Make Music for St. Patrick’s Day

By on March 16, 2010 in For Music Therapists, Older Adults

There are a million ways to get in the Irish spirit this season. Leprechauns, rainbows, and shamrocks are posted in store windows and on community walls. Irish fiddlers are sitting on street corners. Everybody is wearing green socks, shirts, earrings, tattoos. It’s everywhere!

The easiest way to get my older adult clients in the spirit is to bring loads of green shakers, a penny whistle, and a bodhrán.

A penny whistle is a fun, easy instrument that you can carry around in a purse or a guitar case. Bring it to the beach or to the mountains and play it in nature. Or play it with friends. You can make up your own melody or learn some traditional Irish tunes.

The shakers are great for keeping the rhythm of tunes such as When Irish Eyes are Smiling, I’ll Take You Home Again Kathleen, and Cockles and Mussels.

The bodhrán is a traditional Irish frame drum that is commonly used in Irish music today. You can keep the downbeat on your drum with 2,700 other musicians here at the world’s largest Irish music jam session:

Finally, if a green shaker, penny whistle, and bodhrán are too far out of reach, simply turn on some Van Morrison, U2, or Lisa Hannigan and make up your own Irish jig!

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Music Therapy in the NICU: An RN’s Perspective

By on March 11, 2010 in NICU Infants

I recently asked Shelley Frazier, RN, BSN, IBCLC, what she thought about music therapy. She is the Lactation Consultant, Discharge Planner, and Education Coordinator for the Newborn ICU at Tallahassee Memorial Hospital in Florida. Shelley also helps facilitate the National Institute for Infant & Child Medical Music Therapy at Florida State University. The research in NICU music therapy program at Shelley’s hospital has been established since the early 1990s.

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What do you notice that music therapy does for the infants, and what criteria do you use for referrals?

The babies love the music therapy!  We do several different kinds here. They enjoy when we take them out of the isolette and gently touch them and sing softly to them. So often touch in the ICU is harsh and disturbing to the baby. Rolling them over, sticking them for labs, putting nasogastric tubes down their noses. The touch from music therapy is kind, soft and gentle. The babies love it. We also do the music therapy where they suck on a pacifier to turn on the music, and I have found that this is helpful for getting the ready to suck/swallow/and breathe babies ready to eat. They will suck to hear the music and music gives them pleasure and the longer they suck the better it is. It helps to increase their endurance for sucking and in the long run helps them to be ready to feed.

The criteria is not really in hard print. A baby needs to be intermediate care status. In an isolette or open crib. Not having a lot of apneic episodes. Stable on an oxygen source or on room air. Not an irritable BPD baby.  Someone that can benefit from suck endurance. Around 31 weeks gestation or more.

Does music therapy overstimulate infants?

We watch the babies closely for when they are physiologically ready for music therapy. Everything kind of has to fall into place for the individual baby to receive Music Therapy….and stay in place. In other words, a baby can qualify one week, start to feel bad the next week, and we will need to postpone the therapy until later. We really don’t start music therapy until the kids are ready to start getting a bit of stimulation. Music therapy is also a way to teach parents about the right kinds of stimulation for their baby (e.g. gentle though, quiet voices).

How does music therapy change the general NICU environment?

I feel that music therapy is very helpful to the parents as a calming tool, something they can do/ be trained to do with their baby. It is something that they can continue to do at home after the baby is discharged. It can lend some “normalcy” to an otherwise very high tech environment. As for the babies, they love it. They respond well to it, and it can also be a continuation of activities at home. It can lower their heart rate and assist them with becoming accustomed to touch and sound in our world.

How does music therapy change parents’ attitudes, visitations, and/or behaviors in the NICU?

