Music Therapy for Children With Learning Disabilities

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Table of Contents

Annotations
Outline and Topic Sentences
Research Paper
References

Annotations

Rose, D., Jones Bartoli, A., & Heaton, P. (2018). Learning a musical instrument can benefit a child with special educational needs. Psychomusicology: Music, Mind, and Brain, 28(2), 71-81. Web.

This mixed methods study explored the effect of music learning on the IQ score, motor skills, and socio-emotional performance of a child with comorbidities – autism, ADHD, and dyslexia – compared to 38 typically developing learners. The subjects received music lessons (playing tenor horn) of up to three hours weekly at both school and home. Posttest results (after one year) indicated significant improvements in musical aptitude and IQ from the baseline. These findings suggest a positive impact of flexible instructional strategies, coupled with family support, on the learning outcomes of children with learning comorbidities. This source will be included in optimal testing and teaching methods for music education for learners with learning disabilities. I would want to compare the efficacy of different musical instruments or genres in improving IQ, motor skills, and socio-emotional outcomes in such children.

Crawford, M. J., Gold, C., Odell-Miller, H., Thana, L., Faber, S., Assmus, J., Bieleninik, Ł., Geretsegger, M., Grant, C., Maratos, A., Sandford, S., Claringbold, A., McConachie, H., Maskey, M., Mössler, K. A., Ramchandani, P., & Hassiotis, A. (2017). International multicentre randomised controlled trial of improvisational music therapy for children with autism spectrum disorder: TIME-A study. Health Technology Assessment, 21(59), 1-40. Web.

This randomized control trial study investigated the impact of improvisational music therapy (IMT) on the social skills of children with autism spectrum disorder (ASD). Enhanced standard care (ESC) – an hour-long sessions of counsel and guidance – was given to learners aged 4-7 years diagnosed with ASD and their parents randomized into low (one ESC period weekly) and high treatment (three ESCs weekly). No significant improvements were found between the two groups in social affect and responsiveness scores from the baseline, compared to standard care after a 5-month follow-up (Crawford et al., 2017). I will include this source in designing music therapy delivery for children with learning disabilities but will explore two key improvements: more regular sessions and individualized support.

Colbert, T., & Bent, C. (Eds.). (2018). Working across modalities in the arts therapies: Creative collaborations. Routledge.

This book gives in-depth insights into working collaboratively using creative art therapies, including music, as an intervention for children and adults affected by homelessness. It features Syrian refugee children with anorexia, and the positive effect of music therapy and dance on their mental health outcomes. Throughout its 13 chapters, the book documents therapeutic stories and collaboration examples that could be useful in designing effective partnerships with other practitioners in joint client interventions. It will be a valuable resource as evidence for the efficacy of collaborative clinical work to meet the needs of children with learning disabilities. An idea that will be developed in this project includes possible collaborative approaches (including with non-health allied professionals, such as music instructors and speech-language pathologist) that can be used with autistic children.

American Music Therapy Association. (2021). Fact sheet: Music therapy and autism spectrum disorder (ASD). Web.

This site provides the DSM-5 criteria for ASD diagnosis, rationales for music therapy for autistic individuals, and the evidence base for the intervention. The position held is that music therapy supports learning in people with ASD through sensory stimulation, eliciting consistent, structured, and predictable responses. Thus, it is an evidence-based intervention for promoting the development of cognitive, behavioral, and socio-emotional skills. This resource will be used for defining music therapy and demonstrating its significance to autistic children. A new idea that I would want to explore further is comparing intervention outcomes between autistic savants displaying exceptional musical ability and amateurs.

Johnston, D., Egermann, H., & Kearney, G. (2018). Innovative computer technology in music-based interventions for individuals with autism moving beyond traditional interactive music therapy techniques. Cogent Psychology, 5(1), 1-10. Web.

This review includes the evidence supporting music therapy as an effective strategy for promoting auditory, communication, and socio-emotional progression in children with ASD. The article examines the additional benefits of music therapy delivered via digital technology over traditional acoustic instruments. Innovative mobile devices and multi-sensory systems, such as virtual and augmented reality, are shown to achieve better language, communication, and socio-emotional and behavioral development outcomes in autistic children than a guitar, piano, or other musical instruments. This resource will be useful for developing music therapy accessible to autistic children in their homes. A new question that will be explored further is if the new technology can be used to deliver the intervention in a group setting.

Kern, P., & Humpal, M. (Eds.). (2019). Early childhood music therapy and autism spectrum disorder: Supporting children and their families. Jessica Kingsley Publishers.

The book gives the latest DSM-V criteria for diagnosing ASD – the most prevalent learning disability in childhood. The levels of ASD symptomatology are described to inform the provision of appropriate music therapy based on need. Further, guidelines on how to develop and implement evidence-based interventions are provided for therapists. Of particular interest to me were the evaluation methods in music therapy in chapter 4. The assessment tools (Four-Step Assessment and SCERTS) adaptable to ASD client needs are provided according to age and population (Kern & Humpal, 2019). I will use these instruments to evaluate the efficacy and validity of music therapy for children with ASD and explore if these tools can work with other learning difficulties.

