autism, music, music therapy, music therapy for autism, musical stories, neurologic music therapy, singing, special needs

Creating a musical story for ASD

The idea of a musical story for ASD was inspired by social stories that are being used with more and more frequency within the ASD world. Carol Grey officially created Social Stories in 1990 after working with a team of incredible parents, professionals, and students for many years. One of Grey’s first stories was a step-by-step story that described how to follow and complete directions in a sewing pattern.  We were creating a curriculum that would enable us to teach from a distance, one story and social packet at a time. Grey provides an in depth example while writing about a student named Eric in The Discovery of Social Stories (1990-1992).

The three principles of the Social Story philosophy that guide the development of each Story.

  1. Abandon all assumptions.
  2. Recognize that the social impairment in autism is shared, with mistakes made on all sides of the social equation.
  3. When Typical people interact with people with autism, both perspectives are equally valid and deserving of respect.

While embracing the practice of taking the unique perspectives of ourselves and those with whom we are working into account, a musical story also embraces the impact of music upon the brain. An article published in Autism Research revealed that “functional fronto-temporal connectivity, disrupted during spoken-word perception, was preserved during sung-word listening in ASD, suggesting alternate mechanisms of speech and music processing in ASD.” If you’re a visual learner, the images in this article, particularly the one on page 6, may give you a better idea of these implications. According to this research, singing rather than speaking, enhances neural activity.

At Music Therapy Services of Portland, we want to coach parents, caretakers and allied health professionals working with ASD on how to create a musical story. Our workshop will walk you through the process of creating a social story from your child’s perspective.

We will take you through the three primary steps involved in creating a musical story. Come with a challenge in mind that you’d like to help your child overcome through a musical story. Some examples for inspiration:

  • Going to the bathroom independently
  • Eating lunch at school
  • Taking a shower
  • Getting dressed in the morning
  • Getting ready for bed

Eventbrite - Workshop: Creating Musical Stories for ASD

The next workshop is on March 15th from 6-8pm for $25. Register here or contact us with any questions: angie@musictherapyportland.com, 971-221-7144. We are offering 20% off for a group of 3 or more. Please contact us for the discount code.


Angie Kopshy, MM, MT-BC
Angie Kopshy, MM, MT-BC

Angie Kopshy, MM, MT-BC, is a board-certified music therapist and founder of Big Sky Music Therapy. Upon completion of her Master’s in Music from Boise State University, Angie returned to Portland to study music therapy. Before moving to Montana, her work included a private practice that incorporated neurologic music therapy techniques, the supervision of practicum students and interns and a teaching position at Pacific University. Angie is also a singer/songwriter with the band, Stoneface Honey.

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music therapy, music therapy for autism, special needs

Improvisational music therapy for ASD

There’s an extremely well written article recently published in the Journal of Music Therapy entitled Common Characteristics of Improvisational Approaches in Music Therapy for Children with Autism Spectrum Disorder.  The article defines the ways in which improvisational music therapy (IMT) can be used with ASD and explains many of the rationales and motives behind the actions of a music therapist. I strongly recommend that practitioners, families and caretakers read this article and wanted to highlight some of the key elements with which Music Therapy Services of Portland resonates and strives to implement these methodologies. Please see endnotes for the many resources used within this article.

IMT employs improvising as a primary therapeutic experience where the client and therapist spontaneously create music using singing, playing, and movement (Bruscia, 2014). IMT is described as a procedure of intervention that makes use of the potential for social engagement and expression of emotions occurring through improvisational music making (Geretsegger, Holck, & Gold, 2012). Improvised music can be made to be very predictable, containing repetitions at different levels while at the same time providing “controlled” flexibility in the form of variations in melody, harmony, rhythm, phrasing, or dynamics (Wigram, 2004; Wigram & Elefant, 2009).

Targeted areas of interventions for individuals with ASD include: 

  • imitation (e.g., Hobson & Hobson, 2008; Landa, 2007)
  • joint attention (Leekam, López, & Moore, 2000)
  • reciprocity (Landa, 2007)
  • affective sharing (Wetherby et al., 2004)
  • initiation of interaction (Landa, 2007; Landa, Holman, & Garrett-Mayer, 2007).

These interventions share characteristics such as:

  • following the child’s lead
  • encouraging initiations from the child
  • responding to all types of communicative behavior as if it was purposeful
  • focusing on emotional expression
  • adjusting any language and social input to the child’s developmental stage and attentional focus (Ingersoll et al., 2005).

