireland Jason Noone.......................................................... Spain Melissa Mercadal Brotons....................................... Israel Dorit Amir.............................................................. Belgium Freya Drossaert...................................................... Denmark Stine Lindahl Jacobsen............................................ Indonesia Amelia D. Kho........................................................ Chile Paulina Alejandra Hernandez Quezada..................

resources ‣



Publications 2011-2012 ‣ Petra Kern.............................................................. 92


wisdom 10

Tips and Suggestions from Dr. Jayne Standley

Infant Stimulation and Development Jayne M. Standley, Ph.D., MT-BC Director of the Music Therapy Program and National Institute for Infant and Child Medical Music Therapy The Florida State University Inventor of the Pacifier Activated Lullaby (PAL速)

When possible, infant developmental interventions are benefitted by direct infant contact combined with parent training. Therefore, intervention suggestions are given in both areas. It should be noted that in many cases these suggestions are contraindicated with premature infants in the Neonatal Intensive Care Unit since their neurologic systems are too immature for this level of stimulation.

Effective Instructional Techniques for Infants 1. CAUSE /EFFECT LEARNING is the primary capability of

young infants. Brain development is most rapid from the third trimester of fetal development to age 3 years. Cause/effect learning happens quickly and has been documented as early as 28 gestational weeks. Hearing is one of the first senses to develop and is present from 18 gestational weeks. Since infants show a fixed, sustained attention to music, music is a highly effective reinforcement during early infancy. Research shows that a stimulus presented non-contingently will not later function as reinforcement. Therefore, the best teaching methodology would be to select a stimulus that is most likely to cause the infant behavior desired and then immediately use music as reinforcement. Examples of this include: Pacifier stimulus with music reinforcement to improve feeding; participatory, soothing music presented immediately when a crying infant quiets and discontinued when crying returns to reduce distress and improve self-control of behavior state, or music accompanying motor movements that lead to developmental milestones such as rolling over and discontinued when motor activity ceases.

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2. SURPRISE is a highly effective teaching technique. In the

first year of life, the infant’s brain responds to all new stimuli. Infants who are distracted or upset will alert to a novel stimulus allowing an opportunity for learning to occur. Additionally, attention can be sustained across time to a single stimulus by altering its presentation through overt changes in the therapist’s vocal style, facial affect, use of gestures, or placement of objects. Music is a perfect cue for presentation of diverse stimuli.

3. Infants learn by WATCHING OTHER CHILDREN and mimicking

their responses to novel stimuli and situations. Infant stimulation groups will be enhanced with inclusion of various ages and capability levels, especially that of older siblings who can demonstrate the desired skill and be taught a nurturing, mentoring role for infant brothers and sisters.

4. Infant activities should be DEVELOPMENTALLY APPROPRIATE and feature use of concrete examples and objects to manipulate. There should be ample time to explore, participate, mimic, manipulate objects, and develop selfcontrol. Placement of objects and music can facilitate use of major motor skills such as stooping, standing, walking, and running.


ONLY A FEW MINUTES IN DURATION. Change activities with infants every 2 to 3 minutes. Repeat activities 2 to 3 times within the same session and return to prior activities adapted across days to expand learning.

Critical Parenting Skills 6. New parents often do not know how to recognize and

respond to INFANT SIGNALS OF DISTRESS VS. DISPLEASURE, INTEREST VS. OVERSTIMULATION. New parents do not recognize infant signals and/or lack of sensory response. They do not know the successive approximations that babies exhibit as they move toward accomplishing developmental milestones. These should be systematically demonstrated and appropriate responses suggested.

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7. ATTACHMENT between mother and infant does not

automatically occur, especially if they are separated due to hospitalization or social needs. Since the mother-child relationship is the best predictor of the child’s future growth and development, attachment behaviors and emotional responses should be assessed and taught.

8. A primary component of good parenting is GOOD TEACHING. Parents should be taught to facilitate infant activities, not dictate or direct them. The usual sequence is to present a cue/object, wait for a response, then give feedback. If the infant is exploring an object, the parent should facilitate the activity and comment on it, not interrupt it or change it.

9. TALKING as much as possible in the presence of the infant develops language more quickly and comprehensively. Infants will demonstrate reciprocity and mimicry almost immediately. The more time spent by the parent in running commentary about the child’s immediate environment, the faster language will develop. If a child is being raised bilingually, the two languages will each develop faster if identified with one individual, (i.e., one parent speaks only Spanish in the infant’s presence and the other speaks only English in the infant’s presence).

10. PARENTING FEEDBACK should be in a ratio of 4 positives to

1 negative. This high positive ratio allows the child to discriminate appropriate from inappropriate behavior in a warm, loving environment. Parents should learn to respond calmly and with an a priori plan rather than emotionally react to inappropriate behavior. Alternatives to punishment are redirecting, correcting, giving a direction with guided assistance for following it the first time if the child does not spontaneously respond, and clear cuing for expected responses.


reports 2011 Early Childhood Music Therapy Special Target Population Network Meeting Report from 11-18-2011 Angela Snell, MS, MT-BC Co-Chair Early Childhood Network Monroe, MI

1. Welcome and Introductions. Dr. Petra Kern and Angie Snell, Early Childhood Network (ECN) Co-Chairs, welcomed all those in attendance and reviewed the meeting agenda. Attendees included 20 colleagues from 13 states (CA, FL, IL, GA, KS, MA, MD, MI, NV, NY, OH, PA, and TN). Dr. Kern expressed gratitude to the AMTA conference planners and Special Target Populations chairs for continued support for the ECN Special Target Population network session. She acknowledged the value of sharing and networking annually at the network session and thanked all for attending during an especially busy conference schedule. Angie Snell facilitated attendee introductions. Items handed out included: An attendance list, a presentations and publications list, a sign-up sheet for submissions to imagine 2012, a form to submit iPad application resources, and the 2012 ECN meeting agenda. 2. Early Childhood Network Information 2.1. What’s new with imagine? The 2011 issue was posted September 15, 2011. Dr. Kern, Editor, reported that there were 51 submissions for the ECN’s online magazine, imagine, published in this year’s edition. The multimedia and interactive nature of the magazine continues to be creative and current. This issue of imagine had eight podcasts, four photo stories, and numerous audio-visual samples. Dr. Kern mentioned a multimedia article on English as a Second Language (ESL) by Noelle Pederson and Dr. Barbara Reuer. Dr. Kern thanked Marcia Humpal for being the first contributor to the “Wisdom” section featuring seasoned music therapy colleagues who are experts in

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early childhood. Additionally, Dr. Blythe LaGasse authored the submission for the new “research snapshots” section. The “Color of Us” series in this issue focuses on early childhood music therapy practices in Europe. Dr. Kern noted that the ECN Asian “Color of Us” series was presented at the World Congress in Seoul, Korea in July, 2011. imagine continues to have a growing international readership, garnering over 8300 internet visitors since the inception of the website in September 2010. Dr. Kern reported that ECN outreach efforts to groups outside of the music therapy profession have increased awareness of imagine and early childhood music therapy. Dr. Kern was a guest on the Music Therapy Radio Show with Janice Harris and was invited to introduce imagine in the journal of the Early Childhood Music & Movement Association (ECMMA). ECMMA now posts complimentary articles from their professional journal, Perspectives, on the members’ only section on the AMTA website. Dr. Kern facilitated a discussion on keeping current with technology to further enhance member interaction, networking, and resources. The ECN and imagine have been mentioned in music therapy blogs. The group discussed the pros and cons of different ways to set up online discussion. The pilot of imagine will end in November, 2012. Discussion ensued about future options for the multimedia online magazine given its growing readership, content volume, and need for technology expertise. It may be necessary to expand the editorial board to assist with the time-consuming tasks of editing and providing feedback to the large number of contributing authors. Dr. Kern thanked editorial assistants Marcia Humpal and Lisa Jacobs. Appreciation was extended to all current and future authors.


Marcia Humpal spoke on behalf of all present in recognizing Dr. Kern’s work on imagine and the ECN website. The online magazine and website is now being visited by other professions and target audiences, such as parents and families of young children. The deadline for submissions to the 2012 issue is May 15, 2012. Submissions can now be submitted in a more efficient manner online on the ECN website under guidelines for authors. Assistance in recruiting more authors was requested. All are encouraged to submit articles and resources by the May 15 deadline. 2.2. Favorite apps. Dr. Kern solicited information on members’ favorite iPad apps for the next issue of imagine. Members briefly shared some sample favorites. A form was distributed to encourage all to write down apps and/or their willingness to share app resources. 2.3. Facebook Group. The group discussed ways to increase activity on the ECN Facebook page, such as posting resources and activities. Monitoring discussion threads was also explored. 3. Year 2011 in Review 3.1 Government Relations. Angie Snell reported that the Department of Education released the final regulations for Part C in the IDEA. Music therapy was not specifically listed as a recognized service in early intervention. The response to the regulation listed in the Federal Register on September 28, 2011 (pp. 60146-60147) states that the list of providers is not meant to be exhaustive and, in fact, specifically mentions music therapy as a viable service for early intervention (see Music Therapy Matters, Fall 2011, p. 3). Beth Schwartz provided further details and fielded questions from members struggling with school districts and early childhood providers. Dr. Dena Register reported that she was involved with developing a document from one of the AMTA State Task Forces that aligns the CBMT Scope of Practice with Part C. Members had several questions and shared case examples of students and young children needing music therapy services. A discussion of access to services through Part C and Part B ensued. Members suggested that supporting documents or simplified information be shared via imagine or the ECN Facebook page. 3.2 Presentations and Publications Presentations and new publications by ECN members were shared as well. The following list is a sampling of professional presentations given by ECN members in 2011: Denton, D.: Music Therapy and Music Education for Early Childhood, OMTA; Yoga and Early Childhood, ECMMA; DIR®/Floor Time™, Autism, and Music Therapy, Ohio Music Therapy Conference.

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Bolton, D.: Music in the Early Childhood Classroom, Davidson County Child Care Resource and Referral Agency Super Saturday Training. Register, D., Walworth, D., Hanson-Abromeit, D. and Kern, P.: The Impact of Music on Cognitive and Social Development in Early Intervention. Research symposium presented at the Third ISEI International Conference, New York, New York, May 2011. Kern, P., Chung, H. W., Sato K., Liu,M., Hsieh, F.-N., Ng, W. F.: The Color of Us: Music Therapy for Young Children in Asia. Roundtable presented at the 2011 World Congress of Music Therapy in Seoul, Korea, July 2011. Please review the “New Publications”section and book reviews for 2011-2012 publications of ECN members. Outlook: Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their Families edited by Petra Kern and Marcia Humpal (including 12 contributing authors) will be released by Jessica Kingsley Publishers at the 2012 AMTA conference. Please visit the ECN Facebook Group for additional professional activities of ECN members. About the Author Angela M. Snell, MS, MT-BC has specialized expertise in all areas of school music therapy, including assessment, program design, special education law, inclusion and community initiatives for Pre-K through PostSecondary students. She is a local, regional, and national presenter, author, and advocate on related topics. Contact:

Special Target Populations Network Session 2012 The next meeting will take place at the 2012 Annual AMTA Conference on Friday, October 12, 2012 12:00 - 1:45 PM St. Charles, IL See you there!


Changing Winds: Innovation in Music Therapy Sandi Curtis, Ph.D., MTA, MT-BC AMTA Vice President and Conference Program Chair

Don’t miss AMTA's 2012 conference in St. Charles, Illinois. The music therapy event of the year will focus on the winds of change, new directions, innovations and new answers for both professionals and students engaged in music therapy. Explore science and song. Discover research, rhythm, and blues you can use. Share strength in numbers, in harmony and in humor. Let the wind take you to the hottest topics, trends and compelling educational sessions. And of course, there will be many learning opportunities in the area of early childhood music therapy. Here is a sampling of these 2012 AMTA Early Childhood Events: Institutes, Pre-conference Training NICU Music Therapy Leading the Way – Music Therapy Businesses of the Future Tones, Tunes and Timbre: Creating a Music-Rich Therapeutic Environment In Early Childhood Music Therapy Ensuring Children’s Right to Music: Music Therapists Can Make it Happen

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Autism & Music Therapy: Connecting with Toddlers, Teens, and Adults on the Spectrum Music, Art, Dance, Drama, Play!: Grow Your Practice with Collaborative Pediatric Programming Developing Literacy through MusicBased Instruction Plus, a special FREE 3-credit Institute on Clive Robbins & His Legacy Concurrent Sessions Winds of Change: Contemporary Aspects of Serving Young Children with ASD The Role of Touch in Infant Development Music Therapy in Pediatric Hospice Developmental Speech Language Training through Music Hot Topics in Special Education: Music Therapy Practice and SelfDetermination for Students with Disabilities Orff Schulwerk Techniques for the Music Therapist Music Therapy for MedicallyFragile Infants and Toddlers Unlimited: Apps Starter Kit for Early Childhood Music Therapists Give Me Your Attention!: Techniques for Promoting Attention in Children with Autism Spectrum Disorders Working in the 21st Century Schools: Awesome Apps for Special Learners From Chaos to Community: Early Childhood Groups for Young Children with Autism

Making Connections: MT Interventions for Children and Adolescents in Psychiatric Facilities Roundtable Discussion: The iPad and Music Therapy in Special Education Using Music and Assistive Technology in Sensory Play for Children with Disabilities Music Therapy to Support Language Development in Children with Language Disorders Ethics in NICU Treatment and Research: Protecting This Most Fragile Population iPads and Electronic Instruments for Children with Autism Music Therapy Interventions and Observations of Babies Diagnosed with NAS A Voice From the Cocoon: Music & Imagery Interventions in Childhood Trauma Work Music Therapy Program Development to Improve Music Perception of Young Children with Cochlear Implants The Use of Music for Relaxation and Imagery in Pediatrics Action-Music: Family Intervention for promoting Joint Engagement of toddlers with autism Music, Emotions, and Children with Autism Autism Speaks and Sings Bright Start Curriculum: Adaptations for Multicultural Inclusion


State Recognition of Music Therapy in Early Intervention Submitted by Judy Simpson, MT-BC AMTA Director of Government Relations

In 2005, the American Music Therapy Association (AMTA) and the Certification Board for Music Therapists (CBMT) developed a state recognition operational plan with the major goal of achieving state recognition for the music therapy profession and the MT-BC credential required for competent practice. Over the past seven years, music therapists from around the country have worked together through state task forces to implement the action items outlined in this plan. One aspect of this recognition process is advocating with state agencies responsible for creating the regulations that guide early intervention programs. About the Author As AMTA’s Director of Government Relations, Judy Simpson, MT-BC represents the interests of members with state and federal legislators and agencies. Judy’s clinical experience has involved developing music therapy programs for clients of all ages in general hospital settings, including physical rehabilitation, oncology, labor and delivery, psychiatry, ICU, and general medicine.

Although many states may recognize the benefits of music therapy in early intervention, very few states actually list music therapists as qualified providers within state regulations. In an effort to assist state task force members as they educate state officials about how and why music therapy should be considered an early intervention service, the AMTA and CBMT state recognition team (Dena Register, CBMT Regulatory Affairs Advisor; Kimberly Sena Moore, CBMT Regulatory Affairs Associate; and Judy Simpson, AMTA Director of Government Relations) have developed the following document. This supportive information contains helpful references to the U.S. Department of Education’s Individuals with Disabilities Education Act (IDEA) Part C final regulations, effective October 28, 2011. It is recommended that all music therapists become familiar with this regulatory language as they advocate for improved access to music therapy in early intervention programs.


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State Recognition of Music Therapy in Early Intervention

Music Therapy in Early Intervention As representatives of The American Music Therapy Association (AMTA) and the Certification Board for Music Therapists (CBMT), we provide information to state agencies across the country when questions arise about the application of music therapy in education and healthcare settings. It appears that there are some misconceptions about the education, clinical training, recognition and acceptance of music therapy, not only within early intervention, but also within the education and healthcare industry as a whole. With over 60 years of clinical history in the United States, music therapists have long been officially recognized as qualified providers. In addition to the music therapy discipline specific coursework of the degree program, music therapists are required to study clinical foundation topics, including exceptionality and psychopathology, normal human development, principles of therapy and the therapeutic relationship. AMTA’s Professional Competencies and CBMT’s Scope of Practice outline detailed areas of knowledge and skills each clinician must demonstrate as a Board Certified Music Therapist. This includes knowledge of the potentials, limitations, and problems of exceptional individuals; knowledge of the causes and symptoms of major exceptionalities and terminology used in diagnosis and classification; and knowledge of typical and atypical human systems and development (e.g., anatomical, physiological, psychological, and social.) In the information below, we note our justification and precedence for access to music therapy services within Early Intervention Programs: The U.S. Department of Education continues to provide policy guidance regarding recognition of music therapy as a related service under IDEA, most recently in a June 2010 document titled, “Questions and Answers on Individualized Education Programs (IEPs), Evaluations, and Reevaluations.” Music therapy has a Procedure Code of 93.84 in the International Classification of Diseases-9th Revision Manual (ICD-9) used in reimbursement.

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Music therapy is listed on the U.S. General Services Administration (GSA) schedule under PROFESSIONAL AND ALLIED HEALTHCARE STAFFING SERVICES: 621-047. Music therapists are eligible to apply for the National Provider Identifier (NPI) system for billing under taxonomy code 225A00000X, which is included in the category of “Respiratory, Developmental, Rehabilitative and Restorative Service Providers”. In the states of Arizona, Indiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, North Carolina, Pennsylvania, Texas, and Wisconsin, music therapy has been a covered service under Medicaid and other disability waiver programs (i.e., Autism Spectrum Disorders, PACE, Developmental Disabilities, Traumatic Brain Injury). Recognition in Other Healthcare Service Areas The United States Code lists music therapy as a disease prevention and health promotion service and as a supportive service under Title 42: The Public Health and Welfare; Chapter 35: Programs For Older Americans; Subchapters I and III. CMS recognizes music therapy for Medicare reimbursement in Partial Hospitalization Programs (PHP). Music therapy is included under the Healthcare Common Procedure Coding System (HCPCS) Code G0176 for billing purposes. CMS recognizes music therapy on the revised Minimum Data Set (MDS) 3.0 assessment tool utilized for Medicare and Medicaid billing in skilled and residential nursing facilities. IDEA Part C Regulations References The U.S. Department of Education IDEA Part C Regulations published September 28, 2011 in the Federal Register state that early intervention services: “(4) Are designed to meet the developmental needs of an infant or toddler with a disability and the needs of the family to assist appropriately in the infant's or toddler's development, as identified by the IFSP Team, in any one or more of the following areas, including— (i) Physical development; (ii) Cognitive development; (iii)


Communication development; (iv) Social or emotional development; or (v) Adaptive development;” (Federal Register, September 28, 2011, p. 60247) Music therapists are eligible to provide services in early intervention programs through the clarification outlined in the Part C Regulations Section (d) Other Services: “(d) Other services. The services and personnel identified and defined in paragraphs (b) and (c) of this section do not comprise exhaustive lists of the types of services that may constitute early intervention services or the types of qualified personnel that may provide early intervention services. Nothing in this section prohibits the identification in the IFSP of another type of service as an early intervention service provided that the service meets the criteria identified in paragraph (a) of this section or of another type of personnel that may provide early intervention services in accordance with this part, provided such personnel meet the requirements in § 303.31.” (Federal Register, September 28, 2011, p. 60249) This reference to Section 303.31 regarding qualified personnel further clarifies that music therapists are eligible to provide early intervention services, as the profession has an established national exam-based board certification required to practice: “Qualified personnel means personnel who have met State approved or recognized certification, licensing, registration, or other comparable requirements that apply to the areas in which the individuals are conducting evaluations or assessments or providing early intervention services.” (Federal Register, September 28, 2011, p. 60251) Additional support for recognizing music therapy as an early intervention service is provided in the Part C Regulations Analysis of Comments and Changes: “Section 303.13(d) clearly conveys that the early intervention services identified in §303.13(b) are not an exhaustive list and may include other developmental, corrective, or supportive services that meet the needs of a child as determined by the

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IFSP Team, provided that the services meet the criteria identified in §303.13(a) and the applicable State’s definition of early intervention services. We added the previous definitions of nursing services and nutritional services to these final regulations because these definitions are defined in the current regulations and relied upon by the field. However, adding new definitions of additional services identified by the commenters, such as music therapy and respite care, is not necessary.” (Federal Register, September 28, 2011, p. 60147) Music therapy is a cost-effective, efficient, professional therapy. In fact, preliminary cost analyses conducted in cooperation with AMTA’s members indicate a net increase in future costs if access is denied and other professional services are substituted for music therapy. The therapy that takes place among clients with disabilities, and offered by Board Certified Music Therapists, is able to address multiple domains in one session i.e., communication, motor, and cognitive skills. Music therapy also deals with the behaviors and psychosocial issues that often present barriers to meeting almost all other needs of the client. Music therapists accomplish it in a unique way that is unmatched, but complementary to other important related services. The cost savings realized by these interventions demonstrate one way to effectively utilize taxpayers’ money, which we know is a primary concern at this time. Thank you for your attention to this important matter. We hope this information helps to clarify federal recognition of music therapy so that access to evidence-based interventions may be maintained for those individuals who demonstrate the need for this service. We welcome your questions and look forward to future opportunities to discuss the benefits of music therapy for the children of your state. Judy Simpson, MT-BC AMTA Director of Government Relations Dena Register, Ph.D., MT-BC CBMT Regulatory Affairs Advisor Kimberly Sena Moore, MM, MT-BC CBMT Regulatory Affairs Associate


reflection “Sunny Days” for Music Therapy: Sesame Street and AMTA Share the Value of Making Music with Young Children Ilene Berger Morris, LCAT, MT-BC Alternatives for Children Suffolk County, NY

© 2012 Sesame Workshop

You can tell that Hoots the Owl really has “the blues” as soon as the Music Works Wonders begins. His finefeathered band-mates are heading south to meet their newest hatchlings, flying the coop right before the big jam session! The plaintive notes that Hoots plays on his saxophone attract the attention of little Elmo, who tries to think of a solution to help salvage the jam session. While deep in thought, Elmo begins humming, which gives Hoots an idea: Music doesn’t have to come from formal instruments playing specific notes. Music is all around us every day, and everyone can make music! A dozen years ago, the producers of Sesame Street Music Works hosted a symposium, inviting authorities in early childhood development, music education, and other related fields to take part in a meeting of minds. The purpose was to develop a state-of the-art multimedia outreach initiative in the form

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of a video and related material, espousing the value of music in the lives of young children. Among the experts were representatives from the American Music Therapy Association (AMTA), Dr. Deforia Lane and Marcia Humpal. Beth McLaughlin served on a project focus group that facilitated incorporation of music therapy ideas and principles. Each of these music therapists greatly influenced the direction and message of the project. Marcia Humpal described the “painstaking attention to detail and appropriateness, and hours of work around a big conference table” as the project took shape to meet the needs and goals determined by the diverse team. Music Works Wonders would give parents, educators, and caregivers an understanding of the role music plays in a young child’s development, provide a means for parents and caregivers to make music with children regardless of


musical training, celebrate a shared enjoyment and value of making music, encourage a love of music in children right from the start, and demonstrate both cultural uniqueness and commonality through music. The idea that facilitating musical experiences for children need not require costly instruments or equipment was critical as the intended audience included consumers with limited resources. The final multimedia kit consisted of a video, parent/caregiver guide, information on music as it relates to childhood development in the preschool years, a colorful poster depicting families of instruments (i.e., percussion, strings, brass/wind, and body/voice) with instructions for making homemade versions, and a response card requesting feedback. A website offered supplemental information and music games. All components of the kit were in English and Spanish and were available, free of charge, to families, day care providers, early childhood educators, and other community programs involved with young children. The music therapists who advised Sesame Street Music Works advocated demonstrating the role of music as a bridge between children of different needs and abilities and as a vehicle to bring different cultural ideas together. They suggested ways to expand the

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use of music for academic enhancement. Dr. Deforia Lane explained how the music therapy perspective promoted “using music in a purposeful, intentional way, to affect behavior and create community.” To that end, the Music Works Wonders video included a unique segment – a board-certified music therapist working with an integrated class of preschoolers. This unscripted portion was recorded in an actual classroom. The first scene shows the group making music with rhythm sticks, playing creatively and interacting with each other, encouraged by the music therapist. In the next scene the children are filling empty bubble bottles with seeds to make shakers and decorating oatmeal containers to make drums. Then the group resumes music-making using their homemade instruments, accompanied by the music therapist on guitar. Hoots and Elmo provide voice-over commentary on all the action, and when the scene transitions back to the Muppets set, Elmo is singing the “bye-bye”song the group had been singing. Due to my experience in and commitment to working with special needs preschoolers in bilingual settings, I had the honor of being the music

therapist in these scenes. In its few minutes of duration, the on-location classroom segment gets to the heart of the project’s message. Watching the children playing, creating, and learning, one can clearly see that music is enjoyable, everyone can make music, we express ourselves through music, music brings people together in a shared experience, children learn about music by participating in music, and music can be made with simple as well as quality instruments. These themes are reinforced throughout the remainder of the video as Elmo broadens his notion of music to include such sounds as body percussion noises, the swish of a broom sweeping, animal/nature sounds, and banging on a garbage can lid. When Elmo arrives

© 2012 Sesame Workshop


© 2012 Sesame Workshop Music therapist Lee Morris handing out rhythm sticks to preschoolers.

© 2012 Sesame Workshop The music therapy group making shakers out of empty bubble bottles and drums out of oatmeal containers.

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at the jam session at the culmination of the video, he has brought a cylindrical box to beat, just like the drums that were made in the classroom music session. A crowd of children and other puppets make up the rest of the impromptu band, using orchestral instruments such as trumpet and violin, culturally diverse instruments such as djembe and guiro, “found” or non-traditional instruments, such as trash can lids and a peck-able corn cob, and body percussion such as clapping and stomping. What’s more, the viewer is invited to play along to the jam session’s catchy song “That’s Music!.” According to Jeanette Betancourt, Senior Vice President for Outreach and Educational Practices at Sesame Workshop, the response to Music Works Wonders since its release about 10 years ago has been profound. “Parents realized that they could expose their children to music in a variety of ways,” Dr. Betancourt recently reported, adding “educators found the materials easy to use and incorporate,” and many others appreciated “how easily you can engage young children in the music experience.” Anecdotal praise was joined by wider and formal recognition as the video garnered 11 different awards, including a Cine Golden Eagle award, Aurora awards, and International Film & Video awards. Dr. Betancourt remarked that at the advisory level, AMTA was critical to the success of the project and likened Dr.

Deforia Lane to a music therapy ambassador, “guiding the transfer and integration of information between worlds.” Although the funding to support the outreach initiative is no longer in place, the video is still available and can be downloaded for free from iTunes. Search “Learn Along with Sesame” and select “Music Works Wonders.” For the Spanish version, click on “Aprende con Sesame” and select “¡Maravillas Musicales!” The video can also be accessed through Amazon Video On Demand. The partnership between the music therapy world and Sesame Street has been productive and symbiotic, and I look forward to reporting on future collaborative projects like Music Works Wonders. The author wishes to thank Jeanette Betancourt, Ed.D., Marcia Humpal, M.Ed., MT-BC, and Deforia Lane, Ph.D., MT-BC for the details and comments they provided and for their work in ensuring that music is an integral part of the lives of young children. Additional information was obtained from member-programs/sesame-streetmusicworks.


Sesame Workshop’s Music Works Wonders was developed and distributed through collaboration, support, and/or funding from partnering organizations and companies including: National Association of Music Merchants (NAMM), Music Educators National Conference (MENC), American Music Therapy Association (AMTA) and Chevron/Texaco.

About the Author A music therapy clinician for over 30 years, Lee Morris, LCAT, MT-BC lives and works in Suffolk County, NY. She works in special education settings with young children and adolescents, and in a hospital with patients of all ages.


