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The Effects of Rhythmic Auditory Stimulation
on Gait Disturbance of Patients With Cerebellar Ataxia
Mutsumi Abiru, Chizuru Nakano, Yutaka
Kikuchi, Koji Tokita, Yoshiko Mihara, Mikio Fujimoto, & Ban Mihara,
Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Japan
Abstract
Seven patients with
cerebellar ataxia (six male and one female, aged 61.1±18.6, disease
duration 36.6±10.5) were enrolled in this study. The type of stroke was
2 cerebral hemorrhages and 5 cerebral infarctions. The lesion site was
localized by MRI (3 cerebellum, 2 ventral pons, 2 medulla oblongata).
The mean score of Functional Independence Measure was 110.7±9.8 (motor:
77.3±8.7, cognitive: 33.4±1.6). The mean score of Trunk Impairment Scale
was 17.1±5.1. In addition to conventional gait trainings (60 min/day, 7
times/week) by physical therapists, RAS gait trainings (30 min/day, 5
times/week) were applied for 22.2 days±13.2 days by music therapists.
Tempo of RAS was set to a specific tempo for each patient, and then the
tempo was increased/decreased (by 3-5%) when necessary. All auditory
cues were played on the Autoharp. After the pattern of auditory
stimulation to enhance their movement was established, their preferred
music was then applied to enhance their motivation. The cadence, stride
length, step length (affected/unaffected side), velocity, and stride
width were measured by 3-dimentional-motion analysis before and after
RAS intervention. The analysis of previous RAS intervention was
implemented to study the immediate effect of rhythm, and the analysis of
after RAS intervention was implemented to study long-term effect of
RAS. Wilcoxon signed-rank test was used for statistical analyses. All
data were presented as mean ± SD. As an immediate effect, right after
the rhythmic stimulation, cadence(74.8±22.8 steps/min to 89.4±22.1
steps/min), stride length(0.67±0.18 m to 0.78±0.21 m), affected side of
step length(0.33±0.09 m to 0.40±0.11m), unaffected side of step
length(0.33 ±0.11m to 0.38±0.10m), velocity(0.4 ±0.2 m/min to 0.6±0.2
m/min), and single support phase(29.8±5.7 % to 31.9±5.9 %) were
significantly increased respectively (p<0.05). Double support
phase(40.5±11.6 % to 34.9±12.9 %) was significantly decreased (p<0.05).
Stride width (0.23±0.05 m to 0.20±0.06 m) was not changed (p=0.09 ). As
a long term effect, after the all RAS sessions, cadence(74.8±22.8
steps/min to 93.6±20.9 steps/min), stride length(0.67±0.17 m to
0.97±0.28 m), affected side of step length(0.33±0.08 m to 0.48±0.12 m),
unaffected side of step length(0.32±0.11 m to 0.49±0.16 m),
velocity(0.43±0.19 m/min to 0.78±0.31 m/min) and single support
phase(29.8±5.7 s to 36.3±6.2 s) were significantly increased
respectively (p<0.05). Double support phase(40.5±11.6 s to 27.2±13.6s)
was significantly decreased (p<0.05). Stride width (0.22±0.05 m to
0.22±0.02 m) was not changed (p=0.09 ). The above data indicates that
RAS for the stroke patients with cerebellar ataxia had beneficial
effects on their gait. Furthermore, the combinations of RAS and
conventional gait training have promising effects on their gait
disturbance.
The Effect of Music on Pediatric Anxiety and
Pain During Medical Procedures in the Main Hospital or in the Emergency
Department
Sabina Barton, MT-BC, NICU MT-BC
Florida State University
Tallahassee Memorial Healthcare
Abstract
The purpose of this
study was to use music to distract and relax pediatric patients during
medical procedures. Procedural support via live music therapy
interventions included a variety of activities such as music paired with
breathing exercises, counting to music, developing sequence in song, and
manipulation of musical and play objects. Because invasive and
non-invasive are two radically different types of procedures, two
separate experimental designs were implemented and administered to a
total of 40 pediatric patients between the ages of 5 and 12, in the main
area and the emergency department of a southeastern regional hospital in
North Florida. Invasive procedures included intravenous starts, finger
pricks, incision and draining, suturing, and removal of foreign material
in the skin. Non-invasive procedures included X-rays, computed
tomography scans, and breathing treatments. All subjects were randomly
assigned to a control or experimental group. Demographics were collected
on all pediatric patients; this information included gender, age,
procedure, and length of procedure. For self-report, The Pain Intensity
and Assessment Tool, modeled after the Wong-Baker FACES Pain Rating
Scale, was administered to each child pre and post treatment to measure
each child's level of pain, and modified to measure each child's level
of anxiety. Results indicated no significant difference in control
versus experimental groups receiving either invasive or non-invasive
procedures in the main hospital or emergency centers. Mean and standard
deviation scores, however, showed a decrease in anxiety and pain levels
when comparing pre to post procedures. A behavioral checklist was used
post-intervention to record the number of times an anxiety-related
behavior occurred. Regardless of procedure, groups receiving music
intervention displayed fewer aversive behaviors than groups that did
not. In addition, patient satisfaction with MT assistance during the
medial procedures was 100%.
Premature Infants' Lullaby Rating Scale:
Content Validity and Reliability
Debbie Bates, MMT, LCAT, MT-BC, Akron
Children's Hospital and The Cleveland Music School Settlement; Ronna
Kaplan, MA, MT-BC, The Cleveland Music School Settlement; Anne Reed,
MT-BC, Beechbrook; Courtney Whitmer, MMT, MT-BC, Family Connections
Abstract
The Premature Infants'
Lullaby Rating Scale (PILRS) is an in-depth assessment of recorded
music. Its purpose is to classify lullaby recordings with regard to the
appropriateness for use with premature infants. The PILRS rates a
lullaby collection in its entirety and assesses ten music elements:
vocals, instrumentation, timbre, tempo, meter, harmony, style, melody,
rhythm, and dynamics. Songs on each album are assessed individually and
then compared to each other to achieve a final stimulation rating. The
purpose of this research study was to evaluate the reliability of the
tool, Premature Infants' Lullaby Rating Scale. The hypothesis for this
study was that the PILRS is a reliable tool by which to evaluate the
sedative nature of commercially recorded music. Institutional Review
Board (IRB) approval was granted by a Midwestern children's hospital for
the duration of the study. All changes to study protocols, including
repeated phases of testing, were done with permission by the IRB.
Participants were given background information about the PILRS,
participation requirements for their particular phase of the research
study, potential risks of participation, how confidentiality and
anonymity would be maintained, as well as the contact information of the
researchers and the IRB. Consent for participation was implied through
research packets that were completed and returned. The research was
designed in three phases. Phase 1 consisted of Content Validity, in
which three board-certified music therapists with advanced degrees and
extensive clinical music therapy experience in neonatal intensive care
were asked to evaluate the PILRS for content review. Phase 2 consisted
of a small-group reliability test to determine if the musical element
categories of the PILRS accurately reflected the sedative nature of
music. Six professional members of the Association for Ohio Music
Therapists were asked to rate five lullabies individually, using the
PILRS and also providing a subjective rating for each lullaby using a
scale of 1-4, where 1 equaled highly sedative and 4 equaled minimally
sedative. The five lullabies were chosen for their contrasting musical
elements, including vocalizations, instrumentation, tempo, harmony, and
style. Phase 3 consisted of a large-group reliability test to determine
whether or not the PILRS was effective for evaluating an entire
commercially recorded lullaby CD. Forty participants were randomly
selected from the 2006 AMTA Music Therapy Sourcebook and asked to
utilize the PILRS to rate Olivia Newton-John's Warm and Tender lullaby
CD. Based on preliminary statistical analysis completed after Phase 2
of research, the PILRS tool was revised. The first two phases of
research were repeated before proceeding to the third and final research
phase. The reported results are for those of the revised (current) PILRS
tool. For Phase 2, internal consistency of the subjective ratings and
the ratings derived by using the PILRS was determined by computing
Chronbach's alpha. A Chronbach's alpha coefficient > 0.7 is generally
considered adequate for reliability of a scale (DeVillis, 1991; Nunnally
& Bernstein, 1994). For Phase 3, internal consistency of the PILRS
ratings was computed using Chronbach's alpha. Interrater reliability
for all phases was assessed by examining the intraclass correlation
coefficients (ICC) for both the subjective and PILRS ratings. An ICC of
.75 or higher is considered a good indicator of intterater reliability (Dworkin,
Le Resche & DeRouen, 1988; Portney & Watkins, 2000). In Phase 2, the
Chronbach's alpha for the subjective score was very high, a = .86, while
the interrater reliability was ICC = .46. The internal consistency of
the PILRS was a = .98, and the interrater reliability was ICC = .73. In
Phase 3, both the internal consistency (a = .90) and the interrater
reliability (ICC = .82) of the PILRS were very high. The high interrater
reliability would indicate that the scoring instructions and items
within the PILRS are clear and readily understandable by those
therapists using it. Further research to test the validity of this tool
is needed, however, it is hoped that this tool will provide music
therapists who work in neonatal intensive care units (NICU) with a
concrete method by which to evaluate recorded music and help them to
choose recorded music that is developmentally appropriate for their
patients. It may also help music therapists to identify individual
tracks on lullaby recordings that are appropriate for NICU patients and
families to facilitate the creation of individualized compilation
recordings.
