imagine 2017 by imagine

imagine.magazine Fall 2017 l Vol.8, No.1

2017 your resource for early childhood music therapy imagine 8(1), 2017

editor-in-chief Petra Kern, Ph.D., MT-BC, MTA, DMtG contributing editor Marcia Humpal, M.Ed., MT-BC editorial assistance Gretchen Chardos Benner, LMSW, MT-BC Dana Bolton, M.Ed., MMT, MT-BC Ashley Miller, MM,MT-BC editorial support Ellary Draper, Ph.D., MT-BC Laura Brown, Ph.D., MT-BC business manager & design production Petra Kern, Ph.D., MT-BC, MTA, DMtG publisher de la vista publisher

about imagine imagine is an annual online magazine sharing evidence-based information and trends related to early childhood music therapy through various media.

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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 children's corner 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 audio podcast photo story, or invited teaching episode for more details, visit our website at www.imagine.musictherapy.biz next submission deadline April 15, 2018

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online shop Visit the imagine online shop and purchase the 2017 issue of imagine as an e-book. All issues of the imagine magazine are available for immediate download. advertise in imagine imagine is the perfect place to advertise your products and services to music therapists, early childhood music educators, daycare providers, service providers, administrators, higher education faculty, and of course, parents. 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.

imagine.magazine

Editorial

Technology and Interactive Media: Facing 21st Century Learning in Early Childhood Music Therapy Today, digital media literacy is essential for young children of all abilities. While play will always be vital for children’s development, technology and interactive media oﬀer new opportunities for learning, communication, collaboration, and creativity. Digital devices and apps are now commonplace household tools, accessible anywhere at any time. However, are these digital tools being used intentionally and in an engaging way, encouraging learning and development? In this issue, authors explore the “what, when, with whom, where, why, how, and how much” questions regarding technology and interactive media use in music therapy practice with young children of all abilities. Empowering parents to engage their children in meaningful ways, music therapists can model quality screen time, connect screen experiences to real life, use media to encourage children’s creativity and curiosity for learning, and promote a positive family media ecology at home.

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

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In the 2017 featured multimedia article, Nicole Rivera interviews Chip Donohue, Director of the Technology in Early Childhood Center at the Erikson Institute and a senior fellow of the Fred Rogers Center for Early Learning and Children’s Media. “Empower children to use technology as a tool for 21st century learning” is one of the ten tips he shares in the “Wisdom” section, along with a wealth of resources to explore – similar to the six listserves shared by Young Exceptional Children’s columnist, Camille Catlett. Dana Bolton, the imagine editorial assistant and mom of 3-year-old Jack, contributes a vivid and data-driven reflection of technology and interactive media use with young children that includes organizational position statements, careful considerations, and digital life skills for music therapists. This year’s imagine “Practice” and “Podcast” sections highlight the application of innovative technology and interactive media within music therapy sessions and daily business operations. Lori Gooding describes the ins and outs of digital documentation, while Rachel Rambach shares tools and apps she uses to run an efficient music therapy practice. More useful apps for music therapy practice (i.e., AUMI, behavior management apps, the App Wheel, and Music Together’s Family Music Zone and Hello Everybody app) are introduced by seven authors. Four contributions focus on the therapeutic impact of audio recordings in different settings (i.e., NICU, pediatric unit, early intervention, and community) and provide guidelines and instructions for implementation. New technology such as Point Motion, Makey Makey®, hightech innovations for ASD as well as MOXI’s Giant Guitar, Reactable by Foley Studios, and Weather Orchestra may inspire music therapists to offer cutting-edge early childhood music therapy services. Podcasts by Beth McLaughlin, Katie Myers, Hannah Jade Watson, and Dawn Sandel give additional examples of purposeful technology use in music therapy practice, as do the tips for parents in the “ParentsCan” section. An infographic sums up basic considerations for using technology and interactive media with young children.

The annual research snapshot, 2016-2017 publication list, and book reviews help keep readers informed. In addition, this issue includes innovative research reports. Amy Roberts writes about blogging as a new way to educate primary caregivers in the NICU. For the first time, Michael Detmer and his team share their awardwinning research on infants with neonatal abstinence syndrome; a news report about this work has gone viral with over 9.6 million views to date. Readers may also be interested in the data-based infographic on how music therapists work with young children worldwide (Petra Kern and Daniel Tague). The current issue covers the university-based news report about an intergenerational music therapy study (Michael Detmer and Petra Kern) and an overview of the forthcoming PINPOINT study (Katherine Myers-Coﬀman, Amanda Henley, and Sheri Robb) that is funded by a $1.4 million grant and has garnered much interest in music therapy. Finally, imagine authors share conference reports (from NAECY, AMTA, INSAR, and WFMT), featuring latest trends applicable to early childhood. Elizabeth Schwartz provides an US policy update and oﬀers a passionate opinion letter encouraging readers to take action and be responsible advocates on behalf of the children and families we serve. “We the People are United in Music in Order to Form a Perfect World” – an infographic created by our youth artist, Madeleine Walworth, using an iPad drawing app – is spot on. In a technology- and media-driven world, we must stay abreast of innovations that make lives better; however, we must never forget that human interactions, creativity, and play are essential for healthy child development and the nurturing of compassionate world views in our youngest citizens. Sincerely,

Don’t forget to check out our 15 new intervention ideas and visit imagine’s “Unlimited” section (i.e., color of us, photo stories, favorites, children's corner, and teaching episodes) on the imagine website.

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CONTENTS inside this issue editorial

Technology and Interactive Media: Facing 21st Century Learning in Early Childhood Music Therapy Petra Kern............................................................

wisdom

10 Tips For Using Technology and Interactive Media With Young Children Chip Donohue...................................................... 10

reflection

reports

Expanding Circles: One Small Voice 2016 NAECY Annual Conference Report Elizabeth K. Schwartz.......................................... 12 Under the Canopy: The Music Therapy Profession 2016 AMTA Annual Conference Report Madison Whelan, Holly Hankin and Kelly Morgan........................................................ 14 International Meeting for Autism Research 2017 INSAR Annual Conference Report Petra Kern............................................................ 18

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Moving Forward With Music Therapy: Inspiring the Next Generation 2017 WFMT World Congress of Music Therapy Catherine Farquharson........................................ 21 Taking Action in Times of Uncertainty 2016/2017 Policy Update USA Elizabeth K. Schwartz.......................................... 24 Infographic: We The People Madeleine Walworth............................................ 27

Technology and Interactive Media: Considerations for Music Therapists Dana Bolton......................................................... 28

featured

Using Technology and Interactive Media With Young Children: An Interview With Chip Donohue Nicole Rivera....................................................... 36

research

2017 Early Childhood Research Snapshot Andrew Knight...................................................... 42 The PINPOINT Study: Understanding the Role of Engagement Katherine Myers-Coﬀman, Amanda K. Henley, and Sheri L. Robb............................................... 46 The Adaptive Use Musical Instrument (AUMI): A Useful App for Inclusive Practice Abbey Dvorak and Sherrie Tucker....................... 48 Blogging: The New Way to Educate Amy Robertson................................................... 52 The Eﬀect of NICU Music Therapy on the Symptoms of Infants with Neonatal Abstinence Syndrome Michael R. Detmer, Darcy DeLoach, K. Dawn Forbes, and Rebekah Gossom............................ 54 Infographic: How Do Music Therapists Work With Young Children? Findings from an international survey of music therapists worldwide Petra Kern and Daniel B. Tague.......................... 59 Young and Old Together: Implementing an Intergenerational Music Therapy Program Michael R. Detmer and Petra Kern...................... 60

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parents can Tips for Parents Developing Melodies Music Therapy................. 108 Tips for Parents Annapolis Music Therapy................................... 110

intervention ideas

practice Digital Documentation in Early Childhood Music Therapy Settings Lori F. Gooding.................................................... Apps for Behavior Management in Early Childhood Music Therapy Amelia Ehmling, Melissa Deaton, and Olivia Swedberg Yinger.................................................. Apps to Enhance Learning in Children With Autism Spectrum Disorder Edward Todd Schwartzberg................................ Extending the Therapeutic Impact of Music in the NICU Through Developmentally Appropriate Recorded Music Michael R. Detmer............................................... Heartbeat Songs for Pediatric Patients with a Terminal Diagnosis Katherine E. Goforth............................................ On Permanence: Audio Recording in Music Therapy Ilene Berger Morris..............................................

Keeping it Current: New High-Tech Innovations to Use With Children With Autism Spectrum Disorder Holly M. Hankin................................................... 92 New Technology: Point Motion and Music Therapy Charlay Yates....................................................... 98 Makey Makey®: Creating a Digital, Sensory, and Music Experience James Maxson.................................................. 100 Infographic: Technology and Interactive Media use in Early Childhood Music Therapy Sarah Hallgrimson.............................................. 102 MOXI Makes Music Magic Ron Skinner and Danielle Harlow....................... 103

76 79 84

It’s Time for Music Michael R. Detmer and Petra Kern.................... How Do We Say Hello? Petra Kern and Michael R. Detmer..................... We’re All Done With Drumming Michael R. Detmer and Petra Kern.................... Goodbye to You My Friend Petra Kern and Michael R. Detmer.................... When I Need Help Samantha Hinson............................................... Let’s Say Some Kind Things Samantha Hinson.............................................. Musical Garden Kelsey Norris...................................................... Calm Necessities A’Marie Rust...................................................... Going to the Store,Hooray! Christina Koenig................................................ The Fruit and Veggie Song Christian Patterson............................................ Beautiful Planet Audrey Weatherstone........................................

112 113 114 115 116 117 118 119 120 121 122

Animals Are Everywhere! Emily Cooley...................................................... Please and Thank You Ethan Gross....................................................... Hot, Hot, Hot Lydia Heitman.................................................... Five Little Snow Flakes Dawn Stewart....................................................

123 124

resources

125 126

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publications Early Childhood Music Therapy Publications 2016–2017 Christopher R. Millett........................................ 138

Roundtable: Moving Forward with Inclusion Programing Worldwide Petra Kern......................................................... 128

podcasts

Using Technology to Support Communication in the Music Therapy Classroom Beth McLaughlin............................................... 130 Music Therapy: The Intersection of Play and Technology Katie Myers....................................................... 130 A Day in the Life: The Role of Technology in Running an Early Childhood Music Therapy Practice Rachel Rambach............................................... 130 Supporting Parents and Young Children Through Interactive Media Carol Ann Blank................................................. 130 Just the Basics – Apple Music 101 Hanna Jade Watson........................................... 131 #MTBaby: Music Therapy with Generation Tech Dawn M. Sandel................................................ 131 Todos Hacemos Música–We All Make Music Ralf Niedenthal.................................................. 131

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Hot Oﬀ the Press: Electronic Resources to Support Your Work Camille Catlet.................................................... 132 Curated Resources on Technology and the Young Child Technology in Early Childhood (TEC) Center at Erikson Institute................................. 134

reviews

Myers, K. (n.d.). Painting the Piano!: An Adapted Piano Songbook. Retrieved from: http:// www.musictherapyebooks.com/downloads/ painting-the-piano/ Bethany Wilker.................................................. 140 Jessica Kingsley Publishers (2017). Music Therapy with Families: Therapeutic Approaches and Theoretical Perspectives. London, UK Kelsey Norris..................................................... 141

Visit our website www.imagine.musictherapy.biz Like us on facebook https://www.facebook.com/ ECMT4U Follow us on twitter @imagineECMT Follow us on instagram imagineecmt View all issues online at www.issuu.com

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WISDOM Chip Donohue, Ph.D.,Â is Dean of Distance Learning and Continuing Education and Director of the TEC Center at Erikson Institute in Chicago, and a Senior Fellow and Advisor of the Fred Rogers Center for Early Learning and Children's Media at Saint Vincent College.

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Chip Donohue

10 Tips For Using Technology and Interactive Media With Young Children 1.

Remember that relationships matter most — Using technology with young

children begins with low tech, high-touch opportunities for interactions, shared experiences, discoveries, and joint-engagement with media. 2.

Integrate technology use into social and emotional learning — Technology should be used in ways that support positive social interactions, mindfulness, creativity, and a sense of initiative.

Empower children to use technology as a tool for 21st century learning — Select technology that encourages inquiry, exploration, discovery, documentation, and demonstration of what they know.

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Make media use a language-rich experience — Narrate your own use of technology and talk to children about what they are doing when they are using screen media; ask questions, make comments, and suggest what they can do after the screen is turned oﬀ.

Trust your instincts — Focus less on how many minutes a child engages with screen media and more on the quality of the content, the context for using media, and the level of engagement.

are engaging and interactive; include positive interactions with others; give the child control; emphasize interactions, language use, and relationships; and invite co-viewing and joint engagement with media.

Use technology as a tool — Technology is one more important tool you can put in children’s little hands for exploring, learning, and creating; it is not more or less important than other tools children use to learn in the early years.

Provide beneficial technology experiences — Oﬀer media experiences that

Help children progress from just consuming media to creating it — When paired with the curiosity and creativity of a child, simple tools like a digital camera can become powerful media creation tools.

Pay attention to your own technology use in front of children — Children learn media habits and how and when to use technology by observing the important adults in their lives.

10.

Be a media mentor — Young children need to be safely guided in the digital age by trusted adult role models who are active and intentional media mentors.

REPORTS

2016 NAEYC Annual Conference Expanding Circles: One Small Voice November 2-5, 2016 I Los Angeles, California

Elizabeth K. Schwartz, MA, LCAT, MT-BC Raising Harmony: Music Therapy for Young Children

The National Association for the Education of Young Children (NAEYC) is a membership organization devoted to promoting high quality learning for children birth through eight, providing professional development, leadership training, a widely-recognized system of accreditation standards, and extensive research and practice resources. The mission of NAEYC also seeks to influence local, state, and federal legislation to ensure equal access to quality, developmentallyappropriate early childhood education for all children (www.naeyc.org). Thousands of early educators, preschool teachers, classroom assistants, support staﬀ, parents, and administrators gathered in Los Angeles, California from November 2-5, 2016 for the annual conference, wearing distinctive red and blue conference badges to support the organization’s message that young children deserve attention.

A Familiar Face

Held just days before the 2016 US presidential election, the conference featured a non-partisan phone bank initiative to encourage people from all across the country to get out and vote. The slogan Early Ed for President united participants in advocating for young children and their families.

NAEYC organized hundreds of concurrent session options into special tracks, with certain presentations designated as President’s Featured Sessions. Sticking with the theme of social justice that wove its way through the conference, a number of these featured sessions gave a glimpse into the significant barriers that many children and families face when trying to access early education. One of the most powerful was

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The conference started oﬀ with a highly personal and motivating keynote address by “Maria” from the early education program Sesame Street. Actress Sonia Manzano, known as Maria for over 40 years, has spent a lifetime fighting for quality early education. Her topic, E is for Equality, supported the overall theme that ran through the entire program, that all young children deserve equal access to education. Manzano’s Hispanic heritage helped to shine a spotlight on NAEYC’s Grandes Comienzos initiative which strives to make sure that Spanish-speaking children and families are included in high quality educational programming and trainings. Over 40 sessions were held in Spanish, and Manzano’s speech was simultaneously translated in Spanish and Mandarin.

What’s Really Going On?

entitled Elevating Our Power to Create a More Just World and was a very open and thought-provoking examination of power, influence, and social change. NAEYC President Tammy L. Mann, Valora Washington of the Council for Professional Recognition, and Sherri Killins of the BUILD Initiative led work groups, honest discussions, and strategy building exercises to help audience members recognize how interpersonal, institutional, and structural biases in early childhood education limit not only children and families, but our society. To follow up, several concurrent sessions provided models of practice that sought to reverse the trend of exclusion due to poverty, race, injustice, or social class. An example was a program from Orange County, California, called Safe from the Start, a collaborative eﬀort that combines law enforcement, medical, educational, faith-based, community, and therapeutic agencies in reducing early exposure to violence. More information on this program can be found at http://www.ocde.us/OCSFTS/Pages/ default.aspx.

piedmont music therapy, llc Proudly serving Greater Charlotte area of the Carolinas

Founded in 2013 by Gretchen Chardos Benner, LMSW, MT-BC

Where Do We Go From Here? The focus of NAEYC during the 2016 conference on social justice and equality is an opening for music therapy and music therapists to bring their services to the wider early childhood community. Personal experience at this conference showed that one small voice can make a diﬀerence. Instead of feeling insignificant, my role as a music therapist was met throughout this large and influential organization with understanding, respect, and eagerness to have more of us join in their eﬀorts. While membership in NAEYC provides a number of benefits to music therapists, including access to resources and advocacy, membership can also help the leadership and members of NAEYC understand and draw on the resources that music therapy and music therapists can bring to young children, families, educators, and communities.

Melissa Reinhardt

Perrin Jones

Ashley Tisdale

About the Author Elizabeth K. Schwartz is the Co-Founder and Director of Education and Training at Raising Harmony™: Music Therapy for Young Children. She blogs on music therapy and early childhood music at www.Raisingharmony.com and www.SproutingMelodies.com. Contact: Elizabeth@raisingharmony.com

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www.piedmontmusictherapy.com

2016 AMTA Annual Conference Under the Canopy: The Music Therapy Profession November 10-13, 2016 I Sandusky, Ohio

Madison Whelan, MT-BC, Holly Hankin, MT-BC, Kelly Morgan, Music Therapy Student University of Louisville, Louisville, Kentucky

Hundreds of professional music therapists, music therapy students, and vendors attended the annual conference of the American Music Therapy Association (AMTA) in November, 2016. The program included numerous presentations and continuing education courses in addition to business meetings and networking opportunities. This report highlights selected early childhood music therapy sessions attended by the three authors.

Summarized by Madison Whelan

Working with Parents and Adult Caregivers in Early Childhood Music Therapy Andrew Knight, Ph.D., MT-BC and Carol Ann Blank, MMT, MTBC

This presentation focused on the Music Together Within Therapy program. The presenters stressed the importance of including parents and caregivers in sessions so that they learn strategies and techniques for use at home. This may support meaningful interactions and children’s skill generalization in the natural environment. In a family-centered approach, the music therapist should assess the needs of the child and empower parents to use music for learning and development. Encouraging parents to actively participate

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in sessions allows them to learn how to use music intentionally and in a spontaneous, playful way. This presentation involved several music-making opportunities using songs from the Music Together curriculum to demonstrate how to include parents in a music therapy session.

Summarized by Madison Whelan

imagine Presents: Advocacy for Early Childhood Music Therapy

Petra Kern, Ph.D., MT-BC, MTA, DMtG; Marcia Humpal, MEd, MTBC; Rose Fienman, MSW, MT-BC; Gretchen Chardos Benner, LMSW, MT-BC, Dana Bolton, MEd, MMT, MTBC; Ashley Miller, MT-BC, and selected authors What should a […] know about early childhood music therapy with […]? This roundtable presented by the imagine editorial team highlighted how music therapists may serve as representatives, spokespersons, ambassadors, or advocates for early childhood music therapy. Key topics featured from the 2016 imagine online magazine included: a reflection on eﬀective advocacy strategies in the past, present, and future; a letter from a child describing her/his perspective of a music therapy session;

a checklist for parents on high quality music therapy services and resources to use at home; short advocacy essays addressing early childhood music therapy matters around the world; and Parent testimonials and tips for parents from parents. The presentation concluded with an advocacy quiz that identified participants’ unique advocacy style and tips on how to use individual strengths in advocating for early childhood music therapy.

Summarized by Madison Whelan

Neurologic Music Therapy Techniques for Children with NeuroDevelopmental Disorders

Hayoung A. Lim, Ph.D., MT-BC and Hyun-Jung Lee, Ph.D., MT-BC This presentation addressed common neurologic music therapy (NMT) techniques used with children with neurodevelopmental disorders, including autism spectrum disorder, attention-deficit hyperactivity disorder, cerebral palsy, and Down syndrome. The NMT approach focuses on using naturally occurring elements of music (e. g., rhythm, form, and melodic patterns) to elicit specific responses within the brain, thereby producing a particular response from a client. The presenters referenced recent literature published from the fields of neuroscience and music therapy as a rationale for using basic principles of NMT (e.g., rhythmic motor training, rhythmic entrainment, rhythmic auditory stimulation, musical attentional control training, and musical executive function training). Frequent goal areas addressed by NMT within this population include cognitive, speech and language (communication), sensorimotor, and social/emotional behavioral goals. The presenters also showed video clips and used live audience participation to demonstrate the application of diﬀerent NMT techniques within a clinical setting.

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Summarized by Madison Whelan

Creating Songs with Therapeutic Intention for Early Childhood and School Aged Clients Elizabeth Schwartz, MA, LCAT, MT-BC

This presentation focused on using elements of music as an agent of change within a clinical setting. By understanding how these elements (e.g., dynamics, mode, meter, lyrics, and form) along with the inherent organizational and structural properties found within music can be used to elicit a particular response, a music therapist can keep young children engaged and focused during sessions. The elements of music were compared to “ingredients,” with music therapists, who are trained to understand the impact of music and how to use it for therapeutic change, being the “cooks.” Audience participation was encouraged during the session, and frequent demonstrations of songs and the musical elements within were used to reiterate how and why music can be a powerful therapeutic tool.

Summarized by Kelly Morgan

Unanticipated Findings from a Parent-Delivered Active Music Engagement Study Sheri L. Robb Ph.D., MT-BC and Amanda Henley MM, MT-BC

This presentation addressed findings from a music engagement pilot study. The study was conducted with the thought that reducing child stress during cancer treatment would also reduce parent stress. In other words, if stress symptoms are managed, one can hopefully reduce long-term stress symptoms in survivorship. In the study, parents in the experimental group were trained over the course of three days to implement certain elements of music-based therapeutic play at home when their children were discharged from the hospital. The training consisted of three sessions, each becoming more parent-led. Parents in the control group were given audio-storybooks to enjoy with their children. The participants in each group were given 30 days at home to implement their respective therapeutic

elements and instructed to rate their experiences over the course of the 30 days. Overall, the parents with the Active Music Engagement (AME) training utilized the activities more often than the parents with the audiostorybooks, and child stress levels decreased. However, the parents with the AME training reported higher stress levels over the 30 days than the parents with the audiostorybooks. Although parents reported enjoyment of being able to have a connection through music, it seemed as though placing parents (rather than a therapist) in the role of facilitator added one more caretaking duty that increased parental stress.

Summarized by Holly Hankin

Need Support? Let Us “Prop” You Up! Elizabeth Buckmaster, M.Ed., MTBC and Susan Hegedus, M.Ed., RMT

This presentation oﬀered a rationale for using visual supports and materials with young children with disabilities in a music therapy session. First, the presenters referred to research-based benefits such as improved communication, emotional expression, sustained attention and focus, reducing anxiety, and increasing understanding of abstract concepts (Roa & Gagie, 2006). Second, the presenters shared several intervention ideas including song sheets, interactive boards, picture cues, apps, games, worksheets, and others. Finally, they shared the following link to access the materials: https://www.dropbox.com/ sh/u6szvw9mhdt0q1x/AADUkt8Q2iSKwxK53xhYWREa?dl=0. Rao, S.M. & Gagie, B. (2006). Learning through seeing and doing: Visual supports for children with autism. Teaching Exceptional Children, 38(6), 26-33.

Summarized by Holly Hankin

Expanding Potentials: Music Therapy with Cochlear Implant Recipients Ages 1-18

Laura Pawuk MM, MT-BC This presentation featured materials, intervention ideas, and descriptions of working with children who have cochlear implants. The presenter

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demonstrated that music and language share the elements of volume, tempo/speed, timbre/sound quality, and prosody/melody. Therefore, music can be an eﬀective tool for teaching speech skills to young children with cochlear implants. Music can help teach the diﬀerence between loud and soft, and foster structure and on-task behavior. It can also set the child up for success via repetition embedded in song lyrics or melodies, and create predictability to build selfconfidence and self-esteem when completing tasks. The presenters shared the following helpful resources from fellow music therapists: BabyBeats: https://advancedbionics.com/us/en/ campaign/babybeats.html TheRhythmTree: DVD, CD, and Songbook; http:// www.therhythmtree.com Christine Barton MT-BC: christinebarton.net and https://thelisteningroom.com About the Authors Madison Whelan, MT-BC, a NICU Music Therapist and graduate from the University of Louisville, currently works as a contract music therapist in Tallahassee, Florida and is pursuing a Master's degree in music therapy from Florida State University. Contact: madison.whelan@hotmail.com Holly Hankin, MT-BC is a music therapist from Cincinnati, Ohio, and a graduate of the University of Louisville. She currently serves populations in southern Indiana as a member of the Sweet Behavior, LLC team. Contact: hollymariehankin@gmail.com Kelly Morgan, originally from Oklahoma, is a senior music therapy student at the University of Louisville in Kentucky. Contact: kamorg03@louisville.edu

imagine authors and readers, come and see the imagine editorial team at the

imagine Happy Hour

Thursday, November 16, 2017 from 6-7 PM at the St. Louis Union Station Hotel

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INSAR 2017 Annual Conference International Meeting for Autism Research May 10-13, 2017 I San Francisco, California

Petra Kern, Ph.D., MT-BC, MTA, DMtG Music Therapy Consulting, Santa Barbara, California

The Annual Meeting of the International Society for Autism Research (INSAR) oﬀered a global platform for hundreds of scientists from various disciplines to discuss novel ideas and discoveries related to Autism Spectrum Disorder (ASD). This year, members from over 40 countries met in San Francisco, California. The exceptional amount of scientific discoveries, methods, and technologies was evident in over 1,600 preconference workshops, keynotes, panels, special interest group meetings, oral sessions, and topic-specific poster sessions that elicited lively discussions among the participants. A “Tech Demo Session” explored 30 researched technology innovations. This report showcases six selected tech innovations that could be of interest to early childhood music therapists working with children with ASD and their families.

Autism Navigator®: Using Implementation Science to Improve Global Access to Early Detection and Intervention of ASD

C. Nottke, E. Kaiser, C. North, M. Nottke, D., JonesEllis, S. Mazzatenta, L. Newton, J. L. Stapel-Wax, N. J. Chambers, J. Woods, A. Klin, and A. M. Wetherby (USA)

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Given the raising worldwide prevalence rate of Autism Spectrum Disorder (ASD), gaining global access to reliable tools supporting healthcare providers in detecting early signs of ASD and identifying eﬀective early interventions is essential. Developed at the Florida State University’ Autism Institute, the Autism Navigator® oﬀers a collection of web-based courses and tools with video illustrations for medical, social service, families, and intervention systems. Within the Autism Navigator®, users have access to the following tools: Primary Care, Smart Early Screening for Autism and Communication (ESAC), an E-Co-System, resources of the FIRST WORDS Project, the 16-by-16 Lookbooks and Social Communication Growth Charts and more. Users from over 100 countries have accessed the tool since its launch in 2015. Easily accessible through mobile devices, the Autism Navigator® is a valuable resource for early childhood music therapists worldwide who wish to expand their competences in ASD.

Autism Focused Intervention Resources and Materials (AFIRM): Supporting Teachers’ Use of EBPs

Sam, A. W. Cox, S. L. Odom, A. Zembo, and V. Waters (USA)

Selecting and implementing Evidence-Based Practices (EBP) for individuals with ASD seems to continuously challenge practitioners from various fields. Established at the Frank Porter Graham Child Development Institute, the e-learning resource AFIRM (Autism Focused Intervention Resources and Modules) provides selfpaced learning modules on the 27 evidence-based practices identified by the National Professional Development Center on Autism Spectrum Disorder (NPDC). Each video module includes step-by-step guides, implementation checklists, tip sheets, and data sheets which users have rated highly useful and relevant to their work. Early childhood music therapists who are unsure how to embed evidence-based practices in their music therapy sessions may find the modules and accompanying resources helpful in improving their services for children with ASD and their families.

A Smartphone Application to Measure Response to Name in Everyday Environments

R. P. Thomas, L. A. Wang, J. Miller, J. W. Pennington, S. Hassan, A. Grasmeder, J. Swanick, and N. Minyanoum (USA) Several ASD assessment tools use children’s response to their name as an indicator for the level of severity of the diagnosis and subsequent treatments. Yet, the method of data collection seems to be more an assessor’s or parental judgment than a data-based outcome. This data-tracking device, developed at the Children’s Hospital of Philadelphia’s Center for Autism Research, measures children’s response rate to their names by recording data in the natural environment and throughout the day. The app includes a picture-based tutorial as well as video recording and text file uploads. Parents who field-tested the app implemented the trials with great fidelity and thought that it was meaningful. Should the app be released to the public, early childhood music therapists could use the app to contribute to an accurate diagnostic profile and to measure change during treatment.

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JEMImE, a Serious Game to Teach Emotional Facial Expressiveness for Individuals with Autism Spectrum Disorder

S. Hun-Billiaut, S. Serret, J. Bourgeois, P. Foulon, D. Cohen, C. Grossard, O. Grynszpan, F. Askenazy, A. Dapogny, S. Dubuisson, L. Chen, and K. Bailly (France) Emotion recognition, expression, and interpretation in social context are primary challenges for children with ASD. Developed by an interdisciplinary research team in France, the JEMImE project tackles the issue through a game-based computer software that includes avatars. First, children with ASD are encouraged to imitate emotions such as joy, anger, and sadness modeled by an avatar. Second, children are invited to produce one of these facial expressions on request within or without social contexts. This innovative computer software allows for real-time automatic detection and evaluation of children’s facial expression and gives feedback on the quality of the emotional response. As a next step, the researchers suggest to field-testing the computer software. Early childhood music therapists may be interested in engaging in this process that may yield opportunities for intervention and evaluation.

Child-Directed PlayBased Identification of Sensory Preferences: A Report on the Sensory Toy Box Experience with ASD and Typically Developing Children

S. Valencia, M. Mademtzi, P. E. Ventola, K. Chawarsaka, and F. Shic (USA) Sensory issues may lead to unique sensory preferences in children with ASD. Therefore, researchers at the Yale Child Study Center and Seattle’s Children’s Research Institute developed a prototype of an interactive Sensory Toy Box to assess sensory preferences in children with

ASD as compared to those who are typically developing. The device can be activated in nine diﬀerent ways by pressing a button, touching a texture, or placing an object on the toy box; each activation is recorded while giving auditory or visual feedback as a response. Preliminary outcomes suggested that children with ASD had higher engagement with the device than their typically developing counterparts, especially in the visual feedback mode. Should the Sensory Toy Box become a product, music therapists may use it as an assessment tool for determining sensory preferences of their young clients with ASD.

My Hospital Story: A Hospital Narrative App K. Blakeslee, C. Wilkinson, K. Diezel, C. Mauras, N. Goodman, S. Al Ayubi, N. Gujral, and B. Resner (USA)

Medical visits and procedures may cause anxiety in children with ASD and their families due to the unpredictable environment. This mobile app, developed at the Boston Children’s Hospital, provides 13 hospital narratives spanning over six departments (i.e.,

Developmental Medicine, Psychiatry, Neurology, Surgery, Audiology, and Phlebotomy). Each story uses images and step-by-step text illustrations and allows users to enter the little patients’ names and gender. The app is currently being pilot-tested at the department of audiology. The researchers hope to prepare children with ASD and their families for a positive medical visit by lowering anxiety levels, increasing coping skills, and removing barriers to care. If this or a similar app becomes available, music therapists could develop, a medical music therapy narrative that includes sound samples. For more information (including session recordings, abstracts, and the program book), please visit INSAR’s Meeting Archive at http://www.autism-insar.org/page/ IMFARarchives. About the Author Petra Kern, Ph.D., MT-BC, MTA, DMtG, business owner of Music Therapy Consulting, is Adjunct Associate Professor at the University of Louisville, serves as editorin-chief of imagine and sits on CBMT’s Board of Directors. Specializing in ASD, Dr. Kern has been a member of INSAR since 2011. Contact: petrakern@musictherapy.biz

The next INSAR 2018 Annual Meeting will be in Rotterdam, Netherlands from May 9-12, 2018.

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WFMT 2017 15. World Congress of Music Therapy Moving Forward With Music Therapy: Inspiring the Next Generation July 4-8, 2017 I Tsukuba, Japan

Catherine Farquharson, Bachelor of Music Therapy Shenandoah University, Winchester, Virginia

In July 2017, more than 2,800 people from 49 countries attended the 15th World Congress of Music Therapy in Tsukuba, Japan. Brimming with opportunities to learn from numerous clinicians, researchers, students, and interns worldwide, this international event was also filled with Japanese hospitality, ceremonies, and traditional music. The following summary report reflects six notable presentations related to early childhood music therapy topics.

N. Suzuki (Japan)

Practice of Medical Music-Care for Children with Developmental Disorders

This workshop introduced a medical music-care intervention facilitated by Dr. Suzuki and her colleagues at the Tsukuba Clinic for Mentally Sick Children & Adolescents. The approach combined training cerebellar function with developing communication, social, and behavioral skills in children with developmental disorders. A typical session outline included children greeting each other, followed by music therapists accompanying children with songs. The songs in use were composed from a neurological practice standpoint to enhance cerebellar function. For example, children were musically guided to stand on one foot, step with/without arm swing, and working on tandem gait (i.e.,

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walking from heel to toe). Creating an errorless learning environment along with positive reinforcement seemed to be key to the success of the presenterâ&#x20AC;&#x2122;s intervention.

C. Moloney (Australia)

Speech Pathologists and Music Therapists: An Interdisciplinary Partnership Supporting Children with Hearing Impairments

This paper presentation discussed preliminary research outcomes related to speech and language development in children with hearing impairments. This study aimed to address the following goal: to gain insight into the experience of speech pathologists collaborating with music therapists to develop speech and language for children with hearing impairments. Speech pathologists co-facilitated group therapy sessions with babies and toddlers with cochlear implants with the goals of teaching them how to interpret sounds they hear and to formulate speech. Using a qualitative method, data were collected through interviews with speech pathologists and evaluated using a thematic analysis. In the interviews, many speech pathologists commented on how well the music therapy goals and interventions aligned with the speech goals. The speech pathologists found themselves working towards the same goals as

the music therapists, but in diﬀerent ways. Participants noted that music provided motivation for the children, as it is a natural way to interact with people, and created a positive environment that encouraged children to work towards speech goals. Preliminary outcomes suggest that collaboration between music therapy and speech pathology at an early intervention center can be useful in developing listening and social skills, providing motivation, and creating a positive learning environment.

M. Fuller and R. McLeod (Australia)

“What’s That Sound?” Tele-Intervention Music Therapy for Young Children with Hearing Loss

This paper presentation discussed the emergence of tele-intervention music therapy programs that could potentially reach children across Australia. Teleinterventions are becoming increasingly popular as a way of providing therapeutic services to families who live in rural locations because they allow clients to have access to specialists. To explore the benefits of tele-intervention music therapy programs, the presenter established a partnership with an organization that provided services to children with hearing impairment and their families. The research team evaluated three models of the teleintervention (i.e., Workshop Model, a Weekly Model, and a Mixed Model). The intervention was oﬀered via videoconferencing platforms (i.e., Skype, Lync, Zoom, and Lifesize), face-to-face sessions, or a mixture of both. Each tele-intervention session was led by registered Australian music therapist and supported by contributing language specialists. The overall goals of the program focused on encouraging positive parent-child interactions, supporting early learning and child development, creating opportunities for creative fun time, and supporting theory of mind goals. The preliminary outcomes of this study depicted a positive trajectory for tele-intervention music therapy programs as indicated by a) favorable feedback on the programs from parents/care givers and b) potential for increased parent-child interaction outside of music therapy sessions. Challenges with tele-intervention music therapy programs included sound delay, diﬃculty with

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responding in the moment, and limited opportunity for dialogue in group settings.

