imagine 2013 by imagine

imagine.magazine Fall 2013 l Vol.4, No.1

2013 Your resource for early childhood music therapy imagine 4(1), 2013

editor-in-chief Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA contributing editor Marcia Humpal, M.Ed., MT-BC editorial assistance Rose Fienman, MT-BC Gretchen Chardos Benner, LMSW, MT-BC copy editing Lisa Jacobs, MM, MA, MT-BC business manager & design production Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA 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 www.imagine.musictherapy.biz to access additional multimedia contributions and 17 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 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 www.imagine.musictherapy.biz

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 imagine@musictherapy.biz 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, 2014

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editorial Your Doorway to EvidenceBased-Practice in ECMT Welcome to a new edition of imagine, the primary online magazine dedicated to enhancing the lives of young children and their families by sharing knowledge, strategies, ideas, and policies related to music therapy with colleagues and parents worldwide.Â As of January 1, 2013, imagine found a new home with de la vista publisher. The American Music Therapy Association (AMTA) continues to endorse imagine following the joint pilot project that was completed in 2012. Looking for new expansions and ongoing growth, imagine joined imagine.unlimited, a global collaboration bringing together wellestablished institutes, publications, and initiatives oďŹ&#x20AC;ering training, information, connections, and consultation related to early childhood music therapy. Learn more about this collaboration at www.imagine-unlimited.net. As is evident in this issue, the imagine editorial team strives to bring high quality and cuttingedge information to you. Therefore, imagine continues to be your doorway to evidencebased practice in early childhood music therapy.

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Starting with tips from Ruthlee Adler, recipient of the 2012 AMTA Lifetime Achievement Award, this issue includes over 60 contributions from authors working in the USA, Japan, UK, Argentina, Costa Rica, Austria, Netherlands, Portugal, Greece, and Antigua. Our featured article, written by Sarah Pitts and Kirsten Meyer, addresses the increased application of multimedia such as YouTube videos in music therapy practices. The authors give various video examples from learning songs and dance steps to creating music videos and video modeling interventions, which may support the therapeutic process. Reading on, you will find reports from the 2012 AMTA Early Childhood Network meeting, the AMTA’s Director of Government Relations, and the editor of ECMMA’s Perspectives, reiterating the benefits of collaborating for the greater good. The reflection on “Walking a New Path with Families” coauthored by Nicole Rivera and Danara Barlow demonstrates the trend toward family-centered practice, which is also addressed in articles by Erin McAlpin, Amy Clemens-Cortés, Becky Wellman and Anita Gadberry, and Satoko Mori-Inoue. Furthermore, we have created the new parents can section with the intention of empowering families of children with specific disabilities to use music for learning in their home environment. In addition, Deb Discenza offers a helpful list of parents’ networks. Blythe LaGasse presents the annual research snapshot, followed by a summary of Jennifer Whipple’s recent meta-analysis confirming that music therapy interventions are very effective for developing communication, interpersonal skills, personal responsibility, and play in young children with Autism Spectrum Disorder (ASD). Dana Bolton describes singlecase experimental designs and states that “teaching a form of research that is a realistic option may encourage more music therapy clinicians to seek opportunities for conducting their own research.” Likewise, Eric Waldon emphasizes the importance of data-based decision making to meet the therapeutic goals of clients and offers a model that can be applied to early childhood music therapy. The information he presents goes hand in hand with Elizabeth Schwartz’s

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introduction to ”Response to Intervention.” Of additional practical use are articles related to structuring early childhood music therapy groups (Lori Gooding), the Toddler Rock Program (Edward Gallagher, Deforia Lane, and Laura Onkey), using the Pacifier Activated Lullaby® with infants diagnosed with Neonatal Abstinence Syndrome (Ellyn Hamm and Darcy Walworth), suggestions for using children's literature and AAC Systems (Lorissa McGuire and Anita Gadberry), and cultural matters reflected in writings by Ilene Berg Morris, Roy Kennedy, and resources for international music by Rose Fienman. Besides ten “ready-to-go” intervention ideas shared by long-standing imagine authors and newcomers, we have included an early childhood music program section supplying information on each program’s purposes and goals, key concepts, and music therapy applications. imagine continues to provide readers with its popular established oﬀerings such as a list of latest publications, book reviews with audio bookmarks, and audio/video podcasts representing knowledge, experiences, and perspectives in the authors’ “own words.” Finally, I hope that the color of us series focusing on European countries will inspire you to attend the 2014 World Congress of Music Therapy in Vienna/Krems. Furthermore, let us all strive to establish music therapy as an eﬀective intervention option for children and families around the world. Be part of this global community by learning, reading, and sharing your talents. Imagine...together we can make it happen. Sincerely,

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

contents inside this issue editorial Your Doorway to Evidence-Based-Practice in ECMT Petra Kern............................................................

wisdom 10 Tips for Music Therapists Working with Young Children and their Families Ruthlee Figlure Adler............................................ 10 reports 2013 Early Childhood Music Therapy Special Target Population Network: Meeting Report from 10-12-2012 Gretchen Chardos Benner................................... 12 National Update (USA) Judy Simpson......... ............................................ 16 Voices of the Sea: Music Therapy @Florida Sandi Curtis......................................................... 18 Collaboration for the Greater Good Angela Barker........................................................ 19 reflection Walking a New Path with Families Nicole R. Rivera and Danara Barlow..................... 20 featured Next Generation Music Therapy: Clinical Applications of YouTube Videos Sarah E. Pitts and Kirsten E. Meyer.................... 24

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research 2013 Early Childhood Research Snapshot Blythe LaGasse.................................................... 30 Recent Findings: Music Therapy for Young Children with Autism Spectrum Disorder Jennifer Whipple.................................................. 34 The Scientist-Practitioner: Single-Subject Research Methodology for Music Therapy Clinicians Dana Bolton......................................................... 38 photos Photo Stories 2013.............................................. 45 practice Data-Based Decision Making in Music Therapy Eric G. Waldon..................................................... 46 Utilizing Response to Intervention: Implications and Opportunities for Music Therapy Elizabeth K. Schwartz.......................................... 51 Structuring Early Childhood Music Therapy Groups Lori F. Gooding.................................................... 54 Toddler Rock: The Backbeat of Rock in Early Childhood Edward P. Gallagher, Deforia Lane, and Lauren Onkey....................................................... 62 Using the Pacifier Activated Lullaby速 with Infants Diagnosed with Neonatal Abstinence Syndrome Ellyn Hamm and Darcy Walworth........................ 62 Attachment in Adoptive Families: Parental SelfReflection Erin Lyn McAlpin.................................................. 64

Luba’s Theme Amy Clements-Cortés......................................... 70 Including Parents in the Therapeutic Process Becky Wellman and Anita L. Gadberry................ 74 Sing a Story: Suggestions for Using Children’s Literature and AAC Systems Lorissa McGuire and Anita L. Gadberry.............. 77 Culture Matters: Latin American Cultural Attitudes toward Disability and their Implications for Music Therapists Working with Young Children Ilene Berger Morris.............................................. 80 The Cloud Forest School: A Music Therapy Service Project Roy Kennedy....................................................... 84 Showing Visually: The Impact of Graphic Analysis of Music Therapy Services at a Local Child Developmental Center in Japan Satoko Mori-Inoue............................................... 87 parents can Ideas for parents of children with Autism Spectrum Disorder Michelle Lazar....................................................... 91 Ideas for parents of children with Down Syndrome Jennifer W. Puckett, Jessica Pitts, Alison Williams, Chelsea Kinsler, Hannah Ivey Bush, and Hannah Owenby................................................... 92 Ideas for parents of children with Visual Impairments Petra Kern............................................................ 93

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programs Sing & Grow© Daniel Thomas..................................................... 94 Sprouting Melodies® Elizabeth K. Schwartz and Meredith R. Pizzi........ 96 Music Together® Carol Ann Blank.................................................... 98 ideas Moving to Music Ruthlee Figlure Adler........................................... 100 There Once was a Chicken: Encouraging Play Alexis Bron.......................................................... 101 Give Yourself a Squeeze: Imitation and Body Awareness Beth McLaughlin................................................. 102 Jump Up and Spin Around: Transitions and Color Identification Meryl Brown........................................................ 103 Once there was a Music Class: Exploring Music Talia Girton.......................................................... 104 Hey Mr. Monkey: Stimulating Oral-Motor Skills and Vocal Play Margie LaBella..................................................... 105 It is Time to Say Good-bye: Closure and Reflection Laura Mesén....................................................... 106 The Train Went into the Tunnel: Movement Imitation Amy O’Dell.......................................................... 107 Everybody Has a Name: Promoting Self-Awareness and Group Interaction Rachel Rambach................................................ 108

Ribbit, Ribbit, Jump: Fostering Anticipation Kumi Sato........................................................... 109 color of us Hawaii–USA Kazumi Yamaura................................................ Austria Monika Geretsegger and Thomas Stegemann... The Netherlands Barbara Krantz.................................................. Portugal Teresa Leite....................................................... Greece Giorgos Tsiris and Elizabeth Georgiadi...............

110 112 114 116 118

podcasts The Importance of Performance Opportunities for Young Children During Music Therapy Jamie George, Andrew Littlefield, Laurie Peebles, and Andrea Johnson.......................................... 120 Strategies for Working with Children's Choirs Angela Hughey and Justin Smith....................... 120 The Betz-Held Strengths Inventory: A Music Therapy Assessment Tool Stephan Betz and Josef Held............................. 120 Ten Essential Skills for Working in Early Childhood Settings Matt Logan......................................................... 121 Keep a Beat™: A Music Enrichment Program for Early Childhood Educators Kamile Geist....................................................... 121 Let’s Collaborate Laurel Rosen-Weatherford.................................. 121

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Five Practical and Creative Ways to Use a Shaker Julia Beth Kowaleski.......................................... 121 Itty Bitty Steps: Individually Tailored Music Therapy Song Interventions Kayla C. Daly...................................................... 121 Drum Games for Preschoolers in Inclusive Classrooms Kalani Das and Petra Kern................................. 121 resources Expanding Horizons: Finding International Music Rose Fienman.................................................... 122 Reflections Connect: Networks for Parents Deb Discenza..................................................... 123 publications Publications 2012-2013 Petra Kern......................................................... 124 reviews 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 Beth McLaughlin................................................ 127 Register, D., Hughes, J., Standley, J. M. (2012). The sounds of emerging literacy: Music-based applications to facilitate pre-reading and writing skills in early intervention. Silver Spring, MD: AMTA. Kamile Geist......................................................... 128

The production of imagine 2013 was partially supported by the Marylhurst University's Faculty Innovation and Excellence Grant awarded to Dr. Petra Kern and Maya Story.

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wisdom 10

Tips for Music Therapists Working with Young Children and their Families 1. Live the three “E’s”–Empathy, Enthusiasm, and Energy and the four “C’s” – Consistency, Contingency, Compassion, and Courage. 2. Introduce music at the earliest possible age, even in the womb. 3. Use honest praise and positive reinforcement. Be specific – praise the action and not the child. 4. Talk as little as possible – your body language and facial expressions are as important as your vocal tone. 5. Use short repetitive music with a strong basic rhythm. 6. Select repertoire appropriate for the ages, cultures, abilities, and needs of your children. 7. Provide as many multi-sensory experiences as possible – include pictures, props, and sign language. 8. Provide opportunities for movement. 9. Emphasize the social-emotional development of young children – encourage everyone to participate, allowing each to learn and grow through play. 10. Plan ahead – know the music, lyrics, instruments, materials, and your goals before beginning your session. Ruthlee Figlure Adler, MT-BC 2012 AMTA Lifetime Achievement Award Recipient

Share your positive attitude, maintain a sense of humor, and allow yourself to enjoy each experience. Young children are the best teachers; they keep us young! Above all, have fun while making music together!

Ruthlee Figlure Adler, MT-BC

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i p h s i r n e A b M m TA e

MTA is your professional association... your intellectual home. Becoming a member of AMTA not only supports our mission (to advance public awareness of the benefits of music therapy and to increase access to quality music therapy services in a rapidly changing world), but also shows your commitment to your profession by supporting the programs and initiatives that make music therapy strong.

What You Get: $235 Professional Membership: t t t t t t t t t t

Journal of Music Therapy & Music Therapy Perspectives Subscriptions AMTA-pro: Free, Convenient, Online Continuing Education Member Area of AMTA Website Conference Discount Publications Discount NMTR Maintenance Discount Job Center/Job Hotline/Referral List Inclusion/Posting a Job Online Directory/Workforce Study Private Practice/Reimbursement/Technical Assistance Public Education, Advocacy and Job Creation

Worth: Over $3200/year: t t t t t t t t t t

$450 $600 (â&#x2030;&#x2C6;$50 per podcast value) $218 (based on average subscription rates) $235 $75 (based on â&#x2030;&#x2C6;value of 5 purchases) $215 $350 (based on average subscription rates) $50 $50 (per 30 minute phone call) $1000

But the best reason to join AMTA is for a strong national voice for music therapy standing beside you. As a member, you support the music therapy profession and make it possible for that profession to grow. imagine 4(1), 2013

reports 2. Early Childhood Network Information

2012 Early Childhood Music Therapy Special Target Population Network Meeting Report from 10-12-2012 Gretchen Chardos Benner, LMSW, MT-BC imagine, Editorial Assistance Fort Mill, SC

1. Welcome. Co-chairs Dr. Petra Kern and Angie Snell greeted attendees. 17 colleagues were in attendance, representing nine states (CA, IL, MD, MI, MN, NV, NY, OH, PA). It was noted how welcoming and supportive the Early Childhood Network (ECN) is.

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Update on imagine The three-year pilot project of publishing imagine with AMTA concludes in November 2012. Dr. Kern, the editor of imagine, submitted a proposal to the AMTA Board of Directors suggesting future directions and funding of AMTAâ&#x20AC;&#x2122;s first early childhood online magazine. The AMTA Board of Directors is in the process of reviewing the proposal and will make a decision whether the online magazine can be continued as an AMTA publication or not due to limited funding. Over the past three years, imagine disseminated 192 publications, including 80 audio and video clips. The interactive digital viewing mode, the accompanying website, QR code scanning, and continued implementation of innovations made imagine a unique product for AMTA, while also contributing to the recognition and credibility of the field and meeting a need for disseminating knowledge on Early Childhood Music Therapy (ECMT). Dr. Kern and the editorial team assured attendees that they will find a way to continue publishing imagine in 2013. imagine 3(1), 2012 includes 61 contributions from 9 countries as well as 17 audio clips and 10 video clips. The featured article was a tribute to Dr. Clive Robbins spotlighting his work with young children with special needs. The issue has been distributed to approximately 7,000 music therapists, 300 early childhood music educators, 15,000 daycare professionals, administrators, and parents. The

average web traﬃc is 780 visitors per month. There are about 146 links to external groups. Dr. Kern thanked all authors for their contributions and support in developing imagine as well the editorial team for their dedication, excellence, and time commitment. The deadline for submission to the 2013 issue is May 15, 2013. ECMT Facebook Group The ECMT Facebook Group has over 400 members. Dr. Kern encouraged members of the ECN to post relevant and meaningful information, but to distinguish between information sharing and promoting one’s own business. 3. Year 2012 in Review Government Relations Beth Schwartz reminded members of the ECN about the provision of music therapy through Part C of IDEA (see Simpson in imagine 2, (2011). She also encouraged music therapists working with young children to contact AMTA to find out if they qualify as providers under Race To The Top. Angie Snell suggested staying abreast with the latest national policies by subscribing to the National Policy Digest Newsletter. Beth McLaughlin mentioned the IDEA Paper Work Reduction and reminded attendees that goals must be measurable and observable. Presentations and Publications Beth Schwartz self-published You and Me Makes… We: A Growing Together Songbook. Dr. Petra Kern and Marcia Humpal published Early Childhood Music Therapy and Autism Spectrum Disorders: Developing Potential in Young Children and their Families. This book has 12 contributing authors many of whom are members of this network. The co-editors did a book signing at the Jessica Kingsley Publishers booth at the 2012 AMTA conference. Dr. Kern announced that there will be an ASD Panel at the 2012 AMTA conference including several contributing authors. Additionally, Dr. Kern and Marcia Humpal will be on the Radio Show with Janice Lindstrom on

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October 27, 2012 to talk about the content of the recently published book. Kamile Geist’s manuscript Bridging Music Neuroscience Evidence to Music Therapy Best Practice in the Early Childhood Classroom: Implications for Using Rhythm to Increase Attention to Learning will be published in the next issue of Music Therapy Perspectives. She will give a keynote address to teachers in Puebla, Mexico on a similar topic. Her training unit on Keep a Beat (KaB) for early childhood educators is in the initial phases of development. Kamile Geist will present the current statutes of her KaB research at the poster session during the 2012 AMTA conference. Todd Schwartzberg co-authored an article titled Eﬀects of Pitch, Rhythm, and Accompaniment on Short- and Long-term Visual Recall in Children with Autism Spectrum Disorders. It is published in The Arts in Psychotherapy journal. He also presented a research poster on Musical Social Stories at the 2012 AMTA conference. Marcia Humpal, Amy Furman, and Ronna Kaplan co-authored the AMTA E-course Music Therapy in Early Childhood: Meaningful Music from Infancy to Kindergarten, which is available at the AMTA online book store. Dr. Becky Wellman contributed a book chapter in Treatment Planning for Music Therapy Cases (Editor: Gadberry) published by Sarsen Publishing. Meryl Brown will present on Music and Movement with EC Care Providers for McLean County Early Childhood Educators. She also will provide an inservice for in-home care givers. Beth Schwartz was invited by the Association for Music Therapy (Singapore) to give a five-day inservice related to ECMT. She shared that there was great interest relative to the presentation. Dr. Becky Wellman will facilitate a 5-hour CMTE on Early Development at the GLR-AMTA Conference. Dr. Petra Kern was invited to speak at the National Early Childhood Inclusion Institute alongside national leaders of inclusion. She also was invited by ECMMA as a special speaker next to Dr. Edward Gordon and others at their international convention in Green Lake, Wisconsin. She shared that the collaboration with ECMMA is fruitful. At this convention, ECMMA provided a music therapy

track with CMTE credit options. Additionally, Dr. Becky Wellman is a music therapy blogger for ECMMA. Angie Snell organized local parent/child workshops and training for music educators. She advised music therapists to partner with music educators. Music therapists are needed to educate teachers on working with special learners for improved inclusion. A discussion about similarities and diﬀerences between music therapy and music education followed. Angie Snell oﬀered to share with the ECN what worked in her community. Dr. Kern mentioned that Dorothy Denton gave an excellent presentation on this topic at the 2012 ECMMA international convention. 4. Innovative Practice/Research

Kamile Geist reported increasing referrals and collaborations with Head Start Programs. Beth Schwartz shared that Sing and Grow© is a successful early childhood music program targeting children at-risk, which is supported by the Australian government. Beth Schwartz introduced the latest development of Sprouting Melodies®, an early childhood music program she started with Meredith Pizzi. The Rebecca Center for Music Therapy at Molloy College on Long Island will participate in an international research study investigating developmental trajectories and eﬀectiveness of interventions. Dr. Kern is conducting a national survey in collaboration with Dr. Nicole Rivera, Alie Chandler, and Marcia Humpal from the AMTA Strategic Planning Task Force and Workgroup about the

current music therapy trends and practices related to serving individuals with ASD. Todd Schwartzberg is planning a survey study about songs being used with individuals with ASD. 5. Sharing our Resources

Due to time constrains, attendees have been referred to the forthcoming issue of imagine. 6. Upcoming Events

Please visit the event calendar on the imagine website. Join the ECN Facebook Group to learn more about upcoming events and member activities. 7. Other Marcia Humpal announced that Ruthlee Adler, a long-standing member of the ECN network received the 2012 AMTA Lifetime Achievement award. Dr. Petra Kern, co-chair of the ECN network and editor of imagine received the 2012 AMTA Service Award.

About the Author Gretchen Chardos Benner, LMSW, MT-BC is owner of Piedmont Music Therapy, LLC. She has a bachelor’s degree from Duquesne University and a Master’s in social work from the University of Pittsburgh. Contact: piedmontmusictherapy@gmail.com

next ECN meeting in Jacksonville, Florida

November 22, 2013 imagine 4(1), 2013

!!!Watch video about Ruthlee Adler’s 2012 AMTA Lifetime Achievement Award at https://www.youtube.com/watch?v=iOE-sKnW6O0&feature=player_embedded

Two Members of the Early Childhood Network Honored by AMTA !!!Watch video about Dr. Petra Kern’s 2012 AMTA Service Award at http://www.youtube.com/watch?v=RU56goNFSmM&feature=youtu.be

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Photo Credit: Dr. Mary Adamek

NationalUpdate (USA) Judy Simpson, MT-BC American Music Therapy Association Silver Spring, Maryland One of the primary tasks of government relations work within the American Music Therapy Association (AMTA) includes monitoring federal and state legislative and regulatory activity that impacts music therapy practice. AMTA educates members on these significant issues while simultaneously engaging members in the advocacy process. This work is completed not only through staff, but also through the strong grassroots network of AMTA members who serve on related committees and state task forces. With the association’s mission of increasing awareness of the benefits of music therapy and increasing access to quality music therapy services as the guide, AMTA communicates and directs advocacy efforts with federal and state legislators, federal and state agency officials, national and state healthcare and education organizations, and national and regional third party payers regarding the provision of music therapy services. Music therapists are well-represented on the national level as AMTA staff actively participate in several Washington, D.C.-based health and education professional coalitions. In addition, by providing public policy and reimbursement technical assistance, AMTA frequently serves as a resource for clinicians, educators, students, related professionals, families, and the general public. The following news items are being presented in an effort to support professionals focused on early intervention services.

Sequestration took effect on March 1, 2013, which includes an automatic 8.4 percent cut to program funding levels for most defense and non-defense discretionary programs, equaling approximately $85 billion in cuts affecting every government agency. Federal agencies have implemented plans in response to these cuts, including employee furloughs and decreased services. The Office of Head Start in the Administration for Children and Families estimates that approximately 70,000 children will lose access to Head Start services because of this reduction. The National Head Start Association has created a FAQ document to assist programs as they deal with these budget cuts. See http://www.nhsa.org/files/static_page_files/ 4B17D5B0-1D09-3519-ADF2596FBA091A8B/ SequestrationFAQ-FINAL.pdf AMTA is collaborating with other national organizations in Washington, advocating with Congressional staff regarding the need to address the federal budget deficit through mechanisms that do not have such a significant impact on the nation’s most vulnerable populations. The Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services recently published draft amendments to the Child Care and Development Fund (CCDF) regulations. Since these regulations have not been amended since 1998, the ACF is addressing several areas of need through the proposed changes. These areas include: • Strengthening health and safety requirements for child care providers; • Reflecting current state and local practices to improve the quality of child care; • Infusing new accountability for federal tax dollars; and • Leveraging the latest knowledge and research in the field of early care and education to better serve low-income children and families.

“One of the primary tasks of government relations work within the American Music Therapy Association (AMTA) includes monitoring federal and state legislative and regulatory activity that impacts music therapy practice.”

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For more information, please visit https://www.federalregister.gov/articles/ 2013/05/20/2013-11673/child-care-and-developmentfund-ccdf-program

intervention services. To view this new resource, please visit: http://nichcy.org/laws/idea/legacy/partc/module1 About the Author

The Ounce of Prevention Fund, based in Chicago, publishes a bi-weekly newsletter National Policy Digest that shares up-to-date and noteworthy developments in state and federal early childhood news, policy and funding changes, research, policy trends and analyses, and upcoming events. To subscribe, please contact Anna Torsney-Weir, National Policy Associate (see atorsneyweir@ounceofprevention.org). ZERO TO THREE is a national nonprofit organization that informs, trains and supports professionals, policymakers and parents in their eﬀorts to improve the lives of infants and toddlers. The ZERO TO THREE Policy Center is a nonpartisan, research-based resource for federal and state policymakers and advocates on the unique developmental needs of infants and toddlers. The Center recently published a new resource titled, “Nurturing Change: State Strategies for Improving Infant and Early Childhood Mental Health,” which provides an in-depth look at some of the promising strategies states have employed to address I-ECMH access, delivery, financing, evidence base, and systems-level issues across the promotion, prevention, and treatment continuum. Please visit the following link to view this new publication: http://www.zerotothree.org/public-policy/ pdf/nurturing-change.pdf In October 2012, the U.S. Department of Education announced the release of “The Basics of Early Intervention,” which is the first module of the Individuals with Disabilities Education Act (IDEA) Part C Training Curriculum. The full curriculum, titled “Building the Legacy for Our Youngest Children with Disabilities: A Training Curriculum on Part C of IDEA 2004” is being produced by the National Dissemination Center for Children with Disabilities (NICHCY) at the request of the Oﬃce of Special Education Programs (OSEP) at the U.S. Department of Education. The curriculum is intended to help all those involved with infants and toddlers with disabilities understand and implement Part C of IDEA 2004, which is the federal law that authorizes early

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As AMTA’s Director of Government Relations, Judy Simpson, MT-BC, represents the interests of members with state and federal legislators and agencies. Judy’s clinical experience has involved developing music therapy programs for clients of all ages in general hospital settings, including physical rehabilitation, oncology, labor and delivery, psychiatry, ICU, and general medicine. Contact: simpson@musictherapy.org

Don’t miss AMTA's 2013 conference in Jacksonville, Florida. The conference hotel is situated on a 4-mile palm tree lined riverfront boardwalk close to area attractions. Jacksonville Landing, a major downtown food and entertainment hub, is just steps away. In 2013 we will celebrate the best in music therapy everywhere, as well as highlight the incredibly vibrant music therapy scene in Florida. The conference will oﬀer outstanding networking opportunities for you to meet and connect with the best and brightest. You will delight in sharing your music and your therapy experiences with 1,500 music therapy colleagues! And of course, there will be many learning opportunities in the area of early childhood music therapy, as well as in general areas to enhance your music therapy skills. Here is a sampling of the 2013 AMTA early childhood music therapy sessions. Pre-Conference Trainings, Institutes, and CMTEs –––––––––––––––––––––––––––––––– Medical Music Therapy for Infants and Children: Enhancing and Humanizing Medical Treatment One Child at a Time

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Early Childhood Developmental Music Therapy: Assessing, Implementing, and Evaluating Skill Achievement through the Bright Start Curriculum Applications of Evidence-Based Data on Music and the Brain in Autism Concurrent Sessions –––––––––––––––––––––––––––––––– Music and Movement: Two Ingredients for Infant and Toddler Development Sprouting Melodies®: An Early Childhood Music Program Designed Especially for Music Therapists Musical Bonds: A Program for Parents and Young Children with Developmental Disabilities From Research to Practice: Interventions for Children with Special Needs More Than Co-Treating: Child Life and Music Therapy Working Together. Tap, Drag, and Swipe: Select the Best Music App for the Task Early Brain and Child Development: The American Academy of Pediatrics and Music Therapy Infant-Directed Singing and Self-Regulation in Infants with Down Syndrome

Family-Centered Music Therapy and Young Children with ASD: A Randomized Controlled Trial Hot Topics in Special Music Education: Music Therapy and the Common Core The Eﬀects of a Music Therapy Group on the Prosodic Speech of Children with ASD. Integrating Child and TherapistLed Strategies for Improving Communication in Children with Autism Autism Spectrum Disorders: Evidence-based Strategies Transposed to Music Therapy Sessions Giving Practitioners a Voice: Outcomes of the National Survey Study on ASD –––––––––––––––––––––––––––––––– From the desk of Sandi Curtis, Ph.D., MTA, MT-BC AMTA Vice President and Conference Program Chair

Collaboration for the Greater Good Angela Barker, Ph.D. Early Childhood Music & Movement Association Snohomish, Washington Since 2010, the editorial teams of ECMMA’s Perspectives and imagine have explored collaborative avenues through which we can support the interests of our respective readerships while providing a useful service to the parents and caregivers of young children. As partners, our collective effort not only makes our organizations stronger and better equipped to enable effective change in early childhood education, but also promotes the dissemination of information and research related to children’s development and learning. Additionally, our collaboration increases the scope and availability of professional development opportunities for practitioners in music education, music therapy, and related disciplines. Perspectives is a peer-reviewed, quarterly publication featuring research-based articles, book reviews, reviews of current research studies, practical tips for parents and educators, and information relevant to the development of young children through music and movement. The journal, available in print and online, offers readers quick access to the content of previous and current issues through a searchable online database. Articles published in Perspectives over the past year covered a wide range of topics and were authored by researchers and educators representing the fields of music education, music therapy, psychology, neuroscience, and education. A review of the articles revealed seven broad themes: children’s musical development, music and community building, music and early intervention strategies, music and literacy, music and movement, music and play, and teacher preparation and certification. The articles and topics listed here are but a sampling of a larger body of professional information and resources available to early childhood researchers and educators through the combined efforts of ECMMA Perspectives and imagine.

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Broad possibilities and unique opportunities are unfolding as we work together and move forward for the sake of children. As editor of Perspectives, I look forward to continuing to collaborate with Dr. Petra Kern and the imagine editorial team, and I invite you to explore the networking opportunities and professional resources available online and in print. Articles Featured in Perspectives 2012-2013 *AMTA members have free online access to these articles. Children’s Musical Development *Gordon, E. E. (2012). Newborn, preschool children, and music: Undesirable consequences of thoughtless neglect. Perspectives, 7(3/4), 6-10. Music & Brain Research *Flohr, J. W., & Persellin, D. C. (2013). Move to learn! Strategies based on recent brain r esearch. Perspectives, 8(1), 11-15. Music & Community *Ilari, B., & Broock, A. (2013). Musical participation and community building in an “ alternative” program for young children. Perspectives, 8(1), 5-10. Music & Early Intervention Strategies *Elizandro, A., Bramlett, R. K., & Crow, R. (2012). The effects of musically adapted and traditionally read social stories on the prosocial and negative behaviors of hyperactive-impulsive preschool children. Perspectives, 7(1), 9-15. *Jones, T., & Harril, K. (2012). Music therapy intervention with young children with autism: Contributions of sociocultural theory. Perspectives, 7(2), 5-13. Music & Literacy Register, D. (2012). Examining the relationship between family-reported literacy behaviors, early literacy skill Measures and engagement in early childhood music groups. Perspectives, 7(3/4), 16-24. Music & Movement Cooper, S. C. (2012). Bringing Ring Around the Rosy into the living room. Perspectives, 7(1), 5-8. Music & Play Koops, L. H. (2012). Creating music play zones for children. Perspectives, 7(3/4), 11-15. Teacher Preparation & Certification Tschida, J. (2012). College effectively implements ECMMA Level 1 certification program. Perspectives, 7(2), 14-16.

About the Author Angela Barker, Ph.D., editor of Perspectives teaches beginning piano students, and, on occasion, serves as a distance education facilitator for the College of Fine Arts at Boston University. Contact: abarker@ecmma.org

reflection Walking a New Path with Families Nicole R. Rivera, Ed.D., MT-BC Danara Barlow, Student North Central College Naperville, Illinois “So you must go out and buy new guidebooks. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.” ~Emily Perl Kingsley, 1987 The 1987 poem, “Welcome to Holland” written by Emily Perl Kingsley, recounts a parent’s experience of the beginnings of an unexpected journey of having a child with special needs. All of the plans and expectations related to parenting are diﬀerent and new. As music therapists, we live day to day in our professional roles. We have learned the language and customs of music therapy and service frameworks in which we work (i.e., private clinical practice, early intervention, and special education). We are the music therapy natives. We know how to work within the system. It is critical for us to understand, however, that every family we encounter is somewhere on their own journey into this new world. When working with young children, it is even more likely that the experience is new for the parents and families we are serving.

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One way to explore the idea of the family’s transition into this new world is to look at the disability and treatment/ education communities through a cultural lens. Culture is defined as “what happens when people spend time together; they act and they interact, they produce artifacts and they use artifacts, and they do this as they make rules and break rules, if only to make new rules” (Stige, 2002, p. 38). People who work in similar settings build shared knowledge and practices. Families who share similar experiences may also interact with common language, artifacts, and rules. Kalyanpur & Harry (2012) examined how special education represents a cultural group with “shared implicit and explicit rules and traditions that express the beliefs, values, and goals of a group of people” (p. 4). By virtue of their child’s diagnosis, parents are suddenly thrust into a new group. They journey into new therapeutic and educational spaces or may seek connections with disability related support groups or associations. For each new group or space that parents encounter, they will need to learn about new rules and traditions. Therapeutic services, early intervention, and early childhood special education all represent specific systems that are rich with their own language, rules, and structures. Parents bring their own prior cultural experiences into this process and are expected to acculturate to the new groups and settings. From the moment that parents first become aware that their child may have a disability, they are exposed to new languages and practices. They learn new labels for their child’s behavior or medical needs. They learn about communities of people that they might not have previously known about. As they begin to navigate therapeutic services for their child, parents learn new practices and protocols. Unless the parent grew up with a disability, they learn an entirely new aspect of school experiences through connections with special education. As Emily Perl Kingsley reminds us, the parents are entering this new world. We must understand what parents are experiencing and thoughtfully reflect on how we can support these transitions. Receiving an initial diagnosis for a child is a powerful transitional experience for families. Heiman (2002) found that having a child identified with a special need created

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significant changes in the family’s social life and strong emotional responses. Families were, however, responsive to a variety of formal and informal supports and benefitted from having an optimistic outlook for their child’s future, “looking holistically at the child as a part of the family, not a separate entity” (Heiman, 2002, p. 169). Accessing and integrating services into the life of the family also represent an important transition.

Joann is a parent of a 2-year-old who was diagnosed with autism, cognitive delay, and receptive and expressive communication delay earlier this year. Joann described in an interview how a caring family member with many years of experience in school settings first alerted her and her husband to her son’s needs. She then contacted the local early intervention agency and arranged for an evaluation. Her son received speech therapy, developmental therapy, and occupational therapy services and then was formally evaluated for a diagnosis of autism spectrum disorder. Joann described the process of working with the early intervention team as “very informative.” Her case coordinator and therapy team consistently provided her with information about the process and her son’s disability. When asked about the challenges of the process, Joann explained that it was diﬃcult to juggle schedules to arrange for therapy sessions and the three trips to the evaluation center that was located over an hour from their home. She said, “You do it because you have to; you manage.” In addition to the case manager and therapeutic team, the family continues to receive support from the family member who first alerted them regarding their son’s needs. Their son is transitioning to early childhood special education programming in their local school district. When asked how therapists could have further supported her family’s transitional experience, Joann replied, “Try to keep things in simple terms.” She elaborated that therapists often use jargon and it would be helpful to have things explained in simple yet thorough terms. She recommended that professionals personalize their comments towards the child and the family rather than categorizing children according to their disability. Joann receives support from both family and her relationships with professionals. The information and support from her son’s team facilitated this important transition, yet her words remind us to be cognizant of orienting our messages in a manner that is unique to the child and understandable to the family.

