imagine 2015

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imagine.magazine Fall 2015 l Vol.6, No.1

celebrating five years of the imagine.magazine

5 imagine 6(1), 2015

2015 years your resource for early childhood music therapy 1

imagine.magazine ISSN 2153-7879 All rights reserved.

editor-in-chief Petra Kern, Ph.D., MT-BC, MTA, DMtG contributing editor Marcia Humpal, M.Ed., MT-BC editorial assistance Rose Fienman, MSW, MT-BC Gretchen Chardos Benner, LMSW, MT-BC Dana Bolton, M.Ed., MMT, MT-BC Lisa Jacobs, MM, MA, MT-BC business manager & design production Petra Kern, Ph.D., MT-BC, MTA, DMtG publisher de la vista publisher imagine is the primary annual online magazine dedicated to enhancing the lives of young children and their families by sharing knowledge, strategies, ideas, and policies related to early childhood music therapy with colleagues and parents worldwide. Visit to access additional multimedia contributions and 19 years of archives.

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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 professional wisdom event reports and reflections research snapshots and reports innovative clinical practice parents can series children's corner early childhood music programs intervention ideas color of us series video/audio podcasts teaching episodes photo stories useful online resources book reviews with audio bookmarks ....and much more possible formats mutlimedia article video or audio podcast photo story, or invited teaching episode for more details, visit our website at

sponsorship imagine is currently free and accessible to everyone. Make a donation and help us to cover the editing, production, and website costs. Sponsors are listed as supporting partners on the imagine website. advertise imagine is the perfect place to advertise your products and services for young children and their families, or music therapy education. Advertisement rates and specifications may be obtained by visiting the imagine website or sending an email to disclaimer The opinions and information contained in this publication are those of the authors of the respective articles and not necessarily those of de la vista publisher or members of the editorial team. Accordingly, de la vista publisher and the editorial team 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. No endorsement of authors, products, or services is intended or implied.

next submission deadline May 15, 2016

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editorial Celebrating Five Successful Years In 2010, we started publishing imagine as a multimedia online magazine. Since then, we have released over 340 colorful contributions from research to practice articles, intervention ideas to podcasts, resources to book reviews, and more. With about 1.5 million potential readers reached last year, imagine continues to grow as a worldwide evidence-based resource for early childhood music therapy. As part of our celebrations, we started a Facebook Fan Page and invite you to like us. We are also oering the past five issues of imagine as full-color paperback books for purchase and continue to keep the current online issue available to you for free. Joining in the anniversary celebrations for the rights of people with disabilities this year, imagine 2015 focuses on inclusion practices and skill generalization through early childhood music therapy interventions. Inclusion is a worldwide topic that should concern everyone as it is about equal access, participation, and supports for all children, regardless of ability. The authors in this issue describe music therapy inclusion practices that support children with disabilities and their families to participate in a broad range of activities and contexts, helping them to grow to full members of their communities and society at large.

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“Inclusion is a way of life,” says Elizabeth Schwartz, recipient of the 2014 AMTA Professional Practice Award, in the imagine Wisdom section. Judith Jellison, one of the pioneers and advocates of inclusive music therapy practices, reflects on 40 years of history, groundbreaking ideas, and the dramatic changes in overall attitudes toward individuals with disabilities. Pamela Winton, Director of the National Professional Development Center on Inclusion (NPDCI), summarizes in her featured multimedia article policies and research evidence that support early childhood inclusion and gives examples of how music therapists can be critical partners in providing inclusive learning opportunities. Federal agencies, politicians, and organizations focus on early childhood inclusion as well. Judy Simpson, AMTA Director of Government Relations, reports about the early intervention initiative on inclusion by the U.S. Department of Education in collaboration with the U.S. Department of Health. As a kickoff for President Obama’s Summit on Early Education, ZERO TO THREE conference attendees called on policy makers to “Invest in Babies,” reports Dana Bolton. Music therapists also discussed the ongoing trend of inclusion practices during their 2014 AMTA Early Childhood Network meeting (Rose Fienman) and how to include children with disabilities in early childhood music classes at the 2014 ECMMA International Convention (Becky Wellman). Co-authored by Blythe LaGasse and Andrew Knight, the 2015 research snapshot keeps our readers informed about the effects of evidence-based music therapy intervention, as do the latest early childhood music therapy publication list (Christopher Millett) and book reviews (Laura Brown, Adrienne Steiner) as well as the article on Music Therapy as Brain Care for Premature Infants by Jayne Standley. A wealth of music therapy inclusion practices can be found in the Practice section addressing principles of inclusion and research synthesis points (Petra Kern), a literature review on skill generalization (Lori Gooding), integration video and video self-modeling (Edward Schwartzberg), the museum as a space for inclusive learning (Nicole Rivera and Edward Gallagher), creating and collaborating in nature (Edward Gallagher and Jennifer McDowell), constraint-induced movement therapy (Ilene Berger Morris), using SMART Board® Technology (Beth McLaughlin), and music

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therapy groups for NICU graduates (Lelia Emery and Alejandra Ferrer). Other articles focus on collaborative music playgroups (Evelyn Pinder and Meghan Sims), contributions of Music Together® teachers to inclusion (Carol Ann Blank), and caring for the caregiver (Adrienne Steiner). International perspectives on inclusion practices are described by Amy O’Dell (Bright Children International), Kumi Sato and Satoko MoriInoue (Japan), and in the color of us series featuring eleven countries. Furthermore, Holly Lesnick as well as Lorna Heyge (the early pioneer of Kindermusik® and founder of Musikgarten®) describe the benefits of two international early childhood music programs. Not to be missed are our four visually enticing photo stories on inclusion, the poignant answers in the children's corner to “What happens in music therapy?,” our favorite home videos, and the informative and useful teaching episode on music for skill generalization created by the team of the George Center for Music Therapy. Our imagine podcasts are frequently accessed and bring you more tips and strategies on successful early childhood music therapy inclusion and skill generalization by 11 renowned colleagues. The intervention idea section, especially popular with our student authors, offers original music created to address therapeutic goals for young children of all abilities. This year’s parentscan series, written by experienced medical music therapists, presents specific musical ideas that parents can easily utilize during or post hospitalization. Finally, “click it,” “pin it,” and “post it” deliver free resources that will keep you informed long after the release of imagine 2015. I invite you to take a stand on inclusion and create a sense of belonging, positive relationships, and friendships for all our clients. By so doing, you will empower the young children with disabilities and the families you serve to achieve the reality of reaching their full potential. Sincerely,

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


contents inside this issue editorial Celebrating Five Successful Years Petra Kern............................................................


wisdom Inclusion Early Included for Life Elizabeth K. Schwartz.......................................... 10 reports 2015 Early Childhood Music Therapy Special Target Population Network: Meeting Report from 11-7-2014 Rose Fienman...................................................... 12 Early Intervention Policy News (USA) Judy Simpson...................................................... 14 Cutting-Edge Research. Best Practices. Relevant Policy Dana Bolton.......................................................... 16 AllTogether in Music ECMMA International Convention Report Becky Wellman...................................................... 19 reflection Inclusion and Music Therapy Past and Future Judith Jelllison...................................................... 20 featured Music Therapists: Ideal Partners in Providing Inclusive Learning Opportunities Pamela J. Winton................................................ 28

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research 2015 Early Childhood Research Snapshot Blythe LaGasse and Andrew Knight.................... 32 Music Therapy as Brain Care for Premature Infants Jayne M. Standley............................................... 36 photos Photo Stories 2015.............................................. 39 practice Inclusion Practice in Music Therapy: Creating A Win-Win Situation for Everyone Petra Kern .......................................................... 40 Skill Generalization in Music Therapy: A Review of the Literature and Practice Suggestions Lori F. Gooding.................................................... 44 Facilitating Generalization: Integrating Video and Video Self-Modeling Into Music Therapy Practice Edward T. Schwartzberg...................................... 48 Museum: Community Spaces for Inclusive Learning Opportunities Nicole Rivera and Edward P. Gallagher................ 52 Arts in the Garden: Creating and Collaborating within Nature Edward P. Gallagher and Jennifer C. McDowell.. 56 A Song of One Hand: Music Therapy and Constraint-Induced Movement Therapy Ilene Berger Morris.............................................. 60 Using SMART BoardÂŽ Technology in the Music Therapy Room to Enable Young Learners with Autism Spectrum Disorder Beth McLaughlin................................................. 65


Music Groovin’ Grads: Establishing a Music Therapy Group for NICU Graduates Lelia Emery and Alejandra Ferrer........................ 68 Collaborative Music Playgroups to Support Early Learning and Language Development Evelyn C. Pinder and Meghan Sims.................... 72 Embedding Music in the Early Childhood Inclusion Classroom: Contributions of Music Together® Teachers Carol Ann Blank................................................... 76 Caring for the Caregiver: What Practitioners Need to Know about Parents and Caregivers of Children with Special Needs Adrienne Steiner.................................................. 78 Where in the World is Inclusion? Amy O’Dell........................................................... 82 Inclusive Music Therapy Programming in Japan Kumi Sato and Satoko Mori-Inoue...................... 86 parents can Ideas for Parents of Premature Infants Jennifer Jarred Peyton, Jessy Rushing, and Christopher R. Millett............................................ 91 Ideas for Parents of Children with Cancer Deborah Benkovitz, Kathryn Bruno, Elizabeth Harman and Brian Schreck................................... 92 Ideas for Parents of Children with Burn Injuries Christine Neugebauer........................................... 93 programs Kindermusik® Holly Lesnick........................................................ 94

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Musikgarten® Lorna L. Heyge...................................................... 96 ideas The Scat Song: Starting with the Child’s Name Macy Ellis............................................................ 98 Down on the Farm: Greetings and Animal Sounds Briana Browne...................................................... 99 All the Seasons: Learning about the Weather and Nature Jessica Pouranfar,............................................... 100 Animal Friends: Awareness, Labeling and Imitating Sounds Briget Price......................................................... 101 Hey, Mr. Snowman: Body Part Identification and Placement Hailey Kater ........................................................ 102 Working Together: Encouraging Team Work Lindsay Feist....................................................... 103 Oh, I Can Sing: Encouraging Listening, and Expressive Language Christopher R. Millett.......................................... 104 Five Little Fishies: Practicing Counting Meryl Brown........................................................ 105 Dot to Dot Drumming: Teaching Early Literacy Skills Kathy Schumacher.............................................. 106 Esta es la canción de Juan (This is John's Song): Learning about Pitches Cecilia Di Prinzio................................................. 107 Mr. Chameleon: Reinforcement of Pre-Academic Concepts Andrea Vallejo Wead........................................... 108


The Shape Chant: Reinforcement of Pre-Academic Concepts Andrea Vallejo Wead........................................... 109 color of us Inclusion Programming Worldwide Petra Kern and Rose Fienman.......................... 110 podcasts Isolation to Integration: Thoughts on Music Therapy Interventions to Support Inclusion Elizabeth K. Schwartz......................................... 122 Tips from the Trenches Jean Nemeth...................................................... 122 Working Together with Parents: Songs for Skill Generalization Rachel Rambach................................................ 122 Music is for Everyone: Inclusion in Early Childhood Music Classes Dana Bolton....................................................... 123 Music Therapy in the Cloud Esther Thane...................................................... 123 Children’s Access to Chords, Melodies, and Bass: A Different Way of Thinking in Sweden Sten Bunne......................................................... 123 Emotion Regulation Development, Rote-Based Learning, and Generalization: An Exploration Kimberly Sena Moore......................................... 123 Music Therapy with Peter: A Young Boy with Fragile X Syndrome at Home and in an Inclusive Preschool Setting Laura Heller......................................................... 123 Communication Toolkit: A Universal Design Approach to Inclusion in the Pre-school Classroom Anita L. Gadberry............................................... 123

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Interdisciplinary versus Transdisicplinary Integrative Care within Music Therapy for Children with ASD Darcy DeLoach and Michael Detmer.................. 124 The Family is the Therapy Team: A Case Example Jeffrey Wolfe....................................................... 124 resources Click It: Inclusion Info at Your Fingertips Petra Kern ......................................................... 126 Pin It: Find Music Therapy and Inclusion Practices Online Holly Mead and Jessica Simpson...................... 128 Post It: Join the Instagram Early Childhood Music Therapy Community Gretchen Benner................................................ 130 publications Publications 2014-2015 Christopher R. Millett........................................ 126 reviews Jellison, J. A. (2015). Including Everyone: Creating Music Classrooms Where all Children Learn. New York: Oxford University Press. Laura Brown...................................................... 134 Rook, J., West, R., Wolfe, J., Ho, P., Dennis, A., Nakai-Hosoe, Y., & Peyton, K. (2014). Music Therapy Social Skills Assessment and Documentation Manual: Clinical Guidelines for Group Work with Children and Adolescents Jessica Kingsley Publishers Adrienne Steiner.................................................. 136


Acknowledgment We would like to express our gratitude to all authors and collaborators who have supported the success of imagine over the past five years.

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wisdom Inclusion Early Included for Life A woman has a steady job in a local store and goes home at night to listen to music in a room in town that she decorated herself. A young man grew from a child who could not tolerate sitting in a group of peers to a scientist doing post-doctoral research. The girl who had trouble walking and forming words? She is in law school. And that young adolescent boy with Down syndrome sings with his school choir and talks back to his mother like so many other eighth graders. Forty years ago, the United States of America began a journey toward recognizing and including all children in its system of public schools through passage of the IDEA education law assuring equal access. The students who have benefitted from that law, are now adults. Fundamental shifts in services, housing, and employment for people with disabilities of all ages have become common. Inclusion and access to all aspects of life are accepted and expected as a right. As a result of early intervention and early inclusion, people of all abilities often are now included for life. Music therapists, with the powerful universality of music as their tool, can have an impact on opportunities for inclusion. Providing for this profound change, though, is not as simple as establishing a program, or a classroom, or a mandated ratio. Inclusion is an attitude toward individuals, families, and society. Elizabeth K. Schwartz, MA, LCAT, MT-BC

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Inclusion is a way of being and a way of approaching communication and interaction. Inclusion is a way of life. Inclusive practices in music therapy should reflect this larger concept of people and societies. Successful inclusive environments share these important components:

By adhering to these components and ideals, music therapists have the opportunity to provide early inclusion experiences that lay a foundation for a lifetime of being included.

Respect for community Recognition and support of individual strengths Expectation of competence and resiliency Opportunity for self-organization and selfregulation Time for exploration Music therapy interventions that support true inclusive environments include: Shared, meaningful experiences Peer-to-peer interaction Opportunity for mastery and accomplishment Independent problem solving Choice making Collaboration

Inclusion is a way of being and a way of approaching communication and interaction. Inclusion is a way of life!

Within music therapy, all people need and deserve experiences that provide: A sense of belonging Trust and security Purpose and meaning Value and worth

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reports themselves and recognized Elizabeth K. Schwartz for receiving the 2014 AMTA Professional Practice award. 2. Early Childhood Network Information

2014 Early Childhood Music Therapy Special Target Population Network Meeting Report from 11-7-2014 Rose Fienman, MSW, MT-BC imagine, Editorial Assistance Alameda, California

1. Welcome The early childhood network (ECN) co-chairs Dr. Petra Kern and Angela Snell welcomed the attendees and explained the purpose of this meeting. 23 colleagues were in attendance, representing 14 states (CA, MI, IL, OH, KY, NY, CT, MA, NM, NV, NJ, TN, ID, MD). The Early Childhood Network (ECN) members introduced

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Update on imagine Dr. Kern, the editor-in-chief, thanked the imagine editorial team for their continued volunteer work, which allows them to keep imagine an open access magazine. Since 2010, imagine has published 322 articles from 37 counties as well as 55 audio clips and 92 video clips. imagine 5(1), 2014 included 73 contributions from nine countries as well as 32 audio and video clips. Dana Bolton, who joined the editorial team, wrote the featured article titled “One, Two, Three, and Do, Re, Mi: Early Childhood Musical Development for Music Therapists.” The 2014 issue reached approximately 1.5 million music therapists, early childhood music educators, daycare professionals, related service providers, administrators, and parents via social media and over 21,000 via email. The average web traffic in 2014 was 1270/month from over 90 countries. The imagine team introduced the topic of inclusion and generalization as a featured theme for the 5th anniversary issue. The deadline for Next ECN meeting in submission to the 2015 Kansas City, Missouri anniversary issue is May 15, 2015.

November 13, 2015


Social Media The ECMT Facebook Group has grown to over 940 members (about 280 more members than in 2013). Rose Fienman (imagine editorial assistant) gave a social media update, asking ECN members to interact with imagine on Twitter and Facebook, as well as respecting basic social media guidelines for both platforms. The Twitter account @imagineECMT now has 135 followers. Rose Fienman encouraged ECN members to follow the handle to receive new updates and current information during the year. Government Relations Elizabeth K. Schwartz gave a brief update on government regulations related to early childhood practice, including information on the recent DEA regulations. During the conference, she presented “Music Therapy and IDEA: The latest updates in Special Education Law and Regulation.” Her informative handout can be dowloaded at https:// Amta-IDEA-Handout.pdf Additionally, an NICHY online course on IDEA Part C can be found at Advocacy and New Trends Dr. Kern announced the release of the new DEC Recommended Practices in Early Intervention/ Early Childhood Special Education and shared the website access at recommendedpractices/. She also circulated a copy of it and encouraged all ECN members to familiarize themselves with the streamlined recommendations. The ECN Group also discussed the ongoing trend of inclusion practices and how everyone could contribute in their communities Finally, ECN members discussed the growing interest in technology and social media use with young children and shared resources such as webinars (e.g., Technology for Early Childhood Center,) and websites (e.g., http://

3. Year 2014 in Review Research Projects/Reports Marcia Humpal, chairperson of the AMTA Strategic Priority on Autism Spectrum Disorder (ASD), referred to the newly released AMTA Fact Sheet on MT and ASD. It can be downloaded along with additional evidence-based online resources for music therapists at the AMTA website. She thanked steering committee member Dr. Petra Kern and her advisory board team for their dedication to this specific task. Todd Schwartzberg reported about his ongoing research endeavors related to short- and longterm memory of individuals with ASD and parent perceptions. Carol Ann Blank offered an update on her dissertation topic “Music Therapists’ DecisionMaking in Music Together Within Therapy®: Towards a Theoretical Framework.” Presentations & Publications See 2014 AMTA conference program for preconference trainings, institutes, and CMTEs as well as concurrent sessions on ECMT. See imagine 4(1), 2014, p. 126-217 for ECMT publications in 2014. 4. Sharing Resources Fact pages about disabilities in English and Spanish and more. Fred Rogers Center: Offers technology and social media guidelines for young children. 5. Upcoming Events

Please visit the event calendar on the imagine website at About the Author Rose Fienman, MSW, MT-BC is currently working as a Case Manager at the Regional Center of the East Bay in Concord, California. She is a former President of AMTAS and joined the imagine editorial team in 2012. Contact:

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Early Intervention Policy News (USA) Judy Simpson, MT-BC American Music Therapy Association Silver Spring, Maryland

For music therapists to successfully implement early intervention programs, it is important for them to understand the policies that guide service access. The American Music Therapy Association (AMTA) is pleased to support students, practitioners, and educators as they navigate these laws and regulations. By representing music therapists with federal and state agencies, AMTA works to not only increase stakeholder awareness of music therapy benefits but also to enhance member knowledge of government initiatives. In reviewing the organizational structure behind early intervention, it helps to know these basic facts: The Office of Special Education and Rehabilitative Services (OSERS) within the U.S. Department of Education includes the Office of Special Education Programs (OSEP). OSEP provides guidance and support for The Early Intervention Program for Infants and Toddlers with Disabilities. This program is frequently referred to as Part C of the Individuals with Disabilities Education Act (IDEA). A current early intervention initiative was released on May 15, 2015 by the U.S. Department of Education in collaboration with the U.S. Department of Health and Human Services. These federal agencies created a draft policy statement on the inclusion of young children with disabilities in high-quality inclusive early childhood programs. Public comments were invited for one week in response to this draft. A final publication date has not yet been announced.

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An excerpt from the draft statement purpose reads: “It is the Departments’ position that all young children with disabilities should have access to inclusive highquality early childhood programs, where they are provided with appropriate support in meeting high expectations. This joint ED and HHS policy statement aims to advance this position by: Providing a definition of inclusion in early childhood programs; Increasing public understanding of the science that supports meaningful inclusion of children with disabilities, from the earliest ages, in early childhood programs; Highlighting the legal foundations supporting inclusion in high-quality early childhood programs; Providing recommendations to States, LEAs, schools, and early childhood programs for increasing inclusive early learning opportunities for all children; and Identifying free resources for States, programs, early childhood personnel, and families to support highquality programming and inclusion of children with disabilities in early childhood programs.” Recommendations from the agencies for the early childhood system include: 1. Partner with Families 2. Adhere to Legal Provision of Supports and Services in Inclusive Settings with IFSPs/IEPs 3. Assess and Improve the Quality of Inclusion in Early Childhood Programs 4. Review and Modify Resource Allocation 5. Enhance Professional Development 6. Establish an Appropriate Staffing Structure and Strengthen Staff Collaboration 7. Ensure Access to Specialized Supports 8. Develop Formal Collaborations with Community Partners. Although music therapy is not listed as a specific example in this draft, the Department does recognize music therapy as a related service, as well as a specialized support within early intervention. Language regarding this category of providers, which may be of interest to music therapists, is found in recommendations #5 and #7.


In discussing professional development (#5), the draft statement discusses the role of Early Interventionists, Special Educators and Related Services Personnel in the following way:

to additional support services, as needed. Specialists should be coordinated so that each is aware of the goals, strategies, and progress of the others.”

“Special education teachers and related services providers should deliver services to children with disabilities in early childhood programs and with support embedded in everyday routines and/or co-teach and coach early childhood teachers and providers, as opposed to working with children in separate settings or pulling children out of their settings for specialized instruction. In addition to having strong competencies in working directly with children with disabilities, leaders should ensure that these professionals have the capacity to: Understand the goals, curriculum, and approach used in the early childhood program; Build relationships and partnerships with early childhood providers and teachers; Use evidence-based consultation and coaching models; Co-teach in an early childhood program; and Build trusting relationships with families and work with them to identify inclusive options.”

For practitioners working in early intervention, the AMTA Standards of Clinical Practice and Code of Ethics outline many of the strategies and professional responsibilities identified within this draft policy statement. Music therapists are skilled at promoting active involvement of children with disabilities alongside their typically developing peers. This provides a great opportunity to advocate for music therapists as early intervention personnel who truly specialize in providing quality inclusive programming!

Additionally, the agencies highlight the importance of ensuring access to specialized supports (#7): “Early childhood programs, schools, and family child care networks should have access to specialized supports delivered by experts like early interventionists, inclusion specialists, early childhood mental health consultants, behavior consultants, special educators, developmental specialists, or other related services providers, such as speech-language pathologists and occupational therapists. This specialized support can increase the quality of early learning experiences for all children. It would provide assistance in adapting the program’s environment, activities, and instructional support to promote full participation of children with disabilities. Specialists may also assist schools and programs by conducting classroom observations and developing strategies to meet children’s goals, including IFSP and IEP goals; including behavior support plans for children who require them and provide guidance on implementing those plans; and connecting children, families, and staff

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To read the DRAFT Policy Statement on Inclusion of Children with Disabilities in Early Childhood Programs: Executive Summary (PDF, 341KB), visit guid/idea/memosdcltrs/inclusion-policyexecutive-summary-draft-5-15-2015.pdf To read the entire DRAFT Policy Statement on Inclusion of Children with Disabilities in Early Childhood Programs (PDF, 902KB), visit http:// memosdcltrs/inclusion-policy-statementdraft-5-15-2015.pdf About the Author Judy Simpson, MT-BC, AMTA Director of Government Relations represents the interests of association members with state and federal agencies, staff, and legislators. Contact:


Cutting-Edge Research. Best Practices. Relevant Policy Zero to Three National Institute Report Dana Bolton, M.Ed., MMT, MT-BC Bolton Music Therapy, Murfreesboro, Tennessee

More than 2,000 early childhood professionals from 47 states and 15 countries attended Zero to Three’s 29th Annual National Training Institute (NTI) in Ft. Lauderdale, Florida, from December 10-12, 2014. Five plenary and 72 breakout sessions were presented with the theme of “Cutting-Edge Research. Best Practices. Relevant Policy.” The NTI kicked off with the Rally4Babies on December 10th, a social media day of action sponsored

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by the White House, Zero to Three, the National Women’s Law Center, and MomsRising. At the kickoff for President Obama’s Summit on Early Education, NTI attendees, as well as early childhood advocates around the country, called on policy makers to “Invest in Babies” by investing in Early Head Start, early intervention, paid family leave, home visiting, and quality child care. The main conference program started on December 11th with a keynote plenary by Jack P. Shonkoff, MD, director of the Center on the Developing Child at Harvard University, entitled Moving Beyond Why and What to the Compelling Question of “What’s Next.” According to Dr. Shonkoff, everything that has been done for children over the last 40 years has only made a moderate impact on outcomes. He called for more focus on enhancing quality and taking effective models to scale, building strong systems for coordinated service delivery and data management, and formulating enhanced theories of change, testing new ideas, and learning from interventions that do not achieve sufficient impacts. He


stated that brain plasticity occurs across the lifespan, but new discoveries have shown the impact of adversity on critical periods of development in children. He argued for more attention in the infant and toddler years for the most disadvantaged children, stating that age 4 is early, but not early enough. He believes that improving child outcomes can be achieved by transforming the lives of the adults around them by building adult capacity for parents and caregivers. He urged researchers to move beyond small, statistically significant effects on multiple measures and seek larger impacts on a smaller number of key outcomes through specific strategies linked to science-based theories of change. Other tasks for early childhood researchers include determining who benefits the most from a defined intervention to inform targeted replication and scaling, identifying who benefits the least or not at all to start a search for new ideas, and building a diversified portfolio that matches interventions to identified needs. In conclusion, he stated that moving to what’s next requires robust theory, rigorous measurement, and constructive dissatisfaction with the status quo. Dr. Shonkoff’s work in the early childhood field can be found online at The practice plenary, What is Known About Outcomes for Boys in Very Early Childhood, was presented by Oscar Barbarin, PhD, and Hiram Fitzgerald, PhD, on December 12. They discussed the genetic and environmental differences between girls and boys that often lead to more challenging behaviors in boys, as well as the importance of fathers and father figures in positive outcomes for young boys. Other plenary topics included the interaction of environment and epigenetics in the development of young children, a panel discussion of needed policy changes in early education, and mindfulness practices for children, parents, and early childhood professionals. Breakout sessions covered a multitude of topics and included a Spanish-language track. Cecilla Carrillo and Kendra Bonilla from The Growing Place in Santa Monica, CA, discussed The Young Scientist: Infant and Young Toddler Thinking and Theory Building Through the Lens of Educators. They believe that even the youngest infant has a voice, and babies and young children use the same processes as scientists as they discover the world around them. They advocated for uninterrupted play for

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children and honoring what children communicate about their interests as they play, rather than adults projecting their ideas onto children. Rachel R. Sacks from the Illinois Chapter of the American Academy of Pediatrics presented What to Expect at Well-Child Visits: Using Bright Futures to Meet the Needs of Families. She outlined a new program many pediatricians are using for well-child care that provides a timeline for regular pediatrician visits, vision and hearing screenings, and routine childhood immunizations. The program also includes regular developmental assessments to identify children with or at risk for developmental delays as early as possible. Parents are provided with handouts at each visit outlining child development, safety practices, and what to expect at each visit. These handouts are also available at Resources-for-Families.aspx Harvey Karp, MD, author of The Happiest Baby on the Block, presented a session titled Talking with Tots: An Innovative Approach to Reduce Struggles and Boost Cooperation (8 Months to 5 Years Old). Dr. Karp believes that toddlers have a rich emotional life that they have difficulty expressing. Unexpressed emotions and stress can affect DNA expression in the brain, affect white blood cell function, and lead to physical ailments. Dr. Karp reviewed his technique to use when toddlers are upset in order to help them express their emotions and assure them they are understood. He suggests that parents give a play-by-play of what the child is doing, using the “sportscaster technique.” He reminds adults that what they say to children is not as important as how they say it. The more upset a child is, the more basic the language adults use should be. He suggests that parents mirror about one-third of the emotion their child is expressing so that they feel sincerely empathized with. It may take 5 to 10 repetitions before a child calms down. He reminded adults that we naturally do this when children are happy, and it can also be effective when a child is upset. After children are calm, adults can use explanations and reassurances with them. Dr. Karp acknowledges this technique is not effective all the time. When it fails, he suggested a hug, resolving the problem, or a kind ignore (acknowledge the emotions, then lovingly turn away for 10 seconds, being aware that an extinction burst may occur).


Improving Developmental Trajectories of Infants and Toddlers with Autism Spectrum Disorder: Strategies for Bridging Research to Practice was an intensive breakout session presented by Serena Wieder, PhD, Tal Baz, OTR, Ami Klin, PhD, and Amy Wetherby, PhD. They described autism as a disorder of connectivity which disrupts multiple areas of the mind and begins in utero. They believe that autism itself is not the problem, but the associated disabilities affecting cognition, speech, and behavior are. They desire to make autism an issue of diversity, not disability. Dr. Klin presented research regarding eye fixation in children with autism. Babies with autism are born with reflexive eye fixation, but as it becomes interactional and experience dependent, their eye fixation declines over time. When watching a 5minute video, 35 typical 2-year-olds focused on the same part of the screen 80% of the time. Children with autism were all over the place and focused on different things such as doors or handles rather than faces. According to statistics given, only 20% of children with disabilities are receiving early intervention, highlighting a need for better and earlier identification. They also reviewed the Autism Navigator website (http:// which is a collection of research and training courses using extensive video footage for parents and professionals.

Two early childhood music therapists were represented in the poster session at the NTI. Elizabeth K. Schwartz, LCAT, MT-BC presented Strengthening Bonding and Attachment Through Mutual Music Making for At-Risk Infants and Toddlers. Carol Ann Blank, LCAT, LPC, MTBC and Lauren K. Guilmartin presented Music and Infant-Toddler Development: A Playful, Holistic, and Developmentally Appropriate Approach to Supporting Early Learning. A third poster about early childhood music was presented by Siobian J. Minish and Tiffany Coers from the University of Georgia, entitled Using Music, Large-Body Movement, and Relaxation to Facilitate Self-Regulation with Infants. In addition, Music Together LLC and Kindermusik were among the more than 70 vendors in the NTI Marketplace. About the Author Dana Bolton, MEd, MMT, MT-BC coowns Bolton Music Therapy in Murfreesboro, TN, and has worked in the early intervention field for 11 years. Dana is a new member of the imagine editorial team as of 2014.


ZERO TO THREE REACHING A MILESTONE: CONNECTING SCIENCE, POLICY, AND PRACTICE 30th National Training Institute December 2-4, 2015 Washington State Convention Center Seattle, Washington

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AllTogether in Music ECMMA International Convention Report Becky Wellman, Ph.D., MT-BC/L B. Well Therapy and Wellness Las Vegas, Nevada

Early childhood music educators and therapists from around the globe gathered in Atlanta, Georgia, from June 22-25, 2014, to share music, research, and practical applications at the Early Childhood Music and Movement Association (ECMMA) International Convention. Cochaired by music therapist Jan Boner, the convention’s theme was Grow in Harmony. Dr. Suzi Tortora, a board-certified dance and movement therapist, started the convention with her presentation, The Dance-Movement-Music Link in Creative Expression. She offered a greater understanding of how multisensory experiences (through dancing and movement activities) contributed to young children’s development. John Feierabend continued the momentum with his featured session, Endangered Musical Minds. He addressed the need for “appropriate early [musical] intervention” to sustain innate musical responses. The keynote address, Early Childhood Music Education: Respecting the Past, Creating a Brighter Future, was presented by Joyce Jordan-DeCarbo. She discussed the advancements of early childhood music education including social and cultural aspects. Ken Guilmartin finished out the first day of learning by presenting What Does the Future Hold? The second day began with a general session titled Honing our Craft-The Art of Teaching presented by Jill Hannagan. She reviewed the need to adapt music activities by identifying individual differences while capitalizing on group experiences. Lynn Kleiner shared The Orff Spirit! and invited participants to sing, play, and move along with her.

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On the final day, Carol Penny reviewed how music can make a difference in the community with In This Circle Dance Together. Throughout the convention, music therapists were featured in multiple breakout sessions. Becky Wellman presented Building Relationships and Attachment Through Music as well as…And Movement for All. She focused on specific interventions to support parent-child relationships and adapted movements to include all children in music. Elizabeth Schwartz discussed That One Kid: Recognizing and Working with Special Needs in Early Childhood Music Settings. She shared strategies for how to include children with special needs in early childhood music classes and when to contact a music therapist for support. Dorothy Denton spoke about how music can build emotional connections during ATTUNED: Building Relationships Through Music-Based Play. The ECMMA Executive Board met with music therapists to discuss future collaborations and how to support each other in including children with special needs in early childhood music classes. Additionally, the 2016 convention organizing committee brainstormed ideas on how to bring more music therapists to the next ECMMA International Convention, which will be held in Salt Lake City from June 26-29, 2016. The theme of the 2016 convention will be Move Along, Catch a Song. About the Author Becky Wellman, Ph.D., MT-BC/L has a private practice in Las Vegas, NV, and is part-time faculty at Ivy Tech Community College of Indiana and Indiana University Purdue UniversityIndianapolis. She is the ECMMA “Meaningful Music” blogger. Contact:


reflection Inclusion and Music Therapy Past and Future Judith Jellison, Ph.D., RMT Butler School of Music, The University of Texas at Austin

I am honored by the invitation of the editor-inchief of imagine to share my personal reflections about music therapy services in schools before and after the passage of the Individuals with Disabilities Education Act (IDEA) in 1975, and to offer ideas for future directions. History gives us perspective. More than a picture of the past, history can help us predict and even determine the future. History not only describes where we have been and clarifies where we are now. History helps us think about where we want to be in the future.

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In the pages that follow I describe some of the most significant changes in special education practices that have occurred as a result of the unwavering efforts of legislators, parents, professionals, and advocates to improve the quality of life of millions of marginalized and vulnerable individuals. Their goal was and continues to be the removal of all barriers to inclusion, affording all children full participation in schools and communities. As you read, do some reflecting on your own. Think about where you were during the times I write about, what you were doing, and what you perceived to

be the prominent music therapy philosophies and practices at the time. If you are a young professional, think about what you have heard and read about those “early days,” and as a member of a new generation of music therapists, look beyond what seem to be impossible barriers regarding school music therapy services. Throughout history, it is the individuals who refuse to accept less than what’s right, and who form a collective vision of a better world, who have effectively improved the lives of children.