The Perception of Pre-Internship Training
for New Music Therapists
Melita Belgrave, MM; Lori Gooding, MM;
Satoko Mori-Inoue, MM;
The Florida State University
Abstract
The purpose of this
study was to examine the perceptions of pre-internship clinical training
for new music therapists who had been practicing in the field of music
therapy for 5 years or less. A brief survey was sent via email to
current professional American Music Therapy Association members with 5
years or less experience. Questions were asked about pre internship
clinical experiences, including questions about supervision practices,
observation and leading opportunities, opportunities for exposure to
different populations and perception of preparedness after pre-intem
clinical training. Additional questions about the institution size, size
of the surrounding area and availability of instruments and equipment
were also asked.
Perioperative Music and Its Effects On
Anxiety, Hemodynamics, and Pain In Women Undergoing Mastectomy
Pamela G. Binns-Turner, Ph.D., CRNA, Union
University, Jackson, Tennessee; Gwendolyn Boyd, M.D., University of
Alabama at Birmingham, Birmingham, AL; Erica R. Pryor,Ph.D., University
of Alabama at Birmingham, Birmingham, AL; Jacqueline Ann Moss, Ph.D.,
University of Alabama at Birmingham, Birmingham, AL; Carol Prickett,
Ph.D., University of Alabama, Tuscaloosa, AL; Lynda Harrison, Ph.D.,
FAAN, University of Alabama at Birmingham, Birmingham, AL
Abstract
The study purpose was
to examine the effects of a perioperative music intervention on changes
in mean arterial pressure (MAP), heart rate (HR), anxiety, and pain in
women with a diagnosis of breast cancer undergoing mastectomy surgery.
The convenience sample included 30 women between the ages of 42 and 70
who were undergoing mastectomy in a large urban hospital in the southern
United States. Exclusion criteria included male gender, psychiatric
disorder, use of psychotropic medications, cognitive mental disability,
and American Society of Anesthesiologists (ASA) status 4 or greater. In
a quasi-experimental, repeated measures design, participants were
randomized equally into music intervention and control groups. Women in
the intervention group listened to music throughout the perioperative
period, and women in the control group did not listen to music. Study
variables were measured preoperatively (T1) and postoperatively (T2) at
the time of discharge from the recovery room. Independent t-tests were
used for statistical analyses of change scores. Results indicated that
women in the music group had a decreased MAP from T1 to T2, whereas
women in the control group had an increase in MAP (p=.003). Women in
the music group had a decrease in level of anxiety from T1 to T2,
whereas anxiety levels increased from T1 to T2 for women in the control
group (p=.000). Women in the intervention and control groups had
increased levels of pain from T1 to T2, but this increase was
significantly lower for women in the intervention group (p=.007). There
were no significant group differences for heart rate change scores.
Experiences and Concerns of Students During
Music Therapy Practica: A Quasi Replication of Wheeler's (2002) Study
Laura S. Brown, MT-BC
Appalachian State University
Abstract
Wheeler (2002) studied
student experiences and concerns about music therapy practica. In this
extension of Wheeler's study, 6 students were interviewed twice during
the semester, 2 in each of three levels of practicum. The common themes
that resulted from the student interviews were challenges of the
practicum setting and population, personal challenges encountered during
the practicum setting, preparation, the student-client relationship, and
supervision. Overall, interviewing the students resulted in gaining
significant insight about the practicum experience from a student
perspective.
Music Perception and Self-Reported Cognitive
Dysfunction in Breast Cancer Survivors
Debra Burns, PhD, IU School of Music @ IUPUI;
Tonya Bergeson-Dana, PhD, IU School of Medicine; Brian Schneider, MD, IU
School of Medicine; Frederick W. Unverzagt, PhD, IU School of Medicine;
Victoria Champion, DNS, lndiana University Simon Cancer Center
Abstract
The integration of
music-based interventions into traditional cancer care continues to gain
momentum. Several studies have examined the benefits of music
interventions during active cancer treatment. Results of these studies
are mixed, with both positive and null findings. Studies with null
findings are often underpowered and the interventions are not
theoretically derived 8. Additionally, recent literature suggests that
the neurotoxic effects of adjuvant treatments may change the perceptual
and cognitive processes required for music experiences, negatively
influencing the potential benefits of music during adjuvant treatment.
A variety of chemotherapy agents have ototoxic effects that can decrease
both high and low frequency hearing. Additionally, a recent preliminary
study documented high rates of reduced hearing sensitivity in women
receiving adjuvant treatment for breast cancer. Several studies have
shown that chemotherapy may also induce cognitive impairments such as
decreased information processing speed motor function verbal memory
visuospatial skill, and visual memory. It is unclear whether reports of
qualitatively different and negative musical listening experiences in
cancer patients who have received chemotherapy are due specifically to
the ototoxic effects (i.e., hearing loss) or to more general neurotoxic
effects (e.g., decreased cognitive function). Alternatively, the
emotional impact of the diagnosis and cancer treatment could alter
patients' music listening experience perhaps making patients more
sensitive to the emotional content within musical pieces or making
aesthetic experiences more difficult. Finally, it is also unclear
whether such changes in music perception are domain-specific (i.e.,
limited to music) or domain-general (i.e. cognition). Therefore,
determining the impact of hearing and perceptual changes to music as a
result of adjuvant breast cancer treatment is essential to determine
whether or not current music-based interventions are relevant to this
population. This could have wide-ranging implications for the use of
music within oncology. Therefore, the overall goal of this study is to
examine if self-reported cognitive dysfunction in breast cancer patients
who have received adjuvant cancer treatment is related to performance on
auditory-based perceptual tests.
Comparison of Board-Certified Music
Therapists and Music Therapy Students/Interns' Use of Technology to Meet
Specific Therapeutic Outcomes
Andrea M. Cevasco, The University of
Alabama; Angie Hong, Carolina Center for Music Therapy, LLC
Abstract
Recently researchers have focused
on differences in age cohort's use of technology in society, including
their experience with technology, amount of money spent on various types
of technology, use of specific types of technology, and even attitudes
toward technology. From November 2007 through April 2008 Cevasco and
Hong conducted a survey of technology use by board-certified music
therapists (MT-BC) and music therapy students and interns (MTSI). The
survey assessed use of computers, software, and portable music devices,
herein referred to as technology, used by MT-BC as well as MTSI to
address specific therapeutic goals and objectives in their clinical
work. The purpose of this study was to compare similarities and
differences of these two groups. A total of 110 MTSI and 233 MT-BC
completed the survey. Based on the aforementioned technology devices,
both MT-BC and MTSI used technology for a variety of music therapy
interventions. While MTSI had greater access to technology than MT-BC,
oftentimes MT-BC utilized technology more than students for their
clinical work. Overall, a majority of both MT-BC and MTSI agreed that
they would benefit from receiving basic training on how to use
technology effectively as well as occasional in-service training on how
to use technology effectively.
Effect of Music on Cancer Patients: A
Meta-Analysis
Andrea M. Cevasco and Carol A. Prickett
The University of Alabama
Abstract
Cancer is the second
leading cause of death in the United States (Centers for Disease
Control, 2008). In the United States approximately 11,098,450 people
were diagnosed with cancer on January 1, 2005; this number represents
those who had been diagnosed with cancer, had active disease, and were
cured of their disease (Ries, Melbert, Krapcho, Stinchcomb, Howlader,
Homer, et al., 2008). In 2008 it is estimated that 1,437,180 people will
be diagnosed with cancer, and 565,650 people will die of cancer. About
40% of individuals born today will be diagnosed with cancer during their
lifetime (Ries, Melbert, Krapcho, Stinchcomb, Howlader, Homer, et al.,
2008).Some types of cancer react best to a single type of treatment;
however, other types of cancer are treated through combinations of
treatment (National Cancer Institute [NCI], 2006). Common treatment
methods include surgery, radiation therapy, or chemotherapy. Other
treatments involve hormone therapy or biological therapy. Sometimes stem
cell transplantation is used so a patient is able to receive high
dosages of chemotherapy or radiation therapy. Side effects are commonly
experienced by cancer patients, which varies according to the type and
amount of the treatment. Furthermore, side effects are different for
each person and can even change from treatment to treatment. Health care
teams, consisting of nurses, dietitian, physical therapist, and others
provide recommendations to help individuals handle the various side
effects (NCI, 2006).A recent literature review indicated that music has
been used to help cancer patients prior to, during, and following cancer
treatment (Cevasco, 2008). Additional analysis, however, might be
advantageous in understanding the value of music in the treatment of
cancer patients. A meta-analysis is a statistical procedure in which
quantitative research data are compiled and statistically analyzed. This
allows greater confidence in making conclusions about the effectiveness
of specific clinical procedures. Standley (1986) conducted the first
meta-analysis in music therapy, evaluating music in medical and dental
treatment. Over the past twenty years additional music therapy
meta-analysis have been conducted, including treatment of individuals
with dementia (Koger, Chapin, & Brotons, 1999), premature infants (Standley,
2002), psychiatric patients (Silverman, 2002), pediatric patients (Standley
& Whipple, 2003), and individuals experiencing stress (Pelletier,
2004).The purpose of this meta-analysis is to determine the overall
impact of music interventions by comparing music versus nonmusic
conditions on individuals undergoing cancer treatment. Included were
quantitative studies that dealt with individuals undergoing cancer
treatment. Studies involving hospice or palliative care patients as well
as cancer treatment for management of cancer pain of hospice patients
were not included.
Choral Singing in Prisons: A Collective Case
Study of Five Male Prison Choirs
Mary Cohen, PhD, University of Iowa
Abstract
Research and historical
documents suggest that prison choirs may help with inmate
rehabilitation. This multiple case study examines the history and
practices of five U.S. male prison choirs and their perceived impact.