G. A. Thompson (Australia)

Music Therapy with Young Children on the Autism Spectrum: Partnership with Parents

This presentation discussed meaningful and valuable experiences of music therapy interventions for preschoolers with autism spectrum disorder (ASD) from a parent perspective. To address challenges related to this neurodevelopmental disorder, contemporary service delivery directly involves the family. In Australia, a family-centered approach in which early interventionists partner with parents is considered “best practice.” A family-centered approach in music therapy emphasizes collaboration and family participation. Children, parents, and siblings can participate in activities that are not only motivating and engaging, but essential in providing opportunities for learning in the home environment and across family members. Throughout the implementation of music therapy interventions, the music therapist prioritized facilitating quality interactions between family members, respecting the family’s wishes, and promoting the sustainable use of music.

P. J. Winter (USA)

Interprofessional Music Therapy and Speech/ Language Therapy for Preschool-Aged Children and their Caregivers

This oral presentation discussed the impact of interdisciplinary relationships between music therapists and speech pathologists at Radford University’s Preschool Language Lab. This lab works with preschool aged children who have speech and language disorders including ASD, cochlear implants, polymicrogyria, phonological disorders, developmental apraxia of speech, and sensory processing disorders. At the center, children are immersed in a musical and language-filled

environment focused on the development of play, communication, and peer to peer social interactions. Speech pathologists and music therapists in the Language Lab work together to support the achievement of developmental milestones for children, providing opportunities for social interaction, acquisition of speech/language skills, and emotional exploration through play focused interventions. Speech pathology goals address perception and production of speech, detection of sound, recognition of sound, and understanding the meaning of sounds; music therapy goals support speech goals, provide opportunities for creativity, and provide opportunities for social and musical interactions. Music therapy is vital in supporting these goals as the music holds attention, provides structure, and allows for both speech and language goals to be integrated within music experiences.

M. Ettenberger (Colombia)

Family-Centered MT in the NICU: Culture(s), Clinical Practice and Research in Colombia

This presentation started with background information on Neonatal Intensive Care Unit (NICU) music therapy in Columbia. Music therapy is still an emerging field and is not a common form of treatment

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in medical settings in Columbia. Due to the research and pioneering of clinical practice in various NICUs, music therapy is now available in three main hospitals in Bogota, Columbia. The key focus of this presentation was to discuss social, cultural, and structural realities when establishing NICU music therapy services in a country that did not previously have a strong presence. Similarities between the culture of Columbia and the core values of music therapy include a) importance of family structures, b) social relationships, c) music and ‘musicking.’ These aspects have the potential to influence how music therapy in the NICU can be developed, how it will be received, and how it will continue to grow. Besides cultural aspects, the presenter suggested that evidence-based practice and continued research will be essential in establishing more music therapy programs in Columbia and beyond. The 2020 World Congress of Music Therapy will be in South Africa followed by the 2023 in Australia. About the Author Catherine Farquharson recently received her Bachelor of Music Therapy at Shenandoah University, Virginia and completed her internship at Children’s National Health Systems in Washington, D.C. This fall she begins work with school-aged children and adults in Albany, New York. Contact: cfarquha12@su.edu

2016/2017 Policy Update USA Taking Action in Times of Uncertainty May 15, 2017 I Wakefield, Massachusetts

Elizabeth K. Schwartz, MA, LCAT, MT-BC Alternatives for Children, Long Island, New York

The past year has been marked by policy uncertainty and concern over legal and regulatory supports for young children and their families. Shifts in administrative, congressional and regulatory leadership present us, as early childhood professionals, with the opportunity for taking action to assure that all children and families are given access to safe environments, quality healthcare, and appropriate education. The updates below give a brief overview of some of the key areas of new law or proposed change.

Education Every Student Succeeds Act (ESSA) The Every Student Succeeds Act (ESSA) was signed into law on December 10, 2015 and reauthorizes the Elementary and Secondary Education Act (ESEA) of 1965. The original law was meant to assure education for all children as a civil right. ESSA will now replace the prior reauthorization known as No Child Left Behind or NCLB. ESSA 2015 continues the focus on high academic standards for all learners, access to quality educational programs, emphasis on early learning through increased access to high quality preschool, and continued measures for accountability.

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ESSA 2015 provides for expanded Preschool Development Grants as well as a renewed focus on family engagement and high risk groups. In October of 2016, the Department of Education released guidance on how ESSA aﬀects early learning programs. The entire document can be found at https://www2.ed.gov/policy/ elsec/leg/essa/essaelguidance10202016.pdf. The document states in part: The Department’s strategic goal for early learning is to improve the health, social-emotional, and cognitive outcomes for all children from birth through third grade. This will ensure that all children, particularly those with high needs, are on track to graduate from high school college- and career-ready. This guidance is intended to remind State and local decision-makers about the importance of investing in early learning, highlight the opportunities available under the law to strengthen early education, and provide examples of how States and local communities may support young children’s success in school.

ACTION

Respond to requests for comments and suggestions as regulations under ESSA are written and implemented.

Individuals with Disabilities Education Act (IDEA) It is important to be aware that The Individuals with Disabilities Education Act or IDEA, last reauthorized in 2004, is still in effect. All of the regulations and clarifications on music therapy provision under IDEA also are still in effect. For further information, visit https:// sites.ed.gov/idea/.

ACTION

Knowing current law and regulations is essential to insure local schools and programs maintain adherence to the safeguards of IDEA.

Federal Department of Education The Federal Department of Education changed leadership early in 2017. A number of new initiatives have been proposed that will impact early services. One possible change may be an increase in the number of charter schools. To learn more about how children with disabilities would be aﬀected by this change read: https://www2.ed.gov/policy/speced/guid/idea/ memosdcltrs/faq-idea-charter-school.pdf. Organizations that advocate for young children, such as NAEYC (www.naeyc.org); Zero to Three (www.zerotothree.org); and Council for Exceptional Children (https://www.cec.sped.org/) are monitoring actions by the new head of the Department of Education. Join one of these larger groups to gain up-todate information and action plans.

ACTION

Healthcare

of the Council for Exceptional Children (http://www.decsped.org/) among others.

ACTION

Keep apprised of proposed changes to healthcare and voice your opinion to legislators through letters, email, phone call or meetings.

Safety Being safe and secure in the environment is key to physical, mental, emotional, social and academic health for young children. Poverty, violence, and discrimination all contribute to unsafe environments. All of the organizations listed above monitor legislation and practices that may aﬀect the safety of children and families. Individual actions that support safe communities can be extremely eﬀective. Join local groups that promote social justice, tolerance, inclusion and community. Step up on a daily basis to confront bigotry, discrimination and exclusion.

ACTION

About the Author Beth practices music therapy in New York State and frequently presents on issues relating to music therapy in public education. She is currently Chair of the Education and Training Advisory Board of the American Music Therapy Association and a member of the New York State Task Force on Occupational Regulations. Contact: ekschwartzmtbc@gmail.com

The current state of healthcare funding in the United States is fluid and complex. A number of proposed changes could have a significant and negative impact on young children and families. Of particular concern is the move to change Medicaid, often the lifeline for seriously ill young children. Up-to-date advocacy eﬀorts that support access to quality healthcare for babies, infants and toddlers can be found through the American Music Therapy Association (https://www.musictherapy.org/ policy/grupdate/ ) and at the Division of Early Childhood

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I Can’t Shut the Door

Elizabeth K. Schwart

Anymore: An Opinion

z, MA, LCAT, MT-BC

The room where I practi ce music therapy is lar ge and spacious and welcoming aura. Every bright with beautiful ins day I am enveloped wit truments and a h my clients in this almost sac can happen. As the ch red place where wond ildren and families wa erful things lk in, I turn and carefully hope and help. And thi shut the door, giving us s is the way it has been a pri vat e home for for many, many years. relationships in. I shut I shut the door. I shut everything else out. My ou r litt le cir cle of world was enclosed an clients. As a music the d embedded in the he rapist, I thought I was re and now of my be ing eth ical and professional an most often relieved to d thorough. The familie open up about the ch s were allenges outside the clin give thoughts and solut ic door. I would listen ions. But when they cro an d em pa thi ze and ssed the threshold, I sta them well but not join yed inside the room, sile ing hands or choosing ntl y wis hing to travel on with them. At night, I would move into my cozy home an d watch the 6:00 news to be one dimensiona . The images on the TV l, but I would catch my screen seemed self drawing the link be children that I had jus tw ee n the terrible topics of the t recently played with. day and the Poverty, disease, hung fooled myself into think er, violence, bigotry, de ing that the moments po rta tio n, injustice. I of relief that came in ou enough. I was using my r music therapy sessio profession as a defen ns we re somehow se, somehow making because I was helping an excuse for my silenc in a small way. In my job e on the big issues , I would encourage my my own life, I feared the clients to be brave, to conflict and discord tha risk , to change. In t would come from sp past year, though, the eaking out in a wider po door will no longer sta litic al arena. This y shu t against the tide of politic States. The challenges al change that has sw facing my clients are no ep t the United w a flood of policy an cause greater harm. Ou d legal moves that ca n and will directly r sacred space is threa tened. More importantl aloft are now being thr y the safeguards that own away like a crump have held our clients led piece of paper in sw irling storm runoff. I can’t shut the door an

ymore. As a music therapist tha t cares for children an d their families, I need space. I need to be wil to see my role as bigge ling to step up and ou r than the clinic t. I ne ed to understand the politic harm my clients. I need al and legal events tha to have an opinion. I ne t will help or ed to support what is confronting politics, be right for my clients. I ne cause my clients and ed to be brave in the ir fam ilies often don’t have the that for themselves. I resources or the stami need to be brave. I ne na to do ed to open the door an d step boldly into the my legislators – local, fray. I need to contact regional, statewide an d federal. I need to ma social media. I need to ke my thoughts know attend gatherings to vo n in newspapers and ice my opinions. The iss on beyond the politics of ues that I need to care party. They should be ab ou t sho uld ab be out people. Here are so embrace. me that I know I will no w need to Education: Our children need fair access to qu ality education. I can’t advocate for renewal shut the door anymore of the education rights , so I will for children under the Ind safe, free and public qu ividual with Disabilities ality education for all thr Ed uc ation Act; oughout the United Sta education. tes; and equitable acce ss to higher Healthcare: Our childr en and families need ac cess to healthcare. Ou reliable source of food. r children and families Our children and familie need to have a s need support for qualit anymore, so I will advo y childcare. I can’t shut cate for universal healt the door hcare; Women Infants Service; funding for Me and Children (WIC) Fo dicaid; and childcare od an d Nutrition subsidies. Safety: Our children an d families need to be safe from violence and to have a safe place to bigotry. Our children an live. Our children and d families need families need to feel saf community. To help my e fro m being excluded from children and families fee their home or l safe, I need to engage and tolerance. I need in politics that support to understand and pro inc lusiveness mote reasonable and anymore, so I will advo just immigration polici cate for safe neighborho es. I ca n’t shu t the door ods; gun control; cultu immigration system. ral and gender equality and a fair I can’t shut the door an

ymore. How about yo

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INFOGRAPHIC About the Author: Madeleine Walworth is our youth artist who created this illustration with an iPad drawing app for imagine 2017. She lives with her family in Louisville, Kentucky.

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REFLECTION Using Technology and Interactive Media: Considerations for Music Therapists Dana Bolton, M.Ed., MMT, MT-BC Bolton Music Therapy Murfreesboro, Tennessee

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Growing up, the most sophisticated pieces of technology in my home were a black and white television set, a few cassette players/recorders (including my well-loved Fisher Price tape player), a Show â&#x20AC;&#x2DC;N Tell record player that showed filmstrips on an attached screen, and a Texas Instruments keyboard console that hooked up to a television where I could play educational games from cartridges. When I compare that to my home now, and the technology that my 3year-old son is growing up with, it astounds me: color flat screen television, Blu-ray/DVD player, gaming console, multiple laptop and desktop computers, portable DVD player, tablets, and smartphones. I can use my phone as a TV, radio, computer, calculator, level, wallet, library, gaming system, camera, video camera, navigation system, watch, alarm clock, weather radio, voice recorder, and mirror, and it all fits in my pocket. I can order food, buy groceries, deposit checks, and even remote start a gas pump across town for my husband without ever leaving my living room.

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In recent months, a new term was coined for my generation, born between 1977 and 1983 (Curtis, 2017). Xennials grew up with an analog childhood and adolescence, but easily adapted to the digital age as young adults. Generations are increasingly defined by their attitudes toward and use of technology. Baby Boomers and Generation X can be described as “digital immigrants” (Prensky, 2001) who have learned to use technology to varying degrees of fluency, while still maintaining their pre-digital age “accent.” In contrast, Millenials are considered “digital natives,” having never known life without advanced computer technology. So how can we as music therapists, spanning all these generations, with varying attitudes toward and aptitude for technology, help today’s generation of young children strike a balance between “unplugged” play and learning how to use technology in a meaningful and responsible way?

What Does the Research Say? Much research has been conducted on the effects of screen media on young children (Zero to Three, 2014; Campaign for a Commercial-Free Childhood, 2012). When applying this research, readers must be aware of how each study defines “media,” as it can include television/movie viewing, tablets, computers, or handheld devices. One area of research has focused on whether children are able to learn academic, language, and social-emotional skills through media usage. Studies have found that children can transfer learning to the real world after multiple demonstrations on screens (Barr, Muentener, & Garcia, 2007; Brito, Barr, McIntyre, & Simcock, 2012), but will learn faster with face-to-face, real-world interactions (Barr & Hayne, 1999; Troseth & DeLoache, 1998; DeLoache, et al., 2010). Video modeling has been used with young children with Autism Spectrum Disorder as an effective means to teach play (D’Ateno, Mangiapanello, & Taylor, 2003; Hine & Wolery, 2006; MacDonald, Clark, Garrigan, & Vangala, 2005) and communication skills (Wert & Neisworth, 2003). Active parental involvement during media usage enhances the transfer of learning by helping children make connections between what they see on a screen and what happens in the real world (Zack, 2010) and can mitigate the detrimental effects of media exposure on language development (Mendelsohn, et al., 2010).

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Interactive television programs in which characters speak directly to children, label objects, and invite children to respond have shown a positive impact on language development (Linebarger & Walker, 2005). While some interactive media can help children learn, having too many options to click on, such as in e-books, could distract children from the storyline and impair their comprehension of the story (Parish-Morris, Mahajan, Hirsh-Pasek, Golinkoff, & Collins, 2013). Conversely, another study found no difference between comprehension of e-books and paper books, with engagement levels being higher for e-books (Lauricella, Calvert, & Barr, 2014). An iPad app was an effective tool for teaching phonological skills to young children with developmental delays (Chai, Vail, & Ayres, 2014). A recent study found that preschoolers who watch the PBS show Daniel Tiger’s Neighborhood and discussed content with parents showed higher levels of socialemotional skills such as empathy, self-efficacy, and recognition of emotions (Rasmussen, et al., 2016). In light of this research, PBS released the Daniel Tiger for Parents app this year to give parents concrete strategies on how to use songs and clips from the show to enhance the social-emotional development of their child (http:// pbskids.org/apps/daniel-tiger-for-parents.html). Parents are most frequently concerned with the effects of the total amount of “screen time” and are bombarded with news articles and social media posts on the topic. Research on the effects of amount and duration of media exposure almost always studies the effects of television viewing (Zero to Three, 2014), thus having limited applicability to the interactive media that is the focus of this issue. There is research that indicates duration of daily TV exposure negatively impacts the language development of children in low-income families (Tomopoulos, et al., 2010); other studies dispute that association among middle-class families (Schmidt, Rich, Rifas-Shiman, Oken, & Taveras, 2009; Linebarger, Barr, Lapierre, & Piotrowski, 2014). Attention problems may result when children have high levels of media usage (more than 7 hours per day) (Christakis, Zimmerman,

DiGiuseppe, & McCarty, 2004; Foster & Watkins, 2010) or when they are exposed to violent and nonviolent “entertainment” programs (Zimmerman & Christakis, 2007). Several studies note that merely having a television on in the background distracts children’s play and learning and impacts the quality of parent-child interactions (Ackerman & Brown, 2010; Barr, Lauricella, Zack, & Calvert, 2010; Schmidt, Pempek, Kirkorian, Lund, & Anderson, 2008; Kirkorian, Pempek, Murphy, Schmidt, & Anderson, 2009). Fast-paced programs also can negatively impact executive functioning skills (Lillard & Peterson, 2011). A final area of research has looked at the effects of media exposure on the physical health of young children. Longer durations of television watching and use of touchscreens are associated with disrupted sleep schedules (Thompson & Christakis, 2005; Cheung, Bedford, De Urabain, Karmiloff-Smith, & Smith, 2017). Viewing violent content is linked to sleep problems in young children (Garrison, Liekweg, & Christakis, 2011), while replacing that content with age-appropriate educational and prosocial content mitigates those effects (Garrison & Christakis, 2012). Several studies have found increased media usage to be a risk factor for childhood obesity (Jackson, Djafarian, Stewart, & Speakman, 2009; Manios, et al., 2009; Epstein, et al., 2008; Dennison, Erb, & Jenkins, 2002; Anderson & Whitaker, 2010).

What Do Early Childhood Organizations Say? Several organizations devoted to the health and development of children have released position statements and recommendations on the use of media and technology with young children. Perhaps the best known, the American Academy of Pediatrics (APA, 2016) recommends no use of digital media (with the exception of video-chatting) for children younger than 18-24 months. If digital media is used, it should be of high quality and used in conjunction with parental interaction. For children ages 2 to 5 years of age, the AAP recommends limiting screen use to 1 hour per day of high-quality programming that parents watch with their children. Other recommendations include avoiding fastpaced programs and violent content, turning oﬀ devices when not in use, employing other strategies to help

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children calm down, monitoring content and usage, creating media-free zones and times such as bedrooms and mealtimes, turning screens oﬀ 1 hour before bedtime, and developing a Family Media Use Plan. Other organizations recognize that technology is an integral part of the daily lives of young children and take a more balanced approach in their recommendations, acknowledging that parents need guidance on how to use it in a meaningful way. The National Association for the Education of Young Children (NAEYC) and the Fred Rogers Center for Early Learning and Children’s Media (2012) make a distinction between interactive media (i.e., allowing for active and creative use and encouraging social interaction) and noninteractive media (i.e., involving only passive viewing). They take the position that not all screens are equal, and thus each type of screen (tablet, smartphone, computer, television, etc.) needs its own set of criteria for best usage. Early childhood educators are encouraged to view technology and interactive media as tools that can be used to address developmental and learning goals within the context of a well-designed, developmentallyappropriate educational program. The use of screens for children under the age of 2 is discouraged. However, some forms of technology may be appropriate, such as video chatting with family, looking at e-books with parents, and utilizing some interactive apps. Early childhood educators and administrators must develop their own media and digital literacy skills to determine which forms of technology are appropriate based on the age, developmental level, and cultural and linguistic characteristics of the children they serve. Technology and media should never supplant active exploration or social engagement. Teachers should be intentional with their use of technology and explore ways it can enhance the development of young children. Furthermore, teachers are advised to ensure that adaptations are made to allow children with disabilities to have equal access to technology. NAEYC and the Fred Rogers Center acknowledge the unique role that teachers have in educating parents about appropriate use of

technology in the home environment. Whether in the classroom or the home setting, all decisions regarding the use of technology and interactive media should be made in the context of developmentally appropriate practice. Zero to Three released their Screen Sense guidelines in 2014, stating that quality, content, and context are more relevant than quantity when it comes to evaluating screen use for young children. They recognize that there is no research to support independent media use to enhance development in children under the age of 2. Zero to Three recommends parents ensure children have plenty of opportunities for play and exploration in the real world, are involved during children’s media use to create language-rich and interactive experiences and to help children make connections to real-world learning, choose content carefully with a focus on interactive experiences

How Are Young Children Using Technology? The Erickson Institute (2016) conducted a national survey of 1000 parents and found that only 15% of children under the age of 6 did not access technology at home, with most of those children being under the age of 3. Eighty-four percent of parents engaged with technology with their child, with most doing so between one-half and 3 hours per day. Parents of children under age 3 were more likely to express negative feelings about their use of technology with their children. Over half of parents felt that educational technology benefited their child’s school readiness in areas such as academics, language, and computer skill development. Parents also expressed the following concerns with children’s technology habits: too much screen time, inappropriate content, commercial messages, reducing active play and outdoor time, and sleep disruption. Parents reported seeking advice from pediatricians, family members, and early childhood teachers about technology use for young children.

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and limit fast-paced programs, and focus on storylines rather than technological features. Other recommendations for helping children develop healthy media usage habits include removing screens from children’s bedrooms, limiting snacking and eating during screen time, and limiting adult use of devices in the presence of children.

What Should Music Therapists Do? Technology is here to stay and is an integral part of the daily lives of young children. As early childhood service providers, music therapists are in a position to help guide families and young children through the digital age. In this issue’s Featured Article, Chip Donohue, Ph.D., Director of the Technology in Early Childhood Center at the Erikson Institute and a senior fellow of the Fred Rogers Center for Early Learning and Children’s Media, discusses music therapists’ roles as “media mentors” in the lives of young children and gives practical suggestions of how this can be achieved. Music therapists also can have a voice in the development of a standardized definition of developmentally appropriate technology use as advocated by the RAND Corporation (Daugherty, Dossani, Johnson, & Wright, 2014). Music therapists should consider these elements of developmentally appropriate practice when incorporating interactive media into therapy sessions: When? Carefully consider how to incorporate technology into a session without interrupting the music making process or creating a distraction. With whom? The key to interactive media is being interactive. Engage in technology with clients rather than letting them use it independently. Where? Model for and teach parents how to incorporate technology and interactive media wherever it is appropriate during daily routines. Use it as a way to extend therapy goals into the home setting. Why? Technology use should always be meaningful and purposeful. Never use technology just for the sake of using it. Music therapists can demonstrate technology as a tool for running their business or collecting data, a means of connecting with a child, a novel way to introduce concepts, or an avenue of communication with families.

How? Consider the features of the device being used and ensure that it is safe and appropriate for clients. Purchase cases to protect devices from damage. Consider what adaptations may be necessary to make the device accessible to all children, regardless of their ability or disability. How much? Technology can enhance interventions, but should never supplant a child’s experience with social interactions or playing real musical instruments (unless there are extenuating circumstances such as infection control precautions that limit a child’s ability to interact with real instruments). As a profession, music therapy is represented by professionals who span multiple generations and display a wide range of technological aptitude. To be eﬀective media mentors, we must first assess and develop our own “digital intelligence” or DQ (Park, Jun. 2016; Park, Sep. 2016). DQ can be broken down into the following eight digital life skills: digital identity, digital use, digital safety, digital security, digital emotional intelligence, digital communication, digital literacy, and digital rights (see sidebar). These skills are especially essential to this generation of young children growing up as “digital natives” who are in need of mentors to teach them these skills. As music therapists in early childhood, we are in a unique position to model these behaviors and assist families as they navigate the digital age with their young children.

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Digital Life Skills: Tips for Music Therapists

1. Digital identity (Creating and maintaining your online presence and reputation): Use your personal and business social media profiles in ways that demonstrate respect for all people and reflect a commitment to honesty and integrity. 2. Digital use (Having the skills to use technology and develop healthy digital habits): Work with assistive technology specialists to ensure that children of all ability levels can access developmentally appropriate technology. 3. Digital safety (Avoiding or limiting online risks and inappropriate content): Preview all media before using in a session, even seemingly innocent videos of children’s songs on YouTube. 4. Digital security (Recognizing cyber threats and keeping personal information and data safe): Use HIPAA-compliant documentation tools to ensure safety and confidentiality of client information. 5. Digital emotional intelligence (Displaying empathy and developing positive online relationships): The Daniel Tiger for Parents app (http://pbskids.org/apps/daniel-tiger-for-parents.html) provides a library of short, catchy tunes that can be used in therapy and at home to remind children to use and practice socialemotional skills in a variety of situations, from sharing toys to expressing feelings of frustration and anger. 6. Digital communication (Communicating and collaborating with others through online digital technologies): Help children email audio and video recordings of original compositions or of themselves singing or playing instruments to parents, teachers, or other important people. This will help the child take pride in their achievements and share them with others, as well as facilitate collaboration of therapy goals between multiple settings. 7. Digital literacy (Developing skills in critical thinking, computational thinking, and content creation): Teach children to use digital tools to create their own songs and compositions. Choose an interface to match the developmental level of the child. 8. Digital rights (Honoring the personal and legal rights of others): Ensure that proper releases have been signed before sharing any photos, videos, or audio recordings of children on social media or other platforms. Respect parents’ wishes regarding their child’s digital footprint.

References AAP Council on Communications and Media. (2016). Media and young minds. Pediatrics, 138(5). Retrieved from http:// pediatrics.aappublications.org/content/early/ 2016/10/19/peds.2016-2591 Ackerman, B. P., & Brown, E. D. (2010). Physical and psychosocial turmoil in the home and cognitive development. In G. W. Evans & T. D. Wachs (Eds.), Chaos and its influence on children’s development: An ecological perspective (pp. 35-48). Washington, DC: American Psychological Association. Anderson, S. E., & Whitaker, R. C. (2010). Household routines and obesity in US preschool-aged children. Pediatrics, 125, 420-428. Barr, R., & Hayne, H. (1999). Developmental changes in imitation from television during infancy. Child Development, 70, 1067-1081. Barr, R., Lauricella, A., Zack, E., & Calvert, S. L. (2010). The relation between infant exposure to television and executive functioning, cognitive skills, and school readiness at age four. Merrill Palmer Quarterly, 56, 21-48. Barr, R., Muentener, P., & Garcia, A. (2007). Age-related changes in deferred imitation from television by 6to 18-month-olds. Developmental Science, 15, 812-816. Brito, N., Barr, R., McIntyre, P., & Simcock, G. (2012). Long-term transfer of learning from books and video during toddlerhood. Journal of Experimental Child Psychology, 111, 108-119. Campaign for a Commercial-Free Childhood, Alliance for Childhood, & Teachers Resisting Unhealthy Children’s Entertainment. (2012, October). Facing the screen dilemma: Young children, technology and early education. Boston, MA: Campaign for a Commercial-Free Childhood; New York, NY: Alliance for Childhood. Retrieved from http:// www.commercialfreechildhood.org/screendilemma Chai, Z., Vail, C. O., & Ayres, K. M. (2014). Using an iPad application to promote early literacy development in young children with disabilities. Journal of Special Education, 48(4), 268-278. Cheung, C. H. M., Bedford, R., De Urabain, I. R. S., Karmiloﬀ-Smith, A., & Smith, T. J. (2017). Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep

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onset. Scientific Reports, 7. Retrieved from https:// www.nature.com/articles/srep46104 Christakis, D. A., Zimmerman, F. J., DiGiuseppe, D. L., & McCarty, C. A. (2004). Early television exposure and subsequent attentional problems in children. Pediatrics, 113, 708-713. Curtis, R. (2017, June 22). If you were born between 1977 and 1983, there’s a new name for you. Retrieved from http://www.mamamia.com.au/ xennial-generation/D’Ateno, P., Mangiapanello, K., & Taylor, B. A. (2003). Using video modeling to teach complex play sequences to a preschooler with autism. Journal of Positive Behavior Interventions, 5(1), 5-11. Daugherty, L., Dossani, R., Johnson, E. E., & Wright, C. (2014). Moving beyond screen time: Redefining developmentally appropriate technology use in early childhood education. Retrieved from http:// www.rand.org/content/dam/rand/pubs/ research_reports/RR600/RR673z2/ RAND_RR673z2.pdf DeLoache, J. S., Chiong, C., Vanderborght, M., Sherman, K., Islam, N., Troseth, G. L., . . . & O’Doherty, K. (2010). Do babies learn from baby media? Psychological Science, 21, 1570-1574. Dennison, B. A., Erb, T. A., & Jenkins, P. L. (2002). Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics, 109, 1028-1035. Epstein, L. H., Roemmich, J. N., Robinson, J. L., Paluch, R. A., Winiewicz, D. D., Fuerch, J. H., & Robinson, T. N. (2008). A randomized trial of the eﬀects of reducing television viewing and computer use on body mass index in young children. Archives of Pediatric and Adolescent Medicine, 162, 239-245. Erickson Institute. (2016). Technology and young children in the digital age. Retrieved from https:// 50.erikson.edu/wp-content/uploads/2016/10/ Erikson-Institute-Technology-and-Young-ChildrenSurvey.pdf Foster, E. M., & Watkins, S. (2010). The value of reanalysis: TV viewing and attention problems. Child Development, 81, 368-375. Garrison, M., & Christakis, D. (2012). The impact of a healthy media use intervention on sleep in preschool children. Pediatrics, 130(3), 492-499. Retrieved from http://

pediatrics.aappublications.org/content/ 130/3/492.full.pdf+html Garrison, M. M., Liekweg, K., & Christakis, D. A. (2011). Media use and child sleep: The impact of content, timing, and environment. Pediatrics, 128, 29–35. Hine, J. F., & Wolery, M. (2006). Using point-of-view video modeling to teach play to preschoolers with autism. Topics in Early Childhood Special Education, 26(2), 83-93. Jackson, D. M., Djafarian, K., Stewart, J., & Speakman, J. R. (2009). Increased television viewing is associated with elevated body fatness but not with lower total energy expenditure in children. American Journal of Clinical Nutrition, 89, 1031-1036. Kirkorian, H. L., Pempek, T. A., Murphy, L. A., Schmidt, M. E., & Anderson, D. R. (2009). The impact of background television on parent–child interaction. Child Development, 80, 1350–1359. Lauricella, A., Calvert, S., & Barr, R. (2014). Parent-child interactions during traditional and computer book reading for children’s story comprehension. International Journal of Child-Computer Interaction, 2(1), 17-25. Lillard, A. S., & Peterson, J. (2011). The immediate impact of diﬀerent types of television on young children’s executive function. Pediatrics, 128, 644-649. Linebarger, D., Barr, R., Lapierre, M., & Piotrowski J. (2014). Parenting, media use, cumulative risk, and children’s executive functioning. Journal of Developmental and Behavioral Pediatrics, 36, 367– 377. Linebarger, D. L., & Walker, D. (2005). Infants’ and toddlers’ television viewing and language outcomes. American Behavioral Scientist, 48, 624-645. MacDonald, R., Clark, M., Garrigan, E., & Vangala, M. (2005). Using video modeling to teach pretend play to children with autism. Behavioral Interventions, 20(4), 225-238. Manios, M., Kondaki, K., Kourlaba, G., Grammatikaki, E., Birbilis, M., & Ioannou, E. (2009). Television viewing and food habits in toddlers and preschoolers in Greece: The GENESIS study. European Journal of Pediatrics, 168, 801-808. Mendelsohn, A. L., Brockmeyer, C. A., Dreyer, B. P., Fierman, A. H., Berkule-Silberman, S. B., & Tomopoulos, S. (2010). Do verbal interactions with

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infants during electronic media exposure mitigate adverse impacts on their language development as toddlers? Infant and Child Development, 19, 577-593. NAEYC & Fred Rogers Center. (2012). Technology and interactive media as tools in early childhood programs serving children from birth through age 8. Retrieved from http://www.naeyc.org/content/ technology-and-young-children Park, Y. (2016, June 13). 8 digital skills we must teach our children. Retrieved from https://www.weforum.org/ agenda/2016/06/8-digital-skills-we-must-teach-ourchildren/ Park, Y. (2016, September 6). 8 digital life skills all children need – and a plan for teaching them. Retrieved from https://www.weforum.org/agenda/ 2016/09/8-digital-life-skills-all-children-need-and-aplan-for-teaching-them/ Parish-Morris, J., Mahajan, N., Hirsh-Pasek, K., Golinkoﬀ, R. M., & Collins, M. (2013). Once upon a time: Parent–child dialogue and storybook reading in the electronic era. Mind, Brain, and Education, 7(3), 200-211. Prensky, M. (2001). Digital natives, digital immigrants. On The Horizon, 9(5), 1-6. Retrieved from http:// www.marcprensky.com/writing/Prensky%20%20Digital%20Natives, %20Digital%20Immigrants%20-%20Part1.pdf Rasmussen, E. E., Shafer, A., Colwell, M. J., White, S., Punyanunt-Carter, N., Densley, R. L., & Wright, H. (2016). Relation between active mediation, exposure to Daniel Tiger’s Neighborhood, and US preschoolers’ social and emotional development. Journal of Children and Media, 10(4), 443-61. Schmidt, M. E., Pempek, T. A., Kirkorian, H. L., Lund, A. F., & Anderson, D. R. (2008). The eﬀects of background television on the toy play behaviors of very young children. Child Development, 79, 1137-1151. Schmidt, M. E., Rich, M., Rifas-Shiman, S. L., Oken, E., & Taveras, E. L. (2009). Television viewing in infancy and child cognition at 3 years of age in a US cohort. Pediatrics, 123, e370-e375. Thompson, D. A., & Christakis, D. (2005). Among children less than 3 years of age the association between television viewing and irregular sleep schedules. Pediatrics, 116, 851-856.

Tomopoulos, S., Dreyer, B. P., Berkule, S., Fierman, A. H., Brockmeyer, C., & Mendelsohn, A. L. (2010). Infant media exposure and toddler development. Archives of Pediatric and Adolescent Medicine, 164, 1105-1111. Troseth, G. L., & DeLoache, J. S. (1998). The medium can obscure the message: Young childrenâ&#x20AC;&#x2122;s understanding of video. Child Development, 69, 950-965. Wert, B. Y., & Neisworth, J. T. (2003). EďŹ&#x20AC;ects of video self-modeling on spontaneous requesting in children with autism. Journal of Positive Behavior Interventions, 5(1), 30-34. Zack, E. A. (2010). Infant transfer of learning across 2D/ 3D dimensions: A touch screen Paradigm (Unpublished doctoral dissertation). Georgetown University, Washington, DC. Zero to Three. (2014). Screen sense: Setting the record straight. Retrieved from https:// www.zerotothree.org/resources/series/screensense-setting-the-record-straight

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Zimmerman, F. J., & Christakis, D. A. (2007). Associations between content types of early media exposure and subsequent attentional problems. Pediatrics, 120, 986-992.

About the Author Dana Bolton, MEd, MMT, MT-BC coowns Bolton Music Therapy in Murfreesboro, Tennessee. She has worked in the early intervention field for 13 years and is an editorial assistant to the imagine.magazine since 2014. Dana supports her son Jack to become digital literate while keeping him safe in the digital world. Contact: dana@boltonmusictherapy.com

FEATURED

Using Technology and Interactive Media With Young Children: An Interview With Chip Donohue Nicole Rivera, Ed.D., MT-BC North Central College Naperville, Illinois

In a world filled with devices and apps, recognizing their meaningful use for young children’s learning and development can be challenging. Guiding parents through their own decisions about using technology and interactive media may be difficult as well. How can music therapists inform themselves to become effective media mentors for young children and their families? An interview with Chip Donohue, Ph.D., Director of the Technology in Early Childhood Center at the Erikson Institute and a senior fellow of the Fred Rogers Center for Early Learning and Children’s Media provides insights.