Outline and Topic Sentences

Outline

Learning disabilities in children and their characteristics
Effective music therapy interventions
Neurological benefits of music therapy
Multidisciplinary team and family involvement
Assessment methods
Conclusion

Topic sentences

Learning disabilities (LD) encompass diverse deficits in language, speech, emotions, or perceptions that impact academic outcomes in children.
Different interactive music therapy methods can help address behavioral and socio-emotional deficits.
Flexible delivery methods and involvement of parents or siblings are critical factors in designing an effective music therapy for ASD children.
Maximum participation in music training for children with LD can contribute to cognitive progression that positively impacts language and emotional domains.
Collaborative clinical work is a fundamental aspect of effective music therapy for children with LDs.
Clinical assessment is critical to develop therapeutic goals and meet client-specific needs.
In conclusion, effectively designed music therapy intervention can alleviate cognitive impairments that cause learning difficulties in children.

Research Paper

Learning disabilities (LD) encompass diverse deficits in language, speech, emotions, or perceptions that impact academic outcomes in children. They include heterogeneous diagnosable conditions such as ASD, attention deficit hyperactivity disorder, dyscalculia, and dyslexia that lead to academic underachievement in children (Rose et al., 2018). LDs may not be detected until a child joins school and is engaged in cognitive tasks. The developmental areas mostly affected include cognition, speech (speaking ability), motor ability, and socio-emotional domains. The underlying reasons for LDs relate to sensory processing dysfunction that is predominant in ASD compared to other learning disabilities. ASDs manifest as impaired socio-emotional development, communication, and repetitive behaviors (Crawford et al., 2017). In general, children with ASD exhibit challenges in different domains, including tactile, auditory, and perceptual aspects. According to the American Music Therapy Association (2021), the abnormal sensory processing triggers maladaptive self-regulatory behaviors, including wailing or covering the ears in response to sound stimuli. Thus, sound sensitivity is a major factor in ASD symptomatology that can be aggravated through exposure to challenging acoustic environments. Early intervention is critical to improve learning outcomes due to high brain plasticity during childhood (Johnston et al., 2018). Effective therapies in this period can promote the development of neural networks involved in socio-emotional and language behaviors.

Different interactive music therapy methods can help address behavioral and socio-emotional deficits. It is defined as a proactive, evidence-based practice utilizing music interventions to meet personalized goals in a therapeutic context that involves a qualified professional (American Music Therapy Association, 2021). The aim is to promote social, language, motor, emotional, and cognitive performance for children with ASD. Music therapy often involves integrated activities targeting specific client needs. Extensive evidence supports using music to improve language, social, emotional, psychomotor, and neurologic development (American Music Therapy Association, 2021). One music therapy intervention that has been shown to be effective with children with comorbid learning difficulties is flexible music instruction. Learning a traditional acoustic instrument (tenor horn) at home and school improved the musical aptitude and IQ scores of a child with multiple LDs (Rose et al., 2018). Thus, parental involvement is a key consideration in music therapy intervention.

Flexible delivery methods and involvement of parents or siblings are critical factors in designing an effective music therapy for ASD children. In the context of family-centered intervention, computer-assisted multi-sensory technologies, including augmented reality (AR), can yield better language, socio-emotional, and behavioral outcomes than therapy based on traditional acoustic instruments (Johnston et al., 2018). The integrated music and video content on AR, coupled with the interaction capabilities of virtual reality, can help address socio-emotional challenges that limit learning. Further, AR technologies allow personalization of aesthetic and acoustic aspects to fit client needs remotely (Johnston et al., 2018). Finally, individualized support is an important consideration when designing a music therapy intervention. Family-centered improvisational music therapy can promote social development in children with ASD but it must involve many sessions of counseling and support (Crawford et al., 2017). Adequate lessons (over five months of therapy) would be needed to produce long-term effects on social affect and responsiveness in pediatric populations.

Maximum participation in music training for children with LD can contribute to cognitive progression that positively impacts language and emotional domains. Compared to typically developing controls, a child with comorbid LDs who received tenor horn lessons displayed significantly improved musical aptitude scores (Rose et al., 2018). Music training induces structural changes in the brain regions involved in processing language and speech. As a result, children with ASD will develop proficiency in discriminating pitch following music education (Johnston et al., 2018). The exceptional sensitivity is the result of multi-sensory stimulation that underlies many developmental skills. In a therapy context, quality learning is achieved when the training involves improvisation – the music therapist guides the child to spontaneously generate sounds and tunes. Thus, improvisational music therapy (IMT) supports self-exploration by the client, which helps in emotional regulation. Overall, the evidence suggests that IMT promotes the development of group attention and turn-taking attribute in autistic children (Crawford et al., 2017). They develop competencies in interpreting and responding to social stimuli, resulting in better interactions and relationships with peers, teachers, and parents. Optimal music therapy activities are enjoyable to the child, spontaneous, and frequent. Further, they are designed to have a relaxing effect on the client, while eliciting positive feelings about oneself. Maximum participation in music therapy can promote socialization because of its positive effect on cognitive functioning and language development. A notable finding is that the exposure to acoustic tools (tenor horn) increases music aptitude when delivered in a family-centered context (Rose et al., 2018). Therefore, the collaborative partnerships with parents, music instructors, and other practitioners should be considered in therapeutic interventions.