Where have we been? Since the historical foundation of music therapy was medicine, for decades, music therapy services for children and adults focused on medical care: physical and mental health (Davis, Gfeller, & Thaut, 2008). Beginning with the founding of the National Association for Music Therapy in 1950, registered music therapists (the RMT was the credential at the time) most often provided services in hospitals and state residential institutions. In November 1964, a census of all state institutions found that 91,592 (47 percent) of all state institution residents were children and youth 21 years old or younger (Breedlove, Decker, Lakin, Prouty, & Coucouvanis, 2005). Forty years later, on June 30, 2004, the number of children and youth in state institutions had decreased to an estimated 1,641 (4.1 percent). In the 1960s, I was a music therapist in a large state institution named Sunland (a misnomer to be sure). I worked with infants, children, and adults, all of whom resided in the institution and had intellectual disabilities or multiple disabilities (as best we could assess). Although we talked about “school,” there was no formal education. At the time, few states had early childhood programs, even for typically developing children. Most all of the toddlers and children I worked with at Sunland would today be in regular schools and classrooms. To give you some idea of the life in institutional settings at the time, imagine your “home” as a place

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where you live with several hundred other people of all ages in a large building. There is no school, only a few basic living or academic skills classes that are held in the very same building where you live. This building is where you will live your entire life. You have little privacy and few choices of significance. Days follow a strict schedule. There is a scheduled time to wake, bathe or be bathed, eat all of your meals or be fed, do work for which you receive no pay, or sit without work, go to class, and sleep, often with many others in the same room. There are hundreds of people in the building but very little communication among them. Everyone is very busy with routines. There are some friendships and kindnesses from workers, but workers and volunteers come and go in your life. There is little variety, except for holidays, when people seem exceptionally generous and kind and when there are many special activities and music. Although these types of institutions became more humane across several decades, as the line goes, “There’s no place like home,” a real home. There’s also no place like a real school, not just a few classes but a real school with all of its diversity and opportunity. Because a developmental model dominated special education practices during the 1960s and 1970s, and people thought that “mental age” was a real thing, there were few successes regarding the transfer of skills and knowledge to new, realistic situations. Music was used to help children of all ages use

play money, ride play buses, and label pictures of everything from fruit to transportation vehicles. We sang songs about numbers, letters, animals, brushing teeth, pottying, you name it. The curriculum was anything but chronologically age appropriate and the practices were generally ineffective in developing meaningful lives. The children learned what we taught them, but as a result of inappropriate curricula and a lack of individualized education plans and transition plans, children learned very little about ways to function with maximal independence in the real world. They were not prepared to participate to the fullest extent possible in real schools and communities. As the ineffectiveness of these practices became known more widely among parents and families, policy makers, and concerned professionals, things began to change. Music was used to help children of all ages use play money, ride play buses, and label pictures of everything from fruit to transportation vehicles. It was during this time that I met and became friends with several rebels from the field of special education who were shortly to become the founders of the organization dedicated to breaking barriers for individuals with significant disabilities. The organization, originally named the Association for the Education of the Severely and Profoundly Handicapped, is now simply knows as TASH (TASH, n.d.). The influence


of these audacious, tenacious, advocates influenced all aspects of my work as director of a music therapy program and as a teacher, therapist, and researcher. One of my earliest published articles (1979) described what was then the groundbreaking idea of applying a functional curriculum to music therapy practices in schools. Even in the face of inspiring philosophies in special education and dramatic progress in laws, changes in music therapy practices came slowly. Separate schools became the new barriers to inclusion. As the founder and director of the University of Minnesota music therapy program for more than 10 years, I saw few opportunities for my students to experience practica, internships, or employment in regular schools. Music therapy positions were largely at separate schools in school districts or at the campuses of state institutions (the deinstitutionalization movement was underway during the late 1970s and 1980s, a process that seemingly took forever, and separate schools were established during that time). The separation of children with disabilities from regular schools and teachers, from typically developing children, fostered the continuation of outdated curricular and instructional practices in special education. By the 1990s, mainstreaming (as it was called then) was evolving in various locations, depending upon

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the regulations being established by state and local policies. Models of music therapy mainstream programs were being piloted and implemented in district-wide K-12 programs (Hughes & Robbins, 1996), public school early education centers (Furman & Furman, 1996) and early childhood community interagency settings (Humpal & Dimmick, 1996). Yet mainstreaming was far from the norm; if opportunities existed, usually they were part of pull-out programs or special events and far from inclusion as is known today. By 2011, however, a total of 62.4 percent of children ages 3 through 5 served under Part B of IDEA were in a regular early childhood program for some amount of their time in school, and a total of 94.9 percent of students ages 6 through 21 served under Part B of IDEA were educated in regular classrooms for at least some portion of the school day (U.S. Department of Education, 2014). Placement in regular schools, however, is just the beginning. Inclusion means more. Where are we now, and what about the future? The past 40 years brought dramatic changes in overall attitudes toward individuals with disabilities (e.g., person-first language, and antidiscrimination laws), in collaborative eorts among professionals and community agencies, in technological advancements, and in curricular and instructional practices. Practices are now designed to facilitate academic achievement in inclusive classrooms (with a focus on universal strategies, positive

behavior supports, response to intervention, and technology) to increase positive interactions with typical peers; foster emotional growth, self-determination, and autonomy; and create transition plans for meaningful adult living. The idea of school music therapy is now more prominent in AMTA activities and in the activities of tenacious, passionate parents, therapists, teachers, scholars, administrators, and advocates. Although a few school-related articles were published in the Journal of Music Therapy in the late 1970s (e.g., Alley, 1977; Jellison, 1979; Steele, 1977), many more appeared during the 1990s (e.g., see Humpal, 2006, for a brief history of music therapy in education and early childhood settings). Recent books focus on early childhood and school age settings (Humpal & Colwell, 2006), specific disability populations (Adamak & Darrow, 2010), and diverse populations in inclusive classrooms (Jellison, 2015). There is also an interest in evidence-based practices and research with school age populations. Systematic reviews of research across the past 40 years show positive outcomes for music/ music therapy interventions with children (Brown & Jellison, 2012; Jellison & Draper, 2015), although few studies have examined the generalization of outcomes, and few have been conducted in inclusive school settings. There is a need for both quantitative and qualitative research to examine research questions tied closely to policies and practices found in IDEA (e.g.,


students’ participation and progress in inclusive classrooms, and transfer of IEP goals skills to regular classrooms and the community). Clinicians would benefit from an awareness of music therapy models where inclusion is fostered and other successful models in special education (e.g., the Schoolwide Integrated Framework for Transformation [SWIFT], n.d.). It is challenging for music therapists to engage in inclusive practices since they often work with children who spend most of their 6-hour school day in segregated classrooms. The most current report on the implementation of IDEA (U.S. Department of Education, 2014) shows a wide discrepancy in inclusionary programing. Only 39% of those with autism spectrum disorder, 17% with intellectual disabilities, and 13% with multiple disabilities spent at least 80% of their time in regular classroom settings; many are served in regular educational settings for less than 40% of their day (33.7 % of those with autism spectrum disorder, 48.8% with intellectual disability, and 46.2% with multiple disability. Opportunities for inclusion may be limited for these populations in academic classes, but they are not limited in regular music classes. In a recent survey, all elementary and a majority of secondary music teachers indicated that they taught in inclusive classrooms (VanWheelden & Whipple, 2014). Although teachers were generally positive regarding inclusion, they found it more difficult to work with students with multiple disabilities

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and intellectual disabilities than with students with other types of disabilities. Here, then, is the opening for music therapists to engage in collaborations to facilitate inclusion. Inclusive music classrooms provide opportunities for music therapists and music teachers not only to structure activities for positive interactions among students, but also to practice IEP goals (Draper, 2015). If inclusive music therapy practices are to be implemented, music therapists and their colleagues will need to present effective arguments to schools and school districts that define their roles based on legislative policies (e.g., regular class settings and curricula; transition) and effective specialeducation models. Music therapy models of the past can be replaced by exciting new practices that will not only benefit the students, but also provide opportunities for therapists and teachers to become more creative and flexible. Below are several ideas that music therapists can implement in collaboration with music teachers (as well as special and regular education teachers, early education and developmental specialists, related service providers, and support staff)—ideas that will help build a climate of inclusion and facilitate students’ learning. Make inclusive music education a goal for all children with disabilities. Some music teachers are responsible for segregated music classes for students with disabilities. A reasonable goal for music therapists and music teachers would be the

elimination of special music sessions in favor of inclusive music classes with resources and support from music therapists that would allow children, even those with severe disabilities, to participate successfully. Develop a climate of inclusion in all educational environments. Structure frequent opportunities for positive social interactions and cooperation in small groups early in the school year. Prepare typical children to communicate with students who use alternative forms of communication, assistive listening devices, or other types of assistive technology. Prepare children for “all kinds of children” by discussing specific responses they could use (with simulated practice as needed) for those occasions when a peer may be uncooperative, distracting, and so on. Teach routines and rules as well as and social skills that facilitate positive interactions (e.g., respecting others’ space, ignoring distractions, requesting assistance and permission, working cooperatively in a group and with a partner). Teach all children when and how to help those with disabilities. Structure occasions in the regular classroom and early intervention settings no matter how brief, when students with disabilities demonstrate their capabilities and teach and help their typical classmates.


Share information about goals, strategies, and adaptations; develop transfer activities. Collaborate on ways to incorporate IEP and IFSP goals into music activities. Consider in your discussions both short- and long-term objectives for the transfer of skills to other types of music experiences (e.g., school music performances) and music experiences outside of school, in the home, and community settings. Design universal strategies that allow children to participate in meaningful ways in the same activities in which their typically developing peers engage in; discuss individual adaptations (to be used only as needed) that will apply in a variety of activities. Collect observation data, and assess progress in a variety of activities in inclusive settings. The effectiveness of strategies and adaptations to teach IEP and IFSP goals cannot be determined on the basis of assessments in separate music therapy sessions only. Progress is determined when learning is demonstrated in a variety of environments and with other individuals. Music teachers, (as well as others such as early intervention specialists, regular education teachers, and support staff) and music therapists can collect and share data that will inform decisions about children’s learning, goals, and strategies. This information will be greatly appreciated by parents and special educators, and can contribute to the development of future learning goals. imagine 6(1), 2015

Enjoy and share your successes and those of each individual with whom you work. One of the great joys of being a music therapist or music teacher is sharing stories of individuals’ successes with others. Inclusive practices can foster a collective, communal spirit among competent, responsible therapists, teachers, administrators, and parents who, on a daily basis, interact with each other, trying to provide their children with the best education possible. Among the most uplifting and powerful actions that any group of adults can undertake are those that will influence a child’s future, a future that is dependent most often on success in school. The individuals who drew up the regulations for IDEA had a great deal of confidence in the collective expertise and goodwill of people. Those lawmakers were correct in their belief that responsible teachers, therapists, parents, and schools could work together to improve the lives of children with disabilities. For these caring adults, collaboration is a personal core value and process that will benefit their children and define the character of their educational settings. It is with this spirit, and with the initiative of music therapists eager to expand practices beyond a single classroom, that a model of inclusive music therapy will emerge. References Adamek, M. A., & Darrow, A. A. (2010). Music in special education (2nd ed.). Silver Spring, MD: American Music

Therapy Association. Alley, J. (1977). Education for the severely handicapped: The role of music therapy. Journal of Music Therapy, 14, 50-59. doi: 10/1093/jmt/14.2.50 Breedlove, L., Decker, K. C., Lakin, R., Prouty, R., & Coucouvanis, L. (2005). Placement of children and youth in state institutions: 40 years after the high point, it is time to just stop. Mental Retardation, 43, 235-238. doi: 10/1352/0047-6765(2005)43[23 5:pocayi];2 Brown, L., & Jellison, J. (2012). Music research with children and youth with disabilities and typically developing peers: A systematic review. Journal of Music Therapy, 49, 335-364. doi: 10.1093/jmt/49.3.335 Draper, E. A. (2015). Observations of children with disabilities in four elementary classrooms. Manuscript submitted for publication. Furman, A., & Furman, C. (1996). Music therapy for learners in a public school. In B. Wilson (Ed.), Models of music therapy interventions in school settings: From institution to inclusion. Silver Spring, MD: National Association of Music Therapy. Hughes, J., & Robbins, B. (1996). Music therapy for learners who are mainstreamed in a districtwide K-12 program. In B. Wilson (Ed.) Models of music therapy interventions in school settings: From institution to inclusion. Silver Spring, MD: National Association of Music Therapy. Humpal, M. E. (2006). Introduction and brief history. In M. E. Humpal & C. Colwell (Eds.), 24

AMTA monograph series: Effective clinical practice in music therapy. Early childhood and school age educational settings (pp. 1-7). Silver Spring, MD: American Music Therapy Association. Humpal, M. E., & Dimmick, J. (1996). Music therapy for learners in an early childhood community interagency setting. In B. Wilson (Ed.) Models of music therapy interventions in school settings: From institution to inclusion. Silver Spring, MD: National Association of Music Therapy. Jellison, J. A. (1979). The music therapist in the educational settings: Developing and implementing curriculum for the handicapped. Journal of Music Therapy, 16, 128-137. Jellison, J. A., & Draper, E. A. (2015). Music research in inclusive

school settings: 1975-2013. Journal of Research in Music Education, 62, 325-331. doi: 10.1177/0022429414554808 Steele, A. L. (1977). Directive teaching and the music therapist as consultant. Journal of Music Therapy, 14, 17-26. doi:10.1093/jmt/14.1.17 SWIFT (n.d.). Schoolwide integrated framework for transformation. Retrieved from TASH (n.d.). Retrieved from VanWeelden, K., & Whipple, J. (2014). Music educators’ perceived effectiveness of inclusion. Journal of Research in Music Education, 62, 148-160. doi: 10.1177/0022429414530563 U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office

of Special Education Programs. (2014). 35th Annual report to congress on the implementation of the Individuals with Disabilities Act, 2013. Washington, D.C. Retrieved from about/reports/annual/osep/ 2013/parts-b-c/index.html About the Author Judith A. Jellison, Ph.D., RMT is the Mary D. Bold Regents Professor in Music and Human Learning and University Distinguished Teacher at The University of Texas at Austin. An internationally and nationally recognized speaker, teacher, and researcher, she is widely published on topics concerning inclusion and is the author of Including Everyone. Contact:

Photograph by John Cotter

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SIGNIFICANT CHANGES IN PRACTICES: 1970S TO THE PRESENT 1970S AND 1980S: MOVE FROM DEVELOPMENTAL TO FUNCTIONAL, CHRONOLOGICAL AGEAPPROPRIATE CURRICULA WITH COMMUNITY-REFERENCED PRACTICES Developmental model dominates special education practices for children and adults; many reside in institutional settings with separate schools on institutional grounds. Curricular and instructional decisions are based on practices used in infant and preschool programs; preschool skills and knowledge are considered prerequisites for children and adults with significant disabilities. The concept of “mental age” is prominent. Research and assessments of outcomes show slow educational progress and poor quality-of-life outcomes. The model is eventually deemed ineffective and for the most part, eliminated from special education practices. Groundbreaking ideas emphasize a model focusing on quality-of-life outcomes. Curricular and instructional practices are chronologically age-appropriate, are community-referenced, and focus on functional outcomes (e.g., domestic and social knowledge and skills, vocational skills). The concept of “chronological age” is prominent. The concept of “partial participation” allows for greater participation in a variety of activities. Research and assessments of outcomes show positive quality-of-life outcomes. A model developed initially for individuals with significant disabilities, many of whom reside in institutional settings, gains recognition in special education practices in school settings. Focus on independence to the maximum extent possible and access to programs and facilities continues to gain ground as a result of laws—Section 504 of the Rehabilitation Act, IDEA, and the Technology-Related Assistance for Individuals with Disabilities Act (Tech Act). Sweeping advances are seen in technology.

1990S: PROMINENCE OF SOCIAL INCLUSION, SELF-DETERMINATION, AND ASSISTIVE TECHNOLOGY Practices focus on social justice and inclusion as a civil right. Increase in civil rights activities by individuals with disabilities, self-advocacy groups, and supportive individuals and professional organizations, all working for full membership of people with disabilities in their schools, neighborhoods, and communities. Professionals produce a wealth of articles on social inclusion, social interactions, and selfdetermination. IDEA 1997 mandates access to the general curriculum to the maximum extent possible and also participation in the general curriculum, extracurricular activities, and other nonacademic activities, all to be documented in the IEP; participation in state and district tests is required (using alternative tests if necessary). Special education begins to be viewed as a service rather than a place (i.e., special education rooms or separate schools). Transition requirements from IDEA 1990 and IDEA 1997 strengthen the importance of postschool adultliving objectives in educational programs.

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Greater access and opportunities for participation in all aspects of life in the public and private sectors are a result of Section 504 of the Rehabilitation Act of 1973 and the passage of the Americans with Disabilities Act of 1990 (ADA amended in 2008). Technological advancements continue with amendments in 1999 to the Tech Act and increased access to academic learning and activities of daily life.

2000S: ACCESS TO THE GENERAL CURRICULUM AND ASSESSMENT OF STUDENT PROGRESS Earlier priorities and eective practices of the 1980s and 1990s are prominent, but the biggest thrust is access to academic subjects in the general curriculum and assessment of student progress. IDEA 2004 continues to focus on access to the general education curriculum and instruction, academic performance, and assessment of students’ progress. Both academic and functional (daily-living) goals are included, assessed, and integrated into regular educational practices to the degree possible. Scientifically based instructional practices and services based on peer-reviewed research are used to the extent possible. Access to instructional materials and assistive technology (AT) devices and services is required. The concept of universal design specific to assessment practices (introduced in IDEA 2004) gains prominence as an instructional approach. Response to Intervention (RTI) emerges from language in IDEA 2004 and develops into a schoolwide, multitiered instructional model that receives much attention in general education at all levels, particularly as a proactive process designed to identify and meet diverse learning needs of students with disabilities and those at risk.



Adapted from Jellison, J. A. (2015). Including Everyone: Creating Music Classrooms Where All Children Learn. New York, NY: Oxford University Press. Reprinted with permission!

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featured Music Therapists: Ideal Partners in Providing Inclusive Learning Opportunities Pamela J. Winton, Ph.D. FPG Child Development Institute at University of North Carolina at Chapel Hill

Early childhood inclusion embodies the values, policies, and practices that support the right of every infant and young child and his or her family, regardless of ability, to participate in a broad range of activities and contexts as full members of families, communities, and society. The desired results of inclusive experiences for children with and without disabilities and their families include a sense of belonging and membership, positive social relationships and friendships, and development and learning to reach their full potential (DEC/NAEYC, 2009). The publication of the above definition of inclusion by the two major early childhood professional organizations (Division for Early Childhood of the Council for Exceptional Children and the National Association for the Education of Young Children) was a seminal moment in advancing the principle of inclusion;

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that is, the rights of young children with disabilities to be cared for and educated alongside their typically developing peers and to participate in a broad range of activities as full citizens of society. Music therapists are in an ideal role to help support the implementation of the practices associated with the inclusion principle. This article first shares a summary of the policies and research evidence that support early childhood inclusion, then outlines how music therapists can be critical partners in implementing practices that are associated with high quality inclusion, using the Recommended Practices in Early Intervention/Early Childhood Special Education (DEC, 2014) as a guide. Policy Support for Inclusion The principle of inclusion is supported by decades of legislation related to basic equal rights to educational opportunities. Starting with Brown vs. the Board of Education in 1954 and moving through the Individuals with Disabilities Education Act (IDEA), the American with Disabilities Act (ADA) and the Section 502 of the Rehabilitation Ac, the rights of individuals with disabilities to have equal access to educational and developmental services within community settings with their peers has been reinforced again and again. To hear a parent talk about the benefits of early childhood inclusion, visit the video library of the California’s Desired Results Access Project (Edelman, 2014). Watch video “A Parent's Perspective on Inclusion in Early Childhood”

To learn more about policies that support inclusion, review the CONNECT Foundations of Inclusion online curricula and short overview video. Watch video “CONNECT Foundations of Inclusion Birth to Five”

Research Support for Inclusion Research studies over the years have yielded important information about early childhood inclusion and the factors that influence its acceptance and implementation. A summary of key conclusions or

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“synthesis points” drawn from a review of the literature is available from the National Professional Development Center on Inclusion (2009). Among these findings is that inclusion has numerous benefits for children with and without disabilities. However, it is important to note that to achieve desired outcomes for children in inclusive environments, certain factors are important, one being that children receive specialized instruction and support to meet their individualized needs. The most recent compilation of practices that support inclusion, based on a combination of the best available research evidence and validation from the field, is the Recommended Practices in Early Intervention/Early Childhood Special Education (DEC, 2014). The purpose of this document is “to provide guidance to practitioners and families about the most effective ways to improve the learning outcomes and promote the development of young children, birth through five years of age, who have or are at-risk for developmental delays or disabilities (p. 1).” The document highlights “those practices specifically known to promote the outcomes of young children who have or are at risk for developmental delays/disabilities and to support their families in accordance with the DEC/NAEYC (2009) position statement on early childhood inclusion” (p. 3), thus making a strong connection between the practices and inclusion. The practices are specific, observable, and focused on practitioners who work with young children, birth-5 (through kindergarten), who have or are at risk for developmental delays and disabilities but are not limited to those eligible for IDEA services (e.g., children with severe challenging behavior). They build on, but do not duplicate, standards for typical early childhood settings (e.g., Developmentally Appropriate Practice in Early Childhood Programs Serving Children from Birth Through Age 8 (3rd ed.), 2009). The practices are organized into seven topical areas: Assessment, Environment, Family, Instruction, Interaction, Teaming and Collaboration, Transition.


Examples A music therapist provides a model for positive interactions for family members or teachers by commenting upon what a great helper the child is when he joins her in gathering up the musical instruments they have been using. A music therapist smiles frequently at the children with whom she/he is working, shows genuine pleasure in the company of children, and shows authentic approval of each child’s accomplishments. Photograph by John Cotter

Music Therapists and Implementation of the DEC Recommended Practices in Early Intervention/Early Childhood Special Education (2014) As partners with families, teachers and other specialists in supporting children’s learning and development in natural environments, music therapists are in an ideal role to implement the DEC recommended practices as part of their delivery of services and supports. To provide specific information about how a music therapist could use the practices as a guide, the following five DEC Recommended Practices in the topical area Interactions are listed. Interaction is defined as follows: “Sensitive and responsive interactional practices are the foundation for promoting the development of a child’s language and cognitive and emotional competence” (DEC, 2014, p. 13). Also included herein are examples of how a music therapist might implement each of the practices, especially highlighting partnerships with family members and other professionals when appropriate. The examples are modeled after a set of guidelines developed by the DEC Recommended Practice Commission (2015). To download the complete list of all of the DEC Recommended Practices, visit the DEC website. Download Recommended Practices %20Practices/DEC%202014%20Recommended%20Practices.pdf

INTERACTION: INT1. Practitioners promote the child’s socialemotional development by observing, interpreting, and responding contingently to the range of the child’s emotional expressions.

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INT2: Practitioners promote the child’s social development by encouraging the child to initiate or sustain positive interactions with other children and adults during routines and activities through modeling, teaching, feedback, or other types of guided support. Examples A music therapist working in an inclusive classroom supports a teacher to pair a child with disabilities with a developmentally sophisticated peer in order to teach and reinforce the hand motions associated with a popular song that is frequently sung at group time. Watch video “Routine in a Program: Singing a Song”

A music therapist works with teachers to encourage and reinforce a child for initiations and engagement with musical materials and activities like singing by providing choices, making suggestions, and providing descriptive feedback. Watch video “Routine in a Program: Singing with Friends”

INT3: Practitioners promote the child’s communication development by observing, interpreting, responding contingently, and providing natural consequences for the child’s verbal and nonverbal communication and by using language to label and expand on the child’s requests, needs, preferences, or interests.


Examples A music therapist works with a teacher to embed ideas for promoting children’s early literacy skills by using an alphabet song which includes teaching children to fill in lyrics with words that start with certain alphabet letters. A music therapist teaches developmentally sophisticated peers and other adults to recognize, interpret, and respond to nonverbal children’s communicative attempts during musical activities.

Practices (DEC, 2014) provide a means for identifying explicit strategies to use in the context of music therapy. For more examples of how to use music with young children during daily routines in inclusive settings see Kern (2008). Examine the complete list of practices and be inspired to imagine the many examples of how the practices can be a guide for your work with Photograph by John Cotter children. Then utilize this information to demonstrate that music therapists are indeed ideal partners for providing inclusive learning opportunities.

INT4: Practitioners promote the child’s cognitive development by observing, interpreting, and responding intentionally to the child’s exploration, play, and social activity by joining in and expanding on the child’s requests, needs, preferences, or interests. Example A music therapist extends and expands upon a child’s exploration of musical instruments by imitating the child’s behavior and then adding steps that show how instruments work and how the child can perform other actions with the instruments. INT5: Practitioners promote the child’s problemsolving behavior by observing, interpreting, and scaffolding in response to the child’s growing level of autonomy and self-regulations. Examples A music therapist observes a group of children beginning to interact with musical instruments and helps them plan their activity (e.g., identify what roles and instruments they might use as they interact with each other) to expand and build upon what they have learned. A music therapist models strategies and the use of words to work out problems when children engage in aggressive behavior. In summary, music therapists have multiple opportunities to support the development and learning of children with disabilities in inclusive and natural environments as part of their role of “using music to reach non-musical goals” (Bolton, 2014). The DEC Recommended

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References Bolton, D. (2014). One, two, three, and do, re, me: Early childhood musical development for music therapists. imagine 5(1), 38-41. Retrieved from Division for Early Childhood (DEC). (2014). DEC recommended practices in early intervention/early childhood special education. Retrieved from http:// Edelman, L. (Producer) (2014). A parent's perspective on inclusion in early childhood [video]. Rohnert Park, California: Desired Results Access Project. Kern, P. (2008). Singing our way through the day: Using music with young children during daily routines. Children & Families, 22(2), 50-56. National Association for the Education of Young Children (NAEYC). (2009). Developmentally appropriate practice in early childhood programs serving children from birth through age 8 (Position Statement). Retrieved from positions/position%20statement%20Web.pdf National Professional Development Center on Inclusion. (2009). Research synthesis points on early childhood inclusion. Chapel Hill, NC: The University of North Carolina, FPG Child Development Institute, Author. About the Author Pamela J. Winton, Ph.D. has been involved in research, outreach, professional development, and scholarly publishing related to early childhood inclusion for the last three decades. She has taught courses, intensive workshops, and curricula on families, teaming, and professional development for many years. Contact:


research 2015 Early Childhood Research Snapshot Blythe LaGasse, Ph.D., MT-BC Andrew Knight, Ph.D., MT-BC Colorado State University Fort Collins, Colorado

About the Authors Blythe LaGasse, Ph.D., MT-BC is Associate Professor and 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: Andrew Knight, Ph.D., MT-BC is Assistant Professor of Music Therapy at Colorado State University, and supervises practicum students in early childhood settings in the community.

Practitioners who serve the early childhood (EC) population may have noticed how the research base has evolved and become more sophisticated over recent years. The purpose of this research snapshot is to help practitioners parse out the value of various research topics for their own professional understanding. Staying informed on current research is a key aspect of maintaining evidence-based practice by relating research to practice with children and families. This research snapshot includes highlights of recent research on the use of music in early childhood published in 2014 and early 2015. 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 (http:// pubmed/) or the digital object identifier (doi) number (http:// ). Musical Attention in Infants Music engagement in infants continues to be an area studied by researchers. By forming a better understanding of typical development of infants, practitioners can improve their basis for therapeutic interventions. Costa-Giomi and Illari (2014)

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investigated attention to sung versus spoken stimuli in 11-month-olds. The researchers used spoken and sung renditions of an unfamiliar folk song and recorded eye gaze responses of 24 infants. There was no significant difference found in infant attention to sung and spoken stimuli, indicating that both types of stimuli elicited similar responses. Rhythmic movement has also been used as a measure of infant engagement. Illari (2015) recorded the rhythmic movements of infants listening to music, infant-directed speech, and contrasting rhythmic patterns. This replication study confirmed previous results that there were more spontaneous movements to metrically regular musical stimuli than to other metrically irregular stimuli. Furthermore, the authors hypothesized that culture plays a role in movement response due to their finding that infants in this study moved more than infants from another culture included in a previous study. The engagement of children with special needs is another area of research from this past year. de l’Etiole (2015) studied whether children with Down syndrome (DS) would respond similarly to typical children when exposed to infant-directed singing. Results indicated that infant-directed singing maintained attention in both groups of children. However, children with DS demonstrated difficulties with shifting attention and selfregulating arousal level when compared to typical children. Although music may assist children with special needs in maintaining attention, music therapy practitioners should be aware of the impact that musical stimuli may have on factors such as self-regulation. Music in Early Childhood Experience Several studies have investigated access to music in early childhood curricula and the impact of music in early childhood education. Vaiouli (2014) used a mixedmethods design to assess children’s engagement and early literacy skills after participating in an intervention group with music or a control group without music. A qualitative analysis was conducted on the teacher’s perspectives of using music in the classroom and the impact of music on children with disabilities. Results indicated that children in the music condition had significantly greater improvement on literacy scores than children in the control group. Further, the researcher stated that music was especially effective in engaging children with disabilities in the classroom, an observation

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that was supported by the qualitative analysis of the teacher’s comments. As several studies have indicated that the inclusion of music in the early childhood setting can yield benefits, other researchers have investigated the inclusion of music in educational curricula. One longitudinal study including over 20,000 children tracked exposure to music education from kindergarten through eighth grade (Miksza & Gault, 2014). Variables included frequency of music instruction, use of music to teach math, and formal music instruction outside of school. Results indicated significant differences in experiences based on socio-economic status, urbanicity, and race. This disparity in musical experiences was also found in a study investigating the use of music in two Reggio Emilia-inspired schools. Bond (2015) compared the inclusion of Reggio music instruction in suburban and urban early childhood settings. The researcher found differences in the use of music in these locations, with more focus on popular music in the urban setting and chanting, instrument play, and dialogue about music in the suburban site. The researcher stated that complex music making was more prevalent at the suburban site. Studies like these are important for understanding the differences between formal musical instruction and informal experiences with music for young children. Informal Musical Experiences of Young Children Research from this past year has also focused on the use of music in the home setting. Mehr (2014) investigated three areas: (a) the connection between music experiences in childhood and later music making in adulthood, (b) the amount of music making occurring in the household, and (c) parent perceptions of the benefits of music classes. Seventy-eight parents of 4year old children were surveyed and randomly assigned to participate in music, art, or no classes. Results indicated that the parent’s musical experiences in childhood significantly predicated their later use of music with their own children. Parents reported high frequencies of music activities in the home regardless of their own early childhood music experience. However, there was a significant correlation between being sung to by a parent and singing as a parent. The frequency of music making was unrelated to income or participation in the music classes. This study indicates that parents with


non-professional music experience provide musical experiences to their children; however, it did not measure the relationship between those informal experiences and the child’s musical abilities. O’Keefe (2014) investigated the role of gender and experience in the musical play of young children. Surveys gathered from teachers and parents were analyzed along with naturalistic observations of children’s musical behaviors. Results indicated significant differences in children’s musical play depending on the child’s age, sex, and some aspects of play gender. Play gender was defined as “the type of gender norms the child displays at play” (p. 19). There were no differences found for some aspects of play gender, exposure to music at home, parents’ selfreported musicality in the home, and the parent’s musical background. Implications for early childhood educators who want to support children’s musical development are discussed, and music therapists might offer these considerations to providers with whom they work. In another observational study, Koops (2014) took a qualitative approach by examining how families with children from 10 months to 4.5 years incorporated music from an early childhood music course they participated in with the researcher. The researcher then observed their child’s musicality outside the classroom setting. Through parent journaling, video recording, and field research notes of the investigator, it appeared that children interacted with music very similarly in automobiles and in the home, and there were numerous advantages in this environment, such as fewer distractions and closer proximity to siblings. This study highlights the importance of practitioners taking into consideration the settings in which young children experiment with music. Music Therapy with Young Children Fees and colleagues (2014) found that a music therapist who trained early childhood teachers in social songs improved waiting behaviors in children 3 to 5 years old in inclusive part-day classes on a military installation. During interviews conducted by the research team, the teachers expressed appreciation for the guidance and felt the training was a success over the 3 month time period. Finally, Music Therapy Perspectives Volume 32

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provided a scholarly overview of Nordoff-Robbins Music Therapy (NRMT), which included children of many ages and abilities. References Costa-Giomi, E., & Ilari, B. (2014). Infants’ preferential attention to sung and spoken stimuli. Journal of Research in Music Education, 62(2), 188–194. doi: 10.1177/0022429414530564 de l'Etoile, S. K. (2015). Self-regulation and infantdirected singing in infants with Down syndrome. Journal of Music Therapy, [Epub ahead of print] PMID: 25957338 Fees, B. S., Kaff, M., Holmberg, T., Teagarden, J., & Delreal, D. (2014). Children’s responses to a social story song in three inclusive preschool classrooms: A pilot study. Music Therapy Perspectives, 32(1), 71-77. doi:10.1093/mtp/miu007 Illari, B. (2015). Rhythmic engagement with music in early childhood: A replication and extension. Journal of Research in Music Education, 62(4), 332-343. doi: 10.1177/0022429414555984 Koops, L. H. (2014). Songs from the car seat: Exploring the early childhood music-making place of the family vehicle. Journal of Research in Music Education, 62, 52-65. doi: 10.1177/0022429413520007. Mehr, S. A. (2014). Music in the home: New evidence for an intergenerational link. Journal of Research in Music Education, 62(1), 78-88. doi: 10.1177/0022429413520008 Miksza, P., & Gault, B. M. (2014). Classroom music experiences of U.S. elementary school children: An analysis of the Early Childhood Longitudinal Study of 1998-99. Journal of Research in Music Education, 62(1), 4-17. doi: 10.1177/0022429413519822. O'Keefe, K. (2013). An investigation of gender's role in three-and four-year-old children's musical play (Unpublished doctoral dissertation). University of North Dakota, Grand Forks, ND. Vaiouli, P. (2014). Music, engagement, and early literacy in inclusive early childhood settings (Unpublished doctoral dissertation). Indiana University, Bloomington, IN.


