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Behavior serves a function.  From infants to the elderly, humans behave the way they do for a reason.  When it comes to our clients, addressing the reason can sometimes be the first step towards making progress in their goal areas.

Recently in symposium, Shannon Wallace and Maryann Le of AEFCT came to present to our staff on “Function of Behavior Training”.  (Find out more about AEFCT here: http://aefct.com/)  Their presentation opened my eyes to several important factors to consider while working with clients.

A key concept in knowing how to address the behavior of a client is understanding the function of the behavior.  I learned that this is a phrase commonly used amongst behavior therapists that basically answers the question: why is the client doing what they are doing?  Is their behavior seeking to gain the attention of somebody or to meet a physical need (are they hungry.. thirsty.. need to use the restroom)?  What is their specific purpose for what they are doing?  Sometimes this can be a very tricky question to answer.

Consider the fact that many of the behaviors we as therapists view as “challenging” are behaviors the client probably views as functional, because engaging in them gets their needs met in one way or another.  Maybe screaming at the top of their lungs in the store gets them the toy they wanted (mom gives in to alleviate the situation).  Maybe engaging in disruptive behavior in the classroom gets them out of doing difficult work (they are removed from classroom for disciplinary purposes).

The 3 functions of behavior are:

  1. Positive reinforcement (behavior produces an outcomes that is desired by the child)
  2. Negative reinforcement (maladaptive behavior like escape or avoidance)
  3. Sensory Regulation (maladaptive behavior occurs in order to regulate the level of input from environment)

First determining the function of behavior helps us understand how to appropriately address it.  According to Shannon and Maryann, “When we know the antecedents and consequences of behavior, we can intervene in ways that provide an appropriate behavior that achieves the same function.”  This was one of the biggest lessons I learned through this presentation: the importance of providing an appropriate alternative to undesired behavior.  Since this time, I have been applying this principal in many of my sessions.  This includes things like redirecting a client who hits the table vigorously with his palms to playing a drum in order to receive that sensory feedback as well as redirecting a client who constantly asks what’s next by helping them give positive compliments to other group members.  Always be thinking how you can provide clients with a functional, appropriate alternative.

One final important aspect to consider is being on board with the parents with your strategies and approach towards behavior.  It is important that you are handling the behavior in a way that is congruent with how the parents are handling it at home.  Although this is not always possible, when it is, it can be extremely effective for the client.  Discuss strategies and approaches with your client’s family in order to determine what is best for them.

I’ll leave you with a short story of how these ideas have manifested themselves over the past month of my internship.  I have been working for 5 months with a non-verbal 8 year old client who, ever since I started with him, will manage to have a handful of my hair at some point in almost every session.  I have worked so hard on developing my “mom” voice, being stern, changing my affect, letting him know that is not okay, singing songs about having “gentle hands” and practicing what that looks like, redirecting him to a drum or other instrument or ignoring the behavior.  Although some of these tactics have seemed to work in the moment, we had a session 2 weeks ago where we were in the middle of an intervention at the piano together and I felt like we were connecting more than we ever have – he was sustaining eye contact, following directions, smiling at me – we were communicating so much nonverbally to each other through our playing.  I look down at him and he’s smiling so huge and then suddenly he reaches out and grabs two handfuls of my hair.  In this moment I realized that my assessment of the function of his behavior may have been off all along – maybe the reason he is engaging in this behavior is because he wants to communicate something to me and doesn’t have a way to do so.  I didn’t struggle against him or whip out my stern voice and say “not okay”, I instead maneuvered my head so that I could make eye contact with him and just looked at him with a neutral affect, locking eyes – simply letting him know I was there and present with him.  After a moment, he let go, no words were said and we continued with the intervention.  Since this time, I have been motivated to give him absolutely every opportunity to make a choice, communicate with his device, and request activities in an attempt to provide him with a means to communicate whatever it was he was trying to say by grabbing my hair.  Through my clients I am learning countless lessons about the function of behavior, communication and human connection.

-Marissa

 

This weekend marked a celebration – many friends gathered together to share in the joy of Reid Moriarty and his family over the completion of Reid’s newest album, “Shine”.

Shine album

Reid has been a client of Angela’s at The Music Therapy Center for many years and several of the songs from this album were ones they wrote together (with the help of many other talented musicians!)  It is a worship album that tells a beautiful story of the hope, joy, and fulfillment that Reid has found in God.  Over 14 musicians came together to be a part of this project – from writing the songs, to recording in the studio, to mixing the finalized product – and had the privilege of celebrating the end result at yesterdays “Listening Party”  hosted by the Moriarty’s.