Families must become familiar with the structures, children enter into music therapy services, families must policies and documents that guide early intervention and again learn new language, practices, and artifacts. early childhood special education services. In the United States, all students who receive special education The transition to music therapy services can be services through the public school district must have an supported by the family’s previous relationship to music. Individual Education Program (IEP). An “IEP” is both a In a study that examined the impact of institutional and process and a meeting. Parents should be actively family culture (Rivera, 2012), music therapists shared involved in this process, but researchers have shown that clinical experiences of working with families who already the IEP process can be very had a relationship with challenging for families music. One clinician Susan is a mother of an 8-year-old daughter with (Hammond, Ingalls, & described working with a autism spectrum disorder, who receives music Trussell, 2008). Researchers family that had a regular therapy services with a private practice music completed a study over a 4Friday evening music hour, therapist in her community. Susan indicated that year time period with 212 indicating, “the more (the her daughter was first introduced to structured families to investigate their family) is in involved with music experiences through early childhood music classes. Susan said that she “could tell that music experience with initial IEPs. music culture, the better the was a real key for her.” In music classes, her Fifty percent of parents relationship you have with daughter was imitating, attending, and singing. indicated they were the family.” We know that Although her daughter’s first music therapy prepared for the news about families and children do not experience through a local disability program was their child’s disability. need previous experiences not successful, Susan still believed in the potential of music therapy. She sought out private music Seventy-two percent were with music to benefit from therapy services, and reported that through music overwhelmed, anxious, and music therapy, but prior therapy, her daughter is working on IEP goals. She shocked as they entered the relationships with music felt very fortunate that her family can provide meeting; 42% indicated they may facilitate the entry into music therapy services for their daughter. Music is understood either some or the world of music therapy. a part of this family’s life. Susan studied piano through high school, sings, and recently learned to none of IEP terms and Music therapists in this play the guitar; her older daughter sings and plays issues communicated to study described how they the piano. This family’s ongoing relationship with them. However, 65% of the modify early discussions music likely shaped their perception of music as parents felt comfortable about functions and an agent to address whatever weaknesses the voicing their opinions and practices of music therapy child was having. were confident that their based on their perception of child was receiving the family’s relationship with appropriate services, though music. a large percentage of the families indicated a level of discomfort or uncertainty, reinforcing the importance of When working with families who do not have strong recognizing the parents’ perspective in this process. relationships with music, the music therapist may need to take a more active role in facilitating the emerging Many families seek music therapy services for their relationship with music and the understanding of music children either through institutionalized or private clinical as an agent of learning and development. The music services. Those who directly engage music therapy therapist may also need to support the family’s services must interpret who is a qualified music therapist understanding of the structures and language of music. and determine realistic expectations for their child. The American Music Therapy Association (AMTA) provides As professionals working within the structures of early information on the qualifications of a music therapist as intervention, special education or the disability well as what consumers might expect from services community, we can help families access organizations (“How to find a music therapist,” and associations that provide families with explicit http://www.musictherapy.org/about/find/). Yet, as instruction and support regarding language, structures

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and practices. We can become more aware of the organizations in our geographic area that can help families, and look to national organizations whose mission is to provide information and support. The ARC for People with Intellectual and Developmental Disabilities was created in the late 1950s by parents and others who were interested in standing up for those with developmental disabilities. It is now a national organization with about 700 chapters throughout the United States. The ARC is a known advocate for people with Fetal Alcohol Syndrome, Down Syndrome, Autism Spectrum Disorder, and a significant amount of intellectual and developmental disabilities and also works to protect people with intellectual and developmental disabilities with regard to federal public policy. The ARC oﬀers services to assist families (e.g., information and referrals, individual advocacy to address various concerns, promotion of self-advocacy, family support, employment training, and some leisure activities). State and national organizations help to provide explicit teaching that facilitates family transitions. As clinicians, we should learn about resources that are available to our families to support their experiences. As music therapists, we have incredible opportunities to engage with children and their families as they begin what is very often a new and unexpected path. Providing families with explicit information and support is a valuable way to support the family’s transition into new therapeutic and educational spaces. We spend years training and doing the job that helps us develop insider knowledge about the language, practices and artifacts of our work. By recognizing the perspective of the family, we can better facilitate their process and therefore, better serve their child. References Hammond, H., Ingalls, L., Trussell, R. (2008). Family members’ individual involvement in the initial Individual Education Program (IEP) meeting at the IEP process: Perceptions and reactions. International Journal about Parents in Education, 2(1), 35-48. Heiman, T. (2002). Parents of children with disabilities: Resilience, coping, and future expectations. Journal of Developmental Physical Disabilities, 14(2), 159-171.

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Kalyanpur, M. & Harry, B. (2012). Cultural reciprocity in special education. Baltimore, MD: Paul Brookes Publishing Co. Kingsley, E. P. (1987). Welcome to Holland. Retrieved from http://www.creativeparents.com/Holland.html Rivera, N. (2012, October). Examining Cultural Practices and Contexts of Development: Implications for Clinical Music Therapy Practices. Paper presented at the American Music Therapy Association Conference, St. Charles, IL. Schwager, I. (2001). Interview with Emily Perl Kingsley author of Welcome to Holland. Retrieved from http:// www.creativeparents.com/EPKinterview.html Stige, B. (2002). Culture-centered music therapy. Gilsum, NH: Barcelona Publishers. About the Authors Nicole R. Rivera, Ed.D., MT-BC, worked as a clinical music therapist for over 17 years serving children with Autism Spectrum Disorder. She is a Visiting Assistant Professor of Psychology at North Central College in Naperville, IL. Contact: nicolelrivera@hotmail.com Danara Barlow is a psychology student at North Central College with a strong interest in advocacy for persons with disabilities. She currently studies with Dr. Rivera. Contact: danarabarlow@gmail.com

Resources for Families Equip for Equality http://www.equipforequality.org/ Family Disability Resource Center http://www.frcd.org/ Wright’s Law http://www.wrightslaw.com/ The ARC http://www.thearc.org/

featured Next Generation Music Therapy: Clinical Applications of YouTube Videos Sarah E. Pitts, MA, MT-BC Georgia Regional Hospital at Savannah Savannah, Georgia Kirsten E. Meyer, MA, MT-BC Music Speaks, LLC Council Bluffs, Iowa Introduction Music therapists are currently in an era of ever-changing technology. In the last two decades, the way in which people listen to music, transport music, and create and write music has been transformed. These advances have a direct eﬀect on how music therapists use music in sessions as well as how they can create and distribute music to their clients. One way music therapists are able to learn and access music is through the use of videos available on websites, such as YouTube. Publicly shared videos can assist in teaching concepts, learning songs, or providing an avenue for expression. The purpose of this article is to discuss the increased use of technology among music therapists and to describe how certain types of YouTube videos may be used in clinical settings, with a special focus on applications and adaptations for settings involving children aged 0-5 years old. According to the professional competencies of the American Music Therapy Association (AMTA), music therapists are expected to be able to “demonstrate basic understanding of technologically advanced instruments” (AMTA, 2009). Crowe

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and Rio (2004) surveyed music therapy clinical training directors and professors as well as reviewed literature to investigate the use of technology in music therapy research, education, and training. Their recommendations indicated that a more detailed survey of music therapists regarding their use of technology was needed, as well as continued education on developments in technology related to working with people of all abilities. More recently, researchers asked music therapists and interns about their specific uses of technology and the goals addressed with such usage. Results indicated that professional music therapists use technology more often than interns in clinical practice; however, both groups would like continued training on the clinical applications of technology (Cevasco & Hong, 2011). Using music videos found on YouTube is one way that both students and professionals may first become exposed to or learn a song. Clients may request an unfamiliar selection, and an easy way for the therapists to familiarize themselves with the song is to find an online audio or video recording. Although songs written before the creation of the modern music video may not have “oﬃcial” videos for viewing, many have videos created from audio recordings and photo collages or live performances. In fact, the content of a music video can change or enhance the therapeutic eﬀect of music used in sessions, as well as possibly influence the decisions clinicians make about how they use music within the clinical setting. Students who viewed the music video of a song as opposed to just listening to the audio recording were more likely to select the possible age range, possible population, and appropriate population that most related to the video’s content (Gooding & MoriInoue, 2011). Both professionals and students may need to be cautious if utilizing music videos for familiarization with songs or within the context of a session. Such uses might influence clinical applications of specific musical selections.

The authors have utilized “how-to” videos for songs such as “The Cupid Shuﬄe” and “Achy Breaky Heart” to teach group dances during music therapy sessions. !!!Watch video Achy Breaky Heart Demo and Walkthrough !!! http://www.youtube.com/watch?v=JbHBbFIFH2o

These dances might need to be modified based on children’s ages and motor skill development. Children who can stand independently and walk should be encouraged to participate in these dances with minimal assistance in order to strengthen gross motor coordination, spatial awareness, and balance. Music therapists may want to learn how to play the song on a live instrument so that the tempo can be increased or decreased based on the various levels of the abilities of the children. Parent-child dyads might also practice dances to help strengthen the relationship between the two partners (Standley & Walworth, 2010). Another type of video involves instruments made from non-traditional materials. These videos may be instructional in nature and explain the process of making a certain type of instrument, or may involve performances featuring homemade instruments. Some of the non-traditional instruments found in YouTube videos include vegetables carved to create wind instruments, a pop bottle orchestra, and PVC pipes cut to diﬀerent lengths to recreate Boomwhackers® or Joia Tubes®. Watch video: Big Broccoli Ocarina Angels We Have Heard on High

http://www.youtube.com/watch?v=_GabHGlGm14

!!!Watch video: St. Luke’s Bottle Band Peacherine Rag

http://www.youtube.com/watch?v=k26nt3Y4cmg

!!!Watch!video:!Homemade PVC Joia Tubes Ocarina of Time Medley http://www.youtube.com/watch?v=BTinHVB9lyE

Types of Videos Music videos can be utilized to address a variety of goals across populations. “How-to” videos typically provide the viewer with a series of broken down steps or modified versions of dances. There are a number of videos teaching dance sequences to songs of all genres.

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While these videos may be used as inspiration, there is no limit to what items may be used to create instruments or ensembles. In fact, many children do this naturally, engaging in spontaneous musical play using sounds found in the environment, such as banging on kitchen

pots and pans. A characteristic of musical play is that it is multimodal; children blend movement with the creation of sounds (Marsh & Young, 2006). When given a selection of household items and the encouragement to explore various timbres and sounds, children will likely display active music making, both aurally and kinesthetically, which can be used to address a variety of cognitive and gross motor goals. Children aged 0-5 years may lack the fine motor coordination required to create instruments from nontraditional materials on their own, but with modification or assistance from a music therapist, children may be able to complete the steps necessary to create a simple instrument, and thus address goals related to fine motor coordination and creativity. Children in the upper end of this age group may be able to give input in designing the instrument, giving them an opportunity to use teamwork and increase communication skills. Music therapists may also draw inspiration from YouTube videos of vocal ensembles or instrumental ensembles that use standard instruments. !!!Watch video: Eric Whitacreâ&#x20AC;&#x2122;s Virtual Choir Lux Aurumque

http://www.youtube.com/watch?v=D7o7BrlbaDs

Watch video: The Ukulele Orchestra of Great Britain The Good, the Bad and the Ugly

http://www.youtube.com/watch?v=pLgJ7pk0X-s

Although children 0-5 years likely would not already know how to play a melodic instrument, the concepts in these ensemble videos could be modified to be http:// www.youtube.com/watch?v=7YLy4j8EZIkappropriate for young children. Adaptations could include simplified or open tuning, arrangements of familiar songs, adaptive notation, or modification of the instruments themselves. For example, children may benefit from an OrďŹ&#x20AC; ensemble (possibly using adaptations such as removing extra bars from the instruments) as a way to experience teamwork, increase communication and socialization, and practice gross and/or fine motor coordination. Children may also be exposed to instruments, vocal traditions, or ensembles of other cultures and thereby increase cultural awareness. However, for the youngest children, musical

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play is most often spontaneous, rather than pre-planned or based on a specific genre of music (Marsh & Young, 2006). For this reason, the use of ensembles with young children should be structured in a developmentally appropriate manner; children may often respond more creatively to musical play when it is not directed by adults (Marsh & Young, 2006). Music therapists may consider supporting musical play by engineering the environment and limiting the amount of actual direction during an intervention to nurture the creative process. Music therapists have recently begun creating music videos as part of interventions with both individuals and groups. Using this intervention with groups of students can be a way to increase socialization and promote conflict resolution, positive feedback, and healthy, creative expression among peers. Smith (2012) assisted adolescent girls from impoverished neighborhoods to create a therapeutic music video over the course of nine sessions. Each girl wrote her own solo verse and the group wrote a chorus together. They also included dances and had a premiere party inviting friends and family. At the conclusion of the nine sessions, the author discussed how the students had exhibited changes in socialization, self-expression, and creating healthy relationships and boundaries with peers. Other groups of youth also have written their own songs and created their own music videos without the direct assistance of a music therapist. !!!Watch video: Thriller Therapeutic Music Video http://www.youtube.com/watch?v=18bIvdZbBmU

! Watch video: Hot Cheetos and Takis

http://www.youtube.com/watch?v=7YLy4j8EZIk

Researchers have used therapeutic music videos as an intervention available to patients who are experiencing long-term treatment, such as stem cell transplantation (Burns, Robb, & Haase, 2009). In this case, patients were allowed to rewrite the lyrics of one of ten songs representing a variety of genres. The process took six sessions that were structured based on the physical health of the patient. Results indicated positive changes in quality of life, distress related to symptoms, defensive coping, and spirituality, as well as trends in other measured areas. Therapeutic music videos also could be implemented with parent-child dyads in which the child

is experiencing long term hospital treatment. Parents may find that creating music videos with children may result in tools for advocacy or create beautiful memories of the child's life. Young children could benefit from the process of creating music videos featuring songs and/or characters that are familiar or age appropriate. Including parents in the process may strengthen the relationship between parents and children and bring an element of normalcy into an otherwise stressful environment. Children who spend long periods of time in hospitals for treatment can regress academically and developmentally, so music therapists could use this intervention to maintain or teach skills in a fun, interactive way. Children born in the current generation may already be familiar with learning through technological means (e.g., Leapfrog, iPads, tablets). Future additional research in this area is indicated. Parody videos oﬀer another possibility for therapy. Merriam-Webster (2013) defines a parody as “a literary or musical work in which the style of an author or work is closely imitated for comic eﬀect or in ridicule.” Parody videos are easily found on YouTube, ranging from studio productions (e.g., Share it Maybe) to homemade (e.g., Minnesota Gurls; I’m Farming and I Grow It). These videos may feature lyrics that have been adapted from the original version, as well as video footage to reinforce the changes in the lyrics. While young children may not have developed many of the skills required to plan, write, and produce a therapeutic music video or to understand the concept of a parody video, these formats may be generally adapted for use within early childhood music therapy sessions. Children may be asked for input related to song choice, themes, props, or lyrics. These choices can be made using open-ended questions, giving options for the children to choose from, fill-in-the-blank songwriting, or adapted communication such as a Picture Exchange Communication System (PECS). By participating in such a process, children learn to use teamwork, conflict resolution, and peer-to-peer feedback, and have opportunities to increase language skills, creativity, and self-esteem.

! Watch video: Share it Maybe

http://www.youtube.com/watch?v=-qTIGg3I5y8

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Watch video: I’m Farming and I Grow It

http://www.youtube.com/watch?v=48H7zOQrX3U

Music videos depicting actual music therapy sessions are also available on YouTube. However, professionals should be cautious regarding their usage for education or advocacy. During a descriptive analysis of music therapy related videos, researchers identified over 26,000 videos under the search criteria “music therapy” while only 32 depicted “music therapy sessions” (Gooding & Gregory, 2011). Only five videos were analyzed for depiction of professional competencies in music therapy or evidence of the MT-BC credential. The researchers recommended that music therapists be cautious about uploading session videos to social networking websites and be clear about the competencies, credentials, and other professional issues. However, using websites such as YouTube by professional organizations to keep members informed or provide advocacy may be the next “big thing” in the world of technology (AMTA, 2010). The researchers completed a similar analysis on music therapy online documentaries, and found that while these videos might provide a more accurate representation of music therapy, professionals still need to use them with caution (Gregory & Gooding, 2012) and to be vigilant about obtaining permission from families prior to posting. Professionals and clinical training directors may use videos for modeling behavior. Many music therapy educators video record students conducting music therapy interventions with clients and then have fellow students analyze those videos as part of their observational skill development. Alley (1980) completed two studies with students to see if this method was more efficient than using purely educator feedback. Results indicated that video analysis increased skill development and transfer of skills to different settings more than oneto-one feedback with educators. However, students did enjoy the interaction with their professor. Some music therapists utilize videos as part of a behavior-modeling program (e.g., for children with Autism Spectrum Disorder) (Bellini & Akullian, 2007). Typically the children create a video of themselves completing an appropriate behavior within the context of a music therapy session and then take the video with them for use in different settings. Parents of clients are able to

view the behavior and then help to generalize it to other settings, such as home or school. While videotaping is used for education or research studies, music therapists may want to consider creating videos with clients for skill development or creating a tangible record of goal progress. Research on the use of videos for clients is warranted. Current Recording Technology There are many options available for video and audio recording, for both Mac and PC, ranging from free programs to professional editing software. A common audio recording and processing option available for both Mac and PC is a free application called Audacity. This program allows recording, importing and exporting of various file formats, and multi-track editing. Both PC and Mac users can record audio through iPods. There are recorders built specifically for inserting in the bottom of the iPod using the iPod’s memory as the storage. Users then upload the audio files to iTunes when syncing the iPod. iPhones have built in microphones, but have similar capabilities. Olympus also makes a digital recorder with a USB connection for easy uploading. Mac users can edit audio through a program called GarageBand™, which allows users to record instrument tracks or use prerecorded loops to create songs. Users can utilize MIDI keyboards or other electronic instrument equipment through USB access and record straight into the GarageBand™ program. Using an iPad or iPhone is a simple and popular way to record video. Many professionals are able to obtain iPads for use in their facility and take them directly to the clients. A video editing option for PC is Windows Movie Maker, which is currently a part of the Microsoft Windows standard software package. A low cost option for video editing on Mac or PC is Adobe Premiere Elements, sibling to the professional level Adobe Premiere Pro. Mac users can use iMovie, which is a step-by-step program for editing and making videos. The program allows for frame by frame editing and is created to be fairly user friendly. Conclusion Music videos can be an eﬀective intervention for working with a variety of populations as well as a tool for advocacy and education for the field of music therapy.

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However, there are several cautionary aspects to consider when utilizing or creating music videos. Always remember to respect client confidentiality. This may seem very basic, but sometimes even professionals with the best intentions can overlook minor details. Parents may want to use or show videos for different purposes, but professionals do not have that same permission to release videos. With that in mind, remember that once a video is uploaded to a website such as YouTube, there is no way to completely “delete” it from the Internet. Even if the video is taken off one website, it may still be on other websites. The World Federation of Music Therapy (WFMT, 2010) has compiled recommendations about client information or therapeutic material and the Internet. This may be accessed at: http://www.wfmt.info/WFMT/ WFMT_Documents_files/Internet%20and%20Privacy %20Issues%20related%20to%20Music%20Therapy.pdf References Alley, J. M. (1980). The effect of self-analysis videotapes on selected competencies of music therapy majors. Journal of Music Therapy, 17, 113-132. American Music Therapy Association (2009). Professional competencies. Retrieved from http:// www.musictherapy.org/about/competencies/. American Music Therapy Association. (2010). AMTA music therapy’s channel. Retrieved from http:// www.youtube.com/user/AMTAmusictherapy. 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(3), 264-287. Burns, D. S., Robb, S. L., & Haase, J. E. (2009). Exploring the feasibility of a therapeutic music video intervention in adolescents and young adults during stem-cell transplantation. Cancer Nursing, 32(5), E8E16. Cevasco, A. M., & Hong, A. (2011). Utilizing technology in clinical practice: A comparison of board-certified music therapists and music therapy students. Music Therapy Perspectives, 29, 65-73. Crowe, B. J., & Rio, R. (2004). Implications of technology in music therapy practice and research for music therapy education: A review of literature. Journal of Music Therapy, 41, 282-320. Gooding, L. F., & Gregory, D. (2011). Descriptive analysis of YouTube music therapy videos. Journal of Music Therapy, 48, 357-369.

Gooding, L. F., & Mori-Inoue, S. (2011). The eﬀect of music video exposure on students’ perceived clinical applications of popular music in the field of music therapy. Journal of Music Therapy, 48, 90-102. Gregory, D. & Gooding, L. F. (2012). Music therapy online documentaries: A descriptive analysis. Music Therapy Perspectives, 30, 183-187. Marsh, K., & Young, S. (2006). Musical play. In G. E. McPherson (Ed.), The child as musician: A handbook of musical development (pp. 289-310). New York: Oxford University Press. Parody. Def. 1. (2013). In Merriam-Webster Online. Retrieved from http://www.merriam-webster.com/ dictionary/parody Smith, L. (2012). Sparking divas! Therapeutic music video groups with at-risk youth. Music Therapy Perspectives, 30, 17-24. Standley, J., & Walworth, D. (2010). Music therapy with premature infants: Research and developmental interventions (2nd ed.). Silver Spring, MD: American Music Therapy Association. World Federation of Music Therapy (2010). Internet and privacy issues related to music therapy. Retrieved from http://www.wfmt.info/WFMT/ WFMT_Documents_files/Internet%20and %20Privacy%20Issues%20related%20to%20Music %20Therapy.pdf About the Authors Sarah E. Pitts, MA, MT-BC is the Recreation & Volunteer Coordinator and music therapist at Georgia Regional Hospital at Savannah. She currently provides music therapy services to adult psychiatric and forensic patients as well as directs the hospital’s volunteer program and develops a variety of psychosocial rehabilitation programming.

Gretchen Chardos Benner, LMSW, MT-BC

Passionately serving Rock Hill, SC and Charlotte, NC Areas Individual Music Therapy Sessions Group Music Therapy Sessions Drumming Circles Music Education Consultations

Achieving personalized goals through the use of music therapy!

Contact: sepitts9@gmail.com Kirsten E. Meyer, MA, MT-BC is a music therapist with Music Speaks, LLC, serving seven counties in southwest Iowa and eastern Nebraska. Her experience includes work in psychiatric, hospice, early childhood, and Veterans Aﬀairs settings.

www.piedmontmusictherapy.com

The 2013 featured article is

Contact: kirsten.meyer@gmail.com

available as a full multimedia publication on the imagine website.

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research 2013 Early Childhood Research Snapshot Blythe LaGasse, Ph.D., MT-BC Colorado State University Fort Collins, Colorado

Research on music and early childhood populations continues to be published in numerous journals. This research snapshot will cover recent research on the use of music in early childhood, with specific attention to research published in 2012 and 2013. The purpose of this article is to help the music therapy clinician stay apprised of such research so as to maintain an evidence-based practice. Early Music Experience and the Brain Many researchers have questioned if musicality is an acquired or inherent skill (Marcus, 2012). Although adults are often drawn to music and engage in music in numerous ways, when and how does the infant or child develop musically? As discussed in the 2011 imagine Research Snapshot, there is likely interplay between nature and nurture â&#x20AC;&#x201C; where the childâ&#x20AC;&#x2122;s brain is ready to engage with stimuli (including music) and continued engagement changes the brain. Current research supports this idea with two major findings: 1) very young children demonstrate musicality and 2) children who continue to engage with music show brain changes.

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Evidence from previous research studies demonstrates that children as young as 9 months can discriminate between happy vs. sad musical excerpts (Flom, Gentile, & Pick, 2008). In a more recent study, Flom and Pick (2012) established that 5 and 7-month-olds also discriminate happy and sad music. To test their hypothesis, Flom and Pick used a habituation method, exposing infants to musical excerpts from one affective state (i.e., happy) until they showed a 70% decrease in visual attention. When presented with another excerpt from the same affective group, the children did not show increased attention. However, when excerpts from a different affect group were played, the infants demonstrated discrimination through increased attention. Several studies have indicated that young children react to different aspects of music including rhythm, consonance/dissonance, pitch, and meter (Stalinski & Schellenberg, 2012). If young children can discriminate music, does long-term exposure to music impact functioning? In one study, Putkinen and colleagues (2013) investigated the impact of music experience on auditory skills in young children. They utilized electroencephalograph (EEG) to measure event related potentials (ERPs; brain responses to stimuli) in 2-3 year old children, controlling for socioeconomic factors, age, and gender. A correlation existed between the amount of informal home music activity and EEG responses. The authors proposed that more exposure to music activity resulted in heightened sensitivity to temporal acoustic changes, better auditory change detection, and less auditory distractibility. However, correlation is not causation; more information is needed from studies that compare children exposed to music verses children who receive no extra music experiences to determine direct effects of music engagement on auditory processing and/or cognitive skills. Gerry and colleagues (2012) attempted to determine if adding a certain type of music experience to a young child’s routine would change musical and nonmusical skills. Six-month-old children who attended passive weekly group music experiences (recorded music without instruction) were compared to children who were engaged in weekly active music-making experiences (i.e., singing, instrument playing, movement to music).

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Twenty-four families were randomly assigned to the passive group and twenty-five families were randomly assigned to the active group. At the end of six months, children in active music experiences demonstrated superior development of prelinguistic communicative gestures and social-emotional behaviors (Gary, Unrau, & Trainor, 2012). Another study from the same research group (Trainor, Marie, Gerry, Whiskin, & Unrau, 2012) focused on the children’s responses to musical tones after the 6-month active or passive music experience. At baseline, the children in both groups demonstrated similar ERPs in response to piano tones. After the 6-month active or passive group intervention, children in the active group demonstrated significant differences in ERPs in response to the same tones, indicating more advanced tone processing in the active group. Collectively, the aforementioned studies signify that music engagement may drive brain changes; however, active engagement in music may yield greater responses in musical and nonmusical skills. The idea that music engagement drives neuroplasticity (brain changes) is gaining acceptance; however, the mechanisms of the underlying changes are not yet understood (Herholz & Zatorre, 2012). Researchers have sought to determine whether there is a particular age at which children must engage formally with music to demonstrate differences in skills or neurological structures. Bailey and Penhune (2012) found that individuals who received music training before the age of seven had superior rhythmic matching abilities than those who learned music after age seven or those with no formal music training. Most cognitive skills were similar in the musicians and non-musicians, with the exception of better matrix reasoning (visual processing and spatial perception) in musicians and verbal abilities in non-musicians. Similarly, Steele and colleagues (2013) found that musicians who received training before the age of seven had greater connectivity in the corpus callosum (connection between two hemispheres of the brain) and superior sensorimotor synchronization abilities. Both researchers proposed that, like language, there is a sensitive window for music learning that can affect brain connectivity and sensorimotor abilities.

This information provides further indication that early experience in music is beneficial, and continued engagement may lead to lifelong cortical diﬀerences. Although this information is very interesting, music therapists use music engagement to develop nonmusical skills. Additionally, early skill training may yield “more profound eﬀect on brain plasticity,” training can change the brain at any age (Herholz & Zatorre, 2012, p. 496). Research demonstrating that exposure to music engagement and music activity build a theoretical basis for why music may be applicable to develop nonmusical skills in persons with disabilities. However, as clinicians we look for research indicating how music therapy (i.e., using the music for treatment) impacts functioning in persons receiving services. The following studies focused on music therapy treatment for nonmusical skill acquisition in young children. Parent-Child Interactions Williams, Berthelsen, Nicholson, Walker, and Abad, (2012) investigated interactions between parents and their children with disability. Two hundred and one mother-child dyads attended a ten-week Sing & Grow© program, with 8-10 families in each group. Measures included pre- and post-parental questionnaires and clinician observation measures. Researchers found statistically significant improvements in parental mental health, child communication and social skills, parental engagement, and child interest in program activities. Parents reported high satisfaction and social benefits from attending the group. Addressing the influence of the quality of interactions, Pasiali (2012) investigated the impact of music therapy on mutually responsive orientation (MRO) behaviors in four young children (3 to 5 years) and their family members. Common risk factors included low income and maternal depression. A cross-case analysis revealed that music therapy sessions provided opportunities for interaction and the development of MRO behaviors. This study may indicate that music therapy could help to establish stronger parent-child interactions in typically developing children. Collectively, these two studies support the use of music for increased interaction; however, more studies comparing music with nonmusical interventions are needed.

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Music for Premature Infants Research demonstrating the benefits of music for premature infants continues to be published. Standley (2012a) published a discussion of studies focused on contingent music for feeding in premature infants. She cited numerous studies indicating that contingent music can increase frequency, duration, and pacing, which leads to improved feeding and earlier discharge from the Neonatal Intensive Care Unit (NICU) (see Standley 2012a; 2012b for full review). Malloch et al. (2012) compared self-regulation and social engagement in 20 infants in the NICU. Ten children were randomized into the live music therapy group and ten received no music therapy. Results indicated that children in the music therapy group showed significant improvement in neurodevelopment, with the ability to better maintain self-regulation during adult social interaction. Another study compared physiologic and developmental data in 272 premature infants (Loewy, Stewart, Dassler, Telsey, & Homel, 2013). This multisite study employed three live music therapy interventions over a period of two weeks. Interventions included sung lullaby, ocean entrained breathing sounds using a live ocean disc, and entrained heartbeat sounds using a live gato box. Compared to the control condition, infants demonstrated a significant decrease in heart rate after all three live music conditions, with decreased heart rate during the intervention for the lullaby and gato box intervention. The ocean disc condition also yielded significant differences in positive sleep patterns. These results demonstrate that different music timbres and the principles of entrainment can result in different responses from premature infants, warranting further research and discussion of NICU interventions. The above studies continue to demonstrate the importance of early childhood music engagement and the efficacy of music therapy in early intervention. The reference list below has direct links to the study abstracts via PubMed (http://www.ncbi.nlm.nih.gov/ pubmed/) or the digital object identifier (DOI) number (http://www.doi.org) to provide readers with the opportunity to explore these studies further.

References Bailey, J., & Penhune, V. B. (2012). A sensitive period for musical training: Contributions of age of onset and cognitive abilities. Annals of the New York Academy of Sciences, 1252, 163-70. doi: 10.1111/j. 1749-6632.2011.06434.x. PMID: 22524355 Flom, R., Gentile, D. A., & Pick, A. D. (2008). Infants' discrimination of happy and sad music. Infant Behavior and Development, 31(4), 716-728. doi: 10.1016/j.infbeh.2008.04.004. Flom, R., & Pick, A. D. (2012). Dynamics of infant habituation: Infants' discrimination of musical excerpts. Infant Behavior, 35(4), 697-704. doi: 10.1016/j.infbeh.2012.07.022 PMID: 22982268 Gary, D., Unrau, A., & Trainor, L. J. (2012). Active music classes in infancy enhance musical, communicative and social development. Developmental Science, 15(3), 398-407. doi: 10.1111/j. 1467-7687.2012.01142.x Herholz, S. C., & Zatorre, R. J. (2012). Musical training as a framework for brain plasticity: Behavior, function, and structure. Neuron, 76(3), 486-502. doi: 10.1016/ j.neuron.2012.10.011 Loewy, J., Stewart, K., Dassler, A. M., Telsey, A., & Homel, P. (2013). The eﬀects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics, 131(5), 902-18. doi: 10.1542/peds. 2012-1367 Malloch, S., Shoemark, H., Crncec, R., Newnham, C., Paul, C., Prior, M., & Burnham, S. (2012). Music therapy with hospitalized infants: The art and science of communicative musicality. Infant Mental Health Journal, 33(4), 386-399. Marcus, G. F. (2012). Musicality: Instinct or acquired skill? Topics in Cognitive Science 4(4), 498-512. doi: 10.1111/j.1756-8765.2012.01220.x Pasiali, V. (2012). Supporting parent-child interactions: Music therapy as an intervention for promoting mutually responsive orientation. Journal of Music Therapy, 49(3), 303-334. Putkinen, V., Tervaniemi, M., & Huotilainen, M. (2013). Informal musical activities are linked to auditory discrimination and attention in 2-3-year-old children: An event-related potential study. European Journal of Neuroscience, 37(4), 654-661. doi: 10.1111/ejn. 12049

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Trainor, L. J., Marie, C., Gerry, D., Whiskin, E., & Unrau, A. (2012). Becoming musically enculturated: Eﬀects of music classes for infants on brain and behavior. Annal of the New York Academy of Science, 1252, 129-138. doi: 10.1111/j.1749-6632.2012.06462.x Stalinski, S. M., & Schellenberg, E. G. (2012). Music cognition: A developmental perspective. Topics in Cognitive Science, 4(4), 485-497. doi: 10.1111/j. 1756-8765.2012.01217.x Standley, J. (2012a). A discussion of evidence-based music therapy to facilitate feeding skills of premature infants: The power of contingent music. The Arts in Psychotherapy, 39, 379-382. Standley, J. (2012b). Music therapy research in the NICU: An updated meta-analysis. Neonatal Network, 31(5), 311-316. doi: 10.1891/0730-0832.31.5.311 Steele, C. J., Bailey, J. A., Zatorre, R. J., & Penhune, V. B. (2013). Early musical training and white-matter plasticity in the corpus callosum: Evidence for a sensitive period. Journal of Neuroscience, 33(3), 1282-1290. doi: 10.1523/JNEUROSCI. 3578-12.2013 Williams, K. E., Berthelsen, D., Nicholson, J. M., Walker, S., & Abad, V. (2012). The eﬀectiveness of a shortterm group music therapy intervention for parents who have a child with a disability. Journal of Music Therapy, 49(1), 23-44. About the Author Blythe LaGasse, Ph.D., MT-BC is 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: blagasse@colostate.edu www.musictherapyresearchblog.com

For additional 2013 articles and books check the publications and reviews section.

Recent Findings: Music Therapy for Young Children with Autism Spectrum Disorder Jennifer Whipple, Ph.D., MT-BC Charleston Southern University Charleston, South Carolina

What We Know The Bottom Line: Music therapy is extremely effective (overall effect size of d = 0.76; p <.0001) for developing communication, interpersonal skills, personal responsibility, and play in young children with Autism Spectrum Disorder (ASD), according to the results of a recent meta-analysis (Whipple, 2012). A metaanalysis uses statistical procedures to compile quantitative research data resulting in an effect size to make the large base of literature more manageable by highlighting relevant research findings and building confidence in treatment options (Gold, 2004; Whipple, 2004).

Note: This article is based on the meta-analysis published in the following book chapter: Whipple, J. (2012). Music therapy as an eﬀective treatment for young children with Autism Spectrum Disorders: A meta-analysis, In P. Kern and M. Humpal (Eds.), Early childhood music therapy and Autism Spectrum Disorders: Developing potential in young children and their families, (pp. 58-73). London and Philadelphia: Jessica Kingsley Publishers.