Research questions addressed were: (a) What are the histories and
practices of these five choirs? (b) How do prison choir conductors and
inmate singers perceive their programs? (c) What are the personal,
societal, and musical implications of choirs in prison contexts? (d) How
does this information enlighten future prison choir practice and
research? Primary sources included recordings of the choirs, paper
programs, pictures, open ended questionnaires completed by seven prison
choir conductors, follow up interviews with the conductors, observations
of rehearsals and performances, and informal interviews with inmates.
Other data collected included an online survey completed by audience
members (N-35), field notes, and researcher reflections. Open coding,
axial coding, and selective coding were employed to analyze data.
Despite contrasts in prison contexts where these five choirs are based,
common themes were evident across all choruses. Conductors indicated
that learning to sing, focus, and develop a sense of group
responsibility was a slow process for inmates, many of whom had not
participated in choirs in the past. Choral performances provided a means
for inmates to develop self esteem, promoted positive social
interactions, and led to changes in behaviors. Each prison chorus
offered a safe environment for inmates to explore their feelings and to
build group trust. Inmates in all the choruses recognized their choral
participation as an opportunity to do something positive for society.
Specific future research directions such as examining pedagogical
practices of prison choirs, disciplinary reports of inmate singers, self
esteem measurements, and family perspectives of prison choir
participation are suggested.
Recovery of Motor Skills: A Cellist's
Journey
Elaine J. Colprit, Bowling Green State
University
Abstract
In this study I
documented the performance of an advanced cello student during his
recovery from traumatic brain injury. Lessons are ongoing, but the
videotapes analyzed for this investigation were recorded during a sixth
month period of cello instruction. Lessons were intended to encourage
(1) recollection of simple tunes known to the student before the injury
occurred, (2) correct alignment of cello and player's body, (3) balanced
posture, which includes position of legs, feet, and torso, (4)
independent action of the left hand fingers and arm, including spacing
for half, and whole steps between fmgers (5) ability to locate first
position on fingerboard (first finger one whole step above the open
string), (6) ability to balance the bow hold between the fingers and the
thumb and to adjust the hand, fingers, and thumb as the bow travels from
frog to tip and back, (7) ability to coordinate physical gestures in
time, (8) ability to read written symbols and to perform pitch and
rhythm, (9) ability to maintain body posture to support cello over a
long period of time, and (10) ability to realize previously known tunes
on the cello. Secondary goals included facilitating practice in (1)
pairing words and pitches with symbols, (2) articulating thoughts in
spoken words, (3) singing, and (4) extending the student's span of
attention. One of the most difficult aspects of rehabilitative
instruction is that progress is not necessarily continuous, sustained,
or linear. This makes planning and carrying out instruction and
designing appropriate assessment measures problematic, especially for a
teacher who is accustomed to supporting sequential learning. Often the
student in this study plays with coordinated physical gestures for only
a few seconds perhaps due to either a decrement in attention span or an
inability to sustain muscle control. Post lesson observation of video
recordings makes it easier to recognize moments in which a student
demonstrates musical skills and motor skills essential for successfully
playing the cello. In this study I attempt to document reawakening of
previously learned skills by describing student behaviors during
performance of scales, or phrases of a melody in terms of long term
goals for reclaiming the ability to play the cello independently.
A Content Analysis of Articles Addressing
the Orff Approach with Special Populations Published in the Journal of
Music Therapy, Music Therapy Perspectives and Orff Echo
Cynthia Colwell, PhD, MT-BC, The University
of Kansas
Abstract
The researcher was
interested in examining what work has been completed and disseminated
using the Orff approach with special populations either in a music
education setting with individuals with special needs or in a music
therapy setting with diverse clients. The intent of this study was to
examine anecdotal and research materials that have integrated the Orff
process with individuals with special needs in music education and music
therapy in an effort to outline a research agenda for the use of the
Orff approach with special populations. To this end, the purpose of this
study was to locate articles addressing the Orff approach with special
populations in professional journals of the American Music Therapy
Association (AMTA) and the American OrffSchulwerk Association (AOSA)
through a content analysis approach. A content analysis is a systematic
method for determine the presence of certain words or concepts and
compressing large amounts of text in to content categories following
specific predetermined guidelines (Krippendorff, 2004; Neuendorff, 2002;
Stemler, 2001; Weber, 1990).Articles were examined and data were
categorized and recorded on a Coding Form. The Coding Form recorded: (a)
journal, (b) date of publication, (c) volume, issue, pages, (d) name of
the authors, (e) authors credentials, (f) special population addressed,
(g) age grouping of the population, (h) setting for the intervention, (i)
Orff technique or media mentioned, (j) article type, and (k) educational
or therapeutic intended outcomes. The researcher provides a reference
list of articles that were included in the categorization and a brief
narrative summation of information found in these articles beyond that
which was coded. In addition to this categorization, the researcher
summarized the content of the articles in an effort to determine a
potential research agenda for using the Orff process with special
populations in educational and therapeutic settings.
Participants' Perceived Personal and
Therapeutic Effects from Participation in an Intergenerational Music
Program
Alice-Ann Darrow; Melita Belgrave
The Florida State University
Abstract
The purpose of the
present study was to examine older persons' and college music majors'
perceived personal and therapeutic effects from participation in an
intergenerational music program. Twenty college music majors and
twenty-two older adults served as participants in the present study.
Participants were given a preassessment—the Age Group Evaluation and
Description (AGED) Inventory to determine their pre-existing attitudes
toward four groups: college males, college females, senior males, and
senior females. Following the pre-assessment, participants met twice a
week for eight weeks to rehearse standard rock songs from the 1970s to
the 1990s. At the end of the eight weeks, participants gave a rock
concert at the cooperating university college of music. After the
concert, subjects were given a post-assessment using the same
attitudinal scale. In addition, the older adults were interviewed in
focus groups. The interviews were later transcribed and a content
analysis done on the transcriptions. Results of the post-assessments
indicated that attitudes of male and female college music majors
improved toward themselves and each other. Their attitudes toward the
older adults also moved in a positive direction. No differences were
found in the attitudes of the older adults toward themselves, but
significant differences were found in their attitudes toward the
college-age participants. From the content analysis of interviews, the
older adults identified twenty-three perceived therapeutic benefits that
resulted from their participation in the intergenerational music
program. From an analysis of survey comments, college students
identified eighteen personal benefits that results from their
participation in the intergenerational music program.
Immediate Effects of Music Therapy
Interventions on Persons in an Intensive Outpatient Psychiatric
Treatment Program: Analysis of Mean Changes within a Single Session
Cara Davis, MT-BC, NMT, University Hospitals
Case Medical Center; Michael J. Silverman, PhD, MT-BC, University of
Minnesota
Abstract
There is a scarcity of
quantitative psychiatric music therapy research (Choi, 1997; Gold,
Heldal, Dahle, & Wigram, 2005; Silverman, 2003b). The purpose of this
study was to evaluate the immediate effects of eight single music
therapy interventions (music game, songwriting, lyric analysis, music
drama, group improvisation, music and art, music listening, and music
and relaxation) on psychiatric outpatients' perceptions of happiness,
sadness, anxiety, feelings of discouragement, annoyance, energetic
feelings, and perceptions of treatment continuity using a pre-posttest
design similar to that of Silverman and Marcionetti (2004). Results
indicated there was a statistically significant difference between the
number of positive mood changes and the number of no changes or negative
changes, with the number of positive mood changes occurring most
frequently. Further, there was a statistically significant difference
between the number of positive treatment continuity changes and the
number of no changes or negative changes, with the number of positive
treatment continuity changes occurring most frequently. Overall, it
would seem that music therapy interventions tended to have positive
effects on psychiatric consumer rated dependent mood and treatment
continuity measures within the time constraints of a single session. The
majority of participants indicated they thought music therapy
interventions were beneficial. Further, the majority of participants
indicated they would incorporate music into their daily lives. From the
results of this study, it seems that a single music therapy session can
have a positive impact upon psychiatric consumers concerning a number of
mood and treatment continuity measures. Limitations of the study and
suggestions for future research are discussed.
The Clinical Effects of Music Therapy in
Palliative Medicine and Hospice Patients
Lisa M. Gallagher, M.A., MT-BC
The Harry R. Horvitz Center for Palliative
Medicine at the Cleveland Clinic Taussig Cancer Center & The Cleveland
Music School Settlement, Ellen Shetler, MT-BC; The Cleveland Music
School Settlement & The Hospice of the Cleveland Clinic, Ruth Lagman,
MD, MPH; Declan Walsh, MSc, FACP, FRCP; Edin Mellar P. Davis, MD, FCCP;
Susan B. LeGrand, MD, FACP; The Harry R. Horvitz Center for Palliative
Medicine at the Cleveland Clinic Taussig Cancer Center
Abstract
There are few
quantitative studies involving music therapy with individuals with
advanced illness. The aim of this study was to assess the differences
in clinical effects of music therapy in palliative medicine and hospice
patients. One hundred age and gender matched palliative medicine and
hospice patients were retrospectively evaluated. The effect of music
therapy on these patients is reported. Visual analog scales, the
Happy/Sad Faces Assessment Tool, and a behavior scale were utilized to
record pre- and post-music therapy scores. Rating was done by music
therapists. Symptoms included pain, anxiety, depression, shortness of
breath, and mood. Behaviors were facial expression, body movement, and
verbalizations/vocalizations. A paired t-test (P<0.05) demonstrated
that with palliative medicine and hospice all symptoms and behaviors
improved and were statistically significant. Only three of these were
found to be statistically significant when compared between programs.
