Page 67

music is “sound and silence expressively organized in time” (Madsen & Madsen, 1997, p. 24) and the provision of music “consistently has a positive and significant impact in the NICU” (Standley, 2012, p. 314). Key acoustical properties including pitch, melody, tempo, harmony, and rhythm, make music highly organized and predictable, functioning to soothe and stabilize the neurologically immature infant more effectively than speaking (Standley & Whipple, 2003). Furthermore, term infants show a fixed, sustained attention to music (Standley & Walworth, 2010) and longer periods of attention during singing compared to speaking (Nakata & Trehub, 2004), which may also be true in preterm infants, indicating an optimized parent-infant interaction during parental singing. Parental Singing Research on parental singing has revealed a variety of benefits for premature infants. Arnon et al. (2014) found when mothers sang during kangaroo care, their infants exhibited better autonomic stability as evidenced by heart rate variability changes. Chorna, Slaughter, Wang, Stark, and Maitre (2014) revealed that when mother’s voice was played through a pacifier-activated lullaby® during nonnutritive sucking, premature infants demonstrated significantly increased oral feeding rates, volume intake, number of oral feeds per day, and faster time to full oral feeds, as well as shorter hospital stays. Cevasco (2008) also showed a decrease in hospital stay for preterm infants who listened to recordings of their mother’s singing. Benefits of maternal singing also transcend those for the infant. Mothers who sang to their premature infants showed increased parental involvement while reporting improved coping and bonding with their child (Cevasco, 2008) as well as decreased anxiety (Arnon et al., 2014). While singing is more effective than speaking (Nakata & Trehub, 2004; Standley & Whipple, 2003) and the use of live music produces the greatest benefits (Standley, 2012) for premature infants, live parental singing may not always be feasible for a variety of reasons including: Medical needs of the mother post-delivery; Limited resources for transportation or a long commute to and from the hospital; Needs of other children or family members at home; A short or unobtainable maternity/paternity leave; Single parenting; and

imagine 7(1), 2016

Parental stress, anxiety, or depression related to the infant’s hospitalization or fragility. All of these, and more, may prevent or limit a family’s ability to be at the bedside with consistency and regularity, indicating the need for increased promotion of family-centered care and supportive services, such as NICU music therapy (NICU-MT) in the form of parental lullaby recording. Recording Lullabies NICU music therapists often work with families to create lullaby recordings for use with their infant when they are unavailable or as an activity to improve the family’s coping and adjustment to their child’s hospitalization. NICU parents are encouraged to use recordings of their own singing with their child as it is preferred over unfamiliar voices and important for language stimulation and bonding. Furthermore, commercially available music via tape, CD, or electronic/online platforms rarely complies with evidence-based recommendations on appropriate music for NICU infants consisting of: Voice only or voice with one instrument, Light rhythmic emphasis, Constant rhythm and volume, Melodies in a higher vocal range, Female vocalists, and In the native language of the family (Standley & Walworth, 2010). As well as Three chords or less, Major chords, and Played slowly and softly in a repetitive lullaby style (Nguyen, Jarred, Walworth, Adams, & Procelli, 2005). In compliance with these recommendations, one approach NICU-MTs use for parental lullaby recording is having parents sing familiar lullabies such as “Twinkle Twinkle Little Star” or “You Are My Sunshine,” which could be accompanied by the music therapist on guitar. Another more personalized approach is to have the parents complete a fill-in-the blank songwriting task in which they replace some words or phrases in familiar lullabies with the baby’s name or personalized messages. An additional option would be to use an Orffbased songwriting approach.

67

Profile for imagine

imagine 2016  

In this issue, over 70 authors from 12 countries share their dedication and passion for early childhood music therapy with imagine readers....

imagine 2016  

In this issue, over 70 authors from 12 countries share their dedication and passion for early childhood music therapy with imagine readers....