For this meta-analysis (Whipple, 2012), studies were analyzed only if they met stringent criteria, including that they used music as a separate, independent variable; treatment was provided by a music therapist; the published report of the study included enough quantitative data to perform the statistics required; and they were published in peer-reviewed journals. Ultimately, eight published studies related to music therapy for young children with ASD were included in the meta-analysis (Finnigan & Starr, 2010; Kern & Aldridge, 2006; Kern, Wakeford & Aldridge 2007; Kern, Wolery & Aldridge, 2007; Kim, Wigram & Gold, 2008; Lim, 2010; Lim & Draper; 2011; Wimpory, 1995). The Details: The National Autism Center (NAC, 2009) provided a list of target areas for treatment of children with ASD. Four of these areas, increased communication, interpersonal skills, personal responsibility, and play, were addressed in the included studies. For example, in the area of communication, Kern, Wolery, and Aldridge (2007) taught classroom teachers a routine and original morning greeting song to aid morning transitions into the classroom and increase interaction among

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peers. To address both play and interpersonal skills, Kern and Aldridge (2006) constructed a “Music Hut” on a preschool playground and taught teachers original compositions and a procedure to use for helping children initiate active music play and peer interactions. Finally, Kern, Wakeford, and Aldridge (2007) addressed concepts of personal responsibility to guide a preschool child with ASD through daily tasks by teaching the classroom teacher an original song that outlined the steps of handwashing, toileting, and cleaning up. Seven of the eight studies incorporated live music and active involvement of children. Six specified the use of child-appropriate (though not specifically child-preferred or -selected) songs for music play or music-making, including original songs composed specifically for the children. Of these, three incorporated “piggyback” versions of familiar melodies. Questions Still to Answer What other types of goals and objectives can be aided by music therapy treatment? Unfortunately, more than two-thirds of the NAC’s (2009) treatment target areas were not addressed by studies included in the metaanalysis. These were increased academic skills, higher cognitive functions, learning readiness, motor skills, placement skills, and self-regulation; and decreased behaviors related to general symptoms of ASD, problem behaviors, restricted repetitive nonfunctional patterns of behavior, and sensory or emotional regulation. While the number of publications related to music therapy treatment for young children with ASD has vastly increased within the past decade, music therapists still need to document treatment for the remainder of these outcome categories, which are likely addressed daily in clinical practice. How do the music skills of children with ASD aﬀect music therapy treatment? It seems that some children with ASD may have increased sensitivity to musical pitch and timbre (Heaton, 2003, 2005), yet skills equal to their typically developing peers in perception of musical structure, contour, and emotions (Heaton, 2003, 2005; Heaton, Williams, Cummins & Happe, 2007). However, because children with ASD are very diﬀerent from one another, and because no related study has included children younger

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than seven, it is impossible to generalize to the entire population of children (or even young children) with ASD. Also, the music areas in which some children with ASD seem to exhibit advanced skills are not the only indicators of an individual’s musical success, nor is advanced natural musical ability necessary for a client to benefit from music therapy. While these related studies were not included in the meta-analysis (Whipple, 2012), the existing research supports the need for further investigation into how children with ASD of all ages and functioning levels process music, so that music therapists may learn to best meet their needs. How do we improve scientific rigor of music therapy studies? Study design and implementation standards are best measured by the Scientific Merit (NAC, 2009) and Evidence-Based Practice (Reichow, Volkmar & Cicchetti, 2008) rating systems. Based on the strict Scientific Merit Rating rubric criteria which issues ratings of 1 (low) to 5 (high), all but two of the studies received a 1 and none received a 5. Typically, the low rating was caused by one factor within one of the five rubric categories of research design, measurement of dependent and independent variables, participant ascertainment, and generalization. However, the Evidence-Based Practice Rating provided opportunities for individualization based on specific study aspects, which allowed half of the studies to earn the highest possible rating (strong) and the other half to earn the mid-rating (adequate). Deficits in the areas of sample size and generalization within published music therapy studies, especially those focusing on diverse populations like ASD, long have been targets of criticism (Whipple, 2004). Diﬃculty gaining access to enough clients and maintaining access and funding are ongoing challenges. Because of these issues regarding sample sizes and generalization, currently the Evidence-Based Practice Rating system is a more accurate measure of scientific rigor within the field of music therapy. Still, improvements in the areas of sample size, generalization, and age range and diagnosis inclusion criteria will lend greater scientific integrity to music therapy research. Sample size. Several studies within this meta-analysis had very small samples, many with only one participant,

and incorporated a single-case experimental design. Appropriately, these studies often reported data using graphic rather than statistical analysis. However, that format does not translate well to data extraction and meta-analysis calculations. Further, the Scientific Merit Rating for several studies was damaged by their small sample sizes. For example, both Finnigan and Starr (2010) and Wimpory (1995) would have received a midscale rating of 3, but because each had a sample of one, considered a fault within the research design category, they received the lowest rating. Music therapists must focus on increasing sample sizes, yet continue to incorporate both single case and group experimental designs. A treatment becomes an Established EvidenceBased Practice with 5 single case experimental studies of strong scientific integrity or 10 of adequate quality, and a Promising Evidence-Based Practice requires only three studies of adequate quality (Reichow, Volkmar & Cicchetti, 2008). Generalization. Lim and Draper (2011), Lim (2010), and Kim, Wigram, and Gold (2008) had large enough samples, but none included any generalization or maintenance data, which reduced the Scientific Merit Ratings for those studies from the highest to the lowest possible. Age range and diagnosis inclusion criteria. Researchers should consider tighter limitations on age ranges so that all participants within studies addressing early childhood fall within the accepted range. In addition, researchers should include only children with ASD or report data for those participants separately from data for children with other diagnoses. Studies without clean parameters for subject inclusion were excluded from the meta-analysis. Otherwise, this aspect of research design would have adversely aďŹ&#x20AC;ected the scientific integrity ratings of any such studies. Final Thoughts We know music therapy is a powerful tool for developing the four areas of communication, interpersonal skills, personal responsibility, and play in young children with ASD. In order to continue to advance the field of music therapy, clinicians and researchers should become familiar with standard measures of scientific integrity, focusing most on adequate samples, incorporation of

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generalization and maintenance into treatment, and documentation of benefits for additional goal areas for this population, so that the profession may move toward the establishment of Evidence-Based Practices. By creating sophisticated research respected within and beyond the field of music therapy, therapists will be able to better secure clients and funding. Furthermore, they will become increasingly confident that the treatment they provide best meets the needs of the young children with ASD and their families whom they serve. References Finnigan, E., & Starr, E. (2010). Increasing social responsiveness in a child with autism: A comparison of music and non-music interventions. Autism, 14 (4), 321-348. Gold, C. (2004). The use of eďŹ&#x20AC;ect sizes in music therapy research. Music Therapy Perspectives, 22(2), 91-95. Heaton, P. (2003). Pitch memory, labeling and disembedding in autism. Journal of Child Psychology and Psychiatry and Allied Disciplines, 44(4), 543-551. Heaton, P. (2005). Interval and contour processing in autism. Journal of Autism and Developmental Disorders, 25(6), 787-793. Heaton, P., Williams, K., Cummins, O., Happe, F. G. E. (2007). Beyond perception: Musical representation and on-line processing in autism. Journal of Autism and Developmental Disorders, 27(7), 1355-1360. 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(4), 270-294. Kern, P., Wakeford, L., & Aldridge, D. (2007). Improving the performance of a young child with autism during self-care tasks using embedded song interventions: A case study. Music Therapy Perspectives, 25(1), 43-51. Kern, P., Wolery, M., & Aldridge, D. (2007). Use of songs to promote independence in morning greeting routines for young children with autism. Journal of Autism and Developmental Disorders, 37, 1264-1271. Kim, J., Wigram, T., Gold, C. (2008). The eďŹ&#x20AC;ects of improvisational music therapy on joint attention behaviors in autism children: A randomized

controlled study. Journal of Autism and Developmental Disorders, 38, 1758-1756. 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, 48(1), 2-26. Lim, H. A., & Draper, E. (2011). The effects of music therapy incorporated with Applied Behavior Analysis Verbal Behavior approach for children with Autism Spectrum Disorders. Journal of Music Therapy, 48(4), 532-550. National Autism Center. (2009). National standards report: The national standards project–addressing the need for evidence-based practice guidelines for Autism Spectrum Disorders. Randolph, MA: Author. Reichow, B., Volkmar, F. R., & Cicchetti, D. V. (2008). Development of the evaluative method for evaluating and determining evidence-based practices in Autism. Journal of Autism and Developmental Disorders, 38, 1311-1319. Whipple, J. (2004). Music in intervention for children and adolescents with Autism: A meta-analysis. Journal of Music Therapy, 41(2), 90-106. Whipple, J. (2012). Music therapy as an effective treatment for young children with Autism Spectrum Disorders: A meta-analysis, In P. Kern and M. Humpal (Eds.), Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their families. London and Philadelphia: Jessica Kingsley Publishers. Wimpory, D., Chadwick, P., & Nash, S. (1995). Brief report: Musical interaction therapy for children with Autism: An evaluative case study with two-year follow-up. Journal of Autism and Developmental Disorders, 25(5), 541-552.

YOUR

F A L L Reading Early Childhood Music Therapy and Autism Spectrum Disorders: Developing Potential in Young Children and Their Families

About the Author Jennifer Whipple, PhD, MT-BC is Associate Professor and Director of Music Therapy at Charleston Southern University in South Carolina and is a Fellow of the National Institute for Infant and Child Medical Music Therapy. Her primary research interests are developmental intervention with preterm infants and teacher training for successful integration of students with special needs. She is the author of two metaanalyses on music intervention for individuals with autism spectrum disorder. Contact: jwhipple@csuniv.edu imagine 4(1), 2013

The ScientistPractitioner: Single-Subject Research Methodology for Music Therapy Clinicians Dana Bolton, MEd, MMT, MT-BC Bolton Music Therapy Murfreesboro, Tennessee Single-subject research methodology is a form of quantitative research with a long history in the fields of special education and applied behavior analysis (Horner et al., 2005). Singlesubject research has been included in over 45 diďŹ&#x20AC;erent professional journals. Unlike the traditional narrative case study, single-subject research methodology is able to document experimental control and can be used to establish evidencebased practices. Randomized control-group research designs are often used for this purpose in music therapy but may be diďŹ&#x192;cult to conduct, particularly for music therapists in private practice. Backman, Harris, Chisholm, and Monette (1997) acknowledged that most rehabilitation settings are not able to conduct large group design studies due to a lack of clients with similar characteristics. The main characteristics of single-subject research, including repeated data measurement and data-driven decision making, mirror the ways music therapists collect and use data during daily practice (Hanser, 1999). Horner et al. (2005) identified several characteristics of single-subject research that match well with special education and can also be applied to music therapy, including the focus on the individual, the ability to identify and evaluate characteristics of participants who do not respond to intervention, providing intervention in typical settings, and the cost-eďŹ&#x20AC;ectiveness of single-subject designs compared to randomized control-group designs. In the music therapy literature, single-subject designs were identified as providing music therapists a way to evaluate their clinical practice (Kern, 2005).

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Indicators for single-subject research were developed by Horner et al. (2005). These following quality indicators can be used by music therapists when designing their own research studies or when critically evaluating published research. Participant and setting description. This indicator encompasses participant description, participant selection, and setting description. It includes a description of participants beyond basic demographic information (age, gender, diagnosis), inclusion criteria for how subjects are chosen, and a description of the physical setting such that it can be replicated in future studies. Dependent variable. Five components make up the dependent variable indicator. First, the dependent variable, or target behaviors, being measured needs to be operationally defined so that any observer can tell when the behavior occurs. Second, the dependent variable needs to be measured with a procedure that yields quantitative information (e.g., frequency, rate, duration). Third, the measurement system needs to be valid and described in enough detail that it can be replicated by other researchers. Fourth, the dependent variable must be measured repeatedly over time, defined by Lane, Kalberg, and Shepcaro (2009) as at least three data points per condition. Finally, interobserver agreement (IOA) needs to be reported, with a minimum criterion of 80% for the mean of scores reported. Independent variable. The first component of this indicator is a description of the independent variable or intervention used that provides enough detail for the procedure to be replicated in future studies. Second, the independent variable needs to be systematically manipulated by the researcher. This may be accomplished by using an accepted single-subject research design. The final component is the reporting of procedural fidelity (also fidelity of implementation or treatment integrity). The most common designs used in music therapy research are the withdrawal/reversal and multiple baseline designs, and their variations. In a withdrawal/ reversal design, baseline data is measured for condition A, with the intervention introduced in condition B.

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Baseline conditions are then reintroduced, with a return to intervention as the final condition. A variant of this design, the multitreatment design, is the most often used design in music therapy. This design allows multiple interventions to be studied (e.g., A-B-A-B-C-B-C-B), with B and C being two different interventions. In this design, it is important to note that only adjacent conditions can be compared, thus, no conclusions could be drawn between conditions A and C in the example as they are never adjacent to each other (Gast, 2010). In the multiple baseline design, the introduction of the intervention is staggered over time across different participants exhibiting the same behavior, the same participant with different behaviors, or the same participant in different settings. This design is often combined with a withdrawal/reversal design to show even greater experimental control (Gast, 2010). Baseline. This indicator requires baseline conditions to be described with enough detail to be replicated. In general, three data points for baseline are recommended, unless the behavior is severe or dangerous enough to warrant immediate intervention. In addition, some designs, such as alternating treatments design or multielement design, do not require the use of a baseline condition. Experimental control/internal validity. The first component of this indicator requires three demonstrations of experimental effect through either within-subject or inter-subject replication. Experimental control is achieved when changes in the dependent variable correspond to changes in the independent variable as it is manipulated according to the research design chosen. The second component requires that threats to internal validity be controlled. Threats to internal validity include history, maturation, testing, adaptation/reactivity, instrumentation, procedural infidelity, attrition, data instability/variability, cyclic variation, counter-therapeutic trends, multiple treatment interference, subject selection, and experimental effects. Finally, the published article must include a graphical display including data points for all data collection sessions in each condition. Data are analyzed primarily with visual inspection of the data (Gast, 2010). Inclusion of the graph allows readers to examine the data to

determine if they would reach the same conclusions as the author(s) of the study. External validity. In order to show external validity, findings must be replicated at least three times across participants, settings, behaviors, or materials. In addition, Lane et al. (2009) require all components of internal validity to be met in order to meet criteria for external validity. Social validity. Social validity concerns the goals, procedures, and eﬀects on society and participants. The first component requires the dependent variable to be socially important. Second, the change in the dependent variable needs to be socially important in that it meets a clinical need of the participant. The third component of this indicator is cost eﬀectiveness, and the final component is whether the intervention is administered in a typical context. Use of Single-Subject Research Methodology in Music Therapy Three American music therapy journals, Music Therapy, Music Therapy Perspectives, and Journal of Music Therapy were reviewed to determine the use of singlesubject research methodology in the music therapy field

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in the United States. Table 1 displays the total number of articles in each journal analyzed, along with the number and percent of quantitative articles and studies using single-subject research designs. Overall, 1,391 articles were published in all three journals between 1964 and 2012, with 724 (52%) using quantitative methods and 74 (5.3%) using single-subject research methodology. Articles using single-subject methodology represented 10.2% of the total quantitative studies in all three journals. Table 2 shows a breakdown by decade of the articles published in the Journal of Music Therapy and displays a decreasing trend in the number of singlesubject articles being published, with none being published since 2010. The 74 articles identified as using single-subject methodology were coded according to a system developed by Lane et al. (2009) based on Horner’s quality indicators. Only one article met all criteria for all seven quality indicators (Kern & Aldridge 2006), and one additional article exceeded the 80% threshold for weighted scoring (De Mers et al., 2009) with a score of 5.66. Table 3 presents the number and percent of articles meeting each quality indicator and component and average scores. It is important to note that many of the articles were published before Horner’s article in 2005,

thus the quality indicators were applied retroactively to those studies. One of the most notable features lacking among almost all studies was the inclusion of treatment fidelity data; only two (2.7%) articles included treatment fidelity data.

behaviors. Behaviors were measured using momentary time-sampling, and each step of the measurement procedure was listed. Behaviors were measured for between 30 and 71 days across the participants. Interobserver agreement was 98.2%.

Single-Subject Research in Early Childhood Music Therapy Kern and Aldridge (2006) received the only perfect score with this coding procedure. Reichow and Volkmar (2010) evaluated the same study in a review of social skills interventions for individuals with autism spectrum disorders and gave it a rating of strong methodological rigor using the rating system developed by Reichow et al. (2008). The Kern and Aldridge article stands out as an excellent example of a music therapy study using strong single-subject research methodology.

The independent variable description included detailed descriptions of the equipment used, including exact dimensions and materials used to build the Music Hut on the playground. Detailed descriptions of staďŹ&#x20AC; training activities and conditions for baseline and intervention phases were also provided. The independent variable was manipulated through a multiple baseline across participants design. Procedural fidelity data were measured on the teacher behaviors, and overall remained at a very high level. Baseline conditions were described in detail and were measured repeatedly. Baseline measurements were low and stable before the intervention was introduced.

Participants included four children with autism spectrum disorder, ages 3 to 5 years old. Information was provided regarding scores on diagnostic tests, age, ethnicity, gender, length of time enrolled in child care program, and specific behaviors observed in each participant on the playground. In addition, typical peers and teachers who participated in the study were described. Four criteria were given on which inclusion in the study was based. A description of the playground where the study took place included dimensions of the playground and a list of all equipment present on the playground. To define the dependent variable, operational definitions were provided for specific play and engagement

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A graphical display of all data for all four participants was provided in the article. Four demonstrations of experimental control were displayed, and all threats to internal validity were addressed through the use of the multiple baseline design. The behavior being measured, peer engagement on the playground, is a socially important goal, and there was a positive change in the behavior as a result of the intervention. The intervention was applied in a typical context: on the playground at a child care program with typical peers present. The intervention is also cost-eďŹ&#x20AC;ective (i.e., all instruments

to the highest standards of quality for the fields in which they practice. Teaching a form of research that is a realistic option may encourage more music therapy clinicians to seek opportunities for conducting their own research.

used are easily available to most music therapists or could be substituted with other instruments). The design and materials used for the Music Hut could be adapted by other centers to fit their playground and budget. In addition, the intervention was applied by classroom teachers after being trained by the music therapist, which is a cost-eďŹ&#x20AC;ective option for centers unable to hire a full-time music therapist. Implications for Practice The low numbers of single-subject studies published in the music therapy literature could indicate two things. First, a possible bias against single-subject designs may exist in the music therapy field. Second, there may be a lack of knowledge regarding this form of research. The quality of existing single-subject research indicates a need for further education for music therapists regarding methodological quality. Regardless of the research method used, music therapists should hold themselves

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Even with expanded research education, barriers for music therapy clinicians interested in conducting research may still exist. Two of the main concerns are cost and access to Institutional Review Boards (IRBs). The American Music Therapy Association (AMTA) is attempting to address these issues through the Clinician-Based Grant Program. Clinicians can apply for grants up to $5,000 towards conducting research. AMTA requires the identification of an academic partner to assist the clinician with research management, including access to IRBs. Expanding collaborations between music therapy clinicians and researchers in music therapy and other fields will open doors to new avenues of clinicianbased research. Music therapists must recognize that all kinds of research, randomized control trials, single-subject research, qualitative research, etc., are valid forms of research that can work together to establish an evidence-base for music therapy. High-quality research focused on the clinical needs of music therapy practitioners and their clients may begin to bridge the gap between music therapy research and practice. References Backman, C. L., Harris, S. R., Chisholm, J. M., & Monette, A. D. (1997). Single-subject research in rehabilitation: A review of studies using AB, withdrawal, multiple baseline, and alternating treatments designs. Archives of Physical Medicine and Rehabilitation, 78, 1145-1153. Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-97.

De Mers, C. L., Tincani, M., Van Norman, R. K., & Higgins, K. (2009). Eﬀects of music therapy on young children's challenging behaviors: A case study. Music Therapy Perspectives, 27, 88-96. Gast, D. L. (Ed.). (2010). Single subject research methodology in behavioral sciences. New York: Routledge. Hanser, S. B. (1999). The new music therapist’s handbook (2nd ed.). Boston: Berklee Press. Horner, R. H., Carr, E. G., Halle, J., McGee, G., Odom, S., & Wolery, M. (2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71, 165-179. Kern, P. (2005). The use of single case designs in an interactive play setting. In D. Aldridge (Ed.), Case study designs in music therapy (pp. 119-144). London: Jessica Kingsley Publications. 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. Lane, K. L., Kalberg, J. R., & Shepcaro, J. C. (2009). An examination of the evidence base for functionbased interventions for students with emotional and/or behavioral disorders attending middle and high schools. Exceptional Children, 75, 321-340. Reichow, B., & Volkmar, F. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40, 149-166. Reichow, B., Volkmar, F. R., & Ciccetti, D. V. (2008). Development of the evaluation method for evaluating and determining evidence-based practice in autism. Journal of Autism and Developmental Disorders, 38, 1311-1319. Single Subject Research in Early Childhood Music Therapy (studies include participants 5 years old and younger) Baird, S. (1969). A technique to assess the preference for intensity of musical stimuli in young hard-of-hearing children. Journal of Music Therapy, 6, 6-11. Burleson, S. J., Center, D. B., & Reeves, H. (1989). The eﬀect of background music on task performance in

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psychotic children. Journal of Music Therapy, 26, 198-205. De Mers, C. L., Tincani, M., Van Norman, R. K., & Higgins, K. (2009). Effects of music therapy on young children's challenging behaviors: A case study. Music Therapy Perspectives, 27, 88-96. Harding, C., & Ballard, K. D. (1982). The effectiveness of music as a stimulus and as a contingent reward in promoting the spontaneous speech of three physically handicapped preschoolers. Journal of Music Therapy, 19, 86-101. Kern, P. (2005). The use of single case designs in an interactive play setting. In D. Aldridge (Ed.), Case study designs in music therapy (pp. 119-144). London: Jessica Kingsley Publications. 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. Kern, P., Wakeford, L., & Aldridge, D. (2007). Improving the performance of a young child with autism during self-care tasks using embedded song interventions: A case study. Music Therapy Perspectives, 25, 43-51. Kern, P., & Wolery, M. (2001). Participation of a preschooler with visual impairments on the playground: Effects of musical adaptations and staff development. Journal of Music Therapy, 38, 149-164. LaGasse, B. (2012). Evaluation of melodic intonation therapy for developmental apraxia of speech. Music Therapy Perspectives, 30, 49-55. Register, D., & Humpal, M. (2007). Using musical transitions in early childhood classrooms: Three case examples. Music Therapy Perspectives, 25, 25-31. Staum, M. J. (1993). A music/nonmusic intervention with homeless children. Journal of Music Therapy, 30, 236-262. Steele, A. L., & Jorgenson, H. A. (1971). Music therapy: An effective solution to problems in related disciplines. Journal of Music Therapy, 8, 131-145. Wolfe, D. E. (1980). The effect of automated interrupted music on head posturing of cerebral palsied individuals. Journal of Music Therapy, 17, 184-206.

For Further Reading About Single-Subject Research Methodology Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-97. Barton, E. E., & Reichow, B. (2012). Guidelines for graphing data with Microsoft® Office 2007™, Office 2010™, and Office for Mac™ 2008 and 2011. Journal of Early Intervention, 34(3), 129-150. Gast, D. L. (Ed.). (2010). Single subject research methodology in behavioral sciences. New York: Routledge. Horner, R. H., Carr, E. G., Halle, J., McGee, G., Odom, S., & Wolery, M. (2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71, 165-179. Lane, K., Wolery, M., Reichow, B., & Rogers, L. (2007). Describing baseline conditions: Suggestions for study reports. Journal of Behavioral Education, 16, 224-234.

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Steele, A. L. (1977). The application of behavioral research techniques to community music therapy. Journal of Music Therapy, 14, 102-115. Wolery, M., & Harris, S. R. (1982). Interpreting results of single-subject research designs. Physical Therapy, 62, 445-452. About the Author Dana Bolton, MEd, MMT, MT-BC is a developmental therapist and private practice music therapist in Murfreesboro, Tennessee. She recently graduated with a Masters in Early Childhood Special Education from Vanderbilt University, where she developed an inservice to introduce music therapists to single-subject research methodology. Contact: dana@boltonmusictherapy.com www.boltonmusictherapy.com

photos 2013: 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 onesentence description of what happens in each picture during the music therapy session. Story #13 Music Therapy Student: K. Danielle Oar Affiliation: Marylhurst University, Portland, OR Photographer: Nancy Oar Story #14 Music Therapist: Rachel See, MA, MT-BC Affiliation: Music Therapy Services of Austin, LLC Photographer: Colleagues at “Language & Movement” Story #15 Music Therapy Student: Kezia Karnila with teacher Milla Widyawati, A.Md. Affiliation: Sekolah Musik Indonesia Photographer: Kezia Karnila, K’Photography Story #16 Music Therapist: Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA Affiliation: Music Therapy Consulting, Santa Barbara, CA Photographer: Petra Kern

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practice Data-Based Decision Making in Music Therapy Eric G. Waldon, Ph.D., MT-BC University of the Pacific Stockton, California

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The work of all music therapists involves the collection, synthesis, and analysis of data to meet clinical aims of consumers. Diﬀerences exist, however, in how music therapists conceptualize data and the ways in which data are used to make treatment decisions. The purpose of this article is to present a data-based decision making (DBDM) model in music therapy and illustrate its application in early childhood education. Defining DBDM Sometimes referred to as data-driven decision making, DBDM has seen widespread use within education as a means of improving educational outcomes (Sagebrush, 2004). In many schools, these data-driven approaches have been implemented to address accountability regulations specified in No Child Left Behind (NCLB) Act of 2001, Pub. L. No. 107-110, § 115, Stat. 1425 (2002) and as part of the reauthorization of the Individuals With Disabilities Education Improvement Act (IDEIA), 20 U.S.C. § 1400 (2004). More specifically, DBDM has been used to improve the provision of special education services in districts adopting a Response to Intervention (RTI) approach. In RTI, data are collected on all students to inform educational programming prior to special education referral (Greenwood, Bradfield, Kaminski, Linas, Carta, & Nylander, 2011). Consequently, based on a student’s response to “pre-referral” interventions, educational specialists can determine whether a child requires an intensive (i.e., more restrictive) versus a general educational program. However, beyond accountability and student identification, some schools have found that DBDM promotes home-school involvement, improves curriculum, enhances teaching, and assists educators when communicating bestpractices (Sagebrush, 2004).

While specific models diﬀer, all appear to agree that DBDM is systematic, ongoing, and collaborative. According to Marsh, Pane, and Hamilton (2006), datadriven approaches involve “teachers, principals, and administrators systematically collecting and analyzing various types of data, including input, process, outcome and satisfaction data, to guide a range of decisions to help improve the success of students and schools” (p. 1). In their work for the San Bernardino Unified School District (California), Johns and Patrick (2013) describe DBDM as “an ongoing process of analyzing and evaluating information to inform important education decisions and actions.” The Heartland Area Education Agency (Heartland AEA, 2007) uses a model based on four data-driven practices: 1) Reviewing; 2) Observing; 3) Interviewing; and 4) Testing. The R.I.O.T. model is particularly advantageous because it encourages multi-method data collection across the decision making process. This approach provides diﬀerent perspectives on problem-solving, multiple sources of evidence to support decisions, and an examination of convergent and divergent patterns (in educational performance or behavior), which guide intervention planning. A summary of the R.I.O.T. model follows. (R) Reviewing refers to examining pertinent records, artifacts, archival data, and work samples. In early childhood educational settings, cumulative files, Individualized Family Service Plans (IFSP), Individualized Education Plans (IEP), grade books, attendance records, and medical records may play an important role in determining strengths and needs. Reviewing also involves examining the relevant literature for best-practices with certain populations. (I) Interviewing encompasses direct data collection methods whereby information is obtained, formally or informally, from clients, parents, teachers, educational specialists, and medical professionals. Beyond the value of gathering historical information, interviews are inherently helpful to DBDM because informants’ views of the problem and perceptions of improvement can be used to guide treatment. (O) Observing involves directly examining client behaviors across settings, times of the day, and in

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the presence of different people. Observations may include descriptions of the environment (e.g., classroom, home) and involve both formal (e.g., time sampling or functional assessment) and informal (e.g., narrative description of a client engaged in play) methods. In addition to providing information about behavior and the influence of environmental factors, observations may be conducted by parents and teachers (informal observations) as a means of gauging a client’s response to interventions; this may provide evidence for transfer of learning in settings not routinely accessed by interventionists. (T) Testing comprises any method wherein a consistently administered set of items or procedures are used with the aim of obtaining a score. While not all members of a treatment team are involved in administering and interpreting test results, measurement data (from norm-referenced or curriculum-based tests) may be available for use in the design, implementation, and monitoring of interventions. Relevance of DBDM to Music Therapy Some may be reluctant to adopt an approach which is rooted around the word “data.” As one of its earliest proponents in music therapy, Hanser (1987) acknowledges this hesitation and explains that a databased model is a “set of procedures for accurate assessment, efficient planning, and objective evaluation in music therapy” (p. 17). Furthermore, she explains that the approach assists the music therapist by identifying the effectiveness of particular interventions and increases client awareness of progress towards goals. In a later edition of the text, Hanser (1999) described how she applied a data-based sensibility to caring for her newborn daughter. By using this approach, she explained: By learning her routine, I was not only in better control of our interaction, but I became more confident and relaxed as a mother. I devoted more of my energy to our play, getting to know her through singing, talking, touching, moving and loving her every moment (p. 28). Applying this same sensibility to a clinical music therapy situation, freed from uncertainty through a data-based

structure, therapists can devote more time to building the therapeutic relationship, listening and responding more actively to client needs, and engaging clients musically. Ultimately, implementing treatment in this manner may lead to consistency of intervention and growing the body of evidence-based practice in music therapy. A DBDM Model in Music Therapy A modified version of John and Patrick’s (2013) definition is used here to define DBDM in music therapy: “Databased decision making in music therapy involves an ongoing process of collecting, analyzing, and evaluating information to inform important decisions and actions across treatment” (Waldon, 2013). The aim of this reimagined definition is to broaden the applicability of the model beyond educational settings and encourage intentional treatment decision-making using multiple sources of evidence. In particular, the proposed DBDM model in music therapy (see Figure 1) is built on three characteristics described in the educational literature: (a) multi-method data collection, (b) ongoing data collection, and (c) cyclical decision making. First, Heartland AEA’s multi-method approach (R.I.O.T.) is deployed across all stages of music

therapy treatment. Furthermore, the American Music Therapy Association’s (2012) Standards of Clinical Practice is used to define the various treatment stages: (a) Referral (Acceptance), (b) Assessment, (c) Treatment Planning, (d) Implementation, and (e) Termination. Secondly, data collection, analysis, and decision-making are ongoing and, therefore occur over the entire course of treatment. DBDM activities are not confined to a fixed point during treatment. This means, for example, that specific data-based activities such as observing and interviewing may occur at both the Assessment (to ascertain strengths and needs) and Implementation (to monitor client responses) stages. This assures that multiple sources of evidence are being used to guide treatment decisions. Finally, as suggested by Mandinach, Honey, and Light (2006), the process of DBDM is cyclical. This means that data-based procedures at one treatment stage are used to justify advancement to subsequent stages (as represented by descending, rectilinear arrows in Figure 1).

Figure 1. A Data-Based Decision Making Model in Music Therapy

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Likewise, data collected and analyzed at later stages may justify returning to an earlier stage (as represented by ascending, curvilinear dashed arrows in Figure 1). Moreover, when decisions to either advance or return to stages of treatment are based on multiple sources of evidence, overall decision-making power is strengthened thereby increasing probability of a successful outcome. To further illustrate the use of the approach, the following questions and guidelines are presented to highlight the ways in which DBDM may be applied to early childhood music therapy: Referral Review: What information is present within the written referral? To what extent have referral criteria been met (see Hanser, 1999, for example referral criteria)? What research evidence is available which supports the use of music therapy to address the referral problem(s)? Interview: What information can be obtained directly from the referring provider or parent? Identify data that may be absent from the original referral which are important in making a referral acceptance decision. Observe: Can the prospective client be observed prior to accepting the case? Informal observations (in the school cafeteria, playground, or during free time) may be appropriate and warranted prior to referral acceptance. Test: What test scores or measurements (e.g., cognitive or adaptive behavior estimates) are available that may influence the referral decision? Assessment Review: What records are available and pertinent to the identification of strengths and needs? What work samples (homework or artwork) are available for examination? What does the literature recommend with regard to assessment for this population? Interview: Who should be interviewed? Can an interview with the client be conducted to directly assess communication, cognitive, motor, and aﬀective functioning? Observe: What types of systematic or descriptive observational techniques will yield the most relevant data? What are the most clinically relevant environments in which to observe the client?

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Test: What cognitive, behavioral, academic, developmental, or curriculum-based data are available? Are additional test data pending? What music therapy measures (e.g., IMTAP by Baxter, Berghofer, MacEwan, Peters, & Roberts, 2007) may be relevant? Planning Review: In formulating a treatment plan, what does the clinical and research literature reference as best practice (e.g., Humpal & Colwell, 2006)? What current educational and/or clinical goals and objectives are listed (e.g., from IFSPs or IEPs)? Determine whether music therapy is an appropriate method of addressing these needs. Interview: What are the parents’ and client’s thoughts about the proposed plan? To what extent are consultation and/or collaboration with other allied professionals warranted? Observe: What observations are available which support the treatment plan? Does the intervention (timing, length, and intensity) fit the client’s environment? If others will be responsible for administering a component of the treatment, are they capable of carrying out that responsibility? Test: Can baseline data be collected before implementation? Could archival data be used as a proxy for baseline measurement? In the latter case, the use of routine developmental screening tools, curriculum-based measures, and records (disciplinary or academic) may be useful. Implementation Review: What permanent products or records will be kept to monitor progress? Is there a component of treatment that requires parents or teachers to monitor progress by keeping a record or log? Interview: Aside from clients, parents, or teachers, who else may be able to provide pertinent progress monitoring information? What interview information may suggest a need to reformulate the treatment plan or approach? Observe: While providing direct services, what client observations might prompt: (a) a modification of treatment; (b) a reformulation of goals/objectives; or (c) other changes in treatment? If third-party observers (other professionals, parents, or teachers)

are involved in collecting progress-monitoring data, what training is needed? Test: What specific measures (i.e., behavior counts, inventories, or developmental tools) are being used to monitor progress? Are data being collected consistently? Do these measures occur naturally in the client’s educational or home environment? When possible, use measures that fit the ecology of the client’s environment. In other words, avoid developing a new system of measurement when an appropriate system already exists. Termination Review: What evidence suggests that termination is appropriate? What instructions or follow-up materials will be included as part of an after-care or follow-up plan? Interview: What are the client’s, parents’, or teacher’s views about termination? To what extent have treatment expectations been met? Observe: What observations are relevant to either discontinuing treatment or changing the level of service? If generalization was a goal, to what extent was that met? Test: What quantitative data are available supporting the discontinuation or change in treatment? Summary The model presented is one way in which DBDM can be applied in music therapy. While the example above illustrated its application in early childhood education, the DBDM paradigm has wider application across populations and settings in music therapy. The strengths of the approach come from the use of multiple data collection methods, ongoing data-based strategies across treatment stages, and using data to drive all treatment decisions. Ultimately, the objective of DBDM is to improve outcomes for clients while elevating the standard of care in music therapy. References American Music Therapy Association (2012). Standards of clinical practice. Retrieved from http:// www.musictherapy.org/about/standards/ Baxter, H. T., Berghofer, J. A., MacEwan, J. N., Peters, J., & Roberts, P. (2007). The Individualized Music Therapy Assessment Profile. London and Philadelphia, PA: Jessica Kingsley Publishers.

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Greenwood, C., Bradfield, T., Kaminski, R., Linas, M., Carta, J. J., & Nylander, D. (2011). The response to intervention (RTI) approach in early childhood. Focus on Exceptional Children, 43(9), 1 – 22. Hanser, S. B. (1987). Music therapist’s handbook. St. Louis, MO: Warren H. Green, Inc. Hanser, S. B. (1999). The new music therapist’s handbook (2nd ed.). Boston, MA: Berklee Press. Heartland Area Educational Agency 11. (2007). Improving children’s educational results through data-based decision-making. Retrieved from http:// www.aea11.k12.ia.us/spedresources/modulefour.pdf Humpal, M. E., & Colwell, C. (Eds.) (2006). Early childhood and school age educational settings: Using music to maximize learning. Silver Spring, MD: American Music Therapy Association. Johns, S., & Patrick, J. (2013). MODEL: Modeling on-site discipline for eﬀective learning. Retrieved from http:// www.modelprogram.com Mandinach, E. B., Honey, M., & Light, D. (2006, April). A theoretical framework for data-driven decision making. Paper presented at the annual meeting for the American Educational Research Association, San Francisco, CA. Marsh, J. A., Pane, J. F., & Hamilton, L. S. (2006). Making sense of data-driven decision making in education [Occasional paper]. Santa Monica, CA: Rand Corporation. Retrieved from http://www.rand.org/ content/dam/rand/pubs/occasional_papers/2006/ RAND_OP170.pdf Sagebrush (2004). Data-driven decision making: A powerful tool for school improvement [White paper]. Minneapolis, MN: Author. Waldon, E. G. (2013, April). From referral to termination: Data-based decision making in music therapy. Paper presented at the Annual Conference of the Western Region Chapter of the American Music Therapy Association, Tempe, AZ. About the Author Eric G. Waldon, Ph.D., MT-BC is a board-certified music therapist, credentialed school psychologist, and California licensed psychologist. He is currently an Assistant Professor of Music Therapy at University of the Pacific, Stockton, California. Contact: ewaldon@pacific.edu

Response to Intervention: Implications and Opportunities for Music Therapy Elizabeth K. Schwartz, LCAT, MT-BC Raising Harmony: Music Therapy for Young Children Melrose, Massachusetts

An estimated 55.5 million students are currently enrolled in preschool through high school public education in the United States (http://www.census.gov/ compendia/statab/). Since a free, appropriate public education is ensured by federal law, classrooms across the country provide educational opportunities for all children from a variety of socioeconomic backgrounds and ability levels. Responsibility for making sure that every child receives a quality education from publicly funded schools is shared by federal, state, municipal and local agencies. Laws such as No Child Left Behind (NCLB) and Individuals with Disabilities Education Act (IDEA) have guided teachers, therapists and administrators in creating specific practices designed for commonly accepted educational outcomes.