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NR: Thank you for your time. First of all, I want to get your impression about where technology fits into the wonder of childhood.

CD: That’s a great question. Often, we think that wonder and technology are not compatible and I’m trying to change that impression. I think wonder comes first; technology comes in next when it supports wonder. I think sometimes we have that backwards. I see technology as a tool for children’s exploration of the world, for inquiry, for discovery, for showing you what they know, for documenting what they’re learning. So, it’s simply a tool. And if it’s a tool that can support the child’s wonder and questions about the world, then I’m all for it.

learning is interesting because here at Erikson, that is actually at the core of what we’re all about. From the very beginning we’re looking for ways to use tech to support social/emotional learning, not stand in its way. All of our work is focused on that, and that gives us a diﬀerent perspective.

NR: You just mentioned screen time. I really appreciated your delineating screen time versus healthy and smart media decisions in the book Becoming a Media Mentor. Can you add a little more to that delineation?

CD: Sure; I think we’ve gotten ourselves twisted in knots over screen time. I often get asked when I’m out presenting to parents or educators, “How many minutes?” I think that’s the wrong metric. I think time is a metric. It is important to have a sense of how long the child has been looking at this screen or doing this media activity. But what else do we need to look at? What’s the quality of the content? What’s the context with which the child is engaged with the media? Who else is there? Are there social interaction opportunities? Is it an adult and child interaction moment, or one with peers? I think if we just say how many minutes, we miss a larger picture. I also tell parents all the time to trust your instincts. If you think it’s been long enough, it’s been long enough.

Watch video about Technology and the Wonder of Childhood at https://youtu.be/to_4TBWebi4

NR: How do you deal with some of the fears that come along with technology such as challenges to social/ emotional learning, etc.?

CD: There are a lot of fears and headlines that grab our attention, suggesting that technology’s really bad for kids. There was one out of New Zealand over the weekend around toddlers and screen time that was really alarming if you just read the headline and didn’t go further. In our role at the TEC Center, we help curate and interpret research and help people understand. Yes, there are concerns and I’m passionately committed to paying attention to the concerns, but I’m also committed to getting past them when we can. Social/emotional

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NR: How have ideas about technology and young children been changing over the past few years?

CD: I think a big change was the arrival of the multi-touch screen — like on the iPhone and then the iPad because it gave children a new, accessible interface right into technology. We’ve constantly seen technology used in early childhood and we’ve certainly been doing computer-based technology for a long time, but this has been a game changer. It’s a diﬀerent kind of device; it’s highly likely that the adults in children’s worlds are carrying one of those as well. So, the way we as adults are using technology has changed and we need to get in sync on those two.

NR: I love in the books how it brings up the idea of adults not necessarily being the experts in this new domain. I think that’s really fascinating how that shifts that balance in the relationship.

the breakthrough that I’m seeing; kids don’t feel diﬀerent because they’re using similar equipment that’ can support them.

CD: I think that’s a great moment. I call it the reverse teachable moment. Educators need to be confident enough to say to a child, “I don’t know. Can you help me?” That doesn’t always come easily. The younger you are as an educator, the more you think you’re supposed to have all the answers. But, parents can do the same thing. These kids are growing up in the digital age. They were born into it. They actually do know how to do things that we’re baﬄed by. What an opportunity to shift the balance and let the child take the lead and be the one! That’s why I love the use of technology for documentation, because children can show me what they know. They’re in charge.

NR: The NAEYC and the Fred Rogers Center Joint Position Statement talk about some special considerations for infants and toddlers. Do you think there are also special considerations when we’re thinking about using technology with children with specific disabilities?

CD: Yes, so let me start with infants and toddlers. Back when we wrote that statement in 2012, infants and toddlers was the most controversial age group because why do little babies need screen time? The answer is that they don’t. What they need is relationship time. But we also saw some limited opportunities for screens to be a way for the child to see a photograph of themselves or their family or to use Skype to see grandma or whatever. What we really said was it has to be in the context of a relationship. Now, I think the larger conversation is around inclusion and assistive technologies and the ways in which technologies can support all children. I’m seeing perceptual barriers coming down. We’re starting to realize that if a tool can help a child, then we should be using it. In schools in particular, we’ve often had very expensive technologies for working with a child. Suddenly we have a consumer-based technology that everybody else has and uses and knows; and actually, it can also be a powerfully assistive tool. That’s probably

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Watch video about Joint Position Statement at https://youtu.be/taYbwDBeiJM

NR: I appreciate you commenting on that because I remember previously when I was working in schools, the technology that was available for children with language disorders was often so expensive and there was often an issue of access. Parents often felt uncomfortable navigating those technologies. Now that a family can use an iPad as a communication device, it’s much more accessible and much more aﬀordable.

CD: Absolutely. And it connects the home and the school in new powerful ways so the child can actually have the same technology in both places. Adults in both places can be talking with each other about what works and how they are doing. That really is the big breakthrough. Technology is always going to have an expense to it, but these devices are getting less and less expensive. I also always want to remind educators and parents that we don’t want to privilege digital media over all of the other kinds of technology that are in classrooms and homes. We’re caught up in the excitement of the iPad for example, the tablet computer, and I know why I’m excited about that; but I don’t want to lose sight of what’s worked well before and what might be a better fit for a particular child. We don’t want to take everything oﬀ the table if it’s not digital. That would be a shame.

NR: What does it mean to be a media mentor? CD: The phrase “media mentor” really began in the library world where children’s librarians were starting to see that they could play a very unique role in helping families answer questions and gain confidence using digital media with young children. So, when parents come to the library for story time with their child, the librarian can model using digital media and also reading from a book. So, really finding that balance. That is really where the idea started to percolate; to be perfectly honest, I grabbed it and went, “Well everybody’s a media mentor,” an adult in a child’s life who can help them navigate the digital age, show them healthy ways to use the media, sit down with them and engage jointly. That’s our responsibility in this new age. Often, because we don’t feel as comfortable with the tools, we back oﬀ. The other part of media mentorship is reflecting about our own technology use. What we may find is that what we’re modeling for children, when we’re not just sitting and thinking about it, may be a conflicting message for the child.

Technology is a tool to solve a problem. Technology is a tool to help us learn something. That kind of modeling and mentoring is very positive. We spend way too much time monitoring and not mentoring. And we really need to find that balance. In terms of music therapy practice and work with children, can we use technology to improve the communication between home and our work? Can we reach children in a new way? Can we reach a child that we haven’t been able to reach? Can we give the child a voice and control? At what point is there eﬃcacy around this tool that helps this child feel more confident, more able than they did before?

Watch video about Considerations for Music Therapists at https://youtu.be/c7Hcm3egxCY

NR: Are there specific skills that you think are a part of that?

CD: I think in the early years I divided it into

Watch video about Media Mentor at https://youtu.be/hFP1bFEIee0

NR: As we’re thinking about how music therapists might serve in that role, what else should music therapists learn?

CD: I think one of the things that media mentors can do is model a healthy relationship with technology.

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three categories. Very young children just need to know how to use the literacy of pieces of technology, similar to handling a book. We need to stop and take time to teach those things. Just because a child can swipe across and iPad screen doesn’t mean the child knows how to use it. We start with good use, good stewardship of the technology, then I think we go to using the technology to learn. That’s the most important thing, that it’s a tool. We’re not learning about technology, we’re learning with technology. As children get ready for kindergarten and on, now we actually do want them to understand how it works and how they can make it work.

I think one of my rallying cries lately has been that we have to help children understand that they are smarter than the technology. They have to understand that they are in control. It does nothing without them. That will serve them well in the world that they’re going to live in.

NR: How can a music therapist interpret the quality of technology that’s out there?

CD: The quality is really a tough question for a music therapist, for a parent, for an educator in a classroom. How do we know? We’ve been buried with so much content. Apps were the flavor of the day. When this all started, everyone wanted to know what app to have. I’m backing away from that and saying, “How am I going to use this tool that can record video or audio?” The child can enter information into it. So, less app specific. More quality tool use. But these questions around “What’s any good?” is baﬄing for all of us. There’s too much. We know there are media producers who are making some meaningful connection to how children learn and develop, but there’s a lot that isn’t so good as well. I’m going to go back to, “Trust your instincts.” But, I would say to a music therapist, “You’ve got to play with it first. You’ve got to try it on your own time and decide if this going to be helpful for this child or not?”

Watch video about Quality of Technology at https://youtu.be/CR7PJrMKtG8

NR: I like how in the books there’s a suggestion for

your own and doing that with colleagues. That’s a great suggestion.

CD: I think the notion of parent play time, educator play time, therapist play time, that’s really important. If I fundamentally want children to have adults in their lives who are playful with technology, they need to take some time to play with technology and to not have it work and to figure it out and realize that it’s a process. I think the risk of me always talking about it as a tool is that it gets interpreted as a tool for formal learning and I think it’s a tool for the whole child. That’s an interesting aspect of this new media and what it can oﬀer.

NR: Are there any specific things you recommend that music therapists can be thinking about for supporting parents?

CD: I think this new connection between digital media and parent engagement is a powerful one and one that we really ought to be thinking hard about. I would start by saying meet the parents where they are; you have to know where they are. How do they want to communicate? What’s most useful? It has to be reciprocal. It has to be something that goes back and forth so it’s truly a conversation. But in today’s world, most families have smart phones, so maybe we start there with a text message or a link to something that the parents can explore on their own. We can provide documentation of how the child is doing or how our time with the child has become so much easier and in real time. We also hear from parents who are busy, working too many hours, and stressed out. They don’t want to be flooded either. So, taking the time to respectfully ask, “What do you want to hear from me? How often do you want to hear from me? What’s the best way for me to get information to you?” Because we have new tools to do that. I think we discovered as we did the book on family engagement that we have lots of tools; they will work best when the parent sees them as the right tools. And some parents still are going to want a piece of paper and still are going to want other ways of understanding what’s happening with their child.

creating space for that kind of play time; doing that on

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NR: It seems like ideas around technology change as

NR: Final question. Is there any advice that you would

quickly as technology changes. What are your few “go to” resources for staying up on the conversation?

give to music therapists as they’re considering improving their use of technology or their role as a media mentor?

CD: That’s a great question. I think that what doesn’t

CD: As we consider ourselves as media mentors, my

change is child development and early learning. Not that we don’t adjust those along the way, but that’s kind of like a glacier compared to the speed of this. So, when in doubt go back to the theory. What would Piaget have said about this? What would Montessori have said about this? What do I know from theory that can help me make decisions today? And we do the same thing around what is great classroom practice. If you’ve got things that are working, maybe technology can take it up a notch; maybe technology can’t. That’s a moment of decision. It’s not technology all the time, so I would go back to that. What do we know about how children learn? What do we know about child development? We need to ask ourselves the hard questions. In my case, because I’ve been working with the Fred Rogers Center for so many years, we go back to Fred and what he had to say about the technology of his time, because he had the same goals as we have which is supporting the whole child’s development. There’s a lot to be learned from this very thoughtful man who was very intentional. Maybe the most important lesson is the word that I just said— intentionality. Use it because you know why you’re using it and you know what you hope to get out of it. That doesn’t mean you won’t have adjustments along the way, but too many times I think educators feel that they’ve got to get it in there and do something. That’s not going to work very well.

first advice is that we first think about yourself and how you use media. That’s not a critique; just be honest with yourself. Are you using it in a way that you want children to use it? Because they are watching you, they are watching their parents, and other adults in their lives. So, be a very intentional media mentor. Back when I was in teacher education, I would say to my students, “Since the children are watching and listening to everything you do, give them great things to hear and see.” Be clear about what you want to introduce, embrace it, and do so when you’re ready. That’s my big thing these days. I love the thought that music therapists can be thinking about technology in my context, how does this translate and what can I do to better support children and families with these new tools. That’s’ really the question I think; being very thoughtful about that and really trusting your own instincts. If it’s not right, it’s not right. It’s never technology for technology’s sake. About the Author: Nicole R. Rivera, Ed.D., MT-BC worked as a music therapist for over 17 years serving children with autism spectrum disorder and their families. She is an Assistant Professor of Psychology at North Central College in Naperville, IL. Contact: nicolelrivera@hotmail.com

In this issue:

Check out Dr. Chip Donohue’s 10 Tips For Using Technology and Interactive Media With Young Children and Curated Resources on Technology and the Young Child

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RESEARCH 2017 Early Childhood Research Snapshot Andrew Knight, Ph.D., MT-BC Colorado State University Fort Collins, Colorado

Staying up-to-date on research in early childhood music therapy is important for clinicians and providers for at least two reasons:

1 2

A growing number of early childhood music therapy research studies are being published in music therapy as well as population-specific journals each year. Music therapists continuously assess clients; likewise we must continuously assess our practices in early childhood and the research that supports them. This snapshot provides a year-in-review of prevalent early childhood music therapy studies published in music therapy journals. The first section summarizes articles that include work done with young children with various diagnoses. Studies conducted with premature infants in Neonatal Intensive Care Units follow. The final section includes publications that focus on family-centered practices, family systems, and family theories â&#x20AC;&#x201C; pertinent topics for any music therapist working with young children.

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Research Overview Geretsegger and colleagues (2016) published a feasibility study to address the strengths and limitations of a research design used to evaluate the Trial of Improvisational Music Therapy’s Eﬀectiveness for Children with ASD (TIME-A) protocol with children ages four to six years old. The authors stated that with rigorous randomization and control methodology, it is possible to evaluate interventions that are true to the work clinicians do with this client population.

Christenbury’s (2017) case study detailed how music therapy was implemented with a 6-year-old who had been physically and sexually abused. The author documented six months of music-making for establishing rapport and trust with the child. Following this stage, the therapist composed songs that responded to the child’s artwork, basing interventions on them. This case study oﬀers insight into the creativity and clinical decision-making process a music therapist may use to address emotional goal areas for a young child.

In the medical arena, Yinger (2016) examined music therapy as procedural support for children and their The outcomes of the recently released TIME-A study suggested that the caregivers during routine improvisational approach to music therapy does not work for children with immunizations. In this study, four- to ASD. The researchers conclude: “Among children with autism spectrum six-year-olds participating in live, disorder, improvisational music therapy, compared with enhanced standard cognitive-behavioral music therapy care, resulted in no significant diﬀerence in symptom severity based on the had better coping skills and fewer ADOS social aﬀect domain over 5months. These findings do not support distress behaviors, and their parents the use of improvisational music therapy for symptom reduction in children reported lower levels of distress. with autism spectrum disorder” (Bieleninik et al., 2017, p. 534). Parents in the music therapy group also displayed fewer distress-promoting behaviors during the procedures. Kim, Kim, and Yoo (2016) used a music perception training program to facilitate the discrimination and identification of musical elements with five 4-5-year-old NICU Care recipients of cochlear implants (CI). Significant changes Similar to Yinger’s (2016) article, procedural support for from pre- to post-test on rhythm-related subtests venipuncture in neonates was studied by Ullsten and “conforms to the research finding that rhythmic cues colleagues (2017). Using parent-preferred lullabies, pain could be a primary factor in successful processing of scores (using standardized observation inventories), sound information when multiple cues exist” (p. 54). heart rate, respiratory rate, and oxygen saturation were Clinicians working with particularly young clients with CI used as dependent measures. While pain scores did not are encouraged to be creative and age-appropriate by change significantly, calmer breathing patterns did using chants and other engaging rhythm-based stimuli. emerge in the lullaby condition.

TIME-A OUTCOMES

While the previous study examined a receptive communication issue, Tan and Shoemark (2017) published a case study of two 6-year-olds with specific language impairment (SLI), one of the most common diagnoses in preschool to primary school-aged children. The authors provided detailed session-by-session descriptions that compare the use of musical cues to traditional speech cues in developing syntax and morphology skills. Results indicated that the musical elements in the song condition may result in more eﬃcient learning of syntax.

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Two studies put forward systematic programs for engaging neonates, parents, and music therapy in the NICU. Shoemark (2017) contributed a program to improve parent-infant interactions in the NICU. She demonstrated that music therapists have the necessary knowledge needed to facilitate this relationship. Working with 13 mothers of newborns in the NICU, her program, called “Time Together,” used contingent singing principles to foster a musical connection. This qualitative feasibility trial is explained in great detail to encourage replication in a single session setting. Strengths and limitations are included in her analysis of the study.

Focusing on a case study, Lander (2017) described another program for newborns and parents called “BabySounds.” Working with poor and often young parents who were averse to government literature attempting to educate them on best practices for the very early years, the author used “a flexible approach tailored to the individual’s background…(to enable) successful processing of new information” (p. 20). Lander reported positive outcomes of helping the parents learn about and understand the musical connection they could make with their newborns. Ettenberger (2017) published a mixed methods study in Colombia plus a discussion on the pillars of familycentered care in Colombian music therapy (2017). The mixed methods study (Ettenberger et al., 2016) explored diﬀerences between standard care (control group) and a standard care plus music therapy group, an adaptation of Loewy’s First Sounds: Rhythm, Breath, Lullaby, model (2015). Quantitatively, babies in the music therapy group weighed significantly more than the control group, and mothers in the music therapy group scored significantly lower on an anxiety inventory. Qualitative concepts, gained through a series of interviews with parents of the children in the study, centered around parental wellbeing, bonding, and fostering development. In a subsequent article, Ettenberger (2017) explained this family-centered approach. Clinicians working with young children in several areas, at-risk families in the community, children with intellectual and developmental disabilities (including autism), child psychiatry, and families without diagnosed children may benefit from information contained therein.

Family-Centered Practice The area of newborn growth and development is clearly a focus for music therapy researchers around the world. But, what happens to the parent-child bond after infancy, when the children become toddler-aged? Loth (2017) published a case study of a mother with triplets; one of the babies was born with restricted growth and medical complications. Later, at age 2, the triplets still had diverse needs. The mother was struggling to manage the diﬀerent personalities and bond with the baby with the most needs. The author explains why the child with the highest needs was referred to music therapy, but she also helps music therapists recognize the entirety of the

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family dynamics. Similar to several other authors this year who focused on the concept of family-centered care, she describes her ideas on the topic and addresses how to achieve prioritization of issues. The final two papers for this snapshot address the spectrum of early childhood in the context of family systems and theories. Mitchell (2017) published a case study about a girl and her family and their path through the National Health Service in the United Kingdom. She makes several points about establishing a musical rapport with the entire family, regardless of their initial interest in being part of music therapy services. Although health care systems vary greatly from country to country, music therapists can use this information as an important guide for assisting families in navigating the early childhood services around their community, up until and through the period when the child may be entering a public school system. Cobbett (2016) examined the issue from the systemic approach, and spotlighted two case studies to explain how he weaves it into music therapy practice. While the case studies are not descriptive of the early childhood period (one client is fifteen years old, the other is eight), much of the theoretical background for working with families is applicable across ages. Music therapists who are looking for more context for understanding the families with whom they work may find this study valuable.

Summary Clinicians are seeing an important and interesting evolution in the field of early childhood music therapy. NICU work continues to grow rapidly and the importance of engaging the entire family in music therapy service delivery is gaining increasing recognition. Clinicians working with young children and their families should be encouraged to take a systematic look at the process of integrating music therapy into the family unit. Whether that results in case studies, theoretical inquiries, or experimental designs with increasingly more rigorous methodologies, demonstrating the importance of music therapy to young children, their families, and other early childhood professionals should be the primary goal for early childhood music therapists around the world.

References Bieleninik, Ł., Geretsegger, M., Moessler, Assmus, J. Thompson, G., Gattino, G., Elefant, C., Gottfried, T., Igliozzi, R., Muratori, F., Suvini, F., Kim, J., & Crawford, M., Odell-Miller, H., Oldfield, A., Orla, C., Finnemann, J., Carpente, J., La Park, A., Grossi, E., & Gold, C. (2017). Eﬀects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder: The TIME-A Randomized. Journal of the American Medical Association, 318 (6), 525-535. doi: 10.1001/jama.2017.9478. Christenbury, K. R. (2017). I will follow you: The combined use of songwriting and art to promote healing in a child who has been traumatized. Music Therapy Perspectives, 35(10), 1-12. Cobbett, S. (2016). Context and relationships: Using the systemic approach with music therapy in work with children, adolescents and their families. British Journal of Music Therapy, 30(2), 65-73. Ettenberger, M. (2017). Music therapy in the neonatal intensive care unit: Putting the families at the centre of care. British Journal of Music Therapy, 31(1), 12-17. Ettenberger, M., Rojas Cárdenas, C., Parker, M., & Odell-Miller, H. (2017). Family-centred music therapy with preterm infants and their parents in the Neonatal Intensive Care Unit (NICU) in Colombia–A mixed-methods study. Nordic Journal of Music Therapy, 26(3), 207-234. Geretsegger, M., Holck, U., Bieleninik, Ł., & Gold, C. (2016). Feasibility of a trial on improvisational music therapy for children with autism spectrum disorder. Journal of Music Therapy, 53(2), 93-120. Kim, S. J., Kim, E. Y., & Yoo, G. E. (2016). Music perception training for pediatric cochlear implant recipients ages 3 to 5 years: A pilot study. Music Therapy Perspectives, 35(1), 50-57. Lander, J. (2017). ‘BabySounds’: Promoting bonding and attachment, pre-and post-natally, with vulnerable first-time parents. British Journal of Music Therapy, 31(1), 18-25. Loewy, J. (2015). NICU music therapy: Song of kin as critical lullaby in research and practice. Annals of

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The New York Academy of Sciences, 1337, 178– 185. doi:10.1111/nyas.12648 Loth, H. (2017). Cacophonies of discord, moments of harmony: Managing multiple needs in short-term music therapy with triplets and their mother. British Journal of Music Therapy, 31(1), 26-31. Mitchell, E. (2017). Music therapy for the child or the family? The flexible and varied role of the music therapist within the home setting. British Journal of Music Therapy, 31(1), 39-42. Shoemark, H. (2017). Time together: A feasible program to promote parent-infant interaction in the NICU. Music Therapy Perspectives. Advance Online Publication. doi.org/10.1093/mtp/mix004. Tan, E. Y. P., & Shoemark, H. (2015). Case study: The feasibility of using song to cue expressive language in children with specific language impairment. Music Therapy Perspectives, 35(1), 63-70. Ullsten, A., Hugoson, P., Forsberg, M., Forzelius, L., Klässbo, M., Olsson, E., Volgsten, U., Westrup, B., Aden, U., Bergqvist, & Eriksson, M. (2017). Eﬃcacy of live lullaby singing during procedural pain in preterm and term neonates. Music and Medicine, 9(2), 73-85. Yinger, O. S. (2016). Music therapy as procedural support for young children undergoing immunizations: A randomized controlled study. Journal of Music Therapy, 53(4), 336-363.

About the Author Andrew Knight, Ph.D., MT-BC is Associate Professor of Music Therapy at Colorado State University and a Music Together Within Therapy provider for early childhood music and movement. Contact: Andrew.knight@colostate.edu

PUBLICATIONS Visit the imagine 2016/2017 publications listed for more articles related to music therapy and young children with their families.

The PINPOINT Study: Understanding the Role of Engagement Katherine Myers-Coffman, MS, MT-BC, Amanda K. Henley, MM, MT-BC, and Sheri L. Robb, Ph.D., MT-BC, Indiana University School of Nursing, Indianapolis, Indiana

During acute treatment, parents and young children with cancer experience high levels of emotional distress that can interfere with parent-child interactions, family function, and quality of life (Bennett, English, Rennoldson, & Starza-Smith, 2013; Rodriguez et al., 2012). In addition, there is evidence that this interrelated parent-child distress contributes to the incidence of traumatic stress symptoms after treatment ends (Graf, Bergstraesser, & Landolt, 2013; Lindahl Noberg, PĂśder, Ljungman, & von Essen, 2012). The Active Music Engagement (AME) intervention was designed to help minimize acute treatment distress through engagement in music-based play, with the longer-term goal of preventing traumatic stress symptoms in survivorship. Several pilot studies have examined child engagement and positive coping behaviors in response to AME, as well as the potential benefit for parents (Robb, 2000; Robb et al., 2008; Robb et al., 2017). Findings indicate that AME has been beneficial in lowering emotional distress in children during acute cancer treatment, and that child engagement and parent self-eďŹ&#x192;cacy may be important mediators for benefits observed in these studies (Robb et al., 2017). In July 2016, the National Institutes of Nursing Research awarded the PINPOINT study team a $1.4 million grant (R01NR015789) to examine the underlying processes (i.e., mechanisms of action) that may explain how and for whom play-based interventions, like AME, work. As a result, the team will have the opportunity to examine how music therapists tailor music and other play-based experiences to increase parent and child engagement, and whether parent education plays a role in any observed benefit, and if so, how to best incorporate parent education into interventions. These findings will help the study team identify factors that can directly inform music therapistsâ&#x20AC;&#x2122; clinical decision making, as they work to tailor or individualize interventions for

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children and parents. The hypothesis is that engagement will mediate parent and child benefit, and if this hypothesis holds true, it would be helpful to have a brief clinical measure of engagement. Currently, the study team uses a behavioral observation coding form that is time intensive and not practical for use in clinical settings. Fortunately, the study team has the opportunity to develop a brief engagement measure that might prove useful for clinical assessment and documentation, and subsequent research. The PINPOINT study team includes fifteen BoardCertified Music Therapists across three sites who are implementing AME and storybook play interventions. Participating hospitals include Riley Hospital for Children at Indiana University Health (Indianapolis, IN), Children’s Mercy Hospital (Kansas City, MO) and Children’s Healthcare of Atlanta (Atlanta, GA). As an interdisciplinary team eﬀort, the study brings together the disciplines of music therapy, nursing, medicine, and biostatistics. The plan is to enroll 184 parent and child participants over the next two years; we are excited about what participating children and families will help us learn about the role of engagement in music and play interventions.

References Bennett, E., English, M. W., Rennoldson, M., & Starza‐ Smith, A. (2013). Predicting parenting stress in caregivers of children with brain tumours. PsychoOncology, 22(3), 629-636. doi: 10.1002/pon.3047 Graf, A., Bergstraesser, E., & Landolt, M. A. (2013). Posttraumatic stress in infants and preschoolers with cancer. Psycho‐Oncology, 22(7), 1543-1548. doi:10.1002/pon.3164 Lindahl Norberg, A., Pöder, U., Ljungman, G., & von Essen, L. (2012). Objective and subjective factors as predictors of post-traumatic stress symptoms in parents of children with cancer–a longitudinal study. PLOS one, 7(5), e36218. https://doi.org/ 10.1371/journal.pone.0036218 Robb, S. L. (2000). The eﬀect of therapeutic music interventions on the behavior of hospitalized children in isolation: Developing a contextual support model of music therapy. Journal of Music Therapy, 37, 118 -146. https://doi.org/10.1093/jmt/ 37.2.118

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Robb, S. L., Clair, A. A., Watanabe, M., Monahan, P. O., Azzouz, F., Stouﬀer, J. W., … Hannon, A. (2008). Randomized controlled trial of the active music engagement (AME) intervention on children with cancer. Psycho‐Oncology, 17(7), 699-708. doi: 10.1002/pon.1301 Robb, S. L., Haase, J. E., Perkins, S. M., Haut, P. R., Henley, A. K., Knafl, K. A., & Tong, Y. (2017). Pilot randomized trial of Active Music Engagement Intervention parent delivery for young children with cancer. Journal of Pediatric Psychology, 42(2), 208-219. doi:10.1093/jpepsy/jsw050 Rodriguez, E. M., Dunn, M. J., Zuckerman, T., Vannatta, K., Gerhardt, C. A., & Compas, B. E. (2012). Cancerrelated sources of stress for children with cancer and their parents. Journal of Pediatric Psychology, 37(2), 185-197. https://doi.org/10.1093/ jpepsy/jsr054

About the Authors Katherine Myers-Coﬀman, MS, MT-BC, is a Ph.D. candidate at Drexel University who works in trauma care with youth and adults as well as in early intervention and pediatric specialty care settings. Her research interests involve developing and evaluating resilience-focused interventions for youth in grief and trauma care. Contact: k.myers-coﬀman@drexel.edu Amanda K. Henley, MM, MT-BC, is a Research Associate at Indiana University. She is the core project manager for the NIH funded Pinpoint: Music Play and Stories study. Her past clinical experiences include working with children and adults with special needs as well as adolescents and young adults with cancer. Sheri L. Robb, Ph.D., MT-BC, serves as Editor-in-Chief for the Journal of Music Therapy, Director of the Indiana Clinical and Translational Sciences Institute KL2 Young Investigators Program, and is an Associate Professor at the Indiana University School of Nursing, Indianapolis, IN. Her program of research focuses on development and testing of music therapy interventions to manage distress, improve positive health outcomes, and prevent secondary psychosocial morbidity in children and adolescents with cancer and their parents.

The Adaptive Use Musical Instrument (AUMI): A Useful App for Inclusive Practice

Abbey Dvorak Ph.D., MT-BC and Sherrie Tucker Ph.D. University of Kansas, Lawrence, Kansas

What is the AUMI? The Adaptive Use Musical Instrument (AUMI) is a downloadable software interface that transforms any computer, laptop, or Apple mobile device with a front-facing camera into a musical instrument. Participants create sound by moving in front of the screen. The camera-tracking feature follows body movements, which in turn, trigger preselected sounds (Deep Listening Institute, 2015). The impetus for the AUMI’s creation came from occupational therapist Leaf Miller, who led a weekly drum circle for children with narrow range of voluntary movement and was concerned about the many participants who required hand-over-hand assistance. She wanted a way for everyone to autonomously participate. Developers at the Deep Listening Institute and Rensselaer Polytechnic Institute designed the AUMI to adapt to small movements--the tilt of a chin, a slight movement of a finger, or a side-to-side

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sway--thus enabling all bodies to access the entire range of the instrument (Oliveros, Miller, Heyen, Siddall, & Hazard, 2011; Pask, 2010). Originally led by renowned composer Pauline Oliveros (1932-2016), an international team continues to support, develop, and maintain the instrument, and to ensure that it remains aﬀordable, adaptable to every body, and a wonderful tool for artists, teachers, students, and clinicians.

The AUMI in Clinical Practice The AUMI is a flexible, accessible, and adaptable intervention that may be used eﬀectively by clinicians in a therapeutic setting. Music therapists and occupational therapists observed improved physical, social, cognitive, and emotional outcomes in children with severe physical and neurodevelopmental disabilities as a result of individual and group music making using the AUMI (Finch, LeMessurier Quinn, &

Waterman, 2016; Oliveros et al., 2011). Therapists reported improved control and range of voluntary movements of upper limbs and trunk, improvements in fine movements of the head and neck, improved midline orientation, increased dynamic movement control, expansion of the movement repertoire, and increased respiratory capacity in children with severe physical disabilities using the AUMI (Oliveros et al., 2011). In addition, psychosocial benefits reported include active participation in a group, enhanced interactions with others, willingness to attempt new tasks, strengthened self-esteem, and increased independence, motivation, attention, and awareness of cause and eďŹ&#x20AC;ect (Finch et al., 2016; Oliveros et al., 2011). As with any other musical instrument, the AUMI is a versatile therapeutic tool that requires practice, adaptation, and goal-setting, with the understanding that individuals may respond diďŹ&#x20AC;erently due to need, preference, experience, and personality (Finch et al., 2016). Although playing the AUMI is intuitive, immediate, and requires no musical experience, therapists are encouraged to become well versed in the settings associated with tracking, sensitivity, contrast, and instruments in order to quickly make therapeutic changes based on participant response. Therapists may adapt the AUMI to any body, such that even the slightest (e.g., breathing) or largest movement may be set to trigger musical response (Oliveros et al., 2011). The adaptability of the instrumentâ&#x20AC;&#x2122;s settings make it possible to quickly connect specific ranges, directions, and types of body movements to preferred sounds, making it possible to link individual goal-setting with relationship-building, community-formation, and performance. (Finch et al., 2016). With both desktop and iPad versions available, the AUMI continues to develop in an interdisciplinary manner with use and feedback from clinicians, teachers, dancers, artists, faculty, students, and performers in individual, group, and community settings.

Intergenerational Community Formation Improvisation with the AUMI is an ongoing practice of inclusive community-formation and increases the accessibility of musical expression for all people, regardless of age or ability (AUMI-KU InterArts, 2017; Tucker et al., 2016). In monthly intergenerational community jam sessions at the Lawrence Public Library Sound+Vision Studio, community members of all ages and abilities create music together in small group improvisations and recording experiences using the AUMI. These types of intergenerational programs are inclusive and may decrease segregation due to age, space, social, culture, disability, and environment; diminish misconceptions and stereotypes; and provide psychosocial benefits for all generation members (Belgrave, Darrow, Walworth, & Wlodarczyk, 2011). Children, adolescents, adults, and older adults create music together in a supportive and inclusive environment with the recordings professionally mixed and uploaded by a sound engineer to SoundCloud, an online audio distribution platform. Participants choose sounds and settings on the AUMI and improvise with others to create musical compositions. Sanchez (2017) follows participants as they improvise together in a typical session in this video from The University Daily Kansan.

Watch video about creating music with AUIMI https://youtu.be/IJugdAgMmJU

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Recommendations for Using the AUMI in Early Childhood Settings When using the AUMI in early childhood settings, the authors recommend the following: Practice with the AUMI—as you would with any other musical instrument--before introducing it to your client(s); Assess tracking, sensitivity, and contrast settings on the AUMI that best meet the needs of the client(s); Allow time for children to explore the sounds, colors, keys, and tracking before using the AUMI in a more formal manner; Remember that children will respond diﬀerently to the AUMI based on need, preference, experience, and personality; Lock the screen once the settings are established so accidental touching of the screen does not minimize the tracking area; Consider purchasing a protective case that easily attaches to a mounting system (such as the aXition Bold with MagConnect Shockproof Case Mount and C-clamp mount from Joy Factory) so the AUMI may be stationary; Connect the AUMI to a table or stationary object, not a wheelchair, as client movement causes vibrations through the chair that aﬀect AUMI functioning; and Establish a user ID and login for individual clients so the same settings are saved and easily accessed each session.

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In a discussion after recording together in the studio and then listening closely to their piece, participants name their improvisation and group. In this example of a piece created by two children and two adults, participants named their improvisation “Animal Parade” and called their quartet The Human Pianos: https:// soundcloud.com/sound-vision-studio-1/animal-parade. The intergenerational community jam sessions also provide novice music therapy students with community engagement and service learning opportunities as they develop their own musical expression and creativity through improvisation. A short 30-second video displaying the environment and highlighting the experiences of music therapy students: https:// www.youtube.com/watch?v=dNPPBeqlihI.

References AUMI-KU InterArts. (2017). AUMI-KU InterArts: Improvising across abilities, media, communities. Retrieved from http://aumi.ku.edu. Belgrave, M., Darrow, A., Walworth, D., & Wlodarczyk, N. (2011). Introduction to intergenerational programming and music therapy. In Music therapy and geriatric populations: A handbook for practicing music therapist and healthcare professionals (pp. 177-187). Silver Spring, MA: American Music Therapy Association.