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Š 2012 Sesame Workshop


featured Coming into Being in Music: Clive Robbins’ Work with Young Children Nina Guerrero, M.A., MT-BC, LCAT David Marcus, M.A., CMT, LCAT Alan Turry, D.A., MT-BC, LCAT Nordoff-Robbins Center for Music Therapy Steinhardt School of Culture, Education, and Human Development


New York University New York, NY

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Photo courtesy of the Nordoff-Robbins Center, New York.

Clive Robbins, CMT/RMT, DHL, DMM Co-Founder of Nordoff-Robbins Music Therapy



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Dr. Clive Robbins was a pioneer, a visionary, and a joyful human being. He loved making music and using music to reach individuals whom many considered unreachable. The music therapy community lost a true friend and advocate when he passed away on December, 7, 2011. Because of Clive’s extensive and excellent work with young children, AMTA’s early childhood online magazine imagine is a perfect venue for giving a tribute to him. Clive Robbins and the Music Child A natural place to begin exploring the work of Dr. Clive Robbins with young children is the concept of the music child – the universal human capacities for musical perception and response that are uniquely manifested in every individual, embodying his or her creative core potential for growth and development irrespective of disabilities (Nordoff & Robbins, 2007). With singular clarity of vision, Clive found ways to call forth the music child and to work at each child’s developmental threshold, cultivating the child’s motivation toward positive interaction and self-actualization. The special qualities that he brought to working with young children are best illuminated by the simple fact that he could easily and without self-consciousness access his own child-like wonder and exuberance. He conveyed unabashed joy when playfully interacting with young children. This was striking to watch because he was a tall man, yet when he worked with children he never seemed to tower over them. The age difference seemed to disappear as he gleefully engaged with them in a heartfelt manner. One never felt that Clive was calculating; he naturally responded to young children with spontaneity and humor.


Yet he very much had a therapeutic agenda, an idea of what a child’s next developmental step could be. Clive was not merely having fun, though there was joy underlying everything he did. He valued the experience of joy and felt it was a transformative one for young children. At the same time, he could perceive and intuit a child’s dormant capabilities and find ways to potentiate these capabilities. And Clive did ask children to work, to strive. They seemed to feel the depth of his joy and love for them even as he challenged them to take a step in their development. In sessions, he rarely appeared to become frustrated. When a child was resistive or hard to reach, a wry smile would appear on Clive’s face, as if to say, “I like this challenge. Now how are we going to work this out? What are we going to learn from you? I’m ready to learn my lesson from you today.” Sunfield and Philadelphia: Early Work Clive Robbins began his collaboration with American pianist and composer Paul Nordoff in 1959 at Sunfield Children’s Homes in Worcestershire, England. Over the next sixteen years, these two pioneered the application of improvisational and compositional techniques in music therapy, as well as detailed analysis of therapy sessions, which allowed for innovations in research and theory. The therapeutic approach that they developed at Sunfield effectively engaged children with severe developmental delays, autism spectrum disorders (ASD), psychotic characteristics, and physical challenges. In the 1960s, Nordoff and Robbins became involved in a project in the Department of Child Psychiatry at the University of Pennsylvania School of Medicine through the support of two successive National Institute of Mental Health (NIMH) applied research grants. Encompassing treatment, training, research, and publication components, the project was an unprecedented study of music therapy as a means of establishing communication and relationship with children with ASD and other developmental disabilities. Building upon existing assessment tools in clinical psychology, Nordoff and Robbins developed rating scales that captured the qualities of musical and personal interaction unique to creative music therapy. Many of the cases that became the basis of their teaching were conducted during the period of this grant, and were eventually published in their seminal text, Creative Music

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Therapy, originally published in 1977 (Nordoff & Robbins, 2007). Among them was the case of Edward, a five-year-old boy with minimal functional communication, aversion to social interaction, frequent tantrums, repetitive behaviors, and lack of daily living skills. The audio excerpts depict the therapists’ use of clinical improvisation to meet and engage Edward in the very midst of his tantrums, leading him over the course of nine sessions into “self-expressive intercommunicative singing.” As they describe, “personal and musical conditions so combined to make it possible for him to participate in sustained two-way communication. He became a successfully active partner in an interactive situation…” (p. 40). Through empirical review of session recordings, Nordoff and Robbins closely examined the therapeutic relationship as an interpersonal field of musical communication. They observed the dynamics of intersubjectivity and attunement in interactive, improvisational music-making with clients, and their organizing potential – helping the child to self-regulate emotionally, and thereby build the capacity to think and reflect. Their findings had strong resonances with psychological research on preverbal communicative interaction between infants and their primary caregivers. What Trevarthen (1980) called the "protoconversation" of infant and caregiver is a richly musical exchange with mutually responsive shifts in rhythm, phrasing, melody, and dynamics. Aspects of attunement and the developmental processes of intersubjectivity became the focus of a vast body of research on infant communication that brought about a paradigm shift during the last decades of the 20th century: A shift to conceiving of human development as a relational process — a dynamic interpersonal world before words which forged and fostered perception, cognition, emotion, communication, and all aspects of the individual and social self. While the infancy researchers were mainly working with normally developing infants and their parents, Nordoff and Robbins utilized the therapeutic potential of music as a medium for communicative interaction with atypically developing children, often with significant impairments. In his preface to Therapy in Music for Handicapped Children (Nordoff & Robbins, 1971), composer Benjamin Britten wrote that amidst a political and social climate in which "the validity of communication in art" had been called into question, here was a musical approach "where the concentration is entirely


on just this: On communication, pure and simple” (p. 9). Bringing Music to Children with Hearing Loss In 1975, Clive formed a new team with his wife Carol. From 1975 through 1981, with support from federal funding, the Robbinses developed a comprehensive music program for students aged 3 through 18 at the New York State School for the Deaf (NYSSD) in Rome, New York (Robbins & Robbins, 1980). Their work with children with hearing loss beautifully exemplified their conviction that musicality is a fundamental, integral capacity of human cognition and emotion, not simply of the ear. Especially for the youngest children, this work had profound significance in promoting the natural development of communication through immersion rather than didactic instruction. Clive and Carol immersed the children in a holistic context of auditory stimulation, playful vocalization, and the creative possibilities of non-verbal expression through music. Beyond the development of speech and auditory skills, they offered children with hearing loss an opportunity for mutual listening in a deeper sense, involving the integration of all of one’s senses in response to another’s presence and expression. As the children were being challenged to listen, they also were having the experience of being closely listened to – and it is on the basis of being listened to that young children develop a sense of communicative efficacy (Stern, 1990; Trevarthen, 1980). In the following two video excerpts, Clive leads a preschool group at NYSSD in singing, signing, and moving to Carol’s musical piece I Can Sing.

Watch Preschool Group at NYSSD – I Can Sing, Part I

Watch Preschool Group at NYSSD – I Can Sing, Part II

In 1989, Clive and Carol Robbins returned to the U.S. to cofound the Nordoff-Robbins Center for Music Therapy at New York University, where Clive maintained a vital presence until his death in December, 2011. Today the Center serves over 100 children and adults each year with a wide range of needs and also conducts clinical research in collaboration with educational and health-care institutions in the community. In addition, the Center offers specialized post-graduate training to music therapists, as well as practicum placements for music therapy, music education, psychology, social work, and drama therapy students. Nicole: The First Child Served at the Nordoff-Robbins Center, NY Four-year-old Nicole was the first child at the Center with whom Clive and Carol Robbins worked. Blind, autistic, and so small that her foot was the size of a penny when she was born in the twenty-fourth week of gestation, Nicole had not been expected to survive. Because the facilities of the Center were not yet ready, she began her sessions in the living room

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of Clive and Carol’s home. The sense of being at home, of coming home to music, was a pervasive theme throughout the many years of her therapy. It was as if she were engaging with family when she came to music therapy. It is interesting to note that Clive and Carol did not have a child of their own, and perhaps Nicole embodied their “music child” in more ways than one. They saw her strong potential to thrive and develop through musical interaction, as she immediately conveyed musical sensitivity, exquisite listening skills, and joy in music. Clive and Carol recognized how meaningful this could be to Nicole’s mother, who worked so hard to nurture her. When the Robbinses began working at the Center, they made sure that Nicole’s mother could view every session through a closed circuit system. Nicole relished making music with Carol at the piano. She began to share ideas, wait and respond musically, and laugh appreciatively when Carol would play something surprising or amusing. In a sense, Carol was a maternal presence nourishing Nicole's unfolding musicality and ability to relate to others. Nicole often looked ecstatic, evidently having what Maslow (1982) would call “peak experiences” as she engaged in various music-making activities with Carol. She loved to improvise at the piano while Carol provided a grounding ostinato bass pattern. Carol's music was nurturing, her voice loving and maternal. If Carol was a kind of musical mother, Clive was her spiritual father. He sang to her and with her, danced with her, held her, guided her, encouraged her, laughed with her. They had a special relationship that led to developmental “firsts” for Nicole. She began to use language in response to Clive's playful yet insistent singing of questions. To see Clive in action with Nicole was to see love in action. And Nicole loved him dearly. Because Clive was able to convey his complete and authentic self in his voice – laughing, singing, urging – Nicole drew close to him and they had a very intimate relationship. She loved to hold him, sit in his lap, feel his physical presence as she engaged in music. Clive was as much a part of the musical experience as Carol's music was. One of the most touching moments in the course of therapy occurred when Clive encouraged Nicole to invite her mother into the session so that they could playfully interact with each other during the song “What's That?” (Nordoff & Robbins, 1968), which focuses on identification of body parts. After Clive had completed the song several times with Nicole, he encouraged her to sing the song to her mother. This had emotional intensity, as Nicole very rarely communicated verbally with her mother, and in fact had never before used the word “Mama.” Clive guided her to touch and identify her mother’s hair, nose, and so on; and at the end of this very close physical interaction, Nicole was able to complete the final line, “That's Mama.” Her mother was visibly moved.

Watch Nicole – That’s Mama


It is important to note that Clive was not sentimental about this tender moment, but very matter of fact. As he proceeded with the session and the course of therapy, he always worked to find the key to Nicole’s further development. He clearly loved all of the children he worked with, and utilized that love to discern the unfolding potential of each child. Morgan: In Therapy with Alan and Clive Clive’s work with four-year-old Morgan, with Alan Turry as primary therapist, was another case in point. According to Morgan’s mother, he had been developing normally until age two when he “stopped trying to communicate.” She reported that he was not a happy child, was uninterested in other people, and had trouble sleeping at night. He appeared tired when entering his first music therapy session. But a positive tone was set through improvised music that matched his assertive stride into the room, with Clive welcoming him and inviting him to play instruments, while allowing him space to explore. As a co-therapist, Clive maintained an exquisite balance between patiently, unobtrusively waiting for a child’s initiatives, and actively facilitating the child’s engagement.

Watch Morgan – Discovering Music

In this first session, as Alan played at the piano with Morgan who alternated between drum, cymbal, and xylimba, Clive was visibly enthralled. His enthusiasm for Morgan’s discoveries encouraged both Morgan and Alan to continue, to listen to each other, to find ways to meet in the music. Clive’s expression of joy was genuine – he truly took pleasure seeing how creative and active Morgan quickly became in the music room. Yet he was also assessing what Morgan could do next: Could he respond to a song with words celebrating his discovery that music could be a wonderful way to relate to others? Clive began to sing the theme that would be brought back throughout the course of therapy: “It’s Morgan’s music day. It’s Morgan’s music day! It’s music, music, music, music, music all the way.” Though simple, it captured the essence of Morgan’s attitude and celebrated the experience of shared music-making. As the sessions went on, Clive continually found new ways to engage Morgan, whether by singing, playing, or spontaneously dancing. Clive always had what seemed like an inexhaustible reservoir of energy to tap into when engaging with young children.

Watch Morgan – It’s Morgan’s Music Day

Even late in his life, when he was clearly struggling physically, Clive would occasionally come into sessions with clients. On one such occasion, Clive substituted for the co-therapist with a young child who was having difficulty relating to the primary therapist at the piano. He quietly observed the boy, sensing the possibilities for engaging him. The boy was sitting close to

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the wind chimes, and Clive was sitting on the other side. Slowly, Clive moved his face closer to the boy. The wind chimes were between him and the child, and Clive kept moving closer, until his nose – a nose not insignificant in size – crossed over to the other side where the boy was situated. This amused the boy to no end, and he became interested in playing the wind chimes. It was a key moment in the therapy process and Clive had initiated it in his own inimitable way. Closure Over the past five decades, Nordoff-Robbins music therapy has expanded into diverse settings and populations internationally, reflecting the extensive reach and enduring influence of Clive Robbins’ clinical practice, research, teaching, writings, and media presentations. In his teachings, no less than in his clinical work, Clive was a motivator, a visionary whose passion was contagious. He imparted the essence of Nordoff-Robbins Music Therapy largely by enabling his audiences to share his own experiences. Using the vast archive of case material that he had recorded, he shared with students all over the world his experience of working with music, and the remarkable growth and development it facilitated. They were enthused by his enthusiasm; inspired by his inspiration; transformed by the transformations they heard occurring, one after another, in the music therapy sessions. Just as he sparked intrinsic motivation within children to come more fully into being through creative musical exchange, Dr. Clive Robbins empowered therapists to work from their own direct experience of relationship in music with each client. As he wrote, The longer music therapists work in this way and experience directly the commitment children bring to bear on discovering or extending musical interactivity – and experience the intensifying individual presence of a child in his or her musical activities – the more evident it becomes that within the music child, and self-actualizing within it, manifests the core self of the individual, the center of personhood, the being child (Nordoff & Robbins, 2007, p. 17). By embracing this experience, therapists place their “creative potential, musical resources, and personal maturity” at the service of clients’ needs; allow themselves “to be led and taught” by each client; and open themselves to “a source of untold and unforeseeable inspiration for the realization of creative healing in music therapy” (Nordoff & Robbins, 2007, p. 17).

Watch Dr. Clive Robbins – Enthusiastic Teaching


References and Resources Aigen, K. (1995). The aesthetic foundation of clinical theory: A basis of Nordoff-Robbins music therapy. In Carolyn B. Kenny (Ed.), Listening, playing, creating: Essays on the power of sound (pp. 233–257). New York, NY: State University of New York Press. Aigen, K. (1995). Cognitive and affective processes activated in music therapy: A model for contemporary NordoffRobbins practice. Music Therapy, 13(1), 13-46. Aigen, K. (1996). Being in music: Foundations of NordoffRobbins music therapy. Nordoff-Robbins Music Therapy Monograph Series #1. St. Louis, MO: MMB Music. Aigen, K. (1998). Paths of development in Nordoff-Robbins music therapy. Gilsum, NH: Barcelona. Forinash, M. (1992). A phenomenological perspective of the Nordoff-Robbins approach to music therapy: The lived experience of clinical improvisation. Music Therapy, 11, 120-141. Maslow, A. H. (1982). Toward a psychology of being (2nd ed.). New York, NY: Van Nostrand Reinhold. Nordoff, P., & Robbins, C. (1968). The second book of children’s playsongs. New York, NY: Presser. Nordoff, P., & Robbins, C. (1971). Therapy in music for handicapped children. London: Gollancz. Nordoff, P., & Robbins, C. (1983). Music therapy in special education. St. Louis, MO: MMB Music. Nordoff, P., & Robbins, C. (1998). Edward. Nordic Journal of Music Therapy, 7(1), 57-64. Nordoff, P., & Robbins, C. (2007). Creative music therapy: A guide to fostering clinical musicianship (2nd ed.). Gilsum, NH: Barcelona. Robbins, C. (1993). The creative processes are universal. In M. Heal & T. Wigram (Eds.), Music therapy in health and education (pp. 7–25). London and Philadelphia: Jessica Kingsley Publishers. Robbins, C. (1997). What a wonderful song her life sang: An anthology of appreciation for Carol Robbins. New York, NY: The International Trust for Nordoff-Robbins Music Therapy. Robbins, C. (1998). Introduction to the study of Edward. Nordic Journal of MusicTherapy, 7(1), 55-56. Robbins, C. (2005). A journey into creative music therapy. Gilsum, NH: Barcelona. Robbins, C., & Robbins, C. (1980). Music therapy for the hearing impaired and other special groups. St. Louis, MO: MMB Music. Robbins, C., & Robbins, C. (1991). Self-communications in creative music therapy. In K. E. Bruscia (Ed.), Case studies in music therapy (pp. 55-72). Phoenixville, PA: Barcelona. Robbins, C., & Robbins, C. (Eds.) (1998). Healing heritage: Paul Nordoff exploring the tonal language of music. Gilsum, N.H.: Barcelona. Robbins, C., & Forinash, M. (1991). A time paradigm: Time as a multilevel phenomenon in music therapy. Music Therapy, 10(1), 46-57. Stern, D. (1990). Diary of a baby: What your child sees, feels, and experiences. New York, NY: Basic Books.

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Trevarthen, C. (1980). The foundations of intersubjectivity: Development of interpersonal and cooperative understanding in infants. In The social foundations of language and thought: Essays in honor of Jerome S. Bruner (pp. 316-341). New York: Norton. About the Authors Nina Guerrero, M.A., MT-BC, LCAT is Research Coordinator at the NordoffRobbins Center. She currently oversees projects investigating effects of Nordoff-Robbins music therapy on the development of communication, social interaction, and creative expression in young children with autism spectrum disorders; music perception and speech perception in children with cochlear implants; and physical, psychological, and social well-being in stroke patients. Contact:

David Marcus, M.A., CMT, LCAT, Coordinator of Special Projects and Publishing at the Nordoff-Robbins Center, contributed extensive coauthorship to the revised edition of Creative Music Therapy (Nordoff & Robbins, 2007). A senior clinician and supervisor at the Center, he is also cofounder and co-director of the Creative Music Therapy Studio, a private NRMT practice in Manhattan; and serves as adjunct faculty in the graduate music therapy program at NYU. Contact:

Alan Turry, D.A., MT-BC, LCAT, Managing Director at the NordoffRobbins Center, was the first certified instructor of Nordoff-Robbins Music Therapy, and is renowned for his innovative contributions to the approach. He oversees the graduate internship program and Advanced Certification training at the Center, teaches clinical improvisation and develops course work in the NYU graduate music therapy program, and is in demand internationally as a teacher and presenter. Contact:



We must remember that the power of music in therapy stems from the reality that music is an art, that music therapists are privileged to mediate this art to meet many areas of need and experience. –Clive Robbins, 1993

Note: The 2012 featured article is available as a full multimedia article on the imagine website. imagine 3(1), 2012


research 2012 Early Childhood Research Snapshot Blythe LaGasse, Ph.D., MT-BC Assistant Professor of Music Therapy Colorado State University The purpose of this snapshot is to support music therapy practitioners to stay abreast of the latest research and to maintain an evidencebased practice. The 2012 imagine research snapshot covers research related to using music with young children, with an emphasis on scientific outcomes demonstrating a link between music and speechlanguage development. Music Training and Language There has been a recent proliferation of music education and neuroscience research demonstrating a relationship between auditory skills, musical skills, and nonmusical skills (Jentschke, Koelsch, Sallat, & Friederici, 2008; Lathroum, 2011; Loui et al., 2011; Marin, 2009; Milovanov & Tervaniemi, 2011). This line of research can provide insight into child development and the potential for auditory treatment methodologies to impact development. Perhaps the most prominent finding in the literature is the link between musical skills and literacy.

Blythe LaGasse, Ph.D., MT-BC

Advances in technology have allowed researchers to measure cortical and brainstem responses to auditory stimuli. Strait, Hornickel and Kraus (2011) measured brainstem sensitivity to acoustic regularity in speech and music in 42 children ages 8 -13. Responses were compared to auditory working memory and attention, music aptitude, and reading ability. Findings indicated that both music aptitude and literacy were related to the children’s auditory working memory and the ability of their brainstem to adapt to regularities of auditory input. These results suggest that the ability to process patterned information directly impacts music and literacy skills. Patterned information processing also has been compared to phonological awareness in children. Huss, Verney, Fosker, Mead, & Goswami (2011), found a relationship between perception of musical meter and phonological awareness, with metrical sensitivity predicting phonological awareness. Furthermore, children with dyslexia performed significantly more poorly on the simplest metrical

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tasks. These studies indicate that there are shared mechanisms between language processing and music that may be similarly impacted with delay. Interestingly, it has been suggested that strengthening one skill could influence the other (Moreno et al., 2009). In recent years, research has examined the ability of auditorybased interventions to change cortical and brainstem processing. Russo, Hornickel, Nicol, Zecker, & Kraus (2010) found that an auditory-based treatment improved brainstem and cortical response timing in five children with Autism Spectrum Disorders (ASD), relative to a control group that did not receive the treatment. This study utilized a computer-based program focused on listening, sound sequencing, auditory attention, auditory discrimination, memory, and phoneme discrimination. In a similar study, Stevens et al. (2008) demonstrated that children who underwent six weeks of auditory-based training showed significant improvement in cortical responses and standardized receptive language scores. These studies provide initial evidence that auditorybased training programs may change brain responses and influence nonmusical skills. Impact of Musical Training on Language Skills Several studies have indeed shown that music training in children results in improvements in language skills including speech pitch perception (Moreno et al., 2009), phonemic learning/awareness (Corradino, 2009), phonological memory (Gross, Linden, & Ostermann, 2010), reading comprehension (Corrigall & Trainor, 2011), reading ability (Moreno et al., 2009), vocabulary learning (Piro & Ortiz, 2009) and preliteracy skills (Moreno, Friesen, & Bialystok, 2011). In a study focused on preschool children, Degé & Schwarzer (2011) tested phonological awareness and then randomly assigned children to a music group, phonological skills group, or sports group. The music group consisted of joint singing, drumming, rhythmic exercises, dance and basic music skills (notation, meter, and intervals). Children in the music and phonological groups significantly improved in measures of phonological awareness, particularly in large phonological units (words). This study provides some evidence that participation in music can positively affect language skills.

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In order to determine if long-term exposure to music was correlated to higher level nonmusical skills, Corrigall and Trainor (2011) compared reading comprehension and word recognition in children with and without musical training. After accounting for age and socioeconomic status, the researchers found a robust correlation between musical training and reading comprehension skills. Several other studies have found similar results; children who are exposed to music instruction demonstrate increased speech, language and literacy skills (Kraus & Chandrasekaran, 2010; Loui et al., 2011; Marin et al., 2009). It is important to note that many of these studies are completed on typically developing persons. Furthermore, it could be argued that children who are attracted to music training have naturally higher cognitive skills (Schellenberg, 2011). However, the collective body of causal and correlation studies is beginning to come to a similar conclusion: Engagement in music has the potential to impact development. In an effort to explain the influence of music on encoding of speech and language, Patel (2011; 2012) proposed the “OPERA” hypothesis. The acronym OPERA stands for: 1) Overlap between music and nonmusical processing in the brain; 2) Precision of processing for musical stimuli; 3) Emotion elicited from engaging in music; 4) Repetition of and within musical activities; and 5) focused Attention promoted in music engagement (Patel, 2011, p. 1). Patel (2012) proposed that musical training enhances speech encoding when the above five conditions of the OPERA hypothesis are met. Enhanced speech encoding then influences language and reading skills. This hypothesis provides an interesting perspective on how the systematic application of music could enhance nonmusical skills. What does all this mean for early childhood music intervention? There appears to be a relationship between music and language (including speech and literacy). This relationship may be due to the shared brain activations observed in language and music engagement (Patel, 2012; Schön et al., 2010). Furthermore, the evidence suggests that skills can be enhanced with auditory-based interventions. Since music has been shown to facilitate brain changes in children, providing music experiences during early childhood


could promote language skills during the critical period for language development. Therefore, early intervention could potentially lead to life-long changes in auditory, musical, and language functioning. Speech and Language Development Over the past year, a few studies emerged on speech and language skills in children with ASD. One such study by Wan et al. (2011), though it focused on older children with ASD, demonstrated significant gains in verbal communication following music intervention. This study was a “proof of concept” study, completed on six low- or non-verbal children who underwent 8 weeks of intensive therapy (5 days a week for 45 minutes). The researchers used a protocol that included intoning short phrases while hitting tuned drums, a technique they call Auditory Motor Mapping Training. Music for communication has also been tested in a behavioral approach. Lim and Draper (2011) added music to an Applied Behavioral Analysis Verbal Behavioral approach. Results indicated that children in speech and music groups showed significant improvements; however, there were no differences between the groups. One area where the music condition was found to be more effective was in promoting echoic production of speech. Although the literature in this area is limited, these initial studies indicate that music may be useful in speech and language training of children with ASD. Music for Mothers and Infants A study by Keith, Weaver, and Vogel (2012) focused on determining the effect of a music intervention on the amount of breast milk produced by mothers with pre-term infants. Mothers who listened to music produced more milk, with higher fat content than mothers who did not listen to music. In another study, mothers involved in live harp music therapy paired with kangaroo care demonstrated a significant reduction in anxiety as compared to kangaroo care alone (Schlez et al., 2011). Schlez et al. reported no significant effect on the infants’ physiological measures. A reduction in maternal anxiety was also demonstrated in a study that compared music listening, magazine reading and no stimuli prior to an amniotic fluid test (Ventura, Gomes, & Carreira, 2012). These studies continue to add to the literature

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demonstrating the positive effects of music for mothers and infants. The featured studies highlight some of the current research in early childhood settings. Although more research is needed to show the efficacy of music therapy in early intervention, the initial evidence indicates that music could be an extremely powerful tool in child development. In order to provide readers with the opportunity to explore these studies further, the reference list below has direct links to the study abstracts via PubMed ( pubmed/) or the digital object identifier (DOI) number (http:// References Corradino, G. (2009). Improving letter recognition and beginning sound identification through the use of songs with special education kindergarten students. (Unpublished Masters Thesis). Caldwell College, Caldwell, NJ. Corrigall, K. A., & Trainor, L. J. (2011). Associations between length of music training and reading skills in children. Music Perception, 29(2), 147-155. Degé, F., & Schwarzer, G. (2011). The effect of a music program on phonological awareness in preschoolers. Front Psychol., 2, 124. Gross, W., Linden, U., & Ostermann, T. (2010). Effects of music therapy in the treatment of children with delayed speech development – results of a pilot study. BMC Complement Altern Med., 10(1), 39. PMID: 20663139 Huss, M., Verney, J.P., Fosker, T., Mead, N., & Goswami, U. (2010). Music, rhythm, rise time perception and developmental dyslexia: Perception of musical meter predicts reading and phonology. Cortex, 47, 674–689. Jentschke, S., Koelsch, S., Sallat, S., & Friederici, A.D. (2008). Children with specific language impairment also show impairment of music-syntactic processing. J. Cogn. Neurosci., 20, 1940–1951. Keith, D. R., Weaver, B.S ., & Vogel, R. L. (2012). The effect of music-based listening interventions on the volume, fat content, and caloric content of breast milk-produced by


mothers of premature and critically ill infants. Adv Neonatal Care, 12(2), 112-9. PMID: 22469966 Kraus, N. & Chandrasekaran, B. (2010). Music training for the development of auditory skills. Nat. Rev. Neurosci., 11, 599–605. Lathroum, L. M. (2011). The role of music perception in predicting phonological awareness in five- and six-yearold children. Retrieved from Open Access Dissertations. (Paper 685). Lim, H. A. & Draper, E. (2011). The effects of music therapy incorporated with applied behavior analysis verbal behavior approach for children with autism spectrum disorders. Journal Of Music Therapy, 48(4), 532-550. Loui, P., Kroog, K., Zuk, J., Winner, E., & Schlaug, G. (2011). Relating pitch awareness to phonemic awareness in children: implications for tone-deafness and dyslexia. Front. Psychol., 2, 111. doi: 10.3389/fpsyg.2011.00111. Marin, M. (2009). Effects of early musical training on musical and linguistic syntactic abilities. Annals of the New York Academy of Sciences, 1169, 187-190. doi: 10.1111/j. 1749-6632.2009.04777 Milovanov, R., & Tervaniemi, M. (2011). The interplay between musical and linguistic aptitudes: A review. Front. Psychol., 2, 321. doi: 10.3389/fpsyg.2011.00321 Moreno, S., Friesen, D. & Bialystok, E. (2011). Effect of music training on promoting preliteracy skills: Preliminary causal evidence. Music Perception, 29(2), 165-172. doi: 10.1525/mp.2011.29.2.165 Moreno, S., Marques, C., Santos, A., Santos, M., Castro, S. & Besson, M. (2009). Musical training influences linguistic abilities in 8-year-old children: More evidence for brain plasticity. Cerebral Cortex, 19(3), 712-723. Patel, A. D. (2011). Why would musical training benefit the neural encoding of speech? The OPERA hypothesis. Front. Psychol., 2, 142. doi: 10.3389/ fpsyg.2011.00142 Patel, A. D. (2012). The OPERA hypothesis: Assumptions and clarifications. Annals of the New York Academy of Sciences, 1252, 124–128. doi: 10.1111/j. 1749-6632.2011.06426.x Piro, J. M., & Ortiz, C. (2009). The effect of piano lessons on the vocabulary and verbal sequencing skills of primary grade students. Psychology of Music, 37, 325–347. doi: 10.1177/0305735608097248

