Music Therapy & ASD

The month of April is Autism Awareness month, so it is the perfect time to bring awareness of the impact music therapy can have on individuals with autism spectrum disorder (ASD). The Center for Disease Control reported in 2021 that 1 in every 44 children is diagnosed with ASD in the United States (Autism Speaks Inc., 2022). ASD is a developmental disorder that affects the nervous system and is based on impairments mainly in social interaction, communication, and repetitive behaviors (Thompson, 2012). Symptoms vary widely and can include developmental, behavioral, cognitive, psychological, and mental health symptoms. Music therapy has been identified as an effective treatment approach for social interaction, verbal communication, and socioemotional reciprocity (LaGasse, 2017). 

One of the main reasons that music therapy has been so effective as a treatment approach for individuals with ASD is because music is naturally present in many homes and often involves social settings whether intended or not (Thompson, 2012). For example: music may already be present in the home through a parent singing a lullaby to their child, music being played over a speaker, or family members playing live music through instruments and voice. Even when it is not as present in the home, it is often viewed as a fun, safe, and structured way to help individuals feel more secure in social engagements (LaGasse, 2017). There have been many studies that noted that people with ASD also have a unique attraction to musical stimuli and often have a more enhanced musical ability even without much musical training (LaGasse, 2017). 

Not only is music fun and naturally present, but it can activate neural networks in the brain to help synchronize neural firings, especially between similar functions such as singing and speaking, making it easier to generalize to a nonmusical context (LaGasse, 2017). Many individuals with ASD have the neural firings but lack the organization and structure leading to incongruent sensory information (LaGrasse, 2017). The rhythmic structure of music can function as a cue to help organize the neural firings to better predict and respond in social settings. Similarly the neural organization can aid in cueing things like turn taking or impulse control (LaGrasse, 2017). Something as simple as singing a consistent hello song can help aid an individual in pragmatic reciprocal communication to engage in greetings such as saying “hello,” “goodbye,” and asking or answering questions like “How are you feeling today?” 

Another huge benefit of music therapy for individuals with ASD is that it is individualized to the person, which means that the therapist can address all levels of ASD, focusing on specific areas of need (LaGrasse, 2017). Though many therapeutic approaches are individualized to some degree, music therapy is highly individualized. Music therapists are trained to create treatment plans based on thorough assessments that are adapted to the individual needs with interventions that use client preferred music. They can be used with people of all socioeconomic backgrounds, cultures, and ages and can be used in schools, homes, clinics, or medical settings (LaGrasse, 2017). According to Thompson, the more natural the therapeutic environment, such as a school or a home, the more effective the therapy is for kids with ASD which is more attainable for music therapists than most other types of therapists (2012). Fuller and McLeod went a step further in their research and discovered that there were higher levels of engagement and socialization from clients with ASD when they were using telehealth as the therapeutic modality (2019). It is also believed that better learning takes place in daily routines such as those that take place in a home or natural setting (Thompson, 2012).

Music therapy can have positive effects on social skills by increasing the ability to engage in greetings, joint attention, social interactions, as well as cognitive social skills (LaGrasse, 2017). Music therapy is not the only effective therapeutic approach to help people with ASD increase social skills and communication, but it is certainly one that can be fun, in a natural setting, and broadly generalized to nonmusical contexts. It can also incorporate the parents or family by taking place in those natural environments, such as the home, building the attachment bond with family members which ultimately increases support and confidence in safe and familiar relationships (Thompson, 2012).

-Charlotte Reeder, Music Therapy Intern

References

Autism Speaks Inc. (2022). Autism statistics and facts. Autism Speaks. Retrieved April 25, 2022, from https://www.autismspeaks.org/autism-statistics-asd

Fuller, A. H., and McLeod, R. G. (2019). The connected music therapy teleintervention approach (CoMTTA) and its application to family-centered programs for young children with hearing loss. Australian Journal of Music Therapy 30, 13-30. 

