Modern Music Matters 1

Individuals rely on music for a variety of reasons. Music can evoke nearly every emotion,

accompanying humanity through its highest moments of euphoria and lowest points of sorrow.

Throughout years of research, observation, and development, musicians and scientists discovered

that by manipulating music and the tools that lie within it, music can assist individuals with a

variety of conditions. Thus, the field of music therapy was born. Generally practiced in a clinical

setting, music therapy utilizes music interventions to address and improve upon social,

behavioral, communicative, psychological, sensory-motor, physical, and / or cognitive

functioning within individuals (American Music Therapy Association, 2012).

Some of the first writings regarding music in a therapeutic sense occurred in the early

1800s. Two medical dissertations were written by Samuel Mathews and Edwin Atlee, both

students of Dr. Benjamin Rush, a psychiatrist and physician who was a strong proponent of

using music to treat medical diseases, (American Music Therapy Association, 2017). Several

years following, music therapy evolved into an organized clinical profession, academic programs

sprouted in universities, and national allegiances were established in support of the field.

Music therapy has proven to be particularly effective with individuals who have Autism

Spectrum Disorder, a common developmental disability that inhibits a persons ability to interact

and communicate with others. One of the most debilitating symptoms is the inability or difficulty

in recognizing and understanding social cues, many of which are non-verbal. The condition

affects individuals to varying degrees and in different ways; therefore, individuals fall on

different places on the spectrum. Some people are more severely affected than others.

Currently, there is not a definite cure for Autism, but measures can be taken to alleviate the

symptoms, particularly within the music therapy realm.

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Throughout this paper, we will come across several references to Early Childhood

Music Therapy and Autism Spectrum Disorders: Developing Potential in Young Children and

Their Families by Marcia Earl Humpal and Petra Kern. This text proves useful for framing

several of the interventions included in this paper.

Communication and social interaction issues largely define Autism. Children on the

spectrum may struggle utilizing and comprehending verbal and non-verbal elements of

communication involved in social exchanges, such as facial expressions, eye contact, and speech

prosody (the manner in which someone stresses and emphasizes their speech). Despite these

challenges, children often possess innate musicality that serves as grounds for development of

their communication skills and relationships (Humpal & Kern, 2012). Dr. Lori Gooding,

Associate Professor of Music Therapy at the Florida State University College of Music, explains

that music inherently contains these social properties, such as communicating, listening,

interacting, and being part of a group, so exercises can be designed to engage them in those

skills. To address these skills, for example, a music therapist could group together three or more

children and have them interact by taking turns playing a drum. Alternatively, call and response

songs in which the therapist sings and the client listens (and vice versa) helps the duo explore

the parameters of communication in terms of conversation together (Gooding, 2017). Through

these types of exercises, music therapists can often find success when other approaches may not

be effective.

Watching a portion of a music therapy session at the Cadenza Center for Psychotherapy

and the Arts (an agency based in Hollywood, Florida), gave me more insight on the exercises

previously described. In the excerpt, the therapist, Miss Lauren, held the objective of teaching

her client, an adorable, energetic, young boy named Nicolas, how to count to five. First, without
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any music, she counted to five using her fingers and voice simultaneously. Nicolas was

instructed to repeat each number after her. Once Nicolas mastered each of the numbers without

music, Miss Lauren proceeded to play a lighthearted song about five frogs jumping into a pond

one-by-one to further assist Nicolas in learning to count to five. This song incorporated aspects

of call-and-response in that Miss Lauren would halt her singing and guitar playing briefly to

allow Nicolas to say the number she was prompting him to say (1 through 5). If Nicolas

struggled to say the proper number the first time, Miss Lauren held up her hand with the proper

number of fingers in order to aid him. Once Nicolas successfully completed the task of counting

to five with the incorporation of the song, Miss Lauren positively reinforced him with a high

five. The call-and-response tactic proves especially useful for teaching young children simple

tasks and improving their communication skills. Music Therapy Session

Music therapy treatment can vary among children and adults, from the setting of the

treatment to the treatment approaches themselves. For instance, children typically receive music

therapy treatment through school and community settings, although some music therapists also

work in hospitals or run their own private practices. Facilities for folks with developmental

disabilities typically serve adults on the spectrum (Davis, Gfeller, & Thaut, 2008). However,

while there is seemingly a clear difference in children and adults, treatment methods themselves

go beyond those two categories and must be personalized to cater to the individuals specific

needs and cognitive abilities. Dr. Gooding explains, if theyre forty, but they function more

along the lines developmentally of a ten-year-old, were going to try to use music thats

appropriate for a forty-year-old, but present it in a way that a ten-year-old could manage it.