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Russo, N. M., Hornickel, J., Nicol, T., Zecker, S., & Kraus, N. (2010). Biological changes in auditory function following training in children with autism spectrum disorders. Behav Brain Funct., 6(60). doi:10.1186/1744-9081-6-60 Schlez, A., Litmanovitz, I., Bauer, S., Dolfin, T., Regev, R., & Arnon, S. (2011). Combining kangaroo care and live harp music therapy in the neonatal intensive care unit setting. Isr Med Assoc J., 13(6), 354-358. Schön, D., Gordon, R., Campagne, A., Magne, C., Astesano, C., Anton, J.L., & Besson, M. (2010). Similar cerebral networks in language, music and song perception. Neuroimage, 51, 450-61. Strait, D., Hornickel, J. & Kraus, N. (2011). Subcortical processing of speech regularities underlies reading and music aptitude in children. Behavioral And Brain Functions, 7. Stevens, C., Fanning, J., Coch, D., Sanders, L., & Neville, H. (2008). Neural mechanisms of selective auditory attention are enhanced by computerized training: Electrophysiological evidence from language-learning impaired and typically-developing children. Brain Res., 1205, 55-69. Ventura, T., Gomes, M.C., & Carreira, T. (2012). Cortisol and anxiety response to a relaxing intervention on pregnant women awaiting amniocentesis. Psychoneuroendocrinology, 37(1), 148-56. Wan, C. Y., Bazen, L., Baars, R., Libenson, A., Zipse, L., Zuk, J., Schlaug, G. (2011). Auditory-Motor Mapping Training as an intervention to facilitate speech output in non-verbal children with autism: A proof of concept study. PLoS ONE, 6(9), e25505. doi:10.1371/journal.pone.0025505 About the Author Blythe LaGasse, Ph.D., MT-BC is Coordinator of Music Therapy at Colorado State University. She is also the founder of the Music Therapy Research Blog, a resource aimed at helping music therapy clinicians maintain an evidence-based practice. Contact: URL:


Music as a Preventive Intervention for Language Delay in Toddlers of Low Socioeconomic Status Linda Robbins, MME University of Missouri-Kansas City Kansas City, MO

Introduction Impoverished children are more likely to experience language delays than their more affluent peers (Law, McBean & Rish, 2011; Nelson, Welsh, Vance Trup & Greenberg, 2011). Without intervention, these children face potentially significant difficulties related to reading and writing, as well as an increased likelihood of emotional, social, and behavioral issues (Gross, Linden, & Ostermann, 2010). Too often these deficiencies set the stage for a lifetime of underachievement and perpetuate the cycle of generational poverty (Farah, et al., 2006). A proactive approach to preventing speech and language delays in at-risk children may provide better long-term outcomes than the more common practice of treating problems after they have arisen. One intervention that shows promise is music therapy (Gross et al., 2010; Hanson-Abromeit, 2011; Ma, Nagler, Lee, & Cabrera, 2001; Michel & May, 1974). This paper examines the literature to determine whether music therapy is an effective intervention in preventing speech and language delays with at-risk toddlers in an early intervention setting. Review of Literature According to the U.S. Bureau of the Census, 22% of American children under the age of 18 lived in poverty in 2010 (National Poverty Center, 2012). Children of low socioeconomic status (SES) are more likely than their higher income peers to live in a single-parent home, have parents and/or caregivers with low educational attainment, and have a parent who suffers from depression or other psychological disorder (Lucchese & Tamis-LeMonda, 2007; Jensen, 2009). They are less likely to experience attunement, or mutually pleasurable give-and-take, between caregiver and child during the crucial formative 6-24 month age range (Jensen, 2009). These and other environmental factors increase the odds that impoverished children will exhibit deficiencies in language during early childhood and the school age years (Law, McBean & Rish, 2011; Lucchese & Tamis-LeMonda, 2007; Nelson, Welsh, Vance Trup & Greenberg, 2011). Children from middle- and upper classes typically acquire language skills more than four times faster than their counterparts of low SES (Lucchese & Tamis-LeMonda, 2007). Their parents are

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more likely to promote cognitive stimulation by providing a greater number of books, toys, and learning experiences, enroll their children in high quality daycare, and exhibit frequent parental responsiveness to their child’s vocalizations, play, and other activities (Farah, et al., 2006; Lucchese & Tamis-LeMonda, 2007). The importance of environmental influences and caregiver responsiveness is reinforced in the social interactionist theory of language development (Poll, 2011). An early proponent of social interactionism was Lev Vygotsky (1896-1934), who contended that environment is “the source of development, not merely the setting” (Gredler & Shields, 2008, p. 155) and that learning is promoted and advanced through increasingly complex social interaction, or “input” from caregiver to child (Poll, 2011). Vygotsky and his contemporary, Alexander Luria (1902-1977), also noted a strong relationship between language development and the ability of children to selfregulate their behaviors (Diaz, Neal, & Amaya-Williams, 1990; Gredler & Shields, 2008; Winsler, Ducenne, & Koury, 2011). Luria outlined a hierarchical age-based model in which: 1) the language of caregivers regulates children’s behaviors during infancy; and 2) children begin to regulate themselves through the use of “private” or internal speech during the preschool years (Winsler, Ducenne, & Koury, 2011). Caregivers who gradually reduce the amount of regulatory control while retaining a sense of nurturing and warmth tend to promote self-regulatory skills in their children (Diaz, et al., 1990). Conversely, it follows that a lack of quality caregiver input contributes to delays in communication, and ultimately, behavioral issues. If impoverished children lack sufficient or appropriate input at home, other caregivers, daycare providers, and therapists can help bridge the gap between language delays and potential long-term consequences. While speech and language therapy is important, it may not be sufficient; everyone who interfaces with children should share responsibility for enhancing speech and language skills (Law, McBean, & Rish, 2011). At-risk children may need to be engaged in two to four hours of focused language activity each week, both in a classroom setting and through therapy (Nelson, et al., 2011). In a survey of more than 1,500 children diagnosed with a language


Photo courtesy of Operation Breakthrough.

disability, Nelson, et al. (2011) found that treatment occurred less than one hour per week on average. Alternative means of increasing exposure to language are indicated if optimal levels are to be achieved. Music and Language Researchers have studied the relationship between music and language development, specifically as it relates to phonological awareness, or the capacity to recognize and articulate the individual sounds that comprise words. In a study examining the correlation between the development of reading and music skills in four- and five-year old children, Anvari, et al. (2002) concluded that phonological awareness in language requires the listener to segment the various components of sound, including pitch, tempo, and context, just as he/she does when listening to music. Seeman (2008) examined the efficacy of employing music activities as an intervention to increase language skills, specifically those related to phonemic awareness, in at-risk preschool children. She concluded that phonemic awareness increased an average of 34.67% following treatment. Michel and May (1974) reported on a substantial number of studies taking place at Florida State University (FSU) from 1958-1974. As early as 1968, the FSU departments of music therapy, music education, and psychology conducted a study with 216 lowincome preschool children with language-related problems. They concluded that music-based interventions were significantly more effective than verbally based treatment (Michel & May, 1974). Another case study indicated that both phonological ability and speech comprehension increased following music therapy treatment utilizing the Nordoff-Robbins approach (Gross et al., 2010). Ma and colleagues (2001) conducted a study to determine whether music therapy is effective in the treatment of children with pervasive developmental disorder (PDD). Their subjects (N=6) were selected from a pool of preschool-aged children with speech and communication delays. Although the experimental sample was too small to produce significant results, the investigators concluded that musical intervention did enhance communication skills in the subjects.

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Conclusion Some level of efficacy using music to address language delays in at-risk populations has been demonstrated in the existing research. However, the target populations were generally children age four and up, for whom language delays had already been diagnosed. According to typical child development scales, children should begin to use spoken language and develop a working vocabulary at around 18 months (Schwartz, 2008). In order to adopt a preventive approach, more research is needed with younger toddlers, beginning at 18 months of age or earlier. Longitudinal studies comparing low SES toddlers with those from the middle class, and comparative studies of music-based versus non-musicbased interventions are suggested to examine the issue from a preventive or proactive standpoint as opposed to the more common reactive treatment. Another argument in favor of music therapy is that a natural relationship exists between music and language. Just as music is rhythmically and tonally based, speech and language also have an inherent rhythm and intonation known as prosody. Trevarthen and Malloch (2000) coined the term Communicative Musicality (CM) to describe the prosody that predates speech, but takes place, both vocally and through gesture, in a normal exchange between parent and infant. Aldridge, Gustroff and Neugebauer (1995) also emphasized the importance of rhythmic interaction between parent and infant for the development of language and socialization. Music therapy in the first two years of life could help address potential developmental deficits in at-risk toddlers caused by the absence of attunement with primary caregivers. Participation in music activities helps develop social skills, motor development, and cognitive functioning (Schwartz, 2008). Children have an innate rhythmic and musical sensibility from birth, and are instinctively attracted and attentive to musical activities (Schwartz, 2008). Several studies promoted the use of play-based therapy with young children, and contended that music provides a natural medium for structured play (Aldridge, Gustorff & Neugebauer, 1995; Humpal & Tweedle, 2006; Schwartz, 2008; Trevarthen & Malloch, 2000). Structured guidance from a music therapist using play-based activities such as nursery rhymes, childhood


songs, vocalizations, and rhythmic movement can promote both receptive and expressive language. Music therapists also can work with daycare teachers and other staff to enhance outcomes (Humpal & Tweedle, 2006). By modeling intervention strategies, working collaboratively, and providing consultative support, music therapists can ensure that their work is augmented through music-based learning as part of the daily classroom routine. An intervention regimen that begins at an early age, before the typical onset of speech, and combines regularly scheduled music therapy with therapist-guided day-to-day classroom activities, could help atrisk children achieve the recommended two to four hours weekly of focused language activity (Nelson, et al., 2011). References Aldridge, D., Gustorff, D., & Neugebauer, L. (1995). A preliminary study of creative music therapy in the treatment of children with developmental delay [electronic version]. The Arts in Psychotherapy, 22, 189-205. Anvari, S. H., Trainor, L. J., Woodside, J., & Levy, B. A. (2002). Relations among musical skills, phonological processing, and early reading ability in preschool children. Journal of Experimental Child Psychology, 83, 111-130. Diaz, R. M., Neal, C. J., & Amaya-Williams, M. (1990). The social origins of self-regulation. In L. C. Moll (Ed.): Vygotsky and Education: Instructional Implications and Applications of Sociohistorical Psychology. New York, NY: Cambridge University Press. Farah, M. J., Sherab, D. M., Savagea, J.H., Betancourta, L., Giannettac, J. M., Brodskyc, N. L., et al. (2006). Childhood poverty: Specific associations with neurocognitive development. Brain Research, 1110, 166-174. Retrieved from pubmed/16879809 Gredler, M. E., & Shields, C. C. (2008). Vygotsky’s legacy: A foundation for research and practice. New York: The Guildford Press. Gross, W., Linden, U., & Ostermann, T. (2010). Effects of music therapy in the treatment of children with delayed speech development: Results of a pilot study. BMC Complementary and Alternative Medicine, 10. Retrieved from: Hanson-Abromeit, D. (2011). Early music therapy intervention for language development with at-risk infants. imagine, 2 (1), 34-35. Retrieved from http:// imagine__online_magazine.html Humpal, M. E., & Tweedle, R. (2006). Learning through play – a method for reaching young children. In M. Humpal & C. Colwell (Eds.), Early childhood and school age educational settings: Using music to maximize learning (pp. 153-173). Silver Spring, MD: American Music Therapy Association, Inc. Jensen, E. (2009). Teaching with poverty in mind: What being poor does to kids’ brains and what schools can do about it. Alexandria, VA: ASCD.

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Law, J., McBean, K., & Rish, R. (2011). Communication skills in a population of primary school-aged children raised in an area of pronounced social disadvantage. International Journal of Language and Communication Disorders, 46, 657-664. Lucchese, F., & Tamis-LeMonda, C.S (2007). Fostering language development in children from disadvantaged backgrounds. Encyclopedia of Language and Literacy Development. Retrieved from index.php?

Ma, Y. C., Nagler, J., Lee, M. H., & Cabrera, I. N. (2001). Impact of music therapy on the communication skills of toddlers with pervasive developmental disorder [Electronic version]. Annals of the New York Academy of Sciences, 930, 445–447. Michel, D. E., & May, N. H. (1974). The development of music therapy procedures with speech and language disorders. Journal of Music Therapy, 11, 74-80. National Poverty Center (2012). Poverty in the United States: Frequently asked questions. University of Michigan. Retrieved from Nelson, K. E., Welsh, J. A., Vance Trup, E. M., & Greenberg, M. T. (2011). Language delays of impoverished preschool children in relation to early academic and emotion recognition skills. First Language, 31, 164-194. doi: 10.1177/0142723710391887 Poll, G. H. (2011). Increasing the odds: Applying emergentist theory in language intervention [Electronic version]. Language, Speech, and Hearing Services in Schools, 42, 580-591. Schwartz, E. (2008). Music, Therapy, and Early Childhood: A Developmental Approach. Gilsum, NH: Barcelona Publishers. Seeman, E. (2008). Implementation of music activities to increase language skills in the at-risk early childhood population (Master’s thesis). Retrieved from http:// Trevarthen, C., & Malloch, S. N. (2000). The dance of wellbeing: Defining the musical therapeutic effect. Nordic Journal of Music Therapy, 9, 3-17. Winsler, A., Ducenne, L. & Koury, A. (2011). Singing one's way to self-regulation: The role of early music and movement curricula and private speech [Electronic version]. Early Education and Development, 22, 274-304. About the Author Linda Robbins, MME has enjoyed rewarding careers as a music educator, arts administrator, and, most recently, as Director of Major Gifts at the University of MissouriKansas City (UMKC) Conservatory of Music and Dance. She currently is an intern at John Knox Village Hospice in Lee's Summit, Missouri. Contact:


Tackling Children’s Weight Issues through Music Therapy Satoko Mori-Inoue, Ph.D., MT-BC Mejiro University Clinic Chiba, Japan Lori Gooding, Ph.D., MT-BC University of Kentucky Lexington, KY

According to the Centers for Disease Control (CDC, 2012), approximately 17% (or 12.5 million) of U. S. children and adolescents ages 2-19 are obese. Research suggests that this epidemic-proportion problem with overweight and obesity is due to unhealthy eating and a lack of physical activity. The data also suggest that the development of video games and the increased availability of fast food have contributed to childhood obesity, and that current economic difficulties may have led people to eat more processed food and to participate in fewer leisure activities (Janssen et al., 2005; Urrutia-Rojas et al., 2008). Research suggests that physical and psychological problems occur as hidden health issues for children who are obese as well as for adults who were obese as children (Schwimmer, Burwinkle, & Varni, 2003). Childhood obesity increases one’s risk for contracting a number of diseases in adulthood, including cardiovascular disease, type 2 diabetes, bone and joint problems, heart disease, stroke, several types of cancer and osteoarthritis (CDC, 2012). Childhood obesity also increases psychological problems. In fact, overweight children may experience various types of social discrimination such as being teased by others or being excluded from social events. As a result, children who are overweight and obese often suffer from poor self-esteem and depression (Reeves, Postolache, & Snitker, 2008). Additionally, weight issues in children may actually be a family problem; the research suggests that family dynamics, childhood weight issues, and treatment progress are correlated (Kitzmann, William, Dalton, & Buscemi, 2008). According to the American Music Therapy Association (2012), music therapy interventions can be designed to promote wellness. Music can motivate adults and children to participate in physical activity, enhance exercise enjoyment, and structure movement (Abrams, 2008; Ghetti, Hama, & Woolrich, 2008). As a result, music therapy-based approaches can be used to facilitate healthy behaviors. The research literature suggests that music impacts physical performance via increased productivity, increased cooperation, improved mood and increases in workout duration or distance (Boldt, 1996; Edworthy & Waring, 2006; Gfeller, 1988; Gray, 1997; Greig, 1996; Hume & Crossman, 1992).

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Most of the studies on music and wellness have been conducted with adults, but the potential for music to be used effectively with younger individuals is great. A recent study by Mori-Inoue (2010) introduced a music therapy-based intervention program for children’s weight loss. The program occurred in a school setting, lasted for six weeks, and targeted children ages 8-10. This program was divided into two components: An exercise component and a health education portion. During the exercise component, drumming and movement-to-music based exercises were used to increase physical activity and promote weight loss. During the health education component, songwriting and singing were used to teach better eating habits. Information on vegetables, the digestive system of the human body, and appropriate food portions were all included. All music was culturally and developmentally appropriate. Results suggest that the program had a positive impact on the children who participated. However, the intervention appeared to be more effective for children who were overweight and less effective for children who were obese. These results further suggest that children who are obese may need a) longer involvement in similar programs, b) tailored interventions, and c) interventions that take into consideration outside factors like school scheduling and parental involvement (Mori-Inoue, 2010). Beside the Mori-Inoue (2010) study, there is limited information on health and wellness exercise programs in children. These types of programs may become increasingly important as the country continues to struggle with weight issues in children. As a result, it is helpful to consider some of the important factors gleaned from the Mori-Inoue (2010) study when starting new programs. Considerations include Program length (a minimum of six weeks is ‣ recommended) Number of sessions per week (a minimum of three ‣ times is recommended) Participant demographics (designing programs that ‣ target similar ages and weight ranges can be more effective) Program location (school, afterschool, facility, ‣ nursery, HeadStart, etc.) Outside factors (school stressors, family stressors, ‣ lack of family education about nutritional foods, etc.) Starting age (consider starting exercise programs at ‣ an early age to prevent later health issues) Parent training (providing education to the parents ‣ may increase child success) Family lifestyle (promoting healthy life-behaviors that ‣ can be incorporated into the overall family lifestyle may be helpful)

Other considerations include Consulting a physician for all medical issues. ‣ Understanding children’s healthy growth patterns; ‣ following federal dietary guidelines for healthy growth. Consulting a dietician for healthy eating and specific ‣ ways to cut down on the amount of fat and calories. When applicable, working with school staff to ‣ facilitate an effective program. The above considerations are based on work with elementary school-age children, but given that almost 10 percent of infants and toddlers carry excess weight for their length, and approximately 20 percent of children between the ages of two and five are either overweight or obese, it is important to consider ways to prevent obesity and promote healthy behaviors for even the youngest of children (Institute of Medicine of the National Academies, 2011). Music therapists who want to incorporate wellness-promoting interventions or programs in early childhood settings should also take into account and promote the following: The importance of early risk assessment (promoting ‣ well-care visits) The importance of breastfeeding as a preventative ‣ measure (breastfeeding is associated with a reduced obesity risk) The importance of a diet rich in nutrient-dense fruits, ‣ vegetables, low-or non-fat dairy (over age 2), and whole grains The importance of age-appropriate portions ‣ The importance of physical activities and the ‣ opportunity to participate in them throughout the day The importance of placing children in childcare ‣ facilities that follow recommended federal exercise and food/nutrition guidelines As the struggle to promote healthy eating and exercise in children continues, it will become increasingly important to incorporate wellness-based music therapy activities into children’s programs, including those that target early childhood settings. This article outlines some considerations that can help music therapists successfully develop wellness programs for children. Both clinicians and researchers should consider how music therapy can be used in the future to facilitate the health of children in the United States and beyond.

Drums by REMO, Inc. Photo courtesy of Satoko Mori-Inoue.

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References Abrams, B. (2008). Music as therapy. Coping. Retrieved July 28, 2009 from search/articles/music_as_therapy/ American Music Therapy Association (2012). What is Music Therapy? Retrieved from Boldt, S. (1996). The effects of music therapy on motivation, psychological well-being, physical comfort and exercise endurance of bone marrow transplant patients. Journal of Music Therapy, 33(3), 164-188. Centers for Disease Control and Prevention. (2012). Obesity rates among all children in the United States. Retrieved from Centers for Disease Control and Prevention. (2012). Childhood obesity facts. Retrieved from http:// Edworthy, J., & Waring, H. (2006). The effects of music tempo and loudness level on treadmill exercise. Ergonomics, 49(15), 1597-1610. Gfeller, K. (1988). Musical components and styles preferred by young adults for aerobic fitness activities. Journal of Music Therapy, 25(1), 28-43. Ghetti, C. M., Hama, M., & Woolrich, J. (2008). Music therapy in wellness. In Darrow, A. A. (Ed.), Introduction to approaches in music therapy (2nd ed.) (pp. 131-152). Silver Spring, MD: American Music Therapy Association. Gray, K. M. (1997). The effects of music on aerobic exercise. (Unpublished master’s thesis). Florida State University, Tallahassee, FL. Greig, E. F. (1996). Athlete responses to variety of background music in the weight training room. (Unpublished master’s thesis). Florida State University, Tallahassee, FL. Hume, K. M., & Crossman, J. (1992). Musical reinforcement of practice behaviors among competitive swimmers. Journal of Applied Behavior Analysis, 25(3), 665. Institute of Medicine of the National Academies (2011, June). Early childhood obesity prevention policies. Washington, DC: Author. Janssen, I., Katzmarzyk, P. T., Boyce, W. F., Vereecken, C., Mulvihill, C., Roberts, C., et al. (2005). Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obesity Reviews, 6(2), 123-132. Kitzmann, K. M., William T., Dalton III, & Buscemi, J. (2008). Beyond parenting practices: Family context and the treatment of pediatric obesity. Family Relations, 57(1), 13-23. Mori-Inoue, S. (2010). The effect of a music exercise and healthy eating habits program on children’s weight loss. (Unpublished doctoral dissertation). Florida State University, Tallahassee FL. Reeves, G. M., Postolache, T. M., & Snitker, S. (2008). Childhood obesity and depression: Connection between these growing problems in growing children. International Journal Child Health Human Development, 1(2), 103-114. Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W., (2003).

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Health-related quality of life of severely obese children and adolescents, Journal of American Medical Association 289(14), 1813-1819. Urrutia-Rojas, X., Ahmad, N., Bayona, M., Bae, S., Rivers, P. A., & Singh, K. P. (2008). Risk factors associated with obesity in children of different racial backgrounds. Health Education Journal, 67(2), 121-133. About the Authors Satoko Mori-Inoue, Ph.D., MT-BC is music therapy researcher at Mejiro University (Japan) and is currently establishing a music therapy clinical practice within the Mejiro University Clinic. Her current early childhood practice is with infants with sensorineural hearing loss and children with developmental disabilities.


Lori Gooding, PhD, MT-BC is the Director of Music Therapy at the University of Kentucky. Clinically she works with patients of all ages, including older preterm infants in the NICU setting. Contact:


Transforming the Early Childhood Classroom: The Keep a Beat (KaB) Music Enrichment Program Kamile Geist, MA, MT-BC Associate Professor Ohio University Athens, Ohio

behaviors in children; Zentner and Eerola (2010) found that 120 infants, ages 5-24 months, were more engaged with rhythm only stimulus (e.g., dry steady beats) vs. speech only stimulus. They spontaneously moved to the rhythm and smiled more when they were in synchrony with the steady beat. The results of this study indicate that children have the potential to be more rhythmically engaged when listening to steady beats rather than when listening to verbal only instructions.

Photo courtesy of Head Start Athens, Ohio. .