LaGasse, A. B., (2017). Social outcomes in children with autism spectrum disorder: A review of music therapy outcomes. Patient Related Outcome Measures, 8, 23-32.

Thompson, G. (2012). Family-centered music therapy in the home environment: Promoting interpersonal engagement between children with autism spectrum disorder and their parents. Music Therapy Perspectives, 30(2), 109-116.

the effects of music therapy on Pediatric Patients with Preoperative Anxiety

Preoperative anxiety is a common experience in patients who are receiving a surgical procedure.  Preoperative anxiety is a feeling of intense uneasiness due to a lack of understanding, control, inability to communicate feelings, as well as past negative medical experiences (Gooding & Millett, 2017). This can lead to many adverse effects psychologically as well as physically. While preoperative anxiety is experienced by all ages, 75% of children are especially susceptible to these feelings of distress before an operation (Billick & Fronk, 2020). Young children typically reveal their anxiety differently from adults with behaviors such as trembling, restlessness, crying, or being silent due to the inability to verbalize their concerns or communicate effectively because they are distressed (Getahun et al., 2020). These adverse effects can lead to complications during procedures, as well as have negative long-term effects on the child. Children who experience high levels of preoperative anxiety have a greater risk of injuring themselves by trying to take control, such as accidently ripping out an IV. In addition, preoperative anxiety has also been linked to negative long-term effects such as separation anxiety, tantrums, nightmares, and bedwetting up to 12 months after a surgical procedure (Gooding & Millet, 2017).

There are multiple methods in aiding a child who is experiencing preoperative anxiety, which can be broken down into pharmacological and non-pharmacological methods (Gooding & Millet, 2017). Sedatives are a commonly used pharmacological method to ease preoperative anxiety. One of the most popular medications used for preoperative anxiety is the benzodiazepine midazolam because of its fast-acting effects and its significant reduction of nausea in patients. However, midazolam has also been linked to negative post-operative effects on behavior, cognition, and mental state (Billick & Fronk, 2020). Along with pharmacological methods being linked with adverse effects post-operation, pharmacological methods tend to be costly (Gooding & Millet, 2017). 

Music therapy is a non-pharmacological method that has been proven to be an excellent alternative to medication (Montgomery, 2016). Research has indicated that music can help individuals process emotions, and positively increase their emotional wellbeing (Montgomery, 2016). Scientific research has verified that music releases chemicals and hormones such as dopamine and endorphins within the brain. Dopamine is linked to an individual’s reward system and gives a sense of pleasure, while hormones such as endorphins also release a feeling of euphoria as well as being a known pain reliever. The release of these hormones has been shown to reduce feelings of anxiety in most individuals (Montgomery 2016). Additionally, music can also impact a person’s physical state. Scientific evidence shows that music can manipulate a person’s heart rate as well as blood pressure (Montgomery 2016). The ability to slow heart rate and lower blood pressure can lead to a calming effect on pediatric patients experiencing high levels of distress. 

Due to music’s power over the brain and body, a board-certified music therapist who has been trained to use music to manipulate these factors can greatly impact the level of preoperative anxiety experienced before surgery. According to Gooding & Millet, their research found that music therapy reduced preoperative anxiety in pediatric patients as well as their caregiver (2020). The researchers also found that none of the participants within the study showed negative post-operative outcomes unlike studies using pharmacological means (Gooding & Millet, 2020). Although there needs to be further research about music therapy and its direct effects on preoperative anxiety, research points to it being a viable alternative to medications. 