The effectiveness of music therapy in addressing specific goals was
compared between programs using the Chi-square test (P<0.05). The study
results suggest that there are differences in responses to music therapy
between palliative medicine and hospice patients.
The Impact of Live Religious Music Versus
Live Secular Music on Pre-Wandering Behaviors of Persons Diagnosed with
Dementia of the Alzheimer’s Type
Renata L. Geyer, M.M. MT-BC
Abstract
The purpose of this
study was to identify the impact of live religious music versus live
secular music during a music therapy session on pre-wandering behaviors
of persons diagnosed with dementia of the Alzheimer's type. A secondary
purpose for this study was to identify the impact of live music therapy,
using religious and secular music, on wandering behaviors occurring on a
nursing unit. It was hypothesized that live religious music would help
to decrease pre-wandering behaviors more than live secular music within
a music therapy session. It was also hypothesized that music therapy,
whether consisting of religious or secular music, would help to decrease
wandering behaviors on a nursing unit. A pretest-posttest control group
design with two dependent variables, pre-wandering and wandering
behavior was used. For the purpose of this study, pre-wandering behavior
was defined as a subject's attempt to perform motor activity that takes
the individual from a seated position to a position in which contact is
no longer made with the seat of the chair. In addition, the individual
must also take at least one step to move away from the chair. Wandering
was defined as aimless or purposeful motor activity that causes a social
problem such as getting lost, leaving a safe environment or intruding in
inappropriate places.
The Effect of Behavioral Contracting on the
Acquisition of Guitar Performance Skills in a College Level Beginning
Guitar Class
Lori F. Gooding, MM, MT-BC, The Florida
State University
Abstract
The purpose of this
study was to determine the impact of behavioral contracting on the
acquisition of guitar performance skills in a college beginning guitar
class. Participants (N=27) were divided into four groups, with 2 groups
serving as control (G1, G2) and two groups serving as experimental (G3,
G4). After taking baseline data for all groups, a multiple baseline
format was implemented, with participants in the experimental groups (G3
and G4) receiving behavioral contracts in which group members were
allowed to make structured choices about evaluation procedures. Members
of the experimental groups were also allowed to select a reward to be
earned if all contract stipulations were met. Data on speed increase and
accuracy were collected via videotaping and analyzed by an independent
reviewer. . All groups improved in both speed and accuracy, with the
control groups improving speed by an average of 41% (G1) and 38% (G2).
The experimental groups improved speed by an average of 76% (G3) and 67%
(G4), with each group improving an average of 8% beyond the required
amount to meet contract stipulations. A 2-way repeated- measures ANOVA
indicated a significant difference in speed increase between both
control groups and experimental Group 3 and a significant difference
between experimental Group 4 and control Group 2. Though there was a
decrease in errors / across time, there was no significant difference
among the groups in error reduction. However, it is important to note
that the contracting groups started with fewer errors and saw the
greatest decrease in errors during their contracting conditions.
Instruction and Accessibility Analysis of
Commercial DVDs for Beginning Guitarists
Dianne Gregory, The Florida State University
Abstract
Guitar classes are
popular alternatives in middle and high school general music education
and excellent opportunities for including students in special education
programs in the regularly scheduled music instruction. Options for
guitar teachers include modifying traditional instructional methods for
all students, accommodating the needs of students with disabilities, and
adapting instruments for individuals. Commercially produced DVDs,
primarily designed for self-directed instruction, are also popular and
could possibly bridge the gap for all students between class instruction
and practice at home. Does the content of commercial DVDs address skills
related to MENC standards? Are some DVDs more accessible than others for
students with disabilities? Seventy one new guitar instruction DVDs were
added to Amazon.com during 2007. A listing of the top 100 best sellers
of all available DVDs, including the new ones, revealed a preponderance
of DVDs devoted to either a single style of a specific guitarist (e.g.,
Eric Johnson, Stevie Ray Vaughn), a specific type of guitar (e.g.
electric, bass), or a specific genre (blues, soul, rock, jazz). Only 19
were specific to general guitar instruction. The top 4 that included
"beginning" in the title, the subtitle or the description (#1, 4, 24,
and 91) were selected for this analysis. They are: House of Blues
Beginning Guitar (2005), Learning Guitar for Dummies (2001), Hal Leonard
Guitar Method for Beginner Acoustic and Electric (2000), and eMedia
Essential Guitar (2006). Descriptions of content revealed different song
selections, different chord instruction sequence, and different strum
and pick patterns across the 4 DVDs. MENC Music Education Standards for
middle school and high school students related to guitar performance
were used to determine the appropriate "grade level" of each DVD based
on the evaluation of content. All DVDs appeared appropriate for high
school students and relevant to the MENC standards. Only Learning Guitar
and eMedia Essential Guitar seemed appropriate and relevant for middle
school students. Additional content analysis revealed that each DVD had
a unique set of "bells and whistles" that separated it from the others
such as random "pop up" facts (Learning Guitar) and bottom-of-the-screen
tab and notation (eMedia Essential Guitar). Each DVD was also analyzed
using a content delivery checklist based on accepted principles for
learning: Was the delivery sequential, cumulative and repetitive?
Although the content varied across the DVDs, three of them met these
criteria but used different methods, such as reviews, quizzes, and
repetitive menus. Each DVD was also analyzed across several factors
related to accessibility for students with learning and physical
disabilities. The factors included (1) single concept presentation
within a unit, (2) rate of speech, (3) consistent visual display across
chapters, (4) split screen applications, (5) use of color, (6) print
size, (7) verbal descriptions of written words, (8)static or animated
visual cues, (9) demonstrations, (10) closed captioning, and (11)
transcriptions. No single DVD excelled in all of the accessibility
factors. The analysis, however, provides the strengths and weaknesses of
single DVDs and possibly functions as a guide for selecting a single
beginning guitar instruction DVD for an individual student or a group of
students with similar needs.
The Use of the Lydian Mode in American
Popular Culture: Implications for Music Therapy
Robert Groene, University of Missouri —
Kansas City
Abstract
The Lydian Mode has
been used in American culture to often represent feelings and values
related to nostalgia, happiness, wonder, and the fantastic. Its
pervasiveness in concert music, musicals, film soundtracks, television
shows, commercials and (after reflection) in the presenter's own
compositions has intrigued the presenter to try to identify the
programmatic and cultural messages its composers wish to impart. As
such, the Lydian Mode can be a potential tool for music therapy personal
and clinical work with a variety of populations. This paper will explore
the Lydian Mode and its variations through identified cultural examples
and its implications for music therapy clinical work.
Between Group Differences and Changes in
Perceptions of Students in the Music Therapy Introductory Course: A
Mixed Methods Approach
Ann Houck, PhD, MT-BC; Michael J. Silverman,
PhD, MT-BC
University of Minnesota
Abstract
The introduction to
music therapy course is often the first formal experience students have
with the profession. This course can be a method of
attracting/recruiting majors and, therefore, potentially increasing the
size of the field. However, although there is a good deal of literature
concerning the training of upper level music therapy students, there is
little published research on students enrolled in the introductory music
therapy course. The purpose of this study was to study changes and
between group differences of students in an Introduction to Music
Therapy course using qualitative and quantitative methods in a
pre-posttest design. Results indicated music therapy majors were more
excited and interested in the course and thought it was less difficult
than groups composed of other majors. Music therapy majors were the only
group to have a mean increase in "excitement about becoming a music
therapist" from pre to posttest. Additionally, perceptions concerning
clinical populations that students were interested in changed over the
course of the semester. Participants indicated that ability to relate,
interpersonal, and therapeutic skills were the most important qualities
of music therapists, although musical ability was never selected.
Participants had a number of concerns about the profession, primarily
lack of jobs and lack of awareness of music therapy. During pre and
posttest, participants tended to indicate that people would be
interested in becoming a music therapist due to a passion for music and
altruism. Definitions of music therapy changed from pre to posttest and
tended to indicate a deeper understanding of the variety of clinical
populations served and a more evidence-based and scientific approach to
the profession. Suggestions for future research, implications for
therapy and education, and limitations of the study are provided.
The Development of a Music Therapy Protocol
for Determining the Spiritual Needs of Hospice Patients
Ann J. Whitehead Houck, Ph.D., University of
Minnesota
Abstract
The innovative use of
music with those facing end-of-life issues provides a positive influence
on patients' physical, emotional, social, and spiritual well-being
(Foxglove & Tyas, 2000). Clair (1996) outlines a number of reasons to
show music therapy's viability in hospice and palliative care. Among the
reasons she lists are for reminiscence and life review, relating to
others, distraction from pain, emotional comfort, relief from anxiety,
provision of enjoyment, and release in the last hours of life. Aldridge
(1996) recognizes that terminally ill patients and their loved ones
undergo challenges and changes with which they must cope as they deal
with end of life issues. Along with physical, personal and relationship
changes, spiritual changes are also present and need to be recognized.