Deep Listening Institute. (2015). AUMI: Adaptive use musical instruments. Retrieved from http:// deeplistening.org/site/adaptiveuse. Finch, M. LeMessurier Quinn, S., & Waterman, E. (2016). Improvisation, adaptability, and collaboration: Using AUMI in community music therapy. Voices: A World Forum for Music Therapy. doi.org/10.15845/ voices.v16i3.834 Oliveros, P., Miller, L., Heyen, J., Siddall, G., & Hazard, S. (2011). A musical improvisation interface for people with severe physical disabilities. Music and Medicine, 3(3), 172-181. Pask, A. (2010). The adaptive use instruments project (Interview with Pauline Oliveros and Zevon Polzin). In Sounding the Margins: Collected Writings, 1992-2010 (pp. 186-190). Kingston: Deep Listening Institute. Sanchez, O. (writer/producer), B. Dickman (videographer). (2017). KU and the Lawrence community is helping those with disabilities create music with AUMI (video). In How a motion-tracking musical software is breaking down barriers for people with disabilities. University Daily Kansan. Retrieved from https:// kansan.atavist.com/a-new-instrument-atthe-university-of-kansas-is-breaking-thesocial-barriers-against-disability Tucker, S., Heyen, J., Sun Kim, C., Miller, L., Oliveros, P., Rolnick, N., Tomaz, C., & Whalen, D. (2016). Stretched boundaries: Improvising across abilities. In E. Waterman and G. Siddall, (Eds.), Negotiated Moments: Improvisation, Sound, and Subjectivity (p.181-198). Durham, NC: Duke University Press.

About the Authors Dr. Abbey Dvorak, Assistant Professor of Music Therapy at the University of Kansas, is a member of AUMI-KU InterArts since 2014 and co-facilitator of "Do You AUMI?" community jams and recording sessions. AUMIKU InterArts was the recipient of a 2017 National Endowment for the Arts Multidisciplinary and Presenting Works Grant for their project "Improvising Inclusive Communities with the Adaptive Use Musical Instrument." Contact: dvorak@ku.edu Dr. Sherrie Tucker is Professor of American Studies at University of Kansas. She is a member of two major collaborative research initiatives: International Institutes of Critical Studies in Improvisation (IICSI) and Improvisation, Community, and Social Practice (ICASP). Her research interests are improvisation, democracy, and diﬀerence.

Watch video about experiences of KU students https://www.youtube.com/watch?v=dNPPBeqlihI

AUMI Information and Tutorials For more information and tutorials on the AUMI, please go to the Adaptive Use Musical Instrument site at http:// deeplistening.org/site/adaptiveuse. If interested in using the AUMI, the desktop version is celebrating its 10th anniversary and is available for free from http://deeplistening.org/site/content/aumidownload. The IOS version – for use on mobile devices (e.g., tablet, phone) – is now four years old. The newest version, AUMI 1.1.6, is available for free from the iTunes store https://www.apple.com/itunes/. For more information about AUMI-KU InterArts or the international AUMI Research Consortium, check out the website at http://aumi.ku.edu.

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Blogging: The New Way to Educate

Amy Robertson, Ph.D., MT-BC Florida State University Tallahassee, Florida The dissemination of pertinent information regarding music therapy services and evidence-based research to other disciplines is a top priority among music therapy professionals. However, providing educational inservices can be cumbersome for music therapists and other clinical staﬀ due to time constraints and location restrictions. The use of social media blogs is becoming a more preferred option among healthcare professionals when needing to disperse current clinical and research information in a timely manner (Grajales, Sheps, Ho, Novak-Lauscher, & Eysenbach, 2014). Unlike current music therapy blogs that provide educational information specifically to music therapy professionals and clients, other healthcare professionals such as physicians, nurses, and rehabilitative therapists can benefit from music therapy blogs that provide instant access to important treatment and research content.

Blogging in the Healthcare Community Healthcare professionals such as physicians have adopted blogs as an educational resource allowing them to stay connected with fellow colleagues, network with a wider community, engage in continued medical education, and share knowledge (Panahi, Watson, & Partridge, 2014). More than 1.5 million blogs exist currently, with a small, but increasing number focusing on psychiatry, medicine and neuroscience. Educational institutions such as The Mayo Clinic utilize The Clinical

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Cases Blog which acts as a virtual round for clinicians and features cases that focus on cardiology, pulmonology, gastroenterology, immunology, etc. (Grajales et al., 2014). Hospitals have started to use blogs as well to provide educational information among clinical staﬀ members. Western Sussex Hospital in England created a blog called “Snippets” that provides direct links to journal articles, external websites, guidelines and presentations which benefit a large community of practitioners who are often restricted by work schedules and distance to attend educational meetings (Glenday, Mathew, & Roddham, 2014).

Music Therapy Blogs as an Educational Tool By utilizing a blog, music therapists can save valuable time disseminating pertinent information to other healthcare professionals eﬃciently through the Internet in place of traditional educational in-services that are time and location restrictive. Within the field of music therapy, there are blogs that focus on the distribution of information related to research, business development, and current trends in clinical practice for board-certified music therapists. However, based upon an extensive search in multiple online search engines, there were not any blogs found that focus on educating primary care givers, such as physicians or nurse practitioners, about music therapy services.

The Neonatal Beat was created to improve awareness and confidence in primary care givers working in the neonatal intensive care unit when ordering music therapy services for their patients by attempting to increase communication and knowledge within an online format (Robertson, 2016). The blog was created in WordPress and includes the latest information regarding current research in NICU music therapy practice, commonly used evidence-based interventions, and resources. A pilot study was conducted at a large tertiary facility in the southeast region of the United States in which 12 primary care givers, consisting of neonatologists, nurse practitioners, and physician assistants, participated. The hospital’s music therapy department had been providing music therapy services on a consistent basis for 8 years prior to the study. Once a week for 4 weeks, the participants received an email with a link to the blog when a new post was made, allowing them to acquire information at their convenience. Each blog post consisted of a couple of paragraphs related to NICU music therapy interventions and recent research. All participants were assigned to one of two groups: A Link/ Description group that received an email containing a short description of the blog with the link, and the Link only group which received an email with the blog link only. A repeated measures reversal pretest/posttest design was implemented across four weeks so that each group was exposed to both information dissemination approaches for a period of 2 weeks. Results showed that the blog significantly increased awareness of music therapy services in the NICU for the group that received the blog description with the link the first two weeks of the study. During the last two weeks when they were receiving only the link, this group visited the blog site more than did the other group who received the email with only the blog link the first two weeks. All of the participants reported high scores for the usefulness of the blog for acquiring information. Music therapy staff working in the NICU reported an increase in requested services during the study period, reflecting the effectiveness of the blog on the primary care givers’ awareness of NICU music therapy treatments. With the addition of a simple blog description, participants seemed to be more motivated to visit the blog, thus increasing blog traffic.

Currently, the blog is being edited and will be oﬃcially launched this summer. Over 30 neonatologists, nurse practitioners, and physician assistants working in a NICU with music therapy services have signed up to The Neonatal Beat. All members will receive an email with a description of the blog as well as the link once a month when a new entry is posted to help motivate members to look at the site. Future endeavors include video recorded interviews of neonatologists and other staﬀ discussing their experiences and perceptions of music therapy services in their NICUs as well as approval to provide continuing medical education credits through online NICU music therapy courses. If you are a music therapist or primary care giver interested in signing up for The Neonatal Beat blog, please send an email to mt4healing@yahoo.com.

References Glenday, E. J. S., Mathew, A., & Roddham, M. (2014). Snippets: Paedeatric blogging as an educational tool. Archives of Disease in Childhood, 99(1), 121-122. Grajales, F. J., Sheps, S., Ho, K., Novak-Lauscher, H., & Eysenbach, G. (2014). Social media: A review and tutorial of applications in medicine and health care. Journal of Medical Internet Research, 16(2). Retrieved from http://www.jmir.org/2014/2/e13 Panahi, S., Watson, J., & Partridge, H. (2016). Social media and physicians: Exploring the benefits and challenges. Health Informatics Journal, 22(2), 99-112. Robertson, A. (2016). Eﬀects of a social media website on primary care givers’ awareness of music therapy services in a neonatal intensive care unit. The Arts in Psychotherapy, 50, 17-21.

About the Author Amy Robertson is the newly appointed Director and Assistant Professor of Music Therapy at the University of Missouri-Kansas City. She also serves as a fellow of the National Institute for Infant and Child Medical Music Therapy. Contact: mt4healing@yahoo.com

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The Effect of NICU Music Therapy on the Symptoms of Infants with Neonatal Abstinence Syndrome

Michael R. Detmer, MME, MT-BC, University of Louisville, Norton Women’s and Children’s Hospital; Darcy DeLoach, Ph.D., MT-BC, University of Louisville; K. Dawn Forbes, MD, MS, FAAP Norton Children’s Neonatology; Rebekah Gossom, MS, CCC, SLP, Norton Women’s and Children’s Hospital, Louisville, Kentucky

Abstract The purpose of this clinical quality improvement project was to compare and determine the eﬀects of comfort care versus music therapy on the symptoms of infants with neonatal abstinence syndrome (NAS). Participants (N = 20) were newborns admitted to a regional level-3 NICU who met the project’s inclusion criteria and were randomized to a control or experimental group. The control group received standard care using a standard pacifier (orange GumDropTM). The experimental group received music therapy using the Pacifier Activated Lullaby (PAL®) 3-4 times per week throughout their hospital stay. Researchers retrieved symptom data from each patient’s

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electronic medical record including three Finnegan scores prior to and after each intervention. When the average Finnegan scores for the three assessments after the intervention were compared between groups, a significant difference was found (M experimental = 64.2, M control = 75.3, U = 2759.5, p = .05). Based on pilot data, staff observations, and previous documentation of clinical outcomes (Hamm & Walworth, 2013), music therapy may be an effective adjunct treatment to decrease withdrawal symptoms in newborns with in-utero drug exposure.

Introduction Neonatal abstinence syndrome (NAS) is a generalized disorder caused by physiological dependence from inutero drug exposure to drugs such as methamphetamines, heroin, methadone, other opiates, and SSRIs (selective serotonin reuptake inhibitors). This exposure sometimes results in symptoms of central nervous system hyperirritability, gastrointestinal dysfunction, respiratory distress, and a range of autonomic symptoms including tremors, poor feeding and sleep, excessive rooting/poor suck, and inconsolability. Symptoms of NAS are most commonly assessed using the Finnegan Neonatal Abstinence Scoring System, a 21-item, scoring tool used to measure and track symptoms of withdrawal and ultimately decide when to start, stop, increase, or decrease dosing of pharmaceuticals (Kocherlakota, 2014). The incidence of NAS has increased by almost 400% in the United States in the past decade, with some states showing significantly higher rates than others (Ko et al., 2017). For example, Kentucky (KY) has seen a 23-fold increase with 46 cases in 2001 and 1,060 in 2014. Additionally, the average total cost for all NAS admissions in KY grew from $11 million in 2005 to over $90 million in 2014 with nearly 80% of these costs incurred by Medicaid (Kentucky Department for Public Health, 2015). For more information on this topic, readers are directed to a NAS review article by Kocherlakota (2014). While pharmacological intervention is the mainstay of treatment for NAS, it can lead to a variety of adverse eﬀects. Opiate exposure to the developing brain, regardless of whether it is illicit or licit via the placenta or part of the treatment of withdrawal in the newborn, is of concern due to the potential for developmental delays. Decreasing the dosing or length of opiate treatment through the use of non-pharmacological methods such as music therapy can help minimize the iatrogenic opiate exposure and possibly decrease length of hospital stay as a result of lower Finnegan scores. Anecdotal reports from nursing staﬀ and clinical observations by the researchers of this study, including improved sleep and feeding behavior following music therapy sessions, led to the development of a protocol-driven Neonatal Intensive Care (NICU) MT program for infants with NAS at this hospital.

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The use of music as a contingency is strongly supported by research to teach infants new behaviors (Larson, 1990; Standley, 1996, 2012), including those related to feeding/sucking (Chorna, Slaughter, Wang, Stark, & Maitre, 2014; Standley et al., 2010). Standley’s (1996) meta-analysis of 98 contingent music studies demonstrated that the benefits of contingent music are almost three standard deviations greater than control/ baseline conditions, with an extremely large effect size of 2.90. In addition, Standley found that music is a) more effective than other contingent non-music stimuli and b) more effective than music played continuously. Chorna and colleagues (2014) reported that the mother’s singing voice as a contingency for sucking on a pacifier resulted in significantly increased oral feeding rates, oral volume intake, oral feeds/day, and faster time to full oral feeds.

PAL® The PAL® is an FDA approved device, which was originally developed to support premature infants in acquiring sucking skills for nipple feeding. The PAL® uses a standard pacifier (green Soothie®) fitted on a pressure-sensitive sensor that activates contingent lullaby music as positive reinforcement for the infant sucking on the pacifier. Sucking on a pacifier is a natural self-soothing skill used by many infants, however, infants with NAS demonstrate great diﬃculty with latching onto a pacifier and using it to calm due to the common withdrawal symptom of an excessive rooting reflex. Considering the reward of music for sucking delivered via the PAL®, the authors hypothesized the device would improve the infants’ ability to suck on the pacifier, thus improving their behavior state immediately prior to a feeding, a period when they can easily become agitated and inconsolable. Agitation and crying before and during a feeding can result in increased gastrointestinal symptoms and irritability due to ingested air. These increased symptoms then disrupt subsequent sleep, decrease their interest in feeding, and cause intolerance of care, which can ultimately increase their Finnegan score, and possibly their medication requirement (Detmer, 2015). Thus, the purpose of this study was to compare and determine the eﬀects of comfort care versus music therapy on the symptoms of infants with NAS.

standard pacifier (orange GumDropTM) for 10 minutes, within 30 minutes of a feeding, 3-4 times per week throughout their hospital stay. The experimental group received standard care along with music therapy via the PAL® device beginning within 72 hours of starting pharmacological intervention (i.e., morphine and clonidine). PAL® therapy was also provided for 10 minutes, within 30 minutes of a feeding, 3-4 times per week throughout each infant’s stay. Independent Variable The PAL® device uses evidence-based and ageappropriate recorded lullaby music intended for soothing neonates. The music was played via speakers within the PAL® device at the head of the infant’s bed. After the infant activated the music by sucking on the pacifier, the

Method Study Design The study design of this quality improvement project was a prospective, randomized controlled trial. It included one experimental group and one control group. The study period lasted four months, from mid-September 2016 until mid-January 2017. Participants Participants (N = 20) were newborns with a gestational age greater than 36 weeks who were admitted to a regional hospital’s level-3 NICU with a diagnosis of NAS and were treated with morphine and clonidine. The experimental group comprised of 11 participants, while the control group included 9. A diagnosis of NAS was given to newborns if they had 2 Finnegan scores of 8 or greater or 1 Finnegan score of 12 or greater. Researchers excluded patients if they had a diagnosis that would interfere with feeding, were referred based on their hearing screen, were transferred to another facility, or had neurological symptoms not associated with NAS. Procedure Following a physician’s order for music therapy, the researchers confirmed that an eligible participant met inclusion criteria, after which they randomized patients to either the control group or the experimental group using an online random number generator. The control group received standard care, which included the provision of a

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music automatically played for 10 seconds and subsequently shut oﬀ unless reactivated by the infant's suck. The settings on the PAL® were adjusted to match the infant’s suck strength. For example, if the infant had a strong suck strength (measured by the “threshold” with scores from 1-10) the therapist would increase the threshold setting, requiring the infant to suck at the higher threshold in order to activate the music. Dependent Variable An electronic medical record review retrieved three Finnegan scores prior to and after each intervention for both groups. Interventions occurred within 30 minutes of a feeding, 3-4 times per week. Nursing staﬀ, who were trained and completed annual competencies on the Finnegan scoring tool, recorded Finnegan scores at each feeding time.

Results Finnegan scores were coded for level of behavior to allow comparative analysis. The level of data was ordinal, therefore all data were analyzed with a Mann Whitney U test. The composite Finnegan scores for the three assessments prior to each intervention and the three assessments after each intervention were averaged and compared between groups. No significant diﬀerences between groups were found for the three assessments prior to the intervention, indicating the groups were similar (M experimental = 73.3, M control = 65.3, U = 2100, p = .12). When the average Finnegan scores for the

three assessments after the intervention were compared between groups, a significant diﬀerence was found (M experimental = 64.2, M control = 75.3, U = 2759.5, p = . 05). As displayed in Figure 1, the control group increased mean rankings while the experimental group decreased mean rankings after the intervention, indicating the experimental group had lower Finnegan scores, thus were less symptomatic following the intervention.

In future studies with infants with NAS, it would be interesting to look at the eﬀects of music therapy using the PAL® on length of morphine treatment; length of hospital stay; feeding behavior; sleep behavior and duration; and gastrointestinal (GI) disturbances, a section of the Finnegan scoring system. The severity of GI symptoms may decrease as infants’ suck pattern improves because they may not consume milk as quickly and/or have an uncoordinated suck pattern, causing less irritation to their digestive systems. In summary, the improvement in Finnegan scores for those receiving PAL® interventions warrants further investigation on how the PAL® device can be used as a non-pharmacological intervention to improve withdrawal symptoms in those with NAS.

References

Figure 1: Composite Finnegan Scores before and after each intervention by group.

Discussion These data indicate music therapy via the PAL® is an effective treatment modality and is more effective than only a pacifier, as indicated by the improvements in Finnegan scores. This may be due to increased nonnutritive sucking—a self-soothing behavior often compromised in infants with NAS—as a result of the contingent music reinforcement offered by the PAL®. Music therapists can also empower and involve parents at the bedside, and interventions such as the PAL® are reimbursed by many third-party payers. This innovative quality improvement project will serve as a pilot to support the design of a more rigorous, multi-site study expected to launch in the next year. Finally, this study and the associated music therapy program for the hospital is a winner of the 2017 Kentucky Hospital Association Quality Award. As a quality improvement project, there are many limitations including the small sample size, not tracking the length of time infants were held and rocked by family or visitors, and lack of grouping by drug of exposure.

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Chorna, O. D., Slaughter, J. C., Wang, L., Stark, A. R., & Maitre, N. L. (2014). A pacifier-activated music player with mother's voice improves oral feeding in preterm infants. Pediatrics, 133(3), 462-468. Detmer, M. R. (2015). Using music for calming with neonatal abstinence syndrome (NAS). Paper presented at the Substance Exposed Pregnancies, Louisville, KY. Hamm, E. L., Walworth, D. (2013). Using the Pacifier Activated Lullaby ® with infants diagnosed with neonatal abstinence syndrome. imagine, 4(1), 62-63. Kentucky Department for Public Health, Division of Maternal and Child Health (2015). Neonatal abstinence syndrome in Kentucky: Annual report. Frankfort, KY. Kocherlakota, P. (2014). Neonatal abstinence syndrome. Pediatrics, 134: e547-e561. Ko, J. Y., Wolicki, S., Barfield, W. D., Patrick, S. W., Broussard, C. S., Yonkers, K. A., . . . Iskander, J. (2017) CDC grand rounds: Public health strategies to prevent neonatal abstinence syndrome. Morbidity and Mortality Weekly Report, 66(9), 242-245. Larson, K., & Ayllon, T. (1990). The effects of contingent music and differential reinforcement on infantile colic. Behaviour Research and Therapy, 28(2), 119-125. Standley, J. M., Cassidy, J., Grant, R., Cevasco, A., Szuch, C., Nguyen, J., . . . Adams, K. (2010). The effect of music reinforcement for non-nutritive sucking on nipple feeding of premature infants.

Continuing Nursing Education, 36(3), 138-145. Doi: 20687305 Standley, J. (2012). Music therapy research in the NICU: An updated meta-analysis. Neonatal Network, 31(5), 311-316. Standley, J. (1996). A meta-analysis on the eﬀects of music as reinforcement for education/therapy objectives. Journal of Research in Music Education, 44(2), 105-133.

About the Authors Michael R. Detmer, M.M.E., MT-BC is the co-founder of Innovative Therapeutix, Inc., a NICU music therapist, and adjunct faculty member at University of Louisville and Norton Women’s and Children’s Hospital in Louisville, KY. His primary clinical and research focus is the neurodevelopment of infants including those with neonatal abstinence syndrome and feeding problems. Contact: michael.detmer@louisville.edu

Darcy DeLoach, Ph.D., MT-BC is the Director of Music Therapy at the University of Louisville. Her research focuses are neonatal intensive care unit music therapy interventions, music therapy for procedural support, and early childhood development including children with autism spectrum disorder. K. Dawn Forbes, MD, MS, FAAP is a senior neonatologist with Norton Children’s Neontology in Louisville, KY, covering five neonatal intensive care units. Dr. Forbes is board certified in neonatal-perinatal medicine and pediatrics and specializes in the care and improved outcomes of infants and families aﬀected by substance use disorder and infant withdrawal. Rebekah R. Gossom, MS, CCC-SLP is the co-founder of Innovative Therapeutix, Inc. and a speech-language pathologist at Norton Women’s and Children’s Hospital in Louisville, KY. She specializes in the evaluation and treatment of neonatal and pediatric feeding and swallowing disorders, craniofacial abnormalities, and enhancing developmental outcomes for infants within the NICU.

Learn more about this study and working with infants with NAS at the 2017 AMTA conference in St. Louis: CMTE H on Thursday and MTex on Friday.

Congratulations to the study team for receiving the Kentucky Hospital Association Quality Award.

Acknowledgment The authors would like to express sincere gratitude to students of the University of Louisville, particularly Madison Whelan and Alex Ruﬀner, Sanya Mehta, and Aakash Mehta who were truly invaluable to the success and completion of this study; the staﬀ at Norton Women’s and Children’s Hospital for their patience and support during data collection; and the parents and families who allowed us the opportunity to work with their child.

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INFOGRAPHIC

HOW DO MUSIC THERAPISTS WORK WITH YOUNG CHILDREN? Findings from an international survey of music therapists worldwide. Conducted by Petra Kern and Daniel B. Tague

38.2% of music therapists work with infants/children (birth-5) who are mainly referred by therapists, doctors, family members, and teachers.

32.7% see 21-50 clients per week offering individual and group sessions as well as other services for children, families, and communities.

Most music therapists address communication, emotional, and social goals and assess/document their young clientsâ&#x20AC;&#x2122; progress continuously.

Music therapists most frequently use instrument play, singing/vocalization, and musical improvisation in music therapy sessions with young children.

Over 88% of music therapists feel confident in providing effective music therapy services to young children, but would like to see more certificate training opportunities.

Source: International survey of 2,495 music therapists representing members of WFMT affiliated organizations in 7 regions. More on the survey can be found in an upcoming issue of the Journal of Music Therapy. Icons made by Freepik from www.flaticon.comÂ

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Photo courtesy of Tom Fougerous

* Michael R. Detmer M.M.E, MT-BC Petra Kern, Ph.D., MT-BC, MTA, DMtG University of Louisville Louisville, Kentucky

Michael Detmer, MME, MT-BC, and Petra Kern, Ph.D., MT-BC, MTA, DMtG, are investigators of the Intergenerational Music Therapy study conducted at UofL’s Early Learning Campus. Contact: michael.detmer@louisville.edu

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Implementing an Intergenerational Music Therapy Program Intergenerational programming is mutually beneficial for participating generation groups. Children and older adults involved in intergenerational activities demonstrate improved attitudes toward and interaction with the opposite age group (Belgrave, 2011; Isaki & Harmon, 2015). Older adults also demonstrate increased physical activity/function, intellectual ability, and improvements in areas related to quality of life (Sakurai et al., 2016). However, a wide gap exists in intergenerational research literature due to the existence of very few music-based studies, with even a smaller number involving young children. Moreover, to date, there has only been one published intergenerational music therapy study (Belgrave, 2011). The intent of this article is twofold: 1) to provide a brief summary of a study conducted at the University of Louisville’s Early Learning Campus and 2) to oﬀer lessons learned for planning and implementing an intergenerational music therapy program with young children and older adults.

* * * * * *

Purpose The purpose of the study was to measure the eﬀects of an intergenerational music therapy program on a) children’s alphabet knowledge and receptive vocabulary skills, b) older adults’ physical functioning and self-worth, and c) the intergenerational interactions between the two groups.

Participants Participants of the study were three and four-year-old children (n = 30) from a university-based child care setting and older adults (n = 13) between 72 and 98 years old from a senior living facility, some with cognitive impairments such as Alzheimer’s disease, dementia, and Parkinson’s disease.

Settings/Materials The study took place at the University of Louisville's Early Learning Campus in a large open space art studio. Materials used in each session included video/photo equipment, instruments, craft items, visuals/props, chairs, and 12 carefully selected, singable storybooks.

Study Design The study used a true experimental, single blind, pretest-posttest design consisting of a experimental group and a wait-list control group.

Measures The following tools were used in this study: Alphabet Knowledge Test, Peabody Picture Vocabulary Test™, Elder-Child Interaction Analysis Tool, Fitbit® Device, Berg Balance Scale, Rosenberg Self‐Esteem Scale©, and structured interviews.

Procedures The experimental group participated in 30-minute semi-weekly music therapy groups for 12 weeks, after which post-testing was conducted during a one-week break; then the wait-list control group began, following a similar, but shorter program for four weeks. Each session was co-led by two board-certified music therapists.

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Stay tuned for the results of this study!

1 3

Each session followed an evidence-based structure for early-childhood music therapy groups (Gooding, 2013). Twelve session plans, following a theme based on each of the books, were designed and implemented each week, and then repeated once for the second 6 weeks. For the wait-list control group, 4 of the 12 experimental sessions were randomly selected and then implemented in chronological order, and similarly repeated during the second two weeks.

Next, the therapists began playing and singing the greeting song (3 minutes), How Do We Say Hello (Kern & Detmer, 2017), to promote intergenerational interaction. Embedded in the song were prompts for the children to oﬀer suggestions on how they could greet one of their grandfriends. Next, the lead therapist began the transition song, We’re All Done With... (Detmer & Kern, 2017) to cue the participants for the next activity. At this time, a movement activity (5 minutes) to improve older adults’ physical functioning was introduced, which often required all chairs to either be moved to the center or perimeter of the room before beginning. Orange tape was used on the floor to create a movement path around the perimeter of the room, which provided structure and boundaries for the participants. The signature transition song, We’re All Done With..., was then used to move chairs back to their original places.

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The older adults were instructed to arrive early to get situated and get their walkers/ canes arranged outside the group circle. The walker/canes of the adults were then placed behind their chairs or around the perimeter of the room if they were not needed for moving short distances. During the 10 minutes leading up to the session, one music therapist played and sang the gathering song, It’s Time for Music (Detmer & Kern, 2017), to orient participants and allow for room set-up. During this time, the other music therapist retrieved the children from their classrooms. When the children were in a line outside of the session room, the therapist led them in slowly. Staﬀ and student volunteers directed them toward their chair, which had been labeled with their name. Once seated, every participant was given two egg shakers. The music therapists repeated the song two more times, increasing the tempo to actively engage and energize the participants. This served as a cue for staﬀ and assistants to collect all the egg shakers.

Instrument play/music making (5 minutes) to promote intergenerational interaction was next, followed by storybook singing (5 minutes) to improve literacy skills. The therapists and assistants were positioned around the room, holding the books for the participants to see during the singing of the text. Next, was storybook reading (5 minutes) to improve literacy skills. At this time, each adult received a copy of the story book, with which all were familiar, having seen it on the bus ride to the child care center. Then, they were instructed to read the book to the assigned children. At the end of the storybook reading, the lead therapist led an exercise, We’re Going on a Letter Hunt, in which 3-4 diﬀerent letter visuals were held up one at a time. The children were instructed to find the letter in their book. Each of the 26 letters were used in this activity at least two times over the course of the 12-week study period. The therapists and assistants moved around the room during the letter hunt to reinforce or assist the children if needed. They also asked a follow up question, “What sound does the letter ___ make?” after the children had successfully pointed to the indicated letter. After the letter hunt, the lead therapist again used the signature transition song, We’re All Done With Drumming. (Detmer & Kern, 2017), to collect the books and signal the end of the session. At this point, the goodbye song, Let’s All Say Goodbye (Kern & Detmer, 2017), was sung to promote intergenerational interaction. All grandfriends were encouraged to use their bodies (e.g., wave, shake hands, or give a hug) to say goodbye. Following the goodbye song, the children were instructed to quietly line up and follow a staﬀ member out of the room and back to their classroom. The adults were then given their walkers/canes, took the elevator to the ground floor, and departed on the bus.

Watch video about the Clinical Protocol at https://youtu.be/vdgLm4UXTRo

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Running an intergenerational music therapy program with limited evidence-based information to draw from was challenging, but rewarding experience. Many logistical issues presented, and excellent lessons learned will be applied in future programs. First, for a group of this size, two to three assistants are needed to pass out materials during the session to eﬀectively facilitate transitions. Before each session, assistants should be told of when transitions will occur and when instruments/materials should be passed out and collected. This can be accomplished by using an assistant session plan. Lag times during a session involving young children and adults with memory impairments may result in increased problem behaviors. Physical prompting may be less intrusive and more eﬀective than verbal prompting. Finally, the use of volume variability (e.g., whispering and melodic vocal contour) is critical of the therapist’s voice to optimize engagement and/or redirect participants during periods of distraction or disengagement. Next, a clear walking path should be laid out on the floor. For this study, American Educational Products 2” floor tape was used to create a visual “sidewalk.” This path was referred to often during the sessions; it aided participants during large transitions such as getting up out of their chair, moving the chair to the perimeter of the room, then coming back to get in a standing circle for the movement activity. The musical complexity and instrument choices for interventions should be thoughtfully planned and designed to promote success for each age group. For example, three-year-olds may not play rhythmically or use a pitched instrument such as a boomwhacker on a designated beat to create harmony. Instead, this age group is much more successful with music making that is more reliant on starting and stopping, or changing the dynamic or quality of playing.

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The room set-up is also critical to facilitate meaningful interactions between the adults and children. The children’s chairs should be facing the adults’, otherwise the children will focus their attention on the music therapist(s) leading the activity. Two to three children per adult seems to work best, but for those adults with more cognitive impairment, working with one child at a time may be more eﬀective. Another consideration is whether or not to randomize the seating chart for each session. For this study, the authors randomized which children were placed with which adult each day to control for variability in cognition or interaction behavior so that each child was exposed to every adult for the same dosage. Future studies should address if keeping the children with the same adult would more quickly increase their positive interaction behaviors. Finally, if measuring physical activity, be aware that some pedometers are not able to accurately detect step counts for those that use a walker or cane. In addition, adults with memory impairments may not be compliant with wearing a pedometer or may lose it. Additional staﬃng may be needed to ensure devices are placed correctly, charged, and data is synced regularly. Waterproof pedometers are recommended. Furthermore, if a visual display is available, many adults prefer having it set on the clock option.

Watch video about the UofL News Story at https://youtu.be/hzmspyAKHY0

References Belgrave, M. (2011). The eﬀect of a musicbased intergenerational program on children and older adults’ intergenerational interactions, cross-age attitudes, and older adults’ psychosocial well-being. Journal of Music Therapy, 48(4), 486-508. Gooding, L. F. (2013). Structuring early childhood music therapy groups. imagine, 4(1), 54-57. Isaki, E., & Harmon, M. T. (2015). Children and adults reading interactively: The social benefits of an exploratory intergenerational program. Communication Disorders Quarterly, 36(2), 90-101. Sakurai, R., Yasunaga, M., Murayama, Y., Ohba, H., Nonaka, K., Suzuki, H., . . . Fujiwara, Y. (2016). Long-term eﬀects of an intergenerational program on functional capacity in older adults: Results from a seven-year follow-up of the REPRINTS study. Archives of Gerontology and Geriatrics, 64, 13-20.

Note Signature songs composed by Detmer and Kern for this study are available in the Intervention Ideas section.

Acknowledgement The authors would like to thank the collaborating researchers Dr. Jill Jacobi-Vessels and Dr. Kristi King as well as Joanie Lepping Gills; Bailey Carter; the interns Samantha Hinson, Madison Whelan, Alex Ruﬀner, and Holly Hankin; and students enrolled in the research course for their incredible support and enthusiasm for this study.

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PRACTICE

Digital Documentation in Early Childhood Music Therapy Settings Lori F. Gooding, Ph.D., MT-BC Florida State University Tallahassee, Florida

Documentation of information related to clinical services is intended to assist with treatment and facilitate communication with clients, families, and other providers. Music therapists must meet documentation standards outlined in the American Music Therapy Association Standards of Clinical Practice, adhere to compliance standards set by local, state, and federal entities, and ensure that data is secure. The use of digital documentation in music therapy is growing, and digital documentation practices can save time, promote standardization, and provide information that will enhance treatment. However, digital documentation is not without its challenges. This article provides an overview of digital documentation, strategies for implementation, and suggestions for ethical and legal compliance in early childhood settings.

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Introduction Documentation in early childhood settings typically focuses on observing and recording a child’s development and learning (Parnell & Bartlett, 2012). Specific documentation practices vary, but common elements include descriptions of activities or interventions, samples of a child’s work (e.g., photos), provider/parent comments, child comments, and/or analysis or interpretation of the experience and the child’s development (Seitz, 2008). Music therapists are required to document whenever services are provided, but what and how to document is the music therapist’s purview (AMTA, 2015; Waldon, 2016). Typically, music therapy documentation includes information related to clinical services for a client that is collected and recorded throughout the music therapy treatment process (Waldon, 2016). Music therapists, like other early childhood providers, often rely on behavioral observations to document progress, and technology has been used to facilitate data collection for over 20 years (Jellison & Gainer, 1995; Standley & Hughes, 1996; Sussman, 2009). In the mid-1990s, Jellison and Gainer (1995) used a computer program to document child participation while Standley and Hughes (1996) used video recordings and a checklist to document developmentally appropriate objectives. More recently Sussman (2009) also used video recordings to collect data on preschool aged children’s sustained attention. Modern documentation practices have become even more technology dependent (Parnell & Bartlett, 2012; Piper, D’Angelo, & Holland, 2013; Waldon, 2016), and providers now use technology to collect, store, and convey information. For example, providers often use smartphones and tablets to take notes and/or make audio/video recordings. Apps for the iPad and other tablets have also altered documentation practices, and apps like ABC Data Pro, Behavior Tracker Pro, and iReward Chart are readily available for use in music therapy practice (Knight, 2013). These apps are particularly useful for behavioral observations as they can facilitate timely and accurate data collection (Gregory, 2000; Knight, 2013). Information collected during music therapy services can be stored electronically in narrative, behavioral, and/or audio/visual formats. Tangible products (work samples)

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may likewise be included (Parnell & Bartlett, 2012). Perhaps most importantly, technology has expanded how providers communicate information, with email, digital storage devices, blogs, classroom technology (e.g., computer or projector), and online portfolios all used in early childhood settings (Hertzog & Klein, 2005; Parnell & Bartlett, 2012). Regardless of the format or tools used, it is important to remember that documentation must be compliant with facility, local, state, and federal standards including the Health Insurance Portability and Accountability Act (HIPAA) and the Family Educational Rights and Privacy Act (FERPA). As a result, music therapists must be aware of who has access to child records and must monitor the quality, content, and relevance of all documentation (Waldon, 2016).

Benefits of Digital Documentation Digital documentation has several benefits. Technology allows for easy aggregation of data across children and time (Piper, D’Angelo, & Holland, 2013) and facilitates standardization, enhances treatment, and provides helpful information (Gregory, 2000). Digital documentation can save time, allow for convenient access to data, and increase accuracy (Gregory, 2000; Knight, 2013; McFadden & Thomas, 2016). Digital documentation can also help providers reflect on and refine their instructional practices, share information with colleagues, communicate with families, and make learning visible (McFadden & Thomas, 2016; Piper, D’Angelo, & Holland, 2013). Digital documentation can even enhance parent involvement and connect the home and learning environments (Hertzog & Klein, 2005; McFadden & Thomas, 2016). Finally, for tech-savvy providers, digital documentation may reduce workload (McFadden & Thomas, 2016).