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Response to Intervention (RTI) is one educational initiative that has federal and state support and is being implemented in many, if not most K through 12 programs. For music therapists working in schools, RTI may have implications for practice but can also provide opportunities for greater educational collaboration and consultation.

This article spotlights facts about RTI and oﬀers suggestions on how music therapists working in both school-age and early childhood can use their unique knowledge and skill set to contribute as part of a RTI team. For specific IDEA statute language used to support RTI, please visit http://idea.ed.gov/ explore/view/p/,root,regs,300,D, 300%252E307.

Although currently targeted for kindergarten through high school classrooms, the thinking and practices behind RTI has recently been endorsed for use in early childhood settings by the Division for Early Childhood of the Council for Exceptional Children, the National Association for the Education of Young Children and the National Head Start Association (http://www.naeyc.org/content/ frameworks-response-intervention).

What is RTI? Response to Intervention is an educational framework that assists teachers to provide eﬀective instruction strategies so that every child in their classroom can learn the material presented. RTI relies first on using research-based teaching methods that have been proven to support targeted educational outcomes. Second, RTI requires frequent and ongoing assessment of each child’s

progress in order to identify children who might be at risk for educational failure. And third, RTI involves designing and implementing a series of educational interventions for students at risk to increase the chances of educational success.

calls for collaboration among all school personnel including resource room teachers, special educators and therapists. Under IDEA, a portion of funds can be used to support RTI.

What is the purpose of RTI? The main purpose of RTI is to provide early identification of children at risk for educational diﬃculties and to put interventions in place within the classroom setting that will aid in educational success.

What does RTI look like in the classroom? Many schools use a tiered approach to apply RTI principles. The first tier is to provide quality, research-based education to all students. Tier two is put into place for students who are identified through assessment as not meeting the learning standards with tier one teaching. This tier might involve a portion of the class working on specific skills with the teacher using certain strategies that meet the individual learning styles of the students in the group. In tier three interventions, a student might work individually or in a dyad with the teacher or with another school professional. This instruction can be in the classroom or in another location (for more information see http://www.rtinetwork.org/essential/ tieredinstruction). Who provides RTI? The classroom teacher is generally the prime facilitator in the RTI process. However, the RTI initiative

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This means that special education professionals as well as therapists can be involved in helping the regular classroom staﬀ with implementing the tiered interventions.

allow more students to remain in regular education. In addition, there is a possibility that funds from special education could be used to support RTI, leaving reduced funds for special education services. These two points are still highly speculative, and need to be monitored as RTI becomes more widespread. What do music therapy and RTI have in common? Music therapists will be very familiar with the cycle of assessment, individualized goals, intervention, and evaluation used in RTI as this is part of the therapeutic process of music therapy service provision.

How is RTI diﬀerent from special education? RTI is not the same as special education and is not to be a replacement for special education evaluation or services. The frequency of assessment and the interventions put into place through RTI are supposed to help in early identification of students in need of special education and therapeutic services.

What opportunities exist for music therapists in the RTI team? Music therapists bring unique and valuable knowledge and skill to public education. For children who struggle with print-based or language-based instruction, music therapists can create opportunities for multi-modal learning. Music therapists understand the importance of motivation in learning and can create musical environments that are stimulating. Music therapists are also skilled in providing music experiences that support children to self-regulate and self-organize.

What are the implications of RTI for music therapists? Although the ideas behind RTI have been around for quite some time, the implementation is just beginning to be common in schools. While it is not designed to keep students out of special education, it is possible that RTI teaching strategies could

What might an RTI and Music Therapy collaboration look like? Ms. Smith’s 1st grade class is learning a new concept. Ms. Smith teaches the concept to the whole class using research-based educational techniques and materials (Tier 1). The children then have a chance to demonstrate their

grasp of the concept through interactive play. As Ms. Smith observes her students, she notices that 7 out of her 22 students are not able to independently show that they understand the lesson. Later in the day, Ms. Smith contacts the school-based music therapist and explains that some of her students need more multi-modal learning opportunities. Together, they target certain learning goals for the children. The music therapist then finds research on the connection between the identified specific learning difficulties and effective music interventions. With this information, the music therapist creates an intervention and teaches it to Ms. Smith. The next day when Ms. Smith works with those 7 students, she uses the music intervention as part of her small group work (Tier 2). Incorporating the music intervention works for 5 out of the 7 students, and those five students are then folded back into the large group instruction. Ms. Smith is concerned about the two students who are still struggling with the concept. Neither student is identified as having special needs, and neither student has an Individual Education Plan. Ms. Smith contacts her administrator and requests the help of the music therapist to work with these two students with music therapy interventions. Ms. Smith, the administrator and the music therapist meet to discuss the underlying learning difficulties. The music therapist then is given the opportunity to work with these two students for a short session every day for the next week using music interventions that have proven to be

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successful in addressing the targeted learning issues (Tier 3). One of the two students does remarkably well with learning the concept with the support of the music intervention. The music therapist observes through music participation that the other student struggles with some fundamental learning issues and reports her finding to Ms. Smith. A team meeting is then held to examine whether this student would require special education. The music therapist is a part of that team. Music therapists can share this knowledge and expertise with the classroom teacher through demonstration or consultation. Music therapists, as with other special education professionals, can be made available within the RTI model to support the regular education classrooms.

Approach school administrators with a plan for music therapy based RTI support For more information on RTI, visit these websites: National Center on Response to Intervention http://www.rti4success.org/ Parent Frequently Asked Questions (FAQs) About Response to Intervention http://www.rti4success.org/ resourcetype/parent-frequentlyasked-questions-faqs-aboutresponse-intervention National Association for the Education of Young Children http://www.naeyc.org/files/naeyc/ RTI%20in%20Early %20Childhood.pdf About the Author

How can a music therapist go about becoming part of a school’s RTI team? Become knowledgeable about the principals and practices of RTI Explore how RTI is being implemented in local school(s) Meet with local educators to discover their challenges with implementing RTI Create a proposal for how music therapy interventions can be adapted for use within RTI Gather research articles to support how music therapy interventions support the learning environment Design a schedule and funding plan for incorporating RTI into music therapy practice

Elizabeth K. Schwartz, LCAT, MT-BC has been practicing music therapy for over 25 years. She is internationally recognized as an expert in early childhood music therapy and is the author of Music, Therapy, and Early Childhood: A Developmental Approach and You and Me Makes We: A Developmental Songbook. Contact: Elizabeth@RaisingHarmony.com

Structuring Early Childhood Music Therapy Groups Lori F. Gooding, Ph.D., MT-BC University of Kentucky Lexington, Kentucky

It has been suggested that group instruction is the most effective way to prepare children for future education (LeBlanc, 1982). Music therapy, which incorporates a wide range of goals and objectives into the music therapy group session, allows for individualization within a group setting (Humpal, 1990; Humpal, & Tweedle, 2006; Pellitteri, 2000). The research suggests that music therapy groups in early childhood settings can be an effective way for young children with and without disabilities to develop meaningful communication skills, social skills, motor skills, and academic/pre-academic skills (Standley & Hughes, 1997; Humpal, & Tweedle, 2006). As a result, music therapy may be a valuable way to ensure that learning is both age- and individually appropriate while also imparting large amounts of information in a group format (Standley & Hughes, 1996). In order for early childhood group music therapy to be effective, there are three primary areas that must be considered when planning music therapy sessions. These areas include: Child developmental functioning level Success-promoting techniques, and Session structure. Understanding child development, both in terms of typical and atypical aspects, is important for effective music therapy services (Wellman, 2011). Early childhood music therapy groups must allow for individual and/or social responses based on the child’s developmental stage (Schwartz, 2008). Adequate adult support and the flexibility for children to join/leave at their discretion are also important for successful group services, particularly for toddlers (Barrickman, 1989). For older preschoolers, the use of a variety of appropriately paced activities can promote on-task behavior (Standley & Hughes, 1996). Success-promoting techniques are also essential to successful early childhood group music therapy services. Furman and Furman (1993) suggest use of the following techniques to promote participation and effective learning for young children: Imitation Repetitive prompts Varied but systematic instructional presentations Individualizing roles, and Large number of trials Finally, Knoll (2009) suggests that sessions should be structured for success. The use of a structured session format in music therapy has been promoted for many years, with proponents

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like Cartwright and Huckaby (1972) citing the benefits of using a systematic format to provide constant structure as far back as the early 1970s. It is this idea of structure, perhaps one of the most important elements to consider, that is addressed herein. The Structured Session Format Pellitteri (2000) provides an overview of the “established” group music therapy session structure, outlining the basic format used by many therapists. He states that groups frequently start with a “hello song” and end with a “good-bye song,” incorporating singing, playing instruments, and moving in between. Davis (1990) recommends that group music therapy sessions for preschoolers occur one-two times per week for 20-30 minutes and contain a) singing/chanting, b) instrument play, c) movement to music, d) listening, e) song writing, f) simple notation reading, and g) classroom themes. Schwartz (2009) further recommends that early childhood group music therapy sessions provide a) familiar routines, b) facilitate maximum involvement, c) and incorporate musical interactions that foster bonding, socialization, and connections as well as promote transitions/generalization, movement and play.

30-minute session. These characteristics include: Activities designed to maintain prolonged interest and participation Each activity only lasts a few minutes Directions embedded within music Minimal delay between activities Preparation/instruction time without music never more than 15 seconds Deliberate activity order to promote attention and a high level of correct responses Activities designed to accommodate a variety of learning styles Activities provide multiple opportunities for appropriate response Activities allow for diﬀering developmental levels Activities foster peer interaction Music is used to structure, cue, and reinforce responses

One example of a structured group format in the literature can be found in Seybold’s (1971) work with speech delayed children. Seybold built his sessions upon a constant session format but varied individual song choices across sessions to address specific objectives. Each session contained nine diﬀerent activities, averaging 3.33 minutes per activity in a 30-minute session. Standley and Hughes (1996) also incorporated a set session format into their study of children enrolled in early intervention classes. As proponents of appropriately paced activities, these authors incorporated approximately 12 activities in their session plan, which would equate to approximately 2.5 minutes per activity. Table 1 provides more information on the session formats. Finding their session format to be eﬀective, Standley & Hughes (1997) thus incorporated a similar format in their subsequent study of 4-5 year olds enrolled in Early Intervention and Exceptional Student Education Programs. The authors identified a number of characteristics they believed necessary for a successful

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Register (2003), Walworth (2007), and Standley, Walworth, and Nguyen (2009) took the above characteristics and incorporated them into their study of emergent literacy of young children and parental responsiveness and infant social development,

respectively. The authors found significant benefits for those participants involved in music therapy group sessions, as did Standley and Hughes (1996; 1997) in both of their studies. Seybold (1971) and Schwantes (2009) also found benefits, although their results were not at the same level of significance. These results, when examined as a whole, suggest that the structured format indeed contributes to successful outcomes.

can serve as a starting point for planning successful group music therapy experiences for even the youngest of clients. Table 3 provides a summary of important factors to consider when planning early childhood group music therapy sessions.

Session Plan Elements As demonstrated in Table 1, there have been a number of session formats highlighted in the music therapy literature. Among the session plans presented, formats vary with the number of activities ranging from 9-12 per session, with an average of 10 per session. The length of activities also presumably varies, but the average length would be approximately 3 minutes per activity. Likewise, the order in which activities occur (i.e., movement first, then academic) varies as do the overarching goals. Furthermore, not all of the session formats contain the same concepts embedded within the session. It is important to note however, that there are more similarities than diﬀerences among the session formats. As outlined in Table 2, all of the session plans start with a “hello song” and end with a “good-bye song.” All of the session plans also include developmentally appropriate objectives (e.g., speech, social development). Likewise, all of the formats contain activities that incorporate instruments, movement, singing, and manipulatives, and these activities are interspersed throughout the session to promote engagement. This is consistent with the established format properties cited by Pellitteri (2000) and Davis (1990). Additionally, all of the formats include pre-academic/cognitive aspects, motor skills, and social/ emotional/personal and communication skills allowing for multiple objectives within the group format (i.e., individualization within group structure). Recommendations Identifying eﬀective parameters is especially important in light of the move toward evidence-based practice. Kern (2010) promoted the use of evidence-based practices in early childhood stating that evidence-based practice allows clinicians to identify the best available interventions, strategies and supports for clients. The parameters identified in the session plans included here

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References Barrickman, J. (1989). A developmental music therapy approach for preschool hospitalized children. Music Therapy Perspectives, 7, 10-16 Cartwright, I., & Huckaby, G. (1972). Intensive preschool language program. Journal of Music Therapy, 9, 137-146. Davis, R. K. (1990). A model for the integration of music therapy within preschool classrooms for children with physical disabilities and language delays. Music

Therapy Perspectives, 8, 82-84. Furman, A. G., & Furman, C. E. (1993). Music for children with special needs. In M. Palmer & W. L. Sims (Eds.), Music in Prekindergarten (pp.33-36). Reston, VA: MENC. Humpal, M. (1990). Early intervention: The implications for music therapy. Music Therapy Perspectives, 8, 31–34. Humpal, M., & Tweedle, R. (2006). Learning through play – A method for reaching young children. In M. Humpal & C. Colwell (Eds.). Early Childhood and School Age Educational Settings: Using Music to Maximize Learning (pp. 153-173). Silver Spring, MD: American Music Therapy Association. Kern, P. (2010). Evidence-based practice in early childhood music therapy: A decision-making process. Music Therapy Perspectives, 28, 116-123. Knoll, C. (2009, January). Circle time in early childhood: Managing behaviors in music therapy groups. [AMTAPro Audio Podcast Series]. Retrieved from http:// amtapro.musictherapy.org/?p=3. LeBlanc, J. M. (1982). Instructing diﬃcult-to-teach children. In K. E. Allen & E. M. Goelz (Eds.). Early childhood education (pp. 229-251). Rockville, MD: Aspen Systems. Pellitteri, J. (2000). Music therapy in the special education setting. Journal of Educational and Psychological Consultation, 11, 379-391. Register, D. M. (2003). The eﬀects of live music groups versus an educational children’s television program on the emergent literacy of young children. (Doctoral Dissertation). Retrieved from http:// diginole.lib.fsu.edu/cgi/viewcontent.cgi? article=4413&context=etd&sei-redir=1&referer=http %3A%2F%2Fscholar.google.com%2Fscholar%3Fhl %3Den%26q%3Dregister%2Bmusic%2B %26as_sdt%3D1%252C18%26as_sdtp %3D#search=%22register%20music%22 Schwartz, E. (2008). Music, Therapy, and Early Childhood. Gilson, NH: Barcelona Publishers. Schwartz, E. K. (September, 2009). In the beginning: Music therapy in early intervention groups. imagine: Early Childhood Newsletter, 15, 13-14. Retrieved from http://imagine.musictherapy.biz/Imagine/ archive.html Schwantes, M. (2009). The use of music therapy with children who speak English as a second language:

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An exploratory study. Music Therapy Perspectives, 27, 80-87. Seybold, C. D. (1971). The value and use of music activities in the treatment of speech delayed children. Journal of Music Therapy, 8, 102-110. Standley, J. M., & Hughes, J. E. (1996). Documenting developmentally appropriate objectives and benefits of a music therapy program for early intervention: A behavioral analysis. Music Therapy Perspectives, 14, 86-94. Standley, J. M., & Hughes, J. E. (1997). Evaluation of an early intervention music curriculum for enhancing prereading/writing skills. Music Therapy Perspectives, 15, 79-86. Standley, J. M., Walworth, D., Engel, J. N., & Hilmer, M. (2011). A descriptive analysis of infant attentiveness in structured group music classes. Music Therapy Perspectives, 29, 112-116. Standley, J. M., Walworht, D., & Nugyen, J. (2009). Eﬀect of parent/child group music on toddler development: A pilot study. Music Therapy Perspectives, 27, 11-15. Walworth, D. D. (2007). The eﬀect of developmental music groups for parents and premature or typical infants under two years on parental responsiveness and infant social development. (Doctoral Dissertation). Retrieved from http://etd.lib.fsu.edu/ theses/available/etd-04062007-174757/unrestricted/ walworthdissertationmanuscript.pdf Wellman, R. (2011). Understanding development in early childhood music therapy. imagine, 2, 61-63. Retrieved from http://imagine.musictherapy.biz/ Imagine/archive.html About the Author Lori Gooding, Ph.D., MT-BC, developed the clinical and academic music therapy programs at the University of Kentucky. As Program Director, she is actively involved in clinical work, academics, and research. Contact: lori.gooding@uky.edu

Toddler Rock: The Backbeat of Rock in Early Childhood Edward P. Gallagher, MT-BC Beck Center for the Arts Lakewood, Ohio Deforia Lane, Ph.D., MT-BC University Hospitals Seidman Cancer Center Cleveland, Ohio Lauren Onkey, Ph.D. The Rock and Roll Hall of Fame and Museum Cleveland, Ohio Melrose, Massachusetts

What happens when one combines The Rock and Roll Hall of Fame and Museum, music therapy, Head Start, 400 hundred kids ages 3-5, and a hunger for learning? One gets Toddler Rock, an award-winning and eﬀective early childhood music therapy-based program that has worked with several thousand children since its founding in 1999. Fred LeBlanc (2008) wrote, “I believe in the spirit of rock and roll,” and that spirit is alive and well in Cleveland with youthful enthusiasm and a desire to grow in every session of Toddler Rock. How it All Started Rock and Roll was a term first coined by DJ Alan Freed in Cleveland, Ohio. This was one of many reasons that Cleveland was the site chosen to house the history and education of Rock and Roll. According to The Rock and Roll Hall of Fame and Museum, Inc. (2013): Disc jockey Alan Freed, an Ohio native, is credited with coining the phrase "rock and roll" to describe the rhythm and blues records he played beginning in 1951 on Cleveland radio station WJW. He also helped to stage the Moondog Coronation Ball in 1952 in Cleveland, now considered the first rock and roll concert. Freed's importance was one of the many

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reasons that Cleveland was chosen to house the Rock and Roll Hall of Fame and Museum, which opened in 1995. The Museum's mission is "to educate visitors, fans and scholars from around the world about the history and continuing significance of rock and roll music. It carries out this mission through its operation of a world-class museum that collects, preserves, exhibits and interprets this art form and through its library and archives as well as its educational programs.” (History and Overview section, paragraph 2) The museum's extensive and award-winning educational programs include K-12 classes both onsite and through distance learning, as well as classes and programs for adults and university students. In 2012, the museum opened its library and archives, a hub for scholars and researchers to explore the impact of rock and roll. In 1999 Ruthie Brown, Director of Community Programs at The Rock and Roll Hall of Fame and Museum, together with Dr. Deforia Lane at University Hospitals Case Medical Center and Edward Gallagher at the Beck Center for the Arts, created an innovative and successful program known as Toddler Rock. This program brought

together several Cleveland music therapists with the intention to improve the lives of Cleveland's youngest children through the use of music, especially Rock and Roll (Lane & Gallagher, 2008). What Toddler Rock is All About Toddler Rock is a music therapy-based program for under-served preschoolers, their parents/caregivers, and teachers, oﬀered for no charge by the The Rock and Roll Hall of Fame and Museum. Its purpose is to increase academic, music, and social skills through the structured use of music. From the moment children (ages 5 and under) walk through the front doors of the Rock Hall their learning begins. Children are educated about music, its many roots and influences, and its involvement in the shaping of culture. They also learn about instruments, musical notation, and Rock and Roll Hall of Fame Inductees. Toddler Rock has been featured in the Cleveland Plain Dealer, on The Today Show, and by The Associated Press. The Cleveland Metropolitan Housing Authority received a National Award of Merit from the National Association of Housing Redevelopment for its participation in Toddler Rock. Celebrities who have visited Toddler Rock have included Rock and Roll Hall of Fame Inductees Mary Wilson of the Supremes and Johnnie Johnson, Chuck Berry’s piano player. Singer Maureen McGovern also visited, and commented “I have witnessed firsthand the extraordinary eﬀect the Toddler Rock program has on inner-city preschoolers and their parents – all to create an inspiring, bonding, educational and joyful noise!” (Lane & Gallagher, 2008). In 2006, Toddler Rock was a Semi-Finalist in the Coming Up Taller Award from the Presidential Committee on the Arts and the Humanities. Partnerships over the years have included individuals from Sesame Street Workshop, dancers from The Repertory Project, a storyteller/ librarian from the Cleveland Public Library, graduate students from Ursuline College’s art therapy program, student musicians from the Cleveland Institute of Music, local artists-in-residence, and numerous music therapy students and interns (Lane & Gallagher, 2008). Evaluating the Program’s Success In addition to conducting the Toddler Rock sessions, the music therapists also collect clinical data to determine

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the success of the music program. Results of the initial program evaluation indicated that while participating in Toddler Rock sessions, parents provided more positive reinforcement to their children, and a decrease of children’s oﬀ-task behaviors was seen (Lane & Gallagher, 2008). As children who achieve pre-reading skills before they enter school are more likely to become successful readers (U.S. National Early Literacy Panel, 2008), Toddler Rock sessions also focused on the acquisition of pre-literacy skills. One-hour sessions were designed to introduce letters, sounds and words by using multiple music and movement experiences. To evaluate each child’s progress, the standardized Dynamic Indicators of Basic Early Literacy Skills (DIBELS) was administered prior and after the 30-week program. Lane & Gallagher (2008) reported that Toodler Rock chidlren named at least three parts of the guitar (94%) identified at least seven harmonic or rhythmic instruments (94%) aurally diﬀerentiated between five rhythm instruments (93%) demonstrated impulse control and led peers in musical activities (93%) collectively and individually followed directions for soft, loud, stop, play (93%) recognized notation for quarter rests and quarter notes (85%), and named at least seven of 12 letters (58.3%). Recently, Toddler Rock has focused on the acquisition of letters during each of the 10-week sessions. Children learn numerous words beginning with a featured letter by singing a variety of songs including the targeted letter and learn about an Inductee whose first/last name or band name begins with the targeted letter.

I got a J Recorded 2013 by Deforia Lane

Currently, each participant is pre- and post-tested every ten weeks using the protocol and data sheet displayed in Figures 1 and 2. BEFORE:

1. Obtain copy of attendance sheet from teachers and if pre-test, record names alphabetically and birth dates. Complete information on top of each testing page.

2. Choose a table with two chairs. Best if you can sit

across from the child and face the him/her and best if it’s in a quiet area (ask if there’s a another room you can go to) Usually the child is taken out of an activity to test, so you may say to the child, “We’re going to play a quick game. Then you can go back and play with your class.”

DURING: Letter Recognition Introducing CAPITALS FIRST, say, “TELL ME ALL THE LETTERS YOU KNOW ON THIS PAGE.” If no response, say, “WHAT IS THIS LETTER?” as you point to each one. If no response again, say, “THIS LETTER IS CALLED____” Repeat for lower case. Recording: CIRCLE the letter in the corresponding case only if child is CORRECT Sound Identification Transition: say, “LETTERS HAVE SOUNDS TO THEM.” Introducing ONLY CAPITALS, say, “WHAT IS THE SOUND FOR THIS LETTER” as you point to each one. If no response, say, “(Letter) SOUNDS LIKE _____?” Recording: SLASH the letter in the CAPITAL AREA only if child is CORRECT. STAR next to the slash if child answered option question. Word Identification Transition: say, “LETTERS COME TOGETHER TO MAKE WORDS.” Introducing ONLY CAPITALS, say, “WHAT IS A WORD THAT STARTS WITH THIS LETTER?”?” as you point to each one. If no response, say, “(Letter) IS FOR ______” Recording: WRITE the word that the child identifies on line below the appropriate capital letter. STAR next to the word if child answered option question. TIPS: If post-testing and then pre-testing for same class, may be advantageous to keep the child. So first, post-test and then say, “WE’RE GOING TO LOOK AT DIFFERENT LETTERS NOW,” to introduce pre-testing of next session’s letters.

Figure 1. Toddler Rock Testing Protocol 2012-2013

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Figure 2. Toddler Rock Data Sheet 2012-2013 Continuous Growth In 2008, the PNC Grow Up Great (2013) and the PNC Foundation provided funds to double the size of Toddler Rock. Fourteen Board Certified Music Therapists and Interns are currently serving about 400 toddlers in weekly sessions. Over the past 14 years, Toddler Rock has served about 4,000 children in the Cleveland area. Toddler Rock has benefited from technological advancements, teacher support, talents in the community, and collaborating partners. For example, music therapists and teachers have been equipped with iPads that include early childhood learning and music apps such as GarageBand™. Teachers have been provided resources (e.g., pictures, song lyrics, music, and books) and supported by implementing musicbased actives reinforcing following directions and smooth transitions, or academic skills through music. Community musicians have exposed the children to a variety of instruments, careers, and “characters” who have demonstrated their expertise with the spirit of engagement. Current collaborators include the Rock and Roll Hall of Fame and Museum, University Hospitals Case Medical Center, Beck Center for the Arts, Music Therapy Enrichment Center, independent music therapists, the Council for Economic Opportunities in Greater Cleveland Head Start, and PNC Grow Up Great. Altogether, these have increased the visibility and recognition of Toddler Rock and supported the notion to embed music for learning in every child’s classroom. Through the Toddler Rock program, the need for expanded exposure to learning through the arts becomes evident. The spirit of Rock and Roll is alive and well!

References Lane, D., & Gallagher, E. P. (2008). Toddler Rock: Sound experiences for early childhood. Triad, 75(5), 83-86. LeBlanc, F. (2008). I Believe. On Fearless [CD]. New York, NY: Valley Entertainment. PNC Grow Up Great. (2013). Why PNC Grow Up Great? Retrieved from http://pncgrowupgreat.com/about/ index.html The Rock and Roll Hall of Fame and Museum, Inc. (2013). History and overview. Retrieved from http:// rockhall.com/visit-the-museum/learn/history-andoverview/ U.S. National Early Literacy Panel. (2008). Developing early literacy: A scientific synthesis of early literacy development and implications for intervention. Washington, D.C.: National Institute for Literacy and National Center for Family Literacy. Retrieved from http://lincs.ed.gov/publications/pdf/ NELPReport09.pdf

the American Cancer Society, has served as a consultant to the Ohio Department of Mental Health, the Mayo Clinic, Ohio Hospice Organization, the National Department on Aging, and Sesame Street (Children's Television Workshop). Contact: deforialane@usa.net Lauren Onkey, Ph.D is Vice President of Education and Public Programs at The Rock and Roll Hall of Fame and Museum. She is responsible for developing educational programs and materials in the Museum’s award-winning pre-K, K-12, university, and adult programs, on site and through distance learning that reach more than 30,000 people annually. Contact: lonkey@rockhall.org

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. He has taught in the early childhood program at Cuyahoga Community College, is a frequent presenter on the uses of music therapy and music in early childhood, and received the Great Lakes Region’s Service Award in 2007.

Watch video Toddler Rock on the Today Show http://www.youtube.com/watch?feature=player_embedded&v=3SXqXfDmM48

Contact: egallagher@beckcenter.org

Deforia Lane, Ph.D., MT-BC serves as resident director of music therapy at University Hospitals Case Medical Center. She has designed and implemented music therapy programs for diverse populations including individuals with developmental disabilities, abused children, pediatric and adult oncology patients and clients who are terminally ill. She is a spokesperson for

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Watch video about the Education Department's program for kids, "Toddler Rock.”

http://rockhall.com/education/inside-the-classroom/toddler_rock/video/1188/ !

Using the Pacifier Activated Lullaby® with Infants Diagnosed with Neonatal Abstinence Syndrome Ellyn L. Hamm The Florida State University Tallahassee, Florida Darcy Walworth University of Louisville Louisville, Kentucky

Neonatal Abstinence Syndrome Infants are diagnosed with neonatal abstinence syndrome (NAS) when born to mothers dependent on illicit substances during pregnancy or intoxicated at the time of birth (Hamdan, 2010). The illicit substance intake includes opioids, stimulants, sedatives, and alcohol. Data from 2009 demonstrate that approximately 10-11% of live births have some prenatal exposure to illicit substances (Hamdan, 2010). Sarkar and Donn (2006) found that most Neonatal Intensive Care Units (NICUs) use urine and/or meconium tests to get a toxicology report, even when the mother’s history of illicit substance use is known prior to treatment for withdrawal or other NAS symptoms. Additionally, NICU staﬀ use the Finnigan abstinence scoring system to decide when to start, stop, decrease, or increase dosing of pharmaceutical treatment for NAS symptoms (Sarkar and Donn, 2006). When these tests or scoring systems are used, statistics indicate that 55-94% of infants born to mothers using opioids experience withdrawal (Hamdan, 2010).

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The PAL® in Music Therapy The Pacifier Activated Lullaby ® (PAL®) was developed to support premature infants in acquiring sucking skills for bottle feeding through musical reinforcement. The FDA approved the device; the application is reimbursed by many third party payers. The PAL® uses lullabies that are pre-recorded in English by a female vocalist singing a capella. The lullabies are all in the same key and played at a tempo of 60 beats per minute. The recommended dB level is 65. Other songs (e.g., sung by the mother) can be recorded and played on the PAL® as well. Cevasco and Grant (2005) found trends of greater weight gain in premature infants when using the PAL®. The positive effects of the PAL® also may benefit infants diagnosed with NAS who experience similar difficulties related to gaining weight and uncoordinated sucking patterns (Sarkar & Donn, 2006). The clinical need for additional interventions during the withdrawal period for those vulnerable infants is widespread. Many music therapists working in medical settings are providing intervention services for NAS infants to decrease infant agitation and increase comfort. Without research-based data refining an evidence-based clinical protocol for use with NAS infants, each music therapist should identify the best available treatment at hand. Until research is readily available, the authors offer the following recommendations for music therapists using the PAL® with infants experiencing withdrawal attributed to NAS: Assess the infant’s withdrawal process, coordination of sucking reflex, current agitation level, and family support systems after receiving a referral for music therapy services. Check the infant’s medical chart, which includes information recorded by the NICU nurses about each infant’s progress pertaining to weight gain. Use the PAL® for infants with NAS based on their individual daily needs. If agitated, the PAL® may provide the infant the ability to remain calm in the crib without being held by parents, or medical personnel. Attach the infant’s pacifier (i.e., Phillips AVENT BPA Free Soothie Pacifier) to the PAL® sensor and place it in the infant’s mouth. Set the music to start on the lowest threshold of the

infant’s current strength of sucking. When the infant sucks on the pacifier, the PAL® device starts playing the recorded lullabies for ten seconds. If the infant sucks again, the music continues; if not, the music stops. This process may continue until the infant falls asleep. Increase the threshold of sucking for infants with stronger and more coordinated sucking skills. Theoretically, the stronger the sucking, reinforced by the PAL®, the more the infant with NAS will develop a mature sucking pattern and self-soothing behaviors. Apply the continuous music setting on the PAL® for infants who have a very weak and uncoordinated sucking behavior. The lullabies on the continuous setting are arranged to promote sleep by systematically decreasing the melodic movement in the lullabies and ending with lullabies that are hummed without any words sung.

References Cevasco, A. M., Grant, R. E. (2005). Eﬀects of the Pacifier Activated Lullaby on weight gain of premature infants. Journal of Music Therapy, 42(2), 123-139. Hamden, A. (2012). Neonatal abstinence syndrome. Retrieved from http://depts.washington.edu/ nicuweb/NICU-WEB/nas.stm. Sarkar, S., & Donn, S. M., (2006). Management of neonatal abstinence syndrome in neonatal intensive care units: A national survey. Journal of Perinatology, 26, 15-17. About the Authors Ellyn Hamm, MT-BC is a graduate assistant at the Tallahassee Memorial Hospital and will be graduating with a Master of Music in music therapy from The Florida State University in summer 2013. During her graduate studies she engaged in a master's research residency at the University of Louisville, where she received advanced training in NICU music therapy research. Contact: elhamm7789@gmail.com

Watch video about the PAL® at

http://www.youtube.com/watch?v=W7Y8M9CKvKM

Clinical observations indicate positive outcomes related to increased time spent in calm states, to pace sucking, and to promote sleeping behaviors in infants with NAS. NICU nurses report that infants are less fussy and sleep longer after PAL® sessions. The PAL® is a cost-eﬀective and easy to use treatment for those vulnerable, young patients that present many challenges to healthcare professionals. However, rigorous studies are needed to understand and verify the relationship between the use of the PAL® and the positive gains made for infants with NAS.

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Darcy Walworth, Ph.D,. MT-BC is the Director of Music Therapy at the University of Louisville. Her research focus areas include neonatal and early childhood developmental music therapy interventions, procedural support, and music therapy interventions for children with Autism Spectrum Disorder. Contact: darcy.walworth@louisville.edu

Attachment in Adoptive Families: Parental SelfReflection Erin Lyn McAlpin, MT-BC University of Missouri-Kansas City Kansas City, Missouri

Adoption Growing a family through adoption includes unique challenges and rewards to parenthood. The majority of adopted children have experienced prenatal malnutrition and low birth weight, prenatal substance abuse, older age at adoption, early deprivation, abuse or neglect, multiple placements, and emotional conflicts related to loss and identity issues. These factors of early deprivation or maltreatment increase children’s risk for developmental, physical, psychological, emotional, or behavioral challenges (Evan B. Donaldson Adoption Institute, 2010). Children who have experienced a lack of consistent and responsive care early in life have problems diﬀerentiating or recognizing various aﬀective states, forming close interpersonal relationships, and exploring the

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environment (Shapiro & Shapiro, 2006). Common behaviors for adopted children who have experienced trauma, abuse, or neglect can include overt friendliness as a means of controlling a situation, independent behaviors that assume a parent must be manipulated or intimidated, or withdrawn behaviors to conceal pain, vulnerability, and the need for nurture and comfort (Hughes, 1999). Adoptive parents have expressed fear and and feeling pressured to hold even higher parenting standards than biological parents as a result of raising someone else’s child, perfectionism after waiting so long and working so hard for adoption, and lack of support from friends and family due to perceived expectation that they need to be constantly happy in their parental role (McKay & Ross, 2010).

