Summer Recital!!!! Blog post by Stephanie Schecter

I felt like a proud mom watching each one of my kids perform during the recital. The weeks leading up to it, I could feel the excitement growing in each of the clients.

I actually got little nervous butterflies when it was performance time. I wanted everyone to do so well and I just hoped I could be there for each one if he or she needed. I knew they were ready – I had a good feeling everyone would do well and boy did they! 

It was amazing to see some kids who had been so nervous before, come up on stage, perform for a big audience, and proudly take a bow. One of my clients had been too nervous to bow after giving a practice performance in our session one day, but after he performed at the recital, not only did he take his bow, but he also raised his arms up high and shouted “Yea!” while running back to his seat! It was awesome to witness how thrilled he was about his accomplishment! 

Another client I see made me get all teary-eyed and get goose bumps. He sings so well and we had worked a lot with him to have appropriate performance etiquette, such as holding the microphone properly, not making loud noises into the microphone, and keeping his hands down so not to lick and wipe his mouth nervously. When he sang, he exhibited absolutely none of the off-task behaviors and gave such an amazing and sweet performance of “Hallelujah”. I was so proud of him, I just wanted to go up and give him the biggest hug. I can’t even imagine how proud his family felt!

I had fun performing with two other clients! They both charmed the crowd, one with his dance moves and the other with his original lyrics, in which he included family members into the song. Their enthusiasm was infectious.

Two brothers I see did a duet on piano and recorder and it was so sweet to see them working together, listening to the other for musical cues of when to play.

One kid went right for the trophy after he finished his performance…it was adorably hilarious! He just knew he did so well!

It was truly a special day watching everyone become so focused, striving to do their best as they performed their songs. They all did wonderfully. My heart swells again just thinking about it! Like I said, it was a proud mom feeling over here. Seriously one of the most heart-warming things I’ve ever been a part of. It made me so thankful to be doing what I’m doing!!

Music Therapy with Patients with Alzheimer's Disease - An Intern Perspective by Perry Wright

“Speak to one another in psalms, hymns, and spiritual songs, singing and making melody in your heart to the Lord.” –Ephesians 5:19

               What a blessing that being an intern at Therabeat, Inc. has allowed me the opportunity to work not only with children, but now also with older adults. Alzheimer’s Disease (AD) is something that effects so many people of this population, and it is something that is very close to my heart. My grandmother of 89 has been diagnosed with AD for a few years, and my family and I have begun to see some of her cognitive abilities begin to fade. However, this is the amazing woman who taught me the meaning of music, and how precious of a gift it is. Growing up, she was the one who encouraged me to sing and explore music more than anyone else in my life. She always said “If music can soothe the little babies, then God must have meant it for all of us.” I truly believe that her influence is a major reason why I was led to the field of music therapy! So now that she has been effected by AD—it’s pretty awesome to see how music plays a therapeutic role in her life, and also the life of so many other people suffering from the same disease.

               A lot of research has been conducted to give some evidence to show that music (especially live music between two or more people) accesses memories and personality in people that may seem lost as cognitive abilities of individuals with AD. “The Role of Singing Familiar Songs in Encouraging Conversation among People with Middle to Late Stage Alzheimer’s Disease” in the Journal of Music Therapy (JMT) is a great article that demonstrates the role that music therapy plays in helping a deep sense of self emerge. In this article, the researcher notes that patients with AD often lose their conversational skills. This includes a lost in speech fluency, decrease in spontaneous speech, difficulty naming things, and a loss of meaningful content of speech. This can be frustrating for the patients and for families as well. However, in this study, group music therapy with patients with AD was shown to improve conversational and spontaneous speech. This occurred through singing music from the patients’ formative years. In a disease in which the hallmark is memory loss, music elicits not only memory of melody and lyrics, but also of memories and emotions associated with the music. In this study, music therapy was shown not only to elicit conversation, but to access long forgotten emotions, a sense of self, and a sense of belonging. This helps to improve the quality of life for patients with AD (Dassa, 2014).

               I saw this in action this past weekend while singing some old hymns with my grandmother I mentioned earlier who has AD and my grandpa, who does not have AD. They often have trouble communicating as the cognitive abilities of my grandmother decrease. However, whenever we start to sing some of their favorite old hymns—the verse in Ephesians quoted above rings so true! Communicating and sharing with one another through song is such an encouraging and edifying experience for them both. My grandmother is starting to forget lots of things, but she remembers all her old favorite hymns—even some that she hasn’t sung since childhood. After singing together she said to the family—“When you can’t do anything else, you can always sing. And this will bring joy to your heart.” To me, this quote sums up how special and effective music therapy is to patients with AD—it provides an outlet for success and joy in a situation that seems hopeless.