References

Fronk, E., & Billick, S. B. (2020). Pre-operative anxiety in pediatric surgery patients: Multiple case study analysis with literature review. Psychiatric Quarterly, 91(4), 1439–1451. https://doi.org/10.1007/s11126-020-09780-z

Getahun, A. B., Endalew, N. S., Mersha, A. T., & Admass, B. A. (2020). Magnitude and factors associated with preoperative anxiety among pediatric patients: Cross-sectional study. Pediatric health, medicine and therapeutics, 11, 485–494. https://doi.org/10.2147/PHMT.S288077

Millett, C. R., & Gooding, L. F. (2017). Comparing active and passive distraction-based music therapy interventions on preoperative anxiety in pediatric patients and their caregivers. Journal of Music Therapy, 54(4), 460–478. https://doi.org/10.1093/jmt/thx014 

Montgomery, E. (2016, November 1). The Science of Music therapy. Peterson Family Foundation. Retrieved February 6, 2022, from https://petersonfamilyfoundation.org/music-therapy/science-music-therapy/ 

Welcome, Charlotte!

Hello! I’m Charlotte Reeder and I am so excited to be interning here at Therabeat, Inc. I have loved music my whole life and knew I wanted to pursue music as a career but I was not sure what I wanted to do with music long term. When I was diagnosed with type 1 diabetes at age 11, I knew quickly that I wanted to work in the helping profession. I started researching career ideas in music and came across music therapy and have had my heart set on it ever since! I studied music at Covenant College where I focused primarily on percussion and piano. After graduating in 2016 I started teaching piano lessons while trying to decide what my next step was going to be. Two years later I started graduate school for clinical mental health counseling at Richmont Graduate University in Chattanooga, TN, where I was hoping I could somehow morph the music degree with the counseling degree to start doing music therapy work. In my last year at Richmont, I started the new music therapy equivalency program at the University of Tennessee at Chattanooga and realized quickly that music therapy was the perfect fit for my skills and interests.

I have completed all of my class work and now only have my internship left to complete. Though I have only been here at Therabeat for a week and a half, I have already seen the rich blessings that music therapy can provide for clients from the work of many skilled therapists in the field. I am so excited to learn from each of the music therapists and to grow in my knowledge, experience, empathy, and musicianship. I really feel blessed to be in this internship placement and am so incredibly thankful for the time I have here to gain experience as a music therapist. 

Some of my favorite things include spending time with my husband, hanging out with my friends, cooking, hiking, playing board games or card games, doing puzzles, making crafts, watching movies, going to concerts, making music, and traveling.

-Charlotte Reeder, Music Therapy Intern

Welcome, Reed!

My name is Reed Tanner, and I am so blessed to be given the opportunity to be an intern at Therabeat! Ever since I can remember, I have had a passion for two things, helping others and music. I am originally from Carrollton, GA, and went to the University of West Georgia, majoring in music education until I heard about music therapy. As soon as I started learning about this field, I knew I had to be a music therapist someday. I decided to move to Milledgeville, Ga, and begin working on my degree in Music Therapy at Georgia College & State University. My primary instrument is saxophone, but I also love singing, guitar, and playing the piano. I will be graduating from GCSU in the Fall of 2022!

            GCSU allowed me the opportunity to work with a variety of diverse populations. One of my favorite experiences was working in a first-grade class with seven children between the ages of six and eight. I was immediately drawn to kids and loved to see them grow and accomplish their goals. Along with this, I loved sharing my passion for music. I also enjoyed working with the older adult population and seeing how powerful music can be for memory and emotional needs. Unfortunately, due to the pandemic, I was only able to work with children in person for two semesters before I had to start working with children through telehealth. Although this was a great experience, and I learned a great deal about conducting sessions remotely, I knew that working with kids in person was one of my best experiences. I spent the last couple of years working with assisted living and memory care populations, and although I loved working with the older adult population, I knew children were my passion. 

            I first heard about Therabeat from my friend Amanda Brennen, who was also a music therapy student at GCSU. When she received an internship position at Therabeat, I decided to follow them on Facebook, and immediately was interested. Not only did I see the sweetest kids accomplishing their goals, but also phenomenal music therapists. After seeing a couple of videos, I realized that I wanted to do what they were doing. After talking with Amanda about her internship, I realized that Therabeat not only did music therapy, but co-treated with occupational therapy, physical therapy, and speech therapy. The various therapies were another reason I knew Therabeat was the internship I wanted and needed. Through learning about different therapies, as well as how music therapy enhances them, I can only get better.  I am very excited to start learning from the incredible team at Therabeat and strive to be as knowledgeable and successful in my discipline as they are.