Challenges of Digital Documentation Though digital documentation has many benefits, it is not without its challenges. Technical issues may interfere with use and increase the time burden for providers and families (McFadden & Thomas, 2016). Music therapists must remember that documentation technology should not disrupt or diminish therapeutic practices in the classroom or other settings (Piper, D’Angelo, & Holland, 2013); instead it should accommodate user needs

(Knight, 2013). Privacy and security concerns also exist, and digital formats require providers to be aware of potential security breaches and understand how to keep data secure (Knight, 2013). This is especially important given that research has shown that parents are concerned about the ethical use, security, and privacy of electronic records (Cavanaugh, 2015; McFadden & Thomas, 2016). Consequently, music therapists need to familiarize themselves with FERPA and HIPAA regulations, and ensure that all technology-based documentation practices are both ethical and compliant with the standards outlined in the laws (e.g., compliant with HIPAA regulations for cloud-computing services) (Bates, 2014). If your facility does not have a digital policy, then it is important to develop strict protocols that safeguard all clinically relevant information. These

policies should include everything from digital storage to social media (Reamer, 2013).

Conclusion Digital documentation can be a powerful tool for music therapy practice. Music therapists must ensure that digital formats accurately communicate the development of the children that they serve, and that all documentation formats are compliant with organizational, local, state, and federal ethical and legal standards. Music therapists who use digital documentation may benefit greatly, but they should also be aware of the technical and usage challenges. Ultimately, digital documentation should enhance documentation practices and improve communication between providers and families.

Strategies for Using Digital Documentation Eﬀective use of digital documentation requires music therapists to consider what is most important to convey when choosing appropriate documentation strategies (Parnell & Bartlett, 2012). Likewise, the diverse needs of individuals and families must also be considered when developing documentation policies (McFadden & Thomas, 2016). The following points should be carefully considered when choosing the best documentation approach for music therapy practice:

• • • • • • • • • •

Collaboration and communication with families is essential (Knight, 2013; McFadden & Thomas, 2016); music therapists should consider working with families to determine which practices best facilitate communication (Knight, 2013; Parnell & Bartlett, 2012). Ensure that all parties have access to digital documentation before incorporating it into their practice (McFadden & Thomas, 2016). Issues that may impede access include cost, applicable devices or systems (e.g., apple, android, smartphone, desktop, etc.), and skills required for use (Knight & Krout, 2016). Address parent concerns regarding digital documentation (McFadden & Thomas, 2016). Retain ethical best practices in all documentation procedures, including those based in technology (Knight, 2013; Waldon, 2016). Music therapy documentation practices must correspond to best practices and standards of care (Waldon, 2016). Obtain permission to post and/or ensure that information is password protected when using social media for documentation purposes (Parnell & Bartlett, 2012). Ensure that digital devices are ready for use at all times (Parnell & Bartlett, 2012). Consider using apps or software to help organize the information that you collect (Parnell & Bartlett, 2012). Commit the time to learn how to use the technology before implementing it in music therapy practice. Be willing to ask for help or seek out training if needed (Kern & Hayhurst, 2016; Knight, 2013; Parnell & Bartlett, 2012). Stay current in terms of technology changes and be aware of how these changes will impact clinical and documentation practices (Knight & LaGasse, 2012).

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References American Music Therapy Association (2015). Standards of clinical practice. Retrieved from http://www.musictherapy.org/about/standards/ . Bates, D. (2014). Music therapy ethics 2.0. Preventing user error in technology. Music Therapy Perspectives, 32, 136-141.doi: https://doi.org/ 10.1093/mtp/miu030 Cavanaugh, S. (2015, September 21). Parents at ease with use of student data, but not for commercial purposes. Retrieved from http:// blogs.edweek.org/edweek/DigitalEducation/ 2015/09/parents_comfortable_with_schoo.html? _ga=1.90943580.737908353.1492189096 Gregory, D. (2000) Information sharing: Technological assistance in client assessment–Implications for music therapy. Music Therapy Perspectives, 18, 69-71. doi: https://doi.org/10.1093/mtp/18.1.69 Hertzog, N., & Klein, M. (2005). Beyond gaming: A technology explosion in early childhood classrooms. Gifted Child Today, 28, 24-31; 65. Jellison, J. A., & Gainer, E. W. (1995). Into the mainstream: A case-study of a child’s participation in music education and music therapy. Journal of Music Therapy, 32, 228-247. doi: https://doi.org/10.1093/jmt/32.4.228 Kern, P., & Hayhurst, B. (2016). Skill generalization: Intentional use of apps in music therapy sessions and beyond. imagine, 7, 98-101. Knight, A. (2013). Uses of iPad applications in music therapy. Music Therapy Perspectives, 31, 189-196. doi: https://doi.org/10.1093/mtp/ 31.2.189 Knight, A., & LaGasse, A. B. (2012). Re-connecting to music technology: Looking back and looking forward. Music Therapy Perspectives, 30, 188-195. doi: https://doi.org/10.1093/mtp/ 30.2.188 Knight, A., & Krout, R. (2016). Making sense of today’s electronic music technology resources for music therapy. Music Therapy Perspectives. Advance online publication. doi: https://doi.org/10.1093/ mtp/miw025 . McFadden, A., & Thomas, T. (2016). Parent perspectives on the implementation of a digital documentation portal in an early learning

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centre. Australasian Journal of Early Childhood, 41(4). Parnell, W. A., & Bartlett, J. (2012). iDocument: How smartphones and tablets are changing documentation in preschool and primary classrooms. Young Children, 67(3), 50-59. Piper, A. M., D’Angelo, S. D., & Holland, J. D. (2013). Going digital: Understanding paper and photo documentation practices in early childhood education. Proceedings of the 2013 Conference on Computer Supported Cooperative Work (pp. 1319-1328). San Antonio, TX. Reamer, F. G. (2013). Social work in the digital age: Ethical and risk management challenges. Social Work, 58, 163-172. doi: https://doiorg.proxy.lib.fsu.edu/10.1093/sw/swt003 Seitz, H. (2008). The power of documentation in the early childhood classroom. Young Children, 63, 88- 93. Retrieved from https://www.naeyc.org/ files/tyc/file/Seitz.pdf 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, 87-94. doi: https:// doi.org/10.1093/mtp/14.2.87 Sussman, J. E. (2009). The eﬀect of music on peer awareness in preschool age children with developmental disabilities. The Journal of Music Therapy, 46, 53-68. doi: https://doi.org/10.1093/ jmt/46.1.53 Waldon, E. G. (2016). Clinical documentation in music therapy: Standards, guidelines, and laws. Music Therapy Perspectives, 34, 57-63. doi: https:// doi.org/10.1093/mtp/miv040

About the Author Lori Gooding, Ph.D., MT-BC, is Past President of the SER-AMTA and Assistant Professor of Music Therapy at Florida State University. Contact: lgooding@fsu.edu

Apps for Behavior Management in Early Childhood Music Therapy

Amelia Ehmling, MT-BC, Melissa Deaton, MT-BC, and Olivia Swedberg Yinger, PhD, MT-BC University of Kentucky, Lexington, Kentucky This article reviews five easy-to-use mobile applications, or apps, that early childhood music therapists can use for behavior management, four of which users can download at no cost. Two of the apps provide information about how to address diďŹ&#x192;cult behaviors (Changing the Worst Classroom Behavior and A Closer Look at Behavior, both of which are available for Android OS and Apple iOS). Three of the apps allow users to track behaviors (Behavior World Reward Chart: Class and Chore Tracker, MyClassRules Noise Monitor and Class Management, and Best Behavior, which are available for Apple iOS).

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Introduction The past decade has seen incredible growth in the number of apps, particularly since the release of the Apple iPhone in 2007 (Ritchie, 2017). A year later, in 2008, the first Android phone became available (German, 2011). Although tablets had been in use in some form for decades, mobile apps were not widely used on tablets until the release of the Apple iPad in 2010 (Nations, 2017), followed closely by the Samsung Galaxy Tab 8.9, which used the Android OS, in 2011 (Nield, 2016). As of March 2017, the two largest app stores were Google Play (for devices that

use Android OS), which contains approximately 2,800,000 apps, and the Apple App Store (for devices that use iOS), which contains approximately 2,200,000 apps (Statista, 2017). Educators, parents, and therapists have written about the use of apps with children who have disabilities (More & Travers, 2012; Roth, 2013), particularly autism spectrum disorder (ASD) (Hourcade, Williams, Miller, Huebner, & Liang, 2013; Joshi, 2011). There are numerous apps that can be used in music therapy practice (Hayhurst, 2015; Hayhurst & Antes, 2017; Mews, 2013) for various purposes, including business, communication, documentation, relaxation, making music with digital musical instruments (e.g., guitar, piano, drums), musical games, music readers, music storage, music video creation, and picture schedules (Hayhurst & Antes, 2017; Kern 2013). The purpose of this article is to provide reviews of five apps that can be used by music therapists for behavior management in early childhood settings, either by

providing information about how to address diďŹ&#x192;cult behaviors or by allowing users to track behaviors. The authors first determined inclusions and exclusion criteria for apps. In order to be included in this review, apps needed to be able to either provide information on behavior management strategies or track progress toward behavioral goals. Given the large body of literature that already exists regarding apps for children with ASD, apps that were created solely for use with children on the autism spectrum were excluded, as were apps that cost more than $20. Two of the authors searched the Apple App Store and the Google Play Store for apps that met inclusion criteria. In addition to recording information about the developer, the price, the purpose of the app, and the app store review rating (see Tables 1 through 5), the authors rated the ease of use of each app based on the authorsâ&#x20AC;&#x2122; opinions. The authors also used an appraisal form created by More & Travers (2013) to review Behavior World.

A Closer Look at Behavior (Android, Version 2)

Store

Developer

Price

Purpose

App Store Rating

Ease of Use

Google Play Store (also available from Apple App Store)

alma beaudoin

Free

to provide information on behavior management

No ratings

Very easy

A Closer Look at Behavior provides information about children with behavioral or mental health needs for teachers or therapists working in educational settings. Information is sorted into categories so that users can navigate to information on specific behaviors or symptoms, although the navigation system is not completely intuitive. This app could serve as a quick review guide on behavior management, although it is not intended to serve as the only resource on behavior management for educators or therapists. Music therapists or students looking for a quick supplemental pocket guide of behavior management tips would find this app most helpful. Because the information is organized into short bullet points and divided into categories of types of behavior, specific management techniques can be accessed and reviewed quickly before and in between sessions.

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Behavior World Reward Chart: Class & Chore Tracker (Apple, Version 1.1.3)

Store

Developer

Price

Purpose

App Store Rating

Ease of Use

Apple App Store

Helping Hand System, LLC

Free

to create customizable positive reinforcement reward charts

5/5

Very easy

Behavior World Reward Chart was created by pediatric occupational therapists in collaboration with Applied Behavior Analysis (ABA) specialists. The instructions are clear and walk the user through the setup step-by-step. The initial instructions were simple (register account, name, person using app, childâ&#x20AC;&#x2122;s name, etc.) but at one point, the app requires the user to email the childâ&#x20AC;&#x2122;s guardian for consent to use the app. The user sets specific target behaviors, types of positive reinforcement, and the number of times the target behavior needs to occur before the child receives reinforcement. The authors also included an additional review format because the app encourages the child to participate. The child may choose a character to represent them and a setting in which their character exists. Every time the target behavior occurs, the childâ&#x20AC;&#x2122;s character jumps to a new spot on the screen and earns a token. If the behavior does not occur, the character can jump back a space and lose a token. Once the child earns the set amount of tokens, fireworks shoot across the screen and the app shows the positive reinforcement earned. Behavior World has features that would make creating behavior charts fun for children.

This could be a great app to use with three- to five-year-old children who are working on learning any type of target behavior addressed in music therapy treatment. Because the app requires input from the child, the process of creating a reward chart engages the child and promotes autonomy. The aesthetic appeal of the chart and the app could also make the incorporation of a reward chart into treatment plans less tedious. The app is extremely user friendly and simple enough for a child to look at, understand, or even help operate. When appraising Behavior World with the More & Travers (2013) criteria, it scores 75/100 (i.e., Accessibility: 23; Content: 30; and Individualization 14).

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MyClassRules Noise Monitor & Class Management (Apple, Version 1.6)

Store

Developer

Price

Purpose

App Store Rating

Ease of Use

Apple App Store

Tap Play Learn Pty. Ltd.

$2.99

to keep students/ clients quiet in classroom

5/5

Very easy

MyClassRules uses the microphone on the user's mobile device to record sound levels in a treatment room or classroom. Instead of sounding an alarm when the sound level gets too high, students receive points as a reward when the sound stays below a certain level chosen by the therapist. Points are not traded in for anything on the app itself, but since the app records students' scores, users can review and compare progress over time, allowing the app to function as an electronic reward chart. This app uses positive reinforcement instead of positive punishment to decrease inappropriate group noise. It is easy to use and would be simple to incorporate within a music therapy setting, particularly when teaching young children appropriate sound levels when playing instruments, singing, or speaking with an "inside voice."

Best Behavior (Apple, Version 1.0.8)

Store

Developer

Price

Purpose

App Store Rating

Ease of Use

Apple App Store

eKrios Consulting, LLC

Free

to track and graph student/client behavior

No reviews

Easy

Best Behavior allows the user to track and chart various behaviors seen in the treatment setting. The user specifies the antecedent, behavior, and treatment. After the user records how many times the behavior occurred, the app creates a graph to show how the eďŹ&#x20AC;ectiveness of the treatment. Best Behavior allows the user to make multiple individual profiles for children. This app is visually appealing, organized, and easy to use. The only drawback is that the instructions are not entirely clear, so users should set aside time to become familiar with the app before incorporating it in a treatment setting.

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Changing the Worst Classroom Behavior (Android, Version 1.1)

Store

Developer

Price

Purpose

App Store Rating

Ease of Use

Google Play Store (also available for $1.99 from Apple App Store)

Cristia LesherAssociates, LLC

Free

to provide information on behavior management, with video demonstrations

4.2/5

Very easy

Changing the Worst Classroom Behavior provides a catalog of filmed presentations by Polly Bath, a teacher and behavior consultant with Cristia Lesher Associates, an organization that provides K-12 staﬀ development and consulting. The videos in this app are short and oﬀer quick tips on managing specific behaviors likely to be encountered in a special education, inclusive, or general classroom setting. Information presented is tied to reallife, practical examples. There is a summary of the information provided below each video. Videos can be shared directly to Facebook, Twitter, and Google Plus. All of the videos found on the app, as well as a few additional videos, can be accessed on the presenter’s YouTube channel: PollyBathBehaviorTV. Although the information presented in the Changing the Worst Classroom Behavior app is useful, the content and additional videos are easily accessible through YouTube, making this app somewhat unnecessary for those with access to YouTube.

Summary There are many behavior management apps available, and finding the right app for use in an early childhood music therapy setting can be overwhelming. This list of behavior management apps is not intended to be exhaustive; rather, it is meant to provide a quick guide for music therapists hoping to learn more about behavior management or to track behaviors. All of the apps reviewed are inexpensive and easy to use. The decision about which app to use largely depends on the purpose for which the app is intended.

References Alma Beaudoin. (2015). A Closer Look at Behavior (2.0) [Mobile application software]. Retrieved from http:// play.google.com. Cristia Lesher Associates. (2016). Changing the Worst Classroom Behavior (1.2) [Mobile application software]. Retrieved from http://play.google.com

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eKrois Consulting. (2016). Best Behavior (1.0.8). [Mobile application software]. Retrieved from http:// itunes.apple.com German, K. (2011, August 2). A brief history of Android phones. Retrieved from https://www.cnet.com/ news/a-brief-history-of-android-phones/ Hayhurst, B. (2015). There's an app for that TWO! Retrieved from https://musictherapyed.com/ courses/bonnie-hayhursts-ipad-cmte/ Hayhurst, B., & Antes, E. (2017). App recommendations and reviews for music therapists. Retrieved from http://groovygarfoose.com/apps/ Helping Hand System. (2015). Behavior World Chart: Class & Chore Tracker (1.1.3) [Mobile application software]. Retrieved from hrrp://itunes.apple.com Hourcade, J. P., Williams, S. R., Miller, E. A., Heubner, K. E., & Liang, L. J. (2013, April). Evaluation of tablet apps to encourage social interaction in children with autism spectrum disorders. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. (pp. 3197-3206). ACM.

About the Authors Amelia Ehmling, MT-BC, graduated from The University of Louisville and is currently pursuing her Masters of Music Therapy at the University of Kentucky. She works in the medical setting as a part time music therapist at University of Kentucky Healthcare. Contact: amelia.ehmling1@uky.edu Melissa Deaton, MT-BC graduated from William Carey University after completing her internship in hospice and palliative care. She is currently a graduate student at the University of Kentucky and works with children with developmental disabilities. Contacts: melissa.deaton@uky.edu Olivia Swedberg Yinger, Ph.D., MTBC is Director and Assistant Professor of Music Therapy at the University of Kentucky. Her research interests include neonatal and pediatric music therapy, as well as the use of music with children with disabilities in educational settings. Contacts: olivia.yinger@uky.edu

Joshi, P. (2011). Finding good apps for children with autism. New York Times Gadgetwise Blog. Retrieved from http:// gadgetwise.blogs.nytimes.com/2011/11/29/ finding-good-apps-forchildren-with-autism/ Kern, P. (2013). Resources within reason: Technology applications to support your work, Part 3. Young Exceptional Children, 16(3), 39-40. Mews, J. (2013, December 2). Music therapists sharing favourite apps. Retrieved from https:// musicheals.ca/music-therapists-sharing-favouriteapps/ More, C. M., & Travers, J. C. (2013). Whatâ&#x20AC;&#x2122;s app with that? Selective educational apps for young children with disabilities. Young Exceptional Children, 16, 15-32. doi:10.1177/1096250612464763 Nations, D. (2017, April 16). The history and evolution of the iPad. Retrieved from https://www.lifewire.com/ history-of-the-ipad-1994668 Nield, D. (2016, July 5). 15 memorable milestones in tablet history. Retrieved from http:// www.techradar.com/news/mobile-computing/10memorable-milestones-in-tablet-history-924916 Ritchie, R. (2017, January 9). History of the iPhone: Apple reinvents the phone. Retrieved from http:// www.imore.com/history-iphone-original Roth, K. (2013). Adapt with apps. Journal of Physical Education, Recreation & Dance, 84(2), 4-6. doi: 10.1080/07303084.2013.757168 Statista. (2017). Number of apps available in leading app stores as of March 2017. Retrieved from https:// www.statista.com/statistics/276623/number-ofapps-available-in-leading-app-stores/ Tapplaylearn. (2012). MyClassRules Noise Monitor & Class Management (1.6) [Mobile application software]. Retrieved from http://itunes.apple.com

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Apps to Enhance Learning in Children With Autism Spectrum Disorder Edward Todd Schwartzberg University of Minnesota Minneapolis, Minnesota

Today, technology and interactive media, such as iPads and applications (apps), are prevalent in many early childhood education settings across the United States. Hence, early childhood music therapists should be prepared, comfortable, and knowledgeable about selecting and embedding digital devices and media in music therapy sessions and family routines to enhance children's learning

opportunities across settings (Kern & Hayhurst, 2016; Maich & Hall, 2016). This article shortly describes recent research outcomes related to iPads and apps as a learning tool for children with ASD, and introduces the App Wheel (Coppin, 2016) for use in music therapy practice. Two videos demonstrate the use of a communication and sensory sensitivity app in combination with music.

Proloquo2Go Conversation Builder Articulation Scenes Answers:YesNo HD TapSpeak Sequence Plus

Apps for Students with Autism Spectrum Disorders v.4

ArtikPix Fun with Directions HD

Speech with Milo - Verbs Proloquo4Text Predictable

Clicker Sentences

Behavior Tracker Pro

Text-to-Speech Apps

ChorePad HD Time Timer iPad Edition

Behavior Tracking Apps

Social Dectective

Language Development Apps

Sentence Construction Apps iCreate...Social Skills Stories

Conversation Choice Making Apps Apps Vocabulary Apps

Articulation Apps AAC Apps

Video Modeling

Emotions from I Can Do Apps Apps Difficulty Expressing Needs Echolalia Social Script Difficulty with Rigid Behavior Difficulty with Apps Conversations Language Grammar Management Apps Difficulty with Social Skills Look into my Eyes Hyperactive Poor Receptive Limited Use Apps SocialCue Lacks Common Video Modeling of Language Vocabulary Language Pictello Sense Apps Easily Frustrated BehaviorLens Eye Contact Difficulty Problem Reward AutismXpress Apps Solving Generalization System Apps Lack of Safety Social Skill Builder Impulsive First Then Visual Schedule Awareness Story Telling Visual Timer Poor Eye Contact Self Control Apps WordToob

Communication

Visual Schedules Apps

Choiceworks

Apps

i Get It My Daily Schedule

Explosive

Self Management Apps

Difficulty with Personal Management

Behavior

Difficulty Identifying Emotions

Potty Training Social Story

Self Care Apps

Difficulty with Auditory Processing

Social Skills

Everyday Social Skills HD

iChoose

StoryPals

Sequencing Apps

Injini DTT/ Autism Words

Abilipad

Generalization Apps Organization Apps

Splinter Skills Difficulty Summarizing Developmental Delays Visual Concrete Learners Learners

Prefer Sequential Difficulty Info Synthesizing

ABA Apps

iDress for Weather

Difficulty with traditional Learning Methods

Test Adapting Apps Literacy Apps SpellBoard Special Words

Organization

Sensory Sensitivity

Video Modeling Apps

Need for Sameness or Routine

Food Sensitivity

Time Apps

Visual InFlexible

Time Timer iPad Edition

Video Modeling Apps

Difficulty Generalizing

Difficulty Problem Solving Sleep Issues Difficulty Under Active Generalizing Difficulty Motor Sensitive to Processing Sound Over Active

Math Apps

Visual Schedules Apps

Choiceworks

Picture Schedule Apps

Rigid Routines

Sequencing Apps

Ritualistic

ChorePad HD iPrompts XL

Organization Apps

Tactilely Sensitive

When looking for apps for students on the autism spectrum (ASD), it is important to look at all educational apps and not just those that are tagged as autism apps. They have many of the same learning needs that other students have. This list was developed to provide apps based on common learning characteristics and traits that are typical for students with ASD. It is important to remember that all students learn differently and selecting apps should be based on the unique learning needs of the student. This list is only a sampling of apps available for each skill area. This is not, nor is it meant to be a definitive list. This list is intended to give you a starting place and a rationale for picking certain apps.

ChoiceBoard - Creator

Visual Timer Apps

Common Learning Characteristics

iModeling

Common Learning Traits

GoWorksheet Sentence Builder for iPad

Life Skills Apps

Auditory Training Apps

White Noise Apps Fine Motor Apps

Book Creator for iPad

Medical Apps

WordToob

Sensory Processing Therapy

Shelby’s Quest EASe Pro Listening Therapy

Dexteria

First Then Visual Schedule

Writing Apps

Sensory Apps

Clicker Sentences

Clicker Docs

Choice Making Apps

Fluidity HD Awareness! The Headphone App

Relax Melodies Premium HD Brainworks Too Noisy Pro

iStudiez Pro

App Categories Apps Developed by Mark Coppin August 2016

"Design based on the Padagogy Wheel designed by Allan Carrington and modified by Cherie Pickering" © Mark Coppin 2016

Figure 1. Coppin’s (2016) App Wheel. Reprinted with permission.

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Impact of Technology and Media

The App Wheel

Recently, researchers have studied the potential advantages and impact of the iPad and apps in the educational environment. Neely et al. (2013) found iPad instruction led to decreased challenging behaviors and increased academic engagement compared to traditional instruction. iPad-based video modeling as part of a treatment package is eﬀective in teaching numeracy skills (Jowett, Moore & Anderson, 2012), while video selfmodeling improved mathematics skills in adolescents with ASD (Burton, Anderson, Prater & Dyches, 2013). A study by Penuel and colleagues (2012) found that children who received the media supplement that focused on literacy skills made greater gains on letter recognition, phonics, and print and story concepts than did children in a comparison condition that utilized a media supplement focused on science skills. Aronin and Floyd (2013) addressed how the iPad and apps should be used in inclusive preschool settings. They suggest that the child should:

Coppin’s (2016) App Wheel may be an invaluable resource for music therapists as they select appropriate apps for children with ASD. Displayed in Figure 1, the App Wheel targets the following six learning categories and provides easy of selection based upon client need:

be the source of the action, be able to see the cause and eﬀect, observe the change of the variable, and experience the action and reaction immediately.

1. Communication skills (11 apps; one app is currently not available in the US App Store; price range: $0.00-249.99); 2. Social skills (nine apps; three apps are currently not available in the US App Store; price range: $2.99-24.99); 3. Need for sameness or routine (nine apps; $1.99-49.99); 4. Sensory sensitivity (nine apps; price range; $0.00-8.99); 5. Diﬃculty with traditional learning methods (12 apps; one app is currently not available in the US App Store; price range: $1.99-32.99); and 6. Behavior (10 apps; price range: $0.00-29.99). Download the App Wheel with interactive links to each app at http://3bigty2864hl1ccx944e3roqwpengine.netdna-ssl.com/wp-content/uploads/2016/08/ Apps-List-V4.pdf

As research continues to evolve, evidence-based music therapists should stay informed.

Watch video demonstration of the Fluidity App at https://youtu.be/ KPfEgAGFBmE

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Watch video demonstration of the Artikpix App at https://youtu.be/ iLCda5fVJx4

References

About the Author Edward Todd Schwartzberg, M.Ed., MT-BC, is professor and music therapy clinic coordinator at the University of Minnesota. He served as the President for the Autism Society of Minnesota and is currently on the Assembly of Delegates for the Great Lakes Region of AMTA. Contact: schwa155@umn.edu

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Aronin, S., & Floyd, K. K. (2013). Using an iPad in inclusive preschool classrooms to introduce STEM concepts. Teaching Exceptional Children, 45, 34-39. Burton, C. E., Anderson, D. H., Prater, M. A., & Dyches, T. T. (2013). Video self-modeling on an iPad to teach functional math skills to adolescents with autism and intellectual disability. Focus on Autism and Other Developmental Disabilities, 28, 67-77. doi: 10.1177/1088357613478829 Coppin, M. (2016). Apps for students with autism spectrum disorders: Version 4. Retrieved from http:// 3bigty2864hl1ccx944e3roq-wpengine.netdnassl.com/wp-content/uploads/2016/10/Apps-ListV4.pdf Jowett, E. L., Moore, D. W., & Anderson, A. (2012). Using an iPad-based video modeling package to teach numeracy skills to a child with an autism spectrum disorder. Developmental Neurorehabilitation, 15, 304-312. doi: 10.3109/17518423.2012.682168 Kern, P., & Hayhurst, B. (2016). Skill generalization: Intentional use of apps in music therapy sessions and beyond. imagine, 7, 98-101. Maich, K., & Hall, C. (2016). Implementing iPads in the inclusive classroom setting. Intervention in School and Clinic, 51, 145-150. doi: 10.1177/1053451215585793

Neely, L., Rispoli, M., Camargo, S., Davis, H., & Boles, M. (2013). The eﬀect of instructional use of an iPad on challenging behavior and academic engagement for two students with autism. Research in Autism Spectrum Disorders, 7, 509 – 516. doi: https:// doi.org/10.1016/j.rasd.2012.12.004 Penuel, W. R., Bates, L., Gallagher, L. P., Pasnik, S., Llorente, C., Townsend, E., Hupert, N., Dominguez, X., & VanderBorght, M. (2012). Supplementing literacy instruction with a media-rich intervention: Results of a randomized controlled trial. Early Childhood Research Quarterly, 27, 115–127. doi: http://dx.doi.org/10.1016/j.ecresq.2011.07.002.

* Extending the Therapeutic Impact of Music in the NICU Through Developmentally Appropriate Recorded Music Michael R. Detmer, M.M.E., MT-BC University of Louisville Norton Women’s and Children’s Hospital Louisville, Kentucky It is well established that age-appropriate music facilitated by a neonatal intensive care unit music therapist (NICU-MT) can significantly improve the clinical and neurodevelopmental outcomes of premature infants in the NICU (Standley, 2012). Early exposure to meaningful auditory stimuli including music, whether in utero or in the NICU environment, is needed for fine-tuning of the hair cells of the cochlea to occur and for appropriate neural pathways to be formed (Graven & Browne, 2008; McMahon, Wintermark, & Lahav, 2012), thus neonatal experts

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strongly support the use of appropriate music for brain development (McMahon et al., 2012; Neal & Lindeke, 2008). Surveys of NICU staﬀ also show support for music in the NICU and agree it may reduce infant stress and crying, improve sleep, stabilize heart rate, relieve pain, decrease parent stress and anxiety, and improve staﬀ’s mood and enjoyment in their job (Field, Hernandez-Reif, Feijo, & Freedman, 2006; Kemper, Martin, Block, Shoaf, & Woods, 2004; Pölkki, Korhonen, & Laukkala, 2012).

In addition to music therapy protocols used by NICUMTs, such as multimodal neurological enhancement for sensory processing (Walworth et al., 2012) and the Pacifier Activated Lullaby for non-nutritive suck development and feeding readiness (Chorna, Slaughter, Wang, Stark, & Maitre, 2014), the use of carefully selected and well-planned recorded music can provide preterm infants with age appropriate and meaningful auditory experiences to optimize physiological and neurodevelopmental outcomes (Detmer & Whelan, 2017). However, due to the preterm infant’s immature neurologic system and thus the harmful eﬀects that may be caused by complex or inappropriate music, it is imperative healthcare professionals follow evidence-based guidelines such as those suggested by Detmer & Whelan (2017) when using recorded music in the NICU. These guidelines include information related to the duration, frequency, characteristics, and presentation of recorded music.

unobtainable maternity/paternity leave; single parenting or lack of involvement from the family; and parental stress, anxiety, or depression related to the infant’s hospitalization or fragility. NICU staﬀ and volunteers often try to oﬀset inconsistent or infrequent parental interaction, but a congested census may overshadow the developmental needs of infants in this situation. Furthermore, infants under isolation precautions or those in private rooms may be at a greater disadvantage for lack of exposure to meaningful language and human interaction, potentially impacting acquisition of speech and language skills.

In an effort to optimize neuroprotective interventions and enhance the medical and developmental outcomes of preterm infants, nursing and rehab therapy staff may work with NICU-MTs to extend the therapeutic impact of music via music recordings. This may involve the NICUMT initially working with the family to create original parental recordings to use during their absence in the NICU. Parental Recorded music should be recordings may consist of standard lullabies 1. simple, non-alerting, and in lullaby style; (e.g., ABCs, Itsy Bitsy Spider), personalized 2. introduced no earlier than 28 postmenstrual weeks; lullabies using alternate lyrics to include the 3. played for a maximum of 30 minutes at a time, and no more infant’s name or other familiar words (e.g., than 4 hours/day; hello, smile, love, mommy), or original 4. at a volume of 65-75 db (scale C) or lower; transition songs to be used as support 5. turned off during painful/stressful procedures; and during routine care (e.g., bath-time, waking 6. discontinued with persistent signs of infant overstimulation. up, going to sleep). The NICU-MT should use this time to empower parents and encourage feelings of control and When used appropriately, recorded music can decrease contribution related to their child’s care. In the event length of hospitalization (Bailey & Kantak, 2005; Caine, there is no NICU-MT on staff, nurses or other healthcare 1991); improve physiological variables including oxygen staff may consult with a NICU-MT to select appropriate saturation, heart rate, and respiratory rate (Cassidy & commercially available recordings and establish Standley, 1995; Coleman, Pratt, Stoddard, Gerstmann, & procedures to ensure all music provision follows Abel, 1997; Standley & Moore, 1995); reduce stress evidence-based guidelines (Detmer & Whelan, 2017). behavior; and increase weight gain and caloric intake (Caine, 1991; Coleman, et al., 1997). While health care providers recognize the importance of human contact and exposure to live voice (Graven, 2000), recordings may be used when live parental singing is not feasible for a variety of reasons including: medical needs of the mother post-delivery; limited resources for transportation or infrequent visits due to a long commute; needs of other children or family members at home; a short or

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Audio System There are many financial, equipment, environmental, and logistical considerations to be made prior to implementing a recorded music program with premature infants in a NICU. First, a discussion and agreement on infant eligibility based on gestational age and medical needs should be scheduled with leaders of the NICU care team (e.g., nurse manager or developmental care committee). This will help determine how many infants would be appropriate based on the average census; this will be helpful for, establishing a music equipment budget. If there are budgetary restrictions as to how many audio systems can be purchased, the NICU-MT can work with staﬀ to triage infants with the greatest need (e.g., with limited or no social interaction, born very prematurely, with physiological instability, or with frequent periods of irritability). Next, identify the brand and model of products to be purchased for the audio system; a music player, speaker, and an equipment lock should be included. One recommendation for this audio system is Apple’s iPod Nano©, Cambridge Soundworks® OontZ Angle 3 speaker (if using in an open-crib only), and Pacsafe’s® retractasafe 250 4-dial retractable cable lock (see image). The iPod Nano has a touch screen that allows parents an opportunity for control by choosing which playlist to use. The Oontz speaker is Bluetooth enabled and is water resistant. The Pacsafe® lock is small enough to be secured to the back of the iPod using a heavy-duty adhesive. Panagiotidis and Lahav (2010) oﬀer alternative recommendations for the audio system including options for speakers to be used in an isolette, as speakers must be resistant to high temperatures and humidity. Next, a media management application and account, such as iTunes© should be created to store all lullaby music as organized playlists lasting no longer than 30 minutes. This ensures the music will stop after the recommended playback time. Volumes of individual songs should be checked and adjusted so dynamic levels are steady from song to song. Volume level should be checked as music plays through the speaker(s). Using a decibel meter, measure the volume from the infant’s head to confirm that levels do not exceed the 67-75 dB (scale C) guideline. When at an optimal level, lock the volume on the device (e.g., on the iPod Nano, this can be done under Settings > Music > Volume Limit). Finally, place adhesive labels with a contact name/phone number on all equipment of the audio system. This will avoid confusion if the isolette/crib is moved or patient is discharged.

Set up Now that the audio system and music are ready for use, prepare NICU staff on the purpose, function, and delivery of recorded music. This may include an email summary of the recorded music program and the role of staff, or hands-on education on how/when to play music and clean/remove equipment. Next, obtain a physician’s order for music therapy that specifies the “use of recorded music to promote neurodevelopment and physiological homeostasis.” After an order has been placed, meet with the patient’s attending nurse to again provide education and answer any questions. The RN may also suggest an optimal bedside placement of the audio system to avoid contact or entanglement with other frequently used care items or equipment. After placing the audio system, post an instruction sheet for parents/staff addressing charging and how the music should be used; this can be summarized from the guidelines provided by Detmer and Whelan (2017). Post a log-sheet at the bedside to track when music was played each day (this should not be more than 8 times per day if playlists are 30 minutes in duration). Finally, write a note in the patient’s medical chart indicating the therapeutic need for recorded music and when to play/stop. Include a statement about overstimulation and cessation of music during painful/stressful procedures.