Dassa, A. (2014). The Role of Singing Familiar Songs in Encouraging Conversation

               Among People with Middle to Late Stage Alzheimer’s Disease.” Journal of

               Music Therapy 51(2), 131-153. doi: 10.1093/jmt/thu007.

Music Therapy with Alzheimer's Disease- An Intern Perspective By: Stephanie Schecter

Even though this internship is focused on kids being that it is a pediatric center, Perry and I have the wonderful opportunity to see one very special geriatric client. She has been diagnosed with Alzheimer’s disease and is in the early to middle stages. Though she likes to think she is already 90 years old, this sweet 89-year-old lady welcomes us each week and loves singing along to the familiar music we present to her. She may not remember who we are each week, or that she has repeated the same couple of sentences 3 times already, but she does remember the lyrics to old songs she grew up hearing. Why is that? 

This topic of music on the effects of Alzheimer’s disease has been and continues to be studied by researchers all around the world. Over recent years, stories have been hitting the news about the positive effects music has on elderly patients with dementia and Alzheimer’s. A story Atlanta Alive did on music therapy in memory units of nursing homes brought tears to a news anchor because, he describes, it’s an eye-opening experience seeing how beneficial music therapy is in bringing these patients momentarily out of their confusion and back into good times of the past.

Researchers in a 2014 study titled, The Role of Singing Familiar Songs in Encouraging Conversation Among People with Middle to Late Stage Alzheimer’s Disease report that this neurodegenerative disease causes the loss of more than just memory and cognition. It affects communication both expressively and receptively, making it troublesome for these patients to speak fluidly, spontaneously, or purposefully and thus can produce social isolation (Dassa & Amir, 2014).

While our client is still capable of producing speech, it is upon arriving to her house that we can usually hear her humming and making nonsensical vocalizations to herself, filling the silence. It seems that she craves music and dialogue, and we have the privilege of providing that for her!

Two weeks ago, I sang “Battle Hymn of the Republic” with the very catchy “Glory, glory, hallelujah” refrain. She kind of nodded along, but did not sing along much at all. Just last week, I presented the song again and she sang along every time that refrain came up, with enthusiasm! She even sang parts of the verses too. She seemed more present and moved her feet along to the beat. Did the repetition of the song spark an uplifting memory within her? Connie Tomaino, a well-renowned music therapist who works mainly with individuals who have suffered from stroke, other brain injury, and neurodegenerative diseases, states that the structural form of music (melody, lyrics) is not the only thing people remember about familiar songs, but that these songs also elicit memories and “rich associations” related to the song. Listening or singing along to these memorable tunes can bring to the forefront a sense of self that may have gotten lost through the progressive disease (Tomaino, 2002). Oliver Sacks, neurologist and author of Musicophilia: Tales of Music and the Brain, calls music a “memory aid that elicits long-forgotten emotions and associations, giving the patient access to moods, memories, and thoughts” (Sacks, 2008).  

It is well known that individuals with Alzheimer’s have difficulty staying focused and engaged in the topic at hand. Despite this, the researchers found in the aforementioned 2014 study that after singing familiar songs with a group of 65-83-year olds with middle to late stage Alzheimer’s disease twice a week for 4 weeks, the participants were more able to concentrate and take part in the following conversations than they were able to before without music (Dassa & Amir, 2014).  

               Using music therapy with individuals with Alzheimer’s disease is beneficial in a variety of ways. Participating in singing or playing along to familiar songs allows the client to feel a sense of belonging, a sense of accomplishment; engage in communication, gross and fine motor movements, breath control, relaxation; and of course recall memories associated with the music, which can bring back that sense of self, maintaining their dignity. Dassa & Amir reference a 2009 study concluding that, “in a disease that destroys memory, preserved musical memory could serve as an important tool to enhance the quality of life for people who have lost so many other abilities” (Dassa & Amir, 2014).

It is a joy to watch our client sing along and exercise gross and fine motor movements to the beat of the song. She always expresses her gratitude when we are leaving and asks us to come again! After researching more about music therapy with patients with Alzheimer’s, I now plan on integrating a little more dialogue and open-ended questions into the sessions after the songs to not only engage our client in conversation, but also to assess how much and what kinds of memories and associations the songs evoke in her.

                                                                References

Dassa, A., & Amir, D. (2014). The role of singing familiar songs in encouraging conversation among people with middle to late stage Alzheimer’s disease.                Journal of Music Therapy, 51(2), 131-153. doi: 10.1093/jmt/thu007.

Sacks, O. (2008). Musicophilia – Tales of music and the brain. New York: Alfred A. Knopf.

Tomaino, C. (2002). The role of music in the rehabilitation of persons with neurologic diseases. Music Therapy Today (online). Retrieved from  http://www.wfmt.info/Musictherapyworld

WHAT'S IT LIKE BEING A HARMONY KIDS MUSIC TEACHER?