Prospective Music Teachers Reflect on First
Experiences as Artists in Elementary Classrooms
Jacqueline Henninger, Laurie Scott, Judith
Jellison, The Center for Music Learning
The University of Texas at Austin
Abstract
We examined changes
that took place in the perceptions of 18 prospective music teachers
during their first experiences performing and teaching in two different
field experiences in elementary music classrooms. The field experience
provided students with an opportunity to combine their excellent
musicianship with newly learned teaching skills in a performance-type
format. Based on instruction and feedback from the course, each
undergraduate integrated their knowledge and skills into written plans
from which they taught twice—each lesson with a different classroom in
one grade level (most often fifth grade). Following each experience,
participants were asked to individually view videotapes of their
lessons, analyze the experience using specially designed observation
forms, select two 10-minute excerpts (one labeled by the participant as
“good” and the other “not so good”), and write two reflection
paragraphs, one for each excerpt. To analyze paragraphs written by
undergraduates in the study, ideas were coded as positive, negative, or
neutral using the categories of Teacher (Use of strategies; Affect;
Music skills and knowledge; Other) and Students (Music skills and
knowledge; Social skills; Affect; Other). Although 75% of all statements
related to participants’ perceptions of themselves as teachers and only
25% related to their students’ behaviors, changes were reflected for
several categories between the first and second experiences.
Participants gave greater attention to the “Student Music Behaviors” in
Experience II than they had in Experience I. Overall, however,
participants were more positive about their use of strategies and
expressed less negative affect.
Students Pursuing a Degree in Music at the
Undergraduate and Graduate Level: A Qualitative Study on Motivation
Rachael L. Johnson, Western Illinois
University
Abstract
This study was
undertaken to gain a better understanding of the motivations of students
pursuing a degree in music at the undergraduate and graduate level.
There were 4 undergraduate music students and 1 graduate music student
who participated in a 30-minute interview answering 8-10 guiding
questions about their motivations. The interviews yielded 27 pages of
transcript with differences and similarities in how and what each
participant spoke about concerning motivation. Five main factors are
discussed including practicing, audience, interest, privilege and
relationship. The concept of right and wrong motivations was also
discussed.
Music Therapy as a Supplemental Teaching
Strategy for Kindergarten ESL Students
Roy Kennedy, The University of Georgia
Abstract
The purpose of this
study was to give a descriptive account of the use of music therapy
techniques on the English speaking and story retelling skills of
Kindergarten students in English as a Second Language (ESL) classes.
Nine students in a community based after-school ESL class and 9 students
in a regular public school ESL class received music therapy sessions
designed as supplemental teaching strategies in addition to their
regular ESL classroom routines. Observers indicated that both groups
performed well on story retelling skills and English speaking skills;
although, the after-school ESL group performed better than the public
school group. This study suggests that the community setting may be a
more relaxed and less intimidating environment for young English
language learners.
The Relationship Between Pitch Processing
and Phonological Awareness in Five- and Six-Year-Old Children
Linda M. Lathroum MA, MT-BC, Doctoral
Candidate, University of Miami
Abstract
Studies have shown that
phonological awareness is a good predictor of children's later reading
success. Phonological awareness is the awareness that spoken language
can be subdivided into words, syllables, and phonemes. Additionally,
phonological awareness involves perceiving, manipulating, separating,
and blending sounds in speech. Research suggests an apparent overlap
between pitch processing skills and phonological awareness. This
perceptual overlap revolves around the fact that children appear to
perceive and organize tonal patterns into auditory Gestalts in the same
way that they perceive and process linguistic sounds related to
phonological awareness. Additionally, the same neuroanatomical
structures are involved in these two processes. Participants (N=27) were
five- and six-year-old-children in three private classrooms in South
Florida. Participants' parents filled out a demographic questionnaire.
The investigator administered the Primary Measures of Music Audiation
Test (PMMA) in order to assess pitch processing. The pitch or tonal
sub-test was administered. This test measures pitch processing by
assessing audiation, or the skill of organizing isolated pitches into
tonal patterns. Additionally, the investigator assessed phonological
awareness skills using the Comprehensive Test of Phonological Processing
(CTOPP). Three tasks were used to assess the phonological awareness of
five- and six-year-old children: elision, blending words, and sound
matching (first sound and last sound). The phonological awareness
component of the CTOPP is a composite score of the three sub-tests. This
study supports the need for further research regarding the relationship
between pitch processing and various components of phonological
awareness. Additionally, this study's findings could be used to develop
therapeutic interventions for children who are at high risk for reading
disabilities.
The Effect of Developmental Speech-Language
Training through Music on Speech Production in Children with Autism
Spectrum Disorders
Hayoung A. Lim, Ph.D., MT-BC, NMT, Sam
Houston State University
Abstract
Children with Autism
Spectrum Disorders demonstrate deficits in speech and language, with the
most outstanding speech impairments being in comprehension, semantics,
prosody, and pragmatics. Perception and production of music and speech
in children with ASD appear to follow the same principles of Gestalt
pattern perceptual organization. In addition, common neuroanatomical
structures and similar patterns of cortical activation mediate the
perception and production of speech and music. Therefore, the purpose of
this study was to explore how the perception of musical stimuli would
impact the perception and production of speech and language in children
with ASD. The study examined the effect of developmental speech-language
training through music on the speech production of children with ASD.
The participants were 50 children with ASD, age range 3 to 5 years, who
had previously been evaluated on standard tests of language and level of
functioning. The children completed the pretest, six sessions of
training, and the post-test. The pre-and post-tests consisted of the
Verbal Production Evaluation Scale (VPES) and measured each
participant's verbal production including semantics, phonology,
pragmatics, and prosody, of 36 target words. Eighteen participants
completed music training, in which they watched a music video containing
six songs and pictures of the 36 target words. Another group of eighteen
participants completed speech training, in which they watched a speech
video containing six stories and pictures of target words. Fourteen
participants were randomly assigned to a no-training condition. Results
of the study showed that participants in both music and speech training
significantly increased their scores on the VPES from the pre-test to
the post-test. Both music and speech training were effective for
enhancing participants' speech production including semantics,
phonology, pragmatics, and prosody. Participants who received music
training made greater progress on speech production than participants
who received the speech training; however, the difference was not
statistically significant. Results of the study also indicated that the
level of speech production was influenced by the level of functioning in
children with ASD. An interaction between level of functioning and
training conditions on speech production approached significance. The
results indicate that both high and low functioning participants
improved their speech production after receiving either music or speech
training; however, low functioning participants showed a greater
improvement in speech production after the music training than after the
speech training. Collectively, music training was more effective for
speech production in low functioning children with ASD than was speech
training. The study suggests that the superior performance in speech
production in children with ASD who received music training might be
generated from music stimuli which were organized by the Gestalt laws of
pattern perception. In conclusion, children with ASD appear to perceive
important linguistic information (i.e., target words) embedded in music
stimuli, and can verbally produce the words as functional speech. These
results provide evidence for the use of music as an effective way to
enhance speech production in children with ASD.
A Cross-cultural Comparison of an
Audio-Visual Presentation
Katia Madsen, Louisiana State University;
Clifford K. Madsen, John M. Geringer, Florida State University
Abstract
This study is an
extension of a line of research that investigated musicians’ perceptions
of a performance of Strauss’ Blue Danube Waltz performed by the Vienna
Philharmonic Orchestra when the performance was edited such that it
included portions of five orchestral performances with five different
conductors. Participants were graduate music majors in Argentina (N =
30) who indicated their focus of attention to designated music elements
while listening to the performance without seeing the video, and who
then commented on the total listening experience after experiencing the
audio-visual presentation. A one-way ANOVA with repeated measures
indicated a significant difference (p = .017) across focus of attention
elements. Subsequent statistical analysis revealed that participants
focused their attention less on “everything” than they did on the
“dynamic” and “melodic” elements of the performance. Participants
focused on the “melodic” elements of the performance more than the
“timbral” elements. No other significant differences were found. As in
the previous studies, no participants identified that the performance
had been an edited version of different conductors conducting different
orchestras. It seems that when musicians listen to music within context,
there is a “gestalt” effect that may influence their perceptions, even
when they report focusing their attention more on individual aspects of
the music than on “everything.”
The Effect of Music Therapy on Relaxation,
Anxiety, Pain Perception, and Nauseain Adult Solid Organ Transplant
Recipients: A Pilot Study
Amy T. Madson, Michael J. Silverman
University of Minnesota
Abstract
Organ transplant
recipients characteristically experience low levels of relaxation and
high levels of anxiety, pain, and nausea. Although music therapy has
demonstrated effectiveness in ameliorating these types of conditions
with patients in other areas of medical hospitals, no studies have
quantitatively evaluated the effects of music therapy on solid organ
transplant patients. The purpose of this study was to assess the impact
of single session music therapy on anxiety, relaxation, pain, and nausea
levels in patients recovering on the transplant unit of the hospital
utilizing a pre-posttest design. Participants (N= 59) received an
individual 15-35 minute music therapy session consisting of live
patient-preferred music and therapeutic social interaction. To remain
consistent with the hospital's evaluative instruments during this pilot
study, participants' self-reported levels of anxiety, relaxation, pain,
and nausea, were based on separate ten-point Likert-type scales. Changes
in affect and verbalizations were observed, and anecdotal data were
collected from participants and hospital staff. Results indicated there
were significant improvements in self-reported levels of relaxation,
anxiety, pain, and nausea (p < .001). Chi square tests demonstrated
increases in positive verbalizations and positive affect to be
statistically significant. All participants reported that they would
like to receive music therapy again during a future long-term hospital
stay. From the results of this pilot study, it seems that music therapy
can be a viable psychosocial intervention for hospitalized postoperative
solid transplant patients. Implications for clinical practice and
suggestions for future research are provided.