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Music Therapy as Brain Care for Premature Infants Jayne M. Standley, Ph.D., MT-BC Florida State University Tallahassee, FL

About the Author Jayne M. Standley, Ph.D., MT-BC is a Robert O. Lawton Distinguished Professor at Florida State University with appointments in the Colleges of Music and Medicine. Dr. Standley is Director of the National Institute for Infant and Child Medical Music Therapy, a network affiliation of universities and medical centers to promote research and training in NICU-MT. Contact:

Neonatal intensive medical care for premature infants can increase survival rates, but, unfortunately, can also result in maladaptive and interrupted neurological wiring of the brain during the final critical phase of fetal growth and development. New imaging technology is enabling neurologists to identify the extent and frequency of such damage that appears to be caused by medical treatment pain, environmental stress, and/or side effects of medications (Radiological Society of North America, 2013). Progressive Neonatal Intensive Care Unit (NICU) neurologists are seeking improved treatment protocols that lessen neurologic damage or create opportunities for adaptive learning that will offset brain damage by promoting alternative brain cell growth (Bonifacio, Glass, Peloquin, & Ferriero, 2011). Research shows that evidence-based NICU-MT (Neonatal Intensive Care Unit Music Therapy) benefits neurobehavioral development with protocols that enhance growth and maturation. Hearing is the first sensory mode to develop during gestation, and music is a highly successful auditory stimulus for activating brain wiring and maximizing neural plasticity for even the most premature infants. Unlike other NICU treatment methods, no negative side effects or physiologic responses have resulted from music protocols designed and provided by board-certified music therapists (MT-BC) with the NICU-MT certificate indicating specialized training (Standley & Walworth, 2010). NICU-MT is a highly effective component of brain-care oriented treatment for preterm infants that improves neurobehavioral outcomes such as earlier discharge to home while reducing medical costs. Research shows that the fetus is capable of learning early in the third trimester. Therefore, neural mechanisms are sufficiently developed during premature NICU care for early learning interventions. Such protocols can provide neural protection through facilitating adaptive wiring and can be

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included as an essential element of early intervention medical treatment (James, 2010). Bader (2014) listed premature infant objectives for brain-care oriented treatment. NICU-MT protocols have been documented for each of these objectives: Calming Objectives: MT reduces stress and prevents release of cortisol and epinephrine, hormones that cause neurologic damage; increases coping skills such as non-nutritive sucking that release beneficial hormones in the brain; and promotes faster return to sleep after painful procedures allowing brain cells to resume dividing. Lullaby listening is a pleasant stimulus that masks aversive NICU sounds that increase stress and can be provided for up to 4 hours/day (Baily & Kantak, 2005). Contingent music increases non-nutritive sucking, a self-regulating coping skill (Standley, 2000). Music reinforced sucking leads to falling asleep faster following painful medical treatment (Whipple, 2008). Parental Objectives: MT increases parental involvement in care and teaches parents to interpret infant cues to individualize and promote beneficial interactions. Parent-based music interactions, especially those using the mother’s singing voice, increase parental involvement and promote bonding (Cevasco, 2008). Teaching parents how to identify and react to infant cues while combining quiet singing with positive touch reduces infant hypersensitivity, increases visiting time, and reduces parental over-stimulation of the infant (Whipple, 2000). Positive Touch Objectives: Since touch in the NICU often accompanies painful or stressful medical procedures, the brain may wire with aversive reaction to all touch. The infant needs opportunities for the brain to wire in response to positive touch. Music combined with positive touch reduces hyperresponsiveness, extends parent interaction time, and leads to earlier discharge (Standley, 1998; Walworth et al., 2012). It includes positive facial touch designed to offset aversion caused by painful or irritating medical treatment. Language Objectives: Early birth ends exposure to the mother’s voice that usually occurs in the womb from 18 weeks to the end of pregnancy at 38-40 weeks. This exposure teaches the fetus basic

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language concepts that are apparent at birth of term infants. Vocal lullabies convey important language information to offset the developmental delay resulting from premature birth (Trehub, Unyk, & Trainor, 1993). Lullabies may therefore be particularly effective when sung by the mother and are theorized to promote attachment. In addition to the above list, NICU-MT also facilitates early neurodevelopmental learning experiences that offer opportunities for adaptive wiring of the brain. Music reinforces non-nutritive sucking at 34 gestational weeks, which leads to faster independent oral feeding and earlier discharge (Standley et al., 2010; Chorna, Slaughter, Wang, Stark, & Maitre, 2014). Music reinforces patient-triggered ventilation and greatly increases spontaneous breathing over lengthy periods of time which may lead to reduced time on the ventilator or lessen future development of oral aversion and failure to feed. Music listening also increases oxygen saturation and leads to reduced oxygen provision for the fragile preterm infant (Cassidy & Standley, 1995). Therefore, NICU-MT may be beneficial in preventing some aspects of oxygen-related development of retinopathy (damage to the eyesight) or lack of proportional development of neurologic white/ grey matter which has been identified as one factor in the development of Autism Spectrum Disorder. In summary, evidence-based music therapy is an effective and critical component of brain-care oriented treatment with multiple benefits. The evidence-based protocols of music therapy for premature infants (NICUMT) lead to neural protection, promote neurobehavioral development, improve NICU outcomes, and reduce medical costs through earlier discharge (Standley, 2012). It is a method of optimizing opportunities for alternative neurologic wiring with no documented negative effects that is beneficial both in the NICU during the earliest days following premature birth and following hospital discharge (Standley & Walworth, 2010). Research in this area and the certificate training are specializations of the National Institute for Infant and Child Medical Music Therapy located at Florida State University. More information about NICU-MT can be found at


References Bader, L. (2014). Brain-oriented care in the NICU: A case study. Neonatal Network, 33(5), 263- 267. Baily, K., & Kantak, A. (2005, October). Music therapy in the neonatal intensive care unit, a multi-site study: A randomized control blind study of music therapy with high risk neonates cared for in Neonatal ICU. In R. Kaplan (Chair), Music therapy in the NICU: A symposium on research and applications of music therapy in the neonatal intensive care unit. Symposium conducted at the meeting of Cleveland Music School Settlement, Cleveland, Ohio. Bonifacio, S., Glass, H., Peloquin, S., & Ferriero, D. (2011). A new neurological focus in neonatal intensive care. Nature Reviews, 7, 485-493. Cassidy, J. W., & Standley, J. M. (1995). The effect of music listening on physiological responses of premature infants in the NICU. Journal of Music Therapy, 32(4), 208–227. Cevasco, A. M. (2008). The effects of mothers’ singing on full-term and preterm infants and maternal emotional responses. Journal of Music Therapy, 45(3), 273-306. Chorna, O., Slaughter, J., Wang, L., Stark, A., & Maitre, N. (2014). A pacifier-activated music player with mother’s voice improves oral feeding in preterm infants. Pediatrics, 133, 462-468. James, D. (2010). Fetal learning: A critical review. Infant and Child Development, 19, 45-54. Radiological Society of North America. (2013, November 26). MR spectroscopy shows differences in brains of preterm infants. ScienceDaily. Retrieved from 2013/11/131126092658.htm Standley, J. (1998). The effect of music and multimodal stimulation on physiologic and developmental responses of premature infants in neonatal intensive care. Pediatric Nursing, 24(6), 532-538. Standley, J. M. (2000). The effect of contingent music to increase non-nutritive sucking of premature infants. Pediatric Nursing, 26(5), 493–495, 498–499. Standley, J. (2012). Music therapy research in the NICU: An updated meta-analysis. Neonatal Network: The Journal of Neonatal Nursing, 31(5), 311-316. Standley, J., Cassidy, J., Grant, R., Cevasco, A., Szuch, C., Nguyen, J., . . . Adams, K. (2010). The effect of music reinforcement for non-nutritive sucking via

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the PAL (Pacifier-Activated Lullabies Apparatus) on achievement of oral feeding by premature infants in the NICU. Pediatric Nursing, 36(3), 138-145. Standley, J. M. & Walworth, D. (2010). Music therapy with premature infants: Research and developmental interventions (2nd ed). Silver Spring, MD: American Music Therapy Association. Trehub, S. E., Unyk, A., & Trainor, L. (1993). Adults identify infant-directed music across cultures. Infant Behavior and Development, 16(2), 193-211. Walworth, D., Standley, J., Robertson, A., Smith, A., Swedberg, O., & Peyton, J. (2012). Effects of neurodevelopmental stimulation on premature infants in neonatal intensive care: Randomized controlled trial. Journal of Neonatal Nursing, 18(6), 210-216. Whipple, J. (2000). The effect of parent training in music and multimodal stimulation on parent-neonate interactions in the Neonatal Intensive Care Unit. Journal of Music Therapy, 37(4), 250-268. Whipple, J. (2008). The effect of music-reinforced nonnutritive sucking on state of preterm, low birthweight infants experiencing heelstick. Journal of Music Therapy, 45(3), 227-272.

UPCOMING TRAINING National Institute for Infant & Child Medical Music Therapy NICU-MT Lecture AMTA National Conference Kansas City, MO November 11, 2015


photos 2015: Photo Stories One section of the imagine website is dedicated to photo stories related to early childhood music therapy. The photo stories are a sequence of three pictures along with a one-sentence description of what happens in each picture during the music therapy session. Story #21 Music Therapist: Bonnie Hayhurst, MT-BC Affiliation: The Groovy Garfoose, Hudson, OH Photographer: Bonnie Hayhurst, MT-BC Story #22 Music Therapist: Dana Bolton, M. Ed., MT-BC Affiliation: Bolton Music Therapy, Murfreesboro, TN Photographers: Music Therapy Practicum Student Story #23 Music Therapist: Michael Detmer, MME, MT-BC Affiliation: Music Therapy Clinic at the University of Louisville, KY Photographer: Adrienne Steiner, MM, MT-BC Story #24 Music Therapist: Petra Kern, Ph.D., MT-BC, MTA, DMtG Affiliation: Music Therapy Consulting, Santa Barbara, CA Photographer: Don Trull imagine 6(1), 2015


practice Inclusion Practice in Music Therapy: Creating A Win-Win Situation for Everyone Petra Kern, Ph.D., MT-BC, MTA, DMtG Music Therapy Consulting Santa Barbara, California

While celebrating the 40th anniversary of the Individuals with Disabilities Education Act (IDEA) and the 25th anniversary of the Americans with Disabilities Act (ADA) in the USA, music therapists around the world may advocate and support the concept of inclusion in their communities. Yet, inclusion practice and research in music therapy seem to be sparse (Brown & Jellison, 2012). This article gives examples of how music therapists can apply the principles of inclusion outlined in the joint definition by the Division for Early Childhood (DEC) of the Council for Exceptional Children and the National Association for the Education of Young Children (NAEYC) (2009) and oers music therapy-related comments on research synthesis points published by the National Professional Development Center on Inclusion (NPDCI) (2009) that support early childhood inclusion.

Photographs by Petra Kern and Don Trull

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Rights, Activities, Full Members Early childhood inclusion embodies the values, policies, and practices that support the right of every infant and young child and his or her family, regardless of ability, to participate in a broad range of activities and contexts as full members of families, communities, and society (DEC/ NAEYC, 2009). Ralph is a 4-year-old boy with cerebral palsy. As every child, he likes to laugh, sing, and play the drums. Besides benefitting from the widely held value and societal view of inclusion, he has the right and is protected under the law to play, develop, and learn together with other children in various community-based settings – including music therapy services in the home, early childhood program, or playground. Regardless of his abilities, Ralph can participate in a variety of music activities, which provide natural opportunities for all children to learn. As music is one of his favorite activities, he is motivated to practice and engage with others. Hence, music activities can encourage inclusion by the sharing of a common interest with peers. In all cultures, music is part of family life, community activities, and society at large. Thus, fostering Ralph's musical interest and abilities may allow him to participate as a full member of his communities and society throughout his lifespan.

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Belonging, Relationships, Potential The desired results of inclusive experiences for children with and without disabilities and their families include a sense of belonging and membership, positive social relationships and friendships, and development and learning to reach their full potential (DEC/NAEYC, 2009). Sam is a 5-year-old boy with Pfeier Syndrome. Medical and surgical needs prevent his being in the preschool on a regular basis. Yet, he likes to participate in circle time and is a valued member of his class. Encouraging a sense of belonging through music therapy group sessions keeps him smiling and engaged with his peers when times are rough in his life. In inclusive music therapy practice, playing instruments, singing, dancing, or listening to music are all used intentionally to assist children both to learn new concepts and to practice positive peer interactions. As a result, children like Sam and his peers may develop positive social relationships and friendships with each other. Within a group music therapy session, Sam learns and develops skills that are outlined on his Individualized Education Program (IEP). One goal for him is to take a leading role in musical play. Performing at a family day, Sam reaches his full potential by playing the cymbal loudly – a proud moment for him!


Access, Participation, Supports The defining features of inclusion that can be used to identify high quality early childhood programs and services are access, participation, and supports (DEC/ NAEYC, 2009). Phillip is a 4-year old boy with Autism Spectrum Disorder. For him, access means being enrolled in an inclusive community-based childcare program. Further, a musical modification of the playground allows him to meaningfully engage with other children in daily outdoor routines. In addition, a simple musical curriculum adaptation provides him multiple opportunities for learning in the outdoor environment. Some children like Phillip may need additionally individualized accommodations for full participation. Utilizing the Tiered Models of instruction, an individualized adult/ peer-mediated song intervention based on Phillip’s abilities and needs supports him in increasing his positive peer interaction on the playground. To implement high quality inclusion, an infrastructure of system-level supports (i.e., access to professional development, collaboration, and coordination/integration of specialized services) must be in place. In Phillip’s case, educators receive training on effective inclusion practices, collaborate as transdisciplinary team, and the music therapy intervention is embedded in Phillip’s daily routines. imagine 6(1), 2015

Research Synthesis Points The following key points on early childhood inclusion are based on a literature review (NPDCI, 2009) and the DEC monograph on quality inclusive services (Peterson, Fox, & Santos, 2009). Comments are offered to music therapists for reflecting on their own inclusion practices. Inclusion takes many different forms. Inclusion occurs in a wide variety of contexts addressing all aspects of life. Hence, music therapy services need to be embedded in children's natural environments, activities, and daily routines using a variety of service delivery models (e.g., consulting, coaching, or direct service delivery). Universal access to inclusive programs for children with disabilities is far from reality. While progress has been made to ensure access to inclusive programs, many children in the U.S. and around the world are still not fully included in their communities and societies. Thus, music therapists need to continue being active advocates for including young children with disabilities in communitybased settings and leading by example. Inclusion can benefit children with and without disabilities. Children enrolled in inclusive settings demonstrate greater gains in social development, while peers without disabilities seem to develop more tolerance and acceptance of individual differences. Music therapists can support inclusion by embedding systematic peer-mediated interventions in which children without disabilities prompt and maintain social engagement throughout the day. Factors such as child characteristics, policies, resources, and attitudes influence the acceptance and implementation of inclusion. The nature and severity of a child’s disability, financial incentives, professional experiences and attitudes, and parents preferences and priorities for various types of services impact inclusion practices. To provide effective inclusion services, music therapists need to be part of a systemslevel support endeavor. Specialized instruction is an important component of inclusion and a factor affecting child outcomes. Evidence-based instructional strategies (e.g., using prompts, organizing the learning environment, planning for transitions) enhance the development of children with 42

disabilities and learning in an inclusive setting. Therefore, music therapists should embed effective instructional strategies used by family members and the entire support team in music therapy sessions. Collaboration among parents, teachers, and specialists is a cornerstone of high-quality inclusion. Multiple opportunities for communication and collaboration among parents, teachers, and specialists are necessary to make inclusion successful. Music therapists should be part of the intervention team of their young client with disabilities. Families of young children with disabilities generally view inclusion favorably although some express concerns about the quality of early childhood programs and services. While most parents report positive experiences with inclusion, some are concerned about the quality of services and supports their child with disabilities receives. Music therapists should clearly communicate their qualifications, inclusion practices, and client outcomes to families of children with disabilities. Limited research suggests that the quality of early childhood programs that enroll children with disabilities is as good as, or slightly better than, the quality of programs that do not enroll these children. Although there is some evidence on the effects of high quality inclusion programs, assessing the dimensions of quality inclusion (i.e., access, participation, supports) is needed. Likewise, music therapy inclusion practices are understudied and need more attention by music therapy researchers. Early childhood professionals may not be adequately prepared to serve young children with disabilities and their families in inclusive programs. Some early childhood training programs only require one special education course, which may result in lack of knowledge and comfort of caring for children with disabilities by early childhood personnel. While “special education” is part of every music therapy university curriculum, it is unknown to what extent high quality inclusion practices of children with disabilities are taught. A central focus for the music therapy field should be to identify high quality inclusion practices and offer professional development.

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Conclusion Early childhood inclusion is a societal matter that should concern everyone. While progress has been made related to policies, access, participation, and supports, much more needs to be done to include every child with disabilities and to create a win-win situation for everyone. Music therapists can play an important role by offering high-quality interventions that support child outcomes of children with and without disabilities alike in an inclusive context. Additionally, more research and professional development opportunities on music therapy inclusion practices are needed. References Brown, L. S., & Jellison J. A. (2012). Music research with children and youth with disabilities and typically developing peers: A systematic review. Journal of Music Therapy, 49(3), 335-364. DEC/NAEYC (2009). Early childhood inclusion: A joint position statement of the Division for Early Childhood (DEC) and the National Association for the Education of Young Children (NAEYC). Chapel Hill, NC: The University of North Carolina, FPG Child Development Institute. National Professional Development Center on Inclusion (2009). Research synthesis points on early childhood inclusion. Chapel Hill, NC: The University of North Carolina, FPG Child Development Institute, Author. Peterson, C. A., Fox, L., & Santos A. (Eds). (2009). Quality inclusion services in a divers society [Monograph]. Missoula, MT: Young Exceptional Children. About the Author Petra Kern, Ph.D., MT-BC, MTA, DMtG, business owner of Music Therapy Consulting is online professor at the University of Louisville and serves as editor-inchief of imagine. Her research and clinical focus is on young children with ASD, inclusion programming, and educator/parent coaching. Contact:


Photograph by Petra Kern

Skill Generalization in Music Therapy: A Review of the Literature and Practice Suggestions Lori F. Gooding, Ph.D., MT-BC Florida State University Tallahassee, FL

Acquiring a skill within one specific context and then extending or transferring it to another is known as generalization (Fischer & Farrar, 1987). Generalization occurs when relevant behaviors are demonstrated in a different situation or applied to a new problem, and it requires individuals to transfer skills learned to different conditions – across time, persons, subjects, behaviors, and settings (Stokes & Baer, 1977). In order to successfully generalize a skill, a child must possess the necessary resources to transfer the learned skill, recognize that a situation is appropriate for generalization, and be motivated to transfer previously learned skills (McKeough, Lupart, & Marini, 1995). In the past it was assumed that skills learned would “spill over” (Perkins & Salomon, 1988, p. 23) to other contexts. However, researchers now believe that skills taught in one setting do not automatically transfer to another (Daugherty, Grisham-Brown, & Hemmeter, 2001; Perkins & Salomon, 1988). Therefore it has been argued that we must teach for transfer (Perkins & Salomon, 1988). Music Therapy Research and Generalization Generalization has been a largely understudied component in the field of music therapy. Jellison and Draper (2015) reviewed music research in inclusive preschool and elementary settings and found that only 3

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of 22 studies (13.6%) included generalization data. Likewise, Brown and Jellison (2012) systematically reviewed music research on children and youth with disabilities and their typically developing peers and found that only 9% studied generalization. Given the limited research available, it is understandable why researchers like Kern and Aldridge (2006) and Jackson (2003) have highlighted the need to incorporate generalization into future research. Though limited, the available music therapy research on generalization suggests that the transfer of skills learned in music therapy is possible (Rickson & Watkins, 2003). Studies, like those by Twyford (2012) and Kaplan and Steele (2005), have identified a number of skills successfully generalized outside of music therapy treatment. Twyford (2012) evaluated inclusive music therapy groups for children between the ages of 5 and 10 and concluded that skills acquired in music groups often generalized to other settings like the classroom and the playground. Generalized skills included (a) socialization, (b) communication, (c) participation, (d) coordination, (e) independence, (f) cooperation, and (g) confidence. Kaplan and Steele (2005) surveyed parents of individuals with diagnoses on the autism spectrum between the ages of 2 and 49 years. One hundred


percent of respondents indicated that skills learned in music therapy were generalized outside of sessions either occasionally or frequently. The types of skills generalized included (a) behavioral/psychosocial, (b) language/communication, (c) perceptual/motor skills, (d) cognitive, and (e) musical. Music Therapy Practice and Generalization Therapists must recognize that skill generalization is rarely spontaneous and can be difficult to achieve, especially for children with more severe developmental disabilities (Coates, 1987). Music therapists must be aware of the role that they play in generalization, keeping in mind that it is the music therapist’s responsibility to ensure that individuals generalize skills outside the therapy setting (Sandness, 1991). Structuring Sessions to Promote Generalization According to Johnson and Zinner (1974), therapy can be divided into three steps: (a) establishing desired behaviors, (b) generalizing these behaviors to natural settings, and (c) maintaining the behaviors. In order for generalization to occur, change must first occur during treatment (Krout, 1984). Therapists must establish new behaviors and provide opportunities for children to practice transferring newly acquired skills within the structure of the session (Coates, 1987; Johnson & Zinner, 1974; Nelson, Anderson, & Gonzales, 1984). One example of how to include transfer training within a music therapy session can be found in a study by Eidson (1989). During his investigation of behavioral music therapy to improve interpersonal skills in adolescents with emotional disorders, Eidson (1989) defined desired behaviors and provided structured opportunities to discuss how target behaviors might occur in both music therapy and the classroom setting. Results indicated that students who received transfer training demonstrated interpersonal behaviors that were almost twice as stable as control participants. Successful Strategies for Establishing Behaviors Music therapists have used a variety of strategies including peer-to-peer interactions and behavior modification techniques to establish desired behaviors. Peer-to peer interactions may be helpful in promoting generalization of skills, especially for certain groups of children (e.g., individuals with Autism Spectrum Disorder) (Walworth, 2007). Consequently it is important to

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carefully select peer models to promote learning and generalization to other settings (Twyford, 2012). Use of specific behavior modification techniques may also promote skill development and generalization. For example, Abbott and Sanders (2013) discussed the use of modeling (demonstrating desired behaviors) to promote sensory, emotional, cognitive, and kinesthetic learning, deeper meaning-making and understanding, and ultimately generalization of learning to additional settings. Johnson and Zinner (1974) promoted the use of cues (physical, visual, or verbal stimuli) to prompt specific behaviors followed by fading (withdrawing cues) so that the natural environment itself could then prompt the behaviors. Staum and Flowers (1984) also used modeling and cues, in addition to shaping (reinforcing successful approximations of a desired behavior). Results from their case study showed that these strategies were successful in eliminating inappropriate behaviors. Generalizing and Maintaining Behaviors After establishing desired behaviors, music therapists must promote transfer to other situations and settings (James, 1987). This ensures that progress gained in the therapy session will generalize to the client’s skill repertoire. Reinforcement can be one effective tool to promote generalization. Contingent reinforcement (the application of a reward following a desired behavior) has been cited by several authors including Staum and Flowers (1984) and Eidson (1989). Specifically, the authors used music lessons as a reward and a token economy system respectively. Both resulted in successful generalization of behaviors. Parents can also be an effective means for skill generalization, so music therapists should develop strong parent/professional relationships (Allgood, 2005). The data have shown that parents and caregivers want to learn strategies that support skill generalization outside of the music therapy session (Molyneux et al., 2012). The data have also indicated that parents have transferred music intervention strategies at significantly high rates outside of music therapy sessions (Nicholson, Berthelsen, Abad, Williams, & Bradley, 2008). For example, Nugent and Warren (2010) surveyed parents and asked them to comment on the transfer of skills addressed in music therapy to other settings. One hundred percent of parents stated that they used music


strategies learned during music therapy at home. Parents also provided specific examples of generalization including (a) improved turn taking during reading time, (b) use of music to self-regulate at home, (c) increased participation in music activities at preschool, (d) improvements in vocalizations, speech-language, and communication skills, and (e) increased awareness of sound. After skills have been learned and generalized, they must be maintained. Music therapists Johnson and Zinner (1974) suggested the use of intermittent reinforcement to maintain behaviors. Intermittent reinforcement involves the reinforcement of a behavior in some settings but not in others. The use of this technique is consistent with research on generalization and maintenance in other fields (Stokes & Baer, 1977). The data also suggest that reinforcing unprompted generalizations can be helpful in promoting maintenance of behaviors (Stokes & Osnes, 1986). Use of such techniques may ensure that behaviors not only generalize, but also continue to occur. Conclusion In order for the changes that occur during music therapy to be sustainable, behaviors learned must transfer across time and setting (Stokes & Baer, 1977). Generalization occurs when skills are taught effectively in music therapy sessions, music therapists provide specific opportunities to transfer learned behaviors to natural settings, and skills are maintained through effective reinforcement techniques. Peer and parental involvement can be used effectively to promote generalization of a variety of skills, including behavioral, psychosocial, and cognitive skills. Ultimately, it is the music therapist’s responsibility to ensure that children generalize skills outside the therapy setting. References Abbott, E. A., & Sanders, L. (2013). Perspectives of paraeducators on collaboration in music therapy sessions. Canadian Journal of Music Therapy, 19, 47-65. Allgood, N. (2005). Parents’ perceptions of family-based group music therapy for children with Autism Spectrum Disorders. Music Therapy Perspectives, 23, 92-99. Brown, L. S., & Jellison, J. A. (2012). Music research with

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children and youth with disabilities and typically developing peers: A systematic review. Journal of Music Therapy, 49, 335-364. Coates, P. (1987). “Is it functional?” A question for music therapists who work with the institutionalized mentally retarded. Journal of Music Therapy, 24, 170-175. Daugherty, S., Grisham-Brown, J., & Hemmeter, M. L. (2001). The effects of embedded skill instruction on the acquisition of target and nontarget skills in preschoolers with developmental delays. Topics in Early Childhood Special Education, 21, 213-221. Eidson, C. E. (1989). The effects of behavioral music therapy on the generalization of interpersonal skills from session to the classroom by emotionally handicapped middle school students. Journal of Music Therapy, 26, 206-21. Fischer, K. W., & Farrar, M. J. (1987). Generalizations about generalization: How a theory of skill development explains both generality and specificity. International Journal of Psychology, 22 (5-6), 643-677 doi: 10.1080/00207598708246798 Jackson, N. (2003). A survey of music therapy methods and their role in the treatment of early elementary school children with ADHD. Journal of Music Therapy, 40, 302-323. James, M. R. (1987). Implications of selected social psychological theories on life-long skill generalization: Considerations for the music therapist. Music Therapy Perspectives, 4, 29-33. Jellison, J. A., & Draper, E. A. (2015). Music research in inclusive school settings: 1975 to 2013. Journal of Research in Music Education, 62, 325-331. Johnson, J. M., & Zinner, C. C (1974). Stimulus fading and schedule learning in generalizing and maintaining behaviors. Journal of Music Therapy, 11, 84-96. Kaplan, R. S., & Steele, A. L. (2005). An analysis of music therapy program goals and outcomes for clients with diagnoses on the autism spectrum. Journal of Music Therapy, 42, 2-19. 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, 270-294. Krout, R. (1984). Music therapy in the summer camp


setting: New avenues for behavior change. Music Therapy Perspectives, 2, 14 -16. McKeough, A., Lupart, J., & Marini, A. (Ed.). (1995). Teaching for transfer: Fostering generalization in learning. New York: Routledge. Molyneux, C., Koo, N. H., Piggot-Irvine, E., Talmage, A., Travaglia, R., & Willis, M. (2012). Doing it together: Collaborative research on goal-setting and review in a music therapy centre. The New Zealand Journal of Music Therapy, 10, 6-38. Retrieved from http:// accountid=11836 Nelson, D. L., Anderson, V. G., & Gonzales, A. D. (1984). Music activities as therapy for children with Autism and other pervasive developmental disorders. Journal of Music Therapy, 21, 100-116. Nicholson, J. M., Berthelsen, D., Abad, V., Williams, K., & Bradley, J. (2008). Impact of music therapy to promote positive parenting and child development. Journal of Health Psychology, 13, 226-238. Nugent, N., & Warren, P. (2010). The “Music Connections” programme: Parents’ perceptions of their children’s involvement in music therapy. The New Zealand Journal of Music, 8, 8-33. Rickson, D., J., & Watkins, W. G. (2003). Music therapy to promote prosocial behaviors in aggressive adolescent boys: A pilot study. Journal of Music Therapy, 40, 283-301. Sandness, M. I. (1991). Developmental sequence in music therapy groups: A review of theoretical models. Music Therapy Perspectives, 9, 66-72. Staum, M. J., & Flowers, P. J. (1984). The use of simulated training and music lessons in teaching appropriate shopping skills to an autistic child.

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Music Therapy Perspectives, 1, 14-17. Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349-367. Stokes, T. F., & Osnes, P. G. (1986). Programming the generalization of children’s social behavior. In P. S. Strain, M. J. Guralnick, & H. M. Walker (Eds.), Children’s social behavior: Development, assessment, and modification (pp. 407-444). Orlando: Academic Press. Twyford, K. (2012). Getting to know you: Peer and staff perceptions of involvement in inclusive music therapy groups with students with special educational needs in mainstream school settings. The New Zealand Journal of Music Therapy, 10, 39-73. About the Author Lori Gooding, Ph.D., MT-BC has worked with children in behavioral health, medical, and school settings. She is an Assistant Professor of Music Therapy at Florida State University and serves as President of the SER-AMTA. Contact:


Facilitating Generalization: Integrating Video and Video Self-Modeling Into Music Therapy Practice Edward Todd Schwartzberg University of Minnesota Minneapolis, Minnesota

Rationale for the Use of Video and Video-Self Modeling Generalization of social, communication, motor, academic, and functional life skills can be a challenge for care providers, especially those who do not work with their clients in naturalistic settings such as the client’s home. As defined in the American Music Therapy Association’s Scope of Music Therapy Practice (AMTA, 2015) as well as in the AMTA Standards of Clinical Practice (AMTA, 2015) it is the ethical duty of music therapists to utilize strategies that facilitate successful generalization of skills being practiced during music therapy sessions. Video and video-self modeling is one evidence-based approach that music therapists can consider to help facilitate generalization (and continued maintenance) of targeted skills in their therapy sessions (NAC, 2009, 2015). Defining Video and Video-Self Modeling Modeling can be defined as one’s attempt to try to be like and to behave like someone else (Webster, 2015). As a method for enhancing instruction and learning, Bandura (1977) discussed the importance of integrating a variety of continuous modeling opportunities to enhance the educational success of children. Throughout society, and especially within educational settings, care providers often utilize visual supports in

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order to communicate with and teach children and adults with Autism Spectrum Disorder (ASD) and other similar intellectual/developmental disabilities (National Research Council, 2001). Moreover, modeling is considered an established intervention for working with children with ASD by the National Autism Center (NAC, 2009, 2015). The NAC defines both live and video modeling as an approach that relies on an adult or peer providing a demonstration of the target behavior that should result in an imitation of the target behavior. Video Modeling (VM) has been utilized to foster development of and improvement in social, communication, motor and academic/cognitive skills of individuals with ASD. Many schools are now offering web-based and video instruction to assist with acquisition and generalization of skills. Bellini (2006) concludes that VM and video self-modeling (VSM) can be used to: promote acquisition of new skills, enhance performance of existing skills, combine with other strategies or interventions, allow for the use of visual supports and prompt fading, increases self-confidence through the viewing of efficacious behavior(s), and promote self-awareness. Moreover, the NAC (2015) identified peer-reviewed research articles, on the topic of modeling and concluded that researchers have indicated modeling as an approach that leads to improvements in


higher cognitive functions, academic, communication, interpersonal, personal responsibility, and play skills as well as decreases in problem behaviors and improvements in sensory or emotional regulation. In a meta-analysis conducted by Bellini and Akullian (2007), the researchers analyzed 23 published studies on the topic of VM as an intervention to improve skills of individuals with ASD. They concluded that VM and VSM interventions were effective strategies for targeting social-communication, functional skills, and behavioral skills of individuals with ASD. An overview of their specific findings indicated that in 18 out of the 23 studies, researchers demonstrated moderate effects in either maintenance or generalization of targeted skills. In analyzing for differences between VM and VSM, Bellini and Akullian found no significant difference between the two types of modeling based on the findings of the 23 studies. Within the profession of music therapy, there is a small amount of published research on the topic. Researchers have investigated the effects of VM on the educational preparation of music therapy students (Alley, 1980; Hanser & Furman, 1980; Darrow, Johnson, Ghetti, & Achey, 2001; Greenfield, 1978). In each of these studies, participants demonstrated increases in the targeted areas, including: giving directions, prompts and reinforcements, and in offering of approving behavior(s). Integrating VM and VSM: A Protocol Buggey (2009) and Bellini (2006) defined and outlined a protocol for integrating VM and VSM into the educational and therapeutic milieu of individuals with ASD. This protocol can be utilized with children and adults with a myriad of disabilities. The primary difference between VM and VSM is in who is doing the modeling. In VM the model is a caregiver, peer, sibling, or care-provider, whereas in VSM the student/client is the model. The protocol addresses three primary types of video-self modeling approaches: Positive Self-Review, Video Feedback, and Video Feedforward. When deciding on how to best implement video self-modeling, music therapists should be aware of the difference between each of these approaches, in order to determine the best approach for the client. Positive Self-Review, is used to help the individuals view themselves successfully engaging in a behavior or activity that is currently in their repertoire – this is typically aimed at maintenance or

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“honing” skills. Video Feedback involves individuals viewing themselves engaging in various behaviors that are not currently in their repertoire. Video Feedforward is utilized with individuals who present with separate skills, but cannot put them altogether to complete the desired task or behavior. When utilizing Video Feedforward, the facilitator will video record the individual demonstrating the separate skills and edit the skills so they occur in the desired order. Then the individuals view themselves as they might “perform” the desired behavior or task at a future time.

Watch video “Social-Communication Skill Demonstration”

Bellini (2006) proposed and defined eight guidelines for utilizing VM and VSM as an intervention to promote acquisition or maintenance of targeted skills. The first step is to select the skill/behavior to teach. This should be done through a comprehensive assessment process that includes the care provider’s assessment as well as feedback from caregivers, other care providers, and, if possible, the individuals themselves. During the first step, it should be determined whether video or video-self modeling would be the more effective tool. As recommended by Bellini, the decision should be made, based on two key questions: Is the skill a communication, social, motor, functional, or selfregulation skills? Is the need acquisition of a new skill or maintenance of current skills? The second step is to identify the actors or additional models that will be needed to help with demonstrating (modeling) the desired behavior (e.g., peers, siblings, parents, or interns). The third step is planning the production towards implementing VM/VSM. This involves the music therapist planning how best to organize and structure the environment in which the videoing will take place. During this stage, music therapists should consider integrating a

➡ ➡


Social Story ™ (Gray, 2004) as a script or utilizing a music-based social story (Brownell, 2002; Kern, Wolery, & Aldridge, 2007; Schwartzberg, & Silverman, 2013) to assist with the learning, maintenance or generalization of the targeted skill. Moreover, additional materials and props should be considered. For example, if the targeted skill is appropriate meal etiquette, the care provider might consider integrating eating utensils, play food, and a table and chairs in order to make the scenario as real (generalizable) as possible. The fourth step is an extension of the previous step and encourages the care provider to determine the additional supports necessary to portray the student successfully engaging in the targeted skill. Bellini refers to these as “hidden” supports and can be verbal, visual, musical, or physical cues presented by the facilitator that are provided “off camera” so that all that is captured in the video is the efficacious behavior being targeted. Some facilitators may use off screen cue cards, or a copy of the Social Story™ out of the view of the camera, but in view of the client. They may also choose to skillfully place, descriptive and coaching sentences within the music based social story, reminding the individual of the behavior(s) they need to demonstrate. The fifth step is the filming stage, however it should begin with practicing with the recording device first. Prior to filming, the music therapist should place the video camera in the location in the room where it will remain for the recording. This will help with desensitizing the participant to the video camera so that when actual recording occurs, the camera is not seen as a distraction. Several practice recordings may need to take place, before the official recording is taken. However, the music therapist may observe the individual succeeding during a practice run. In this case, the music therapist can make the decision to continue to record, record again, or to stop recording.

Watch video “Emotional Regulation Demonstration”

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➡ The sixth step occurs when the video is obtained.