Through this approach, therapists work to ensure that not only is the treatment developmentally
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and culturally appropriate, but the patients or clients preference is also honored (Gooding,

2017).

Several therapeutic methods are linked together beneath the umbrella of a concept called

applied behavioral analysis. Applied behavioral analysis (ABA). ABA is the applied science of

modifying and studying behavior to promote a desired change. ABA studies learning and

behavior and examines how environmental and biological factors affect fluctuations in behavior

(Humpal & Kern, 2012). Four main components set the groundwork for ABA: reinforcement,

prompting, task analysis, and generalization. Different exercises performed in music therapy

sessions are crafted to utilize these principles.

Reinforcement uses the addition of an activity or item that is enjoyable or the removal

of a positive stimulation to increase a preferred behavior. In order to properly use music as a

reinforcer for a particular client, therapists should assess their clients preference in musical

instruments, dance or movement songs, and recorded music. From there, therapists can

determine the most efficient music strategy to adopt as a reinforcer. It is important, when

determining an appropriate reinforcement technique, to consider the environment in which the

strategy will be performed, whether the reinforcement will be performed sporadically, or

immediately after each time the desired behavior occurs (Humpal & Kern, 2012).

Another component of ABA is a tactic called prompting, the intentional supply of help

or cues to aid the acquisition of the desired skill or task. Prompting itself contains several

different types of strategies to assist in reaching the end goal. One of these sub-strategies that

is particularly effective when applied to music therapy is the graduated guidance strategy. This

strategy begins with manipulating a prompt that guarantees a correct action or response. Once

the client has mastered this, the therapist must decrease the level of the prompt gradually until
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the client can successfully perform the task without any assistance. On a musical scale, the

therapist can, for example, teach the client information, such as an address, within the melodic

and rhythmic framework of a song. Once the client has memorized that information within that

context of the song, certain elements of the song are gradually stripped away: the therapist may

first strip the lyrics, then the melodic structure, then the rhythmic cues, and so on, until the client

can successfully deliver their address independent of any cues from the music (Humpal & Kern,

2012).

For larger activities and goals, task analysis proves rather effective in a musically

therapeutic setting. Task analysis is, simply, breaking down an activity or task into a series of

steps, or individual components that compromise the whole. Utilizing the structure of a pop

song, with the verses and the chorus, is one way to incorporate task analysis into music therapy

sessions. For example, each song verse teaches one element of the task, whereas the

(reoccurring) chorus of the song reiterates the task as a whole. This particular method supplies

clients with opportunities for repeating and practicing a task.

The fourth major component of ABA is generalization. The primary goal of

generalization is to take the skills the clients learn in their structured therapy sessions and apply

them to a variety of different people, settings, times, materials, or behaviors. One could think of

it as cross-contamination. Individuals with ASD struggle particularly with generalization due to

their physiological processing difficulties (Humpal & Kern, 2012). Because social skills do not

come naturally for individuals on the spectrum, they often must learn social skills in a specific

manner in a particular environment and memorize how to perform this skill. For example, they

could be learning how to visit a teacher after class and ask them a question. They could become a

master at learning how to ask a teacher a question one-on-one, but the moment they try to
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introduce themselves to a new classmate, they could be at a loss for what to do. As this skill

poses as a particularly large mountain for autistic individuals to climb, these individuals

generally required advanced treatment or programming to overcome this issue. However,

generalization can be adapted for a music therapy standpoint to make this skill more accessible

to those on the spectrum. A therapist could create a song designed to demonstrate to a young

autistic child how to appropriately as for a snack during the childs scheduled snack time. This

song can also be taught in a separate environment from snack time, then incorporated into snack

time once it is mastered. The song can also be adapted to teach different skills. Generally, the

more environments in which a certain skill is practiced, the more successful the client will be in

generalizing that skill.

