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autoharp

Ever since myfirst semester of music therapy coursework, I did not find the autoharp very useful. I figured, I can play the guitar, I prefer the guitar, therefore i have no use for the autoharp. However now that I am in an internship in Neurologic Music Therapy. I see a the the autoharp in a whole new light.

If I have learned anything about Sensorimotor Movement in my internship it is that you want the music to do the work in driving the movement.The music should tell the body what to do. For the music to reflect a movement like shoulder rotations (such as swinging the arms above the head)  the music should simulate a rolling motion, such as the sound that you would hear if you were to strum every string of the autoharp. The autoharp having 36-48 strings,  which allows for large rolling movements such as hip flexion’s (swinging your leg as sing in the following video) and shoulder rotations (mentioned above).   (*Disclosure, I am not belittling the guitar with it’s 6 strings. The guitar can still be played with the intention of inspiring movement)

Below you will find definitions of the two Sensorimotor NMT techniques that I have become familiar with over the last 5 months of internship.

Patterned Sensory Enhancement (PSE) is a technique which uses the rhythmic, melodic, harmonic and dynamic-acoustical elements of music to provide temporal, spatial, and force cues for movements which reflect functional exercises and activities of daily living. PSE  is (a) applied to movements that are not rhythmical by nature (e.g., most arm and hand movements, functional movement sequences such as dressing or sit-to-stand transfers) and (b) it provides more than just temporal cues. PSE uses musical patterns to assemble single, discrete motions (e.g., arm and hand movements during reaching and grasping), into functional movement patterns and sequences. PSE cues movements temporally, spatially, and dynamically during training exercises (Thaut et al. 1991).

Therapeutic Instrumental Music Performance (TIMP) is the playing of musical instruments in order to exercise and stimulate functional movement patterns. Appropriate musical instruments are selected in a therapeutically meaningful way in order to emphasize range of motion, endurance, strength, functional hand movements, finger dexterity, and limb coordination (Elliot 1982, Clark and Chadwick, 1980). During TIMP, instruments are not typically played in the traditional manner, but are placed in different locations to facilitate practice of the desired functional movements (Thaut 2005). Speech and Language Rehabilitation

-Kristin

Our team recently met to brainstorm essential teaching components, strategies, adaptations, accommodations, methods, and resources for teaching adapted lessons. I want to share with you what I learned in the article “Ten Characteristics for Teaching Students with Special Needs” by Beth A. Bauer.

  1. Consistency is crucial. This consistency applies to the rewards we provide, routine, schedule, home practice routines, time of day and location of the lesson,.
  2. Adaptability, find something that makes sense in their world. Examples include; using stress balls to teach hand positioning for piano, or creating fun mnemonic devices to learn the notes of lines and spaces in the music staff.
  3. Flexibility is a MUST. This flexibility pertains to lessons plans, studio setup and pacing of the lesson. Some days a student may come into the lesson after having a rough day at school and have a melt down. As the therapist “you need to find a way to work on something that will redirect the student away from whatever is bothering them and still be applicable to the lesson.”
  4. Setting Expectations “for students with special needs should be no different from the expectations and goals for students who do not have disabilities. By setting consistent, high expectations for everyone, the students know that we believe in them and that we know that they can be successful.”
  5. Patience, is your  best friend. Patience with repetition, multiple methods, reinforcement and redirection, and patience with getting to know your students.
  6. Compassion. Tell the parents of your students what their children CAN do instead of what they CANNOT do. Treat the child as a person first, without regard for a disability label. Focus on the positive aspects of the lesson, even when there is a meltdown, there is at least one positive aspect to find and share with the parent.
  7. Have a Sense of Humor.
  8. Learn from your mistakes. “We should always try our hardest but know that you will make mistakes. Mistakes are acceptable and the important lesson is that you learn from those mistakes.”
  9. Lose the Ego. Perfection is not everything, and it is not about the therapist. We will learn far more from our students than they will ever learn form us.
  10. Have FUN!!

