Three young children with autism spectrum disorders sat expectantly in a semi-circle, their teachers behind them. To begin the session the music therapist presented a picture schedule of what was about to happen.
The first picture showed it was time to sing "Hello." Aiden waved when it was his turn, maintaining a skill he had recently mastered. Candace answered "hi" after her teacher prompted her. Jordan waited patiently for his turn, swaying from side to side with the beat, but when he heard his name he could no longer contain himself. He jumped up and down during his turn, singing "hello" at the appropriate time in the phrase and clapping at the end of his verse.
With the Hello song finished, the music therapist sang and played a simple original transition song, which she then repeated after each music experience, to help the children know what to expect. As part of this transition, each child removed the next picture from the list and put it in numerical order on the board.
For The Bear Went over the Mountain the music therapist distributed boomwhackers, large plastic cylindrical instruments, asking each child to name the color he/she wanted. She started tapping the floor with her boomwhacker to establish a steady, organized beat; encouraged the children to join her; and then proceeded to sing. At the part about the bear going over the mountain to "see what he could see," she invited everyone to look through their boomwhackers and see small stuffed animals. Opportunities occurred to answer questions about animals... a cat, a horse, a bunny.
In Willoughby Wallaby Woo a kangaroo "jumped" on each child and the child passed it to another, a good opportunity to systematically encourage and enhance social interaction skills, like taking turns, that are generally lacking in children with autism spectrum diagnoses but needed in other aspects of preschool and later in life. Candace had her hand out ready to receive the kangaroo, so she was learning to anticipate that passing might occur. Jordan spontaneously said "thank you" as he passed to the therapist!
Music therapists sometimes use arts integration to address state academic content standards. In a preschool class where many of the children had speech and language delays, the music therapist helped children identify matching sounds and recognize rhymes in songs and words, part of a core pre-kindergarten language arts standard. The group chanted:
"Let's play the rhyming game,
Find a word that ends the same."
Each child matched two pictures of words that rhymed, then played a hand drum while saying the words, for example: "Cat, cat, ends like bat; cat, cat, ends like bat."
Music therapy in a preschool class for children who are "at-risk" focused on math standards such as counting with 1:1 correspondence, determining "how many" objects in a set, and identifying and naming numerals, all through singing simple number songs, clapping and playing instruments. Teachers reported that almost all the students improved in these cognitive skills and used the songs and rhymes throughout their day.
In another class for children who are "at-risk," the theme was identifying and appropriately expressing emotions. As the music therapist distributed pictures of individual children, each depicting a particular emotion -- happy, angry, excited, sad, and scared, the class discussed and role-played what their faces and bodies do when showing each of these feelings. They might smile or dance when happy; make a mad face, clench fists or stomp feet when they're angry; jump up and down and shout "woo-hoo" when they're excited; cry or frown when they're sad; and shiver or hide when they're scared. The music therapist asked for examples of what made them feel certain ways. Even if they couldn't label the picture of the emotion, when asked, "What scares you?" the children provided varied answers -- ghosts, alligators, bad people. Teachers modeled responses too... One teacher was afraid of snakes. A minute later, an aide's laughter provided a perfect opportunity to ask, "How does she feel?"
A "Happy/Mad Game" involved first staff and then children taking turns to play, verbalize and act out one of two emotions. The music therapist demonstrated playing loudly on a large drum and simultaneously saying, "I am mad!" She shook the maraca and danced around, singing:
"I feel happy and I'm wearing a smile,
I feel happy, and I'm dancing around,
I feel happy, and I'm laughing out loud,
I'm sooo happy."
While directing all students to stand up, she reminded them, "Don't pop your bubble," a strategy begun months earlier to help the children stay in their own space. When some students were chattering away and not paying attention, she suggested they put the "bubble" in their mouths and puffed out her cheeks. That strategy helped them quiet down. Another rhythmic cue, "1, 2, 3, eyes on me," focused their eye contact to her. Lots of repetition of happy vs. mad music ensued, with turns for all. The therapist commented that the children were "doing a great job using their words" when taking turns to play and say "I am mad" or "I am happy."
Now seated, the therapist led an activity where she was really introducing the concept of tensing and releasing, a common technique in relaxation. In the future maybe the children could use these skills to self-calm when necessary. She modeled squeezing her hands to form fists, squeezing her body as though hugging herself, squeezing her knees, and letting go after each squeeze, and she modeled deep breaths, breathing in and blowing out. She used her guitar as an added musical cue to contrast the squeezing from the "letting go" by loudly pulling the strings upward for the "squeeze" and playing in soft, arpeggiated chords for "letting go" and breathing.
This week the music therapist led all the music experiences, but the next week she guided teachers through leading the experiences. She thereby increased their comfort level with using music as a regular part of the school day and generalized skills learned by both teachers and students to other environments and times. In this setting the music therapist not only provided direct service to the children but functioned as a consultant for the staff. She combined features of two basic models of school music therapy service delivery described by Coleman (2002): direct service and consult service. Chester et al (1999) coined this approach as "program-based consultative service delivery."
Music therapists might work with young children with disabilities in inclusive or "self-contained" classrooms or on the playground, facilitate group music therapy in a district-wide programmatic model for enrichment of many students, perform music therapy assessments and make recommendations to the IEP (Individualized Education Plan) team as to whether a particular student might benefit from music therapy, provide music therapy as a Related Service under IDEIA (Individuals with Disabilities Education Improvement Act) for specific students to reach educational goals, and serve as consultants to music educators to help successfully include students with disabilities in their classes and/or to other teachers or professionals to help them use and integrate music in their classes to enhance learning and development or improve behavior.
Music can stimulate a variety of the senses and involve the child at many levels. According to the AMTA, "Quality learning and maximum participation occur when children are permitted to experience the joy of play. The medium of music therapy allows this play to occur naturally and frequently." You can access a multitude of articles and resources in AMTA's latest issue of imagine, an online magazine dedicated to early childhood music therapy. The AMTA website provides a wide array of additional music therapy information.