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Once an audio system is placed at the bedside, it is important to check in with nursing staﬀ and parent(s) on a regular basis to ensure all equipment is working properly and is charged, the infant’s medical status has not been compromised, and the infant is responding appropriately to the music. Also, create a binder log or electronic database to keep a record of which devices are at which bedside. Once the patient has been discharged or is no longer requiring recorded music, retrieve the audio system from the crib/isolette and disinfect in accordance with the hospital infection control guidelines.

Putting it into Practice 1. Prepare budget based on unit needs 2. Purchase MP3 players, speakers, bedside locks, and music 3. Create media manager account with 30 minute playlists 4. Check, set, and lock volume 5. Place labels on all equipment 6. Create log binder or equipment database 7. Provide staﬀ education 8. Receive music therapy order 9. Place audio system, parent/staﬀ instructions, and log sheet at bedside 10. Write note in medical chart 11. Check in regularly with RN/parent(s) 12. Retrieve and sanitize equipment at discharge

Age-appropriate music has significant impacts on premature infants’ clinical course and developmental outcomes. When live singing is not an option, recorded music can be provided to help infants reach physiological homeostasis or a stabilized behavior state, among other benefits. As NICU staff explore the option of implementing recorded music on the unit, evidencebased guidelines related to duration, frequency, sound levels, and presentation should be followed. NICU-MTs may facilitate the development of a recorded music initiative or assist staff in establishing an effective, impactful, and evidence-based music listening program.

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References Bailey, K., & Kantak, A. (2005). Music Therapy in The Neonatal Intensive Care Unit, a Multi-Site Study: A Randomized Control Blind Study of Music Therapy With High Risk Neonates Cared for in Neonatal ICU. Presentation at Music Therapy in the NICU: A symposium on research and applications of music therapy in the neonatal intensive care unit, Cleveland, OH. Caine, J. (1991). The effects of music on the selected stress behaviors, weight, caloric and formula intake, and length of hospital stay of premature and low birth weight neonates in a newborn intensive care unit. Journal of Music Therapy, 28(4), 180-192. Cassidy, J. W., & Standley, J. M. (1995). The effect of music listening on physiological responses of premature infants in the NICU. Journal of Music Therapy, 32(4), 208-227. Chorna, O. D., Slaughter, J. C., Wang, L., Stark, A. R., & Maitre, N. L. (2014). A pacifier-activated music player with mother's voice improves oral feeding in preterm infants. Pediatrics, 133(3), 462-468. Coleman, J. M., Pratt, R. R., Stoddard, R. A., Gerstmann, D. R., & Abel, H. H. (1997). The effects of the male and female singing and speaking voices on slected physiological and behavioral measures of premature infants in the intensive care unit. International Journal of Arts Medicine, 5(2), 4-11. Detmer, M. R., & Whelan, M. L. (2017). Music in the neonatal intensive care unit: The role of nurses in neuroprotection. Neonatal Network, 36(4), 213-2017. Field, T., Hernandez-Reif, M., Feijo, L., & Freedman, J. (2006). Prenatal, perinatal and neonatal stimulation: A survey of neonatal nurseries. Infant Behavior & Development, 29(1), 24-31. Graven, S. N. (2000). Sound and the developing infant in the NICU: conclusions and reommndations for care. Journal of Perinatology, 20(8 Pt 2), S88-S93. Graven, S. N., & Browne, J. V. (2008). Auditory development in the fetus and infant. Newborn and Infant Nursing Reviews, 8(4), 187-193. Kemper, K. J., Martin, K., Block, S. M., Shoaf, R., & Woods, C. (2004). Attitudes and expectations about music therapy for premature infants among staff in a neonatal intensive care unit. Alternative Therapies, 10(2), 50-54.

McMahon, E., Wintermark, P., & Lahav, A. (2012). Auditory brain development in premature infants: The importance of early experience. Annals of the New York Academy of Sciences, 1252(1), 17-24. Neal, D. O., & Lindeke, L. L. (2008). Music as a nursing intervention for preterm infants in the NICU. Neonatal Network, 27(5), 319-327. Panagiotidis, J., & Lahav, A. (2010). Simulation of prenatal maternal sounds in NICU incubators: a pilot safety and feasibility study. The Journal of Maternal-Fetal and Neonatal Medicine, 23, 106-109. Pölkki, R., Korhonen, A., & Laukkala, H. (2012). Nurses' expectations of using music for premature infants in neonatal intensive care unit. Journal of Pediatric Nursing, 27(4), e29-e37. Standley, J. (2012). Music therapy research in the NICU: An updated meta-analysis. Neonatal Network, 31(5), 311-316.

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Standley, J. M., & Moore, R. S. (1995). Therapeutic eﬀects of music and mother’s voice on premature infants. Pediatric Nursing, 21(6), 509-512. 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.

About the Author Michael R. Detmer, M.M.E., MT-BC is a NICU music therapist and adjunct faculty member at University of Louisville and Norton Women’s and Children’s Hospital in Louisville, KY. Contact: michael.detmer@louisville.edu

* Heartbeat Song Recorded 2017 by Katherine E. Goforth

Heartbeat Songs for Pediatric Patients with a Terminal Diagnosis Katherine E. Goforth, MM, MT-BC UK Healthcare Kentucky Childrenâ&#x20AC;&#x2122;s Hospital University of Kentucky Lexington, Kentucky The death of a child is a profound and incomprehensible loss that is felt by many individuals. It is especially challenging for parents to endure. The grief experienced by a parent from the death of a child is extremely personal and painful but appropriate due to the magnitude of the loss experienced (Rando, 1993). An estimated total of 24,923 children under the age of five

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die each year from trauma, congenital defects, extreme prematurity, heritable disorders or acquired illnesses in hospitals across the United States (United Nations Childrenâ&#x20AC;&#x2122;s Fund, 2015). Pediatric medical programs aim to assist parents and siblings through the end-of-life and death of a child. Specifically, pediatric palliative care aims to provide an interdisciplinary, family-centered approach to enhance the quality of life for a child, as well as ensure that a bereaved family is supported, functional, and remains intact (American Academy of Pediatrics, 2000). Bereavement support for the family is provided through memory-making projects, such as handprints, hand molds, locks of hair, and pictures to provide a concrete transitional memory for parents and siblings following the death (Borgman, Meyer & Fitzgerald, 2014; Gibson, 2004; Wender, 2012). Music therapy can play an integral role in bereavement support through the art of memory-making within pediatric palliative care (American Academy of Pediatrics, 2000; Heath & Lings, 2012).

Understanding the Role of Music Therapy in Pediatric Palliative Care Music therapy within pediatric palliative care focuses on increasing quality of life for a patient and family, utilizing a family-centered approach to care (Linderfelser, Hense & McFerran, 2012). Specifically, the music therapist can provide evidence-based therapeutic interventions to meet the physical, emotional, and spiritual needs of the pediatric patient and family at the end-of-life (Linderfeiser, Grocke, & McFerran, 2008). Music therapy objectives include decreasing anxiety, fear, and pain, plus increasing opportunities for self-expression, family interactions improved comfort, and family-centered support (Froehlich, 1996; Hilliard, 2003; Sweeny-Brown, 2005). Previous research indicates music therapy can structure shared experiences to relieve stress, facilitate emotional bonding, and provide a positive focus for both child and parent while increasing the overall coping of the pediatric patient (Asagard, 2001; Lathom-Radocy, 2002; Robb, 2003). Furthermore, song writing has been perceived as a significant component of remembrance for parents who have experienced music therapy treatment with their terminally ill child (Linderfeiser, Grocke, & McFerran, 2008).

Memory-Making and Music Therapy Memory-making is a common focus throughout pediatric palliative care and bereavement, where transitional objects are created to aid in parental and sibling comfort, mourning, and the grief process following death (Borgman, Meyer & Fitzgerald, 2014; Gibson, 2004; Wender, 2012). Music therapists can engage families in original songwriting and create recordings to serve as a transitional object, serving as a powerful, profound, and unique legacy of loved ones during the end-of-life and following death (Heath & Lings, 2012). With advances in technology, music therapists can incorporate new components such as the patient's voice, inspirations, and even a heartbeat into songwriting.

Function of the Heartbeat Song The music therapists at UK Healthcare Kentucky Children’s Hospital (KCH) oﬀer the creation of heartbeat songs to parents of a fetus, infant, or child with an acute

Technology

Description

or chronic diagnosis with a terminal outcome. The music therapist works closely with the KCH Pediatric Advanced Care Team (PACT) to identify appropriate patients and families who would benefit from music therapy at the end-of-life. At KCH, the creation of a heartbeat song specifically targets clinical music therapy goals related to assisting with anticipatory grief, bereavement support, and family-centered care.

Creating the Heartbeat Song The creation of a heartbeat song requires specific technology to ensure a successful quality product. Technology allows the music therapist to capture and edit the heartbeat, as well as add live or recorded preferred music (as indicated by the family) to be paired with the child’s heartbeat. Prior to creating a heartbeat song, it is important for the music therapist to prepare and familiarize themselves with each aspect of the technology. A description and function of the technology utilized follows (Schreck, 2014).

Function

Apple iPad

A touch screen tablet PC without a keyboard.

Recording device to capture patient’s heartbeat at bedside into GarageBand Application.

GarageBand Application (for iPad and MacBook)

Application for iPad that Application utilized on Apple iPad to capture recording of features instruments and a full patient’s heartbeat at bedside. recording studio.

Stethoscope and smartLav+ Rode Microphone Duo

Instrument used to listen to the sounds of the body.

MT-BC assembled product that is placed on the patient’s chest to record the heartbeat at bedside into GarageBand Application. (To assemble, remove fabric cover of microphone; cut tube of stethoscope; leaving 2 inches attached and place microphone in remaining tubing.)

Apple MacBook

Laptop PC

Device for operating Adobe Audition CC 2015 and GarageBand Application.

Adobe Audition CC 2015

Digital audio workstation to record, edit and mix sound.

Program to edit patient’s recorded heartbeat.

Headphones

Electronic listening device worn around the ears.

Device used to listen while editing recorded heartbeat, looping, and recording preferred song.

Blue Snowball Microphone

An easy-to-use USB condenser microphone that captures a recording.

Device utilized to record vocal and/or instrumental track(s) with edited heartbeat in GargeBand Application.

Universal Serial Bus (USB)

Device used to store and transfer digital information.

Data storage device utilized to save and provide heartbeat song to child’s family.

Table 1. Heartbeat Song Technology

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The implementation of each step taken to create a heartbeat song is a detailed process that occurs within three phases. A three-phase implementation approach ensures the music therapist is able to provide a quality product, ensure eﬀective time management, and balance direct-patient care. Below, each specific phase is identified and detailed steps are provided (J. Rushing, personal communication, June 2016).

Phase One: Capturing the Heartbeat • • • • • • • • • • • • • • •

Introduce music therapy services and the idea of a heartbeat song. MT-BC assesses parents preferred music choice to pair with child’s heartbeat. Educate parents on process to capture child’s heartbeat. Connect stethoscope microphone to iPad. Open GargeBand Application on iPad. Tap create a new song and/or select audio recorder. Turn oﬀ metronome. Turn oﬀ count. Turn on automatic song length. Decrease all extraneous noise within environment. Have nurse to place stethoscope microphone in appropriate place on patient’s chest. Obtain 45 – 60 second recording of heartbeat. Confirm heartbeat recording was obtained. Name and save to iPad. Create duplicate copy to ensure original heartbeat recording is saved.

Phase Two: Editing the Heartbeat

• • • • • • • • • • •

Airdrop from iPad to MacBook. Open Adobe Audition CC 2015. Open recording in Adobe Audition CC 2015. Edit heartbeat. Save edited heartbeat. Open GarageBand on MacBook. Open edited heartbeat in GarageBand. Loop edited heartbeat. Listen to loops – ensure each heartbeat is consistent and spacing is appropriate. Remove all unneeded tracks. Save project to GarageBand.

Phase Three: Adding the Preferred Song

• • • • • • • • • •

Connect Blue Snowball Microphone to MacBook. Add song and/or instrumental track. Record vocal and/or instrumental track. Review completed heartbeat song. Save completed heartbeat song. Export heartbeat song to USB, CD or preferred data storage device. Ensure recording is properly saved to data storage device. Label USB with patient’s name. Add distribution and reproduction label. Provide heartbeat song to patient’s family.

”

The heart can represent so many things to us: the pump that carries our life’s blood, the place where our deepest love and feelings are located and the thing that can break into a million pieces when our loved one dies.The ability for our music therapists to capture the heartbeat of our smallest patients and lovingly parallel this sound to music has been transformative. We meet parents who are told their unborn baby may die soon after birth and we are able to provide a lasting reminder that their baby existed and was important and meaningful by capturing its heartbeat during an OB appointment. We have had parents tell us how much they cherish this lasting legacy of the heart that used to beat inside their child. We are so thankful for the partnership with music therapy and their willingness to join with us on this most crucial project to help families on their journey through grief and bereavement. –Dr. Lindsay Ragsdale, Director Pediatric Advanced Care Team, Section Chief, Pediatric Palliative Care, Kentucky Children’s Hospital

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As technology advances and becomes more widely used in the music therapy clinical setting, both quantitative and qualitative data are needed to support evidencebased practice. Currently, there are no known studies specifically related to the function, implementation, or perception of a heartbeat song with any specialized population. Objectively, it can be concluded from the research literature related to pediatric palliative care, music therapy and parental perceptions at the end-oflife, a heartbeat song provides three positive outcomes: 1) serves as a memory-making transitional object; 2) facilitates achievement of music therapy goals at the end-of-life; and 3) provides an interdisciplinary approach to pediatric palliative care (American Academy of Pediatrics, 2000; Borgman, Meyer, & Fitzgerald, 2014; Gibson, 2004; Heath & Lings, 2012; Linderfeiser, Grocke, & McFerran, 2008; Wender, 2012). Music therapists who currently create heartbeat songs in pediatric medical settings are encouraged to conduct research to evaluate the eﬀectiveness and perception of this intervention. This will help to continuously learn the best way to provide support for families at this diﬃcult time.

References American Academy of Pediatrics. (2000). Palliative care for children. Pediatrics, 106(2), 351-357. Asagard, T. (2001). An ecology of love: Aspects of music therapy in the pediatric oncology environment. Journal of Pediatric Palliative Care, 17(3), 177-181. Borgman, C., Meyer, M., & Fitzgerald, M. (2014). Pediatric bereavement services: A survey of practices at children’s hospitals. Omega, 69(4), 421-435. Froehlich, M. (1996). Music therapy with the terminally ill child. In M. Froehlich (Ed.), Music therapy with hospitalized children: A creative arts approach (pp. 209-217). Cherry Hill, NJ: Jeﬀery Books. Gibson, M. (2004). Melancholy objects. Mortality, 9(4), 285-299. Heath, B. & Lings, J. (2012). Creative songwriting in music therapy at the end of life and in bereavement. Mortality, 17(2), 106-118. Hilliard, R. (2003). Music therapy in pediatric palliative care: Complementing the interdisciplinary approach. Journal of Palliative Care, 19(2), 127-132. Lathom-Radocy, W. (2002). Psychological aspects of care of other health-impaired children: Developmental issues and psychological needs. In

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W.B. Lathom-Radocy (Ed.), Palliative music therapy, (pp. 224-238). Springfield, IL: Charles C. Thomas Publisher, LTD. Linderfeiser, K., Grocke, D. & McFerran, K. (2008). Bereaved parents’ experiences of music therapy with their terminally ill child. Journal of Music Therapy, 45(3), 330-348. Linderfeiser, K., Hense, C., & McFerran, K. (2012). Music therapy in pediatric palliative care: Family-centered care to enhance quality of life. American Journal of Hospice and Palliative Medicine, 29(3), 219-226. Rando, T. (1993). Treatment of complicated mourning. Champaign, IL: The Compassionate Friends, Inc. Robb, S. (2003). Designing music therapy interventions for hospitalized children and adolescents using a contextual support model of music therapy. Music Therapy Perspectives, 21, 27-40. Schreck, B. [Cincinnati Children’s]. (2014, May 1). Heartbeat music therapy helps parents cope with loss of teen. Retrieved from https:// www.youtube.com/watch?v=jbTrbySS3fU Sweeny-Brown, C. (2005). Music and medicine: Music therapy within a medical setting. In M. Pavlicevic (Ed.), Music therapy in children’s hospices (pp. 48-61). London & Philadelphia: Jessica Kingsley. United Nations Children’s Fund. (2015). Child mortality estimates [Data File]. Retrieved from http:// data.unicef.org. Wender, E. (2012). Supporting the family after the death of a child. Pediatrics, 130(6), 1164-1169.

About the Author Katherine E. Goforth, MM, MT-BC, serves as the lead clinical music therapist at UK Healthcare Kentucky Children’s Hospital, where she has developed, coordinated and implemented the grant funded pediatric music therapy program. Her research interests include neonatal music therapy, pediatric music therapy, and interdisciplinary collaboration. Contact: katherine.goforth@uky.edu

* On Permanence: Audio Recording in Music Therapy Ilene Berger Morris, MM, LCAT, MT-BC Alternatives for Children East Setauket, New York

Though three-year-old Marco enjoyed playing rhythm instruments and singing, he was very self-directed in his musical behavior, and if his mother attempted to join him in singing, Marco would cover his ears and yell, "No!" So, when his mother learned that Marco could sing interactive phrases and take turns on the drum with his music therapist, his mother wanted to see him demonstrating these skills; however, when she came in to school to observe his music therapy session, Marco simply cried. The therapist decided to record Marco's next music therapy session and sent the recording to his mother, enabling her to

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listen to the music Marco engaged in during music therapy. During subsequent sessions, Marco helped choose what songs to play "for Mommy." Marco began to look forward to listening with his mother to the recorded music from his music therapy session. Gradually, when his mother tried singing or saying some of the prompting phrases embedded in his music therapy songs, Marco began providing the response. At the end of the school year, Marco's mother described how she recently replayed earlier recordings, and commented on how far Marco had come in his social development.

Benefits and Advantages

•

Nothing lasts forever. But some things are more fleeting than others. Music enters the auditory environment, presents itself for a while, and then exits, returning the listener to the preceding soundscape. Music is a temporal entity, which, by its nature, exists in time. That quality can give a musical experience its preciousness, and to its listener, an awareness that the present unique event must be appreciated before it is over. Special moments can occur during the span of a musical happening—moments of connection, insight, or beauty. They may be tied to the specific circumstances of that rendition and setting in time, and therefore, impossible to reproduce naturally. A recording, however, allows music to be replayed over and over at the convenience of the listener. Recording technology continues to evolve and improve. The earliest sound reproductions involved etching waveforms on a rotating cylinder. Flat vinyl disks of various diameters replaced the cylinder and remained popular for decades. Magnetic cassette tapes facilitated recording as well as replaying music. Appearing in the early 1980’s, CD’s, which use digital rather than analog signals, were embraced by music listeners. The convenience of recording, playing, editing, purchasing, storing, and sharing audio files in formats such as mp3 has fueled the latest transition of the digital revolution (Crane, 2012). Audio recording technology has enabled revisiting not only musical performances of our favorite bands, but also the sound events of music therapy sessions. Clients’ musical eﬀorts can be preserved with a quality close to that of the original episode. Increasingly sensitive recording equipment and reproduction technology can change the transitory into something realistic and permanent. This type of permanence oﬀers benefits in music therapy but also poses concerns.

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•

Allows the participants to review and even re-experience the emotions felt and connections forged during the original event. Listening again to music created previously may rekindle the aesthetic pleasure and self-esteem engendered when it first occurred. Multiple auditions enable the listener to form a relationship with the recorded music particularly due to its portability and accessibility, as well as its permanence and unchanging state (Newhoff, 2015). Conveys a sense of importance and worth to the music created. By turning a passing event into something permanent, the moment is protected and immortalized; a picture is kept from deteriorating in a frame, baby shoes can be bronzed, and flowers may be preserved. As the creator of the music, the client is, by extension, acknowledged and valued with each playing of the recording. Enables the client to share the musical experience with others, including people who may not have been present during the original event. This may be especially important for young children, who are developing their joint attention skills. The opportunity to say or convey “Listen to what I did!” and have it reinforced by the positive reactions of significant others who listen to their music increases the affective sharing of the joint attention interaction. The ability to share affective states with others is an important social skill that develops in early childhood (Kasari, Sigman, Mundy, & Yirmiya, 1990). Allows authorized listeners to gain an understanding of what occurred during music therapy. Listening to a recording offers a unique opportunity for significant others to understand what has transpired in the child’s session, or to do so in a more controlled way, especially if their presence would have altered the way the participants interacted musically.

Benefits and Advantages (cont.)

•

• •

•

Provides opportunities for analysis, deeper listening and awareness of nuance that might have been overlooked during the original event. Although the main elements of music can be notated in writing, interaction, laughter, and other significant musical and non-musical sounds do not necessarily lend themselves to transcription. Sound recordings can preserve all auditory happenings that occur during music therapy, demonstrating the history and development of progress towards goals. Repeated auditions of the same recording can continue to reveal information about the musical interaction. The ability to re-examine and analyze music therapy sound events can be useful to the client him/herself, to family members, and to the music therapist. Serves as an aspect of the music therapy intervention itself. Technologically-assisted demonstrations of cause and eﬀect, such as playing back the music just created during the session, can engender excitement in a child for musical creation, and help to develop his/her identity as “an agent of music-making” (Magee & Burland, 2008, p. 132). This awareness may encourage more musical expression or spark other creative directions. Songwriting interventions can involve recording ideas that arise during therapy and develop into larger musical projects. Listening carefully to recordings can also be a mechanism to help the child improve auditory perception and to modulate aspects of musical production, such as vocal tonality and articulation. Allows for revision and reshaping. When a musical episode is saved in digital form, it gives the client a form of control via editing. If the original experience was not musically satisfying or an accurate portrayal of the client’s creative intent, the recording can be engineered into a more preferred sound product. The editing experience itself can be a creative and therapeutic process. Gives a concrete form to an auditory experience. Unlike live music that exists only during its performance, recorded music is permanent. When represented in the form of an audio file retrievable on a music playing device or burned onto a CD, the music is not only permanent, but also tangible, and literally allows clients to “carry the experience with them beyond the scope of the therapeutic setting” (Martino & Bertolami, 2013, p. 176). Although a CD represents somewhat outdated technology, it is a secure source for preserving the client’s music from music therapy sessions when electronic sharing of files is not permissible due to an agency’s policies protecting clients’ confidentiality and privacy. Maintains memories and aﬃrm the musical self. Permanence is particularly poignant and meaningful in musical legacy projects, when recording can capture musical events that highlight the child’s self-expression and/or life sounds. This application of music therapy, used especially in palliative and hospice settings, provides the family with lasting connections and memories (Cadrin, 2006).

Caveats Privacy and confidentiality must be placed at the forefront. The auditory events that arise during music therapy are products of the client’s therapeutic process, and the therapist must ensure that ethical errors are avoided (Bates, 2015). The parents/guardians, and the child him/herself (when appropriate) should be able to authorize who is permitted to listen to the musical fruits of the work in therapy. Ownership of recordings should be discussed (Bates, 2014) and the proper consent

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obtained for airing or sharing. Adherence to ethical standards and privacy/confidentiality policies should be even more stringent when video recording. The American Music Therapy Association’s Code of Ethics (AMTA, 2015) is a living document set up to evolve over time to assist us in managing our increasingly technological and complex world (Bates, 2015). Music therapists can avoid overstepping boundaries by consulting this document for guidance and updates.

Emotional needs and preferences of the child need to be considered in the decision to record. There may be reasons why having the session recorded is not in the best interests of the child and may impact the therapeutic relationship and progress. Recording in music therapy is contraindicated if the client is selfconscious about his/her voice or musical expression and output (Magee, 2014). Distinctions in the properties of electronicallyderived and acoustic music exist despite technological improvements in recording sound quality. These differences range from being clearly discernible, to inaudible but perceptible, and can deliver different aesthetic and sensory effects to the listening experience (Magee & Burland, 2008). Such effects may impact the type of response from the client and the results of the intervention. Examining the advantages and disadvantages of music recording in music therapy may assist the music therapist in two ways: in understanding the potential and ramifications of this interventional medium, and in determining its appropriateness with particular clients and therapeutic situations. Both themes will remain pertinent to music therapy practice as innovations in recording develop and technology continues to advance.

References American Music Therapy Association (2015). Code of ethics. Retrieved from https:// www.musictherapy.org/about/ethics/. Bates, D. (2015). Ethics in music therapy. In B. Wheeler (Ed.), Music therapy handbook, pp. 64-75. New York: The Guilford Press. Bates, D. (2014). Music therapy ethics “2.0”: Preventing user error in technology. Music Therapy Perspectives, 32(2), 136-141. Cadrin, M.L. (2006). Music therapy legacy work in palliative care: Creating meaning at end of life. Canadian Journal of Music Therapy, 12(1), 109-137.

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Crane, K. (2012). Spread the sound: A brief history of music reproduction. Illumin 18(1), 1-6. Hadley, S., Hahna, N., Miller, V., & Bonaventura, M. (2014). Setting the scene: An overview of the use of music technology in practice. In W. Magee (Ed.), Music technology in therapeutic and health settings, (pp. 25-44). London: Jessica Kingsley Publishers. Kasari, C., Sigman, M., Mundy, P. & Yirmiya, N. (1990). Aﬀective sharing in the context of joint attention interactions of normal, autistic, and mentally retarded children. Journal of Autism and Developmental Disorders, 20(1), 87-100. Magee, W. L., & Burland, K. (2008). An exploratory study of the use of electronic music technologies in clinical music therapy. Nordic Journal of Music Therapy, 17(2),124-141 Magee, W. (2014). Indications and contra-indications for using music technology with clinical populations: When to use and when not to use. In W. Magee (Ed.), Music technology in therapeutic and health settings, pp. 83-110. London: Jessica Kingsley Publishers. Martino L., & Bertolami, M. (2013). Using music technology with children and adolescents with visual impairments and additional disabilities. In W. Magee (Ed.), Music technology in therapeutic and health settings, pp. 165-180. London: Jessica Kingsley Publishers. Newhoﬀ, D. (2015, September 8). Recorded music is the MOST valuable [Blog post]. Retrieved from http:// illusionofmore.com/recorded-music-most-valuable/

About the Author A music therapy clinician for 35 years, Ilene "Lee" B. Morris lives and works in Suﬀolk County, Long Island, NY. Lee provides music therapy to young children and adolescents in special education settings, and to patients of all ages in a community hospital's inpatient rehabilitation center. Contact: CLIMBmusictherapy@gmail.com

A recording set-up, with the presence of equipment in or near the therapy space, can be distracting and even a barrier to therapy (Hadley, Hahna, Miller & Bonaventura, 2014). When adjusting devices and manipulating controls, the therapist may be unable to give full attention to the child.

Dupere, K. (2017, April 9). 8 ingenious innovations helping autistic children communicate. Retrieved from http:// mashable.com/2017/04/09/ autism-innovations/

Skoog The Skoog cube is a fun tool to facilitate joint interaction with peers. It also provides children with positive reinforcement for communicating preferences on the iPad application.

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Video demonstration available

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at https://www.youtube.com/ watch?v=Tojf78iMQGk Possible Goal Areas: Social interaction, attention span, fine motor skills, and active engagement in tasks Implications for Music Therapy: The Skoog cube can be used to facilitate joint interaction with peers. Children could also be positively reinforced for communicating preferences on the iPad application.

kin, M . Han Sample Intervention: Play a â&#x20AC;&#x153;Simon Saysâ&#x20AC;? M LLC y l vior, Hol a h e tB diana tism game on the Skoog with a client by playing a Swee h Au le, In l t i i v at a w n g n o n e s i r r c d e series of 3 notes and asking them to repeat Jeff dvan r chil nces gy fo een a ical adva o b l o s n a tech SD) h technolog them. Make the intervention more challenging for ntly, er (A d r o ew Rece ways s n i n g D O w n . e i t by increasing the length of each sequence of trum de n vices pora Spec provi y ser Incor n p . a a e r c c e t a ctice sic th ghts eigh notes, incorporating varying note durations, or fast p i al pra ate in mu l c h i g n i i l h c p i e o r e c t i in by touching two sensors at the same time. prov part Dupe to im ts to . This Kate d D , e S , m n t clien A o ig c h oduc s des ildren wit able. ch pr duct a Mash h o e r c f p in no rapy ative skills riptio c the i f n c s s o i u innov e t d me o unica and m short le so m s i a h a m e o r s W c a vide lic or one. goal e pro e pub for each ntial h e y t t b o articl o t p d rtant able with resse avail impo t along tions add s i e y t i t t new en get, re no abou interv y bud cts a e p l out u a b d r a o e ly ab th ge pr e d c e v i e i s l t s e a u w th em kno k cre may ed th to be o thin ients l t s t c n s i exce r h a rap whic as le c the well ch to e s t musi a h y olog te hig techn ncorpora i . to cess how ve ac a h y d alrea

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Synchrony Synchrony is a drum-like device with a smooth silicone surface that plays music.

Video demonstration available at https://vimeo.com/119652663

Possible Goal Areas: Joint attention, nonverbal communication, emotional expression, coping skills, sustained attention, and motor skills Implications for Music Therapy: Synchrony is a multi-functional tool that can be used in many ways to meet the needs of each client. With Synchrony, clients can play preferred music using diďŹ&#x20AC;erent instrumentation options. Using diďŹ&#x20AC;erent parts of the hand, individual fingers, or a full palm supports the development of motor skills. Playing Synchrony with others facilitates social interaction with therapists, parents, peers, teachers, or siblings. Synchrony also provides an option for independent leisure and a strategy for self-regulation. Using the device in creative ways encourages emotional expression, particularly for individuals who communicate nonverbally. For example, children can play the drum hard and loud or soft and quiet, enabling clients to show how they feel. Sample Intervention: Pentatonic Drum Song, to the tune of Arirang, a traditional Korean song, follows a pentatonic scale used on the Synchrony device and addresses emotional expression through the lyrics. Visual cues like pictures of faces that represent emotions may be a helpful tool to use during this intervention. Changing the lyrics allows the song to be adapted to a question and answer song or a song with embedded cues that tells the child to play loudly, softly, quickly, or slowly.

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Smartstones Touch Smartstones Touch is a small, hand-held device that interacts with a smartphone application to allow individuals to speak pre-programmed phrases using certain touch patterns or movements.

Video demonstration available at https://www.youtube.com/watch?v=2CNA2ucU5io

Possible Goal Areas: Communication, independence, socialization, and emotional expression Implications for Music Therapy: Smartstones Touch provides accessibility and individualization for children while also promoting generalization of skills to other settings such as the classroom or playground. Smartstones Touch allows children who are nonverbal to make choices, communicate ideas, and greet others without typing on a screen. Simple gestures, movements, and touch patterns are used to communicate without typing, making this a very accessible form of communication to many individuals. It can also be individualized with preloaded phrases for use during music therapy. The device is small and portable, with a sturdy design, allowing children to carry it to music therapy, school, home, or in the community. Sample Intervention: During the song Chattin’, clients can use the Smartstones device to say a phrase following the prompt at the end of each verse. Possible choices include “thank you,” “please help,” “yes,” “no thanks,” “I’m sorry,” or “My name is Sarah.”

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Proloquo4Text

Proloquo4Text is a text-based AAC app for tablets by the developers of Proloquo2Go, a symbol-based AAC app used by many children with Autism Spectrum Disorder. Video demonstration available at https://www.youtube.com/watch? v=fd8enUFymXE

Kaspar the Robot Kasper is a child-sized robot, controlled by an adult with a

remote, it interacts with children and displays Possible Goal Areas: Communication, independent living, socialization, self-confidence, choice-making, and self-expression Implications for Music Therapy: This application provides a means for non-verbal children to choose preferred music or activities, answer questions, or participate in lyric analysis and songwriting. Using the app, children who are able to read have the ability to compose sentences with the help of the music therapist; theses are then spoken aloud by the app. Frequentlyused phrases can be saved on the side of the screen for easy access. For children who are not yet literate, Proloquo2Go provides the same functionality using symbols rather than words.

facial expressions; models appropriate eating behaviors, and even says “ouch” if the child is too rough with it. Video demonstration available at https://www.youtube.com/ watch?v=Q6lRefbmDGo Possible Goal Areas: Social skills, nonviolent behavior, independent living skills, and selfawareness Implications for Music Therapy: Kasper the

Sample Intervention: This song addresses the skills of answering open-ended questions and associating emotions with events, people, and daily activities. The song lyrics prompt children to choose an emotion, such as happy, sad, excited, scared, or nervous by typing it into the app with musical support from the therapist.

Robot may be a good starting point tool for children with severe behavior problems to learn social skills in a more controlled environment. Sample Intervention: Using the food needs and preferences of an individual child, compose a song with lyrics describing the steps of the task analysis for the eating skill being addressed. Sing it along with Kasper’s demonstration of the skill to encourage the child to imitate the robot’s actions.

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Leka Leka is a spherical, electronic “buddy” that can be customized to meet the needs and interests of children with ASD. The robot rolls around, lights up, plays sounds and music, and even displays diﬀerent emotions on a screen.

Video demonstration available at https://www.youtube.com/watch?v=1vx9OlBlpas

Possible Goal Areas: Independent leisure skills, coping skills, emotion recognition, attention span, and motor movement

About the Author Holly Hankin, MTBC, is a graduate of the University of Louisville. She is the clinical coordinator of music therapy services at Sweet Behavior, LLC.

Implications for Music Therapy: Leka can function both as behavior reinforcement and as a fun and engaging activity to do alone or with others. In music therapy, Leka could be used to promote social interaction with peers by playing with the spherical robot together. The device can also be used for breaks during sessions. Sample Intervention: The Leka Song is appropriate for music therapy groups or dyads. The song lyrics direct clients to roll Leka to a certain person, addressing social skills and the ability to follow directions.

Contact: hollymariehankin@gmail.com

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Google Glass Software

The Autism Glass project at Stanford uses a program paired with Google Glass, a device worn like a pair of glasses, that helps individuals with ASD identify emotional expressions in real time by displaying a word that describes the facial expression of people to whom they are in close proximity.

Smart Watch Conversation Coach This smart watch technology records audio and presents data in real-time to

help individuals with high-functioning autism recognize emotion within a conversation. It uses speech characteristics such as intonation, speed, and volume to predict the emotional state of a conversational partner. Video demonstration available at

Video demonstration available at https://www.youtube.com/watch?

https://www.youtube.com/

v=CpCC6okoVHI Possible Goal Areas: Emotional understanding and social interaction Implications for Music Therapy. Google Glass represents a more accessible and individualized tool for children to associate facial expressions to emotions; it is especially applicable to group settings. Unlike flashcards or other types of visual aids, Google Glass interprets the emotions of people the individual interacts with on a daily basis. Overtime, some individuals may be able to fade out the glasses after the skill has been learned. Sample Intervention: During greeting songs or social activities in a group music therapy session, use Google Glass to help a child who has diﬃculty interpreting facial expressions identify emotions of peers. This will help to improve eye contact and social interaction.

watch?v=ZZFcgg-7dlc Possible Goal Areas: Increasing emotion recognition, improving self-confidence, and increasing accessibility and inclusion in the community Implications for Music Therapy: This technology has strong research implications for music therapy. Measuring the contours of speech to determine emotional state may help music therapists measure progress for clients in terms of their speaking inflections and whether or not they match the client’s emotional state. Sample Intervention: Following a conversation with a client, code the client’s statements for emotional content. Compare this to the readings on the conversation coach to see if there is a strong or weak correlation between the two sets of data.