The music therapist needs to edit the recording in order to insure that the video only depicts the desired skill. In their meta-analysis, Bellini and Akullian (2007) concluded that the average length of time for a video should be 3 minutes. Oftentimes, music therapists may video tape an entire therapy session, therefore, they will want to delete any video prior to and after the client “performing” the desired behavior. The final version should only portray the client (or other model) modeling the desired behavior. Once the music therapist has edited the video, the video should be shared with the participants so they can both view themselves (or the model) engaging in the desired skill. This way, the client can regularly practice the desired skill outside of the therapy/educational setting(s). The seventh step encourages the music therapist to share the video via email, DVD, or other secured and confidential means. Moreover, the music therapist should consider sharing the video with all members of the participant’s education and treatment team so that other care providers can integrate what was depicted in the video as well as consider utilizing VM or VSM in their own work. The eighth step is for the facilitator to collect data on the effectiveness of the video and to make any changes to the script, supports, and approaches used to facilitate the desired skill.

Watch video “Sensory Regulation Demonstration”

Video modeling (VM) and video self-modeling (VSM) are techniques that can be utilized by any care provider to assist their student/client in acquiring, maintaining, and generalizing social, communication, behavior, motor, activities of daily living, or other skills. To fine-tune techniques and add verification of this approach, researchers should consider conducting research into the effects of integrating music therapy into VM and VSM for the development and maintenance of skills.


References Alley, J. (1980). The effect of self-analysis of videotapes on selected competencies of music therapy majors. Journal of Music Therapy, 17, 113-132. American Music Therapy Association. (2014). Professional competencies. Silver Spring, MD: Author. American Music Therapy Association. (2014). Standards of Practice. Silver Spring, MD: Author. Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall. Bellini, S. (2006). Building social relationships. Shawnee Mission, KS: Autism Asperger Publishing Company. Bellini, S. & Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Children, 73, 264-287. Brownell, M. D. (2002). Musically adapted Social Stories™ to modify behaviors in students with autism: Four case studies. Journal of Music Therapy, 39, 117-144. Buggey, T. (2009). Seeing is believing: Video selfmodeling for people with autism and other developmental disabilities. Bethesda, MD: Woodbine House, Inc. Darrow, A. A., Johnson, C. MN., Ghetti, C. M., & Achey, C. A. (2001). An analysis of music therapy student practicum behaviors and their relationship to clinical effectiveness: An exploratory investigation. Journal of Music Therapy, 38, 307- 320. Gray, C. (2004). Social stories 10.0: The new defining criteria. Jenison Autism Journal, 15, 1-21. Greenfield, D. G. (1980). The use of visual feedback in training music therapy competencies. Journal of Music Therapy, 17, 94-102. Hanser, S. B., & Furman, C. E. (1980). The effect of videotape-based feedback vs. field based feedback on the development of applied clinical skills. Journal of Music Therapy, 17, 103-112. Kern, P., Wolery, M., & Aldridge, D. (2007). Use of songs to promote independence in morning greeting routines for young children with autism. Journal of

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Autism and Developmental Disorders, 37, 1264-1271. Modeling [Def. 4]. (n.d.). Merriam-Webster Online. In Merriam-Webster. Retrieved from http:// National Autism Center. (2009). National Standards Project findings and conclusions: Addressing the need for evidence-based practice guidelines for Autism Spectrum Disorders. Randolph, MA: NAC. National Autism Center. (2015). Findings and Conclusions: National Standards Project, Phase 2. Addressing the need for evidence-based practice guidelines for Autism Spectrum Disorder. Randolph, MA: NAC. National Research Council. (2001). Educating children with autism. Washington, DC: National Academies Press. Schwartzberg, E. T., & Silverman, M. J. (2013). Effects of music-based social stories on comprehension and generalization of social skills in children with autism spectrum disorders: A randomized effectiveness study. The Arts in Psychotherapy 40, 331-337. About the Author Edward Todd Schwartzberg, M.Ed., MT-BC, is professor and music therapy clinic coordinator at the University of Minnesota. He teaches classes, conducts research, and provides private and group music therapy sessions for children with ASD and other neurological and physical disabilities through the OnCampus Music Therapy Clinic. Todd is also the current President of the Board of Directors for the Autism Society of Minnesota and Assembly Delegate for the Great Lakes Region of the American Music Therapy Association. Contact:


Museum: Community Spaces for Inclusive Learning Opportunities Nicole R. Rivera, Ed.D., MT-BC North Central College Edward P. Gallagher, MT-BC Beck Center for the Arts

Museums are important community spaces that provide opportunities for people to engage in dynamic learning experiences. Researchers who investigate learning in museums have described the learning as “free choice,” because the experience is typically directed by the individual or group in attendance (Falk & Dierking, 2013). For young children, the interaction with family, peers, and the exhibits all provide important opportunities for learning. Because of the open-ended nature of most exhibits, museums are ideal spaces for inclusive learning opportunities. In fact, many museums intentionally plan exhibit space and programs to facilitate inclusive experiences for young children (Golden & Walsh, 2013). There are also specific programs such as the Rock and Roll Hall of Fame and Museum’s Toddler Rock program, which represent important partnerships between museums, music therapists, and community agency. Museums and Free Choice Learning Researchers in the museum field define a “museum” as a free-choice or informal learning environment – a definition that includes a range of institutions such as children’s museums, traditional collections-based museums, zoos, aquariums, and arboretums (Falk & Dierking, 2013). The nature of a visit to a museum has been described by Falk and Dierking (2013) through their Contextual Model of Learning as one that focuses on

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personal, sociocultural, and physical aspects of the experience. In short, the experience of visiting a museum is unique to the visitor him- or herself, with those he or she visits the museum, and the nature of interactions with exhibits. Zollinger Henderson and Atencio (2007) make a case for museums as dynamic learning environments for young children based on four factors: 1) learning is social, 2) knowledge is integrated into the community, 3) the child is motivated to learn and participate in the community of practice, and 4) knowledge gained from the experience depends on engagement in the practice. The authors go on to make connections to constructivist ideas defined by the work of both Piaget and Vygotsky which emphasize the child’s active engagement in his or her own learning process as well as guided play experiences (Zollinger, Henderson, & Atencio, 2007). Many people in the museum community advocate for social inclusion. Social inclusion promotes “personal empowerment and increased creativity for the individual” in order to “enhance social engagement in [the] community” (Tazi, Vidal, & Stein, 2015, p. 159). Social inclusion initiatives may focus on individuals of specific racial/ethnic groups, socio-economic status, disabilities, or other groups, which may typically be underserved by


the general museum. The goals to facilitate inclusive opportunities are important to the development of both the individual child and the society. Families with Young Children with Autism Spectrum Disorder: Frequent Visitors to a Children’s Museum The DuPage Children’s Museum is located approximately 45-minutes outside of Chicago. The museum typically attracts over 300,000 visitors per year. The exhibits are designed to provide hands-on, open-ended learning experiences with a focus on science, technology, engineering, art, and math (STEAM) learning for young children. One of the unique features of the museum is the suburban location and high membership numbers. It is seen by many people as a “neighborhood” museum with many visitors that attend frequently. A study was completed to examine the experience of frequent visitors that attended the DuPage museum approximately 20 times per year (Rivera & Schacht, 2013). While the study had a small sample, one unique aspect of this sample was the fact that two of the ten families had a child who was diagnosed with Autism Spectrum Disorder. The families were interviewed regarding their patterns of visitation and perceptions of their child’s experience at the museum. Parents of both families talked about the importance of feeling that their child was accepted at the Children’s Museum. One mom stated, “…there are not that many places that if things go completely south, it’s ok.” She went on to describe how staff helped if her son exhibited challenging behaviors. She also felt safe at the museum because of the safety procedures and familiar staff. The sense of safety allowed her to have spontaneous and frequent visits to the museum. The learning experiences were also important to both parents. The other mother in the study shared that her son’s interests focused on “something he can manipulate and do with his hands.” Therefore, the large water table, bubbles, and construction areas attracted and held her son’s attention. Over time, the mother noticed an increase in persistence and more sophisticated play. She stated, “He will actually build these elaborate structures with the pipes to see where the water goes. So, I would definitely say the length of time that he spends has increased.” Additionally, frequent visits

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provided opportunities for her son to interact with other children. She observed him engaging in spontaneous verbal greetings and collaborative play with other children during museum visits. Promoting Inclusive Opportunities in Museums Many museums specifically focus on how to better serve children with disabilities and their families. Three Chicago area institutions provide examples of how museums can serve as inclusive spaces. The DuPage Children’s Museum mentioned in the previous section provides access to adaptive materials, free admission for personal care assistants, and suggestions for exhibit experiences. The museum also hosts the “Third Thursday” event in which they bring in representatives from disability-related organizations to provide access to community resources for families. The Chicago Children’s Museum has a long history of serving children with a wide range of learning needs (Golden & Walsh, 2013). In 2004, the museum made a concerted effort to examine their provisions of services for children with disabilities. Museum staff surveyed families about their perceptions of the museum, and the staff about their comfort in working with children with disabilities. Based on their inquiry, the team-based Play for All initiative was developed which provided for staff training, the integration of Universal Design for Learning principles for exhibit design and program staff, and the development of supportive structures such a visuals that were designed to support visitor experiences. The Chicago Zoological Society (Brookfield Zoo) provides a guide for visitors with disabilities, quiet space locations within the park, detailed visual supports, and social stories for various exhibits, and special programs such as Autism Awareness Day. As a partner of the National Inclusion Project, the zoo promotes opportunities for children with disabilities. The Project’s Let’s All Play program provides training and resources for their partners around to the country to promote inclusive practices in recreational spaces. Each of these dynamic programs represents a contemporary model of promoting inclusive opportunities in a museum. Intentional efforts across the different institutions provide staff training, thoughtful exhibit


design, adaptive resources, and specialized programming. Toddler Rock At the Rock and Roll Hall of Fame and Museum in Cleveland the young are welcomed with open arms as they take part in Toddler Rock, a weekly program that serves nearly 400 underserved children, ages 3-5, and teachers from Head Start programs. Since its founding in 1999, Toddler Rock has been meeting the Rock Hall’s mission to engage, teach, and inspire through the power of rock and roll by focusing on the development of music, social, and academic skills while participants experience every aspect of the museum. This collaborative program is led by Board- Certified Music Therapists and music therapy interns from University Hospitals Case Medical Center, Beck Center for the Arts, the Music Therapy Enrichment Center, and independent music therapists from the Cleveland area in coordination with the education staff of the Rock and Roll Hall of Fame and Museum (Gallagher, Lane, & Onkey, 2013). Each week participants are greeted at the main entrance by Rock Hall staff members who welcome them to another week of fun learning. Music therapists accompany the children and teachers to their session area which is within one of the many dynamic exhibit spaces in the museum. In each session the children take part in a variety of singing, instrument playing, movement, and listening experiences that expand each individual’s musical skills and knowledge. All genres of music are used with a unique emphasis placed on rock and roll. Social skills are increased through peer interaction, taking turns, following directions, and working together. Meanwhile, literacy and pre-reading skills are addressed through a multi-pronged approach of teaching four letters per 10-week session in upperand lower case, its hard sound, and a word that begins with the letter. Songs that teach letters and sounds are utilized with participants taking an active role in every step of the session. At this point, the museum becomes the central focus of programming. Each letter, studied over a two-week period, is paired with a Hall of Fame Inductee. For example, the letter “S” was the catalyst for the study and use of the music of 2015 Inductee, Stevie Ray Vaughan and Double Trouble.

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Listen to “The Letter S” Recorded 2015 by Ed Gallagher

Utilizing all aspects of the museum, the Toddler Rockers set out to learn while making the museum their own. They may spend time touring the “2015 Rock and Roll Hall of Fame Inductee Exhibit” where they view pictures, clothing, and instruments played by Stevie Ray Vaughan. Later, they may tour “The Roots of Rock and Roll” or “Cleveland Rocks” exhibits looking for the letter “S” in its upper and lower case form within the text that describe exhibits and, moving through the museum, they may learn about other “S” performers such as The Supremes or Ringo Starr as they view countless artifacts and videos. Students and teachers frequently immerse themselves in hearing select influential songs in the exhibit entitled “Experience the Music: One Hit Wonders and The Songs That Shaped Rock and Roll.” The museum truly belongs to each student when they take part in the program. This became quite apparent during the first two “Families Rock” days during which participants and families attended a special weekend program. It was here that the Toddler Rockers served as “tour guides” for their families as they showed them around the great expanse of exhibit space in “their” Rock and Roll Hall of Fame and Museum. Promoting Inclusive Opportunities in Museums Museums, which serve as anchors in the community, provide important opportunities for community integration and learning. Many museums are actively seeking to promote social inclusion and increase accessibility to visitors with disabilities, thus creating unique opportunities for music therapists. Music therapists can serve in an advisory role with local museums to help develop adaptive materials, promote museums as community learning spaces to families with whom they work, or seek to develop collaborative programming that utilizes museum exhibits to create learning opportunities similar to the Toddler Rock program.


References Gallagher, E., Lane, D., & Onkey, L. (2013). Toddler Rock: The backbeat of rock in early childhood. imagine, 4(1), 58-61. Golden, T., & Walsh, L. (2013). Play for all at Chicago Children's Museum: A history and overview. Curator, 56(3), 337-347. doi:10.1111/cura.12032 Falk, J., & Dierking, L. (2013). The museum experience revisited. Walnut Creek, CA: Left Coast Press, Inc. Rivera, N., & Schacht, P. (2013). Exploring the practices of frequent visitors to a children’s museum. (Unpublished Manuscript). Tazi, Z., Vidal, H., & Stein, K. (2015). Art together; Promoting school readiness among Latino children with parent engagement and social inclusion in a suburban museum. Museum & Society, 13(2), 158-171. Zollinger Henderson, T., & Atencio, D. J. (2007). Integration of play, learning, and experience: What museums afford young visitors. Early Childhood Education Journal, 35, 245-251. doi 10.1007/s10643-007.0208.1

About the Authors Nicole R. Rivera, Ed.D., MT-BC, holds a full-time faculty appointment in Psychology at North Central College in Naperville, IL. In addition to music therapy research, Nicole also maintains an active research agenda that focuses on informal learning experiences with the DuPage Children’s Museum. Contact:

Edward P. Gallagher, MT-BC is the Director of Education at Beck Center for the Arts in Lakewood, Ohio, where he founded Ohio’s first communitybased creative arts therapies program in 1994. He has taught in the early childhood program at Cuyahoga Community College and is a frequent presenter on the uses of music therapy and music in early childhood. Contact:

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Arts in the Garden: Creating and Collaborating within Nature Edward P. Gallagher, MT-BC Beck Center for the Arts Jennifer C. McDowell, CIG Cleveland Botanical Garden

A mother’s voice sings softly to a swaddled infant in her arms as she sways back and forth Rock a bye baby, On the treetop, When the wind blows, the cradle will rock… As the child grows, the father teaches a finger-play as they sing together Twinkle, twinkle little star How I wonder where you are…

From the moment children are born, they are welcomed into the world with song. Soothing melodies calm and comfort while many express connections to the natural world (Güneş & Güneş, 2012). It is inherent that arts and nature go hand in hand, and many artists of different genres look to nature for inspiration. One theory of the origin of Rock a Bye Baby (originally called Hush a Bye Baby) is an observation of Native American bark bassinets hanging in the trees and rocking in the wind, soothing baby to sleep. Twinkle Twinkle Little Star from English author Jane Taylor’s poem, “The Star,” reflects the wonders of the stars in the sky and how these beacons in the night sky light the way for travelers. Benefits of Nature Just as the arts may have a therapeutic effect, nature itself may also be healing and relaxing. Nature’s chorus of whispering wind, singing birds and insects, and trickling water can bring respite during a stroller walk or bicycle ride outside for children with and without disabilities alike. A groundbreaking study by Ulrich (1984) began looking into the physical and mental benefits to nature: reduced blood pressure, lower stress levels,

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and improved mood are just a few of the beneficial outcomes reported. In an age of technology, Louv (2005) writes about “nature-deficit disorder.” It seems like in the U.S. it is becoming more and more important to get children back outside and allow them opportunities to explore, discover, and learn in nature. Sobel (2008) also supports the notion of outdoor play. He explains principles of place-based education, linking curriculum, and renewing a sense of environmental stewardship as children play outside and appreciate nature. Once outside, children can stimulate their senses. Perhaps they build a fort with sticks, balance on a log, or search a pond for frogs. Maybe they choose to climb rocks and jump down, or listen to the sounds of birds, insects, water, and wind. These outdoor skills may encourage creativity, inspire, and foster imagination. Outdoor play is also becoming an important intervention setting for children of different abilities. Through newer techniques of nature-based child-centered play therapy (NBCCPT), councelors may maintain the important relationship and interaction with their client through the use of natural items as the therapeutic tools (Swank & Shin, 2015). Children may use their five senses to reconnect to the natural world and their relationship with other living things to aid in healthy development. For example, one case study involved an easily distracted child with disruptive behaviors. In part of the sessions, the child used natural items like sticks and tree cookies to create drumming rhythms that expressed different emotions and feelings including frustration. After the period of intervention with NBCCPT, the child showed improved on-task behaviors. The Intersection of Nature and the Arts Drawing upon the connection between nature and the arts is the focal point of Arts in the Garden, a collaborative summer program between two of Cleveland, Ohio’s leading arts and culture organizations – Cleveland Botanical Garden and Beck Center for the Arts. Founded in 1930, Cleveland Botanical Garden is home to 10 acres of outdoor gardens and the 18,000square-foot Eleanor Armstrong Smith Glasshouse. A recent integration with The Holden Arboretum in Kirtland makes the new entity the thirteenth largest public garden in the U.S. The Beck Center for the Arts is an 82-year old organization featuring theater, education, exhibits, outreach, and creative arts therapies. This partnership

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program, designed for young children between the ages of 2-6 and their adult family members, takes place in the outdoor environment of The Hershey Children’s Garden. The Garden is a unique space focusing on the child’s health and well-being that welcomes children to explore outdoor opportunities – it is here that participants are immersed in creating and experiencing the arts in nature. The Arts in the Garden program brings both cultural organizations together for a 4-week series. Children are involved in different art forms and hands-on experiences. Programming is co-led by Beck Center’s creative arts therapists and early childhood arts specialists alongside the Garden’s Education staff. Through the art forms of music, theater, visual arts, and dance/movement, the program encompasses the very essence of nature and the outdoors. For example: Music – Children play the rain stick while singing about spiders climbing a water spout. Theater – Children act out animals found in the garden and other natural environments. Visual Arts – Children explore bird nests and create their own woven patterns. Dance/Movement – Children begin as small seeds, and stretch and grow into a developed plant. When shared in Hershey Children’s Garden, traditional children’s songs take on new meaning. For example, She’ll Be Coming ‘Round the Mountain is morphed into singing about the children’s observations outside. Verses change to include hearing birds chirping, watering flowers, tip-toeing in grass, and splashing in puddles when participants sing “we’ll be splashing in the puddles when she comes.” For visual arts, children may explore the environment looking for bird nests in the trees and later have the opportunity to sit in a human-sized nest before designing a woven bird’s nest using art materials. Of course, the arts are related, and the four main areas of concentration are blurred when participants make and decorate their own shaking egg (e.g., a maraca-like instrument) and play it while acting out the roles of individuals playing in a summertime parade. The possibilities for children to create artistically are nearly limitless when surrounded by sun, shade, water, grass, and sand, encircled by a myriad of trees and flowers in the summer warmth. The stage is truly set for the freedom to create and express.


Listen to “Getting Our Garden Ready” Recorded 2015 by Ed Gallagher

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An overarching goal of Arts in the Garden is to encourage participation in the arts and nature for each child and adult that takes part in the program – especially after the program has ended. A weekly themed arts and nature sheet is distributed at the end of each session (see example of Getting our Garden Ready with song recording). Additionally, handouts provide ideas, lyrics, and directions for various activities (e.g., making wind chimes) and crafts that may be enjoyed at home. Family members offered positive feedback related to the materials, specifically because the resources afford reinforcement to concepts learned previously. My three-year old grandson really enjoyed the Art in the Garden program. He loves music and has already acquired the ability to sit through a concert. He participated in the activities combining the out of doors (walking over logs, etc.) with music and was eager to return for the next program. He loves to share what he learned about the instruments that were demonstrated. The take-home activities were unique and interesting, too, and help to integrate the program into the home environment…I would recommend the program for any preschooler. In a true collaborative spirit, Arts in the Garden served as a spring board for the creation of engaging and educational experiences for patrons of each organization. Cleveland Botanical Garden staff members join in the quarterly early childhood program Super Saturdays @ Beck Center, lead an artistic wreath making class, teach early childhood professional development sessions, and organize Garden-focused photo exhibits for Beck Center. Meanwhile, Beck Center staff lead interactive musical experiences during the Garden’s Halloween Boo-tanical Bash Celebration, conduct frame drum making workshops and provide creative staff for other programs. The multi-faceted collaboration continues to seek new ways to meet the nature- and artistic-focused needs of patrons from both Cleveland Botanical Garden and Beck Center for the Arts. The organizations recognize strength in partnering with another cultural institution that looks to broaden horizons through different, yet intersecting, subject matter.

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References Güneş, H., & Güneş, N. (2012). The effects of lullabies on children. International Journal of Business and Social Science, 3 (7), 316-321. Louv, R. (2005). Last child in the woods: Saving our children from Nature-Deficit Disorder. Chapel Hill, NC: Algonquin Books of Chapel Hill. McDowell, J. (2013). Arts in the Garden. Legacy - The Magazine of the National Association for Interpretation. 24(4), 30-32. McDowell, J., & Gallagher, E. (2014). Getting our garden ready. Beck Center for the Arts and Cleveland Botanical Garden. Sobel, D. T. (2008). Childhood and nature: Design principles for educators. Portland, ME: Stenhouse Publishers. Swank, J., & Shin, S. M. (2015). Nature-Based ChildCentered Play Therapy: An innovative counseling approach. International Journal of Play Therapy, 24(3), 151-161. Ulrich, R. (1984). View through a window may influence recovery from surgery. Science, 224(4647), 420-421. About the Authors Edward P. Gallagher, MT-BC is the Director of Education at Beck Center for the Arts in Lakewood, Ohio where he founded Ohio’s first communitybased creative arts therapies program in 1994. He has taught in the early childhood program at Cuyahoga Community College and is a frequent presenter on early childhood music therapy. Contact:

Jennifer McDowell, CIG is Director of Public Programs at Cleveland Botanical Garden in Cleveland, Ohio, and has been an informal science educator for nearly twenty years. Jennifer is an active member of the National Association for Interpretation as a Certified Interpretive Guide and serves on the organization’s regional board. Contact:


A Song of One Hand: Music Therapy and Constraint-Induced Movement Therapy Ilene Berger Morris, MM, LCAT, MT-BC St. Charles Hospital Port Jefferson, New York

Reflecting on the joys of childhood evokes scenes of engagement in playful activities – throwing and catching a ball, swimming, building sandcastles, baking cookies, drawing pictures, and playing a musical instrument, to name a few. These childhood pastimes are not only fun, but also play an important role in advancing and enhancing children’s development. For a child who suffers from upper extremity hemiparesis, participating in activities such as these may be difficult or even impossible. The condition is characterized by muscular weakness or partial paralysis affecting the arm and hand on one side of the body. Hemiparesis presents challenges to many aspects of early childhood development, often extending to participation in typical preschool routines. It potentially limits a child’s ability to write, use scissors, manipulate objects, or even perform common bilateral self-care tasks. Constraint-Induced Movement Therapy, or CIMT, is a therapeutic approach that has resulted in positive outcomes for people with hemiparesis due to cerebral palsy, stroke, and other central nervous system damage

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(Grotta et al., 2004; Shumway-Cook & Woollacott, 2007; Taub, Uswatte, & Pidikiti, 1999; Taub & Wolf, 1997; Teasell & Hussein, 2013; Wolf et al., 2006). The Development of Constraint Induced Movement Therapy The concept of CIMT was developed by Edward Taub and colleagues (Taub, Uswatte, & Pidikiti, 1999; Taub & Wolf, 1997) who found that the restoration of a paretic upper limb in primates could be induced by immobilizing the unaffected limb and training the affected limb. Current application of CIMT with children with cerebral palsy involves constraining the more functional upper extremity using a temporary cast or other immobilizing device for several hours daily over a period of 2 to 3 weeks, coupled with intensive training of the affected side with goal-oriented tasks (Matthews, Kaufman, & Knis-Matthews, 2008; Taub, Uswatte, & Pidikiti, 1999; Thompson, Chow, Vey, & Lloyd, 2015). CIMT seeks to counter the effects of “learned non-use,” a theory that suggests that as the individual increasingly relies on the fully-functional side, cortical representation of the


impaired side diminishes, inhibiting recovery (Charles & Gordon, 2005; Grotta et al., 2004; Sunderland & Tuke, 2005; Takeuchi & Izumi, 2012; Teasell & Hussein, 2013). Current research in neurological rehabilitation has yielded evidence that the brain is “plastic,” or able to reorganize itself in response to changes in situational factors and behavioral demands (Charles & Gordon, 2005; Grotta et al., 2004; Puh, 2012; Rice & Johnson, 2013; ShumwayCook & Woollacott, 2007; Whithall, McCombe, Waller, Silver, & Macko, 2001). CIMT induces synaptic connections by compelling the individual to use the impaired side, forcing the brain to adapt. Long-term improved function in the hemiparetic arm of children receiving CIMT has been reported in some of the literature (Matthews, Kaufman, & Knis-Matthews, 2008; Taub, Uswatte, & Pidikiti, 1999; Taub & Wolf, 1997; Wolf et al., 2006). At St. Charles Hospital, located in Port Jefferson, New York, CIMT is offered to qualifying children between the ages of 3 and 8 in the form of an intensive 3-week summer day camp. Specialty focus and selfimprovement camps are increasingly common in this region, making this context for therapy mainstream and natural. When the children arrive at camp in the morning, their stronger arm is placed in a temporary cast, restricting use of the limb for six hours. During the day, campers participate in a wide range of recreational activities, games, and sports designed to compel and train use of the weaker arm, hand, and fingers. A counselor/trainer is assigned to facilitate the participation of each camper. Campers’ abilities are assessed before camp begins, at the conclusion of the 3-week session and then again 6 months later, with increases in movement and functional use of the hemiparetic side typically seen over pre-camp baseline scores. One of a handful of CIMT camps in the country, St. Charles specifically incorporates music therapy into the program.

the CIMT camp schedule. These interventions encourage, train, and shape isolation of fingers, grasp, stability, dexterity and coordination, upper body movement in all planes of motion, and bilateral movements that relate to participation in activities of daily living – the skills that CIMT aims to improve. Therapeutic Instrumental Music Performance Therapeutic Instrumental Music Performance, or TIMP, is a Neurologic Music Therapy technique that shows promise for improving functional movement in people with hemiparesis (Yoo, 2009), and is frequently used at St. Charles’ CIMT camp. TIMP provides opportunities for massed repetitions of movements to improve motor strength and endurance and to reinforce motor learning through musical instrument play (Mertel, 2014; Rice & Johnson, 2013). In TIMP, therapeutic exercises and functional motor tasks are recast as music-making actions utilizing instruments. TIMP experiences give the music-maker auditory feedback directly related to the movement patterns employed in effecting sound. But the sound feedback received by TIMP participants does more than inform them about their movement patterns is highly rewarding and motivating. The children at CIMT camp love to interact with the instruments and determinedly keep at the task in order to create sound and be part of the music making. Because the effectiveness of CIMT is dependent on intensive training, consisting of multiple repetitions and practice trials of movements with the less capable arm/hand, it would seem that the motivation of playing instruments could contribute positively to compliance with the program and investment in the trials. Examples of TIMP activities and movements used in CIMT are outlined in Table 1. Grasping differently sized mallets and instruments Striking and sounding instruments using appropriate joint deviations, extensions and flexions Holding and shaking maracas and rhythm eggs Gripping and rotating cabasa

Research into the effects of music on rehabilitation of movement has shown that auditory rhythmic stimuli can prime, enhance, or promote motor responses and serve to elicit movement (Thaut, 2008). Like CIMT, music therapy can induce neural reorganization (Mertel, 2014; Schneider, Münte, Rodriguez-Fornells, Sailer, & Altenmüller, 2010; Thaut, 2008). At St. Charles, the music therapist creates musical activities, games, and instrument playing opportunities that are integrated into

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Picking up and releasing (letting go of) instruments for gauging grasp, motor control Supporting weight of instrument against gravity “Pinching” (pincer or lateral prehension) hold of plectrum, adjusting for resistance of guitar strings when strumming Clicking together halves of castanets for finger opposition/reposition Finger isolation through piano keyboard or deskbell play Reaching or striking instruments set at different angles or spatial planes for coordination, range of motion and endurance Passing instruments to fellow campers for balance and strength

Table 1: TIMP activities and movements


Case Example The director of St. Charles’ CIMT camp, Alannamarie Fassett, M.S., OTR/L., is a staunch supporter of music therapy in CIMT camp. She pointed out that, with music interventions, the children don’t need reminders from their counselors to make sure they actively use their weaker hand because “the instrument tells them.” The drive to engage in movements required to play instruments and follow directives related to music participation “is so innate” (A. Fassett, personal communication, April 21, 2015). Ms Fassett described the case of a camper, Arianna (name has been changed) who turned 4 during the 2014 camp season. Before the summer, Arianna's use of her right hand was very limited – it was primarily a stabilizer for actions she would perform with her left hand. She had trouble playing with toys, coloring with markers, and holding her own cup, achieving a total performance score of only 17 (out of 50) on the 5 functional parameters of the Canadian Occupational Performance Measure (COPM). Arianna loved the camp’s music activities, especially shaking the rhythm egg, striking the cymbal and drum with a drumstick, and working with a partner to support and balance the ocean disc before slowly tipping it to create the cascading wave sound. Her post-camp performance score was 35, more than double the baseline total. At her six-month follow-up, with on-going OT, Arianna exhibited right hand dominance, using what had been her weaker hand for writing, reaching, and grasping, and gained another 28% on the COPM (45). Ms Fassett was particularly gratified by a video shared by the child’s mother a few months after the follow-up, in which Arianna is seen tickling her baby sibling using both hands, wiggling all of her fingers with dissociated (isolated) movements, something she would not have been able to do before she attended camp. (A. Fassett, personal communication, April 21, 2015). For Arianna and her fellow campers, participating in music therapy and the other activities at CIMT camp is fun and natural, and an effective way to gain increased function, independence, and social inclusion.

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Secondary Gains Although the emphasis is on improvement in the functional movement domain, the type of atmosphere promoted in CIMT camps supports development in social and emotional domains as well. Improved social skills likely stemming from increased feelings of selfconfidence, self-esteem, independence, and motivation were reported at the end of the day camp experience (Gilmore, Ziviani, Sakzewski, Shields, & Boyd, 2010; Thompson, Chow, Vey, & Lloyd, 2015). Unlike individual therapy settings, the camp scenario is inherently social, and the children bond with each other as they experience both challenges and enjoyment together. Disabilities can be isolating, and the social as well as physical gains achieved through participation in CIMT camp can help to level the playing field, positively influencing how the children function in home, school, and community environments. Music can enhance a sense of social connectedness (Mazer, 2014), and the addition of music therapy at St. Charles seems to reinforce the social framework of the CIMT camp model, stressing ability and cooperation as music is created and shared by the group. The Music Train The Music Train is an intervention that exercises several functional movements successively in one group musical experience. Chairs are arranged in a train-like line, with a percussion instrument placed under each chair. The instruments are selected for the specific grips and movements required to hold and sound each one, as well as for playability with one hand. Once the children are seated in a chair, they pick up and play the instrument to the rhythm of the song “Music Train” led by the music therapist on guitar. The child’s counselor/trainer facilitates as necessary. Each verse gives the child practice in reaching to retrieve an object (instrument), adjusting hand position to accommodate its unique shape and weight, manipulating it in order to create music, and repositioning it under the chair for the next child. When the verse is over, the children move forward one chair on the train, with the child at the head of the line going back to the “caboose.”


The experience is repeated until the children are back in their original positions. This particular intervention gives each child a chance to make music in a variety of ways using a different type of movement per set. Other TIMP activities may concentrate on a particular muscle group with focused repetitions of a specific movement pattern. Need for Further Research In spite of the plausible compatibility of CIMT and music therapy, extremely little research serves as an evidentiary basis for this type of blended treatment approach. A Neurologic Music Therapy technique called Patterned Sensory Enhancement (PSE), in which sound patterns cue movements, was discussed in conjunction with CIMT (Massie, 2014). The research found that PSE improved functional capacity in the affected arm/hand of stroke patients and suggested that concepts from PSE and CIMT would integrate well, particularly when applied to tasks of a cyclical nature. Lim, Miller, and Fabian (2011) compared TIMP and standard occupational therapy (OT) in neurologic and orthopedic rehabilitation and found less perception of fatigue and exertion levels with TIMP. No research was found that examined the use of TIMP in conjunction with CIMT. The only study that looked at both active instrument playing and constraint-induced therapy (alternate term, abbreviated as CIT) in upper extremity recovery was a comparison/contrast between the two distinct approaches (Schneider et al., 2010). Music-supported training, in which functional movement exercises were carried out using an electronic keyboard (fine motor) and a drum set (gross motor), was superior to CIT in improving speed, precision, and smoothness of movements after stroke (Schneider, Münte, RodriguezFornells, Sailer, & Altenmüller, 2010). The success of the CIMT camp program at St. Charles Hospital, as well the limited available research, suggest that music therapy and CIMT are complementary modalities. One might hypothesize that combining TIMP and CIMT interventions will produce a cumulative therapeutic effect, compounding the benefits of the individual components, and it is hoped that research investigating this possibility will be undertaken.

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References Charles, J., & Gordon, M. (2005). A critical review of constraint-induced movement therapy and forced use in children with hemiplegia. Neural Plasticity, 12(2-3), 245-261. Gilmore, R., Ziviani, J., Sakzewski, L., Shields, N., & Boyd, R. (2010). A balancing act: Children’s experience of modified constraint-induced movement therapy. Developmental Neurorehabilitation, 13(2), 88-94. Grotta, J., Noser, E., Ro, T., Boake, C., Levin, H., Aronowski, J., & Schallert, T. (2004). Constraintinduced movement therapy. Stroke, 35, 2699-2701. Lim, H. A., Miller, K., & Fabian, C. (2011). The effects of therapeutic instrumental music performance on endurance level, self-perceived fatigue level, and self-perceived exertion of inpatients in physical rehabilitation. Journal of Music Therapy, 48, 124– 148. Massie, C. (2014). Patterned sensory enhancement and constraint-induced therapy: A perspective from occupational therapy to interdisciplinary upper extremity rehabilitation. In M. Thaut & V. Hoemberg (Eds.), Handbook of neurologic music therapy. (pp.


