Music Therapy for Social, Behavioral,
Physical Needs of Students with Disabilities
written by Michelle
Agudelo and Christine
Stopka, University of Florida
Many physical education teachers have
used music in their physical education classes, and witnessed
its motivational, psychomotor, rhythmic, social, and emotional
benefits. The purpose of this article is to take a closer
look at music therapy itself; what it entails, and (especially)
to understand its effects and benefits.
Defining Music Therapy
Music therapy can be defined in many
ways because it is a form of therapy that is currently being
applied to many different needs. The American
Music Therapy Association provides this definition. "Music
Therapy is the clinical and evidence-based use of music interventions
to accomplish individualized goals, within a therapeutic relationship,
by a credentialed professional who has completed an approved
music therapy program. It is a well-established allied-health
profession that uses music therapeutically to address behavioral,
social, psychological, communicative, physical, sensory-motor,
and/or cognitive functioning." (1)
There is a wide variety and range
in the type of patients who use music therapy. According to
the American Music Therapy Association "the malleability
of music makes it a medium that can be adapted to meet the
needs of each individual." (1) In other words, music
therapy provides a very unique and flexible form of therapy
that can be applied to different types of patients at the
current level of need of each patient.
History of Music Therapy
The American
Music Therapy Association states "the idea of music
as a healing influence which could affect health and behavior
is at least as old as the writings of Aristotle and Plato."
(2) It then goes on to say that it was not until the 20th
century that music therapy began as a formal profession. According
to multiple sources, true recognition of music being used
as therapy began after World War I and II when different types
of musicians would go play for the veterans who had physical
and emotional trauma.
In the 1900's there were associations
that were formed as a result of support for music therapy,
but none of these were ever able "to develop an organized
clinical profession." (2) Between the 1930s and 1940s
is when there was a true organizational effort to make music
therapy a recognized academic program. The first University
that was successful in establishing the first academic program
in music therapy was Michigan State University in 1944. The
first true association for music therapy was the National
Association for Music Therapy (NAMT), which was founded in
1950.
According to the American Music Therapy
Association they were the first to create a constitution and
bylaws, develop university-level curriculum, educational and
clinical training requirements, make research and clinical
training a priority, create a registry and board certification
requirements (1985), and to publish research and clinical
journals (2). The American Association for Music Therapy (AAMT)
began in 1971, and in 1980 published its first research and
clinical journal.
Between 1983 and 1985 The Certification
Board for Music Therapists (CBMT)
became fully accredited by the National Commission for Certifying
Agencies, and is in place to assure competency and credibility
of music therapists. According to the American Music Therapy
Association (AMTA), the American Music Therapy Association
"was formed in 1998 as a merger between the National
Association for Music Therapy (NAMT) and the American Association
for Music Therapy (AAMT)." (2)
According to their site, "AMTA
is the single largest music therapy association in the world,
representing music therapists in the United States and in
over 30 countries around the globe." (2) Their mission
is to "advance public knowledge of the benefits of music
therapy, and to increase access to quality music therapy services
in a rapidly changing world." (2)
How Does Music Therapy Work?
According to multiple sources of research,
the basis for how music therapy works is based on the idea
that because music is processed in multiple areas of the brain
at the same time, there is deeper access of the pathways between
neurons. Also, since music is interpreted in a different way
than is speech and certain motor functions, listening to,
engaging in, and learning music is a way that the brain develops
new pathways for learning and communication.
The most recent public example of
music therapy being proven effective is the story of Congresswoman
Gabrielle
Giffords who suffered a gunshot wound to the head January
8, 2011. She has needed rehabilitation to recover some of
her ability to walk, speak, as well as to read and write.
Music therapy is one of the main reasons she has regained
her ability
to speak.
The brain learns and interprets language
and speech with the left side of the brain. On the other hand,
the right side of the brain is responsible for processing
information intuitively and creatively. Music activates parts
of the corpus
callosum, which is the area of the brain that allows the
left and right brain to work together. In the example of congresswoman
Giffords, her brain injury damaged the area of her brain that
affects her ability to speak. Music therapy allows the brain
to use a different pathway, when verbalizing along with music,
that allows for connection with the left hemisphere. Music
provides an alternate route around traumatized or damaged
areas of the brain, and helps it to grow new pathways to recall
memories and words, and how to speak.
Music Therapy and Autism
The same concept can be applied to
certain diseases and conditions. Music therapy is entering
the fields of physical and occupational therapy because it
is being proven effective in many different areas. There are
a variety of studies performed by different institutions where
research is supporting that music therapy is producing results
sooner than other treatments that have been used for years.
A recent study, referred to in the
article reporting congresswoman Giffords recovery of speech,
states that according to a recent study with autistic children
at Harvard Medical School, "music therapy helped all
of them better articulate words and phrases… Some said
their first words after just eight weeks of music-based therapy."