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New Technology: Point Motion and Music Therapy Charlay Yates, MA, MT-BC William E. Carter School Boston, Massachusetts

As technology continues to play a larger role in everyday life, there are additional opportunities for its use within music therapy practice. Clements-Cortés (2013) states that electronic music technologies (EMTs) are an “excellent motivator for clients to engage in music therapy, particularly for children and adolescents” (p. 37). EMTs can be adjusted to meet the particular needs of children with disabilities and aﬀord additional means of self-expression and identity formation. Electronic music technologies can be embedded in many music therapy services, including individual and groups sessions, recreation, performing, and composing. According to Magee and Burland (2008), EMTs should be used in conjunction with acoustic instruments and only introduced if a client’s needs cannot be met with acoustic instruments. Music therapists agree that technology is best used with active interventions, and acoustic instruments are preferred for receptive music activities. Use of technology is warranted when it creates experiences that could not otherwise occur, while still maintaining a high-quality music experience (Crowe & Rio, 2004). Point Motion was developed with these thoughts in mind.

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What is Point Motion? Developed by Berklee College of Music Alumni Kevin Clark, Point Motion was created to give therapists a means of collecting client assessments remotely via interactive motion control software. Targeted to fit the needs of early childhood and elementary aged children, Point Motion oﬀers a variety of activities or “games.” The program is a motivating tool for helping children with severe disabilities and complex medical health needs independently experiment with music. With a combination of recorded music and computer technology, available on any computer or iPad with a camera, students move to music while the program tracks the movement of the user’s body. It then sends the data to the computer which translates it into a specific sound or musical phrase. Individuals “calibrate” by assuming a pre-determined position after which they are free to move however they wish. During the virtual instrument mode, arm movements trigger diﬀerent notes, either sustained or staccato, to create a melody. Another mode allows individuals to pop bubbles as they fall from the top of the screen. The frequency at which the bubbles fall can be modified, allowing for faster or slower movements. A third mode is a game of musical Simon Says where the individual must “assume the

position” in a given amount of time. The final mode is a freeze dance, where the individual must freeze when the music stops. The program collects data, including reaction time and range of motion, from each of these modes and charts them to be analyzed later. It shows which extremities move and the frequency of that movement.

Point Motion in Music Therapy

Case Example

Point Motion was implemented for the last year in classrooms of five students ages 12 to 22 who presented with both severe, intensive disabilit ies and complex medical health needs. The music therapist and physical therapist selected students with a wide range of abilities to interact with the program. Studen ts appeared motivated by the novel technology and demons trated decreased levels of distress as evidenced by calm er bodies, more intentional movements, and decreas ed crying behaviors. Students also appeared motivated by the use of the diﬀerent modes as evidenced by increased attention and increased range of motion. During the virtual instrument mode, students were able to dev elop cause and eﬀect skills which helped them to develop a sense of self and their relationship with the world.

Along with academic goals, music therapy can address functional life skills such as communication, socialization, and self-help. According to Pellitteri (2000), “The goals of music therapy are to improve one’s psychological functioning through the use of musical experiences. Music therapists tap into the power of music to arouse emotions that can be used to motivate and engage clients” (p. 381). A child with limitations in hand and arm movements, when motivated to engage in music making, may reach for an instrument at a strategically placed distance, thus increasing extension. In the area of perceptual awareness, music is used to enhance awareness of the client and their surroundings. As a non-threatening and play-based modality, Point Motion addresses a variety of music therapy goals, such as: Enhancing awareness of self and others Developing sustained attention and focus Increasing range of motion Understanding cause and eﬀect Learning relaxation skills Video demonstration available at https://www.youtube.com/watch? v=Sy0akKXliRM

Conclusion Point Motion’s goal is to give every child 24/7 access to monitored therapeutic enrichment. Point Motion will continue to develop programs which serve the needs of children with developmental delays and special needs. To learn more about the use of Point Motion, visit www.poinmotioncontrol.com.

References Clements-Cortés, A. (2013). High-tech therapy: Music technology in music therapy. Canadian Music Educator, 54(4), 37-39. 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. Magee, W. L., & Burland, K. (2008). An exploratory study of the use of electronic music technologies in clinical music therapy. Nordic Journal of Music Therapy, 17(2), 124-141. Pellitteri, J. (2000). Music therapy in the special education setting. Journal of Educational and Psychological Consultation, 11(3&4), 379-391.

About the Author Charlay Yates, MA, MT-BC, works with adolescents with severe disabilities and complex medical health needs in Boston, MA. Her passion is to use the latest technology to support her clients in music making and expression. Contact: charlay.yates@gmail.com

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Makey MakeyÂŽ: Creating a Digital, Sensory, and Music Experience James Maxson, MM, LCAT, MT-BC Elizabeth Seton Pediatric Center Yonkers, New York

Makey Makey Technology

James Maxson, MM, MT-BC, LCAT is a music therapist at the Elizabeth Seton Pediatric Center in Yonkers, New York. Contact: jmaxson@setonpediatric.org

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Imagine children playing the piano by squishing their hands into PlayDoh or playing drums by giving high-fives to their mom, dad, and siblings. Thatâ&#x20AC;&#x2122;s what Makey Makey can make happen! The Makey Makey is a unique piece of hardware developed by students at the MIT Media Lab. By replacing the keys and buttons with real-world objects, it can function as an alternate computer keyboard or mouse that can be used with websites and computer programs. The possibilities are limitless, especially when paired with the web-based programming language, Scratch. Scratch uses a drag-and-drop technique to help users develop interactive music, games, or stories, that can have therapeutic or educational components. Because it is an open-sourced environment, users can freely share ideas and projects that can be adapted to meet unique needs and goals of specific clients.

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Makey Makey Technology Making music out of non-traditional items requires a little technological know-how. The Makey Makey primary website has a helpful list of web apps and a support community to get users started. For example, conductive tape can be placed on musical instruments to control the movement of a character created in Scratch. Even the carbon from a pencil conducts electricity, so a pencil drawing of a piano (or a drawing of anything) can be used to make music. By using Scratch, a therapist can have the computer count how many times a target has been hit, making data tracking an easy possibility. Music therapists can use the Makey Makey kit with virtual online pianos; specific computer keys are assigned to specific piano notes (e.g., the computer keys, A, S, D, F, and G correspond to the notes C, D, E, F, and G). Instead of pressing the computer keys, children can make music by playing the virtual piano with anything in their environment that can conduct electricity: Play-Doh, wet sponges, crumpled up pieces of aluminum foil, or by giving high-fives. Music therapists can also use the Makey Makey to control playlists on YouTube or iTunes using various conductive elements (e.g., weaving conductive textiles into a stuﬀed animal’s paws to play iTunes).

Video Tutorial and Examples Original video created by the creators of Makey Makey https://www.youtube.com/watch?v=rfQqh7iCcOUK Children explain how to use Makey Makey https://www.youtube.com/watch?v=yRuQc5XkeOU Author demonstrate using Makey Makey with families INSERT VIDEO LINK FROM IMAGINE CHANNEL

Makey Makey in Music Therapy Music therapists can address many therapeutic goals with the Makey Makey and Scratch. However, before using the tool, they should determine the need, function, and adaptability of the device and consider goals it will support, as it might not be appropriate for every

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situation. Yet, the combination of the Makey Makey and Scratch gives the therapist endless possibilities. For example, the author collaborated with a speechlanguage pathologist to develop a “musical spoon” to address self-feeding skills. When the child put the spoon in his mouth, the computer played a short sample of music, continuing when he performed the skill again. A musical walking mat for gait training, crawling, or mat play for children was another beneficial creation. The Makey Makey has been utilized with children in many other surprising and engaging ways such as using metal tines on a kalimba to play the voices of a child’s therapists or caregivers, creating shakers with real bananas that make monkey sounds when held, programming the notes on the metallophone to change the colors of the background in a Scratch Project, or stacking sponges that play different notes to play different chords to create a sponge-bell choir. The Makey Makey can enhance family interaction. The device can connect people to the internet; when various family members physically interact through touch, different sounds or instruments will play on the computer. The family can become a drum set: Mom is the snare drum, dad is the high hat, brother is the base drum, and the sister is the crash cymbal.

Conclusion The necessity of understanding wire placement, grounding, and conductive materials add to a definite learning curve. Just like learning any new instrument, the clinician needs to know how it works, how to play (with) it, and how to fix it if something goes wrong. YouTube videos of young children creating music with the Makey Makey are great resources for inspiration and education. The MakeyMakey has the potential to merge music and computers into a tangible, sensory interface. With a little ingenuity and planning, it certainly can have a place in the music therapist’s gig-bag for supporting many goal areas.

www.makeymakey.com

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TECHNOLOGY AND INTERACTIVE MEDIA USE IN EARLY CHILDHOOD MUSIC THERAPY

! AL C I IT CR

PRICE

ADAPTABILITY

KID FRIENDLY

EASE OF USE

THERAPY FOCUSED

REFERENCES

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* MOXI Makes Music Magic Ron Skinner Director of Education MOXI, The Wolf Museum of Exploration + Innovation Danielle Harlow, PhD Associate Professor University of California, Santa Barbara

Imagine a toddler crawling around the inside of a giant guitar, listening as the sound gets louder in some areas and quieter in others. When she places her hands against the body of the guitar, she feels the vibrations of the sound. Pulling herself up to stand and look through the sound hole, she can see her older brother plucking at the strings stretched across the neck. He moves a giant capo along the strings of the guitar, testing how the length of a plucked string changes the pitch of the sound. A third child plays alongside him, strumming multiple strings simultaneously, exploring how the combinations of strings work together. The toddler investigates sound vibration and volume while the

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older children improvise experiments to explore the musical possibilities of this over-sized instrument. This giant playable guitar, invites self-directed discovery, enabling curiosity and collaboration to guide childrenâ&#x20AC;&#x2122;s learning. The Giant Guitar sits at the entrance to a room of exhibits dedicated to exploring sound at MOXI, the Wolf Museum of Exploration + Innovation, a new science and technology museum in Santa Barbara, California. The exhibits and spaces in MOXI were intentionally designed to support diverse learning goals across multiple age levels and abilities.

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Designing for Exploration

MOXI Music Exhibits

The Reggio Emilia approach to early childhood education highlights the important role of the places and spaces where children interact and play. Well-designed spaces allow children to learn through experiences that involve multiple senses. They touch, hear, see, and move around the objects they interact with, constructing knowledge as they interact spontaneously with other children and adults (Edwards, Gandini, & Forman, 1998). Drawing on Piaget (1973) and Dewey (1966), who describe children as researchers investigating their surroundings, the Reggio Emilia philosophy sees children as “natural researchers as they question what they see, hypothesize solutions, predict outcomes, experiment and reflect on their own discoveries” (Stately, 1998, p. 20, as cited in Hewett, 2001, p. 96). A space in which families explore together is ideal for engaging children in active, selfdirected investigation in collaboration with others.

MOXI has several exhibits that provide opportunities to explore and create sounds and music in a creative, hands-on, socially collaborative way that are resources for practitioners of music therapy. Four examples of these and how they meet goals for early childhood development (i.e., varied interactions, collaboration, and multiple senses) are described below.

The Reggio Emilia approach to learning coupled with content objectives related to Science, Technology, Engineering, Art, and Math (STEAM) drove the design of MOXI’s exhibits. The result is a new resource for creative, experiential education designed to ignite learning through interactive experiences in science and creativity. MOXI is a place to explore and discover new things about the world, ask questions, seek answers and have fun. While MOXI is a hands-on destination for families and curious minds of all ages, it oﬀers many opportunities for learning, communication, collaboration, and creativity in early childhood development. MOXI’s exhibits are designed to aﬀord its youngest visitors opportunities to 1) engage in multiple types of interactions with the exhibit that are determined by the needs and interests of the individual; 2) engage in collaborative exploration or creation with other children and adults; and 3) use multiple senses and whole body experiences when interacting with exhibits. In addition to these goals for early childhood guests, all exhibits were designed for accessibility using principles of universal design (King-Sears, 2014), include connections to STEAM content, and are engaging for guests of all ages.

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Giant Guitar The Giant Guitar is a large-scale, fully functioning instrument that visitors can play from the outside and stand inside to hear areas of resonance. The Giant Guitar allows for childre n to engage with it in many ways depending on the interest and abilities of the child. A simple strumming song can be played by a single chil d using fingers or a giant guitar pick, with the tem po of the song adjusted to the child’s strumming (Wright, Calderon, & Sharp, 2016). Childre n can explore volume and tones and the relation ship between length of a string and its pitch. Additionally, multiple children can play more complex songs by pressing strin gs onto the fretboard and/or adjusting the slid ing capo to change the pitch of the strings. Num bered stickers along the fretboard can help groups articulate where and when to pre ss to coordinate a song or an experiment. Childre n can stand inside the guitar and feel the vibr ations as the strings are plucked. They can see the giant guitar and the vibrating strings and hea r the sounds made by the plucking the strings. They can move their bodies all around and inside the guitar. 104

Reactable The Reactable is the most technolo gical musical exhibit at MOXI. Part digital DJ tab le, part futuristic musical instrument, the Reactab le can produce everything from simple sounds to complex music. Manually manipulated shapes con trol and modify the sounds while light patterns on the table surface and wall create visual representations of the sound patterns. The default is for the sha pes to produce short melodies or beats played by an assortment of musical instruments, but these sou nds can be replaced by recordings of childre n’s voices talking or singing, of the child’s own voice, or other sounds that invite exploration. The Reactable allows simple to com plex interactions to fit the ability of the child. Young children can produce simple sounds by rotating a shape or turning a shape so that a diﬀerent side is facing down. Even undirected manipulation results in interesting sounds. The Reactable can be simplified to allow manipulation of only one or a few shapes and the sounds produced by manipulating those shapes can be programmed for diﬀerent age groups. The Reactab le also allows for much more complex musical pro duction as sounds are layered and manipulated. Multiple children can play the Rea ctable simultaneously for collaborative musical creation, with each child manipulating their own shape to control a sound, melody or beat. Children produce and hear music by manually manipulating shapes around a graphic table surface. Light pattern s on the table surface and wall create visual rep resentations of the sound patterns.

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The Foley Studios Movie sound effects can include such sounds as footsteps, scratching, rainfall, crac king ice, or crumpling metal. MOXI guests exp lore their creativity as a Hollywood Foley artist when they step into MOXI’s Foley Studios to create thei r own sound effects for popular film clips. Afte r choosing a movie clip and listening to the sound trac k, guests are prompted to create their own sou nd effects using a wide array of objects, tools, and instruments. Children are enthralled by the films and cha llenged to experiment and figure out which objects to use to create the different sounds. The Foley Studios offers a variety of possible experiences. Children can interact with musical instruments, trying to match the sound effects in clips from their favorite movies or they can try to make sounds that provide a comedic effe ct (e.g., banging noises when someone is tiptoein g). They can use the microphone to create sounds with their voice. Young children play with sounds, moving a wire brush against a washboard or stomping on a hard surface to hear what happens. The experience is not unlike the play children engage in when banging pots with wooden spoons in a kitchen. However, the technology of the Foley Studios challenges childre n to make sounds synchronized with a visual image and provides the ability to playback the sounds crea ted, fostering additional challenges beyond typi cal sound play. This is another collaborative exhibit whe re each member of a group can contribute a sound to create the overall effects for the film clip. Playing with the objects in the Foley Studios allows kinetic interact ions. Children strum, stomp, shake and bang obje cts together. They hear the effect as they see the vide o clip.

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Conclusion MOXI’s exhibits are designed to provide access to learning through principles that align with best practices for early childhood education. Children engage in playful multi-sensory explorations that engage their entire bodies and multiple senses. MOXI’s exhibits provide a platform for designing interactions for children of all abilities and for individualizing the experiences to meet the children’s diverse needs.

Weather Orchestra Children work together to create a wind, sun, and human-powered symphony with the Weather Orchestra exhibits on the roof-top sky garden. The Weather Orchestra has several instruments such as the Pendulum Piano that make sounds and music powered by the wind. There are also humanpowered exhibits such as Whirligigs, which produce higher pitched musical notes the faster they are spun, and Rain and Thunder, which mimics the sounds of a storm. The Hole Saw Rhythms exhibit includes movable metal cylinders that chime when struck by a mechanical arm that children control

with a solar panel. Children can vary the size, number, and spacing of bells to change the pitch, number, and temporal spacing of the musical notes played. In addition, the tempo of the ringing bells can be changed by varying the amount of light on the solar panel, which powers the motion of the

ringing armature. The multiple instruments allow children to interact with those they find most compelling. Very young children might simply move a metal sheet back and forth to make the sound of thunder. Older children might manipulate the Hole Saw Rhythms to investigate rhythm while also changing the amount of surface area collecting light to vary the tempo. The weather orchestra aﬀords children opportunities to hear sounds, observe the instruments and physically manipulate the exhibits.

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MOXI oﬀers an environment in which therapists can employ play-based strategies to encourage appropriate infant and toddler development. MOXI’s sound and music exhibits provide many opportunities for learning, communication, collaboration, and creativity in music. But music is only the beginning. MOXI has three floors of interactive experiences, organized around seven themes that all relate to STEAM. Guests can explore technology, light, sound, forces, and motion, or visit the rooftop sky garden, interactive art gallery, or interactive media theater. A visit to MOXI is a journey of selfdiscovery and creativity in a learner-centered environment, where children playfully experiment, formulate and ask questions, test ideas and designs, and make observations and connections.

References Dewey, J. (1996). Democracy and Education. NY: Free Press. Edwards, C. P., Gandini, L., & Forman, G. E. (1998). The hundred languages of children: The Reggio Emilia approach--advanced reflections. London: Greenwood Publishing Group. Hewett, V. (2001). Examining the Reggio Emilia approach to early childhood education. Early Childhood Education Journal, 29(2), 95-100. Humpal, M., (2016). Eight ways music makes a diﬀerence. imagine, 7(1), 80-81. King-Sears, P. (2014). Introduction to Learning Disability Quarterly special series on universal design for learning. Learning Disability Quarterly, 37(2), 68-70. Piaget, J. (1973). To understand is to invent: The future of education. New York, NY: Grossman Publishers.

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Schulz, L., Goodman, N., Tenenbaum, J., & Jenkins, A. (2008). Going beyond the evidence: Abstract laws and preschoolers’ response to anomalous data. Cognition, 109, 211-223. Wright, B., Calderon, A., & Sharp, E., (2016). Strum song: Enhancing fine motor skills. imagine, 7(1), 132.

About the Authors Ron Skinner is Director of Education at MOXI, The Wolf Museum of Exploration + Innovation. His passion is engaging diverse audiences with the physical sciences through innovative informal and formal educational programs. Contact: ron.skinner@moxi.org

Danielle Harlow is an Associate Professor in the Gevirtz Graduate School of Education at University of California, Santa Barbara and a content adviser to MOXI, The Wolf Museum of Exploration + Innovation. Her work focuses on science and engineering education for K-12 teachers and for elementary school students. Contact: dharlow@education.ucsb.edu

For information about MOXI’s location, hours, special activities, and memberships, please see www.moxi.org

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PARENTS CAN

parentscan

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The 2017 parentscan series oďŹ&#x20AC;ers tips for parents whose children use digital devices and interactive media on a daily basis.

The Developing Music Melodies Music Therapy team describes four essential considerations when using digital media at home. Boardcertified music therapists from the Annapolis Music Therapy Services share seven of their favorite low-cost or no-cost apps for engaging your children in music and more. Be informed and make technology and interactive media part of your childrenâ&#x20AC;&#x2122;s learning experience while staying engaged.

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parentscan Tips for Parents

1. Know When to Use Technology Your child will use technology, regardless of access in early years. Rather than allowing constant access or barring access altogether, use technology to support learning and interactions. Limit time on devices so that children continue to thrive outside of the technology world.

2. Understand How To Use Technology Be a role model and demonstrate appropriate use of technology and interactive media. Spend time with your child while using devices and applications to promote positive independent exploration as the child grows and learns.

3. Have Realistic Expectations Choose technology, applications, and digital games that are aligned with your childâ&#x20AC;&#x2122;s developmental age and abilities. When in doubt, check age recommendations and quality reviews for each device or app you choose.

4. Monitor Use of Technology You are encouraged to monitor your childâ&#x20AC;&#x2122;s use of technology and interactive media tools. Many devices offer parental control features to limit the scope and maturity of the apps available for young children. Make use of them to protect your child.

Written by Meryl Brown MM, MT-BC, DT, owner, and Janel Metzger MT-BC, lead therapist, of Developing Melodies Music Therapy Center in Bloomington, Illinois.

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parentscan Tips for Parents 1. Play A Steady Beat We encourage all of our families to download a metronome app to have handy on a phone or tablet. When your child is feeling dysregulated or on the verge of a meltdown, turn on a steady beat between 60-100 beats per minute and clap, stomp, or count the beat. If your child is having difficulty feeling the beat, offer support by providing deep pressure squeezes or rhythmic pats on his or her body, starting with the feet, hands, and head. Our favorites: The Metronome by Sound Brenner (free) & DrumBeats+ (US$3.99)

2. Use Choice Boards to Promote Communication Free choice board apps can be a helpful way to encourage your child to build expressive communication and self-advocacy skills at home. Many of these apps are structured so that you can personalize choice boards for specific needs at home and include real pictures of your child’s favorite items, people, and phrases. Consider making a choice board with songs, movements, and stop/go symbols for a rousing game of freeze dance the whole family can play! Our favorites: SoundingBoard by AbleNet (free) and GoTalk Now Lite (free)

3. Experiment With Playlists Music can have a powerful effect on our mood. Create playlists of songs that your child likes that reflect various emotions to help your child express and connect with his or her emotions. Consider categories like calm, angry, happy, or sad music, and try using playlists to help with transitions, bedtime routines, and brushing teeth. The possibilities are endless! Our favorites: Spotify Music (free) and Apple Music (free)

4. Take a Sensory Break Sensory apps with calming music and visual stimuli are a great way to support your child’s auditory, visual and tactile sensory needs. Sometimes, taking just a few minutes to meet these needs can help improve your child’s attention and engagement at home and can be very calming if your child is feeling overstimulated. Our favorite: Relax App (free or US$1.99 to remove ads)

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parentscan (cont.) 5. Make a Schedule Visual schedules can be used to motivate your child to complete challenging tasks by offering a list of “to-dos” before engaging in preferred activities like singing, playing, and screen time. Picture-based schedules may provide support during challenging, multistep self-care or academic tasks and daily routines (e.g., getting ready for school, afternoon activities, meal preparation). A visual schedule is a great way to increase your child’s motivation and success in planning and executing daily tasks. Our favorite: Choiceworks (US$4.99): This app provides additional tools such as a “waiting board” with timer.

6. Light the Way With a Lighted Keyboard The lighted keyboard was originally created to teach learners of all ages how to play the piano; however, this innovative yet inexpensive instrument (priced under $150) can be used in many creative ways to target and refine skills such as finger isolation, bilateral coordination, visual tracking, auditory perception, pattern recognition, imitation, turn-taking, and executive functioning. Take time during the day to explore the keyboard together and play simple songs, melodies, and rhythms. Our favorites: Casio Lk-175 (61 keys) or older LK-100 models can be found online or at major local retail marts.

7. Sing a Silly Song Work on speech goals by experimenting with creative apps designed to stimulate vocal exploration. Try modeling sounds like vowels, consonants, and funny sound effects, and encourage your child to repeat them back or to create his or her own. We also encourage families to sing songs together during the day to promote bonding and speech development! Our favorites: Bla Bla Bla (free) and Singing Fingers HD (US$.99)

Written by Kerry Devlin, MMT, MT-BC, Joshua Brown, MT-BC, Kahlilah Davidson-Brooks, MT-BC, and Heather Flaherty, MT-BC of Annapolis Music Therapy in Annapolis, Maryland.

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INTERVENTION IDEAS

Photo courtesy of Tom Fougerous

It’s Time for Music Michael R. Detmer M.M.E, MT-BC Petra Kern, Ph.D., MT-BC, MTA, DMtG University of Louisville Louisville, Kentucky

them to assigned seats. 3. Place name tags on children and move assistive walking devices behind or to the side of the older adults’ chairs. 4. Give each person a shaker after seated and engage all in music making.

Description The purpose of this gathering song is to get children and older adults ready for an intergenerational music therapy session. Goals to gather in a semi-circle to get oriented to the session to build rapport Behavior Observation The child will find his/her seat labeled with his/her name participate by shaking an egg shaker demonstrate joint attention

It’s Time for Music Live Recording 2017 by faculty, staﬀ, and research participants.

About the Authors Michael Detmer, MME, MT-BC, and Petra Kern, Ph.D., MT-BC, MTA, DMtG, are investigators of the Intergenerational Music Therapy study conducted at UofL’s

Materials Accompaniment instrument (e.g., guitar) Egg shaker and name tags Directions 1. Sing and play the song softly and in a relaxed style to allow for conversation while providing instruction. 2. Greet children and older adults and direct

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Early Learning Campus. Contact: michael.detmer@louisville.edu

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Photo courtesy of Tom Fougerous

How Do We Say Hello?

2. Model waving hands and shaking hands as indicated in the lyrics. 3. Move around the room and provide support (i.e., verbal, gestural, and tactile prompts) to those who seem hesitant or disoriented. 4. Ask children for alternative ways to say “hello” at the fermata and embed their suggestions in the song. 5. Encourage all children to initiate interactions with their grandfriend, and provide immediate praise for successful accomplishment. Adaptations Ask children, “What letter does ‘hello’ start with?” Invite children to spell “hello.” This should include visual prompts of letters. Use chaining technique to identify all letters in “hello.” Extend by asking, “What sound does the letter _____ make?”

Petra Kern, Ph.D., MT-BC, MTA, DMtG Michael R. Detmer M.M.E, MT-BC University of Louisville Louisville, Kentucky Description The purpose of this greeting song intervention is to promote intergenerational interaction. Goals to learn appropriate greeting gestures to practice ways to say “hello” to initiate greeting a grandfriend (i.e., an older adult) Behavior Observation The child will listen and participate in the song wave hello or shake hands when prompted suggest how to greet a grandfriend Materials Accompaniment instrument (e.g., guitar) Alphabet visuals: H, E, L, L, O Directions 1. Sing the song and play up-tempo to diﬀerentiate from the gathering song and to engage children and older adults in an energized interaction.

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How Do We Say Hello? Live Recording 2017 by faculty, staﬀ, and research participants.

About the Authors Petra Kern, Ph.D., MT-BC, MTA, DMtG, and Michael Detmer, MME, MT-BC, are investigators of the Intergenerational Music Therapy study conducted at UofL’s Early Learning Campus. Contact: petra.kern@louisville.edu

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Photo courtesy of Tom Fougerous

We’re All Done With...

Directions 1. Start the song and collect materials from children and older adults. 2. Get all children’s and older adults’ attention and build excitement for the next activity. 3. Make sure transitions move quickly and have all materials in place for the next part of the session. 4. Have classroom assistants help with the transition. 5. Be informed, which children might need more support for transitioning and which older adults need more time to be oriented to the next activity. Adaptations Request children to list completed tasks (i.e., “All done with drumming.”) Invite children to collect and distribute materials. Ask children, “What do you think comes next?” Use a picture schedule indicating each activity of the session.

Michael R. Detmer M.M.E, MT-BC Petra Kern, Ph.D., MT-BC, MTA, DMtG University of Louisville Louisville, Kentucky Description The purpose of this song intervention is to transition children and older adults attending an intergenerational music therapy session from one activity to another. Goals to signal the end of an activity to shift attention to prepare for a smooth transition to the next activity Behavior Observation The child will: return materials demonstrate focus of attention on facilitator anticipate the next activity Materials Accompaniment instrument (e.g., guitar) Materials needed for next activity

We’re All Done With Drumming Live Recording 2017 by faculty, staﬀ, and research participants.

About the Authors Michael Detmer, MME, MTBC, and Petra Kern, Ph.D., MT-BC, MTA, DMtG, are investigators of the Intergenerational Music Therapy study conducted at UofL’s Early Learning Campus. Contact: michael.detmer@louisville.edu

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Photo courtesy of Tom Fougerous

3. Encourage children to wave, hug, or shake their grandfriend’s hand. 4. Move around the room and provide support and encouragement where needed. 5. Ask children to line up and leave the room quietly. 6. Provide support to older adults to get out of their chairs and bring their assistive walking devices to them if needed. Adaptations Ask children, “What letter does,‘goodbye’ start with? Invite children to spell “goodbye.” This should include visual prompts of letters. Extend by asking, “What sound does the letter _____ make?”

Goodbye to You My Friend Petra Kern, Ph.D., MT-BC, MTA, DMtG Michael R. Detmer M.M.E, MT-BC University of Louisville Louisville, Kentucky Description The purpose of this closure song intervention is to promote intergenerational interaction and friendship. Goals to signal the end of the session to facilitate a goodbye gesture Behavior Observation The child will listen and participate in the song wave, shake hands, or hug a grandfriend (i.e, an older adult) Materials Accompaniment instrument (e.g., guitar) Alphabet visuals: G, O, O, D, B, Y, E Directions 1. Sing the song and decrease the tempo over 2-3 repetitions to prepare for a smooth transition to the children’s classroom. 2. Model waving “goodbye” as indicated in the lyrics.

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Goodbye to You My Friend Live Recording 2017 by faculty, staﬀ, and research participants.

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4. Assist children in identifying polite aspects of the question or statement, and discuss a situation in which that phrase could be used. 5. Sing song again and repeat process for all picture cards. Adaptations Have children act out a scenario in which they would need to politely ask for help. Have children identify which of the phrases were their favorite and why.

When I Need Help Samantha Hinson, Music Therapy Intern University of Louisville Louisville, Kentucky Description The purpose of this song intervention is to practice appropriate phrases for requesting help. Goals to expand vocabulary of polite phrases to develop polite behavior Behavior Observation The child will make a statement requesting help identify the polite aspects of an interaction Materials Accompaniment instrument (e.g., guitar or piano) Visual of help scenarios Directions 1. Ask children about situations in which they may need help. Then start singing song, prompting child to participate in the call and response. 2. Have one child draw a picture card. 3. OďŹ&#x20AC;er a matching help request question or statement and have children repeat it.

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When I Need Help Recorded 2017 by Samantha Hinson

About the Author Samantha Hinson is a graduate of Drury University in Springfield, Missouri. She recently completed her music therapy internship at the University of Louisville Music Therapy Clinic in Louisville, Kentucky and is currently working as a private contractor in the Louisville area. Contact: samijhinson@gmail.com

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3. Ask for a volunteer to go first and pick a peer to give a compliment to. If needed, assist child by giving an example. 4. Prompt the compliment recipient to make a follow-up statement such as “thank you.” 5. Continue with the song until all children have given and received a compliment. Adaptations Provide a real life scenario and ask children what an appropriate compliment and response would be.

Let’s Say Some Kind Things Samantha Hinson, Music Therapy Intern University of Louisville Louisville, Kentucky Description The purpose of this song intervention is to practice being kind and polite. Goals to give compliments to respond to compliments Behavior Observation The child will give an appropriate compliment to a peer say “thank you” or make another appropriate statement after receiving a compliment Materials Accompaniment instrument (e.g. guitar or piano) Directions 1. Facilitate conversation about what a compliment is and give diﬀerent examples (e.g., I like your smile). 2. Start singing the song, prompting children to sing along.

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Let’s Say Some Kind Things Recorded 2017 by Samantha Hinson

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4. Invite each child to sound out the name of the vegetable or fruit while tapping the syllables on the drum (e.g., ba-na-na = 3 beats). 5. Model complete sentences and keep the beat on the drums (e.g., “I like ba-na-nas” = 5 beats). Adaptations Invite all children who have vegetables to play together; next instruct all children with fruit drums to play. Have them identify each others vegetables and fruits in complete sentences (e.g., Tom has a ba-na-na.) and keep drumming. Provide examples for children who do not understand the imaginary “musical garden” theme.

Musical Garden Kelsey Norris, Music Therapy Intern University of Louisville Louisville, Kentucky Description The purpose of this song intervention is to develop subject-specific vocabulary and expressive communication. Goals to enhance expressive vocabulary to increase formulating 3-5 word sentences Behavior Observation The child will name the fruit/vegetable on the drum say “I like _______.” Materials Accompaniment instrument (e.g., guitar) Hand drums with colorful pictures of fruits and vegetables Directions 1. Place the hand drums in the middle of a circle. 2. Sing the song and have children walk in a circle. 3. Each time the song stops, ask one of the children to pick up a fruit or vegetable drum.

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Musical Garden Recorded 2017 by Kelsey Norris

About the Author Kelsey Norris was an intern at the University of Louisville’s Music Therapy Clinic, where she provided music therapy services for a variety of populations. This song intervention was written for a group she worked with at the University of Louisville’s Autism Center. Contact: kelseynorris16@gmail.com

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Adaptations Slow down the tempo of the song to calm children. Introduce props, such as bubbles to practice deep breathing.

Calm Necessities A’Marie Rust, Music Therapy Intern University of Louisville Louisville, Kentucky Description The purpose of this song intervention is to deal with anxiety and stress in various situations. Goals to identify appropriate coping strategies to transfer coping skills to daily life situations Behavior Observation The child will name desired coping strategies demonstrate at least one coping skill Materials Accompaniment instrument (e.g., guitar or ukulele) Directions 1. Have children sit in a circle. 2. Ask children what they can do to calm down. 3. Play the song and lead children in practicing desired coping strategies (e.g., taking deep breaths). 4. At the end of the song, ask each child to identify one of the coping strategies mentioned and to share how it might be applied in a daily life situation.

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Calm Necessities Recorded 2017 by A’Marie Rust

About the Author A’Marie Rust is currently interning at Brooks Rehabilitation in Jacksonville, Florida. This song intervention was successfully implemented during her practicum at the University of Louisville’s Autism Center.

Contact: acrust01@louisville.edu

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behaviors and ask children to act out situation that the song presents. Adaptations Write a new verse with the children by asking what other behaviors are appropriate for a store visit.

Going to the Store,Hooray! Christina Koenig, Music Therapy Student Shenandoah University Winchester, Virginia Description The purpose of this song intervention is to learn appropriate behaviors for a store visit with parents. Goals to learn proper store behavior to display appropriate social behaviors Behavior Observation The child will answer questions about song content act out proper store behavior Materials Accompaniment instrument (e.g., guitar or ukulele) Directions 1. Ask children to share their favorite stores to visit. Explain that there are certain expectations to follow while in a store. 2. Sing the song, using verbal and nonverbal cues to prompt the children to answer the question, â&#x20AC;&#x153;What do I do?â&#x20AC;? during each verse. 3. After completing the song, review appropriate store

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Going to the Store, Hooray! Recorded 2017 by Christina Koenig

About the Author Christina Koenig is a sophomore music therapy major at Shenandoah University. She is involved in the worship arts, choir, NW Works Chimers, and she volunteers at the Child Safe Center.

Contact: ckoenig14@su.edu

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3. Invite children to fill in lyrics such as “...keeps the doctor away,” “...is a sure way to win it,” “...is a great way to be healthy.” Adaptations Bring fruit and vegetables to the session and let children taste them after the song intervention. Create new verses with food types that are healthy.