Reid at listening party

Listening Party fun Shine

I have had the pleasure of working with Reid during my internship and am constantly amazed at his creativity, genuine care for others, and love of life.  He will make your day with just a few words, guaranteed!

If you’re interested in buying Reid’s album as well as learning about any of his upcoming gig’s and other projects, please visit: http://www.reidmoriarty.com/

Reid, you are truly an inspiration and I’m so grateful that I came to know you during my time at MTCCA.

Keep on shining!

Reid Allie and Marissa.jpg

-Marissa

Jam session.jpg

This past week, Banding Together’s Spring season of Jam Sessions came to a bittersweet end.  Throughout the past 5 months of being an intern, Jam Sessions became one of my weekly highlights and I will treasure some very special moments and memories from my first season being a mentor with Banding Together.

This Jam season I learned to watch, listen, and learn (in that order!).  I truly learned so much from observing the mentors/volunteers interact with and encourage participants as well as from participants being genuine friends to one another.  In my experience as an intern, so often I am jumping into things – taking leadership and problem solving – that this experience proved to be a very important opportunity for me to sit back and learn from watching others.  The patience, wisdom, and gentle, humble leadership I observed in other mentors taught me to be more aware of myself and to consistently encourage clients to be the absolute best they can be.

Another highlight from this season, was having the privilege of seeing participants experience such excitement and sheer joy when Jason Mraz performed as a Guest Musician.  This was such a special night of sharing in music with someone who has touched the world with his message and gift.  Thank you, Jason!

Lastly, Jam Sessions proved to be a complete blast!  The dance moves, the drum circle grooves, the action leader skills, personalities shining through with solos or at the mic, the relationships deepened and laughs shared… for me it was a true expression of the power and joy of making music with others.

On a final side note, Chiara and I thoroughly enjoyed ourselves while taking the “Dress up as your favorite rock star!” prompt to heart.  Enjoy these pics of us as Jelena (Justin and Selena), Sonny and Cher, and Billary (Bill and Hillary).  (Oh, the many perks of being an intern!)

IMG_7002.JPG

That’s a wrap for our Spring session – here’s to another great one this fall!

Cheers!

-Marissa

First of all, let me give a special thanks to Veronica May, MT-BC, NMT for coming to The Music Therapy Center to, in her words, “brickity break down” some Neurologic Music Therapy physical and sensorimotor techniques for us, and give us specific tools to use with our clients. The following information is based on her helpful instructions.

Music motivates movement! That is why there is a whole category of neurologic music therapy techniques that address physical and sensorimotor goals. One technique is Patterned Sensory Enhancement (PSE). PSE uses the elements of music – harmony, dynamics, rhythm, melody, tempo, and duration – to mirror a specific movement. It is used in motor rehabilitation, maintenance, or modulation.

In PSE, music is not only motivating movement, but it’s also illustrating the movements. When a music therapist chooses what type of music to play and how to play it in order to facilitate a specific movement, he/she must take all the elements of music into consideration: 1. Timing elements: meter, tempo, pattern, form; 2. melodic elements that indicate spatial aspects of movement: pitch, dynamics, sound duration, harmony. In addition to musical elements, the music therapist must also be aware of the elements of the movement his/her client is being prompted to do. What are the steps involved in making the specific movement? Where is the force of the movement coming from?

 

Enough with the technicalities! How about some examples for how MUSIC can ILLUSTRATE and FACILITATE MOVEMENT!

Example: Knee lifts from a seated positionSeatedKnRse2

First, where is the force of the movement? The LIFT, because this is going against gravity. Therefore, the “force” – or most emphasized – part of the music will be on the lifting motion.

 

Second, let’s think about the music.

  1. Meter: Knee lifting is like marching, so we would likely want a march meter (i.e. 2/4 or 4/4). Find a song, or plan your improvisation in that meter.
  2. Tempo: At what speed do you want your client making each movement? Choose the tempo that is most appropriate for your client’s age and motor challenge. Remember, slower tempos are sometimes harder for clients to maintain because there is less auditory info happening between each beat.
  3. Pitch: You want your client to make an upward movement, so instinctively, you play higher pitches to cue the lifting movement (e.g. a high C chord), and lower pitches to cue the lowering movement (e.g. low C).
  4. Dynamics: In this case, dynamics will help you emphasize the pitches that cue the lifting movement. Play the higher pitches louder and the lower pitches softer. E.g. Loud high C chord, soft low C.
  5. Duration: You can cue how long you want your client maintaining his/her knee in that lifted position by sustaining the high pitches (e.g. sustained high C chord), or making those same pitches very shor
  6. Harmony: Harmony doesn’t play a crucial role in this knee-lift example. But it can tie in to the emphasis piece. Emphasize the lifting motion by making the high pitch a chord (e.g. high C chord), and the low pitch just a single note. I’ll give another example. A clenching movement may be associated with a dissonant chord, while a relaxed/releasing movement may be associated with a consonant chord.