Research indicates that young children from neighborhoods with lower incomes are at greater risk for developing emotional and behavioral problems, in part due to the social and psychological stressors of poverty (Kauffman & Landrum, 2009). Children with behavioral concerns are at greater risk for academic failure (Birch & Ladd, 1998; Finn & Chester, 2009; Hamre & Pianta, 2001; Rimm-Kaufman, Storm, Sawyer, Pianta, & LaParo, 2006). However, the literature suggests that early childhood teachers can learn to relate to children with externalizing behaviors and break down barriers to learning (Kauffman & Landrum, 2009; Reddy, Newman, Anne De Thomas, & Chun, 2009). Introducing music-based enrichment strategies may help teachers connect with and intrinsically motivate pre-school children from lower socioeconomic status (SES) environments in a developmentally appropriate way. However, there is limited research that evaluates the effectiveness of easily accessible early childhood music-based interventions for teachers who may not have a background in music. Music Neuroscience Research Studies on how rhythm can improve focused, sustained, selective, alternating, or divided types of attention behaviors in adults and children are emerging (Thaut, 2005; Mateer, 2000; Sohlberg & Mateer, 1989; Kim, Wigram, & Gold, 2008). Recent music neuroscience research indicates that rhythm, specifically a steady beat, does affect engagement

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Bridging Neuroscience Evidence to Classroom Practice In a keynote speech to music therapists, Dr. Aniruddh Patel, a leading music neuroscientist, spoke of the need for music therapists to conduct studies that link laboratory evidence to outcomes in real-world settings (Patel, 2009). Early childhood music therapy researchers should begin to establish a link from how rhythm effects brain processes in children to its effect on improved learning in the early childhood classroom. Music therapy research might further address how music therapists can effectively coach early childhood educators to most effectively utilize music within this process. The implications of using rhythm in early education lessons are potentially powerful. An early childhood educator might simply add a repeated rhythm, such as a steady beat, as an auditory/visual/kinesthetic stimulus to effectively help teach children in a large group lesson or to help them focus during a lesson. If the research evidence holds true, children might exhibit improved attention and engagement prior to and while learning. Also, as disruptive behaviors of non-attentive child decrease, perhaps stress-related behaviors of teachers also might decrease, and all would benefit from this more enjoyable learning environment. Based on the neuroscience evidence that rhythm can facilitate improved attention and the evidence indicating that music promotes attention and learning, the author and colleagues conducted a study to observe the effect of a steady beat stimulus on engagement and learning (Geist, Geist, & Kuznik, 2012). In this study, teachers of 3 and 4-year-old children were asked to teach mathematics lessons with and without implementing a rhythmic stimulus. Prior to the math/music group lessons, the


early childhood educators were trained to implement the following steady-beat protocol: Chant, “Let’s keep a beat.” ‣ Instruct children to pat their laps for 4 or 8 beats, in ‣ the tempo of a song that is to be chanted or sung. Insure that all the children in the group are engaged. ‣ Begin the mathematics lesson by chanting or singing ‣ the words created for the activity, while simultaneously tapping the steady beat on your lap. The study included 30 children (two classes with 15 students in each) and five early childhood educators (two for each class and one instructional assistant for a student with special needs). Engagement was evaluated through documentation of observed behaviors. The analysis indicated that students showed more active engagement, focused and sustained attention, during the math/music lessons as compared to math only instruction. Teacher journal analysis comparing pre math/music intervention to post math/music intervention entries indicated that teachers were impressed and surprised at the level of attention of children when the steady beat stimulus was used. When interviewed individually, all but one child either tapped the beat and/or sang a song as part of an answer when was asked to explain a particular mathematics concept (Geist et al., 2012). Although the authors were looking at mathematics outcomes, the evidence that children showed behaviors of being ready to learn were the most revealing, even when teacher training was minimal. Effective Teacher Training Yields Positive Learning Outcomes Training teachers to use positive behavioral techniques in Head Start classrooms is well documented. For example, in the Research-Based Developmentally Informed (REDI) program, it was found that teacher training combined with mentoring in the classroom yielded significant outcomes on socially appropriate behaviors of preschool children rather than just training alone (Domitrovich et al., 2009). The mentoring program involved modeling how to implement various techniques and offering immediate feedback to teachers. Results also support the idea that enriched curricular components and professional development support can

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produce improvements in multiple domains of teaching quality, and therefore increase engagement (Domitrovich et al., 2009). Hence, methods to train teachers are documented and can be implemented. The music therapy research is emerging on how music-based strategies delivered by early childhood educators can impact the early childhood classroom (Kern, Wakeford, & Aldridge, 2007; Kern & Aldridge, 2006; Register, Darrow, Standley, & Swedberg, 2007; Humpal & Colwell 2006; Furman & Humpal, 2006; Robb, 2003; Standley & Hughes, 1997; Register, 2001). The literature gives us a glimpse of steps to train early childhood educators to use music enrichment for increased academic learning and improved social behavior. However, training teachers to use rhythm to increase engagment has not yet been tested. Therefore, the primary research question for the KaB program is the following: Does a rhythm-based music therapy intervention delivered during academic instruction by a classroom teacher increase engagement of children ages 3-5 in a preschool classroom? The Keep a Beat (KaB) Music Enrichment Program The Keep a Beat, (KaB) music enrichment and teacher training program is designed to help teachers transform their classrooms using music based strategies. The first focus in the KaB project is on rhythm. Not only can rhythm-based strategies enrich academic lessons, the brain research is showing us how rhythm can prime children for learning. The KaB program is based on this premise. Grounded in recent music neuroscience research and anecdotal reports, KaB is an innovative and easy-to-implement music-based addition to learning activities in the early childhood classroom. The goal of the Keep a Beat (KaB) program is to provide teachers with an effective music-based strategy to be used with groups of children in integrated classrooms to support and enhance academic learning. The program goals will be achieved by (1) implementing an effective teacher-training program on KaB rhythm-based strategies, (2) generating an observation scheme that can be used to reliably measure engagement, (3) evaluating the impact of the intervention and (4) disseminating results to the early childhood community. So far, the KaB has received startup funding from Ohio University


for development and pilot testing of the teacher-training model at one site. The next step will be to continue to solidify the observation scheme to reliably measure engagement during the intervention and expand the project to multiple sites so the impact of the intervention can be evaluated. References Birch, S. H., & Ladd, G. W. (1998). Children's interpersonal behaviors and the teacher-child relationship. Developmental Psychology, 34(5), 934. Domitrovich, C. E., Gest, S. D., Gill, S., Bierman, K. L., Welsh, J., & Jones, D. (2009). Fostering high quality teaching with an enriched curriculum and professional development support: The Head Start REDI program. American Educational Research Journal, 46(2), 567-597. Finn, J., & Chester E. (2009). Slow the preschool bandwagon. Human Events, 65(19), 21-21. Furman, A., & Humpal, M. (2006). Goals and treatment objectives, settings, and service delivery models in early childhood and early intervention settings. In M. Humpal & C. Colwell (Eds.), Early Childhood and School Age Educational Settings: Using Music to Maximize Learning. Silver Spring, MD: American Music Therapy Association. Geist, K., Geist, E. A., & Kuznik, K. (2012). The patterns of music: Encouraging mathematical development through music. Young Children, 76, 74-79. Hamre, B. K., & Pianta, R. C. (2001). Early teacher窶田hild relationships and the trajectory of children's school outcomes through eighth grade. Child Development, 72(2), 625. Humpal, M. & Colwell, C. (Eds.) (2006). Effective clinical practice in music therapy: Early childhood and school age educational settings. Silver Spring, MD: American Music Therapy Association. Kauffman, J. M., & Landrum, T. J. (2009). Characteristics of emotional and behavioral disorders of children and youth (9th ed.). Upper Saddle River, NJ: Merrill PrenticeHall. Kern, P., & Aldridge, D. (2006). Using embedded music therapy interventions to support outdoor play of young children with autism in an inclusive community-based child care program, Journal of Music Therapy, 43(4), 270-294. Kern, P., Wakeford, L., & Aldridge, D. (2007). Improving the performance of a young child with autism during self-care tasks using embedded song interventions: A case study. Music Therapy Perspectives, 25(1), 43-51. Kim, J., Wigram, T., & Gold, C. (2008). The effects of improvisational music therapy on joint attention behaviors in autistic children: A randomized controlled study. Journal of Autism and Developmental Disorders, 38(9), 1758-1766. Mateer, C. A. (2000). Attention. In S.A. Raskin and C.A. Mateer (Eds.), Neuropsychological management of mild traumatic brain injury (pp. 73-92). New York, NY: Oxford University Press. Patel, A. D. (2009). Building bridges between music neuroscience and music therapy. Keynote presented at the

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AMTA Annual Conference, San Diego, CA, November 2009. Reddy, L. A., Newman, E., Anne De Thomas, C., & Chun, V. (2009). Effectiveness of school-based prevention and intervention programs for children and adolescents with emotional disturbance: A meta-analysis. Journal of School Psychology, 47, 77-99. Register, D. (2001). The effects of an early intervention music curriculum on prereading/writing. The Journal of Music Therapy, 38(3), 239-248. Register, D., Darrow, A., Standley, J., & Swedberg, O. (2007). The use of music to enhance reading skills of second grade students and students with reading disabilities. Journal of Music Therapy, 44(1). Rimm-Kaufman, S., Storm, M. D., Sawyer, B. E., Pianta, R. C., & LaParo, K. M. (2006). The teacher belief Q-sort: A measure of teachers' priorities in relation to disciplinary practices, teaching practices, and beliefs about children. Journal of School Psychology, 44(2), 141-165. doi: 10.1016/j.jsp.2006.01.003 Robb, S. (2003). Music interventions and group participation skills of preschoolers with visual impairments: Raising questions about music, arousal, and attention. Journal of Music Therapy, 40(4), 266-82. Sohlberg, M. M. & Mateer C. A. (1989). Attention process training. Puyallup, WA: Association for Neuropsychological Research and Development. Standley, J. M., & Hughes, J. E. (1997). Evaluation of an early intervention music curriculum for enhancing pre reading/ writing skills. Music Therapy Perspectives, 15(2), 79-85. Thaut, M. (2005). Rhythm, music, and the brain. New York, NY: Taylor and Francis Books. Zentner, M., & Eerola, T. (2010). Rhythmic engagement with music in infancy. Proceedings of the National Academy of Sciences of the United States of America, 107(13), 5768-5773. About the Author Kamile Geist, MA, MT-BC is the Program Coordinator of Music Therapy at Ohio University. Her research interests include how music elements support learning for young children. Contact:


2012 Our Photo Stories 2012 Available at http:// Imagine/our_photo_stories.html One section of the imagine website is dedicated to photo stories related to early childhood music therapy. The photo stories consist of a sequence of three pictures along with a one-sentence description of what happens in each picture during the music therapy session. Photo stories are open for submission during the year. If you would like to contribute, please review the submission guidelines on the imagine website and contact us.

Early Childhood Conferences 2012/2013

Photo Story #9 Music Therapist: Dana Bolton, MMT, MT-BC Affiliation: Bolton Music Therapy, Murfreesboro, TN Photographer: Parent of client Photo Story #10 Source: Early Years Literacy Team Affiliation: Northern Territory Library, Australia Graphic Design: Batchelor Insititute of Indigenous Tertiary Education Photo Story #11 Music Therapist: Jennifer W. Pucket, MT-BC Affiliation: Therabeat, Inc. at In Harmony Pediatric Therapy, Canton, GA Photographer: Jennifer W. Puckett and Parent of client Photo Story #12 Music Therapist: Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA Affiliation: Music Therapy Consulting, California Photographer: Don Trull

The Division for Early Childhood 28th Annual International Conference on Young Children with Special Needs & Their Families October 28-30, 2012 in Minneapolis, MN National Association for the Education of Young Children 2012 NAEYC Annual Conference & Expo November 7-10, 2012 in Atlanta, GA ZERO TO THREE 27th National Training Institute December 9-11, 2012 in Los Angeles, CA

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Council for Exceptional Children Convention & Expo April 3-6, 2013 in San Antonia, TX Young Children 2012 Expo and Conference April 17-19, 2013 in New York, NY National Early Childhood Inclusion Institute May 13-15, 2013 in Chapel Hill, NC International Society on Early Intervention Regional Conference July 1-3, 2013 in St. Petersburg, Russia


practice Because I Said So: Effective Strategies for Dealing with Challenging Behaviors Dana Bolton, MMT, MT-BC Bolton Music Therapy Murfreesboro, TN

Music therapists working in the early childhood field will eventually deal with challenging behaviors. This article is intended to provide tools beyond, “Because I said so,” to use when these behaviors arise.

Photo courtesy of Kevin Bolton.

Challenging behaviors manifest in a variety of forms. Common examples in early childhood include self-injurious behaviors, aggression, tantrums, property destruction, social avoidance, and selfstimulatory behaviors (McEvoy, Neilsen, & Reichle, 2004). While the forms of behavior may vary, there are only two basic functions, or purposes, of challenging behavior: Obtaining something and avoiding or escaping from something (Umbreit, Ferro, Liaupsin, & Lane, 2007). These “somethings” that are obtained or avoided include attention (both positive and negative), tangibles or activities, and sensory experiences. Remembering that challenging behaviors are always communicating the desire to either access or avoid something is the key to developing effective strategies. Determining the function of the behavior is achieved through observation and gathering A-B-C data (Umbreit, Ferro, Liaupsin, & Lane, 2007). In this model, behaviors are analyzed in the context of what happens before the behavior (“antecedent”) and what happens after the behavior (“consequence”). The antecedent includes the specific event that triggers the behavior, as well as conditions such as fatigue, hunger, or illness that influence behavior. Next, the target behavior is defined using specific examples. It is important to state exactly what the child has done (e.g., threw toys, hit parent) rather than merely stating that the child acted out. The consequence is the event(s) that follows the behavior. A consequence that causes a behavior to occur more often is called a reinforcer; one that causes a behavior to occur less often is called a punisher. It is important to remember that the same consequence can act as a punisher or a

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reinforcer depending on the individual and the situation. A reprimand may serve as a punisher for one child, but for the child who is acting out to seek attention, whether positive or negative, the reprimand could be a reinforcer.

greetings, especially if the same routine cannot be used during each session. Harris (2012) stated that anxiety is fear of the unknown. When children do not know what is coming next, they become anxious, which can manifest as challenging behaviors. Structure, along with visual schedules, can alleviate this anxiety and uncertainty.

There are three categories of strategies that can be developed to address challenging behaviors: Teaching a replacement behavior, improving the environment, and adjusting the contingencies (Umbreit et al., 2007). The Center on the Social and Emotional Foundations for Early Learning provides a useful planning chart for organizing observation information and strategy ideas (see module3a/handout7.pdf). Replacement behaviors accomplish the same function as the challenging behavior, but in socially acceptable ways. Replacement behaviors that may be taught include asking for help or requesting wants; learning how to join a group and respond to aggression and anger; strengthening prerequisite academic skills; and utilizing strategies for self-monitoring behavior. These skills can easily be incorporated into a child’s individual goals for music therapy. Improving the environment refers to changes made that set up an environment for positive behaviors and attempt to avoid possible triggers for challenging behaviors. Strategies for changing the environment include: ‣

Set clear expectations of behavior. Instead of telling children what not to do, tell them what they should do by phrasing expectations positively. For example, say, “Gentle hands,” instead of, “Don’t hit.” Review rules often, either by incorporating them into a social story or posting visual reminders in the therapy room. For young children, pair simple words with pictures or photographs to illustrate the expectations. For some children, using photos of themselves performing the expected behaviors may be effective. Develop a predictable routine for music therapy sessions. Most music therapists already use greeting songs to develop structure. Visual schedules are an easy way to let young children know what will be happening in between

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Pictures for visual schedules can be obtained from software such as Boardmaker®, downloaded from the Internet, or taken with a digital camera. The Technical Assistance Center on Social Emotional Intervention for Young Children provides information on how to create visual schedules in their Teaching Tools for Young Children with Challenging Behavior (see http:// teaching_tools/toc/ folder5/5b_how_make_vis_sched.pdf). For children with vision impairments, tactile schedules can be made using small objects to represent each activity. ‣

Develop techniques for easing transition times. Transitions, especially completing preferred activities or initiating non-preferred ones, are hard for young children. Transition songs can be used to help children transition into or out of therapy areas, to signal the end of activities, or to instruct children to clean up. Therapists can use songs they compose or pre-composed songs such as the ever-popular Clean-up Song by Barney & Friends. Giving warnings is another way to prepare young children for transitions. Warnings can be given based on the number of times the child needs to perform an action before being done (e.g., sing one more song, hit the drum three more times, etc.). If warnings are based on the number of minutes left, it is best to pair them with a visual timer (such as the Time Timer®) as young children do not yet understand the concept of how long time is. Some children need transition objects to help them with transitions. For example, before coming to the music therapy session, the child is given an object that represents music therapy, such as an egg shaker or drum mallet. At the end of the music therapy session, he or she


are given an object that represents the next activity on the schedule. These objects give the child a concrete example of what is coming next. ‣

Pace sessions to alternate active activities with less-active ones. If a child becomes fidgety, it may be that they he or she has been expected to sit still for too long and need to participate in a movement activity. If children become too out-of-control during movement activities, they could be overstimulated and need a quieter activity. Some children may need a quick 5-minute break to walk in the hallway during sessions. Decisions about pacing are often made in the spur of the moment by reading the child’s cues and will change depending on the child and the day. Allow children appropriate choices to give them a level of control during the session. Children who are not given choices regarding what they would like to do may act out in an attempt to exert some control. Choices could include which activities to do during a session, the order in which to do activities, how to do an activity (e.g., loud, soft, fast, slow), what song to sing, or what instrument to use. The therapist can determine the pool of choices given to the child so that any choice will address the child’s music therapy goals.

The final strategy for addressing challenging behaviors is to change the contingencies. This involves changing what happens following challenging behaviors and what happens following desired behaviors. Strategies for changing your response to challenging behaviors include: ‣

Utilize or implement planned ignoring. When a child’s behaviors do not harm himself or others and do not destroy property, simply ignoring it can be an effective way to extinguish the behavior. It is important to note that when planned ignoring is used, the challenging behavior will often increase in intensity and/or duration as the child attempts to gain the desired outcome that he achieved before (Adamek & Darrow, 2005). Therapists must be careful not to give in to a child’s behaviors during this “extinction burst.” By doing so, a therapist will inadvertently use an intermittent schedule of reinforcement (not every behavior is reinforced and there is no fixed schedule for when reinforcement will be delivered), which is the strongest way to maintain a behavior (Cooper, Heron, & Heward, 2007).

Give warnings. When a child begins engaging in challenging behaviors, give a warning of what the consequence will be if the child continues the behavior. Only give one warning and be sure to follow through with the consequence stated so that it does not become empty threats.

Redirect child to an appropriate behavior. Children may engage in challenging behaviors when they do not know what behaviors are appropriate in a situation.

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Showing the child an alternate activity to engage in can interrupt the challenging behavior. For example, a child may begin climbing and jumping off furniture in the waiting room while the therapist and parent discuss the session. Redirecting the child to toys or books teaches her what activities are appropriate during times he must wait. When dealing with challenging behaviors, a therapist must also purposefully and systematically respond to desired behaviors. Formal or informal preference assessments can be administered to determine what reinforcers are most motivating for a child. It is important to note that what is reinforcing to one child may not be reinforcing to another, and what is reinforcing on one day for a child may not be reinforcing the next day. A reinforcer menu allows the therapist or the child to choose which reinforcer will be applied during a session. Verbal praise is frequently used as a reinforcer for children. When using verbal praise, it is important that the praise be contingent on the positive behavior, specifically state what behavior is being praised, and be sincere (Adamek & Darrow, 2005). However, for children who do not like attention, praise may not be a reinforcer. Some children may even be averse to statements like “good job.” A token economy can be used as a way to earn a reinforcer. A token, such as a ticket or a sticker, is earned for each expectation that the child meets for the entire session, or for each activity that the child completes without displaying challenging behavior. At the end of the session, the tokens are traded in for a reinforcer such as a tangible item or the opportunity to engage in a highly preferred activity. For young children, it is important to see how many tokens must be earned.

Photo courtesy of parent of client.


Clinical Example D. began music therapy in his home at the age of two years, shortly before being diagnosed with Autism Spectrum Disorders. During his sessions, he wandered around, attempted to open doors to escape, or watched the fish in the fish tank. His behaviors appeared to be attempts to escape engagement with the music therapist and participation in structured activities. The music therapist and D.’s family implemented several strategies to address his behaviors. First, the sessions were moved from the living room into his parents’ bedroom where there were fewer distractions. Second, supported seating was used to help D. focus and become familiar with the music therapy routine. The parents began by placing him in a booster seat strapped to a kitchen chair with the belt fastened. Over time, this was faded by placing the booster seat on the floor with the belt fastened, then having him sit in the seat on the floor without the belt fastened. Now, D. sits on a small heart-shaped pillow while the music therapist sits on a larger, similar pillow. In fact, D. runs to get his pillow at the start of each music therapy session. Finally, desired behaviors were reinforced, even when accidental. In one session, D. was asked to hit the drum one more time to end the session. During his attempts to resist, he accidentally hit the drum. He was allowed to leave the session after he did, even though it was accidental. After two years of therapy, D. is ready to increase the duration of his sessions with his initial therapist and has added an additional weekly session with another music therapist in the same practice. This article provides tools and strategies for music therapists dealing with challenging behaviors of young children. Remembering that challenging behaviors are communicating something is the key to developing strategies that will work and provide a positive environment for learning to occur. References Adamek, M. S., & Darrow, A. A. (2005). Music in special education. Silver Spring, MD: The American Music Therapy Association, Inc. Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Upper Saddle River, NJ: Pearson Education, Inc. Harris, J. (2012, February 16). Brain smart education: Seven things you need to know. Break-out session presented at the Tennessee Annual Special Education Conference, Nashville, TN. McEvoy, M. A., Neilsen, S., & Reichle, J. (2004). Functional behavioral assessment in early education settings. In M. McLean, M. Wolery, & D. B. Bailey (Eds.), Assessing infants and preschoolers with special needs (3rd ed.) (pp. 236-261). Upper Saddle River, NJ: Pearson Education, Inc. Umbreit, J., Ferro, J., Liaupsin, C. J., & Lane, K. L. (2007). Functional behavioral assessment and function-based intervention: An effective, practical approach. Upper Saddle River, NJ: Pearson Education, Inc.

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About the Author Dana Bolton, MMT, MT-BC, is a music therapist, developmental therapist, and parent advocate in the Nashville area. She is currently completing a Master’s in Early Childhood Special Education at Vanderbilt University, and, along with her husband, owns a private music therapy clinic in Murfreesboro, TN. Contact: URL:


selection include the client’s current communication needs and strengths, visual acuity, and mobility. Many music therapists are familiar with the use of sign language, an unaided form of AAC, and may incorporate signs into their sessions. Additionally, there are other communication modes that may be utilized in sessions, such as aided AAC systems. Aided AAC involves the use of an object or device that is external to the user (Mirenda, 2003). Most systems are activated by touch, yet some individuals are unable to make controlled movements or may have visual difficulties. Thus, other activation options are available, such as eye gaze. Photo courtesy of Christine Ambrose Music therapy intern Christy Joy Shiloh uses an iPad with the application Prologue2GO TM in one of her music therapy sessions.

Utilizing Augmentative and Alternative Communication in Music Therapy Sessions Anita L. Gadberry, Ph.D., MT-BC Director of Music Therapy at Marywood University Scranton, Pennsylvania

Do you work with a child who has communication delays? Do the children you work with not communicate their wants and needs in appropriate ways? If you answered yes to either of these questions, you may wish to investigate Augmentative and Alternative Communication (AAC). AAC allows individuals to communicate in ways other than using verbal speech. According to the American Speech-Language-Hearing Association (ASHA) (2012), over two million people in the United States currently use AAC. AAC System Acquisition Therapists, parents, day care providers, or other individuals may notice that a child is delayed in utilizing speech. When this occurs, an evaluation by a speech-language pathologist is necessary to determine possible strategies for competent communication. The speech-language pathologist may recommend an AAC system to supplement the child’s verbal capability. As outlined in Mirenda (2003) and Cress and Marvin (2003), an AAC system is not intended to replace speech, it simply provides the means necessary to communicate effectively. Thus, AAC systems can be implemented when a concern about communication arises (Cress & Marvin, 2003) since there are no prerequisites for utilizing an AAC system (ASHA, 2012). There are a variety of aided AAC systems available, and the speech language pathologist will determine which system is best for an individual. Some considerations for system

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Low, Light, and High Tech ACC Systems Aided AAC systems may be low tech, light tech, or high tech. Low tech systems could consist of pictures or objects. Pictures and symbols are typically used, yet some individuals need more than two dimensions to understand a symbol. Thus some individuals may need actual objects to communicate. Low-tech examples for a music therapist include using the actual instrument as an object or photographs of the music instruments used during a music therapy session. Another option is to use a software program such as Boardmaker from Mayer-Johnson. Light tech systems may include vocal output, yet are not computer based. These systems function like a switch; when the button is pressed the system is activated. Examples include BIGMack®, Go Talk Button, and Talking Symbols Notepad™. A benefit of light tech systems is that the vocalization may be recorded on the spot, thus it is easy to adjust the communication options available to the participant. High tech AAC systems have a computer component to them. There are many examples on the market today including the iPad, iPod touch, and iPhone as well as DynaVox, and MyTobii. The Apple products have several apps to facilitate communication. An informative video and spreadsheet of apps can be found at Groovygarfoose. Another resource blog can be found at the Friendship Circle Blog. AAC System Implementation Once the system has been selected, the individual will need to learn how to use it. It is also helpful for caregivers, teachers, and therapists to know how to utilize the system so each person can encourage the individual to communicate. Often, the success of a system depends a lot on the communication partner (Drager, 2009). Just as adults prompt, encourage, and reinforce verbal communication with children, opportunities for communication and all attempts via AAC systems need to be attended to by therapists, parents, teachers, and peers in similar ways. To reinforce the use of appropriate communication, conversation partners need to be highly responsive to any attempts at communication (Siller & Sigman, 2002). Music therapists may facilitate communication as a treatment goal within sessions. Thus, if a child has an AAC system in use, it needs to be accessible in the music therapy environment


(Gadberry, 2011). One might wonder how to incorporate another electronic device into the session when the therapist and client are using instruments or other props and materials. Gadberry (2011) described two important ways for music therapists to utilize aided AAC in music therapy sessions: Augmenting input for reception and modeling for expression. These two aids go hand-in-hand when a therapist begins to utilize AAC in sessions.


If an individual has difficulty taking in, holding, and processing information, it may be beneficial to utilize augmented input. Augmented input can occur with or without an AAC system. Many music therapists may utilize visual supports, such as pictures, clip art, and objects to enhance receptive communication and organization. When the individual has an aided AAC system, the music therapist might request to use the client’s AAC system to assist in receptive communication. Then the music therapist can activate or point to the corresponding icon on the aided AAC system. By utilizing the visual representation of the word, individuals have more time to process the information, and can access the static visual representation as opposed to the temporal verbalization. According to Porter and Cafiero (2009), augmented input refers to the practice of a conversation partner using an individual’s AAC system to assist in the reception and expression of language by modeling AAC system use while speaking verbally. By pairing speech with the AAC system (pointing to it or activating it), the therapist is modeling an appropriate response by utilizing the system that the child will use to provide expressive language (Drager, 2009).

References American Speech-Language-Hearing Association (2012). Communication services and supports for individuals with severe disabilities: FAQs. Retrieved from Cress, C. J., & Marvin, C. A. (2003). Common questions about AAC services in early intervention. Augmentative and Alternative Communication, 19(4), 254-272. Drager, K. D. R. (2009). Aided modeling interventions for children with autism spectrum disorders who require AAC. Perspectives on Augmentative and Alternative Communication, 18(4), 114-120. Gadberry, A. L. (2011). Augmentative and alternative communication in music therapy for children with autism spectrum disorders. imagine, 2(1), 40-43. Retrieved from imagine__online_magazine.html. Mirenda, P. (2003). Toward functional augmentative and alternative communication for students with autism: Manual signs, graphic symbols, and voice output communication aids. Language, Speech, and Hearing Services in Schools, 34, 203-216. Porter, G., & Cafiero, J. M. (2009). Pragmatic organization dynamic display (PODD) communication books: A promising practice for individuals with autism spectrum disorders. Perspectives on Augmentative and Alternative Communication, 18(4), 121-129. Siller, M., & Sigman, M. (2002). The behaviors of parents of children with autism predict the subsequent development of their children’s communication. Journal of Autism and Developmental Disorders, 32, 77-89.

It is also important to have appropriate responses listed on the AAC system. For example, one might make a music therapy page with instruments and songs listed on it, from which the client can make choices. Related responses for particular interventions, such as words to fill in the blanks in songs, possible answers to questions, or words for songwriting will need to be programmed in as well. Pre-composed songs that work well with aided AAC systems are ones that have repeated words or phrases. With multiple opportunities to express a word or phrase, the child has a more active role. If a music therapist is unsure how to add vocabulary to the AAC system, it might be helpful to consult with the speech-language pathologist. In summary, it is helpful to facilitate AAC use as a part of the music therapy session for the children who need assistance with receptive and/or expressive communication. There are several steps that may be taken to encourage AAC use: 1. 2. 3.

Refer client to a speech-language-pathologist for an AAC evaluation if she or he does not communicate competently. Become familiar with the client's AAC system and learn how to use it. Make sure appropriate communication responses are available on the aided AAC system. Ask to use the system to model and/or augment input if needed.

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Prompt the client to use her or his AAC system to communicate during music therapy sessions. Be responsive to any communicative attempts made by the client.

Using music in conjunction with AAC to encourage and facilitate communication will assist clients to be more competent communicators.