The Fruits and Veggies Song Christian Patterson, Music Therapy Student Shenandoah University Winchester, Virginia Description The purpose of this song intervention is to promote healthy eating habits. Goals to identify vegetables and fruits to develop healthy eating behaviors Behavior Observation The child will name fruits and vegetables connect healthy food with positive phrases

The Fruits and Veggies Song Recorded 2017 by Christian Patterson

About the Author Materials Accompaniment instrument (e.g., guitar or ukulele) Fruit and vegetable shakers Directions 1. Introduce the topic by asking children to share what they had for breakfast, lunch, or dinner. 2. Have children pick a fruit or vegetable shaker and invite them to play along the song.

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Christian Patterson is pursing his undergraduate degree in music therapy at Shenandoah University. He hopes to create music that helps and heals. Contact: cpatters14@su.edu

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nature, and the animals on the poster. 4. Play through the song’s chord progression or improvise on the guitar while the children draw. 5. After the drawing is finished, invite the children to sing along with the chorus. Adaptations Use this song intervention during Earth Day celebrations in children's classroom. Cut out visuals of the people and animals in the song and have children stick them to the poster with tape or Velcro if drawing is too challenging.

Beautiful Planet Audrey Weatherstone, Music Therapy Student Shenandoah University Winchester, Virginia Description The purpose of this song intervention is to promote respect for nature, people, and all creatures. Goals to learn about the earth to promote respect and kindness Behavior Observation The child will draw a picture about the earth participate in a group discussion Materials Accompaniment instrument (e.g., guitar or ukulele) Poster paper, crayons, and markers Directions 1. Sing the song once through and invite children to listen for diﬀerent places, people, and animals. 2. Facilitate group discussion with questions related to the song, such as, “Who lives on the earth?” “What does it mean to be kind to each other?” 3. After each verse, invite children to draw themselves,

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Beautiful Planet Recorded 2017 by Audrey Weatherstone

About the Author Audrey Weatherstone is a sophomore music therapy student and cellist at Shenandoah University. She is hoping to one day practice music therapy with children. Contact: aweather132@su.edu

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ocean, park). 5. Let children choose another animal and repeat the entire song. Adaptations Discuss the natural habitats of the animals. Invite children to bring their own animals to the music therapy session and ask them what they eat, how they take care of them etc. Make a field trip to the zoo, ocean, or park and take the song along.

Animals Are Everywhere! Emily Cooley, Music Therapy Student Shenandoah University Winchester, Virginia Description The purpose of this song intervention is to have children learn about animals and where they live. Goals to increase animal identification to identify animalsâ&#x20AC;&#x2122; natural habitats Behavior Observation The child will name animals place animals in their natural environments

Animals Are Everywhere! Recorded 2017 by Emily Cooley

About the Author Materials Accompaniment instrument (e.g., guitar or ukulele) Animal puppets Directions 1. Ask the children to name their favorite animals. 2. Invite children to listen to the first verse and pick up a puppet mentioned in the lyrics. 3. Repeat activity for the second and third verses. 4. Sing the song again and ask children to name other animals that live in the same environment (i.e., zoo,

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Emily is currently a sophomore music therapy student at Shenandoah University. She looks forward to working with people of all ages, especially with young children.

Contact: ecooley15@su.edu

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Please and Thank You Ethan Gross, Music Therapy Student Shenandoah University Winchester, Virginia Description The purpose of this song intervention is to learn about the friendly interactive behaviors between peers. Goals to demonstrate positive interactions to encourage politeness Behavior Observation The child will shake hands, give high fives, smile, share toys say “please” and “thank you”

Please and Thank You Recorded 2017 by Ethan Gross

Materials Accompaniment instrument (e.g., guitar or ukulele) About the Author Directions 1. Greet children with a hand shake, high fives, and a smile. Then play first part of the song and invite children to model after you. 2. Ask children which other friendly actions they could do during the day (e.g., share toys, say “please” and “Thank you”) and continue with the song. 3. Repeat the song to give all children the chance to practice.

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Ethan Gross is a sophomore music therapy student at Shenandoah University who has a desire to help others through the power of music. Contact: egross14@su.edu

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hot, hot!” 3. Introduce other items displayed on the picture cards. 4. Let children pick a card and build it into the song. 5. Explain consequences of being hurt when touching those items and invite children to sing the chorus again. Adaptations Introduce other household hazards in a similar style. Brainstorm other dangerous situation (e.g., traﬃc).

Hot, Hot, Hot! Lydia Heitman, Music Therapy Student Shenandoah University Winchester, Virginia Description The purpose of this song intervention is to teach children about dangerous household items that could hurt them. Goals to identify dangerous household items to practice safe behavior Behavior Observation The child will name household items that are too hot to touch identify the consequences of being hurt when touching hot items Materials Accompaniment instrument (e.g., ukulele or piano) Poster board, picture cards representing household items that are hot. Directions 1. Gather children in a circle and introduce the idea that some things are too hot to touch. 2. Ask children for examples and respond with the chorus “It’s hot, hot, hot...ouch that ________was hot,

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Hot, Hot, Hot! Recorded 2017 by Lydia Heitman

About the Author Lydia Heitman is a sophomore music therapy major at Shenandoah University. She is currently the comanager of NW Works Chimers.

Contact: lheitman14@su.edu

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3. Repeat the song so that each child has a turn and all the snowflakes are removed. Adaptations Reverse the intervention: pass out the snowflakes to the children and have them place the snowflakes on the mounting surface when it is their turn. Have them count the remaining snowflakes. Use other props to represent the snowflakes, such as beanbags or egg shakers. Use raindrops instead of snowflakes to match current weather.

Five Little Snow Flakes Dawn Stewart, MT-BC/DS II Sunshine Music Therapy Inc. Albuquerque, New Mexico Description The purpose of this song intervention is to practice turntaking and counting in a group setting. Goals to improve turn-taking to improve counting skills Behavior Observation The child will take turns with peers count snowflakes Materials One laminated snowflake per child Mounting surface for snowflakes (e.g., chalkboard ledge laminated piece of paper, or poster board) Directions 1. Display the snowflakes so that all the children can see them. 2. Introduce the song. At the fermata on â&#x20AC;&#x153;one did melt and left behind,â&#x20AC;? have one child remove one snowflake and count the remaining ones.

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Five Little Snowflakes Recorded 2017 by Dawn Stewart

About the Author Dawn Stewart, MT-BC/DS II is an early intervention music therapist with Sunshine Music Therapy Inc. in Albuquerque, New Mexico. She developed this intervention during her internship in Columbus, Ohio, for young children on the autism spectrum. Contact: dawn.es@live.com

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Integrate Music Together® into Your Music Therapy Practice

Bring the internationally recognized, research-based Music Together curriculum into your work with individual clients through the Music Together Within Therapy® program. Participating clinicians have access to Music Together family and educator materials as well as tools specifically designed to facilitate the therapeutic process. Your clients will receive their own professionally produced songbook and CD set, and you’ll join an active online community of other practitioners with whom to share ideas and resources. You’ll also be eligible for marketing support, mentoring from a boardcertified music therapist, and a variety of CBMT-approved professional development opportunities.

Visit our website or call us to learn more about how Music Together can enhance your music therapy work.

(800) 728-2692 x332 • musictogether.com/mtwt

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COLOR OF US

Moving Forward with Inclusion Programing Worldwide Petra Kern, Ph.D., MT-BC, MTA, DMtG Music Therapy Consulting Santa Barbara, California A roundtable presented by imagine authors at the 2017 World Congress of Music Therapy in Tsukuba, Japan, brought together music therapists from the USA (Petra Kern, Rose Fienman), Japan (Kumi Sato), Argentina (Gabriel Federico), Thailand (Patchawan Poopityastaporn), and Poland (Krzysztof Stachyra) who have been involved in inclusion programing in their respective countries. While reviewing research-based facts of inclusion and the benefits it may bring to communities, presenters shared the following content: Reflection: Meaning of Inclusion Panorama Overview: Current Status and Challenges Case Example: Highlighting Inclusion Programming Recommendations: Successful Strategies

Watch a video collage of the 2017 color of us roundtable at https://youtu.be/s-ea42M7G1A

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PODCASTS imagine 8(1), 2017

Beth McLaughlin, MSE, MT-BC Former Wildwood School Schenectady, New York

Katie Myers, MM, MT-BC Levine Music Alexandria, Virginia

Using Technology to Support Communication in the Music Therapy Classroom

Music Therapy: The Intersection of Play and Technology

In this podcast Beth McLaughlin interviews Amy Myers on how to successfully embed technology into music therapy sessions.

This podcast discusses incorporating technology while keeping the playfulness crucial for child development.

Rachel Rambach, MM, MT-BC Listen & Learn Music Springfield, Illinois

Carol Ann Blank, Ph.D., MT-BC Music Together Worldwide Hopewell, New Jersey

A Day in the Life: The Role of Technology in Running an Early Childhood Music Therapy Practice

Supporting Parents and Young Children Through Interactive Media

This podcast leads through a typical day in an early childhood music therapy practice enriched by technology and interactive media. Â

This podcast describes the use of the Music Togetherâ&#x20AC;&#x2122;s Family Music Zone app and the Hello Everybody app.

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Dawn M. Sandel, M.A.Ed., MT-BC RISE Center, Tuscaloosa at the University of Alabama

Just the Basics – Apple Music 101

#MTBaby: Music Therapy with Generation Tech

This podcast discusses music subscription services such as Apple Music and its advantages for use in early childhood music therapy practice.

This podcast discusses low, mid, and high tech devices and provides examples of how they can be utilized purposefully in early childhood music therapy sessions.

Ralf Niedenthal, Lic. in MT Música (We All Make Music) Teacher at the University Buenos Aires, Argentina Todos Hacemos Música – We All Make Music

This podcast describes a non-profit organization's projects including music videos created with people with disabilities.

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IN THEIR WORDS... ONE CLICK AWAY!

Hanna Jade Watson, MT Student University of Alabama Tuscaloosa, Alabama

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RESOURCES

1.Baby Talk If you work with infants and toddlers, you may want to subscribe to BabyTalk. This one-way listserv is distributed monthly and shares free research, resources, and practical strategies to use in supporting children from birth to 36 months and their families. Join by sending an email with no message to subscribe-babytalk@listserv.unc.edu. Past issues are archived at http://fpg.unc.edu/resources/baby-talk-archive

2.DLLNWG The Dual Language Learner National Work Group produces a regular e-newsletter that shares research and resources to improve outcomes for dual language learners, children from birth through age eight who are learning English in addition to their native languages. To subscribe, go to https:// www.newamerica.org/subscribe/, enter your contact information and select DLL National Work Group Newsletter.

3.Faculty Finds Faculty Finds is a one-way listserv that is targeted to individuals who teach, train, or provide other forms of professional development. Distributed six times per year, each issue oďŹ&#x20AC;ers free early childhood content resources, instructional resources, and information about eďŹ&#x20AC;ective preparation of early childhood professionals. To subscribe, send an email with no message to subscribe-facultyfinds@listserv.unc.edu. Past issues are archived at http://fpg.unc.edu/esources/faculty-finds

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Hot Off the Press: Electronic Resources to Support Your Work Camille Catlett, M.A. Scientist Emerita, Frank Porter Graham Child Development Institute at UNC at Chapel Hill Does your computer inbox receive regular deliveries of good, readily available, high quality resources and information? Do you have access to a steady stream of free information and ideas to support your work? If you answered no to either of these questions, here are six examples of ways the use of technology can help you stay current.

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4.Natural Resources

6.WAECE

Natural Resources is a one-way listserv that drops a free resource in your inbox every Wednesday. Items shared range from new policies and evidence-based practices, to articles, research, checklists, and tools. To sign up for Natural Resources, send an email to listserv@unc.edu with a blank subject line. The text of the message must be: subscribe natural_resources2 (retype it; don't copy/paste) Be sure the subject is blank. Then send the message.

The Weekly Bulletin of the World Association of Early Childhood Educators (WAECE) oﬀers a useful blend of research, activities, and resources in English and Spanish. Each section features an area called Recommended App that reviews early childhood-related applications. A recent issue, for example, shared the Easy Music for Kids, a program in which cute cartoon critters and objects lead children through various games that hone their skills in listening and repeating percussive beats, pitches, and notes. The games get harder and harder as kids move along the levels. Then they can switch to a composing mode and tap on the animals and items to create music, from jazz to fusion. Subscribe at http://www.waece.org/webingles/ centro/02/index.php (English) or http:// www.waece.org/boletines.html

5.Resources within Reason Resources Within Reason is a new listserv that is distributed every other month as a service of the Division for Early Childhood (DEC). Each issue synthesizes resources on a specific topic related to supporting young children with or at risk for disabilities, their peers, and families. The January 2017 issue featured resources that provide evidence in support of inclusion and the March 2017 issue shared gems on the topic of Universal Design for Learning. View past issues or sign up at http://www.dec-sped.org/resourceswithin-reason

About the Author Camille Catlett, M.A. is a Scientist Emerita from the Frank Porter Graham Child Development Institute at UNC at Chapel Hill. She is a frequent presenter at state, national, and international conferences who also coordinates four national listservs, two state listservs, and authors a regular column on implementing evidence-based practices in Young Exceptional Children. Watch video about Camille Catlett’s Resources at https://youtu.be/5T2fSyRJfk4

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Contact: camille.catlett@unc.edu

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Websites and Online Resources

Curated Resources on Technology and the Young Child provided by the Technology in Early Childhood (TEC) Center at Erikson Institute About the Institute TEC Center at Erikson Institute empowers early childhood educators to make informed decisions about the appropriate use of technology with children from birth to age 8. Through carefully selected resources and real-world examples, the Center strengthens educators’ digital literacy and their ability to intentionally select, use, integrate, and evaluate technology in the classroom and other early childhood settings. Learn more…TEC Center Email TECCenter@erikson.edu Facebook www.facebook.com/ teccenter.erikson Twi%er h%ps://twi%er.com/#!/tec_center

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AAP, American Academy of Pediatrics, Media and Young Minds ALSC, Media Mentorship in Libraries Serving Youth AT&T Especially for Parents | Digital You Campaign for a Commercial Free Childhood CASEL, Collaborative for Academic, Social and Emotional Learning CAST: About Universal Design for Learning CEELO, Center for Enhancing Early Learning Outcomes Center on Media and Child Health & CMCH Research Database Center on Media and Human Development CSEFEL, Center for the Social and Emotional Foundations of Early Learning Child Learning & Development Center Tech Tools Site, Pacific University Children's Technology Review Common Sense Media & Parent Concerns, Early Childhood & Graphite Early Childhood Australia, Live Wires & Digital Business Kits Early Childhood Investigations Webinars ECEtech.net edWeb.net PreK-3 Digital Learning Eﬀective Technology Integration in Early Childhood Education, Sharon Hirschy Fred Rogers Center for Early Learning and Children's Media Fred Rogers Company Professional Resources HealthyChildren.org HITN Early Learning Collaborative Integrating Technology in Early Literacy International Society for Technology in Education, ISTE Standards for Teachers Joan Ganz Cooney Center at Sesame Workshop NAEYC, National Association for the Education of Young Children NAMLE, National Association for Media Literacy Education PAEYC Digital Media Literacy page Results Matter Video Library, iPads in Early Childhood, Colorado Department of Education SAMR Model - Redefinition, Modification, Augmentation, Substitution, Kathy Schrock’s Guide to Everything Tap, Click Read Toolkit Technology and Young Children Interest Forum TPACK Model - Technological Pedagogical Content Knowledge

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Selected Blog Posts, Articles and Reports Annotated Bibliography: Using Technology in Early Childhood Classrooms, CEELO, 2015 Aprendiendo en casa: media as a resource for learning among hispanic-latino families, Joan Ganz Cooney Center, 2015 Bringing the Tech Revolution to Early Learning, Homeroom blog, US DOE, Libby Doggett, 2014 Can An App Teach Empathy and Mindfulness? Fred Rogers Center blog, Kathleen Costanza, 2014 Can You Turn Screen Time into Family Time? Joan Ganz Cooney Center, 2014 Developmentally Appropriate Technology, Teaching Strategies Blog, 2014 Differences in Hispanic-Latino Families Access to and Use of Educational Media, New America, 2015 Digital Media Literacy for Early Childhood Educators, Fred Rogers Center Blog, Chip Donohue, 2014 Diversity in Children’s Media Is More Than Just Race or Gender, Fred Rogers Center Blog, Kevin Clark, 2013 Early Connections: A Parent Education Toolkit for Early Childhood Providers, Commons Sense Media, 2014 Early Education, Technology and the Role of NAEYC, NAEYC Blog, Rhian Evans, 2014 Ed Tech Developer’s Guide, Richard Culatta, Department of Education, Office of Educational Technology, 2015 Envisioning a Digital Age Architecture for Early Education, Lisa Guernsey, New America, 2014 Exploring Play and Creativity in Pre-Schoolers’ Use of Apps, Lydia Plowman, TAP, University of Sheffield, 2015 Facing the screen dilemma: Young children, technology and early education, Campaign for Commercial Free Childhood 2012 Family Engagement in Anywhere, Anytime Learning, Harvard Family Research Project, Lopez & Caspe, 2014 Family Time with Apps: A Guide to Using Apps with Your Kids, Joan Ganz Cooney Center (Available from the iTunes store) Kids and Screen Time: What Does the Research Say? NPR Ed, National Public Radio, 2014 Learning at Home: Families' Educational Media Use in America, Joan Ganz Cooney Center, 2014 Moving From Child Advocacy to Evidence-Based Care for Digital Natives, Michael Rich, 2014 Parenting in the Age of Digital Technology, Center for Media and Human Development, 2013 Screen Sense: Setting the Record Straight, Zero to Three, 2014 Screen Sense: Setting the Record Straight – Research-based Guidelines for Screen Use for Children Under 3 Years Old Key Research Findings Tips for Using Screen Media with Young Children 5 Myths about Young Children and Screen Media Tech in the Early Years: What Do We Know and Why Does It Matter?, Fred Rogers Center Blog, Chip Donohue, 2014 Technology in Early Education, Lisa Guernsey for the Education Commission of the States, 2012 Technology and Early Learning: Part One – Five, Susan Magsamen, Houghton Mifflin Harcourt, 2015 Part One: A Healthy Digital Diet: Three Tips for Balancing Screen Time for Kids Part Two: Building Blocks for a Nourishing Digital Diet Part Three: Bridging the Digital Divide: Practical Resources for Educators Part Four: Grey Matter: Child Development and Technology

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Transforming the workforce for children birth through age 8” A unifying foundation, Institute of Medicine and National Research Council of the National Academies, 2015 Using Early Childhood Education to Bridge the Digital Divide, RAND Corporation Reports, 2014 Moving Beyond Screen Time: Redefining Developmentally Appropriate Technology Use in ECE Getting on the Same Page: Identifying Goals for Technology Use in Early Childhood Education How Much and What Kind? Identifying an Adequate Technology Infrastructure for Early Childhood Education Getting Early Childhood Educators Up and Running: Creating Strong Technology Curators Families, Powered On: Improving Family Engagement in Early Childhood Education Through Technology Using technology appropriately in the preschool classroom, HighScope, 2015 What Makes An App Educational?, Fred Rogers Center blog, Michael Robb, 2015 Young Children, New Media, and Libraries: A Guide for Incorporating New Media into Library Collections, Services, and Programs for Families and Children Ages 0-5 A crowdsourced book from Little eLit, 2015 Young children (0-8) and digital technology. JRC Science and Policy Reports, Oﬃce of the European Union, 2015

d nding an le b e h t it is Perhaps tive of interac ith g in c n la ba actions w r e t in d n gy a ost technolo ers the m f f o t a h t d others fective an f e r o f gy in e promis technolo f o s e s u te appropria years. the early nohue –Chip Do

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Blogs Joan Ganz Cooney Center EdCentral Early Ed, New America Fred Rogers Center Innovate, Ignite, Inspire, Kristin Ziemke Language Castle Blog, Karen Nemeth Mind/Shift, KQED Raising Digital Natives, Dr. Devorah Heitner The Spoke, Early Childhood Australia Technology Rich Inquiry Based Research, Diane Kashin

Books Berthiaume & Lovely, 2014. Using an iPad with Your Preschooler. Suddenly It Clicks. Buckleitner, 2016. Buckleitner’s guide to using tablets with young children. Campbell & Haines, 2016. Becoming a media mentor: A guide for children’s librarians. Donohue, 2017. Family Engagement in the Digital Age: Early Childhood Educators as Media Mentors. Donohue, 2015. Technology and Digital Media in the Early Years: Tools for Teaching and Learning. Guernsey, 2012. Screen Time: How Electronic Media-From Baby Videos to Educational Software--Affects Your Young Child. Guernsey & Levine, 2015. Tap, Click, Read: Growing Readers in a World of Screens. Levin, 2013. Beyond Remote-Controlled Childhood: Teaching Young Children in the Media Age. Muhtaris & Ziemke, 2015. Amplify: Digital teaching and learning in the K-6 classroom. Parette & Blum, 2013. Instructional Technology in Early Childhood: Teaching in the Digital Age. Puerling, 2012. Teaching in the Digital Age: Smart Tools for Age 3 to Grade 3. Sadao & Robinson, 2010. Assistive Technology for Young Children: Creating Inclusive Learning Environments. Scheibe & Rogow, 2012. The Teacher’s Guide to Media Literacy: Critical Thinking in a Multimedia World. Simon & Nemeth, 2010. Digital Decisions: Choosing the Right Technology Tools for Early Childhood Education. Vasquez & Felderman, 2012. Technology and Critical Literacy in Early Childhood.

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Selected Recent Literature Aikens, N., Akers, L., & Atkins-Burnett, S. (2016). Professional Development Tools to Improve the Quality of Infant and Toddler Care: A Review of the Literature. OPRE Report 2016-96. Washington, DC: Oﬃce of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. American Academy of Pediatrics, Council on Communications and Media (2016). Media and young minds. Pediatrics 138 (5). e20162591; DOI 10.1542/p3ds.2016-2591 Armstrong, A., Donohue, C., & Highfield, K. 2015, September. Technology integration: Defining what is appropriate for young children. Exchange, 28-33. Blackwell, C.K., Lauricella, A.R., & Wartella, E. 2016. The ready to learn program: 2010-2015 policy brief. Chicago, IL: Northwestern University. Connell, S. L., Lauricella, A. R., & Wartella, E. 2015. Parental co-use of media technology with their young children in the USA. Journal of Children and Media, 991), 5-21, DOI: 10.1080/17482798.2015.997440 Department of Education & U.S. Department of Health and Human Services. (2016). Early learning and educational technology policy brief. Washington, DC: U.S. DOE. Donohue, C. (2016). Technology in early childhood education. SAGE Encyclopedia of Contemporary Early Childhood Education. Thousand Oaks, CA: SAGE. Donohue, C. (2017, March/April). Digital age family engagement: The role of media mentors. Exchange, 12-16. Early Childhood STEM Working Group (2017). Early STEM Matters: Providing High-Quality STEM Experiences for All Young Learners. Chicago, IL: University of Chicago Center for Elementary Mathematics and Science Education (CEMSE). Hirsh-Pasek, K., Zosh, J.M., Golinkoﬀ, R.M., Gray, J.H., Robb, M.B., & Kaufman, J. 2015. Putting education in “educational” apps: Lessons from the science of learning. Psychological Science in the Public Interest, 16, 3-34. Lauricella, A. R., Wartella, E., & Rideout, V. 2015. Young children’s screen time: The complex role of parent and child factors. Journal of Applied Developmental Psychology, 36, 11-17. McClure, E. R., Guernsey, L., Clements, D. H., Bales, S. N., Nichols, J., Kendall-Taylor, N., & Levine, M. H. (2017). STEM starts early: Grounding science, technology, engineering, and math education in early childhood. New York: The Joan Ganz Cooney Center at Sesame Workshop. Pasnik, S., & Hupert, N. (2016). Early STEM Learning and the Roles of Technologies. Waltham, MA: Education Development Center, Inc. Radesky, J. S., Schumacher, J., & Zuckerman, B. 2015. Mobile and interactive use by young children: The good, the bad, and the unknown, Pediatrics, 135,1 1-3. DOI: 10.1542/peds.2014-2251 Wartella, E. 2015. Educational apps: What we do and do not know. Psychological Science in the Public Interest, 16, 1-2, DOI: 10.1177/1529100615578662 Zero to Three & Bezos Family Foundation. (2016). Tuning in: Parents of young children speak up about what they think, know Thank you to Dr. Chip and need. Washington, DC: Zero to Three. Donohue and his team at the Erikson TEC Center for sharing these valuable resources.

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PUBLICATIONS

Early Childhood Music Therapy Publications 2016–2017 Compiled by Christopher R. Millett, M.M., MT-BC Florida Hospital Orlando, Florida

2016

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Edwards, J., & Kennelly, J. (2016). Music therapy for hospitalized children. In J. Edwards & J. Edwards (Eds.), The Oxford Handbook of Music Therapy (pp. 53-65). New York, NY: Oxford University Press. Geretsegger, M., Holck, U., Bieleninik, Ł., & Gold, C. (2016). Feasibility of a trial on improvisational music therapy for children with autism spectrum disorder. Journal of Music Therapy, 53(2), 93-120. doi:10.1093/jmt/thv038 Liao, M., & Campbell, P. S. (2016). Teaching children’s songs: A Taiwan-US comparison of approaches by kindergarten teachers. Music Education Research, 18(1), 20-38. McPherson, G. E. (2016). The child as musician: A handbook of musical development (2nd ed.). Oxford, England: Oxford University Press. Oldfield, A. (2016). Family approaches in music therapy practice with young children. In J. Edwards & J. Edwards (Eds.), The Oxford Handbook of Music Therapy (pp. 158-175). New York, NY: Oxford University Press. Pitt, J., & Hargreaves, D. J. (2016). Attitudes towards and perceptions of the rationale for parent-child group music making with young children. Music Education Research. Advance online publication. doi:10.1080/14613808.2016.1145644 Shoemark, H., & Dearn, T. (2016). Music therapy in the medical care of infants. In J. Edwards & J. Edwards (Eds.), The Oxford Handbook of Music Therapy (pp. 24-52). New York, NY: Oxford University Press. Waldon, E. G., Lesser, A., Weeden, L., & Messick, E. (2016). The music attentiveness screening assessment, revised (MASA-R): A study of technical adequacy. Journal of Music Therapy, 53(1), 75-92. Yang, Y. (2016). Parents and young children with disabilities: The eﬀects of a home-based music therapy program on parent-child interactions. Journal of Music Therapy, 53(1), 27-54.

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2017 Brown, L. S. (2017). The influence of music on facial emotion recognition in children with autism spectrum disorder and neurotypical children. Journal of Music Therapy, 54(1), 55-79. doi: 10.1093/jmt/thw017 Christenbury, K. R. (2017). I will follow you: The combined use of songwriting and art to promote healing in a child who has been traumatized. Music Therapy Perspectives, 35(1), 1-12. doi: 10.1093/mtp/miv005 Cobbett, S. (2016). Context and relationships: Using the systemic approach with music therapy in work with children, adolescents and their families. British Journal of Music Therapy, 30(2), 65-73. Ettenberger, M. (2017). Music therapy in the neonatal intensive care unit: Putting the families at the centre of care. British Journal of Music Therapy, 31(1), 12-17. Ettenberger, M., Rojas Cárdenas, C., Parker, M., & Odell-Miller, H. (2017). Family-centred music therapy with preterm infants and their parents in the neonatal intensive care unit (NICU) in Colombia – A mixed-methods study. Nordic Journal of Music Therapy, 26(3), 207-234. doi:10.1080/08098131.2016.1205650 Gooding, L. F., Yinger, O. S., & Iocono, J. (2016). Preoperative music therapy for pediatric ambulatory surgery patients: A retrospective case series. Music Therapy Perspectives, 34(2), 191-199. doi:10.1093/mtp/ miv031 Kim, S. J., Kim, E. Y., & Yoo, G. E. (2017). Music perception training for pediatric cochlear implant recipients ages 3 to 5 years: A pilot study. Music Therapy Perspectives, 35(1), 50-57. doi:10.1093/mtp/miw009 Lander, J. (2017). ‘BabySounds’: Promoting bonding and attachment, pre-and post-natally, with vulnerable first-time parents. British Journal of Music Therapy, 31(1), 18-25. Loth, H. (2017). Cacophonies of discord, moments of harmony: Managing multiple needs in short-term music therapy with triplets and their mother. British Journal of Music Therapy, 31(1), 26-31. Marsh, K. (2017). Creating bridges: Music, play and well-being in the lives of refugee and immigrant children and young people. Music Education Research, 19(1), 60-73. doi:10.1080/14613808.2016.1189525 Metell, M., & Stige, B. (2016). Blind spots in music therapy. Toward a critical notion of participation in context of children with visual impairment. Nordic Journal of Music Therapy, 25(4), 300-318. doi: 10.1080/08098131.2015.1081265 Mitchell, E. (2017). Music therapy for the child or the family? The flexible and varied role of the music therapist within the home setting. British Journal of Music Therapy, 31(1), 39-42. Ortiz, G., O’Connor, T., Carey, J., Vella, A., Paul, A., Rode, D., & Weinberg, A. (2017). Impact of a child life and music therapy procedural support intervention on parent perception of their child’s distress during intravenous placement. Pediatric Emergency Care. Advance online publication. doi:10.1097/PEC. 0000000000001065 Shoemark, H. (2017). Time together: A feasible program to promote parent-infant interaction in the NICU. Music Therapy Perspectives. Advance online publication. https://doi.org/10.1093/mtp/mix004 Tan, E. Y. P, & Shoemark, H. (2017). Case study: The feasibility of using song to cue expressive language in children with specific language impairment. Music Therapy Perspectives, 35(1), 63-70. doi:10.1093/mtp/ miv039 Ullsten, A., Eriksson, M., Klässbo, M., & Volgsten, A. (2016). Live music therapy with lullaby singing as aﬀective support during painful procedures: A case study with microanalysis. Nordic Journal of Music Therapy, 26(2), 142-166. doi:10.1080/08098131.2015.1131187 Ullsten, A., Hugoson, P., Forsberg, M., Forzelius, L., Klässbo, M., Olsson, E., Volgsten, U., Westrup, B., Aden, U., Bergqvist, & Eriksson, M. (2017). Eﬃcacy of live lullaby singing during procedural pain in preterm and term neonates. Music and Medicine, 9(2), 73-85. Yinger, O. S. (2016). Music therapy as procedural support for young children undergoing immunizations: A randomized controlled study. Journal of Music Therapy, 53(4), 336-363. doi:10.1093/jmt/thw010

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REVIEWS

options to color coordinate the piano include: post-it flyers, dry erase markers, and regular stickers. One way to include the child in this process is to have them color pieces of paper that are then taped to the keys.

Myers, K. (n.d.). Painting the Piano!: An Adapted Piano Songbook. Retrieved from: http://www.musictherapyebooks.com/ downloads/painting-the-piano/ 31 Pages. Cost: $29.99 Available from Music Therapy E-Books, Painting the Piano!: An Adapted Piano Songbook is a resource helpful for music therapists or music educators looking for new ways to teach children how to play the piano. Many children want to learn how to play simple and familiar melodies on the piano, but are unable to read musical notation.This book color coordinates keys to words of familiar songs in a manner that is easy for children to interpret and play. The first page of this book is a depiction of an octave of the piano with colored stars on some of the keys, including a table listing the colors and correlating notes. For example, C is designated as red, D is orange, E is yellow, and so on. There are then 27 children's and folk songs written out with each word or syllable in Listen to my a diﬀerent color, coordinating audio bookmark with the key the child is to play. Some songs include: Are you Sleeping?, Baa Baa Black Sheep, She'll be Coming 'Round the Mountain, and You Are My Sunshine. In her introduction, Myers recommends using vinyl stickers to color coordinate the piano, as they are easy and clean to remove. Other

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This book can be used to meet many diﬀerent goal areas that music therapists often address including fine motor skills, color and letter identification, joint attention, and hand-eye-coordination. Fine motor skills can be addressed when the child presses individual keys to play a song. A music therapist could also ask the child to identify colors and eventually the letter names for the notes as they become more familiar with the songs. Children who are developing joint attention can practice when they look up at the book and then back down at their hands– also improving hand-eye-coordination. While many music therapists and music teachers may already use their own colorcoding system, the book, Painting the Piano!: An Adapted Piano Songbook, includes familiar tunes and is set up in a standardized form across all songs, in a book the child can use at home with some assistance from a parent or caregiver. This engaging text with big letters and bright, engaging colors allows music therapists to address many diﬀerent goals while children enjoy playing familiar tunes.

About the Author Bethany Wilker is currently a senior in the music therapy program at the University of Louisville. She has been playing the piano since she was 8 years old and is always looking for new ways to incorporate the keyboard into music therapy sessions. Contact: bethany.wilker@louisville.edu

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Lindahl Jacobsen, S., & Thompson, G. (Eds.) (2017). Music Therapy with Families: Therapeutic Approaches and Theoretical Perspectives. London, UK. ISBN: 978-1-84905-630-4. 342 Pages. Cost: $33.96

Thirteen chapters address various clinical populations by describing the population and setting, theoretical background, research, and therapeutic approach. Each chapter also includes a case vignette, discussion, and references. The book discusses families of children in neonatal care and other pediatric medical settings, families of children with ASD, families in early childhood programs, foster and adoptive families, families of at-risk and emotionally neglected children, refugee children, families living with dementia, and families in palliative care. In the final chapter, editors Stine Lindahl Jacobsen and Grace Thompson synthesize the common characteristics from all the music therapy approaches mentioned in the book, discuss research studies, and give a personal account of their own experiences in working with families in music therapy. They present emerging characteristics and common goals that arose from all of the authors. One unique aspect of this book is the variety of clinical settings, nationalities, and training represented by the contributors. Together, these authors provide a global expertise which is important to recognize in the journey to be a culturally-aware music therapist. While specific practices may be different in each country, the therapeutic approaches and theoretical perspectives shared by each author can be adapted and applied to families anywhere. Having different cultural perspectives brings new ideas and insights to topics that may be directly applicable to the reader's practice. The authors provide examples of several different music therapy programs around the world. For example, the Croft Children's Unit psychiatric unit in Cambridgeshire, UK employs a relatively unique approach to treating

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children's emotional and behavioral diﬃculties by housing a parent or caregiver with them for 6-8 weeks. It has been shown that the context of the family dynamic is extremely important in a child's treatment process. This kind of intensive treatment may be unfamiliar to many who have not heard of such an inclusive family setting. Author Friederike Haslebeck presents a case vignette and notation of a German lullaby that the author used with a family in the NICU in Switzerland. This gives the reader a personal insight into a unique, adaptive, familybased therapy session that takes into account cultural standards and diverse music therapy techniques. An Australian music therapy project entitled Sing&Grow is described by providing an example of the structure of a typical session. The rise and fall of dynamic musical activities that are used during every Sing&Grow session are analyzed. This book covers a wide-range of populations and would be a great addition to any music therapist's collection. Readers can gain insight into family-based music therapy practice and practical ideas to implement in their particular setting. Additionally, readers can learn about a wide variety of other family-based therapeutic approaches.

Listen to my audio bookmark

About the Author Kelsey Norris is an Intern at the University of Louisville’s Music Therapy Clinic. Her current work includes a wide variety of settings including premature infants in the NICU and children with ASD.

Contact: kelseynorris16@gmail.com

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