Brain-Jamming for Focus: Helping AHDH
Children with Music and Neurofeedback
Eric B. Miller, Ph.D. MT-BC, Expressive
Therapy Concepts
Abstract
Within the backdrop of
a societal healthcare paradigm swing, this study of EEG neurofeedback
with music therapy protocols added an experimental group (NF-MUS) to an
existing Philadelphia Office for Mental Health multi-site study of two
traditional neurofeedback (NF) protocols. Thirty-eight subjects
completed the pre- and postintervention assessment comprised of the
Stroop, Toni-3, NEPSY Attention/Executive core domain score, Conners CPT
and ADHD Parent and Teacher Rating Scales Revised (S). NF-MUS subjects
also received pre- and post-quantitative EEG (QEEG) topographical
brain-mapping. NF-MUS utilized a Theta/Beta protocol variation,
incorporating brain-triggered musical tones assigned to Theta amplitude
in key with background musical selections. Individual results within the
NF-MUS group showed improvement on NEPSYcore domain scores and
improvement individually on the Stroop Color and Word tests, but showed
mixed results on the combined Stroop Color/Word test. Three out of four
NF-MUS subjects improved their TONI quotient. CPT results were mixed,
with some individuals displaying dramatic improvement on the CPT's ADHD
index score. A paired samples T-test showed no significant differences
between pre- and post-Toni-3 scores or Stroop Color/Word scores.
Significant improvement was found for the Stroop Color and Stroop Word
scores individually and for the NEPSY Executive Function/Attention
subscale index scores. Between-group analysis showed the NF-MUS group
significantly superior to the other NF groups and control subjects on
three measures: the NEPSY audio subtest (p = .01); the Conners Parent
Rating Scale ADHD index (p = .015); and, the Conners Parent Survey
Cognitive subscale (p = .043). Differences in QEEG brain maps ranged
from very little change pre- and postintervention to noticeable
normalization patterns. NF-MUS subjects decreased their Theta/Beta ratio
(p=.004) and increased their SMR (p=.012) as hypothesized. Theta
reduction alone, however, was not significant (p=.189).These results
indicate that a brain-triggered musical component to neurofeedback
protocols may yield superior remediation of ADM symptoms than standard
neurofeedback protocols. Acceptance of these results and incorporation
of findings into clinical practice, however, is unlikely until further
investigation corroborates these results, and medical community
attitudes continue to shift in the direction of holistic therapies.
Influence of Music Teacher Affect on
Kindergartner's Affective Responses and Participation in Music Class
Randall Moore, University of Oregon; Sally
Webber, Adams Elementary School
Abstract
A music specialist
taught four 20 minute music lessons with 20 Kindergartners in their
classroom over a four week period. A total of 80 minutes were videotaped
with two cameras to observe affective responses of teacher and students.
Primary activity focused on singing songs and using movements to enhance
contextual meaning of song lyrics. Subjects were six year old children
who were completing one year of Kindergarten education in a neighborhood
school; composition of students included one autistic boy and children
from Hispanic, African-American, Asian and Caucasian backgrounds, all of
whom spoke English. Purpose of the study was to observe the influence of
teacher's affective behavior and students' affective responses.
Procedures followed permission requirements of the school district and
initial acceptance of school teacher and principal. Students' parents
all signed a consent statement allowing their children to be videotaped
for research purposes. Two professional photographers videotaped four
20-minute music lessons using two video cameras, and results were
combined into one film with running time shown in minutes and seconds
for analysis purposes. Two observers independently observed the 80
minutes of film and rated the percent on-task of subjects, type of
motions exhibited by teacher and students, as well as their affective
behavior during lessons. Affective responses were counted by frequency
and intensity and included visual and aural behaviors. Observational
data were collected at 20 second intervals or three times per minute.
Observers marked intensity of affective responses on a scale from 1-5
with 1 being low intensity and 5 being high intensity. Typical affective
responses were observed visually and aurally and included such behaviors
as smiling, laughing, sadness, and crying. Animated movements were seen
as affective expressions of student involvement. Cheerful and sad moods
were incorporated into selected songs and participants demonstrated
clear contrasts in affective responses. Humorous songs included such
titles as, "One Finger-One Thumb Keep Moving" and "Hokey-Pokey" which
contrasted with the sad lyrics of "Don Gato." The illustrated text of
"Don Gato" was used to focus attention from the teacher onto written
lyrics that were enhanced by colorful drawings in a printed text.
Contrasts between facial expressions of glee and sober feelings were
observed in video observation. Results showed that students imitated the
music teacher's physical and affective responses throughout the lessons.
The animated character of the music teacher was reflected almost
immediately in the students' responses. Over 90% on-task behavior
occurred in the group of subjects. Focused observation on the autistic
subject revealed a much higher involvement in group activities during
music activities compared with non-music learning periods. The classroom
teacher was startled by the high rate of participation of her group of
students and in particular, by the high on-task behavior of the student
with autism. Classroom teacher remarks revealed high consistency with
observational findings and indicated that individuals showed more
on-task behaviors during music lessons when singing with highly animated
movements as contrasted to passive music listening which opened each
day's classroom activities. Findings corroborate A. Bandura's research
that consistently found the prominent and powerful influence of teacher
modeling on student behavior. Recommendations for music therapists and
teachers suggest that song leaders will have more positive influences on
clients and students when they utilize animated and enthusiastic
presentations when song leading. Affective responses of the music
teacher in this study were instantly reflected in students' reactions
and led for over 90% participation and 80% affective responses in all
subjects. Students' behavior mirrored the affective behavior of the
music teacher and the nature of materials presented.
The Effect of Music Listening on the Let
Down Reflex and Milk Production while Pumping
Valerie Oakley, The Florida State University
Abstract
The purpose of this
study was to determine whether music had an effect on the let down aim
and milk production during a breast pumping session. The subject
participated in four breast pumping sessions. Sessions were designed in
the complete reversal method, with music interventions being used in the
second and fourth sessions. Results showed that there was no difference
in the time that the let down reflex took. There was an increase in milk
volume when the subject listened to music while pumping.
Expectations of Two Undergraduate Music
Therapists Regarding the Role of theClinical Practicum Supervisor
Varvara Pasiali, MME, MT-BC, NMT, LCAT,
Michigan State University
Abstract
The purpose of this
study was to identify expectations of undergraduate music therapy
students (n=2) regarding the role of the clinical supervisor and the
process of supervision. Both participants had completed all required
core music therapy coursework, including clinical practicum. Data
included one personal semi-structured interview with each participant
regarding their experiences and thoughts. Results included themes and
salient points about: (a) Treatment Planning Skills, (b) Professional
Role, (c) Treatment Implementation, (d) Music Skills, (e) The
Therapeutic Relationship, and (f) Assessment and Documentation. The
participants also shared thoughts about most and least valuable aspects
of the program as well as most and least useful advice received during
clinical supervision. Discussion includes the researcher's
interpretations and conclusions as well as implications for future
research.
Word Usage and Thematic Content of Song
Lyric Analyses: A Comparison of Adolescents Living in Community and
Residential Environments
Thomas J. Petterson, Florida State
University
Abstract
Interventions for
adolescents at-risk may be viewed as a form of treatment and
preventative care. Although many adolescents already exhibit high-risk
behaviors before being exposed to any sort of formal treatment, more
severe consequences can be anticipated in the absence of sufficient
intervention. Many guidelines are used in order to determine the most
appropriate setting for intervention to take place. The most frequently
mentioned principle is that of least restrictive environment;
identifying a treatment setting which is least disruptive to the
individual's natural environment, yet still efficiently addresses the
individual's needs. In surveying the treatment options available to
adolescents, a continuum becomes apparent. At the least restrict end of
this continuum are nonresidential treatments, including outpatient,
home- and school-based therapies. At the most restrictive end of the
continuum are inpatient hospitalization and institutional treatment.
Information on evidence-based practices within these settings is
essential to providing optimal service delivery and treatment for
adolescents. An individual's music of choice tends to carry a special
level of significance in the lives of adolescents. Songs are a medium
through which adolescents communicate regularly, articulating values and
beliefs with comfort and ease. Songwriting and lyric analysis are two
music therapy techniques which take advantage of the communicative
aspect of songs and the appeal of preferred music. Songwriting and lyric
analysis are highly adaptable forms of therapeutic interventions, and
both have been found to be highly effective with adolescent-aged youth.
The purpose of this study was to examine the compare the thematic
content and word use patterns found lyric analysis responses and
songwriting lyrics of at-risk adolescents from community and residential
settings. Adolescents living in a voluntary, short-term residential
facility (n = 15) and adolescents living with family members in a
typical home environment (n 15) served as participants. The study was
conducted in three phases: a lyric analysis phase, participant interview
phase, and group songwriting phase. During the first two phases,
participants individually listened to two popular songs—one rap and R&B,
and then responded orally to a series of questions regarding the lyrics
of each song. Oral responses of participants were audio recorded and
transcribed. Content analysis was employed to code interview responses
and participant-composes song lyrics into thematic categories.
Linguistic Inquiry and Word Count, a software program that analyzes the
content of written text, was also employed to identify trends in word
usage. Content analysis revealed a focus on themes within the responses
of the residential group that was not found in the community group.
These themes were: regret, loss of control, feeling restrained, and
finding happiness regardless of wealth. Conversely, song lyric lines of
the community group contained more thematic content in the categories of
negative experiences and social/peer groups. Significant differences
were also found in the lyric analysis responses of the two at-risk
groups. Word use of the community group was significantly greater than
the residential group in two categories—total pronouns and impersonal
pronouns. Similarities were found between the two at-risk groups in
their use of feeling words, their music preferences, and thematic
category of family in their lyric analyses and songwriting lyrics. Data
found in this study align with typical therapeutic objectives of
adolescents receiving residential and non-residential treatment. The
alignment indicates that lyric analysis and songwriting interventions
may be effective methods for providing therapy to at-risk youth.