About the Author Anita Gadberry, Ph.D., MT-BC, Director of Music Therapy at Marywood University, serves as the North American Regional Liaison for the World Federation of Music Therapy Council. Her primary clinical and research areas are autism spectrum disorders and augmentative and alternative communication. Contact:


Music Preferences of Young Children Darcy Walworth, Ph.D., MT-BC University of Louisville Louisville, Kentucky

Children tend to form preferences for certain songs or types of music in quite predictable ways. This process seems to be based on the child’s developmental age and exposure to music. Children are first intrigued by simple and repetitive, consonant, higher pitched melodies with faster tempos (Baruch, Panissal-Vieu, & Drake, 2004; Trainor & Heinmiller, 1998; Trainor & Zacharias, 1998; Trehub, Unyk, and Trainor, 1993; Zentner & Kagan, 1998). The number of times a child hears a song will determine how interesting or captivating it becomes (Palmer, Jungers, & Jusczyk, 2001). The following paragraphs address key elements in developing music preferences in young children, learning new songs, and responding to children’s music; a list of suggested children songs concludes this article. Developing Preference Developing preference for favorite music follows the same pattern in adults as children and is based on the optimal complexity theory by Berlyne (North & Hargreaves, 1995). The difficulty of the words being sung, the range of the melody, the repetition of the melody, and the complexity of the rhythm within the song constitute the elements of music complexity that contribute to how much the child likes the song. If a song is too complex, the child will not be able to process it, and most likely will not like the song. It is not possible for a child to learn and then sing along with songs that have very complicated words. Some parents may say that a child likes complicated music; however, it may be that the parents listen to this type of music around the child. Children may develop a preference for those songs based on the number of times they have heard them, and may be able to sing a few words if the song has a repetitious chorus or simple words. Typically though, the child will not be able to learn the

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entire song, because some elements of the song are too complex. Learning New Songs It is common for young children to hear a song repeated multiple times and thereby begin to predict the song’s melody and rhythms. Once the child is familiar with the song, he or she will start humming the melody and try to sing along with some key words that are memorable and are repeated often in the lyrics. The melody typically is learned in full with more and more words filled in from the song lyrics. Eventually all words have been learned and the child’s interest in the song is near its peak. From this point, the amount of time spent singing the song usually varies based on the intensity of enjoyment the song elicits. After the song proceeds through the very peak of interest, there might be a noticeable decline in the number of times the child initiates, requests, and asks to hear the song multiple times in a row. After the interest in the song begins to decline, there will still be some time when the song is desired but will most likely continue to decline. Responding to Children’s Music Interestingly, lullabies are common in every culture (Trehub, Unyk, & Trainor, 1993). Infants all respond positively to lullaby style music. As children develop, their ability to understand and relate to more complex music evolves. If the developmental aspect of liking and processing music was not a reality, there would be no children’s genre of music. We would all listen to the same style of music. Children who have never heard children’s music will not develop a preference for it; naturally, they can only develop preferences for what they have heard. But, if children are exposed to both the music their parents listen to and children’s music, they will typically develop a preference for children’s music. This is because children’s music has simple words they can learn to say, melodies that have a short range and are repetitious, and a short verse and chorus. All of these elements enable children’s songs to be easily sung by young children. This is important for music therapists and parents to understand, as they choose the music the children are hearing in everyday life. The child will more likely respond to the interventions discussed if the music used to address therapeutic


goals includes songs that are easily learned and enjoyed. It is worth investing in several children’s song compilations if attempting music interventions with young children. The following list includes selected songs that are appropriate for young children.

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Dan Zanes & Friends (2009). 76 Trombones [CD or MP3 download]. Brooklyn, NY: Festival Five Records. Dan Zanes & Friends (2003). House Party [CD or MP3 download]. Brooklyn, NY: Festival Five Records. Dan Zanes & Friends (2000). Rocket Ship Beach [CD or MP3 download]. Brooklyn, NY: Festival Five Records. Elizabeth Mitchell (2006). You Are My Little Bird [CD or MP3 download]. Little Bird Records. Elizabeth Mitchell (2002). You Are My Sunshine [CD or MP3 download]. Little Bird Records. Laurie Berkner Band (2010). The Best of The Laurie Berkner Band [CD or MP3 download]. New York: Two Tomatoes. Ralph’s World (2008). The Rhyming Circus [CD or MP3 download]. Burbank, CA: Walt Disney Records. Recess Monkey (2008). Tabby Road [CD or MP3 download]. Seattle, WA: Recess Monkey. Sesame Street (2008). Platinum All Time Favorites [CD]. Koch Records. The Okee Dokee Brothers (2010). ¡Excelente Fabuloso! [CD or MP3 download]. Minneapolis, MN: Okee Dokee Music. The Okee Dokee Brothers (2010). Take It Outside [CD or MP3 download]. Minneapolis, MN: Okee Dokee Music.

References Baruch, C., Panissal-Vieu, N., & Drake, C. (2004). Preferred perceptual tempo for sound sequences: Comparison of adults children and infants. Perceptual and Motor Skills, 98, 325-339. North, A. C., & Hargreaves, D. J. (1995). Subjective complexity, familiarity, and liking for popular music. Psychomusicology, 14, 77-93.

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Palmer, C., Jungers, M. K., & Jusczyk, P. W. (2001). Episodic memory for musical prosody. Journal of Memory and Language, 45, 526-545. Standley, J. (2003). Music therapy with premature infants. Silver Spring, MD: American Music Therapy Association. Trainor, L. J., & Heinmiller, B. M. (1998). The development of evaluative responses to music: Infants prefer to listen to consonance over dissonance. Infant Behavior and Development, 21, 77-88. Trainor, L. J., & Zacharias, C. A. (1998). Infants’ prefer higher-pitched singing. Infant Behavior and Development, 21, 799-806. Trehub, S. E., Unyk, A. M., & Trainor, L. J. (1993). Adults identify infant-directed music across cultures. Infant Behavior and Development, 16, 193-211. Walworth, D. (2009). Effects of developmental music groups for parents and premature or typical infants under two years on parental responsiveness and infant social development. Journal of Music Therapy, 46(1), 32-52. Whipple, J. (2005). Music and multi-modal stimulation as developmental intervention in neonatal intensive care. Music Therapy Perspectives, 23 (2), 100-105. Zentner, M. R., & Kagan, J. (1998). Infants’ perception of consonance and dissonance in music. Infant Behavior and Development, 21, 483-492. About the Author Darcy Walworth, Ph.D., MT-BC is Director of Music Therapy at the University of Louisville. Dr. Walworth has published in the Journal of Music Therapy, Journal of Pediatric Nursing, Pediatric Nursing Journal, and Journal of Neonatal Nursing. Her research focus areas include neonatal and early childhood developmental music therapy interventions.   Contact:


Assessing Early Childhood Development through Music Responses Elizabeth K. Schwartz, LCAT, MT-BC Center for Early Childhood Music Therapy Melrose, Massachussetts

About the Author Elizabeth K. Schwartz, LCAT, MTBC practices music therapy in early childhood in New York and is an adjunct instructor at Molloy College. She is the author of Music, Therapy, and Early Childhood: A Developmental Approach. Contact:

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The importance of music therapy in addressing the developmental needs of children is gaining acceptance from the medical and educational communities as well as from the therapists, teachers, care givers and most significantly the families of children with special needs (Humpal & Colwell, 2006). Brain research is providing a solid foundation for understanding how the young mind processes and responds to musical information and supports a developmental context for understanding music responses (Patel, 2008). Extensive studies on music development in early childhood are now available in music therapy, music education and early childhood journals and publications (Gooding & Standley, 2011; Schwartz, 2008). At the same time, numerous studies of best practices and clinical outcomes have demonstrated that music interventions are effective and valuable in creating the opportunity for developmental growth in young children (LaGasse, 2011; Walworth, 2009). But how are music therapists measuring developmental change? What parameters are we using in our observations to evaluate developmental growth? Are specific music responses a valid indication of overall early childhood development? Can music responses become an accepted norm in assessing a child’s developmental growth? Lipe and York in the introduction to the 2000 issue of Music Therapy Perspectives stated “Assessment is an important issue for

music therapists because of its importance in the treatment process, and its role in furthering the credibility of the profession” (Lipe & York, 2000). This article will present an assessment tool that was created to determine early childhood development through musical responses – the Music Indicators of Early Childhood Development (MIECD). It is the hope that sharing this assessment tool with early childhood colleagues through imagine will spark investigation into and debate around the issue of music-based assessment of young children. MIECD was first published in 2008 as part of the music therapy developmental framework outlined in Music, Therapy, and Early Childhood: A Developmental Approach (Schwartz, 2008). It is currently used as one assessment tool at Alternatives for Children, a New York State early intervention and preschool center and has also been shared with colleagues in regional and national conference presentations. Rationale The rationale for creating the MIECD was to develop a simple to use, sequenced checklist of musical responses across the developmental range of young children ages birth to 5 that could be used to indicate developmental levels purely through musical responses. The framework of development was tied to levels


created by the author rather than chronological boundaries (Schwartz, 2008). The levels range from Awareness to Trust, to Independence, Control, and Responsibility.

Design The design of the MIECD is based on the format of other widely accepted early childhood developmental screening and assessment tools (Ringwalt, 2008). Key considerations in creating the tool included 1) assessment items that occur naturally in the child’s environment or can be easily elicited in a developmentally appropriate intervention, 2) assessment items that are measurable and observable, 3) music based, 4) simple to use and score, and 5) measures both demonstrated music responses and clinically relevant music involvement. Purpose The purpose of the MIECD is to determine the child’s developmental level through music responses. It is meant to provide a unique perspective on the child and to support the findings of other developmental assessment tools. The uses of the MIECD can be both to understand a child’s needs and strengths during developmental assessment as well as to demonstrate developmental growth as an outcome of music therapy interventions. At Alternatives for Children, the MIECD is used in initial assessment of a child for music therapy services and again as one indication of developmental progress during evaluation of services. Please note, the MIECD is not intended as a diagnostic tool. It is not meant to be used solely to determine eligibility for services.

Table 1. Music Indicators of Early Childhood Development Source: Schwartz, E.K. (2008). Music, therapy, and early childhood: A developmental approach. Gilsum, NH: Barcelona Publishers. Reprinted with permission.

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Research and Background The musical responses used as items on the MIECD were selected from an extensive review by the author of the research literature on early childhood music development and correspond to the levels listed above. Since the research examined was most often within an identified chronological age, the author was able to create a sequenced, or developmental, list of very specific musical actions or responses across the span of early childhood practice.

Format The MIECD format includes the following items: Child Identifying Information; Assessment items across three response categories – singing; playing instruments, and music movement; identification of general range of musical involvement across nine categories; scoring within developmental level; comment area; and appendix of indications of early childhood musical involvement. Administration The MIECD was designed to be simple to administer during a typical


It is important to note that within each response category (i.e., singing, playing instruments, and music movement) there are only four musical items per developmental level. The sequential nature of the items on the MIECD generally means that the child will naturally demonstrate responses in the order listed within each response category. It is recommended that the music therapist who would like to use the MIECD become familiar first with the entire concept of the music developmental framework. Scoring Scoring for the MIECD combines numerical information from the musical responses and more subjective information from the Indicators of Early Childhood Musical Involvement outlined in Figure 1. Once again, the score will provide the music therapist with a music based indication of early childhood development, which can be used for assessment, progress toward growth and to share with families and other early childhood professionals.

Table 1 cont. Music Indicators of Early Childhood Development

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music therapy session. There is no set protocol for interventions or methods, and music therapists are encouraged to create their own style of musical engagement. Items can generally be observed during developmentally appropriate singing, playing instruments or movement activities (Schwartz, 2008). The MIECD does require that the music therapist be extremely observant of the details of the child’s musical responses in order to accurately and objectively ascertain solidified responses. The MIECD form is easy to use and items can be discretely checked off by the therapist during a session if it does not disrupt the child’s natural engagement. Video and audio recordings of the assessment session would provide more detailed evaluation of subtle or momentary actions.

Validity Although not yet scientifically validated, the use of the MIECD at Alternatives for Children has shown a consistent relationship between the music-response based findings of developmental levels of the MIECD and the determination of the child’s development found through other non-music based assessment tools for the majority of children. Alternatives for Children services children five and under with a variety of developmental needs as well as typical children, and so comparison of the MIECD results with other assessments is convenient. One interesting discrepancy has surfaced with regard to young children who either have a diagnosis of Pervasive Developmental Delay or who are at risk for such a diagnosis. Scoring of the MIECD for a number of these children has been scattered rather than progressive as is seen in children with more generalized developmental delay.


In Summary Creation and use of the MIECD is a small and preliminary glimpse into the possibility that music response as an indicator of early development is a valid and unique predictor of overall development. It is the author’s hope that the music therapy community of imagine will field test this assessment tool in their clinical work and research. Assessment through music responses, when viewed from a developmental framework, can reinforce the importance of music therapy in early childhood and also support the unique and vital place of music-making in the lives of all young children. References Gooding, L., & Standley, J. (2011). Musical development and learning characteristics of students: A compilation of key points from the

research literature organized by age. Applications of Research in Music Education, 30(1), 32-45. Humpal, M. & Colwell, C. (Eds.) (2006). Effective clinical practice in music therapy: Early childhood and school age educational settings. Silver Spring, MD: American Music Therapy Association. LaGasse, B. (2011). Research snapshots 2011: Music and early childhood development. imagine 2(1), 28-30. Retrieved from http:// Imagine/ imagine__online_magazine.html Lipe, A. & York, E. (2000). Guest editorial: Special issue on assessment in music therapy. Music Therapy Perspectives, 18(1). Silver Spring, MD: American Music Therapy Association. Patel, A. D., (2008). Music, language, and the brain. City, NY: Oxford University Press.

Ringwalt, S. (2008). Developmental Screening and Assessment Instruments. Retrieved from pubs/screening.pdf Schwartz, E. K. (2008). Music, therapy, and early childhood: A developmental approach. Gilsum, NH: Barcelona Publishers. Walworth, D. D. (2009). Effects of developmental music groups for parents and premature or typical infants under two years on parental responsiveness and infant social development. Journal of Music Therapy, 46(1), 32-52.

Table 1 cont. Music Indicators of Early Childhood Development

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Photo courtesy of Petra Kern.

Ancient Wisdoms for Current Times: Yoga, Music, and Young Children Dorothy S. Denton, BM., MT-BC Music Moves Studio Mansfield, Ohio Yoga Today It might be easy to dismiss traditional ways of working with the mind/body/spirit connection in the American climate of evidence-based practice and hyper-focus on neuroscience. However, the modern interest in the ancient practice of yoga and meditation should be also acknowledged. This may reflect a growing realization that the frantic pace of our culture is at odds with our basic needs and our children’s healthy growth. Yoga, Music, and Therapy Yoga practice for the therapist cultivates mindfulness (the art of calm presence), a balanced frame of mind, and physical stamina. When working with young children there is value in a prescribed set of movements, coordinated and supported with breath and sound. Working with the body and breathing as instruments is indeed a very musical experience, similar to practicing, where one might be intensely connected to the motor flow of the body while deeply listening to the underlying emotional qualities of silence and sound. Yoga is not just a series of movement poses with catchy names. Typically it has many areas of practice that might include asanas (i.e., active/passive body postures), pranayama (i.e., breathing exercises), cleansing practices, music and sound therapy, and deep relaxation. With proper instruction and regular practice yoga can foster feelings of emotional and physical well-being, self acceptance, and a positive sense of balance (Feuerstein, 2003).

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Yoga for Children Sharing yoga with children can be centering, calming, and playful. Using yoga as a therapeutic approach alongside music therapy gives a child active ways of working on their own psychological and physical well-being. It is recommended that practitioners have more than a cursory understanding of yoga (certification preferable), as well as awareness of each child’s individual needs and capabilities before applying it therapeutically. Done casually it could be ineffective or possibly dangerous. Although there is a current lack of high quality studies of yoga with children, evidence suggests that children who have performed yoga have improved cardiovascular status, physical functioning, increased in calmness, reduced obesity and discipline problems, anger, and panic attacks, along with enhanced imagination, concentration, and academic performance (Flisek, 2001; Galantino, Galbavy, & Quinn, 2008). The world is experiencing an unprecedented number of children with unusual neurodevelopmental patterns who need assistance with sensorimotor regulation, movement, attachment, and subsequently, communication. They are in essence traumatized by their inability to move out into the world and process coherent sensations (Rosenblatt & Gorantla, 2011). Yoga, a body of work about the work of the body, may align provocatively with current research in psychology and the neuroscience of trauma, which suggests that yoga can be a robust treatment and somatic resource. (Van Der Kolk, 2006; Kenny, 2002). In young children who demonstrate a lot of anxiety and motor movement, yoga relaxation and breath awareness can increase feelings of emotional and social wellbeing and decrease anxiety and heart rate variability (Mehrotra, Phadke, Kharche, Pranita, & Joshi, 2012; Ross & Thomas, 2010). Provocative future research might explore “what works” when combining the emotional language of music with the rich movement language of yoga.


Assessing: Fostering Awareness of the Child’s Resources Awareness of a child’s movement repertoire may be informed by yoga and music therapy assessment. Early treatment goals often revolve around initiation and inhibition, anxiety and poor motor coordination. As a result of treatment, one might see increased socialization, confidence, respiratory support and joyfulness. Yoga can also gradually provide new physical patterns that can counter and replace chronic ways of responding to tension (Weintraub, 2012). Encouraging a Therapeutic Environment: Safety and SelfRegulation “Generally speaking, somatic resources that involve awareness and movement of the core of the body, e.g. centering, grounding, breath, alignment, provide a sense of internal physical and psychological stability and therefore support auto regulation” (Ogden, Minton, & Pain, 2006, p. 222). It is probable that non-judgmental yoga practice and music therapy may support a child’s need for self-calming, orienting to task, attention, and anticipation. Working with children under 5 years often necessitates initially cultivating impulse control. The challenge is to match the qualities and interests of children who have difficulty calming. Yoga and music strategies (i.e., breath control, chanting and sounding, working through the body’s movement, and sensations) are a way of working in a bottom-up (body to mind) fashion. A mindful, gradual pace allows children to feel in charge of their participation. The best sessions flow from the humor and creativity of the therapist and the child. Breathing: Nurturing a Calm Relationship Singing and sounding with yoga is a positive, warm way to interact, increase breath control and the coordination of mouth, rhythm and voice. Songs encourage inhaling/ exhaling together. Using scarves and pinwheels can give tangible sensory feedback that can be valuable for a child’s selfcontrol. Encourage a child to breathe slowly through the nose; the breath should not be forced or held (Khalsa, 1998). Evaluating an emotional state requires attention to a child’s breathing patterns. For example, children with a dysrhythmic or shallow breath pattern may get frustrated at first, but with repeated attempts can become self-aware of their breath. Older children who can lie on their backs might benefit from placing a prop on their tummy and instructing them to breathe “from the belly” as they watch the prop rise and fall with the breath. A child struggling with hyperactivity or anxiety may calm when counting to lengthen the exhale. Accompaniment with quiet music with a steady “breathing” pulse seems to be very helpful during this type of work. There are also energizing breathing practices that extend the limbs and coordinate the breath (i.e., in and out) with strong motions.

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Breathing Ideas Jeremiah blew the fire (e.g., child and adult put a scarf ‣ over their face) Puff, puff, puff (i.e., emphasis on the inhale and exhale with each puff) First he blew it gently… (i.e., gentle, sustained exhale) Then he blew it ROUGH! (i.e., child heartily blows into the scarf with a complete exhale). “Sipping breath” such as sucking milkshake through a ‣ straw while pulling the spine up. Train breath (“choo-choo”), which begins slowly and then ‣ speeds up. Trade breaths (e.g., “blow a bubble” to one child and ‣ have him or her return it). Mantras Mantras are words, sounds or phrases that are intoned or combined with melody, rhythm and hand movements (Wenig, 2003). Traditional chants often include rounded, open vowel sounds such as “OM.” The rhythmicity of breath and sound for calming and focusing contributes to the ideal therapeutic environment. The soothing lilt and repetitive refrains of many lullaby and folk melodies lend themselves well to this concept (e.g., Kumbaya, Down in the Valley, or The Water is Wide). A mantra can be passed as a rhythm or used as a back and forth imitation game to warm up the head, ears, breath and singing voice. Asanas: Supporting Movement Yogis must have spent significant time observing babies. The primary moves of a baby often radiate out from the core of the body (i.e., spinal column, pelvis, and ribs) and then contract inward. Development parallels yoga poses, or asanas, which are used for balance, body awareness, strength, flexibility and general awareness (Khalsa, 1998). Young children need to create and participate in their own way, with safety in mind and within the context of their own energy levels and body flexibility.

Props Although props are kept at a minimum in this work, consider using Yoga mats that define children’s personal spaces without ‣ forcing them to sit. It gives great input to bare feet with its gripping surface. Clean after use. Blankets with heft and weight are valuable for the ‣ sensation of grounding and provide comfort when needed. Long scarves or stretchy bands, or hoops to hold onto ‣ and pull against, can be supportive. They also are helpful when physically and playfully including someone who has little muscle control. Instruments: Guitar, singing bowls, bells of different types, ‣ and several types of drums.


Thematic Materials It is important to discern the developmental level of a child to inform clinical practice as a music therapist as well as yoga practitioner. If the children are at a symbolic stage where they can imagine and imitate, then using story narrative may help sequence the flow of movement. Many simple early childhood music games and topics that reflect nature themes lend themselves to yoga work. The collection of songs, games, chants and stories contained in the nature based Musikgarten® curriculum are inspiring examples. The seasonal cycles, trees, cats, birds, butterflies and even donkeys all lend themselves to movement expression through yoga poses. A first step might be to simplify and practice the movements appropriate to the story/rhyme. Then listening to the music, which is live if possible, followed by singing the musical sequence/rhyme helps anchor learning. Rest and Relaxation Standard to a yoga session is a period of deep relaxation. Do not eliminate this chance to allow children to settle under a blanket on their mats and practice relaxing muscles. Some children will find this extremely difficult! It is crucial time for consolidation of gains, for inviting muscles to relax and for learning to appreciate silence internally and externally. Summary Research is greatly needed to provide evidence for yoga, and the combination of yoga and music therapy in children with different special needs. However, yoga and music can both be viewed as a foundation for the health and nurturance of children. References Feuerstein, G. (2003). The deeper dimension of yoga. Boston, MA: Shambhala. Flisek, L. (2001). Teaching yoga to young schoolchildren. Positive Health, 70, 50-54. Freeman, D. (2009). Once upon a pose. Trafford Publishing available at Galantino, M., Galbavy, R., & Quinn, L. (2008). Therapeutic effects of yoga for children: A systematic review of the literature. Pediatric Physical Therapy, 20(1), 66- 80. Kenny, M. (2002). Integrated movement therapy™: Yogabased therapy as a viable and effective intervention for autism spectrum and related disorders. International Journal of Yoga Therapy, 12(7), 71. Khalsa, S. K. (1998). Fly like a butterfly: Yoga for children. Portland, OR: Rudra Press. Koch, I. (2006). Like a Fish in Water: Yoga for children. Rochester, VT: Inner Traditions. Mehrotra, R., Phadke, A. V., Kharche, J. S., Pranita, A.,& Joshi, A. R. (2012). Effect of Yoga on anxiety score and resting heart rate. National Journal of Integrated Research in Medicine, 3 (2), p. 142-146. Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to pyschotherapy. New York, NY: Norton & Co.

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Rosenblatt, L., & Gorantla, S. (2011). Relaxation responsebased yoga improves functioning in young children with autism: A Pilot study. Journal of Alternative & Complementary Medicine, 17(11), 1029-1035. Ross, A., & Thomas, S. (2010). The health benefits of yoga and exercise: a review of comparison studies. Journal of Alternative and Complementary Medicine, 16(1), 3-12. Sumar, S. (1998). Yoga for the special child: A therapeutic approach for infants and children with Down Syndrome, Cerebral Palsy and Learning Disabilities. Buckingham, VA: Special Yoga Publications. Van Der Kolk, B. (2006). Clinical implications of neuroscience research in PTSD. Annals of New York Academy of Sciences, 1070, 277-293. Weintraub, A. (2012). Yoga skills for therapists: Effective practices for mood management. New York: Norton. Wenig, M. (2003). YogaKids: Educating the whole child through yoga. New York, NY: Stewart, Tabori, & Chang. Williams, N. (2012). Yoga therapy for every special child. London: Singing Dragon. Online Resources www.theyogagardengame ‣ ‣ ‣ ‣ ‣ ‣ www. ‣ www. ‣ ‣

Author Note Many thanks to my patient yoga teachers & fellow travelers, Jeanne Scheff and Claudia Cummins. Namaste! About the Author Dorothy S. Denton, MT-BC is the owner of Music Moves Studio in Mansfield, Ohio. She has a private practice for families with children with developmental disabilities and conducts inclusive early childhood music and movement classes. Contact:


Storybook Dancesm: A Multiart Approach Using Creative Movement to Engage Boys in Learning Karen R. Davidson, BS Education Storybook Dancesm Guilford, Cincinnati

The article in imagine 2011 introduced the Storybook Dancesm teaching method, which integrates music, dance, children’s literature and art. This article focuses on supporting the needs of boy’s while learning through Storybook Dancesm. Gartrell (2004) affirms that physical activity is important to all children, especially young boys. In his chapter, Guidance with Boys in Early Childhood Classrooms, he encourages integrating large motor and whole body experiences into activities including art and music. Sprung (2010) reports that boys typically enter classrooms less developmentally mature than girls in terms of literacy and social-emotional skills. Hence, providing them opportunities to engage in all forms of play is essential to their learning and development. Sprung says, “The concept of free and guided play to advance cognitive development is especially critical for boys who need a learning environment that challenges them in appropriate ways...” (p. 47). Storybook Dancesm is a playful learning experience and includes picture books using creative movement to tell a story, music, and related art projects to enhance them. Books that appeal to boys most likely address movement and action. A few familiar examples are: Where the Wild Things Are (Sendak, 1963), House for a Hermit Crab (Carle, 1987), and Who’s in Rabbit’s House (Aardema, 1977). Each of these stories features natural movements of animals, distinctive art and an underlying social-emotional theme, which may encourage boys to express themselves. These books also suggest great mask ideas in their illustrations. Projects that worked well in classes of five-year-old boys were inspired by two less well-known books. Kites: Magic Wishes That Fly Up to the Sky (Demi, 1999) is based on the history of kite flying in China. The illustrations are colorful and stimulated the children to imagine their own designs. Discussions included how kites move using both hand gestures and whole body movements. The boys designed, constructed and danced with their own kites to tell the story. The three pieces of Asianinfluenced music featured in the video clip are Contortionists and Fairy of Water by Kitaro and Inochi No Sharin (Wheel of

Life) by Riley Lee. Both works supported the boys’ movements to tell the story.

Watch Kite Dance

The second project began with the introduction of Pacific Northwest Totem Poles. The text books used (Clark, 2001; Kramer, 2004) were filled with colorful designs, and taught children how to represent animals. The children chose their favorite animals and constructed colorful masks. Additionally, Photo courtesy of Karen Davidson. they built and decorated large totem poles out of cardboard boxes. The music used with this “story dance” was Totem by Gabrielle Roth. These books and activities engaged and supported the boys’ learning through the use of creative movement. References Aardema, V. (1977). Who’s in Rabbit’s House. New York, NY: Dial Books for Young Readers. Carle, E. (1987). A House for Hermit Crab. Saxonville MA: Picture Book Studio. Clark, K. (2001). Learning by Doing-Northwest Coast Native Indian Art. Union Bay, BC: Raven Publishing. Demi, D. (1999). Kites: Magic Wishes That Fly Up to the Sky. New York, NY: Crown Publishers, Inc. Gartrell, D . (2004). The Power of Guidance-Teaching Socialemotional Skills in Early Childhood Classrooms. Belmont, CA: Delmar, Cengage Learning. Kramer, P. (2004). An Altitude SuperGuide to Totem Poles. Canmore, Alberta: Altitude Publishing Canada Ltd. Sendak, M. (1963). Where the Wild Things Are. United States of America: Harper & Row, Publishers. Sprung, B., Froschl, M., & Gropper, N. (2010). Supporting Boys’ Learning- Strategies for Teacher Practice, Pre-KGrade 3. New York, NY: Teachers College Press. About the Author Karen R. Davidson, BS Education, owner of Storybook Dancesm, taught music and movement classes for infants and toddlers as well as Creative Dance, Modern Dance, and Storybook Dancesm for 25 years. She currently trains teachers and offers teacher development workshops.


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Photo courtesy of the Northern Territory Library.