47-59). Oxford: Oxford University Press. Matthews, S., Kaufman, C., & Knis-Matthews, L. (2008). Camp Helping Hands: Addressing hemiplegia in children with cerebral palsy. OT Practice, 13(1), 12-16. Mazer, S. (2014). Health care. In W. Thompson (Ed.), Music in the social and behavioral sciences: An encyclopedia. (Vol. 8, pp. 540-544). Thousand Oaks, CA: Sage Publications, Inc. Mertel, K. (2014). Therapeutic instrumental music performance (TIMP). In M. Thaut & V. Hoemberg (Eds.), Handbook of neurologic music therapy (pp. 116-139). Oxford: Oxford University Press. Puh, U. (2012). Brain plasticity induced by constraintinduced movement therapy: Relationship of fMRI and movement characteristics. In R. Sharma (Ed.) Functional magnetic resonance imaging - Advanced neuroimaging applications (pp 131-148). Rijeka, Croatia: Intech. Rice, R., & Johnson, S. (2013). A collaborative approach to music therapy practice in sensorimotor rehabilitation. Music Therapy Perspectives, 31, 58-66. Schneider, S., Münte, T., Rodriguez-Fornells, A., Sailer, M., & Altenmüller, E. (2010). Music-supported training is more efficient than functional motor training for recovery of fine motor skills in stroke patients. Music Perception, 27, 271-280. Shumway-Cook, A., & Woollacott, M. (2007). Motor control: Translating research into clinical practice (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. Sunderland, A. & Tuke, A. (2005). Neuroplasticity, learning and recovery after stroke: A critical evaluation of constraint-induced therapy. Neuropsychological Rehabilitation, 15(2), 81–96. Takeuchi, N., & Izumi, S. (2012). Maladaptive plasticity for motor recovery after stroke: Mechanisms and approaches. Neural Plasticity, 1-9. Taub, E., Uswatte, G., & Pidikiti, R. (1999). Constraintinduced movement therapy: A new family of techniques with broad application to physical rehabilitation — a clinical review. Journal of Rehabilitation Research and Development, 36(3), 25-32. Taub, E., & Wolf, S. L., (1997). Constraint induced movement techniques to facilitate upper extremity use in stroke patients. Topics in Stroke

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Rehabilitation, 3, 38-61. Teasell, R., & Hussein, N. (2013). Background concepts in stroke rehabilitation. Evidence-Based Review of Stroke Rehabilitation, 3, 1-48. Thompson, A., Chow, S., Vey, C., & Lloyd, M. (2015). Constraint-induced movement therapy in children aged 5 to 9 years with cerebral palsy: A day camp model. Pediatric Physical Therapy, 27, 72–80. Whithall, J., McCombe Waller, S., Silver, K., & Macko, R. (2000). Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. Stroke, 31(10), 2390-2395. Wolf, S., Winstein, C., Miller, J., Taub, E., Uswatte, G., Morris, D., Giuliani, C., Light, K., & Nichols-Larsen, D. (2006). Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: The EXCITE randomized clinical trial. JAMA, 296(17), 2095-2104. Yoo, J. (2009). The role of therapeutic instrumental music performance in hemiparetic arm rehabilitation. Music Therapy Perspectives, 27(1), 16-24.

About the Author A music therapy clinician for over 30 years, Ilene "Lee" B. Morris, MM, LCAT, MT-BC lives and works in Suffolk County, Long Island, NY. Lee provides music therapy to young children and adolescents in special education settings, and to patients of all ages in a community hospital and rehabilitation center. Contact:


Using SMART Board® Technology in the Music Therapy Room to Enable Young Learners with Autism Spectrum Disorder Beth McLaughlin, LCAT, MT-BC Wildwood School Schenectady, New York

Visual Supports and ASD Visual supports (VS) are recognized as an effective protocol for young children with Autism Spectrum Disorder (ASD). It is an evidencedbased intervention that is used to organize the environment, establish behavioral expectations, and provide prompts for self-initiated response through the use of “concrete cues that provide information about an activity, routine, or expectation” (Wong et al., 2014, p. 104). VS include, but are not limited to, photographs, schedules, written words, or objects. They are important for children with ASD because VS provide a vehicle for social communication as well as an opportunity to increase activity repertoire and opportunities for selfdetermination. A visual schedule that depicts a sequence of learning tasks with time increments can help reduce anxiety and facilitate transitions between activities. Appropriate behaviors can be reinforced with a first/then board that uses pictures to pair a reward with a target behavior. Children with ASD use VS to communicate their

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needs, answer questions, make choices, and interact with their peers. Visual supports are widely used by music therapists working with young children with ASD. According to a national survey study (Kern, Rivera, Chandler, & Humpal, 2013), 81% of music therapists use VS in the form of pictures to support their interventions and optimize the learning environment. SMART Board® Technology in the Music Therapy Room Technology offers a variety of platforms and tools for developing visual supports that engage the child in learning and expand their interests. Augmentative and Alternative Communication (AAC) systems such as the iPad, Go-talk, and Dynavox® are widely used to address the daily communication needs of individual children with speech and language delays. A SMART Board® is an interactive whiteboard that allows the user to manipulate objects on a screen using touch technology. When used in a music therapy setting, children are able to generalize their

communication skills and interact with their peers. It is an effective tool for creating an environment that can address multiple goals in a group setting while teaching targeted skills to young children (Torreno, 2012). The SMART Board® is accompanied by SMART® Notebook software that provides resources and editing tools that allow educators and therapists to adapt and create virtual notebooks of lessons using visuals that can be projected onto a large screen. There is an extensive library of tools both within the program and online for downloading entire lessons that can then be adapted by the user. In 2014, the music therapy department at Wildwood School in Schenectady, New York was chosen to have a SMART Board® installed in their classroom. Because the music therapy program at Wildwood is structured to meet both the individual needs of children and instructional needs of groups, the music therapy staff custom design their SMART Board® sessions rather than utilize


the internal resources available within the software. The pictures used to create the visuals can come from any digital source. Photographs, downloaded public domain images, or drawings captured by the SMART Board® tool are all easily dragged onto the page then sized accordingly. They can be locked into place or remain movable depending on the session. They can be animated to spin, disappear, or magnify when touched. There are many other interactive features as well, too numerous to mention in this article. Interventions The music therapists at Wildwood School use the SMART Board® to create visual schedules, structure song writing and lyric completion activities, teach sequencing skills, and reinforce peer identification. Other skills that are addressed include attention and focus, selfdetermination, following directions, and turn taking. Three of these interventions are explained in more detail below. Transition, Sequencing, Taking Turns Each session begins with a visual schedule on the SMART Board® that includes four or five pictures depicting the sequence of activities for that particular session. The last icon in the sequence is a picture of the reinforcement to be given at the conclusion of the session. Depending on the season or theme, a large picture is placed in the center of the page to which the smaller icons are moved at the completion of each intervention. As they are moved into the larger

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picture, the smaller icons can be programmed to disappear. The children are highly motivated to move the icons into the ‘receptacle’ and will raise their hands to take turns to do so. This visual sequence of tasks helps children process what is coming next and facilitates their transitions between activities.

Making Choices, Using Visual Discrimination and Object Identification The drums pictured on the SMART Board® page are present in the music therapy session. The rectangles beneath the pictures indicate the number of each item that is available. Once all rectangles under a drum are filled with names, the students know that they need to make a different choice. After selecting the preferred instrument, the child is asked to independently find the drum that matches the picture chosen.

Following Multi-Step Directions, Attention and Focus, Peer Awareness, Taking Turns Five Little Ducks is an intervention that involves the child in a multistep task. A different child is pictured or named on the screen at the beginning of each verse to indicate whose turn it is at the SMART Board®. The lyrics cue the child to move the ducks “over the hill” at which point they disappear. The next step is to touch the icon that brings them to the next page on which a large duck is pictured. A loud “quack, quack, quack” sound has been linked to the duck that is activated by the child’s touch. Finally, the child completes his/her turn by touching the “duck” icon in the lower right hand corner to progress to the next verse of the song.

Benefits of SMART Board® Technology in the Inclusive Classroom Since more and more children with ASD are being educated in inclusive environments, an increasing number of educators and therapists are learning about the importance of using visual supports to “increase the understanding of language, environmental expectations, and to provide structure and support to students with ASD” (Harris, 2012). Having access to SMART Board®


technology provides the opportunity for individuals of all abilities to work together in an environment that recognizes the kinesthetic, visual, and auditory needs and strengths of diverse learners. The educator or therapist is able to create the visual supports needed for structuring a session and teaching a sequence of skills to enable all students to acquire new skills, demonstrate understanding, and express their own ideas. Sounds and words can be linked to the visuals that are activated by the child’s touch providing auditory cues that further engage the child. Children are able to make choices or answer questions using the interactive pens or with a simple finger touch. SMART Board® technology is inherently flexible and creative and enables the user to create meaningful and appropriate educational opportunities for all children while meeting their individual needs. Moreover, it helps to erase boundaries and build confidence so that all children, regardless of disability, are included in the learning experience. Finally, it facilitates generalization so that children are able to adapt and practice their skills across multiple environments.

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References Harris, A., (2014). Visual supports for students with autism. Retrieved from PD/newhorizons/Journals/ specialedjournal/Harris Kern, P., & Humpal, M. (Eds.). (2012). Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their families. Philadelphia and London: Jessica Kingsley Publishers. Kern, P., Rivera, N. R., Chandler, A., & Humpal, M. (2013). Music therapy services for individuals with autism spectrum disorder: A survey of clinical practices and training needs. Journal of Music Therapy, 50(4), 274-303. Torreno, S. (2012). Using SMART Boards® in special education classrooms. Retrieved from http:// special-ed-inclusion-strategies/ 55013-advantages-of-usingsmartboards-for-students-withspecial-needs/ Wong, C., Odom, S. L., Hume, K., Cox, A. W., Fettig, A., Kucharczyk, S., ... Schultz, T. R. (2014). Evidence-based practices for children, youth, and young adults with Autism Spectrum Disorder. Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-Based Practice Review Group.

Resources Giving Students with Special Needs a Change to Succeed arra/arra2011/11-0023ARRAUpdate-SMARTStory.pdf SMART Board® Literacy–Preschool v=BEskv8-sEk0 SMART® exchange #tab=0 Technology in Early Childhood Family Education Classrooms v=wOhb4n4ADbM About the Author Beth McLaughlin, MSE, LCAT, MTBC has been providing music therapy services to children of all ages at Wildwood School in Schenectady, New York, since 1981. She is a frequent presenter at regional and national music therapy conferences on the subject of special education and Autism Spectrum Disorder and is a regular contributor to imagine. Contact:


Understanding these issues, a community-based music therapy group for NICU graduates and their family members and caregivers was developed. The group was established to be safe and appropriate for immunosuppressed infants and toddlers to attend while taking into consideration their various ability levels and medical status. Other considerations included caregivers’ schedules, possible financial challenges, needs and wants surrounding the experience, and cultural differences. Most importantly, the group was designed to support the participants’ development and enhance bonding within the caregiver/family unit (Zelkowitz, Papageorgiou, Bardin, & Wang, 2009).

Groovin’ Grads: Establishing a Music Therapy Group for NICU Graduates Lelia Emery, MT-BC and Alejandra Ferrer, Ph.D., MT-BC NICU Music Therapist Nationwide Children’s Hospital Columbus, Ohio Following a lengthy hospitalization in the Neonatal Intensive Care Unit (NICU), infants and their families may face an array of challenges that preclude typical development, disrupt the family unit, and negatively impact the parents’ sense of well-being and autonomy. Often, the events that are considered a part of “normal childhood” (e.g., play dates, trips to the zoo, or attending structured community classes) get lost amid numerous doctor’s appointments, intensive physical, occupational, and speech therapy sessions, and the ongoing presence of a chronic illness. Parents of NICU graduates often experience high levels of stress and anxiety (OlshtainMann & Auslander, 2008), attempting to do everything possible so their infant will remain healthy and free of acute illness and hospitalization (Cho et al., 2012). Undoubtedly, such behaviors may lead to social isolation and contribute to an even more “atypical” childhood.

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Participants The infants and toddlers invited to participate in the group were NICU graduates from a free-standing children’s hospital who had been diagnosed with complex medical problems including bronchopulmonary dysplasia (BPD) and developmental delay. All of the invitees had been preemies, with gestational ages of 24-33 weeks at the time of birth, and all had been hospitalized for an extensive period of time. At the start of the group, all invitees were between 6 months and 2 years corrected gestational age. Some participants were immunosuppressed, and some were still receiving supplemental oxygen via nasal cannula, while other group members had tracheostomies. Almost all of the participants had a formal diagnosis of global developmental delay, speech and language delay, fine motor delay, gross motor delay, mixed receptive/ expressive language disorder, and/or cerebral palsy. The invitees were accompanied to the group by a variety of caregivers including parents, grandparents, other family members, home nursing staff, and early intervention teachers, all of whom spent a great deal of time with the child at home. Preparation Infection control guidelines specific to the group were developed prior to proposing the group to primary care physicians and hospital administrators who were concerned with the medical fragility of the NICU graduates. Examples of guidelines developed included ensuring that the instruments and props used would not be shared among participants, each child/caregiver dyad would have a designated sitting space defined by the


caregiver’s own blanket or mat, each dyad would be provided with a predetermined set of materials, and all instruments and props could be easily sanitized prior to and following the session. It was also stressed that caregivers would be required to contact their child’s primary care physician to verify if it was appropriate to participate in a group setting, and that parents would be regularly reminded to keep their child at home if signs of illness were present within the previous 24 hours. Additionally, groups would not be conducted during flu season. It was crucial that all involved understood that participant safety was the highest priority for the group. Determining an appropriate location for the sessions to take place was also of great importance. One of the infection control guidelines required participants to sit at least 3 feet away from each other, necessitating a large space to accommodate 12-15 child/caregiver dyads. A room in the hospital was chosen that supported emergency respiratory equipment, was in a non-patient area of the hospital, was easily accessible from the underground parking/security area, and was attractive and non-medicalized, with colors, curtains, and decorated walls to support a normalizing experience for the participants (Varni et al., 2004). Group Design and Session Structure As the group developed, it was important that participants had some level of control and input for the group. Research shows that parents and caregivers of children who have been hospitalized for a long period of time and remain medically compromised often experience a decreased level of autonomy and may feel as though they play a diminished role in their child’s life (Miles & Holdith-Davis, 1997). For this reason, the music therapists regularly sought feedback from group participants, administering brief surveys at the end of every group series. Questions included, “What is your favorite part of the group?,” “Are there other types of activities that you would like to see in our group?,” and “Has the group motivated you to use music at home?” Surveys also contained questions regarding best times and days for the group to take place. During the initial class series, group members were asked to vote on a name for the program, and chose to call the group “Groovin’ Grads.”

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Groovin’ Grads was designed with clear goals to enhance the overall development of the participants as well as support bonding between the caregiver and child. The developed curriculum reflects the influences many well-known music-based child/caregiver programs including Music Together®, Gymboree Play and Music®, Kindermusik®, and Bright Start Music (Walworth, 2013). While these previously established curricula served as guiding examples, the music therapists leading the group carefully tailored each component to specifically target developmental milestones as specified by the American Academy of Pediatrics (2015), while also addressing the unique needs of each child in attendance. Each group session lasted 45 minutes, beginning with a Hello Song followed by lap songs, instrument/object exploration, movement and dances, body awareness activities, book reading, affection/bonding experiences, and a goodbye song (see Figure 1). During each session, a specific theme was explored and reinforced. Examples of themes included animals, colors, numbers, nature, languages, and world cultures. In addition, basic baby sign language was incorporated into portions of the sessions, as many of the participants were using sign language to communicate with others, some as a temporary bridge to spoken language, and others as a permanent mode of communication. Throughout the session, caregivers were encouraged to be as engaged as possible with their child, providing hand-over-hand assistance, offering choices, supporting their child in sitting or holding them in their lap, providing reinforcement, and participating in all activities. To enhance the music interventions and support the achievement of developmental milestones, materials appropriate for infants and toddlers were used, including instruments (shakers, ocean drums, rain sticks, drums, bells, castanets, and tambourines), manipulatives (animals, puppets, and balls), and other visual aids such as picture books, art cards, and felt picture boards. In addition to the group sessions, participants were given a number of resources and educational handouts to encourage and optimize the use of music at home. These handouts included song titles and lyrics to familiar and original children’s songs, simple music-based activities that the caregiver could implement, and websites with additional information on how to use sign


language with their child. Reception from Participants Outcomes from clinical surveys distributed at the end of each 8-week class series showed that caregivers treasured the social aspects of the group and engaged in the experience not only for its enjoyable, educational, and meaningful nature, but also for the opportunity to interact with other parents and caregivers who were facing similar situations. Caregivers commended the strict measures taken to promote safety, citing that community groups of a similar nature often lacked such measures and therefore deterred them from taking their child. Within their comments, caregivers showed appreciation for the diversity of the experiences offered, with “singing” and “playing instruments” mentioned as top favorites. All of the families and caregivers involved reported an increased use of music at home.

Table 1: Sample Session Plan – Week One of Colors/Featured Signs: Red, Eat

Conclusion Caring for an immunosuppressed child after a long hospitalization can be incredibly isolating and stressful to parents and caregivers. Multiple challenges, including overwhelming medical and social restrictions placed on the family unit in order to keep the child healthy, can significantly impact typical childhood development and everyday experiences. A music therapy group specifically designed for this population can assist in increasing the caregiver’s feelings of autonomy and belonging while also promoting child/caregiver bonding and the child’s overall development. The group

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described here offered a normalizing, “typical” experience of early childhood to the participants. It served as a meaningful, unifying, and enjoyable time for all involved, and hospital administrators viewed the group as an important component in continuity of care for the hospital’s most fragile patients. As the need for specialized services for NICU graduates grows as medical advancements lead to increased survival rates for premature infants, hospitals and outpatient clinics across the nation can implement similar groups to improve long-term developmental outcomes for these children and their caregivers.


References American Academy of Pediatrics. (2015). Ages and stages. Retrieved from http:// Pages/default.aspx Cho, J. Y., Lee, J., Youn, Y. A., Kim, S. J., Kim, S. Y., & Sung, I. K. (2012). Parental concerns about their premature infants' health after discharge from the neonatal intensive care unit: A questionnaire survey for anticipated guidance in a neonatal follow-up clinic. Korean Journal of Pediatrics, 55(8), 272-279. Miles, M. S., & Holditch-Davis, D. (1997). Parenting the prematurely born child: Pathways of influence. Seminars in Perinatology, 21(3), 254-266. Olshtain-Mann, O., & Auslander, G. K. (2008). Parents of preterm infants two months after discharge from the hospital: Are they still at (parental) risk? Health and Social Work, 33(4), 299-308. Varni, J. W., Burwinkle, T. M., Dickinson, P., Sherman, S. A., Dixon, P., Ervice, J. A., …Sadler, B. L. (2004). Evaluation of the built environment at a children’s convalescent hospital: Development of the pediatric quality of life inventory parent and staff satisfaction measures for pediatric health care facilities. Developmental and Behavioral Pediatrics, 25, 10-20. Walworth, D. (2013). Bright start music: A developmental program for music therapists, parents, and teachers of young children. Silver Spring, MD: American Music Therapy Association. Zelkowitz, P., Papageorgiou, A., Bardin, C., & Wang, T. (2009). Persistent maternal anxiety affects the interaction between mothers and their very low birthweight children at 24 months. Early Human Development, 85(1), 51-58.

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About the Authors Lelia Emery, MT-BC received her music therapy degree from the University of Alabama and is a NICU Music Therapist at Nationwide Children’s Hospital in Columbus, Ohio. Prior to her current position, Ms. Emery worked at Gymboree Play and Music where she led music and play classes for infants, toddlers, and their caregivers. Contact:

Alejandra Ferrer, PhD, MT-BC is Program Coordinator and Assistant Professor of Music Therapy at Belmont University in Nashville, TN. Dr. Ferrer has experience working with a variety of clinical populations including neonatology, oncology, mental health, and Alzheimer’s/ dementia. Alejandra is an active presenter in regional and national music therapy conferences on topics pertaining to medical music therapy, program development, and professional issues.


Collaborative Music Playgroups to Support Early Learning and Language Development Evelyn C. Pinder, MM, MT-BC and Meghan Sims, MA, CCC-SLP Progressive Pediatric Therapy Services Tallahassee, Florida Introduction From birth through early childhood and beyond, music therapy playgroups are used to facilitate daily living skills in every developmental domain including motor skills, pre-academic and academic skills, cognitive skills, and emotional regulation. Through group music intervention, young children develop strategies for successful peer interaction, giving participants the opportunity to increase receptive and expressive

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language skills and social skills. Since language and social skills directly correspond with treatment domains of speech-language pathologists (AMTA & CBMT, 2011; ASHA, 2007), music therapy playgroups present a unique opportunity for collaboration. By establishing a collaborative relationship and facilitating music therapy playgroups using a cotreatment model, music therapists (MTs) and speech-language pathologists (SLPs) have the ability

to increase engagement of young children in the development of language and social skills and provide an inclusive environment in which children with disabilities demonstrate full participation. Building Cross-Disciplinary Relationships MTs are trained to build rapport with clients and clients’ families or caregivers, and these same skills can be used to foster relationships across disciplines. It seems to be a


music therapist’s second nature to approach these cross-disciplinary interactions with the intention to educate colleagues on the benefits of this innovative profession. But developing a relationship of mutual respect starts with a shared interest: the wellbeing of each client. Collaboration can begin by discussing treatment goals, successful interventions, or techniques for serving challenging clients. As speech and music share common elements including breath support, rhythm, rate, frequency, frequency range, and diction (Cohen, 1994; Lim, 2010), MTs and SLPs can discuss successful non-music interventions to adapt for music therapy, as well as successful music interventions to adapt for speech therapy. During playgroup collaboration, this foundation of mutual respect ensures participants are receiving the best possible intervention for increased language and social skills. Co-Treatment Groups for Increased Language Skills Research shows that music therapy intervention strategies are effective in increasing articulation (Zoller, 1991; Hurkmans et al, 2015) and increasing expressive and receptive language skills (Miller, 1982; Tomaino, 2012). These group intervention strategies allow participants to repeatedly practice articulation and language skills within one music activity, compared to nonmusic activities where repetition seems unnatural after a certain point (Geist, McCarthy, RogersSmith & Porter, 2008). In group

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music therapy settings, singing with guitar playing works to structure language-based activities by providing a familiar, predictable framework for eliciting appropriate responses among group participants. As a co-facilitator, the SLP enhances the group music therapy intervention by providing appropriate prompts, using handover-hand assistance, and posing follow-up questions for increased comprehension. In the spirit of collaboration, the roles of the MT and SLP are regularly reversed; the SLP provides a non-music structured intervention while the MT reinforces playgroup participants using various techniques.

Clinical example: Group participants took turns sorting vehicles into three categories: air, land, and water. The SLP sat in front of each child during his or her turn and prompted participants to choose from a field of two or three developmentally appropriate pictures. The MT structured the activity by playing guitar and singing the directions. To the tune of Frère Jacques: “Find the boat, find the boat, Here we go, here we go, Put it on the water, put it on the water, here we go, here we go.”

Co-Treatment Groups for Increased Social Skills In the same way singing gives children the opportunity for multiple repetitions of a skill during one activity, social music therapy

intervention strategies give children the opportunity to observe and practice social skills within a single activity. A study by Kern and Aldridge (2006) found that incorporating music interventions into a child’s environment facilitated play and social interaction. Children were attracted to the sound of the instruments and took the opportunity to play the instruments themselves. The research goes on to state that a collaborative approach enhanced the outcome by giving collaborators the tools to facilitate the musical adaptation of the environment. MTs’ and SLPs’ combined training in assessing musical, social, and language skills, works in tandem to facilitate interest in music activities and facilitate social and play interactions (Duffy & Fuller, 2001; Geretsegger, Elefant, Mössler, & Gold, 2014; Seybold, 1971).

Clinical example: Group participants took turns playing an ocean drum. The MT sang a familiar song with accompaniment, modeled appropriate use of the instrument, and cued participants to pass the instrument to a neighbor. The SLP supported each participant by prompting eye contact, expressive language, social interaction, and appropriate use of pronouns to verbalize, “It’s your turn.”

In this example of a co-treatment group intervention, the MT provided musical structure while


the SLP simultaneously transferred social interaction skills by facilitating spontaneous communication among participants. This model also allowed the MT and SLP to adapt collaborative social activities to meet the developmental skill level of each participant.

Co-Treatment Groups for Inclusion In contrast to individual music therapy, group music therapy has the added benefit of incorporating peer models. Research has long supported the use of peer models for increased motivation and the development of cognitive skills (Dammon, 1984; Schunk, 2011). Music therapy playgroups give children with disabilities the opportunity to observe typically developing peers and practice daily living skills in a structured and predictable music intervention. In a co-treatment model, the MT structures a music intervention by singing with accompaniment, giving each participant the best opportunity to predict an appropriate response and demonstrate increased participation. Meanwhile, the SLP provides one-to-one support for participants who require it. This support fades as individual participants develop independence and master targeted social and language goals. With support from the MT and SLP,

Clinical example: Children engaged in a cooperative play activity using a parachute. The MT provided musical structure and cued group participation through direction following, while the SLP prompted individual participants to go under the parachute and give a neighbor a high five.

children with disabilities observed typically developing peers demonstrating full participation and

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having fun. Together, the SLP and the MT assessed which children would benefit from peer observation and supported those participants to elicit full engagement. Conclusion Because music therapy playgroups work to develop language and social skills in young children, they present a unique opportunity for collaboration with SLPs. MTs should strive to build and maintain relationships with cross-disciplinary colleagues, not only to increase education on the benefits of music therapy, but also to develop mutual respect for the purpose of implementing a co-treatment model. During music therapy playgroups, this co-treatment model enhances mastery of language and social skills for young children and gives children with disabilities the opportunity for full inclusion.

References American Speech-LanguageHearing Association (ASHA). (2007). Scope of practice in speech-language pathology. Retrieved from http:// SP2007-00283/ Certification Board for Music


Therapists (CBMT). (2011). CBMT scope of practice. Retrieved from upload/CBMT_SOP_2011.pdf Cohen, N. S. (1994). Speech and song: Implications for therapy. Music Therapy Perspectives, 12(1), 8-14. doi: 10.1093/mtp/ 12.1.8. Dammon, W. (1984). Peer education: the untapped potential. Journal of Applied Developmental Psychology, 5(4), 331-343. doi: 10.1016/0193-3973(84)900066. Duffy, B., & Fuller, R. (2001). Role of music therapy in social skills development in children with moderate intellectual disability. The Journal of Applied Research in Intellectual Disabilities, 13(2), 77-89. doi: 10.1046/j. 1468-3148.2000.00011.x. Geist, K., McCarthy, J., RogersSmith, A., & Porter, J. (2008). Integrating music therapy services and speech-language therapy services for children with severe communication impairments: A co-treatment model. Journal of Instructional Psychology, 35(4), 311-316. Geretsegger, M., Elefant, C., Mössler, K., & Gold, C. (2014). Music therapy for people with autism spectrum disorder. Cochrane Database of Systematic Reviews, 2014. doi: 10.1002/14651858.CD004381. pub3. Hurkmans, J., Jonkers, R., de Bruijn, D., Boonstra, A. M., Hartman, P. P., Arendzen, H., & Reinders-Messelink, H., A. (2015). The effectiveness of

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speech–music therapy for aphasia (SMTA) in five speakers with apraxia of speech and aphasia. Aphasiology, 29 (8), 939-964. doi: 10.1080/02687038.2015.10065 65. 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. The Journal of Music Therapy, 43(4), 270-294. doi: 10.1093/ jmt/43.4.270. Lim, H. A. (2010). Effect of developmental speech and language training through music on speech production in children with autism spectrum disorders. Journal of Music Therapy, 47(1), 2-26. doi: 10.1093/jmt/47.1.2. Miller, S. (1982). Music therapy for handicapped children: Speech impaired. Project Monograph Series. Washington, DC: National Association for Music Therapy. Schunk, D. H. (2011). Self-efficacy and academic motivation. Educational Psychologist, 26(3-4), 207-231. doi: 10.1080/00461520.1991.96531 33. Seybold, C. D. (1971). The value and use of music activities in the treatment of speech delayed children. The Journal of Music Therapy, 8(3), 102-110. Tomaino, C. M. (2012). Effective music therapy techniques in the treatment on nonfluent

aphasia. Annals of the New York Academy of Sciences, 1252, 312–317. doi: 10.1111/j. 1749-6632.2012.06451.x. Zoller, M. B. (1991). Use of music activities in speech-language therapy. Language, Speech, and Hearing Services in Schools, 22, 272-276. doi: 10.1044/0161-1461.2201.272. About the Authors Evelyn C. Pinder, MM, MTBC is a graduate of Samford University and Florida State University. She develops and facilitates music therapy programs for the Tallahassee community, and provides group and individual music therapy services for a variety of populations. Contact:

Meghan Sims, MA, CCC-SLP graduated from University of Central Florida and currently works in pediatrics. She specializes in treating speech, language, and feeding disorders in individual and group settings.


Embedding Music in the Early Childhood Inclusion Classroom: Contributions of Music Together® Teachers Carol Ann Blank, LCAT, LPC, MMT, MT-BC

Inclusion means that all individuals, regardless of apparent ability, participate in cultural, societal, and family activities and practices together (DEC/NAEYC, 2009). Music Together’s® philosophy of “accept and include” naturally promotes inclusion, especially in daycare and preschool settings. However, accommodated experiences of music should not be limited to time when the music specialist comes to the classroom. In fact, according to the joint statement on inclusion by the Division of Early Childhood and the National Association for the Education of Young Children (2009), inclusion practices “…support the right of every infant and young child…to participate in a broad range of activities and contexts as full members of communities…” (DEC/NAEYC,

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2009, p.1). Singing, dancing, creative movement with props, and playing instruments are basic experiences of music that are easily incorporated into the early childhood inclusion classroom and other environments by music therapists, early childhood educators, and family members. Song as Ritual Singing a song at the beginning of the day ritualizes the moment of transition from home to school and helps focus the experience of being in the classroom community. Singing songs such as Hello Everybody is a good way to greet classmates and practice the mechanics of greetings. For example, once the class is familiar with the song, each child could learn to sing the first phrase to their neighbor: “Hello Samir, so glad to see you.” Samir would then sing

back to his neighbor, “Hello Jennifer, so glad to see you, too.” In this way, each child has a chance to be the greeter and the recipient of the greeting. Children who require multiple repetitions to learn a task receive many opportunities to see and experience the greeting sequence. Combine singing with customary waving and hand shaking, and the simple beginningof-the-day song becomes a full lesson in social conventions of greeting peers. Watch video “Hello Everybody”

Songs with Instructive or Informational Content Songs can also be paired with instructions about activities of daily living. All Around the Kitchen is an example of a song that explains the


function of a kitchen while encouraging appropriate and playful use of kitchen tools and food. By pairing the classroom discussion of the kitchen with the song, children might find their way into imaginative play in the play kitchen during center time. Watch video “All Around the Kitchen”

A Safe Space for Dance and Movement Dancing and creative movement with props can be fun-filled class activities, and, with some attention to detail, each child in the inclusion classroom can participate in these experiences successfully. Children may find that dancing inside their own hula hoop placed on the floor helps to prevent accidental, unexpected physical contact with peers. Alternatively, the Octaband® is an option for creative movement props that encourage children to maintain a safe distance from each other. The ends of the “arms” of the Octaband® have loops for easy gripping. The connecting circle in the Octaband® provides a visual cue and a place for each child to move in a circle. Watch video “Octaband®”

Child-Initiated Music: Singing and Instrument Playing The right to participate in music making also extends to childinitiated singing and instrument playing. An example of childinitiated music making is spontaneously singing songs that

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were previously learned or creating new songs. Children with expressive communication delays may engage in spontaneous singing as a an attempt to communicate in a musically enriched environment. An example of child-initiated musicmaking is demonstrated in the following video. A class of preschoolers who are Deaf are engaging in an experience of sticks with their early childhood educators and a Music Together® trained music therapist. One child is offered the opportunity to choose how the sticks will be used in the next verse. After several moments, the child indicates that he wants to highlight the fact that his sneakers will light up if he stamps his feet. He leads the class in a verse of the song with his unique contribution. Watch video “Sticks”

Furnishing a “Music Center” Finally, the preschool classroom’s music center is where child-initiated music making can occur. With the freedom to choose from a variety of instruments and movement props, children can explore music and movement on their own and with peers. The instruments themselves should be of high quality, with different timbres to choose from (i.e., wooden, metal, jingle, shake, scrape, strike). It is also a good idea to include a pair of noise canceling head phones to allow children who have sensory issues to participate. All instruments should be positioned in a way that encourages easy selection and reach. Clean up of the music center is made easier

by using labels and pictures to assist children in returning instruments and props to their proper place. Making music together is possible in an early childhood inclusion classroom that is set up in a specific way and offers music activities that provide opportunities for all children to learn.

References DEC/NAEYC. (2009). Early childhood inclusion: A summary. Chapel Hill, NC: The University of North Carolina, FPG Child Development Institute. Retrieved from http:// resources/articles/ Early_Childhood_Inclusion_Sum mary About the Author Carol Ann Blank, MMT, MT-BC, doctoral candidate at Drexel University, is Manager of Special Needs Services at Music Together LLC in Princeton, New Jersey. Contact:


Caring for the Caregiver: What Practitioners Need to Know about Parents and Caregivers of Children with Special Needs Adrienne Steiner University of Louisville Louisville, Kentucky

Music therapists in the early childhood field often work closely with the parents and caregivers of the clients they serve. The focus of treatment is mainly on the needs of the child, however, parents and caregivers may have their own challenges. As these adults play an important role in their child’s therapeutic progress, their challenges cannot be ignored. This article reviews literature related to caregivers of those with special needs, including complex medical needs, and provides clinical suggestions on how to address the needs of clients’ parents or caregivers to maximize progress for their children. Patient and Family Centered Care A recent focus within American healthcare has been advancing “patient and family centered care,” also referred to as “person and family centered care.” According the Institute for Patient-and Family-Centered Care,, “[it] is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families.” The approach recognizes the importance of families in the well-being of those of all ages along with promoting this well-being among individuals and their families so that dignity is restored and control over health oriented decisions is given (Institute for Patient-And Family Centered Care, 2015).