            During my first week at Therabeat, I was nervous and had no idea what to expect. From the first day, I was immediately accepted by the entire team. Everyone was so nice, and the music therapists are so knowledgeable and helpful. I knew from the first day that I would learn so much from them. I would have to say the best part about the first week has been the kids! This first week has reminded me that I am still learning how to be who I want to be, and it will not come right away. Along with this, the concept of flexibility was solidified. Most of the time, things do not go as planned, and that is okay. I cannot wait to continue learning and growing as a person, and as a music therapy intern for the next six months at Therabeat! 

Until next time!

-Reed Tanner, Music Therapy Intern

Kathryn Trujillo’s Internship Reflection

How it started:

I first became interested in the Music Therapy (MT) field when my maternal grandmother moved to assisted living in 2015. With my small electric keyboard and guitar in hand, I visited her when she was moved to hospice care. Not knowing I was providing relief through music, I did see the impact that familiar songs had on her level of agitation and her short-term memory. My nana sang Johnny Cash’s “Ring of Fire” without missing a single word. She was then able to have a brief, cognizant, and presently-oriented conversation with me afterwards. I walked out of the room, and through happy tears, told my husband “this is what I want to do. I want to continue helping others through music.” 

Applying to Therabeat:

During the pandemic, I completed my 2nd year of graduate school and searched online for MT practices that were beginning to open up again for clinical internships. Therabeat, whose mission statement is “We use music therapy interventions to enhance the lives of individuals of all ages & abilities,” truly caught my attention. This private practice, run and owned by women, was breaking glass ceilings in GA and genuinely caring for their community. As I learned more about each MT-BC on staff, my desire to be an intern with Therabeat grew. I am very blessed that my husband, our dog, and I were able to pack up our life in CA and travel  2,500+ miles across the country to work with and learn from Team Therabeat.  

Lessons Learned:

Though Team Therabeat and the internship experience taught me a multitude of lessons, here are two lessons that truly impacted me and my therapeutic practice: 

1. Session plans and ISO-principle
   Before each session, I prepared detailed session plans which included an order and clinical breakdown of each intervention. Though I was prepared and had thought through each intervention purposefully, if the client needed to be met where they were at that particular moment, I leaned into the ISO-principle and provided interventions that would benefit the client most where they were. I have learned to prepare a plan, but to also hold space for flexibility so that I can see through the plan and into the therapeutic moments.

2. Co-treating is such a pleasure!
   My bachelor’s degree from Saint Mary’s College of California, is in Kinesiology with an emphasis on Health and Human Performance. During internship, I expressed interest in wanting to co-treat with Physical Therapy. I had always wanted to see how both of my career interests could work together, and only In Harmony Pediatric Therapy provided me with the opportunity to see both Physical Therapy and MT in action. During one particular session, I worked with a client on independent living skills while the PT walked the client through an obstacle course. Our obstacle course was specifically set up to cue and prompt recognition of each safety sign I was prompting the client to sing and think about. Together we taught the client what signs to look for and what they mean, while also providing tangible and tactile feedback related to each safety sign with a musical and physical prompt. The purpose of the combined intervention was to improve the client’s self-esteem and provide them with a sense of increased independence when outside of the clinic. I hope to continue co-treating and creating unique interventions in the future. 

Thank You Team Therabeat 

Thank you Team Therabeat for investing in me, for trusting the care of clients to me, for providing a safe space to learn and grow in therapeutic practice, and for truly providing a wholesome internship experience. I feel more confident in myself, in my ability to turn feedback into practice, and in the prayerful choice to pursue MT as God has called me to.