Families Sharing Stories Anja Tait, BMus(Thpy), Grad Dip Primary Ed Koulla Giannikouris , Assoc.Dip.Arts (Lib.Prac) Northern Territory Library Darwin, Australia

About the Author Anja Tait is a music therapist, educator, and researcher who combines these disciplines in her role as Library Program Advisor in urban, rural and remote communities throughout the Northern Territory of Australia. Contact:

About the Author Koulla Giannikouris is a Literacy Project Officer with Northern Territory Library, working with communities in remote areas of the Northern Territory. Contact:

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The Northern Territory covers a vast area of the Australian continent but is sparsely populated. Northern Territory Library is the equivalent of a state library, and one of the library's key tasks is to collect, preserve and provide access to the cultural heritage and memories of the Northern Territory. The Northern Territory Collection tells the many stories of this small, yet diverse and multilingual population. There are many ways to tell stories.... Storytelling by people of all ages is enhanced by current and emerging technologies. Creating stories using technology brings local cultural and family knowledge to life. Stories can be told in local languages with accompanying images, artworks and music created by community. These stories are tangible, long lasting, and a contemporary record of culture for future generations. Northern Territory Library is using iPads, talking photo albums, XO laptops, mobile phones and print media

to capture and disseminate stories. .... and more than one story to tell In remote Indigenous communities in Northern Australia, Northern Territory Library uses a participatory approach. Local community involvement is strengthened in this way. Involvement in this case means a sense of ownership and valuing what everyone brings to the shared endeavor. Community members, library staff and local service providers build collaborative working relationships. Over time, leading individuals become visible, and it is these people who sustain community interest and involvement. They inspire others to grow in confidence, generate new ideas, and contribute to a growing hub of community activity around storytelling and technologies.  This way of working is meaningful, flexible, demanding, responsive and transparent.


When working in remote communities, Northern Territory Library articulates the possibilities and restrictions of funding agreements, acknowledges time limitations for all involved, and negotiates clear parameters for the anticipated products, such as bilingual baby board books, CDs and eBooks. Community participation is sustained by the employment and involvement of community members in leading roles. Remuneration is made possible from funding that Northern Territory Library sources from government and philanthropy. Northern Territory Library works with little ones and their extended families. This is intergenerational teaching and learning. People are creating and sharing stories of everyday life and times past, in print, melodies, spoken word, artworks and multimedia. Positive messages of pride, purpose, self-respect and empowerment are developed into new stories, chants and songs. The role of music in a remote context is observable and undisputed. The arts are “a fundamental aspect of Indigenous community life ... Family members may be involved in the arts as a part of daily life and ceremony from an early age” (Costantoura, 2001, p. 195). Northern Territory Library uses an arts-based approach to community library programs that is engaging and inclusive of people of all ages. Anyone, Anywhere can Create and Share Their Stories Practitioners from diverse disciplines now work with libraries the world over, bringing new perspectives and skill sets

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to contemporary library practice. Northern Territory Library employs educators, historians, and arts practitioners. Creative arts practitioners such as music therapists are trained and experienced in collaborative, community practice, and in particular the capacity to be inventive and open to learning from unexpected connections and collaborations. These qualities are valued in the gathering and honoring of stories in any setting. Anyone, anywhere can create and share their stories. Topic Related Publications Bartleet, B.L., Brunt, S., Tait, A., & Threlfall, C. (in press). Community music in Australia and New Zealand. In K. Veblen & D. Elliott (Eds.), Community Music Today. USA: Rowman and Littlefield Publishers. Costantoura, P. (2001). Australians and the Arts: Report to the Australia Council from Saatchi & Saatchi Australia. Sydney: Australia Council. Tait, A., Atfield, M., Gray, T., Murrungun, L., Musco, E., Orton, C. (2010). Music in Indigenous education. In J. Ballantyne & B. L. Bartleet (Eds.), Navigating music and sound education. Meaningful music making for life 2 (pp. 129-160). Newcastle upon Tyne: Cambridge Scholars Publishing. Tait, A. (2011). ArtStories: Intergenerational learning and involvement with the arts in Northern Australian communities. Music Therapy Today, Special Issue, 9(1), 62-63.

Tait, A. & Murrungun, L. (2010). ArtStories: Early childhood learning in remote Indigenous Australian communities. imagine, 1(1), 52-54. Tait, A. (2010). ArtStories: Arts-driven initiatives in education, health and community settings. In B. Hesser & H. N. Heinemann (Eds.), Music as a natural resource: Solutions for social and economic issues compendium (pp. 108-109). New York: The International Council for Caring Communities (ICCC), United Nations Headquarters. Wallace, R. & Tait, A. (2006). Community control & knowledge management: Practitioners & community working together. Proceedings of the International Consortium for Intergenerational Programs: Connecting Intergenerational Communities Through Creative Exchange Conference, Melbourne 2006. Authors’ Note The authors acknowledge contributions to the text and professional reflections presented in this article by Kate King, Senior Literacy Advisor, Northern Territory Library and Catherine Threlfall, music therapist, ArtStories.

Photo courtesy of the Northern Territory Library.


ideas If I Had a Hammer: Engaging in Creative Movement with Rhythm Sticks Bill Matney, M.A., MT-BC Lewisville Independent School District Denton, Texas

Description The purpose of this intervention is to promote fine and gross motor development, and individual creativity. The idea can be implemented in large classroom settings with varied levels of ability. The intervention song is an adaptation of If I Had a Hammer by Pete Seeger and Lee Hays. Goals ‣ ‣ ‣

To encourage imitation of movements To encourage creatively initiated movements To identify common household tools

Behavior Observation The child will: imitate movements and sounds with rhythm sticks. ‣ create movements and sounds with rhythm sticks ‣ related to the tool mentioned. label a common household tool by picture or by ‣ action related to the tool. Materials Rhythm sticks, two per child, preferably with one ‣ ridged stick. Toolbox with tools (optional, but potentially useful as ‣ an introduction) Directions 1. If helpful, introduce toolbox and tools. 2. Pass out rhythm sticks to children. Provide any relevant directions regarding safety. 3. Choose a particular “tool” to model movements and actions. Some possible examples include:

4. 5.

Hammer and nail: Striking one vertical rhythm stick (nail) with the other as it is held like a hammer. Saw and wood: Scraping the ridged stick against the other. Screwdriver and screw: Using a rotating motion with one stick tip on top of the other. Wrench and nut: Rotating with one stick perpendicular to the other. Create tools and movements that are challenging but attainable for the students. Introduce song with initial tool/movement choice. Model movement if needed. Repeat song and include new tools and actions.

Adaptations Allow children to come up with their own ‣ demonstrations of each tool. Give children pictures, and have them either identify ‣ the tool by labeling it or by demonstrating the action/ sounds associated with that tool. If doing the latter, other children can guess the tool by the actions and sounds they observe. Continue the process by having children “build” ‣ shapes, using rhythm sticks in collaboration with each other. Listen to If I Had a Hammer Recorded 2012 by Bill Matney

About the Author Bill Matney, M.A., MT-BC currently works at the Lewisville Independent School District. Bill is an adjunct lecturer at Texas Woman’s University, and owns a book publishing company that focuses on materials for music therapists and music educators. Contact:

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My Puppy: Teaching Appropriate Interaction with a Family Pet Beth McLaughlin, LCAT, MSE, MT-BC Wildwood School Schenectady, New York

Description The purpose of My Puppy is to help young children learn appropriate ways to interact with a new puppy or other family pets. Goals ‣ ‣

To encourage appropriate interaction with pets To teach empathy for animals

Behavior Observation The child will: gently pat stuffed animal on top of the head or gently ‣ tickle stuffed animal under the chin demonstrate feelings such as happy, sad, and mad ‣ Materials Stuffed puppy or dog puppet ‣ Photographs of animals ‣ Directions 1. Sit in circle and introduce a stuffed animal as your new pet 2. Introduce the song and model how to gently pat or or scratch the puppy as the song lyrics suggest. 3. Pass the puppy around the circle so that children can practice petting with a gentle touch while singing the song. Adaptations Change the words to the song to include examples of ‣ other family pets such as a kitten or a hamster. Ask children to bring pictures of their family pets and ‣ make a collage of happy, mad, and sad animals.

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Listen to My Puppy Recorded 2012 by Beth McLaughlin

About the Author Beth McLaughlin, LCAT, MSE, MT-BC is coordinator of music therapy services and internship director at Wildwood School in Schenectady, New York. She is a regular contributor to imagine and a frequent presenter on music therapy in special education and early childhood. Contact:


Thank You Song: Learning Appropriate Social Skills Anna Piper, MT Intern Wildwood School Schenectady, New York

Description The purpose of the Thank You Song is for children to learn the sign for and the appropriate usage of the words "thank you.” Goals ‣ ‣

to encourage appropriate use of “thank you” to teach expressive communication using verbal, sign language, and augmentative communication systems

Behavior Observation Child will say or sign “thank you” ‣ initiate “thank you” after receiving an instrument ‣ Materials Guitar ‣ One instrument (e.g., shaker, rhythm stick) per child ‣ Directions 1. Introduce the song before the instruments are handed out 2. Repeat the song form twice 3. Keep singing the song as the guitar is put down and instruments are handed out 4. Encourage each student to say or sign "thank you" upon receipt of an instrument 5. Assist children who use assistive devices to respond with “thank you” through voice output.

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Adaptations Children may distribute instruments and say “thank ‣ you” to each other. Children could create and hand out thank you cards. ‣ Add verses with examples of conversational ‣ exchanges (e.g., “Have a good day”) that prompt a “thank you.”

Listen to Thank You Song Recorded 2012 by Anna Piper

About the Author Anna Piper is an Intern at the Wildwood School in Schenectady, NY under the supervision of Beth McLaughlin. She is a graduate of Berklee College of Music. Contact:


Shaky Eggs: Following Directions and Body Awareness Meryl Brown MM, MT-BC, DT Developing Melodies Bloomington, Illinois

Description The purpose of the Shaky Eggs song is to address stop versus go, sound versus silence, and body awareness. Goals ‣ ‣ ‣

To encourage vocalization To learn body parts To address attending behaviors

Behavior Observation The child will: vocalize “shhhh” and verbalize “and then we go” as ‣ sung throughout the song identify body parts ‣ stop and start egg shaking as prompted by the adult ‣ Materials Egg shakers ‣ Directions 1. Pass out the egg shakers to children and invite them to practice shaking eggs and “freezing” eggs. 2. Sing the song, exaggerating “STOP!” 3. When the song stops, emphasize the silent eggs by saying “Ssshh!” 4. Lead the children in again with “And then we GO!” 5. Repeat the song several times, inviting children to shake on various body parts as directed throughout the song.

Listen to Shaky Eggs Recorded 2012 by Meryl Brown

Adaptations Use a different instrument (e.g., tapping/sticks) ‣ Use body movements in place of instruments (e.g., ‣ jumping, running, walking) Change the tempo of the song ‣ About the Author Meryl Brown MM, MT-BC, DT is the owner of Developing Melodies, a private practice in Bloomington, IL where she works with children and adults with special needs in addition to being lead blogger and songwriter for her company. Contact: URL:

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Left and Right: Enhancing Differentiation and Motor Planning Ruthlee Figlure Adler, MT-BC Private Practice Bethesda, Maryland

Description The purpose of the two intervention songs is to engage children in left/right differentiation and motor planning while singing and playing music instruments. Goals ‣ ‣

To differentiate between left and right hand To increase motor planning and coordination

Behavior Observation The child will: use the correct hand in response to visual and ‣ auditory cues play a drum with both hands to the rhythm of a song ‣ Materials Songs: Left Right and Play the Drum ‣ Hand drum (e.g., Buffalo drum) and other instruments ‣ Directions 1. Sing the first line of Left Right while waving the left hand; second line while waving the right hand; sing and clap the third line, repeating the song until all children demonstrate successful right left waving. 2. Place a hand drum in front of a child. Mirror the left/ right hand actions while singing the song Play the Drum. Repeat with each child until they successfully play the drum beats with the prompted hand. Adaptations Use a variety of instruments such as maracas, jingle ‣ bells, or castagnettes for practicing right and left hand and adapt the song lyrics.

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About the Author With over 50 years of passionate commitment to music therapy, Ruthlee Figlure Adler, MT-BC, now maintains a part-time private music therapy practice/consultancy for varied ages and populations in Bethesda, Maryland. Contact:


The Colors of Communication: Listening and Responding to Cues Kathryn A. Quattlebaum, MHR, MT Student and Nicole D. Ribet, MT Student William Carey University Hattiesburg, MS

Description The purpose of this intervention is to enhance receptive language skills (a school readiness skill) in young children with intellectual and developmental disabilities through music. Goals ‣ ‣ ‣

To foster pre-academic skills To increase receptive language skills To improve turn-taking

Behavior Observation Child will identify colors during music-making ‣ listen and respond to verbal cues in the music ‣ participate during her/his color’s mentioning ‣ Materials Semi-circle of red, blue, green, and yellow plastic ‣ chairs arranged in groups of two or three according to color Hap Palmer’s Colors song from the CD Learning Basic ‣ Skills through Music (Vol.1) and Lead Sheet Music. Directions 1. Review the color of each chair that a child is seated in. 2. Introduce the song and demonstrate what to do as the song lyrics suggest. 3. Repeat at least 2 times while modifying the tempo as needed. 4. Vary the order of colors to prevent memorization.

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Adaptations Replace standing/sitting lyrics with raising/lowering ‣ or shaking/tapping colored instrument such as egg shakers or rhythm sticks Make a collage of items mentioned in the song and ‣ use as a visual cues. Once a song is mastered, ask for volunteers to swap ‣ colored chairs or instruments. Create song lyrics about other colors. ‣ Teach American Sign Language (ASL) for the Chorus. ‣

Listen to Colors Recorded 2012 by Kathryn Quattlebaum & Nicole Ribet

About the Author Kathryn A. Quattlebaum, MHR, is a music therapy student at William Carey University in Hattiesburg, MS. Kathryn aspires to work with children, and is interested in researching music therapy and child development. Contact:

Nicole D. Ribet is also a music therapy student at William Carey University in Hattiesburg, MS. She will finish her undergraduate degree in music therapy November 2012 and begin her internship at Children’s Hospital New Orleans, LA in January 2013.



Ocean Adventures: Exploring Music and Creative Play Gretchen Chardos Benner, LSW, MT-BC Pittsburgh, PA

Description The purpose of this intervention is to utilize music while exploring the sounds and sights of an ocean. The activity promotes creativity with replicating ocean sounds and exploring related senses. Goals ‣ ‣ ‣

To foster creativity To socialize with peers about preferred adventures To improve sensory awareness

Behavior Observation The child will: recreate sounds of an ocean ‣ share ocean related idea or memories from beach ‣ vacation trips include an ocean related sensation, sound, taste, or ‣ sight in the song Materials Ocean Drum ‣ Guitar or other accompaniment (optional) ‣ Directions 1. Introduce the ocean drum and demonstrate what to do as the song lyrics suggest, including movements. 2. Add or change song lyrics about other sensations, sounds, tastes or sights. Examples include sunscreen lotion, beach balls, sandcastles, boats, salt water, kites, etc. 3. Use visual aids to organize client’s ideas. 4. Inquire about clients’ visits or experiences with an ocean.

Listen to Ocean Adventures Recorded 2012 by Gretchen Chardos Benner

Adaptations Listen to the waves of an ocean through a conch shell ‣ before the song. Bring seashells or sand for extra sensory integration. ‣ Assist clients to create ocean drums out of round ‣ plastic container and other craft supplies. Use a map to pinpoint clients’ visits to the ocean. ‣ About the Author Gretchen Chardos Benner, LSW, MT-BC is a practicing music therapist in Pittsburgh, PA. She is grateful having served the music therapy community regionally and nationally, with the most recent position of joining the imagine editorial team. Contact:

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color of us 25 countries available for download on our website, 8 additional countries featured in this issue.

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Lutz Neugebauer Dr. rer. medic., MT-DMtG Kinder- und Jugendlichenpsychotherapeut Nordoff-Robbins Center Witten, Germany

Snapshot Area 357,022 square kilometers; Germany is located in central Europe, South of Denmark, between the Netherlands and Poland, and bordering the Baltic and North Seas.

Population 81,305,856 (July 2011)

Official Language German

Ethnic Groups German 91.5%, Turkish 2.4%, other 6.1% (i.e., Greek, Italian, Polish, Russian, Serbo-Croatian, Spanish)

Median Age 44.9 years

Children under 6 4 million

Sources Statistisches Bundesamt (2010) The World Factbook publications/the-world-factbook/geos/ gm.html

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“Music offers an understandable experience that needs no abstract thinking.” – Clive Robbins and Paul Nordoff

Demographics Germany has five music therapy organizations with approximately 2000 practicing members. The Deutsche Musiktherapeutische Gesellschaft ( is the largest organization focusing on the professional development of music therapy as a scientific-based health profession. There are currently nine university-based training programs that offer music therapy degrees at both undergraduate and graduate levels, as well as several private institutes providing certificate degrees and professional development courses. Several research institutes investigate the benefits of music therapy with various populations. Scientific reports can be found in the German journal Musiktherapeutische Umschau as well as other national and international scientific journals.

Background Information The well-established German health system offers developmental screening of every child during regular well-child check-ups. Children who are at-risk receive various supports through early childhood intervention centers. Usually, children under the age of three stay at home with their families or attend daycare

centers. Schooling starts at the age of three, when every child has the right to attend a preschool in his or her community. Children with special needs are either included in regular preschools or are placed in special education groups. Special services, including music therapy are offered within those settings or in collaboration with community service providers. Music therapy in Germany has a long tradition in serving young children and their families. One of the first training programs established at the University of Witten-Herdecke in the 1970s focused on on the Nordoff-Robbins Music Therapy approach.

Common Approaches In 1990, a research and practice conference at the Institute for Music Therapy at the University of Witten/ Herdecke revealed that approaches applied in early childhood music therapy are eclectic in nature and focus on the needs of the children served. The various approaches include anthroposophical, behavioral, psychoanalytical, developmental, integrative and humanistic, and regulative music therapy as well as Nordoff-Robbins Music Therapy and Getrud Orff (Carl Orff’s wife) music therapy. Music therapy for children under 5 is mostly offered in medical settings (e.g., NICU, pediatric


and psychiatric units, and rehabilitation centers), educational settings (e.g., early intervention centers, inclusive preschools, and special education facilities), and through private practice. Reimbursement for services in medical settings is covered by most health insurances whereas other music therapy services are mainly funded by foundations, sponsors, or private pay.

Prominent Publications Aldridge, D., Gustorff, D., & Neugebauer, L. (1995). A pilot study of music therapy in the treatment of children with developmental delay. Complementary Therapies in Medicine, 3, 197-205. Haselbeck, F. (2012). Music therapy for premature infants and their parents: An integrative review. Nordic Journal of Music Therapy, 1-38. doi: 10.1080/08098131.2011.648653. Neugebauer, L. (2001). Kann Musiktherapie kĂśrperlich behinderten Kindern helfen? [Can music therapy help the physically handicapped child?]. In D. Aldridge (Ed.), Kairos V: Musiktherapie mit Kindern: Beitraege zur Musiktherapie in der Medizin (pp. 4-11). Bern, Switzerland: Verlag Hans Huber. Noecker-Ribaupierre, M. (Ed.) (2004). Music therapy for premature and newborn infants. Gilsum, NH: Barcelona Publishers.

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Plahl, C. & Koch-Temming, H. (2005). Musiktherapie mit Kindern. Grundlagen, Methoden, Praxisfelder [Music therapy with children. Foundations, methods, and settings]. Bern, Switzerland: Verlag Hans Huber. Schumacher, K., Calvet, C. & Reier, S. (2011). Das EBQ-Instrument und seine entwicklungspsychologischen Grundlagen [The EBQ instrument and its psycho developmental foundations]. Goetting: Vandenhoeck und Ruprecht. Stiff, U., & TĂźpker, R. (Ed.) (2007). Kindermusiktherapie. Richtungen und Methoden [Music therapy for children. Directions and methods]. Goetting: Vandenhoeck und Ruprecht.

About the Author

Lutz Neugebauer, Dr. rer. medic., MT-DMtG is the co-director of the Nordoff-Robbins Centre in Witten, Germany. His work focuses on young children with special needs and their families. From 1988 to 2006, Dr. Neugebauer was the Head of the Institute for Music Therapy at the University of Witte/Herdecke. Currently, he serves on the board of directors of the Deutsche Musiktherapeutische Gesellschaf. Contact:


Ireland Jason Noone MA (Music Therapy), BA (Applied Psychology) Music Therapist, Lecturer Irish World Academy of Music and Dance University of Limerick, Ireland

Snapshot Area The Republic of Ireland is a small country (70,273 km2) at the Western edge of Europe. Northern Ireland is part of the same landmass but is part of the United Kingdom.

Population 4,588,252 (Census, 2011)

Official Language The official languages of the Republic of Ireland are Irish (Gaeilge) and English.

Ethnic Groups Irish 87.4%, other white 7.5%, Asian 1.3%, black 1.1%, mixed 1.1%, unspecified 1.6% (2006 census)

Median Age 34.8 years (2011 census )

Children under 5 325,000 (Census, 2011 est.)  

Sources Census 2011 Highlights census/documents/census2011pdr/ Census%202011%20Highlights %20Part%201%20web%2072dpi.pdf

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“We music therapists have as our therapeutic agent a universal means of human contact, communication, and expression - music. The potential is unbounded.” – Edith H. Boxill

Demographics Music therapy has not yet achieved state recognition in Ireland. Therefore it is not possible to give an exact number for music therapists working in Ireland. The representative body for creative arts therapists in Ireland, IACAT, is working to improve the status of music therapy within the Irish health system and representations have been made to the government to emphasize the value of music therapy as an early childhood intervention. Ireland has one masters-level music therapy course at the Irish World Academy of Music and Dance at the University of Limerick, from which 8 to 10 music therapists graduate each year.

Background Information In Ireland, music therapists providing services for young children under 5 work most on a sessional or on private basis. Funding for music therapy programs is usually provided by schools or facilities directly or through charitable contributions. Music therapists in this country have worked with early intervention services, mainstream and special schools, children’s hospitals, facilities for asylum seekers and parent-infant programs. Young children with additional needs such as physical

and intellectual disabilities, emotionalbehavioral disturbances or medical needs have participated in music therapy interventions to promote communication, social, emotional and physical well-being and development.

Common Approaches Music therapists educated in Ireland are trained in an eclectic approach. There are also Nordoff-Robbins and psychodynamic music therapists working in the country. Depending on the developmental or clinical needs of the child and the nature of sessions (i.e., individual or group), a music therapist will naturally vary the methods and techniques he or she uses. Children receiving care in certain hospitals have had access to both music therapy and music in health programs. Parent-infant interventions have been carried out based on the “Sing and Grow” model (see http://

Prominent Publictions Ireland. Oireachtas. Joint Committee on Arts, Sport, Tourism, Community, Rural and Gaeltacht Affairs (2006). An taonú tuarascáil déag: Teiripe cheoil a mhíniú –Eleventh report: Defining music therapy. Retrieved from documents/committees29thdail/ jcastrag/reports/Music_Therapy.pdf


Kelly, K. (2011). Supporting attachment in vulnerable families through an early intervention school-based group music therapy program. In J. Edwards (Ed.), Music therapy and parent-infant bonding (pp. 101-114). New York, NY: Oxford University Press.

About the Author

Jason Noone, MA divides his time between working with children and adults with developmental disabilities and lecturing on the M.A. Music Therapy Training Program at University of Limerick in Ireland. Contact:

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Spain Melissa Mercadal Brotons Ph.D., MT-BC Universitat Pompeu Fabra, Barcelona Escola Superior de Música de Catalunya, Barcelona

Snapshot Area 505,307 square kilometers; Spain is located into Southwestern Europe and divided in 17 provinces including the Balearic and the Canary Islands.

Population 47,042,984 (July 2012 est.)

Official Language The offical language is Castilian Spanish (74%) followed by Catalan (17%), Galician (7%), and Basque (2%).

Ethnic Groups Composite of Mediterranean and Nordic types

Median Age 40.5 years (2011 est.)

Children under 5 2,601,100 children, 22% of those have disabilites (CIIMU, 2007)

Source The World Factbook publications/the-world-factbook/ geos/sp.html CIIMU(2007)

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“Children are like wet cement. Whatever falls on them makes an impression.” – Haim Ginott

Demographics Although music therapy has a long tradition in Spain, it is still a developing profession. This is evidenced by the lack of unification of organisations and the difficulty involved in working towards this goal. Currently, there are nine Universities that offer training programs in music therapy at the postgraduate level as well as three private institutes. According to a study by Poch (2008), 1336 people were identified as trained music therapists since 1986. Due to the high number of music therapy associations in Spain (approximately 18-20) it is difficult to provide reliable data clearly indicating current music therapy practice, especially as related to specific populations and work settings . Sources: Poch, S. (2008). Los profesionales Musicoterapeutas en España en la actualidad. Actas del II Congreso nacional de Musicoterapia [Proceedings of the II National Congress of Music Therapy]. Zaragoza, Marzo 2008, 110-114. Founded in 2007, the Professional Association Asociación Española de Musicoterapeutas Profesionales (AEMP), started to focus on governmental recognition of music

therapy as a health profession. For more information please visit http:// To support this endeavor and to provide data on current trends related to clinical practice of music therapy in Spain, Sabbatella and Mercadal-Brotons (in progress) conducted a survey study. Preliminary results indicate that, out of 150 respondents from different parts of Spain, 69 music therapists work part-time in early childhood settings, especially with children between the ages of 2 to 7 years. The diagnosis most frequently represented in this were Developmental Disabilities, Autism Spectrum Disorders, behavioral issues, Attention Deficit Hyperactivity Disorder, physical disabilities, multiple disabilities, sensory disorders, language disorders, learning disabilities, and premature birth. Currently, many music therapists are hired under other job titles (i.e., music teachers or psychologists) as a specific professional description of music therapy still does not exist. Although there are some public institutes that employ music therapists, most music therapists work with private agencies specializing in early childhood (e.g., special education centers, children’s hospitals, organizations, child care centers/ preschool settings, music schools, music therapy clinics, and other type of clinics).


The funding mainly comes from private sources or grants.

Background Information The special education laws in Spain have evolved from 1970 to 2006. Article 74 of the Ley Orgánica de Educación 2/2006 (Organic Law 2/2006 on Education) of May 3, states that the schooling of students with special educational needs shall be governed by the principles of normalization and inclusion. It also provides for the possibility of schooling within special education centers, when children’s needs cannot be adequately met in the context of in regular schools.

educational approaches (e.g., Orff, Dalcroze, and Kodaly) are also part of early childhood music therapy practice, especially since some of the interventions take place in music schools.

Prominent Publications

Although music therapy services are not specifically included in the law, music is part of the curriculum of many institutes offering early childhood education, esecially in special education centers. As part of this subject, and as an extracurricular activity, music therapists are often solicited to provide their services for this age group.

Del Olmo Barrios, M. J. (2009). Musicoterapia en cuidados intensivos pediátricos [Music Therapy in Pediatric Intensive Care Units]. In P. Martí Augé & M. Mercadal-Brotons (Eds.), Musicoterapia en medicina. Aplicaciones prácticas [Music therapy in medicin: Practical Applications] (pp. 127-142). Barcelona: Editorial Médica JIMS. Lacárcel Moreno, J. (1995). Musicoterapia en Educación Especial. Murcia: Universidad de Murcia. Mateos Hernández, L. A. (2004). Actividades musicales para atender a la diversidad [Musical activities to address diversity]. Madrid: Instituto Calasanz de Ciencias de la Educación. Mercadal-Brotons, M., & Martí Augé, P. (in press). Música, musicoterapia y discapacidad [Music, music therapy and disability]. Barcelona: Editorial Médica JIMS. Vaillancourt, G. (2012). Música y Musicoterapia: Su importancia en el desarrollo infantil [Music and music therapy: Its importance for child development]. Madrid: Narcea Ediciones.