Within this IMT framework, a child-centered approach is incorporated in which active, spontaneous music making enhances the relationship between the child and therapist. The therapist generally follows the child’s focus of attention, behaviors, and interests to facilitate growth in the child’s social communicative skills and promote development in other areas of need, such as awareness and attention, sense of self, or self-efficacy (Bruscia, 1998; Kim, 2006; Kim, Wigram, & Gold, 2008, 2009; Wigram, 2002).

Involving parents/caregivers in the process can support both children and parents in building interactions with one another and facilitating the generalization of therapy outcomes into the child’s and caregivers’ everyday life (Oldfield, 2006; Warwick, 1995). This involvement may include family members directly in therapy sessions (Thompson, McFerran, & Gold, 2013), describing the activities to parents upon completion of the sessions, or even recording the sessions and inviting the family to watch the sessions at home together. 

References

Geretsegger, M., Holck, U., Carpente, J., Elefant, C., Kim, J., Gold, C. (2015). Common Characteristics of Improvisational Approaches in Music Therapy for Children with Autism Spectrum Disorder: Developing Treatment Guidelines.  Journal of Music Therapy, 52(2), 258–281 doi:10.1093/jmt/thv005

Accordino, R., Comer, R. & Heller, W. B. (2007). Searching for music’s potential: A critical examination of research on music therapy with individuals with autism. Research in Autism Spectrum Disorders, 1, 101–115. doi:10.1016/j. rasd.2006.08.002

Bruscia, K. E. (1998). Defining music therapy (2nd ed.). Gilsum, NH: Barcelona Publishers.

Bruscia, K. E. (2014). Defining music therapy (3rd ed.). Gilsum, NH: Barcelona Publishers.

Geretsegger, M., Holck, U., & Gold, C. (2012). Randomised controlled trial of improvisational music therapy’s effectiveness for children with autism spectrum disorders (TIME-A): Study protocol. BMC Pediatrics, 12(2). doi:10.1186/1471-2431-12-2

Gold, C., Wigram, T., & Voracek, M. (2007). Predictors of change in music therapy with children and adolescents: The role of therapeutic techniques. Psychology and Psychotherapy: Theory, Research, and Practice, 80(4), 577–589.

Hobson, R. P., & Hobson, J. A. (2008). Dissociable aspects of imitation: A study in autism. Journal of Experimental Child Psychology, 101, 170–185. doi:10.1016/j. jecp.2008.04.007
Ingersoll, B., Dvortcsak, A., Whalen, C., & Sikora, D. (2005). The effects of a developmental, social-pragmatic language intervention on rate of expressive language production in young children with autistic spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20, 213–222. doi:10.1177/1088357605020004 0301

Kim, J. (2006). The effects of improvisational music therapy on joint attention behaviours in children with autistic spectrum disorder (PhD thesis, Aalborg University).

Kim, J., Wigram, T., & Gold, C. (2008). The effects of improvisational music therapy on joint attention behaviors in autistic children: A randomized controlled study. Journal of Autism and Developmental Disorders, 38, 1758–1766. doi:10.1007/ s10803-008-0566-6

Kim, J., Wigram, T., & Gold, C. (2009). Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy. Autism, 13, 389–409. doi:10.1177/1362361309105660

Landa, R. (2007). Early communication development and intervention for children with autism. Mental Retardation and Developmental Disabilities Research Reviews, 13, 16–25. doi:10.1002/mrdd.20134

Landa, R. J., Holman, K. C., & Garrett-Mayer, E. (2007). Social and communication development in toddlers with early and later diagnosis of autism spectrum disorders. Archives of General Psychiatry, 64, 853–864. doi:10.1001/ archpsyc.64.7.853

Leekam, S. R., López, B., & Moore, C. (2000). Attention and joint attention in preschool children with autism. Developmental Psychology, 36, 261–273. doi:10.1037/0012-1649.36.2.261
Oldfield, A. (2006). Interactive music therapy—A positive approach: Music therapy at a child development centre. London: Jessica Kingsley.

Thompson, G. A., McFerran, K. S., & Gold, C. (2013). Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: A randomized controlled study. Child: Care, Health, and Development, 40(6), 840–852.

Warwick, A. (1995). Music therapy in the education service: Research with autistic children and their mothers. In T. Wigram, B. Saperston, & R. West (Eds.), The art and science of music therapy: A handbook (pp. 209–225). Oxford: Routledge.