– Chiara (the new intern!)

If you are a music therapist, you know the feeling – you’re on an airplane or in an elevator when someone asks you what you do for a living.  The 30 seconds that follow have the potential to forever shape that individual’s understanding and view of the vast world of music therapy.  No pressure!

The vital importance of being an effective communicator and speaker cannot be over stated.  Whether your field is music therapy, marketing, or dog sitting, you have the power to help others understand the value and efficacy of your work.  So much about an individual brand or company is communicated in the initial, first-impression conversation and it’s crucial that you are prepared.

Recently in symposium, we discussed the (slightly overwhelming) topic of public speaking/presenting/communicating effectively.  Here are some helpful take aways if you’re looking to boost your ability to persuade, engage, and win-over others.

  1. Know your audience! Before you are able to effectively “sell” anything (whether services, an idea, a suggestion) to anyone, you first have to understand why it matters to them.  If you were speaking to a woman who has an 85-year-old mother with Dementia, do you think you would describe music therapy differently than if it were a man with a 4-year-old son with Autism?   Knowing your audience is so important to understanding how to effectively communicate with a variety of people.  When beginning a conversation, practice asking quick questions to get to know the person, where they’re coming from, and what they’re looking for in music therapy (or any other topic/field you may be discussing).
  1. Know your material. If you are educated, knowledgeable and well-rounded in your area of expertise, you are already set up for success to be an amazing communicator!  Remember, you are the expert.  Own what you say.  Use confident language like “we do” and “we are”, and be prepared to answer a variety of questions that might arise.  If you truly know your material, whether it is a 60-minute presentation, or a quick exchange in line at the grocery story – it will make all the difference in your confidence and will impact the other person’s quickly-forming opinion of you and of the field.
  1. Focus on the message, not on yourself. This is key!  As soon as we stop worrying about what the audience/other person is thinking of us, or how our voice sounds, or what our hair looks like, etc. etc., our message immediately becomes more impactful!  Focus on exactly what you want to communicate and on the power of your message.

For more helpful tips, visit Toastmasters.org.  They have a variety of free resources, from articles and videos to podcasts and conventions.  Some of the above tips were drawn from the following video:

And remember, haaaaave fun with it!

haaaaave fun with it

-Marissa

Neurologic Music Therapy group was led by Becca this past week in symposium.  She presented a TDM (Transformational Design Model) on one of her clients who is working on a speech and language goal of improved articulation.  She is using an OMREX intervention with kazoo as an initial step to address this goal area.

After Becca presented, the team got creative thinking of ways to expand this intervention to include language.  We discussed the importance of always tying breath support exercises with functional speech and language.  In order to put this into practice, we split into two groups and created interventions that focused on 2 bilabial consonants: p and m.  In less than 30 minutes, we created songs with visuals that focus on each of these letters.  The videos of our final products are included below, along with the chords/lyrics and visuals!

Screen Shot 2016-05-01 at 11.45.54 PM

Screen Shot 2016-05-01 at 11.48.00 PM

-Marissa

 

Adapted guitar is another area in which I’ve had to expand my bag of tricks. Clients constantly inspire me to create new resources that help them learn and grow. As a result, I have developed this resource for teaching the blues in an adapted guitar lesson. The song includes melodic cues as to when and where to switch chords, and is accompanied by a colored chord chart. In some cases, I have used matching stickers on a guitar to show where to play each chord, with colors that correspond to the ones used on the song sheet. The blues are a fun and adaptable way to teach beginning guitar! The student only needs to learn two chord shapes, then they are moved between the frets to make various chords. You can see from the picture below how the shape for A7 and B7 is constant.

Blues chords.jpg

The chord and lyric sheet is attached below. In true blues fashion, verses could be added by you or the student to prolong the song.

Blues.jpg

-Becca

I have started teaching adapted ukulele lessons, and over the past couple of months have developed some materials for teaching young children. This song uses the percussive elements of the instrument to imitate the sounds of a train. The rest of the song is used to practice transitioning between chords and can be altered to do some songwriting with your clients.