What’s it like being a Harmony Kids music teacher?

 I have worked for Therabeat Inc. since March 2012. My first job as a Therabeat Inc. employee was a Kindermusik educator. I was so excited to begin this part of my job as I had completed my Kindermusik educator training the previous summer. I was so anxious to teach my first class. I had so many notes and had written out exactly what I wanted to say. I was so nervous because I wanted each family to know just how important music is to the development of their child. I am so passionate about music therapy and the benefits of music for the brain. I prayed that I could be that vessel for each parent to learn how to best help their child develop a love for music. Music has always been my saving grace. I have been apart of music for as long as I can remember. It was always apart of me. It was what I turned to when I felt alone and when I felt joyful. I long each and every day to share just a glimpse of that passion with the families and children I serve.

 In June 2014, Therabeat Inc. moved to teaching Harmony Kids music classes. This seemed like a perfect fit, because as a music therapist we understand how to develop curriculum. We know how to design each session to fit the needs of the children, socially, emotionally, and physically. The sessions are developed to incorporate the levels of play and to target the age appropriate development for each child. It has been an incredible blessing and the highlight of my week to see kids return each week to class. They run down the hall, bursting with energy and relationships have formed. Families have become friends and the children have become friends. There is a routine and sense of predictability in the sessions. I love when families show me videos of their child singing the songs at home and in their daily life. Children are forming lasting memories and they are doing it with music!

 I highly recommend Harmony Kids music classes! Music is a wonderful medium to promote joy, relationships, and physical well-being. I hope to see you in a class this semester!

 Chelsea Kinsler LPMT, MT-BC 

Incorporating Music Therapy research with Cerebral Palsy into Physical Therapy/Music Therapy co-treats.

Incorporating Music Therapy research with Cerebral Palsy into Physical Therapy/Music Therapy co-treats.

               Over the past few weeks, I’ve had the amazing opportunity to work with and get to know this awesome guy with cerebral palsy at the clinic. I look forward to these sessions with him, because they are co-treats—physical therapy and music therapy working together to help him reach his goal of walking independently. When it came time for me to start treating in this setting, I was a bit apprehensive, because I didn’t know what to look for or how to plan to incorporate physical therapy into a session. So, that meant it was time for me to do some research in the good ol’ Journal of Music Therapy (and also go back and read some of my Anatomy text book J).

               This proved to be very helpful in acclimating myself to the type of therapy being done in the co-treat, and to some helpful tips that I could use in planning effective interventions. The first article I found was “Music and Rhythmic Stimuli in the Rehabilitation of Gait Disorders.” This article helped me understand the types of interventions being done to facilitate walking from a neurological standpoint. The researchers find in their experiment that significant improvements were made in the participants’ walking with an even and steady gait when they walked to rhythmic stimuli. By matching the tempo of the music with their steps, their brains were able to internalize and entrain the beat of the music to each step, facilitating an even gait. The participants were even able to keep their improved steady gait when the music was taken away by hearing the beat in their head (Staum, 1983). This is exactly what we are working on with our client in the co-treat. I strum the guitar at a steady walking tempo while singing (we always use the same song to ensure that the beat is “stuck in his head”) and the PT facilitates him and steadies him while he is walking. This is an awesome thing to be a part of! I can tell when our client is really hearing the music in his head—he gets such a focused and grounded look and his steps fall with steadiness and ease. I can also see whenever he loses focus, which brings me to the next helpful article I found to incorporate into the co-treat.

               Whenever this awesome guy loses focus, his head will drop or his posture will droop. I decided to incorporate the use of music as reinforcement for this behavior—this idea is found in “The Effect of Automated Interrupted Music on Head Posturing of Cerebral Palsied Individuals.” It is simple—whenever undesirable posture is observed, the music is stopped, then the music resumes whenever posture is corrected (Wolfe, 1980). I’ve found that this works really nicely! By stopping the music, our client can immediately correct his posture, and refocus himself on the walking to the beat of the music.

               These interventions have made a huge difference in walking independently for this amazing dude!! It is so amazing how rhythm works to synchronize our movements with our brains. He is gaining so much confidence and walking with so much “swagger” J J

Staum, M.J. (1983). Music and Rhythmic Stimuli in the Rehabilitation of Gait

               Disorders. Journal of Music Therapy, 20(2), 69-87. doi: 10.1093/jmt/20.2.69.

 Wolfe, D.E. (1980). The Effect of Automated Interrupted Music on Head Posturing of

               Cerebral Palsied Individuals. Journal of Music Therapy, 17(4), 184-206.

               doi: 10.1093/jmt/17.4.184.

-Posted by Perry Wright (Music Therapy Intern) on 7/13/15