Wetherby, A. M., Woods, J., Allen, L., Cleary, J., Dickinson, H., & Lord, C. (2004). Early indicators of autism spectrum disorders in the second year of life. Journal of Autism and Developmental Disorders, 34, 473–493. doi:10.1007/s10803-004-2544-y

Wigram, T. (2002). Indications in music therapy: Evidence from assessment that can identify the expectations of music therapy as a treatment for autistic spectrum disorder (ASD): Meeting the challenge of evidence-based practice. British Journal of Music Therapy, 16, 11–28.

Wigram, T. (2004). Improvisation: Methods and techniques for music therapy clinicians, educators, and students. London: Jessica Kingsley.

Wigram, T., & Elefant, C. (2009). Therapeutic dialogues in music: Nurturing musi- cality of communication in children with autistic spectrum disorder and Rett syndrome. In S. Malloch & C. Trevarthen (Eds.), Communicative musicality (pp. 423–446). Oxford: Oxford University Press.

autism, music therapy, music therapy group

How sensory integration plays into music therapy groups

At Music Therapy Services of Portland, we love facilitating small groups. The art of creating an ideal music therapy group for children diagnosed on the autism spectrum is a challenge that involves the help of parents, caretakers, and allied health professionals. One of the most important elements that we take into consideration is sensory processing. Linn Wakeford’s chapter in Early Childhood Music Therapy and Autism Spectrum Disorders explains that researchers have categorized sensory processing into three primary patterns:

  • Hypo-responsiveness (under responsiveness)
  • Hyper-responsiveness (overly responsive)
  • Sensory seeking behaviors

Many children are a mix of some hyper-responsive patterns and other hypo-responsive patterns. The sensory systems include: auditory, visual, olfactory, tactile, gustatory, vestibular, and proprioceptive.

As a music therapist, being aware of the sensory systems of each individual in a group is critical and impacts the instruments and interventions I utilize.  So how can parents help their child end up in the most appropriate music therapy group? Consider how your child responds to each of these musical elements:

  • Intensity – Does she prefer loud or soft sounds?
  • Frequency – Does he want the same sound over and over again or new sounds?
  • Duration – How long does she enjoy the sensation?
  • Rhythm – Does he enjoy rhythmic predictability or more variation and unpredictability?
  • Novelty – Does she respond aversively to change and newness?
  • Complexity – Does he enjoy multiple sensations within music like an orchestra or minimal instruments like only voice or guitar?

Many sensory processing theories incorporate adaptations and modifications that are much easier to address in a one-to-one setting. The children who are able to receive both individual and group music therapy sessions are certainly at an advantage because we are able to learn and address their sensory needs better. But even new children can succeed within a group when communication with parents and caretakers is incorporated. Our ultimate objective is to minimize the influence of sensory processing differences at all times.

Share what you notice about your child’s response to music by calling, sending an email, or completing our survey. If you’re a returning family, we invite you to resubmit our survey or provide us with any additional information you’ve observed or received from allied health professionals. Help us make your child’s music therapy group experience as beneficial as possible!

For those of you facilitating groups or individual sessions, consider the following:

  • The lighting
  • The temperature
  • Noises such as cars, the air conditioner, people talking
  • Do the kids need movement, deep pressure, or a familiar songs at a slow and steady tempo?
  • Can you have the child who is up and moving around be an assistant while the child under the blanket plays with the cabasa?

If a child gets up, walks to the corner, and comes back, they may be practicing self regulation. If they’re hiding under a blanket, they may be coping with their sensory needs. Ask yourself whether these actions are important or if you can work around them and possibly address these issues down the road. Otherwise, is there a way to meet these different needs within the various interventions of your group session?  We will address these questions more in an upcoming blog explaining the iso-principal approach during music therapy sessions.

Meanwhile, here are two additional video resources – the first is more for parents and the second is one you can watch with your child:

A detailed video by Chirp on sensory processing needs and strategies.

A Child’s View of Sensory Processing

Angie Kopshy, MM, MT-BC
Angie Kopshy, MM, MT-BC

Music Therapy Services of Portland is directed by board-certified music therapist, Angie Kopshy. Upon completion of her Master’s in Music from Boise State University, Angie returned to Portland to study music therapy at Marylhurst University. Music Therapy Services of Portland specializes on working with children on the autism spectrum. Angie is also a singer/songwriter with the band, Stoneface Honey.