 

-Kristin

[youtube https://www.youtube.com/watch?v=ZsABTmT1_M0&w=560&h=315]

Alright, alright… Parks and Recreation aside, never underestimate the power of self care!  Which was (conveniently enough) the topic of our symposium last week.  Although our discussion of self-care didn’t exactly include cupcakes and new clothes, we did discuss some very practical and helpful tips on taking care of your body for the long-run.

Whether it be exercising 3 times a week, taking a full day to relax and do no work, or catching a sunset at the beach, everybody has their own routine for decompressing and maintaining some balance (and sanity!) in their lives.  As music therapists, it is so important for us to take care of our bodies in order to be at our best with our clients every day, as well as preserve our health and well-being so we will still be as able at 50 (and up) as we were at 25.

In Kate Montgomery’s book, “End your Carpal Tunnel Pain without Surgery” she has coined a 12 step method of stretches and self-care exercises to maintain healthy joints and muscles.

self care book

Here are a few tips from her method to maintain health and function in important areas like the wrists, back, and fingers!

  1. Posture – It’s all about those 90 degree angles when it comes to posture. Bad habits in posture can cause recurrent minor injuries to the neck joints, so it’s so important to be aware of how you carry yourself throughout the day, whether it’s working at a desk or bending down to be on a client’s level, be mindful of keeping 90 degree angles in your back, neck, and legs.
  1. Wrists – There are 3 exercises for the muscles, tendons and joints in the wrist. Wrist presses, wrist pulls, and wrist squeezes.  Practicing these daily will help keep your wrists in alignment and free of pain.
  1. Fingers – What an important part of the body for music therapists! Finger exercises are done one at a time, practicing dexterity and isolation of each finger.  Finger pulls, circles, bends (at each of the three joints) are a few ways to help open and restore energy within the finger joints as well as maintain strength in each individual finger (which can be really helpful for guitar).

You can practice these exercises on your lunch break, at a stop light, or any time between clients in the office.  Make them a part of your self-care practices after exercising or while relaxing in order to maintain dexterity and full function of these important parts of our bodies!

 

-Marissa

“Hide not your talents. They for use were made. What’s a sundial in the shade?”
— Benjamin Franklin

If someone asked you ‘What are your top strengths are how do you take advantage of them regularly?’ would you be able to give them a confident answer?  For many of us, it can be difficult to identify our areas of talent and even more difficult to make the most of them on a daily basis.  The MTCCA team uses a tool called StrengthsFinder 2.0 to categorize different strengths and better understand how to interact with others and become our best selves.

StrengthsFinder 2.0 by Tom Rath is a small but mighty book!

strengthsfinder

After purchasing, you’ll receive an access code in order to complete an online assessment and discover your top 5 strength themes.  The book includes 34 strength themes such as Empathy, Achiever, Communication and Maximizer.  A list of the themes along with a short description can be found here.  StrengthsFinder 2.0 gives full descriptions of each strength theme, personal accounts from others who posses that strength, as well as some tips for communicating with others who may or may not have that same strength.  This aspect is especially helpful when working with a team of individuals.

During symposium, each of our staff members shared their top 5 strengths and how they play out most into our lives.  Seeing someone else’s talents categorized can you help you understand so much more about a person!  What I found to be most helpful about seeing everyone’s strengths was learning about what that person needs and how to best communicate with them.  I often find myself communicating with others in the way I would like or need for them to communicate with me, but many times this is not the most effective way for their learning style or personality.  For example, I have Input as a strength and enjoy knowing many details and lots of information about the task or situation at hand.  Being educated on the topic helps me feel like I am completing my job to the best of my ability.  However, someone who has Achiever as a strength would much rather get it done quickly and efficiently instead of spending time mulling over the details.  Understanding these differences in others can drastically improve communication, relationships, and outcomes in the workplace.  StrengthsFinder 2.0 is unique because it encourages individuals to take advantage of their strengths consistently instead of spending time trying to improve their weaknesses.  By focusing on our natural gifts and inclinations, we maximize our potential.