Additionally, finding of this study suggest that adolescents are willing
to disclose information and engage in dialogue related to therapeutic
issues within the context of lyric analyses and songwriting. These music
therapy interventions, therefore, appear to be viable and effective
therapeutic strategies for use with at-risk adolescent populations.
The Effects of a Music-based Literacy
Curriculum on Essential Literacy Skills of Pre-Kindergarten children.
Dena Register, Ph.D., MT-BC, University of
Kansas
Abstract
The purpose of this study was to investigate
the use of music to support early literacy learning in the early
intervention classroom. Subjects (N=87) enrolled in one of six different
Pre-Kindergarten classes in a public school and were grouped by
district-determined classroom. Participating classes were assigned to
one of three conditions each semester. During the fall semester groups
were defined as 1) no music, 2) music for recreation and music learning
and 3) music for literacy learning. In the spring semester the groups
were altered. The no music group received music for recreation and music
learning and the remaining two groups received music for literacy
learning. All contact groups met one time per week for a total of
fifteen weeks with sessions lasting approximately 30 minutes each.
Subjects were be pre- and post-tested individually using two subtests of
the Dynamic Indicators of Basic Early Literacy Skills (DIBELS). Groups
engaged in music for literacy learning received music interventions
designed to increase letter naming and initial sound fluency in early
intervention. Children in the group that received music interventions to
teach reading skills scored higher on the Initial Sound Fluency subtest.
Results suggest that music interventions designed to teach specific
material is more effective than music for general purposes.
The Effect of Songwriting on Knowledge of
Coping Skills and Working Alliance in Psychiatric Patients: A Randomized
Controlled Trial
Michael J. Silverman, University of
Minnesota
Abstract
Coping skills are
considered an essential part of healthy well-being while working
alliance can be an indicator of therapeutic outcome and treatment
retention. Presently, there is a lack of quantitative psychiatric
research and researchers have not evaluated the effect of music therapy
on these aforementioned variables. The purpose of this study was to
determine the effects of a songwriting intervention on psychiatric
patients' knowledge of coping skills and working alliance. Participants
were randomly assigned to scripted and manualized experimental (n = 48)
or control (n = 41) conditions. The experimental condition was a group
psychoeducational music therapy songwriting session concerning coping
skills while the control condition was a group psychoeducational session
concerning coping skills. Results indicated no significant between group
differences in measures of knowledge of coping skills, consumer working
alliance, or enjoyment (p > .05), although the experimental condition
tended to have slightly higher mean scores than the control group.
However, there was a significant between group difference in measures of
therapist working alliance (p < .001), with the experimental group
scoring higher than the control group. All participants but one
indicated they would attend another session if given the opportunity,
suggesting that, regardless of condition, participants felt there was a
therapeutic benefit from attending sessions. Results of this study are
congruent with existing psychosocial research indicating diminutive
differences between experimental and active control conditions. It seems
that group songwriting about coping skills can be an effective
psychosocial intervention for teaching psychiatric inpatients how to
proactively manage their illness. Implications for clinical practice,
limitations, and suggestions for future research are provided.
NICU Music Therapy: A 1-year Post Hoc
Clinical Analysis of Premature Infant Characteristics and MT
Interventions
Jayne M. Standley, PhD, MT-BC, NICU-MT;
Olivia Swedberg, MM, MT-BC, NICU-MT
The Florida State University
Abstract
The incidence of
premature births in the United States is increasing as are medical costs
related to this problem. Research has shown benefits for NICU-MT in
research with controlled clinical trials but small sample sizes. Such
benefits have included significantly earlier discharge dates and a
consistent pattern of increases in weight gain that have not been
statistically significant. The NICU music therapy program at TMH has
been in effect for over 5 years and includes referral for music
listening, multi-modal stimulation, Pacifier-Activated-Lullaby
treatment, and parent training in infant stimulation. Multi-site
research has indicated that the length of stay for NICU infants at TMH
is shorter than that in comparable NICUs in the Southeast. The purpose
of this post hoc analysis of clinical records for all NICU infants
treated at Tallahassee Memorial Hospital during the year 2006 was to
describe the MT interventions provided by the Florida State University
Medical Music Therapy Program and to ascertain whether music therapy
contributed to patient benefits in hospital length of stay or weight
gain. Further, the study analyzed whether benefits were differentiated
by gender, severity of prematurity, length on ventilation, or other
clinical diagnoses/medical interventions. The design of the study was
post hoc analysis of clinical records. The dependent variables were
length of NICU stay and weight gain. These data were collected by
persons blind to the music therapy condition. The independent variable
was music therapy treatment in the NICU vs NICU treatment without music
therapy. Subjects were all infants born low birth weight in the calendar
year 2006 and treated in the TMH NICU. Subjects were identified from the
TMH medical records with clinical information obtained from Powerchart,
the computerized medical records used at TMH and from departmental
records of the Music Therapy Program. Infant records were excluded for
those discharged to another hospital, rather than to home, and for those
who died during their NICU stay. The sample size of NICU infants for
2006 was approximately 800 with approximately 45% of those having MT
treatment. Since this was post hoc analysis of existing records,
informed consent was not needed from individual patients, but IRB
approval was obtained with a HIPPA waiver of confidentiality of records.
Descriptive analyses by group were computed for severity of diagnoses,
length of ventilation, and level of prematurity (extremely, very low
birthweight, and low birthweight). For infants receiving music therapy,
descriptive analyses were computed for days to discharge and weight gain
by type of MT intervention (music listening, multi-modal stimulation,
PAL treatment) and by duration of MT. Prior research at TMH shows that
NICU infants receiving music therapy are discharged earlier than at
other hospitals. This post hoc analysis describes the NICU-MT
contribution to a nationally innovative and beneficial program of
therapy for premature infants.
The Perception of Emotion in Music Among
Women with Breast Cancer
Julie Stordahl, MA, MT-BC; Doctoral
Candidate, The University of Miami
Abstract
Existing research
indicates that women with breast cancer are likely to experience
depression. In addition, an estimated 70 – 100% of cancer patients
experience significant fatigue following cancer treatment. Fatigue
contributes to greater levels of depression, anxiety, and mood
disturbance. Chemotherapy is a common treatment for breast cancer. Both
depression and chemotherapy may influence the perception of sensory
stimuli, which may include the perception of music and of emotion in
music. The purpose of this study was to determine the perception of
emotion in music and the perceived magnitude of emotion in music among
breast cancer survivors and women who have not experienced breast
cancer. Specifically, this study exposed any differences existing in the
perception of music between breast cancer survivors and women who have
not experienced breast cancer. Demographic data were collected to
identify and compare participants' age and cultural affiliation. Medical
data were obtained to determine presence or absence of breast cancer.
For those participants with breast cancer, information was reported by
the participant concerning time of diagnosis, type and stage of breast
cancer, and completed treatment(s). The breast cancer survivors
responded similarly to the comparison group in terms of the perception
of emotion in music and the perceived magnitude of emotion in music.
When the data were averaged according to group, no differences were
found. However, when data for each of the 15 test items were analyzed,
statistically significant differences were found between the two groups
for three individual test items.
Exploring Music in the Lives of Breast
Cancer Survivors: A Qualitative Research Study
Julie Stordahl, MA, MT-BC. Doctoral
Candidate, The University of Miami
Abstract
This study is
comprised of two case studies exploring the unique role and function of
music in the life of a breast cancer survivor. During the course of this
research, I conducted two observations and two interviews. I observed
and interviewed "C," an avid dancer, and "Z," an accomplished soprano.
Both women are also breast cancer survivors.I observed C during a belly
dance class that she attends regularly; I observed Z as she sang with
her church choir during a religious service. Field notes were taken
during each observation. Then, after each observation, I interviewed the
two women. The interviews were audio-recorded and transcribed.As part of
the data analysis, both the observation notes and interviews were coded,
using both open and axial codes, and then placed into clusters. I
compared the codes and clusters within each data set and across the two
data sets. The analysis suggests that life-long involvement with music
or dance served as a buffer following the diagnosis of breast cancer. As
the result of their respective illness experiences, both C and Z
developed a personal philosophy and continued to be involved with music
or dance, although in a modified manner. The model below was developed
after to reflect the commonalities in the two case examples.
