[Jessica Triana]

All four areas are addressed in some capacity in the majority of my sessions that involve active participation. The exceptions are during those sessions that are focused on passive engagement (comfort care) or when working with individuals who are mute, deaf, or paralyzed, although they may still be able to participate at the awareness level. In my day care groups, the sessions are structured in a way that there is always an instrument song, a listening/following directions song and a movement song. It is common for two areas (or even three!) to overlap when a song or intervention addresses multiple simultaneously. I appreciate the organization of each area as it was presented in this module and think it will be useful in assessment and evaluation of patients functioning during sessions. I also think this information is helpful when communicating with other professionals and caregivers about developmentally appropriate expectations for musical responses.

[Jessica Triana]

Singing:
Awareness: produces vocalizations in response to music stimuli
Trust: produces vocalizations in response to caregiver
Independence: produces vocalizations for self-pleasure
Control: can follow melodic contour of familiar phrases
Responsibility: recalls and reproduces familiar songs
Playing:
Awareness: reaches to explore presented instruments
Trust: increased exploration of instruments with mouth and hands
Independence: purposeful and functional exploration of instruments
Control: attends and responds to starts and stops in the music
Responsibility: increased use and organization of musical elements
Movement:
Awareness: instinctual movement to music
Trust: produces rhythmical responses to music
Independence: clapping and increased coordination of rhythmic movements
Control: imitates rhythmic movements and patterns
Responsibility: movement becomes sequential and relative to musical structures
Listening:
Awareness: turns head to localize sound
Trust: recognition of familiar melodies and ability to discriminate overt changes in given melodies
Independence: begins to coordinate physical movement with changes in musical structures
Control: maintains participation while pausing to listen to the music
Responsibility: active role in music listening and increased attention to others’ music

[Jessica Triana]

My motivation to continue working with this population has only grown with my participation in this training. I feel validated in my work as a music therapist and refreshed by reading everyone’s experiences and ideas. Just this week I proposed a community-based model for an outpatient group for young children and their families to my directors and colleagues. I was able to use so much of the information on early childhood development and music therapy implications that were presented in this training to very clearly articulate the need and importance of this kind of group for our patients. I was met with overwhelming support and the green light to start as soon as possible. This training provided me with more confidence to move forward with this idea and implement these ideas into practice!

[Jessica Triana]

Being the only music therapist on staff at my current place of work, I often get to receive and answer all questions music therapy related. I am excited to be able to provide richer information given the knowledge I now have after participating in this training. I have already been able to share this information with my colleagues and administrators in a proposal to implement a new early childhood outpatient group at our hospital. I have also begun incorporating this new information into my sessions to educate and empower parents and family members of infants and toddlers. Similarly, I find myself constantly educating our nursing staff while seeing patients at bedside. I am grateful to have more information and a deeper understanding of my work to be able to share with them.

[Jessica Triana]

It is clear that a great challenge for music therapists is creating a music environment that captures the attention and preferences while meeting the needs and abilities of most, if not all, of the group participants. I, too, echo many of points expressed already.
In addition, I have witnessed parents (although only once outside of groups) compare their child’s development, behavior and abilities with the other children in the group. They may do it alone with their partner after the group, with me, their medical provider, or with other parents. It’s human nature and there are ways to be constructive about, but many do not always consciously take that route. Multiple ages and a wider range of abilities may unfortunately be more conducive to this comparative mindset. This is just another reason why the emphasis on parent support, education and reassurance throughout these modules is so important!

[Jessica Triana]

Based on my understanding, music for skill building is the use of music to intentionally elicit a specific, predetermined target (e.g., CV babbling or identifying body parts). In contrast, music for development is the use of a musically-rich environment to support one’s progression towards larger-defined developmental milestones. Sprouting Melodies provides opportunities for skill performance rather than objective-driven clinical interventions. Despite this, the songs presented in these modules can definitely be used for skill building.

[Jessica Triana]

Although I do not think that we can ensure total success for every child, every parent, every group (something I know I have to remind myself), there are definitely strategies that we can implement to increase success. Overall, I think the key to fostering successful experiences for the entire group is the creation of a supportive environment that can hold and support each member. As the creator of this environment, the leader must be able to demonstrate flexibility, spontaneity and empathy. Alice, I think that your sentiment about unconditional positive regard is spot on.
In addition, I am big on providing non-verbal praise and specific, labeled praise for both the child and the caregiver; whether it is a “great job listening to directions and stopping your body when the music stopped!” or and extra smile. I believe strongly in the effect of this type of praise in particular on self-esteem and intrinsic motivation. I have found that parents benefit from modeling and coaching to implement this praise with their child.

[Jessica Triana]

I appreciate family-centered work and I think that Sprouting Melodies offers providers a unique way to support and empower the adult family members. I value the ability of the program to foster bonding between multiple relationships in the family. What is most unique about Sprouting Melodies to my current work is the support that families can receive from their community. As others have mentioned, there are opportunities for exchanges and connections between families, which can last long after the groups have ended.

[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.