The song begins by muting the strings of the ukulele (of guitar) and making the “chugga, chugga” in 16th notes for four measures of 4 to imitate the sound of a train. The “choo, choo” sound is made by playing the strings above the fret board but below the tuning pegs.

Percussion Uke.jpg

The rest of the song uses three chords. It is a fun and easy way for children to start to learn an instrument! The lyrics can also be changed to accommodate different interests (i.e. the princess train or the animal train). Below is a chart for the ukulele chords. The ukulele is an easy way to learn the basics of guitar. It has only four strings and so requires the use of less fingers at a time. It is a wonderful introductory instrument and great for all ages!

Ukulele Chords

Railroad Song
Becca Paoni

(Percussion break – 2x)

Verse 1:

C
Train is starting down the track

C
There’s no turning back

F
Going down the railroad

C                        G G F F
Nice and slow

C
Here we go!

Verse 2:

C
Train is coming down the line

C
Getting there by nine

F
Going down the railroad

C                        G (slide to) F
Pretty fast

C
Just like that!

Bridge:

F
When we get

C
To our stop

F
We won’t walk

C
We will bop

G
As we rock

G
To the tune of a song!

This Sunday, we helped run a fundraiser at Newbreak Coffee and Cafe in Ocean Beach for a non-profit organization that we work closely with called Banding Together. Banding Together is dedicated to providing music therapy scholarships, mentorships, and instruments to youth with special needs.

They offer free community programs called Jam Sessions in three locations around San Diego, in which each participant is paired with a mentor. Each week, a new social skill is taught through music and a guest musician from the community comes to perform. Guest musicians have included Steph Johnson, Dr. Seahorse, and Jason Mraz. After the guest musician performs an interactive set of songs, the group gets to join in and have a “jam session” together. Participants get to choose the songs and instruments are provided for them to play, such as piano, drums, shakers, and guitars.

This week’s fundraiser featured six participants as well as Bad Band Mother, a local indie/folk/pop band. The participants also performed two sets of songs and spread the word about the positive effects of music therapy. It was a blast! A day of music and coffee – what could be better?

For more information about Banding Together or volunteer opportunities, visit:

http://bandingtogethersd.org/

or

https://www.facebook.com/Banding-Together-139584314369/?ref=br_rs

Banding Together-Becca

Before starting my internship, most of the songwriting I had done with clients was in mental health populations – mostly adolescent and adult drug and alcohol rehab and clients with eating disorders.  It got very heavy at times, but was often extremely therapeutic and cathartic for many clients.  I believe this shaped my view of songwriting as something narrow and used primarily for deep, personal issues within therapy.  That being said, over the past 3 months I’ve come to view songwriting as an amazing expressive outlet for many young children with developmental disabilities.  Even simple song re-writing exercises (like “All you need is love” for Valentines Day) provide an opportunity for the client to make choices (MEFT – Musical Executive Functioning Training), exercising their executive functioning skills.

What I’ve come to observe, is that many clients with disabilities have the majority of things done for them by parents and caretakers.  When they are given a choice between two activities/songs/etc. they will choose, but when left with an open ended question like “What should we write a song about?” they often have a blank expression on their face and no idea where to start without being given suggestions of different ideas.  But once you help them get the ball rolling, they are full of ideas, imagination, and creativity and the end product is amazing!  For some clients, re-writing the words to a favorite song of theirs is the best bet because they have a clear idea of where the song is going and already enjoy how it sounds.  Other clients have the ability to help write (or independently write!) a chord progression/melody, and this is where you can challenge them to exercise their creativity.  Below is a helpful chart of chords to use in a variety of keys that can quickly spice up any songwriting session!

Somewriting tips

 

When writing songs with your clients, remember that every answer is valid!  As long as what the client suggests is appropriate and relevant, there is no better answer as to what to put in the lyrics than what they give you.  After all, it’s their creation and masterpiece and should have their unique personality written all over it.  If you can, think ahead about the wording of prompting questions you might ask your client in order to generate ideas.  It’s also helpful to think about the goal of the exercise – for example, is your client’s primarily reason for songwriting to express themselves or to practice decision making or leadership skills?  Determine what questions you will ask and how you will go about the process with their particular goal in mind.  If they are practicing leadership skills, let them lead you through the process and if they are struggling, challenge them to find a way to figure it out instead of offering a solution to them.  If their goal is self-expression, validate every answer they give you and do your best to reflect the sentiment of their words in the music you create.  It’s also always a fun idea to record your completed songs and give your client choices of what instruments to incorporate and how they’d like the finished product to sound.