Collaborative clinical work is a fundamental aspect of effective music therapy for children with LDs. Establishing a joint therapeutic relationship provides opportunities to address client needs holistically. Shared goals and cooperation among therapists, music instructors, and parents models important relationship-building tactics to the child (Colbert & Bent, 2018). Client trust is gained by displaying mutual respect in an inter-professional therapy space. An area of such collaborative partnerships is music therapy for disadvantaged populations, including refugee or minority children exhibiting learning difficulties. A speech-language pathologist can work with music therapist to address communication deficits (Colbert & Bent, 2018). Through such a collaboration, the child’s communicative behavior, including speech and nonverbal expressions (gestures and body language), are improved. Thus, inter-professionalism inspires codependent relationships between practitioners, resulting in optimal outcomes for pediatric clients. Music and speech therapy each address specific impairments when applied separately; however, in combination, they build client strengths. Therefore, clinical collaboration between professionals can improve outcomes in multiple areas – speech, language, socio-emotional, and cognitive domains (Colbert & Bent, 2018). Another aspect of collaboration is family involvement in music therapy interventions. Family-based interventions have multiple advantages over school-based approaches. They are less costly and offer rich contexts for extra support from parents and siblings (Johnston et al., 2018). Additionally, music therapy that includes partnerships with the family increases the motivation to apply the new social skills after the intervention. Shared experiences and interests at home, including singing, reinforces turn taking and imitation in children with ASDs (Crawford et al., 2017). Thus, a key consideration in designing music therapy is the involvement of parents or siblings in joint activities, including client evaluation.

Clinical assessment is critical to develop therapeutic goals and meet client-specific needs. Children with LDs present with impairments in diverse domains, ranging from socio-emotional to communicative areas. Therefore, finding an assessment method that can evaluate multiple needs for effective intervention is a challenge (Kern & Humpal, 2019). The diverse impairments of ASD that differ in severity means that evaluation must be tailored to the individual needs of each child. Severe learning difficulties are candidates for intensive interventions that require maximum participation from the client. Further, determining children eligible for music therapy needs validated assessment tools that measure specific needs (Kern & Humpal, 2019). Thus, these approaches are critical in identifying clinical goals for the intervention. The chosen assessment depends on age, population, and the goal of the tool. The key methods that can be used to assess children with ASD include the Four-Step Assessment Model and the SCERTS framework. The first model is suited for structural family therapy that involves parents and siblings to explore client needs and develop shared goals. Four steps include considering the context in assessing the presenting problem, determining the interactions that maintain this condition, exploring the past, and creating joint goals for change (Kern & Humpal, 2019). In contrast, the SCERTS framework is relevant to autistic pediatric population. The evidence-based model focuses on three developmental domains: “social communication, emotional regulation, and transactional support” (Kern & Humpal, 2019, p. 64). The goal is to address communicative and socio-emotional impairments in children with ASD. The assessment models can help identify eligible children, obtain information, and guide the development of music therapy goals.

In conclusion, effectively designed music therapy intervention can alleviate cognitive impairments that cause learning difficulties in children. Early intervention improves learning outcomes by promoting typical development of neural connections implicated in socio-emotional and language processing (Johnston et al., 2018). Interactive music therapy targets deficits in language, socio-emotional, and psychomotor domains (American Music Therapy Association, 2021). However, for this intervention to be effective, it must involve a flexible delivery approach. Music training at home and school was shown to improve musical aptitude in children with comorbid LDs (Rose et al., 2018). Further, a family-centered model ensures additional support to the child in post-therapy settings. Computer-based, multi-sensory technologies also promote personalization of music therapy. Improvisational music and adequate sessions help maintain improved social affect and behavioral outcomes in post-therapy contexts (Crawford et al., 2017). Optimal results can be realized through inter-professional collaboration in defining client needs and developing clinical goals. Parental training is also critical to enhance the motivation to apply the social skills learned in joint activities at home. Effective assessment is required to address the individual needs of a child with LDs. Various models, including the Four-Step Assessment Model and SCERT framework, can be used to gather information and define goals for music therapy.

References

American Music Therapy Association. (2021). Fact sheet: Music therapy and autism spectrum disorder (ASD). Web.

Colbert, T., & Bent, C. (Eds.). (2018). Working across modalities in the arts therapies: Creative collaborations. Routledge.

Kern, P., & Humpal, M. (Eds.). (2019). Early childhood music therapy and autism spectrum disorder: Supporting children and their families. Jessica Kingsley Publishers.

Rose, D., Jones Bartoli, A., & Heaton, P. (2018). Learning a musical instrument can benefit a child with special educational needs. Psychomusicology: Music, Mind, and Brain, 28(2), 71-81. Web.

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