Parenthood also requires the ability to resolve personal feelings of helplessness, despair, rejection, and loss in the midst of diﬃcult child behaviors (Siegel & Hartzell, 2003). Although adoption does not mean that all families will experience challenges or diﬃculties, adoptive families often report a higher use of clinical services, a greater willingness or desire to seek help, and a greater need for assistance (Evan B. Donaldson Adoption Institute, 2010; Howard, Smith, & Ryan, 2004; Vandivivere, Malm, & Radel, 2009; McKay & Ross 2010). Despite impressive gains in growth and development after being placed into an adoptive family, a child who has been adopted is more likely to show delays in normal development compared to a non-adopted child. This includes social emotional domains of attachment, reciprocal

relationships, and emotional understanding (Dozier, Albus, Fisher, Sepulveda, 2002; Lloyd & Barth, 2011; Palacios, Roman, Caracho, 2010; Van IJzendoor & Juffer, 2006; Vorria et al., 2006). A connection has also been found between a child’s lack of attachment with adoptive parents and adoption disruptions (Coakley & Berrick, 2008). Parents are more likely to give up on the adoption if they are unable to perceive attachment with a child or improve their child’s behavior within the first 12-15 months of placement (Triseliotis, 1991). Even without a disruption of the adoption, the lack of parent-child attachment can create difficulties within the adoptive family. As stated by Van IJzendoor and Juffer (2006), “It is of crucial importance to support adoptive parents in facing the challenges of developing an attachment bond with the adopted child who in the first instance may be overly friendly to anyone or rejecting of the contact the adopted parents eagerly try to establish” (p. 1240). Music Therapy The body of literature on music therapy with adoptive families, although small, offers a strong foundation to provide music therapy services to support and promote the attachment needs of adoptive families (Drake, 2011; Laymen et al., 2002; Laymen & Hussey, 2003; Salkeld, 2008; Seles, 2009). The theoretical framework of attachment and bonding has also become a theme within music therapy practice, prevention, intervention, specialty, and research. Music

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therapists are promoting attachment and bonding across a range of populations to enhance family relationships through musical and music-like interactions (Edwards, 2011a; 2011b). Edwards (2011b) states, “it is essential that [the work of bonding] continue to grow through the voice of practitioners and the research collaborations broadcasting as widely as possible the opportunities available” (p. 194). Attachment Attachment research has found that the Adult Attachment Interview (protocol of 20 interview questions regarding childhood, descriptions of parents and life history to place an adult into one of three attachment categories including secureautonomous, dismissing, or preoccupied) significantly predicts infant behavior or attachment during the Strange Situation examination (a method used to evaluate the attachment relationship between a caregiver and child at 12-18 months of age) (Hesse, 2008; Main & Goldwyn, 1984). There is a direct correlation between the way a parent describes or has experienced the relationship and the type of attachment their child will develop (Hesse, 2008). Secureautonomous adult attachment (valued attachment relationships and experiences) was associated with the Strange Situation infant security attachment. Dismissing adult attachment (dismissed, devalued, or cut-oﬀ attachment relationships and experiences) was associated with the Strange Situation infant avoidant attachment. Preoccupied adult

attachment (preoccupied with attachment-related relationships and experiences) was associated with the Strange Situation infant anxious attachment (Hesse, 2008; Main & Goldwyn, 1984; Siegel, 1999). Therefore, what and how a parent recalls personal experiences is the most powerful feature that determines how they will relate to his or her own child. Children that develop secure attachments typically have secure-autonomous parents who demonstrate the value and influence of significant attachment figures in their own lives. Thus, secure-autonomous parents are able to recognize and support their own child’s signals and need for attachment and connection (Siegel, 1999). The profound correlation between parental narrative and child attachment provides clinicians with an opportunity to support secure parent-child attachment bonds. This viewpoint provides an avenue for adoptive parents to see beyond their child’s diﬃcult behaviors and oﬀer empathy and understanding (i.e., characteristics of parenting that strengthen a secure parentchild attachment bond) through examining their own personal experiences. This however, requires parental reflection, awareness, and self-understanding to become the highlighted focus of care and practice. Providing support for adoptive parents to practice self-examination and reflection shifts the focus away from viewing emotional reactions as deficits in the child and becomes an

opportunity to understand unresolved personal issues. Unresolved feelings, such as abandonment or helplessness, can leave parents unable to tolerate similar expressions and experiences in a child. This creates disconnection from a child during difficult situations or experiences, leaving a child feeling ignored and, as a result, disconnected from their own feelings. Therefore, parents must be able to contain a child’s difficult emotions, such as anger, or rage and view a child’s behavior as an expression of her or his need to be understood. This perspective allows parents the ability to see beyond a child’s difficult behavior and have compassion for the overwhelming or frightening feelings that a child is communicating (Siegel & Hartzell, 2003). Conclusions As adoptive parents begin developing empathy for their own fears and past emotional experiences of pain, they also develop empathy for a child’s early experiences and perceptions of painful events. As a result, gained self-understanding allows a parent to remain present and connected with a child experiencing difficult situations or feelings, and fosters reciprocal, sensitive parent-child communication (Siegel & Hartzell, 2003). It has been found that parental perceptions that facilitate successful adoptive family integration include: (a) finding strengths in the children overlooked by previous caregivers, (b) viewing behaviors in context, (c) reframing negative behavior, and (d) attributing improvement in behavior

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to parenting eﬀorts (Clark, Thigpen, & Moeller, 2006). This perspective requires adoptive parents to view their own strengths and behaviors in context of past experiences and to acknowledge the direct connection between parental perceptions and child behavior. As adoptive parents are able to develop a more empathic and compassionate lens through which to view their own experiences, so too can they begin to better understand their child's experiences, relationships, and perceptions of the world around them. Likewise, when clinicians can be compassionately self-reflective, they can better support the needs of the adoptive parents with whom they work. This approach to practice also requires the same demand, viewpoint, and practice of clinicians. A clinician must first practice self-reflection through a lens of empathy and understanding before supporting the needs of adoptive parents. References Clark, P., Thigpen, S., & Moeller, Y. (2006). Integrating the older/ special needs adoptive child into the family. Journal of Marital and Family Therapy, 32(2), 181-194. Coakley, J. F., & Berrick, J. D. (2008). Research review: In a rush to permanency: Preventing adoption disruption. Child and Family Social Work, 13, 101-112. Dozier, M., Albus, K., Fisher, P., & Sepulveda, S. (2002). Interventions for foster parents: Implications for developmental

Suggestions for Practitioners Recommended parental attitudes and characteristics that promote a sense of safety through reciprocal play and dialogue (crucial for enhancing attachment security and the parent-child relationship) (Hughes, 2009):

P (Playfulness): Reciprocal laughter, gentle teasing, humor, telling funny stories, creating temporary space and time for shared interactions (with no agenda of correcting or fixing), and admitting parental mistakes.

A (Acceptance): Perceiving a child beyond their behaviors, discipline directed toward behavior and not self (child’s thoughts, emotions, or intentions that might relate to the behavior), assuming positive motives for a child’s behavior, and accepting a child’s inner life (including thoughts or feelings of dislike toward parent).

C (Curiosity): Nonjudgmental, open curiosity about a child’s thoughts, feelings, and intentions (including positive experiences and behaviors).

E (Empathy): Exaggerated nonverbal expressions attuned to a child’s expressions of joy or fear.

theory. Developmental and Psychopathology, 14(4), 843-60. Drake, T. (2011). Becoming in tune: The use of music therapy to assist the developing bond between traumatized children and their new adoptive parents. In J. Edwards (Ed.), Music therapy and parentinfant bonding (pp. 22-41). New York: Oxford University Press. Evan B. Donaldson Adoption Institute (2010). Keeping the promise: The critical need for post-adoption services to enable children and families to succeed. Retrieved from http:// www.adoptioninstitute.org/ publications/ 2010_10_20_KeepingThePromi se.pdf Hannah’s Dream (2010). Positive Adoption Language. Unpublished document. Hesse, E. (2008). The adult attachment interview. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment (pp. 552-598). New York: Guilford. Holt International Children’s Services (2013). Positive adoption language and terminology. Retrieved from http:// www.holtinternational.org/ media/language.shtml. Howard, J. A., Smith, S. L., & Ryan, S. D. (2004). A comparative study of child welfare adoptions with other types of adopted children and birth children. Adoption Quarterly, 7(3), 1-30. Hughes, D. A. (1999). Adopting children with attachment

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problems. Child Welfare, 78(5), 541-60. Hughes, D. A. (2009). Attachmentfocused parenting: Eﬀective strategies to care for children. New York: W.W. Norton & Company. Laymen, D., & Hussey, D. (2003). Music therapy issues and strategies for working with adopted and foster children. In D. J. Betts (Ed.), Creative arts therapies approaches in adoption and foster care: Contemporary strategies for working individuals and families (pp. 114-127). Illinois: Charles C Thomas. Laymen, D., Hussey, D., & Laing, S. (2002). Foster care trends in the United States: Ramifications for music therapists. Music Therapy Perspectives, 20, 38-46. Lloyd, E. C., & Barth, R. P. (2011). Developmental outcomes after fives years for foster children returned home, remaining in care, or adopted. Children and Youth Services Review, 33, 1383-1391. Main, M., & Goldwyn, R. (1984). Adult attachment scoring and classification system. Unpublished manuscript, University of California at Berkeley. McKay, K., & Ross, L. E. (2010). The transition to adoptive parenthood: A pilot study of parents adopting in Ontario, Canada. Children and Youth Services Review, 32, 604-610. Palacios, J., Roman, M., & Carnacho, C. (2010). Growth and development in internationally adopted

children: extent and timing of recovery after early adversity. Child: Care, Health and Development, 37(2), 282-288. Salkeld, C.E. (2008). Music therapy after adoption: The role of family music therapy in developing secure attachment in adopted children. In A. Oldfield & C. Flower (Eds.), Music therapy with children and their families (pp.141-157). London and Philadelphia: Jessica Kingsley Publishers. Seles, K. L. (2009). The eﬀects of family music therapy on the attachment behaviors of children and adolescents in foster and adoptive families. Unpublished master’s thesis. Florida State University, Tallahasee, FL. Retrieved from http://etd.lib.fsu.edu/theses/ available/ etd-06042009-143410/ unrestricted/SelesKThesis.pdf Shapiro, V. B., & Shapiro, J. R. (2006). The adoption of foster children who suﬀered early trauma and object loss: Implications for practice. In K. Hushion, S.B. Sherman, & D. Siskind (Eds.), Understanding adoption: Clinical work with adults, children, and parents (pp. 91-114). Oxford, UK: Jason Aronson. Siegel, D. J. (1999). The developing mind. New York: Guilford Press. Siegel, D. J., & Hartzell, M. (2003). Parenting from the inside out. New York: Jeremy P. Tarcher/ Putnam. Triseliotis, J. (1991) Adoption outcomes: A review. In E.D. Hibbs (Ed.), Adoption:

International perspectives (pp. 291-310). Madison, CT: International Universities Press. Vandivivere, S., Malm, K., & Radel, L. (2009). Adoption USA: A Chartbook Based on the 2007 National Survey of Adoptive Parents. U.S. Department of Health and Human Services, Retrieved from http:// aspe.hhs.gov/hsp/09/NSAP/ chartbook/index.pdf. Van IJzendoorn, M. H., & Juﬀer, F. (2006). The emanuel miller memorial lecture 2006: Adoption as intervention. Meta-analytic evidence for massive catch-up and plasticity in physical, socioemotional, and cognitive development. Journal of Child Psychology and Psychiatry, 47 (12), 1228-1245. Vorria, P., Papaligourna, Z., Sarafidou, J., Kopakaki, M., Dunn, J., Van IJzendoorn, & M. H., Kontopoulou, A., (2006). The development of adopted children after institutional care: A follow-up study. Journal of Child Psychology and Psychiatry, 47(12), 1246-1253.

Positive Adoption Language Adoption competency and sensitivity among professionals working with adoptive families provides an additional source of adoption support and advocacy (Evan B. Donaldson Adoption Institute, 2010). Education and proficiency begins with the adoption language and terminology used by professionals. Language to Avoid Natural or real parent Real Father or Mother Children of your own Unwanted child Child taken away Give away or give up Choose to keep Adopted child Adoptive parent Was adopted

Positive Adoption Language Biological parent Birth Father or Mother Biological or birth children Child placed for adoption Court termination Make an adoption plan Choose to parent My child Parent Is adopted

Adapted from Holt International Children’s Services (2013) and Hannah’s Dream (2010).

About the Author Erin McAlpin, MT-BC completed her undergraduate degree at the University of Missouri-Kansas City and music therapy internship at the Royal Children's Hospital in Melbourne, Australia. Ms. McAlpin recently completed her graduate degree, also through the University of Missouri-Kansas City, and is pursuing the adoption of her first child with her husband Jon.

Note: This article is partially based on Erin’s Master’s thesis: McAlpin, E. L. (2013). Promoting parent-child secure attachment bonds in adoptive families through community-based family music groups: A heuristic grounded theory study. Unpublished master’s thesis. University of Missouri-Kansas City, Kansas City, MO. Retrieved from https:// mospace.umsystem.edu/xmlui/ bitstream/handle/10355/36646/ McAlpinProParChi.pdf?sequence=1

Contact: elmcalpin@gmail.com

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Luba’s Theme Amy Clements-Cortés, PhD, MTA, MT-BC University of Windsor Windsor, Ontario

The following case description is of Luba, a 4-year-old girl diagnosed with Tay-Sachs disease and her music therapy process. Foundational information on Tay-Sachs disease is provided alongside a discussion of anticipatory grieving, and the death of a child. Foundational Concepts Tay Sachs Disease. Tay Sachs Disease is a rare genetic disorder that destroys nerve cells in the brain and spinal cord. It is caused by mutations in the HEXA gene that prevent the substance GM2 Ganglioside from breaking down. In turn, this causes an accumulation of this substance, which leads to progressive neuron damage. In infancy, children with Tay-Sachs Disease appear healthy. At age 3-6 months, their development slows down and their muscles weaken, causing them to lose motor skills like crawling or turning over. Seizures, vision and hearing losses, intellectual disabilities, and paralysis may be experienced as the child ages. Children with Tay Sachs Disease generally only live until early childhood (U.S. National Library of Medicine, 2013). Anticipatory Grieving. Anticipatory grief was first defined by Lindemann (1944) as feelings or symptoms of grief in someone who has not experienced actual

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bereavement, but instead is threatened by a possible upcoming death. Friedman (1967) suggests that anticipatory grief looks similar to general grief but takes place over a longer span of time. In parents of a dying child, anticipatory grief may show itself as a renewed interest in other children and past hobbies, and limited hope (Friedman, 1967). This may lead to discussing the possibility of the child’s death, grieving in anticipation of the loss, thinking what the future would be like without the child, acknowledging that the child is going to die, discussing the child’s death with the child, planning the type of death they want, making funeral preparations, and beginning to disengage themselves emotionally from the child (Rando, 1983). Friedman (1967) further suggests that anticipatory grieving is a positive experience that can help a parent control their feelings of grief when the death finally occurs. Specific behaviors may help parents experience a positive amount of anticipatory grief, including receiving detailed information from health care professionals and being able to take care of and hold their child before death (Rini & Loriz, 2007).

Death of a Child. The death of a child can provoke feelings of depression, anger, vulnerability, hopelessness, and fear; almost all parents experience this intense loss (Arnold, Gemma, & Cushman, 2005). In addition the death may aﬀect parents’ relationships with remaining children. Parents may be overly cautious, anxious, and guarded with other children or may even experience an improved relationship (Arnold, Gemma, & Cushman, 2005). Spouses may also experience marital strain (Arnold, & Gemma, 2008). On the other hand, in several studies, bereaved parents reported feeling stronger, more sensitive, more courageous (Arnold, Gemma, & Cushman, 2005), and more compassionate (Arnold & Gemma, 2008). Some factors that were helpful to parents processing their grief included inner strength, family support, friendship, spirituality or religion, support groups and individual counseling (Arnold, Gemma, & Cushman, 2005). Introducing Luba Luba was a 4-year-old girl of Romanian descent. She was diagnosed with Tay–Sachs disease at 18 months. Luba and her parents, Luis and Anna, were referred to music therapy by the social worker at the pediatric hospital as part of the out-patient package of services to be provided to the family. The interdisciplinary team believed that music therapy could be useful in helping the parents in their grieving process as they were in denial regarding Luba’s prognosis. All music therapy sessions were provided in the family’s home, two times per week for a total of 18 sessions. Luis immigrated to Canada and began working in the 1990’s. After two years he returned to Romania and married Anna, and the couple relocated to Ontario, Canada. They had no family in Canada but did have a small supportive circle of friends. Luis and Anna had struggled to conceive for several years and were overjoyed when they learned Anna was pregnant with Luba. Luba was born six weeks premature and began her life with health issues attributed to premature birth. Around the six-month mark, it was found that Luba was suﬀering from advanced symptoms that could be attributed to Tay-Sachs disease. The Therapeutic Process Luba’s therapeutic process consisted of 18 sessions that

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can be divided into 4 phases: “Assessment,” “Creating an Environment of Love” (Sessions 2-6), “Luba’s Theme (Sessions 7-14), and “Saying Goodbye” (Sessions 15-18), which included planning funeral music and assisting Luis and Anna with the grieving process. Assessment During the assessment session, Luis and Anna were in great denial about Luba’s prognosis. They explained that the doctor had told them that Luba would die soon, but they believed that God would answer their prayers. Luba had flaccid muscle tone and was no longer able to sit up. She was confined to her bed and no longer able to speak. Luba had limited head movement, but appeared very much aware of her surroundings and maintained long stretches of eye contact during the music interactions. Luba’s parents were invited and encouraged to participate in the sessions but only Anna accepted and sat at Luba’s bedside. The assessment session was used as a way to determine Luba’s responses to a variety of musical instruments, timbres and musical styles. She tracked the sources of the music with her eyes and engaged in extended eye contact with her mother and therapist when they sang. In collaboration with Anna, the following goals were established for music therapy sessions: to provide opportunities for: a) sensory stimulation, b) cognitive stimulation and c) social interaction to provide distraction from pain to provide and enhance opportunities for relaxation to provide alternative methods for Luba and her parents to interact Sessions 2-6 “Creating an Environment of Love” Sessions 2-6 focused on engaging Luba in music, and creating an environment in the home where love was conveyed to Luba. Luba’s favorite songs were the primary focus and the lyrics of several songs were changed to personalize them for Luba. The music therapist encouraged Anna to sing with her, and at times she did but often became labile and instead held Luba's hand as the therapist sang. Luis would peek into

sessions but was not yet able to participate. It appeared that perhaps Luis had begun the anticipatory grieving process in terms of disengaging from interaction with Luba as described above by Rando (1983). A CD of the songs used in sessions was created by the therapist for Luis and Anna to play for Luba and provide further opportunities for them to interact with her. Sessions 7-14 “Luba’s Theme” During these sessions a focus continued to be on using Luba’s favorite songs. Additionally several hymns also became a part of the receptive music interventions. Slowly, Luis began to join in the music therapy sessions with the amount of time he stayed in sessions increasing from 10 minutes to the full length of the sessions by week 11. Hymns were important for Luis and Anna, and singing them for Luba provided a supportive platform for them to begin to understand Luba’s prognosis and essentially begin the anticipatory grieving process.

It was also during this period that songwriting was introduced, and together with the therapist, Anna and Luis composed several songs for Luba. These songs were recorded and given to Luis and Anna by the therapist. “Luba’s Theme” became her signature song played at the beginning and end of each session commencing in session 10. Bailey (1984) avers writes that music therapy can stimulate cognitive function, improve communication between family members and enhance relationships. For these reasons, music therapy was introduced into the therapeutic process. In these sessions the iso-principle was applied and was used to ease Luba’s labored breathing and pain. The isoprinciple is defined as matching music to the client’s current emotional or physical state using the elements of music such as tempo, rhythm, volume, and mood (Altschuler, 2001). Clinical improvisation was also a central part of the work at this stage. These sessions ended with a musical relaxation and “Luba’s theme.”

Luba’s Theme You are a shining star Always bright and warm Your smile lights up our hearts And fills them up with love. We loved you Luba before you were born And we love you more each day That love will always be there And grows stronger everyday. Your eyes are large and beautiful Your hair is golden sun You are our sunshine Our ever bright rays of light!

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Sessions 15-18 “Saying Good-bye” Luba died after session 15. During the last three sessions with this family, music therapy involved planning music for Luba’s funeral and supporting Anna and Luis in the grieving process. Luba’s parents requested that the therapist provide the music at Luba’s funeral and together they selected the important hymns for the service. In addition to these hymns, Anna and Luis confirmed they wanted “Luba’s Theme” to be a prominent part of the funeral service music. After the funeral, the last two sessions were held with Anna and Luis to help facilitate and initiate their grieving process. In these sessions songwriting and improvisation were the primary tools that led to emotional expression and discussion between Anna and Luis. Wolfe and Waldon (2009) assert “music serves as a carrier wave on which troubling feelings may ride. In other words, [music] becomes a concrete representation of that which was previously difficult to put into words” (p. 48). The words that Anna and Luis could not speak to each other they were able to put into a song and we used this song as a springboard for discussing those difficult questions and emotions that were raised in their lyrics. Conclusion McDonnell (1984) acknowledges that “In family sessions, child and parent often have pleasure together for the first time” (p. 55) and that songwriting, moving to music and singing are effective interventions in supporting children and their families in reducing anxiety, alleviating emotional strain and increasing verbalization. This was reflective of the experience of Luba and her parents; music therapy sessions provided the family with a new way of interacting through songwriting, moving to music and singing. This intervention was successful in enhancing and facilitating communication between Luis and Anna while reducing emotional angst and providing a way of communicating with Luba. Improvisation and songwriting were also central interventions in facilitating the grieving process for Luis and Anna. References Altschuler, I. (2001). A psychiatrist’s experience with music as a therapeutic agent. Nordic Journal of Music Therapy, 10(1), 69-76. Arnold, J., & Gemma, P. B. (2008). The continuing

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process of parental grief. Death Studies, 32, 658-673. Arnold, J., Gemma, P. B., & Cushman, L.F. (2005). Exploring parental grief: Combining quantitative and qualitative measures. Archives of Psychiatric Nursing, 19(6), 245-255. Bailey, L. M. (1984). The use of songs in music therapy with cancer patients and their families. Music Therapy, 4, 5-17. Friedman, S. B. (1967). Care of the family of the child with cancer. Pediatrics, 40(3), 498-504. Henneman, E. & Cardin, S. (2002). Family-centered critical care: A practical approach to making it happen. Critical Care Nurse, 22(6), 12-19. Lindemann, E. (1944). Symptomatology and management of acute grief. American Journal of Psychiatry, 101(2), 141-148. Rando, T. A. (1983). An investigation of grief and adaptation in parents whose children have died from cancer. Journal of Pediatric Psychology, 8(1), 3-20. Rini, A., & Loriz, L. (2007). Anticipatory mourning in parents with a child who dies while hospitalized. Journal of Pediatric Nursing, 22(4), 272-282. U.S. National Library of Medicine (2013). Tay-Sachs disease. Retrieved from http://ghr.nlm.nih.gov/ condition/tay-sachs-disease Wolfe, D. E. & Waldon, E. G. (2010). Music Therapy and Pediatric Medicine: A Guide to Skill Development and Clinical Intervention. Silver Spring, MD: American Music Therapy Association. About the Author Amy Clements-Cortés, Ph.D., MTA, MT-BC is a music therapy instructor and clinical supervisor at the University of Windsor and Wilfrid Laurier University; and Senior Music Therapist/Practice Advisor at Baycrest Centre, Toronto, Canada. Contact: notesbyamy2@yahoo.ca www.notesbyamy.com

Including Parents in the Therapeutic Process Becky Wellman, Ph.D., MT-BC, DT Wellman Therapy Services Itasca, Illinois Anita L. Gadberry, Ph.D., MT-BC Marywood University Scranton, Pennsylvania

Working in early childhood is unique from other areas of music therapy. The family of each client is an added dimension to the therapeutic experience. Shoemark and Dearn (2008) call this a “triadic” relationship. The child, the parent, and the therapist should work closely together to make therapy successful. This requires that music therapists are comfortable not only in their interactions with young children, but also in communicating and interacting with parents. Educating parents about child development or the child’s diagnosis, where the client is in the therapeutic process, and explanations of interventions may be necessary to gain the parents’ complete support of the music therapy treatments. Therapists may need to provide demonstrations, allow for practice by the parents,

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and provide feedback and praise (Fitzgerald, 2006) Many times educating parents within or immediately following a session is the best way to help them understand the therapy experience. Pointing out what is “normal” and what is “delayed” or “abnormal” within the context of music therapy interventions can clarify progress more eﬀectively than a simple progress report. If the parent is not in attendance, video recording sessions and then reviewing the recording with the parent may be a beneficial alternative and may also serve as reminders for implementing certain strategies throughout the week between therapy sessions (Shanley & Niec, 2010). Discussion can illuminate potential issues or concerns that the

therapist would like to bring to the parents’ attention. It is vital to address these subjects in such a way that parents do not feel that they or their child are being isolated or singled out. Parents often have fears or diﬀerent expectations for children with special needs. These may include not being able to provide enough for a child with special needs or not being able to devote enough time to all of their children. They may wonder if their child will be able to play with or be like other children, if their child will ever communicate with them, and worry that their child might die or suﬀer (Walworth, 2012). As a parent participates in the session or during feedback after a session, music therapists should also assess the parent to determine his/her emotional state (Shoemark & Dearn, 2008). If parents are

presenting a calm and open demeanor, they may be open to education, direction, and a discussion about their child. If they appear fearful or upset, the therapist may need to address these issues and help the parent work through their concerns. Parents of children may be grieving the loss of their “typical” child and the milestones they feel their child is not reaching (Fitzgerald, 2006). While one may expect this to be more severe with younger children, it can ebb and flow throughout the life of the child. Being aware of the parents’ needs can build a higher level of trust and therefore increase the eﬀectiveness of therapy (Burden & Thomas, 1986). In many environments, parents of children with special needs receive negative feedback about their child. They often are told about the weaknesses and limitations yet rarely hear about positive attributes of their child with special needs (Thomsen, 2012). By oﬀering positive statements about their child’s progress and development, music therapists can embolden parents to continue to work with their child at home. Parents may not always be comfortable making music with their child. Many times, parents are afraid that they do not have the skills necessary to make music. Adults need reinforcement that everyone can sing and that children want to hear their parent’s voice, regardless of how it sounds to other adults. By listening to the parents, giving positive reinforcement, and constructive redirection, music therapists can not only show the parents what

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their children can do, but what they can do as well (Thomsen, 2012; Walworth, 2012). There are some additional benefits to empowering parents through music therapy interventions. Parents who receive positive reinforcement from a professional in a mutually beneficial activity have greater self-confidence in their parenting skills and have a sense of connection with a child from whom they may otherwise feel distant (Nicholson, Berthelsen, Abad, Williams, & Bradley, 2008; Pasiali, 2012). Parents may feel more comfortable utilizing positive coping skills, find joy in interacting with their child, and be able to use a “positive/calm vocal behavior” when communicating with their child (Shoemark & Dearn, 2008). All of these will benefit not only the parent, but the child as well. The following are some specific suggestions to keep in mind while working with children and families in early childhood music therapy: Don’t take things personally. Families are at various stages of accepting their child’s needs. What is great today may not be successful tomorrow. Accept where the parent is on that day. Parents may be working through grief, unexpected news, personal concerns, financial crises, or a multitude of other aspects of life which they will bring to the session. The next session may be completely diﬀerent; therapists must acknowledge and accept where the parent is at the moment.

Don’t share every concern the minute you notice something. Unless it is something extremely dangerous or concerning, make a note of it and continue to observe the behavior for a few sessions. If the child continues to demonstrate what you have noticed, then it should be brought to the parent’s attention. Ask questions rather than make statements. For example, “I’ve noticed that Johnny is doing this during the sessions. Are you seeing that at home?” This approach may be less confrontational and gives the impression of a concerned therapist as opposed to a judging elitist. Make positive observations during or immediately after the session. Simple statements such as “Did you see that?” or “Listen to him sing!” can mean much more than lengthy explanations of what their child is doing. Keep communication simple. Big words and lengthy explanations may isolate parents and cause them to feel that they aren’t adequate because they don’t know everything the therapist knows. By discussing and explaining in clear, concise language, the music therapist will seem more present and accessible. Encourage parents to be an equal and full partner in the session. Have them engage in interactive play so that they will learn how to complete the interventions for home music

sharing and continue to build a bond with their child. They will also be more comfortable integrating music into their everyday interactions. Invite the child to communicate his/her wants and needs within the session in a way the parents can replicate and support at home. Be aware of talking about vs. talking with the children themselves. Children may not fully understand what is being said but are very aware of their environment. Involve them in any way possible in the discussion of their treatment so that they, too, will become an equal partner in their future. Be prepared to make suggestions as to how parents can use everyday household items to replicate the instruments used in the session. These families may be limited financially and the added expense of drums, shakers, and other equipment may further isolate them. Probably the most important recommendation is to listen. Hear not only what parents are saying with their words, but what they are not saying as well. Be aware of their breathing, body language, and engagement. Actions speak louder than words; we should listen. Be yourself. Parents appreciate the human side of their therapists. References Burden, R., & Thomas, D. (1986). Working with parents of

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exceptional children: The need for more careful thought and more positive action. Disability, Handicap & Society, 1(2), 165-171. Fitzgerald, M. (2006). “I send my best Matthew to school every day”: Music educators collaborating with parents: For success in music students need the support that results from a strong, positive partnership between teacher and parents. Music Educators Journal, 92(2), 40. 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(2), 226-238. Pasiali, V. (2012). Supporting parent-child interactions: Music therapy as an intervention for promoting mutually responsive orientation. Journal of Music Therapy, 49(3), 303-334. Shanley, J. R., & Niec, L. N. (2010). Coaching parents to change: The impact of in vivo feedback on parents’ acquisition of skills. Journal of Clinical Child & Adolescent Psychology, 39(2), 282-287. Shoemark, H., & Dearn, T. (2008). Keeping parents at the centre of family centered music therapy with hospitalized infants. The Australian Journal of Music Therapy, 19, 3-24. Thomsen, G. (2012). Familycentered music therapy in the home environments: Promoting interpersonal engagement between children

with autism spectrum disorder and their parents. Music Therapy Perspectives, 30(2), 109-116. Walworth, D. (2012). Familycentered practice: Integrating music into home routines. In Kern, P. & Humpal, M. (Eds.), Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their families (pp. 233-244). London and Philadelphia: Jessica Kingsley Publishers. About the Authors Becky Wellman, PhD, MT-BC, DT has a private practice in the Chicago suburbs where she works with young children with special needs and older adults with memory loss. Contact: wellmantherapy@gmail.com

Dr. Anita Gadberry is the Director of Music Therapy at Marywood University and the North American Regional Liaison for the World Federation of Music Therapy. Contact: gadberry.anita@gmail.com

Sing a Story: Suggestions for Using Children’s Literature and AAC Systems Lorissa McGuire MME, MT-BC Gardner Edgerton School District Gardner, Kansas Anita L. Gadberry, Ph.D., MT-BC Marywood University Scranton, Pennsylvania

Children begin to gain literacy skills in their first three years of life. These early literacy skills include building vocabulary, gaining a sense of story, letter identification, and beginning phonological awareness (Register, 2001). Real life settings involving positive experiences with books, language, and people are the best means to build early literacy skills (Zero to Three, 2003). This article describes ways to promote literacy development in children with and without Augmentative and Alternative Communication (AAC) systems. Music and Early Literacy There are many similarities between literacy and music (Register, Darrow, Standley, & Swedberg, 2007). Oral language is recognized as a necessary component of both reading and music literacy. Before individuals learn to read, they rely on oral language as their primary means for acquiring language. Listening to and participating in music activities helps build an individual’s vocabulary and communication skills. Songs, like books, often tell a story, which helps children gain a sense of story and beginning comprehension skills. Fluency and phonics also are elements of literacy that can be addressed through music. Songs that rhyme are particularly useful when learning phonological awareness

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while the music’s rhythm aids in fluency. Because of these similarities, books that are paired with music can promote literacy development (McIntire, 2007; McGuire, 2010). Children’s Literature in Music Therapy Young children of various ability levels may respond well to musical multi-sensory experience in the educational setting. Music can motivate, facilitate, and teach multiple skills at once (McGuire, 2010). Children’s literature combined with music has numerous functions in a music therapy session. Musical stories not only promote literacy skills, but may also positively influence academics, communication, and social skills making this intervention highly useful in the music therapy setting (McGuire, 2010). A wide array of children’s literature including literacy components such as rhythm, repetition or short phrases can be embedded in music therapy sessions (see examples). Rhyme: Poetic or rhyme patterns in stories easily transform into songs. Young children are naturally attracted to rhyme patterns because they begin to predict words that complete each phrase.

Snowmen at Night by Caralyn Buehner I like Myself by Karen Beaumont Repetition: Repeated phrases, words, and/or concepts help children predict what is coming next and oﬀer a way to participate in the story. Additionally, children are more likely to memorize repeated phrases and then connect oral language to the printed text. Click, Clack Moo: Cows that Type by Doreen Cronin Pete the Cat: I Love my White Shoes by Eric Litwin Short Phrases: Stanzas that are 3-4 lines per page allow for the use of a simple melody that can be repeated each page. Simple text is also easier for young children and children with disabilities to comprehend, which increases the chance of maintaining their attention. How can You Dance? by Rick Walton The Way I Feel by Janan Cain Concrete Pictures: Illustrations that are clearly displayed and not too abstract help children comprehend the story text. One Little, Two Little, Three Little Apples by Matt Ringler We’re Going on a Leaf Hunt by Steve Metzger Piggyback Stories: Many authors create new words to a traditional song or books based on a familiar tune. These types of books make the story easy to sing for both the therapist/teacher and students. Itsy Bitsy Spider by Iza Trapani It’s Raining, It’s Pouring by Kin Eagle Based on Goals: With so many children’s books to choose from, finding a story that includes goals or concepts that the student is currently learning is easy (e.g., letters, numbers, animals). Naughty Little Monkeys by Jim Aylesworth (letters) Ten Little Eggs by Jean Marzollo (colors and numbers) Augmentative and Alternative Communication (AAC) and Literacy Children who utilize AAC systems are at a disadvantage with learning literacy skills due to the environments and current culture of AAC. There are often lower expectations for students with AAC in regard to literacy

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(Hetzroni, 2004; Pufpaﬀ, 2008) . This may lead to an AAC user’s lack of interaction with print materials (including books), restricted access to vocabulary, and fewer opportunities to relate through language (Hetzroni, 2004). Though literacy is very important to all individuals, AAC users often are not given as many opportunities or the literacy supports they need to succeed (Pufpaﬀ, 2008). Individuals who utilize AAC systems need access to books, and the time and space to practice with them. One may need to access the physical location and the individual’s ability to grasp and manipulate books. Individuals will need time with a teacher, mentor, peer, parent, or therapist so they can ask questions while interacting with print. Access to print materials and human support is needed for increasing vocabulary and understanding of words. In order to answer and ask questions and to comment, an AAC user needs the book-relevant vocabulary to be programmed on to their AAC system. Questions and vocabulary common to typical interactions with the print materials should be programmed onto the AAC system before the AAC user interacts with the book. Other options for increasing opportunities and access to print materials for AAC users include utilizing electronic supports such as VoiceInk™ and V-Pen™ to read print aloud Bookworm™ to read preprinted books aloud Reading Time Communicator to read preprinted books aloud Music therapists also can create their own audio books with applications (apps) such as Pictello™, which allows combining pictures, text, and verbal language. In addition to high tech applications, low tech systems may be easily utilized within the music therapy session. For example, simply taking photos of relevant objects with a digital camera is helpful for aided input. Also, if there are repetitive phrases within a book, they may be programmed on a switch, such as a BIGMack® for the child to operate and contribute to the reading of the story.