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This focus on patient and family care has changed many aspects of the relationships formed during service delivery and has allowed clinicians to take into consideration all aspects of clients’ lives during treatment, including their caregivers. According to the Family Caregiver Alliance, there are two types of caregivers: formal and informal (Family Caregiver Alliance, 2012b). Formal caregivers are those individuals who are paid to provide care in one’s home or a care setting, while informal caregivers are those unpaid individuals involved in assisting others with activities of daily living and/or medical tasks (Family Caregiver Alliance, 2012b). Both formal and informal caregivers can experience negative effects. Demerouti (as cited in Hilliard, 2006, p. 395), defined burnout, a common concern for formal caregivers, as “a syndrome of feeling emotionally exhausted and having a sense of inability to feel satisfied with work performance.” Informal caregivers may experience considerable atypical stress that impacts physiological and psychological functioning (Vedhara, Shanks, Anderson, & Lightman, 2000), as well as increased amounts of frustration, anxiety, exhaustion/ anger, depression, and substance use, reduced immune response, poor physical health, more chronic medical conditions, and higher mortality rates (Family Caregiver Alliance, 2012a). In literature comparing caregivers and


non-caregivers, Vedhara, Shanks, Anderson, and Lightman (2000) found significant decreases in levels of subjective well-being, physical health, and self-efficacy in caregivers. Another difference between caregivers and non-caregivers is in the increased rates of depression and stress among caregivers (Pinquart & Sorensen, 2003). Such findings provide evidence that adults acting as caregivers experience higher stress in daily activities as compared to individuals not caring for another person. Caring for Children with Special Needs In the Caregivers of Children report from the National Alliance of Caregiving in 2009, results indicated caregivers of children with special or medical needs spent 29.7 hours providing care versus approximately 11 hours of caregiving duties by their counterparts caring for those 18 years or older. This is partially attributed to the immense amount of time caregivers of children spend in supportive services, which may include the following: monitoring the child’s condition, ensuring that others know how to deal with the child, advocating on behalf of the child with schools, government agencies, and other care providers, and attending physical and medical therapies (National Alliance for Caregiving, 2009). The duties of those who are caregivers for children with special needs present challenges and effect health. Within the National Alliance for Caregiving’s Report (2009), findings indicated that although caregivers of children with special needs are younger, they report lower health ratings. For instance, caregivers of children with special needs more commonly experience high levels of physical strain than caregivers of adults. For those who have a child with cerebral palsy, this includes back pain, migraines, and stomach/intestinal ulcers (National Alliance for Caregiving, 2009, Murphy, Christian, Caplin, & Young, 2007). The emotional stress of caregivers of children and adults is comparable (National Alliance for Caregiving, 2009). Hastings and Beck (2014) noted stress and mental health needs, specifically depression, were common in parents of children with intellectual disabilities. In Murphey and colleagues’ (2007) investigation of the health of caregivers for children with disabilities, the literature indicated high levels of anxiety, anger, guilt, frustration, sorrow, social isolation, sleep deprivation, and

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depression of parents who had a child who was technology dependent and a higher correlation between increased levels of distress with increased hours spent on caregiving duties. For those who have children who are considered medically complex, a 2011 study by Kuo quantified some of the caregivers’ burden profile with ten or more physician visits occurring over a twelve month period, higher unemployment rates of parents due to caregiving duties, and spending more then $1000 out-ofpocket for health care annually. With the rate of childhood disabilities rising 16% between 2001 and 2011 (Houtrow, Larson, Olson, Newacheck, & Halfon, 2014), the challenges faced by caregivers of children with special needs will continue to be a pressing concern. Music Assisted Relaxation for Caregivers in a Medical Setting In a study by Steiner (2014) with caregivers of hospice and palliative patients, music assisted relaxation was the preferred music therapy intervention. This selection was based on previous research supporting music for counteracting stress response (Pelletier, 2004; Yehuda, 2011; Elliott, Polman, & McGregor, 2011), the evidence for using meditation and relaxation techniques in decreasing pain (Teixeira, 2008) and stress (Jain et al., 2007), and the use of progressive muscle relaxation in music therapy practice (Choi, 2010; Robb, 2000). The sessions conducted during the study were family-based, meaning caregivers were encouraged to take part in the proposed intervention with their loved one. If the patient was cognizant, he/she was encouraged to participate, however data were only collected on the caregivers present. Caregivers ranged in age and gender as well as if they were the primary caregiver to the patient or a secondary caregiver. The results indicated that the music assisted relaxation decreased caregivers’ behavioral stress responses such as tense muscles, tense brow, high shoulders, low eye gaze, frown, and watery eyes and increased perception of their relaxation state. A majority of participants of participants (with 53.5% and 25% strongly agreeing) indicated via post session survey that they would try a similar relaxation technique on their own (Steiner, 2014).


Music Assisted Relaxation for Caregivers of Children with Special Needs Caregivers of children with special needs experience similar stress and health issues as do caregivers of other populations. Research is needed to provide evidence of the effects of music-assisted relaxation for parents and caregivers of children with special needs. The script outlined in Figure 1 had positive outcomes for caregivers of hospice and palliative patients and may be effectively transferred to those who care for children with special needs (Steiner, 2014). The “Loving-Kindness” music assisted relaxation script (MP3 recording) is an example that could be utilized to promote self-care in parents and caregivers of young children with disabilities.

Parent Support Group Example A caregiver support group was established at the University of Louisville’s music therapy center. While parents took part in the music assisted relaxation for caregiver intervention, students offered age- and developmentally-appropriate games and instrument play to their children in a separate room. This support group was offered under a separate billing code from the child’s session and for the rate the clinic typically uses for groups. Though parents appreciated the offer, scheduling and logistical difficulties were major concerns, despite having a place for their child to go. As an alternative, the following Loving-Kindness recording (with brief suggestions on how to use it) was distributed to parents. Listen to the “Loving-Kindness Script” Recorded 2015 by Adrienne Steiner

The benefits of a parent support group may be manifold. Several authors discuss parent support models (e.g., Hasting and Beck, 2004) that could be modified to music therapy-based parent support groups. For example, parent support groups could be offered in a secured online forum. Music therapists could either encourage parents of children with similar needs to connect with each other to share experiences and resources or offer educational sessions including information and tips for using music intentionally with their children at home.

Figure 1. Relaxation script for parents and caregivers of children with special needs

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In conclusion, the well-being of the parents and caregivers of children with special needs is an important aspect of a child’s intervention plan. Caregivers’ needs should be considered in relation to the patient- and family-centered care model. Giving caregivers resources for self-care or a support group may positively affect the progress of children with special needs.


References Choi, Y. K. (2010). The effect of music on progressive muscle relaxation on anxiety, fatigue, and quality of life in family caregivers of hospice patients. Journal of Music Therapy, 47, 53-68. Elliott, D., Polman, R., & McGregor, R. (2011). Relaxing music for anxiety control. Journal of Music Therapy, 48, 264-288. Family Caregiver Alliance. (2012a). Caregiving issues and stress. Retrieved from caregiver/jsp/content Family Caregiver Alliance. (2012b). Selected caregiver statistics. Retrieved from selected-caregiver-statistics Green, R. (2014). Loving-kindness guided meditation script. Retrieved from ei-mindfulness-meditation/2012/4/2/3-lovingkindness-guided-meditation-script.html Hilliard, R. E. (2006). The effect of music therapy sessions on compassion fatigue and team building of professional hospice caregivers. The Arts in Psychotherapy, 33, 395-401. Houtrow, A. J., Larson, K., Olson, L. M., Newacheck, P. W., & Halfon, N. (2014). Changing trends of childhood disability, 2001-2011. Pediatrics, 134(3), 530-538. Institute for Patient-And Family-Centered Care (2015). Frequently asked questions. Retrieved from http:// Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., & Schwartz, G. E. R. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33, 11-21. Murphy, N., Christian, B., Caplin, D, & Young, P. (2007). The health of caregivers for children with disabilities: Caregivers perspectives. Child: Care, Health and Development, 33(2), 180-187. National Alliance for Caregiving. (2009). Caregiving of children: A focused look at those caring for a child

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with special needs under the age of 18. Retrieved from Report_Caregivers_of_Children_11-12-09.pdf Pelletier, C. L. (2004). The effect of music on decreasing arousal due to stress: A meta-analysis. Journal of Music Therapy, 41, 192-214. Pinquart, M., & Sorensen, S. (2003). Differences between caregivers and non-caregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18, 250-267. Robb, S. L. (2000). Music assisted progressive muscle relaxation, progressive muscle relaxation, music listening, and silence: A comparison of relaxation techniques. Journal of Music Therapy, 37, 2-21. Steiner, A. (2014). The effect of family centered music therapy sessions on relaxation states of informal caregivers of hospice and palliative care patients (Unpublished master’s thesis). University of Kentucky, Lexington, KY. Teixeira, M. E. (2008). Meditation as an intervention for chronic pain. Holistic Nursing Practice, 22, 225-234. Vedhara, K., Shanks, N., Anderson, S., & Lightman, S. (2000). The role of stressors and psychosocial variables in the stress process: A study of chronic caregiver stress. Psychosomatic Medicine, 62, 374-385. Yehuda, N. (2011). Music and stress. Journal of Adult Development, 18, 85-94. About the Author Adrienne Steiner, MM, MT-BC is the Clinical Coordinator at the University of Louisville’s Music Therapy Clinic and Lecturer in the music therapy program. She provides individual and group sessions to a diverse populations. Contact:


Where in the World is Inclusion? Amy O’Dell, MT-BC BRIGHT Children International Sacramento, California

The U.S.: Paving the Way for Inclusion Forty years ago, a law passed in the U.S. that allowed for education for individuals with special needs in the least restrictive environment (LRE). This meant that children could attend classes with their typically-developing peers instead of only in a segregated special education classroom (IDEA, 2004). While this concept has not always transferred to the general public’s mind, heart, and attitude, the U.S. has agreed that segregation is not the solution. However, ideas and attitudes on inclusion vary significantly between countries and cultures. At one end of the spectrum, Native American tribes do not have words in their language that translate to “handicapped,” “crippled,” or “disabled” (Locust, 1986). Rather, an individual is given a task equitable to their abilities, and expected to participate in the community. In contrast, children born with disabilities in some Eastern European countries are abandoned, sent to an orphanage, and then transferred to institutions at the age of five (Kole, 2005). BRIGHT Children International exists to address this gaping discrepancy and help set the blueprints for inclusion in the places that are ready to embrace it.

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BRIGHT Children International BRIGHT Children International is a non-profit organization based out of Sacramento, California. BRIGHT stands for Bringing Resources to Inspire Growth, Healing, and Transformation, and exists to serve orphans and children with special needs around the world. BRIGHT’s mission is three-fold: 1) to provide equipment and resources, 2) to provide staff/parent training, and 3) to implement therapy. Since it’s founding in 2010, BRIGHT Children International has served children in Bulgaria, Haiti, China, Nicaragua, and Guatemala. What began with two music therapists has grown to include physical therapists, occupational therapists, speech-language pathologists, recreational therapists, special educators, social workers, and family therapists. Once a year, team members undertake an international travel mission to advocate for children with special needs and help them reach their potential. The response to the concept of inclusion and potential of children with special needs varies significantly by country and even from one institute to another.


Photograph by Corinne Michele Photography

A Snapshot of Inclusion: Nicaragua During a visit in 2013, the BRIGHT Children International team worked at Sor Maria Romero, a school for children with disabilities in Rivas, Nicaragua. This is the only school dedicated to educating students with special needs in the country. Some children live hours away and stay with a relative during the week in order to attend school. During the visit, the music therapists had the privilege of working in the preschool classroom with the educators and children. The therapists presented several musical interventions in the classroom to address skill areas such as movement, direction-following, labeling body parts, identifying colors, vocabulary building, instrument playing, turn taking, and speech.

Cristian’s arms are being guided to meet at midline so he can gain improved muscle tone.

Watch video “La Bamba”

BRIGHT Children International was able to deliver two walkers to Nicaragua during the 2014 trip. In conversing with the mother of a three-year-old with cerebral palsy, the physical therapist asked, “What do you want for your son?” She simply responded, “I just want him to walk.” As they spoke, the physical therapist was able to adjust a walker for her son, Utman. When given the equipment, Utman was able to take his first steps with little guidance.

In 2014, BRIGHT returned to Nicaragua to visit Tesoros de Dios, a school for children with disabilities in Managua. Tesoros has an early intervention classroom for children ages five and under. Parents bring their children and are required to stay for the program, which offers them a framework for supporting their children outside the classroom. These children have a variety of disabilities and needs, which allowed for excellent collaboration between BRIGHT Children International team members. The directors at Tesoros de Dios had pre-selected which children would see each professional to maximize time spent and expertise offered. For instance, the infant educator spent her time in the early intervention classroom, working with children like Cristian.

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Photograph by Corinne Michele Photography

Capturing Utman’s first steps towards his mother.


Photograph by Corinne Michele Photography

The music therapist spent the majority of her time with children with Autism Spectrum Disorder, though other children were able to benefit from music therapy services as well.

Summary This snapshot of inclusion in Nicaragua offers a sneak peak into the work of BRIGHT Children International. Inclusion practices both in society and in academic settings are critical to children’s development and growth. While these practices vary across the world, some countries, like Nicaragua, are making leaps and bounds in the care and education of children with special needs. Through BRIGHT and other organizations, music therapists continue to play an important role in this global initiative.

References Individuals With Disabilities Education Act, 20 U.S.C. § 612 (2004). Kole, W. J. (2005, November 13). The Unwanted Children of East Europe. Retrieved from http:// Locust, C. (1986). American Indian beliefs concerning health and unwellness. Native American Research and Training Center. University of Arizona: Tucson. About the Author Amy O'Dell is a music therapist in Sacramento, CA, holding both an MTBC and a Special Education credential. She is the secretary of BRIGHT Children International and loves taking her professional skills to children who need therapeutic services throughout the world. Contact:

For more information on BRIGHT Children International, please visit

Looking to learn more about Music Therapy and Autism Spectrum Disorder? Register for the 3 hour CMTE (FREE for AMTA members) to be held at the AMTA National Conference in Kansas City on Saturday, November 14th, 2015 from 2:30–5:30 PM. "Music Therapy and ASD: We Have the Scoop and Tools for You!," will provide information and spotlight resources that have been developed as part of AMTA’s Strategic Priority on ASD and Music Therapy. Presenters will introduce E-packet products and demonstrate how they can be effectively utilized to benefit the needs of various stakeholders. If you are unable to attend, all spotlighted Music Therapy and ASD E-Packet products will be available on the AMTA website following the conference.

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Inclusive Music Therapy Programming in Japan Kumi Sato, MS, MT-BC University of Tsukuba Tsukuba, Japan Satoko Mori-Inoue, Ph.D., MT-BC Child Development Center “Kokko” Music Therapy Connection Group “Kakehashi” Tokyo, Japan

Introduction After Japan signed the UN Convention on the Rights of Persons with Disabilities in 2007, the government reviewed their policies and supports for people with special needs. Consequently, the amendment to the Basic Law for Persons with Disabilities was approved by the Senate in 2011. The purpose of the amendment was to foster a culture that recognizes and respects diversity and individuality. It provides basic regulations to support the independence and social participation of persons with disabilities – ultimately creating the foundation for a more cohesive society. In Japan, a cohesive society means that people respect each other and actively participate in society despite a disability. Ideal of a Cohesive Society in Japan To create a Cohesive Society the Japanese government has built an inclusive education system. The definition of inclusive education in Japan encompasses Article 24 of the UN Convention on the Rights of Persons with Disabilities, emphasizing equal opportunity for persons with and without disabilities to learn together in the same environment (Ministry of Education, Culture, Sports, Science, and Technology, 2012). It is seen as very important that children experience an integrated educational environment in the hopes that they will continue to uphold the principles of

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the Cohesive Society for the next generation to come. In 2012, the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) started a project called The Promotion of Special Needs Education in order to build an inclusive education system in Japan. According to MEXT, special needs education should be aligned with the following three principles: a) children with disabilities will receive a rich education partnering with medical care, health, welfare, and labor to encourage independent participation in society; b) children with disabilities will be integrated into their community; and c) people will understand persons with disabilities by learning and living with them. According to the MEXT report (2012), providing “various learning environments” in elementary and lower secondary schools is indispensable for an inclusive education system. To meet individual educational needs, the learning system is flexible and continuous so that all children receive the most appropriate guidance. Since elementary and lower secondary education are compulsory in Japan, most schools are public, including schools for special needs education. All schools follow the same curriculum which allows teachers and parents, as well as other related professionals, to share information that guarantees smooth transitions between schools and grade levels.


The Meaning of Inclusion Over the past 10 years, the term “inclusion” is used by educational staff, but not yet by those in other areas (Tokunaga, 2005). The Japanese government, however, implements the policies for a cohesive society, which include applying the Universal Design to facilities or products as well as support for the elderly, foreigners, and victims of crimes (Cabinet Office, Government of Japan, 2014). If Japanese children grow, learn, and live in inclusive settings, the term inclusion will hopefully soon become a household term in every environment.

Figure 1. Outline of various learning settings that are available to all children (National Institute of Special Needs Education, n.d.). Current Situation of Children with Disabilities One of the major challenges that the existing education system faces is providing guidance to children with disabilities who are placed in regular school classes, but receive special education services in a different environment (MEXT, 2013). Children diagnosed with a) speech impairment, b) Autism Spectrum Disorder, c) emotional disturbance, d) low vision, e) hard-of-hearing, f) Learning Disabilities, g) Attention Deficit Hyperactivity Disorder, and others frequently learn in regular classes but are separated to resource rooms for special activities such as guidance on reading and writing for social skill training based on individual needs. According to the MEXT (2013), the number of children in regular classes receiving special services is 77,882 (0.8% of all children in compulsory education) while the number of children in schools for special education is 67,173 (0.7% of all children in compulsory education). Hence, training for teachers in regular classes is a high-priority for students with disabilities leaning in regular classes. Since there is a limit to provide the best support for teachers, the government also stated that school administrators should consider cooperating with specialists such as school counselors and social workers, speech and language pathologists, occupational therapists, physical therapists, and other experts. While other experts is not clearly defined, music therapists could potentially fit into this category.

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Inclusive Music Therapy Programming In Japan, inclusive music therapy programming not only offers learning opportunities for all children, but also helps parents to understand their children’s needs better. Music therapists co-lead sessions with childcare educators and other therapists (e.g., Occupational Therapists, Speech-Language Pathologists, and Physical Therapists), while educating parents about their child’s development. Parents attending the inclusive music therapy program have the opportunity to observe their children’s abilities in various developmental areas and learn how to support them in specific areas of needs (Jellison, 2012; Nemeth, 2010). An example of an early childhood inclusive music therapy program is the Ichihara-City Child Development Support Center in Japan (Mori-Inoue, 2013). Over the course of one year, monthly music therapy sessions were provided for children ages 2-5 and their parents. Most of the children had not been diagnosed yet, but were regularly observed and monitored by physicians, nurses, and various therapists in addition to their early childhood educators. During the year, the music therapist focused on the following child-centered goals: a) positive parent-child interactions, b) basic social skills, and c) increased selfconfidence through developmentally-appropriate activities while also offering parental support. Music therapy techniques included dancing, singing, playing instruments, and relaxation exercises for children and parents alike.


Program Evaluation To evaluate the success of the one-year music therapy program, clinical data were collected on the set objectives. Behavioral observations were taken and a Likert-type questionnaire form (see Figure 2) was given to parents to compare both their own mood and their child’s mood before and after the music therapy sessions.

Figure 3. Change in children’s mood before and after music therapy intervention.

Figure 4. Change in parental mood before and after music therapy intervention.

Figure 2. Illustrating examples of questions that parents were asked to answer. Comparison of both child and parent moods before and after music therapy indicated improvements in parental ratings of both conditions (see Figure 3 and Figure 4). Children's mood improved an average of 13.5% while parents’ mood improved 12.8% (from sad to happy) after each session.

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Overall, children and parents alike benefited from the inclusive early childhood program even when offered only once a month. Parents learned positive parenting skills and better understood their children's developmental needs. While small, this program may have demonstrated the beginnings of an inclusive and welcoming community for all children to learn and thrive – the core idea of Japanese cohesive society. References Cabinet Office, Government of Japan. (2014). Policies on cohesive society. Retrieved from http:// Jellison, J. A. (2012). Inclusive music classrooms and programs. In G. E., McPherson & G. F. Welch (Eds.). The Oxford Handbook of Music Education, (pp. 65-83). doi: 10.1093/oxfordhb/ 9780199928019.013.0005 Ministry of Education, Culture, Sports, Science, and Technology. (2012). Report on promotion of special needs education to build inclusive education system


for establishing cohesive society education. Retrieved from shingi/chukyo/chukyo3/044/attach/1321669.htm Ministry of Education, Culture, Sports, Science and Technology. (2013). The current states of special needs education. Retrieved from http:// Mori-Inoue, S. (2013). Showing visually: The impact of graphic analysis of music therapy services at a local child developmental center in Japan. imagine 4(1), 87-89. National Institute of Special Needs Education. (n.d.). Interpretation on related words. Retrieved from Nemeth, J. (September, 2010). Music therapy in inclusive classrooms, [Audio podcast]. Retrieved from http:// The Basic Law for Persons with Disabilities. (2014). Retrieved from http:// id=2436&vm=04&re=01&new=1 Tokunaga, Y. (2005). Comparative study on inclusive education for children with special needs, integration and inclusion for children with disabilities. Retrieved from kenshuka/josa/kankobutsu/pub_d/d-265/ d-265_9.pdf#search='inclusion+2005++Japan'

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About the Authors Kumi Sato, MA was trained as a music therapist in the U.S. Now living in Japan, she is a Ph.D. candidate at the Tsukuba University researching the use of music to support children with special needs.


Satoko Mori-Inoue, Ph.D., MT-BC, music therapy researcher at Mejiro University Otology Clinic Institute (Japan) is currently establishing a music therapy program within the Child Development Center "Kokko." Her early childhood music therapy practice focuses on infants with sensorineural hearing loss and children with developmental delays. Contact:


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This year’s parentscan series is dedicated to parents of premature infants, young children with cancer, and young children with burn injuries. Experienced medical music therapists oer specific musical ideas that can be easily embedded by parents during or post hospitalization. Singing, humming, listening to music, moving, or playing an instrument oer joyful and empowering moments for young children with health issues that may distract them from pain and anxiety, reduce stress, assist with relaxation, and more. Make the most of your time together by supporting your child through music. imagine 6(1), 2015


parentscan Ideas for Parents of Premature Infants Use these various music activities after going home or in the NICU with the assistance of a board certified music therapist. If and when you see any signs of overstimulation (e.g., splayed/tense fingers, cry face, arched back, sticking out tongue, hiccups, crying), pause until the baby is calm.

1. Connect During Kangaroo care (baby dressed only in a diaper lies on your bare chest and snuggles with you skin to skin), use recorded music, or even better, live singing or humming to your favorite songs in a lullaby style. Any song can become a lullaby when you make it slow and repetitious. Think of songs special to you and your family, or songs you may have sung while being pregnant.

3. Movement Sing songs that have movements such as marching in The Ants go Marching One by One or arm and leg movements in “Open and shut them” (listen below). Place the baby on your lap or on the floor facing you and gently assist the baby through the slow movements.

2. Social/Emotional Awareness Sing a song with clear facial cues such as If You’re Happy and You Know It with verses such as “If you’re happy and you know it give a smile,” “surprised…give a gasp,” “sad…give a frown,” and others! Feel free to make up your own expressions to share and watch to see if the baby mimics you.

4. Learning Get a head start teaching the baby the alphabet by singing the ABCs during diaper changes, walks, and baths. Sing songs with numbers such as This Old Man, Five Green and Speckled Frogs, and Ten Little Kittens (listen below) to promote counting. Be sure to show the baby the numbers using your fingers! Ten Little Kittens Recorded 2015 by Jennifer J. Peyton

Open and Shut Them Recorded 2015 by Jennifer J. Peyton

Written by Jennifer Jarred Peyton, MM, MT-BC Jessy Rushing, MM, MT-BC, and Chris Millett, MM, MT-BC of University of Kentucky HealthCare.

5. Grip, Reach, and Play Use songs with simple hand motions such as The Itsy Bitsy Spider, The Wheels on the Bus, and Head, Shoulders, Knees, and Toes that give the baby a chance to watch you with their eyes and follow what you're doing.

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parentscan Ideas for Parents of Children with Cancer

1. Sing to your Child! Favorite songs distract from pain and anxiety and help with relaxation before sleep. If the favorite songs are fast, slow them down so they are more soothing. Singing the same songs nightly can help signal sleep, especially if your child is getting days and nights mixed up during hospitalization.

3. Get the Most out of your Electronics Create a playlist of favorite songs for your child. Consider a playlist of meaningful and empowering songs. Use upbeat music to get your child moving and dancing! Have a soothing playlist on hand for rest. Consider song-writing applications like GarageBand to create your own music.

2. Sing with your Child! Not only does singing encourage us to breathe more deeply, thus reducing stress hormones and boosting the healing hormones, it is familiar and fun! Write your own songs or parodies. Make up songs about doctor visits and upcoming procedures to help prepare your child. Use your favorite melodies and have fun.

4. Learn an Instrument with your Child This can be a bonding experience and perhaps an opportunity for your child to show Mom or Dad a few things. Learning an instrument will also exercise your child’s brain and help provide a means of self-expression and creativity.

5. Set up the Environment for Success Turn off the TV. Focus on the live singing or playlist. If your child is tired, dim the lights. Speak in a calm, relaxed voice. Let the magic happen!

Written by Deborah Benkovitz, LSW, MT-BC, Kathryn Bruno, MT-BC, Elizabeth Harman, MTT, MT-BC, Caleb Hastings, MT-BC, and Brian Schreck, MA, MT-BC from the Cincinnati Children’s Hospital Medical Center.

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parentscan Ideas for Parents of Children with Burn Injuries During hospitalization these activities can help give your child a feeling of safety, normalcy, and control.

1. Hospital Variation on Wheels on the Bus Changing the lyrics to include things in the hospital room or hospital staff can make the hospital less scary. Sample verses include: • The IV machine goes beep, beep, beep…here at the hospital • The bed in your room goes up and down…here at the hospital • The nurse comes in to check on you….here at the hospital • The doctors will help you get well soon…here at the hospital

2. Musical Follow the Leader Each person in the room has an egg shaker or other musical instrument. Sing the following lyrics to the tune Following the Leader: We’re following the leader, the leader, the leader, we’re following the leader, let’s all follow along. With the child as the leader, each person plays when the child plays and stops when the child stops. Variations can include playing fast, slow, loud and soft. Have the child choose the next musical leader.

Post-hospitalization, these activities will help your child maintain range of motion and developmental motor skills.

3. Beach Ball Fun Sung to the tune He’s Got the Whole World in His Hands: Verse 1 - You can hold the ball up high, yes you can… Verse 2 - You can kick the ball far, yes you can… Verse 3 - You can roll the ball to me, yes you can… Verse 4 - You can bounce it on the floor, yes you can… Sung to the tune Do Your Ears Hang Low? Can you hold it up high, can you hold it down low? Can the ball touch your nose and then touch your toes? Can you pass it to a friend and then back to you again? Let’s sing it over again!

4. Variation on Musical Chairs This variation of musical chairs reinforces the skills sit and stand. Use 4 child-size chairs and put a different musical instrument on or under each seat. Play your child’s favorite recorded music to cue walking around the chairs. When the music stops, the child sits down and plays the musical instrument assigned to that chair until the music starts again. Then repeat.

Written by Christine Neugebauer, MS, MT-BC, LPC of the Covenant Children's Hospital in Lubbock, Texas.

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programs Kindermusik® offers developmentally-specific educational music programs for children ranging in age from newborn to seven years. The curriculum is based on the principles of Kodaly, Suzuki, and Orff and is based on research demonstrating the benefits of music at each stage of a child’s development. In the Beginning... Kindermusik Founder, Dan Pratt spent 20 years in Germany studying and educating in music and voice performance. In the early ‘80’s he returned to the U.S. as Head of the Voice Department at Westminister Choir College in Princeton, New Jersey. He invited Dr. Lorna Heyge to teach the English version of the highly successful German music curriculum (known today as Kindermusik), educating hundreds of teachers from the U.S. and Canada. Dan Pratt devoted all his time to Kindermusik, parted ways with the German publisher, and re-wrote the Kindermusik curriculum and materials for American business. In 1993, Dan Pratt expanded internationally, brought in several investors, incorporated, and changed the name to Kindermusik International, Inc. In 2002, Kindermusik’s employees purchased the company from its 96 investors, a model it maintains to this day. Over the last 15 years, new, research-based programming has been added to the curriculum, including digital options. Kindermusik continues to introduce new curricula and products for young children.

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Who and Where? The Kindermusik International headquarters is located in Greensboro, North Carolina, led by CEO Scott Kinsey and a team of owners. The headquarters house all distribution of products and teacher resources and hosts the digital teacher curriculum resources. Licensed Kindermusik Educators have a choice of two training paths: a business owner or teach-only path. Kindermusik business owners run their own studio and offer the Kindermusik curriculum to their community. Teach-only Kindermusik Educators work for an already established studio. Kindermusik Educators have all completed a short, rigorous training, steeped in child development and music concepts, in order to earn their Kindermusik license. Purpose and Goals Parents know instinctively what scientists have now proven: young children thrive on music. Kindermusik takes musical learning to the next level; early childhood musical learning has proven to enhance child brain development (Bergland, 2013). Kindermusik starts from where a child is, regardless of age, and provides activities that stimulate his or her mind, body, and sense of play. A research study of the Kindermusik curriculum (Kindermusik International, 2013) proved effectiveness of the program. With as little as 30 minutes a week of class, 3-year-olds that attended over a nine-month period had literacy gains that were 32% higher than the control group. Psychologists, neuroscientists, and experts in early childhood development have demonstrated that music does more for children than bring them joy; it


helps their brain cells make the connections needed for virtually every kind of intelligence (Welch, 2014). Kindermusik’s curriculum is built on this research. When young children are consistently engaged by music in an age-appropriate, socially accepting environment, they benefit at many levels such as the area of socialemotional, physical, creative, math, and early literacy. Additionally, children develop a lifelong love of music.

program, many music therapists use or recommend this curriculum to families whose children experience physical, emotional, cognitive, or social challenges. Each 30-45 minute long class may incorporate rhythm, movement, instrument exploration, active listening,

Profile of Clients Kindermusik programming is offered for infants through age seven in a parent or caregiver/child setting, or a school/therapy setting. Training is required in order to teach and offer Kindermusik and includes a vocal review, online learning and testing, and a hands-on practicum. A monthly license fee, which provides access to all online tools needed to teach the curriculum, is required to keep a current license. Client fees for Kindermusik are determined by individual studio owners.


Services and Products Kindermusik International offers various inclusive curricula: Classes for Babies, Classes for Toddlers, Classes for Preschoolers, Music Classes for Big Kids, and ABC Music & Me. Designed specifically for school and early childcare environments, ABC Music & Me serves children and families who may not have the ability to participate in studio-based programs. All programming includes home-based supplemental activities and materials. Key Elements of the Program Kindermusik is focused on nurturing the development of the whole child. Using music and movement, mixed with various research-based approaches, children benefit in their social-emotional, language and literacy, cognitive, physical, and musical development. Kindermusik can complement one-on-one therapy with group classes that allow music therapists to attract new clients and integrate children with special needs and their typically developing peers while increasing income and employment opportunities. Music Therapy Applications All Kindermusik curricula are adaptable for a therapeutic setting. While ABC Music & Me is not a therapeutic

vocalization, cooperative play, and so forth. The large library of music, variety of activities, plus at-home materials, are a great addition to any therapeutic setting.

Watch video Kindermusik®

References Bergland, C. (2013). Musical training optimizes brain function. Psychology Today. Retrieved from https:// 201311/musical-training-optimizes-brain-function Kindermusik International. (2013). A study of the effectiveness of the ABC Music & Me Program. Retrieved from http:// %20Summary%20of%20the%20ABC%20Music %20&%20Me%20Efficacy%20Study%20July %202013.pdf Welch, G. (2006). The musical development and education of young children. In B. Spodek & O. N. Saracho (Eds.), Handbook of Research on the Education of Young Children, 2nd ed., (pp. 251-267). London: Routledge. About the Author Holly Lesnick, BMT is a Licensed Kindermusik Educator of 13 years. Her studio, Grow and Sing Studios, has won several awards, including eight consecutive years of the Kindermusik Maestro Conductors Circle award. Contact: imagine 6(1), 2015


“We hope every child will be a joyful, literate musicmaker.” In the Beginning… In the 1960s a group of German music educators and researchers collaborated to develop a program called “Curriculum Musikalische Früherziehung” [Music for the Young Child] for the widely spreading Community Music School movement. In 1971, Dr. Lorna Heyge joined the group, initially teaching classes in German, and soon applying the principles in English-speaking classrooms at the Bonn diplomatic community. In 1974, Dr. Heyge returned to the USA to adapt her newly learned practices in early childhood music education to an American population. In North America, Heyge was deeply influenced through her work with Audrey Sillick, director of the Toronto Montessori Institute, as well as Dr. Dee Coulter, Neuroscience Educator, and Dr. Edwin Gordon‘s Music Learning Theory. Over four decades of research and experience have led to today’s Musikgarten® curriculum. Who and Where? Heyge and Sillick founded Musikgarten in 1994 and began offering teacher trainings across the USA and Canada and publishing materials for children, parents, and teachers. The Musikgarten Foundation (Foundation for Music-Based Learning), established in the same year, founded the research and practice journal Early Childhood Connections and supported research with the University of North Carolina at Chapel Hill. Today, it works to bring the Musikgarten program to disadvantaged communities. Musikgarten is committed to supporting all adults whose lives intersect with the lives of young children, whether in the role of teacher or parent. Currently, there are Musikgarten teachers in the United States and Canada, as well as Germany, Malaysia, Korea, China,

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Austria, Switzerland, South Africa, New Zealand, and Taiwan implementing the program in private studios, music schools, university programs, churches, and preschools. The Musikgarten curricula are also used to support the practice of music therapists. Recognizing that the training and mentoring of teachers is key to successful education, Musikgarten has put great emphasis on cultivating a core of excellent Teacher Trainers. These gifted master teachers meet regularly for further study with experts in the field, and continue to influence the development of the programs. Emphasis continues to be put on live training experiences. Purpose and Goals The guiding principals of Musikgarten’s philosophy are: All children are musical. Music meets the needs of children. Music-making is active and joyful! Children’s primary learning motivation comes from being in a pleasant and friendly environment. A well-planned music environment offers the intentional movement and listening experiences which children need. Music makes a difference in the lives of children. Music improves overall development, decreases learning problems, and enhances brain functioning, all in a learning environment that fosters the building of community. Music-making belongs in the family as children are best supported through their parents and the entire family. Following, observing, and understanding the child is the key to effective teaching and learning. Profile of Clients Musikgarten offers age-specific music classes for children from infancy through age 7, as well as group piano classes for children starting at age 6. Classes for babies and toddlers include parents and caregivers, while parents join older children at the end of class. Individual Musikgarten teachers can decide whether to include siblings of other ages in their classes. The Musikgarten business model appeals to those who are musically inclined, interested in young children, and want to be their own boss.


Services and Products Classes for children ages birth to seven years: Family Music for Babies, Family Music for Toddlers, Cycle of Seasons for Preschoolers, Music Makers, and Music Makers: At the Keyboard Parent education materials, including CD recordings, digital music, parent activity books, and instruments and scarves for at-home use Online and in-person trainings for teachers covering specific developmental stages of musical and general development and working toward the artistry of teaching, and Ongoing business support, including extensive marketing materials and peer mentorship. Key Concepts of the Program Musikgarten is a holistic and integrated approach to music education, addressing the whole mind-brain/body entity, giving children a total musical experience. It offers structured materials (e.g., activities, recordings, lesson plans, parent education materials, and business support) that are flexible in how they may be used. Whether listening or moving, vocalizing or playing an instrument, creating or reading music, or enjoying an ensemble, the focus is on the process, not on a performance. The core areas of the Musikgarten curricula are movement, focused listening, singing, and playing instruments. A pathway to literacy is a key element in all Musikgarten curricula. Educators and parents alike wish for their children a lifetime of music. The end result may take many shapes – playing an instrument, singing in a choir, being an avid concert-goer, or rocking and singing with children. Lesson planning is built as a spiral experience. The challenge is to build complexity, while still returning to basic experiences for the children so they can delight in their growing independence, selfconfidence, and self-esteem. The creative input from the children is always sought; the Musikgarden educator invites the children to make suggestions in order to tailor the activity to the individual class.