I trust that the joy in your clients face when you play back the final version and they hear themselves singing and making music will be enough to fuel many more rewarding songwriting experiences in your sessions!

-Marissa

We all know those kiddos – even when they are (miraculously) sitting in their seat for more than 2 minutes at a time, they’re still squirming, sliding down in their chair or moving their body side to side.  They are constantly seeking to interact with their environment.  Or maybe you can relate to leading groups every week and feeling the urge to bring in something new and different for the clients to experience other than instruments.  Lucky for us, the world of Neurologic Music Therapy has an answer in 4 simple letters: MSOT.  Musical Sensory Orientation Training.

Thaut, in Rhythm, Music and the Brain, describes MSOT as follows:

“Musical Sensory Orientation Training (MSOT) is the use of music, presented live or recorded, to stimulate arousal and recovery of wake states and facilitate meaningful responsiveness and orientation to time, place, and person. In more advanced recovery of developmental stages, training would involve active engagement in simple musical exercises to increase vigilance and train basic attention maintenance with emphasis on quantity rather than quality of response (Ogata 1995).”

Let’s all say it together now: MSOT is my friend!  It is so important to ensure that our clients are learning to self-regulate and getting the sensory input that their bodies crave.  Sensory integration is a neurobiological process that refers to the integration and interpretation of sensory stimulation from the environment by the brain.  Individuals with developmental disabilities often have either over- or under- reactive sensory systems, which can mean sensory input from the environment is not being organized properly in the brain.  This makes the sensory experiences we as music therapists provide for them particularly important.  Below are several MSOT strategies I’ve recently been exploring with clients – the possibilities are endless!

  1. Cabasa – I never understood the power of the cabasa until internship.  It is an easy way to take a sensory “break” while keeping the music and instruments going throughout the activity.  For my non-verbal clients I use a simple “I want ____” visual and have them choose a body part (i.e. hands, arms, legs, back) for where they want the cabasa.  You can make up a simple song or chant about where you’re playing the cabasa and use a background loop to free up your hands to provide that input for the client.  You can also use this same format but instead give deep pressure squeezes and simply substitute the lyrics to “I like squeezes on my arms”.

I want visual

2. Therapy Ball – I love using the therapy ball because it’s a great way to incorporate sensory integration into whatever intervention you’re working on (like Bi-lateral drumming).  This targets the the Proprioceptive System – helping our clients understand where their body is in space.

3. Get Creative – Have fun with exploring MSOT strategies!  For adult groups, my co-intern and I have been enjoying bringing in essential oils (stimulating olfactory system), fun themed props for Spring Holidays (tactile), instruments like chimes, cabasa, and drums, bubbles, scarves, and scented squeeze balls.  I hope you’ll find that this brings a fun, novel element to your groups.

Music making (with an instrument) naturally stimulates 3 out of our 5 senses (auditory, tactile, and visual).  If you can add some type of olfactory element, we have 4 out of the 5 covered – a great goal to aim for while session planning.  It’s great to have a variety of MSOT strategies in your tool-belt in order to adapt to what your client needs in the moment – get creative and have fun with it!

-Marissa

banding together secret show

Banding Together’s Jam Sessions provide youth with special needs with an opportunity to come together for a one-hour jam session where we play drums, sing songs, dance and have a great time with friends. After EVERY Jam Session, I leave feeling completely inspired, full of enthusiasm for life and a heart full of love and appreciation. I always feel incredibly grateful to be involved with this organization but I also feel the desire to share it with others. I want everyone to know how amazing these youth are and how music therapy allows them to shine at their brightest.

On February 12th, 2016 that desire to share with others became a reality. Banding Together was recognized by professional skateboarder/snowboarder, two-time Olympic gold medalist Shaun White and his band Bad Things! We were invited to a secret show by Bad Things, sponsored by San Diego’s local radio station 91X. We all arrived and got to hang out with the members of Bad Things, rock out with them, take pictures with Shaun White and just plain ol’ have a good time. The best part of it all was getting to see the Jam Session participants in an inclusive environment, thrilled by this unique and exclusive opportunity just for them

When I started internship, I had no idea that I would get to hang out with the coolest people ever and get to go to events with celebrities sponsored by radio stations! Every week I get to jam and hang out with the best of the best! This is definitely one of my top internship highlights.

-Kristin