The Effects of Participation in a Structured
Music Group on the Development of Infants andToddlers: Parents'
Perceptions and Use of Music Activities in Other Settings
Olivia L. Swedberg, MME, MT-BC, NICU-MT;
Jayne M. Standley, Ph.D., MT-BC, NICU-MT; Darcy D. Walworth, Ph.D.,
MT-BC, NICU-MT; The Florida State University
Miriam G. Hillmer, MME, MT-BC, NICU-MT;
Tallahassee Memorial HealthCare
Abstract
Three interactive music
groups designed to teach developmental skills, separated by the age of
the children (6-11 months, 12-17 months, and 18-23 months), meet for 30
minutes weekly and are led by a music therapist. Each group follows a
12-week curriculum of age-appropriate music activities to promote child
development. During the music groups, music therapists educate parents
in ways to use music with their children to promote development. Parents
and music therapists also model and encourage appropriate cognitive,
communication, motor, and social skills for infants and toddlers. During
their child's first visit to the group, parents receive a packet with
lyrics of songs that are used in the curriculum, a packet with American
Sign Language signs that are paired with songs in the curriculum. Within
the first few weeks of attendance, parents also receive a free CD which
contains age-appropriate songs for young children. Parents are given a
new handout each week which gives ideas of other developmentally
appropriate activities, some of which involve music, to try at home with
their children. A questionnaire regarding parents' use of songs and
activities from the groups in other settings was distributed to all
parents (approximately 80) of infants and toddlers who attended the
groups over a period of six months. The questionnaire consisted of four
questions: 1.) Since you began attending the music group, how
often have you used songs/activities from the curriculum with your child
outside of the group? [Options for response were "never", "1-2 times",
"3-5 times", or "6 or more times".] 2.) How often have you used
activities from the handouts? [Options for response were "never", "1-2
times", "3-5 times", or "6 or more times".] 3.) Which activities do
you use with your child outside of the group? [Activities performed each
week in the group were listed as follows: greeting songs, transitional
songs, songs with sign language, songs with movement, songs with
puppets, songs with stories, songs with scarves, songs with emotions,
and songs for affection and bonding.] Please check all that apply and
list any specific songs used for each activity.4.) Have you noticed any
development in your child that you attribute to use of the music
curriculum? Please explain. Questionnaires were returned by 20 parents
(approximately 25% of all parents surveyed) regarding their use of songs
and activities in other settings. All parents who responded reported
using songs and activities outside of the group at least once. The
majority of parents (85%) reported using songs and activities in other
situation at least six times. Almost all parents (95%) reported using
activities from handouts outside of the group at least once, while most
parents (60%) reported using activities from handouts at least three
times. Songs and activities most frequently mentioned by parents as
having been used outside of the group are (in order of frequency):
transitional songs (mentioned by 95% of parents), greeting songs (90%),
songs for affection and bonding (60%), and songs paired with movement
(55%). Songs paired with scarves (used for color identification and
visual tracking) and songs paired with sign language were the two types
of activities that were cited least often by parents as being used
outside of the group. Most parents wrote on the questionnaire the names
of the songs and activities that they frequently use in other
situations. Songs identified by more than five respondents include (in
order of frequency): "Hello, Baby, How are You Today?" (a greeting
song), "All Done" (a transitional song), "Time to Go" (a greeting song),
and "If You're Happy and You Know It" (a song used to practice emotional
identification). Many parents wrote positive comments about the benefits
of participation in the groups on their children's development, reported
using songs and activities learned in the group in multiple other
settings (at home, when traveling, while shopping, etc.), and reported
making up their own songs/activities based on their experiences with the
group. The results of the questionnaire indicate that direct parent
instruction in a music group setting with demonstration of appropriate
activities and handouts describing ways to use music at home is an
effective format for teaching parents to use music with their children
to enhance development. Songs and activities that teach and reinforce
social skills were most often used by parents in other situations.
Recognition of Geriatric Popular Song
Repertoire: A Comparison of Senior Citizens and Music Therapy Students
Kimberly VanWeelden, Florida State
University; Andrea M. Cevasco, University of Alabama
Abstract
The purpose of the
study was to compare senior citizens' and music therapy students'
recognition of 32 specific popular songs and songs from musicals.
Results found 90% or more of the seniors had heard 28 of the 32 songs,
80% or more of the graduate students had heard 20songs, and 80% of the
undergraduates had heard 18 songs. The seniors only correctly identified
three songs with 80% or more accuracy, which the graduate students also
correctly identified; the undergraduates identified only two of the
three same songs. Seniors only identified the decades of 3 songs with
50% or greater accuracy. However, neither the undergraduate nor graduate
students were able to identify any songs by the correct decade with over
50% accuracy. Further results are discussed.
Effects of Developmental Music Groups For
Parents And Premature or Typical Infants Under Two Years On Parental
Responsiveness And Infant Social Development
Darcy D. Walworth, Ph.D., NICU-MT, MT-BC
Abstract
The purpose of this
study was to examine the effect of music therapy intervention on
premature infants' and full term infants' developmental responses and
parents' responsiveness. Subjects (n=56) were parent-infant dyads who
attended developmental music groups or a control condition assessing
responsiveness during toy play. All subjects were matched according to
developmental age and were also matched by group for socioeconomic
status and for maternal depression. Types of infant play and parent
responsiveness were measured using observation of a standardized toy
play for parent-infant dyads. Observations were coded with the number of
seconds spent in each behavior using the SCRIBE observation program.
Parents completed a questionnaire on the perception of their infant's
general development, interpretations of their child's needs, the purpose
of using music with their child, and their child's response to music.
The infants attending the developmental music groups with their parents
demonstrated significantly more social toy play (p < .05) during the
standardized parent-infant toy play than infants who did not attend the
music groups. While not significant, graphic analysis of parent
responsiveness showed parents who attended the developmental music
groups engaged in more positive and less negative play behaviors with
their infants than parents who did not attend the music groups. This
study demonstrates the first findings of positive effects of
developmental music groups on social behaviors for both premature and
full term infants under two years old.
Educational Supports for Students with
Special Needs: Preservice Music Educators' Perceptions
Jennifer Whipple, PhD, MT-BC, Charleston
Southern University; Kimberly VanWeelden, PhD, Florida State University
Abstract
Historically, music
educators have expressed concerns about inadequate preparation to work
with students with special needs, specifically desiring acquisition of
new skills and competencies related to instruction adaptation for
students with special needs. Therefore, it is important to identify
those educational supports which are most beneficial to beginning
teachers in order for university music education faculty to prepare them
for working with special learners. Preservice music educators (N= 30)
taught general music concepts to secondary students with special needs
in a self-contained classroom during a 5-week field experience, and
subsequently completed a survey regarding the importance of color
coding, icons, echoing, buddy system, and other visual aides in general
music, ensemble, and private studio settings. Results indicated that
preservice teachers considered echoing to be significantly more
important than written words, color coding, icons, and buddy system in
general music, ensemble, and private studio settings combined;
considered icons, echoing, buddy system, and other visual aides to be
better than written words, and icons to be better than color coding in
general music settings; and considered echoing to be more important than
icons in ensemble settings, and more important than all other supports
in private studio settings. However, when survey responses were examined
for preservice teachers divided by semester in which they participated
in the field experience (n = 15 for each of two semesters), results were
somewhat different. Similar to combined semester results, responses from
the semester I indicated that preservice teachers perceived echoing to
be more important than written words, color coding, and icons for all
settings combined; and when divided into separate educational settings,
preservice teachers perceived echoing to be better than the same three
supports in ensemble settings, and better than all other types of
supports in private studio settings. However, responses from semester II
indicated that for teaching in general music, ensemble, and private
studio settings combined, preservice teachers perceived both echoing and
color coding to be more important than written words; and when divided
by educational setting, they perceived all types of supports to be
better than written words in general music settings; color coding to be
better than written words, icons, buddy system, and other visual aides
in ensemble settings; and echoing to be better than written words and
color coding in private studio settings.In addition, the survey included
items which asked preservice teachers to evaluate the same supports as
well as the use of small groups or stations for implementing assessments
in general music and ensemble settings. Responses of preservice teachers
in both semesters separate and combined reached some consensus in that,
in addition to other significant difference pairings, the use of small
groups or stations was consistently rated significantly higher than
echoing for implementing assessments in general music and ensemble
settings combined and in general music settings alone. Potential
explanations for the between-semester differences in perceptions of
educational supports for use in instruction are discussed, as are plans
for additional data collection and implications for further research.
The Effect of a Live Music Interaction on
the Stress Levels of Hospice Staff Members During a Hospice
Interdisciplinary Team Meeting
Natalie Wlodarczyk, MM, MT-BC, NICU-MT,
Florida State University
Abstract
The purpose of this
study was to determine the effect of live music on the stress levels of
hospice interdisciplinary team (IDT) members. This study used a
post-test only reversal design (ABAB) and participants were used as
their own control. The design was counter-balanced (BABA) for half of
the participants to control for order effect. Session A consisted of
participants indicating their current level of stress on a Visual
Analogue Scale (VAS) at the start of the IDT meeting. Session B
consisted of participants listening to three minutes of live music
provided by a music therapist with voice and guitar followed by
participants indicating their current level of stress on the VAS. The
study took place in the conference rooms of a local hospice. The members
of four different hospice interdisciplinary teams agreed to participate
in the study. The participants (N= 23) included nurses, home health
aides, doctors, social workers, volunteers, and chaplains. Data were
collected over a period of four weeks during weekly IDT meetings. All
participants gave written consent prior to participation in the study.
Data results were graphically and statistically analyzed after four
weekly IDT meetings using a Friedman Two-Way Analysis of Variance
(ANOVA). Results of self-report stress showed no significant difference
between experimental and control conditions, k = 4, df = 3, χr² =
4.33, p = 0.23, p > .05. Sequential graphed responses without regard to
condition across the four weeks showed a slight decline in stress that
may have been due to repeated use of the VAS. Free responses collected
from participants support the use of live music in the IDT meetings as a
favorable practice among hospice workers, and though the study did not
yield significant results, several implications for future researchers
in the area of music for stress relief for hospice staff are
presented.
Harmonica Therapy: The Healing and Health
Power of Playing the Harmonica
Victor Yun, PhD, Stanford University Medical
School Health Improvement Program (HIP)
Abstract
The basic concepts
presented in this article are based on consolidation of the existing
body of knowledge, wisdom, traditions, anecdotal testimonies and
evidence not only from harmonica playing communities and the general
public but also from medical science communities. Working hypotheses
regarding the physiology of harmonica playing and the theoretical
implications for health benefits have been steadily on the rise in
recent years. This article offers guiding principles for researching the
supportive elements of harmonica, an instrument believed to be a source
of life power and energy that harmonizes mind, body and soul. Thus
harmonica therapy can be regarded as an integral part of mainstream
music therapy.
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