Sample Intervention Idea The book One More Bunny by Rick Walton includes several musical qualities listed above. There are four phrases, including a consistent rhyme pattern, on each page of this book. The words easily sync to a simple melody based oﬀ the familiar tune Five Little Ducks. Additionally, at the end of each page is the repetitive phrase, “Here comes one more bunny.” This book targets number sense (1-10) and beginning addition skills. The pictures are clear and have many familiar objects to identify and count throughout the story. Possible goals to aid listening comprehension to recall story events to use an AAC device to continue the story to use an AAC system to comment or answer questions regarding the story Materials Book: One More Bunny by Rick Walton Boardmaker® icons/Picture cards of play equipment, activities, and characters in the story BIGmack® or other switch with recording device Child’s personal AAC system, if the student has an individualized system

References Hetzroni, O. E. (2004). AAC and literacy. Disability and Rehabilitation, 26(21/22), 1305-1312. McGuire, L. (2010). The effects of text presentation (sung/chanted/spoken) on reading comprehension of children with developmental disabilities. (Master’s Thesis). Available from ProQuest Dissertations and Theses database (UMI No. 1494627). McIntire, J. M., (2007). General music: Developing literacy through music [Electronic Version]. Teaching Music, 15(1), 44-48. Pufpaff, L. A. (2008). Barriers to participation in kindergarten literacy instruction for a student with augmentative and alternative communication needs. Psychology in the Schools 45(7), 582-599. Register, D. (2001). The effects of an early intervention music curriculum on prereading/writing. Journal of Music Therapy, 38(3), 239-248. Register, D., Darrow, A. A., Standley, J., & Swedberg, O. (2007). The use of music to enhance reading skills of second grade students and students with reading disabilities. Journal of Music Therapy, 44(1), 23-37. Zero to Three (2003). Early Literacy [Online Handout]. Retrieved from http://www.zerotothree.org/aboutus/areas-of-expertise/free-parent-brochuresAbout the Authors

Directions 1. Introduce the book by title. 2. Using the tune Five Little Ducks, sing the story lyrics. 3. Have the child answer WH questions about the story (e.g., What is the bunny doing? Where is the bunny?) at the end of each page. Adaptations for AAC use Have the child activate the switch with the repetitive phrase pre-recorded before turning the page Have the child use the AAC system to answer WH questions Allow the child time to comment on the story through use of the AAC system Oﬀer picture choice cards to answer WH questions and identify numbers if a personal AAC system is not available or adequately programmed One more bunny Recorded 2013 by Lorissa McGuire

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Lorissa McGuire, MME, MT-BC is a music therapy clinician in Gardner Edgerton School District in Kansas. She has worked with children and adolescents with special needs for more than 10 years. Contact: lorissamt@gmail.com

Anita L. Gadberry, Ph.D., MT-BC is the Director of Music Therapy at Marywood University and the North American Regional Liaison for the World Federation of Music Therapy. Contact: gadberry.anita@gmail.com

Culture Matters: Latin American Cultural Attitudes toward Disability and their Implications for Music Therapists Working with Young Children Ilene Berger Morris, MM, LCAT, MT-BC Alternatives for Children Suffolk County, NY

Fernando is a beautiful 4-year-old boy with wavy black hair, big round eyes, and a diagnosis of Autism Spectrum Disorder (ASD). His mother carries him cradle-style into the special education center. When she sets him on his feet in the meeting room, he drops to the floor and screams, until she pulls him to her and lifts her blouse to nurse him. Two of the professionals present for Fernando’s CPSE meeting exchange a disparaging glance. Seeing through a cultural lens affords us a different interpretation of attitudes and behaviors that may otherwise seem incomprehensible or unacceptable. As client population groups become more diverse (Darrow & Molloy, 1998; Young, 2009), the challenge of understanding cultural distinctions and cultivating diverse cultural awareness becomes greater for service providers such as music therapists. Shapiro (2005) maintained that acknowledging culture results in an enhanced therapeutic relationship and a sense of mutual respect. Gaston (1968) pointed out that in order for music therapy to be effective and to elicit desired responses, the music used must be sufficiently familiar and specific to one’s culture. The American Music Therapy Association (AMTA) recognizes in its Standards

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of Clinical Practice the necessity of incorporating “music, instruments, and musical elements from the client's culture as appropriate” into treatment planning (AMTA, 2011). In order to create the most relevant musical experiences for a culturally diverse clientele. Music therapists must expose themselves to and familiarize themselves with the music, culture, and language of their clients to the greatest degree possible (Moreno, 1988). The 2010 Census counted 50.5 million Hispanics in the United States, comprising 16.3% of the nation’s population. Already the largest minority, Latinos are the fastest-growing population in the United States. Among children ages 17 and younger, there were 17.1 million Latinos in 2010, or 23.1% of this age group. (Pew Hispanic Center, 2011). Therapists and other professionals who work with young children with developmental and neurological disabilities are familiar with some of the common goal areas for these clients. An Individual Education Program (IEP) may indicate the child’s need to increase self-help skills. A teacher may expect the child to independently follow a classroom routine. A psychological evaluation may point to the child’s need for autonomy and empowerment. A

music therapist may oﬀer compelling instruments or musical opportunities to motivate the child to assertively request a turn. Yet in their home environments, the value system of the family may stress diﬀerent types of responses and behavior from children. Cultural awareness impacts treatment, interaction and expectations. Some of the cultural features germane to music therapists who treat children from Latin American families are "traditions and beliefs, help-seeking behaviors, coping behaviors, methods of dealing with pain, patterns of communication, [and] the role of family and community" (Valentino, 2006, p. 109). As parents have the responsibility and choice to navigate the service system and determine the course of intervention for their children, it is necessary to consider attitudes of the family and even the home community as they relate to an individual child with a disability. A lack of awareness of these cultural issues can result in negative consequences for the therapeutic relationship and outcome (Valentino, 2006). The level of acculturation to U.S. majority concepts of disability, health care and the educational system will factor significantly into the types of beliefs and viewpoints of the family and the degree to which they are held (Parish, 2010; Rilinger, 2011). It is important to point out that Latin Americans are a heterogeneous category of people from many countries, including the U.S., with overlapping but not identical cultural characteristics. The following terms and explanations were compiled from various sources, and need to be interpreted as generalizations. Allocentrism/Collectivism is an orientation to the needs, objectives, and points of view of the group rather than the individual, and it fosters empathy and the willingness to sacrifice for others (Brice, 2002; Gannotti, Handwerker, Groce, & Cruz, 2001; Stone, 2005). Latinos tend to be allocentric; European heritage Americans tend to be individualistic (Peña & Fiestas, 2009). Añoñar means to pamper, and sobreprotectiva refers to an overprotective mindset directed towards a child with a disability. Many Latino parents will “baby” a child with a disability, especially a boy (R. Amador-Cortes, SLP, personal communication, March 27, 2013). In many cases, independent functioning is not the family’s goal

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for the child (Almanza, n.d.; Brice, 2002; Gannotti, Handwerker, Groce, & Cruz, 2001, Stone, 2005). Familismo means family unity, welfare and honor. Latinos who embrace familismo believe that it is their responsibility to care for one another within the family under any circumstance (Almanza, n.d.; Brice, 2002; Santana & Santana, 2001; Schwantes & McKinney 2010; Stone, 2005; Taylor Dyches, Wilder, Sudweeks, Obiakor, & Algozzine, 2004). Mal de Ojo, or the “Evil Eye” is when a sudden decline in physical or emotional health or ability of an infant or young child is believed to have been caused by admiration or jealousy of another person (Almanza, n.d.; Brice, 2002; Gannotti, Handwerker, Groce, & Cruz, 2001; Langdon, 2009; Santana & Santana, 2001; Stone, 2005). Parents who believe that their children’s disabilities were the result of supernatural forces tend to feel they have little control over their children’s outcomes (Hauser-Cram & Howell, 2003). Marianismo includes characteristics such as submission, charity, self-sacrifice, and enduring suﬀering, particularly in a woman. With marianismo, one looks upon diﬃculties such as the disability of a child as gifts one was deemed strong and worthy enough to receive. Marianismo represents the ideal qualities of a good woman and mother (Blacher & McIntyre, 2006; Taylor Dyches et al., 2004; Rilinger, 2011; Santana & Santana, 2001; Stone, 2005). Living up to the ideal of marianismo without adequate support may result in stress, poor health and depression in the mother (Chavez Dueñas, 2008; Hauser-Cram & Howell, 2003). Alternately, a belief in parental culpability may exist, suggesting that the disability of a child was caused by a family member’s (usually the mother’s) thoughts, actions, or sins, commonly held in Puerto Rico, Cuba, and Mexico (Brice, 2002; Langdon, 2009; Stone, 2005). With personalismo, one demonstrates the ability to be personal (with warmth, kindness, interest, humor) in interactions, including professional relationships (Brice, 2002; Santana & Santana, 2001; Schwantes & McKinney, 2010).

Physical disabilities are more accepted and merit more empathy and support than mental disabilities. Some Latin Americans adhere to the belief that if disability can’t be seen, it can be ignored (Almanza, n.d.; Brice, 2002; Santana & Santana, 2001; Stone, 2005). This is an especially relevant attitude to consider when a child has ASD, the diagnosis of which is increasing in the Hispanic population (Baio, 2012). ¡Que sea lo que Dios quiera! is an acceptance of God’s will - what many people from Latin American cultural backgrounds believe is the reason for a person’s affliction (Almanza, n.d.; Brice, 2002; Lòpez–De Fede & Haeussler-Fiore, 2002; Santana & Santana, 2001; Stone, 2005). Respeto (respect) is given to elders, parents and people in authority, and is expected in return. Health care providers and educators are afforded significant respect and trust, and their opinions are given great weight. (Schwantes & McKinney 2010; Santana & Santana, 2001; Stone, 2005). Families may assume a passive role in their child’s therapeutic program, allowing the “experts” to take over, unless invited to and encouraged to be involved (M. Wingert, SLP, personal communication, April 25, 2013). Simpatia is a style of behavior that emphasizes the ideal of smooth, pleasant social interactions (Brice, 2002; Gannotti et al., 2001). It is expected that children will be complimented and praised (R. Amador-Cortes, SLP, personal communication, March 27, 2013). Though we need to be truthful about the child’s difficulties, positive comments should be offered as well. With such a balance, a more accurate picture of the child can be shared from both sides. When music therapists recognize the cultural values of the client and the client’s family, the stage is set for a beneficial partnership that enriches professional perspective and bolsters that of the family. The parent/ family role is of the utmost importance in the life of a young child, and when a child is disabled, like Fernando, it’s critical that the family and educational/therapeutic personnel truly work together. Cultural awareness, respect and sensitivity send a message of faith in the ability of the family to provide the child with the

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supportive foundation and secure environment he/she needs. This needs to happen to make therapeutic efforts a success and have the maximum impact. References American Music Therapy Association. (2011). Standards of clinical practice. Retrieved from http:// www.musictherapy.org/about/standards/. Almanza, A. (n.d.). Latino culture and disability: A different approach. Proyecto Vision. Retrieved from http://www.proyectovision.net/english/news/02/ culture.html. Baio, J. (2012). Prevalence of Autism Spectrum Disorders. Atlanta: U.S. Centers for Disease Control and Prevention. Blacher, J., & McIntyre, L. L. (2006) Syndrome specificity and behavioural disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50, 349-361. Brice, A. (2002). An introduction to Cuban culture for rehabilitation service providers. Center for International Rehabilitation Research Information and Exchange. Buffalo, N.Y. Retrieved from http:// cirrie.buffalo.edu/culture/monographs/cuba.pdf. Chavez Dueñas, N. (2008). The relationship between acculturation, parenting style and parental adherence to traditional cultural values among padres mexicanos. (Doctoral dissertation). Retrieved from ProQuest. Darrow, A. A., & Molloy, D. (1998). Multicultural perspectives in music therapy: An examination of the literature, educational curricula, and clinical practices in culturally diverse cities of the United States. Music Therapy Perspectives, 16(1), 27-32. Dyches, T. T., Wilder, L. K., Sudweeks, R. R., Obiakor, F. E., & Algozzine, B. (2004). Multicultural issues in autism. Journal of Autism and Developmental Disorders, 34(2), 211-222. Gannotti, M. E., Handwerker, W. P., Groce, N. E., & Cruz, C. (2001). Sociocultural influences on disability status in Puerto Rican children. Physical Therapy, 81, 1512-1523. Gaston, E. T. (1968). Music Therapy. New York: MacMillan. Hauser-Cram, P., & Howell, A. (2003). The development of young children with disabilities and their families:

Implications for policies and programs. In R. M. Lerner, F. Jacobs, & D. Wertlieb (Eds.), Handbook of applied developmental science, Vol. I. (pp. 259-279). Thousand Oaks, CA: Sage Publications. Langdon, H. W. (2009). Providing optimal special education services to Hispanic children and their families. Communication Disorders Quarterly, 30(2), 83-96. Lòpez-De Fede, A. & Haeussler-Fiore, D. (2002). An introduction to the culture of the Dominican Republic for rehabilitation service providers. Center for International Rehabilitation Research Information and Exchange. Buffalo, N.Y. Retrieved from http:// cirrie.buffalo.edu/culture/monographs/domrep.pdf. Moreno, J. (1988). Multicultural music therapy: The world music connection. Journal of Music Therapy, 25(1), 17-27. Parish, S. (2010). Racial and ethnic disparities in family burden and the access, service utilization, and quality of health care for US children with autism and other developmental disabilities. Rockville, MD: Health Resources and Services Administration. Peña, E., & Fiestas, C. (2009). Talking across cultures in early intervention: Finding common ground to meet children’s communication needs. Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations, 16, 79–85. Pew Hispanic Center. (2011). Census 2010: 50 million Latinos. Washington, D.C. Retrieved from http:// www.pewhispanic.org/files/reports/140.pdf. Rilinger, R. (2011). Music therapy for Mexican American children: Cultural implications and practice. Music Therapy Perspectives, 29(1), 78-85. Santana, S., & Santana, F. O. (2001). An introduction to Mexican culture for rehabilitation service providers. Center for International Rehabilitation Research Information and Exchange. Buffalo, N.Y. Retrieved from http://cirrie.buffalo.edu/culture/monographs/ mexico.pdf. Schwantes, M., & McKinney, C. (2010). Music therapy with Mexican migrant farmworkers: A pilot study. Music Therapy Perspectives, 28, 22-28. Shapiro, N. (2005). Sounds of the world: Multicultural influences in music therapy in clinical practice and training. Music Therapy Perspectives, 23(1), 29-35 Stone, J. S. (2005). Culture and disability: Providing culturally competent services. Thousand Oaks, CA:

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Sage Publications. Valentino, R. E. (2006). Attitudes towards cross-cultural empathy in music therapy. Music Therapy Perspectives, 24(2), 108-114. Young, L. (2009). Multicultural issues encountered in the supervision of music therapy internships in the United States and Canada. The Arts in Psychotherapy, 36, 191–201 About the Author A music therapy clinician for over 30 years, Ilene "Lee" Morris, MM, LCAT, MT-BC lives and works in Suﬀolk County, Long Island, NY. She provides music therapy to young children and adolescents in special education settings, and to patients of all ages in a local hospital. Contact: Lee@CLIMBmusictherapy.com

The Cloud Forest School: A Music Therapy Service Project Roy Kennedy, Ph.D., MT-BC The University of Georgia Athens, Georgia

This article spotlights a music therapy service project at the Cloud Forest School (CFS), an environmental education, English/ Spanish bilingual school, located in Monteverde, Costa Rica. El Centro de Educación Creativa The Cloud Forest School, referred to as El Centro de Educación Creativa by the local community, is located in a fragile, tropical montane cloud forest environment, which is home to many endangered species of birds, mammals, and plants (Cloud Forest School– Mission, para, 1). The cornerstone of the school’s curriculum is environmental and bilingual education, which is reflected in the school’s mission statement to “educate ecologically aware, academically well-rounded, bilingual individuals” (Cloud Forest School–Mission, para, 3). The

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campus is located in a 106 acre cloud forest and enrolls about 200 preschool through 11th graders (Cloud Forest School, 2013). Ninety-five percent of the students attending the CFS are local Costa Rican students, while the remaining five percent is comprised of international students. Music Education at CFS Music is frequently used at CFS. Students and teachers gather regularly in an open-air classroom for community singing sessions. During this time, spirited and enthusiastic cultural exchanges occur as songs are sung in both English and Spanish. Most of the students are Spanish speakers. However, from preschool through the 6th grade, they are exposed to English language learning. While receiving literacy instruction in Spanish, they also have an English-

speaking lead teacher (Cloud Forest School–Bilingual, paragraph 1). Music Therapy Service Project In 2007, the author presented two workshops for the ESL teachers at the CFS. The content focused on music therapy activities promoting comprehensible language input (Kennedy, 2008). Music was also utilized to create a relaxing and enjoyable learning environment for ESL students (Krashen, 1983; Schunk, 1999). The author modeled several activities which included singing songs with parallel texts in both English and Spanish, drum circle call and response chants designed as vocabulary building exercises (e.g., the food chant), and singing songs with everyday conversational content and then

reviewing the songs’ lyrics using the cloze procedure (i.e., leaving an operative word in the sentence blank).

expressive language and also inspire students to learn the second language (Krashen, 1983; Krashen, 2003). Watch video Noche de talentos: Waka Waka

http://www.youtube.com/watch?v=gY48afPjV7c

For example, the lyrics of the rock song by The Doors Hello, I Love You Won’t You Tell Me Your Name? were presented as, “Hello how are you won’t you tell me your name?” during the initial singing of the song and then presented on the chalk board as, “Hello, how are you won’t you tell me your _______ ?” The group then identified the missing word, discussed the meaning of the word and as a byproduct of the comprehensible input, discussed the use of contractions (e.g., the word won’t).

Song lyrics presented in this manner serve as comprehensible input used for language rehearsal during the “silent” and “emerging language” phases as students utter their first words or short phrases during the beginning stages of language acquisition (Krashen, 2003; Schumk, 1999). In addition, movement to music activities paired with song lyrics in both English and Spanish and action songs, using instructions such as “stand up” and “sit down” were applied as examples of the Total Physical Response (TPR) technique – a well-known strategy used in teaching languages (Krashen, 1983; Schunk, 1999). The following video represents an example of the TPR practiced by students a the CFS.

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The Science Behind Schunk (1999) utilized Krashen’s ideas of language acquisition for second language learners when she investigated the effects of singing paired with American Sign Language (ASL) on the receptive vocabulary skills of elementary ESL students. She compared the effects of sung text paired with signs, spoken text paired with signs, sung text alone, and a control group that used spoken text only. Her findings indicated that the sung text paired with sign groups, and the spoken text paired with sign groups yielded significantly greater gains in vocabulary recognition than the spoken text only group. Significantly better gains in vocabulary recognition also were achieved by the sung text only group, as compared to the spoken text only group. Schunk stated “music has become a valued tool in the theoretical design and practical application of English-as-aSecond-Language instruction. There are cognitive functions common in processing both language and music” (Schunk, 1999, p. 111). Schunk cited Krashen’s “Din in the Head” phenomenon, a type of spontaneous cognitive language rehearsal that provides additional practice for the language learner and also lowers students’ affective filter. This involuntary language rehearsal in which ESL students at all levels participate may produce

Furthermore, Murphey (1990) expanded on the Din in the Head concept by identifying what he called the “Song Stuck in My Head” phenomenon (SSIMH). It seems that many people have experienced the lyrics of a song, or a certain phrase of a song, replaying in their minds. For example, a favorite chorus or hook line of a song may actually become stuck in a person's mind. According to Murphey, having the lyrics of a song continuously running through one's mind is analogous to Krashen's Din in the Head concept when language learners hear language information repeated over and over again as inner speech. The advantage, however, of the Song Stuck in My Head phenomenon is that it only takes a few minutes for the language information to become imbedded in a person's mind, in contrast to the Din in the Head eﬀect, which may take several hours of language instruction. The following example demonstrates the CFS teachers’ use of these techniques to enhance the immersion of preschool and kindergarten students in extracurricular language activities by performing a play based on “The Very Hungry Caterpillar” (Cloud Forest School, 2013).

Watch video Pre-K: The Very Hungry Caterpillar

http://www.youtube.com/watch?v=Aeu81u5nfF4

Recent communication with the current music teacher at the CFS supports Krashen’s concept of using comprehensible input and lowering the aﬀective filter of learners in second language instruction and Schunk’s assertion that the use of music is a valued teaching technique in the ESL and SSL classrooms. Her remarks are especially poignant as she reflects on the participation of her own children in the SSL program at the CFS. Yes, music is used quite a bit in the classrooms here at Creativa. In my own music classes, I try to always have both English and Spanish songs, and often bring in songs that include both languages in them. Almost all the songs have movement attached to them. We are also starting to work a lot with rhythm, so we are singing and also doing some basic, simple body percussions as we do that. [...] I have two children at the school: a 4-year-old in Kinder and a 7 year old in 3rd grade. My 4-year-old has definitely exhibited the SSIMH thing! She came here with no Spanish language skills and the songs she learns in Kinder have absolutely helped her gain vocabulary as well as a feel for the language. After school, she will often play by herself and

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while she does so she is singing a song over and over again. My son gets his language instruction more formally (vs. immersion); he has SSL class every afternoon. The SSL teachers definitely use music and that is when I have seen my own child the most engaged. They actually just recently learned a song by a Costa Rican artist and performed it at Sing. They had to memorize the words, practice it every day, etc. He, too, was singing it at home and so our whole family ended up learning it! (K. Mostow, personal communication, April, 19, 2013). In summary, the CFSl is a unique, energetic, and hands on/ experiential setting for preschool and kindergarten second language students, located in one of the most admired and studied ecoenvironments on the planet. The CFS has many teachers from the United States that visit the campus. Some teachers who visit take the tour of the school and return home with pleasant memories of an extraordinary learning environment while others become so enamored with the CFS that they apply to teach there for a few years. References Cloud Forest School. (Producer). (2013). Exploring the world from the ground up [Web log post] Retrieved from http:// cloudforestschool.org/ Cloud Forest School (Producer). (2013). Noche de talentos: Waka Waka [Video]. Available

from http://www.youtube.com/ watch?v=gY48afPjV7c Cloud Forest School (Producer). (2013). Pre-K: The very hungry caterpillar. Available from http://www.youtube.com/ watch?v=Aeu81u5nfF4 Kennedy, R. (2008). Music therapy as a supplemental teaching strategy for Kindergarten ESL students. Music Therapy Perspectives, 2, 94-98. Krashen, S. D. (1983). The natural approach. Hayward, CA: The Alemany Press. Krashen, S. D. (2003). Explorations in language acquisition and use. Portsmouth, NH: Heineman. Murphey, T. (1990), The song stuck in my head phenomenon: A melodic din in the LAD. System, 18, 53-64. Schunk, H. A. (1999). The eﬀect of singing paired with signing on receptive vocabulary skills of elementary ESL students. Journal of Music Therapy, 36, 110-124. About the Author Roy Kennedy, Ph.D., MT-BC is the Director of Music Therapy at The University of Georgia. His current research is focused on using music to teach "English as a Second Language" to students of Hispanic ethnicity. Contact: rkennedy@uga.edu

Showing Visually: The Impact of Graphic Analysis of Music Therapy Services at a Local Child Developmental Center in Japan Satoko Mori-Inoue, Ph.D., MT-BC Child Development Center “Kokko” Music Therapy Connection Group “Kakehashi”

Early identification of developmental delays or disorders can be challenging, especially if children demonstrate restlessness, difficulty with transitions, or language delays. For Japanese families, child developmental support centers are a good place for screening and getting answers to open questions. However, finding music therapy services for families with toddlers who may demonstrate signs of developmental delays can be difficult. Introduction In Japan, child developmental support centers connect families to local medical settings and introduce various services such as consultation, physical therapy, speech therapy, and occupational therapy. Additionally, the Japanese government offers medical check-ups at community health centers for 18 to 36 month old children. However, the basic examination often does not identify developmental issues. Child development support centers may more likely detect potential problems and even reduce child neglect and child abuse (FRIENDS, 2013). Music therapy may play an important role in the screening process and can provide an early intervention service that promotes appropriate development and school readiness.

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Brief History of Music Therapy in Japan In 1967, a nationwide Japanese music therapy research group was formed. The Japan Federation of Music Therapy (JFMT) was established in 1995, initiating a qualification system for Japanese music therapists. Subsequently, the Japanese Music Therapy Association (JMTA) was formed in 2001 and the institutional response for music therapists became stabilized (JMTA, 2013). However in 2012, only 9.6 % of music therapists were employed full-time and 3.6 % held only a part-time position, mostly when services were requested (Kato, 2012). Music Therapy in Child Development Support Centers in Japan Several Japanese child development support centers oﬀer music therapy services once or twice a month. In very few cases, a full time music therapist provides services on a daily basis. Often music therapists provide consultative service to parents who have diﬃculty distinguishing between a challenging child and one with a developmental delays. Consulting with experts from an interdisciplinary team is highly advantageous for parents. In particular, after the 18-month developmental examination visit, music therapists may provide

information about the child’s developmental stages through music making. Music Therapy Services at the Ichihara-City Child Development Support Center The Ichihara-City Child Development Support Center is located in a suburb of Chiba (i.e., near Tokyo). In this center, music therapy sessions were introduced to children and families as part of the early intervention program. Based on the children’s ages and developmental characteristics, children and their family members were divided into four groups, including six children, their caregivers, and two classroom teachers per group. The contracting music therapist provided services once a month. During each visit, she oﬀered four group sessions, parent consultation, and participated in therapist-teacher conferences. The music therapist carefully developed clinical goals and objectives, tracked children’s progress during each session, and analyzed the results for each group. The music therapy sessions provided opportunities to share meaningful moments between children and parents to support basic living skills and school readiness of the children to enhance parental communication to provide knowledge and tools to promote child development to oﬀer an emotional outlet for parents, and to ask questions and individually discuss each child’s developmental functioning. As part of the clinical program evaluation, parents were given a questionnaire following each of the sessions. They were asked to rate their child’s behavior and provide comments on their child’s changes. Additionally, the music therapist observed participants’ behaviors such as the children’s eye contact with the therapist, the mothers’ facial expressions, and the children’s frequency of modeling tasks. The following four examples provide clinical outcomes from the questionnaire that were essential in supporting the continuance of the music therapy program. Displaying the clinical data from both parents and the music therapists in graphics assisted parents and the funders to more easily analyze the success of the program.

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Example 1: Caregivers were asked to rate their children’s participation during the intervention between 0% (a child did not participated any activities) to 100 % (a child participated in all the activities).

Example 2: The music therapist rated the frequency of eye-contact with the therapist on a scale from 1 to 7 (i.e., 1=0-15%, 2=15-30%, 3=30-45%, 4=45-60%, 5=60-75%, 6=75-90%, 7=90-100%).

Example 3: The music therapist rated the frequency of Mother’s facial expression (smile) on a scale from 1 to 7 (i.e., 1=0-15%, 2=15-30%, 3=30-45%, 4=45-60%, 5=60-75%, 6=75-90%, 7=90-100%).

Example 4: The music therapist rated the frequency of modeling on a scale from 1 to 7 (i.e., 1=0-15%, 2=15-30%, 3=30-45%, 4=45-60%, 5=60-75%, 6=75-90%, 7=90-100%).

About the Author Satoko Mori-Inoue, Ph.D., MT-BC is a music therapy researcher at Mejiro University (Japan) and is currently establishing a music therapy clinical practice within the Child Development Center "Kokko" and Mejiro University Clinic. Her current early childhood practice is with infants with sensorineural hearing loss and children with developmental disabilities. Contact: sinoue@mtkakehashi.com

Overall, the music therapy program at the Ichihara-City Child Development Support Center was successful. The documentation of outcomes and their graphic display was important for the music therapist to analyze the children's progress and adjust the clinical goals accordingly. It also assisted the parents to see and recognize their children’s positive development, and provided support for continued funding of the music therapy program. In the future, the Ichihara-City Child Development Support Center will use a similar evaluation system for participating teachers. It is expected that this will improve the understanding of and professional communication about each child's developmental progress. References FRIENDS National Resource Center for CommunityBased Child Abuse Prevention Program (2013). Making the case for preventing child abuse and neglect: An overview of cost eﬀective prevention strategies. Retrieved from http://friendsnrc.org/ joomdocs/Report1.pdf#search='child+development +center+to+reduce+child+neglect+and+abuse' Japanese Music Therapy Association (2013). Foundation news. Retrieved from http://www.jmta.jp/ association/n002/02.html Kato, M. (October, 2012). The current state of Japanese music therapy in 2012. Handout at the JMTA special workshop. Unpublished JMTA special workshop handout. Supervision Workshop and Symposium, Tokyo, Japan.

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parents Just

Parentscan

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This new imagine series is dedicated to parents of young children with disabilities. Experienced music therapists oďŹ&#x20AC;er specific musical ideas that can be easily embedded by parents in daily family routines. Singing, chanting, rhyming, dancing, listening to music, or playing an instrument oďŹ&#x20AC;er joyful and rewarding learning experiences for young children that may enhance communication, academic, motor, social, and communication skills. Make the most of your family play time by supporting learning through music.

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parentscan Ideas for parents of children with Autism Spectrum Disorder

1. The Same Game Place several small instruments on the floor. Tap knees and chant: “Same game, same game, find the same.” Hold up an instrument which matches one of the instruments on the floor. After your child points to the “same” allow him/her to play both instruments as a reward.

3. Stop and Go Create a green card that says “Go” and a red card that says “Stop.” Play instruments along with an upbeat song. Hold up the “Stop” card and pause the song. Wait a few seconds then say “3, 2, 1…..” and have your child say or point to the “Go” card before starting the music again.

Written by Michelle Lazar, MA, MT-BC Autism Specialist and Music Therapist Founder of Tuned in to Learning

2. Who do you see? Gather photos of people, your child knows. Tap on the drum while singing or chanting “Tell me, tell me, who do you see?” Hold up a photo. Chant “I see ______ looking at me.” Have your child fill in the blank by tapping and saying the name on the drum.

4. Copy Cat Say “One, two, three, copy me.” Play rhythm on an instrument and have your child copy you. Instead of playing a certain rhythm you can also have your child copy you playing fast, slow, loud, and quiet.

5. Let’s Count Gather an array of small rhythm instruments and an empty container. Provide your child number flashcards to choose from. After your child chooses a number, say “Let’s count!” and help your child place the correct number of instruments in the bin. Shake up the bin and dump the instruments onto the floor before picking a new number.

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parentscan Ideas for parents of children with Down Syndrome 2. Hammocking Place your child in a blanket or a beach towel. With a caregiver on each side, gently pull both sides of the blanket and rock back and forth while singing your favorite lullaby.

1. Laundry Basket Put your child in a laundry basket and move it around the floor while singing the song “Row Your Boat” or other movement songs.

3. Mirror Play Use simple children’s songs such as “If You’re Happy and You Know It.” Have your child imitate your facial expressions. Overexaggerate your expressions.

5. Making Popcorn Place egg shakers in a real pot or pan. Shake and then “pop” them out while singing Raffi’s Popcorn song. Count each egg shaker remaining after popping out.

4. Paper Plates Draw facial expressions on paper plates to convey emotions such as “happy,” “sad,” “scared,” “angry,” or “surprised.” Pair these with a song about feelings you may know.

6. Pots and Pans Let your child drum on pots and pans with wooden spoons. Give directions such as “Play the pot four times,” or “Play fast.”

Written by team Therabeat Jennifer W. Puckett, MT-BC; Jessica Pitts, MT-BC Alison Williams, MMed, MT-BC; Chelsea Kinsler, MT-BC Hannah Ivey Bush, MT-BC; and Hannah Owenby, MTI

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parentscan Ideas for parents of children with Visual Impairments

1. Hand Search Place instruments with different sounds and textures (e.g., shaker, mini cabasa) around your baby. Play one instrument while naming it. Have your baby search and reach for it from different positions. After your baby touches the instrument, allow him/her to play and explore it with you.

4. Sounding Environment Tap a rhythm on a nearby chair, a wall, or on the kitchen counter and label the sound (e.g., “This is what your living room chair sounds like”). Quiz your child about the different sounds in your home. Additionally, you may use instruments for meaningful events and landmarks in the home environment (e.g., a triangle may identify lunch time in the kitchen).

Written by Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA Music Therapy Clinician, Educator, and Researcher Owner of Music Therapy Consulting

2. Sound Memory Game Use a set of instruments (two of the same). Introduce the sound and texture of each instrument to your toddler. Then activate one instrument and let your toddler find its matching pair.

3. Feel the Beat Let your child feel the vibration of various instruments (e.g., drums, gongs) with his/ her hands. Instead of the hands, have your child lay on a big drum and give him/her a “vibrational body massage” by playing the instrument rhythmically.

5. Musical Mini Route Place your child’s favorite instruments a short distance from each other. Encourage your child to move from one to the next sound source by playing each instruments and ask him/her to move towards you. After your child has successfully navigated the distance, play the instrument with him/her while singing a song as a reward.

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programs Sing & Grow© is an evidence-based international music therapy project that provides services within the community for young children and their families who present with complex needs. In the Beginning... Sing & Grow© originated in Australia in 2001. Since then the program has been evaluated and is supported by scientific research. The project focuses on improving outcomes for young children through prevention and early intervention work with families. In 2010 the British music therapist Daniel Thomas brought Sing & Grow© to the UK. Who and Where? In the UK, Sing & Grow© is a non-profit organization comprised of 23 music therapists and a small oﬃce team that is responsible for business and financial planning, grant/funding support and administration. Sing & Grow© UK accesses expertise from across the music therapy and other sectors via its Advisory Panel that includes music therapist Dr. Amelia Oldfield. Sing & Grow© Australia is led by music therapist Toni Day, National Director, with a core team of 8-10 and approximately 30 music therapists that work throughout Australia with families and communities. There is a close working relationship between the UK and Australian projects ensuring a consistent and developing approach to our work.