I encourage you to evaluate your own top strengths and determine at least one thing you do every day that takes advantage of your unique capabilities and qualities!  Find out the strengths of the people with which you spend time and talk about how you can improve your communication based on each other’s needs.  I hope that what you discover will increase your self-awareness and improve the quality of your communication and relationships.  Here’s to becoming our best selves!

-Marissa

 

Michelle-Hardy-Music-Therapist

Michelle Hardy, MM, MT-BC

Michelle Hardy is a Board-Certified Music Therapist with a master’s degree in Music Therapy from Colorado State University, having received her bachelor’s degree in music therapy from Loyola University in New Orleans in 1995. Michelle has worked with children and adults with various neurological impairments and developmental delays, but her focus is with individuals with autism and sensory processing difficulties. 

MTCCA staff and interns were given the opportunity to speak with Michelle Hardy, MM, MT-BC in our weekly symposium. My personal learnings taken from this meeting include the follwing;

What are the main diagnostic criteria of autism?

  1. Social deficits
  2. Deficits in communication

Did you know that motor movement is also a prominent diagnostic characteristic of autism? Michelle Hardy brought to our attention that motor movement is not included in the leading diagnostic criteria of autism in the DSM-IV not the DSM-V. However, motor movement deficit is a prominent characteristic in individuals with autism. This makes perfect sense because if you take a look at the parts of the brain that are affected by autism you will see that included are the cerebellum and the frontal lobe. These are the areas of the brain that help us with movement planning, grading, and executing. Before any deficits in attention, behavior, higher learning, or social skills can be improved in a child, their brain’s ability to integrate sensory information and program proper motor signals must be re-calibrated through brain activation modalities.

As a music therapist, treatment may include:

  • Rhythm Training
  • Use of a metronome
  • Proprioceptive stimulation

By using rhythm in a purposeful way, we can access the frontal lobe and mend long distance connections within the brain. Rhythm also creates a sense of predictability and strengthens pathways in the brain.

A specific intervention to include all of the above treatment ideas, would be Bilateral Drumming. Here is an example of bilateral drumming with Michelle Hardy.

*Notice the use of rhythm, a metronome and the proprioceptive feedback given from hitting the drums and walking.

-Kristin

Bio PIc

Marissa is currently completing her Bachelor of Arts in Music Therapy from California State University, Northridge.  Her primary instrument is piano, but she enjoys playing guitar and violin as well as singing.  Throughout her time in Northridge, Marissa participated in a wide variety of volunteer and work experiences, including leading weekly music hour in a local class of first graders with autism and serving as a Music Activities Counselor at Camp Ronald McDonald for Good Times, a summer camp for children and teens with cancer and their families, for three summers.  She also served as President of CSUN’s music therapy department student club, The Music Therapy Association of Northridge, where she coordinated campus and community events promoting and advocating for music therapy.

Marissa enjoys the creative process involved in working with clients and desires to use the mediums of both music and art to aid individuals in pursuing their personal growth and realizing their potential.  Marissa’s desire to make music and holistic wellness accessible to all people led her to create Thrive – a program based in Mozambique, Africa that uses music to promote well-being in the lives of Mozambican youth. She traveled to Mozambique in 2015 to launch the program, and is currently in the process of adapting it into a sustainable program that channels the cultural pillar of music into a vehicle for community development, emotional growth and support, and practice skill building goals.

“Some of my earliest and sweetest memories of my childhood are of my grandmother and mother sharing in the joy of making music together. From this young age, I learned to appreciate music and the unique modality it became for me to express myself, communicate, and connect with others. After learning about music therapy and realizing the rich diversity of the field, I was excited to dive into a career that is centered around connecting with others and growing together. It is such a joy and privilege to be able to invest in people’s lives through the medium of music and discover our human potential together.”