For children with disabilities Musikgarten: utilizes a developmental sequence of activities to meet the needs of every child, emphasizes the child’s natural capabilities to explore music and the environment, and allows active involvement in the learning process (e.g., movement, language, and social development). Example

Watch video Musikgarten®

References Coulter, D. J. (2008). The neuroscience of music. Greensboro, NC: Musikgarten. Heyge, L., & Sillick, A. (2007). Family music for toddlers: The cycle of seasons. Greensboro, NC: Musikgarten. About the Author Lorna Lutz Heyge, Ph.D., is the founder of Musikgarten, and the President of the Musikgarten Foundation. In her active retirement in Weimar, Germany, Dr. Heyge’s present emphasis is on developing effective teacher training and furthering the Music for Learning program for children in underprivileged preschools. Contact:

Music Therapy Applications Musikgarten’s emphasis on child development (in publications and in teacher training) offers music therapists strong, practical tools to support their work. imagine 6(1), 2015


ideas The Scat Song: Starting with the Child’s Name

Adaptations Improvise a melody in the refrain and have children repeat. Add props that fit classroom themes and include them in the song.

Macy Ellis, MT Student University of Louisville Louisville, Kentucky Description The purpose of this greeting song is name recognition, imitation of sounds, and turn-taking. Goals to improve name recognition to increase imitation of animal sounds to support turn-taking Behavior Observation The child will: respond to his/her name sing after the music therapist sings wait his/her turn to sing Materials Accompanying instrument (e.g., guitar) Animal props (i.e., bird, cat, dog, cow, pig) Directions 1. Have each child select a favorite animal prop. 2. Sing the song and have children listen for their name. 3. Prompt the child to imitate the sound of the animal prop he/she selects within the lyrics of the refrain. 4. Invite all children to make the sound of the selected animal in the repetition of the refrain.

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The Scat Song Recorded 2014 by Macy Ellis

About the Author Macy Ellis is a sophomore music therapy student at the University of Louisville and successfully implemented this song at the UofL Early Learning Campus Contact:


animals, and ask what sound each animal makes. 3. Start singing the song, and invite the children to participate with the animal sounds. 4. Continue until children have gone through all of the verses/animals. Adaptations Replace the animals with rainforest animals. Ask the children their favorite animals and adapt the song based on their responses.

Down on the Farm: Greetings and Animal Sounds Briana Browne, MT Student University of Louisville Louisville, Kentucky Description The purpose of this song intervention is to encourage group participation, waving “hello,” and learning about animal sounds. Goals to encourage participation in a group to use proper greetings (e.g., waving “hello”) to learn the different sounds that animals make Behavior Observation The child will: orient himself/herself to the activity wave his/her hand make farm animal sounds Materials Accompanying instrument (e.g., guitar or piano) Images of various farm animals (e.g., cow, sheep, chicken).

Down on the Farm Recorded 2014 by Briana Browne

About the Author Briana Browne is a sophomore music therapy student at the University of Louisville and engaged children on a weekly basis at the UofL Early Learning Campus sing-along. Contact:

Directions 1. Ask children to name different farm animals. 2. Show the children the images of the different farm

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Directions 1. Introduce the activity by first going through each prop that symbolizes seasons. 2. Pass out props at random, and tell children to hold up the object that corresponds to the season being described in the song. 3. Sing the song, and, if necessary, prompt the child to hold up the corresponding prop.

All the Seasons: Learning about the Weather and Nature

Adaptations Have children trade props throughout. Have children get in a circle around the ones who have the corresponding props for dancing.

Jessica Pouranfar, MT Student University of Louisville Louisville, Kentucky

Description The purpose of this intervention is to learn about the four seasons of the year and identify weather and nature associated with each. Goals to learn the names of the seasons to associate the seasons with the weather/nature to take turns Behavior Observation The child will: say the names of the fours seasons (i.e., Spring, Summer, Fall, Winter) hold up prop that corresponds to the season waits for his/her turn to hold up the prop Materials Accompaniment instrument (e.g., ukulele or piano) Various cut outs of seasonal props (e.g., pumpkin, flowers, sun, snowflake)

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All the Seasons Recorded 2014 by Jessica Pouranfar

About the Author Jessica Pouranfar is a sophomore music therapy student at the University of Louisville and likes to engage children in learning through music. Contact:


before demonstrating the sound the animal makes to allow children to make a guess. 3. Repeat until children can identify each animal and imitate their sounds. Adaptations Have the children switch animals. Change the animals in the song. Have children imitate movements of the animal.

Animal Friends: Awareness, Labeling and Imitating Sounds Briget Price, MT Student University of Louisville Louisville, Kentucky Description The purpose of this song intervention is to increase sound awareness, labeling, and imitating animal sounds. Goals to enhance sound awareness to identify animal sounds to imitate animal sounds Behavior Observation The child will: make the sound of the animal identify his/her stued animal vocalize appropriate animal sound Materials Accompanying instrument (e.g., guitar or piano) Animal props (i.e., puppy, kitten, bird, bunny, foal, calf)

Animal Friends Recorded 2014 by Briget Price

About the Author Briget Price is a sophomore music therapy student at the University of Louisville and likes to see children develop and grow through music. Contact:

Directions 1. Ask children to pull an animal prop from a bag. 2. Begin singing the song, and pause dramatically after labeling an animal and ask who has it. Also pause

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Directions 1. Spread out the visual aids on the floor or Velcro board and introduce the activity. 2. Start a steady beat, then begin strumming the chords while inviting the children to rhythmically pat their legs or knees. 3. Sing the first verse of the song and pick one body part to identify. 4. Invite children to raise their hands, then call on one child to find the correct body part and place it on the snowman. 5. Repeat steps 2-4 so that every child has a turn in building the snowman, then end the activity by singing the ending verse of the song.

Hey, Mr. Snowman: Body Part Identification and Placement

Adaptations Have children make additional clothing for the snowman to wear (e.g., scarf, top hat). Have all children mime putting on the dierent parts of clothing.

Hailey Kater, MT Student Queens University of Charlotte Charlotte, North Carolina Description The purpose of this intervention is to increase social skills, as well as awareness and identification of body parts. Goals to increase body-part awareness and identification to encourage participation in group activities to increase impulse control Behavior Observation The child will: identify and place the body parts and articles of clothing onto the snowman take his or her turn after being called on play with peers without interrupting the turns of others Materials Accompanying instrument (e.g., guitar) Visual aids (i.e., body parts and clothing of snowman)

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Hey, Mr. Snowman Recorded 2015 by Hailey Kater

About the Author Hailey Kater is a junior music therapy major at Queens University of Charlotte and is the writer of the music therapy blog Contact:


Directions 1. Sit in a semicircle and introduce gestural prompts for singing and playing, then hand each child a drum. 2. Introduce the chorus, then invite all children to sing along. 3. Demonstrate "listen" by pointing to your ears when singing verse 1. 4. Play one measure of a drum rhythm and point to children to imitate your rhythm. 5. Present all verses and encourage children to follow the song instructions. Adaptations Discuss with children when listening and playing together could be beneficial to a daily life situations. Add verses suggested by the children.

Working Together: Encouraging Team Work Lindsay Feist, MT-BC Meaningful Day Services Brownsburg, Indiana Description The purpose of this drum intervention is to encourage listening, waiting, and playing together. Goals to increase listening skills to enhance impulse control to encourage playing together Behavior Observation The child will: follow gestural prompts of playing and singing demonstrate "waiting" as indicated in the song play with the instructor and group when prompted Materials Small drums with mallets for everyone

Working Together Recorded 2015 by Lindsay Feist

About the Author Lindsay Feist, MT-BC recently graduated from the University of Louisville. She currently serves as a music therapist for Meaningful Day Services, working with adults and children with disabilities. Contact:

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Repeat to include various dynamic and tempo changes.

Adaptations Allow children to take turns being the leader of the call-and-response. Encourage children to choose which dynamic or tempo to repeat. Include hand motions to add a layer of difficulty.

Oh, I Can Sing: Encouraging Listening, and Expressive Language Christopher R. Millett, MM, MT-BC Florida Hospital Orlando Orlando, FL Description The purpose of this intervention is to engage children in call-and-response singing to encourage listening and expressive language. Goals to encourage listening to increase expressive language Behavior Observation The child will: repeat musical phrases as cued by the adult mimic changes in dynamics and tempo Materials Shapes to sit on or mats as needed. Directions 1. Introduce activity by providing a rhythmic pulse by patting on legs. 2. Use verbal prompting (e.g., “repeat after me”). 3. Sing line, and use visual hand gesture to prompt the children’s turn. 4. Continue through the verses.

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Oh, I Can Sing Recorded 2015 by Chris Millett

About the Author Chris Millett, MM, MT-BC has recently joined the music therapy team at Florida Hospital Orlando. As a NICU-certified music therapist, he serves a variety of populations in the medical setting and provides intern supervision. Contact:


Directions 1. Place the fishes on the board and invite children to count the number of fishes. 2. Sing the song with arm motions exaggerating the “snap” at the end of the phrase while inviting children to participate in the activity. 3. Encourage children to count the remaining fishes. 4. Repeat the song until all of the fishes are “snapped away” by the imaginary shark. Adaptations Have children bring their favorite stuffed animal fish for the song intervention. Ask children to be fishes and “snap” one after the other away while counting down.

Five Little Fishies: Practicing Counting Meryl Brown MM, MT-BC, DT Developing Melodies Bloomington, Illinois Description The purpose of this song intervention is to address a preacademic skill of counting. Goals to count to five to identify each number Behavior Observation The child will: count from one to five identify the accurate number of fishes Materials Five laminated pictures of fishes Velcro or magnets and felt board or magnet board

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Five Little Fishies Recorded 2015 by Meryl Brown

About the Author Meryl Brown, MM, MT-BC, DT is the owner of Developing Melodies, a private music therapy practice serving Central Illinois, where she works with children and adults with special needs in addition to being lead blogger and songwriter for her company. Contact:


Directions 1. Place one word of a sentence on each drum, with drums arranged in a left to right sequence (e.g., “The - cat - sat - on - the - couch.”) 2. Invite one child to tap each word of the sentence placed on the drums and another child to point to a duplication of the sentence placed on a magnetic dry erase board with prepared visuals. 3. Involve all children by giving a steady count and reading the sentence in a rhythmic fashion. 4. Count the number of words in the sentence using the same rhythmic count off. 5. Choose a student to substitute a word and discuss how the meaning of the sentence has changed.

Dot to Dot Drumming: Teaching Early Literacy Skills Kathy Schumacher, MT-BC Private Practice Oshkosh, Wisconsin Description The purpose of this intervention is to teach pre-literacy skills in an inclusive environment. Learning to attend to larger “chunks” (i.e. words) will set the foundation for later being able to manipulate the smaller “chunks” of syllables and phonemes. Goals to develop left to right directionality to demonstrate reading and listening comprehension Behavior Observation The child will: tap the drums in sequence while saying a word for each tap demonstrate comprehension of the sentence by correctly placing pictures Materials Seven hand drums Laminated words and visuals (available for download)

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Adaptations Create a simple melody for the sentence in use. Add more variables: First, practice changing the subject of the sentence (e.g., Was it the cat or the dog who sat on the chair?), then incorporate prepositions (e.g., Did the mouse sit on the bed or under the bed?). Encourage children to use the intervention independently in small groups during the day. If drums are not available, the same “dot to dot” experience can be created with upside down plastic containers or ice cream buckets.

Dot to Dot Drumming Recorded 2015 by Kathy Schumacher

About the Author Kathy Schumacher, MT-BC is a music therapist in private practice near Oshkosh, Wisconsin, where she focuses on reaching children with diverse learning styles and those with Autism Spectrum Disorder. Kathy blogs at and is passionate about improving literacy for all children. Contact:


Directions 1. Sing the song with guitar accompaniment. 2. Demonstrate with your fingers “up and down” as indicated in the song. 3. Encourage children to match the pitch with their fingers as they "climb" up and down the ladder with their fingers in the song. 4. Use the emotion visuals and insert various emotions into the lyrics for the child to imitate.

Esta es la canción de Juan (This is John's Song): Learning about Pitches

Adaptations Use other body parts to demonstrate climbing up and down following the ascending and descending pitch. Invite children to imitate facial expressions for the emotions without using the visuals.

Cecilia Di Prinzio Universidad del Salvador Buenos Aires, Argentina Description The main purpose of this song is to introduce the musical concept of pitch to toddlers by using body movement and emotions. Goals to improve auditory discrimination of pitch to follow directions to identify different emotions Behavior Observation The child will: associate body movement to various pitches follow the movement indicated in the song lyrics imitate different emotions Materials Guitar Visuals indicating emotions (e.g., happy, sad, angry)

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Esta es la canción de Juan (This is John's Song) Recorded 2015 by Cecilia Di Prinzio About the Author Lic. Cecilia Di Prinzio is a professor at the Universidad del Salvador, in Buenos Aires, Argentina, and directs Melody Time, a music therapy program for mothers and infants. She also owns a private music therapy practice. Contact:


Directions 1. Hold up picture of Mr. Chameleon and introduce him to the group of children sitting in a circle. 2. Explain that chameleons change colors due to the environment around them. 3. Sing through the Mr. Chameleon song, holding up a picture of the chosen food. 4. Have children identify the food selected and the color of the food. 5. Attach the matching colored jacket to Mr. Chameleon.

Mr. Chameleon: Reinforcement of PreAcademic Concepts

Adaptations Have children create their own Mr. Chameleon and color it to match their favorite foods. Then have children share their own verse. Discuss the origins of each food and how they might be grown.

Andrea Vallejo Wead, MM, MT-BC The Music Settlement Cleveland, Ohio Description The purpose of this intervention is to reinforce identification of colors and foods. Goals to improve color and food identification to transfer colors between selected foods Behavior Observation The child will: identify colors and foods from presented cards identify colors between changing objects Materials Colored food cards (i.e., milk, grapes, carrots, lettuces, apples, lemons, blueberries) Picture of a chameleon and jackets matching the colors of the food cards

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Mr. Chameleon Recorded 2015 by Andrea Vallejo Wead

About the Author Andrea Vallejo Wead, MM, MT-BC works at The Music Settlement in Cleveland, OH. She currently provides services to to the Council for Economic Opportunities in Greater Cleveland (CEOGC) Head Start Program and leads music and literacy programs for Cuyahoga County and Cleveland Public Libraries. Contact:


Directions 1. Have children sit in a circle. 2. Introduce the shapes. 3. Pass out rhythm sticks. 4. Establish a steady beat. 5. Re-number next two points which will now become 5. and 6. Adaptations Use 3D and 2D shapes as materials. Have children draw their own shapes and embed them in the song.

The Shape Chant: Reinforcement of PreAcademic Concepts Andrea Vallejo Wead, MM, MT-BC The Music Settlement Cleveland, Ohio Description The purpose of this song intervention is to promote identification of 2D shapes and to generalize shape identification skills to dierent environments. Goals to improve identification of shapes to identify shapes in various settings Behavior Observation The child will: correctly identify shapes point out the shape in at least two settings Materials Pictures and items of shapes (i.e., square and dice, triangle and ice cream cone, rectangle and table/train cars, circle and oranges/clocks) Rhythm sticks

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The Shape Chant Recorded 2015 by Andrea Vallejo Wead

About the Author Andrea Vallejo Wead, MM, MT-BC works at The Music Settlement in Cleveland, OH. She currently provides services to to the Council for Economic Opportunities in Greater Cleveland (CEOGC) Head Start Program and leads music and literacy programs for Cuyahoga County and Cleveland Public Libraries. Contact:


color of us Inclusion Programming Worldwide Interviews prepared by Petra Kern, Ph.D., MT-BC, MTA, DMtG imagine editor-in-chief Interviews compiled by Rose Fienman, MSW, MT-BC imagine editorial assistant

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greece latvia finland bahrain


Since 2008, we have featured early childhood music therapy in 36 countries. The 2-sided fact pages include a statistical snapshot about the country, demographics, background information, common approaches, and prominent publications. We also have held three roundtables at the 2008, 2011, 2014 World Congresses of Music Therapy in Argentina, Korea, and Austria respectively and published congress proceedings and teaching episodes. This year, we contacted many of the previous “color of us” authors and invited them to share information about “inclusion programming” in their countries. Eleven colleagues responded to the following three questions, which are featured under this section of imagine 2015.

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thailand 1. What is the status of inclusion of young children with disabilities? 2. What does music therapy inclusion programming for young children with disabilities look like? 3. How should music therapy contribute to the movement to include children with disabilities over the next decade?


usa What is the status of inclusion of young children with disabilities? In the U.S., long-standing federal legislation and policies (PL94: 142, NCLB, IDEA, IFSP/IEP) and a large body of research (Odom, Buysee, & Soukakou, 2011) support the concept of including individuals with disabilities in natural environments, regular schools, and communities. According to a national position statement (DEC/NAEYC, 2009), key components of making inclusion a success are access (i.e., access to all programs, modification of the physical environment, adaptation of the curriculum), participation (i.e., individualized accommodations to reach a sense of belonging, friendship, and full potential), and supports (i.e., professional development opportunities, collaborations among experts, and coordination of specialized services). Although inclusion practices have been supported over the past 40 years, only 29 of 42 evaluated states promote accommodations for including children with disabilities in early childhood programs in some way (Horowitz & Squires, 2014). What does music therapy inclusion programming for young children with disabilities look like? While many music therapists may share clients’ and families’ views that inclusion is valuable, inclusion programing in music therapy seems to be sparse and uneven across the country. A systematic review by Brown and Jellison (2012) revealed that within the past four decades (1975-2009) only 35 articles authored by a few music therapists addressed inclusion. Music therapists in the U.S. seem to offer small group sessions for children with disabilities and their peers/siblings in various settings (e.g., preschool classrooms, community centers, playgrounds), consultative services to parents and educators (e.g., on how to use music for daily living skills), or community concerts adapted to children with disabilities, their families, and friends.

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How should music therapy contribute to the movement to include children with disabilities over the next decade? First, there should be system-level supports provided for music therapists practicing inclusion. Second, while developing protocols that benefit young children and their families in daily life, a series of studies should evaluate the effectiveness of inclusive music therapy services. Third, there should be a campaign supported by the American Music Therapy Association that promotes inclusion practices in collaboration with other organizations across the U.S. References Brown, L. S., & Jellison J. A. (2012). Music research with children and youth with disabilities and typically developing peers: A systematic review. Journal of Music Therapy, 49(3), 335-364. DEC/NAEYC (2009). Early childhood inclusion: A joint position statement of the Division for Early Childhood (DEC) and the National Association for the Education of Young Children (NAEYC). Chapel Hill, NC: The University of North Carolina, FPG Child Development Institute. Horowitz, M., & Squires, J. (2014). QRIS and inclusion: Do state QRIS standards support the learning needs of all children? (CEELO FastFact). New Brunswick, NJ: Center on Enhancing Early Learning Outcomes. Odom, S. L., Buysee, V., & Soukakou, E. (2011). Inclusion for young children with disabilities: A quarter century of research perspectives. Journal of Early Intervention, 33, 344-356. About the Author Petra Kern, Ph.D., MT-BC, MTA, DMtG, business owner of Music Therapy Consulting is online professor at the University of Louisville and serves as editor-inchief of imagine. Her research and clinical focus is on Autism Spectrum Disorder, inclusion programming, and educator/parent coaching. Contact:


argentina What is the status of inclusion of young children with disabilities? In Argentina, inclusion has become a trend in recent years. However, preschool settings cannot include more than one or sometimes two children with disabilities with a therapeutic aide per room. The children, therefore, often are discriminated against in this scenario. There are some preschools that accept and include children with special needs while others do not. More initiation is needed related to policy-making that addresses the right of children with disabilities to be included in public preschools (Adamek & Darrow, 2008). What does music therapy inclusion programming for young children with disabilities look like? Music therapists who work with young children with disabilities have two challenges: 1) many of the clients do not have a diagnosis and therefore lack official documentation, and 2) staff do not have specific training on effective inclusion programming. Currently, music therapists focus on demonstrating skills that children with disabilities can acquire through music therapy sessions. As each child is unique, interventions are adapted to the specific needs of the child (Ainscow, 1999). How should music therapy contribute to the movement to include children with disabilities over the next decade? Music therapy is a profession that can bring a new understanding of inclusion in preschools, especially through early childhood music programs. The primary goals are to educate the Argentinean society about the benefits of music therapy interventions for young children with special needs and to train music therapists how to offer successful inclusion programs – just placing a child with a disability in an inclusive setting is not a

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representation of full inclusion. The role of a music therapist should be to support the child with disabilities until he or she can function independently (Paymal, 2015). References Adamek, M., & Darrow, A. (2008). Music in special education. Silver Spring, MD: American Music Therapy Association. Ainscow, M. (1999). Understanding the development of inclusive schools. London, England: Falmer Press. Paymal, N., & Tomo, I. (2015). Pedagooogía 3000. Una Pedagogía para el Tercer Milenio. Buenos Aires, Argentina: Editorial Kier. About the Author Gabriel Federico is the Director of Centro Argentino de Musicoterapia e Investigación en Neurodesarrollo y Obstetricia (CAMINO), and teaches at several universities. He is the author of eight books on music therapy and has presented his work nationally and internationally. Contact:

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bahrain What is the status of inclusion of young children with disabilities? The Kingdom of Bahrain is committed to equal educational opportunities for and inclusion of all school children into regular classes in public schools, which is in line with the decree issued by the Ministry of Education in October 2001 (UNESCO, May 21-June 1, 2012). The country ratified the UN Convention on the Rights of Persons with Disabilities, as well as launched an inclusive education campaign and established a Higher Committee for Disabled Affairs in 2012 (Trade Arabia News Service, 2014, May 13). The Inclusion Program started in 2005. Responsibility for special needs education in Bahrain is shared between the Ministry of Social Development and the Ministry of Education, Special Education Administration (Weber, 2012). Many private foreign schools have special education/learning support departments. What does music therapy inclusion programming for young children with disabilities look like? I am the only accredited music therapist in Bahrain. I provide individual music therapy services to children and adolescents with special needs, and conduct individual and group sessions in some special education schools/ centers. In 2009-2010, I led early childhood music classes in one of the preschools, where I had a few children with mild special needs in the classrooms. I also led a group session for families with children with disabilities and their peers. There is a plan now to implement music therapy sessions in one of the early childhood centers which caters to children of various levels of abilities. However, to my knowledge, there is no therapy or social skills trainings provided to children on an inclusive basis in schools.

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How should music therapy contribute to the movement to include children with disabilities over the next decade? This is a difficult matter, as music therapy is a new, practically unknown form of therapy in the country. There is still much to be done to raise awareness about our profession among the parents and specialists alike. In my workshops I always talk about the benefits of music for children and their families, and consult with educators about the use of music in their work. In my private practice, I began encouraging parents to think about bringing siblings from time to time. Right now, however, I only include parents into my sessions, to provide the “three-persons” social experience to children with special needs. References Trade Arabia News Service. (2014, May 13). Unicef calls for more inclusive world for disabled. Retrieved from MISC_258060.html UNESCO. (2012, May 21-June 1). Universal Periodic Review. Bahrain. 13th session. Retrieved from session13/BH/ UNESCO_UPR_BHR_S13_2012_UNESCO_E.pdf Weber, A.S. (2012). Inclusive education in the Gulf Cooperation Council. Journal of Education and Instructional Studies in the World, 2(2), 85-97. Retrieved from ds217232/File/ About the Author Aksana Kavaliova-Moussi, MMT, MTA, Neurologic Music Therapist, has a private practice in the Kingdom of Bahrain, and is the Eastern Mediterranean Regional Liaison for the World Federation of Music Therapy. She serves as a Co-Chair of the Online Conference for Music Therapy. Contact:


poland What is the status of inclusion of young children with disabilities? In Poland, the idea of inclusion of young children with disabilities and equal educational opportunities is legally grounded in an act that ensures all children the right to education according to their needs and possibilities (Educational System Act, 1991; Regulation of the Minister of Education and Sport, 2005). Every year there are more and more kindergartens and schools including children with special needs. In 1993, there were only 84 schools, and in 2008, there were 1,563 educational institutions that embraced the idea of inclsion (Kummant, 2008). Unfortunately, the practice of inclusion is not always consistent with the assumptions. It seems that the biggest challenge is the lack of knowledge among educators about disabilities, and the fears and resistance of embedding integrative activities. Sometimes there is also an unwillingness to accept children with a disability into the class. Within the school environment, the educators do not seem to be prepared to work with inclusive groups.

How should music therapy contribute to the movement to include children with disabilities over the next decade? Discussions pertaining to inclusion mainly take place at the level of educational institutions. First of all, music therapists need to strengthen and promote music therapy as a profession in Poland. The acceptance and understanding of what a music therapist can provide for facilitating educational, emotional, and social goals for children in the classroom will make it more attractive to the schools. Only then can we expect that more people will be interested in participating in music therapy sessions and providing music therapy services in the schools. References Educational System Act 1991 – Ustawa o systemie oświaty z dnia 7 września 1991r. (Dz.U. 1991 nr 95 poz. 425). Kierył, M. (1996). Elementy profilaktyki muzycznej [Elements of music profilaxis]. Warszawa. Kummant, M. (2008). Tendencje w kształceniu integracyjnym w Polsce w latach 2003-2008 [Trends in educational integration in Poland in 2003-2008]. Warszawa: Pracownia Wspomagania Rozwoju i Integracji CMPPP. Regulation of the Minister of Education and Sport 2005 – Rozporządzenie Ministra Edukacji i Sportu z dnia 18 stycznia 2005 r. (Dz. U. z 2005 nr 19 poz. 166 i 167). About the Author

What does music therapy inclusion programming for young children with disabilities look like? Increasingly, music therapy is a welcomed intervention in schools and inclusive settings (only on the primary level). Classes are usually held once a week for 0.5-1 hours; music therapy is treated as part of revalidation. However, growing recognition of music therapy does not go handin-hand with the awareness of who is qualified to work as a music therapist. Therefore, sometimes musicians are hired as "music therapists." In Poland, the Mobile Musical Recreation method by Maciej Kierył has played a big role in music inclusion over the years (Kierył, 1996). Thanks to its affordability, it is very often carried out in inclusive groups, but more often by teachers rather than music therapists.

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Krzysztof Stachyra, Ph.D., MT-BC is head of the Postgraduate Music Therapy Study Program and Assistant Professor at Maria CurieSkłodowska University, Lublin, Poland. He is the President of the Polish Music Therapists Association and European Commissioner in the WFMT Commission on Education and Training. Contact:


finland What is the status of inclusion of young children with disabilities? Finland’s Disability Policy Program VAMPO 2010–2015 (Ministry of Social Affairs and Health, 2012) sets the basis for inclusion and equality in our society. It highlights that “issues related to school attendance, studying, and lifelong learning together with others are most essential to school children and students with disabilities” (p. 24). It also stresses the importance of inclusion and participation in society, accessibility, health care and rehabilitation, social security and legal protection, safety and personal integrity, as well as “culture and leisure, where equal opportunities and inclusion in sports, arts, library services, and travel services are essential issues for persons with disabilities” (p. 25). Overall, Finland’s strong education system provides a good start for children with disabilities to grow as active persons in society. What does music therapy inclusion programming for young children with disabilities look like? In Finland, both music educators and music therapists play an active role in inclusion of young children with disabilities. Finland has a rich culture of music play schools (Koppinen, 2006), based on the Curricula for Basic Education in the Arts (Opetushallitus, 2002). Basic education in the arts is goal-oriented, progressing from one level to another. It teaches children skills in selfexpression and those needed for vocational, polytechnic, and university education in their chosen art form. Since 2002, it has been possible to individualize goals and teaching methods for children with special needs in music schools. School-age children are benefitting from special music education, which has moved forward within the collaboration of music therapists and music educators. However, there are only few studies concerning inclusion, young children, music therapy, and special music education.

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Music therapy is supporting inclusion of children with disabilities and their families (including siblings) at some rehabilitation centers where both individual and community music therapy is available (e.g., the Rinnekoti Foundation, The Mannerheim League for Child Welfare). How should music therapy contribute to the movement to include children with disabilities over the next decade? There should be more opportunities for music therapists to address rehabilitation and leisure skills in education systems and in communities. This would open up doors for more flexible and inclusive music therapy practices and expansion of the profession into new settings. Finally, a series of studies should evaluate the effectiveness of inclusive music therapy services. References Koppinen, M. (2006). The land of music playschools. Finnish Music Quarterly Magazine 3. Retrieved from option=com_content&view=article&id=84&Itemid=9 9%3E. Ministry of Social Affairs and Health. (2012). Strong Bas is for Inclusion AND EQUALIT Y Finland’s Disability Policy Programme VAMPO 2010–2015. Publications of the Ministry of Social Affairs and Health. 2012:7 A Retrieved from document_library/get_file? folderId=5197397&name=DLFE-21116.pdf Opetushallitus (2002). Taiteen perusopetuksen musiikin laajan oppimäärän opetussuunnitelman perusteet 2002. Retrieved from 123013_musiik_tait_ops_2002.pdf About the Author Hanna Hakomäki, Ph.D., is a Music Therapist, Psychotherapist, Registered EMTR-Supervisor, and music educator. She is specialized in special music education and children's music psychotherapy.



latvia What is the status of inclusion of young children with disabilities? When the Soviet Union collapsed, almost all children in Latvia with disabilities were educated in special boarding schools, but today 36% of children with special needs attend mainstream schools. However, only a very small number of these students are taught in regular classrooms, with the majority being placed in special classes within a regular school, thus creating an illusion of integration. A 2012 report focusing on issues of “Effectiveness, Efficiency and Equity,” highlights the fact that 52% of children with special needs still attend special boarding schools, and that there is a great lack of support staff, especially teaching assistants, in mainstream schools. There is still much confusion over the issue of inclusion, largely due to misconceptions of terms, which preclude the production of accurate statistical information; and demographic decline, which results in special schools competing with each other (Kasa, Liepina, & Tuna, 2012). What does music therapy inclusion programming for young children with disabilities look like? Extra government funding for children with special needs in mainstream schools is limited to the provision of speech therapists, psychologists, and special education teachers. In the entire country, there is only one licensed special needs program within a mainstream school that includes a weekly music therapy group, which focuses on behavior, speech, attention, language, and motor skills. Good progress also has been made in the special education sector, where music therapists are often employed as music teachers and ‘shared’ by mainstream schools in the vicinity. However, there remains extensive pioneering work to be done to make services available to all children with disabilities in inclusive settings.

How should music therapy contribute to the movement to include children with disabilities over the next decade? First, there needs to be a shift within the music therapy profession away from working only with children who have an official diagnosis. Within inclusive settings, there may be only a small number of such children, but many more who have special needs that are not officially recognized. Secondly, research needs to examine the variety of ways in which music therapists could support inclusion. Thirdly, the results of this research need to be disseminated in a way that will convince head-teachers in mainstream schools of the benefits of music therapy, thereby leading to an alliance that can effectively lobby the government to expand the range of support staff that may be employed, to create truly inclusive environments in these schools. References Kasa, R., Liepina, K., & Tuna, A. (2012). Funding and governance of education for children with special needs in Latvia: Focus on equity, efficiency, and effectiveness. Latvia: Centre for Education Initiatives. About the Authors Mirdza Paipare, MMus, is a certified music therapist and supervisor who currently serves as the President of the Latvian Association of Music Therapy. She currently serves as the Director of the Music Therapy Program at the Liepaja University. Katie Roth is a British educator and music therapy Master’s student at Liepaja University, Latvia. She is currently working in a rural, mainstream school with children who have emotional and behavioral difficulties. Contact:

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greece What is the status of inclusion of young children with disabilities? Although national legislation (Law 1566/1985) strongly supports the benefits of inclusion and early intervention, inclusion strategies for young children focus primarily on school settings (particularly kindergarten schools) and less on broader community networks and services. More specifically, the law (Law 2817/2000 and Law 3699/2008) provides that the local Centers for Differential Diagnosis and Support are responsible for determining whether children with a disability would benefit most by attending a special needs preschool or a public mainstream preschool. In the public setting, they could attend the inclusion classroom run by a special needs teacher for specific times during the day or stay in the mainstream classroom receiving parallel support also from a special needs teacher. However, this provision applies only to kindergarten students (aged 5-6) and not to younger children with disabilities (aged 2-5). These children usually attend private nursery schools for typically developing children or private therapeutic centers (where inclusion interventions are not the main focus of treatment). What does music therapy inclusion programming for young children with disabilities look like? Since music therapists in Greece work mostly as private practitioners, the majority of music therapy inclusion services are undertaken within this particular framework. Music therapists often work with children with disabilities and their families and –whenever possible – they offer mixed groups with typically-developing children and children with special needs. Some music therapists participate in charity projects that involve consultative work with educators and families, and others engage in inclusion work with young children.

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How should music therapy contribute to the movement to include children with disabilities over the next decade? For as long as music therapy is not a recognized health profession, music therapists’ efforts for effective inclusion interventions will be sparse and isolated. The state should launch long-term interventions that would enable all children to have access to inclusion services from a very young age. Finally, more publications – and research on the effectiveness of music therapy with young children– should be undertaken since the current Greek literature is quite limited. References Kalliodi, C. (2006). Short-term music therapy with a group of three pre-school children. In I. Etmektsoglou, & C. Adamopoulou (Eds.), Music therapy and other music approaches for handicapped children and adolescents (pp. 71-76). Athens: Nikolaidis. Kessler-Kakoulides, L. (2011). Therapeutic Rhythmic: Applications in the education process of children with and without disabilities. Athens: Fagotto Books Soulis, S. G. (2008). A school for everyone: From research to action. Athens: Gutenberg. Tafa, Ε., & Manolitsis, G. (2003). Attitudes of Greek parents of typically developing kindergarten children towards inclusive education. European Journal of Special Needs Education 18(2), 155-171. Zoniou-Sideri, A., Karayianni, P., Deropoulou, E., & Spandagou, I. (2006). Inclusive discourse in Greece; Strong voices, weak policies. International Journal of Inclusive Education, 10(2), 279-291. About the Author Christiana Adamopoulou, a trained music therapist, group analyst, and family therapist has twenty years of experience teaching music both in mainstream and special needs settings. As a practitioner, she works mainly with children with Autism Spectrum Disorder and those with cerebral palsy. Contact:


korea What is the status of inclusion of young children with disabilities? In Korea, the Act on Promotion of Special Education was established in 1994; many children with mild special needs thus had an opportunity to study in school with peers (Lee, 2003). The special education law (Ministry of Education, 2011) grants young children with disabilities from ages three to five the right to receive inclusive education (Lee, 2003). After the Act of Special Education in 2012, the Korean preschool curriculum of young children with disabilities went fully into effect. Although children are included within various environments, this actually is only the first step of an effective inclusion process. Noh and Park (2008) have suggested that various programs and individual education programs for children with special needs should be provided, supported by staff training and a detailed plan for making the process work. What does music therapy inclusion programming for young children with disabilities look like? Music interventions are conducted by educators, special educators, therapists, researchers, and parents, with about 30% of the services provided by music therapist (Won & Joo, 2008). Music therapists in Korea seem to offer small group sessions for children with disabilities in various settings (e.g., preschool classrooms, community centers, private clinics) giving opportunities for them to be included with their families and friends. How should music therapy contribute to the movement to include children with disabilities over the next decade? First, music therapists should offer music therapy for both young children with and without disabilities in preschool settings. Currently, three music therapists are scheduled to offer music therapy sessions to about 40

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children with disabilities in eight preschools once a week within Seoul. This program is funded by the government. Second, more music therapists should conduct research about early childhood music therapy interventions and collaborate with parents and the community. Third, music therapists should create a campaign, targeting young children and their families, about the benefits of inclusion through music interventions. References Lee, S. (2003). The effect of social inclusion of activities centered preschool curriculum for young children with disabilities. The Research of Special Education, 37(4), 97-122. Lee, C. (2003). Discussion of policy making of gratuitous child care for young children with disabilities. Forum of policy for special education. Ministry of Education (2011). Special education curriculum. Seoul, Korea: Ministry of Education. Noh, J., & Park, H. (2008). The status and research of future study about long term and short-term goals for individualized education plans of young children with disabilities. Researches of special education and scientific rehabilitation, 47(2), 101-118. Won, J., & Joo, J. (2008). Analysis of music activity intervention for young children with disabilities. From 2000 to 2007 experimental design research. The Korean Journal of Early childhood Special Education, 8(1) 93-115. About the Author Hyewon Chung, music therapist, is teaching at the Chung-Ang University while persuing her Ph.D. at the Sookmyung Women's University in Seoul, Korea. Her research and clinical work focus on young children and their families. Contact:


singapore What is the status of inclusion of young children with disabilities? In Singapore, the Compulsory Education Act, implemented in 2003, ensures that all children receive six years of education (Singapore Government, n.d.). However, children with physical/intellectual disabilities are exempt (Ministry of Education, 2015). Since 2004, the Ministry of Education has been supporting the inclusion of students with “mild special educational needs in mainstream schools” (Ministry of Education, 2014). Allied Educators for Learning and Behavior Support have been deployed to mainstream schools to support students with special needs, and it has been noted that the need is much greater than the current provision addresses (Ministry of Education, 2015). As a signatory of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), Singapore is engaging industry partners to implement “accessible technologies and best practices for inclusion” (Singapore Government, n.d., p. 147). What does music therapy inclusion programming for young children with disabilities look like? More than 50% of all music therapists currently working in Singapore serve children with special needs in early intervention centers and special education settings. In special education settings, music therapists sometimes offer sessions for children and their siblings targeting social interaction. Workshops for siblings may also feature music therapy groups. In the mainstream setting, music therapy service provision is limited to one elementary school on a contract basis, to target students with special learning needs (e.g. language delay, AD/HD, dyslexia, selective mutism), regardless of whether a formal diagnosis has been made. The children are seen in groups of five or six.