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Purpose and Goals Sing & Grow’s© purpose is to be leaders in the provision of innovative and accessible parent-child music therapy programs. The program aims to build stronger families by Oﬀering early intervention music therapy at an accessible community level Promoting child wellbeing Improving child development outcomes Empowering parents, caregivers and communities to contribute to optimal child development Strengthening the quality of family relationships Connecting families and communities Working collaboratively with a range of partners including government, non-government and community organizations. Sing & Grow© aims to encourage parent-child interactions to build parent confidence and knowledge to enhance social connectedness to improve child development outcomes Profile of Clients Sing & Grow© works with families who have a child under three years old, and normally within the context of up to 10 dyads (parent-child) within each 10 week program. Families who participate in Sing & Grow© may present with a range of complex needs such as childhood disability, parental mental health issues, low socio-economic status or be a family who has recently adopted a child. All Sing & Grow© music therapists receive additional Sing & Grow© training before leading the program. Recognized music therapy qualifications in the UK and

Australia are a prerequisite to working for Sing & Grow©. Programs are funded via government and charitable grants/support and directly commissioned or brokered from Host Organizations. Services and Products Sing & Grow© oﬀers a range of services in the UK and Australia. These include: Standard Programs in accessible venues in collaboration with community organizations Place-Based Services (e.g., intensive music therapy interventions to targeted families who, for a range of reasons, may otherwise not participate in community programs) Workshops for both families and community workers; to help build capacity and confidence in adults to use music in their daily interactions with children. In the UK, Sing & Grow’s© approach, methodology and research is validated by The Centre for Excellence and Outcomes in Children and Young People's Services (C4EO) within their Families, Parents and Carers Theme. This validation is available at http://www.c4eo.org.uk/ themes/families/vlpdetails.aspx?lpeid=463 Key Concepts of the Program Research on parenting characteristics over the past 20 years suggests that the parenting characteristic having the greatest influence on children’s development is responsiveness. Therefore the following three main models or theories inform Sing & Grow’s© practice: Responsive Teaching (RT) evolved from RelationshipFocused Intervention (Mahoney, Robinson & Powell, 1992) Circle of Security (Cooper, Hoﬀman, Marvin, & Powell, 1998) Reflective Parenting (Fonagy, Steele, Steele, Moran & Higgitt, 1991), elaborated on by Fonagy and his colleagues over the course of the next decade. Music Therapy Applications By following a simple structure, each Sing & Grow© session plays its part in enabling secure attachment to

develop. The hello and good-bye songs frame the sessions, bringing emotional containment and providing a clear beginning and endings, so important in mirroring attachment and separation. The repetition of the songs each week and the familiarity of the instruments used also enable parents and children to feel safe. The music therapy session involves action songs, use of hand percussion instruments, dancing, drumming and even the use of props such as scarves and parachutes within this framework. Each activity focuses on diﬀerent child development aims, such as developing social skills, listening skills, fine and gross motor skills and more. Additionally, parents are educated and may become more confident in using music with their child while applying knowledge about child development in daily life. References Cairns, K. (2002) Attachment, Trauma and Resilience: Therapeutic Caring for children. London: BAAF. Mahoney, G., Robinson, C., & Powell, A. (1992). Focusing on parent-child interaction: The bridge to developmentally appropriate practices. Topics in Early Childhood Special Education, 12, 105-120 Cooper, G., Hoﬀman, K., Powell, B., & Marvin, R. (2005). The Circle of Security Intervention. In L. J. Berlin, Y. Ziv, L. M. Amaya-Jackson, & M. T. Greenberg, Enhancing Early Attachments: Theory, Research, Intervention, and Policy. New York: Guilford Press. Salkeld, C. (2013). How does Sing & Grow contribute to healing in families experiencing attachment problems. Leading Note Magazine, 4, 9. Slade, A. (2005). Parental reflective functioning: An introduction. Attachment and Human Development 7(3), 269-283. About the Author Daniel Thomas, National Director of Sing & Grow© in the UK since 2009, is also Director of Music at Work leading a team of music therapists working in educational settings. Mr. Thomas is also a guest lecturer at the Swansea University and Melbourne University. Contact: danielthomas@singandgrow.org.uk

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all young children in a truly inclusive community. The Sprouting Melodies® program strengthens the work and visibility of music therapists in the community by educating others about valuable developmental skills. The goal of Sprouting Melodies® is to support music therapists in building their practices, businesses and future music therapy-based programs. Sprouting Melodies® is an internationally branded music therapy-based early childhood program created by music therapists and offered by board-certified music therapists who complete a training through Raising Harmony™. In the Beginning... Sprouting Melodies® was created in 2009 as a music therapy-based community music program for young children and their families oﬀered through Roman Music Therapy Services. The program grew over the course of three years and was recognized “Best of the Best Children's Music Class” in the Boston area. Due to the request of fellow music therapists who wanted to learn more about the program, Raising Harmony™: Music Therapy for Young Children was founded in 2012. Who and Where? Raising Harmony™: Music Therapy for Young Children is a LLC created by music therapists for music therapists. It is owned and operated by founders Meredith Roman Pizzi, MT-BC and Elizabeth Schwartz, LCAT, MT-BC. The company provides training, referrals, business resources and packages to music therapists looking to increase their knowledge and awareness of early childhood music therapy. Raising Harmony™ is located just outside of Boston, Massachusetts. Sprouting Melodies Providers™ trained by Raising Harmony™ are Board Certified Music Therapists providing classes throughout the U.S. A. and internationally. Purpose and Goals The purpose of Raising Harmony™ is to establish and solidify a niche for music therapists within early childhood music programs. With their musical and clinical skills, Sprouting Melodies Providers™ are uniquely qualified to support emerging development for

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Profile of Clients The Sprouting Melodies® program is for young children ages 0-5 and their caregivers. Caregivers may be a parent, grandparent, extended family member, or a nanny. Classes are designed to foster mutual engagement and development, and are organized into age specific groupings and sibling classes. The Sprouting Melodies® training is open to all Board Certified Music Therapists for continuing education credit and is oﬀered in an institute format and also as online training multiple times each year. Music therapy students may take the training as well, but will not receive continuing education credits and cannot sign a business agreement until attaining board certification. Music therapists outside of the U.S.A. can complete training and take advantage of a business package to become Sprouting Melodies Providers™ if they have the required credentials to practice in their country. Currently, the price for the Sprouting Melodies® training ranges from US $395-495 (onsite or online training). The business package fee includes an annual membership fee and a royalty fee based on a percentage of the Sprouting Melodies® revenue. This allows each Sprouting Melodies Provider™ to price their classes and groups according to their local conditions and specific funding sources. Services and Products Sprouting Melodies® is currently the only branded program oﬀered through Raising Harmony, but additional programs are in planning stages. Key Concepts of the Program The core elements of Sprouting Melodies® are based on repetition and consistent music experiences parent education, and use of functional language and concepts in songs.

Sprouting Melodies® is not a curriculum, but rather a training related to early childhood development, musical development, and a class format. Sprouting Melodies Providers™ are encouraged to create and adapt their sessions to meet the needs of the children and adults in their groups. The founders believe in an “Open Source Model” in which the Sprouting Melodies Providers™ are free to create new music for their groups and share it with their clients. Sprouting Melodies® offers music therapists a chance to use their previous training, skills and experience to bring the best possible early childhood music program to each group they lead, using flexibility and an understanding of individual group needs. As Sprouting Melodies Provider™, music therapists are advocating for the field and increasing awareness of their unique qualities and skills. Providers also may be present at a critical time when families may need a referral for early intervention or support for their child with delays in a community setting. Music Therapy Applications Designed to be responsive and meet the needs of unique communities, Sprouting Melodies® classes usually are community-based and offer inclusive groups for young children and their caregivers. Generally 45 minutes long, sessions run between 6-8 weeks. However, providers may set up their own class schedules. Each session includes singing, moving, playing, and listening in ways that support the growth of each child through the developmental levels. Instruments expand the young child’s musical expression and motor development. They are presented by the music therapist and selected by the child to support progressive and sequential music participation. Sprouting Melodies® is not a clinical music therapy service but does connect music therapists to the community in special ways. For example, Special Sprouts™ classes are offered to children with special medical needs or a developmental delay and the Seniors and Sprouts™ classes are offered as an intergenerational music group in various settings.

Example

Watch video Sprouting Melodies®! Class

http://www.youtube.com/watch?v=IcaMRA8lVB4

Resources Schwartz, E. (2008). Music, therapy, and early childhood: A developmental approach. Gilsum, NH: Barcelona Publishers. Schwartz, E. (2012). You and me makes we: A growing together songbook. Melrose, MA: The Center for Early Childhood Music Therapy. Schwartz, E. K. (2009). In the beginning: Music therapy in early intervention groups. Imagine: Early Childhood Music Therapy Newsletter, 15. Silver Spring, MD: American Music Therapy Association. Schwartz, E. K. (2011). Growing up in music: A journey through early childhood music development in music therapy. In A.Meadows (Ed.), Developments in music therapy practice: Case study perspectives. Gilsum, NH: Barcelona Publishers. About the Authors Elizabeth K. Schwartz LCAT MT-BC is Co-Founder and Education and Training Director of Raising Harmony™. She has practiced music therapy in New York for over 25 years and frequently writes and presents on early childhood music therapy. Contact: Elizabeth@RaisingHarmony.com Meredith R. Pizzi, MT-BC is the Co-Founder and CEO of Raising Harmony. She is also the Founder of Roman Music Therapy Services and the Creator of Sprouting Melodies®. Contact: Meredith@RaisingHarmony.com

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Therapy® (MTWT) providers also receive practical strategies for integrating the Music Together® materials in creative ways into therapy and home-based programs.

Music Together® is an internationally recognized early childhood music and movement program for children from birth through age 7—and the grown-ups who love them™. In the Beginning… Music Together® LLC was founded with the goal of providing the highest quality music and movement experiences to as many young children as possible, involving their parents, primary caregivers, clinicians, and early childhood professionals (Guilmartin & Levinowitz, 2003; Levinowitz & Adalist-Estrin, 1999). Founder Kenneth Guilmartin, composer, Dalcroze trained pedagogue, and father was teaching music at the Montclair (NJ) Cooperative School. Inspired by Gardner's (1983) theory of multiple intelligences, Katz's (1985) research on children's acquisition of "dispositions," and the music learning theory of Gordon (2001), Mr. Guilmartin founded the Center for Music and Young Children (CMYC) in 1985. Dr. Lili Levinowitz, Rowan University and director of research at CMYC, collaborated with Mr. Guilmartin on his project, which culminated in the creation of the Music Together® materials and classroom techniques first oﬀered to the public in the fall of 1987. Who and Where? Music Together® LLC is a privately owned company located in Princeton, NJ. There are licensees in 50 states and nearly 50 countries. Music Together® oﬀers trademark licenses to individuals and organizations who wish to bring any of Music Together’s® programs to their community. Licensees are provided with a mentor for ongoing, proactive support for the growth of each teacher and provider. Additional support includes business mentoring, customer referrals, business technology, ongoing research and development, audio, video and print materials, and the distribution of musical instruments and related products. Music Together Within

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Purpose and Goals Music Together’s® mission is to provide the highest quality music and movement experiences to as many young children as possible and to involve their parents and other adult caregivers, including clinicians and early childhood professionals. Music Together’s® growth is in the domestic and international market in settings with and without parents (Family Class and Music Together In School [MTIS]) and in various therapeutic settings for diﬀerent types of clinicians (MTWT). Music Together® is committed to Bringing Harmony Home®. Profile of Clients Music Together® licensees provide one or more programs: classes for families with children birth to age six (Family Classes), classes in preschools and child care settings (MTIS), and our set of supports and services in clinical settings (MTWT). The three-day basic training currently costs $475 (discount for registering early). Full-time students also receive a discount. Each license application fee is $175.00. Applicants may apply for licenses to oﬀer Family Classes, MTIS, or to be a MTWT provider. All licensees who successfully complete the in-person workshop can sing in tune, move with accurate rhythm, and create a welcoming environment for families and young children. MTWT providers also are credentialed in an allied health profession. Music Together® LLC is an approved provider (P-090) of CMTEs through CBMT. Services and Products Family Classes. The essential Music Together® experience for children birth to age five features family-style learning. In School. Weekly Music Together In School (MTIS) classes occur in school and include songs, nursery rhymes, instrumental jam sessions, fingerplays, and movement activities. Within Therapy. The Music Together Within Therapy® (MTWT) program provides allied health

professionals access to the Music Together® program, materials, and support. Developed over a two-year period by a cohort of board-certified music therapists, MTWT’s supplemental materials may be customized and make session-planning easier. Participating clinicians also have access to a variety of CBMT-approved continuing education courses. MTWT is designed to be implemented with individual children and families and provide very small therapy group experiences. Music Together® LLC oﬀers a continuum of family-based services and quality training and support for licensees to ensure that families are served appropriately. Families participate in community music-making by attending traditional or supportive family classes (a more intimate experience for families with children with special needs). Music Together® licensees/teachers are fully supported by the international headquarters, including mentoring for accommodating students with special needs and their families. MTWT providers include the Music Together® materials in the repertoire of services they oﬀer and engage families in several ways: by including parents in therapy sessions, providing individualized parent education, and designing home-based therapy programs. Key Concepts of the Program Music Together® is based on four principles: All children are musical. Therefore, all children can achieve basic music competence, which we have defined as the ability to sing in tune and move with accurate rhythm. The participation and modeling of parents and caregivers, regardless of their musical ability, is essential to a child's musical growth. This growth is best achieved in a playful, developmentally appropriate, non-performanceoriented learning environment that is musically rich yet immediately accessible to the child's-and the adult's!-participation. The contributions of each child and adult are accepted and included in this developmentally appropriate approach to music making. This adds a unique dimension to the options for music therapists who serve young children with disabilities and their families.

Music Therapy Applications Children and families who participate in MTWT find a more seamless transfer of new skills from the therapy room to home and learn ways to include music-making in their family life. MTWT providers include parents in the therapy process in appropriate ways that reflect best practice. Example

Watch video Music Together® Class

http://www.youtube.com/watch?v=eFGAAbZE64Y

References Gardner, H. (1983). Frames of Mind. New York, NY: Basic Books. Gordon, E. (2001). Learning Sequences in Music: Skill, Content, and Patterns. Chicago, IL: G.I.A. Guilmartin, K. K., & Levinowitz, L. M. (2003). Music and Your Child: A Guide for Parents and Caregivers. Princeton, NJ: Music Together LLC. Katz, L., & Hoﬀman, M. E. (1985). Recent research on young children: Implications for teaching and development implications for music education. In J. Boswell (Ed.), The young child and music: Contemporary principles in child development and music education. Reston, VA: Music Educators National Conference. Levinowitz, L., & Adalist-Estrin (1999). The importance of child development in music education. Center for Music and Young Children. About the Author Carol Ann Blank is a music therapist and developed Music Together Within Therapy®, a trademark license for allied health professionals. A doctoral candidate at Drexel University, she researches family music therapy. Contact: cblank@musictogether.com

musictogether.com

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ideas Moving Through Music Ruthlee Figlure Adler, MT-BC Private Practice Bethesda, Maryland Description The purpose of this intervention is to facilitate movements to a variety of music while encouraging children’s gross motor movements and receptive listening. Goals to increase attention and focus to enhance gross motor skills to follow directions Behavior Observation The child will: discriminate between diﬀerent music selections change his/her movements when the music changes stop when the music stops Materials Instrumental improvisation for jumping, hopping, walking, and other movements or Piano selections/recorded instrumental music such as Parade of the Wooden Soldiers – Leon Jessel (i.e., marching movements) Country Gardens – English folk song (i.e., tiptoe movements) The Wild Horseman, Opus 68, no 8 - Robert Schuman (i.e., galloping or skipping)

• • •

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Directions 1. Instruct children to listen/respond to the changes in music and always stop when the music stops. 2. Play improvised marching music or Parade of the Wooden Soldiers and encourage children to march. 3. Introduce the next and following musical pieces while suggesting corresponding movements. 4. Alternate between the music selections and let children match the movements. Adaptations Give visual prompts (e.g., pictures of the movement) or verbal prompts (e.g., “Freeze;” “Listen, Ready… Stop!”) for children who are lower functioning. Include changing directions with the music changes (e.g., moving backwards) for children who are higher functioning Extend the musical repertoire with classical sections (e.g., Peter and the Wolf – Sergei Prokofieﬀ; Carnival of the Animals – Camille Saint-Saens, and Hansel & Gretel – E. Humperdinck). Include art materials (e.g., animal masks) to make this an integrated arts experience. About the Author With over 50 years of passionate commitment to music therapy, Ruthlee Adler, MT-BC now maintains a part-time private music therapy practice/consultancy for varied ages and populations in Bethesda, Maryland. Contact: radler8209@aol.com

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Ask a child to make the chicken marionette dance to a special song about him. 4. Sing the song and give positive reinforcement to the child manipulating the marionette. 5. Invite each child to lead the chicken dancing while all others clap along to the song. 3.

There Once was a Chicken: Encouraging Play

Adaptations Play the song at diﬀerent tempi and have all children match the chicken’s dance to the pace of the song. Introduce diﬀerent puppets and adjust the song lyrics accordingly (e.g., “There once was a monkey…”) Turn intervention into an improvisatory dance experience (e.g., “There once were some children, some very funny children, they liked to dance and play”).

Alexis Bron, MT Intern Earthtones Music Therapy Services, LLC Portland, Oregon

Description The purpose of this song intervention is to engage children in play while practicing fine motor skills and turn taking. Goals to encourage play to improve fine motor skills to support turn-taking Behavior Observation The child will: interact with the chicken marionette move his/her fingers by manipulating the strings of the marionette wait his/her turn to play with the chicken marionette Materials Ukulele or guitar A chicken marionette Directions 1. Sit in a circle and introduce the chicken marionette. 2. Show how the chicken marionette can move and dance by manipulating the cross top.

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There Once was a Chicken Recorded 2013 by Alexis Bron

About the Author Alexis Bron is an Intern at Earthtones Music Therapy Services, LLC in Portland, Oregon under the supervision of Jodi Winnwalker. She attended Marylhurst University for her undergraduate degree in music therapy. Contact: alexisbron.musictherapy@gmail.com

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Directions 1. Have children seated in chairs in a circle. 2. Sing song and model movements. 3. Pause at each new direction to give children the time to process the positional change. Adaptations Perform activity while seated on the floor and change lyric to “seated everywhere” or “sitting here and there” to maintain rhyme

Give Yourself a Squeeze: Imitation and Body Awareness Beth McLaughlin, LCAT, MSE, MT-BC Wildwood School Schenectady, New York Description The purpose of Give Yourself a Squeeze is to assist children with following multi-step directions and body awareness through a simple sequence of movements sung to a familiar melody (i.e., Hush Little Baby). Goals to enhance attention and focus to increase imitation skills to learn body parts Behavior Observation The child will: be quiet in the presence of music visually attend to model identify body parts Materials None

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Give Yourself a Squeeze Recorded 2013 by Beth McLaughlin

About the Author Beth McLaughlin, LCAT, MSE, MTBC is coordinator of music therapy services and internship director at Wildwood School in Schenectady, New York. She has been providing music therapy services to young children with special needs since 1981. Contact: bmclaughlin@wildwoodprograms.org

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Directions 1. Invite children to participate in this movement activity when they hear the color of their egg. 2. Sing the song, calling only one color at a time. 3. Use prompts when necessary to direct children to place the eggs in the appropriate receptacle. 4. Repeat the song until all eggs are put away. Adaptations Use a diďŹ&#x20AC;erent colored instrument (e.g., rhythm sticks, kazoos) Sing the song with diďŹ&#x20AC;erent movements (e.g., skipping, walking, crawling)

Jump Up and Spin Around: Transitions and Color Identification Meryl Brown MM, MT-BC, DT Developing Melodies Bloomington, Illinois Description The purpose of Jump Up and Spin Around is to identify colors and to help transition to the next activity. Goals to learn colors to follow one and two step directives to transition to the next activity Behavior Observation The child will: stand up when her/his color is called release instrument into proper receptacle as prompted by the song lyrics sit back down to be ready for the next activity Materials Egg Shakers

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Jump up and Spin Around Recorded 2013 by Meryl Brown

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

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Directions 1. Ask children to follow the directions embedded in the song and sing along with the “la la la la la” part. 2. Invite each child to improvise on the drum while accompanying her/him on the guitar. 3. Prepare the child to stop playing by singing “and… stop.” Adaptations Provide instrument choices for the improvisation part (e.g., maracas, rhythm sticks) Use and teach the Spanish version of the song.

Once there was a Music Class: Exploring Music Talia Girton, MT Student University of Louisville Louisville, Kentucky Description The purpose of Once There Was a Music Class is to work on group social skills while simultaneously allowing students to explore their musical creativity. Goals to improve listening skills to foster musical creativity to practice following directions Behavior Observation The child will: follow the directions embedded within the song improvise with the music therapist when it is his/her turn stop playing and return to her/his seat when instructed to do so Materials Guitar Drum (e.g., lollipop drum, bongo, djembe)

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Había una Vez una Clase de Música Recorded 2013 by Talia Girton

About the Author Talia Girton is a senior music therapy and Spanish dual degree student at the University of Louisville, Kentucky. Contact: talia.girton@louisville.edu

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Directions 1. Demonstrate the sound of a monkey using the "ooh," "ah," and "ee" vowels. 2. Using one finger, draw an imaginary small circle around your lips while singing "ooh." Hold both hands in front of your lips, (nearly) touching fingertips together for the "ah" sound. Bring hands apart, and "flatten" out the rounded circle simulating the formation of the "ee" vowel. 3. Encourage children to imitate gestures while singing the chorus. 4. Sing verses while leading childrenâ&#x20AC;&#x2122;s motions and welcome their singing of the chorus.

Hey Mr. Monkey: Stimulating Oral-Motor Skills and Vocal Play

Adaptations Use a microphone to provide auditory feedback. Include other puppets or pictures to elicit and maintain attention. Have children act like monkeys during the verses and return to their seats to sing the chorus. Have children alternate between tapping their knees and clapping their hands during the bridge section.

Margie La Bella MT-BC, MA Deer Park, New York Description The purpose of Hey, Mr. Monkey is to facilitate oral-motor skills of children with speech-language delays. This song is an elaboration and expansion of Matilda the Gorilla and incorporates a sequence of three major vowel sounds throughout the chorus. Goals to stimulate increased vocalization to improve oral-motor skills to produce "ooh," "ah," and "ee" vowels in sequence Behavior Observation The child will: engage in vocal play coordinate oral-motor movements and breath control sing the vowel sequences Materials Monkey puppet

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Watch video Hey Mr. Monkey

http://www.youtube.com/watch?v=wcszy3OSuv0

About the Author Margie La Bella, MA, MT-BC has worked as a music therapist with preschool children for more than 20 years. She has developed over 150 music therapy activities for individuals and groups of all ages and areas of needs, which are available on her website Musictherapytunes.com. Contact: Margie@musictherapytunes.com

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Percussion Instruments (e.g., shakers, sticks, maracas, tambourine) Directions 1. Form a circle and sing the song It is Time to Say Good-bye. 2. Invite children to clap along and dance to the music. 3. Hand out instruments and ask children to play along then return them when hearing their names. 4. Wave good-bye during the final verse. Adaptations Modify instruments and model movements when children have motor diﬃculties. Have a child collect the instruments from peers when singing their names.

It is Time to Say Goodbye: Closure and Reflection Laura Mesén, MMT Colypro Perez Zeledon, Costa Rica Description The purpose of this song intervention is to end a music therapy session while reflecting on the activities experienced. Goals to attend to good-bye activity to increase awareness to transition to the next activity

Es hora de marcharnos Recorded 2013 by Laura Mesén

About the Author Laura Mesén, MMT studied music education at the National University of Costa Rica (2008) and music therapy at Georgia College and State University (2011). She is the academic coordinator of the Music School of Perez Zeledon, Costa Rica, and works with children from five to

Behavior Observation The child will: sing, dance, and play an instrument respond to his/her name when called wave good-bye Materials Accompanying instruments (e.g., guitar, piano) or recording of the song

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12 years old. Contact: lauramesen@hotmail.com

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Directions 1. Begin by patting your knees and ask children to imitate you. 2. Sing the song and add a new movement (e.g., clap your hands, wiggle your fingers, hop like a bunny, gallop like a horse) 3. Ask children to suggest movements for the group to follow. Adaptations Create a mock tunnel with outstretched arms or scarves for children to pass through. Bring train whistle instrument or conductor hat for turn taking of group’s leader. Incorporate book “The Little Engine That Could”

The Train Went into the Tunnel: Movement Imitation Amy O’Dell, MT-BC Music To Grow On Music Therapy Services Sacramento, California Description This intervention idea is adapted from a child’s rhyme and is designed to promote gross and fine motor, and imitation skills. Goals to enhance fine and gross motor movements to receptively identify body parts to follow directions Behavior Observation The child will: imitate body movements move body parts as directed with verbal cues imitate new movements using directed body parts Materials None

The Train Went into the Tunnel Recorded 2013 by Amy O’Dell

About the Author Amy O’Dell, MT-BC and Education Specialist, Mild/Moderate Disabilities works with individuals with various developmental disabilities and is currently employed with Music To Grow On in Sacramento, California. Contact: amyodell10@gmail.com

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Directions 1. Instruct children to sit in a circle and sing the introductory verse of Everybody Has a Name. 2. Sing a verse of Everybody Has a Name for each child in the circle filling in “boy/girl” and the child’s name, followed by its spelling. 3. Sing the closing verse of Everybody Has a Name. Adaptations Pass around a small percussion instrument (e.g., egg shaker, tambourine, hand drum) for each child to play as he/she is addressed.

Everybody Has a Name: Promoting Self-Awareness and Group Interaction Rachel Rambach, MM, MT-BC Music Therapy Connections Springfield, Illinois Description The purpose of Everybody Has a Name is to individually recognize each child in a group in order to promote group cohesion as well as introduce first name spelling. Goals to promote self-awareness in a group setting to support academic skills to encourage interaction amongst peers Behavior Observation The child will: respond to his/her own name when addressed attempt to spell his/her own name take turns acknowledging each member of the group Materials Guitar or other accompanying instrument

Everybody Has a Name Recorded 2013 by Rachel Rambach

About the Author Rachel Rambach, MM, MT-BC is the owner of Music Therapy Connections, a private practice and teaching studio in Springfield, Illinois. She also writes the blog Listen & Learn Music and is cohost of the Music Therapy Round Table podcast. Contact: rachel@listenlearnmusic.com

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Directions 1. Support children in drawing a picture of a frog on the cardboard and attaching the rubber band. 2. Show children how to manipulate the paper toy (i.e., fold it inside out, set it on the floor, and let it go). Note, if you set the folded paper toy too long, it can take a while until the toy jumps. 3. Instruct children to set up the frog on the floor and wait until it is time to let him jump. 4. Sing the song and repeat the frog croaking to increased wait time.

Source: http://www.wanpug.com/top_natu.html

Ribbit, Ribbit, Jump: Fostering Anticipation

Adaptations Bring a picture or sticker of a frog as well as preprepared jumping frog paper toys for children who may have diďŹ&#x192;culty with creating the toy. Let each child lead the song and repeat the frog croaking part. Adapt the song to introduce other jumping animals such as rabbits or kangaroos.

Kumi Sato, MA University of Tsukuba Tsukuba, Japan Description The purpose of this intervention is to foster childrenâ&#x20AC;&#x2122;s engagement and learning by combining crafts and music. Goals to enhance fine motor skills to increase anticipation to facilitate creative play

Ribbit, Ribbit, Jump Recorded 2013 by Kumi Sato

About the Author Behavior Observation The child will: create his/her paper toy frog wait for the his/her turn to let the paper toy frog jump sing the Ribbit, Ribbit Jump song Materials Cardboard (3x6 inches), crayons, scissors, and rubber bands Guiro/Cricket instruments

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Kumi Sato, MA was trained as a music therapist in the U.S. Now living in Japan, she continues her research on the practical use of music to support children with special needs. Contact: ksato.12561@gmail.com

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color of us Hawaii–USA Kazumi Yamaura

"Almost all children respond to music. Music is an open-sesame, and if you can use it carefully and appropriately, you can reach into that child's potential for development.” ~Clive Robbins

Music Therapy Intern Marylhurst University, Portland, Oregon, USA

Snapshot Area 6,423 square kilometers; Hawaii with its eight islands is the 50th state of the U.S.A. located in the Pacific Ocean. Population 1,360,301 (Census, 2011) Official Language English, Hawaiian Ethnic Groups Asian 38.6%, White 24.7%, Native Hawaiian/Pacific Islanders 10%, Hispanic 8.9%, Black/African American 1.6%, American Indian/ Alaska Native 0.3% Median Age 38.6 (2010 Census) Children under 5 6.4% (Census, 2010) Sources Census 2010: Hawaii Census Data http://hawaii.gov/dbedt/info/census/ Census_2010/demographic imagine 4(1), 2013

Demographics There are currently ten board certified music therapists living on three of the eight islands in Hawaii (i.e., Oahu, Big Island, and Maui). Six music therapists provide services to young children in early childhood settings. There is no university-based music therapy training in Hawaii, except for one introduction to music therapy course at the Hawaii Pacific University.

Music therapy strives to empower individuals to discover potential in their own culture and strengths, and has been eﬀective in working with individuals dealing with substance abuse and other issues that aﬀect indigenous people in Hawaii. Music therapy also has been applied as a motivational program for youth, as Hawaii has a particularly high suicide rate among young people.

Background Information Music therapists are currently providing music therapy services related to culturally appropriate music therapy, empowering youth, family mediation, and elder care.

Music therapists in Hawaii also work to strengthen the family bond. In 2008-2011, $92,000 per year was awarded for music therapy services with families in need. A total of 70 families

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received music therapy interventions for three months. Older adults also are receiving music therapy services in adult day centers and nursing facilities. These services are funded by: Hawaii Tourism Authority (HTA) 2013, for homeless individuals (mostly native Hawaiians) Temporary Assistance for Needy Families (TANF) and state grants (DHS) since 2008, for teenagers and families State Foundation on Culture and the Arts (SFCA) grant since 2005, for elderly in day care or nursing facilities. Music therapists in Hawaii who currently work with young children are funded by private pay. In Hawaii, the Department of Education (DOE) and Department of Health (DOH) recognize music therapy as an available service for special education and early intervention. The DOE funded music therapy as a related service under IDEA from 1998 to 2010. Unfortunately, no referrals for music therapy services are currently funded by DOE nor DOH. Music therapists also work in Pediatric Intensive Care Units (PICU) and oncology units. Other populations served by music therapists are children and adults with Autism Spectrum Disorder, Developmental Disabilities, children and adults with physically disabilities, psycho-emotional disorders, stroke, and TBI. There currently are more than 200 referrals for music therapy on-hold due to non-funding.

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In addition, music therapists in Hawaii are a part of the State Recognition Task Force team. Sounding Joy Music Therapy, Inc, has been leading the effort towards state recognition of music therapy as a health care profession and recognition of its licensure in the State of Hawaii. Common Approaches Approaches based on humanistic foundations, as well as NordoffRobbins Music Therapy, are most frequently applied when working with young children in Hawaii. The behavioral and educational approaches to music therapy are sometimes applied. Music therapy with young children is most often offered in individual sessions funded by private pay. Presentations and Prominent Literature Arcayna, N. (2006, July 18). Music makes good medicine. The Star Bulletin. Retrieved from http:// archives.starbulletin.com/ 2006/07/18/features/ story01.html Kajiwara, K. (2010, September 29). Music therapy for early intervention service. Music therapy in-service at Kaneohe early intervention service section. Kaneohe, Hawaii. Haus, R. (2013, April 13). Music therapy in pediatric oncology and for children and adolescents with chronic pain. Presentation offered in a continuing education course at Sounding Joy Music Therapy, Inc. in Honolulu, HI.

Haus, R. & Kajiwara, K. (2011, April 18). Music and autism spectrum disorders: How to meet an autistic child musically. Presentation offered at Annual Pacific Rim International Conference on Disabilities. Honolulu, Hawaii. Kajiwara, K. (2011, October 8). The significance of musical characteristics in early child language development and its implication for music therapy. Presentation offered at the early childhood education conference in Honolulu, Hawaii. Haus, R. (2011, April 20). Music therapy for children under respiratory care. Presentations offered at John A. Burn School of Medicine, Honolulu, Hawaii. Otake, Y. & Koseki, J. (2012, July 14). Music therapy with Hawaiian music. Presentation offered for homeless population at Waianae Civic Center in Waianae, Hawaii. About the Author Kazumi Yamaura graduated from the Marylhurst University in 2013 and completed her internship at Sounding Joy Music Therapy Inc. in Hawaii. Contact: kyamaura@soundingjoymt.org

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Austria Monika Geretsegger Mag.art. Mag.phil. Mag.rer.nat. University of Vienna, Austria Aalborg University, Denmark

Thomas Stegemann Univ.-Prof. Dr. med. University of Music and Performing Arts Vienna, Austria

Snapshot

“Das Finden einer musikalischen Spielform, die von den Äußerungen des Kindes ausgeht, die sie einbettet und damit ‚sinnvoll‘ macht, bietet den Spielraum, in dem sich zwischenmenschliche Begegnung ereignen kann.”* ~Karin Schumacher

Area Situated in Central Europe, Austria covers an area of 83,879 square kilometers.

Population 8,430,558 (2013 estimate)

Official Language German

Ethnic Groups Austrians 91.1%, former Yugoslavs 4% (incl. Croatians, Slovenes, Serbs, and Bosniaks), Turks 1.6%, German 0.9%, other or unspecified 2.4% (2001 census)

Median Age 43.9 years (2013 estimate)

Demographics The beginnings of training and clinical practice in music therapy date back in Austria more than fifty years, making it one of the pioneering countries for music therapy in Europe. In 1959, the first music therapy training program opened at what was then the Vienna Academy of Music. Nowadays, music therapy training programs are oﬀered at the University of Music and Performing Arts Vienna, IMC University of Applied Sciences Krems, and the University of Arts Graz.

Children under 5 5.1 % (2001 census)

Sources Statistics Austria www.statistik.at/web_en/ The World Factbook https://www.cia.gov/library/publications/ the-world-factbook/geos/au.html

Music therapy has been regulated as a healthcare profession by the Austrian Music Therapy Law since July 1, 2009. Currently (May 2013), there are 290 registered music therapists in Austria. According to a survey conducted by the Austrian Association of Music Therapists in late 2011, approximately 36% of

all music therapists work with children and adolescents, though no solid data are available about the total number of music therapists working in the subdomain of early childhood (i.e., with children under 5 years of age). Background Information Young children have been one of the main client groups from very early on. Music therapy pioneers in the late 1950s closely collaborated with eminent physicians in mental health such as Dr. Andreas Rett. Today’s music therapists work as oﬃcially recognized health care professionals in diverse fields of early childhood intervention. Early childhood is also an important area within training, with students acquiring specific knowledge and practical experience in several courses and practicum settings (e.g., developmental psychology,

*[Finding a musical play form that develops from the child’s expressive behaviors and embeds them, thus makes them meaningful, provides the playing space in which interpersonal connections can take place.] ~Karin Schumacher

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childhood psychosomatic disorders, neonatal intensive care).

practice is not yet reimbursed by Austrian health insurance.

Common Approaches Music therapy in Austria is strongly influenced by various psychotherapy approaches such as psychodynamic, humanistic, and systemic traditions. Additionally, developmental theories derived from infant research and attachment research inform today’s clinical practice within early childhood music therapy. Most music therapists working within early childhood in Austria do so in an individual setting using improvisation, musical games or role play, familiar or improvised songs, and various receptive methods to work towards individual therapeutic goals. Modified receptive methods are used in music therapy in NICU settings to positively aﬀect the mental and physical development of infants at risk and to foster bonding between children and caregivers. Regular discussions with parents/guardians and collaboration with other professionals involved in the child’s treatment and care form an important part of music therapy practice. Some music therapists also provide treatment for young children with their parents to promote the parent-child relationship. Music therapy for young children is provided both in clinical settings (e.g., hospitals, child development centers, private practice) and in educational environments (e.g., kindergartens, pre-schools). Although music therapy is funded as part of the treatment oﬀered in institutional settings, music therapy in private

Prominent Literature Geretsegger, M., Holck, U., & Gold, C. (2012). Randomized controlled trial of improvisational music therapy’s eﬀectiveness for children with autism spectrum disorders (TIME-A): Study protocol. BMC Pediatrics, 12(2). doi: 10.1186/1471-2431-12-2 Gold, C., Voracek, M., & Wigram, T. (2004). Eﬀects of music therapy for children and adolescents with psychopathology: A metaanalysis. Journal of Child Psychology and Psychiatry and Allied Disciplines, 45, 1054-1063. doi:10.1111/j. 1469-7610.2004.t01-1-00298. Mössler, K. (2004). Beziehungsaufbau mit minimally responsive Patienten: Musiktherapie in der Frührehabilitation mit Kindern [Building up a relationship with minimally responsive patients. Music therapy in early rehabilitation with children]. Musiktherapeutische Umschau 25, 115-125. Schumacher, K., Calvet, C., & Reimer, S. (2011). Das EBQInstrument und seine entwicklungspsychologischen Grundlagen [The AQR instrument and its basis in developmental psychology]. Göttingen: Vandenhoeck & Ruprecht. Stegemann, T., Hitzeler, M., & Blotevogel, M. (2012). Künstlerische Therapien mit Kindern und Jugendlichen [Arts Therapies for children and

adolescents]. München: Reinhardt. About the Authors Monika Geretsegger, certified music therapist and certified clinical and health psychologist, works both in research (PhD research fellow at Aalborg University/University of Vienna) and in clinical practice. She also serves as the President of the Austrian Association of Music Therapists since 2010. Contact: monika.geretsegger@univie.ac.at

Thomas Stegemann, Univ.-Prof. Dr. med., is a child and adolescent psychiatrist as well as a licensed music therapist. He also studied guitar at the Musicians Institute in Los Angeles, USA. Since March 2011, he is Professor of Music Therapy and head of the Department of Music Therapy at the University of Music and Performing Arts Vienna, Austria. Contact: stegemann@mdw.ac.at

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The Netherlands Barbara Krantz Certified Music Therapist, BA Trainee International Master of Arts Therapies Lecturer HAN University Nijmegen, Department of Creative Arts Therapies

Snapshot

“The power of music is that it goes directly into our world of feelings without the need of an intermediary process of remembering, thinking, associating, and imagining.” ~Henk Smeijsters

Area The Netherlands is a small country (404.3 square kilometers) with three additional Islands in the Caribbean Sea.