(4) The science indicates that it is some combination of rhythm,
pitch, vision, and hearing that helps the brain to use different
pathways to access words and language from memory. The collective
use of these different elements of music is referred to as
melodic
intonation therapy. The use of music therapy for people
with autism, or varying degrees of Autism Spectrum Disorders
(ASD), is being reported as "widely beneficial."
(5)
128 articles were identified in the
Journal of Autism and Developmental Disorders, in regard to
music intervention for children with autism, where music interventions
were used to facilitate social, communicative, and behavioral
skills in young children with the disorder. Another study
published by the Journal of Autism and Developmental Disorders
whose purpose "was to investigate the effects of improvisational
music therapy on joint attention behaviors in pre-school children
with autism" (6) discusses that "the overall results
indicated that improvisational music therapy was more effective
at facilitating joint attention behaviors and non-verbal social
communication skills in children at play." (6)
Of the many reasons that music therapy
is an excellent tool to use for children and people with autism,
some of the most important have to do with the fact that it
is a "medium that can be adapted to meet the needs of
each individual." (1) (According to the article Music
Therapy and Individuals with Diagnoses on the Autism Spectrum)
the American Music Therapy Association states that "music
therapy may include the use of behavioral, biomedical, developmental,
educational, humanistic, adaptive music instruction and/or
other models, enhances quality of life, involving relationships
between the individual and qualified music therapist and his/her
family, and these relationships are structured and adapted
through the elements of music to create a positive environment
and set the occasion for successful growth." (1)
Another study published in Complementary
Therapies in Medicine reports that "there is a continuing
improvement in the hearing and speech, hand-eye coordination,
and personal-social interaction" of children with developmental
delays. It states; “music therapy seems to have an effect
on personal relationships, emphasizing the positive benefits
of active listening and performing, and this in turn sets
the context for developmental change." (3) The data in
this study was investigated further and "revealed the
importance of hand-eye coordination for developmental changes."
(3)
I find it very interesting that music
can serve as a tool or method that can simultaneously improve
cognitive as well as physical function and development. At
times it seems as though the therapies and help, that are
provided for people with disease or disability, are too rigid
or too focused. It is good to know that there are therapies
that can work on the individual in a holistic way. The explanation,
given in the example of the study stated above, is "the
active element of musical playing, which demands the skill
of hand-eye coordination, appear to play a significant role
in developmental changes as they occur in the therapeutic
musical relationship." (3)
People with autism have many social
and behavioral challenges associated with their condition.
Music therapy can provide a way in which a person with autism
can improve their social disposition and relationships, learn
and develop new behavioral patterns, and also participate
in activities that improve cognitive/intellectual function.
They can have the opportunity to improve balance and hand-eye
coordination, which research has indicated is very important
in improved development.
Music Therapy and Parkinson's
Disease
One of the biggest areas where music
therapy is being applied is in the treatment of Parkinson's
disease. According to an article from Psychomotic Medicine,
when music therapy was applied in conjunction with physical
therapy there was positive improvement in balance and gait,
motor function, and emotional function by the end of the therapy
sessions. (3) There are many researchers that have recorded
that when a person with Parkinson's disease is provided with
visual patterns and rhythm to walk to, there is improvement
in symmetrical stride and sense of balance.
It appears to be that the auditory
cue helps the brain to time and regulate each step/body movements.
A study, published in the Psychosomatic Medicine Journal of
Bio-behavioral Medicine, concluded that music therapy had
a significant overall effect on bradykinesia
[which is slow movement, and is associated with nervous system
disorders, particularly Parkinson's Disease. (8)]. (7) This
extensive three month study concluded that "MT (music
therapy) is effective on motor, affective, and behavioral
functions. We propose MT as a new method for inclusion in
PD (Parkinson’s Disease) rehabilitation programs."
(7)
Practical Applications/Conclusions
It is important to point out that Music Therapy is a relatively
new area of interest that physical therapists, occupational
therapists, and other medical professionals are very recently
beginning to research and implement. A lot of the science
is still concerned with discovering the physiological and
biological mechanisms that physically and chemically take
place in the brain to produce the effects that are being seen
in persons with disease and disability who participate in
music therapy.
One of the reasons that it is difficult to explain and defend
the use of music therapy as a recognized field (like physical
therapy and occupational therapy) is that there is not yet
enough data and information to back up all of the applied
uses, advantages, and benefits of music therapy in a substantial
way. It seems as though the passage of time, and more stories
and situations like that of congresswoman Giffords, will need
to reach the public before more importance and recognition
is given to music therapy.
Other diseases and disorders where music therapy is being
applied are muscular dystrophy and rehabilitation for trauma.