Source: LEY ORGÁNICA 2/2006, de 3 de mayo, de Educación. Boe núm. 106.Retrived from contenidos/sistema-educativo/educacionespecial/

Note: The number of publications specific to music therapy with young children is increasing. There are also dissertations and other research projects in the area of early intervention coming out of Spain.

The goal of the specialized schools is to serve students with special needs between the ages of 3 and 21 years to assist them in reaching their full potential realted to personal, academic, and social development. This is achieved through the implementation of measures for diversity with a distinctly specific and personalized character. The law also recognizes that it is the responsibility of educational authorities to provide those services that will meet the needs of students with disabilities.

About the Author

Dr. Melissa Mercadal-Brotons is Director of the Interuniversity Music Therapy Program (UPF-URL) in Barcelona, Spain and professor in the Escola Superior de Música de Catalunya (ESMUC) where she also coordinator the research and graduate programs. Contact:

Common Approaches There are variouse theoretical and methodological music therapy approaches in Spain, ranging from the Benenzon Model of Music Therpay, NordoffRobbins Music Therapy to a CognitiveBehavioral approach. Humanistic and developmental psychology and music

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Israel Dorit Amir, D.A., CMT Head of Music Therapy Program Bar Ilan University, Ramat-Gan, Israel

Snapshot Area 20,700 square kilometers; Israel is located in the Middle East, along the eastern shore of the Mediterranean Sea.

Population 7,836,300 (2011 est.)

Official Language The official languages are Hebrew and Arabic.

Ethnic Groups The largest ethnic group is Jewish (75.3%) followed by Arabs (20.5%). Smaller minorities include Negev Bedouins, Druze, Christians, Circassians and Samaritans (4.2%).

Median Age 28.6 years

Children under 5 Almost 1 million children

Sources CBS (2011) st02_19.pdf Israel Wonders tourism_heb2/Pages/default.aspx

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“There are no bad children. There are children who feel bad.” –Janusz Korczak

Demographics Music therapy as a profession was founded as part of the Israeli Association of Creative and Expressive Therapies (I.C.E.T) in 1971. In music therapy, four main areas of practice have developed throughout the years: Music psychotherapy, music in medicine, music in special education, and community music therapy. Currently, there are four music therapy training programs located at Bar Ilan University in Ramat Gan, David Yellin College in Jerusalem, Levinsky College in Tel Aviv, and Haifa University. There is legislation in motion to license people as music, art, drama, dance-movement, and psychodrama therapists as well as bibliotherapists. There are approximately 120 music therapists who are registered in the professional association, though the total number of music therapists in the country is higher. Music therapists in Israel work with a wide range of populations in a variety of settings, as well as in private practice and as program administrators.

Background Information

only about 15% work with children under the age of five. Practitioners provide services for young children and their families in settings such as child developmental centers, children’s day care centers, children’s wards in hospitals, therapeutic and rehabilitation centers, kindergartens for children with special needs, early intervention programs for children at risk, and private practice. The following are a few examples of such centers and associations which provide music therapy services: •

The Association for Children At Risk index.asp

The Multidisciplinary Center for Children with Hearing Loss (MICHA) page8.html

Israeli Rett Syndrome Foundation English

The Association for Advancing Blind Children and those who Suffer from Vision Deficiencies (ELYA)

The majority of music therapists in Israel work with children. However,


The National Association for the Habilitation of Children and Adults with Intellectual Disabilities (AKIM)

The Israeli Foundation for Handicapped Children (ILAN) index.php?page_id=2

The Israeli Society for Autistic Children (ALUT)

Common Approaches The main approach used by music therapists working with children under 5 is “music as therapy” – an approach that emphasizes music as the main and sometimes only therapeutic element in therapy (e.g., Nordoff-Robbins Music Therapy, Orff Music Therapy). When parents are included, the therapists use “music in therapy” – an approaches that uses words and music in the therapeutic process. There are various music activities which are used by music therapists, such as singing and vocal improvisation, creating songs and using action songs, music and movement, improvisation and role playing with instruments, and listening to songs and/or short classical compositions. Other approaches include combinations of music-art therapy (e.g., painting and sculpting while listening to music), and music-drama therapy (i.e., creating musicals, musical games, and stories). Group music activities are specially designed for children according to the children’s needs and capabilities. Activities such as group drumming, using the body as an instrument, circle games, creating and singing songs, and dancing to music can encourage a feeling of togetherness, strengthen self-confidence, and improve self and body image.

children included, suffer from a shaken identity, cultural loss, and have difficulties in adjusting to a new life. Music therapists who work with these children use music to build and strengthen self- and cultural identity, foster a better understanding between generations and help children, and their parents in dealing with personal and cultural challenges. Being located in the Middle East, Israel’s existence is under constant threat. Many Israelis, including children, suffer from traumas caused by wars and terrorist attacks. Music therapists who work with children suffering from trauma, use music to reduce tension and anxiety and to express and release feelings such as anger, frustration, fear and helplessness.

Prominent Publications Amir, D., & Yair, M. (2008). Music therapy for children at-risk living in residential care. In Susan J. Hadley (Ed.) Qualitative inquiries in music therapy: A monograph series, (pp. 113-116). Gilsum, NH: Barcelona Publishers. Kerem, D. (2009). The effect of music therapy on spontaneous communicative interactions of young children with cochlear implants. Retrieved from 6/6487_kerem_ phd_thesis_22062010.pdf

About the Author

Dorit Amir, D.A., CMT is the Head of the music therapy program at Bar Ilan University, Israel. She was born in Israel and has lived and worked there as a music therapist, researcher, and educator. Dr. Amir has worked with children who have emotional, social and behavioral issues, with women who have experienced trauma in their lives and with people who want to improve their health and quality of life. She lectured and taught in the USA, Germany, Finland, Norway, Denmark, Australia, and New Zealand. Contact:

Author Note Thanks to Vered Simchon and Nili Kaspi for the photos and information, and to Dr. Cochavit Elefant, Dr. Nechama Yehuda, Dr. Chava Vice, Miriam Drux, and Miki Mentch for sharing valuable information with me for this article.

There are specific issues, which need to get special attention when working with children and their families in Israel. Israel is a multicultural society, including immigrants from around the world. There are also refugees and foreign workers who live in the country. Many of them,

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Belgium Freya Drossaert Master in Music Therapy Chairman of BMT and Belgian Delegate of the EMTC

Snapshot Area 30,528 square kilometers; Belgium is located in Western Europe. Bordering countries are France, Germany, Luxembourg, and the Netherlands.


10,438,353 (July 2012 est.)

Official Language Dutch, French and German

Ethnic Groups

Fleming 58%, Walloon 31%, mixed or other 11% (April 2012 est.)

Median Age

42.3 years (April 2012 est.)

Children under 5

0-14 years: 15.9% (male 846,706/ female 812,486) (April 2012 est.)


The World Factbook publications/the-world-factbook/ geos/be.html

“Accept the children the way we accept trees — with gratitude, because they are a blessing—but do not have expectations or desires. You don’t expect trees to change, you love them as they are.” – Isabel Allende

Demographics Ever since the University College of Science & Art founded the music therapy training course in 1993, the profession of music therapy in Belgium has blossomed. As an associated department of the Catholic University of Leuven, this intense 5year training leads to a Master’s Degree in Music Therapy. It is the only official music therapy training program that has been recognized by the Belgian government with six to eight students graduating each year. Additionally, Artevelde College, Ghent offers Bachelor program in creative therapy with a specialization in music therapy, and Association pour la Recherche, l'Enseignement et les Applications de la Musicothérapie en Belgique Francophone (AREAM), Brussels is offering a private music therapy training. Traditionally, Belgian music therapists have been employed by various agencies in health care and special education. However, the number of music therapists working in private practice is steadily growing. In total, there are approximately 85 music therapists practicing in Belgium.

Background Information Belgium has one professional

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organization for music therapists, Beroepsvereniging van Muziektherapeuten asbl (BMT asbl). It was founded in 1998 after the fourth European Music Therapy Congress which took place in Belgium. Since many years, BMT asbl has been an active member of the European Music Therapy Confederation (EMTC). The organization’s legal statutes are based on the EMTC regulations and are the entry requirements for members. Currently, BMT asbl has 45 registered members, qualified at the Master’s level. BMT asbl negotiates with the Belgian governmental departments regarding the recognition of music therapy as a health profession. BMT asbl also offers legal assistance to its members and produces a semi-annual journal of music therapy. The organization also supports ongoing training by organizing workshops, lectures, symposia, and a network of group supervision. Other organizations also exist in Belgium, including: •

Belgische Vereniging voor Creatieve Therapie’ of ‘Association Belge d’arts Thérapies (BVCT-ABAT) is a professional association for creative therapists, including those specialized in music therapy.


Muziek & Handicap asbl is an organization, which focuses on music therapy with persons with mental and/or physical disabilities.

Muzo asbl, founded by music therapists, provides art camps that focus on music for children with and without disabilities.

AREAM asbl, already mentioned above, is an association that focuses on information and clinical practice in music therapy in the French-speaking part of Belgium.

The Music Therapy Research Group supervises doctoral studies in music therapy and is situated at the University College for Science and Arts. This group, located on the Lemmensinstituut at Leuven campus, works together with the Music Therapy Centre of Expertise Belgian music therapists work as part of multidisciplinary teams with infants, young children and adolescents in a variety of settings including intensive care and oncology units in general hospitals, children’s hospitals, psychiatric hospitals, special education settings, music education settings, and schools. Music therapists also work in private practice and provide workshops for parents, including pregnant women, and for other professionals who work with young children.

and group music therapy are offered, although the active form is preferred. The duration of a session is typically 30 to 45 minutes. Music therapists in Belgium lead instrumental and vocal improvisations, song creations, playing forms, and role-play. The child in the session is always the therapist’s source of inspiration.

Prominent Publications Bracke, I. (2007). Just like heaven. Music therapy in pediatric oncology. Newsletter BMT abl, 9th year, 31-34. Van Camp, J. & J. De Backer (2012) Autisme Muzikaal: Rocking, metronoom en compactheid [Autism musically: Rocking metronome and compactness]. In G. Gluckers (Ed.) Het raadsel autisme… psychoanalytische psychotherapie? [(The riddle of autism ... psychoanalytic psychotherapy?]. Antwerpen: Garant.

About the Author

Common Approaches Belgian music therapists are informed psychotherapists. This orientation is founded in the openness psychoanalysis traditionally maintains towards music, and by the intensive theoretical foundation that is prevalent among Belgian psychoanalytic societies related to the relationship between art and the human psyche. Additionally, music therapists are influenced by developmental psychology and psychodynamic theory. Music therapists involved in music education may also use ortho-agogical techniques (focusing on cognitive and motor skills).

Freya Drossaert, Master in Music Therapy, chairman of BMT asbl, has experience in working as a music therapist with children, adults and older adults with psychological and psychiatric issues. Currently, she works at the General Psychiatric Hospital Saint-Lucia, Sint-Niklaas, and with adults at various specialized settings.

In reaching children in early childhood, both expressive and receptive individual


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Denmark Stine Lindahl Jacobsen, Ph.D. Assistant Professor, Aalborg University Aalborg, Denmark

Snapshot Area 4,959 square kilometers; Denmark is comprised of the Jutland peninsula and 443 islands, including the two largest: Zealand and Funen. Greenland and Faroe Island are also part of the Kingdom of Denmark. Bordering countries are Germany, England, Norway, and Sweden.

Population 5,580,516 (2012 est.)

Official Language The official language is Danish.

Ethnic Groups Danish citizens, 95.2%; other Europeans, 3%; Asians, 1%; Africans, 0.5%; others, 0.3%

Median Age 39.8 (2012 est.)

Children under 5 385,709 (i.e., 7% of the population)

Source Statistics Denmark Gyldendal’s Open Encyclopedia 2012

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“Children are great imitators. So give them something great to imitate.” – Anonymous


Common Approaches

Currently, there are 126 members of the Danish Association of Music Therapists. Thirty of these members are working with children with developmental disabilities and disorders. Of these thirty, half are working with children under the age of 5.

Music therapists provide services to young children in a variety of clinical settings including child development services, special needs daycare centers, and preschools. A smaller number of music therapists have temporary contracts with family care centers, refugee centers, rehabilitation centers, and hospital units. Early childhood music therapy is a developing field and not yet fully established within the Danish healthcare system.

Background Information The Master’s program at Aalborg University is where most music therapists are educated in Denmark. One semester of the training program focuses on children and adults with developmental disabilities including research and research methods applied. The Master’s program was established in 1982 and the Doctoral program in 1995. Still, music therapy is not widely recognized in Denmark and there is no possibility of becoming either certified or registered as a music music therapist. However, music therapists are employed by the state and counties. Aalborg University and the Danish Association of Music Therapists are currently working on establishing official recognition from the Danish government.

Early childhood music therapy interventions include assessment of the needs of the child, development of social, emotional, physical and cognitive competences, educational and emotional support to parents, and building healthy parent-child relationships. Music therapists often work in multidisciplinary teams in collaboration with physical therapists, occupational therapists, psychologists, pediatricians, psychiatrists, and speech language pathologists to find the best possible treatment option for the individual child. Some music therapists are employed in permanent positions by the state and counties while others are employed on a temporary basis through funding for research projects. It is also common for music therapists to have private contracts with various health agencies and/or individual families.


At the 5-year Master’s program at Aalborg University, students study an eclectic approach with an emphasis on psychotherapeutic training inspired by Julien Alvin, Mary Priestley, Nordoff and Robbins, and Carl Orff for early childhood practice. Improvisational techniques and child/therapist led activities are considered essential for work with children with developmental disabilities. Imitating, mirroring, matching, and variations of these are seen as vital for the young child’s development of communicational skills. Within other areas of early childhood, music therapists also use gestural, familiar and improvised songs, turn-taking activities, and different kinds of receptive interventions.

Prominent Publications Geretsegger, M. Holck, U., Gold, C. (2012). Randomized controlled trial of improvisational music therapy’s effectiveness for children with autism spectrum disorders (TIME-A): Study protocol. BMC Pediatrics 2012, 12(2), 1-9. Holck, U. (2004). Interaction themes in music therapy: Definition and delimitation. Nordic Journal of Music Therapy, 13(1), 3-19. Holck, U. (2004). Turn-taking in music therapy with children with communication disorders. British Journal of Music Therapy, 18(2), 45-53. Holck, U. (2007). Musikterapi i lyset af musikalske træk i tidlige dialoger [Music therapy from a perspective of musical features in early dialogue.] Psyke & Logos 28, 408-426. Holck, U. (2008). Spilleregler anvendt i musikterapeutisk assessment i børnepsykiatrien – t værgående analyse af 10 forløb. [Play rules used in music therapy assessment in child psychiatry]. In: Holck (Ed.), Musikterapi i Psykiatrien, Årsskrift 5, 48-74. Aalborg Psykiatriske Sygehus – Aalborg University. Holck, U. (2011). Forskning i musikterapi – børn med en Autisme Spektrum Forstyrrelse [Music therapy research – children with an autistic spectrum

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disorder]. Tidsskriftet for Dansk Musikterapi,8(2), 27-35. Sanfi, I. (2006). Musikterapi i pædiatrisk onkologi - Belyst ud fra teori og praksis [Music therapy in pediatric oncology – From a theoretical and clinical perspective]. Børnesygeplejersken, Marts (1), 10-13. Irgens-Møller, I. (1999). Music Therapy in Child Psychiatry – a two-year project on a psychiatric unit for preschool children. Nordic Journal of Music Therapy, 8(1), 72-75. Irgens-Møller, I. (2004). Musikterapi – Børn med betydelige funktionsnedsættelser [Music therapy – children with severe disabilities]. Dansk Musikterapi, 1(1), 9-14. Irgens-Møller, I., & Bjerg, M. (2004). Positiv relationserfaring for børn i musikterapi [Positive relational experience for children in music therapy]. Dansk Musikterapi, 1(2), 4–14. Jacobsen, S., & Wigram T. (2007). Music therapy for the assessment of parental competences for children in need of care. Nordic Journal of Music Therapy, 16(2), 129–142. Rauff-Larsen, A. (2012).Vejledning som integreret element i musikterapeutisk praksis.[Guiding as an integrated element in music therapy practice], Tidsskriftet for Dansk Musikterapi, 9(1), 59-63. Wigram, T., Bonde, L. O. & Pedersen, I. N (2002). Music therapy in clinical practice. In: A Comprehensive Guide to Music Therapy. Theory, Clinical Practice, Research, and Training. London & Philadelphia: Jessica Kingsley Publishers.

About the Author

Stine Lindahl Jacobsen finished her Ph.D. in 2012. Her clinical area focuses on children and families at risk. Jacobsen teaches in the Masters program of Music Therapy, Aalborg University and is also a board member of the Danish Association of Music Therapists. Contact:


Indonesia Amelia D. Kho M.A. in Music Therapy Universitas Pelita Harapan, Lippo Karawaci, Inodnesia

Snapshot Area 1,811,569 square kilometers; Indonesia is the largest archipelago country in the world with 17.508 islands.


248,216,193 (2012 est.)

Official Language

Bahasa Indonesia, local dialects.

Ethnic Groups

More than 350 ethnic groups but the largest groups are Javanese 40.6%, Sundanese 15%, Madurese 3.3%, Minangkabau 2.7%, Betawi 2.4%, Bugis 2.4%, Banten 2%, Banjar 1.7%, other or unspecified 29.9%

Median Age 28.2 years

Children under 5

Approximately 20,000,000 (i.e., 8% of the population)

Source about/people.htm publications/the-world-factbook/ geos/id.html presentationer/seto_mulyadi.pdf

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“Music expresses that which cannot be said and on which it is impossible to be silent.” – Victor Hugo

Demographics Historical records indicate that Indonesia’s first music therapy service existed in the 1980s at the Hospital for Mother and Child Harapan Kita in Central Jakarta, the capital city of Indonesia. Music therapy services are still offered and currently focus on pregnant women only. Academically, the science of music therapy attracts the interest of many other professionals including psychologists, nurses, doctors, musicians, and music educators. Although music therapy is not a new field in Indonesia, it is still an unfamiliar profession in Indonesian society. This is likely the result of the small number of music therapists in the country, which boasts the fourthlargest population in the world. Since 2007, there has been an emphasize on music therapy at the Universitas Pelita Harapan (UPH) Lipo Karawaci. This 4-year training program encompasses a wide range of clinical experience with various populations. Upon completion of the program, students earn a Bachelor of arts degree. As of May, 2012, there have been seven music therapy graduates from UPH.

Other music therapists who currently practice in Indonesia, received their training in the USA, Germany, and England. Presently, most of them serve children with special needs in clinics, hospitals, or schools for children with special needs.

Background Information Over the past decade, early interventions for children with special needs has grown rapidly in Indonesia. In addition to public agencies, many private clinics, schools for children with special needs, and inclusive private schools have been established to better serve children with special needs. There is also support from the government to provide better services for this population. Most sites involve an interdisciplinary team, which may include psychologists, teachers, physiotherapists, speech therapists, and music therapists. The Indonesian society, parents, and other professionals are open to music therapy. They have witnessed the progress in children during music performances. However, Indonesian music therapists working with young children and their families are challenged to communicate that music therapy address goals beyond music skills. The demonstration of scientific evidence of the effects of music therapy interventions is much needed.


Common Approaches

Recent Presentations

Behavioral and integrative approaches are often used with children with special needs. In addition, variouse activities of other music education approaches, such as Kodály, Orff, and Dalcroze, are often embedded to meet clients’ individual strengths and needs. Individual sessions are common. Special instruments, made for children who have difficulty in motor planning, such as the switch bells (see photograph) and the musical machine (i.e., switch adapted devices such as bongo, ring around bell, switch bell, a small drum set that consists of rebana, tambourine, triangle, cymbal and maracas, which will give sound just by pressing the switch).

Chandra, P. (2007, August 25). Terapi musik bagi anak-anak yang mengalami kesulitan kesehatan [Music therapy for children with learning difficulties]. Presentation presented at Faculty of Psychology Universitas Kristen Maranatha, Bandung. Chandra, P. (2010, August 7). Terapi musik [Music therapy]. Presentation presented at the national seminar held by the cooperation of Universitas Pendidikan Indonesia and Radio Walagri, Bandung. Herdianto, P. (2009, April 14). Musical interaction: An approach to developing communication. Presentation presented at the open lecture of Music Therapy Concentration Universitas Pelita Harapan, Tangerang. Kho, A. D. (2010, July 17). Music as a miracle: Music therapy for children. Presentation presented at the seminar held by AMADEUS Science Arts Study Club, Surabaya. Kho, A. D. (2010, August 7). Pemenuhan kebutuhan psikososial dan emosi melalui terapi musik kesehatan [Fulfillment of psychosocial and emotional needs through music therapy]. Presentation presented at the national seminar held by the cooperation of Universitas Pendidikan Indonesia and Radio Walagri, Bandung. Kho, A. D. (2011, May 13). Terapi musik dengan anak ADHD kesehatan ADHD [Music Therapy with ADHD children]. Presentation presented at the seminar held by Music Therapy Concentration Universitas Pelita Harapan, Tangerang. Milyartini, R. (2010, August 7). Peran musik bagi anak berkebutuhan khusus [The role of music for special needs children]. Presentation presented at the national seminar held by the cooperation of Universitas Pendidikan Indonesia and Radio Walagri, Bandung.

Besides music therapy, there are also extracurricular music group activities provided by public schools. The goals of these groups is often to perform at school events. This may give children, parents, teachers, and therapists more motivation to increase clients’ potential, and can showcase a child’s abilities to their parents, teachers, friends, and community. A favorite musical ensemble is the Angklung ensemble, which is relatively easy to be played in a group, and it is very unique to Indonesia. Angklung, a traditional instrument made from bamboo, originally came from Java island. Currently, there is no funding to support music therapy services from the Indonesian government. Most parents pay out of pocket for the therapeutic services of their children. However, there are some scholarships from private sponsors supporting low-income families.

Prominent Publications Bassano, M. (2009). Terapi musik dan warna: Manfaat musik dan warna bagi kesehatan [Music and color therapy: benefits of music and color for health]. Yogyakarta: Rumpun Media. Salim, D. (2006). Terapi musik: Teori dan aplikasi [Music therapy: Theory and application]. Yogyakarta: Galang Press. Satiadarma, M. P. (2001). Terapi musik [Music therapy]. Jakarta: Milenia Populer.

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About the Author

Amelia D. Kho, M.A. holds a Master’s degree in music therapy from the University of Applied Science Heidelberg, Germany. Her academic interest focuses on how music therapists can contribute to the well-being of children and women. She is the Head of the music therapy specialization program at the Universitas Pelita Harapan (UPH) Lippo Karawaci . She also works as a clinician with children with special needs and pregnant women. Contact:


Chile Paulina Alejandra Hernandez Quezada Music Therapist Chilean Association of Music Therapy Santiago, Chile

Snapshot Area 756,102 square kilometer; Chile is located in Southern South America, bordering the South Pacific Ocean, between Argentina and Peru.


17,067,369 (July 2011 est.)

Official Language

The official language is Spanish. Mapudungun, German, and English are also spoken.

Ethnic Groups

White and white-Amerindian 95.4%, Mapuche 4%, other indigenous groups 0.6% (2002 census)

Median Age

32.1 years (2011 est.)

Children under 5 Unknown


The World Factbook publications/the-world-factbook/ geos/ci.html

“Child, bluish from cold fingers, how you come and do not cover you, Oh my God! Child, suffering two jewels, fingers how pass without seeing you people!” – Gabriela Mistral

Demographics In Chile, music therapy is a young discipline and currently gaining recognition. Since 1999, the Universidad de Chile has offered a graduate training program in art therapies with a specialization in music therapy. The program was founded by Susanne Bauer, Patricia Lallana, and Patricia Ubilla, who all studied music therapy abroad. Eightythree music therapists have graduated since then and about 50% are actively practicing music therapy. Within the last few years, Chilean colleagues have studied music therapy in Argentina, USA, Spain, and Austria. Thus, there is a growing number of theoretical approaches in the field. The Chilean Association of Music Therapists (ACHIM, was founded in 2005 and currently has 34 members. Forty percent of them work with young children.

Background Information Music therapy with young children is a subset of the larger field. Music therapists may work with individuals, groups, or families. Music therapists provide services in

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rehabilitation centers for children recovering from burns, special education settings, “play schools” for families at social risk, children’s hospitals, rehabilitation centers for physical disabilities, centers for children who are deaf or hearing-impaired, homes for adolescent mothers and their infants, schools for language impairments, autism spectrum disorders centers, and in private practice. As the profession grows, more music therapist hold permanent part time positions and become part of educational or healthcare teams.

Common Approaches In Chile, the theoretical frameworks and approaches applied with young children are diverse and depend on the context, goals, and objectives of the clients as well as the training of the music therapist. Due to the graduate training program at the Universidad de Chile, the most common music therapy technique is improvisation (i.e., free and thematic improvisation) provided within a one-onone, group, or family session. In general, the voice and the body are considered the main instruments in music therapy with young children. The guitar is seen as a vital instrument in music therapy as it has a central role in Chilean folklore and culture. Songs for children and improvised exploration of music, instruments, and the voice are central to


music therapy with young children in Chile.

About the Author

Other approaches applied are the “plurimodal approach” (after Diego Schapira) the “sound bath,” musical games as well as role play with hand puppets (after Lisa Sokolov).

Prominent Publications Gauna, Gustavo D. (2009). Diagnóstico y abordaje musicoterapéutico en la infancia y la niñez. La musicoterapia en los actuales contextos de la salud y la educación. La clínica con niños Buenos Aires: Koyatun Editorial. Gonzalez, M. (2011). Music therapy in the comprehensive rehabilitation of the burned child. Gallery Psychologica, Santo Tomas University. Mayer, P. (2012). Music therapy in child physical rehabilitation. National Institute of Rehabilitation, Pedro Aguirre Cerda Hospital. Silvia Andreu, S. (n.d.). Growing with children: Music Therapy for children with hearing loss.

Paulina Alejandra Hernandez Quezada, credentials is a graduate from the Universidad de Buenos Aires, Argentina in 2007. She has specialized in the plurimodal approach in music therapy and in palliative pediatric care. In 2009, she returned to Chile, and presently she works in rehabilitation of children with burn symptoms as well as with individuals on the autism spectrum. Ms. Hernandez Quezada is the currently President of the Chilean Music Therapy Association (ACHIM). Contact:

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resources Blog All About It: Early Childhood Music Blogs Rebecca Wellman, PhD, MT-BC, DT Wellman Therapy Services Chicago, IL

There is a plethora of blog posts about early childhood education and early childhood music on the Internet. Some sites are quite basic, and focus on promoting products and services, while others are rich and sophisticated, offering regularly-updated resources for both music therapists and others working with young children. The following is a crosssection of developmentally appropriate early childhood music blogs that do not focus heavily on product or service promotion. Early Childhood Blogs Autism Speaks Official Blog: Written by various authors, the Autism Speaks blog offers information on research, parent concerns, and news for professionals working with children on the autism spectrum. Child in Mind: This blog offers great information about child development and parenting. The information, posted by behavioral pediatrician Dr. Claudia Gold, can be used to fuel parent-child sessions or clarify observations of developmentally appropriate occurrences in music therapy settings.

but offer some helpful ideas, such as how improvised instruments can be utilized in music therapy sessions. Early Childhood Music Blogs Child’s Play Music: This blog is penned by Alec Duncan, an early childhood educator from Australia. While much of the information shared is basic for those who have been working with young children, Alec takes it outdoors. Many of the blog posts talk about how to take music outside and integrate nature into sessions. Color in My Piano: Joy is a piano teacher in Ohio. Her blog includes both general piano skills and early childhood information. One post that is extremely interesting includes a list of resources for early childhood music professionals ( 2010/03/19/early-childhood-online-resources/). The Early Childhood Music and Movement Association: This organization offers several different blogs (including one by this author, and previously by Dr. Darcy Walworth) to help people learn more about early childhood and music. There are frequent posts (up to eight blog posts a month) so up-to-date information is available regularly. Jim Gill’s Words on Play: Jim Gill is a nationally known children’s music performer and child development specialist. His new blog offers tips on integrating play in interaction with children. As of this writing there are only a few posts, but they are all applicable to music therapy clinical practice.

