Share your thoughts.

[Meredith Pizzi]

Share your thoughts with the board on how much stimulation is enough? How much stimulation is too much?

[Rachel Lighty]

The level of stimulation that is enough or too much depends on the child and the situation/environment that the child is in. Enough stimulation would allow the child to be positively engaged in some way (observing, actively participating, etc). However, there is a fine line between having enough stimulation and having too much. Often, the child can show signs of overstimulation through a change in emotion, body language, behaviors, and interaction levels. If a child who typically actively participates and then withdraws for interacting, he might be over stimulated. If a child becomes upset in response to music interventions or other events happening in the space, they might be overstimulated and need less happening in their environment. It comes down to being aware of the environment as a whole and how each child is responding to it.

[Jessica Triana]

We can use standardized developmental guidelines to help us gauge how much stimulation will be enough or too much. However, I agree that the level and type of stimulation varies from child to child, especially when working with children with special needs. An understanding and awareness of the child’s responses to stimulation and his interaction with his environment at baseline will greatly inform our treatment plan and provide insight into his responses when he is engaged in an environment rich with stimulation. A child experiencing “enough stimulation” may present as calm and passive or may be constantly vocalizing, watching her dad play, and kicking her legs. At this age, I have noticed overstimulation to look like fatigue (to the point of falling asleep), increased agitation, and physical withdrawal from the group.

[Tracy Schoenberg]

I agree with Jessica and Rachel, in that it completely depends on the child and his/her special need how much stimulation will be enough. There’s a wide variety of responses for different children and how they respond to environmental stimulation is very helpful. When I worked with younger kids that had autism, they might have been overstimulated immediately by lights, sounds, smells, and so many outside triggers that might not have even been music related. If it looked like it was the music bothering them, I could see they might cover their ears, bite or pinch themself, hit, or scream. Sometimes they would just run. Luckily, I had assistance, but if I could control the music related stimulation, I’d immediately turn down lights and play some calming guitar music or relaxing cd- bubbles usually could help in certain situations as well as scarves or a toy that helped focus or distract that child. Sometimes a child just needed a break and come back when all was well. I like the idea of a hiding spot in the room for a safe place like a tent. My kid hides in a pack and play under a ton of pillows when overstimulated even though he’s 5.

An engaged child at this stage in SM2 will respond playfully and spontaneous with energy, respond with crawling, instrument playing, or walking as movement, enjoy free movement, or stay still and observe his/her environment.

[Cassandra Reyna]

As music therapists, we are trained to observe participants for signs of overstimulation. I agree with my peers that achieving an appropriate level of stimulation depends upon the individual child. Appropriate stimulation at this level looks like a child who is engaged in the activity by playing the instruments, walking, crawling, or even observing the others. Children who are over-stimulated will respond negatively by crying, withdrawing from the group/activity, clinging to the caregiver, or attempting to take instruments from others to signify “stop that!”

[Marchele Gilman]

My own children with Sensory Processing Disorder have been my greatest teachers. They have taught me that the amount of stimulation and what is too much varies day-to-day and sometimes moment-to-moment. What kind of a day has the child had? Has the child been in a stimulating environment? Is the child getting sick? Are there other stressors that we don’t know about?
I did my internship in a psychiatric facility. There, I learned to read people quickly. If I didn’t, a DVD player could be thrown through the window or at me by a person who’s system was overstimulated and out of control.
How much stimulation is too much will vary child to child. What one child can handle might send another into overload. An effective therapist will continually scan the group, read body language quickly, gauge what needs to be modified in the “now” moment with the music to accommodate those who are overstimulated and dysregulated.