Population 16,782,300 (February, 2013)

Official Language Dutch

Ethnic Groups Dutch 79.1%, other Western 9.3% (including Indonesia and Japan), Turkish 2.4%, Moroccan 2.2% Moroccan, Surinamese 2.1%, Antillean and Aruban 0.9%, other non-Western 4.0% (2012)

Median Age 40.8 (April 2013)

Children under 5 912,000 (2013)

Sources CBS Centraal Bureau voor de Statistiek (2013), www.cbs.nl Wereld Informatie (2013), http:// www.wereldinformatie.nl Wikipedia (2013), http://en.wikipedia.org/ wiki/The_Netherlands

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Demographics Five universities in the Netherlands offer a bachelors program in music therapy; one offers a masters program as well. There are more than 500 music therapists in the Netherlands. Music therapy is not a regulated profession and there is no obliged registration for working as a music therapist yet. The largest professional association, the Dutch Association of Music Therapy (NVvMT, Nederlandse Vereniging voor Muziektherapie), has 400 members. A recent survey indicated that about 27% of all music therapists who work in institutions and 74% of all music therapists who work in private practice offer music therapy for children from 0-12 years. The major populations served are children with autism spectrum disorder, attention deficit disorder, mental and physical disabilities, developmental disorders, and behavioral disorders.

Background Information In The Netherlands, there is a growing interest in developmental support and healthcare for young children. New centers for “child and family” have been established in every town to monitor and support the development of young children and their families. Preventive and treatment programs are offered by different institutions, covering a broad spectrum of interventions to support families with young children. Music therapy fits very well into the range of parent-child focused interventions, yet it is rarely seen in programs for families with young children. Different music therapy protocols have been developed but are not yet implemented as standard treatment. Music therapists in the Netherlands explicitly promote music therapy as a strong and valuable tool for children with physical, mental and behavioral

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issues, yet there is still a great need for development, implementation and research of consensus-based and evidence-based music therapy protocols. Common Approaches Historically, music therapy in the Netherlands is closely related to other creative arts therapies: dance and movement therapy, drama therapy and art therapy. All forms of creative arts therapies have common roots in a Dutch theory of the creative process (Wils, 1973). Smeijsters (2008) developed a theory on analogy, which covers all forms of creative arts therapies. Music therapists who work with children refer to different psychological theories dependent on the setting. Many music therapists use a cognitive behavioral approach, others apply mentalization based treatment or a developmental approach. A recent survey indicates that there is a great variance of theoretical underpinnings within the profession. Music therapists who work with children make use of improvisational play, songs and movement. Sometimes music lessons are offered as a therapeutic activity, and in some cases older children produce their own CDs. Many professionals have an eclectic way of working, making use of different music therapy approaches like those of Nordoff-Robbins, Orff, Schumacher, Hegi, and Priestley. A group of Dutch music therapists has recently been trained in Neurological Music Therapy, which offers new ways of working with children with physical disabilities.

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Only 22% of music therapists who work with children also work with parents, and about 28% work with families. There is no information about the way in which parents and families are involved. Music therapists are employed by institutes for children with disabilities, child psychiatry, youth care, as well as in educational settings. A growing number of music therapists work in private practice. Within institutions, treatment costs for music therapy are covered by health insurance companies or other healthcare or welfare bodies. Clients who get treatment via private practice sometimes receive partial compensation by their insurance company. Due to current rising national healthcare costs, all kinds of treatments are experiencing drastic cuts. Prominent Literature Maas, D., Buster, M. (2012) Het product de MuLo methode. Een combinatiebehandeling van muziektherapie en logopedie. Unpublished theses, HAN University Nijmegen, The Netherlands. Retrieved from http://www.surfsharekit.nl:8080/ get/smpid:13600/DS1. Poisman, K. (in press) Geteilte Zeit – Gemeinsame Zeit. Entwicklung eines Messinstruments zum Timing in der Musiktherapie mit autistischen Kindern. Münster, Germany. Smeijsters, H. (2008) Handboek Creatieve Therapie. Third Edition. Bussum, The Netherlands: Coutinho. Smeijsters, H. (Ed.) (2006) Handboek muziektherapie.

Houten, The Netherlands: Bohn Stafleu Van Loghum. Smeijsters, H. (2005) Sounding the self: Analogy in improvisational music therapy. Gilsum, NH: Barcelona Publishers. Snijders, M. (2012) Samen spel. Ontwikkelingsonderzoek naar een muziektherapeutische methode voor opvoeder en kind ter bevordering van de interactie. Unpublished theses, HAN University Nijmegen, The Netherlands. Wils, L. (Ed.) (1973). Bij wijze van spelen: Creatieve processen bij vorming en hulpverlening. Alphen aan de Rijn, The Netherlands: Samsom. About the Author Barbara Krantz, BA is music therapist and lecturer at HAN University. She works with children, adults and older adults with mental health disorders. In her current masters research, she focuses on parent-infant music therapy. Contact: Barbara.Krantz@han.nl Note The author wants to thank the Dutch Association of Music Therapy and the Dutch Federation of Creative Arts Therapies for providing her with the preliminary results of two recent surveys among music therapists and creative arts therapists which have not yet been published.

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Portugal Teresa Leite Ph.D., CMT Associate Professor Universidade Lusíada de Lisboa, Portugal

Snapshot Area Portugal covers an area of 35,560 square miles and is located in Southern Europe at the Atlantic Ocean.

Population 10,562,178 (2011 estimate)

Official Language Portuguese

Ethnic Groups There are no census data on ethnic groups. However a significant number of people of African descent or African birth reside in Portugal.

Median Age 43.9 years (2013 estimate)

Children under 5

“Music most closely relates to the dynamic qualities that the mother and infant need to experience a ‘tuning’ process and guarantee emotional regulation.” ~Gisela Lenz & Dorothee von Moreau

Demographics Presently in Portugal, music therapy is gaining exposure in the Health, Education and Social Intervention fields. However, not many clinical practice settings exist. The Portuguese Music Therapy Association (APMT) promotes the field by organizing seminars, conferences and introductory courses on clinical applications in music therapy. The master’s level training program in Lisbon contributes to the development of music therapy practice through establishing internship sites. Due to financial restrictions, paid work in music therapy is rarely available.

4.6% of the population.

Sources Census 2011 National Institute of Statistics (INE) Lisbon, Portugal

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The exact number of clinicians practicing in Portugal is unknown. However, approximately 30 practitioners provide music therapy services in private practice, educational institutes, nursing homes, or medical and special education settings.

According to Portuguese law, early intervention services must be provided by a multidisciplinary team and include both the child and the family. Background Information The professional community’s interest in music therapy dates back to the 1970’s when a group of special education professionals began researching and inviting music therapy pioneers (e.g., Edith Lecourt, Amelia Oldfield, Joseph Moreno, Violeta Gaínza) to lecture in Portugal. Isolated selftaught interventions in medical hospitals, child psychiatric units and special education schools have been identified within the professional community, but it was not until the 1990’s that a music therapy training program was established by French music therapist Jacqueline VerdeauPaillées, and the Portuguese Music Therapy Association (APMT) was founded. In the 21st century, an expressive therapies

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program that has since closed was established, and in 2004 the Music Therapy Master’s program was started at the Universidade Lusíada de Lisboa. Music therapy has grown primarily within the special education field. Individuals with Autism Spectrum Disorder, developmental disorders, learning diﬃculties, behavioral issues, intellectual and physical disabilities, and older adults are the populations serviced by music therapy practices in Portugal. Common Approaches Increased attention has been devoted to music therapy interventions in medical facilities (e.g., pain unit or pediatrics inpatient unit), OB/GYN private clinics, and multidisciplinary private practice clinics. Music therapist and interns have been included on multidisciplinary teams in these settings. There is also a growing demand from regular school settings, where professionals struggle with the challenges of inclusion as well as the management of an increasing number of children with behavioral and emotional issues. Many Portuguese music therapy professionals have a music education training, thus the Orﬀ method and the developmental approach to music therapy have been widely recognized. However, the psychoanalytic approach of French music therapists has clearly influenced those who come from a psychology or psychosocial rehabilitation background, working in psychiatry and in social intervention agencies.

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The Nordoﬀ-Robbins approach and the use of improvisation are emphasized in the Master’s program, which leads some of its graduates to implement active music-making methods based on this approach. In fact, in more recent years, the Nordoﬀ-Robbins principles have been progressively integrated with a psychodynamic approach, particularly with children with behavioral and emotional problems. In Portugal, the field of early intervention is divided mainly between two types of settings: those which are clearly based on the medical model and those that are based on a psychodynamic approach. Accordingly, the services provided to young children strongly emphasizes relational and developmental aspects, beyond the regular early childhood stimulation and skill achievements. The emphasis on family-based interventions as well as the psychodynamic training of several pioneering music therapists created opportunities to work with young children and their primary caretakers. The following agencies provide music therapy services to their clients in the Lisbon area: Instituto de Terapias Expressivas (a private center providing movement-based therapeutic intervention and music therapy services) CEBI Foundation (a non-profit organization with a residential facility for women and their babies, among other services) Hospital Stª Maria (Lisbon´s main public hospital, inpatient

pediatrics unit, neonatal care unit, and child development center) Unidade de Primeira Infância (an early childhood outpatient care center at the main children’s hospital in Lisbon), and “XS room” at the Lopas Play Center (a city-funded neighborhood day center for underprivileged children from Sintra county). Prominent Literature GIsabel, A. (2012). Musicoterapia e pediatria hospitalar. I[nternship report monograph]. Lisboa, Portugal: Universidade Lusíada de Lisboa. Mendes, L. (2012). Musicoterapia e intervenção precoce: a comunicação e relação nas crianças em idade pré-escolar. [Internship report monograph.] Lisboa, Portugal: Universidade Lusíada de Lisboa. About the Author Teresa Leite, Ph.D., clinical psychologist and music therapist, is the founder and coordinator of the Music Therapy Master’s program at Lusíada University. She also serves as the President of APMT. Contact: teresaleite@netscape.net

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Greece Giorgos Tsiris SpEd (BA), MMT(NR), MPhil Candidate Editor, Approaches: Music Therapy & Special Music Education Athens, Greece

Elizabeth Georgiadi DipMP, PgDipMT President of the Board, Musical Movement Foundation Athens, Greece

Snapshot Area Situated in Southeast Europe, Greece covers an area of 131,957 square kilometers with 13,676 km coastline and over 2,000 islands.

Population 10,787,690 (2011 census)

Official Language Greek

Ethnic Groups Greek 93%, other 7% (including Albanians 4.32%, Bulgarians 0.39%, and Romanians 0.23%) (2001 census)

Median Age 42.5 (2011 estimate)

Children under 5 1,666,888 (15.20%) people are between 0-14 years old (2011 census)

Sources Encyclopedia of the Nations, www.nationsencyclopedia.com European Union National Language, www.eurfedling.org Hellenic Statistical Authority, www.statistics.gr World Health Organization, www.who.int

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"[...] we now know that a baby starts the journey an innately musical/ poetical being, moving and hearing with pulse and rhythm, immediately sensitive to the harmonies and discords of human expression, in the Self and in companionship with close Others." ~Powers & Trevarthen Demographics Today, there are approximately 40 certified music therapists practicing in Greece (Tsiris, 2011a). According to the 2008 statistics (Papanikolaou, 2011), almost 60% of the music therapists work in special educational settings, 30% work in mental health, and less than 10% work in medical and hospital settings. A small number of music therapists work in early childhood. More than 70% of music therapists are employed parttime; the majority work in large urban areas. Background Information Music therapy is in formative stages of development in Greece. In 2004, the Hellenic Association of Certified Professional Music Therapists (ESPEM, www.musictherapy.gr) was founded and serves as the oﬃcial professional body of music therapists in the country. Music therapy is not part of the National

Health System. Despite its inclusion in the special education law (Law 3699/2008), no state registration for the profession has been achieved yet (Tsiris, 2011a). Most music therapy posts have been established through independent and local initiatives. Currently, there is no full music therapy training program at the state university level, and research is very limited (Tsiris, 2011b). Approaches: Music Therapy & Special Music Education (http:// approaches.primarymusic.gr) is the only Greek journal dedicated to music therapy and special music education. Emphasis on early childhood intervention is increasing. In 2000, Diagnostic, Assessment and Support Centers (Law 2817/2000) were established and provided early childhood intervention services. Expanding the remit of their work and their multidisciplinary teams, in 2008 these centers were renamed as

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Centers for Diﬀerential Diagnosis and Support (Law 3699/2008). Although the law defines that music therapists can work as part of these centers’ multidisciplinary teams, to date no music therapy services have been established in these centers. Sources: Papanikolaou, Ε. (2011). Salutation and introductory speech. Proceedings of the 1st conference of ESPEM. Approaches: Music Therapy & Special Music Education, Special Issue 2011, 9-13. Tsiris, G. (2011a). Music therapy in Greece. Voices: A World Forum for Music Therapy. Retrieved from http://testvoices.uib.no/?q=country-of-the-month/ 2011-music-therapy-greece Tsiris, G. (2011b). Music therapy in Greece: Developing indigenous knowledge and research. In Proceedings of the 1st Conference of ESPEM. Approaches: Music Therapy & Special Music Education, Special Issue 2011, 5-6.

Common Approaches Early childhood music therapy is a new and growing field of practice in Greece. Services are oﬀered mostly to infants and children with learning disabilities, Autism Spectrum Disorder and other developmental disorders. Where appropriate, music therapists work not only with the child, but also with the parents to support healthy parent/child relationships. Music therapy early intervention services are oﬀered mainly in the private sector: in specialized music therapy centers, or in other educational/therapeutic centers. Music therapists collaborate, where possible, with psychiatrists, physiotherapists, speech therapists, psychologists and other professionals. The use of improvisational, participatory approaches to music therapy is common. Sessions are

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oﬀered both in individual or group formats. Most practitioners are qualified as music-centered or psychodynamic music therapists, and their work is informed by relevant theories and approaches. The Dalcroze method and the OrﬀSchulwerk approach to music making are also used in early childhood, but mainly by special music educators working in the field.

Psaltopoulou, D. (2005). The music creative expression as a therapeutic means for emotionally disturbed children. Unpublished Thesis. Aristotle University of Thessaloniki. Etmektsoglou, I. & Adamopoulou, C. (Eds.) (2006). Music therapy and other music approaches for handicapped children and adolescents. Athens: Nikolaidis. About the Authors

Although funding music therapy services is currently a crucial challenge in Greece, recent developments in the field are encouraging. A collaborative research project on music therapy for young children with autism spectrum disorder by the Musical Movement Foundation, a charity dedicated to music therapy and early child development, as well as other current initiatives are promising. Prominent Literature Georgiadi, E. Adamopoulou, C. Papanikolaou, K. Giachni, A. Giouroukou, H., & Dre, V. (2009). The ‘Support and Care through Music’ project: Music therapy as a means of therapeutic intervention for children with autism, with concurrent support of their families. 6th PanHellenic Child’s Psychiatry Congress, Athens, 2009. Papailiou, C. (online). Music therapy in early intervention: Theoretical background and practical applications]. Panhellenic Association of Music Teachers in Public Education. Available at http://langcogdev.blogspot.co.uk/ 2011/05/blog-post_23.html

Giorgos Tsiris is the founding editor of Approaches: Music Therapy & Special Music Education. Since 2011, he is the representative of the Hellenic Association of Certified Professional Music Therapists. Currently, Giorgos works at the Research Department of Nordoﬀ Robbins Music Therapy, and at St Christopher’s Hospice in London, UK. Contact: giorgos.tsiris@gmail.com

Elizabeth Georgiadi is a pianist, music therapist and children’s songs composer. She is the founder of the Musical Movement Foundation and external collaborator of the Specialized Clinic for Children with Autism, Medical School of the University of Athens, “Agia Sophia.” Contact: elizgeorgiadi@gmail.com

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podcasts

2013

Jamie George, MM, MT-BC, Andrew Littlefield, MM, MT-BC, Laurie Peebles, MT-BC, and Andrea Johnson, MT-BC The George Center for Music Therapy, Inc., Atlanta, Georgia The Importance of Performance Opportunities for Young Children During Music Therapy In this collaborative podcast, the George Center’s music therapy team discusses the benefits of providing performance opportunity for young children with disabilities as well as how to create a successful recreational experience for the entire family.

Angela Hughey, BMus Elevation Youth Ensemble Portland, Oregon

Stephan Betz, Ph.D., MT-BC Walnut Creek Music Therapy Walnut Creek, California

Justin Smith, DMA Marylhurst University Portland, Oregon

Josef Held, M.Ed, GCFP Rehabilitation Suedwest, Hamburg, Germany

Strategies for Working with Children's Choirs Working with young children in a choral setting requires planning and careful preparation before the rehearsal begins, which is addressed in this innovative and hands-on video podcast created by a children’s choir director and choral faculty.

The Betz-Held Strengths Inventory: A Music Therapy Assessment Tool This thoughtful audio podcast presents a new music therapy assessment tool created by the authors for toddlers and children with special needs that focuses on positive psychology and building the child’s strengths to succeed in life.

available at imagine.musictherapy.biz imagine 4(1), 2013

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Matt Logan, MA, MT-BC Children’s Hospital & Research Center Oakland, California Ten Essential Skills for Working in Early Childhood Settings In this experiential audio podcast, the author shares musical and clinical skills essential for interns and new professionals when working with young children with disabilities in various settings.

Kalani Das, MT-BC Developmental Community Music Granada Hills, California Petra Kern, Ph.D., MT-DMtG, MTBC, MTA Music Therapy Consulting Santa Barbara, California Drum Games for Preschoolers in Inclusive Classrooms This upbeat audio podcast oﬀers various drumming-based experiences for immediate implementation by early childhood educators during circle time with preschoolers in inclusive classrooms.

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Kamile Geist, MA, MT-BC Ohio University Athens, Ohio Keep a Beat™: A Music Enrichment Program for Early Childhood Educators This informative audio podcast introduces Stephanie, an early childhood educator who oﬀered to be the test person for the Keep a Beat™ (KaB) training model.

Kayla C. Daly, MA, MT-BC Thom Child and Family Early Intervention Services Music Therapist Worcester, Massachusetts Itty Bitty Steps: Individually Tailored Music Therapy Song Interventions This musically enriched audio podcast is a case description and series of song interventions designed to enhance specific skills in a child with rigid tendencies.

Laurel Rosen-Weatherford, MM, MT-BC Monroe County Intermediate School District, Monroe, Michigan Let’s Collaborate This musical audio podcast provides an example of a collaborative project that brings together families through a singalong story performance that includes various therapeutic goals and generalization strategies.

Julia Beth Kowaleski, MTA Private Practice St. Johns, Antigua Five Practical and Creative Ways to Use a Shaker This joyful audio podcast demonstrates how instruments such as shakers can be used in many diﬀerent ways and for various therapeutic purposes with young children.

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resources Expanding Horizons: Finding International Music Rose Fienman, MT-BC California State University, Northridge Los Angeles, California Music therapists continue to face the exciting challenge of working with clients of all ages, diverse ethnic backgrounds, and endless musical preferences. Despite the fact that the world grows smaller every day due to online sources and social media, it is still challenging to identify high quality international music for use in music therapy sessions. The following three databases provide solid information about a wide variety of music and are good starting points for expanding the music repertoire of a culturally aware global music therapist.

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WFMT: International Library of Music Compiled by the WFMT Council members, this library site has four categories: lullaby, rhythm, folk, and pop music. Music therapists working in early childhood will likely find the lullaby section very useful to their practice. All songs are screened by the WFMT Clinical Practice Commission and hyperlinked to YouTube videos for review. The rhythm section provides videos demonstrating rhythms from around the world by renowned percussionists who are also music therapists. This collection is expected to expand each year.

AllMusic This commercial-style site has a substantial international section, which contains a plethora of subsections broken down by geography, ethnicity, and religion. It is a great source for song samples, and some of the songs are linked with Spotify and MOG (music streaming programs). A good spot to search for early childhood repertoire is the childrenâ&#x20AC;&#x2122;s genre, which is further broken down into categories, including childrenâ&#x20AC;&#x2122;s folk, educational, and stories. Music therapists may also find inspiration in the folk, religious, holiday, and Latin sections.

International Music Score Library Project/Petrucci Music Library This database provides an extensive array of free, public domain sheet music. The majority of the available entries are classical music. Music therapists may find the following categories useful: national anthems, folk music, religious music, wedding music, and funeral music. Early childhood music therapists may also find inspiration in the lullaby section. Music is further organized alphabetically and can be searched by melody as well.

About the Author Rose Fienman, MT-BC, is pleased to continue her work with the imagine editorial team in 2013. She practices at the Music Therapy Wellness Clinic at the California State University, Northridge while pursuing a Master of Social Work at USC. Contact: rose.fienman@gmail.com

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Connect: Networks for Parents Deb Discenza PreemieWorld Washington, D.C. Parents learn a lot from one another on social networks. The following selection of support groups keeps parents connected and up-to-date with the latest news and trends. Special Needs (General) Special Kids Support Parents can sign up for the email list to be notified when the site launches. In the meantime parents can also join the Facebook group at http://www.facebook.com/ specialkidscom Attention Deficit Disorder Children and Adults with AttentionDeficit/Hyperactivity Disorder (CHADD) CHADD is the premier organization that advocates on behalf of children and adults with Attention Deficit Disorder. The organization hosts support groups nationwide for those not yet diagnosed and those already diagnosed. ADDitude Magazine (online community) This online community is the forum for the online publication, ADDitude Magazine. The magazine itself oﬀers tips, news, and more for those aﬀected by ADD and those that care for them.

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Autism Spectrum Disorder (ASD): Autism Support Network With the main website devoted to news, resources and general information, the online community has a variety of sections devoted to persons with ASD, family members, partners, as well as membersuggested resources. My Autism Team This online community appears to be the parent’s new “Facebook” social network for life with a child with ASD. Providing access to others, to local resources and professionals, this community even has its own app for smart phones. Cerebral Palsy (CP): CP Family Network This network provides legal and medical resources to empower families with children with CP. It also hosts an online forum to connect people. Down Syndrome National Association for Down Syndrome This organization’s site boasts many benefits such as a discussion forum, information, resources and direct support to those in the Chicago metropolitan area.

Sensory Processing Disorder (SPD): SPD Foundation Parents new to Sensory Processing Disorder or looking for connections will find them at this website, which contains news and information as well as a parent-to-parent connection for in person meetings worldwide. About the Author Deb Discenza is the mother of a 30weeker preemie now nine years old and the author of The Preemie Parent’s Survival Guide to the NICU. Contact: ddiscenza@gmail.com www.PreemieWorld.com

Premature Baby/Child Inspire Preemie Support Forum For parents with a child born prematurely, this online forum hosts a number of “rooms” for discussion from “In the NICU” to “Going Home” to “School and Beyond.” It also has specialty areas for fathers, preemies with Cerebral Palsy and more.

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publications New Publications 2012-2013 Compiled by Petra Kern, Ph.D., MT-DMtG, MT-BC, MTA Editor-in-Chief, imagine

The following list features a selection of publications related to early childhood music therapy released in 2012–2013. Brown, L., & 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. Geist, K., Geist, E., & Kuznik, K. (2012). The patterns of music. Young Children, 67(1), 74-79. Haslbeck, F. B. (2012a). Music therapy for premature infants and their parents: An integrative review. Nordic Journal of Music Therapy, 21(3), 203-226. Haslbeck, F. B. (2012b). Research strategies to achieve a deeper understanding of active music therapy in neonatal care. Music and Medicine 4(4), 205-214. Henning, I. (2012). Music therapy with premature infants: Insights and recommendations from the current literature and a German pilot project. Canadian Journal of Music Therapy 18(1), 26-44. Kalas, A. (2012). Joint attention responses of children with autism spectrum disorder to simple versus

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complex music. Journal of Music Therapy 49(4), 430-452. Kern, P., & Humpal, M. (Eds.) (2012). Early childhood music therapy and autism spectrum disorders: Developing potential young children and their families. Philadelphia and London: Jessica Kingsley Publishers. Kern, P. (2012). Musicoterapia con niños pequeños con TEA y sus familias para una mejor calidad de vida. [Enhancing lives: Music therapy for young children with autism spectrum disorders and their families]. In M. Mercadal-Brotons & P. Martí Augé, P. (Eds.). Música, musicoterapia y discapacidad [Music, music therapy and disability], (pp.195-207). Barcelona: Editorial Médica JIMS. Loewy, J., Stewart, K., Dassler, A. M., Telsey, A., & Homel, P. (2013). The eﬀects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics, 131(5), 902-918. Malloch, S., Shoemark, H., Crncec, R., Newnham, C., Paul, C., Prior, M., & Burnham, S. (2012). Music therapy with hospitalized infants: The art and science of communicative musicality. Infant Mental Health Journal, 33(4), 386-399. Parsons, C. (2012). Augmentative and alternative communication during music therapy sessions with persons with Autism Spectrum Disorders. Journal of Clinical Practice in Speech-Language Pathology, 14(2), 105. Pasiali, V. (2012). Supporting parent-child interactions: Music therapy as an intervention for promoting mutually responsive orientation. Journal of Music

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Therapy, 49(3), 303-334. Register, D., Hughes, J., & Standley, J. M. (2012). The sounds of emerging literacy: Music-based applications to facilitate pre-reading and writing skills in early intervention. Silver Spring, MD: AMTA. Saylor, S., Sidener, T. N., Reeve, S. A., Fitherston, A., & Progar, P. R. (2012). Effects of three types on noncontingent auditory stimulation on vocal stereotypy in children with Autism. Journal of Applied Behavior Analysis, 45(1), 185-190. Schwartzberg, E. T., & Silverman, M. J. (2012). Effects of pitch, rhythm, and accompaniment on short-and long-term visual recall in children with autism spectrum disorders. The Arts in Psychotherapy, 39(4), 314-320. Standley, J. M. (2012a). A discussion of evidence-based music therapy to facilitate feeding skills of premature infants: The power of contingent music. The Arts in Psychotherapy, 39, 379-382. Standley, J. M. (2012b). Music therapy research in the NICU: An updated meta-analysis. Neonatal Network, 31(5), 311-316. Thomson, G. (2012). Family-centered music therapy in the home environment: Promoting interpersonal engagement between children with autism spectrum disorders and their parents. Music Therapy Perspective, 30(2), 109-116. Walworth, D., Standley, J. M., Robertson, A., Smith, A., Swedberg, O., & Peyton, J. J. (2012). Effects of neurodevelopmental stimulation on premature infants in neonatal intensive care: Randomized controlled trial. Journal of Neonatal Nursing, 18(6), 210-216. Walworth, D. (2013). Bright Start Music. A Developmental Program for Music Therapists, Parents, and Teachers of Young Children. Silver Spring, MD: AMTA.

We invite colleagues from around the world to send their early childhood music therapy references for future inclusion in this annual list.

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Using music for learning in children's daily life Parent and Teacher Training Autism Spectrum Disorder Inclusion Programming Musical Playgrounds/Outdoor Play Innovative Project Development Evaluation of Clinical Practice Mentoring/Coaching Online Teaching International Issues/Perspectives

Contact: Petra Kern, Ph.D., MT-DMTG, MT-BC, MTA

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reviews 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. 304 pages. ISBN: 978-1-84905- 241-2. $39.95 This book is written by some of the most prominent clinicians and researchers in the field of music therapy. Co-edited by Petra Kern and Marcia Humpal, this publication oďŹ&#x20AC;ers the most current view of music therapy in early childhood and autism spectrum disorder (ASD) with a strong emphasis on evidence-based practice. It provides a broad overview of recognized treatment approaches for children with ASD including applicable research substantiation. A detailed summary of music therapy intervention research that supports evidencebased treatment modalities is provided. Clinical examples shared by the authors further demonstrate the practical applications of music therapy interventions designed to meet the needs of this population. Information on the assessment process, eďŹ&#x20AC;ective strategies and service delivery is also included. The book concludes with a wealth of resources including websites, books, research, and technology.

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This book is divided into five parts that include Introduction and Research, Assessment and Goals, Treatment Approaches, Collaboration and Consultation, and Selected Resources. Within each part, authors have contributed chapters that detail music therapy practice of the highest standard as it relates to the most eďŹ&#x20AC;ective means of supporting learner outcomes. Each chapter concludes with review questions assisting the reader in understanding critical elements of the information provided. In Part 1, the authors provide a comprehensive overview of ASD including core characteristics, diagnosis and interventions. Evidence-based practice is defined and discussed with implications for the practice of music therapy. Specific treatment approaches that have been identified as EBP by national organizations are provided along with examples of supporting music therapy research. The authors emphasize that whether the service is consultative or direct, music therapists need to make well-informed practice decisions. To this end, Kern has outlined a five-step process for making informed clinical decisions based on current research. Part 2 provides information on music therapy assessments including a rationale for conducting assessments and an overview of many of the tools currently in use for children with ASD. The authors focus on three models used in special education settings designed to 1) determine eligibility, 2) provide information about student needs and strengths, and 3) help generate treatment goals. An overview of each model is given with

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clear steps for implementing the tool, interpreting the results, and developing appropriate goals based on the data. While these assessments are non-standardized, the authors who have developed these tools have used them successfully in their respective school districts to provide a consistent rationale for recommending music therapy services for their students with ASD. Treatment approaches that are described in Part 3 include Applied Behavioral Analysis, Social Stories™, Nordoff-Robbins Music Therapy, and DIR®/Floortime™ model. The underlying principles for each of these approaches are explained and the clinical process is outlined by each respective author. Case vignettes and specific song strategies clearly illustrate the goals and the therapeutic environment unique to each approach. A discussion of supporting research and future directions also are included. The editors conclude this section with examples of strategies and techniques used in EBP that should be considered when designing interventions for young children with ASD. Particular attention is given to organizing the learning environment, supporting language with alternative modes of communication, and promoting peer interaction. In Part 4, the reader learns how collaborating with professionals and family members increases understanding of the whole child and enhances music therapy practice. Chapter 10 takes the reader through the process of referral, assessment, program implementation, and termination of music therapy services for a child in an inclusive childcare program. Specific scenarios describe the importance of collaboration with both the family and the interdisciplinary team to determine the type of service delivery and treatment plan that will best meet the developmental needs of the student. In Chapter 11 the author gives a thorough overview of research related to speech and language deficits as well as a description of effective behavioral techniques developed to improve language learning. Finally, she emphasizes the importance of communicating with speech and language pathologists and other team members to assure effective collaboration and learning across environments. Chapter 12 provides the reader with a clear understanding of sensory processing challenges and their impact on learning and behavior. Examples of evidence-based

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strategies are cited that can be used to facilitate participation in daily routines as well as ideas for collaboration between music therapy and occupational therapy to develop interventions that meet sensory needs and maximize learning. Chapter 13 identifies specific behavioral, communication and sensory challenges that impact the home environment and offers tips to parents for effectively using music strategies to help manage those challenges. Chapter 14 includes interviews with parents who describe what living with ASD has taught them about advocacy, hope, partnership, support and love. Hearing their stories strengthens our own insights and compassion, increasing our effectiveness as helping professionals. Finally, in Part 5, the co-editors provide the reader with a collection of resources including a list of professional organizations, technology tools for clinical application, and an annotated bibliography. Early Childhood Music Therapy and Autism Spectrum Disorders is a book whose importance cannot be overestimated in light of today’s focus on ASD and evidence-based practice. It is a rich resource that challenges readers to increase their knowledge of the treatment approaches that are currently supported by research, examine their work in light of the evidence supporting specific modalities, and inform their own practice accordingly. Petra Kern and Marcia Humpal have provided us with a book that is balanced, well informed and critical to our understanding of the young child with ASD.

Listen to my audio bookmarks! About the Author Beth McLaughlin is a music therapist and internship supervisor at Wildwood School. She has 36 years of experience working with young children with autism and complex learning disabilities. Contact: bmclaughlin@wildwoodprograms.org

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The Sounds of Emerging Literacy: V H

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Music-Based Applications to Facilitate Pre-Reading and Writing Skills in Early Intervention

Dena

PhD,

MT-BC

•

Jane

Hughes,

•

Jayne

Standley,

PhD,

MT-BC

Register, D., Hughes, J., o Standley, J. M. (2012). The y sounds of emerging literacy: Music-based applications to facilitate pre-reading and writing skills in early intervention. Silver Spring, MD: AMTA. 184 pages. ISBN: 978-1-884914-29-4. $65.00 and $50.00 for AMTA Members.

A welcome addition to the early childhood and music therapy literature, the primary purpose of this book is to give early childhood teachers, music teachers, and music therapists a resource when using music in their early childhood classrooms to meet the literacy and academic needs of their students. However, other consumers such as educational administrators, researchers, music education and music therapy professors, pre-service music educators, pre-service teachers, and music therapy students might also benefit from this publication. The idea that music experiences function to support academics in early childhood is well supported in the literature. Until now, how music works to support literacy in a developmentally appropriate manner and thus can be applied in an educational setting has been a bit elusive. Register, Hughes, and Standley have successfully filled this gap by providing an easy-to-read/ understand, concise, and easy-to follow textual background about literacy learning for young children. They relate how music uniquely connects to emergent literacy. Special hints are given to non-musicians for overcoming fears of using music in their classrooms as well as helpful adaptations for children with special needs. The majority of the book includes numerous clearly written applications. These are divided into the following categories: Intervention Type, Greeting, Transition, and Closing Applications; Sing and Chant; Listen and Play; and Listen and Move. Each application includes a title, therapeutic objective, therapeutic use of music, materials, procedures, extensions to the application, and adaptations if applicable. The book also contains lead sheets with chord names, melody, and lyrics plus write music score. The authors often give hints

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to readers who may not be able to read the music (e.g., page 70 “The Farmer Plants the Seeds” sung to the melody of “The Farmer and the Dell”). The authors also provide information on assessment instruments, resources and reference materials, children’s books and/or recordings needed in applications. A glossary of terms both from literacy and musical terminology completes the book. An area that seems to be lacking is providing more accessible music information that might increase the book’s value for early childhood educators who may have limited musical experience. For example, a teacher who cannot read music may not be able to grasp the melody of the song “What do we wear in the winter time?” (p. 96). Providing a recording or alternate suggestions such as chanting the song might be helpful. However, to provide this adaptation, the early educator would benefit from having ‘how to’ supportive material (e.g. descriptions of “chanting” or “reading simple rhythms”) presented earlier in the book. Expansion of the section on musical elements (p. 10/11) (e.g., adding simple information about basic music concepts and musical adaptations) might be helpful. The authors’ intention to empower everyone working with young children to use music for enhancing emerging literacy skills is both current and relevant. The Sounds of Emerging Literacy successfully realizes this goal, making the use of music in classrooms less daunting and more accessible to readers of many backgrounds and skill levels. Listen to my audio bookmarks! About the Author Kamile Geist, MA, MT-BC is Associate Professor of Music Therapy at Ohio University. Her research interests include how to teach educators on using music and rhythm to support learning strategies in their classrooms. Contact: geistk@ohio.edu

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World Congress of Music Therapy 2014 www.musictherapy2014.org

Cultural Diversity in Music Therapy Practice, Research, and Education

7 – 12 July 2014 Krems/Vienna Austria/Europe

Topics include: Multicultural perspectives of music therapy practice, research and education Impact of cultural values and awareness in music therapy practice and education researchers and practitioners

Call for Papers: April – August 2013 Registration: June 2013 – June 2014

enhancing the healthcare system New developing areas of clinical practices and populations served Recent research outcomes related to music therapy practice

www.musictherapy2014.org or email wcmt2014@fh-krems.ac.at

Congress Organizer

www.musictherapy2014.org imagine 4(1), 2013

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imagine.magazine Â www.imagine.musictherapy.biz

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