Educational Activities, Inc.: Dr. Patricia Vardin, a professor of early childhood education at Manhattanville College in Purchase, NY offers a variety of information about development and education for young children. Her posts include both music and movement, which can be applied to music therapy practice.

Lynn Kleiner’s Music Box: Lyn Kleiner is a nationally known early childhood music educator who combines early childhood music and Orff principles. Her songs are well known and she has a line of instruments, which are available for use.

Let the Children Play: This blog talks about music, play, outdoor fun, and other often forgotten aspects of early childhood. The posts are not necessarily music focused,

Make Me Musical: This blog is written by Susan Seale, a music educator from Canada. While her blog is not specific for music therapy, she presents many ideas which can easily be transferred to clinical situations. One

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interesting idea is to use a decorated pillow as an abacus to keep track of musical tasks. It’s a creative twist on a visual cuing system that may be the ticket for some children. Moving into Music: Music educator Jennifer StevensBallenger’s blog, Moving into Music, has only two posts to date. They are both great examples of how typical behaviors can be viewed as abnormal. Pre-K +K Sharing: Written by Carole Stephens of Macaroni Soup, this blog shares songs and activities specially designed for young children. Songs for Teaching: A general music website, this blog offers song ideas as well as tips on how to make different instruments. Early Childhood Music Therapy Blogs Developing Melodies: Written by Meryl Brown, board certified music therapist and developmental therapist, Developing Melodies shares ideas for interventions to use with young children. She also includes conference highlights and updates on current programming. Listen and Learn: This blog offers songs, therapy tips, and other tidbits. The songs are not always intended for early childhood, but many can be adapted for younger children. The blog is written by Rachel Rambach, MT-BC.

MusicWorks: Cathy Knoll, MT-BC, often presents information specifically about early childhood music therapy. Roman Music Therapy: Written by Meredith Pizzi, a board certified music and developmental therapist, Roman Music Therapy’s blog presents reflections on group sessions as well as insights into child behaviors observed during music therapy sessions. Tempo Music Therapy Services: This blog is written by various board certified music therapists. It provides blog posts about once a month pertaining to different topics in music therapy. They are not all early childhood-focused, but provide good quality information that easily may be applied to working with young children. Corporate Music Early Childhood Blogs Kindermusik: This blog offers general information about music with young children and some segments on how parents can integrate the use of music at home. Music Together: This blog offers posts from various Music Together staff members providing information about music with young children. The posts share research as well as practical ways to share music both in sessions and at home. The blog is occasionally used as a platform to promote Music Together programs and products. About the Author

MusicSparks: JoAnn Jordan, MT-BC, shares information about music with young children and older adults on her blog, MusicSparks. Not all posts are about early childhood music therapy, but can be transferrable. The Music Therapy Show with Janice Lindstrom/Heart Beat Music Therapy: Janice Lindstrom MT-BC, has a radio show/paired blog which focuses on music therapy issues. Again, not all of the posts are about early childhood music therapy, but the information is often transferable to clinical situations.

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Becky Wellman, Ph.D., MT-BC, DT is the owner and director of Wellman Therapy Services in the Chicago suburbs. She works with young children with special needs and older adults with memory loss. Contact:


Making a Meaningful Mark in the Blogosphere Rachel Rambach, MM, MT-BC Music Therapy Connections Springfield, Illinois

There’s no doubt that music therapists make an impact in the lives of their clients on a daily basis. But in the past few years, they have begun to make their mark in a more public manner: On the Internet. The number of music therapy-related blogs seems to grow every week, with new professionals, interns, and even students creating blogs to share their experiences in the field. But the question heard most often from new bloggers – and even seasoned bloggers who need a little dose of inspiration from time to time – is this: “How do I keep my blog interesting and gain readers?” There are no hard and fast rules for blogging; each blogger needs to develop his or her own unique voice, style, and niche in order to attract readers and keep them coming back on a regular basis. Here are just a few ideas to help music therapists kickstart or rejuvenate their blogs. Write regularly. This is essential for gaining readers, especially when first starting a blog. “Regularly” can mean twice a month, once a week, or once a day (for the extremely ambitious!). Establish a schedule for yourself and your readers. Write for your audience. Are you writing for other music therapists? Educators? Parents? Blogs that are too broad often lose focus, and along with that, readers. Each entry should be written specifically for your targeted audience. Be yourself. The great thing about blogging is that you can be as casual as you want. You don’t have to use APA format and academic jargon (though you’re more than welcome to, if that is your style). A good rule of thumb for blogging is to “write how you speak” so that your true voice and personality shine through. Let passion be your guide. Blogging burnout occurs when a blogger loses interest in his or her own topic area. So stick with an area of focus about which you are

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passionate (and of course, experienced and knowledgeable). Get the word out. People won’t know about your blog unless you tell them! Send an email to friends and colleagues, post links, and ask people to share it with others who might find it interesting and helpful. Great places to start are music therapy forums such as the “Music Therapists Unite!” and the “Early Childhood Music Therapy Network” on Facebook. Use multimedia. Although blogs are most often textbased, other forms of media can create interest and help a blogger gain readers through other channels. Videos uploaded to YouTube, songs posted on Bandcamp, and images shared on Flickr can also be included in blog posts. Create a community. Blogging shouldn’t be a one-way street. Invite readers to connect with you on Facebook (either personally or via a page you create). Ask questions, and encourage comments. Not only do readers feel more included that way, but great topic ideas often come out of interaction with readers. Blogging is an excellent way to advocate for the field of music therapy, educate others about what you do, and share your talents with the world. There are dozens of music therapists already making a meaningful mark on the blogosphere, and hopefully that number will continue to grow exponentially in years to come. About the Author Rachel Rambach, MM, MTBC provides music therapy and lessons to children of all ages and abilities through her private practice, Music Therapy Connections. She also writes and shares original music on her blog, Listen & Learn Music, and is cohost of the Music Therapy Round Table podcast. Contact: URL:


Broadcast Yourself: Music Therapy and Early Childhood on YouTube Rose Fienman, MT-BC Sacramento, California

The Internet can be a great resource for music therapists, though the sheer number of websites, blogs, podcasts, and social media can be difficult to sift through to find high quality materials. YouTube offers individuals the opportunity to selfpublish short video clips. Over the past decade, many music therapists have taken advantage of this platform to showcase their work with clients. Lately, several news broadcasting companies around the world have spotlighted the profession and archived it on YouTube as well. The following list includes both YouTube videos by music therapists sharing their work with young children as well as outstanding news broadcasts. YouTube: Self-broadcasted by Music Therapists Music Therapy with Young Children. This clip shows four music therapy experiences with three different children plus one small group. Text appears on the screen which explains the diagnosis and goal areas for each experience. The narration further describes the music therapy process in each scene. Paige's Music Program: Music Therapy at Children's. A nine-minute segment, this video is a great introduction to early childhood music therapy in a medical setting. There are interviews with music therapists, hospital personnel, and parents interspersed with clips of music therapy with several children. It also gives a solid definition and background of music therapy. Music Therapy Session at Joyful Music and Dance. The camera follows a young girl through her music therapy session, showing brief moments of her singing “hello” to the music therapist, playing the keyboard, and playing a drum. Watch a Music Therapy Session with Flynn. This clip shows a young boy with breathing difficulties participating in various music therapy activities, including singing, playing the guitar, and reaching for instruments. According to the description, music therapy was an important part of his recovery process from major surgery.

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The Magic of the Music Therapy Program. This short, yet touching video shows a young boy at Children’s Hospital Boston. According to the onscreen text, he does not speak often. The audience is treated to his strumming along with the music therapist and singing a few short phrases. YouTube: News Broadcasting BBC Children in Need of Music Therapy. This archived BBC news broadcast describes a music therapy group for parents and young children, with a focus on a 16-month old boy with Down Syndrome. It features a short interview with the boy’s mother, as well as clips of various music experiences. PBS The Healing Power of Music. Though this video does not focus exclusively on early childhood, it is a wonderful example of a news broadcast featuring music therapy. It speaks extensively about the research supporting the profession and shows scenes of music therapists and music therapy students working with a wide variety of client populations. These online resources are a great means to educate music therapists and the public about music therapy practice with young children. However, music therapists must also consider the ethical principles regarding client privacy and confidentiality. To this end, the Research and Ethics Commission of the World Federation of Music Therapy (WFMT) offers recommendations for Reporting on Music Therapy Clients on the Internet and Privacy Issues, a valuable document for contemporary music therapists. About the Author Rose Fienman, MT-BC is very excited to have joined the imagine editorial team in January 2012. She has previously served as Executive Assistant of the World Federation of Music Therapy and as President of AMTAS. Currently, she is in the process of moving to Los Angeles to pursue her Master of Social Work. Contact:




Our Podcasts 2012 Only one click away.....

Ronna Kaplan, M.A., MT-BC The Music Settlement Cleveland, Ohio Reflections on Music Therapy with Young Children Listen to reflections on early childhood music therapy. How far we have come with our network, newsletter, online magazine, other internet presence, research and publications, conference sessions, our workforce and our possible roles in many settings! And the sky’s the limit for where we can go next…

Beth McLaughlin, LCAT, MSE, MT-BC Wildwood School Schenectady, New York Putting the Evidence into Practice: Designing a Plan for Student Success for Children with ASD In this podcast, the author describes how she became acquainted with six young boys with autism spectrum disorders through their behaviors and developed a successful music therapy program that included the behavioral principles of discreet trial teaching. With input from families and the entire educational team, a learning environment was created that promoted full inclusion for each member of the group.

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Debbie Benkovitz, LSW, MT-BC Children’s Hospital of the University of Pittsburgh Medical Center (UPMC) Pittsburgh, Pennsylvania The Final Movement: Music Therapy and Pediatric Palliative Care Studies demonstrate that music therapy improves the quality of life of seriously ill patients and their families by relieving pain and anxiety, helping patients and families communicate, and providing spiritual support. This podcast briefly reviews how music therapy impacts young, seriously ill patients, using case studies to exemplify main points.

Matt Logan, MT-BC Owner, Matt Logan Music Iowa City, IA The Role of Music in Developing Infant Attachment: An Interview with Cynthia Briggs

In this podcast, Matt Logan interviews Cynthia Briggs, a music therapist and psychologist who directs the music therapy program at Maryville University. She lectures and presents on the topic of music and infant attachment. In this interview, the speakers explain the theory of infant attachment, identify music’s role in the process, and present practical applications for parents and clinicians.


Laura Rose Anderson, MT-BC Rebecca Vaudreuil, MT-BC Resounding Joy, San Diego

Kana Kamitsubo, MT-BC Private Practice Boston, Massachusetts

Resounding Joy: Music Therapy in India

Yes, I Can Learn! Incorporating Music Instruction into Therapy to Help Children with ASD

Resounding Joy staff music therapists Rebecca Vaudreuil and Laura Anderson share their experience providing musiccentered wellness for children with multiple disabilities in Southern and Northern India. A total of 13 music therapists and trained volunteers traveled to India. Resounding Joy is a California 501(c)3 non-profit organization whose mission is to promote social, emotional, physical, and spiritual well being through music.

Jennifer W. Pucket, MT-BC Central Canal Creative Arts Therapies Indianapolis, Indiana A Little Tune with a Big Boom!

Do you as a music therapist feel like you are constantly singing the same songs over and over again? If so, it’s important to keep in mind that the simplest tunes can provide a big boom in development by using an interdisciplinary approach in early intervention.

This podcast illustrates an approach to music therapy that incorporates music instruction. It describes the case of a boy with autism who began music therapy exhibiting severe attention difficulties and disruptive behaviors. Within two years, he made significant progress in his life skills and learning to play musical instruments.

Cathy Fink and Marcy Marxer Community Music, Inc. Kensington, Maryland The Magic of Sing-Play

Grammy® Award winners Cathy Fink & Marcy Marxer discuss Sing-Play, a key element of their “Sing To Your Baby®” project. Originally created to help parents and caregivers connect with new babies using the sound of their own voices, music therapists will find delightful tools here, too.

Cathy Knoll, M.A., MT-BC Knoll Music Therapy Services Stephenville, Texas Acoustic Instruments Accessible for Young Children

New technology gives professionals a growing number of options for making music readily available to youngsters in music therapy. This video podcast makes a case for using acoustic instruments in music therapy and offers a dozen strategies for making traditional instruments - piano, guitar, and drums - accessible to pre-schoolers.

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about our podcasts Our imagine podcasts bring you the perspectives, knowledge, and vision of clinicians, researchers, educators, administrators, parents and children connected to early childhood music therapy. You can access and subscribe to the podcasts at our_podcast/our_podcast.html


books Standley, J. M., & Walworth, D. (2010) (2nd Ed). Music Therapy with Premature Infants: Research and Developmental Interventions. Silver Spring, MD: American Music Therapy Association. 248 pages. ISBN 978-1-884914-25-6. $65.00 Music Therapy with Premature Infants: Research and Developmental Interventions by Jayne Standley and Darcy Walworth is a synthesis of over 20 years of music therapy research with premature infants and infant learning. The 2003 first edition laid the groundwork for music therapy practices in the neonatal intensive care setting, and is considered a leading text in the use of music therapy with premature infants. The 2010 second edition builds on the strong foundation established in the original text and includes updated research, new information on reimbursement and post-term infants, and enhanced infant/early childhood developmental information. Though the publication could easily be used as a textbook, it is applicable to students, clinicians, and non-music therapists alike. In narrative and chart format, the authors provide a comprehensive overview of developmental information, outline medical music therapy services within and outside the NICU, and provide evidence-based NICU music therapy protocols. This combination of detailed information and accessible format makes the book both useful and understandable. The first chapter covers an explanation of third trimester fetal development (e.g., development, medical care, phases of developmental intervention, and discharge). Chapter 2 provides an overview of medical music therapy in general. Research highlights, characteristics of NICU studies, and clinical goals also are presented.

NEW The last two chapters focus on music therapy for “older infants�, discussing the post term infant in the NICU plus music therapy post discharge in chapters 5 and 6 respectively. Chapter 5 highlights developmental interventions based on corrected gestational age for older infants in the NICU. Chapter 6 moves into developmental goals and objectives applicable for infants post discharge, discussing the use of music therapy interventions to target the effects of long-term developmental disabilities often associated with premature birth. The text also features a number of practical items, like charts, figures, and tools, including a) the glossary of medical and developmental terminology, b) research summaries, c) protocol summaries, and d) sample forms and care plans. Music therapists will find these tools invaluable, not only from a clinical standpoint, but also from an administrative and teaching standpoint. These items can serve as excellent points of reference when presenting about or discussing NICU music therapy with other professionals. Music Therapy with Premature Infants is an excellent resource for evidence-based music therapy practices in the NICU setting. It readily outlines the role that music therapy can play in the NICU, and serves as a practical tool for those starting or expanding a music therapy program in the neonatal arena. Standley and Walworth have presented a user-friendly text that continues to be a leading resource on music therapy in the neonatal intensive care unit.

About the Author Chapter 3 moves specifically into music therapy in the NICU. Training qualifications, music selection/presentation, and specific techniques (e.g., multimodal stimulation) are addressed. Chapter 4 provides information on reimbursement for evidence-based NICU music therapy. This chapter is new to the second edition, covering both the pros and cons of reimbursement for medical music therapy. Chapter 4 also contains a number of figures and charts with information on CPT codes, progress notes, and estimated revenue.

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Listen to my audio bookmarks!

Lori Gooding, Ph.D., MT, BC is Director of Music Therapy at the University of Kentucky. Contact:


imagine Book Reviews imagine book reviews focus on recently published books and monographs in early childhood music therapy. Reviews (written text) should include a complete bibliographic citation for the work ‣ including full title, author(s), publisher, date of publication, pages, price, and ISBN respectively; a summary of the book, providing sufficient ‣ information so the contents can be understood by the reader; and suggestions for relevance and clinical ‣ implications by the reviewer. Submissions should range between 500-700 words and follow imagine guidelines for authors. See guidelines_for_authors.html Audio Bookmarks (mp3 file) should include 2-3 minute audio recording, including the ‣ reviewer’s personal use of the book. The reviewers might want to point out where ‣ they placed their sticky notes in the book and why. Overall, reviewers are encouraged in the audio bookmarks to give a personal spin in the audio book mark on how the book may be used in clinical practice. Please use the online form for submission at http:// online_submission.html and include a one-sentence bio and headshot.

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Lim, H, A. (2012). Developmental SpeechLanguage Training through Music for Children with Autism Spectrum Disorders. London and Philadelphia: Jessica Kingsley Publishers. 197 pages. ISBN 978-1-84905-849-0. $36.95 Developmental Speech-Language Training through Music for Children with Autism Spectrum Disorders documents a program for developing speech and language skills with young children with ASD. The author presents research from speech therapy, applied behavior analysis verbal behavior approaches, psychology of music, and music therapy. She builds a solid rationale for her model of music therapy to develop speech and language skills for children with ASD. The intervention model is titled developmental speech and language through music (DSLM). The book is organized in two parts. Part one provides information about past research in chapters on speech and language impairments in children with ASD, perception and production of speech, music perception and speech, perception of music and speech, and the effect of music on speech and language in children with ASD. Chapter 1 describes the range of speech and language capabilities for children with ASD. Lim notes that some young children with ASD have significant challenges with both receptive and expressive language. Others may only have “precocious language and unusually large vocabularies” (p. 35), but lack reciprocity and social understanding. Chapter 2 focuses on perception and production. Chapter 3 introduces concepts from Gestalt psychology to frame how music is related to perception, noting that using the structures of musical elements may enhance the understanding of important events such as speech and language components. Chapter 4 draws together information about perception, language and music and firmly couches the work in the research and writing of music therapists. Chapter 5 presents past empirical research that has demonstrated a connection between music on speech and language in children with ASD. The tone of this thorough review is academic and yet understandable. These chapters will provide practicing music therapists with a strong rationale to support their work with young children with ASD. The second part of the book delineates the development of DSLM and makes suggestions for clinical implications and practices. In chapter 6, Lim details her method for designing DSLM protocols. Chapter 7 expands the discussion about DSLM by listing potential goal areas that are consistent with the theoretical foundations earlier described. Lim provides examples of specific interventions including goal areas, musical experiences, and strategies in DSLM. Chapter 8, connects the DSLM model to Applied Behavior Analysis

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Verbal Behavior approaches by carefully mapping the DSLM interventions in terms of protocol, antecedent variable, verbal behaviors, nonverbal behavior, and session format. A strength of this book is the discussion about composing songs to support the intervention model. Lim outlines musical elements that should be present and suggests appropriate tempos and key selection. All suggestions for musical elements are supported by research. Sample songs are presented in the appendix. Lim’s model is supported by an empirical study, strengthening the rationale for the intervention. Appendix C presents an overview of the study in which 50 children (ages 3-5, with high and low functioning ASD) were placed into one of three treatment conditions (music, speech, and no-training). The research demonstrated that while children in both treatment groups showed an increase in the ability to produce the targeted words, children in the music group demonstrated greater change. The song and intervention structures outlined in the book are likely to be familiar to most music therapists. The book’s strength is its carefully crafted construction of the foundation and rationale. How the work relates to other disciplines may be highly beneficial for speaking with colleagues in a meaningful and informed manner. Lim shows how the DSLM intervention model was developed and based on evidence-based practices, utilizing solid research practices to validate the intervention model. There is a highly academic tone to the book yet it provides examples of DSLM protocols. Highly beneficial is the thorough review of the literature that provides a strong foundation for music therapy clinicians working with children with ASD. This text will be an important model for future research as the field of music therapy continues to engage in the discourse about evidence-based practices.

About the Author

Listen to my audio bookmarks!

Nicole R. Rivera, Ed.D., MT-BC, teaches psychology courses at North Central College in Naperville, IL. Contact:


Schwartz, E. (2012). You and Me Makes...We: A Growing Together Songbook. Melrose, MA. Center for Early Childhood Music Therapy, LLC. 147 pages. ISBN: 978-0-615-63486-9. $29.00 You and Me Makes...We: A Growing Together Songbook by Elizabeth Schwartz is a collection of 101 songs written over the author’s distinguished career as a music therapist working with young children. Two CD’s of the songs complete the collection. Though written for children with special needs, the songs are designed for all children and are rooted in the belief that music is both a natural and critical component of development and being in the world. Written examples promote appropriate development through active engagement and are intended to facilitate the creation of a musical environment in which the adult and child share experiences that support the total child. In her 2008 publication Music, Therapy and Early Childhood (Schwartz, 2008), Ms. Schwartz outlines a framework for understanding the developmental levels of young children through the music experience. These levels include awareness, trust, independence, control and responsibility. Her former work provides an important foundation for this text. In her introductory pages she references this framework as it relates to the creation, planning and implementation of developmentally appropriate music activities. Additionally she explores the elements prominent in enduring children’s music and describes how repetition, rhyme, melody and structure can provide a predictable and safe musical environment for children to grow in their awareness, trust and independence. While some of the melodies in You and Me Makes...We are recognizable, Ms. Schwartz has carefully adapted the songs to meet a specific need, demonstrating a clear understanding of the relationship between child development and musical responses. Her original music is engaging, accessible and reflective of various genre and styles. She submits that original music is an opportunity to consider a child’s culture, behavior and functional language needs when choosing a specific intervention. She uses various modes to create an atmosphere of thoughtfulness and discusses the use of consonance and dissonance to reflect the different emotions a child may be experiencing. Meter and rhythm are considered when encouraging movement and synchrony. Created music allows the adult to be responsive to the child in the moment while building a strong relationship.

to the five developmental levels described above. A discussion of how to structure the environment and the process for teaching the songs and engaging the child follows. For example, Gathering Songs encourage group members to come together and jointly attend to a common stimulus. Embedded songs provide an opportunity for building relationship by using music to match the movement and play of a child. Bonding Songs reinforce the developing relationship through shared music activity. Transition Songs help children anticipate and cope with environmental changes throughout their day. Instrument Songs offer children experiences in joyful music making while teaching and reinforcing concepts and social awareness. Movement Songs target understanding of the self in relationship to the environment while building confidence. Songs About Me integrate an understanding of the physical self with more abstract concepts of emotional awareness. Songs about My World invite the children to learn about what they see, hear and feel around them via songs about seasons, animals, holidays and food. Finally, a Developmental Song Grid provides a cross reference relating each song to the developmental levels described in her introductory pages and in her previous work (Schwartz, 2008). In addition, a CD play list includes song titles, track numbers and book chapters to which they relate. You and Me Makes...We: A Growing Together Songbook should be on the shelf of every music therapist, caregiver or adult working in the field of early childhood. The author writes in a way that enables adults to build meaningful relationships with children through singing, playing, moving and creating, plus understand how child development relates to children’s unique response to music. For the music therapist, the book is a treasure trove of activities and theory based on years of research and application that will be a requisite resource for years to come. Listen to my audio bookmarks! About the Author

Beth McLaughlin is a music therapist and internship supervisor at Wildwood School. Contact:

The songs in this book are arranged in eight categories. Each category is introduced with an explanation of how they relate

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publications 2011/2012 New Publications 2011-2012 Complied by Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA

The following list reflects a selection of articles and a podcast related to early childhood music therapy published in 2011-2012.

Creighton, A. (2011). Mother-infant musical interaction and emotional communication: A literature review. Australian Journal of Music Therapy, 22, 37-59. de L'etoile, S. K., & Leider, C. N. (2011). Acoustic parameters of infant-directed singing in mothers with depressive symptoms. Infant Behavior and Development, 18(2), 209-223. Gattino, G., dos Santos Riesgo, R., Longo, D., Leite, J. C., & Faccini, L. (2011). Effects of relational music therapy on communication of children with autism: A randomized controlled study. Nordic Journal of Music Therapy, 20(2), 142-154. Geist, K., Geist, E., & Kuznik, K. (January, 2012). The patterns of music: Young children learning mathematics through beat, rhythm, and melody. Young Children, 74-79. Gfeller, K., Driscoll, V., Kenworthy, M., & Van Voorst, T. (2011). Music therapy for preschool cochlear implant recipients. Music Therapy Perspectives, 29(1), 39-49. Ghetti, C. M. (2011). Clinical practice of dual-certified music therapists/child life specialists: A phenomenological study. Journal of Music Therapy, 48(3), 317-345. Henniger, I. (2012). Music therapy with premature infants: Insights and recommendations from the current literature and a German Pilot Project. Canadian Journal of Music Therapy, 18(1), 26-44. Kern, P., Chung H-W., Sato, K., Lui, M., Hsieh,F-N., & Ng, W. F. (2011). The color or us: Music therapy for young children in Asia. Music Therapy Today 9(1), 142–143. Retrieved from Kern, P., & McLaughlin, B. (2011). Listen, Sing, Play: Naturerelated, low-cost music activities. Teaching Young Children, 4(5), 27-29.

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Knight A,. & LaGasse, B. (Producers). (2012, January 11). MTRB Interviews: Dr. Petra Kern [Audio podcast]. Retrieved from http:// Lim, H. A. & Draper, E. (2011). The effects of music therapy incorporated with applied behavior analysis verbal behavior approach for children with autism spectrum disorders. Journal of Music Therapy, 48(4), 532-550. Preti, C., & Welch, G. F. (2011). Music in a hospital: The impact of a live music program on pediatric patients and their caregivers. Music and Medicine, 3(4), 213-223. Reschke-HernĂĄndez, A. E. (2011). History of music therapy treatment interventions of children with autism. Journal of Music Therapy 48(2), 169-207. Simpson, K., & Keen, D. (2011). Music interventions for children with autism: Narrative review of the literature. Journal of Autism And Developmental Disorders, 41(11), 1507-1514. Standley, J. M., Walworth, D., Engel Nguyen, J., & Hillmer, M. (2011). Descriptive analysis of infant attentiveness in structured group music classes. Music Therapy Perspectives, 29(2), 112-116. Schwartz, E. K. (2011). Growing up in music: A journey through early childhood music development in music therapy. In A. Meadows (Ed.) (pp. 70-85). Developments in Music Therapy Practice: Case Study Perspectives. Gilsum, NH: Barcelona Publishers. Tramo, M. J., Lense, M., Van Ness, C., Kagan, J., Settle, M. D., & Cronin, J. H., (2011). Effects of music on physiological and behavioral indices of acute pain and stress in premature infants: Clinical trial and literature review. Music and Medicine, 3(2), 72-83. Vist, T. (2011). Music experience in early childhood: Potential for emotion knowledge? International Journal of Early Childhood, 43(3), 277-290. Williams, K. E., Berthelson, D., Nicholas, J. M., Walker, S., & Abad, V. (2012). The effectiveness of a short-term group music therapy intervention for parents who have a child with disabilities. Journal of Music Therapy, 49(1), 23-44.


join imagine imagine publishes articles that are directly related to early childhood music therapy (ages: zero to five), grounded in evidence-based practice. topics include reflections or tips of seasoned music therapists event and meeting reports research projects and reports innovative clinical practice intervention ideas international service projects color of us: music therapy with children around the world useful resources: online tools, blogs, products new publications and book reviews with audio bookmarks check which format best fits your contribution article video or audio podcast photo story, or invited teaching episode for more details, visit our website at

next submission deadline: May 15, 2013 imagine 3(1), 2012



imagine: Early Childhood Music Therapy Online Magazine |  ISSN 2153-7879

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Additional early childhood music therapy resources available at

imagine 2012  

Additional early childhood music therapy resources available at