People with muscular dystrophy face many physical challenges
on a daily basis. Music therapy provides them with a mechanism
to cope with their condition as well as actively participate
in activities that encourage movement. However, there is not
a large enough volume of studies, data, or information that
prove the effectiveness of music therapy for persons with
muscular dystrophy.
Traumatic brain injuries, from accidents or strokes, are
also being treated with music therapy. The basic idea that
music encourages the brain to create new pathways also applies
to the treatment of brain injury. The brain can adapt to physical
injury, and the affected person can learn to function better,
and in some cases more independently. This is one of the goals
of any type of therapy or rehabilitation, to restore the body
to the previous level of function, or to establish the highest
attainable level of (independent or dependent) function. (9,10)
Music therapy provides a way for people with disease or disability
to improve their condition or level of function. One of the
many benefits of music therapy is that it can be used in conjunction
with physical therapy, and can also be used for emotional
therapies. Hopefully music therapy can one day become a leading
form of therapy. It is not invasive, does not have any obvious
or reported risk for any type of patient, and is relatively
inexpensive compared to other therapies.
I come from a musical family, and can advocate that music
can be powerful, soothing, and healing. As teachers, therapists,
doctors, or nurses, we can strive to make music a part of
the human experience for everyone. Even those with disease
or disability.
ENDNOTE:
Certainly, when music teachers and physical education teachers
work together to provide active music sessions in music classes,
and physical education teachers offer music oriented physical
activities in their classes - benefits abound. The benefits
of physical activity and music integration seems worthy of
increased implementation, and quite promising for all involved.
For Further Information; specifically linking music therapy
to physical education and dance; please visit: http://www.springerlink.com.
Biography: My name is Michelle Agudelo.
I am a senior Health Education and Behavior major, and International
Development and Humanitarian Assistance minor, at the University
of Florida. I have always wanted to become someone who helps
others, and both this major and minor give me the opportunity
to do that through educational, clinical, and service settings.
I am also an undergraduate researcher currently involved in
research that will help me gain experience and knowledge in
health disparities and health literacy among diverse population
groups, and the research process in general. I am also interested
in international and global health disparities and initiatives.
I am involved in a few on-campus organizations that help develop
professional and leadership skills through service.
When not academically occupied, I truly enjoy activities
that involve both mind and body. When I have time I like to
enjoy a good book. I love sports. I play a lot of intramural
and league soccer, and volleyball for fun. I enjoy biking,
swimming, and challenging sports like scuba diving and rock
climbing. I really enjoy helping others find activities that
they enjoy and excel in.
Growing up my parents did a good job introducing, and involving
my older brother and me to the fine arts. I come from a musical
family where both of my parents play instruments. My brother
recently graduated from UF with a Bachelor in Arts in Piano
Performance, and will soon be going to medical school. I have
played the violin since I was 8 years old, and am recently
learning to play the guitar. I think life is definitely about
experiencing and learning as much as possible about the world
around us. I believe music makes life more interesting and
beautiful.
Biography: Christine Stopka
is an Adapted Section editor for pelinks4u. She graduated
from the University of Virginia with a PhD in Special Physical
Education. Currently she teaches exercise therapy and adapted
physical activity at the University of Florida. Christine
established the Athletic Training & Sports Medicine Undergraduate
and Graduate Specializations, the Student Injury Care Center,
and the athletic training community out-reach program serving
the North Central Florida area high schools.
Christine has also established the Special PE & Exercise
Therapy Specializations, the University of Florida Special
PE & Exercise Therapy Lab, and the Special PE/Exercise
Therapy community out-reach program providing adapted physical
activity services to over 50 schools, centers, sites, and
events each term. She is the recipient of over 60 university,
state, regional, and national honors, and has published over
300 articles, books, abstracts, videos and other media. In
her free time, Christine likes to bike, jog, swim, rollerblade,
ski and weight lift.
References:
- http://www.musictherapy.org/assets/1/7/MT_Autism_2006.pdf
3/30/2012 (no longer found)
- http://www.musictherapy.org/about/history/
3/30/2012
- http://www.musictherapy.org/assets/1/7/bib_habilitation.pdf
3/27/2012
- http://news.discovery.com/human/gabrielle-giffords-photos-111116.html
3/27/2012
- http://www.springerlink.com/content/w3h7k5154u72t245/
3/28/2012
- http://www.springerlink.com/content/a8303q12263805n4/
3/30/2012
- http://www.psychosomaticmedicine.org/content/62/3/386.short
4/2/2012
- http://www.medterms.com/script/main/art.asp?articlekey=11054
4/2/2012
- http://psycnet.apa.org/psycinfo/1993-19183-001
4/7/2012
- http://psycnet.apa.org/journals/rep/45/3/274/
4/7/2012
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