How should music therapy contribute to the movement to include children with disabilities over the next decade? In addition to providing direct intervention services (both individual and small group) in special education schools, music therapists need to reach out to school teachers and allied educators about the benefits of music and music therapy for children with mild special needs (i.e., those who are currently in the mainstream system), and provide support in terms of music resources and strategies for both students and staff. Documenting and evaluating the effectiveness of music therapy outcomes would also help support the movement towards inclusion. References Ministry of Education. (2014). Support for children with special needs. Retrieved from http:// Ministry of Education. (2015). Compulsory education: Exemptions. Retrieved from http:// exemptions/ Singapore Government. (n.d.). Enabling masterplan 2012-2016. Retrieved from Portals/0/Topic/Issues/EDGD/Enabling %20Masterplan%202012-2016%20Report %20%288%20Mar%29.pdf Author Note: The author would like to acknowledge her esteemed fellow Singaporean Music Therapy colleagues for their valuable input: Ms. LOI Wei Ming, Ms. Melanie KWAN, and Ms. Evelyn LEE. About the Author Ng Wang Feng, MMT, MT-BC studied in the United States and worked with various client populations in the United States and Singapore. She is the founding President of the Association for Music Therapy (Singapore). Contact:

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References Ministry of Education. (2014). Education in Taiwan. Retrieved from Education_in_Taiwan/ 2014-2015_Education_in_Taiwan.pdf Ministry of Justice. (2014). The Special Education Act. Retrieved from LawAll.aspx?PCode=H0080027 About the Author

What is the status of inclusion of young children with disabilities? According to the Special Education Act in Taiwan, provision and programming of special education and related services should be based on appropriateness, individualization, localization, accessibility, and inclusion. The education statistics indicate that 92.45% of preschoolers with disabilities were attending regular public schools in 2013 (Ministry of Education, 2014). However, the gap between rural and urban areas for the implementation of inclusion is apparent.

Fu-Nien Hsieh, MA, MM, MT-BC, is an adjunct lecturer at the National Taipei University of Education and Taipei Medical University. She provides music therapy services for various populations, including young children with special needs, patients who are terminally ill or have cancer. Contact:

What does music therapy inclusion programming for young children with disabilities look like? Music therapy inclusion programming within an educational system is rare since music therapy services are provided mostly in medical settings. There are music lessons and music activities for young children with disabilities in inclusion programs. On some occasions, the music therapist joins the multidisciplinary team of professionals (e.g., occupational therapists, physical therapists, and speech therapists) to provide consultative services to educators in school settings. How should music therapy contribute to the movement to include children with disabilities over the next decade? The availability of consultative music therapy services for educators must be increased to emphasize the eectiveness of music therapy in facilitating development in numerous areas of children’s functioning. Advocating for and recognizing music therapy as a part of the multidisciplinary team of professionals in inclusive programs needs to be encouraged. In addition, the Music Association of Taiwan needs to support inclusion practices by increasing the availability (i.e., the number) of qualified music therapists.

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thailand What is the status of inclusion of young children with disabilities? The 1999 National Education Act and the Education for Individuals with Disabilities Act released in 2008 introduced the development of inclusion programs in Thailand, funded by the government (Ministry of Education, 1999, 2008). The Office of the Basic Education Commission (2014) reported that there are currently 22,462 schools in Thailand providing inclusion programs for students with disabilities. Multiple studies have shown the effectiveness of the inclusion programs. However, the lack of qualified teachers, program management skills, suitable environments, and resources are among the main challenges the programs face today (Roungngam, 2012; Saimek, 2012; Thampoonpisai, Benkarn, & Jewpatthanakul, 2013). What does music therapy inclusion programming for young children with disabilities look like? Because the field of music therapy has only recently been established in Thailand, there currently is no systematic study of music therapy for inclusion programs. Only a few trained music therapists work in Thailand, primarily in private and hospital settings. With the Master of Arts degree in Music Therapy newly offered in Thailand, opportunities are increasing for music therapists working with children with disabilities. How should music therapy contribute to the movement to include children with disabilities over the next decade? As the number of trained music therapists increases, a music therapy organization in Thailand must be established to support music therapists working in inclusion programs. There should also be movements to advocate the practical and ethical benefits of inclusion programs to aid in public awareness and knowledge of

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music therapy. Research studies, supporting the effectiveness of music therapy inclusion programs, are also key in garnering wider acceptance and consideration. References Ministry of Education. (2011). National Education Act B.E. 2542 (1999). Bangkok, Thailand: Ministry. Ministry of Education. (2008). Education for Individuals with Disabilities Act B.E. 2551 (2008), Bangkok, Thailand: Ministry. Roungngam, S. (2012). The study of mainstreaming management following standard criteria of special needs education in school under the Bangkok metropolitan (Unpublished master thesis). Srinakharinwirot University, Thailand. Saimek, B., Rooncharoen, T., & Aswabhumi, S. (2012). An operation model for effective mainstreaming on teaching-learning for learner disabilities in basic education school under the office educational service areas in Ubonrachatani province. Journal of Educational Administration Burapha University, 6(1), 87-99. Thampoonpisai, R., Benkarn, P., & Jewpatthanakul, P. (2013). Problem situation and provision management in leading inclusive schools in Narathiwat Prathomsuksa Education Service Area Office: Proceedings of Hatyai Symposium IV (pp. 239-249). Retrieved from conference2013/Proceedings2013/pdf/Book3/ Describe2/356_239-249.pdf About the Author Patchawan Poopityastaporn, MM, MT-BC is the Chair of Music Therapy Department and a full-time lecturer at College of Music, Mahidol University, Thailand. She works with children and adults with developmental disabilities in private practice and clients in hospital settings. Contact:


podcasts 2015

Elizabeth Schwartz, LCAT, MT-BC Raising Harmony: Music Therapy for Young Children Mount Sinai, New York Isolation to Integration: Thoughts on Music Therapy Interventions to Support Inclusion Inclusion is more than putting different children together in the same space. This podcast provides thoughts and tips on creating interventions that lead to integration as the ultimate goal of early childhood music therapy.

Jean Nemeth, Ph.D., MT-BC Cheshire Public Schools Cheshire, Connecticut

Rachel Rambach, M.M., MT-BC Listen & Learn Music Springfield, Illinois

Tips from the Trenches This podcast offers ideas for promoting young children’s inclusion success. Discussion emphasizes a scaffolding approach, session set-up and flow, music selection, the power of rhythm, therapist demeanor, instrument strategies, and positively engaging young children.

Working Together with Parents: Songs for Skill Generalization This podcast discusses the important role parents play in skill generalization from the music therapy session to home and other settings, and includes songs that help them do so. imagine 6(1), 2015


Dana Bolton, M.Ed., MMT, MT-BC Bolton Music Therapy Murfreesboro, Tennessee

Esther Thane, BMT, MTA, AVPT Mundo Pato Inc. Vancouver, Canada

Sten Bunne Bunnemusic Hudiksvall, Sweden

Music is for Everyone: Inclusion in Early Childhood Music Classes Music therapists teaching early childhood music classes often encounter children with special needs in their classes. This podcast offers parent perspectives on inclusive classes and tips for making the experience successful for everyone.

Music Therapy in the Cloud This podcast addresses the growing trend of transitioning to electronic medical records and introduces Unitus TI, a cloud-based data management system and curriculum server.

Children’s Access to Chords, Melodies, and Bass: A Different Way of Thinking in Sweden Making musical instruments accessible for children with different abilities supports inclusion in natural environments. This podcast introduces the Bunne instruments developed for interactive musicmaking with various populations.

Kimberly Sena Moore Ph.D., MT-BC University of Miami Miami, Florida

Lora Heller, M.S., MT-BC, LCAT Baby Fingers, LLC New York, New York

Anita L. Gadberry, Ph.D., MT-BC Marywood University Scranton, Pennsylvania

Emotion Regulation Development, Rote-Based Learning, and Generalization: An Exploration In this podcast, Dr. Sena Moore shares how the emotion regulation development process can be used as a model for understanding the role of rote-based learning in therapy.

Music Therapy with Peter: A Young Boy with Fragile X Syndrome at Home and in an Inclusive Preschool Setting This podcast presents a case study of Peter, who participated in an inclusive music therapy group at his preschool that incorporated musicmediated sign language instruction. The case study highlights how he was able to generalize skills learned in music therapy to his home environment.

Communication Toolkit: A Universal Design Approach to Inclusion in the Pre-school Classroom Utilizing different strategies and resources to promote communication is essential in music therapy practice. This researchbased podcast discusses the use of universal design in the development of a communication toolkit.

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Darcy DeLoach, Ph.D., MT-BC Michael Detmer, M.M.E., MT-BC University of Louisville Louisville, KY

Jeffrey Wolfe, MT-BC Institute for Therapy through the Arts Evanston, Illinois

Interdisciplinary versus Transdisciplinary Integrative Care within Music Therapy for Children with ASD When deciding a treatment approach for children with ASD, the differences between interdisciplinary and transdisciplinary teams yield different intervention environments. In this podcast differences between the two are discussed with examples of clinical approaches and client outcomes given.

The Family is the Therapy Team: A Case Example This podcast reviews a case of a three-year old child diagnosed with Autism Spectrum Disorder. It highlights the importance of creating an alliance with a child’s family so goals can addressed in and out of the session.

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resources Click It: Inclusion Info At Your Fingertips Petra Kern, Ph.D., MT-BC, MTA, DMtG Music Therapy Consulting Santa Barbara, California Around the world, long-standing legislation and policies and a large body of research support the concept of including young children with disabilities in natural environments, regular preschools, and communities. Hence, music therapists should implement successful inclusion practices while being aware of latest global initiatives and developments. The following selection of prominent online resources (i.e., websites, videos, blog posts, podcast episodes, and twitter accounts) offer free professional development materials, inspiration, information, and clinical practice tips related to inclusion around the globe.

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Websites National Professional Development Center for Inclusion Hosted by the Frank Porter Graham Child Development Institute at UNC at Chapel Hill, this center offers landing pads with evidence-based practices to support inclusion. The resources are listed under practices that support access, participation, and system-level supports. CONNECT Project: Foundations of Inclusion Training Curriculum FPG Child Development Institute at UNC at Chapel Hill This four-hour online curriculum serves as an instructional resource for faculty and other professional development providers to support evidence-based inclusion practices. It offers video instructions and slides as well as various handouts and activities for free download. SpecialQuest Developed by the Hilton/Early Head Start Training Program, SpecialQuest maintains a multimedia training library on inclusion and professional development resources open to everyone.

Videos Take a Stand As part of the Special Olympics World Games 2015, this video [1:17 minutes] advocates for acceptance and inclusion of all people and invites the community to stand up for someone who is perceived as different. Produced by children, this music video [3:19 minutes] tells the story of a little girl with Down Syndrome who was neglected by peers and then included by one girl; this turned things around for everyone. Including Issac This video documentation [12:40 minutes] demonstrates full inclusion of a boy with spinal muscular atrophy in a school setting. His parents, teachers, and peers show their compassion for Issac, solutions for his daily challenges, and the impact of his presence on everyone involved. Disabling Segregation This TEDx talk [17:53 minutes] presents the perspective of a father


whose son Samuel was born with cerebral palsy. Belonging to the neighborhood, community, and local school was the family’s major goal for Samuel. Through building awareness, friendships, and the civil courage of his supporters, this goal was achieved. Inclusion Explained in 80 Seconds Published by “Aktion Mensch,” a German non-profit organization, this video [1:20 minutes] demonstrates what inclusion looks like in various community settings. While the narration is in German, the animated visual drawings speak for themselves. Blog Posts Early Childhood Development Champions Converge on UNICEF This blog post describes a meeting hosted by UNICEF that brought together leading experts in early childhood, politicians, company executives, and honorable guests. All are committed to early childhood development, including global inclusion practices. Speakers stressed that a) rigorous science should inform policy-making required to sustain development, and b) funding should be made available to mobilize the initiative. Representatives advocated for promoting a “holistic well-being of all young children around the world” for global development. Special Olympics Highlights Need for Inclusive Development A blog post by Special Olympics International highlights a roundtable of corporate executives, disability advocates (including athletes with intellectual disabilities), politicians,

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and development leaders who discussed “inclusive global development.” While recognizing that more than 200 million individuals with intellectual disabilities have no access to appropriate healthcare, education, and basic social inclusion, roundtable participants committed to forming new partnerships, finding pragmatic solutions, renewing policies, and implementing new programs to bring about greater inclusion for all. Office of Special Education and Rehabilitation Service Blog This U.S. governmental blog provides information about the proposed policy statement on inclusion of young children with disabilities in high-quality early childhood programs. The policy statement addresses a definition of inclusion in early childhood programs, the scientific foundation, the legal structure, challenges to inclusion, building a culture of inclusion, and state recommendations. Podcast Episodes Inclusion Matters Produced by experts of the Center for Inclusive Child Care (CICC), this podcast series addresses specific topics related to inclusion such as the Fundamentals of Consultation, or the Emotional Environment. The Think Inclusive Podcasts Hosted by Tim Villegas of Brookes Publishing Company, this podcast interview series features experts, educators, parents, and people from the community discussing various inclusion topics.

The Inclusive Class Special educators and inclusion experts Nicole Eredics and Terri Mauro feature guests such as Dr. Temple Grandin to get insights and different perspectives on inclusion. Twitter Accounts @InclusionPress “Working towards inclusion for people of all abilities and backgrounds,” this account regularly tweets about latest news, happenings, and quotes about inclusion. @decsped This handle tweets information provided by staff and volunteers of the Division for Early Childhood – the leading voice on young children with special needs in the U.S. Author’s Note The first three resources listed have been provided by Dr. Pam Winton, the author of the 2015 featured article of imagine. About the Author Petra Kern, Ph.D., MT-BC, MTA, DMtG, business owner of Music Therapy Consulting is online professor at the University of Louisville and serves as editor-in-chief of imagine. Her research and clinical focus is on young children with ASD, inclusion programming, and educator/parent coaching. Contact:


Pin It: Find Music Therapy and Inclusion Practices Online Holly Mead, MT-BC Neurologic Music Therapist Palomar Health San Diego, California Jessica Simpson, MM, MT-BC Mobile County Public Schools in Mobile, Alabama Access to the internet provides countless means of finding and sharing new information and ideas worldwide. Whether music therapists are looking for new ideas to revamp their toolbox, or if they have tried all that they have with a client and need new ideas, a few keywords and phrases can be entered into a website and open up a whole new world of possibilities. Keywords can range from broad terms, such as “inclusion,” “generalization,” “music,” or “cognition,” to more specific terms related to goal areas, such as “painting,” “matching colors,” “counting songs,” or “movement songs.” When keywords and phrases are relevant to goals of a specific client or group, music therapists can find many ways to not only provide more effective services, but also to learn and grow as professionals. The following selected resources offer several online tools and information relevant to early childhood music therapy and inclusion.

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MusicTherapyActivities.wikia This website is created by a music therapist for music therapists. While sharing activities and information specific to population, goal/ objective, or use of music, website visitors can also upload their activities and ideas. Internet Search Engines Google or Bing are internet search engines that allow users to search for information worldwide. Keywords, phrases, or questions can be entered into the search bar to retrieve relevant information from other websites and sources. When using Google or Bing the searcher is able to input information into the search bar and then specify one of the tabs (e.g., the Web, Images, Maps, Videos, News, Shopping, Books, and More) to more accurately locate the desired results. For example, a Google search using the phrase “early childhood music therapy inclusion” provides many results, including the following: A PDF document entitled Musical Activities for Early Childhood Inclusion from ( A PDF document of Inclusion Guidelines for Music from the National Core Arts Standards ( An AMTA Pro Podcast from September 2010 entitled Music Therapy in Inclusive Classrooms ( A recorded webinar by music therapist Carol Ann Blank titled Embedding Music in the Early Childhood Inclusion Classroom (

Pinterest Pinterest is a collection of visual bookmarks, called “pins,” that are created, shared, and stored through an online bulletin board. This sharing tool is a massive resource for pictures, activities, books, resources, websites, and ideas. The user can search for keywords or phrases in the search tab and view pictures, or pins. Each pin will take the user to the website where the pin originated, providing the relevant or desired information about the pin. If the user finds that website useful, they can re-pin the picture to their own virtual bulletin board. In this way the user or, “pinner,” will develop collections of relevant information or activities that can be referenced at a later date. Pinners of interest to early childhood music therapists include: The Rhythm Tree (@therhythmtree) Kerry Cornelius (@songsforsuccess) Bear Paw Creek (@bearpawcreek) Kindermusik International (@kindermusik) Inclusion resources on Pinterest include: EC Inclusion Board by Full Circle Teaching (@fullcircleteach) The Inclusive Class (@inclusiveclass) Music Ideas for Preschoolers Board by Play-Based Classroom (@playbasedclssrm)


Blogs Blogs are regularly updated websites, usually written in informal language and developed by an individual, business, or group. These are great resources for music therapy activities as blogs are typically specific to one topic. Authors add new entries to their blogs on a regular basis (e.g., daily, weekly, monthly). These entries can be any information, articles, or activities that the author deems relevant and appropriate to be shared with their readers. Blogs can be found at any number of URL addresses and must be searched either by specific name or by specific topic. Early childhood music therapy blogs of interest include: Listen & Learn Music ( Raising Harmony ( Toneworks Music Therapy ( blog) Teachers Pay Teachers (TPT) This is an open online marketplace where users (mainly teachers) sell their downloadable educational materials they have created. The website offers free registration to the general public, weekly emails with free offerings, several downloads for a small fee, and over 200,000 free downloadable resources. The user is able to simply browse resources or can search for activities relevant to their clients by entering keywords or phrases into the search bar. TPT includes all academic areas, as well as several social, emotional, and physical goals.

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Members offering early childhood music resources include: Music with Sara Bibee Aileen Miracle

selected music from the Music Together, Kindermusik, and Musikgarten curricula. About the Authors

YouTube This video-sharing website allows anyone to upload, share, and view videos. The videos include most popular topics as they are uploaded by millions of people from around the world. The viewer is able to search for videos by typing in keywords or phrases that are specific to the topic or type of video desired. Viewers are able to find, view, or upload videos at Youtube channels highlighting early childhood music therapy ideas include: Chirp! Early Childhood Music Sarah Jane Mason, MT-BC Spotify This online application contains a collection of songs that can be listened to for free. While anyone who creates an account can listen to songs online, subscribers who pay a monthly fee are able to save songs to playlists, listen to them at any time on or offline, and avoid advertisements. Music can be searched for by song titles, keywords, artists, genre, mood an so on. The Spotify mobile app allows users to listen to music anywhere and is available in the Google Play Store, Apple App Store, and the Windows Phone Store.

Holly Mead, MTBC, Neurologic Music Therapist, is the lead music therapist at Palomar Health, a general hospital system in San Diego, California. Her specialties include physical rehabilitation and early childhood development. Contact:

Jessica Simpson, M.M., MT-BC, is a music therapist for Mobile County Public Schools in Mobile, Alabama. Her specialties include hearing and visual impairments and early childhood development.

Popular children’s musicians Laurie Berkner, Dan Zanes, Hap Palmer, and Ella Jenkins are available on Spotify. Users can also listen to


Post It: Join the Instagram Early Childhood Music Therapy Community

songsforsuccess Songs For Success in Maryland contains intervention ideas and resources. spectrumartsllc Spectrum Creative Arts, LLC in New York posts pictures illustrating how they implement their slogan “Inspire, Empower, Create.’

Featured post capturing Coleen Shanagher, MT-BC advertising an inclusive open mic night at tempotherapy

Gretchen Benner, LMSW, MT-BC Piedmont Music Therapy, LLC Fort Mill, South Carolina

The following Instagram accounts highlight early childhood music therapy:

Instagram is a free app available in the Apple App Store or Google Play Store on any smart phone. It allows users to take photos, then select a visual filter to display and share the image with an audience of followers. The posts are shared in real time or tagged as a #latergram to be shared at another time. The app encourages users to make connections through photos! There are a multitude of Instagram users that early childhood music therapists can follow for ideas and resources.

hgmusictherapy Harmony Garden Music Therapy Services in Michigan posts ideas for early childhood music classes and playgroups.

In honor of this year’s topic “inclusion,” a special spotlight goes to Tempo! Music Therapy Services in Nutley, New Jersey and West Chester, Pennsylvania. Their forprofit company provides therapeutic services, while also hosting events to support their non-profit organization Tempo! Arts for Life Foundation.

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morethanmusicllc More Than Music, LLC in Pennsylvania glimpses from #DrawMeASong classes that combine music and art, as well as their inclusive You&Me music classes. piedmontmusictherapy Piedmont Music Therapy, LLC in South Carolina/North Carolina shares music therapy intervention ideas and collaborative projects. rhythms4living Rhythms 4 Living, LLC in Florida captures photos of early childhood music therapy and music education.

toneworksmt Tone Works Music Therapy Services, LLC in Minnesota shares photographs, props, books, and events. Advocate for music therapy and inclusive settings in early childhood by using the following handles: #musictherapy #inclusion #earlychildhood Feeling more motivated and inspired after reading imagine 2015? Share the content on social media using the Twitter handle @imagineECMT. About the Author Gretchen Benner, LMSW, MT-BC is Owner of Piedmont Music Therapy, LLC and provides music therapy services and private music instruction to the Greater Charlotte Area in NC and SC. Contact:


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publications New Publications 2014-2015 Compiled by Christopher R. Millett, MM, MT-BC Florida Hospital Orlando, Florida

This list features a selection of publications related to early childhood music therapy released after imagine 5(1), 2014. Bell, A. P., Perry, R., Peng, M., & Miller, A. J. (2014). The Music Therapy Communication and Social Interaction Scale (MTCSI): Developing a new Nordoff-Robbins Scale and examining interrater reliability. Music Therapy Perspectives, 32(1), 61-70. Bunt, L., & Stige, B. (2014). Music therapy: An art beyond words (2nd ed.). New York, NY, US: Routledge/Taylor & Francis Group. Carpente, J. A., & LaGasse, A. B. (2015). Music therapy for children with autism spectrum disorder. In B. L. Wheeler (Ed.), Music Therapy Handbook (pp. 290-301). New York, NY: Guilford Press. Colwell, C., Memmott, J., & Meeker-Miller, A. (2014). Music and sign language to promote infant and toddler communication and enhance parent–child interaction. International Journal Of Music Education, 32(3), 333-345. Costa-Giomi, E., & Ilari, B. (2014) Infants' preferential attention to sung and spoken stimuli. Journal of

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Research in Music Education, 62(2), 188-194. de l'Etoile, S. K. (2015). Self-regulation and infantdirected singing in infants with Down syndrome. Journal of Music Therapy. PMID: 25957338 Dearn, T., & Shoemark, H. (2014). The effect of maternal presence on premature infant response to recorded music. JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing, 43(3), 341-350. Fees, B. S., Kaff, M., Holmberg, T., Teagarden, J., & Delreal, D. (2014). Children's responses to a social story song in three inclusive preschool classrooms: A pilot study. Music Therapy Perspectives, 32(1), 71-77. Garunkstiene, R., Buinauskiene, J., Uloziene, I., & Markuniene, E. (2014). Controlled trial of live versus recorded lullabies in preterm infants. Nordic Journal of Music Therapy, 23(1), 71-88. Ghetti, C. M., & Whitehead-Pleaux, A. M. (2015). Sounds of strength: Music therapy for hospitalized children at risk for traumatization. In C. A. Malchiodi (Ed.), Creative Interventions with Traumatized Children (2nd ed.), (pp. 324-341). New York, NY: Guilford Press. Gillmeister, G. E., & Elwafi, P. R. (2015). Music therapy for children with sensory deficits. In B. L. Wheeler (Ed.), Music Therapy Handbook (pp. 315-327). New York, NY, US: Guilford Press. Gold, C. (2014). Music therapy in neonatal care. Nordic Journal Of Music Therapy, 23(1), 1. Haslbeck, F. B. (2014). Creative music therapy with premature infants: An analysis of video footage. Nordic Journal Of Music Therapy, 23(1), 5-35. Haslbeck, F. B. (2014). The interactive potential of creative music therapy with premature infants and


their parents: A qualitative analysis. Nordic Journal of Music Therapy, 23(1), 36-70. Hilliard, R. E. (2015). Music and grief work with children and adolescents. In C. A. Malchiodi (Ed.), Creative Interventions with Traumatized Children (2nd ed.), (pp. 75-93). New York, NY: Guilford Press. Hollins Martin, C. J. (2014). A narrative literature review of the therapeutic effects of music upon childbearing women and neonates. Complementary Therapies In Clinical Practice, 20(4), 262-267. Humpal, M. (2015). Music therapy for developmental issues in early childhood. In B. L. Wheeler (Ed.), Music Therapy Handbook (pp. 265-276). New York, NY: Guilford Press. Illari, B. (2015). Rhythmic engagement with music in early childhood: A replication and extension. Journal of Research in Music Education, 62(4), 332-343. Jacobsen, S. L., & Killén, K. (2015). Clinical application of music therapy assessment within the field of child protection. Nordic Journal of Music Therapy, 24(2), 148-166. Kim, J. (2015). Music therapy with children who have been exposed to ongoing child abuse and poverty: A pilot study. Nordic Journal of Music Therapy, 24(1), 27-43. Kirby, L. A., Obi, R. O., & Sahler, O. Z. (2014). Music therapy and pain management in pediatric patients undergoing painful procedures. In J. Merrick, P. Schofield, M., Morad, J. Merrick, P. Schofield, & M. Morad (Eds.), Pain: International Research in Pain Management (pp. 111-122). Hauppauge, NY: Nova Biomedical Books. Koops, L. H. (2014). Songs from the car seat: Exploring the early childhood music-making place of the family vehicle. Journal of Research in Music Education, 62, 52-65. Loewy, J. (2015). Medical music therapy for children. In B. L. Wheeler (Ed.), Music Therapy Handbook (pp. 425-440). New York, NY:: Guilford Press. McLaughlin, B., & Adler, R. F. (2015). Music therapy for children with intellectual disabilities. In B. L. Wheeler (Ed.), Music Therapy Handbook (pp. 277-289). New York, NY: Guilford Press. Mehr, S. A. (2014). Music in the home: New evidence for an intergenerational link. Journal of Research in Music Education, 62(1), 78-88. Miksza, P., & Gault, B. M. (2014). Classroom music

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experiences of Us.S. elementary school children: An analysis of the Early Childhood Longitudinal Study of 1998-99. Journal in Music Education, 62(1), 4-17. Randles, C. (2014). Review of early childhood music therapy and autism spectrum disorders. Psychology of Music, 42(5), 766-767. Schwartzberg, E. T., & Silverman, M. J. (2014). Music therapy song repertoire for children with autism spectrum disorder: A descriptive analysis by treatment areas, song types, and presentation styles. The Arts In Psychotherapy, 41(3), 240-249. Shoemark, H., & Hanson-Abromeit, D. (2015). Music therapy in the neonatal intensive care unit. In B. L. Wheeler (Ed.), Music Therapy Handbook (pp. 415-418). New York, NY: Guilford Press. Thompson, G., & McFerran, K. S. (2015). “We’ve got a special connection”: Qualitative analysis of descriptions of change in the parent–child relationship by mothers of young children with autism spectrum disorder. Nordic Journal of Music Therapy, 24(1), 3-26. Thompson, G. A., McFerran, K. S., & Gold, C. (2014). Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: A randomized controlled study. Child: Care, Health & Development, 40(6), 840-852. Vaiouli, P. (2014). Joint engagement for toddlers at risk with autism: A family, music-therapy intervention. Music Therapy Perspectives, 32(11), 193. Vaiouli, P., Grimmet, K., & Ruich, L. J. (2015). “Bill is now singing”: Joint engagement and the emergence of social communication of three young children with autism. Autism: The International Journal Of Research & Practice, 19(1), 73-83. Vaiouli, P., & Ogle, L. (2015). Music strategies to promote engagement and academic growth of young children with ASD in the inclusive classroom. Young Exceptional Children, 18, 19-28. Wetherick, D. (2014). Music therapy and children with a language impairment: Some examples of musical communication in action. Psychology of Music, 42(6), 864-868.


reviews Judith Jellison’s new book Including Everyone: Creating Music Classrooms Where All Children Learn describes music learning for children with disabilities and for all children. This groundbreaking book takes a unique approach by focusing on good teaching strategies and the strengths of children instead of focusing on deficits based upon individual labels. Jellison begins the book by making the case that all children (those with and without disabilities) deserve quality music instruction. Chapter 2 takes a critical look at music education. Jellison suggests that music education should be focused on meaningful goals that will encourage music participation in adulthood. Her ideas about teaching skills that generalize and transfer across many areas ensure that music learning can occur not just during school years, but across a lifetime. She provides clear guidelines for designing music programs based on lifelong music learning.

Jellison, J. A. (2015). Including everyone: Creating music classrooms where all children learn. New York: Oxford University Press. 248 pages. ISBN: 9780199358779. $27.95

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In Chapter 3, readers will find four principles that are central to providing quality music instruction for all children. The first principle is to provide culturally normative music experiences with socially valued roles for all children, and the second suggests that teachers provide frequent, positive, and reciprocal peer interactions to foster meaningful social development in music. Thirdly, Jellison recommends fostering selfdetermination in environments where students feel safe, experience autonomy, feel competent, and make choices. The last principle is to collaborate with other individuals including parents, teachers, and the child.


The final chapter of Including Everyone provides practical strategies for implementing successful music programs from a universal approach. Jellison provides a model for effective inclusive music programs that includes: creating a quality music program and a culture of inclusion, gathering information about students and environments, planning strategies to meet the diverse needs of students, and thinking ahead to evaluate student progress and making changes as necessary. This final chapter is full of specific suggestions that teachers and therapists will find very useful as they collaborate together to facilitate inclusion. At the end of the book are several helpful appendices outlining a history of special education services in the United States as well as interesting learning activities that students and teachers can use in classes or for personal development. There is a useful companion website to the text that provides the reader with access to student profiles, lesson plans, and further information regarding chapter topics. This book takes an original approach, one that focuses on universal strategies as well as individual adaptations. It is designed to help music teachers provide quality music instruction for all children in inclusive classrooms and to enlighten music therapists of these practices. Jellison expertly combines a solid theoretical foundation with useful and specific strategies that will be beneficial to music teachers and music therapists alike.

Listen to my audio

About the Author


Laura Brown, PhD, MT-BC is assistant professor of music therapy at Ohio University. Her research interests include music with children with Autism Spectrum Disorder and inclusion.

Dr. Judith A. Jellison is the author of this year’s imagine reflection on “Inclusion and Music Therapy Past and Future.”


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Rook, J., West, R., Wolfe, J., Ho, P., Dennis, A., NakaiHosoe, Y., & Peyton, K. (2014). Music therapy social skills assessment and documentation manual: Clinical guidelines for group work with children and adolescents. Philadelphia, PA: Jessica Kingsley Publishers.197 pages. ISBN 978-1-84905-985-5 $65.00 The purpose of the Music Therapy Social Skills Assessment and Documentation Manual (MTSSA) is to provide a step-by-step comprehensive assessment protocol for group-based music therapy sessions. The MTSSA focuses on social skill development of clients from pre-kindergarten through high school age with various special needs. It also includes suggestions for clients who may use communication devices or are nonverbal. The introduction and literature review provide support for the early classification system of social stages of play next to social skill assessment related to specific diagnosis and available evidence from the music therapy literature. This section also includes a comprehensive explanation of levels of prompting for specific behavior, presenting a foundation for the prompt level hierarchy scale developed for the MTSSA. Tips for using the manual and accompanying CD-ROM are also offered. The core of the manual provides direction and guidelines for implementation along with helpful resources. The first section addresses initial interactions with educators, staff, and caregivers and indicates which forms (available for download on the accompanying CD-ROM) may be most useful for the initial meeting. Next, the MTSSA provides detailed instructions for the assessment protocol applied during the following sessions (i.e., NonMusical Assessment, Musical Observation Assessment of Social Skills, Musical Observational Assessment with Prompting I, Musical Observational Assessment with Prompting II, and Initial Music Therapy Session) using data tracking forms.

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Unique to this manual is the outline of musical interventions (including original music on a CD) that can be implemented during the assessment sessions. Specific social behaviors (i.e., cooperative, reciprocal, joint attention, parallel, or onlooker) to be assessed are embedded in the song lyrics and reflected on the data tracking forms. The authors encourage using a music therapy assistant (or staff available in school systems) to manage data collection so that the specific levels of prompting for each behavior can be noted. The final part of the book addresses how to a) analyze the assessment data and b) develop individualized social goals for each client in collaboration with the educators, staff, and caregivers. Forms and case study examples for weekly session document, evaluation of quarterly progress, and progress reports are also presented. The book closes with steps to undertake for using the MTSSA for client assessment after accomplishing the set social goals. Overall, the manual is a comprehensive tool, providing music therapists with valuable resources. MTSSA offers a thorough description of specific social behaviors and levels of prompting that can be useful for working with young children in various group settings. The evidencebased protocol can be utilized to report specific and measurable data to parents and administrators.

Listen to my audio bookmarks! About the Author Adrienne Steiner, MM, MT-BC is the Clinical Coordinator at the University of Louisville’s Music Therapy Clinic and Lecturer in the music therapy program. She provides individual and group sessions to a diverse population. Contact:


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