Some parents are very receptive to outsiders working with their babies, and some are not. I do find that a very stubborn difficult parent to an NICU nurse/RT/doctor, can be sweet and kind to the music therapist. The parents can have some control with music therapy. I have found that if you prearrange a time with parents, they love to visit during music time.  A large percentage of our parents are from out of town and have a lower socioeconomic status and are unable to visit frequently, but if they live in town and have a car they will visit during music time.

For more information about NICU music therapy, please see the following posts:

9 Research-based Effects of Music in the NICU
 45 Hospitals around the World that Provide NICU Music Therapy
 Does Music Therapy in the NICU Overstimulate Infants?
 NICU Music Therapy Overview (video)
 Book Review: Bella’s Blessings

Let me know you thoughts, comments, and/or questions about music therapy and babies.

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Personal experiment: Music, art, and dance all day

By on March 9, 2010 in Music & Wellness

In the course of a regular work day, I often have thousands of ideas fly through my head faster than I can remember them. These thoughts are mixed with sporadic episodes of spontaneous music-making, singing, and dancing. Sometimes I like to just “be” and let my thoughts fly far, far away and disappear. When I am just “being,” I like to “be” myself to the core.

Inspired by my authentic movement therapist, Draza Jansky, I decided to dedicate Saturday to making music, painting, dancing, sleeping, and eating the entire day. No internet. Very little phone. I awoke with zero anxiety. Nothing to look back on, nothing to look forward to. I was simply present. When my thoughts wandered to yesterday, or I started to feel anxiety, or I craved the computer, I simply changed something in myself. I shifted from dancing to painting, from eating to playing the guitar, from gazing into the canyon to singing, or from dancing vigorously to swaying slowly. And it worked! Full day meditation. Full body freedom. Literally, I felt a tingle of freedom in my neck that I had never felt before. There were many more effects on my body, but I’ll keep my description short.

Now I’m integrating this new-found sense of freedom into my daily life. One of my teachers says that happiness and joy come first, then the drumming, dancing, and singing come. You drum because you are happy. You cannot pursue happiness through making music. In fact, my teacher says you cannot find happiness at all because happiness has always been here. It has always been now. If you try to go find happiness, you will fail. Happiness originates within us. I regularly experience the idea of here and now bliss in little spurts, so I thought I’d try a whole day.

Words don’t come close to conveying the bliss. And, I don’t remember everything about Saturday because keeping memories was not a priority. Here’s how my day generally went:

Early Morning: Wake up, drink tea, gaze into the canyon, eat cereal, listen to the rain
Late Morning: Paint, paint more, play my original songs on the guitar, paint, walk into the canyon
Early Afternoon: Eat sandwich, drink water, twirl around my house, play guitar and sing, paint
Mid Afternoon: Play piano, drink tea, climb up the walls upside down, smell flowers, paint, nap
Late Afternoon: Get a massage, drink water, eat another sandwich, play guitar, drum
Evening: Dance with my shadows, read a book, go to sleep

You may ask “Didn’t you get bored?” Not at all. I was so fascinated the entire day. I especially enjoy that the moments have come and gone. Next time I make the same music or look at the art that I created, it will be completely different than what was in the moment of creation.

Music & wellness tip today: Drum out of happiness. Do not try to find happiness in the drumming.

What’s it like to spontaneously create for you? What medium do you use (art, music, dance, more…)?

Photo courtesy of Max Vuong.

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There’s No Wrong Way to Play!

By on March 4, 2010 in Older Adults

This article is a copy of my guest blog post on www.MusicAfter50.com (woo hoo!). Here is an excerpt:

This is usually my mantra when facilitating a drum class or music therapy session with older adults. There’s no wrong way to play. You can feel the natural, rhythmic flow to the statement when you say it out loud. There’s no wrong way to play! And the best part is that it’s the truth. In music, dance, and art, there really is no wrong way. Whatever comes out is an extension of yourself. (Leave the judgment and criticism behind during this article.) Truly, as much as we urge people to play the “right” notes, get the “right” rhythm, harmonize on the “right” interval, listen for the “right” chord progression, please be mindful that what’s “right” is relative. As a classically trained pianist with an undergraduate degree in piano performance and music theory, I strongly value what we consider to be “high quality” performance, according to the genre. At the same time, I appreciate another aspect of music, something that goes beyond rules and standards. Something that touches our very core.

