Music therapy is a process that involves helping clients, children and adults who have therapeutic needs, to develop skills, adapt their behavior, and overcome obstacles in their lives. Music therapists use different kinds of musical experiences (such as singing, playing instruments, writing songs, listening to, and talking about music) to meet clients’ needs, called goals, using the unique relationship between the client, the music and the therapist to do so.
David is a seven-year-old boy with autism. He goes to a specialized school for children with autism spectrum disorders, and he is involved in an intensive educational program to help him develop his skills and promote learning in a number of areas. David’s educational goals focus on the following:
Developing language skills that include using his language spontaneously to interact with others, and increasing David’s vocabulary
Participating in activities with other children, promoting social skills such as interacting, taking turns, waiting, and being responsive to others
Developing concepts such as time, date, and place
Sally, the music therapist, works with David. She has developed music therapy sessions that help David meet the above goals. Sally began by assessing David, and through this assessment she found that David responded very well to musical activities that included singing songs, playing instruments, and moving to music. In order to meet David’s specific goals, Sally looked at the way David responded to these musical activities and then designed a session plan that addressed David’s therapeutic needs. The session plan includes the following:
1. Greeting song. David needed to begin each session with a predictable song that helped him transition from his classroom into the music therapy room. The greeting song allowed this transition, and as David and Sally sang together (Sally played the guitar to accompany the song), Sally also prompted David to sing as many of the words in the song as he was able. This also helped David address his language goals.
2. Song about the week. This song included lyrics about the day, date, and time. The therapeutic challenge for David was to be able to tell the time, date and day spontaneously, in the appropriate place, in the song. Sally played the guitar while she sang, pausing at each of the places in the song to allow David time to respond. She encouraged him to sing out the time and day, and reflected his singing in her own voice, and on the guitar.
3. Action song. David has some trouble identifying parts of his body. Sally wrote a song about David’s body, and in the lyrics of the song, David is asked to touch and move different body parts. For example, one line of the song has the lyrics “David, David, shake your arm”, while another line contains “Can you find your toes?” This song is challenging for David in two ways. First, he has to listen to the words of the song, and follow the directions. Second, he has to find and/or move parts of his body in response to song lyrics.
4. David’s song. Sally wrote a song about David. This song describes David, the things he likes, where he goes to school, his family, and his friends. When Sally sings with David, she encourages David to sing as much of the lyrics of the song as he is able to. Sally adapts the tempo, dynamics, and accompaniment of the song to match David. Sometimes she sings boisterously and playfully, and at other times quietly and gently. In so doing, Sally is communicating to David that she understands him, is responsive to him, and is trying to meet him where he is. David often responds well to this, allowing a connection between Sally and David that promotes increased interaction with others – another of his goals.
Each of David’s sessions last 25-30 minutes. Sally is always actively making music with David. Sometimes she writes songs for David that she uses in sessions to promote language development, cognition, or interaction. At other times, she improvises music at the piano, encouraging David to be spontaneous, and to interact with her musically. Improvising allows David to experiment and try out different ways of expressing himself and being with another person. At other times, Sally uses the predictability of familiar songs to help center and calm David when he is agitated or upset. In these ways, Sally uses a range of musical experiences – singing songs, playing instruments, moving to music – to help David develop.