We have all seen that wiggly, fidgety child who climbs, touches, bumps into, and jumps onto just about almost anything and everything. The common conclusion that we often come to is that the child is misbehaving and has a surplus of energy. But the truth is that these children may have poor propriocetive sense which adversely effects their awareness of where there bodies are in space and effects their awareness of how fast or slow their bodies are moving. Our sensory processing abilities are supposed to tell us where our bodies are, allowing us to sit up straight and still and to tell us how fast or slow we are moving our bodies so that we can manipulate objects and move around in space without bumping into things. However, children with Sensory Processing Disorder are not being given the sensory information and/or are not able to integrate, modulate, organize and discriminate sensory messages efficiently causing them bounce, wiggle, rock, slide to the floor, and fidget.

There are ways to help these children establish awareness of their bodies which may allow them to listen better, retain information and focus. If you are working with a child who isn’t comfortable in their chair, are sliding off of it or is rocking it on two legs, try giving them an exercise ball to sit on and allow them to bounce while you teach your lesson or facilitate your intervention.  It may seem like they still are unable to pay attention due to their bouncing bodies but check in with them and you may see that they really are paying attention and are able to retain content. This is made possible because the sensory input received from the bouncing tells their bodies where they are, which then clears up the neuro pathways for them to focus on something else other than trying to figure out where their bodies are in space.

A music therapists approach for children in need of sensory input may include creating interventions that involve ample amounts of movement such as rocking, spinning, jumping or pushing.

The Hard Facts:

“Proprioceptive dysfunction is the inefficient processing of sensations perceived through the muscles and skin, as well as the joints.”

The functions of our proprioceptive sense include:

  • Body awareness
  • Motor control
  • Motor planning
  • Regulation of arousal level (aroused or calm)
  • Discrimination of movement in time and space (tells us where our bodies are)

I leave you with this video which provides insight from the perspective of children with SPD and poor proprioception. I share this with hopes that others will think again when they see a wiggly little one.

https://youtu.be/uhsQhGcI0-8?list=PL3opm2WogRKUyk9vStTggyiZQgS26Z0NL

-Kristin

Tuesday’s in the life of an MTCCA Intern are busy, busy days. But Tuesday’s are also one of the best days of the week because the junior and senior interns co-treat together. We have the opportunity to co-treat in individual and group sessions. Let me tell you, it is incredibly helpful in group sessions to have 2 sets of hands and 2 strong voices to help lead interventions. In a perfect world, music therapists would always be able to co-treat large group sessions, but in a the real world we aren’t always so lucky.

In my three months of internship thus far, I have learned that things are not always going to go as expected. Have it be an intervention that you thought was going to be great, but really wasn’t or that you thought you were going to always co-treat in large groups, but you occasionally  have to fly solo. With facing both of the above situations, I have learned to always be prepared with a plan A, B and C, don’t be afraid to work out of your norm and utilize your resources. And with this, I have a few learning’s to share.

Tips for Treating Large Groups Solo

  1. Breathe, you can do this.
  2. Keep the music going and if it stops, talk –  Sing a cappella if you need your hands for something else besides playing guitar (ie. modeling a movement, passing out and collecting instruments) If the music can’t keep going, use the silence as a teaching opportunity, drop a few informational blurbs on the benefits of what you are doing.
  3. Recruit the staff! – When co-treating, one intern is facilitating the music while the other is assisting the clients in movement and interacting 1:1. Since you’re on your own, ask the staff to assist with playing instruments or assist in a movement, they are there to help.
  4. Bring a speaker– If you have the opportunity to use a speaker, do it! Recruiting the staff is incredibly helpful but sometimes you might need more. In this case, have your music cued up and let the music happen while you free  up your hands to interact with the clients.