Read more…

How have you expressed your rhythm recently? Have you ever felt completely raw and authentic with your music-making? If so, what’s that like for you?

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Does music in the NICU overstimulate infants?

By on March 3, 2010 in NICU Infants

Dr. Jayne Standley explains how, why, and when to use music therapy in the neonatal intensive care unit (NICU) in her book Music Therapy with Premature Infants: Research and Developmental Interventions. But, my blog’s title question comes up often, and understandably so! Especially when the medical goal is to promote baby from the “survival/pacification phase” to the “HOME with family phase” as gently and smoothly as possible. So, the question stands: Does music in the NICU overstimulate infants? When music is used improperly, then the answer is a resounding yes. When a radio program or CD plays continuously for hours at a time over a loud speaker, or when musicians play in a NICU with neither NICU music therapy training, nor knowledge of sound level recommendations, then yes, music can be detrimental to the infants’ neurological development. Also, when an infant is in the survival phase, then he/she is not ready for a developmental treatment such as music therapy.

However, music therapy can be beneficial to an infant who is medically stable, during and beyond the cautious stimulation phase. When the medical team decides that baby is ready for developmental stimulation, the occupational therapists and music therapists cautiously provide sensory stimulation, and document observations of infant behaviors. If baby exhibits any signs of overstimulation, then treatment is paused or terminated, according to the research-based protocol. But when baby is tolerating stimuli, then music therapy is a great way for baby to gain practice self-regulating during multi-modal stimulation (MMS), a common NICU music therapy intervention. Deanna Hanson-Abromeit has shown how music therapy interventions produce similar results to NIDCAP (Newborn Individualized Developmental Care and Assessment Program), a widely used and accepted, research-based program for NICU environment and care delivery. Music therapists work together with the medical staff as part of the team. Check out the list of 35 hospitals that already use music therapy in the NICU. Here are some criteria we use when treating infants in a NICU with music therapy:

  1. Minimum weight of approximately 3 lbs.
  2. Clinical stability
  3. Readiness for developmental stimulation

Additionally, referrals can be based upon any of the following infant needs:

  1. Irritability, agitation, behavioral distress
  2. Sedation, sleep, pain
  3. Self regulation
  4. Respiratory difficulties
  5. Feeding, sucking, weight gain
  6. Parent/family bonding
  7. Lengthy hospitalization

A couple of weeks ago, I wrote an easy-to-read list of NICU music therapy research-based effects. Keep in mind that music is acoustically different than noise. Accumulation of sounds in the NICU consists of machine-generated and human-generated noise. Noise in the NICU is unpredictable, disorganized, unfamiliar, with an extremely wide range of frequencies. Music in the NICU provided by a music therapist who has specialized NICU MT training is predictable, familiar, organized, with form and a very narrow range of frequencies. This quality of sound elicits calm behaviors. NICU music therapists first assess the patient, devise a treatment plan, implement the treatment plan in conjunction with other therapies (e.g. physical, occupational, speech), document patient progress, evaluate, and modify the treatment plan to stay on target with patient goals. Also important to take note is that NICU music therapists use culturally-specific, familiar, live music for baby. (For example, if the baby comes from a Spanish-speaking family, the NICU music therapist will probably include Spanish lullabies in the treatment.) Research shows that infants respond preferentially to their native language.

More on the Academy of Pediatrics sound level recommendations, NICU sound level reporting, and modern NICU design is coming up in a blog post soon. Until then, whether you are a NICU music therapist, healthcare professional, or family member, please leave comments if you have any questions or feedback. I’d love to hear your thoughts!

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