[Flora Whitmore]

I feel like it really depends on the kids but when working in groups, I *always* take cues from both how the parents are moving and reacting to their children and the body language of the kids. What is the facial affect of a kid? How are they responding to things like their parents bringing them into the room/ trips the bathoom, the sounds of other kids, doors shutting, cars honking etc.
I also have learned to approach kids on their level- squatting or crouching and keep my body movements slow, and gradual and my voice low and gradual. I also try and take in how the children are reacting to seeing instruments. Beeline to guitar? Backing away? I always let kids initiate exploration and follow the lead of how the parent responds to the choices their kids make, and build the musical interaction with those things in mind, decreasing or increasing volume/speed etc depending on response. I think the key to not overstimulating the clients is 1. being very tuned in 2. realizing that, since you are not PSYCHIC, even if you can read kids and parents well, there may be unexpected responses and you just have to be flexible and receptive and employ your understanding of the developmental stages, keep eyes out for red flags and adapt. Flexibility is really really key.

[Anonymous]

Thank you fall for your insightful answers. I think your answers really highlight how a music therapist can really aide in matching the stimulation to the overall groups needs and finding ways to individualize when needed.

[Gwendolyn Van Baalen]

I agree with other posts that an understanding of typical responses to stimuli and signs of engagement and over-stimulation can be very useful in understanding a child’s level of stimulation and that children and situations are also highly individualized. I’ve found the concept of a “sensory diet” helpful in better understanding children who seem to have atypical responses to stimulation or who are often dysregulated. Though this is generally a resource for older children, I find it helpful that is provides a framework for understanding the nuances of children’s responses, how their responses may differ from one minute or day to the next, and how stimuli that we may not even notice may dramatically alter their experience. For example, a child I worked with actively engaged in and enjoyed playgroup until the beginning of summer when his engagement decreased dramatically. After several weeks of confusion, it was suggested that he might be impacted by the sound of the AC unit, a stimuli that most of us barely noticed, that had been turned on for the summer season.

[Alice Sorensen]

Definitely agreeing with the others, that how much is too much depends on the child and can vary greatly. Like the others, as a music therapist I take cues from the child both in and out of music.

[Alison Albino]

I definitely agree that every child is different! Children who are following instructions (as much as possible for their age group) is a wonderful sign that they are receiving an appropriate amount of stimulation. Watching the music therapist, moving to strum the guitar and finding parents are other signs that children are receiving appropriate stimulation. Children are going to be wandering around the room during music, but if they do not stop running around, they may have hit that limit. Crying, throwing instruments even when prompted not to, and fatigue are other indicators of overstimulation.

[Beth McLaughlin]

This is an interesting question. When we think of over-stimulation we often think of a child OVER reacting to the music stimuli with increased behavior or agitation. I’ve worked with many children who exhibit over-stimulation by under-reacting or tuning out. I know infants’ sensory systems will shut down if overstimulated by their environment (it drives me crazy to see newborns at the mall!). As Jessica mentioned they can only handle so much information then they go to sleep…the perfect defense! As others have also discussed, it is important to assess the environment and understand what other external stimuli might be contributing or interfering with a child’s attention or inability to engage. As we’ve learned in the course, the care with which we choose the size and sound of the instruments and attend to the timbre of our voice is critical to assuring full engagement of the children. I also appreciate what’s been said about really taking the time understand the responses and needs of each individual child. They are our best teachers.

[RaeAnna Zinniel]

I agree with everyone on how each child is different and we have to individualize our amount of stimulation for each child. As a student I am first starting to understand how to watch and gauge each child.

[Elizabeth Ferguson]

That is a difficult questions to answer as most stated already it depends on the child, the group, the day, the moment and even the weather! When holding groups on stormy days, has anyone else noticed different responses and energy than other groups? Keeping an eye for engagement level and over or under reacting behaviors is the best way to gauge group stimulation and have your energy reflect what is needed.

[Ayelet Weiss]

As everyone above mentioned, this has to be assessed on an individual basis. Everyone has a different baseline and threshold, which can be assessed as you get to know each child. Of course there will also be outside factors such as hunger, tiredness, health etc. Enough stimulation should keep the child engaged in the music by exploring instruments, movement to the music, and even listening and watching. Over-stimulation can either present as negative responses like crying, and destructive behavior or just an internal withdrawal. This is why structuring the session with a natural flow of energy in mind is so important (ex: meet the group where they are- increase energy gradually-decrease energy-cool down).

[Anonymous]

Great insights Ayelet!

[Author]

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