Happy Singing

-Kristin

Kristin Hurley is currently pursuing her Bachelors of Arts in Music Therapy from California State University, Northridge, where her primary instrument is flute. Kristin has been actively involved in the community by volunteering as a music companion at Rady Children’s Hospital, Seasons Hospice of Los Angeles, various geriatrics facilities and at various elementary schools working with children with specials needs. Starting in 2009, when Kristin successfully completed the Music Together Teaching Certification developed by the Center for Music and Young Children, Princeton, New Jersey, her principal focus has been in Early Childhood Music. However, through practicum, Kristin gained experience in working with various populations such as; adults with traumatic brain injury, children with special needs including; autism, cerebral palsy and Down syndrome and adults with developmental and intellectual disabilities

Moving onto college, Kristin initially began to study the prerequisites for Nursing while taking a few music classes here and there. After just one semester of college and discovering the field of Music Therapy, Kristin decided to combine her love of music and her desire to heal. Kristin was determined to transfer to California State University, Northridge and study Music Therapy. Kristin’s first experience with music and children with special needs was in the cancer unit of San Diego’s Rady Children’s hospital. Kristin was invited to volunteer her time and music at the department’s monthly birthday celebration. Kristin had no prior experience to working with children with special needs but Kristin was over taken by her natural tendency to nurture as she lovingly brought the joy of music to the children of Rady Children’s hospital. It was after this experience that Kristin knew that music is for everyone and that she had found where she was meant to be.

“My love of music began about seventeen years ago when my aunt gave me my first flute and I began playing in my middle school band. The role that music played in my life began to transform into shaping who I am today. It is in music where I find strength, joy and healing and it is music, love and education that drives my passion to promote well-being in the lives of others.”

This week, Kristin presented a TDM for one of her clients. She did a great job of designed an intervention that played to his strengths to address his needs. The most interesting part was the discussion afterward.

We spent a while analyzing what the real purpose of the intervention was to decide what NMT technique it fell under. This was really helpful because that is something that can be tricky, especially for someone like me who did not come into this internship with a lot of NMT knowledge. It was such a thoughtful and important discussion and helped give direction to our thought process when looking at our interventions. Many of our interventions can be adapted to serve so many purposes and address different goals in various domains, so it is important to remember to take the time to make sure every choice we make has a purpose directed at our goal.

 

  • Becca

Symposium this week wrapped up our three-week discussion on The Out-of-Sync Child. The previous weeks focused more on the information provided in the book to enhance our understanding of sensory processing disorders (SPD). This week, we discussed intervention ideas provided in the book for each area of SPD (i.e. visual, auditory, vestibular, etc.) and brainstormed ways to add music.

There are many ways music can be used to help children with SPD. One common technique we use in our music therapy sessions for children with SPD who are seeking stimulation, is to use a cabasa and roll it on their body while singing a song. The sensory input provided by the cabasa can help a child with SPD become more aware of their body and help them calm down when over-stimulated. Music also provides rhythmic structure, which can be beneficial for vestibular and proprioceptive areas of SPD. Rhythm is used to elicit certain movements and provide stability during interventions. The list goes on an on of ways music can promote the needs of children with SPD. Our series on The Out-of-Sync Child over the last several weeks has helped increase my knowledge of SPD and provided beneficial discussions on interventions we can use in our music therapy sessions.

-Tara

In symposium last week, we began a three-week series on “The Out-of-Sync Child” by Carol Stock Kranowitz. The first portion of the book we were required to read discussed Sensory Processing Disorders (SPD). Some children can only have SPD, while others may have also have similar diagnoses, such as ADHD or Autism. SPD can be defined in four categories; Sensory-modulation problems, sensory discrimination problems, sensory-based motor problems, and associated regulatory and behavior problems. Each category

Sensory-modulation problems are associated with frequency (several times a day), intensity (avoids or seeks sensory stimulation), or duration (unusual responses last for several minutes). A child may be over responsive to sensory stimuli, under responsive, or seeking more sensory stimulation. The second category, sensory-discrimination problems include difficulty in distinguishing one sensation from another. Third, when a child exhibits sensory-based motor problems, they often have problems using both sides of their body (bilateral coordination). Lastly, the fourth category, associated regulatory and behavior problems, includes inefficient sensory processing and other developmental problems. A child with similar diagnoses may not necessarily have SPD. Overall, this first week of our three-week series was an informative overview of SPD.

-Tara