[Jessica Triana]

Discovery, independence, curiosity, playful, nurturing

In Sprouting Melodies 2, we continue to support healthy bonding between you and your child through developmentally-appropriate music and play experiences. At this age, it is healthy for your child to navigate the early stages of independence, which may mean that he will move around the room and interact with other adults more. The music therapist will carefully select songs and musical instruments to focus on: enhancing self-awareness and body awareness, practicing fine and gross motor skills, fostering independence, and having fun! Class time will provide you with opportunities to learn and practice your newly acquired skills so that you can feel comfortable continuing these experiences in your own home.

•Transition into group: allow a few moments for parents to bring in and unload their belongings, re-introduce their child and themselves to the room, and say hello to the other parents; Gathering Song: “Hey, Hey, Come and Play”; Bonding Song: “Hold On Tight”; Self Song: “Just Like Me”; Instrument Song: “I Like This Song”; Movement Song: “March With My Baby”; Goodbye: “Thank You Very Much”

[Jessica Triana]

When I work with groups, each child does not always have an adult to assist them individually, therefore the majority of instruments that I bring in are those that the child can explore and manipulate independently. Small instruments that fit into toddlers hands such as chiquitas, shakers and tambourines are easier to grasp and support independence. Drums are wonderful if they can be positioned correctly. I do use toddler ocean drums virtually every day. A gathering drum is on my wish list. If I play an instrument while leading groups, I’ll use guitar or ukulele. Everything I bring into the session must be easy to clean and in line with infection control policies (no scarves).

[Jessica Triana]

I resonated with the points Meredith and Beth made about the potentially fuzzy definition of music therapy in the setting of a community-based program. I currently provide a few open, community-based groups on an inpatient medical unit. I personally make sure to label them “community music groups” and shy away from “therapy” because the work is not strictly clinical music therapy. The interventions are based on evidenced-based music therapy practices and may hold therapeutic value to the group members. However, as was mentioned in the video, I do not create a treatment plan for all of the patients that may attend groups. Despite this, I think music therapists can provide some of the highest level of care and expertise in these community settings. These services, especially in early childhood, can offer a wealth of benefits to the children and families alike. For parents and family members, community programs can provide empathetic support, instill confidence and self-assuredness, allow for intimate time with the child, motivate parents to leave the house and engage in their communities, and give parents practical resources.

[Jessica Triana]

I work with many little ones in this age group, although the majority of my time with them is spent individually at bedside, rather than in a group setting. The music is continuous and fluid, using infant-directed speech and vocalizations between songs and adapting musical elements to the patient’s changing needs. I often wish that I could spend more time with the parents at bedside as it frequently just the child and me in a session. I love when staff purposely come into my sessions just to watch the child as s/he experiences the music. The musical experiences that occur during this age group are so fascinating to witness! I strongly believe that witnessing and experiencing music therapy first-hand provides an understanding of the work that far exceeds what one could manifest from solely reading about music therapy. As a music therapist without children of my own, I may be the expert on the music and child development but the parents are the experts on being parents (especially that particular child’s parent). The medical team and child life staff spend more time with the patients than I get to and so for me, these three sources become integral when learning about a child at this age.

[Jessica Triana]

bonding; trust; awareness; gentle; encouraging

In the community music program Sprouting Melodies 1, we use music and play to help foster development during these early stages of life. We provide both activating and soothing music experiences with a focus on building a healthy attachment between parent and child. We support your child as she cultivates awareness of self, others and her environment, and begins to place trust in these relationships. There is ample opportunity to learn and practice your newly acquired skills in the class so that you can feel comfortable continuing these experiences in your own home.

Transition into group: allow a few moments for parents to bring in and unload their belongings, re-introduce their child and themselves to the room, and say hello to the other parents; Hello Song: Today’s A Beautiful Day; Bonding Song: Wiggly, Jiggly Car; Self Song: All of This is Me; Instrument Song: In My Little Hand; Movement Song: As Big As Can Be; Goodbye: Nordoff Robbin’s Hello song with lyrics adapted for goodbye

[Jessica Triana]

I love that Meredith pointed out how incorporating parents into the music therapy session allows the caretaker to see and know their child in a new way. It was also nice to be reminded that the relationship between an adult’s education and his/her competency in parenting is not a direct one. I see this frequently in my sessions with other family members and children. As a patient in a rehab hospital, one often experiences some change in self-image, appearance, functioning, daily life activity, etc. In hand, there may be shifts in family dynamics and parent-child relationships. The transition from a typically developing kid to a child with special needs can be significant and abrupt, potentially leaving the caretakers feeling distraught, overwhelmed, and isolated. The interventions that I can bring as a music therapist to the patient’s larger treatment plan are uniquely sensitive to the psychosocial and medical needs of both the child and family throughout their course of treatment and beyond. I have seen how bringing the parents in as active participants gives them the opportunities to be playful again, understand their child’s capabilities, and help them adapt to this new life with their child. They often appreciate working with someone who can act as an expert, but is also willing to be a teacher and motivator. It certainly helps that music is non-invasive, instinctive and fun.

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