The use of Applied Behavioral Analysis translates over to clinical psychology as well.

According to Dr. Ann Pilar Jacobson, licensed psychologist in the Kansas City area, some

psychologists are specifically trained in ABA so they can effectively treat children with severe

autism, as ABA generally works best with young children. However, high functioning

individuals typically benefit from normal psychotherapy. Like others on the spectrum, high

functioning individuals struggle with social interactions and need coaching, but they generally

reap benefits from role playing with the psychologists to map out the steps in social interactions.

Training social interactions is like teaching someone how to do math, speculates Dr. Jacobson.

Teaching people the steps of social interactions and then applying them in a role play scenario is

a non-musical method of incorporating task analysis into therapy sessions. The goal is for them

to learn [the concept of] reciprocity, the give and take of social interactions, she stated.

Another aspect of individuals on the spectrum is the high amount of sensitivity and the

necessity for emotional regulation, so therapists need to navigate how to help these individuals
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manage their emotional reactions. However, males and females often differ in the types of

emotions they experience. Autistic females typically are more prone to sensitivity and anxiety

than autistic males. In order to ease this discomfort, Dr. Jacobson teaches them relaxation,

meditation, and other ways they can sooth themselves because the social environment can cause

them tremendous anxiety. Autistic males, on the other hand, may be subject to more emotional

outbursts, yet similar techniques prove beneficial for them. Some of the males Ive worked with

in the past have anger outbursts and dysregulated emotion, so they can also benefit from

relaxation techniques, speculates Dr. Jacobson. Regarding high-functioning autistic individuals

in the workforce, Dr. Jacobson believes that they could benefit from an on-the-job coach to help

them navigate the arena of socializing within the workplace.

While clinical psychologists can lead individuals on the spectrum to success in many

cases, some argue that music therapy has the upper hand. Often times, individuals with ASD,

particularly those who function at a lower level on the spectrum, struggle with language usage

difficulties, or a reluctance to use language all together. This issue interferes with their ability to

form relationships, as language and communication is the basis for doing so. However, music

therapists have the benefit of utilizing a mode of communication nondependent on language

(music). Through this accessible mode of expression, therapists and clients rehearse and explore

a wide range of reciprocal interactions without solely using words; they also can use musical

instruments and technology to encourage verbal and non-verbal communication (Gadberry &

Harrison, 2016). Communicating through words may be easier than speech and less intimidating

for some individuals. Music, therefore, provides an effective gateway for improving

communication skills.
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We are continuously learning more and more about how to intervene and treat autism to

accommodate the vast population with this disorder. Due to the social, interactive nature of

music, music therapy proves itself as promising method of treatment. With more and more

college training programs sprouting, the growth of the national organizations, and the continued

usage of music therapy in schools, hospitals, and community sites, music therapy continues to

gain recognition as an effective form of therapy, and it is not going away. If anything, it is

becoming mainstream.
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References

C. (2016, October 21). Retrieved November 05, 2017, from

https://www.youtube.com/watch?v=LFw_haI-tuc

Davis, W. B., Gfeller, K. E., & Thaut, M. (2008). An Introduction to Music Therapy - Theory

and Practice (3rd ed.). Silver Spring, MD: American Music Therapy Association.

Gadberry, A. L., & Harrison, A. (2016). Music therapy promotes self-determination in young

people with autism spectrum disorder. International Journal of School & Educational

Psychology, 4(2), 95-98. Retrieved October 22, 2017, from tandfonline.com.

Gooding, L., PhD. (2017, October 25). [Personal interview].

Humpal, M. E., & Kern, P. (2012). Early Childhood Music Therapy and Autism Spectrum

Disorders: Developing Potential in Young Children and Their Families. London: Jessica

Kingsley Publishers.

Jacobson, A. P., PhD. (2017, November 3). [Telephone interview].

Music Therapy as a Treatment Modality for Autism Spectrum Disorders [Created by the

American Music Therapy Association]. (2012).

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Who Can Benefit from Music Therapy? (n.d.). Retrieved October 22, 2017, from

https://musictherapyconnections.org/who-can-benefit-from-music-therapy/